1
|
Hinjoy S, Nelson KE, Gibbons RV, Jarman RG, Mongkolsirichaikul D, Smithsuwan P, Fernandez S, Labrique AB, Patchanee P. A cross-sectional study of hepatitis E virus infection in healthy people directly exposed and unexposed to pigs in a rural community in northern Thailand. Zoonoses Public Health 2012; 60:555-62. [PMID: 23280251 DOI: 10.1111/zph.12030] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Indexed: 12/15/2022]
Abstract
A cross-sectional study of the association between occupational pig exposure and hepatitis E virus (HEV) infection in adult pig farmers and the general population who were not directly exposed to pigs was conducted in Nan Province, Thailand, from November 2010 to April 2011. All participants were interviewed to provide information on their job history, eating habits and other potential confounders. The prevalence of anti-HEV immunoglobulin G antibodies (IgG) among 513 subjects was 23.0%. Hand washing with water and soap was associated with a lower seroprevalence of HEV infection, whereas living in an area with frequent flooding (OR 1.64, 95% CI: 1.00-2.68) and consuming internal pig organs more than twice per week (OR 3.23, 95%CI: 1.15-9.01) were both associated with a higher seroprevalence of anti-HEV IgG. There was no association between HEV seroprevalence and frequent, direct occupational pig contact.
Collapse
Affiliation(s)
- S Hinjoy
- Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Sun W, Eckels KH, Putnak JR, Lyons AG, Thomas SJ, Vaughn DW, Gibbons RV, Fernandez S, Gunther VJ, Mammen MP, Statler JD, Innis BL. Experimental Dengue Virus Challenge of Human Subjects Previously Vaccinated With Live Attenuated Tetravalent Dengue Vaccines. J Infect Dis 2012; 207:700-8. [DOI: 10.1093/infdis/jis744] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
3
|
Srikiatkhachorn A, Rothman AL, Gibbons RV, Sittisombut N, Malasit P, Ennis FA, Nimmannitya S, Kalayanarooj S. Reply to Akbar et al. Clin Infect Dis 2012. [DOI: 10.1093/cid/cis344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
4
|
Anderson KB, Gibbons RV, Edelman R, Eckels KH, Putnak RJ, Innis BL, Sun W. Interference and Facilitation Between Dengue Serotypes in a Tetravalent Live Dengue Virus Vaccine Candidate. J Infect Dis 2011; 204:442-50. [DOI: 10.1093/infdis/jir279] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
5
|
Daum LT, Canas LC, Klimov AI, Shaw MW, Gibbons RV, Shrestha SK, Myint KS, Acharya RP, Rimal N, Reese F, Niemeyer DM, Arulanandam BP, Chambers JP. Molecular analysis of isolates from influenza B outbreaks in the U.S. and Nepal, 2005. Arch Virol 2006; 151:1863-74. [PMID: 16736092 DOI: 10.1007/s00705-006-0777-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2006] [Accepted: 04/06/2006] [Indexed: 10/24/2022]
Abstract
Currently circulating influenza B viruses can be divided into two antigenically and genetically distinct lineages referred to by their respective prototype strains, B/Yamagata/16/88 and B/Victoria/2/87, based on amino acid differences in the hemagglutinin surface glycoprotein. During May and July 2005, clinical specimens from two early season influenza B outbreaks in Arizona and southeastern Nepal were subjected to antigenic (hemagglutinin inhibition) and nucleotide sequence analysis of hemagglutinin (HA1), neuraminidase (NA), and NB genes. All isolates exhibited little reactivity with the B/Shanghai/361/2002 (B/Yamagata-like) vaccine strain and significantly reduced reactivity with the previous 2003/04 B/Hong Kong/330/2001 (B/Victoria-like) vaccine strain. The majority of isolates were antigenically similar to B/Hawaii/33/2004, a B/Victoria-like reference strain. Sequence analysis indicated that 33 of 34 isolates contained B/Victoria-like HA and B/Yamagata-like NA and NB proteins. Thus, these outbreak isolates are both antigenically and genetically distinct from the current Northern Hemisphere vaccine virus strain as well as the previous 2003-04 B/Hong Kong/330/2001 (B/Victoria lineage) vaccine virus strain but are genetically similar to B/Malaysia/2506/2004, the vaccine strain proposed for the coming seasons in the Northern and Southern Hemispheres. Since these influenza B outbreaks occurred in two very distant geographical locations, these viruses may continue to circulate during the 2006 season, underscoring the importance of rapid molecular monitoring of HA, NA and NB for drift and reassortment.
