Browsing by Subject "Clinical Epidemiology"
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Item A Comparative Breast Cancer Study: Stage & Mortality in El Paso County's non-Hispanic white and Hispanic population(2003-05-01) Aravind, Raven; Russel HovermanAravind, Raven, A Comparative Breast Cancer Study: Stage & Mortality in El PasoCounty's non-Hispanic white and Hispanic population, 1990-2000. Master of Public Health (Epidemiology), May 2003, 17pp., 1 table, 3 figures, bibliography, 43 titles. This retrospective breast cancer study compares the stage of breast cancer diagnosis and mortality between Hispanic (HS) and non-Hispanic white women (NHW). The study includes 874 Hispanic women and 802 non-Hispanic white women diagnosed with breast cancer between January 1990 and December 2000 at the El Paso Cancer Treatment Center, El Paso Texas. The objectives of the study were: 1) to determine if this population of Hispanic women is being diagnosed at a later stage of breast cancer 2) to ascertain the relative survival of non-Hispanic white and Hispanic women 3) to verify if Hispanic women were being diagnosed at a younger age; and 4) to examine tumor size at diagnosis to determine if there is a need for more assertive screening measures in this population of women.Item A Comparison of Medicare Prospective Payment Systems on P.T.C.A. and Stent Outcomes in an Urban Hospital(2001-05-01) Compton, Ben H.; Doug A. Mains; P. E. HilsenrathCompton, Ben H., A Comparison of Medicare Prospective Systems on P.T.C.A. and STENT Outcomes in an Urban Hospital. Master of Public Health (Health Services Administration), May 2001, 57 pp., 10 tables, 1 graph, bibliography, 51 titles. To determine if differences in outcomes exist between Medicare prospective payment systems when doing percutaneous transluminal coronary angioplasty (PTCA) or STENT surgeries. From January 1999 and December 2000, 146 Medicare patients were identified with 35 being outpatient and 111 inpatient. A separate group of 1-day inpatients was used as a comparison for the outpatient group. Results from the comparison reveal that in the three groups, the majority of patients were white, non-Hispanic males who were about 70 years of age. The 1-day inpatient group had the highest profit of all three with about $3,000 while the inpatient group broke even. The outpatient group had no in-hospital deaths or complications while all three had equal amounts of comorbidities. The conclusion is that losses will probably occur if PTCA and STENTs are done outpatient. Possible solutions are moving to an inpatient setting or determining which costs can be reduced in the outpatient setting.Item A Look at Diabetes Mellitus and the Effects of a Study Drug on Diabetic Nephropathy(2002-08-01) Schlueter, Cynthia K.; Debbie Lewis; Clifton Cage; Rustin ReevesDuring my internship, I assisted with a twenty-four week, phase 2, double blinded, placebo controlled trial for a drug being developed to slow, if not prevent, the development of ESRD from overt neuropathy in patients with both type 1 and type 2 diabetes. This drug is a naturally occurring component of vitamin B6 and is an AGE-inhibitor. The AGE-inhibitory effect of the study drug was discovered by isolating Amadori products in the pathway to AGE formation. Once the intermediates were isolated, the sponsor’s scientists searched for compounds that could specifically block the conversion of these Amadori products into AGEs. The study drug was found to be a strong inhibitor of this pathway. In comparison, the common AGE inhibitor, aminoguanidine was found to be ineffective in blocking the post-Amadori foundation AGEs. Therefore, it must block AGE formation at one of the less clinically relevant pathways, and should be less effective in treating nephropathy according to the sponsor’s scientists. This study included type 1 and type 2 patients with clinically diagnosed diabetic retinopathy and a urinary albumin excretion rate (UAE) of greater than 300 mg/24h. Other inclusion and exclusion criteria were applied for the safety of the subjects and greater viability of the data.Item A Phase II Clinical Study to Evaluate the Efficacy and Safety of rhThrombin in Subjects Undergoing Arterial Bypass Surgery and AV Graft Formation for Hemodialysis(2004-12-01) Plascencia, Xochitl; Rustin E. Reeves; Della Weis; Don PeskaThe Association of American Medical Colleges Task Force on Clinical Research defines clinical research as a component of medical and health research intended to produce knowledge essential for understanding human disease, preventing and treating illness, and promoting health (Friedman, 1998). A clinical trial is defined as a research study conducted in humans which is designed to answer