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OBJECTIVES: To determine the accuracy of self-reported mammography use and generate a correction factor that adjusts for reporting errors among Mexican-American women. DESIGN: Self-reported mammography use was compared with a medical chart review. PARTICIPANTS: A random sample of 199 Mexican-American women aged 50-74 in southeast Texas. MAIN OUTCOME MEASURES: Self-reported mammography use for the preceding 2 years and mammography use determined by medical chart review. RESULTS: Positive and negative predictive values of mammography self-reports in the previous 2 years were 73.9 and 86.0%, respectively. The correction factor was 79.6%, or approximately 80% of the self-reported mammograms within the preceding 2 years could be verified through medical chart reviews. CONCLUSIONS: Mammography use rates among Mexican-American women were not as high as self-reports indicated. Estimates need to be adjusted downward by approximately 20%. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the association between sensory impairment and cognitive decline in older Mexican Americans., Design: A prospective cohort study., Setting: The Hispanic Established Populations for Epidemiologic Studies of the Elderly from five southwestern states., Participants: The sample consisted of 2,140 noninstitutionalized Mexican Americans aged 65 and older followed from 1993/1994 until 2000/2001., Measurements: The outcome, cognitive function decline, was assessed using the Mini-Mental State Examination blind version (MMSE-blind) at baseline and at 2, 5, and 7 years of follow-up. Other variables were near vision, distance vision, hearing, demographics (age, sex, marital status, living arrangements, and education), depressive symptoms, hypertension, diabetes mellitus, stroke, heart attack, and functional status. A general linear mixed model was used to estimate cognitive decline at follow-up., Results: In a fully adjusted model, MMSE-blind scores of subjects with near vision impairment decreased 0.62 points (standard error (SE)=0.29, P=.03) over 2 years and decreased (slope of decline) 0.13 points (SE=0.07, P=.045) more per year than scores of subjects with adequate near vision. Other independent predictors of cognitive decline were baseline MMSE-blind score, age, education, marital status, depressive symptoms, and number of activity of daily living limitations., Conclusion: Near vision impairment, but not distance vision or hearing impairments, was associated with cognitive decline in older Mexican Americans.

Background: This report describes the prevalence and correlates of functional blindness and visual impairment among older Mexican Americans, using data on 2800 respondents from the Hispanic Established Populations for the Epidemiological Study of the Elderly., Methods: Bivariate and multivariate logistic regression analyses were used to examine the associations between corrected bilateral distant vision and sociodemographic characteristics, selected health conditions, self-reported health status, health care utilization, and functional dependence on the basis of assistance needed for basic and instrumental activities of daily living (ADLs)., Results: Using a modified Snellen test for distance visual acuity, 5% of older Mexican Americans were found to be functionally blind, and 13.5% were found to be visually impaired. Vision loss was significantly associated with older age, lower education, hypertension, diabetes, poor self-rated health, and hospitalization during the year prior to the interview. Over 50% of functionally blind subjects required assistance with at least one basic ADL, compared with 15% of those who were visually impaired and 8% of those who were not visually impaired., Conclusions: The prevalence of functional blindness in this sample of elderly Mexican Americans was higher than reported for the general elderly population, yet they also have higher rates of adequate vision because of the low prevalence of visual impairment. The results suggest a need for more research on the prevalence and impact of functional blindness and visual impairment on the health of older Mexican Americans.

Objective: The health burden of self-reported diabetes was compared across three ethnic groups of older adults., Methods: Analysis of variance and logistic regression were used to compare ethnic differences in the rates of co-morbid chronic health conditions, complications, and disability for older diabetics vs non-diabetics, in a sample of 173 Mexican Americans, 201 African Americans, and 181 non-Hispanic whites, all aged 75 and older., Results: The prevalence of self-reported diabetes was significantly higher in older Mexican Americans (17.6%) and African Americans (16.4%) than in non-Hispanic whites (8.5%). In all three ethnic groups, and after controlling for sociodemographic characteristics, diabetics were found to be generally at higher risk for chronic conditions such as heart disease, stroke, and hypertension, circulation and foot problems, obesity, and impaired vision and activities of daily living. Multivariate analyses indicated that the burden of diabetes appeared to be greatest among non-Hispanic white diabetics. We suggest that this is the result of higher diabetes-mortality rates among minority diabetics at earlier ages., Conclusions: Diabetes is known to be increasing in prevalence and incidence, particularly among the elderly, the fastest growing segment of the population. Our findings indicate that regardless of ethnicity, diabetes carries an increased burden that affects both the functioning and the quality of life of older adults.

