Jail health care in Wisconsin: a report on the State Medical Society of Wisconsin's involvement in a National Jail Health Care Project.
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Where and why do graduates of the University of Wisconsin-Madison Medical School practice in Wisconsin?
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Liver function tests among Michigan and Wisconsin dairy farmers.
Serum activity of SGOT, SGPT, LDH, and alkaline phosphatase was measured in 614 Michigan adults exposed to PBB and 141 Wisconsin adults not so exposed. The Michigan group had higher prevalence of abnormal SGOT (p less than 0.005) and SGPT (p less than 0.005). A clear sex difference was observed. Michigan men had a higher prevalence of abnormal SGPT (p less than 0.005) and LDH (p less than 0.005) than Michigan women, and a higher prevalence than Wisconsin men of abnormal SGOT (p less than 0.005) and SGPT (p less than 0.01). These differences could not be ascribed to differing patterns of alcohol consumption, laboratory error, or choice of criteria for normality/abnormality. Seven Michigan subgroups were defined on the basis of the criteria by which they had been selected to participate. The two subgroups who were essentially self-invited did not differ from the remaining five randomly selected subgroups combined in prevalence of these abnormal liver function tests. Based on 364 serum PBB analyses thus far analyzed of the 614 Michigan participants, no obvious relationship between serum PBB values and liver function tests was observed. However, this is a tentative conclusion that will be further evaluated when remaining serum PBB analyses are completed. The greater prevalence of abnormal SGPT and SGOT among Michigan dairy farm residents compared to the Wisconsin dairy farm residents is tentatively ascribed to the former group's exposure to PBB.
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Carcinoembryonic antigen (CEA) plasma levels in Michigan and Wisconsin dairy farmers.
Carcionogenic embryonic antigen (CEA) titers were determined for 611 Michigan farmers exposed to PBB and a control nonexposed population of 139 Wisconsin farmers. The overall prevalence of elevated CEA titers was slightly higher in the Michigan study group, but the difference was not statistically significant. Smoking and/or significant past or present conditions (inflammatory bowel disease, ulcers, polyps, liver disease, chronic lung disease, or malignancies) were found to result in higher prevalence of elevated CEA titers, in both the Michigan study group and the Wisconsin control group, thus confirming previous reports. In addition, serum PBB concentrations appeared to be positively correlated with CEA titers. The possibility that the effect of PBB concentrations appeared to be positively correlated with CEA titers. The possibility that the effect of PBB may be additive to that of other factors which are known to result in an increased prevalence of elevated CEA titers is discussed.
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Unanticipated prevalence of symptoms among dairy farmers in Michigan and Wisconsin.
Adverse human health effects resulting from exposure to polychlorinated biphenyls (PBBs) were unknown until the accidental contamination of Michigan dairy farm animal feed in 1973-1974. Human exposure resulted from the consumption of contaminated meat, milk, dairy products, and eggs. In November 1976, the Environmental Sciences Laboratory conducted comprehensive examinations of 933 farmers and residents in Mighigan who were likely to have consumed farm products contaminated with PBB. A comparison group of 229 Wisconsin dairy farmers were examined in March 1977 and the same scientific and medical staffs that conducted the Michigan survey were responsible and the same procedures used. A complete history of symptomatology by organ system, including year of first onset, duration, frequency, and severity of each symptom was obtained by a physician on all adults examined. Statistical analysis of the prevalence of symptoms at the time of examination or during the preceding year in the Michigan and Wisconsin populations studied found the Michigan group to have a significantly higher prevalence of skin, neurological and musculoskeletal symptoms. The increase was seen among the younger age groups 16-35 and 36-55. Michigan females had a higher prevalence of neurological symptoms than the Michigan males. The existing differences could not be explained without considering an etiologic role for exposure to PBB.
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Distribution of paratuberculosis in Wisconsin, by soil regions.
A study was undertaken to determine the relationship between concentration of paratuberculosis-infected herds and soil types in Wisconsin. Locations of farms on which paratuberculosis had occurred between 1971 and 1975 were obtained from the Wisconsin Department of Agriculture. The disease occurred mainly in the rolling and undulating areas. Fifty percent of the infection herds were in the southwestern "driftless area" and the southeast uplands; 43% occurred in the western part of the northern silty and loamy uplands; the other 7% were scattered in the east and east-central part of the state. The disease did not necessarily occur in the areas of high cattle concentration. It was concluded that the disease persisted in regions with acid soils but not in regions with alkaline, calcereous soils.
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Dermatophagoides farinae antigen skin test sensitivity in Wisconsin.
