195 results on '"Patz J"'
Search Results
52. Immunology, climate change and vector-borne diseases
- Author
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Patz, J. A. and Reisen, W. K.
- Published
- 2001
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53. Methods for assessing public health vulnerability to global climate change
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Balbus, J. M. and Patz, J. A.
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RISK assessment ,DISEASES ,GEOGRAPHIC information systems - Published
- 1996
54. CHAPTER 9: National assessments of health impacts of climate change: a review.
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Kovats, R. S., Menne, B., Ahern, M. J., and Patz, J. A.
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CLIMATE change , *HEALTH , *HEALTH risk assessment , *CLIMATOLOGY - Abstract
Chapter 9 of the book "Climate Change and Human Health" is presented. It explores several national assessments that have addressed climate change impacts on human population health. It enumerates the common elements of health impact assessments. It provides a comparison between climate change impact assessment and traditional health quantitative risk assessment (QRA).
- Published
- 2003
55. Effect of El Niño and ambient temperature on hospital admissions for diarrhoeal diseases in Peruvian children.
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Checkley, William, Epstein, Leonardo D., Gilman, Robert H., Figueroa, Dante, Cama, Rosa I., Patz, Jonathan A., Black, Robert E., Checkley, W, Epstein, L D, Gilman, R H, Figueroa, D, Cama, R I, Patz, J A, and Black, R E
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- *
DIARRHEA in children , *TEMPERATURE , *MOSQUITO vectors , *EPIDEMIOLOGY , *HEALTH ,EL Nino - Abstract
Introduction: To investigate whether the El Niño phenomenon and ambient temperature had an effect on the epidemiology of childhood diarrhoea, we analysed data on daily number of admissions of children with diarrhoea to the Oral Rehydration Unit of the Instituto de Salud del Niño in Lima, Peru, between January, 1993, and November, 1998.Methods: We obtained daily data on hospital admissions from the Oral Rehydration Unit, and meteorological data from the Peruvian Weather Service, and used time-series linear regression models to assess the effects of the 1997-98 El Niño event on admissions for diarrhoea.Findings: 57,331 children under 10 years old were admitted to the unit during the study. During the 1997-98 El Niño episode, mean ambient temperature in Lima increased up to 5 degrees C above normal, and the number of daily admissions for diarrhoea increased to 200% of the previous rate. 6225 excess admissions were attributable to El Niño, and these cost US$277,000. During the period before the El Niño episode, admissions for diarrhoea increased by 8% per 1 degree C increase in mean ambient temperature. The effects of El Niño and ambient temperature on the number of admissions for diarrhoea were greatest during the winter months.Interpretation: El Niño had an effect on hospital admissions greater than that explained by the regular seasonal variability in ambient temperature. The excess increase in ambient temperature was the main environmental variable affecting admissions. If our findings are reproducible in other regions, diarrhoeal diseases may increase by millions of cases worldwide with each degree of increase in ambient temperature above normal. [ABSTRACT FROM AUTHOR]- Published
- 2000
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56. An Analysis of the Health Effects of Physical Activity due to Active Travel Policies in Rennes, France.
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Fremont H, Younkin S, Roué Le Gall A, Levine N, and Patz J
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Background: Rennes, a midsize city in France, features many opportunities for active travel. City officials seek to increase walking and cycling by 2030 to improve public health. Physical inactivity, a leading risk factor for premature mortality around the globe, has been shown to be associated with many chronic diseases including heart disease, type 2 diabetes, and cancer., Methods: Using the 2018 household travel survey of Rennes residents, we apply the Health-Oriented Transportation statistical model to assess health impacts associated with population-level rates of walking and cycling. We consider two proposed mobility and climate objectives which outline sustainable transportation goals by 2030. These include a shift in transportation mode share to increase walking and cycling trips, as well as a broad reduction in vehicle miles traveled (VMT) across the metropolitan area., Results: Our regression analysis demonstrated that factors of household car access and inner-city residency were predictors of prevalence (observed one-day proportion engaging in walking or cycling), participation (weekly proportion), and intensity (mean individual physical activity achieved through walking/cycling) of active travel. Age and education were additionally associated with prevalence. The 2030 mobility objective (mode share: 9% cycle, 35% walk) was associated with a reduction of 1,051 DALYs (disability-adjusted life-years), translating to $73 million USD ($23-$177) in averted costs. The climate objective (10% reduction in VMT) was associated with a reduction of 369 DALYs when replaced entirely by walking and 714 DALYs with cycling, translating to $26 million ($8-$62) and $50 million ($15-$121) saved, respectively., Conclusions: Rennes residents experience high participation in active travel, particularly those in the inner city. If residents achieve the city's active travel goals for 2030, there is potential for a large reduction in health burden and subsequent costs. Reaching these goals may require significant investment in transportation programming and infrastructure to improve active travel opportunities., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Fremont H et al.)
- Published
- 2024
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57. The influence of socioeconomic characteristics on active travel in US metropolitan areas and the contribution to health inequity.
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Younkin S, Fremont H, Bratburd J, De Los Santos D, and Patz J
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Background: The prevalence of chronic disease in the US adult population varies across socioeconomic groups in the USA where approximately six in 10 adults have a chronic condition. Walking or cycling reduces the risk to many of these diseases and is influenced by the built environment, accessibility, and safety., Methods: We performed multivariate logistic and linear regression on the Health-Oriented Transportation model parameters using the 2009 and 2017 US National Household Transportation surveys, restricted to adults in major metropolitan areas. Model covariates included socioeconomic and environmental characteristics., Results: Using odds ratios (OR) adjusted for model covariates, we observe several significant variables in 2009 and 2017. Residents of households with no cars were more likely to walk or cycle than those with two cars; OR=5.4 (4.8, 6.0). Residents of households in a census block with population density greater than 2,5000 persons/square mile were more likely to walk or cycle than those with a population density of 2000-3999; OR=2.6 (2.3, 2.8). Individuals with a graduate or professional degree were more likely to walk or cycle than those with a high school degree; OR=2.1 (1.9, 2.2). Individuals that self-report as Black or African American, or Asian are less likely to walk or cycle than White; OR=0.60 (0.56, 0.66), OR=0.70 (0.65, 0.75). The proportional increase in all-cause mortality from estimated reductions in physical activity for African American, Asian, and Hispanic populations were 1.0%, 0.7%, 0.8%, respectively., Conclusions: Access to automobiles and the surrounding population density are primary factors in the decision to walk or cycle. After adjusting for these and other factors, members of low-income, low-education, Black or African American, and Asian populations in US metropolitan areas are less likely to walk or cycle than high-income, high-education, or White populations and the discrepancy in physical activity is likely to contribute to health inequity., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Younkin S et al.)
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- 2024
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58. Human fertilization in vivo and in vitro requires the CatSper channel to initiate sperm hyperactivation.
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Young S, Schiffer C, Wagner A, Patz J, Potapenko A, Herrmann L, Nordhoff V, Pock T, Krallmann C, Stallmeyer B, Röpke A, Kierzek M, Biagioni C, Wang T, Haalck L, Deuster D, Hansen JN, Wachten D, Risse B, Behre HM, Schlatt S, Kliesch S, Tüttelmann F, Brenker C, and Strünker T
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- Child, Humans, Male, Calcium Channels genetics, Sperm Motility physiology, Spermatozoa physiology, Fertilization in Vitro, Fertilization physiology, Semen physiology, Infertility, Male therapy, Infertility, Male genetics
- Abstract
The infertility of many couples rests on an enigmatic dysfunction of the man's sperm. To gain insight into the underlying pathomechanisms, we assessed the function of the sperm-specific multisubunit CatSper-channel complex in the sperm of almost 2,300 men undergoing a fertility workup, using a simple motility-based test. We identified a group of men with normal semen parameters but defective CatSper function. These men or couples failed to conceive naturally and upon medically assisted reproduction via intrauterine insemination and in vitro fertilization. Intracytoplasmic sperm injection (ICSI) was, ultimately, required to conceive a child. We revealed that the defective CatSper function was caused by variations in CATSPER genes. Moreover, we unveiled that CatSper-deficient human sperm were unable to undergo hyperactive motility and, therefore, failed to penetrate the egg coat. Thus, our study provides the experimental evidence that sperm hyperactivation is required for human fertilization, explaining the infertility of CatSper-deficient men and the need of ICSI for medically assisted reproduction. Finally, our study also revealed that defective CatSper function and ensuing failure to hyperactivate represents the most common cause of unexplained male infertility known thus far and that this sperm channelopathy can readily be diagnosed, enabling future evidence-based treatment of affected couples.
- Published
- 2024
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59. Source Apportionment of Fine Organic Particulate Matter (PM 2.5 ) in Central Addis Ababa, Ethiopia.
