Glyn G. Caldwell

Alkylating agents as leukemogens in multiple myeloma

Five patients in the Kansas City leukemia surveillance program had a history of multiple myeloma prior to the onset of their acute leukemia. If one applies the Kansas City age/sex‐specific leukemia rates to an estimated population with multiple myeloma living in the study area during the 7‐year collection period, only 0.17 patients would be expected to develop acute leukemia. The five patients presented in this paper represent a significant increase in the observed over the expected incidence. Twenty‐six patients have now been reported who developed acute leukemia during treatment for multiple myeloma, and each had received an alkylating agent. These drugs may be direct leukemogens and the risk involved in their use must be recognized.

Herpes simplex virus type 2 and cancer of the prostate.

A seroepidemiologic study was performed to determine if there was an association between antibodies to herpes simplex virus type 2 and cancer of the prostate, similar to that reported for herpes simplex virus type 2 and cervical carcinoma. No significant difference in herpes simplex virus type 2 antibodies was seen between patients with cancer of the prostate and those with benign prostatic hypertrophy. Further studies are needed to define the possible role of herpes simplex virus type 2 in the etiology of cancer of the prostate.

Serum pesticide levels in patients with chiLDHOOD COLORECTAL CARCINOMA

From September 1974 through November 1976, 13 adolescent patients with mucin‐producing colorectal adenocarcinoma were treated at a Memphis, Tennessee, pediatric oncology center. Ten of these children were from the rural areas of the Mississippi Delta, areas of high pesticide use. None of them had a family history of colorectal cancer, familial polyposis, or ulcerative colitis. Levels of pesticide residues, however, were not generally higher in blood samples from patients and their families than from controls.

Previous and simultaneous cancers in patients with leukemia

Abstract In a 5-yr leukemia surveillance program in the Kansas City area, 31 of 455 leukemic adults were observed with a past or concurrent history of another malignancy. The frequency of occurrence of nonhematologic malignancies in these 31 patients did not represent any increase over that expected in a general population. After the onset of leukemia, particularly CLL, there may possibly be an increased risk of developing another primary malignancy. To further determine a susceptible population, future studies should concentrate on the patients immune capabilities and histocompatibility status. Investigators should always consider the sequence of cancer occurrence in analyzing any data.

Relating West Nile Virus Case Fatality Rates to Demographic and Surveillance Variables

Objective. The purpose of this ecological study was to relate West Nile virus (WNV) human case fatality rates to county-level demographic and surveillance variables, thereby characterizing the populations to which WNV poses the greatest threat. Methods. The authors acquired data on human, avian, and mosquito WNV infections for the 13 states in which there were 100 or more human cases during 2003. The data on avian and mosquito infections were converted into surveillance variables using empirical Bayes methodology. A preliminary logistic regression model was formulated to relate these surveillance variables and demographic variables to case fatality rates. The statistical technique of backward elimination was applied to obtain a final model in terms of the variables most useful for predicting case outcomes. Results. The probability of a fatal outcome depends on the poverty rate for the county in which the infected person lives (p=0.0283), the average temperature (p<0.0001), and surveillance variables reflecting the fractions of Culex pipiens and Culex restuans mosquitoes among infected mosquitoes (p=0.0079; p=0.0076). Conclusions. Effective WNV educational programs and control measures are vital, especially in poverty-stricken areas. A uniform protocol for disseminating county-level data could facilitate timely responses to WNV outbreaks and to emerging infectious diseases more generally.

Chemical Alert! A Community Action Handbook

This volume has been designed to support the thesis that an educated layperson can organize a group of concerned citizens to plan and implement an appropriate preliminary study to confirm their suspicions that an environmental hazard or a health problem exists. The book is organized to assist such persons in developing some preliminary but reasonable data to back up a request for further action about a suspected environmental problem. The organization follows a sequential plan to identify the health problem or suspected hazard, rally the community to action, and collect, analyze, and present the information to governmental agencies or authorities who can cause further steps to be taken. It is pointed out early that sophisticated, professional training is not needed for citizens to collect enough information to document their concerns as an adjunct to requesting better studies or governmental action. However, in order to utilize the plan laid out in

The Health Detective's Handbook: Guide to the Investigation of Environmental Health Hazards by Nonprofessionals

This volume of ten chapters, 20 figures, and 34 tables includes directions on how to plan and carry out a scientifically valid preliminary survey when an environmentally related health problem is suspected. A relatively complete questionnaire and instructions for use in a descriptive epidemiologic study are included. The authors thesis is that any educated lay person can, with careful planning, develop a core group of like-minded concerned persons to carry out a scientifically valuable preliminary study to determine if a problem exists. If the data from the survey confirm their suspicion, then having pertinent, high-quality data to use in requesting and supporting the need for additional analytic studies or some remedial action can and should make their concerns and requests more believable and forceful. The book also provides background information about and examples of the causes of disease in a variety of tables and figures included in both the text

Cancer Among Nuclear Test Participants-Reply

In Reply.— We agree with Dr Gross that experimental evidence in animals and data from human populations exposed to 150 to 200 rad of ionizing radiation suggest that they experienced an increased incidence of leukemia and solid tumors, but we have no data indicating that the nuclear test participants at Smoky were exposed to that level of radiation. Furthermore, the data from studies on populations exposed to ionizing radiation in the 150- to 200-rad range have shown some solid tumors after 15 to 20 years. We do not doubt that susceptibility differs by host and organ system, since that too has been found in irradiated human populations. We have no quarrel with the theory that some synergistic response may have occurred with an unknown virus, a genetically susceptible host, or with prior or subsequent chemical or radiation exposure. We simply lack the data to ascertain if these responses could account

Test tube epidemic.

According to the laboratory reports, a pediatric ward of a university teaching hospital had an epidemic under way. An investigation revealed some surprising information about the real source of contamination and reemphasized that some simple precautions could prevent similar occurrences.