Fifty consecutive patients with allergic asthma and/or rhinitis in Madison. Wisconsin, were tested intradermally with a house dust extract (1:100) and with a Dermatophagoides farinae antigen (1:2000). The close relationship between the two skin test results (mite and house dust) suggests that both contain the same cross-reacting antigens and that mites make a major contribution to the antigens in house dust in Wisconsin.
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Non-polio enterovirus activity in Wisconsin based on a 20-year experience in a diagnostic virology laboratory.
Laboratory test results, demographic information, and clinical data on 1364 patients who had specimens submitted to the Wisconsin State Laboratory of Hygiene and from whom non-polio enteroviruses were isolated during 1957--1976 were examined. Echoviruses (echo) and Coxsackievirus group B (CB) and group A (CA) were isolated from 719, 389, and 256 of the patients, respectively. Thirty-five different serotypes were identified in the 20-year period. The six most frequently occurring serotypes (echo 9, CB 5, echo 18, CB 2, CB 4, and echo 6) were associated with 57 per cent of all illnesses. The first three serotypes occurred in an epidemic-like manner whereas the next three appeared to be endemic. Eighty-eight per cent of all isolations were from patients whose illnesses began in July through October. The percentage of CA isolates obtained from adults was much smaller than the corresponding percentages seen with CB or echo. A majority of the non-polio enteroviruses were obtained from males. Central nervous system and gastrointestinal tract involvement was greatest with echo and CB 5 tract and lowest with CA and CB 1--4 illnesses. The highest frequency of respiratory tract involvement was with CA and echo 9 illnesses and rash was most frequent with CA illnesses. The highest frequency of hospitalization was with CB 5 patients.
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The independent study program at the University of Wisconsin Medical School.
A program for 30 additional medical students for the first two years of the University of Wisconsin Medical School curriculum has been developed, and two groups of students have advanced to the clinical years. Design included providing modules of course materials to students and utilizing faculty predominantly in the developmental and managerial role. Preliminary results are based on student and faculty opinion of the program in categories of faculty acceptance, faculty-student interaction, certifying examinations, student attitudes, material developed, and course objectives. The course has been accepted as a continuing part of the medical school curriculum and provides a more flexible track for some students. There has been no significant difference in performance on Part I of the examination of the National Board of Medical Examiners for the first two groups. The concepts of individualized medical education have strengthened the basic science and core curriculum of the medical school.
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Comparative neurobehavioral study of a polybrominated biphenyl-exposed population in Michigan and a nonexposed group in Wisconsin.
An analysis of findings regarding the prevalence and time course of symptoms and the results of neurobehavioral testing among Michigan and Wisconsin dairy farmers, is reported. Reviewed are: (1) differences in the prevalence of neurological symptoms at the time of examination; (2) differences in the incidence and time course of symptoms for the period 1972--1976; (3) differences among populations and subgroups (sex and age) regarding performance test scores; (4) correlations between performance test scores and neurological symptoms; and (5) correlations between serum PBB levels as indicators of exposure and performance tests and neurological symptoms.
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Ecto- and endoparasites of the black bear in northern Wisconsin.
Parasites collected from free-ranging black bears, Ursus americanus, in northern Wisconsin included Dermacentor variabilis, D. albipictus, Ixodes scapularis, Demodex sp., Trichodectes pinguis euarctidos, Baylisascaris transfuga and Dirofilaria ursi. Mange, possibly caused by the Demodex sp., also was observed. Dental caries were common and periodontal disease was observed in one animal.
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Influenza surveillance of Wisconsin (USA) population-detection of A/New Jersey by isolation and serologic monitoring and vaccine evaluation.
The 1976-77 influenza surveillance in Wisconsin consisted of three major areas of study. Serum and virus isolation specimens were obtained from the practicing medical community and from epidemiologic studies. From all sources 1,132 throat specimens were tested by egg and tissue culture inoculations. Three isolations similar to A/New Jersey/8/76 were recovered from pig farm associated patients. One contact with one of the isolate patients seroconverted to A/New Jersey suggesting patient to patient spread. Serological monitoring of 1,361 patients showed no other A/New Jersey activity in the state. In addition 31 influenza B/Hong Kong and 8 A/Victoria isolates have been recovered as well as 34 B and 11 A seroconversions. A surveillance using primarily syphilis serology premarital serums has been conducted from August 29, 1976 through April 23, 1977. No significant influenza A activity in the state was recognized by this study. However, increased herd immunity from vaccination was detected. The last phase of this surveillance was an evaluation of the mass immunization program and the efficacy of the vaccines. Two-hundred-ninety individuals contributed pre- and post-vaccine serums to this study. Eighty-three percent of those persons with a pre-vaccine titer of 1:80 or less to A/New Jersey/8/76 developed a post-vaccine titer four-fold or greater to that virus type. Those who received vaccine containing A/Victoria/3/75 were less responsive. Refractiveness to vaccine antibody stimulation was greater than or equal to 1:160 for A/New Jersey and less than or equal to 1:40 with A/Victoria.
