Lisa Lepine | The University of Manchester (original) (raw)
Papers by Lisa Lepine
Environmental Health Perspectives, Dec 1, 2002
In Lorain County, Ohio, unexplained infant deaths in homes sprayed with methyl parathion (MP), an... more In Lorain County, Ohio, unexplained infant deaths in homes sprayed with methyl parathion (MP), an organophosphate (OP) pesticide, prompted an investigation to determine whether infants living in treated homes are at higher risk for unexplained death. A case was defined as any death of an infant (≤12 months of age) in Lorain County between 1 January 1990 and 31 December 1994, attributed to sudden infant death syndrome (SIDS) or other unknown natural causes. For each case infant, birth certificate data were used to identify two control infants matched with regard to date of birth, sex, city of residence, and maternal race and educational level. Wipe samples from the home address listed on the birth certificate of control infants or the death certificate of case infants were analyzed for MP. Birth certificates provided additional risk factor information. The relationship between MP contamination and unexplained death was analyzed by exact conditional logistic regression. Wipe samples were collected from the residences of 34 case infants and 72 control infants. MP (>0.02 mg/100 cm 2) was detected in five homes, three of which had been occupied by case infants. Case infants were 4.6 times more likely than control infants to have lived in MP-treated homes, but the confidence interval (CI) was wide (95% CI: 0.2, 274.7) and included 1. Maternal smoking, young maternal age, and the presence of other siblings in the family were each independently predictive of case status. In a multivariate model adjusting for these other variables and the matching variables, the estimated risk associated with MP exposure was 13.0 (95% CI: 0.2, 2685.0). Although this association was not statistically significant and should be interpreted cautiously, it suggests an increased risk for unexplained death among infants living in MP-contaminated homes. The relationship between children's health and exposure to OP pesticides including MP should be evaluated further.
American Journal of Obstetrics and Gynecology, May 1, 2003
The purpose of this study was to determine our institutional success rate with single-dose intram... more The purpose of this study was to determine our institutional success rate with single-dose intramuscular methotrexate therapy for the treatment of ectopic pregnancy and to identify predictors of treatment outcome. STUDY DESIGN: This was a retrospective review of consecutive patients who were treated with methotrexate from January 2000 until April 2002. Successful treatment was defined as the resolution of the ectopic pregnancy without surgical intervention. RESULTS: Our overall success rate was 85% (69/81 patients). The median pretreatment serum β-human chorionic gonadotropin level was lower in those women in whom treatment was successful compared with those women with treatment failure (793 vs 3804 mIU/mL, P < .002). The presence of a yolk sac that was visualized on vaginal ultrasonography was the only significant predictor of treatment failure (adjusted odds ratio, 19.3; P < .002). CONCLUSION: Our institutional success rate (85%) with methotrexate for treatment of tubal ectopic pregnancy is comparable with other published results. However, a finding unique to this study was that visualization of a yolk sac was a risk factor for failure.
(MP), an organophosphate (OP) pesticide, prompted an investigation to determine whether infants l... more (MP), an organophosphate (OP) pesticide, prompted an investigation to determine whether infants living in treated homes are at higher risk for unexplained death. A case was defined as any death of an infant (≤12 months of age) in Lorain County between 1 January 1990 and 31 December 1994, attributed to sudden infant death syndrome (SIDS) or other unknown natural causes. For each case infant, birth certificate data were used to identify two control infants matched with regard to date of birth, sex, city of residence, and maternal race and educational level. Wipe samples from the home address listed on the birth certificate of control infants or the death certificate of case infants were analyzed for MP. Birth certificates provided additional risk factor information. The relationship between MP contamination and unexplained death was analyzed by exact conditional logistic regression. Wipe samples were collected from the residences of 34 case infants and 72 control infants. MP (>0.02 mg/100 cm 2) was detected in five homes, three of which had been occupied by case infants. Case infants were 4.6 times more likely than control infants to have lived in MP-treated homes, but the confidence interval (CI) was wide (95 % CI: 0.2, 274.7) and included 1. Maternal smoking, young maternal age, and the presence of other siblings in the family were each independently predictive of case status. In a multivariate model
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2002
The Centers for Disease Control and Prevention hosted a workshop to formulate recommendations for... more The Centers for Disease Control and Prevention hosted a workshop to formulate recommendations for the control of invasive group A streptococcal (GAS) disease among household contacts of persons with invasive GAS infections and for responding to postpartum and postsurgical invasive GAS infections. Experts reviewed data on the risk of subsequent invasive GAS infection among household contacts of case patients, the effectiveness of chemoprophylactic regimens for eradicating GAS carriage, and the epidemiology of postpartum and postsurgical GAS infection clusters. For household contacts of index patients, routine screening for and chemoprophylaxis against GAS are not recommended. Providers and public health officials may choose to offer chemoprophylaxis to household contacts who are at an increased risk of sporadic disease or mortality due to GAS. One nosocomial postpartum or postsurgical invasive GAS infection should prompt enhanced surveillance and isolate storage, whereas > or =2 c...