Collapse
Affiliation(s)
- L T Daum
- Air Force Institute for Operational Health, Brooks City Base, TX 78235, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
McQuiston JH, Gibbons RV, Velic R, Nicholson WL, Castrodale L, Wainright SH, Vanniewenhoven TJ, Morgan EW, Arapovic L, Delilic A, O'Reilly M, Bajrovic T. Investigation of a focus of Q fever in a nonfarming population in the Federation of Bosnia and Herzegovina. Ann N Y Acad Sci 2003; 990:229-32. [PMID: 12860631 DOI: 10.1111/j.1749-6632.2003.tb07368.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- J H McQuiston
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Rupprecht CE, Blass L, Smith K, Orciari LA, Niezgoda M, Whitfield SG, Gibbons RV, Guerra M, Hanlon CA. Human infection due to recombinant vaccinia-rabies glycoprotein virus. N Engl J Med 2001; 345:582-6. [PMID: 11529212 DOI: 10.1056/nejmoa010560] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- C E Rupprecht
- Rabies Section, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
|
9
|
|
10
|
Abstract
BACKGROUND The American Board of Internal Medicine (ABIM) has recommended a specific number of procedures be done as a minimum standard for ensuring competence in various medical procedures. These minimum standards were determined by consensus of an expert panel and may not reflect actual procedural comfort or competence. OBJECTIVE To estimate the minimum number of selected procedures at which a majority of internal medicine trainees become comfortable performing that procedure. DESIGN Cross-sectional, self-administered survey. SETTING A military-based, a community-based, and 2 university-based programs. PARTICIPANTS Two hundred thirty-two internal medicine residents. MEASUREMENTS Survey questions included number of specific procedures performed, comfort level with performing specific procedures, and whether respondents desired further training in specific procedures. The comfort threshold for a given procedure was defined as the number of procedures at which two thirds or more of the respondents reported being comfortable or very comfortable performing that procedure. RESULTS For three of seven procedures selected, residents were comfortable performing the procedure at or below the number recommended by the ABIM as a minimum requirement. However, residents needed more procedures than recommended by the ABIM to feel comfortable with central venous line placement, knee joint aspiration, lumbar puncture, and thoracentesis. Using multivariate logistic regression analysis, variables independently associated with greater comfort performing selected procedures included increased number performed, more years of training, male gender, career goals, and for skin biopsy, training in the community-based program. Except for skin biopsy, comfort level was independent of training site. A significant number of advanced-year house officers in some programs had little experience in performing selected common ambulatory procedures. CONCLUSION Minimum standards for certifying internal medicine residents may need to be reexamined in light of house officer comfort level performing selected procedures.
Collapse
Affiliation(s)
- C M Hicks
- Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, USA
| | | | | | | | | | | |
Collapse
|
11
|
Baum SE, Morris JT, Gibbons RV, Cooper R. Reduction in human immunodeficiency virus patient hospitalizations and nontraumatic mortality after adoption of highly active antiretroviral therapy. Mil Med 1999; 164:609-12. [PMID: 10495628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Highly active antiretroviral therapy (HAART) has been recommended for human immunodeficiency virus (HIV)-positive patients with a detectable viral load; it typically consists of two reverse transcriptase inhibitors combined with a protease inhibitor. In 1996, Madigan Army Medical Center began offering HAART to HIV-positive patients with a detectable viral load. We retrospectively reviewed the records of our HIV patients before and after the initiation of HAART to determine the impact of HAART on hospitalizations, mortality, and outpatient pharmacy expenditures. Comparing 1997 with 1994 and 1995, we found a greater than 700% increase in the average expenditure on antiretroviral agents after institution of HAART. At the same time, we found a dramatic reduction in hospitalizations and nontraumatic mortality. Therefore, the increase in expenditures on antiretroviral agents may be offset by a reduction in hospitalizations and mortality.