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Tefera W, Kumie A, Berhane K, Gilliland F, Lai A, Sricharoenvech P, Patz J, Samet J, and Schauer JJ
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- Aerosols analysis, Environmental Monitoring, Ethiopia, Particulate Matter analysis, Seasons, Vehicle Emissions analysis, Air Pollutants analysis, Air Pollution analysis
- Abstract
The development of infrastructure, a rapidly increasing population, and urbanization has resulted in increasing air pollution levels in the African city of Addis Ababa. Prior investigations into air pollution have not yet sufficiently addressed the sources of atmospheric particulate matter. This study aims to identify the major sources of fine particulate matter (PM
2.5 ) and its seasonal contribution in Addis Ababa, Ethiopia. Twenty-four-hour average PM2.5 mass samples were collected every 6th day, from November 2015 through November 2016. Chemical species were measured in samples and source apportionment was conducted using a chemical mass balance (CMB) receptor model that uses particle-phase organic tracer concentrations to estimate source contributions to PM2.5 organic carbon (OC) and the overall PM2.5 mass. Vehicular sources (28%), biomass burning (18.3%), plus soil dust (17.4%) comprise about two-thirds of the PM2.5 mass, followed by sulfate (6.5%). The sources of air pollution vary seasonally, particularly during the main wet season (June-September) and short rain season (February-April): From motor vehicles, (31.0 ± 2.6%) vs. (24.7 ± 1.2%); biomass burning, (21.5 ± 5%) vs. (14 ± 2%); and soil dust, (11 ± 6.4%) vs. (22.7 ± 8.4%), respectively, are amongst the three principal sources of ambient PM2.5 mass in the city. We suggest policy measures focusing on transportation, cleaner fuel or energy, waste management, and increasing awareness on the impact of air pollution on the public's health.- Published
- 2021
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60. Fine particulate pollution concentration in Addis Ababa exceeds the WHO guideline value: Results of 3 years of continuous monitoring and health impact assessment.
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Kumie A, Worku A, Tazu Z, Tefera W, Asfaw A, Boja G, Mekashu M, Siraw D, Teferra S, Zacharias K, Patz J, Samet J, and Berhane K
- Abstract
Real-time monitoring of fine particulate matter (PM
2.5 ) concentrations and assessing the health impact are limited in Ethiopia. The objective of this study is to describe current levels of PM2.5 air pollution in Addis Ababa and examine temporal patterns and to consider the health impact of current PM2.5 exposure levels., Methods: PM2.5 concentrations were measured using a centrally-located Beta Attenuator Monitor (BAM-1022) for 3 years (1 April 2017 to 31 March 2020), with data downloaded biweekly. Deaths attributable to current PM2.5 concentration levels were estimated using the AirQ+ tool. The daily average was estimated using hourly data., Results: The daily mean (SD) PM2.5 concentration was 42.4 µg/m3 (15.98). Two daily extremes were observed: morning (high) and afternoon (low). Sundays had the lowest PM2.5 concentration, while Mondays to Thursdays saw a continuous increase; Fridays showed the highest concentration. Seasons showed marked variation, with the highest values during the wet season. Concentration spikes reflected periods of intensive fuel combustion. A total of 502 deaths (4.44%) were attributable to current air pollution levels referenced to the 35 µg/m3 WHO interim target annual level and 2,043 (17.7%) at the WHO 10 µg/m3 annual guideline., Conclusion: PM2.5 daily levels were 1.7 times higher than the WHO-recommended 24-hour guideline. The current annual mean PM2.5 concentration results in a substantial burden of attributable deaths compared to an annual mean of 10 µg/m3 . The high PM2.5 level and its variability across days and seasons calls for citywide interventions to promote clean air., Competing Interests: The authors declare that they have no conflicts of interest with regard to the content of this report.Sponsorships or competing interests that may be relevant to content are disclosed at the end of the article., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Environmental Epidemiology. All rights reserved.)- Published
- 2021
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61. A framework to guide planetary health education.
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Guzmán CAF, Aguirre AA, Astle B, Barros E, Bayles B, Chimbari M, El-Abbadi N, Evert J, Hackett F, Howard C, Jennings J, Krzyzek A, LeClair J, Maric F, Martin O, Osano O, Patz J, Potter T, Redvers N, Trienekens N, Walpole S, Wilson L, Xu C, and Zylstra M
- Subjects
- Climate Change, Health Education
- Abstract
Competing Interests: CAFG declares consulting fees from the Planetary Health Alliance. CH declares consulting fees from the Lancet Countdown on Health and Climate Change and from CODA Change and board positions or steering committee for Global Climate and Health Alliance, the WHO-Civil Society Working Group on Climate Change and Health, the Planetary Health Alliance, the Canadian Association of Physicians for the Environment, and the Canadian Medical Association. EB declares being the chair of the WONCA Working Party on the Environment and was a grant recipient from WONCA Air Health Train-the-Trainer. JP declares being recipient of the Chanchlani Award for Global Health Research. MZ declares consulting work with the Organization for Noetic Ecology NPO and Wildlands Studies; and pro-bono advisor or associate to Sea Change Trust (South Africa), Masiyembo Association (South Africa), The Connective (Australia), and Earthfire Institute (USA). NE declares a previous role as a data analysis consultant at HowGood starting March 17, 2021. Brunel University London has supported provision on OM's time in-kind for this project and preparation of this manuscript. TP declares budget for travel to Planetary Health events, but funds were not used during the writing of this paper. All other authors declare no competing interests.
- Published
- 2021
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62. Improving Human Health in China Through Alternative Energy.
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Scott M, Sander R, Nemet G, and Patz J
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- China epidemiology, Coal, Humans, Power Plants, Air Pollutants adverse effects, Air Pollution adverse effects
- Abstract
In this study, we estimate the health benefits of more stringent alternative energy goals and the costs of reducing coal-fired power plant pollution in China projected in 2030. One of our two overarching alternative energy goals was to estimate the health benefits of complete elimination of coal energy, supplemented by natural gas and renewables. The second was a policy scenario similar to the U.S. 2013 Climate Action Plan (CAP), which played a pivotal role leading up to the 2015 Paris Climate Agreement. We used the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model created by the International Institute for Applied Systems Analysis for our model simulations. We found that 17,137-24,220 premature deaths can be avoided if coal energy is completely replaced by alternative energy, and 8,693-9,281 premature deaths can be avoided if coal energy is replaced by alternatives in a CAP-like scenario. A CAP-like scenario using emission-controls in coal plants costs $11-18 per person. Reducing coal energy in China under a CAP-like scenario would free up $9.4 billion in the annual energy budget to spend on alternatives, whereas eliminating the cost of coal energy frees up $32 billion. This study's estimates show that more stringent alternative energy targets in China are worth the investment in terms of health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Scott, Sander, Nemet and Patz.)
- Published
- 2021
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63. Chemical Characterization and Seasonality of Ambient Particles (PM 2.5 ) in the City Centre of Addis Ababa.
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Tefera W, Kumie A, Berhane K, Gilliland F, Lai A, Sricharoenvech P, Samet J, Patz J, and Schauer JJ
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- Cities, Environmental Monitoring, Ethiopia, Particulate Matter analysis, Seasons, Vehicle Emissions analysis, Air Pollutants analysis, Air Pollution analysis
- Abstract
Ambient air pollution is a growing public health concern in major African cities, including Addis Ababa (Ethiopia), where little information is available on fine particulate matter (PM
2.5 , with aerodynamic diameter <2.5 µm) pollution. This paper aims to characterize annual PM2.5 , including bulk composition and seasonal patterns, in Addis Ababa. We collected 24-h PM2.5 samples in the central city every 6 days from November 2015 to November 2016. The mean (±SD) daily PM2.5 concentration was 53.8 (±25.0) µg/m3 , with 90% of sampled days exceeding the World Health Organization's guidelines. Principal components were organic matter (OM, 44.5%), elemental carbon (EC, 25.4%), soil dust (13.5%), and SNA (sulfate, nitrate, and ammonium ions, 8.2%). Higher PM2.5 concentrations were observed during the heavy rain season, while crustal dust concentrations ranged from 2.9 to 37.6%, with higher levels during dry months. Meteorological variables, vehicle emissions, biomass fuels, unpaved roads, and construction activity contribute to poor air quality. Compared to the Air Quality Index (AQI), 31% and 36% of observed days were unhealthy for everyone and unhealthy for sensitive groups, respectively. We recommend adopting effective prevention strategies and pursuing research on vehicle emissions, biomass burning, and dust control to curb air pollution in the city.- Published
- 2020
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64. Using Satellites to Track Indicators of Global Air Pollution and Climate Change Impacts: Lessons Learned From a NASA-Supported Science-Stakeholder Collaborative.
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Anenberg SC, Bindl M, Brauer M, Castillo JJ, Cavalieri S, Duncan BN, Fiore AM, Fuller R, Goldberg DL, Henze DK, Hess J, Holloway T, James P, Jin X, Kheirbek I, Kinney PL, Liu Y, Mohegh A, Patz J, Jimenez MP, Roy A, Tong D, Walker K, Watts N, and West JJ
- Abstract
The 2018 NASA Health and Air Quality Applied Science Team (HAQAST) "Indicators" Tiger Team collaboration between NASA-supported scientists and civil society stakeholders aimed to develop satellite-derived global air pollution and climate indicators. This Commentary shares our experience and lessons learned. Together, the team developed methods to track wildfires, dust storms, pollen counts, urban green space, nitrogen dioxide concentrations and asthma burdens, tropospheric ozone concentrations, and urban particulate matter mortality. Participatory knowledge production can lead to more actionable information but requires time, flexibility, and continuous engagement. Ground measurements are still needed for ground truthing, and sustained collaboration over time remains a challenge., Competing Interests: The authors declare that they have no conflicts of interest relevant to this study., (©2020. The Authors.)
