A rare urinary tract infection of multidrug-resistant Chryseobacterium urinae sp. nov. isolated from a diabetic, non-catheterized patient

Chryseobacterium demonstrates a diverse environmental presence and a significant pathogenic potential across various ecosystems. This clinical case showcases a rare instance of bacterial infection in a 75-year-old male with untreated diabetes and recurrent urinary tract infections (UTIs). The patient presented symptoms of abdominal pain, burning urination, fever, and an elevated eosinophil count. A subsequent urine culture identified a Chryseobacterium-related bacterium as the causative agent, exhibiting sensitivity to piperacillin/tazobactam, trimethoprim/sulfamethoxazole, and nitrofurantoin, which led to successful treatment using oral nitrofurantoin. Analysis of the 16S rRNA gene sequence of APV-1T revealed a close relationship of 98.2% similarity to Chryseobacterium gambrini strain 5-1St1aT (AM232810). Furthermore, comparative genome analysis, incorporating Average Nucleotide Identity (ANI), Digital DNA-DNA Hybridization (dDDH) values, and comprehensive phylogenetic assessments utilizing 16S rRNA gene sequences, core genes, and amino acid sequences of core proteins, highlighted the unique phylogenetic positioning of APV-1T within the Chryseobacterium genus. Distinct carbon utilization and assimilation patterns, along with major fatty acid content, set APV-1T apart from C. gambrini strain 5-1St1aT. These findings, encompassing phenotypic, genotypic, and chemotaxonomic characteristics, strongly support the proposal of a novel species named Chryseobacterium urinae sp. nov., with APV-1T designated as the type strain (= MCC 50690 = JCM 36476). Despite its successful treatment, the strain displayed resistance to multiple antibiotics. Genomic analysis further unveiled core-conserved genes, strain-specific clusters, and genes associated with antibiotic resistance and virulence. This report underscores the vital importance of elucidating susceptibility patterns of rare pathogens like Chryseobacterium, particularly in immunocompromised individuals. It advocates for further analyses to understand the functional significance of identified genes and their implications in treatment and pathogenesis.

Sex determination using mandibular ramus flexure in South Indian population - A retrospective study

Sex determination or sex estimation from a single or fragment of bone is always difficult in the absence of other bones from the same individual. The current study was an attempt to estimate the sex of an individual from the posterior ramus of mandible or the mandibular ramus flexure. A retrospective study was conducted using orthopantomographs (OPGs) of 200 males and 200 females between the age group of 20 - 70 years. Each radiographic image was examined for the presence of a flexure or notching on the posterior border of the ramus in relation to occlusal plane as the method followed by Loth & Henneberg 1996.The study resulted in samples that were correctly classified as females 59.5% and males 57.5 %. The overall correct sex estimation was achieved in 58.5% of the cases. The predictive accuracy or assessment was higher for females compared to males. Consequently, the posterior ramus of mandible or mandibular ramus flexure can be considered as supplementary rather than a definitive means of sex determination. Hence, it is preferable to include as many parameters as possible to attain optimal accuracy.

Comparative Evaluation of Postoperative Pain in Primary Teeth Obturated With Zinc Oxide Eugenol versus Metapex: A Randomized Clinical Trial

The fundamental objective of pulp treatment is to preserve the integrity and health of oral tissues. Pulp necrosis or irreversible pulpitis is the key indication for performing pulpectomy in primary teeth. It can be performed as a single-visit or multi-visit procedure using suitable obturating material. Various obturating materials can be used like zinc-oxide eugenol or metapex. A controversy reflects in literature and among experts in regard to single-visit or multi-visit endodontics. Hence, the purpose of this randomized clinical trial is to assess the incidence of postoperative pain with zinc oxide eugenol and metapex as an obturating material in single-visit and multiple-visit pulpectomy. The study was conducted at M S Ramaiah Dental College and Hospital, Bangalore in one year duration from 2020 to 2021. Two groups of children, forty in each group, aged between four to eight years, were included in the study. Groups were divided to perform single-visit and multi-visit endodontics with zinc-oxide eugenol and metapex as obturating material. The sample size of 40 were considered and allocated to respective group by concealment allocation. The conventional pulpectomy procedure was carried out. The post operative pain was assessed by using the pain scale through the telephonic conversation with the patient within 24 hours of treatment. Proportions were compared using Chi-square test of significance and the "p" value of less than 0.05 indicates statistical significance. The results showed, no statistically significant difference in teeth obturated with zinc oxide eugenol and metapex in both single-visit and multi-visit pulpectomy. The comparison of zinc oxide eugenol and metapex in single-visit group and multi-visit group had a 'p' value of 0.9233 and 0.4233 respectively. There were no differences between single and multi-visit treatment protocols with respect to the incidence of post operative pain. Single visit pulpectomy can be performed with added advantages with either zinc oxide eugenol or metapex.

