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PubMed1998

Increasing incidence of colon and rectal cancer among Hispanics and American Indians in New Mexico (United States), 1969-94.

OBJECTIVES: This study evaluates time trends in colon and rectal cancer incidence and mortality among the three major race/ethnic groups (Hispanics, American Indians, and non-Hispanic Whites) in New Mexico (United States). METHODS: We used data from the New Mexico Tumor Registry (NMTR) and computed average annual age-standardized incidence and mortality rates. Colon cancer incidence rates were further examined by anatomical subsite. Estimated annual percent change (EAPC) in incidence and mortality over time were computed using Poisson regression. RESULTS: Invasive colorectal cancer incidence rates increased from 1969-89 in all three race/ethnic groups, but decreased among non-Hispanic Whites in 1990-94, while rates continued to increase among minority populations, especially among minority men. Over the 26-year period, EAPC in colon cancer incidence among men was 3.6 percent for Hispanics, 4.7 percent for American Indians, and 0.7 percent for non-Hispanic Whites. Right-sided colon cancers were more common among American Indian women, and among all women aged 65 years and older. Mortality rates decreased steadily among non-Hispanic Whites over the study period, especially among women. CONCLUSIONS: Studies are needed to identify important modifiable risk factors and to develop strategies to increase the use of colorectal cancer screening-procedures among the minority populations.

Age Factors↗

PubMed1997

Issues in establishing an aerosol radiological baseline for the waste isolation pilot plant near Carlsbad, New Mexico.

The Department of Energy has constructed a deep geologic repository for defense transuranic waste disposal. The Waste Isolation Pilot Plant, located in Southeastern New Mexico, is slated to receive transuranic waste by truck delivery beginning in 1998. The Environmental Evaluation Group (EEG) provides an independent evaluation of the impact on the health and environment in New Mexico of the WIPP project. Since 1985, the EEG has operated a network of air monitoring sites around WIPP and in nearby communities. The radionuclide concentration data from these air samples have been assembled into a useful baseline data base after resolution of a number of methodological and quality assurance issues. Investigation thresholds for the principal radionuclides have been calculated from combined data collected from several sites. These action levels will provide a critical quantitative basis for decisions of whether future airborne radionuclide measurements are attributable to accidental releases.

Air Pollutants, Radioactive↗

PubMed2000

Clinical features of spontaneous intracerebral hemorrhage in Hispanics and non-Hispanic Whites in New Mexico: a community study.

OBJECTIVES: To compare clinical features of spontaneous intracerebral hemorrhage (ICH) between Hispanics and non-Hispanic Whites in Albuquerque, New Mexico, occurring during the year 1993. DESIGN: Analysis of data collected during a study of ICH incidence in a community. METHODS: Review medical records with multiple relevant cerebrovascular diagnostic discharge codes in all 9 acute care hospitals in Albuquerque, and in the records of the State Medical Examiner. All suspected cases were verified by cerebral computed tomography or autopsy. Vascular risk factors, test results, and acute outcome were abstracted. RESULTS: There were 38 Hispanics and 46 non-Hispanic Whites with ICH. We found no statistically significant differences between these two ethnic groups in the prevalence of hypertension or diabetes mellitus, in hematoma volume, in seasonal fluctuation of ICH incidence, or in acute mortality. However, based on our sample size, only large differences in the prevalence of risk factors between these two ethnic groups could be detected with statistical significance (>20-30 percentage points). There was a trend toward a higher proportion of subcortical ICH (centered in the basal ganglia, brainstem, or cerebellum) in Hispanics (82%) than in non-Hispanic Whites (62%, P=.09). CONCLUSIONS: The higher proportion of subcortical ICH among the Hispanics suggests that chronic hypertension may play a greater role as a risk factor for ICH in this ethnic group than in non-Hispanic Whites in New Mexico. Our findings should be confirmed by larger community studies.