specific questions using scientifically controlled conditions with specified methodologies and endpoints (Gallin, 2002). Clinical research trials are essential in determining whether or not a drug is safe and effective. There are four phases that investigational drugs go through before they are allowed to be out in the market. Before beginning phase I of a study, there is usually a pre-clinical research and development phase. During this time the initial synthesis of study drug is accomplished and animal testing takes place. Phase I is the initial introduction of an investigational new study drug into humans. Phase I is usually conducted in healthy individuals and the primary goal is to determine the safety profile of the drug. Phase II trials tend to evaluate safety and initial efficacy. Subjects enrolled in this phase tend to have the disease necessary for use of study drug. Phase III studies are conducted to gather additional information about the effectiveness and safety of the drug and to determine the overall benefit-risk relationship of the drug. Finally, phase IV studies are usually referred to as post-marketing studies. During this phase, additional safety information is identified and the drug’s safety during routine use is evaluated. Each phase can range from two to ten years depending on the complexity of the clinical trial (Gallin, 2002). A phase II, randomized, double blind study of the safety and efficacy of topical recombinant human thrombin in patients undergoing peripheral arterial bypass surgery and arterio-venous graft formation for hemodialysis is the focus of the prospective drug study to be carried out in the surgery department at The University of North Texas Health Science Center. The primary objective of this study is to evaluate the safety and efficacy of recombinant human thrombin when used in different types of surgeries. Prior to signing an informed consent, subjects will have to meet inclusion and exclusion criteria set by study protocol. Study specific assessments and procedures will be performed after the informed consent is signed and dated. If bleeding at the anastomosis is found to necessitate intervention, a single application of either rhThrombin or placebo in combination with an absorbable hemostatic sponge to each anastomosis requiring hemostasis will be applied by the surgeon. The safety and efficacy of rhThrombin will be determined by measuring the incidence and severity of adverse events and of laboratory abnormalities. Occurrence of hemostasis within 600 seconds of application of the study drug at the anastomotic surgical site, incidence of anti-rhThrombin product antibodies, and time to hemostasis will also be measured.Item A Review of Dendritic Cell Vaccines in Cancer Treatment and a Managerial Focus on Issues Related to Subject Recruitment(2006-12-01) McFarlin, Tory; Arredondo, LaChelle; Gwirtz, Patricia A.; Oglesby, MichaelMcFarlin, Tory. A Review of Dendritic Cell Vaccines in Cancer Treatment and a Managerial Focus on Issues Related to Subject Recruitment. Master of Science (Clinical Research Management), December 2006, 97 pp., 5 tables, bibliography, 24 titles. Melanoma is form of skin cancer that can become deadly if the cancer progresses to a stage of metastasis. Five year survival rates as low as 10% may be noted in such patients. Decarbazine and Proleukin have been approved by the FDA for the treatment of metastatic melanoma; however both have response rates of approximately 20% or less. New treatment modalities including dendritic cell (DC) vaccines are currently being tested for treating metastatic melanoma with greater safety and efficacy profiles. DC vaccines are made by obtaining a subject’s DCs, priming them with melanoma antigen ex vivo and then injecting them into the patient to initiate an immune response against melanoma tumor cells in vivo. Investigational new treatments such has the DC vaccine must first be tested in clinical trials on research subjects. Subject enrollment issues regarding such a trial can cause delays in advances of the treatment. As an intern with a DC vaccine clinical trial, the author assisted in screening 45 patients and observed many hindrances involving enrollment of subjects. Such hindrances include: low rates of study personnel retention, small patient pools, and competing trials. Recommendations to improve enrollment include: more effective advertisement strategies and increased patient education.Item A Six-Year Analysis of the Distribution of Time to Death Among Colorectal Cancer Patients in the State of Texas(2000-05-01) Williams, Vanessa P.; Antonio A. Rene; Thomas J. Fairchild; Sally BlakleyWilliams, Vanessa P., A Six-Year Analysis of the Distribution of Time to Death Among