Objective: Endoscopic biopsy and serological methods were compared for their ability to detect Helicobacter pylori infection in patients undergoing upper gastrointestinal endoscopy at a state university hospital., Methods: Subjects were characterized on the basis of gastrointestinal symptoms, endoscopic findings, socioeconomic and demographic features, and the use of certain medications, tobacco, and alcohol. Current infection was detected in gastric antral specimens by rapid urease testing, histopathology, and bacterial culture. Serum levels of IgG to H. pylori were measured by ELISA., Results: Of 240 subjects, 115 (47.9%) were currently infected as determined by rapid urease testing, histopathology, and/or culture results, whereas 63.3% had elevated anti-H. pylori IgG levels (p < 0.001). This difference in the prevalence of current infection and seropositivity was preserved when the study population was analyzed according to age, race, gender, and other characteristics. Prior use of antibiotics was associated with a significant reduction in the frequency of H. pylori infection., Conclusions: Serological evidence of H. pylori infection was consistently greater than the prevalence of infection documented by biopsy methods in this study, suggesting suppression or recent clearance of infection. Further studies are needed to examine the factors that may affect the detection of H. pylori infection.

The ability of the Alamar microdilution MIC system to detect vancomycin resistance in enterococci was evaluated by comparing the results with an agar dilution screen method. Of 100 strains tested, 41 were resistant and 47 were susceptible by both tests. Five strains were intermediate and one was resistant by the Alamar MIC system but susceptible by the agar screen. Three strains each were susceptible or intermediate by the Alamar MIC system but resistant by the agar screen. The predictive values for the Alamar MIC system were 94% (susceptible) and 88% (combined intermediate and resistant). The Alamar MIC system does not appear to have sufficient accuracy for the detection or confirmation of vancomycin resistance in enterococci.

Lectins have been implicated as recognition molecules in the invertebrate immune response, yet their capacity to recognize (agglutinate and/or opsonize) potentially invasive microorganisms is largely unknown. In this study, sera from six species of marine molluscs (oyster, clam, octopus, squid, cuttlefish, and sea hare) were found to agglutinate 64 of 94 bacterial isolates (15 genera, 36 species) and seven types of vertebrate erythrocytes. Oyster, clam, and octopus sera agglutinated the greatest number of bacterial isolates and oyster serum exhibited the highest intensity and titer of agglutination. Agglutination was isolate dependent, implying high lectin specificity. Titers were highly variable for wild populations of oysters and sea hares and relatively constant for F4-generation cuttlefish reared in aquaculture systems. Simultaneous agglutination of specific bacterial isolates indicated conservation of lectin specificity between oyster and clam sera (bivalves) and between squid and cuttlefish sera (cephalopods).

A patient with a long history of arthritis developed pneumonia. Two weeks into her hospital course, the patient developed effusions in her knee and wrist that yielded cultures positive for Mycoplasma pneumoniae. To our knowledge, this is the third reported case of M pneumoniae isolation from a joint and the first report of isolation of M pneumoniae from two joints in a patient without hypogammaglobulinemia. The evidence suggests that in individuals with atypical pneumonia and joint effusions, M pneumoniae should be considered as a source of infection.

Biopsy specimens from the gastric antral mucosa of 50 patients with upper gastrointestinal complaints were studied by light and electron microscopy and culture. Of 46 assessable specimens, seven were histologically normal, and 39 showed evidence of gastritis. Twenty-seven of the specimens with evidence of gastritis (69%) contained spiral bacteria, whereas only one of the normal specimens (14%) contained these bacteria (P = .02). Of 17 patients found to have gastric ulcers, 10 (59% [P greater than .10] ) also had spiral bacteria. The bacteria could be seen scattered over the surface of the epithelial cells and just under the layer of mucus but were rarely found inside the epithelial cells. Curved or spiral gramnegative bacilli were isolated from 10 of the specimens on chocolate agar incubated at 37 C under microaerophilic conditions. The bacteria resembled the organism recently named Campylobacter pyloridis by other investigators.