Use of Artificial Intelligence in the Indian Insurance Sector, including Healthcare Companies

This research aims to understand better the application of Artificial Intelligence (AI) cases in the insurance industry, including healthcare companies. In particular, we want to expand the size and market penetration of AI in insurance markets to boost customer satisfaction in the insurance industry. The analytical model attempts to define the relationship between AI and its implementation in the insurance industry. Rigorous research to test the definition was carried out through a sample of international corporations and insurance firms. This work presents various practical findings that insurance companies consider quite useful when responding to dissatisfied customers and certain organizational concerns. This paper aims to identify the challenges and enablers that have evolved in the context of artificial intelligence adoption, specifically in the finance sector, and to analyze the impact of this disruptive technology on the organization’s financial performance and market capitalization. The findings indicate that, in addition to the various risks and challenges associated with artificial intelligence adoption, it is critical for all financial institutes or companies involved in financial tasks to adopt artificial intelligence to compete globally.

Combination of Cytopathology and DNA Ploidy Increases the Performance of Oral Epithelial Dysplasia Prediction in Oral Potentially Malignant Disorders

Background: Grading of oral epithelial dysplasia (OED) by a pathologist is currently the key guide used for treatment planning of oral potentially malignant disorders (OPMDs). Conventional oral examination (COE) clinically detects OPMDs but may not predict their risk status to transform to cancer. Therefore, there is a need for a reliable test to predict OED in OPMDs. Aim: This study was conducted to evaluate COE, liquid based cytology (Cytopath) and DNA image cytometry (Ploidy) in predicting OED in OPMDs. Methods: A total of 179 patients from Malaysia, India and Indonesia underwent COE followed by brush biopsies and scalpel biopsies. Brush-biopsy samples were analyzed for cytopathology and DNA ploidy at Dental Faculty, University of Malaya. Histopathological findings of presence/absence of OED were used as the reference standard. Calculations for sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy (A) were done for individual tools and in combinations. The Youden index (Sn+Sp-1) was used as a measure of overall performance. The relevant medical ethics committees of the different research locations approved the study. Results: For COE, the sensitivity (Sn) was high (100%) and the specificity (Sp) was low (5.9%), while both Cytopath and Ploidy showed a low sensitivity (Sn) (28.6% and 22.2%) and high specificity (Sp) (94.3% and 82.3%). All 3 tools individually have high negative predictive value (NPV) for predicting presence of OED (COE-100%, Cytopath-66.7%, Ploidy-78.5%). When combining outcomes from all 3 tools, the best performance indicated by Youden index (42.1) is which defines a positive case when both COE and Cytopath show abnormal. In general, using results from at least 2 tools had better Youden indices than using these tools individually. Conclusion: COE as a screening tool by virtue of its high Sn would be a suitable first level diagnostic test, while the Cytopath and the Ploidy individually with high Sp may be used as a second level test to predict presence of OED. Combining the COE with cytopathology would be the best combination for a high performance of the tools. Cytopathology (when performed by a trained cytologist) would allow for most of the false positives from the first level test to be correctly identified as true negative at the second level. Longitudinal data are needed to assess which of these may correctly identify the malignant potential of OPMDs. Acknowledgment: Grant: High Impact Research - Ministry of Higher Education (HIR-MOHE UM000025/C3)