Colorectal Cancer Patients in the State of Texas. Master of Public Health (Epidemiology), May 2000, 55 pp., 11 tables, 9 figures, references, 52 titles. The cancer experience of Texans differs substantially by race/ethnicity. Among Caucasian, African American, and Hispanic men and women, colon cancer is either the second or third leading type of cancers among Texans. The distribution of time to death over a six-year period were assessed from a cohort of African American, Hispanic, and Caucasian men and women diagnosed with colon cancer in 1992. The purpose of this study is to determine if there is a difference in the overall death time distribution and tumor histology among African Americans, Hispanics, and Caucasian men and women who were diagnosed with colon cancer in 1992 in the state of Texas. Analysis results indicated that Hispanic females (65.59%) and Caucasian males (65.52%) had higher survival times among the race/ethnic groups. African American males (53.85%) and females (56.40%) experienced lower survival time for the cohort. For overall distribution of time to death among deceased subjects, African American males and Hispanic females experienced the lowest distribution times among the subjects. The overall distribution of time to death for all histology types were the same for each type.Item Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas(2005-08-01) Chaudhary, Prateek; Kristine Lykens; Julian Borejdo; Antonio A. ReneChaudhary, Prateek. Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas. Master of Public Health, August 2005, 52 pp, 6 tables, bibliography. The mismanagement of diabetes care, due to disparities in access, deficiencies in health insurance, or poor quality of primary care, can lead to preventable microvascular complications which force diabetics to utilize hospital emergency departments (ED). This study uses 2002 hospital discharge data from the Texas Health Care Information Collection to determine whether diabetic and elderly (65+) African Americans and Hispanics from Texas counties with a low ratio of physicians per, 1,000 population (PPR) are more likely to be admitted through the ED with complications from diabetes. Findings indicate that while Hispanic ethnicity is significantly associated with ED use as a source of admission, diabetics from counties with higher PPR are more likely to be admitted through the ED for diabetes complications than diabetics from counties with a lower PPR.Item An Analysis of Osteoporosis-Related Hip Fractures, Using Hospital Discharge Data(2001-12-01) Rubin, Bernard; Antonio A. Rene; Douglas Mains; Muriel MarshallThe purpose of this study is to assess whether a current physician practice may inadequately diagnose osteoporosis in a high risk population of postmenopausal women who have sustained a hip fracture. A review of all patients discharged from Texas hospitals during calendar year 1999 was analyzed, using the Public Use Data File provided through the Texas Health Care Information Council. A total of 13,628 women over the age of 55 were admitted to hospital with a fractured hip. Only 2,233, or 16.3%, of women were also coded with the diagnosis of osteoporosis (P [less than] 0.001). Forty to fifty percent of postmenopausal women have osteoporosis. Therefore, women presenting with a fragility fracture form an even more at-risk subset of the population, such that one would expect a majority of these women to carry a diagnosis of osteoporosis. Percentages of Caucasian, non-Hispanic women in each group were comparable. The age distribution in each group was comparable, implying that the coded diagnosis of osteoporosis was not related to the age of the women when admitted to the hospital. In conclusion, physicians practicing in Texas during calendar year 1999 inadequately diagnosed osteoporosis in a high risk population of postmenopausal women who were admitted to hospital with fractured hip. Future analysis of subsequent analysis databases will be able to identify whether or not continuing medical education efforts will cause physicians to diagnose osteoporosis in this high risk population more frequently.Item An Analytical Study of the Perceptions, Prevention Strategies, Treatment and Economic Impact of Equine West Nile Virus(2004-06-01) Galvan, Robert; Lurie, Sue; Singh, Karan; Gonzalez, AdelaGalvan, Robert, M.P.H., M.S. An Analytical Study of the Perceptions, Prevention Strategies, Treatment and Economic Impact of Equine West Nile Virus. Doctor of Public Health, Social and Behavioral Sciences, June 2004, 109 pp., 16 Tables, 15 Figures, 47 Titles. Since the introduction of the West Nile Virus (WNV) in the United State in 1999, WNV has been the cause of disease and deaths in humans, wild birds, zoo