Time trends in sport-caught Great Lakes fish consumption and serum polychlorinated biphenyl levels among Michigan Anglers, 1973-1993.

Polychlorinated biphenyls (PCBs) remain public health concerns because of their persistence in the environment and their potential health impact. We linked data from three mixed cross-sectional/longitudinal surveys of Michigan anglers conducted by the Michigan Department of Public Health in 1973-1974, 1979-1982, and 1989-1993 to examine the association between sport-caught fish consumption and serum PCBs. The reported weight of fish consumed declined over the three surveys (median 40, 38, and 31 lb/yr).

Measuring health status using the Health Utilities Index: agreement between raters and between modalities of administration.

The aim of this study was to evaluate interrater and intermodality agreement in assessing health status using the Health Utilities Index. A random sample from a Dutch cohort of 14-year-old Very Low Birth Weight children and their parents were invited to participate in a face-to-face (n = 150) or telephone (n = 150) interview. All 300 participants were also sent a questionnaire by mail.

Mediators of fetal inflammation in extremely low gestational age newborns.

To establish levels of mediators of inflammation in cord blood and postnatal serum from extremely low gestational age newborns (ELGANs, < or =28 weeks), we measured sixteen markers of inflammation by recycling immunoaffinity chromatography in 15 ELGANs who had serum sampled at days 2-5. Median levels of IL-1, IL-6, IL-8, IL-11, IL-13, TNF-alpha, G-CSF, M-CSF, GM-CSF, MIP-1alpha, and RANTES were considerably higher than published values of these inflammatory mediators from term newborns. In three of eight ELGANS who had serial measurements taken, levels of IL-1, IL-6, IL-8, IL-11, TNF-alpha, G-CSF, and MIP-1alpha declined from initially very high levels to reach an apparent baseline towards the end of the first postnatal week.

Measuring health-related quality of life in adolescents: agreement between raters and between methods of administration.

The aim of this study was to evaluate the agreement between children and proxies as well as the agreement between methods of administration in assessing Health-Related Quality of Life (HRQoL) using the TNO AZL Children's Quality Of Life (TACQOL) questionnaire. A random sample from a Dutch cohort of 14-year-old very low birth weight children and their parents were invited to participate in a face-to-face (n = 150) or telephone interview (n = 150). Participants were also sent a questionnaire by mail.

Predictors of vaccination rates during a mass meningococcal vaccination program on a college campus.

Factors contributing to students' compliance with mass vaccination programs during meningococcal outbreaks have not been well described. A 1997 mass vaccination campaign at Michigan State University provided an opportunity to study such factors. Of 34,024 students in the target population, 17,538 (51.

Do clinical markers of barotrauma and oxygen toxicity explain interhospital variation in rates of chronic lung disease? The Neonatology Committee for the Developmental Network.

Objective: To explore the hypothesis that variation in respiratory management among newborn intensive care units (NICUs) explains differences in chronic lung disease (CLD) rates.

Design: Case-cohort study.

Setting: NICUs at 1 medical center in New York (Babies' and Children's Hospital [Babies']) and 2 in Boston (Beth Israel Hospital and Brigham and Women's Hospital [Boston]).

Antecedents and neonatal consequences of low Apgar scores in preterm newborns: a population study.

Background: To examine the antenatal and early neonatal correlates of low Apgar scores (<3 and <6 at 1 and 5 minutes) in preterm newborns (23-34 weeks' gestation).

Objective: The use of Apgar scoring for premature newborns remains widespread, despite controversy regarding its reliability as a measure of morbidity and mortality in the neonatal period.

Design: A cohort of 852 preterm newborns born during a 34-month period between 1984 and 1987 was studied.

Relation of cranial ultrasound abnormalities in low-birthweight infants to motor or cognitive performance at ages 2, 6, and 9 years.

This study sought to determine whether neonatal cranial ultrasound abnormalities are related to motor and cognitive outcomes in low-birthweight (LBW, <2000 g) children without major motor or cognitive disability. The relation of neonatal cranial ultrasound abnormalities to motor performance and general cognitive ability at ages 2, 6, and 9 years was examined in a prospectively followed regional cohort of LBW children, excluding those with major disability, and controlling for other risk factors. Compared with children without ultrasound abnormalities, children with abnormalities indicative of ischemic white-matter injury had poorer motor performance at all three ages and, at age 2, lower general cognitive ability.

Maternal infection, fetal inflammatory response, and brain damage in very low birth weight infants. Developmental Epidemiology Network Investigators.

