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1.
MMWR Morb Mortal Wkly Rep ; 69(29): 965-970, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32701941

RESUMO

Transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is ongoing in many communities throughout the United States. Although case-based and syndromic surveillance are critical for monitoring the pandemic, these systems rely on persons obtaining testing or reporting a COVID-19-like illness. Using serologic tests to detect the presence of SARS-CoV-2 antibodies is an adjunctive strategy that estimates the prevalence of past infection in a population. During April 28-May 3, 2020, coinciding with the end of a statewide shelter-in-place order, CDC and the Georgia Department of Public Health conducted a serologic survey in DeKalb and Fulton counties in metropolitan Atlanta to estimate SARS-CoV-2 seroprevalence in the population. A two-stage cluster sampling design was used to randomly select 30 census blocks in each county, with a target of seven participating households per census block. Weighted estimates were calculated to account for the probability of selection and adjusted for age group, sex, and race/ethnicity. A total of 394 households and 696 persons participated and had a serology result; 19 (2.7%) of 696 persons had SARS-CoV-2 antibodies detected. The estimated weighted seroprevalence across these two metropolitan Atlanta counties was 2.5% (95% confidence interval [CI] = 1.4-4.5). Non-Hispanic black participants more commonly had SARS-CoV-2 antibodies than did participants of other racial/ethnic groups (p<0.01). Among persons with SARS-CoV-2 antibodies, 13 (weighted % = 49.9; 95% CI = 24.4-75.5) reported a COVID-19-compatible illness,* six (weighted % = 28.2; 95% CI = 11.9-53.3) sought medical care for a COVID-19-compatible illness, and five (weighted % = 15.7; 95% CI = 5.1-39.4) had been tested for SARS-CoV-2 infection, demonstrating that many of these infections would not have been identified through case-based or syndromic surveillance. The relatively low seroprevalence estimate in this report indicates that most persons in the catchment area had not been infected with SARS-CoV-2 at the time of the survey. Continued preventive measures, including social distancing, consistent and correct use of face coverings, and hand hygiene, remain critical in controlling community spread of SARS-CoV-2.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico , Vigilância em Saúde Pública/métodos , Características de Residência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Infecções por Coronavirus/diagnóstico , Feminino , Georgia/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
2.
MMWR Morb Mortal Wkly Rep ; 69(25): 790-794, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32584797

RESUMO

The first reported U.S. case of coronavirus disease 2019 (COVID-19) was detected in January 2020 (1). As of June 15, 2020, approximately 2 million cases and 115,000 COVID-19-associated deaths have been reported in the United States.* Reports of U.S. patients hospitalized with SARS-CoV-2 infection (the virus that causes COVID-19) describe high proportions of older, male, and black persons (2-4). Similarly, when comparing hospitalized patients with catchment area populations or nonhospitalized COVID-19 patients, high proportions have underlying conditions, including diabetes mellitus, hypertension, obesity, cardiovascular disease, chronic kidney disease, or chronic respiratory disease (3,4). For this report, data were abstracted from the medical records of 220 hospitalized and 311 nonhospitalized patients aged ≥18 years with laboratory-confirmed COVID-19 from six acute care hospitals and associated outpatient clinics in metropolitan Atlanta, Georgia. Multivariable analyses were performed to identify patient characteristics associated with hospitalization. The following characteristics were independently associated with hospitalization: age ≥65 years (adjusted odds ratio [aOR] = 3.4), black race (aOR = 3.2), having diabetes mellitus (aOR = 3.1), lack of insurance (aOR = 2.8), male sex (aOR = 2.4), smoking (aOR = 2.3), and obesity (aOR = 1.9). Infection with SARS-CoV-2 can lead to severe outcomes, including death, and measures to protect persons from infection, such as staying at home, social distancing (5), and awareness and management of underlying conditions should be emphasized for those at highest risk for hospitalization with COVID-19. Measures that prevent the spread of infection to others, such as wearing cloth face coverings (6), should be used whenever possible to protect groups at high risk. Potential barriers to the ability to adhere to these measures need to be addressed.


