Insufficient stocking of poisoning antidotes in hospital pharmacies.

Objective: To determine whether antidotes for poisoning and overdose are available in hospitals that provide emergency department care.

Design: Written survey of hospital pharmacy directors, each of whom reported the amount currently in stock of 8 different antidotes: antivenin (Crotalidae) polyvalent, cyanide kit, deferoxamine mesylate, digoxin immune Fab, ethanol, naloxone hydrochloride, pralidoxime chloride, and pyridoxine hydrochloride.

Participants: Pharmacy directors of all hospitals with emergency departments in Colorado, Montana, and Nevada.

Mortality from intentional and unintentional injury among infants of young mothers in Colorado, 1986 to 1992.

Objectives: To investigate the association between maternal age and other risk factors and infant injury deaths in the state of Colorado from 1986 to 1992.

Design: A retrospective cohort design was used to compare rates of unintentional and intentional infant injury mortality by maternal age group. A case-control design explored the importance of various risk factors, particularly maternal age, using multivariate logistic regression.

Treatment of multidrug-resistant tuberculosis.

Recent outbreaks of multi-drug-resistant tuberculosis (MDR-TB) have resulted in significant morbidity and mortality in patients with AIDS. The poor outcomes are attributable to delayed diagnoses, slow reporting of antimycobacterial susceptibility results, inadequate treatment regimens and profound immunosuppression. There are no prospective clinical trials which have evaluated the optimal treatment of MDR-TB.

Multifocal cellulitis and monoarticular arthritis as manifestations of Helicobacter cinaedi bacteremia.

Helicobacter cinaedi (formerly Campylobacter cinaedi) was first detected in the fecal flora of homosexual men. Since 1984, 11 case reports of H. cinaedi bacteremia have been published; most cases have presented as a nonspecific febrile illness in homosexual men infected with the human immunodeficiency virus (HIV).

Reversed-phase liquid chromatographic determination of vitamin D in milk.

Vitamin D in milk is determined by a slight modification of the method of Sliva et al. [J. AOAC Int.

Building a community-based consortium for AIDS patient services.

The authors describe a 3-year effort by a public health care system in a large metropolitan area to obtain Federal funds for treating patients with acquired immunodeficiency syndrome (AIDS). During that process, program planners moved incrementally from proposing an exclusively medical model to one emphasizing the activities of a coalition of community based organizations (CBO). Successive proposals for Federal funding reflected increasing understanding of the nature and functioning of CBOs in providing case management and other support services.

Prehospital considerations in the pregnant patient.

The prehospital care of the pregnant patient is aimed at expeditious transport of the patient to an appropriate facility combined with rapid intervention to stabilize the mother, including oxygen administration and fluid resuscitation. Optimal care of the fetus is dependent on appropriate management of the mother.

Implementing the Boston Healthy Start Initiative: a case study of community empowerment and public health.

This article examines the efforts on the part of a city health department, in partnership with a broad-based coalition of community-based, government, and social service agencies, to plan and implement, using principles of empowerment and community participation, a federally funded infant mortality reduction program. It examines the social and institutional dynamics of sharing power in an environment highly charged politically. Infant mortality in Boston is much more than a public health problem.

Evaluation of an intervention program for the control of an outbreak of shigellosis among institutionalized persons.

After control measures were initiated to stop an outbreak of shigellosis in an institution for the developmentally disabled, there was a sharp decline in the number of cases of Shigella sonnei infection. Among ill residents, those treated with antibiotics had shorter mean duration of diarrhea (2.4 vs.

Disseminated Mycobacterium genavense infection: clinical and microbiological features and response to therapy.

Objective: Mycobacterium genavense is a newly described pathogen that causes disseminated infection in AIDS. It is difficult to detect and identify due to its slow growth and fastidious nature. There is little information available about therapy for this new pathogen.

Direct inoculation of food as the cause of an outbreak of group A streptococcal pharyngitis.

An investigation was conducted of a food-related outbreak of group A streptococcal pharyngitis following an elementary school banquet. Of 166 surveyed banquet attendees, 71 (43%) reported outbreak-associated pharyngitis, and 21 (88%) of 24 tested attendees had evidence of group A streptococcus (GAS) in the throat. Attendees who ate macaroni and cheese were three times more likely to develop pharyngitis than those who did not (66/132 [50%] vs.

The risk of childhood injury on Boston's playground equipment and surfaces.

The Childhood Injury Prevention Program of the Boston Department of Health and Hospitals conducted a survey of injury risk in Boston's playgrounds. A standardized checklist was used to assess a 25% sample of public playgrounds for hazards. Climbers accounted for 34% of the hazards observed and had the greatest proportion of significant hazards.

Forging the future: the public health imperative.

During the 1980s, national policy promoted military expenditures and downsized domestic programs. These priorities, along with tax reform and deregulation, created a "domestic gulf crisis" with a new wave of vulnerable populations--poor children, the homeless, the elderly, and the uninsured. Our lack of a national health program compounds the problem.

Child day care increases the risk of clinic visits for acute diarrhea and diarrhea due to rotavirus.

A case-control study of risk factors for acute diarrhea was conducted among children under 3 years of age attending a health maintenance organization clinic in Houston, Texas. During a 19-month period from September 1985 through March 1987, 339 children with diarrhea and 363 age- and season-stratified controls were enrolled. A total of 90% of cases were under age 2 years.

Survival with AIDS in Massachusetts, 1979 to 1989.

Objectives: The goal of the study was to determine survival time after diagnosis of acquired immunodeficiency syndrome (AIDS) and to identify predictors of survival.

Methods: We conducted a population-based prospective survival analysis of all Massachusetts-resident adult AIDS patients diagnosed from January 1, 1979, through December 31, 1988.

Results: Median survival was 406 days, with a 5-year survival rate of 3%.