Archives of disease in childhood, 2007
Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after i... more Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after investigations including a forensic autopsy are performed to exclude possible organic and environmental causes of death. Israeli society is influenced by the Jewish and Islamic faiths, which permit autopsy only under selected circumstances. Against this background, we carried out a study to determine what examinations are performed to investigate unexplained infant deaths in Jerusalem, Israel. We examined hospital, Ministry of Health and Ministry of Interior records of unexplained infant deaths in the Jerusalem district from the years 1996-2003. Ninety six cases were identified from all sources. Forty nine (51%) infants were brought to a hospital at or near the time of death. Studies to determine the cause of death were performed in 54% of cases for which medical records were available for review. These studies included bacterial cultures (44%), skeletal surveys (12%), computerised tomogr...
Archives of disease in childhood, 2007
Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after i... more Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after investigations including a forensic autopsy are performed to exclude possible organic and environmental causes of death. Israeli society is influenced by the Jewish and Islamic faiths, which permit autopsy only under selected circumstances. Against this background, we carried out a study to determine what examinations are performed to investigate unexplained infant deaths in Jerusalem, Israel. We examined hospital, Ministry of Health and Ministry of Interior records of unexplained infant deaths in the Jerusalem district from the years 1996-2003. Ninety six cases were identified from all sources. Forty nine (51%) infants were brought to a hospital at or near the time of death. Studies to determine the cause of death were performed in 54% of cases for which medical records were available for review. These studies included bacterial cultures (44%), skeletal surveys (12%), computerised tomogr...
American Journal of Obstetrics and Gynecology, 2003
Infection Control and Hospital Epidemiology, 1998
Archives of Internal Medicine, 2006
American Journal of Obstetrics and Gynecology, 1998
Archives of Internal Medicine, 2006
Environmental Health Perspectives, Dec 1, 2002
In Lorain County, Ohio, unexplained infant deaths in homes sprayed with methyl parathion (MP), an... more In Lorain County, Ohio, unexplained infant deaths in homes sprayed with methyl parathion (MP), an organophosphate (OP) pesticide, prompted an investigation to determine whether infants living in treated homes are at higher risk for unexplained death. A case was defined as any death of an infant (≤12 months of age) in Lorain County between 1 January 1990 and 31 December 1994, attributed to sudden infant death syndrome (SIDS) or other unknown natural causes. For each case infant, birth certificate data were used to identify two control infants matched with regard to date of birth, sex, city of residence, and maternal race and educational level. Wipe samples from the home address listed on the birth certificate of control infants or the death certificate of case infants were analyzed for MP. Birth certificates provided additional risk factor information. The relationship between MP contamination and unexplained death was analyzed by exact conditional logistic regression. Wipe samples were collected from the residences of 34 case infants and 72 control infants. MP (>0.02 mg/100 cm 2) was detected in five homes, three of which had been occupied by case infants. Case infants were 4.6 times more likely than control infants to have lived in MP-treated homes, but the confidence interval (CI) was wide (95% CI: 0.2, 274.7) and included 1. Maternal smoking, young maternal age, and the presence of other siblings in the family were each independently predictive of case status. In a multivariate model adjusting for these other variables and the matching variables, the estimated risk associated with MP exposure was 13.0 (95% CI: 0.2, 2685.0). Although this association was not statistically significant and should be interpreted cautiously, it suggests an increased risk for unexplained death among infants living in MP-contaminated homes. The relationship between children's health and exposure to OP pesticides including MP should be evaluated further.