Assuntos
Infecções por Coronavirus/terapia , Hospitalização/estatística & dados numéricos , Pneumonia Viral/terapia , Adolescente , Adulto , Idoso , Cidades/epidemiologia , Infecções por Coronavirus/epidemiologia , Feminino , Georgia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Fatores de Risco , Adulto Jovem
3.
J Anesth Hist ; 6(2): 38-41, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32593375

RESUMO

Milton Antony (1789-1839), an apprenticed trained physician, began educating medical apprentices in 1826 and helped to establish the Medical College of Georgia (MCG) in 1829. Antony recruited additional faculty, Louis Dugas (anatomy and physiology), and Paul Eve (surgery), and together they worked to promote the dissemination of new medical knowledge and enhance and reform medical education. As a result of their efforts, the Southern Medical and Surgical Journal (SMSJ) was established in 1836. The SMSJ became the most successful and widely read regional medical journal. Unfortunately, upon the death of Milton Antony because of the Augusta yellow fever epidemic, the SMSJ ceased publication in 1839. Paul Eve then became Dean of MCG and revived the SMSJ in 1844. Crawford Long (1815-1878) administered ether anesthesia for surgical removal of a neck tumor to James Venable in 1842. For several possible reasons, he did not publish his experience with ether until after Morton's demonstration of ether in Boston in 1846. Crawford Long did meet with Paul Eve, in Augusta at MCG, and was encouraged to publish his experiences with ether in the revived SMSJ, which he did in 1849. It is quite possible that if Milton Antony had lived, and the SMSJ had been continuously published, that Crawford Long may have published his use of ether well in advance of Morton's ether demonstration in 1846. Had that occurred, the great controversy during the mid-nineteenth century over who first used ether for surgical anesthesia would not have existed, and Crawford Long would have received appropriate credit during his lifetime.


Assuntos
Anestesiologia/história , Anestésicos Inalatórios/história , Éter/história , Publicações Periódicas como Assunto/história , Faculdades de Medicina/história , Pessoal Administrativo/história , Georgia , História do Século XIX , Humanos , Faculdades de Medicina/organização & administração
4.
MMWR Morb Mortal Wkly Rep ; 69(18): 545-550, 2020 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-32379729

RESUMO

SARS-CoV-2, the novel coronavirus that causes coronavirus disease 2019 (COVID-19), was first detected in the United States during January 2020 (1). Since then, >980,000 cases have been reported in the United States, including >55,000 associated deaths as of April 28, 2020 (2). Detailed data on demographic characteristics, underlying medical conditions, and clinical outcomes for persons hospitalized with COVID-19 are needed to inform prevention strategies and community-specific intervention messages. For this report, CDC, the Georgia Department of Public Health, and eight Georgia hospitals (seven in metropolitan Atlanta and one in southern Georgia) summarized medical record-abstracted data for hospitalized adult patients with laboratory-confirmed* COVID-19 who were admitted during March 2020. Among 305 hospitalized patients with COVID-19, 61.6% were aged <65 years, 50.5% were female, and 83.2% with known race/ethnicity were non-Hispanic black (black). Over a quarter of patients (26.2%) did not have conditions thought to put them at higher risk for severe disease, including being aged ≥65 years. The proportion of hospitalized patients who were black was higher than expected based on overall hospital admissions. In an adjusted time-to-event analysis, black patients were not more likely than were nonblack patients to receive invasive mechanical ventilation† (IMV) or to die during hospitalization (hazard ratio [HR] = 0.63; 95% confidence interval [CI] = 0.35-1.13). Given the overrepresentation of black patients within this hospitalized cohort, it is important for public health officials to ensure that prevention activities prioritize communities and racial/ethnic groups most affected by COVID-19. Clinicians and public officials should be aware that all adults, regardless of underlying conditions or age, are at risk for serious illness from COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/etnologia , Georgia/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/etnologia , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
5.
MMWR Morb Mortal Wkly Rep ; 69(17): 521-522, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32352957