Collapse
Affiliation(s)
- S E Baum
- Department of Infectious Diseases, Madigan Army Medical Center, Fort Lewis, WA 98431-5000, USA
| | | | | | | |
Collapse
|
12
|
O'Malley PG, Taylor AJ, Gibbons RV, Feuerstein IM, Jones DL, Vernalis M, Brazaitis M. Rationale and design of the Prospective Army Coronary Calcium (PACC) Study: utility of electron beam computed tomography as a screening test for coronary artery disease and as an intervention for risk factor modification among young, asymptomatic, active-duty United States Army Personnel. Am Heart J 1999; 137:932-41. [PMID: 10220644 DOI: 10.1016/s0002-8703(99)70419-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Screening for coronary artery calcium with electron beam computed tomography (EBCT) has potential diagnostic and prognostic implications. Most prior research on this technology has been done on selected, high-risk populations. The goal of the Prospective Army Coronary Calcium (PACC) study is to determine the utility of EBCT for the detection of coronary calcium as a screening test for coronary artery disease and as an intervention for risk factor modification among young, asymptomatic, active-duty personnel undergoing the United States Army's Cardiovascular Screening Program. METHODS AND RESULTS Three study designs will be used to address the objectives of this investigation: (1) a cross-sectional study of 2000 unselected, consecutive participants to determine the prevalence and extent of coronary calcification in the 40- to 45-year-old Army population, (2) a randomized, controlled trial with a 2 x 2 factorial design involving 1000 participants to assess the impact of EBCT information on several dimensions of patient behavior, with and without intensive risk factor case management, and (3) a prospective cohort study of 2000 participants followed for at least 5 years to establish the relation between coronary calcification and cardiovascular events in an unselected, "low-risk" (by conventional standards) Army population. CONCLUSIONS We present a review of the literature on the clinical utility of EBCT, with a focus on the limited research in young, asymptomatic populations. The details of the PACC study (begun in October1998) are presented. The results of the PACC study will determine the clinical utility of EBCT in young, asymptomatic patients.
Collapse
Affiliation(s)
- P G O'Malley
- Department of Medicine, the Cardiology Service, Walter Reed Army Institute of Research, Washington, DC, USA
| | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
Our understanding of infectious diseases continues to expand rapidly, and has led to the realization that microorganisms are responsible for, or at least contribute to, numerous diseases that were never before associated with infectious etiologies. However, a review of medical history reminds us that this is not so novel an idea. Not long after the widespread acceptance of bacteriology and the germ theory and with an increased awareness of public hygiene, there was a period during which it seemed that nearly all diseases would prove to be the result of infections. One popular proposal that championed such an idea was the theory of focal infection. This article reviews this theory by considering the key concepts and developments that likely inspired it, and examines the work of the theory's most visible proponent, Dr. Frank Billings.
Collapse
Affiliation(s)
- R V Gibbons
- Department of Medicine, Madigan Army Medical Center, Tacoma, Washington 98499-5000, USA
| |
Collapse
|
14
|
Abstract
OBJECTIVE To compare physicians' and their patients' attitudes toward pharmaceutical gifts. DESIGN Survey of physicians and their patients. SETTING Two tertiary-care medical centers, one military and one civilian. PARTICIPANTS Two hundred sixty-eight of 392 consecutively surveyed physicians, 100 of 103 randomly selected patients at the military center, and 96 patients in a convenience sample at the civilian center completed the survey. MEASUREMENTS Participants rated 10 pharmaceutical gifts on whether they were appropriate for physicians to accept and whether they were likely to influence prescribing. Patients found gifts less appropriate and more influential than did their physicians. About half of the patients were aware of such gifts; of those unaware, 24% responded that this knowledge altered their perception of the medical profession. Asked whether they thought their own physician accepted gifts, 27% said yes, 20% no, and 53% were unsure. For patients, feeling that gifts were inappropriate was best predicted by a belief that gifts might influence prescribing, while for physicians, the best predictor was knowledge of guidelines. CONCLUSIONS Patients feel pharmaceutical gifts are more influential and less appropriate than do their physicians. Physicians may want to consider this in deciding whether to accept particular gifts. Broader dissemination of guidelines may be one means of changing physician behavior. At the same time, future guidelines should further consider the potentially different viewpoints of patients and physicians.