Hydraulic and hydrogeochemical characteristics of a riverbank filtration site in rural India

A riverbank filtration (RBF) system was tested along the Kali River in rural part of the state of Karnataka in India. The polluted river and water from open wells served the local population as their principal irrigation water resource and some used it for drinking. Four RBF wells (up to 25 m deep) were installed. The mean hydraulic conductivity of the well field is 6.3 x 10(-3) cm/s and, based on Darcy's law, the water travel time from the river to the principal RBF well (MW3) is 45.2 days. A mixing model based on dissolved silica concentrations indicated that, depending on the distance from the river and closeness to irrigated rice fields, approximately 27 to 73% of the well water originated from groundwater. Stable isotopic data indicates that a fraction of the water was drawn in from the nearby rice fields that were irrigated with river water. Relative to preexisting drinking water sources (Kali River and an open well), RBF well water showed lower concentration of dissolved metals (60.1% zinc, 27.8% cadmium, 83.9% lead, 75.5% copper, 100% chromium). This study demonstrates that RBF technology can produce high-quality water from low-quality surface water sources in a rural, tropical setting typical for many emerging economies. Further, in parts of the world where flood irrigation is common, RBF well water may draw in infiltrated irrigation water, which possibly alters its geochemical composition. A combination of more than one mixing model, silica together with stable isotopes, was shown to be useful explaining the origin of the RBF water at this study site.

Carcinogenesis by the cultivated baked Agaricus bisporus mushroom in mice

The mushroom of commerce in the Western hemisphere, Agaricus bisporus, was administered orally to Swiss mice that were 6 weeks old at the start of the experiment The mushrooms were baked at 220-230 degrees C for 10 min. Subsequently, the mushrooms were fed to the animals for 3 days and were followed by a semisynthetic diet for 4 days each week, for life. The treatment induced tumors in the forestomach, glandular stomach, duodenum, and ovaries in the following incidences: 20, 12, 14 and 12% in females and 16, 20, 4 and 0% in males. In the tissues of the untreated controls, only an ovarian tumor was found in a female. Histopathologically, the neoplasms were classified as squamous cell papillomas and carcinomas of the forestomach, and adenomas and adenocarcinomas of the glandular stomach, duodenum, and ovaries. Since Agaricus bisporus is mainly eaten in baked form in the United States, the findings may carry useful implications.

Infraorbital ethmoid (Haller's) cells: a panoramic radiographic study

OBJECTIVE

Haller's cells or infraorbital ethmoid cells refer to the ethmoidal pneumatization of the superior aspect of the maxillary sinus and floor of the orbit. The clinical importance of these entities initiated this study with an aim to determine the prevalence and characteristics of Haller's cells on panoramic radiographs.

METHODS

The study group comprised 600 healthy adults of both genders with an age range of 18-60 years. One panoramic radiograph for each of the patients was made and interpreted for the presence of Haller's cells. The data collected were subjected to statistical analysis: frequencies/percentages, descriptive statistics, χ(2) test and cross-tabulation (contingency table analysis) to obtain the results.

RESULTS

Haller's cells were noted in 96 patients, accounting for a prevalence of 16%. Of these patients, 77.1% were unilateral while 22.9% were bilateral. Among 96 cases, a total of 204 cells were found. The majority of the cells were round or ovoid in shape. The unilocular type of Haller's cells occurring unilaterally was statistically significant.

CONCLUSION

This study has attempted to explore the characteristics of Haller's cells on panoramic radiographs. A description of Haller's cells on these radiographs may prove vital in enumerating the differential diagnosis for patients afflicted with intractable orofacial pain and reduce the risk of untoward intraoperative complications during endonasal procedures.

