Rheumatic fever and rheumatic heart disease; incidence in California

The statistics quoted in this and other published reports appear to substantiate the impression that rheumatic fever in California, although still an important public health problem which varies widely from one locality to another, is of lower incidence and perhaps of more benign character than in most other parts of the United States. It also appears that in California aortic insufficiency may be of higher relative incidence and occurs more frequently as a clinically diagnosable sequel of rheumatic fever than does classical mitral stenosis. Congenital defects of the heart constitute a large proportion of the cases of organic heart disease in children and young adults in this state.     

The California morbidity survey; a progress report

In May of 1954 the California State Department of Public Health began a one-year household sample survey covering the health status of the population of California. Preliminary results from the survey indicate that chronic conditions cause approximately three-quarters of the disability in the California population, while acute conditions are responsible for the remainder. Acute upper respiratory tract disorders account for about half of the total disability from acute conditions. In the older population group, there is a greater amount of disability outside than within metropolitan areas. No significant differences in disability status appear between recent migrants to California and longer term residents. Forthcoming results from the survey, answering more detailed questions, will provide information needed by a number of private and state agencies.     

Tuberculosis; recent trends in infection,disease and deaths in California

Although fewer patients with tuberculosis are reported in a far advanced stage of the disease than ever before, the proportion of persons dying of tuberculosis whose disease had not previously been diagnosed appears to be increasing. The average length of sanatorium treatment, and the intramural case fatality rates have not shown much decrease. Tuberculosis mortality rates fall during economic depressions and rise with business booms. Epidemics of influenza do not always increase tuberculosis death rates. Common claims to the contrary are not sustained by recent California data.     

Water relations of climbing ivy in a temperate forest

Ivy (Hedera helix) is the most important liana in temperate European forests. We studied water relations of adult ivy in a natural, 35 m tall mixed deciduous forest in Switzerland using a construction crane to access the canopy. Predawn leaf water potential at the top of climbing ivy ranged from −0.4 to −0.6 MPa, daily minima ranged from −1.3 to −1.7 MPa. Leaf water potentials as well as relative sap flow were held surprisingly constant throughout different weather conditions, suggesting a tendency to isohydric behaviour. Maximum stomatal conductance was 200 mmol m⁻² s⁻¹. The use of a potometer experiment allowed us to measure absolute transpiration rates integrated over a whole plant of 0.23 mmol m⁻² s⁻¹. Nightly sap flow of ivy during warm, dry nights accounted for up to 20% of the seasonal maximum. Maximum sap flow rates were reached at ca. 0.5 kPa vpd. On the other hand, the host trees showed a less conservative stomatal regulation, maximum sap flow rates were reached at vpd values of ca. 1 kPa. Sap flow rates of ivy decreased by ca. 20% in spring after bud break of trees, suggesting that ivy profits strongly from warm sunny days in early spring before budbreak of the host trees and from mild winter days. This species may benefit from rising winter temperatures in Europe and thus become a stronger competitor against its host trees.     

Enrichment and function of urushiol (poison ivy)-specific T lymphocytes in lesions of allergic contact dermatitis to urushiol

The frequencies of urushiol (poison ivy)-specific T cells were determined in the lesional skin and peripheral blood of patients with allergic contact dermatitis to urushiol. Lesions of urushiol dermatitis were biopsied and the T cells retrieved. Frequencies of Ag-specific cells were determined by limiting dilution assay. Enrichment of urushiol specific T cells was detected in lesional skin or blister fluid of five of five of these donors as well as seven of seven donors with urushiol patch tests. There was also enrichment relative to tetanus toxoid specific T cells in blood and skin of six of seven donors. The frequency of lesional T cells specific for urushiol was less than 1/100 and generally less than 1/1000. Furthermore, the frequency of urushiol specific T cells was often less than 1/10,000 in the peripheral blood during an acute eruption. Autoreactive T cells that proliferated to autologous irradiated PBMC were also enriched in skin lesions relative to blood in 5/5 urushiol patch tests. These autoreactive T cells were expanded and found to be CD4+. It has been proposed that such autoreactive T cells recognize autologous DR and may have a role in immunoregulation. Urushiol-specific T cells were expanded from limiting dilution wells of two donors and characterized. The majority of the urushiol-specific cells were CD8+, and 13/43 lines were suppressive for PWM-induced IgG synthesis.     

Lyme disease in northwestern coastal California.