Echolucent images (EL) of cerebral white matter, seen on cranial ultrasonographic scans of very low birth weight newborns, predict motor and cognitive limitations. We tested the hypothesis that markers of maternal and feto-placental infection were associated with risks of both early (diagnosed at a median age of 7 d) and late (median age = 21 d) EL in a multi-center cohort of 1078 infants <1500 x g. Maternal infection was indicated by fever, leukocytosis, and receipt of antibiotic; fetoplacental inflammation was indicated by the presence of fetal vasculitis (i.

Antenatal corticosteroids and cranial ultrasonographic abnormalities.

Objective: This study was undertaken to determine whether very-low-birth-weight infants whose mothers received a course of antenatal corticosteroids were at decreased risk for 3 cranial ultrasonographic entities that predict neurodevelopmental dysfunction.

Study Design: This retrospective cohort study evaluated 1604 infants weighing 500 to 1500 g who underwent >/=1 of 3 cranial ultrasonographic scans required by design at specified postnatal intervals and whose own and mother's hospital charts were reviewed. Infants were classified according to mother's course of antenatal corticosteroids (none, partial, or complete).

Association of maternal IgM concentrations above the median at 15-19 weeks of gestation and early preterm delivery.

IgM concentrations greater than the median in maternal serum collected at 15-19 weeks of pregnancy were strongly associated (odds ratio 15.6) with delivery before 29 weeks. Our results suggest that the postulated inflammatory component in the aetiology of very preterm delivery may elicit a measurable maternal humoral response as early as mid-trimester.

Phenobarbital compared with phenytoin for the treatment of neonatal seizures.

Background: Seizures occur in 1 to 2 percent of neonates admitted to an intensive care unit. The treatment is usually with either phenobarbital or phenytoin, but the efficacy of the two drugs has not been compared directly.

Methods: From 1990 to 1995, we studied 59 neonates with seizures that were confirmed by electroencephalography.

Hypothyroxinemia of prematurity and the risk of cerebral white matter damage.

Objective: Infants with hypothyroxinemia of prematurity (HOP) are at increased risk for neurodevelopmental dysfunction. Infants born near the end of the middle trimester are also at increased risk for an echolucency (EL) in the cerebral white matter, which reflects white matter damage and is the cranial ultrasound abnormality that best predicts neurodevelopmental dysfunction. We postulated that some of the increased risk of neurodevelopmental problems associated with HOP reflects an increased risk of EL.

Sport-caught fish consumption and conception delay in licensed Michigan anglers.

Between 1993 and 1995, we surveyed 4931 licensed anglers aged 17-34 years residing in 10 Michigan counties bordering a Great Lake. Responses were received from 1443 anglers and 844 of their partners. Lifetime sport-caught fish consumption was estimated as the number of sport-caught fish meals consumed in the previous 12 months times years since 1970 in which sport-caught fish were consumed.

Groups of histopathologic abnormalities in brains of very low birthweight infants.

The neuropathologic changes in brains of very premature infants are well recognized but relatively few studies have attempted to identify if specific neuropathologic features cluster together. These data could assist in determining pathogenetic mechanisms of immature brain injury. The goal of this study is to identify which, if any, combinations of histologic features occur together.

Does transient hypothyroxinemia cause abnormal neurodevelopment in premature infants?

THOP is a relatively common condition whose long-term effects remain uncertain. The preponderance of evidence indicates that at the very least THOP is a marker of elevated risk of neurodevelopmental adversity, but whether this association is truly causal and whether thyroxine treatment in the neonatal period can prevent adverse outcome is as yet unknown. Since the number of infants born and surviving at very early gestations continues to increase, the importance of this condition will be magnified in the future.

A rivalry of foulness: official and unofficial investigations of the London cholera epidemic of 1854.

Contemporaneous with John Snow's famous study of the 1854 London cholera epidemic were 2 other investigations: a local study of the Broad Street outbreak and an investigation of the entire epidemic, undertaken by England's General Board of Health. More than a quarter-century prior to Koch's description of Vibrio comma, a Board of Health investigator saw microscopic "vibriones" in the rice-water stools of cholera patients that, in his later life, he concluded had been cholera bacilli. Although this finding was potential evidence for Snow's view that cholera was due to a contagious and probably live agent transmitted in the water supply, the Board of Health rejected Snow's conclusions.

Variation in use of corticosteroids among infants < or = 1,500 grams across hospitals in three states.

We identified factors associated with no antenatal corticosteroid treatment among 1,369 women who delivered infants < or = 1,500 g and < 34 weeks gestation, 1991-1993. At four hospitals, infants weighing 500-1,500 g were enrolled. Information regarding corticosteroid use, maternal characteristics, and perinatal events were obtained.