birds, and horses. In 2002, more than 15,000 equines in 40 states were diagnosed with illness associated with WNV. Approximately one third of those horses died or were euthanized (Campbell et al, 2002). Horses are infected with the WNV more often than humans or any other mammal. It is becoming on e of the fastest growing health threats to horses nationwide. Texas responded to the discovery of WNV by expanding their surveillance systems in the eastern counties of the state (Texas Department of Health, 2003). Positive reports for WNV were announced in 2002, which prompted an increase in public education and equine vaccination recommendations. Although much has been reported on the economic impact WNV has on human health and hospital care facilities, documentation is lacking on these issues in the equine population. Understanding the biology, epidemiology, economic impact, and how WNV affects the equine industry are important aspects to public health programs and prevention activities. The objectives of this study are to: (1) examine WNV cases in the equine population in Texas in order to better understand the distribution of clinical disease, signs, treatments and outcomes; (2) to provide information regarding the perceptions, knowledge, concerns, and treatment of the WNV by Texas veterinarians; and (3) to determine the economic impact of the WNV on the equine population in the state. A 14 question survey was mailed to licensed veterinarians in Texas in an effort to gather information about their perceptions and beliefs of the WNV, recommended treatment preferences, and the estimated cost of treatment. Outcomes included case fatality rate, descriptive data, veterinarians’ knowledge of WNV, veterinarians’ beliefs/perceptions of WNV, and the economic impact of WNV. Descriptive analyses were performed by using SPSS version 11. The methods used for analysis of WNV data were primarily simple descriptive statistics including summations and frequencies. A cross-tabulation was performed between the results of Questions 1, 2, and 3 and a variable created to approximate the number of veterinarians that actually treated cases of WNV (treat). A cross-tabulation and Chi-square analysis was performed between the treatment variables (treat) and derived variables of Questions 1, 2, and 3 to examine differing beliefs and knowledge between veterinarians who had treated WNV and those who had not. Seven hundred of 4,177 surveys returned yielded a response rate of 16.8 percent. Among the veterinarians, 73.4% (514/691) believed that they are receiving or received enough training and/or education concerning WNV. The vaccination regimen is believed to be effective and reliable by 56.1% (393/691) of the respondents. There were 1,256 cases of equine WNV reported confirmed via laboratory testing. There were also 766 cases reported that were not confirmed via laboratory testing. Among the 2,022 diagnosed cases, 257 were vaccinated against WNV prior to illness; and, 159 cases were vaccinated after signs of illness. A total of 441 horses died as either a direct cause of the disease or by owner or veterinarian elected euthanasia. The most common criteria used to decide euthanasia in these horses was prolonged recumbency as reported by 44.2% (87/197) or the veterinarians. Fifty-two percent (233/488) of the veterinarians did not recommend prevention strategies to equine owners. The cost of vaccination regimen was reported by 63% (269/434) of the veterinarians to be $25 or less. The results of the survey suggest that there could be a need for WVN education among veterinarians in areas of prevention, control, and treatment. Future studies should be conducted to examine owner perceptions, knowledge and beliefs of WNV vaccinations and prevention strategies. Values for lost horses were not solicited in the survey, thus, a total economic impact could not be completely estimated. However, a formula to approximate the aggregate economic impact of the WNV on the Texas equine industry was employed.Item An Epidemiological Profile of Poisoning Episodes Among Texans Utilizing Hospital Discharge Survery Data(2003-05-01) Ramisetty-Mikler, Suhasini; Rene, Antonio; Blakely, Sally; Mains, DouglasRamisetty-Mikler, Suhasini, An Epidemiological Profile of Poisoning Episodes Among Texans Utilizing Hospital Discharge Survey Data. Master of Public Health (Epidemiology), May, 2003, 68pp., 15 tables, references, 43 titles. This retrospective study of hospital discharge data provides an epidemiological profile of admissions, type of poisoning causing the hospitalization, and the intent of injury among Texans (N=12,541) during 1999. Overall, females are more frequently admitted, the rates increased with age through age 50 and