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Mefloquine use and hospitalizations among US service members, 2002-2004.

The safety of mefloquine has not been well described in military populations. This study used standard military databases for mefloquine prescriptions and hospitalizations to investigate mefloquine safety among US service members from 2002 through 2004. Mefloquine-prescribed and deployed personnel (N = 8,858) were compared with two reference groups. The reference groups comprised US service members who were not prescribed mefloquine and resided in Europe or Japan (N = 156,203) or had been otherwise deployed (N = 232,381). In comparison with active-duty US service members residing in Europe or Japan, mefloquine-prescribed service members were at statistically significant decreased hazard for any-cause hospitalization, as well as diseases of the respiratory and digestive systems, musculoskeletal system and connective tissue diseases, injuries and poisonings, ill-defined conditions, and mood disorders. These results suggest there is no association between mefloquine prescriptions and severe health effects, as measured by hospitalizations, across a wide range of outcomes.

Adult↗

Current status of food-borne parasitic zoonoses in the United States.

Although not a major public health problem, food-borne parasitic zoonoses in the United States are the cause of numerous diseases that occur widely in the population. The most common food-borne parasitic diseases in the United States are trichinosis, toxoplasmosis, taeniasis/cysticercosis, diphyllobothriasis, and anisakiasis. Since 1947, when the US Public Health Service began to record statistics on trichinosis cases in humans, the numbers of reported cases in the United States have declined markedly, from an average of about 400 with 10-15 deaths reported each year in the late 1940s, to an average of 57 per year with three deaths overall in the 5 years 1982-1986. Each year throughout the world, Toxoplasma gondii infects millions of persons, who contract it either by eating raw or poorly cooked meat from infected animals such as hogs or sheep or by ingesting soil contaminated with cat feces. In the United States between 400 and 10,000 infants are born each year with congenital toxoplasmosis. Toxoplasmic encephalitis, marked by dementia and seizures, has become the most commonly recognized cause of central nervous system opportunistic infection in AIDS patients. Intestinal taeniid tapeworm infection acquired in the United States is almost entirely caused by Taenia saginata, the beef tapeworm. Neurocysticercosis, caused by larvae of the pork tapeworm Taenia solium, is diagnosed in hundreds of persons in the United States every year. Nearly all patients are immigrants or travelers from Mexico and other disease-endemic areas. Diphyllobothriasis and anisakiasis both have increased in recent years in association with increasing popularity of raw fish dishes. Adequate prevention and control of food-borne parasitic zoonoses require continued and improved programs to educate consumers, producers and medical practitioners.

Animals↗

Trichinella spiralis infection--United States, 1990.

Since 1947, when the Public Health Service began to record statistics on trichinosis, the number of cases reported by state health departments each year has declined: in the late 1940s, health departments reported an average of 400 cases and 10-15 deaths each year; from 1982 through 1986, the number declined to an average of 57 per year (Figure 1) and a total of three deaths (1,2). Although this trend reflects a decline in the number of cases related to commercially purchased pork, recent outbreaks of trichinosis in Iowa and Virginia emphasize the continuing need for education about the dangers of eating inadequately cooked pork.

Asia, Southeastern↗

A profile of Alexandra.

In this article publications on the demography and environmental and health status of Alexandra Township are reviewed and a demographic survey carried out in 1990 is reported. The demographic data presented in the article describe the age, sex and ethnic profile of the population. It also describes the health and disease status, provides some vital statistics, describes the health services and discusses the implications for the development of appropriate health care strategies. Approximately 19% of the population live in informal dwellings or shelters, 14% in the newly upgraded areas and 67% in old Alexandra. Mean household occupancy was 4.04 with a male/female (m/f) ratio of 0.86. It was 3.08 in informal dwellings (m/f = 1.11), 4.30 in the newly upgraded areas (m/f = 0.74) and 4.28 for Old Alex (m/f = 0.82). Old Alex had the highest proportion of inhabitants aged over 60 years. On average females have been resident in Alexandra for 16.8 years and males for 14.9 years.

Adolescent↗

Information for medical decision making. Improving our laboratory reports.

The primary product of the laboratory is information. Greater attention should be devoted to how laboratory reports are presented to ensure that information is being conveyed effectively to the clinician. Different reporting techniques, including test-by-test, interim, cumulative, and completed accession reports, are appropriate for different patient populations and physician needs. This article includes many suggestions for improved layout and content of laboratory reports, including the use of PostScript-based laser printers, as well as display work-stations and voice response.