- Published
- 2020
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65. A 15 Year Evaluation of West Nile Virus in Wisconsin: Effects on Wildlife and Human Health.
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Uelmen JA, Brokopp C, and Patz J
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- Animals, Animals, Wild, Humans, Wisconsin, Culicidae, West Nile Fever, West Nile virus
- Abstract
West Nile virus (WNV) is the most important and widespread mosquito-borne virus in the United States (U.S.). WNV has the ability to spread rapidly and effectively, infecting more than 320 bird and mammalian species. An examination of environmental conditions and the health of keystone species may help predict the susceptibility of various habitats to WNV and reveal key risk factors, annual trends, and vulnerable regions. Since 2002, WNV outbreaks in Wisconsin varied by species, place, and time, significantly affected by unique climatic, environmental, and geographical factors. During a 15 year period, WNV was detected in 71 of 72 counties, resulting in 239 human and 1397 wildlife cases. Controlling for population and sampling efforts in Wisconsin, rates of WNV are highest in the western and northwestern rural regions of the state. WNV incidence rates were highest in counties with low human population densities, predominantly wetland, and at elevations greater than 1000 feet. Resources for surveillance, prevention, and detection of WNV were lowest in rural counties, likely resulting in underestimation of cases. Overall, increasing mean temperature and decreasing precipitation showed positive influence on WNV transmission in Wisconsin. This study incorporates the first statewide assessment of WNV in Wisconsin.
- Published
- 2020
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66. Sleeve gastrectomy in obese Wistar rats improves diastolic function and promotes cardiac recovery independent of weight loss.
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Hayes H, Patz J, Corbett J, Afzal MZ, Strande J, and Kindel TL
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- Animals, Diet, High-Fat, Disease Models, Animal, Heart physiology, Heart Failure, Male, Obesity physiopathology, Rats, Rats, Wistar, Bariatric Surgery methods, Blood Pressure physiology, Gastrectomy methods, Obesity surgery, Weight Loss physiology
- Abstract
Background: Heart failure with preserved ejection fraction is the most common cause of heart failure and is characterized by impaired diastolic relaxation. Bariatric surgery significantly improves diastolic relaxation, but a mechanism beyond weight loss remains unknown., Objectives: We tested the hypothesis that a sleeve gastrectomy (SG) will improve diastolic dysfunction independent of weight loss due to postoperative alterations in the enterocardiac axis., Setting: University research laboratory., Methods: Male Wistar rats were fed a high-fat diet (HFD) or low-fat diet (LFD) for 10 weeks and then divided into SG-HFD, pair-fed sham HFD, ad-lib sham HFD, or ad-lib sham LFD groups (n = 9-14 per group). At least 2 months postoperatively, cardiac function, meal tolerance, glucose tolerance, and cardiac gene expression were compared between groups., Results: Only the SG cohort showed significant improvements in postoperative diastolic relaxation (isovolumetric relaxation time pre-SG: 14.7 ± 2.3 msec, post-SG: 11.2 ± 1.8 msec, P < .001). SG significantly increased active glucagon-like peptide-1 (P = .03). Compared to pair-fed sham HFD rats, SG-HFD rats had significantly altered mRNA cardiac gene expression, including sarco/endoplasmic reticulum Ca2+-ATPase 2 a (SERCA2 a) (P < .001)., Conclusions: SG improves diastolic function independent of weight loss in a rat model of obesity with beneficial alterations in cardiac gene expression of multiple known targets related to cardiac failure, including SERCA2 a. These data support that a greater curve gastrectomy induces beneficial intracellular cardiac signaling for diastolic function mediated by the enterocardiac axis that is independent of weight loss. These findings could translate to offering metabolic surgery to patients with heart failure with preserved ejection fraction., (Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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67. Fracking and Climate Change.
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Frumkin H and Patz J
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- Environmental Monitoring, Humans, Climate Change, Hydraulic Fracking
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- 2018
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68. Response of Power Plant Emissions to Ambient Temperature in the Eastern United States.
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Abel D, Holloway T, Kladar RM, Meier P, Ahl D, Harkey M, and Patz J
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- Air Pollution, Texas, United States, Air Pollutants analysis, Power Plants, Temperature
- Abstract
Past studies have established strong connections between meteorology and air quality, via chemistry, transport, and natural emissions. A less understood linkage between weather and air quality is the temperature-dependence of emissions from electricity generating units (EGUs), associated with high electricity demand to support building cooling on hot days. This study quantifies the relationship between ambient surface temperatures and EGU air emissions (CO
2 , SO2 , and NOX ) using historical data. We find that EGUs in the Eastern U.S. region from 2007 to 2012 exhibited a 3.87% ± 0.41% increase in electricity generation per °C increase during summer months. This is associated with a 3.35%/°C ± 0.50%/°C increase in SO2 emissions, a 3.60%/°C ± 0.49%/°C increase in NOX emissions, and a 3.32%/°C ± 0.36%/°C increase in CO2 emissions. Sensitivities vary by year and by pollutant, with SO2 both the highest sensitivity (5.04% in 2012) and lowest sensitivity (2.19% in 2007) in terms of a regional average. Texas displays 2007-2012 sensitivities of 2.34%/°C ± 0.28%/°C for generation, 0.91%/°C ± 0.25%/°C for SO2 emissions, 2.15%/°C ± 0.29%/°C for NOX emissions, and 1.78%/°C ± 0.22%/°C for CO2 emissions. These results suggest demand-side and supply side technological improvements and fuel choice could play an important role in cost-effective reduction of carbon emissions and air pollution.- Published
- 2017
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69. Environmental and occupational health research and training needs in Colombia: A Delphi study.
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Rodríguez-Villamizar LA, González BE, Vera LM, Patz J, and Bautista LE
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- Biomedical Research, Colombia, Humans, Delphi Technique, Environmental Health education, Occupational Health education
- Abstract
Introduction: Environmental factors contribute with 16% of the burden of disease in Colombia. A main obstacle in implementing national and regional environmental and occupational health policies is the limited knowledge on the local ability to study and control the impact of harmful exposures on health., Objective: To identify needs for research and training in environmental and occupational health in Colombia., Materials and Methods: We conducted a three-round hybrid Delphi study. A group of environmental and occupational health Colombian experts (n=16) from government agencies, universities, and research centers was recruited to participate in the study. Expert´s opinions on research and training needs were gathered through online questionnaires, followed by an in-person meeting. The percentage of agreement and the coefficient of variation were used to measure consensus., Results: Air pollution and chemical products were considered the most important environmental and occupational exposures, due to their significant impact on chronic non-communicable diseases, such as respiratory diseases, cardiovascular diseases, and cancer. Research on the effects of outdoor air pollution on cardiovascular and respiratory diseases was considered of the greatest importance. Priority training areas included environmental and occupational health risk assessment, exposure modeling, advanced statistical methods, urban planning, occupational safety and hygiene, and epidemiology and toxicology., Conclusions: These findings provide a valuable input for the definition and implementation of national environmental and occupational health policies and for the development of a regional hub aimed at strengthening the capacity for research and training in Colombia.
- Published
- 2015
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70. Effects of the 1997-1998 El Niño episode on community rates of diarrhea.
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Bennett A, Epstein LD, Gilman RH, Cama V, Bern C, Cabrera L, Lescano AG, Patz J, Carcamo C, Sterling CR, and Checkley W
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- Age Factors, Child, Child, Preschool, Cryptosporidiosis epidemiology, Cryptosporidium, Diarrhea parasitology, Feces parasitology, Female, Humans, Incidence, Infant, Infant, Newborn, Longitudinal Studies, Male, Peru epidemiology, Seasons, Urban Population statistics & numerical data, Diarrhea epidemiology, El Nino-Southern Oscillation
- Abstract
Objectives: To improve our understanding of climate variability and diarrheal disease at the community level and inform predictions for future climate change scenarios, we examined whether the El Niño climate pattern is associated with increased rates of diarrhea among Peruvian children., Methods: We analyzed daily surveillance data for 367 children aged 0 to 12 years from 2 cohorts in a peri-urban shantytown in Lima, Peru, 1995 through 1998. We stratified diarrheal incidence by 6-month age categories, season, and El Niño, and modeled between-subject heterogeneity with random effects Poisson models., Results: Spring diarrheal incidence increased by 55% during El Niño compared with before El Niño. This increase was most acute among children older than 60 months, for whom the risk of a diarrheal episode during the El Niño spring was nearly 100% greater (relative risk=1.96; 95% confidence interval=1.24, 3.09)., Conclusions: El Niño-associated climate variability affects community rates of diarrhea, particularly during the cooler seasons and among older children. Public health officials should develop preventive strategies for future El Niño episodes to mitigate the increased risk of diarrheal disease in vulnerable communities.
- Published
- 2012
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71. Feasibility and reliability of classifying gross motor function among children with cerebral palsy using population-based record surveillance.