Aged↗

PubMed1993

Fire fatalities among New Mexico children.

STUDY OBJECTIVE: To explore the relationship between social conditions and fire mortality rates among children. DESIGN: Retrospective analysis of fire fatalities in children 0 to 14 years old in New Mexico. SETTING: State Office of the Medical Investigator. TYPE OF PARTICIPANTS: All 57 New Mexico children 0 to 14 years old who died from fire-related injuries from 1981 through 1991. INTERVENTIONS: Medical investigator and autopsy records were reviewed and abstracted. Demographic and housing figures were obtained from US Census reports. Data were analyzed by chi 2 or by Fisher's exact test, with Bonferroni correction for multiple comparisons. RESULTS: Two thirds of decedents were male (P = .0014), and three fourths were less than 5 years old (P < .0001). Children living in mobile homes had triple the mortality rate of those in houses or apartments, and children in homes without plumbing (substandard) had more than ten times the mortality rate of those in houses or apartments (P < .0001). Two thirds of the victims in substandard homes were Native American (P < .0001). Errors or negligence of adults occurred in more than half of the deaths. Eighty-two percent of decedents died at the scene; only 11% reached a burn center. CONCLUSION: Substandard homes are associated with an increased fire mortality rate among children. Strategies to prevent childhood fire fatalities should address housing conditions and adult safety practices. Enhanced prehospital or burn unit care is unlikely to greatly affect childhood fire mortality rates.

Accidents, Home↗

PubMed2000

Patterns of mammography use among Hispanic, American Indian, and non-Hispanic White women in New Mexico, 1994-1997.

For screening efforts to maximally reduce mortality in the general population, a large proportion of women need to utilize mammography routinely. To investigate utilization of mammography in a community setting, the authors used population-based data collected by the New Mexico Mammography Project for residents of the Albuquerque, New Mexico, metropolitan area for the period 1994-1997. The authors computed screening rates and the proportion of women who routinely use mammography. The utilization of mammography was low. Only 50% of the women aged 50-74 years were screened each year. Less than one third of women aged 40-49 years or 75 years and older were screened annually. The percentage of women who routinely used mammography on an annual or biennial basis was low in all age groups, especially among Hispanics and American Indians. Women aged 50-74 years had the highest percentage of routine annual mammography use, ranging from 30% in non-Hispanic Whites to 20% in Hispanics. Current utilization of mammography in community-based screening efforts is unlikely to achieve a potential 30% reduction in breast cancer mortality. Interventions are needed to increase the routine use of mammography.

Adult↗

PubMed1997

Motor vehicle crashes and maternal mortality in New Mexico: the significance of seat belt use.

In recent years, as deaths from medical complications during pregnancy have declined, injuries-specifically those sustained in motor vehicle crashes-represent a growing proportion of all pregnancy-associated deaths. To investigate pregnancy-associated deaths in motor vehicle crashes in New Mexico, we scrutinized the database of the New Mexico Office of the Medical Investigator for all deaths during pregnancy and up to 6 weeks postpartum from 1986 through 1995. A total of 97 deaths were identified, 47 of which were injury-related. Motor vehicle crashes accounted for 33 (approximately 70%) of the injury-related deaths. We analyzed the data on motor vehicle crashes for decedent's age and ethnicity, fetal gestational age, time of crash, rural vs urban location of crash, seat belt use, and drug and alcohol use. Compared with non-Hispanic white women, proportionately higher numbers of Hispanic and American Indian pregnant women were killed in motor vehicle crashes. In searching for modifiable risk factors, we noted that 45% of the crashes involved alcohol and that the majority of pregnant women killed (77%) were not wearing seat belts at the time of the crash. We conclude that education about seat belt use during pregnancy (as well as the dangers of alcohol use and riding with intoxicated drivers while pregnant) is a promising strategy to reduce motor vehicle fatalities.