RESUMO

In the United States, approximately 1.4 million persons access emergency shelter or transitional housing each year (1). These settings can pose risks for communicable disease spread. In late March and early April 2020, public health teams responded to clusters (two or more cases in the preceding 2 weeks) of coronavirus disease 2019 (COVID-19) in residents and staff members from five homeless shelters in Boston, Massachusetts (one shelter); San Francisco, California (one); and Seattle, Washington (three). The investigations were performed in coordination with academic partners, health care providers, and homeless service providers. Investigations included reverse transcription-polymerase chain reaction testing at commercial and public health laboratories for SARS-CoV-2, the virus that causes COVID-19, over approximately 1-2 weeks for residents and staff members at the five shelters. During the same period, the team in Seattle, Washington, also tested residents and staff members at 12 shelters where a single case in each had been identified. In Atlanta, Georgia, a team proactively tested residents and staff members at two shelters with no known COVID-19 cases in the preceding 2 weeks. In each city, the objective was to test all shelter residents and staff members at each assessed facility, irrespective of symptoms. Persons who tested positive were transported to hospitals or predesignated community isolation areas.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pessoas em Situação de Rua/estatística & dados numéricos , Habitação/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Boston/epidemiologia , Cidades , Georgia/epidemiologia , Humanos , Pandemias , Prevalência , São Francisco/epidemiologia , Washington/epidemiologia
6.
Immunogenetics ; 72(4): 263-274, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32300829

RESUMO

Reticulated flatwoods salamander (Ambystoma bishopi) populations began decreasing dramatically in the 1900s. Contemporary populations are small, isolated, and may be susceptible to inbreeding and reduced adaptive potential because of low genetic variation. Genetic variation at immune genes is especially important as it influences disease susceptibility and adaptation to emerging infectious pathogens, a central conservation concern for declining amphibians. We collected samples from across the extant range of this salamander to examine genetic variation at major histocompatibility complex (MHC) class Iα and IIß exons as well as the mitochondrial control region. We screened tail or toe tissue for ranavirus, a pathogen associated with amphibian declines worldwide. Overall, we found low MHC variation when compared to other amphibian species and did not detect ranavirus at any site. MHC class Iα sequencing revealed only three alleles with a nucleotide diversity of 0.001, while MHC class IIß had five alleles with a with nucleotide diversity of 0.004. However, unique variation still exists across this species' range with private alleles at three sites. Unlike MHC diversity, mitochondrial variation was comparable to levels estimated for other amphibians with nine haplotypes observed, including one haplotype shared across all sites. We hypothesize that a combination of a historic disease outbreak and a population bottleneck may have contributed to low MHC diversity while maintaining higher levels of mitochondrial DNA variation. Ultimately, MHC data indicated that the reticulated flatwoods salamander may be at an elevated risk from infectious diseases due to low levels of immunogenetic variation necessary to combat novel pathogens.


Assuntos
Ambystoma/genética , Complexo Principal de Histocompatibilidade/genética , Ambystoma/virologia , Animais , Espécies em Perigo de Extinção , Éxons , Florida , Variação Genética , Georgia , Interações Hospedeiro-Patógeno/genética , Interações Hospedeiro-Patógeno/imunologia , Ranavirus
7.
Am Surg ; 86(3): 213-219, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32223800

RESUMO

Grady Memorial Hospital is a pillar of public medical and surgical care in the Southeast. The evolution of this institution, both in its physical structure as well as its approach to patient care, mirrors the cultural and social changes that have occurred in the American South. Grady Memorial Hospital opened its doors in 1892 built in the heart of Atlanta's black community. With its separate and unequal facilities and services for black and white patients, the concept of "the Gradies" was born. Virtually, every aspect of care at Grady continued to be segregated by race until the mid-20th century. In 1958, the opening of the "New Grady" further cemented this legacy of the separate "Gradies," with patients segregated by hospital wing. By the 1960s, civil rights activists brought change to Atlanta. The Atlanta Student Movement, with the support of Dr. Martin Luther King Jr., led protests outside of Grady, and a series of judicial and legislative rulings integrated medical boards and public hospitals. Eventually, the desegregation of Grady occurred with a quiet memo that belied years of struggle: on June 1, 1965, a memo from hospital superintendent Bill Pinkston read "All phases of the hospital are on a non-racial basis, effective today." The future of Grady is deeply rooted in its past, and Grady's mission is unchanged from its inception in 1892: "It will nurse the poor and rich alike and will be an asylum for black and white."


