Richmond Latino Needs Assessment: A Community-University Partnership to Identify Health Concerns and Service Needs for Latino Youth

The presence of Latinos in Virginia is a new phenomenon and as a result, less is known about the health needs of these newest community members. We formed a community-university partnership to identify health concerns and service needs as they relate to Latino youth living in Richmond, Virginia and the surrounding area. Using a mixed-method approach, survey data was obtained from 212 Latino adults, qualitative interviews were conducted with 15 community leaders and focus groups with 23 Latino parents (16 mothers, 7 fathers) and 6 Latino boys. Participants expressed concern about sexually transmitted infections/pregnancy among youth (76%), youth behavior problems at home/school (75%), and mental health problems (75%). Participants also expressed worry that youth would lose their connection to their Latin culture (83%). Qualitative data provided more information regarding these concerns by linking them with inter-ethnic tensions, and immigration and acculturation-related stressors. Survey participants also indicated a need for bilingual mental health services (88%) and after-school programs for youth (94%). This study provided the local community with information on the health concerns and service needs of a new group of community youth—Latino youth. Findings were presented to local community and City organizations that used the information to respond to the identified needs and/or concerns. The process in which the data was obtained may prove useful to other individuals interested in obtaining local level health information in emerging communities.     

Effects of ultrasound exposure in vitro on neuroblastoma cell membranes

Mechanisms of action of ultrasound on cell membranes were studied on two murine C1300 neuroblastoma cell lines of minimum genetic diversity. Cavitation was established in rotating polystyrene centrifuge tubes by 1 MHz cw ultrasound; exposure time was 5 minutes. NS20Y and N2A cells exposed in suspension responded similarly by 86Rb+ transport and Na+-K+-ATPase activity assays, but differently by trypan blue dye exclusion and lysis assays. This indicates similar overall damage to the cell membranes, despite use of trypsin to release N2As only. Primary evidence of damage was lysis of NS20Ys and permeabilization of N2As. These results indicate that the same ultrasound exposure conditions can produce different effects in cells that differ in their membrane properties.     

Early nosocomial infections in pediatric cardiovascular surgery patients

All patients undergoing cardiovascular surgery between July 1, 1987 and February 29, 1988 were followed from admission to the pediatric ICU (PICU) daily by an intensivist/anesthetist. Patients were characterized by surgical procedure and PRISM score on ICU admission. Of 310 patients, 40 patients (nosocomially infected patient ratio 12.9) developed 78 infections (nosocomial infection ratio 25.2), of which 28% (n = 22) were wounds, within 2 months of surgery. Early wound infection followed 8% of closed, nonpump cases and 6.7% of open, pump cases. Wound infection was more likely if the sternum was open on the ward (elective or emergency) (27.6% open vs. 5.0% closed, p less than .001) or if the PRISM score was greater than or equal to 10 on PICU admission (10.7% greater than or equal to 10 vs. 2.3% less than 10, p less than .01). The causative agents in wound infections in closed cases were Staphylococcus aureus (70%) and coagulase negative staphylococci (CONS) (30%) while in open, pump cases the agents were CONS (33%), Pseudomonas aeruginosa (27%), Candida spp. (27%), and S. aureus (20%). Nonwound infections accounted for 72% of infections (n = 56). The number of bacteremias and other central and arterial line-related infections approximated wound infection in incidence at 6.8/100 patients. Wound infections are more likely if the sternum has been left open on the ward, if the patient has a high PRISM score on PICU admission, and after specific surgical procedures.     

CRUSH SYNDROME: A HAZARD OF PROLONGED BUS JOURNEYS

SUMMARY Compartment syndrome is a devastating condition, with a high morbidity if it goes unrecognised. We describe a case that progressed to muscle ischaemia and crush syndrome in a man undergoing a prolonged bus journey while under the influence of alcohol — an unusual presentation whose outcome is dependent on early recognition.     

