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oai:open-archive.highwire.org:amjepid:112/4/4572015-05-11HighWireOUPamjepid:112:4
ERROR SOURCES IN THE EVALUATION OF SECONDARY ATTACK RATES
KEMPER, JOHN T.
REVIEWS AND COMMENTARY
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/457
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Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/4652015-05-11HighWireOUPamjepid:112:4
INTERACTION AND SYNERGISM
SARACCI, RODOLFO
REVIEWS AND COMMENTARY
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/465
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/4672015-05-11HighWireOUPamjepid:112:4
CONCEPTS OF INTERACTION
ROTHMAN, KENNETH J.
GREENLAND, SANDER
WALKER, ALEXANDER M.
REVIEWS AND COMMENTARY
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/467
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/4712015-05-11HighWireOUPamjepid:112:4
A MILITARY COMMUNITY OUTBREAK OF HEPATITIS TYPE A RELATED TO TRANSMISSION IN A CHILD CARE FACILITY
BENENSON, MICHAEL W.
TAKAFUJI, ERNEST T.
BANCROFT, WILLIAM H.
LEMON, STANLEY M.
CALLAHAN, MICHAEL C.
LEACH, DONALD A.
ORIGINAL CONTRIBUTIONS
An outbreak of hepatitis type A occurred among military personnel and dependents on a military post in Anchorage, Alaska, August 1976–April 1977. One hundred sixteen clinical cases of hepatitis were identified over a nine-month-period. Ninety-six per cent of those cases that were tested demonstrated IgM antibody to hepatitis A virus. A large child care facility was implicated as a major focus of hepatitis virus transmission. Sixty-four (55%) of the cases were directly or indirectly linked to the child care facility. The length of time that a child spent at the facility appeared to increase the child's risk of developing hepatitis and the risk of his transmitting the hepatitis A virus to other members of the immediate household.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/471
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/4822015-05-11HighWireOUPamjepid:112:4
EPIDEMIOLOGIC CHARACTERISTICS OF HEPATITIS A VIRUS INFECTIONS IN GREECE
PAPAEVANGELOU, GEORGE J.
GOURGOULI-FOTIOU, KYRIAKI P.
VISSOULIS, HARALAMBOS G.
ORIGINAL CONTRIBUTIONS
The major epidemiologic characteristics of hepatitis A virus (HAV) infections in Greece were studied in a sample of 877 Air Force recruits, 19–25 years old coming from every geographic region of Greece. Antibodies to HAV (anti-HAV) were detected by solid phase radioimmunoassay in 83.8% of the recruits. Antibody frequency varied significantly in the various geographic regions of Greece and was inversely related to the size of the community. It was further shown that the prevalence of HAV infection was highly related to the recruit‘s social class and years of education as well as number of siblings and number of persons per room. These findings in accordance with previous reported data show that hepatitis A is hyperendemic and should be regarded as a childhood infection in Greece. Prevailing socioeconomic, hygienic living and housing conditions should be considered as the main epidemiologic determinants of HAV infections.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/482
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/4872015-05-11HighWireOUPamjepid:112:4
AN INFLUENZA OUTBREAK DUE TO A/USSR/77-LIKE (H1N1) VIRUS ABOARD A US NAVY SHIP
KSIAZEK, T. G.
OLSON, J. G.
IRVING, G. S.
SETTLE, C. S.
WHITE, R.
PETRUSSO, R.
ORIGINAL CONTRIBUTIONS
An explosive outbreak of influenza caused by an A/USSR/77-like (H<inf>1</inf>N<inf>1</inf>) virus occurred aboard a US Navy ship in December 1977 and January 1978. Two hundred volunteers aboard the ship were studied. Virus was isolated from 36 of 57 patients from whom isolation was attempted. Among virologically confirmed patients, headache (97%), chills (92%), malaise (86%), and cough (75%) were the most frequent symptoms. There were two virologically confirmed cases with complications: one with collapsed lung and the other with pneumonitis. The study subjects were 25 years of age or less, but there was little influenza-like disease in members of the crew greater than 25 years of age. Prior vaccination with bivalent vaccine, containing A/NJ/76 (Hsw<inf>1</inf>N<inf>1</inf>) virus, did not offer significant protection against disease caused by A/USSR/77-like virus. Serologic tests, either or both complement fixation and hemagglutination inhibition, were positive in only 14 of 22 virologically confirmed cases, indicating a poor serologic response to primary infection with this strain of virus. These findings prevented calculation of meaningful disease to infection ratios. However, inapparent infection occurred in 3 of 19 (16%) individuals who denied having illness during the outbreak yet had serologic evidence of recent influenza infection.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/487
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/4952015-05-11HighWireOUPamjepid:112:4
WATERBORNE GIARDIASIS: A COMMUNITYWIDE OUTBREAK OF DISEASE AND A HIGH RATE OF ASYMPTOMATIC INFECTION
LOPEZ, CARLOS E.