Overcoming the challenges of robot-assisted radical prostatectomy

Robot-assisted radical prostatectomy (RARP) is the most commonly performed robotic procedure worldwide and is firmly established as a standard treatment option for localised prostate cancer. Part of the explanation for the rapid uptake of RARP is the reported gentler learning curve compared with the challenges of laparoscopic radical prostatectomy (LRP). However, robotic surgery is still fraught with potential difficulties and avoiding complications while on the steepest part of the learning curve is critical. Furthermore, as surgeons progress there is a tendency to take on increasingly complex cases, including patients with difficult anatomy and prior surgery, and these cases present a unique challenge. Significant intra-abdominal adhesions may be identified following open surgery, or dense periprostatic inflammation may be encountered following TURP; large prostate gland size and median lobes may alter bladder neck anatomy, making difficult subsequent urethro-vesical anastomosis. Even experienced robotic surgeons will be challenged by salvage RARP. Approaching these problems in a structured manner allows many of the problems to be overcome. We discuss some of the specific techniques to deal with these potential difficulties and highlight ways to avoid making serious mistakes.

Enantiomeric LC separation of valsartan on amylose based stationary phase

A simple, rapid and robust LC method was developed and validated for the enantiomeric separation of valsartan in bulk drug and formulation. The enantiomers of valsartan were resolved on a Chiralpak AD-H (amylose based stationary phase) column using a mobile phase consisting of n-hexane: 2-propanol: trifluoroacetic acid (85:15:0.2, v/v/v) at a flow rate of 1.0 mL/min. The resolution between the enantiomers was found to be not less than 3.2. The presence of trifluoroacetic acid in the mobile phase played an important role in enhancing chromatographic efficiency and resolution between the enantiomers. The calibration curve for the (R)-enantiomer showed excellent linearity over the concentration range of 600 ng/mL (LOQ) to 6000 ng/mL. The limit of detection and limit of quantification for the (R)-enantiomer were 200 and 600 ng/mL, respectively. The percentage recovery of the (R)-enantiomer ranged between 98.7 to 100.05 % in bulk drug samples of valsartan. The proposed method was found to be suitable and accurate for quantitative determination of (R)-enantiomer in bulk drug substance.

A pain in the neck -- an unexpected complication of transrectal ultrasound and biopsy

In the UK, over 26 000 cases of prostate cancer are diagnosed annually, with many more patients undergoing investigation. Prostate-specific antigen (PSA) testing and its interpretation has always been controversial. Many patients undergo PSA-driven biopsies, which can cause significant morbidity. We report an unusual but severe complication following transrectal ultrasound and biopsy.

White spongy nevus: a nonhereditary presentation

White spongy nevus (WSN) is a rare hereditary dyskeratotic hyperplasia of the mucous membranes. It is an autosomal dominant disorder with variable penetrance. A few cases of WSN occur due to de novo mutations. We report a case of WSN in a 12-year-old female child, with none of her family members having similar lesions.

A putative gene located at the MHC class I region around the D6S105 marker contributes to the setting of CD8+ T-lymphocyte numbers in humans

Significant associations between human leucocyte antigen (HLA)-A and -B alleles and CD8+ T-lymphocyte numbers have been reported in the literature in both healthy populations and in HFE-haemochromatosis patients. In order to address whether HLA alleles themselves or alleles at linked genes are responsible for these associations, several genetic markers at the MHC class I region were typed on a population of 147 apparently healthy unrelated subjects phenotypically characterized for their CD8+ and CD4+ T-lymphocyte numbers. By using a machine learning approach, a set of rules was generated that predict the number of CD8+ T-lymphocyte numbers on the basis of the information of the D6S105 microsatellite alleles only. We demonstrate that the previously reported associations with HLA-A and -B alleles are due to the presence of common long (up to 4 megabases long) haplotypes that increased in frequency recently due to positive selection and that encompass a region where a putative gene contributing to the setting of CD8+ T lymphocytes is located, in the neighbourhood of microsatellite locus D6S105, in the 6p21.3 region.

Burkitt's lymphoma in an Indian girl: a case report

Burkitt's lymphoma (BL) is a rare monoclonal proliferation of B-lymphocytes and is classified as a poorly differentiated lymphocytic lymphoma. This tumor was first noted in Africans. The cause of this tumor is debatable, but strong evidence implicates Epstein-Barr virus in its development. This tumor predominantly affects children and is probably the fastest growing tumor in humans, with exuberant proliferation. It is a very rare malignancy accounting for only 0.76% of solid malignant tumors among Indian children. A case of BL of the mandible in a 9-year-old girl of Indian origin is reported.