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Benedict RE, Patz J, Maenner MJ, Arneson CL, Yeargin-Allsopp M, Doernberg NS, Van Naarden Braun K, Kirby RS, and Durkin MS
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- Cerebral Palsy physiopathology, Child, Child, Preschool, Feasibility Studies, Female, Humans, Male, Motor Skills Disorders physiopathology, Population Surveillance, Predictive Value of Tests, Records, Severity of Illness Index, Cerebral Palsy classification, Disability Evaluation, Motor Skills physiology, Motor Skills Disorders classification
- Abstract
For conditions with wide-ranging consequences, such as cerebral palsy (CP), population-based surveillance provides an estimate of the prevalence of case status but only the broadest understanding of the impact of the condition on children, families or society. Beyond case status, information regarding health, functional skills and participation is necessary to fully appreciate the consequences of the condition. The purpose of this study was to assess the feasibility and reliability of enhancing population-based surveillance by classifying gross motor function (GMF) from information available in medical records of children with CP. We assessed inter-rater reliability of two GMF classification methods, one the Gross Motor Function Classification System (GMFCS) and the other a 3-category classification of walking ability: (1) independently, (2) with handheld mobility device, or (3) limited or none. Two qualified clinicians independently reviewed abstracted evaluations from medical records of 8-year-old children residing in southeast Wisconsin, USA who were identified as having CP (n = 154) through the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring Network. Ninety per cent (n = 138) of the children with CP had information in the record after age 4 years and 108 (70%) had adequate descriptions of gross motor skills to classify using the GMFCS. Agreement was achieved on 75.0% of the GMFCS ratings (simple kappa = 0.67, 95% confidence interval [95% CI 0.57, 0.78], weighted kappa = 0.83, [95% CI 0.77, 0.89]). Among case children for whom walking ability could be classified (n = 117), approximately half walked independently without devices and one-third had limited or no walking ability. Across walking ability categories, agreement was reached for 94% (simple kappa = 0.90, [95% CI 0.82, 0.96], weighted kappa = 0.94, [95% CI 0.89, 0.98]). Classifying GMF in the context of active records-based surveillance is feasible and reliable. Future surveillance efforts that include functional level among children with cerebral palsy may provide important information for monitoring the impact of the condition for programmatic and policy purposes., (© 2010 Blackwell Publishing Ltd.)
- Published
- 2011
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72. Short-term weather variability in Chicago and hospitalizations for Kawasaki disease.
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Checkley W, Guzman-Cottrill J, Epstein L, Innocentini N, Patz J, and Shulman S
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- Chicago epidemiology, Hospitals, Pediatric, Humans, Medical Audit, Poisson Distribution, Retrospective Studies, Hospitalization trends, Mucocutaneous Lymph Node Syndrome epidemiology, Weather
- Abstract
Background: : Kawasaki disease exhibits a distinct seasonality, and short-term changes in weather may affect its occurrence., Methods: : To investigate the effects of weather variability on the occurrence of this syndrome, we conducted a time-between-events analysis of consecutive admissions for Kawasaki disease to a large pediatric hospital in Chicago. We used gamma regression to model the times between admissions. This is a novel application of gamma regression to model the time between admissions as a function of subject-specific covariates., Results: : We recorded 723 admissions in the 18-year (1986-2003) study period, of which 700 had complete data for analysis. Admissions for Kawasaki disease in Chicago were seasonal: The mean time between admissions was 34% shorter (relative time = 0.66, 95% confidence interval 0.54-0.81) from January-March than from July-September. In 1998, we recorded a larger number of admissions for Kawasaki disease (n = 65) than in other years (mean n = 37). January-March months of 1998 were warmer by a mean of 3 degrees C (1.5 degrees C-4.4 degrees C) and the mean time between admissions was 48% shorter (relative time = 0.52, 0.36-0.75) than in equivalent periods of other study years., Conclusions: : Our findings show that atypical changes in weather affect the occurrence of Kawasaki disease and are compatible with a link to an infectious trigger. The analysis of interevent times using gamma regression is an alternative to Poisson regression in modeling a time series of sparse daily counts.
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- 2009
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73. Health impact assessment of global climate change: expanding on comparative risk assessment approaches for policy making.
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Patz J, Campbell-Lendrum D, Gibbs H, and Woodruff R
- Subjects
- Air Pollution adverse effects, Air Pollution prevention & control, Conservation of Energy Resources, Developed Countries, Developing Countries, Ecosystem, Fossil Fuels adverse effects, Fossil Fuels standards, Fossil Fuels statistics & numerical data, Global Health, Health Status Disparities, Humans, International Cooperation, Risk Assessment, Greenhouse Effect, Public Health, Public Policy
- Abstract
Climate change is projected to have adverse impacts on public health. Cobenefits may be possible from more upstream mitigation of greenhouse gases causing climate change. To help measure such cobenefits alongside averted disease-specific risks, a health impact assessment (HIA) framework can more comprehensively serve as a decision support tool. HIA also considers health equity, clearly part of the climate change problem. New choices for energy must be made carefully considering such effects as additional pressure on the world's forests through large-scale expansion of soybean and oil palm plantations, leading to forest clearing, biodiversity loss and disease emergence, expulsion of subsistence farmers, and potential increases in food prices and emissions of carbon dioxide to the atmosphere. Investigators must consider the full range of policy options, supported by more comprehensive, flexible, and transparent assessment methods.
- Published
- 2008
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74. Variable hematologic presentation of autoimmune gastritis: age-related progression from iron deficiency to cobalamin depletion.
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Hershko C, Ronson A, Souroujon M, Maschler I, Heyd J, and Patz J
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- Adult, Aged, Anemia, Iron-Deficiency physiopathology, Anemia, Pernicious blood, Autoantibodies blood, Disease Progression, Female, Gastrins blood, Humans, Male, Middle Aged, Reference Values, Anemia, Iron-Deficiency blood, Autoimmune Diseases blood, Gastritis blood, Gastritis immunology, Vitamin B 12 genetics
- Abstract
Iron deficiency is a known complication of achlorhydria and may precede the development of pernicious anemia. Among 160 patients with autoimmune gastritis identified by hypergastrinemia and strongly positive antiparietal antibodies, we explored the overlap between 83 subjects presenting with iron deficiency anemia (IDA), 48 with normocytic indices, and 29 with macrocytic anemia. Compared with macrocytic patients, patients with IDA were 21 years younger (41 +/- 15 years versus 62 +/- 15 years) and mostly women. All groups had a high prevalence of thyroid disease (20%) and diabetes (8%) suggestive of the autoimmune polyendocrine syndrome. Stratification by age cohorts from younger than 20 years to older than 60 years showed a regular and progressive increase in mean corpuscular volume (MCV) from 68 +/- 9 to 95 +/- 16 fl, serum ferritin levels from 4 +/- 2 to 37 +/- 41 microg/L, gastrin level from 166 +/- 118 to 382 +/- 299 pM/L (349 +/- 247 to 800 +/- 627 pg/mL), and a decrease in cobalamin level from 392 +/- 179 to 108 +/- 65 pg/mL. The prevalence of Helicobacter pylori infection was 87.5% at age younger than 20 years, 47% at age 20 to 40 years, 37.5% at 41 to 60 years, and 12.5% at age older than 60 years. These findings challenge the common notion that pernicious anemia is a disease of the elderly and imply a disease starting many years before the establishment of clinical cobalamin deficiency, by an autoimmune process likely triggered by H pylori.
- Published
- 2006
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75. Environmental health implications of global climate change.
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Watson RT, Patz J, Gubler DJ, Parson EA, and Vincent JH
- Subjects
- Humans, Risk Assessment, Climate, Environmental Monitoring, Environmental Pollution adverse effects, Global Health, Health Policy
- Abstract
This paper reviews the background that has led to the now almost-universally held opinion in the scientific community that global climate change is occurring and is inescapably linked with anthropogenic activity. The potential implications to human health are considerable and very diverse. These include, for example, the increased direct impacts of heat and of rises in sea level, exacerbated air and water-borne harmful agents, and--associated with all the preceding--the emergence of environmental refugees. Vector-borne diseases, in particular those associated with blood-sucking arthropods such as mosquitoes, may be significantly impacted, including redistribution of some of those diseases to areas not previously affected. Responses to possible impending environmental and public health crises must involve political and socio-economic considerations, adding even greater complexity to what is already a difficult challenge. In some areas, adjustments to national and international public health practices and policies may be effective, at least in the short and medium terms. But in others, more drastic measures will be required. Environmental monitoring, in its widest sense, will play a significant role in the future management of the problem.
- Published
- 2005
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76. Satellite remote sensing can improve chances of achieving sustainable health.
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Patz J
- Subjects
- Animals, Biodiversity, Disasters, Humans, International Cooperation, Meteorological Concepts, Conservation of Natural Resources, Environmental Monitoring, Global Health, Spacecraft
- Published
- 2005
- Full Text
- View/download PDF
77. Microemulsified cyclosporine-based immunosuppression for the prevention of acute renal allograft rejection in unrelated dogs: preliminary experimental study.
