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Prevalence of Axonal Sensory Neuropathy With IgM Binding to Trisulfated Heparin Disaccharide in Patients With Fibromyalgia.

OBJECTIVE: To assess the intraepidermal nerve fiber density in patients diagnosed with fibromyalgia (FM) and to evaluate the role of IgM bin … positive TS-HDS antibodies; of these, 4 had NLDSFN (P = 0.0393). Comparison with a control group at Washington University showed no significant difference in percentage with TS-HDS antibodies (P = 0.41). When compared with Washington University database of skin biopsy, there was a trend for an increased percentage of NLDSFN in patients with FM (P = 0.06). C …

A Case-control Study to Evaluate the Prevalence of Nonalcoholic Fatty Liver Disease Among Patients with Moderate-to-severe Psoriasis.

Objective: International case-control studies have demonstrated that psoriasis is associated with an increased prevalence of nonalcoholic fatty liver disease (NAFLD). The purpose of the present study was to establish an association of psoriasis and NAFLD in patients attending a dermatology clinic center in the United States. Design: This was an observational, case-control study. Setting: The study setting was an outpatient dermatology clinic of the George Washington Medical Faculty Associates in Washington DC. Participants: One hundred fifty-one adult patients with psoriasis and 51 control sub…

One perspective on stakeholder involvement at Hanford.

The Hanford nuclear site in Washington State had a major role in the production of nuclear weapons materials during the Manhattan Project in World War II and during the Cold War that followed. The production of weapons-grade radionuclides produced a large amount of radioactive byproducts that have been stored since the mid-1900s at the Hanford Site. These by-product radionuclides have leaked from containment facilities into the groundwater, contaminated buildings used for radionuclide processing, and also contaminated the nuclear reactors used to produce weapons-grade uranium and plutonium. Th…

Agranulocytosis associated with cocaine use - four States, March 2008-November 2009.

In April 2008, a clinical reference laboratory in New Mexico notified the New Mexico Department of Health (NMDOH) of a cluster of unexplaine … nters. In a separate investigation during April--November 2009, public health officials in Seattle, Washington, identified 10 cases of agranulocytosis among persons with a history of cocaine use. Of the 21 cases, levamisole was detected from clinical specimens in four of the five patients tested. According to the Drug Enforcement Administration (DEA), as of …

Intussusception: hospital size and risk of surgery.

OBJECTIVE: To determine whether the risk of operative management of children with intussusception varies by hospital pediatric caseload. DESIGN: A cohort of all children with intussusception in Washington State from 1987 through 1996. SETTING: All hospitals in Washington State. METHODS: Five hundred seventy children with a hospital discharge diagnosis of intussusception were identified. Sixty-two were excluded because of missing data. Procedure codes for operative management and radiologic management were also identified. RESULTS: Fifty-three percent of the children had operative reduction…

Death due to bioterrorism-related inhalational anthrax: report of 2 patients.

On October 9, 2001, a letter containing anthrax spores was mailed from New Jersey to Washington, DC. The letter was processed at a major postal facility in Washington, DC, and opened in the Senate's Hart Office Building on October 15. Between October 19 and October 26, there were 5 cases of inhalational anthrax among postal workers who were employed at that major facility or who handled bulk mail originating from that facility. The cases of 2 postal workers who died of inhalational anthrax are reported here. Both patients had nonspecific prodromal illnesses. One patient developed predominantly…

The costs of children with sickle cell anemia: preparing for managed care.

PURPOSE: To anticipate the clinical challenges and financial risks facing physicians and managed care organizations who care for children with chronic illnesses, such as sickle cell anemia (SCA), under capitated managed care arrangements. PATIENTS AND METHODS: A cross-sectional study based on claims data from the Washington State Medicaid Program (WSMP) and the Federal Employees Health Benefits Program (FEP). Expenditure patterns were compared for children 18 years of age or younger for whom a claim with a diagnosis of SCA was submitted and paid in the State of Washington during fiscal year 1…

Season and migration alters the corticosterone response to capture and handling in an Arctic migrant, the white-crowned sparrow (Zonotrichia leucophrys gambelii).