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Agglutinins to Brucella canis in stray dogs from certain counties in Illinois and Wisconsin.
In a serologic and blood culture survey for Brucella canis in 2,572 pound dogs from eight Illinois and Wisconsin counties, 173 (6.7%) were reactive in a presumptive slide test, 41 (1.5%) were reactive in a tube agglutination test, and 6 (0.2%) were positive in blood culture.
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A study of family practice in Wisconsin.
Studies of family practice in Wisconsin and elsewhere show that the clinical content of family practice has about 20 to 45 patient contacts per day and about two to six diagnoses per patient contact. Seventy-five percent of patient contacts are in the office and on the telephone, 15 to 20 percent in the hospital, and 5 to 10 percent elsewhere. There is a broad array of patient problems. Special Conditions and Examinations Without Illness contain the largest number of patient problems. About 60 percent of patients are female and present more endocrine and genitourinary problems. Men present more trauma, circulatory, and respiratory problems, and less health maintenance care. Well-baby and well-child examinations stop at age 15 years. Pre and postnatal care decline sharply at age 35 years, at which time surgical care increases. Infectious disease and trauma, ranking high in the young, are low in the elderly. Circulatory problems, obesity, diabetes, and arthritis increase greatly with age. There is no major difference in type of patient problems related to town size (ie, population). However, comparative studies may uncover different disease occurrence rates between regions.
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Lyme arthritis in Wisconsin.
Rash, severe constitutional symptoms, and arthritis developed in three persons who were bitten by ticks in Wisconsin. On comparison with other reports of arthritis related to tick bites, we found that the illness of our patients had clinical features consistent with Lyme arthritis. Lyme arthritis appears not to be restricted to New England as has been previously reported.
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Wisconsin's laboratory evaluation and certification program.
A review of methods used in the evaluation of test performance and certification of laboratories in Wisconsin.
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Antibody levels and immunity to infectious bovine rhinotracheitis virus (IBR) infections in Wisconsin dairy cattle.
Individual cows and calves in 7 Holstein-Friesian herds with a history of respiratory disease in Green County, Wisconsin, USA, were swabbed intranasally and bled monthly, some for periods over 1 year. Virus isolation and serological procedures were completed on the samples in an attempt to recognize the problems and peculiarities that IBR virus continues to cause in dairy cows, in spite of, and possibly because of vaccines available for immunization against this agent. While IBR virus was isolated from animals on 6/7 farms over the period of study the history of vaccination with Nasalgen IP prevented the differentiation of vaccine (avirulent) virus from field (virulent) virus. IBR virus was isolated from apparently healthy animals as well as animals having signs of respiratory disease. IBR virus was assumed to be the cause of recurrent respiratory disease and ocular disease on at least two of the farms studied as established by virus isolation, serology, and the presence of characteristic signs of respiratory disease. While IBR virus was present on the other five farms its precise role in the diseases observed was not determined. IBR virus, whether vaccine virus or field virus, appeared to be persistent in 6/7 of the herds studied. Keratoconjunctivitis and corneal ulceration were the only signs of disease in animals in one herd where the etiologic agent was presumed to be field strain IBR virus. Antibody to IBR virus did not protect animals from respiratory or ocular disease in which IBR virus was thought to be a causative agent. Adult animals that had antibody to IBR virus at the time of vaccination with Nasalgen IP generally did not respond after vaccination with an increase in IBR virus antibody. Those adults that did not have antibody prior to vaccination, generally responded to vaccination with a rise in antibody. Vaccination of calves with Nasalgen IP generally did not cause an increase in antibody. IBR virus antibody was higher in vaccinated herds with recurrent respiratory disease.
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Distribution of HLA antigens in Polish and German populations in Milwaukee, Wisconsin.
Gene and haplotype frequencies for HLA-A and HLA-B antigens were determined in Milwaukee blood donors of German and Polish descent. Gene frequencies for A25 and B18 were significantly higher in Poles than in Germans. Significant gametic associations were noted for A1-B8, A29-B12 and AW30-B13 in both populations. Gametic association for A3-B7 was only found in Germans, while the A25-B18 haplotype frequency was significantly increased in Poles. Since the latter haplotype has also been found in Yugoslavs, Ukrainians and Czechs, it is possible that A25-B18 represents a Slavonic marker.
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