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Bernsteen L, Gregory CR, Kyles AE, Griffey SM, and Patz J
- Subjects
- Administration, Oral, Animals, Azathioprine administration & dosage, Azathioprine therapeutic use, Creatinine blood, Cyclosporine administration & dosage, Drug Therapy, Combination, Emulsions, Female, Graft Rejection prevention & control, Immunosuppressive Agents administration & dosage, Nephrectomy veterinary, Pilot Projects, Prednisolone administration & dosage, Prednisolone therapeutic use, Prospective Studies, Reference Values, Treatment Outcome, Cyclosporine therapeutic use, Dogs surgery, Graft Rejection veterinary, Immunosuppressive Agents therapeutic use, Kidney Transplantation veterinary
- Abstract
Objectives: To determine whether the microemulsified formulation of cyclosporine (MCsA; Neoral; Novartis A.G.), combined with azathioprine (Imuran; Glaxo Wellcome), and prednisolone (Delta-Cortef; Upjohn), would be effective in preventing acute renal allograft rejection in unrelated mongrel dogs. To document any toxic effects associated with this drug combination., Study Design: rospective, pilot study., Animals: Four healthy, adult, mongrel, canine renal allograft recipients., Methods: Heterotopic renal transplantation, with bilateral nephrectomy, was performed in 4 dogs. Allografts were harvested from 2 unrelated dogs that were to be euthanatized for reasons unrelated to this study. The dogs were treated for 100 days or until signs of illness or allograft rejection required euthanasia. Microemulsified cyclosporine (20 mg/kg/day), azathioprine (5 mg/kg every other day), and prednisolone (1 mg/kg/day) were administered for the prevention of acute rejection. Body weight, serum biochemistry profiles, complete blood counts, and trough whole-blood cyclosporine concentrations were measured throughout the study. Cyclosporine dose was adjusted to maintain a trough concentration of 400-500 ng/mL. Azathioprine dose was decreased if evidence of hepatotoxicity developed or if the total blood white cell count was <4,000 cells/micro L. The prednisolone was tapered by 0.25 mg/kg increments every 3 weeks and discontinued 14 days before the end of the study in the surviving dogs. Complications were recorded. A complete necropsy and histopathologic examination were performed in each recipient., Results: Two of the 4 dogs survived the 100-day period. One dog was euthanatized at 8 days because of an intestinal intussusception. One dog was euthanatized at 64 days because of a severe upper respiratory infection. At the time of death, these 2 dogs had plasma creatinine concentrations of 1.5 and 2.6 mg/dL, respectively, with no histopathologic evidence of allograft rejection. All dogs had transient weight loss (range, 4.6%-17.7% of preoperative body weight) between days 7 and 14. Two dogs had evidence of hepatotoxicity. The 2 dogs surviving to 100 days had normal serum creatinine concentrations and no clinical signs of rejection. One of these dogs had evidence of a grade IIa acute/active rejection based on the modified BANFF 97 histopathologic classification. The second dog had no evidence of rejection or inflammation within the allograft., Conclusions: This preliminary experimental study shows that immunosuppression using MCsA, combined with azathioprine and prednisolone, may be effective in preventing acute renal allograft rejection in unrelated mongrel dogs for 100 days. Complications included ileocolic intussusception, upper respiratory infection, weight loss, and transient hepatotoxicity., Clinical Relevance: Immunosuppression using MCsA, azathioprine, and prednisolone may be effective in preventing acute renal allograft rejection in unrelated, mongrel dogs. This triple drug protocol is cost-effective and was easy to administer. Further investigation is warranted to minimize toxic effects and to determine the efficacy of prophylactic renal biopsies to detect and treat subclinical acute/active rejection., (Copyright 2003 by The American College of Veterinary Surgeons)
- Published
- 2003
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78. Environment. Can we defy nature's end?
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Pimm SL, Ayres M, Balmford A, Branch G, Brandon K, Brooks T, Bustamante R, Costanza R, Cowling R, Curran LM, Dobson A, Farber S, da Fonseca GA, Gascon C, Kitching R, McNeely J, Lovejoy T, Mittermeier RA, Myers N, Patz JA, Raffle B, Rapport D, Raven P, Roberts C, Rodriguez JP, Rylands AB, Tucker C, Safina C, Samper C, Stiassny ML, Supriatna J, Wall DH, and Wilcove D
- Subjects
- Animals, Costs and Cost Analysis, Public Policy, Trees, Conservation of Natural Resources economics, Ecosystem, Environment
- Published
- 2001
- Full Text
- View/download PDF
79. The potential health impacts of climate variability and change for the United States. Executive summary of the report of the health sector of the U.S. National Assessment.
- Author
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Patz JA, McGeehin MA, Bernard SM, Ebi KL, Epstein PR, Grambsch A, Gubler DJ, Reiter P, Romieu I, Rose JB, Samet JM, and Trtanj J
- Subjects
- Disasters, Disease Transmission, Infectious, Food Contamination, Humans, Mortality trends, Seasons, Temperature, United States, Air Pollution adverse effects, Climate, Greenhouse Effect, Public Health, Water Pollution adverse effects
- Published
- 2001
80. The association between extreme precipitation and waterborne disease outbreaks in the United States, 1948-1994.
- Author
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Curriero FC, Patz JA, Rose JB, and Lele S
- Subjects
- Animals, Bacterial Infections epidemiology, Climate, Cryptosporidium isolation & purification, Data Interpretation, Statistical, Disease Outbreaks classification, Environmental Exposure analysis, Escherichia coli isolation & purification, Geography, Giardia lamblia isolation & purification, Humans, Protozoan Infections epidemiology, Seasons, Topography, Medical, United States epidemiology, Water Pollution adverse effects, Water Pollution analysis, Water Pollution statistics & numerical data, Disease Outbreaks statistics & numerical data, Environmental Exposure statistics & numerical data, Rain, Water Microbiology, Water Supply analysis
- Abstract
Objectives: Rainfall and runoff have been implicated in site-specific waterborne disease outbreaks. Because upward trends in heavy precipitation in the United States are projected to increase with climate change, this study sought to quantify the relationship between precipitation and disease outbreaks., Methods: The US Environmental Protection Agency waterborne disease database, totaling 548 reported outbreaks from 1948 through 1994, and precipitation data of the National Climatic Data Center were used to analyze the relationship between precipitation and waterborne diseases. Analyses were at the watershed level, stratified by groundwater and surface water contamination and controlled for effects due to season and hydrologic region. A Monte Carlo version of the Fisher exact test was used to test for statistical significance., Results: Fifty-one percent of waterborne disease outbreaks were preceded by precipitation events above the 90th percentile (P = .002), and 68% by events above the 80th percentile (P = .001). Outbreaks due to surface water contamination showed the strongest association with extreme precipitation during the month of the outbreak; a 2-month lag applied to groundwater contamination events., Conclusions: The statistically significant association found between rainfall and disease in the United States is important for water managers, public health officials, and risk assessors of future climate change.
- Published
- 2001
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81. Appendectomy is more frequent but not a risk factor in Crohn's disease while being protective in ulcerative colitis: a comparison of surgical procedures in inflammatory bowel disease.
- Author
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Reif S, Lavy A, Keter D, Broide E, Niv Y, Halak A, Ron Y, Eliakim R, Odes S, Patz J, Fich A, Villa Y, Arber N, and Gilat T
- Subjects
- Adult, Cholecystectomy statistics & numerical data, Female, Humans, Male, Middle Aged, Reference Values, Risk Factors, Tonsillectomy statistics & numerical data, Appendectomy statistics & numerical data, Colitis, Ulcerative prevention & control, Crohn Disease etiology
- Abstract
Objective: Appendectomy was shown to be protective in patients with ulcerative colitis (UC). There are fewer data in Crohn's disease (CD). Other operations were less studied. The aim of this study was to investigate the prevalence of appendectomy, cholecystectomy, and tonsillectomy, including their timing, in patients with inflammatory bowel disease in comparison to controls., Methods: Two hundred seventy-one patients with UC and 260 with CD, 475 clinic controls, and 428 community controls were interviewed., Results: Appendectomy was found in 5.5% patients with UC, in 11% of clinic controls (p < 0.05), and 7.7% of community controls (p = not significant). The differences were more significant for appendectomy before onset of disease. Appendectomy was performed in 19.2% of patients with CD, in 10.9% of clinic controls, and in 10.1% of community controls (p < 0.01). However, there were no significant differences when only appendectomy before onset of disease was considered. Cholecystectomy was found in 1.5% of patients with UC, in 6.1% of clinic controls (p < 0.01), and in 4.5% of community controls (p = not significant). The difference remained significant when confined to operations performed before disease onset. No such difference was found in patients with CD. No significant difference was found in the prevalence of tonsillectomy between patients and controls., Conclusions: Appendectomy is protective in UC; it is more frequent, but not a risk factor in CD. The role of cholecystectomy should be investigated further.
- Published
- 2001
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82. Using remotely sensed data to identify areas at risk for hantavirus pulmonary syndrome.
- Author
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Glass GE, Cheek JE, Patz JA, Shields TM, Doyle TJ, Thoroughman DA, Hunt DK, Enscore RE, Gage KL, Irland C, Peters CJ, and Bryan R
- Subjects
- Animals, Case-Control Studies, Disease Outbreaks, Disease Reservoirs, Humans, Image Processing, Computer-Assisted, Logistic Models, Mice, Peromyscus virology, Rain, Risk Factors, Rodent Diseases epidemiology, Rodent Diseases virology, Seasons, Hantavirus Pulmonary Syndrome epidemiology, Satellite Communications
- Abstract
The 1993 U.S. hantavirus pulmonary syndrome (HPS) outbreak was attributed to environmental conditions and increased rodent populations caused by unusual weather in 1991- 92. In a case-control study to test this hypothesis, we estimated precipitation at 28 HPS and 170 control sites during the springs of 1992 and 1993 and compared it with precipitation during the previous 6 years by using rainfall patterns at 196 weather stations. We also used elevation data and Landsat Thematic Mapper satellite imagery collected the year before the outbreak to estimate HPS risk by logistic regression analysis. Rainfall at case sites was not higher during 1992-93 than in previous years. However, elevation, as well as satellite data, showed association between environmental conditions and HPS risk the following year. Repeated analysis using satellite imagery from 1995 showed substantial decrease in medium- to high-risk areas. Only one case of HPS was identified in 1996.