DYKES, AUBERT C.
JURANEK, DENNIS D.
SINCLAIR, SUSANNE P.
CONN, JUDITH M.
CHRISTIE, ROBERT W.
LIPPY, EDWIN C.
SCHULTZ, MYRON G.
MIRES, MAYNARD H.
ORIGINAL CONTRIBUTIONS
A communitywide outbreak of gastrointestinal illness due to <it>Giardia lamblia</it> infection occurred in the city of Berlin, New Hampshire, during April and May 1977. The clinical, epidemiologic, and laboratory aspects of this outbreak are described here. In 213 predominantly symptomatic cases of <it>G. lamblia</it> infection diagnosed at the local hospital laboratory in a 6-week period, illness was characterized by prolonged diarrhea (median duration 10 days) and 13% of symptomatic infections required hospitalization. Treatment with either quinacrine or metronidazole was generally followed by symptomatic improvement. A communitywide survey of the city residents revealed that the majority (76%) of <it>G. lamblia</it> infections occurring during the epidemic period were asymptomatic and ran a self-limited course without treatment. No significant secondary, person-to-person spread occurred and no enteric pathogens other than <it>G. lamblia</it> were implicated. Water was epidemiologically implicated as the most likely source of infection with <it>Giardia</it> cysts being demonstrated in samples of treated water as well as in raw source water. Evidence supported the occurrence of two simultaneous outbreaks in this city which is supplied by two largely independent water supply systems. Inspection of the two water treatment facilities revealed several defects which permitted untreated (raw) water to mix with treated water. Human or beaver could have been responsible for contaminating source water with <it>Giardia</it> in this outbreak. A marked reduction in both clinical and subclinical giardiasis was apparent two months after onset of the outbreak, apparently as a result of measures applied to interrupt waterborne transmission of <it>Giardia</it>.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/495
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5082015-05-11HighWireOUPamjepid:112:4
LONG-TERM PSEUDOMONAS COLONIZATION IN SPINAL CORD INJURY PATIENTS
MONTGOMERIE, JOHN Z.
MORROW, JAMES W.
ORIGINAL CONTRIBUTIONS
In a previous study, patients with spinal cord injuries were observed to have a high incidence of colonization of the perineum, rectum, and urethra with Pseudomonas. In the current report, 10 men and 10 women with spinal cord injury were studied prospectively during their stay in hospital between June–Dec. 1977 (men) and Jan–Nov. 1978 (women). Colonization seen in men (9/10 men: 14 episodes) was significantly more frequent than colonization in women (3/10 women: 5 episodes). Pseudomonas persisted in two or three sites for up to 105 days (mean 47 days) and serotyping showed that colonization was constant with one or two serotypes. Initial colonization occurred most frequently in the perineum and/or rectum. Colonization of the perineum was significantly more frequent than colonization of the rectum or urethra in men. Fifteen episodes of bacteriuria occurred only after (or with) colonization of perineum, urethra, and rectum. Rates of urethral colonization with Pseudomonas were higher in patients with external condom catheters than patients not using the external condom catheter. Urethral and perineal colonization usually resulted in colonization of the drainage bags even when these patients did not have significant bacteriuria. These drainage bags may be an important potential source of Pseudomonas for nosocomial infection. These studies indicate that Pseudomonas infections of the urinary tract may be prevented if acquisition of this pathogen in the perineum and/or rectum can be avoided.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/508
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5182015-05-11HighWireOUPamjepid:112:4
FACTORS ASSOCIATED WITH THE DISTRIBUTION OF FASTING PLASMA GLUCOSE IN AN ADULT COMMUNITY
BARRETT-CONNOR, ELIZABETH
ORIGINAL CONTRIBUTIONS
The fasting plasma glucose (FPG) was measured in 4170 nondiabetic adult residents of a suburban California community. At all ages the median FPG in men was higher (103–107 mg/dl) than the median FPG in women (96–104 mg/dl). FPG levels correlated weakly with obesity, and male-female differences persisted after adjustment for body mass index. In women, FPG levels rose at the age of menopause and tended to be lower in sex hormone-using women, suggesting that the male-female differences were related to estrogen. The FPG rose little with age (0.7 mg/dl/decade in men; 2.0 mg/dl/decade in women) in contrast to the 6–15 mg/dl/decade increment reported for glucose tolerance tests. These data suggest that the normal range of FPG is relatively independent of age and body mass, and that the male-female differences are not sufficiently great to necessitate sex-specific standards.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/518