Accidents, Traffic↗

PubMed2005

The effect of EDTA on Helianthus annuus uptake, selectivity, and translocation of heavy metals when grown in Ohio, New Mexico and Colombia soils.

The use of two EDTA concentrations for enhancing the bioavailability of cadmium, chromium, and nickel in three natural soils (Ohio, New Mexico and Colombia) was investigated. The resulting uptake, translocation and selectivity with Helianthus annuus after mobilization were also examined. In general, plants grown in the sandy-loam Ohio soil had a higher uptake that resulted in a selectivity and total metal content of Cd>Cr>>Ni and 0.73 mg and Cr>Cd>>Ni and 0.32 mg for 0.1 and 0.3 g kg-1 EDTA, respectively. With the silty-loam New Mexico soil, although the total metal uptake was not statistically different the EDTA level did alter the selectivity; Cd>Cr>>Ni (0.1 g kg-1 EDTA) and Cd>>Cr>Ni (0.3 g kg-1 EDTA). Conversely, with the Colombian (sandy clay loam) soil increasing the EDTA level resulted in a higher total metal uptake (0.62 mg) than the 0.1 g kg-1 (0.59 mg) treatment. For all three soils, the translocation of Cd was limited. Evaluating the mobile metal fraction with and without EDTA determined that the chelator was capable of overcoming mass transfer limitations associated with the expandable clay fraction in the soils. Root wash results and root biomass concentrations indicated that Cd sorption was occurring. Therefore limited Cd translocation was attributed to insufficient phytochelatin levels.

Biodegradation, Environmental↗

PubMed2002

Usefulness of telephone risk factor surveys in the New Mexico border region.

BACKGROUND: We sought to assess prevalence of behavioral risk factors and evaluate the usefulness of survey data gathered by telephone in the New Mexico border region. METHODS: This study compared behavioral risk factor data gathered from two probability sample surveys administered in 1998-1999, one by means of a telephone interview and the second face to face. Prevalence estimates for medical care access, injury, and chronic disease risk factors were compared by survey mode, overall, and stratified by income level. RESULTS: Risk factor prevalence estimates based on telephone interviews resemble estimates obtained from face-to-face interviews. Although risk factor prevalence estimated from face-to-face interviews were in general slightly greater than those from telephone interviews, none of these differences reached statistical significance. When data for each respective survey were examined by income level, prevalence estimates for comparable income groups in both surveys were in general agreement and estimates within survey increased with declining income. CONCLUSION: In the New Mexico border region, telephone survey data appear to be reasonably valid and offer opportunities for population-based health research.

Adolescent↗

PubMed2001

New Mexico breaks the Medicaid mold.

On September 1, 1999, the New Mexico Medical Assistance Division implemented the Medicaid Personal Care service. The goal of Medicaid Personal Care is to improve the quality of life for the disabled and the elderly, and prevent them from having to enter a nursing facility. Personal Care allows consumers to live in their own homes and achieve the highest level of independence they can reach.

Aged↗

PubMed1987

Septicemic plague in New Mexico.

Eighteen of the 71 cases of plague reported in New Mexico from 1980 to 1984 were septicemic. We reviewed these cases to better describe the clinical presentation of this disorder and to identify risk factors for developing septicemic plague. The symptoms (fever, chills, malaise, headache, and gastrointestinal symptoms) and signs (tachycardia, tachypnea, and hypotension) of septicemic plague are similar to those of other forms of gram-negative septicemia. Abdominal pain was reported in nearly half of the cases, and differential white blood cell counts revealed a marked shift to the left. The risk of developing septicemic plague was higher for persons greater than 40 years of age. Because of empirical antibiotic treatment of older persons, deaths from septicemic plague occurred primarily among persons less than 30 years old. Deaths from septicemic plague could be reduced by aggressive antibiotic therapy for patients with a clinical presentation suggesting gram-negative septicemia, especially patients less than 30 years old.