A selected review and personal experience with robotic prostatectomy: implications for adoption of this new technology in the United Kingdom

Robot-assisted laparoscopic prostatectomy (RALP) is a rapidly evolving technique for the treatment of localized prostate cancer. However, cynics point to the increasing role of market forces in the robotic revolution. As yet, Europe has not taken up RALP in large numbers and this may in part relate to the high level of expertise in laparoscopy previously gained. Furthermore, setting up a robotic programme is a major undertaking for many surgical units. This review discusses some of the challenges in the development of a robotic service drawn from personal experience within the United Kingdom. Furthermore, available data on RALP versus open and laparoscopic approaches are reviewed for surgical and cancer-related outcomes. Preliminary data appear to show an advantage over open prostatectomy with reduced blood loss, decreased pain and early mobilisation and shorter hospital stay. Most intra-institutional studies demonstrate better postoperative continence and potency with RALP; however, this needs to be viewed in the context of a paucity of randomized data available in the literature. There is no definitive data to show an advantage over standard laparoscopic surgery, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging: with continued experience, the hope is that results will continue to improve.

Facial plexiform neurofibroma in a child with neurofibromatosis type I: a case report

Plexiform neurofibroma is a non-circumscribed, thick and irregular benign tumor of the peripheral nerve sheath. It is a virtually pathognomonic and often disabling feature of neurofibromatosis type I. The diffuse and soft nature of plexiform neurofibroma is often compared to 'a bag of worms' and is difficult to distinguish from a vascular malformation or a lymphangioma, thus necessitating thorough clinical and histopathological examination and imaging of the lesion. We present a case of plexiform neurofibroma in a 12-year-old male child.

Botulinum toxin and the overactive bladder

Botulinum toxin is now a treatment for many conditions. It is undergoing increasing use in several different unlicensed urological clinical situations which are outlined in this article. The article discusses the available evidence relating to its use, effectiveness and safety.

Botulinum toxin and the overactive bladder

Botulinum toxin is now a treatment for many conditions. It is undergoing increasing use in several different unlicensed urological clinical situations which are outlined in this article. The article discusses the available evidence relating to its use, effectiveness and safety.

Gorlin syndrome: a case report

Gorlin syndrome is an autosomal dominant inherited condition that exhibits high penetrance and variable expressivity. It is characterized mainly by Basal cell carcinomas, Odontogenic keratocysts and skeletal anomalies. However, medical literature documents both common and lesser known manifestations of the disorder involving the skin, central nervous system, skeletal system etc. Diagnosis of the syndrome in childhood is basically through oral abnormalities. A case of Gorlin syndrome has been reported here, with review of literature.

Juvenile aggressive cemento-ossifying fibroma. A case report

Juvenile Aggressive Cemento-Ossifying Fibroma is a benign, fibro osseous neoplasm commonly affected maxilla but also other bones including mandible, arising in children. It is considered to be a locally aggressive and quickly expansile lesion. Because of its aggressive nature and high recurrence rate, an early detection and a complete surgical excision is essential. A case of Juvenile Aggressive Cemento-Ossifying Fibroma in a 9 year old male child who visited the Department of Oral Medicine and Radiology, J.S.S. Dental college and Hospital, Mysore is being reported and discussed.

Juvenile aggressive cemento-ossifying fibroma. A case report

Juvenile Aggressive Cemento-Ossifying Fibroma is a benign, fibro osseous neoplasm commonly affecting maxilla but also other bones including mandible, arising in children. It is considered to be a locally aggressive and quickly expansile lesion. Because of its aggressive nature and high recurrence rate, an early detection and a complete surgical excision is essential. A case of Juvenile Aggressive Cemento-Ossifying Fibroma in a 9 year old male child who visited the Department of Oral Medicine and Radiology, J.S.S. Dental College and Hospital, Mysore is being reported and discussed.