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5242015-05-11HighWireOUPamjepid:112:4
CLUSTERING AND INTERRELATIONSHIPS OF CORONARY HEART DISEASE RISK FACTORS IN SCHOOLCHILDREN, AGES 6-19
KHOURY, PHILIP
MORRISON, JOHN A.
KELLY, KATHE
MELLIES, MARGOT
HORVITZ, RICHARD
GLUECK, CHARLES J.
ORIGINAL CONTRIBUTIONS
Clustering and interrelationships of common and easily identifiable risk factors in 951 children (ages 6–19) from the Cincinnati Lipid Research Clinic's Princeton School District Study were assessed. Several patterns of partial correlation coefficients appeared after multiple regression analysis with adjustment for age, sex, Quetelet index, and race. Systolic blood pressure (SBP) was positively correlated with plasma cholesterol and triglyceride, and with saturated fat intake. Plasma high density lipoprotein cholesterol (C-HDL) was positively associated with occupation of the head of the household and inversely associated with cigarette smoking and sucrose intake. Using multiple regression equations, from 29–41% of the variance for SBP and diastolic blood pressure (DBP) could be explained by the measured variables, with age, skinfold thickness, Quetelet, occupation, and education of the head of the household recurrently appearing in the regression equations. Low density lipoprotein cholesterol (C-LDL) was the variable for which the lowest amount of variance could be explained in the four race-sex groups. Discriminant function analysis allowed an assessment of interrelationships of C-LDL-C-HDL aggregate groups to other risk factor mean residuals. The variables which contributed significantly to the discrimination between lipoprotein groups were Quetelet index, skinfold thickness, and DBP. Children in the highest C-LDL-lowest C-HDL quintile group had by far the highest residual Quetelet index and skinfold thickness, along with above average SBP, while those in the lowest C-LDL-highest C-HDL quintile group had the lowest residual Quetelet index, skinfold thickness, and SBP. Common risk and anti-risk factors for coronary heart disease (CHD) in children cluster, allowing identification of groups of children putatively at relatively high and low CHD risk as adults.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/524
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5392015-05-11HighWireOUPamjepid:112:4
BLOOD PRESSURE CHANGES AND ORAL CONTRACEPTIVE USE: A STUDY OF 2676 BLACK WOMEN IN THE SOUTHEASTERN UNITED STATES
BLUMENSTEIN, BRENT A.
DOUGLAS, MARGARET B.
HALL, W. DALLAS
ORIGINAL CONTRIBUTIONS
Blood pressure (BP) and weight were measured on 2676 black women attending a large southeastern family planning clinic. Repeat measurements were made after a minimum of six and up to 24 months on 673 women who continuously used nonhormonal contraceptive methods (control group), 613 women who initiated oral contraceptive (OC) therapy, and 1390 women who continuously used OCs. The mean change in systolic blood pressure (SBP) adjusted for initial BP and change in per cent ideal body weight is +1.44 mmHg in the new users of OC. This slight increase in SBP is statistically significant (<it>p</it> = 0.04) relative to the +0.41 mmHg increase observed in the control group. However, the adjusted diastolic blood pressure (DBP) change (+0.46 mmHg in new OC users and +1.54 mmHg in the control group) fails to support the hypothesis of a greater increase in DBP in new OC users. The adjusted mean rise in mean arterial BP does not differ significantly between new OC users and the control group. The proportion of women developing a DBP ≥90 mmHg during the average follow-up interval of one year is 2.4% in the control group, 1.0% in the new OC users and 0.2% in the continued OC users. These results provide evidence that OC use has no significant effect on the level of mean arterial BP in black women followed for 6–24 months; and fail to support the hypothesis of a causal relationship between OC use and elevated BP in black women.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/539
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5532015-05-11HighWireOUPamjepid:112:4
METABOLIC CONSEQUENCES OF EXPOSURE TO POLYCHLORINATED BIPHENYLS (PCB) IN SEWAGE SLUDGE
BAKER, EDWARD L.
