Case-control study of a gastroschisis cluster in Nevada.

Objective: To identify potential risk factors associated with a sudden increase in gastroschisis cases in northern Nevada.

Design: Case-control study.

Setting: Medical centers and a pregnancy care center in Reno, Nevada.

Financial impact of reducing door-to-balloon time in ST-elevation myocardial infarction: a single hospital experience.

Background: The impact of reducing door-to-balloon time on hospital revenues, costs, and net income is unknown.

Methods: We prospectively determined the impact on hospital finances of (1) emergency department physician activation of the catheterization lab and (2) immediate transfer of the patient to an immediately available catheterization lab by an in-house transfer team consisting of an emergency department nurse, a critical care unit nurse, and a chest pain unit nurse. We collected financial data for 52 consecutive ST-elevation myocardial infarction patients undergoing emergency percutaneous intervention from October 1, 2004-August 31, 2005 and compared this group to 80 consecutive ST-elevation myocardial infarction patients from September 1, 2005-June 26, 2006 after protocol implementation.

An outbreak of enterotoxigenic Escherichia coli associated with sushi restaurants in Nevada, 2004.

Background: In August and November 2004, 2 clusters of diarrhea cases occurred among patrons of 2 affiliated sushi restaurants (sushi restaurant A and sushi restaurant B) in Nevada. In August 2004, a stool sample from 1 ill sushi restaurant A patron yielded enterotoxigenic Escherichia coli (ETEC). In December 2004, we investigated a third cluster of diarrhea cases among sushi restaurant B patrons.

Emergency department physician activation of the catheterization laboratory and immediate transfer to an immediately available catheterization laboratory reduce door-to-balloon time in ST-elevation myocardial infarction.

Background: Consensus guidelines and hospital quality-of-care programs recommend that ST-elevation myocardial infarction patients achieve a door-to-balloon time of < or = 90 minutes. However, there are limited prospective data on specific measures to significantly reduce door-to-balloon time.

Methods And Results: We prospectively determined the impact on median door-to-balloon time of a protocol mandating (1) emergency department physician activation of the catheterization laboratory and (2) immediate transfer of the patient to an immediately available catheterization laboratory by an in-house transfer team consisting of an emergency department nurse, a critical care unit nurse, and a chest pain unit nurse.

Investigating childhood leukemia in Churchill County, Nevada.

Background: Sixteen children diagnosed with acute leukemia between 1997 and 2002 lived in Churchill County, Nevada, at the time of or before their illness. Considering the county population and statewide cancer rate, fewer than two cases would be expected.

Objectives: In March 2001, the Centers for Disease Control and Prevention led federal, state, and local agencies in a cross-sectional, case-comparison study to determine if ongoing environmental exposures posed a health risk to residents and to compare levels of contaminants in environmental and biologic samples collected from participating families.

Nursing home outbreak of invasive group a streptococcal infections caused by 2 distinct strains.

Objective: To identify factors contributing to a cluster of deaths from invasive group A streptococcus (GAS) infection in a nursing home facility and to prevent additional cases.

Design: Outbreak investigation.

Setting: A 146-bed nursing home facility in northern Nevada.

Nevada's academic-practice collaboration: public health preparedness possibilities outside an academic center.

The Nevada State Health Division developed a local academic-practice partnership with the University of Nevada Reno's Master of Public Health Program to assess the bioterrorism risk communication, information, response, and training needs of professional and public stakeholder groups throughout Nevada. Between October 16, 2002, and April 13, 2004, 22 needs assessment focus groups and 125 key informant interviews were conducted to gather information on the diverse needs of the stakeholders. The themes that emerged from these activities included the need for effective pre-event education and training; a coordinated and responsive public health preparedness infrastructure; honest, accurate, and timely communication in the event of a bioterrorism situation; and appropriate information dissemination methods and technology.

Probability estimates for the unique childhood leukemia cluster in Fallon, Nevada, and risks near other U.S. Military aviation facilities.

A unique cluster of childhood leukemia has recently occurred around the city of Fallon in Churchill County, Nevada. From 1999 to 2001, 11 cases were diagnosed in this county of 23,982 people. Exposures related to a nearby naval air station such as jet fuel or an infectious agent carried by naval aviators have been hypothesized as potential causes.