declined thereafter among non-HIV patients. Psychotropic drugs and analgesics are the top two substances causing more than half of all admissions and one-third among children under age 14. Approximately 61% of all poisoning admissions are self-inflicted. The self-infliction risk is two times greater among non-HIV females and is highest (8 fold) among teenagers (age 15 to 17) compared to children 14 years or younger. The risk decreased with age (7 fold) through middle ages and dropped significantly after age 40 (4.5 times). Self-infliction is less likely after age 60. Whites are 1.5 times more likely than Blacks to self inflict among both HIV and non-HIV patients.Item Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community - A Six Month Follow-Up(1999-12-01) Coustasse, Alberto; Antonio Rene; Doug A. Mains; Gilbert RamirezCoustasse, Alberto, Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community – A Six Month Follow-up. Master of Public Health Track, Public Health Administration, December 1999, 22 pp., 9 tables, 9 illustrations, bibliography, 7 titles. The health fair approach was used as a method to establish individual and population health status baselines and to provide a mechanism to follow-up with an elderly population in a rural Texas community. A controlled trial sample of forty-four seniors was initially screened in a primary care clinic in August 1998. Patients were reevaluated at six months and results demonstrated a 46% increase in BMI [Body Mass Index]; 62% remained obese; 62% maintained elevated cholesterol or increased cholesterol values to abnormal values; 61% maintained or increased their BP [blood pressure] to abnormal values. A significant finding was that a change of one unit in the BMI correlated with a change of 19.88 mmHg [millimeter mercury] of SBP [systolic blood pressure] and 18.59 mmHg of DBP [diastolic blood pressure]. The societal economic impact of mortality and morbidity (without the benefit of target interventions) for the initial forty-four seniors was projected at & 74,949. Keywords: Health fairs; obesity; cardiovascular; cost; case management.Item Association Between Air Pollution and Daily Mortality in Two Texas Counties(2005-05-01) Espinosa, Isabel Y.; Terry Gratton; Sejong Bae; Antonio ReneEspinosa, Isabel Y., Association of Air Pollution and Daily Mortality in Two Texas Counties. Master of Public Health (Environmental Health), May 2005, 36 pp., 11 tables, 2 illustrations, references, 36 titles. The purpose of this study was to investigate the association between ozone and specific daily mortality in two United States counties, Bexar and Tarrant County, Texas. Daily specific mortality, one hour ozone levels, average temperatures, and Air Quality Index values were obtained for both counties. The results from this study suggest that no association is present between air pollution and specific daily mortality in Bexar County. Further statistical analysis is needed to determine if an association is present in Tarrant County as factors inherent in the collected data could be affecting the results. Investigating the association between ozone levels and hospitalization rates may provide a better description of the relationship and should be considered as a future study.Item Bariatric Surgery And The Lap Band: An Analysis of Efficacy(2003-12-01) Crane, Dave; Doug A. Mains; Claudia Coggin; Karan SinghCrane, B.A., M.A., Dave, Master of Public Health (Health Management and Policy), December 2003, Bariatric Surgery and the Lap Band: An Analysis of Efficacy, 40 pages, 15 tables, references, 45 titles. Obesity has quickly become both a national and global health issue. The evidence is increasingly consistent that obesity has a causal relationship with serious medical complications. The Lap Band, a surgical procedure for weight control, was approved by the Food and Drug Administration in June, 2001. The purpose of this study was to assess the efficacy of this procedure by reviewing existing literature and studying a patient population that had received Lap Band surgery. The retrospective review included information on 93 patients in the bariatric program at the University of North Texas Health Science Center at Fort Worth. The preliminary data in this study agrees with other studies , which shows that the Lap Band is an effective intervention for morbidly obese patients.Item Barriers to Health Care Access Among Vietnamese Refugees in Tarrant County, Texas.