- Published
- 2000
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83. Environmental and geographical factors contributing to watershed contamination with Cryptosporidium parvum oocysts.
- Author
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Graczyk TK, Evans BM, Shiff CJ, Karreman HJ, and Patz JA
- Subjects
- Animals, Cattle, Implosive Therapy, Pennsylvania epidemiology, Public Health, Risk Assessment, Animal Husbandry, Cryptosporidiosis epidemiology, Cryptosporidium parvum isolation & purification, Water Pollutants analysis, Water Supply
- Abstract
Cryptosporidium parvum is a waterborne parasite which infects cattle and produces life-threatening zoonosis in people with impaired immune systems. Digital maps of 100-year floodplain boundaries, land use/cover, and livestock operations were used to select and characterize cattle farms in the floodplain area in Lancaster County, Pennsylvania, U.S.A. Over 21% of the cattle farms were located within 100-year floodplain boundaries. On average, a single farm comprised 12.8 ha of pasture (including buildings and farmyard) at risk of inundation. In all farms cattle had unlimited access to the creek. Manure samples collected from closed-in calf pens, cow/heifer yard runoff, and cattle paths through the creek were tested for C. parvum. On 64% of the farms (n=50) at least one sample was positive for C. parvum, and 44% of the farms had oocysts in all manure samples. Concentration varied from 90 to 371 oocysts/g and was significantly higher (P<0.02) in calf samples than in manure from cow and cow/heifer., (Copyright 2000 Academic Press.)
- Published
- 2000
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84. Lack of association between smoking and Crohn's disease but the usual association with ulcerative colitis in Jewish patients in Israel: a multicenter study.
- Author
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Reif S, Lavy A, Keter D, Fich A, Eliakim R, Halak A, Broide E, Niv Y, Ron Y, Patz J, Odes S, Villa Y, and Gilat T
- Subjects
- Adolescent, Adult, Aged, Case-Control Studies, Confidence Intervals, Educational Status, Female, Humans, Israel epidemiology, Jews classification, Male, Middle Aged, Odds Ratio, Smoking Cessation statistics & numerical data, Colitis, Ulcerative epidemiology, Crohn Disease epidemiology, Jews statistics & numerical data, Smoking epidemiology
- Abstract
Objective: The association between smoking and inflammatory bowel disease (IBD) is well established, but data in Jewish patients in Israel were discrepant. The aim of this study was to examine the smoking habits of Jewish IBD patients in Israel in a large scale, multicenter study., Methods: Patients with established IBD aged 18-70 yr were interviewed in relation to smoking and other habits. Two controls (one clinic and one neighborhood control matched by age, sex, community group, and education) were sought for each subject., Results: A total of 534 patients (273 ulcerative colitis [UC], and 261 Crohn's disease [CD]), along with 478 clinic controls and 430 neighborhood controls, were interviewed. There was no significant difference in the smoking habits between CD patients and their controls. Of patients with CD, 24.5% were current smokers, as compared to 19.9% of clinic controls and 25.2% of neighborhood controls (NS). The odds ratio for CD in current smokers was 1.30 (95% confidence interval 0.85-1.99) versus clinic controls, and 0.96 (0.63-1.46) versus neighborhood controls. There were also no significant differences in the proportion of ex-smokers between the groups. Only 12.9% of UC patients were current smokers versus 21.9. % Clinic controls, and 26.4% community controls (p<0.005). The proportions of ex-smokers were higher in UC patients 29.7% versus 25.9%, and 19.5% in their respective controls (p<0.001 vs. community controls). No significant differences were found in the proportions of never-smokers between IBD patients and controls. All the above trends were similar in four different parts of the country. The proportion of current smokers in UC decreased with the extent of disease (19.7% in proctitis, 13.6% in left-sided, and 4.5% in total colitis) (p<0.05). Patients with UC were more likely to be light smokers(1-10 cigarettes/day), whereas patients with CD were more likely to be moderate smokers (11-20 cigarettes/day) in comparison to their controls., Conclusions: The lack of association between smoking and CD has now been established in Jewish patients in Israel. The association was found in UC. The stronger genetic tendency in CD may contribute to this discrepancy.
- Published
- 2000
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85. The effects of changing weather on public health.
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Patz JA, Engelberg D, and Last J
- Subjects
- Communicable Diseases epidemiology, Communicable Diseases etiology, Forecasting, Humans, Models, Statistical, Morbidity, Mortality, Population Surveillance, Primary Prevention methods, Public Health Practice, Socioeconomic Factors, Global Health, Greenhouse Effect, Health Status, Public Health, Weather
- Abstract
Many diseases are influenced by weather conditions or display strong seasonality, suggestive of a possible climatic contribution. Projections of future climate change have, therefore, compelled health scientists to re-examine weather/disease relationships. There are three projected physical consequences of climate change: temperature rise, sea level rise, and extremes in the hydrologic cycle. This century, the Earth has warmed by about 0.5 degrees centigrade, and the mid-range estimates of future temperature change and sea level rise are 2.0 degrees centigrade and 49 centimeters, respectively, by the year 2100. Extreme weather variability associated with climate change may especially add an important new stress to developing nations that are already vulnerable as a result of environmental degradation, resource depletion, overpopulation, or location (e.g. low-lying coastal deltas). The regional impacts of climate change will vary widely depending on existing population vulnerability. Health outcomes of climate change can be grouped into those of: (a) direct physical consequences, e.g. heat mortality or drowning; (b) physical/chemical sequelae, e.g. atmospheric transport and formation of air pollutants; (c) physical/biological consequences, e.g. response of vector- and waterborne diseases, and food production; and (d) sociodemographic impacts, e.g. climate or environmentally induced migration or population dislocation. Better understanding of the linkages between climate variability as a determinant of disease will be important, among other key factors, in constructing predictive models to guide public health prevention.
- Published
- 2000
- Full Text
- View/download PDF
86. Climate change and vector-borne diseases: a regional analysis.
- Author
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Githeko AK, Lindsay SW, Confalonieri UE, and Patz JA
- Subjects
- Africa epidemiology, Europe epidemiology, Humans, North America epidemiology, South America epidemiology, Climate, Disease Outbreaks statistics & numerical data, Disease Transmission, Infectious statistics & numerical data, Disease Vectors
- Abstract
Current evidence suggests that inter-annual and inter-decadal climate variability have a direct influence on the epidemiology of vector-borne diseases. This evidence has been assessed at the continental level in order to determine the possible consequences of the expected future climate change. By 2100 it is estimated that average global temperatures will have risen by 1.0-3.5 degrees C, increasing the likelihood of many vector-borne diseases in new areas. The greatest effect of climate change on transmission is likely to be observed at the extremes of the range of temperatures at which transmission occurs. For many diseases these lie in the range 14-18 degrees C at the lower end and about 35-40 degrees C at the upper end. Malaria and dengue fever are among the most important vector-borne diseases in the tropics and subtropics; Lyme disease is the most common vector-borne disease in the USA and Europe. Encephalitis is also becoming a public health concern. Health risks due to climatic changes will differ between countries that have developed health infrastructures and those that do not. Human settlement patterns in the different regions will influence disease trends. While 70% of the population in South America is urbanized, the proportion in sub-Saharan Africa is less than 45%. Climatic anomalies associated with the El Niño-Southern Oscillation phenomenon and resulting in drought and floods are expected to increase in frequency and intensity. They have been linked to outbreaks of malaria in Africa, Asia and South America. Climate change has far-reaching consequences and touches on all life-support systems. It is therefore a factor that should be placed high among those that affect human health and survival.
- Published
- 2000
87. New challenges, new tools: the impact of climate change on infectious diseases.
- Author
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Patz JA and Lindsay SW
- Subjects
- Animals, Climate, Communicable Diseases microbiology, Communicable Diseases parasitology, Geography, Humans, Malaria parasitology, Malaria transmission, Weather, Communicable Diseases transmission
- Published
- 1999
- Full Text
- View/download PDF
88. Comparative effects of malononitriloamide analogs of leflunomide on whole blood lymphocyte stimulation in humans, rhesus macaques, cats, dogs, and rats.
- Author
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Gregory CR, Silva HT, Patz JD, and Morris RE
- Subjects
- Adult, Alkynes, Animals, B-Lymphocytes drug effects, Cats, Dogs, Humans, Leflunomide, Lymphocyte Activation immunology, Macaca mulatta, Male, Rats, Rats, Inbred Lew, Species Specificity, T-Lymphocytes drug effects, B-Lymphocytes immunology, Immunosuppressive Agents pharmacology, Isoxazoles pharmacology, Lymphocyte Activation drug effects, Nitriles pharmacology, T-Lymphocytes immunology
- Published
- 1998
- Full Text
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89. Climate change and human health.
- Author
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Colwell RR, Epstein PR, Gubler D, Maynard N, McMichael AJ, Patz JA, Sack RB, and Shope R
- Subjects
- Humans, Public Health Practice, Research, Risk Assessment, Climate, Public Health
- Published
- 1998
- Full Text
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90. Global climate change and environmental health: proceedings of the 1997 annual conference of the Society for Occupational and Environmental Health.