Assuntos
Direitos Civis/história , Dessegregação/história , Dessegregação/legislação & jurisprudência , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Georgia , Hispano-Americanos/estatística & dados numéricos , História do Século XX , Hospitais Públicos/história , Humanos
8.
Environ Monit Assess ; 192(5): 306, 2020 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-32323028

RESUMO

Metal pollution commonly occurs in many terrestrial environments and may pose a threat for the animals inhabiting such areas. Here, we present concentrations of six metals (cadmium [Cd], copper [Cu], nickel [Ni], lead [Pb], selenium [Se], and zinc [Zn]) in the liver tissues of seven species of mammals obtained from a study that examined the impact of mesopredator removal on northern bobwhite (Colinus virginianus) populations. A total of 1326 samples were collected from 2003 to 2006 at four sites in southwest Georgia and north Florida from nine-banded armadillos (Dasypus novemcinctus), bobcats (Lynx rufus), feral cats (Felis catus), coyotes (Canis latrans), grey foxes (Urocyon cinereoargenteus), opossums (Didelphis virginiana), and raccoons (Procyon lotor). Data from armadillos, bobcats, opossums, and raccoons were published previously to examine age, sex, spatial (between sites), and temporal (between years) variation. In this paper, we present similar comparisons for the remaining three species as well as comparisons of metal concentrations among all seven species. Concentrations of Cu and Pb exhibited strong negative relationships with body weight in coyotes, while Ni was positively correlated with weight in feral cats. Concentrations of these metals, as well as the other two tested (Cd and Zn), were not significantly correlated with one another in any of the three species. The only sex difference in liver metal concentrations was observed in female feral cats, which had higher levels of Pb than did males. Coyotes exhibited significant differences in Cu concentrations between sites and between years (2005 versus 2006). We also found significant differences between sites in Pb concentrations for both feral cats and grey foxes. There were significant differences in metal concentrations among all seven species for all metals except Cd. With the exception of Cd and Se (tested only in bobcats and opossums), a three-way ANOVA with species, year, and site as the three factors revealed significant differences among species for every metal but only a single main effect of year for Cu, and no main effects of site. In sum, our results provide an extensive survey of metal concentrations in a diverse assemblage of mammals and suggest that metal accumulation may be heavily influenced by species identity, which in turn may reflect ecological lifestyle.


Assuntos
Monitoramento Ambiental , Fígado , Mamíferos , Metais Pesados/análise , Animais , Peso Corporal/efeitos dos fármacos , Gatos , Poluentes Ambientais/análise , Poluentes Ambientais/toxicidade , Feminino , Florida , Georgia , Fígado/química , Masculino , Mamíferos/metabolismo , Metais Pesados/toxicidade
9.
Plast Reconstr Surg ; 145(4): 865-876, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32221191

RESUMO

BACKGROUND: Within the multidisciplinary management of breast cancer, variations exist in the reconstructive options offered and care provided. The authors evaluated plastic surgeon perspectives on important issues related to breast cancer management and reconstruction and provide some insight into factors that influence these perspectives. METHODS: Women diagnosed with early-stage breast cancer (stages 0 to II) between July of 2013 and September of 2014 were identified through the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries. These women were surveyed and identified their treating plastic surgeons. Surveys were sent to the identified plastic surgeons to collect data on specific reconstruction practices. RESULTS: Responses from 134 plastic surgeons (74.4 percent response rate) were received. Immediate reconstruction (79.7 percent) was the most common approach to timing, and expander/implant reconstruction (72.6 percent) was the most common technique reported. Nearly one-third of respondents (32.1 percent) reported that reimbursement influenced the proportion of autologous reconstructions performed. Most (82.8 percent) reported that discussions about contralateral prophylactic mastectomy were initiated by patients. Most surgeons (81.3 to 84.3 percent) felt that good symmetry is achieved with unilateral autologous reconstruction with contralateral symmetry procedures in patients with small or large breasts; a less pronounced majority (62.7 percent) favored unilateral implant reconstructions in patients with large breasts. In patients requiring postmastectomy radiation therapy, one-fourth of the surgeons (27.6 percent) reported that they seldom recommend delayed reconstruction, and 64.9 percent reported recommending immediate expander/implant reconstruction. CONCLUSIONS: Reconstructive practices in a modern cohort of plastic surgeons suggest that immediate and implant reconstructions are performed preferentially. Respondents perceived a number of factors, including surgeon training, time spent in the operating room, and insurance reimbursement, to negatively influence the performance of autologous reconstruction.


Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia/estatística & dados numéricos , Mastectomia/efeitos adversos , Padrões de Prática Médica/estatística & dados numéricos , Retalhos Cirúrgicos/estatística & dados numéricos , Adulto , Idoso , Implantes de Mama/estatística & dados numéricos , Feminino , Georgia , Humanos , Reembolso de Seguro de Saúde/estatística & dados numéricos , Los Angeles , Mamoplastia/economia , Mamoplastia/instrumentação , Mamoplastia/métodos , Pessoa de Meia-Idade , Mastectomia Profilática/estatística & dados numéricos , Programa de SEER/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Retalhos Cirúrgicos/economia , Retalhos Cirúrgicos/transplante , Inquéritos e Questionários/estatística & dados numéricos , Tempo para o Tratamento , Dispositivos para Expansão de Tecidos/estatística & dados numéricos
10.
PLoS One ; 15(2): e0228372, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32027686

RESUMO

Social media is increasingly utilized as a resource in healthcare. We sought to identify perceptions of using social media as an educational tool among healthcare practitioners. An electronic survey was distributed to healthcare administrators, nurses, nurse practitioners, pharmacists, physicians, and physician assistants f hospital systems and affiliated health science schools in Georgia, Maryland, South Carolina, and Wisconsin. Survey questions evaluated respondents' use and views of social media for educational purposes and workplace accessibility using a Likert scale (1 = strongly disagree, 5 = strongly agree). Nurses (75%), pharmacists (11%), and administrators (7%) were the most frequent respondents. Facebook® (27%), Pinterest® (17%), and Instagram® (17%) were the most frequently accessed social media platforms. Nearly 85% agreed or strongly agreed that social media can be an effective tool for educational purposes. Among those who had social media platforms, 43.0% use them for educational purposes. Pinterest® (30%), Facebook® (22%), LinkedIn® (16%), and Twitter® (14%) were most frequently used for education. About 50% of respondents had limited or no access to social media at work. Administrators, those with unlimited and limited work access, and respondents aged 20-29 and 30-39 years were more likely to agree that social media is an educational tool (OR: 3.41 (95% CI 1.31 to 8.84), 4.18 (95% CI 2.30 to 7.60), 1.66 (95% CI 1.22 to 2.25), 4.40 (95% CI 2.80 to 6.92), 2.14 (95% CI 1.53 to 3.01) respectively). Residents, physicians, and those with unlimited access were less likely to agree with allowing social media access at work for educational purposes only. Healthcare practitioners frequently utilize social media, and many believe it can be an effective educational tool in healthcare.


Assuntos
Educação Continuada/métodos , Pessoal de Saúde , Percepção , Mídias Sociais , Adulto , Feminino , Georgia/epidemiologia , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Disseminação de Informação/métodos , Internato e Residência/estatística & dados numéricos , Masculino , Maryland/epidemiologia , Profissionais de Enfermagem/educação , Profissionais de Enfermagem/psicologia , Profissionais de Enfermagem/estatística & dados numéricos , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Assistentes Médicos/educação , Assistentes Médicos/psicologia , Assistentes Médicos/estatística & dados numéricos , Médicos/psicologia , Médicos/estatística & dados numéricos , Mídias Sociais/normas , South Carolina/epidemiologia , Inquéritos e Questionários , Wisconsin/epidemiologia , Adulto Jovem
11.
Food Chem ; 316: 126234, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32036176

RESUMO

Plant-based polyphenolics have been reported to bestow health benefits when consumed, which are partially ascribed to their antioxidant activity. Yet, many current in vitro chemical assays to characterize antioxidant potential do not truly reflect the physiological properties of food antioxidants in vivo. The present study employed biological approaches, including a cellular antioxidant activity (CAA) and protein glycation assays, to offer an improved picture of antioxidant potential of phenolic extracts from Georgia peach cultivars. The phenolic extracts from two peach varieties, showing contrasting antioxidant capacities according to hydrophilic-oxygen radical absorbance capacity (H-ORACFL) and ferric reducing antioxidant power (FRAP) assays, exhibited significant differences in two biological tests when the assays were performed on a fresh weight basis. The procyanidins fraction displayed notable antioxidant capacity, when compared to other phenolic classes in the peach extract, in these two biologically relevant assays.