Adult↗

PubMed1977

Epidemiologic and clinical features of an outbreak of bubonic plague in New Mexico.

An outbreak of seven cases of bubonic plague in New Mexico was investigated. Clinical features were studied and correlated with field studies in an attmept to determine the source of infection in patients with indefinite histories of exposure. Most patients presented with fever, malaise, and an acute painful lymphadenitis (bubo). One death occurred in a patient with bubonic-septicemic plague complicated by meningitis due to Yersinia pestis. All patients lived in rural or semirural areas, and most had been in the general vicinity of their usual residence during the six days prior to onset of symptoms. The outbreak was associated with probable epizootics in rodents in two different areas of the state. One case was traced to direct hand contact with plague-infected rabbits. One patient developed insect bites after sleeping in the same bed with a flea-infested cat. Three of the other five patients had insect bites, presumably flea bites, but none of the five recalled contact with rodents or rabbits. Four of the five, however, had been in contact with dogs or cats that were later shown to have titers of antibody to Y. pestis. These findings provide further support for the hypothesis that contact with domestic dogs and cats may result in direct or indirect transmission of Y. pestis to humans.

Adult↗

PubMed2001

Prevalence of acanthosis nigricans and its association with hyperinsulinemia in New Mexico adolescents.

PURPOSE: To determine whether the association between acanthosis nigricans (AN) and hyperinsulinemia is independent of obesity and other variables. METHODS: A convenience sample of 675 New Mexico middle school students was screened to determine the presence of AN, obesity, and other variables, including: ethnicity, parental history of diabetes, and level of physical activity. Fasting glucose and insulin levels were drawn on 233 students to determine the association between risk factors and hyperinsulinemia. RESULTS: Acanthosis nigricans (AN) was present in 18.9% of students screened. Twenty-one percent of the subsample had hyperinsulinemia. Based on these results, the estimated prevalence of hyperinsulinemia among all middle school students in New Mexico was 8.9%. Forty-seven percent (47.2%) of students who had AN and were obese had hyperinsulinemia, compared with 2.4% of students who did not have either of these conditions. In multiple logistic regression analysis, AN and obesity were independently and positively associated with hyperinsulinemia, whereas physical activity was protective. CONCLUSIONS: The high prevalence of risk factors in this population makes diabetes prevention a priority for public health action. AN screening is an easily performed, noninvasive method for identifying adolescents at risk for type 2 diabetes.

Acanthosis Nigricans↗

PubMed1996

A survey of graduates in practice from the University of New Mexico's conventional and community-oriented, problem-based tracks.

PURPOSE: To survey graduates in practice from the first four classes of the University of New Mexico School of Medicine's (UNMSOM's) parallel curricular tracks, and compare data about the graduates' practice patterns, learning behaviors, and satisfaction with the profession of medicine. METHOD: Between 1979 and 1993, the UNMSOM had two tracks for the first two years of medical school: a conventional track and the Primary Care Curriculum (PCC), a community-oriented, problem-based track. In 1990, a survey was conducted of the 140 graduates from the first four classes (1983-1986) who had completed their postgraduate training: 40 from the PCC and 100 from the conventional track. Statistical methods included two-way analyses of variance, logistic regression, and chi-square, adjusted by Bonferroni methods. Comparisons between tracks are reported after adjustments were made for specialty effects. RESULTS: Thirty-three graduates (83%) from the PCC and 87 (87%) from the conventional tracks responded. The PCC graduates were much more likely to work in medically underserved areas, practice in publicly funded health care settings, and care for non-paying patients. The PCC graduates more often identified patient problems and curiosity as providing motivation for their learning. They more frequently studied clinical medicine and community health topics and spent time in community activities. The PCC graduates felt better prepared for practice by their undergraduate medical education. There was no difference between the graduates of the two tracks in the sizes of the populations in which they practiced, in the criteria they used for deciding on referrals to other physicians, in the ranges of community resource utilization, or in the degrees of satisfaction within their chosen professions. Large percentages of graduates from both tracks (67% conventional and 79% PCC) considered themselves to be practicing either primary care or a combination of primary care and non-primary care. In addition, 38% of all the graduates practiced in the state of New Mexico. More PCC graduates chose careers in family practice; however, no significant difference was found in a comparison between the proportions of PCC and conventional-track graduates who chose primary care careers. CONCLUSION: Track differences favorable to the PCC were evident in relation to the two major goals established by the program: to attract graduates to careers in primary care in rural and underserved areas and to provide graduates with self-directed, lifelong learning skills. Some expected track effects were not found.

