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1.
Sex Transm Dis ; 2022 Aug 05.
Article in English | MEDLINE | ID: mdl-35948302
2.
Disaster Med Public Health Prep ; 13(1): 90-93, 2019 02.
Article in English | MEDLINE | ID: mdl-29208073

ABSTRACT

On August 25, 2017, Hurricane Harvey made landfall near Corpus Christi, Texas. The ensuing unprecedented flooding throughout the Texas coastal region affected millions of individuals.1 The statewide response in Texas included the sheltering of thousands of individuals at considerable distances from their homes. The Dallas area established large-scale general population sheltering as the number of evacuees to the area began to amass. Historically, the Dallas area is one familiar with "mega-sheltering," beginning with the response to Hurricane Katrina in 2005.2 Through continued efforts and development, the Dallas area had been readying a plan for the largest general population shelter in Texas. (Disaster Med Public Health Preparedness. 2019;13:33-37).


Subject(s)
Civil Defense/methods , Cyclonic Storms/statistics & numerical data , Emergency Medical Services/methods , Emergency Shelter/statistics & numerical data , Civil Defense/statistics & numerical data , Emergency Medical Services/statistics & numerical data , Emergency Shelter/methods , Emergency Shelter/organization & administration , Humans , Texas/epidemiology
3.
Emerg Infect Dis ; 24(3): 534-540, 2018 03.
Article in English | MEDLINE | ID: mdl-29460756

ABSTRACT

Interferon-γ release assays (IGRAs) are the preferred diagnostic test for tuberculosis (TB) infection in at-risk populations in developed countries. However, IGRAs have high false-negative rates in patients with TB disease. Population-based studies assessing the factors associated with negative IGRA results in TB patients have not been performed. Using statewide TB surveillance data of culture-confirmed TB patients in Texas, USA, during 2013-2015, we describe the patient characteristics and treatment outcomes associated with false-negative IGRA results. Among 2,854 TB patients, 1,527 (53.5%) had an IGRA result; 97.4% (1,487/1,527) of those had a positive (87.7%) or negative (12.3%) result. Older age, HIV co-infection, non-Hispanic white race/ethnicity, and being tested with T-SPOT.TB were associated with negative IGRA results. TB patients with negative IGRA results had a higher mortality, potentially due to delayed treatment. Healthcare providers should consider these risk factors when making decisions for patients with suspected TB and negative IGRA results and potentially provide treatment.


Subject(s)
Interferon-gamma Release Tests , Mycobacterium tuberculosis , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Adult , Aged , Female , History, 21st Century , Humans , Male , Middle Aged , Odds Ratio , Proportional Hazards Models , Texas/epidemiology , Tuberculosis/history
4.
MMWR Morb Mortal Wkly Rep ; 65(16): 425-6, 2016 Apr 29.
Article in English | MEDLINE | ID: mdl-27123787

ABSTRACT

On August 27-28, 2015, the Texas Department of State Health Services received calls from Fort Bend County and Harris County health departments requesting postexposure prophylaxis (PEP) recommendations for contacts of two nurses (patients A and B) with confirmed hepatitis A virus (HAV) infection. Both nurses had symptom onset during August 15-19 and worked for the same pediatric home health care agency in another jurisdiction. Because of the proximity of the onset dates, a common source exposure was suspected. The state and local health departments began an investigation to identify potentially exposed patients, their families, and other agency personnel; offer PEP; and identify the source of exposure.


Subject(s)
Disease Outbreaks , Hepatitis A/transmission , Home Health Nursing , Infectious Disease Transmission, Patient-to-Professional , Occupational Exposure/adverse effects , Pediatric Nursing , Child , Contact Tracing , Hepatitis A/epidemiology , Hepatitis A/prevention & control , Hepatitis A Vaccines/administration & dosage , Humans , Post-Exposure Prophylaxis , RNA, Viral/isolation & purification , Texas/epidemiology
5.
J Agromedicine ; 21(1): 71-81, 2016.
Article in English | MEDLINE | ID: mdl-26479964

ABSTRACT

Few extensive, national clinical databases exist on the health of migrant and seasonal farmworkers (MSFWs). Electronic health records (EHRs) are increasingly utilized by Federally Qualified Health Centers (FQHCs) and have the potential to improve clinical care and complement current surveillance and epidemiologic studies of underserved working populations, such as MSFWs. The aim of this feasibility study was to describe the demographics and baseline clinical indicators of patients at an FQHC by MSFW status. The authors described 2012 patient demographics, social history, medical indicators, and diagnoses by MSFW status from the de-identified EHR database of a large, multisite Colorado Migrant Health Center (MHC). Included in the study were 41,817 patients from 2012: 553 (1.3%) MSFWs, 20,665 (49.4%) non-MSFWs, and 20,599 (49.3%) who had no information in the MSFW field. MSFWs were more often male, married, employed, Hispanic, and Spanish-speaking compared with non-MSFWs. The most frequent diagnoses for all patients were hypertension, overweight/obesity, lipid disorder, type 2 diabetes, or a back disorder. Although there were significant missing values, this feasibility study was able to analyze medical data in a timely manner and show that Meaningful Use requirements can improve the usability of EHR data for epidemiologic research of MSFWs and other patients at FQHCs. The results of this study were consistent with current literature available for MSFWs. By reaching this vulnerable working population, EHRs may be a key data source for occupational injury and illness surveillance and research.


Subject(s)
Agricultural Workers' Diseases/etiology , Electronic Health Records , Transients and Migrants , Adult , Agricultural Workers' Diseases/diagnosis , Agricultural Workers' Diseases/epidemiology , Agriculture , Colorado/epidemiology , Databases, Factual , Farmers , Female , Hispanic or Latino , Humans , Male , Middle Aged , Seasons , Vulnerable Populations
6.
J Am Acad Dermatol ; 53(5 Suppl 1): S252-5, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16227102

ABSTRACT

Alopecia areata (AA) is an autoimmune disease of uncertain pathogenesis, typically treated with immunomodulators. We report the paradoxical development of AA in two kidney-pancreas transplant recipients receiving immunosuppressive therapy, which included cyclosporine. Review of the literature revealed only 7 other cases of AA occurring in solid organ transplant recipients; all occurred during long-term cyclosporine therapy. The development of AA in this population highlights the complexity of this immunologic disease.


Subject(s)
Alopecia Areata/immunology , Kidney Transplantation/immunology , Pancreas Transplantation/immunology , Adult , Alopecia Areata/diagnosis , Cyclosporine/therapeutic use , Diabetic Nephropathies/surgery , Female , Humans , Immunosuppressive Agents/therapeutic use , Kidney Failure, Chronic/surgery
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