Assuntos
Antioxidantes/química , Prunus persica/química , Antioxidantes/farmacologia , Células CACO-2 , Georgia , Humanos , Fenóis/química , Proantocianidinas/química
12.
Artigo em Inglês | MEDLINE | ID: mdl-32033227

RESUMO

Women diagnosed with breast cancer at a relatively early age (≤45 years) or with bilateral disease at any age are at elevated risk for additional breast cancer, as are their female first-degree relatives (FDRs). We report on a randomized trial to increase adherence to mammography screening guidelines among survivors and FDRs. From the Georgia Cancer Registry, breast cancer survivors diagnosed during 2000-2009 at six Georgia cancer centers underwent phone interviews about their breast cancer screening behaviors and their FDRs. Nonadherent survivors and FDRs meeting all inclusion criteria were randomized to high-intensity (evidence-based brochure, phone counseling, mailed reminders, and communications with primary care providers) or low-intensity interventions (brochure only). Three and 12-month follow-up questionnaires were completed. Data analyses used standard statistical approaches. Among 1055 survivors and 287 FDRs who were located, contacted, and agreed to participate, 59.5% and 62.7%, respectively, reported breast cancer screening in the past 12 months and were thus ineligible. For survivors enrolled at baseline (N = 95), the proportion reporting adherence to guideline screening by 12 months post-enrollment was similar in the high and low-intensity arms (66.7% vs. 79.2%, p = 0.31). Among FDRs enrolled at baseline (N = 83), screening was significantly higher in the high-intensity arm at 12 months (60.9% vs. 32.4%, p = 0.03). Overall, about 72% of study-eligible survivors (all of whom were screening nonadherent at baseline) reported screening within 12 months of study enrollment. For enrolled FDRs receiving the high-intensity intervention, over 60% reported guideline screening by 12 months. A major conclusion is that using high-quality central cancer registries to identify high-risk breast cancer survivors and then working closely with these survivors to identify their FDRs represents a feasible and effective strategy to promote guideline cancer screening.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Detecção Precoce de Câncer , Programas de Rastreamento/métodos , Cooperação do Paciente , Adulto , Aconselhamento , Feminino , Georgia , Humanos , Pessoa de Meia-Idade , Sistema de Registros , Inquéritos e Questionários , Telefone
13.
Int J Syst Evol Microbiol ; 70(4): 2420-2425, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32100691

RESUMO

Yeast strains belonging to a novel anamorphic yeast species were isolated from subsoil groundwater contaminated with hydrocarbons in a metal working factory located in northern Spain, and from a human infection in the USA. Comparison of ITS sequences between the isolates revealed 0.2 % divergence between the Spanish isolates and 0.46 % divergence between those and the USA isolate. Phylogenetic analysis based on the D1/D2 domains of the LSU rRNA gene showed that these isolates belong to the Wickerhamiella clade with W. sorbophila and W. infanticola as their closest relatives. Sequence divergence between the new isolates and W. sorbophila and W. infanticola was 1.97 and 1.79 %, respectively. The isolates in the novel species are not fermentative and pseudohyphae were not produced. Sexual reproduction was not observed for individual isolates or in mixtures of isolates. Conjugation between the isolates in the novel species and close relatives W. sorbophila and W. infanticola was not observed. These data support the proposal of Wickerhamiella verensis as a novel species, with CECT 12028T as the holotype.


Assuntos
Água Subterrânea/microbiologia , Micoses/microbiologia , Filogenia , Saccharomycetales/classificação , DNA Fúngico/genética , Fermentação , Georgia , Humanos , Hidrocarbonetos , Lactente , Técnicas de Tipagem Micológica , Saccharomycetales/isolamento & purificação , Análise de Sequência de DNA , Espanha , Poluentes Químicos da Água
14.
BMC Public Health ; 20(1): 125, 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-31996181

RESUMO

BACKGROUND: Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation. METHODS: Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact of gender minority status, and substance use behaviors as potential mediators for the relationship between perceived stigma and suicidal ideation. All models were controlled for age, race, education, and homelessness. RESULTS: Suicidal ideation was reported by 33% (N = 30) of the study participants. In multivariable analysis, suicidal ideation was associated with sexual abuse (AOR = 3.17, 95% CI = 1.10-9.30), anxiety (AOR = 1.74, 95% CI = 1.10-2.73), family verbal abuse (AOR = 2.99, 95% CI = 1.10-8.40), stranger verbal abuse (AOR = 3.21, 95% CI = 1.02-10.08), and psychosocial impact of gender minority status (AOR = 3.42, 95% CI = 1.81-6.46). Partner support was found to be the protective factor for suicidal ideation (AOR = 0.34, 95% CI = 0.13-0.90). In the mediation analysis, the psychosocial impact of gender minority status mediated the relationship between perceived stigma and suicidal ideation. The estimated conditional indirect effect was 0.46, (95% CI = 0.12-1.11). CONCLUSION: Interventions that aim to reduce suicidal behaviors among TGW should address stigma, psychosocial impact of gender minority status, and different forms of violence and abuse.


