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Biomedical subjects

Steven Marcus

Publications and source records attributed to Steven Marcus.

12 recordsLinked to original sources

Long-term risk for depressive symptoms after a medical diagnosis.

BACKGROUND: This study examines the risk of development of significant depressive symptoms after a new diagnosis of cancer, diabetes, hypertension, heart disease, arthritis, chronic lung disease, or stroke. METHODS: The study used 5 biennial waves (1992-2000) of the Health and Retirement Study to follow a sample of 8387 adults (aged 51 to 61 years and without significant depressive symptoms in 1992) from 1994 to 2000. Time-dependent Cox regression models estimated adjusted hazard ratios (HRs) for an episode of significant depressive symptoms after a new diagnosis for each of the 7 medical conditions. RESULTS: Within 2 years of initial diagnosis, subjects with cancer had the highest hazard of depressive symptoms (HR, 3.55; 95% confidence interval [CI], 2.79-4.52), followed by subjects with chronic lung disease (HR, 2.21; 95% CI, 1.64-2.79) and heart disease (HR, 1.45; 95% CI, 1.09-1.93). The hazard for depressive symptoms for most of these diseases decreased over time; however, subjects with heart disease continued to have a higher risk for depressive symptoms even 2 to 4 years and 4 to 8 years after diagnosis, and a significantly higher hazard for depressive symptoms developed for persons with arthritis 2 to 4 years after diagnosis (HR, 1.46; 95% CI, 1.11-1.92). CONCLUSION: The findings identify several high-risk patient groups who might benefit from depression screening and monitoring to improve health outcomes in this vulnerable population facing new medical illnesses.

Chronic Disease↗

Rapid cyanide detection using the Cyantesmo kit.

BACKGROUND: Sources of cyanide exposure are many, including combustion of plastic and vinyl, such as in a house fire, laboratory or industrial exposures including exposure in the electroplating industry both of printed circuit boards and in jewelry work. Rapid and definitive diagnosis of cyanide poisoning is unavailable in the emergency department setting. It is desirable to make a definitive diagnosis in order to prevent potential complications of empiric treatment of presumptive cyanide poisoning from the cyanide antidote kit currently approved by the US Food and Drug Administration (FDA). We investigated a technique to detect cyanide currently utilized by water treatment facilities to determine if it can be applied to rapidly detect concentrations of cyanide in the clinically important range. METHODS: Varying standardized dilutions of KCN ranging from 0.25 microg/mL to 30 microg/mL were acidified with a drop of sulphuric acid in a closed system under a ventilation hood. Cyantesmo test strips were placed into the test tubes above the fluid level where liberated HCN gas interacted with the test strip to effect a color change. Color changes were compared to negative controls and to each other. RESULTS: The test strips demonstrated an incrementally increasing deep blue color change over a progressively longer portion of the test strip in less than 5 minutes for each concentration of KCN including 1, 3, 10, and 30 microg/mL. The concentrations of 0.25, 0.5, and 0.75 required more than 2 hours to begin demonstration of any color change. CONCLUSION: The Cyantesmo test strips accurately and rapidly detected, in a semi-quantifiable manner, concentrations of CN greater than 1 microg/mL contained in each test sample. Future work to validate this test in blood and in clinical specimens is planned.

Cyanides↗

Trends in age-specific human poisoning exposures reported to a regional poison control center, 1997-2001.

This study examined age-specific trends in the annual incidence rates of poisoning exposures reported to a regional poison control center over a 5-y period. Data from the poison control center's 1997-2001 computerized case records were combined with age-specific population estimates from the US Census Bureau. Incidence rates of reported poisoning exposures were calculated and evaluated for the following age groups: < 6 y; 6 to 12 y; 13 to 19 y; 20 to 35 y; 36 to 65 y; and > 65 years. Ordinary linear regression analysis revealed a statistically significant decreasing trend in the annual crude incidence rate of poisoning exposures/1.000 population (r2 = .87, slope = -.33 p = .02). Different patterns were observed in the rates of reported poisoning exposures between the 6 age groups. While there was a significant decrease in the rate of reported poisoning exposures in children < 6 y of age or less, and for adults 20-35 and 36-65 y-old, the incidence rate among children 6-12 y, adolescents, and people > 65 y-old showed no significant decreasing trend.

Adolescent↗

Rapid communication: sociodemographic differences between counties with high and low utilization of a regional poison control center.

A retrospective review of data from the New Jersey Poison Information and Education System (NJPIES) was conducted to determine whether differences exist in the sociodemographic characteristics between counties with high or low utilization of the regional poison control center (PCC). The goal was to generate hypotheses about the potential reasons for the variances in the utilization rates by different subpopulations, in order to develop culturally sensitive educational and preventive strategies in an effort to enhance the use of PCC services. Data from the NJPIES 2002 computerized medical records were analyzed to estimate the utilization rates (number of calls to NJPIES per 1000 of population) for each county in New Jersey. This information was then combined with county sociodemographic data from the 2000 U.S. Census. Sociodemographic characteristics were compared between the counties with high and low utilization rates and statistically significant differences were found. Counties with low utilization of PCC had significantly higher population density per square mile, smaller proportion of White residents, larger proportion of residents of "other race," and larger proportion of Black, Asian, and Hispanic and Latino residents. Further study is needed to examine the underlying reasons for the underutilization of PCC among such populations and to explore methods for improving their awareness and use of the services provided by PCC.

Adolescent↗

Lionfish envenomation.

Lionfish (Pterois volitans) are venomous fish most often found as aquarium pets throughout the United States. Lionfish envenomations frequently occur on the upper extremities, with pain as the predominant symptom. Immersing the injured part in warm (45 degrees C) water is considered the first and foremost important treatment as it is reported to relieve pain and inactivate the venom. Other methods of analgesia are discussed. We present a case of lionfish envenomation that failed to respond to warm water immersion.

Acetaminophen↗

How should a fever mercury thermometer be disposed of ? A survey of those likely to be asked.

The American Academy of Pediatrics' recent technical report entitled "Mercury in the Environment: Implications for Pediatricians" was widely reported on by the news media. After the media reports, the New Jersey Poison Information and Education System experienced a notable increase in the volume of calls on this topic. We surveyed local, county, and state health officers who would likely be contacted by citizens with the question: "How should a fever mercury thermometer be disposed of?" Our initial contacts with health officers corroborated our caller's account: a lack of uniformity of response. This led us to question if there was any consensus in advice being offered to the public at large.

Data Collection↗