Plasmodium vivax: a cause of malnutrition in young children

We studied the aetiology of malnutrition in a cohort of 1511 children < 10 years old in Espiritu Santo, Vanuatu. Malnutrition was categorized using standard anthropometric criteria as: underweight [weight-for-age (WA) Z score < -2], wasting [weight-for-height (WH) Z < -2], or stunting [height-for-age (HA) Z < -2]. On multiple logistic regression analysis, the only factors significantly associated with wasting were age < 5 years [OR (95% CI) 1.8 (1.2-2.9), p = 0.01] and having suffered one or more episodes of clinical P. vivax malaria in the 6 months preceding nutritional assessment [OR 2.4 (1.3-4.4), p = 0.006]. The incidence of P. vivax infection was significantly higher during the 6 months preceding assessment in underweight vs. non-underweight children [incidence rate ratio (IRR) 2.6 (1.5-4.4), p < or = 0.0001). These groups had similar incidences of clinical P. falciparum infection during the same period [IRR 1.1 (0.57-2.1) p = 0.8] and of either species during the 6 months following assessment [IRR P. vivax 1.3 (0.9- 2.0) p = 0.2; IRR P. falciparum 1.3 (0.9-1.9) p = 0.2]. In these children, P. vivax malaria was a major predictor of acute malnutrition; P. falciparum was not. Wasting neither predisposed to nor protected against malaria of either species. Although P. vivax malaria is generally regarded as benign, it may produce considerable global mortality through malnutrition.      

Adverse reactions in blood donors with a history of seizures or epilepsy

BACKGROUND: Individuals with epilepsy or seizure disorders are restricted from donating blood because of concern that they are prone to adverse donor reactions such as syncope and convulsions. A study evaluating whether that concern is warranted is reported. STUDY DESIGN AND METHODS: During a 2-year period beginning in 1987, blood donors in Maryland with a history of seizures were actively recruited by the American Red Cross. Adverse donor reactions were classified as "slight", indicating dizziness and nausea without loss of consciousness; "moderate," denoting syncope; and "severe," indicating convulsive syncope. RESULTS: There were 329,143 satisfactory blood donations; 613 individuals reporting a history of seizures donated blood a total of 723 times. Among donors with seizures, 186 (35.7%) were taking antiepileptic medication, and 61 (8.4%) had had one or more seizures in the preceding year. Individuals with seizures had a low incidence of adverse reactions (3.34%). Although this incidence was slightly higher than that in the entire population (2.24%), the difference was not significant. In particular, the risk of syncope with or without convulsive activity was low for people with seizures (0.21%) and not significantly greater than that in other donors (0.28%). CONCLUSION: Individuals with seizures or epilepsy are not at greater risk for adverse reactions after blood donation, and major restrictions on their participation as blood donors are not warranted.     

Apparatus for ultrasound tissue characterization of excised specimens

Apparatus is described for measurement of sound speed and ultrasound attenuation coefficients by the substitution technique in the frequency range 3 to 8 MHz. Phase-cancellation artifacts leading to overestimation of attenuation coefficients are avoided by use of an acoustoelectric transducer. Specimens confined by polystyrene windows can be interrogated by focused ultrasound beams at selected locations spaced on a grid of 3 x 3 mm voxels. Pulse time of flight is measured with an accuracy of 30 ns, yielding sound speeds accurate to +/- 6.7 m/s, for samples 10 mm thick. Uncertainties in measured insertion losses range from 0.1 dB in low-loss (10 dB) specimens to 0.5 dB in high-loss (25 dB) specimens.     

Total body potassium and water, and exchangeable sodium, in muscular dystrophy

Total body potassium (40K method) and total body water and exchangeable sodium (both by isotope dilution) were determined in 26 boys, aged 5-17 years, with muscular dystrophy. Total body potassium values were compared with measurements in a large series of normal boys on the basis of height. Total body potassium was reduced even in the youngest patients and was only slightly higher in the older boys, despite their considerably greater height. Exchangeable sodium increased with increasing height in a way similar to that of normal boys. Total body water was also reduced but increased with growth, although to a lesser extent than expected for normal boys. The total body water measurements indicated that many of the affected boys were very obese, despite an apparently normal body weight. An intravenous bolus of 22Na distributed at a similar rate in boys with muscular dystrophy to that in normal males. In relation to the predicted values, total body potassium and 24 h urinary creatinine excretion of the affected boys both declined at a rate of 4% per year.