LANDRIGAN, PHILIP J.
GLUECK, CHARLES J.
ZACK, MATTHEW M.
LIDDLE, JOHN A.
BURSE, VIRLYN W.
HOUSWORTH, W. JERE
NEEDHAM, LARRY L.
ORIGINAL CONTRIBUTIONS
Polychlorinated biphenyls (PCB) were discovered in sewage sludge used for fertilizer in Bloomington, Indiana. The PCB had been discharged into the municipal sewage system by an electrical capacitor manufacturing plant. To study the epidemiology and metabolic consequences of PCB exposure an epidemiologic and clinical survey was conducted. Mean serum PCB levels were 17.4 ppb in 89 sludge users, 75.1 ppb in 18 workers with occupational exposure to PCB, 33.6 ppb in 19 members of those workers' families, and 24.4 ppb in 22 community residents without unusual exposure to PCB. In sludge users PCB levels were associated positively with per cent performance of garden care (<it>p</it> = 0.035) and negatively with wearing gloves while gardening (<it>p</it> = 0.021), but were not significantly associated with the amount of sludge used or the duration of exposure. In no groups were chloracne or systemic symptoms of PCB toxicity noted, nor were significant correlations found between PCB levels and tests of hematologic, hepatic, or renal function. Plasma triglyceride levels increased significantly with serum PCB concentrations in both alcohol drinkers and nondrinkers (<it>r</it> = 0.541, <it>n</it> = 36, <it>p</it> < 0.001 for nondrinkers). These data indicate that PCB may alter lipid metabolism at levels of exposure and bioaccumulation insufficient to produce overt symptoms.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/553
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5642015-05-11HighWireOUPamjepid:112:4
THE EFFECT OF MISCLASSIFICATION IN THE PRESENCE OF COVARIATES
GREENLAND, SANDER
ORIGINAL CONTRIBUTIONS
The effects of misclassification on analyses involving a discrete covariate are examined. The following points are illustrated: 1) Analogous to the 2 × 2 table case, unbiased misclassification of the study exposure leads to reduction in the observed strength of the association of exposure with disease. 2) Both biased and unbiased misclassification will tend to distort the degree of heterogeneity in the measure of association being considered. 3) Misclassification of a confounder leads to a partial loss of ability to control confounding.
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/564
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5702015-05-11HighWireOUPamjepid:112:4
RE: "IMMUNOGLOBULINS IN HEROIN USERS"
Fox, Bernard H.
LETTERS TO THE EDITOR
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/570
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5712015-05-11HighWireOUPamjepid:112:4
RE: "HEALTH EFFECTS OF PARTICULATE POLLUTION: REAPPRAISING THE EVIDENCE"
Bross, Irwin D. J.
LETTERS TO THE EDITOR
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/571
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5742015-05-11HighWireOUPamjepid:112:4
RE: "PRINCIPAL COMPONENT ANALYSIS OF FOUR HEALTH INDICATORS AND CONSTRUCTION OF A GLOBAL HEALTH INDEX"
Savitz, David A.
LETTERS TO THE EDITOR
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/574
en
Copyright (C) 1980, Oxford University Press
oai:open-archive.highwire.org:amjepid:112/4/5752015-05-11HighWireOUPamjepid:112:4
THE AUTHORS REPLY
Jenicek, M.
Cléroux, R.
Lamoureux, M.
LETTERS TO THE EDITOR
Oxford University Press
1980-10-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/112/4/575
en
Copyright (C) 1980, Oxford University Press