- Author
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Kovats S, Patz JA, and Dobbins D
- Subjects
- Communicable Diseases etiology, Environmental Monitoring, Forecasting, Health Status, Humans, Morbidity, Occupational Health, Oceans and Seas, Public Health, Environmental Health, Global Health, Greenhouse Effect
- Published
- 1998
- Full Text
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91. Methotrexate in chronic active Crohn's disease: a double-blind, randomized, Israeli multicenter trial.
- Author
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Oren R, Moshkowitz M, Odes S, Becker S, Keter D, Pomeranz I, Shirin H, Reisfeld I, Broide E, Lavy A, Fich A, Eliakim R, Patz J, Villa Y, Arber N, and Gilat T
- Subjects
- Abdominal Pain prevention & control, Administration, Oral, Adolescent, Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones therapeutic use, Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Antirheumatic Agents administration & dosage, Chronic Disease, Double-Blind Method, Evaluation Studies as Topic, Female, Follow-Up Studies, Health Status, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents therapeutic use, Israel, Male, Mercaptopurine administration & dosage, Mercaptopurine therapeutic use, Mesalamine administration & dosage, Mesalamine therapeutic use, Methotrexate administration & dosage, Middle Aged, Placebos, Recurrence, Remission Induction, Treatment Outcome, Antirheumatic Agents therapeutic use, Crohn Disease drug therapy, Methotrexate therapeutic use
- Abstract
Background: At present only one large controlled study has indicated that parenteral methotrexate may be effective in chronic active Crohn's disease (CD)., Aim: To evaluate the effectiveness of oral methotrexate in chronic steroid-dependent CD., Patients: Patients with active CD, who have received steroids and/or immunosuppressives for at least 4 months during the preceding 12 months and with a current Harvey-Bradshaw index of > or = 7 were studied., Methods: Methotrexate (12.5 mg weekly) or 6-mercaptopurine (50 mg daily), or placebo were given during the 9 months of the trial in addition to steroids and 5-aminosalicylic acid as clinically indicated., Results: Eighty-four patients were included (methotrexate, 26 patients; 6-mercaptopurine, 32 patients; placebo, 26 patients). The proportion of patients entering first remission as well as the proportions of patients relapsing after first remission were not significantly different between the groups. The mean Harvey-Bradshaw index and the mean monthly steroid dose were also similar. However, when each patient was evaluated as his or her own control, the reduction in steroid dose, the general well being, and the reduction in abdominal pain were significantly better in the methotrexate treated patients., Conclusions: Methotrexate at a weekly oral dose of 12.5 mg was found to be moderately better than 6-mercaptopurine and placebo in patients with chronic active CD.
- Published
- 1997
92. Combined immunosuppression with leflunomide and cyclosporine prevents MLR-mismatched renal allograft rejection in a mongrel canine model.
- Author
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Lirtzman RA, Gregory CR, Levitski RE, Griffey SM, Yeh LS, Patz JD, and Morris RE
- Subjects
- Animals, Cyclosporine blood, Dogs, Drug Therapy, Combination, Female, Histocompatibility Testing, Immunosuppressive Agents blood, Isoxazoles blood, Leflunomide, Lymphocyte Culture Test, Mixed, Transplantation, Homologous, Cyclosporine therapeutic use, Graft Rejection prevention & control, Graft Survival drug effects, Immunosuppressive Agents therapeutic use, Isoxazoles therapeutic use
- Published
- 1996
93. Enhanced nitric oxide production induced by the administration of L-arginine does not inhibit arterial neointimal formation after overwhelming alloimmune injury.
- Author
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Gregory CR, Cooke JP, Patz JD, Berryman ER, Shorthouse R, and Morris RE
- Subjects
- Administration, Oral, Animals, Arginine administration & dosage, Femoral Artery drug effects, Femoral Artery immunology, Femoral Artery metabolism, Immunohistochemistry, Male, Neovascularization, Pathologic immunology, Neovascularization, Pathologic metabolism, Neovascularization, Pathologic pathology, Nitric Oxide Synthase antagonists & inhibitors, Nitroarginine pharmacology, Rats, Rats, Inbred Lew, Transplantation, Homologous, Tunica Intima immunology, Tunica Intima metabolism, Tunica Intima pathology, Arginine pharmacology, Femoral Artery transplantation, Neovascularization, Pathologic prevention & control, Nitric Oxide biosynthesis, Tunica Intima drug effects
- Abstract
Background: Nitric oxide suppresses proliferation and function of T cells and inhibits proliferation of smooth muscle cells in vitro and in vivo. The purpose of this study was to determine whether nitric oxide, stimulated by means of the oral administration of L-arginine, would reduce the degree of intimal thickening produced by immune injury in rat arterial allografts., Methods: Orthotopic femoral artery transplantation was done with Brown Norway donors and Lewis recipients. Seven days before operation, and for 39 additional days, one group received 2.25% L-arginine and one group received 0.01% N-omega-nitro-L-arginine in tap water; one group received tap water only. Forty days after operation, all arterial segments were excised and examined by histopathologic, morphometric, and immunohistochemical assays., Results: There was no difference in the rejection response or degree of intimal thickening among the three groups. There were no qualitative differences in numbers of T cells, macrophages, or smooth muscle cells in the neointima, media, or adventitia among the untreated and treated groups. Induced nitric oxide synthase was present in the media and adventitia of the allograft vessels, but not in native rat arteries., Conclusions: Enhanced production of nitric oxide, via the administration of L-arginine, has been shown to reduce tissue pathologic changes in models of mechanical or dietary injury. Enhanced nitric oxide production did not suppress rejection or inhibit intimal thickening in this model of immune-mediated injury.
- Published
- 1996
94. Occupational health in surgery: risks extend beyond the operating room.
- Author
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Patz JA and Jodrey D
- Subjects
- Blood-Borne Pathogens, Communicable Diseases transmission, Female, Humans, Life Style, Male, Risk Factors, Occupational Health, Operating Rooms, Surgical Procedures, Operative
- Abstract
Surgeons routinely work with potentially infectious materials. The risk of acquiring a disease from one percutaneous exposure is 0.3-0.4% for human immunodeficiency virus (HIV) 6-30% for hepatitis B virus (HBV) and 2.7-10% for hepatitis C virus (HCV). Rates of blood contacts vary but may reach up to 11.9 per 100 h in the operating room. Residents are at highest risk, and obstetrics and gynaecology surgeons suffered the highest rate of exposures (10%) as a group. Contributing risk factors include trauma or emergency orthopaedic procedures, high patient blood loss, long procedures and holding tissue by hand while suturing. However, across occupations, nurses and other health workers experience greater risks than surgeons regarding potentially infectious exposures. Preventive measures such as the HBV vaccine and protective devices (i.e. self-capping needles, needle-free i.v. systems and improved barrier materials) have reduced the occupational risk of acquiring a blood-borne infection, which allows attention to be given to the psychosocial risks which may be more significant, yet are often overlooked. Doctors are at greater risk of divorce, alcoholism, substance abuse and suicide than are members of comparable professional groups. One study found that general surgeons had the highest rates of suicide of all doctors. According to family surveys, surgeons tend to be oblivious to the effects of work stressors, and may benefit from greater self-awareness; sharing of feelings and responsibilities with colleagues, family and patients; being willing to delegate work to others; setting work limits; and broadening perspectives in their approach to work.
- Published
- 1995
- Full Text
- View/download PDF
95. A controlled double blind multicenter study of the effectiveness of 5-aminosalicylic acid in patients with Crohn's disease in remission.
- Author
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Arber N, Odes HS, Fireman Z, Lavie A, Broide E, Bujanover Y, Becker S, Pomerantz I, Moshkowitz M, and Patz J
- Subjects
- Adolescent, Adult, Double-Blind Method, Female, Humans, Male, Mesalamine, Recurrence, Treatment Outcome, Aminosalicylic Acids therapeutic use, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Crohn Disease drug therapy
- Abstract
We evaluated the efficacy of an oral formulation of 5-amino-salicylic acid in lowering the relapse rate after remission of Crohn's disease. Included were 59 patients who had proven Crohn's disease of at least 1 year's duration, and who had been in continuous remission for at least 6 months, while taking only 5-aminosalicylic acid or no therapy at all. Remission was defined as a Harvey Bradshaw index score (Softley-Clamp modification) of < 4. Patients were given coded mesalzaine 250 mg or placebo tablets (2 x 2 day). They were seen at 0, 1, and 2 months, and then every 2 months until the end of the study. Trial endpoints were 1 year of follow-up, or clinical relapse results. After randomization, 31 patients were included in the placebo arm, and 28 in the treatment arm. There were no significant differences between the two groups at entry. Ten patients were withdrawn from the trial because of noncompliance, loss of follow-up, or headache. There were more clinical relapses in the placebo arm (15 patients, 55%) than in the treatment arm (6 patients, 27%) (p < 0.05). Mesalazine had a significant advantage over placebo (p < 0.05) only in the subgroups of patients with ileal Crohn's disease and in those older than 30 years. We conclude that mesalazine has a moderate but significant benefit in preventing relapse in Crohn's disease in remission; this occurred only in patients with small-bowel involvement or in those older than 30 years.