Collapse
Affiliation(s)
- R V Gibbons
- Department of Medicine, Walter Reed Army Medical Center, Washington, DC, USA
| | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
BACKGROUND Despite the growth in other home health care services, the number of house calls by physicians has declined dramatically during this century. We determined the frequency of house calls made by physicians to elderly U.S. patients in 1993 and analyzed the characteristics of the physicians and patients involved. METHODS We analyzed a 5 percent random sample of the 1993 Medicare Part B claims data for beneficiaries over the age of 65 who were not enrolled in health maintenance organizations (HMOs). With supplemental information from the Area Resource File and the American Medical Association's Physician Masterfile, we determined how many house calls were made, their cost, and a number of specific characteristics of the physicians and the patients. RESULTS In our 1993 sample, 36,350 house calls were made to 11,917 of the 1,357,262 patients. When extrapolated to all Medicare beneficiaries over age 65 and not enrolled in HMOs, these figures correspond to 727,000 house calls to 238,340 patients nationwide. We estimated the cost of these house calls to be $63 million. The patients who received house calls from physicians were older than those who did not, were more likely to die within the calendar year, had higher rates of hospitalization, and were more likely to receive care from other home health providers, hospice programs, and skilled-nursing facilities. Patients residing in rural areas and those in areas with high physician-to-population ratios had an increased likelihood of receiving a house call. The physicians who made house calls were more likely than others to be generalists, osteopaths, older, male, board-certified, practicing in the Northeast, and in solo practice. CONCLUSIONS A very small percentage (0.88 percent) of elderly Medicare patients, mainly those who are very sick and near the end of life, receive house calls from physicians.
Collapse
Affiliation(s)
- G S Meyer
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | | |
Collapse
|
16
|
Grathwohl KW, Gibbons RV, Dillard TA, Horwhat JD, Roth BJ, Thompson JW, Cambier PA. Bedside videoscopic placement of feeding tubes: development of fiberoptics through the tube. Crit Care Med 1997; 25:629-34. [PMID: 9142027 DOI: 10.1097/00003246-199704000-00012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Transpyloric small intestine feeding tube placement can be difficult and tedious. Currently accepted techniques are associated with disadvantages and risk. The purpose of this study is to describe the development of a new technique: bedside videoscopic placement using fiberoptics through the tube. DESIGN Prospective, descriptive case study. SETTING Intensive care unit in a teaching hospital. PATIENTS Subjects were divided into two groups: a) group 1: eight healthy volunteers (seven male, one female); b) group 2: nine critically ill patients (six male, three female; eight of these patients were intubated). INTERVENTIONS Standard 12-Fr (4.0-mm) feeding tubes (n = 19) were placed. Two patients from group 2 had feeding tubes placed on two separate occasions. The feeding tubes were inserted by the oral (n = 8) or nasal (n = 11) route under direct vision, using a 6.7-Fr (2.2-mm) fiberoptic scope through the feeding tube. MEASUREMENTS AND MAIN RESULTS We visualized enteric structures clearly through the feeding tube in all subjects and patients. Based on visual landmarks, we advanced the feeding tube through the pylorus and into the duodenum in all individuals. Transpyloric tube placement was confirmed videoscopically (n = 19) and radiographically (n = 18). In three subjects from group 1, the feeding tube entered the first part of the duodenum, while, in the remainder of the subjects, the tube passed into or beyond the second portion of the duodenum. In eight (73%) of 11 attempts on the nine critically ill patients from group 2, the feeding tubes were advanced to the distal duodenum or jejunum. The time required for placement in group 2 ranged from 2 to 43 mins (mean 18 +/- 12 [SD]). The feeding tubes remained in place 10 +/- 4 days and patients met their estimated caloric needs within 24 hrs. Residual volumes of nutrition in the small bowel were < 5 mL. There were no documented episodes of aspiration. CONCLUSION This new technique has the potential for rapid, accurate, and safe feeding tube placement in patients requiring nutritional support.
Collapse
Affiliation(s)
- K W Grathwohl
- Department of Medicine, Madigan Army Medical Center, Tacoma, WA 98431-5000, USA
| | | | | | | | | | | | | |
Collapse
|
17
|
Gibbons RV, Meyer GS. Japan's efforts to control pharmaceutical expenditures and the convergence to a common path. Nutrition 1996; 12:649-50. [PMID: 8878179 DOI: 10.1016/s0899-9007(96)00211-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- R V Gibbons
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | | |
Collapse
|