To determine the incidence of physician-diagnosed Lyme disease in an endemic area of California, an active surveillance program was implemented in Lake, Mendocino, Sonoma, and southern Humboldt counties. More than 200 medical care providers were called monthly for their list of suspected cases of Lyme disease. Pertinent information was abstracted from the medical record of each patient. Of 153 cases of possible early Lyme disease ascertained from July 1991 to December 1992, 37% consisted of physician-diagnosed erythema migrans. Only 58% of erythema migrans rashes were at least 5 cm in diameter. An additional 43 patients had suspicious rashes not classified as erythema migrans. Of 166 patients with possible late-stage Lyme disease, 31% had specific clinical symptoms and 75% had a positive serologic test. With an incident case defined as physician-diagnosed erythema migrans of at least 5 cm in diameter, the annual incidence of Lyme disease in northwestern coastal California according to active surveillance only was 5.5 per 100,000. The rate of Lyme disease in California is substantially lower than that in the Atlantic northeastern United States. Many suspected cases of Lyme disease in this endemic area do not meet surveillance criteria, which are intentionally restrictive. Although some of the illnesses not meeting surveillance criteria may be due to infection with Borrelia burgdorferi, it appears that Lyme disease is being overdiagnosed in this area.     

Acute bronchitis therapy with ivy leaves extracts in a two-arm study. A double-blind, randomised study vs. an other ivy leaves extract

Ivy leaves extracts are authorised in medicinal products for the treatment of acute bronchitis. Different studies and the long experience on the market show safety and efficacy of this drug. A double-blind, randomised study was conducted to assess the efficacy and tolerability of ivy leaves soft extract with an other ivy leaves extract. 590 patients with acute bronchitis participated in this study. They were treated with test or comparator for 7 days (±1). The Bronchitis Severity Score (BSS) decreased gradually and to a similar extent from Day 1 to Day 7 in both treatment groups. Starting from values of 6.2-6.3 ± 1.2, the BSS decreased by approximately 4.7-4.9 points until Day 7, so that patients left the study with a mean BSS of 1.4-1.6. The BSS subscales cough, sputum, rhales/rhonchi, chest pain during coughing, and dyspnoea improved to a similar extent in both treatment groups. Overall, 2.7% of patients (per group and overall) experienced an adverse event, all of which were non-serious. Fewer patients younger than ten years had adverse events than would have been expected from their share of the study population (p = 0.015; Fisher's exact test). As a conclusion, the test product with ivy leaves soft extract proved to be non-inferior to the comparator ivy leaves extract in improving symptoms of acute bronchitis.     

Wider dissemination of castor bean allergen; factors presaging increasing incidence of disease in California

With the growing, transportation and processing of castor beans in California rapidly in creasing, it is probable that the incidence of allergic disease owing to sensitivity to the castor bean allergen also will increase.     

IgG-F-actin antibodies in celiac disease and dermatitis herpetiformis

Anti-actin antibodies are found in 52-85% of patients with autoimmune hepatitis or chronic active hepatitis and in 22% of patients with primary biliary cirrhosis. In patients with celiac disease, anti-actin antibodies correlate with the degree of villous atrophy. Studies on their involvement in celiac disease and dermatitis herpetiformis in Romania have not been done. The purpose of this study was to evaluate of the quality of IgG anti-F-actin antibodies (IgG-AAA) tests compared with IgA tissue transglutaminase antibodies (IgA-TgA) having IgA endomysial antibody (IgA-EmA) as gold standard in celiac disease and dermatitis herpetiformis and to see if there is any relationship between them. The study included 70 pediatric patients with celiac disease under gluten-free diets and 10 adult patients with dermatitis herpetiformis, during 2010. The IgG-AAA antibodies levels were determined by ELISA. Assessing the qualities of IgG-AAA compared to IgA-TgA, we obtained the following values sensitivity (Se) 27.8%, specificity (Sp) 79.4%, respectively Se 88.9%, Sp 79.4% in celiac disease and Se 33.3%, Sp 100%, respectively Se 100%, Sp 100% in dermatitis herpetiformis. Also, there was a prevalence of 24.3% and 30% of IgG-AAA in the two groups of patients, but no statistically significant associations were found. Therefore, we concluded that IgG-AAA can not replace IgA-TgA in children patients with celiac disease under gluten-free diets and in adult patients with dermatitis herpetiformis. AAA-IgG serum activity in both diseases exist, but without a relationship of association with them.     

Paleoepidemiology of a central California prehistoric population from CA-Ala-329: dental disease

Ala-329 is a prehistoric central California site located on the southeastern margin of San Francisco Bay, dating from approximately 500 AD up to pre-European contact. A large earth mound, Ala-329, has yielded many well preserved burials, approximately 300 of which are included in this study. The most common pathological lesions seen in this population are in the dentition. Advanced attrition is pervasive, affecting all individuals with teeth in occlusion for 2 years or more. Deciduous teeth are involved even in very young children and often show severe wear before replacement. In the permanent dentition, all elements are involved by the second decade; in the oldest age category (41+ years), all individuals show severe wear throughout their dentitions. In fact, by the end of the third decade, the majority of individuals have no enamel remaining. Mild periodontal involvement is found in 74% of adults, socket resorption in 53%, and abscesses in 31% of the relevant sample. Interestingly, although dental abscesses are found more than twice as often among males, socket resorption is seen more often among females. Dental caries are seen in only 10 individuals. The high incidence of periodontal remodeling, socket resorption, and dental abscesses is probably a secondary result of severe dental attrition. It is hypothesized that a large quantity of abrasives in the diet is responsible for the extreme degree of attrition, in fact, among the most severe for any population yet described.     