Independent association between plasma leptin levels and heart rate in heart transplant recipients

BACKGROUND

Leptin, the protein product of the ob gene, has been linked to a faster heart rate in animal and human studies. The interaction between leptin and heart rate in the denervated heart is not known. Therefore, we studied the relationship between plasma leptin levels and heart rate in heart transplant recipients.

METHODS AND RESULTS

We studied 32 male patients (mean age, 56.5+/-9.3 years; range, 41 to 74 years) after orthotopic heart transplantation. All subjects underwent a physical examination, anthropometric measurements, blood chemistry analysis, and office blood pressure measurements. A blood sample was collected from each subject while fasting. In univariate analysis, heart rate was related to leptin levels (r=0.47, P=0.007) but heart rate was not related to systolic or diastolic blood pressure, mean arterial pressure, body mass index, or catecholamines. Leptin levels were only strongly associated with heart rate and body mass index (r=0.73, P<0.0001). In multivariate analysis, heart rate was independently and positively associated with leptin levels (F=2.61, P=0.017). We also observed a strong, independent association between leptin levels and body mass index (F=5.8, P<0.00001).

CONCLUSIONS

We show an independent association between leptin levels and heart rate in heart transplant recipients. We speculate that this may be due, in part, to a direct effect of leptin on heart rate, conceivably mediated through cardiac leptin receptors.

Health status and access to care among rural minorities

This paper provides a review of the scholarly and applied literature published between 1970 and 1993 on health and health care access problems among racial and ethnic minority group members living in rural U.S. areas. Results on the distribution of specific illnesses and diseases, and utilization of medical services are summarized for two major minority groups--African Americans and Hispanic Americans. Findings generally document the expected pattern of rural and minority disadvantage. A review of the conceptual and methodological limitations of existing research suggests that research does not yet permit any clear understanding of the underlying structures and processes that give rise to racial health disparities. Very little is known about the health of rural minorities living in some areas of the country, for example, the west north central United States (Kansas, Missouri, Nebraska, Iowa, North Dakota, South Dakota and Minnesota).

Lengthening spells of uninsurance and their consequences

The lengths of time adults are without health insurance have increased since 1988, as shown by data from 1,235 household interviews completed during 1992 in Nebraska. Rural residents without insurance have experienced longer such spells than their urban counterparts. Thus, while rates of uninsurance are nearly the same between urban and rural residents, important differences exist. The relationship between insurance status and physician utilization is consistent during the five years (1989 to 1993) covered in this study. Continuously insured persons have the most physician visits, followed by those intermittently insured, followed by those continuously uninsured. The number of physician visits was expected to increase when respondents moved from uninsured to insured status. However, among urban respondents, the number of visits declined; among residents in rural frontier counties (fewer than six person per square mile) and for respondents in rural nonfrontier counties, there was no significant difference. This study points out some differences between rural and urban populations regarding insurance status, even when the overall rates of uninsurance are equal.

Cancer induction studies using different administrations of benzenediazonium sulfate in mice

Benzenediazonium sulfate (BD) was administered as 10 weekly subcutaneous injections at 25 micrograms/g b.w. and as 52 weekly oral gavages at 100 micrograms/g b.w. to Swiss mice, starting at 6 weeks of age. The subcutaneous administration induced tumors in the subcutis with an incidence of 8% in females. The oral treatment gave rise to lung tumors with incidences of 52% in females and 62% in males. In the untreated control female mice, no subcutaneous tissue tumor was observed, but the incidences of lung tumors were 28% in females and 38% in males. Histopathologically, the neoplasms were classified as fibrosarcomas of the subcutis and adenomas and adenocarcinomas of the lungs. In an earlier experiment, BD induced high incidences of subcutaneous tissue tumors in the same species when it was administered as 26 weekly subcutaneous injections at 10 micrograms/g. This indicates the length of treatment is paramount to the dose of carcinogen. The oral route, even though it was carcinogenic in the lungs, failed to elicit the development of cancer in the glandular stomach.

Transdermal nicotine therapy and primary care. Importance of counseling, demographic, and participant selection factors on 1-year quit rates. The Nebraska Primary Practice Smoking Cessation Trial Group

OBJECTIVE

To evaluate the smoking cessation efficacy of nicotine patch therapy as an adjunct to low-intensity, primary care intervention.

