Hepatitis C virus seroprevalence: selected health care settings in Texas.
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Biomedical subjects
Publications and source records attributed to Zunera Gilani.
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Arsenic, cadmium, lead, and mercury are neurotoxins, and some studies suggest that these elements might also be teratogens. Using a case-control study design, we investigated the relation between exposure to these heavy metals and neural tube defects (NTDs) in offspring of Mexican-American women living in 1 of the 14 Texas counties bordering Mexico. A total of 184 case-women with NTD-affected pregnancies and 225 control-women with normal live births were interviewed about their environmental and occupational exposures during the periconceptional period. Biologic samples for blood lead and urinary arsenic, cadmium, and mercury were also obtained for a subset of these women. Overall, the median levels of these biomarkers for heavy metal exposure did not differ significantly (P > 0.05) between case- and control-women. However, among women in the highest income group, case-women were nine times more likely (95% confidence interval (CI) 1.4-57) than control-women to have a urinary mercury 5.62 microg/L. Case-women were 4.2 times more likely (95% CI 1.1-16) to report burning treated wood during the periconceptional period than control-women. Elevated odds ratios (ORs) were observed for maternal and paternal occupational exposures to arsenic and mercury, but the 95% CIs were consistent with unity. The 95% CIs of the ORs were also consistent with unity for higher levels of arsenic, cadmium, lead, and mercury in drinking water and among women who lived within 2 miles at the time of conception to industrial facilities with reported emissions of any of these heavy metals. Our findings suggest that maternal exposures to arsenic, cadmium, or lead are probably not significant risk factors for NTDs in offspring. However, the elevated urinary mercury levels found in this population and exposures to the combustion of treated wood may warrant further investigation.
Forty-two patients with metastatic renal cell carcinoma who were participating in a Phase II clinical trial were randomly assigned to an expressive writing (EW) or neutral writing (NW) group. Patients in the EW group wrote about their cancer, and patients in the NW group wrote about health behaviors. No statistically significant group differences were found in symptoms of distress, perceived stress, or mood disturbance, except for the Vigor subscale of the Profile of Mood States. However, patients in the EW group reported significantly less sleep disturbance, better sleep quality and sleep duration, and less daytime dysfunction compared with patients in the NW group. The results suggest that EW may have sleep-related health benefits in terminally ill cancer patients.
The authors examined the association between maternal polychlorinated biphenyl (PCB) levels and risk of neural tube defects (NTDs) in Mexican American women with NTD-affected pregnancies who resided in the 14 Texas-Mexico border counties during 1995-2000 (cases). Controls were randomly selected from study area women delivering normal live births. For PCB congeners with sufficient numbers of detectable values (PCB 99, 101, 110, 118, 138, 153, 180), there was little association between the proportions with detectable PCB levels in cases and controls. Odds ratios were <1 or compatible with the null, but power was low for some congeners. An index of seven PCB congeners (105, 118, 138, 153, 170, 180, 194) was also not associated with NTD risk. The maternal serum PCB levels in this study population (median PCB 153 level: 18 ng/g) were comparable to those with background exposure and do not appear to have contributed to the high prevalence of NTDs in this population.
The authors describe methods for linking birth certificate and birth defect registry data to potential environmental hazards and assess potential confounding factors. Cases of selected birth defects from the Texas Birth Defects Registry were linked to their respective birth/ fetal death records. Comparison births were randomly selected from the 1996-2000 Texas birth records. Maternal addresses were related through a geographic information system to boundaries of hazardous waste sites and point locations of industries. Approximately 89% of maternal addresses of case births and 88% of comparison births were successfully related in distance to these sites and industries. Maternal characteristics associated with living within one mile of these sites included belonging to any group besides non-Hispanic white and having lower education attainment (< 16 years) or a residence within the city limits. In linking environmental and health outcome databases, researchers should be aware of factors that may confound associations between exposure and outcomes.