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Biomedical subjects

Sarah L Lathrop

Publications and source records attributed to Sarah L Lathrop.

6 recordsLinked to original sources

Amended cause and manner of death certification: a six-year review of the New Mexico experience.

Little is known about the amendment of death certificates (DCs) issued by medical examiners and coroners. This retrospective study examined why, how, and with what frequency cause and manner of death were amended on DCs issued by forensic pathologists over a 6-year period at the New Mexico Office of the Medical Investigator. Approximately 1% of DCs had either cause or manner of death amendments, with arteriosclerotic cardiovascular disease and intoxicants the most commonly amended and resulting causes of death, respectively. There was a significant association between manner of death and number of DCs amended (p<0.001). By percent, natural and suicide DCs were the most frequently amended. The way in which manner of death changed was significantly associated with the amount of time elapsed between DCs (p=0.04). Toxicology was the most common reason for DC amendment.

Accidents↗

Noncorrelating Pap tests and cervical biopsies: histological predictors of subsequent correlation.

Lack of correlation between dysplastic cervicovaginal Papanicolaou (Pap) tests and subsequent cervical biopsies raises the concern that a significant squamous intraepithelial lesion (SIL) may go unconfirmed. Additional tissue sections of cervical biopsies may detect SILs after noncorrelation on initial sections. Complete step sectioning of paraffin blocks was undertaken on 111 noncorrelating biopsy specimens from 95 patients and selected slides were reviewed for the presence of SIL. The initial negative biopsy slides were evaluated for four histological features: chronic cervicitis, acute cervicitis, mucosal erosion, and squamous atypia. Twenty-seven biopsies (24.3%) demonstrated the presence of a SIL in deeper levels. The presence of squamous atypia was significantly associated with the presence of dysplasia deeper in the block (P < 0.002). Acute and chronic cervicitis was seen roughly equally. Additional tissue levels are a productive way of confirming SILs, and squamous atypia allows a refined selection of negative cervical biopsies most likely to reveal an SIL on review of deeper levels.

Acute Disease↗

Unintentional methadone-related overdose death in New Mexico (USA) and implications for surveillance, 1998-2002.

AIMS: To determine death rates from methadone over time, to characterize methadone-related death and to discuss public health surveillance of methadone-related death. DESIGN: We analyzed medical examiner data for all unintentional drug overdose deaths in New Mexico, USA, between 1998 and 2002. MEASUREMENTS: Age-adjusted death rates for methadone-related death, logistic regression models for likelihood of methadone-related death among all unintentional drug overdose deaths and bivariate comparisons within methadone-related death. FINDINGS: Of 1120 drug overdose deaths during this period, there were 143 (12.8%) methadone-related deaths; the death rate decreased over the time period, averaging 1.6 per 100,000. Of 143 methadone-related deaths, 22.4% were due to methadone alone, 23.8% were due to methadone/prescription drugs (no illicit drugs), 50.3% were due to methadone/illicit drugs and 3.5% were due to methadone/alcohol. These groups were significantly different in demographics, health history and circumstances of death. Of 79 decedents (55.2%) with a known source of methadone, 68 obtained methadone through a physician prescription (31 for methadone maintenance treatment (MMT), 27 for managing pain and 10 had unknown reason for prescription). CONCLUSIONS: Methadone-related death rates and the proportion of methadone-related death among all drug overdose deaths decreased in New Mexico from 1998 to 2002. It is important for surveillance of methadone-related death to assess multiple drug causes, not just underlying cause. Also, methadone for pain management must be examined alongside MMT and when possible, methadone co-intoxication should be described in the context of other drugs causing death.

Adolescent↗

Estrogen receptor expression in papillary urothelial carcinoma of the bladder and ovarian transitional cell carcinoma.

CONTEXT: Relatively little is known about estrogen receptor (ER) expression in papillary urothelial carcinoma (PUC) of the bladder. Greater understanding of this feature of PUCs could aid with the treatment and identification of the origin of metastases, particularly with relation to the morphologically similar entity of ovarian transitional cell carcinoma (TCC). OBJECTIVE: To assess the presence of ERs in PUC of the bladder, its metastases, and ovarian TCC. DESIGN: Formalin-fixed, paraffin-embedded archival tissue from 92 primary bladder PUCs, 11 PUC metastases, and 11 primary or metastatic ovarian TCCs was immunostained with a monoclonal antibody against the human ER beta-molecule. The ER-positive and ER-negative tumors were compared by the patients' sex and age, tumor grade, and the presence or absence of invasion. Statistical analysis was performed on the PUC results, first defining a positive result as staining of at least 10% of nuclei and then repeated using any percentage of staining as a positive result. RESULTS: By the 10% criterion, 11% of PUCs of the bladder were ER positive. Invasive PUCs were more likely to be ER positive (P = .10). Women with ER-positive PUCs were older than their male counterparts (P = .03). By the second criterion, 22% of all PUCs were ER positive, and both higher grade and the presence of invasion were significantly associated with ER expression (P = .004 and .01, respectively). All 11 PUC metastases were totally ER negative. Ten of the 11 ovarian TCC cases exhibited strong and diffuse ER expression. CONCLUSION: Depending on the criterion used, up to 22% of bladder PUCs were ER positive. Higher grade and the presence of invasion were significantly associated with ER expression in these bladder carcinomas. In contrast, almost all of the ovarian TCCs marked strongly for ERs, a characteristic that may help differentiate these lesions from PUCs metastatic to the ovary.

Adult↗

Adverse event reports following vaccination for Lyme disease: December 1998-July 2000.

CONTEXT: The vaccine adverse event reporting system (VAERS) monitors vaccine safety post-licensure. Although events reported to VAERS are not necessarily causally associated with vaccination, VAERS reports can be used to identify possible safety concerns that occur at too low a rate to have been identified prior to licensure. OBJECTIVE: To evaluate adverse events following Lyme disease vaccination reported to VAERS during the first 19 months of the vaccine's licensure. DESIGN, SETTING, AND PARTICIPANTS: Analysis of all VAERS reports of adverse events following vaccination for Lyme disease in the US from 28 December 1998 to 31 July 2000. MAIN OUTCOME MEASURE: We evaluated reported adverse events for unexpected patterns in age, gender, time to onset, dose number, and clinical characteristics and compared them to adverse events observed in clinical trials of this vaccine. RESULTS: Over 1,400,000 doses were distributed and 905 adverse events were reported to VAERS, 440 in men and 404 in women, with ages ranging from 10 to 82 years. The majority (56%) of adverse events occurred after administration of the first dose. The most frequently reported adverse events were arthralgia (250), myalgia (195), and pain (157). There were 59 reports coded as arthritis, 34 as arthrosis, 9 as rheumatoid arthritis, and 12 as facial paralysis. Sixty-six (7.4%) events were classified as serious, involving life-threatening illness, hospitalization, prolongation of hospitalization, persistent or significant disability/incapacity, or death. Twenty-two hypersensitivity reactions were reported. CONCLUSION: Based on reporting to VAERS, we did not detect unexpected or unusual patterns of reported adverse events following Lyme disease vaccine administration, other than hypersensitivity reactions, compared with adverse events observed in clinical trials.

Adolescent↗