DESIGN

Randomized, placebo-controlled, double-blind, multisite trial.

SETTINGS

Twenty-one primary care sites in Nebraska.

PATIENTS

A total of 369 smokers of 20 or more cigarettes per day.

INTERVENTION

Two brief primary care visits for smoking intervention with 10 weeks of active or placebo-patch therapy.

MAIN OUTCOME MEASURES

Confirmed self-reported abstinence 3, 6, and 12 months after the quit day.

RESULTS

Compared with placebo control subjects, participants assigned nicotine patches had higher 3-month (23.4% vs 11.4%; P < .01) and 6-month (18.5% vs 10.3%; P < .05) abstinence rates. The 1-year abstinence rates for the active and placebo patch groups were 14.7% and 8.7%, respectively (P = .07). Of smokers aged 45 years and older, 9 (18.8%) of 48 using active patches compared with 0 of 31 using placebo patches achieved 12-month abstinence (chi 2 = 6.56; P < .05). Among those with high nicotine dependency scores (Fagerstrom score > or = 7), 1-year abstinence rates were significantly higher in the nicotine patch group (19.1%) compared with the placebo group (5.0%) (chi 2 = 10.7; P = .001). However, there was no significant difference in 1-year quit rates for participants with low Fagerstrom scores (< 7).

CONCLUSIONS

Nicotine patch therapy enhanced 6 month quit rates as an adjunct to brief primary care intervention. The highest quit rates were achieved by participants who specifically contacted the site to enroll in the study or to obtain a prescription for nicotine patches. Differences in participant selection factors may account, in part, for the lower smoking cessation rates associated with primary care intervention. Duration of counseling, patient age, and Fagerstrom scores may be important factors related to the long-term smoking cessation success of nicotine patch therapy.

The role of uninsurance and race in healthcare utilization by rural minorities

OBJECTIVE

To examine the independent effects of minority status, residence, insurance status, and income on physician utilization, controlling for general health status and the presence of acute or chronic health problems. Of special interest was the question of utilization differences among rural minority populations, as compared with urban non-Latino whites.

DATA SOURCE

Data from the 1992 National Health Interview Survey (NHIS).

STUDY DESIGN

Multivariate analyses used multiple logistic regression methods to detect independent effects of residence and minority status on whether or not individuals used physician services.

DATA COLLECTION/EXTRACTION METHODS

Data were obtained from the National Health Interview Survey, 1992. The survey included information about the race/ethnicity of the respondent, health status, utilization of services, insurance status, and socioeconomic status.

PRINCIPAL FINDINGS

The most salient determinant of utilization of healthcare services is insurance status, regardless of race/ethnicity or (rural or urban) place of residence. Racial and ethnic minorities were less likely than whites to use physician services, and use was generally lower for rural residents. The most striking differences were for rural Latinos and rural Asians/other persons.

CONCLUSIONS

Although the results demonstrate a need to adjust policies designed to improve utilization by accounting for particular problems faced by minority populations, they also demonstrate the primacy of addressing financial access.

Carcinogenesis by benzenediazonium sulfate in mice

Benzenediazonium sulfate (BD) was given to Swiss mice by 26 subcutaneous injections of 10 micrograms/g body weight at weekly intervals. The treatment gave rise to tumors of the subcutis. The tumor incidences in the treated groups were 42% in females and 26% in males. The corresponding tumor incidences in the untreated controls were 0% in females and 2% in males. Histopathologically, the neoplasms were classified as fibrosarcomas, rhabdomyosarcomas, and osteosarcomas of the subcutaneous tissue. BD is formed during the cytochrome P-450 catalyzed metabolism of the carcinogenic 1-(phenylazo)-2-hydroxynaphthalene (Sudan I, Solvent Yellow 14), which was used as a coloring agent for food and other materials in several countries. Further, BD is a metabolic breakdown product of different classes of nitrogen-nitrogen bond- containing chemicals. BD is the fourth benzenediazonium salt found to be carcinogenic in this laboratory.