Academic Medical Centers↗

PubMed1997

Farm-related injury mortality in New Mexico, 1980-91.

To compare the epidemiology of farm with non-farm occupational injury deaths, we reviewed state medical examiner data for all occupational injury deaths in New Mexico from 1980 to 1991. We identified 53 farm-related injury deaths for a rate of 21.3 per 100,000 worker-years. Farm workers were four times more likely than non-farm workers to die from occupational injury. American Indians had the highest farm injury death rate. Farm decedents were older than non-farm decedents (t498 = 6.29, p < 0.0001). Half of the farm decedents were 50 years of age or older; one-third were 60 years of age or older. Crush injuries accounted for half of all farm injury deaths including 18 of 23 motor vehicle deaths, half of these involving a tractor rollover. One in six farm injury deaths were from electrocution: one in five involved alcohol. Our study indicates that New Mexico has high farm-related injury mortality related to tractor use, alcohol intoxication, farm animals, and exposure to electricity. American Indians and older males are especially susceptible to these factors.

Accidents, Occupational↗

PubMed1998

Validity and reproducibility of a food frequency questionnaire among Hispanic and non-Hispanic white women in New Mexico.

The purpose of this study was to assess the validity and reproducibility of an interviewer-administered, semi-quantitative food frequency questionnaire (FFQ) among 132 volunteer New Mexico Hispanic (H) and non-Hispanic white (NHW) women, aged 35-74 years, with (n = 47) and without (n = 85) a breast cancer history, and to add to the limited data presently available on the performance of FFQs among different ethnic groups. Validity was measured at one month and six months from baseline against four-day food records, and reproducibility was tested by comparing FFQs. Unadjusted validity correlation coefficients were highest at one month, ranging from 0.38 (polyunsaturated and monounsaturated fat) to 0.57 (calcium); energy-adjusted correlation coefficients were highest at six months, ranging from 0.15 (polyunsaturated fat) to 0.68 (calcium). Energy-adjusted correlation coefficients were statistically significant by ethnicity for vitamins A and C, protein, carotene and calcium, and by case status for saturated fat, folate, fiber, and vitamins A and E. Reproducibility correlation coefficients (unadjusted) ranged from 0.40 (polyunsaturated fat) to 0.71 (carbohydrate, retinol); energy-adjusted correlation coefficients ranged from 0.42 (vitamin E) to 0.78 (fiber), and differed significantly by ethnicity for saturated fat and retinol, and by case status for carbohydrate. Overall, our FFQ has comparable characteristics to other FFQs and is suitable for use with New Mexico's H and NHW women.

Adult↗

PubMed1980

Anti-rabies treatments in New Mexico: impact of a comprehensive consultation-biologics system.

Fewer than 20% of the 30,000 anti-rabies treatments administered in the United States each year are necessary. New Mexico established a comprehensive consultation-biologics program to assist physicians in making appropriate and systematic rabies treatment decisions. In 1978, 32 individuals received anti-rabies treatments as the result of 144 physician consultation requests. Dog and cat exposures accounted for 70 per cent of consultations and 63 per cent of the treatments. A seasonal peak of both consultations and treatments was observed in the summer and early autumn. The cost of biologics was $212 per treatment. Coordinated use of laboratory diagnostic services and animal control resources obviated the need for treatment in over 60 per cent of the 112 consultations not resulting in treatment. Experience in 1978 suggested that the system was probably responsible for a greater than five-fold reduction in the annual rate of anti-rabies treatments in New Mexico. Efficient physician utilization and high acceptability of the program may be attributed to maximization of private sector input into design and implementation of this public health program.