- Published
- 1995
- Full Text
- View/download PDF
96. The cardiovascular sparing effect of fentanyl and atropine, administered to enflurane anesthetized dogs.
- Author
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Ilkiw JE, Pascoe PJ, Haskins SC, Patz JD, and Jaffe R
- Subjects
- Analysis of Variance, Anesthesia, Inhalation veterinary, Animals, Enflurane adverse effects, Female, Hemodynamics drug effects, Male, Respiration, Artificial veterinary, Atropine pharmacology, Cardiovascular System drug effects, Dogs physiology, Enflurane antagonists & inhibitors, Fentanyl pharmacology
- Abstract
Cardiovascular effects of high dose opioid together with low dose inhalant were compared with inhalant alone to determine whether opioid/inhalant techniques were less depressant on the cardiovascular system. The effects of positive pressure ventilation and increasing heart rate to a more physiological level were also studied. Cardiovascular measurements recorded during administration of enflurane at 1.3 minimum alveolar concentration (MAC; 2.89 +/- 0.02%) to spontaneously breathing dogs (time 1) and during controlled ventilation [arterial carbon dioxide tension at 40 +/- 3 mmHg (time 2)] were similar. At time 2, mixed venous oxygen tension and arterial and mixed venous carbon dioxide tensions were significantly decreased, while arterial and mixed venous pH were significantly increased compared to measurements at time 1. After administration of fentanyl to achieve plasma fentanyl concentration of 71.7 +/- 14.4 ng/mL and reduction of enflurane concentration to yield 1.3 MAC multiple (0.99 +/- 0.01%), heart rate significantly decreased, while mean arterial pressure, central venous pressure, stroke index, and systemic vascular resistance index increased compared to measurements taken at times 1 and 2. Pulmonary arterial occlusion pressure was significantly increased compared to measurements taken at time 2. After administration of atropine until heart rate was 93 +/- 5 beats/min (plasma fentanyl concentration 64.5 +/- 13.5 ng/mL) heart rate, mean arterial pressure, cardiac index, oxygen delivery index, and venous admixture increased significantly compared to values obtained at all other times.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1994
97. Cardiopulmonary effects of halothane in hypovolemic dogs.
- Author
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Pascoe PJ, Haskins SC, Ilkiw JE, and Patz JD
- Subjects
- Animals, Blood Pressure drug effects, Carbon Dioxide blood, Cardiac Output drug effects, Cardiovascular Physiological Phenomena, Cardiovascular System physiopathology, Dogs, Female, Heart Rate drug effects, Hemorrhage blood, Hemorrhage physiopathology, Male, Oxygen blood, Oxygen Consumption drug effects, Partial Pressure, Pulmonary Circulation drug effects, Shock blood, Vascular Resistance drug effects, Cardiovascular System drug effects, Halothane pharmacology, Shock physiopathology
- Abstract
Cardiopulmonary effects of halothane administration were studied in hypovolemic dogs. Baseline cardiopulmonary data were recorded from conscious dogs after instrumentation. Hypovolemia was induced by withdrawal of blood from dogs until mean arterial pressure of 60 mm of Hg was achieved. Blood pressure was maintained at 60 mm of Hg for 1 hour, by further removal or replacement of blood. Halothane was delivered by face mask, dogs were intubated, then halothane end-tidal concentration of 1.13 +/- 0.02% was maintained, and cardiopulmonary effects were measured 3, 15, 30, and 60 minutes later. After blood withdrawal and prior to halothane administration, systemic vascular resistance index, oxygen extraction, and base deficit increased. Compared with baseline values, these variables were decreased: mean arterial pressure, mean pulmonary arterial pressure, pulmonary arterial occlusion pressure, cardiac index, oxygen delivery index, oxygen consumption index, mixed venous oxygen tension, mixed venous oxygen content, venous admixture, arterial bicarbonate concentration, and mixed venous pH. At all times after intubation, arterial and venous oxygen tensions and mixed venous carbon dioxide tensions were increased. Three minutes after intubation, base deficit and mixed venous carbon dioxide tension increased, and mean arterial pressure and arterial and venous pH decreased, compared with values measured immediately prior to halothane administration. Fifteen minutes after intubation, systemic vascular resistance index decreased and, at 15 and 30 minutes, mean arterial pressure and arterial and venous pH remained decreased. At 60 minutes, mean pulmonary arterial pressure and pulmonary arterial occlusion pressure were increased and mixed venous pH was decreased, compared with values measured before halothane administration.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1994
98. Cardiovascular and respiratory effects of propofol administration in hypovolemic dogs.
- Author
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Ilkiw JE, Pascoe PJ, Haskins SC, and Patz JD
- Subjects
- Animals, Blood Pressure drug effects, Dogs, Female, Injections, Intravenous veterinary, Male, Shock physiopathology, Dog Diseases physiopathology, Hemodynamics drug effects, Propofol pharmacology, Respiration drug effects, Shock veterinary
- Abstract
Cardiopulmonary effects of propofol were studied in hypovolemic dogs from completion of, until 1 hour after administration. Hypovolemia was induced by withdrawal of blood from dogs until mean arterial pressure of 60 mm of Hg was achieved. After stabilization at this pressure for 1 hour, 6 mg of propofol/kg of body weight was administered IV to 7 dogs, and cardiopulmonary effects were measured. After blood withdrawal and prior to propofol administration, oxygen utilization ratio increased, whereas mean arterial pressure, mean pulmonary arterial pressure, central venous pressure, pulmonary capillary wedge pressure, cardiac index, oxygen delivery, mixed venous oxygen tension, and mixed venous oxygen content decreased from baseline. Three minutes after propofol administration, mean pulmonary arterial pressure, pulmonary vascular resistance, oxygen utilization ratio, venous admixture, and arterial and mixed venous carbon dioxide tensions increased, whereas mean arterial pressure, arterial oxygen tension, mixed venous oxygen content, arterial and mixed venous pH decreased from values measured prior to propofol administration. Fifteen minutes after propofol administration, mixed venous carbon dioxide tension was still increased; however by 30 minutes after propofol administration, all measurements had returned to values similar to those measured prior to propofol administration.
- Published
- 1992
99. Is duodenal ulcer a seasonal disease? A retrospective endoscopic study of 3105 patients.
- Author
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Braverman DZ, Morali GA, Patz JK, and Jacobsohn WZ
- Subjects
- Chronic Disease, Duodenal Ulcer diagnosis, Duodenoscopy, Humans, Incidence, Israel epidemiology, Retrospective Studies, Seasons, Duodenal Ulcer epidemiology
- Abstract
The monthly pattern of distribution of endoscopically diagnosed duodenal ulcer disease was evaluated for the years 1975-1989. A retrospective review of 3105 endoscopies performed for peptic disease was recorded and analyzed. Among them, 2020 endoscopies revealed duodenal bulb deformity, and 1035 revealed the presence of acute duodenal ulcer. Chi-square analysis of the data for goodness of fit revealed statistical differences for certain months. Slightly more patients with chronic deformity presented in June and November, whereas more patients with acute duodenal ulcer presented in July, November, and December (p < 0.001). The ratio of acute to chronic disease was nearly constant throughout the year. The Edwards chi 2 test for seasonal trends did not reveal any seasonality (p > 0.75). The differences observed in June-July and November-December, as compared with the rest of the year, were so small that they should not be relied upon for the clinical management of peptic disease.
- Published
- 1992
100. Cardiopulmonary effects of etomidate in hypovolemic dogs.
- Author
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Pascoe PJ, Ilkiw JE, Haskins SC, and Patz JD
- Subjects
- Animals, Carbon Dioxide physiology, Dogs, Female, Male, Oxygen physiology, Shock physiopathology, Blood Pressure drug effects, Dog Diseases physiopathology, Etomidate pharmacology, Heart drug effects, Respiratory Transport drug effects, Shock veterinary
- Abstract
Cardiopulmonary effects of etomidate administration were studied in hypovolemic dogs. Baseline cardiopulmonary data were recorded from conscious dogs after instrumentation. Hypovolemia was induced by withdrawal of blood from dogs until mean arterial pressure of 60 mm of Hg was achieved. Blood pressure was maintained at 60 mm of Hg for 1 hour, by further removal or replacement of blood. One milligram of etomidate/kg of body weight was then administered IV to 7 dogs, and the cardiopulmonary effects were measured 3, 15, 30, and 60 minutes later. After blood withdrawal and prior to etomidate administration, heart rate, arterial oxygen tension, and oxygen utilization ratio increased. Compared with baseline values, the following variables were decreased: mean arterial pressure, mean pulmonary arterial pressure, central venous pressure, pulmonary wedge pressure, cardiac index, oxygen delivery, mixed venous oxygen tension, mixed venous oxygen content, and arterial carbon dioxide tension. Three minutes after etomidate administration, central venous pressure, mixed venous and arterial carbon dioxide tension, and venous admixture increased, and heart rate, arterial and venous pH, and arterial oxygen tension decreased, compared with values measured immediately prior to etomidate administration. Fifteen minutes after etomidate injection, arterial pH and heart rate remained decreased. At 30 minutes, only heart rate was decreased, and at 60 minutes, mean arterial pressure was increased, compared with values measured before etomidate administration. Results of this study indicate that etomidate induces minimal changes in cardiopulmonary function when administered to hypovolemic dogs.
- Published
- 1992
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