(2004-05-01) Le, Tuan D.; Chiehwen Ed Hsu; Sue Lurie; Raghbir SandhuLe, Tuan D., Barriers to Health Care Access among Vietnamese Refugees in Tarrant County, Texas. Master of Public Health (Health Management & Policy), May 2004, 88 pp., 17 tables, 11 illustrations, bibliography, 56 titles. The refugee community is the most vulnerable community due to existing medical conditions without proper treatment and many barriers in accessing the health care system, including different language, cultural conflict, legal restrictions, and socioeconomic status. The purpose of this study is to determine the nature of these barriers that keep the Vietnamese refugees from accessing the health care system in Tarrant County. The study found that 45.8% have no health insurance, 17.4% received Medicaid, 53.7% have no primary care physician, and 57.14% of Vietnamese elderly refugees, who have been living in the U.S. between seven and ten years, and have lost SSI and Medicaid. These findings are significant at p [less than] .001. Vietnamese refugees perceived factors that kept them from accessing the health care system as major barriers, including language (14%), legal issues (17%), misunderstanding of the medical system (15%), lack of insurance (14%), and different culture (11%). These results may assist social service providers, health care providers, and policy activists to enhance their services and advocate for legal issues, in order to remove these barriers and help refugees to access health care better.Item Behavioral Disturbances, Chronic Pain, and Cognitive Impairment in Long-Term Care Centers(2004-07-01) Ambavaram, Sukanya; Cipher, Daisha J.; Bayona, Manuel; Coggin, ClaudiaAmbavaram, Sukanya. Behavioral Disturbances, Chronic Pain, and Cognitive Impairment in Long-Term Care. Master of Public Health, July 2004, 45 pp., 8 tables, references. Background- There is increasing interest in finding the relationship between pain, depression, behavioral disturbances and cognitive impairment in patients living in long-term care centers and predicting behavioral disturbances using chronic pain, depression and cognitive impairment as predictors. To date this is the first study identifying the relationship between pain and behavioral problems. Methods- The study population consisted of 412 residents living in 16 long-term care centers in Dallas, TX. Pearson product-moment Correlation was done to find the association between behavioral disturbances and pain, depression and cognitive factors. Multiple regression analysis was performed to obtain best predictors of behavioral disturbances and forward selection procedure to find out best fit model. Conclusion- Statistically significant correlation was achieved between behavioral excess and overall pain. The correlation was statistically significant between behavioral deficit and overall pain, activity interference and depression. Overall pain, activity interference and depression are significantly inter-correlated with each other. Over all pain and activity interference were found to be statistically significant predictors of behavioral excess. Overall pain was found to be statistically significant predictor of behavioral deficit.Item Cardiorespiratory Fitness, Body Mass Index and All-Cause Mortality in Women, ACLS 1970-1994(1999-12-01) Braun, LeeAnn; Sally Blakley; Antonio A. ReneBraun, LeeAnn, Cardiorespiratory Fitness, Body Mass Index and All-Cause Mortality in Women, Aerobics Center Longitudinal Study, 1970-1994. Master of Public Health (Epidemiology), December, 1999, 44 p.p., 9 tables, references, 24 titles. Cardiorespiratory fitness and body mass index are related to morbidity and mortality (Manson, 1996). There is a preponderance of evidence supporting this relation in men (Gibbons, 1983; Blair, 1989, 1995, 1996; Lee, I, 1993; Barlow, 1995; Kampert, 1996; Dorn, 1997; Lee, C, 1999). The evaluation of the stated risk factors have been virtually unexplored in a cohort of women. The aim of this study is to evaluate whether higher levels of cardiorespiratory fitness attenuate the risk of all-cause mortality in overweight and obese women. In this prospective study, the study population consisted of 7572 women ages 20-89 years, who had a medical examination and achieved at least 85% of their age-adjusted maximal heart rate during a maximal treadmill test were followed for 69,979 woman-years. After adjustment for age, exam year, health status and smoking status, unfit women had a higher risk for all-cause mortality across BMI categories [RR 1.70 95% CI (1.18, 2.43)]. The benefits of cardiorespiratory fitness significantly decrease the risk of all-cause mortality in women as the concurrent consideration of cardiorespiratory fitness.Item Cell line authentication and contamination assessment for human cell cultures(2015-05-01) Ormos, Andrea; Arthur J. Eisenberg; Rhonda Roby; John V. PlanzCell line authentication is an essential step in ensuring the integrity and reproducibility of biomedical research. The major contaminants in