Adult↗

PubMed1996

Nonmelanoma skin carcinoma in Albuquerque, New Mexico: experience of a major health care provider.

BACKGROUND: Although nonmelanoma skin carcinomas (NMSC) are increasing nationwide, rates are difficult to measure precisely, because few registries include types of carcinoma. Albuquerque, New Mexico is a high risk site for both melanoma and NMSC. In a National Cancer Institute (NCI) survey conducted between 1977 and 1978, NMSC incidence rates among non-Hispanic white males were the highest of 8 national study sites. METHODS: Experience with NMSC over 28.5 years at the Lovelace Health Systems in Albuquerque, New Mexico is described. The impact of multiple tumors was emphasized, recent annual incidence rates in members of the Lovelace Health Plan (LHP) were calculated, and trends in incidence rates since the NCI survey were estimated. RESULTS: There were 10,760 tumors among 4958 people between 1964 and mid-1992, with an average of 2.2 lesions per person (range: 1-92 lesions). Basal cell carcinoma (BCC) was 6.6 times more common than squamous cell carcinoma (SCC), and more likely to be multiple. There was an excess of males among persons with each tumor type and among subjects with multiple tumors. Only 46.1% of NMSC were first tumors; multiple or subsequent tumors comprised 53.7%. More than half of the concomitant or subsequent tumors were diagnosed within 1 year of the first, but new tumors were still appearing in the same subjects more than 10 years later. The incidence of NMSC between 1989 and 1991 among LHP members increased with age, and rates were higher for non-Hispanic males than females. Hispanics had much lower rates than non-Hispanic whites (NHW), with no sex differential. Incidence rates of BCC have increased markedly since 1977 and 1978 in NHW males, and to a lesser extent in other groups. Rates of SCC have not changed. The ratio of NMSC to other carcinomas at Lovelace has doubled over the same interval and has increased 10-fold over the last 2 decades. CONCLUSIONS: These data confirm the marked effect of age, ethnicity, and sex on NMSC rates. Differences in trends in BCC and SCC highlight their somewhat different etiologies. The increasing rate of BCC since the late 1970s and the large numbers of multiple tumors make a powerful case for intensified efforts at both primary and secondary prevention.

Adolescent↗

PubMed1986

Prevalence of HTLV-III antibody among New Mexico residents with hemophilia.

Persons with hemophilia who have received therapy since 1978 are at risk for the acquired immunodeficiency syndrome. Plasma and serum specimens collected from 1980 to 1985 from 73 New Mexico residents with hemophilia were tested by enzyme immunoassay for antibody to human T-cell lymphotropic virus type III (HTLV-III), and positive results were confirmed by Western blot. Antibody to HTLV-III was first detected in New Mexico residents with hemophilia in 1981. Among 49 persons tested in 1984-1985, seropositivity was found in 35%. Of these, 17 of 32 (53%) commercial concentrate versus 0 of 17 cryoprecipitate users were seropositive (P = .002). Of the 7 with hemophilia B, 3 (43%) were seropositive versus 14 of 42 (33%) with hemophilia A. Of 17 Albuquerque residents with hemophilia, 2(12%) were seropositive as compared with 15 of 32 (47%) persons with hemophilia who resided outside the city (P = .02). Compared with patients with hemophilia outside of Albuquerque, those living in Albuquerque tended to have milder disease and to use cryoprecipitate rather than commercial concentrate. Less frequent treatment (mild disease) and use of cryoprecipitate were associated with a decreased risk of HTLV-III infection.

Acquired Immunodeficiency Syndrome↗