The Gambel's race of white-crowned sparrow (Zonotrichia leucophrys gambelii) migrates each year from their wintering grounds in the Southwes … e were no differences between wintering sites. These were also similar to levels in birds caught in Washington state during fall migration. In contrast, nonstressed corticosterone values were greatly elevated in birds on their breeding grounds in Alaska and similar to stress-induced levels in wintering birds. Corticosterone levels rose even further in respon …

The role of demographic factors of individuals with seizures in emergency care delivery.

OBJECTIVE: To determine whether patient demographics, specifically race and ward of residence, are associated with differences in seizure-related emergency department (ED) care delivery. METHODS: We conducted a retrospective study of adults presenting with epileptic or functional seizures to the ED at the George Washington University (2018-2020). Each visit was mapped to one of Washington, D.C.'s eight wards, and patients were stratified by race and ward (White vs. Black patients from wards 1-6 or wards 7-8). Key ED interventions and outcomes (antiseizure medication (ASM) administration, head…

Twenty Years in the Making: Government, University, and Community Partnership to Advance School Mental Health.

School-based mental health (SBMH) services are a critical strategy for addressing the mental health crisis affecting approximately 28% of US youth; however, persistent challenges remain, including funding constraints, workforce shortages, and difficulty sustaining initiatives amid shifting policy priorities and limited institutional support. This paper chronicles a 20-year government-university-community partnership in Seattle and King County, Washington, illustrating how sustained cross-sector collaboration can address these barriers. The partnership between Public Health of Seattle & King Co…

Prevalence, risk factors, and genetic diversity of Bartonella henselae infections in pet cats in four regions of the United States.

Blood was collected from a convenience sample of 271 pet cats aged 3 months to 2 years (mean age, 8 months, median and mode, 6 months) between May 1997 and September 1998 in four areas of the United States (southern California, Florida, metropolitan Chicago, and metropolitan Washington, D.C.). Sixty-five (24%) cats had Bartonella henselae bacteremia, and 138 (51%) cats were seropositive for B. henselae. Regional prevalences for bacteremia and seropositivity were highest in Florida (33% and 67%, respectively) and California (28% and 62%, respectively) and lowest in the Washington, D.C. (12% and…

Demographic, Clinical, and Immunologic Correlates among a Cohort of 50 Cocaine Users Demonstrating Antineutrophil Cytoplasmic Antibodies.

OBJECTIVE: Cocaine/levamisole-associated autoimmunity syndrome (CLAAS) is a poorly understood form of drug-induced autoimmunity. Our goals were to better characterize the spectrum of clinical and immunologic features of CLAAS, to identify demographic risk factors, and to generate new hypotheses regarding pathogenesis. METHODS: CLAAS subjects were identified between 2001 and 2015 at the University of Washington Medical Center, Harborview Medical Center, and affiliated clinics in Seattle, Washington, USA. Demographic, clinical, and immunologic variables were collected and correlated using conti…

The Impact of "See the City You Serve" Field Trip: An Educational Tool for Teaching Social Determinants of Health.

BACKGROUND: There has been limited evaluation of tools for teaching social determinants of health (SDOH). OBJECTIVE: We evaluated a field trip as a tool for teaching SDOH to incoming medical interns. METHODS: Incoming interns from The George Washington University participated in a bus field trip of Washington, DC, guided by community partners. The field trip introduced trainees to local neighborhoods. Pre- and postactivity surveys developed by the authors were analyzed using a Wilcoxon signed rank test. Reflection responses were recorded and counted for recurrent themes. RESULTS: Incoming i…

Compliance with electrodiagnostic guidelines for patients undergoing carpal tunnel release.

OBJECTIVE: To describe how clinical practice in those who underwent carpal tunnel release (CTR) matched the American Association of Electrodiagnostic Medicine (AAEM) 1993 practice parameters for electrodiagnostic evaluation of carpal tunnel syndrome (CTS). DESIGN: Cohort study using 1998-1999 Medicare billing data. SETTING: Washington State. PARTICIPANTS: State Medicare beneficiaries who underwent CTR in 1999 (N=1567) Interventions Not applicable. MAIN OUTCOME MEASURES: Compliance with the AAEM practice parameters. RESULTS: Of the 1567 [corrected] receiving surgery, 324 [corrected] (20.7%…

Asthma and bronchiolitis hospitalizations among American Indian children.

