Dr. Robert W Farr

In February, protesters started a one-month hunger strike against the plan for General Iron to relocate their metal shredding operations. Through an in-depth literature review, I will investigate the role and history of mobilization in social movements in Chicago and contributing socio-political factors that have led to the hunger strike. The strike is opposing the relocation of General Iron to the Southeast Side of Chicago, a majority LatinX neighborhood, from an affluent predominantly white neighborhood, Lincoln Park. An examination of these varied documents will demonstrate the factors that have contributed to this issue as well as the environmental and health impacts on the community. This act of environmental racism has detrimental health impacts on the surrounding populations including asthma and other immunocompromised disorders.

A suspected case of meningococcal meningitis was diagnosed in a 24-year-old sailor onboard an aircraft carrier at sea in 2003. He was immediately confined to the ship’s hospital ward under respiratory isolation precautions and was treated with intravenously administered antibiotics. His illness resolved without sequelae. A total of 99 close contacts from the ship were identified and given antibiotic prophylaxis, with directly observed therapy. British public health authorities were contacted to trace and treat persons identified as close contacts
during a port call a few days before presentation. Managing a communicable disease such as meningococcal meningitis in the austere shipboard environment represents a unique challenge to military medical personnel. Successful management is possible through prompt treatment, respiratory isolation, and open communication between primary health care providers and public health officials. The identification of shipboard close contacts and other infection control procedures used by the ship’s medical department are reviewed.

This study examines the specific etiologies and aeromedical outcomes of naval aviation personnel with hepatitis.
We searched the Biomedical Database of the Naval Aerospace Medical Institute for waiver requests for hepatitis. We reviewed the records for specific etiologies, possible risk factors, and the aeromedical outcomes of aviators who received waivers for chronic hepatitis.
We examined 48 initial and 95 follow-up waiver requests for hepatitis for naval aviation personnel from July 1988 to May 2001. Initial waiver requests were for chronic hepatitis C (HCV) in 23 (47.9%), chronic hepatitis B in 17 (35.4%), and other etiologies in 8 (16.7%). Asian Americans, who comprise 2% of the aviator population in the Biomedical Database, accounted for a disproportionate number of waiver requests for hepatitis: 7 (14.6%) of the total and 6 (35.3%) of the aviators with HBV. Of the 48 aviators with hepatitis, waivers were granted in 32 (66.7%) cases, all of whom were asymptomatic. Waivers were denied to 16 (33.3%) aviators. One aviator with Hodgkin's disease in remission and one aviator with chronic HCV who became asymptomatic after treatment with interferon later received waivers for a total of 34 (70.8%) waivers. Two waivers were later revoked because of symptomatic HCV requiring interferon in one and incomplete physical exam in another.
Aviation personnel who receive waivers for asymptomatic hepatitis occasionally present with symptomatic hepatitis, but most waiver recipients remain asymptomatic during their aviation careers.

Background: This study examines the aeromedical outcomes of aviation personnel with asymptomatic cholelithiasis or those treated successfully with conventional (open) cholecystectomy (CC), laparoscopic cholecystectomy (LC), or extracorporeal shock wave lithotripsy (ESWL) for previous symptomatic cholecystitis.

Methods: The Biomedical Database of the Naval Aerospace Medical Institute was searched for waiver requests for asymptomatic gallstones, acute cholecystitis, and cholecystectomy. Microfiche records were then reviewed. The rates of development of symptomatic disease and need for cholecystectomy or ESWL were noted in aircrew granted waivers for asymptomatic cholelithiasis. The aeromedical outcomes of aircrew who underwent treatment for symptomatic disease by cholecystectomy (CC or LC) or ESWL were reviewed.

Results: A search of the Biomedical Database revealed waiver requests for cholelithiasis for 79 naval aviation personnel from April 1988 to August 2000. Waiver requests were for previous cholecystectomy in 56 (70.9%) and cholelithiasis in 23 (29.1%). No aviators had undergone ESWL. Of the 56 aviators with previous cholecystectomy, waivers were granted in 51 (91.1%) cases. Waivers were denied to five individuals, primarily for other medical problems. Of the 23 aviators with cholelithiasis, 11 (47.8%) were granted waivers. Waivers were denied in 12 aviators because of symptomatic cholelithiasis (5), asymptomatic cholelithiasis (1), common bile duct stone (1), other medical problems (3), or no explanation (2). The aviator with asymptomatic cholelithiasis and two of the aviators with symptomatic cholelithiasis were subsequently granted waivers after cholecystectomy (LC). The aviator with a symptomatic common bile duct stone received a waiver after cholecystectomy (CC). A total of 66 (83.5%) aviators received waivers. None were revoked during the study period because of symptomatic cholelithiasis or retained common bile duct stones.

Conclusions: Aviation personnel who receive waivers for asymptomatic cholelithiasis or cholecystectomy rarely present with symptomatic biliary disease.

An epidemiologic profile revealed that approximately 1,000-1,600 persons in West Virginia are living with HIV, and that it is the 5th leading cause of death among persons ages 25-44. HIV is also the leading cause of death in black males ages 25-44 in WV, and blacks are disproportionately affected by HIV/AIDS (composing about 3.1% of the general population and 17% of the AIDS population). This is most marked in Kanawha, Raleigh, and McDowell counties. The predominant mode of exposure reported from 1984-1993, and more recently from 1991-1993, has been men having sex with men (MSM), accounting for 57% of all AIDS cases. A substantial proportion of all cases (13%) were attributed to injecting drug use (IDU), especially in Public Health District 1 where 63% of women infected with HIV reported IDU as a risk behavior. It is difficult to draw conclusions about populations at risk in WV because of the large proportion of HIV cases reported without risk behaviors (26.5%). However, among men, most cases initially reported without risk are eventually reclassified to the MSM and IDU categories. Among women, most cases first reported without risk are eventually changed to the IDU and heterosexual contact categories. Map analyses by Public Health District and county suggest some clustering of cases in the southern region of the state which may be secondary to racial/ethnic and sociodemographic factors.

Listeria monocytogenes rhomboencephalitis is an uncommon complication of L. monocytogenes meningitis. It presents in a typical biphasic pattern characterized by a non-specific prodromal period followed by any combination of asymmetrical, cranial-nerve palsies; cerebellar signs; hemiparesis or hypesthesia; and diminished consciousness. The survival rate is greater than 70% when appropriate antibiotic therapy is initiated early. However, approximately 60 percent of the survivors develop neurological sequelae. We present the case of a 33-year-old woman who developed L. monocytogenes meningitis with subsequent rhomboencephalitis and cranial-nerve palsie, and review the literature on this syndrome.

The aim of this study is to investigate the role of adenovirus and respiratory syncytial virus (RSV) in chronic sinusitis using the polymerase chain reaction (PCR) to assay for the viruses. PCR has proved to be more sensitive and specific than viral cultures and immunoassays in the detection of viruses. Adenovirus and RSV are among the most common viruses to cause upper respiratory tract infections. Sinus mucosa biopsies from 20 patients undergoing endoscopic sinus surgery were sterilely collected. Four specimens (20%) tested positive for RSV by PCR and none tested positive for adenovirus. Only one specimen tested positive for RSV and one for adenovirus by viral culture and immunofluorescence. Bacterial cultures tested positive in 40% of the 20 specimens. PCR can be used to detect RSV in patients with chronic sinusitis and PCR is more sensitive than viral culture and immunofluorescence techniques on sinus polyps and mucosa.