cell cultures are fungi, viruses, bacteria and contamination from other cell lines of the same or different species. Contaminants alter the physiology and properties of cells, compromising the results of experiments. In this study, an improved multiplex assay was developed, detecting mycoplasma and mouse cell line contamination, while performing DNA typing. The assay was tested on cell cultures, the reproducibility of the assay was verified, sample collection and procedures were optimized and limit of detection for contaminants were determined. A survey was conducted to assess the interest in an in-house cell line authentication and contamination assessment service.Item Characterization of MRSA Infection at Childrens Medical Center, Dallas, January 2005-June 2005(2006-05-01) Okoro, Ngozi M.; Raghbir Sandhu; Claudia S. Coggin; Sejong BaeOkoro, Ngozi M., Characterization of MRSA infection at Childrens Medical Center, Dallas, January 2005-June 2005. Master of Public Health (Epidemiology), May 2006, 33p., 14 tables, 10 illustrations, bibliography, 13 titles. MRSA infection is increasingly emerging in patients without the established risk factors hence the term CAMRSA. This study is a descriptive secondary data analysis from an ongoing study at UTSM/CMCD and describes the CMCD patients with MRSA infection. Data analysis showed a consistent increase in the incidence rate of the infection with slight female preponderance. Race distribution showed that blacks were the majority. Most children were less than 2years, used Medicaid, had superficial infections and community-acquired infections. All (100%) isolates were susceptible to Vancomycin and Linezolid while many (92.2%) were resistant to Erythromycin. The increasing incidence in CAMRSA infection remains a challenge for public health professionals and the resistant pattern a potential problem to the pharmaceuticals.Item Clinical Internship with the Pediatric Clinic's Clinical Research at the Patient Care Center of the University of North Texas Health Science Center/Texas College of Osteopathic Medicine: Literature Review of Meningococcal Meningitis(2002-07-01) Puckett, Fredric Clark; Harold Sheedlo; Robin Newman; John FlingEpidemic meningococcal meningitis and meningococcemia disease is caused by the bacterial pathogen Neisseria meningitidis. Once infected with meningococci, onset of the disease is rapid with a high rate or morbidity and mortality. Without medical intervention the mortality rate is over 50%. Medical treatment is over 50%. Medical treatment of an outbreak of the disease with antibiotics can reduce the death rate to 10-15%. However, 10-20% of survivors will suffer from neurological damage that may include loss of hearing, paralysis or mental retardation. Recent concerns have been noted regarding the emergence of Neisseria meningitidis strains resistant to antibiotics. Vaccines have been developed in an effort to reduce epidemic outbreaks of meningococcal meningitis and meningococcemia. The first generation polysaccharide vaccines have shown to be safe and possess some degree of effectiveness but have shortcomings of limited length of immune protection and evidence of hyporesponsiveness to subsequent vaccinations. The second generation conjugated polysaccharide vaccines have been able to overcome these problems and show great promise in reducing the sale of epidemic meningococcal outbreaks with implementation of effective mass vaccination campaigns. In addition, reducing the number of infections will limit the exposure of Neisseria meningitidis to antibiotics and, in theory, slow the development of resistance to antibiotics.Item Defining the Prostate Cancer Population in Texas Using Hospital Discharge Data(2004-05-01) Manuel, Christopher J.; Karan Singh; Antonio A. ReneManuel, Christopher J., Defining the prostate cancer population in Texas using hospital discharge data. Masters of Public Health (Biostatistics), May 2004, 25 pp., 6 tables, bibliography, 35 titles. The Texas Health Care Information Council (THCIC) was created by the 74th Texas Legislature in 1995. THCIC’s primary purpose is to provide data that will enable Texas consumers and health plan purchasers to make informed health care decisions. This data also serves the purpose of providing information about disease trends and hospital discharges. The purpose of this study was to describe the disease status of prostate cancer in the state of Texas. Prostate cancer is the most common non-cutaneous male malignancy and ranks as the second cause of cancer-related mortality among men in the United States. Epidemiologic data was extracted from the data set for analysis looking at disease trends based on a variety of factors such as age, race, and insurance.