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The purpose of the present investigation was to examine the impact of blood transfusion on resource utilisation, morbidity and mortality in patients undergoing coronary artery bypass graft (CABG) surgery at a major university hospital. The resources we examined are time to extubation, intensive care unit length of stay (ICULOS) and postoperative length of stay (PLOS). We further examined the impact of number of units of packed red blood cells (PRBCs) transfused during PLOS. This is a retrospective observational study and includes 1746 consecutive male and female patients undergoing primary CABG (on- and off-pump) at our institution. Of these, 1067 patients received blood transfusions, while 677 did not. The data regarding the demography, blood transfusion, resource utilisation, morbidity and mortality were collected from the records of patients undergoing CABG over a period of three years. The mean time to extubation following surgery was 8.0 h for the transfused group and 4.3 h for the nontransfused group ( P ≤ 0.001). The mean ICULOS for the transfused group was 1.6 d and 1.2 d for the nontransfused group ( P < 0.001). The PLOS was 7.2 d for the transfused group and 4.3 d for no-transfused cohorts ( P ≤ 0.001). In all patients and in patients with no preoperative morbidity, partial correlation coefficients were used to examine the effects of transfusion on mortality, time to extubation, ICULOS and PLOS. Linear regression model was used to assess the effect of number of PRBC units transfused on PLOS. We noted that PLOS increased with the number of PRBCs units transfused. Transfusion is significantly correlated with the increased time to extubation, ICULOS, PLOS and mortality. The transfused patients had significantly more postoperative complications than their nontransfused counterparts ( P ≤ 0.001). The 30-day hospital mortality was 3.1% for the transfused group with no deaths in the nontransfused group ( P ≤ 0.001). We conclude that the CABG patients receiving blood transfusion have significantly longer time for tracheal extubation, ICULOS, PLOS and higher morbidity and 30-day hospital mortality. Blood transfusion was an independent predictor of increased resource utilisation, postoperative morbidity and mortality.

A mutation in the CCR5 gene appears to protect newborn babies of HIV-infected mothers from contracting the virus. CCR5 is a cell receptor that HIV uses to enter cells. Blocking the CCR5 receptor could prevent HIV transmission from mother to baby.

The role of maternal plasma HIV-1 RNA levels in mother-to-child transmission was assessed by measuring HIV-1 RNA in 30 HIV positive women and their infants by quantitative competitive-polymerase chain reaction. The results revealed a high correlation between maternal plasma HIV-1 RNA and the percentage of mother-to-child transmission of the disease. This study is expected to provide insight to predicting the risk of transmission of HIV-1 from mothers to their children.

The objective of this study was to determine the accuracy of self-reports of mammography use by low-income women. Mammography van records were used to verify self-reports of mammography use in the past year by women aged 50 through 75 years who had visited five community health centers (n = 237). Van records verified mammography use for 99% of these women (82% within the previous year and 98% within the past 2 years). Forty percent of those with van records who reported both the month and year of the mammogram were accurate. Inaccurately reported dates were more frequently after (74%) rather than before (26%) the actual date. These findings indicate that self-reports of mammography use by low-income women are generally reliable. (Am J Public Health. 1994;84:107-109), Self-reports of mammography use by low-income women appear to be reliable sources of utilization data. Researchers used mobile mammography van records to verify self-reported mammography use of 237 women aged 50 to 75 years. Van records verified mammography use for 99% of the women, 82% of whom had obtained mammograms in the previous year. In addition, 16% of the women had mammogram records within the prior 13 to 24 months and one percent had documentation of mammograms within the previous 25 to 36 months. Eighty-one self-reports agreed completely with van records for month and year of mammogram, 124 were accurate within one month, 161 were within three months and 197 were within one year. The self-reported date was more often after the date of the actual mammogram (74%) than before the actual date (26%). Self-report accuracy declined as the time since last mammography increased.

This study was designed to assess the effects of the North Carolina Improved Pregnancy Outcome (IPO) Project on use of prenatal care and incidence of low birthweight among its primarily Black registrants. Weighted least squares and stratified analysis procedures were used to scrutinize vital statistics data for subpopulation effects. IPO services were received by 51.7 per cent of Black women in the counties served by the project. For all Black registrants, the risk of receiving less than adequate prenatal care was 55.1 per cent of that of the comparison group. For Black teenage registrants, the risk was even less: 37.2 per cent of that of the comparison group. Nevertheless, no corresponding effects on the incidence of low birthweight could be detected. The evaluation methods used in this study can be applied to programs for mothers and infants in other locales to generate useful and practical information for state-level decion-making. [ABSTRACT FROM AUTHOR]

Abstract: To guide the planning of a multifacetted hypertension control program in Edgecombe County, North Carolina. a baseline survey of a stratified (by township) random sample of 1,000 households wan conducted. All adults (>/= 18 years) were interviewed and had their blood pressures (BP) measured Five hundred thirty-nine individuals. 27 per cent of the survey population, had diastolic BP >/= 90 mm Hg or were receiving anti-hypertensive drug therapy. The 539 hypertensives were divided into seven subgroups reflecting successive stages in the control of hypertension based on the awareness, treatment, and control of their hypertension. Unaware hypertensives were further subdivided into three groups according to the recency of their last BP check, and those aware but untreated were subdivided by whether they had previously received treatment. The seven subgroups of hypertensives were compared, separately for women and men. with respect to sociodemographic characteristics, health behaviors, and health status, in general, the progression from undetected hypertension 10 treatment and control appeared to be associated with being older, female, and White. This progression was further associated with greater educational levels and higher family incomes among women and increasing self-reported morbidity among men. The implications tot intervention of these and other described associations are discussed. (Am J Public Health 1984: 74:237-242.) [ABSTRACT FROM AUTHOR]

To investigate the significance and measurement of depressive symptoms in young adolescents, 624 junior high school students were asked to complete the Center for Epidemiologic Studies Depression Scale (CES-D) during home interviews. In 384 usable symptom scales, item-scale correlations (most were above .50), inter-item correlations, coefficient alpha (.85), and patterns of reported symptoms were reasonable. Persistent symptoms were reported more often by Blacks, especially Black males. Prevalence of persistent symptoms in Whites was quite close to reported figures for adults, ranging from 1 per cent to 15 per cent in adolescent males and 2 per cent to 13 per cent in adolescent females. Adolescents reported persistent vegetative symptoms less often and psychosocial symptoms more often. Reports of symptoms without regard to duration were much more frequent in the adolescents, ranging from 18 per cent to 76 per cent in White males, 34 per cent to 76 per cent in White and Black females, and 41 per cent to 85 per cent in Black males. The results support the feasibility of using a self-report symptom scale to measure depressive symptoms in young adolescents. Transient symptoms reported by adolescents probably reflect their stage of development, but persistent symptoms are likely to have social psychiatric importance. [ABSTRACT FROM AUTHOR]