OBJECTIVE: To compare asthma and bronchiolitis hospitalization rates in American Indian and Alaskan native (AI/AN) children and all children in Washington State. METHODS: A retrospective data analysis using Washington State hospitalization data for 1987 through 1996. Patients were included if asthma or bronchiolitis was the first-listed diagnosis. American Indian and Alaskan native children were identified by linking state hospitalization data with Indian Health Service enrollment data. RESULTS: Similar rates of asthma hospitalization were found for AI/AN children older than 1 year compared …

Community-Embedded Low-Barrier Care: A Model for Engaging People With Complex Needs in HIV Treatment and Prevention.

People living homeless and people with substance use disorders are at increased risk for HIV but experience multiple intersecting barriers to accessing medical care. Low-barrier care has emerged as a strategy to engage persons with complex needs in care, particularly in the fields of HIV and substance use treatment. We describe our experience implementing low-barrier whole person care for HIV treatment and prevention at 3 community-embedded sites in King County, Washington, and outline key operational and clinic characteristics that helped facilitate success.

[Apprenticeship system of American NCCAOM Certification of acupuncture and oriental medicine].

The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is the only national institution for the accreditation of clinical practice of acupuncture and Oriental (Chinese) Medicine in the United States. Its qualification certificate or examination certificate is a mandatory document for 47 states and Washington, D.C. to issue the practice license. According to the latest information of the NCCAOM official website, this paper introduced the preceptor qualifications of the apprenticeship, studying hours, quality control, and the evaluation at the end of apprenticeship.…

Primary cutaneous gamma delta T-cell lymphoma with brain involvement and hemophagocytic syndrome.

Primary cutaneous gamma delta T-cell lymphoma is a rare diagnosis with only 40 reported cases. We describe a case of cutaneous gamma delta T-cell lymphoma with hemophagocytic syndrome and brain involvement that was not apparent morphologically on skin biopsy and was diagnosed as perifolliculitis and lobular panniculitis. The biopsy was sent later for molecular studies to the University of Washington, which demonstrated a T-cell clone. This case demonstrates that a T-cell clone may be present in a skin biopsy without morphologic or immunophenotypic evidence of lymphoma.

Иммунизация ВИЧ-инфицированных взрослых: показатели, сроки и ответные меры.

Вакцины, обычно рекомендуемые для ВИЧ-инфицированных взрослых, включают вакцины против гриппа, вируса гепатита А, вируса гепатита В, пневмококковой инфекции и столбняка. На реакцию на вакцинацию могут влиять количество клеток CD4+ и вирусная нагрузка. Ряд живых вакцин противопоставлены ВИЧ-инфицированным населением. В этой статье резюмируется сообщение Дэвида Х. об иммунизации ВИЧ-инфицированных взрослых. В августе 2006 года в Вашингтоне, округ Колумбия, на 9-м ежегодном акте Ran White CARE. С первоначальным докладом можно ознакомиться в Интернете по адресу www.iasusa.org.

Совпадение в аннотации оригинала
Vaccines routinely recommended for HIV-infected adults include those for influenza, hepatitis A virus, hepatitis B virus, pneumococcal infec … nfected adults made by David H. Spach, MD, at the 9th Annual Ryan White CARE Act Clinical Update in Washington, DC, in August 2006. The original presentation is available as a Webcast at www.iasusa.org.

Bioterrorism and its aftermath: dealing individually and organizationally with the emotional reactions to an anthrax attack.

From September 2001 through April 2004, the United States Postal Service (USPS) dealt, for the first time, with bioterrorism resulting in employee deaths and the closure of a large mail processing plant in Washington, D.C. The Employee Assistance Program (EAP) partnered with the USPS throughout this tumultuous time to meet the multiple and evolving behavioral health needs of the employees and facilitate the employees' emotional preparedness for their return to work at the closed facility. This paper discusses the reactions manifested by the employees during this extended period, as well as the…