Light intensity is a limiting factor to the inland expansion of Cape ivy (<Emphasis Type=Italic>Delairea odorata</Emphasis>)

Cape ivy (Delairea odorata) is a highly invasive climbing perennial vine that is primarily distributed in coastal communities of California and Oregon, with patchy infestations in some inland riparian areas. In this study, we evaluated light as a potential environmental limitation to the spread of Cape ivy into inland regions of the western United States. Cape ivy was collected from four locations representing the north to south range. Plants were grown for 9 to 11 weeks in full sunlight and under two shade regimes (20 and 6% of full sunlight). The experiment was conducted twice at two temperature regimes. Results show some within- and among-population variability, with the southernmost San Diego County population having the highest biomass under the warmer growing conditions and the three northern populations responding most favorably in the cooler growing conditions. Despite the minor differences within and between populations, Cape ivy grew very poorly in full sunlight in both experiments. Although plants growing under 6% light grew better than those in full sunlight, they were far less robust compared to plants growing at 20% light. Our results indicate that while Cape ivy will not persist in areas with prolonged high intensity sunlight, characterized by much of the interior regions of California and Oregon, it is expected to invade and spread in areas with reduced light, including coastal regions frequently exposed to fog or cloudy conditions, or sub-canopy layers of riparian forests or woodlands. These communities should be the target areas for early detection and rapid response programs to prevent further Cape ivy invasion.     

Epizootic vesicular disease in captive California sea lions

An epizootic of vesicular disease occurred in a group of semi-domesticated California sea lions (Zalophus californianus) during the months of April and May 1997. Ten castrated mature male sea lions, ages 12 to 19 yr, were housed in three adjacent open-ocean net enclosures in San Diego Bay (California, USA). Four animals (40%) developed oral and extremity vesicles, anorexia, and were reluctant to perform learned behaviors. One animal developed vesicles but maintained a normal appetite and behavior. The remaining animals showed no clinical signs of infection. Virus (designated FADDL 7005) was isolated from four of the five animals that developed vesicles. Serum antibody titers to FADDL 7005, a previously untyped calicivirus, were demonstrated in animals that showed any combination of clinical signs and in two animals that did not show any clinical signs. No virus was isolated from five fecal samples collected from four of the group animals. Clinical signs lasted 4 to 20 days in affected animals. All affected animals recovered from infection. An experimental swine was inoculated with FADDL 7005 and developed vesicular disease, which was transmitted to another experimental swine upon contact. It is proposed that FADDL 7005 is a new San Miguel sea lion virus.     

Trypanosoma cruzi: New foci of enzootic Chagas' disease in California

Trypanosoma cruzi was discovered in 2–3rd instar nymphs of Triatoma protracta protracta from Paicines, 57 of 257 adults from Mulholland Overcrossing, and 2 males of 27 bugs from Juniper Hills, California. Thirty experimentally infected albino Mus musculus revealed low grade parasitaemias. Of 785 laboratory-raised Triatoma fed on 11 mice with Paicines isolate, 675 T. p. navajoensis and 1 T. p. protracta became infected; of 856 T. p. navajoensis fed on 13 mice with Mulholland isolate, 792 were positive; and of 137 T. p. navajoensis fed on 6 mice with the Juniper Hills isolate, 32 were infected with Trypanosoma cruzi. Examination of 7599 mm² area of tissue films for Paicines isolate revealed 31 type b and 15 type c sphaeromastigotes; 5650 mm² for the Mulholland isolate revealed 9 a-, 149 sphaero-, 8 epi-, and 7 trypo-mastigotes; and 15,209 mm² for the Juniper Hills isolate revealed 245 a-, 2865 sphaero-, 42 epi-, and 21 trypo-mastigotes. Field xenodiagnosis of 228 rodents in Juniper Hills revealed 11 Peromyscus truei montipinoris and 1 Neotoma fuscipes macrotis with Chagas' trypanosome.     

Sequelae of encephalitis; report of a study after the California epidemic

In a study of almost 500 patients to determine residual effects, the sequelae of both St. Louis and Western equine encephalitis were more prominent in the younger age group. Infants under three months with Western equine encephalitis had the greatest central nervous system damage. Forty-four per cent of this entire group had sequelae. In patients between one and four years of age, the incidence of sequelae was less. The Western equine infection was associated with the more disabling residual damage. Postencephalitic convulsions were fairly common in the younger patients with Western equine disease, but not in the St. Louis group. After the age of five the sequelae rate dropped. In all age groups the Western equine residual changes were more severe than the damage of St. Louis infection. Some infants, children and adults showed remarkable improvement from sequelae even as much as two years after the abnormalities occurred. With the longer period of follow-up, some late sequelae were noted in children and adults, primarily among those who had Western equine infection.