Clinical Laboratory Information Systems↗

[Facets of control of rheumatic diseases in East Germany].

Guidelines for treating rheumatic diseases in the GDR are formulated based on the sociomedical and economic impact of class XIII (International Classification of Diseases, Injuries and Causes of Death (ICD) of WHO, 9th revision: 1975); these consider trends in temporary incapacity of employees and their utilization of hospital services, as well as statistics of disability pensions. The presentation of the organized cure and care programs, with special emphasis on rheumatology practitioners is followed by a discussion of issues in graduate, postgraduate, and continuing rheumatological education. Finally, a cursory review is given of the priorities and tasks of rheumatology research in the GDR.

Arthritis, Rheumatoid↗

Canadian cardiovascular disease mortality: first generation immigrants versus Canadian born.

Cardiovascular disease (CVD) is the major cause of death in Canada, as it is in most industrialized countries. Studies have shown that CVD mortality rates vary among ethnic groups. Since about one in six Canadian residents is a first generation immigrant, it is important to consider ethnic background when interpreting Canadian health statistics or planning health services. Overall, lower CVD mortality rates were found for first generation Canadians from Latin America, China and South Asia; higher rates are indicated for those from Scandinavia and Africa. The rates for North America are similar to those found for Eastern and Western Europe. Between two five-year time periods (1969-73 and 1984-88), CVD mortality rates generally were found to decrease, except for immigrants from Africa (age 35+). The rates were consistently higher for males than for females.

Adult↗

[Prevalence of antibody against the hepatitis B core antigen (anti-HBc)among hospital personnel in Buenos Aires].

A group of 1,479 employees in 19 Buenos Aires hospitals were tested for antibody to hepatitis B core antigen (anti-HBc) to identify those who should be vaccinated against this infection. The average age of the subjects was 38.22 years; 70.86% of them were women and 85.5% were working in services where the risk of infection was high. The enzyme-linked immunosorbent assay (ELISA) was used, and the data were analyzed by the chi-square test. The results showed that 1,257 subjects (85.0%) did not have anti-HBc and thus were considered candidates for vaccination. The antibody was present in 222 individuals (15.0%). The prevalence of anti-HBc increased with age and with length of service, and it was greater in laboratory technicians, nurses, and those in high-risk services. These differences were statistically significant (P less than 0.01). A total of 23 carriers of hepatitis B surface antigen (AgHBs) were identified. In high-risk groups, vaccination against hepatitis B should be preceded by serological screening of susceptible individuals; the use of anti-HBc for this purpose allows carriers of AgHBs to be identified. The high prevalence of anti-HBc in laboratory technicians, nurses, and nurses' aides might justify their systematic vaccination.

Adult↗

An economic model for nurse manpower planning in the Caribbean--Part 1: The issues.

Below is a noneconomist's view on economic issues impacting on nurse manpower development in the Commonwealth Caribbean. The issues however are of an international nature and are therefore pertinent to all those interested in nurse manpower development. The main objective is to present a model for economic analysis and planning.

Economics, Nursing↗

Factors influencing pharmacists' selection of their first practice setting.

Factors that influenced the choice of initial practice setting among pharmacists who had completed the majority of their experiential training in a hospital setting were determined. A questionnaire was mailed to all eligible pharmacists who successfully completed the Ohio pharmacist licensure examination in June or September 1987. Respondents were asked to (1) provide demographic data, (2) rate the importance of 23 factors that a pharmacist might consider when choosing a practice site, and (3) rate the desirability of a pharmacist position in their major hospital internship site, as well as positions they had considered in other hospitals and in community pharmacies. The predictive accuracy of four decision-making models--the weighted compensatory choice model, the unweighted compensatory choice model, the lexicographic model, and the conjunctive model--also was determined. Of 105 pharmacists surveyed, 53 returned usable questionnaires. Twenty-five had chosen to practice in hospital settings, and 28 had chosen community settings. The factor "is personally rewarding" was mentioned most often by hospital and community pharmacists as the factor that was most important when choosing their first position. The lexicographic model, which postulates that a pharmacist will choose the practice site with the highest performance rating for the most important factor, was the most accurate predictor of respondents' initial practice sites. Pharmacists' perception of how practice sites would rate in terms of the single job-related factor most important to them was the best predictor of whether they chose hospital or community practice initially and whether they chose to work in the hospital in which they served their internship, another hospital, or a community pharmacy.

Attitude of Health Personnel↗