Assuntos
Estigma Social , Ideação Suicida , Pessoas Transgênero/psicologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Georgia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Pessoas Transgênero/estatística & dados numéricos , Adulto Jovem
15.
Int J Biometeorol ; 64(4): 643-650, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31897699

RESUMO

Many high school associations in recent years are developing policies to improve player safety regarding exertional heat illnesses (EHIs). A question is whether states with diverse climates need multiple sets of guidelines with different activity modification thresholds. We examine this question in the state of Georgia, which has a diverse climate. Our study leverages a multi-year dataset of exertional heat illnesses (EHIs) among high school football players to test the hypothesis that EHI rates under similar wet bulb globe temperatures (WBGTs) will be greater among athletes in the cooler, northern region versus warmer, southern region of the state. The focus of this study is on a 3-year period (2012-2014) when uniform heat safety polices, including acclimatization and activity modification guidelines, were implemented across the state. Results show that athletes in the northern region acclimatize to cooler conditions. Almost 68% of practices have WBGTs < 27.8 °C (82 °F) compared to the southern region where athletes receive many times the exposures to hotter WBGTs in the 27.8-30.5 °C and 30.6-32.2 °C categories. In the post-acclimatization period, we observed statistically significantly (p < .05) greater EHI rates among athletes in the northern region of the state, even when controlling for meteorological conditions. Our findings suggest that differential acclimatization between football players in the northern and southern regions of the state is impacting EHI rates and that regional heat safety guidelines may be needed in Georgia and other states with similarly diverse climates.


Assuntos
Futebol Americano , Transtornos de Estresse por Calor , Futebol , Georgia , Temperatura Alta , Humanos , Instituições Acadêmicas
16.
Arch Sex Behav ; 49(1): 185-193, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31950381

RESUMO

There is a disproportionately high HIV incidence among Black men who have sex with men (MSM) despite equal or lower levels of HIV risk behaviors compared to White MSM. Due to high levels of racial segregation in the U.S., Black MSM have an elevated likelihood of living in neighborhoods that contain psychosocial stressors, which, in turn, may increase behaviors promoting HIV infection. We examined associations between perceived neighborhood problems and sexual behaviors among Black MSM in the Deep South, a population at highest risk of HIV. Data came from the MARI Study, which included Black MSM ages 18-66 years recruited from the Jackson, MS, and Atlanta, GA, metropolitan areas (n = 377). Participants completed questions about neighborhood problems (e.g., excessive noise, heavy traffic/speeding cars and trash/litter) and sexual behaviors (e.g., condomless sex and drug use before or during sex). We used Poisson's regression model with robust standard errors to estimate the adjusted prevalence ratio (aPR; 95% confidence intervals [CI]) of neighborhood problems (coded as tertiles [tertile 1 = low neighborhood problems, tertile 2 = medium neighborhood problems, tertile 3 = high neighborhood problems] as well as continuously) with sexual behaviors, after adjustment for sociodemographic characteristics and other variables. About one-fourth of the sample reported at least one neighborhood problem, with the most common (31.6%) being no/poorly maintained sidewalks, which indicates an infrastructural problem. In multivariable models, compared to those in the lowest tertile, those reporting more neighborhood problems (tertile 2: aPR = 1.49, 95% CI = 1.04, 2.14 and tertile 3: aPR = 1.53, 95% CI = 1.05, 2.24) reported more drug use before or during sex (p for trend = .027). Neighborhood problems may promote behaviors (e.g., drug use before or during sex) conducive to HIV infection. Structural interventions could improve community infrastructure to reduce neighborhood problems (e.g., no/poorly maintained sidewalks and litter). These interventions may help to reduce HIV incidence among Black MSM in the Deep South.