American Journal of Obstetrics and Gynecology, May 1, 2003
The purpose of this study was to determine our institutional success rate with single-dose intram... more The purpose of this study was to determine our institutional success rate with single-dose intramuscular methotrexate therapy for the treatment of ectopic pregnancy and to identify predictors of treatment outcome. STUDY DESIGN: This was a retrospective review of consecutive patients who were treated with methotrexate from January 2000 until April 2002. Successful treatment was defined as the resolution of the ectopic pregnancy without surgical intervention. RESULTS: Our overall success rate was 85% (69/81 patients). The median pretreatment serum β-human chorionic gonadotropin level was lower in those women in whom treatment was successful compared with those women with treatment failure (793 vs 3804 mIU/mL, P < .002). The presence of a yolk sac that was visualized on vaginal ultrasonography was the only significant predictor of treatment failure (adjusted odds ratio, 19.3; P < .002). CONCLUSION: Our institutional success rate (85%) with methotrexate for treatment of tubal ectopic pregnancy is comparable with other published results. However, a finding unique to this study was that visualization of a yolk sac was a risk factor for failure.
(MP), an organophosphate (OP) pesticide, prompted an investigation to determine whether infants l... more (MP), an organophosphate (OP) pesticide, prompted an investigation to determine whether infants living in treated homes are at higher risk for unexplained death. A case was defined as any death of an infant (≤12 months of age) in Lorain County between 1 January 1990 and 31 December 1994, attributed to sudden infant death syndrome (SIDS) or other unknown natural causes. For each case infant, birth certificate data were used to identify two control infants matched with regard to date of birth, sex, city of residence, and maternal race and educational level. Wipe samples from the home address listed on the birth certificate of control infants or the death certificate of case infants were analyzed for MP. Birth certificates provided additional risk factor information. The relationship between MP contamination and unexplained death was analyzed by exact conditional logistic regression. Wipe samples were collected from the residences of 34 case infants and 72 control infants. MP (>0.02 mg/100 cm 2) was detected in five homes, three of which had been occupied by case infants. Case infants were 4.6 times more likely than control infants to have lived in MP-treated homes, but the confidence interval (CI) was wide (95 % CI: 0.2, 274.7) and included 1. Maternal smoking, young maternal age, and the presence of other siblings in the family were each independently predictive of case status. In a multivariate model
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2002
The Centers for Disease Control and Prevention hosted a workshop to formulate recommendations for... more The Centers for Disease Control and Prevention hosted a workshop to formulate recommendations for the control of invasive group A streptococcal (GAS) disease among household contacts of persons with invasive GAS infections and for responding to postpartum and postsurgical invasive GAS infections. Experts reviewed data on the risk of subsequent invasive GAS infection among household contacts of case patients, the effectiveness of chemoprophylactic regimens for eradicating GAS carriage, and the epidemiology of postpartum and postsurgical GAS infection clusters. For household contacts of index patients, routine screening for and chemoprophylaxis against GAS are not recommended. Providers and public health officials may choose to offer chemoprophylaxis to household contacts who are at an increased risk of sporadic disease or mortality due to GAS. One nosocomial postpartum or postsurgical invasive GAS infection should prompt enhanced surveillance and isolate storage, whereas > or =2 c...
Archives of disease in childhood, 2007
Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after i... more Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after investigations including a forensic autopsy are performed to exclude possible organic and environmental causes of death. Israeli society is influenced by the Jewish and Islamic faiths, which permit autopsy only under selected circumstances. Against this background, we carried out a study to determine what examinations are performed to investigate unexplained infant deaths in Jerusalem, Israel. We examined hospital, Ministry of Health and Ministry of Interior records of unexplained infant deaths in the Jerusalem district from the years 1996-2003. Ninety six cases were identified from all sources. Forty nine (51%) infants were brought to a hospital at or near the time of death. Studies to determine the cause of death were performed in 54% of cases for which medical records were available for review. These studies included bacterial cultures (44%), skeletal surveys (12%), computerised tomogr...
Archives of disease in childhood, 2007
Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after i... more Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after investigations including a forensic autopsy are performed to exclude possible organic and environmental causes of death. Israeli society is influenced by the Jewish and Islamic faiths, which permit autopsy only under selected circumstances. Against this background, we carried out a study to determine what examinations are performed to investigate unexplained infant deaths in Jerusalem, Israel. We examined hospital, Ministry of Health and Ministry of Interior records of unexplained infant deaths in the Jerusalem district from the years 1996-2003. Ninety six cases were identified from all sources. Forty nine (51%) infants were brought to a hospital at or near the time of death. Studies to determine the cause of death were performed in 54% of cases for which medical records were available for review. These studies included bacterial cultures (44%), skeletal surveys (12%), computerised tomogr...
American Journal of Obstetrics and Gynecology, 2003
Infection Control and Hospital Epidemiology, 1998
Archives of Internal Medicine, 2006
American Journal of Obstetrics and Gynecology, 1998
Archives of Internal Medicine, 2006