Assuntos
Afro-Americanos/psicologia , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Características de Residência/estatística & dados numéricos , Comportamento Sexual/psicologia , Adolescente , Adulto , Idoso , Georgia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Mississippi/epidemiologia , Prevalência , Adulto Jovem
17.
Sex Reprod Health Matters ; 28(1): 1686201, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31892281

RESUMO

Fetal "heartbeat" bills have become the anti-abortion legislative measure of choice in the US war on sexual and reproductive health and rights (SRHR). In 2019, Georgia House Bill 481 (HB 481) passed by a narrow margin banning abortions upon detection of embryonic cardiac activity, as early as six weeks gestation. The purpose of this study was to distinguish and characterise the arguments and tactics used by legislators and community members in support of Georgia's early abortion ban. Our data included testimony and debate from House Health and Human Services and the Senate Science and Technology Committees; data were transcribed verbatim and coded in MAXQDA 18 using a constant comparison method. Major themes included: the use of the "heartbeat" as an indicator of life and therefore personhood; an attempt to create a new class of persons - fetuses in utero - entitled to legal protection; and arguments to expand state protections for fetuses as a matter of state sovereignty and rights. Arguments were furthered through appropriation by misrepresenting medical science and co-opting the legal successes of progressive movements. Our analysis provides an initial understanding of evolving early abortion ban strategy and its tactics for challenging established legal standards and precedent. As the battle over SRHR wages on, opponents of abortion bans should attempt to understand, deconstruct, and analyse anti-abortion messaging to effectively combat it. These data may inform their tactical strategies to advance sexual and reproductive health, rights, and justice both in the US context and beyond.


Assuntos
Aborto Induzido/legislação & jurisprudência , Início da Vida Humana , Regulamentação Governamental , Direitos Humanos/legislação & jurisprudência , Pessoalidade , Feminino , Viabilidade Fetal , Georgia , Humanos , Gravidez , Gestantes
19.
Environ Entomol ; 49(1): 88-97, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-31904078

RESUMO

Megacopta cribraria (F.) (Hemiptera: Plataspidae) is an invasive pest of soybean that has spread across the southeastern United States since its initial discovery in 2009 in Georgia. Previous studies in the southeastern states have documented both the population dynamics of this pest and host plant resistance (HPR) among soybean varieties, although the specific mechanisms of HPR remain unknown. The objectives of this study were, therefore, to 1) quantify field resistance to M. cribraria in multiple soybean varieties in two states previously affected by severe M. cribraria infestations, North Carolina (NC) and South Carolina (SC); and 2) study the role of soybean trichome density in imparting resistance against M. cribraria. Soybean variety 'Camp' was least attractive to M. cribraria, through time and locations, suggesting consistent resistance. Other varieties showed variable performance among the locations and sampling dates. A significant difference in trichome density was evident. However, there was no correlation between trichome density and M. cribraria infestation. Compared to a previously published study in the same location, when M. cribraria adults emerging from overwintering dispersed into soybeans, in our study only first-generation adults dispersed into soybeans. Considering the current trend of significantly lower M. cribraria infestation rates in North and South Carolina, this pest may be finally succumbing to indigenous natural enemies and should be managed by incorporating integrated pest management tactics, such as HPR, that help conserve natural enemy populations.


Assuntos
Heterópteros , Soja , Animais , Georgia , North Carolina , Ninfa , South Carolina , Tricomas
20.
J Vet Diagn Invest ; 32(1): 166-168, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31916501

RESUMO

Porcine rabies is exceedingly rare worldwide. We describe herein the neuropathology and the diagnostic features of an outbreak of rabies in a litter of piglets attacked by a skunk in Georgia, United States. Rabies viral infection was confirmed in 2 of 3 piglets submitted for testing. Inflammatory and degenerative changes were more prominent in the brainstem and consisted of lymphoplasmacytic meningoencephalitis with glial nodules, neuronal necrosis, and neuronophagia. No viral inclusions (Negri bodies) were observed in multiple sections of brain. A fluorescent antibody test on fresh samples of brainstem and cerebellum was confirmatory for the eastern United States raccoon rabies virus variant. Immunoreactivity for rabies virus was detected across all brain sections in both cases but was more prominent in the thalamic and brainstem nuclei, as well as in the medial lemniscus. Rabies is an important differential diagnosis in pigs with neurologic disease.


Assuntos
Raiva/veterinária , Doenças dos Suínos/virologia , Animais , Encéfalo/patologia , Encéfalo/virologia , Georgia/epidemiologia , Raiva/diagnóstico , Raiva/epidemiologia , Vírus da Raiva/classificação , Vírus da Raiva/isolamento & purificação , Suínos , Doenças dos Suínos/diagnóstico , Doenças dos Suínos/epidemiologia , Estados Unidos
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