[Based on the incidence of Creutzfeldt-Jakob disease in the Lanzarote healthcare area. Description of two definitive cases].

Science.gov (United States)

Hernández-Ramos, F J; Martínez Martín, M; Esteban Robayna, M; Jensen Toll, F; Palacios Llopis, S

2005-01-01

We present two cases who have been diagnosed of definitive Creutzfeldt-Jakob disease in the health area of Lanzarote in the period January 2002 to January 2004. The two cases are presented with clinical description, complementary tests -- including electroencephalogram, 14-3-3 protein determination -- study of the prionic protein gene, and histopathologic findings. In this article, we try to show the importance of trying to reach a definitive diagnosis with the histopathologic study once there is clinical suspicion (a diagnosis that is probable or possible). In addition our cases show that communication between the clinical and the epidemiological coordinator of the regional community and the National Center of Epidemiology is very important. We refer to the clear growth in the incidence of the disease in the population of Lanzarote in the period above mentioned. Finally, we discuss whether this growth is or is not an isolated event.

Huntington's disease: current epidemiology and pharmacological management in UK primary care.

Science.gov (United States)

Sackley, Catherine; Hoppitt, Thomas J; Calvert, Melanie; Gill, Paramjit; Eaton, Benjamin; Yao, Guiqing; Pall, Hardev

2011-01-01

Recent debate suggests Huntington's disease (HD) may be more prevalent than previously reported. In addition, relatively little is known about current disease management. This study aims to provide epidemiological data and describe the pharmacological management of HD in the United Kingdom. A primary care research database was accessed to identify incident and prevalent HD cases between January 1, 2004, and December 31, 2008. Patients with Read codes denoting a definite diagnosis or possible diagnosis, and undiagnosed patients with a positive family history were identified. A subset of patients with a definite diagnosis and prescribed medication indicating symptom onset was also identified. Epidemiological data were estimated. Pharmacological prescriptions to HD patients from 2004 to 2008 were identified, and prescription frequencies were grouped according to the British National Formulary categories. HD incidence estimates ranged from 0.44 to 0.78 per 100,000 person-years, and HD prevalence ranged from 5.96 to 6.54 per 100,000 of the population. Forty-four percent of pharmacological prescriptions targeted the central nervous system. Nearly half of the HD patients were prescribed antidepressants, and over 40% were prescribed analgesics. Although prevalence estimates fell short of figures suggested in recent debate, it is feasible that the true prevalence may be much higher than previously reported. Pharmacological management appears to rely heavily on central nervous system drugs and nutrition support. Many of these drugs are prescribed to HD patients for reasons other than the medication's primary use. Further work is required to evaluate the impact of alternative management strategies, such as therapist intervention, counselling, and organisation support, on the patients' quality of life. Copyright © 2011 S. Karger AG, Basel.

Looking forward to 20/20: a focus on the epidemiology of eye diseases.

Science.gov (United States)

West, S K

2000-01-01

The encouraging scenario of international efforts to eliminate preventable and avoidable blindness is the legacy of public health ophthalmology in the 20th century. With active programs currently in place or beginning for the major cause of blindness in childhood and two of the leading infectious causes of blindness, it is natural that research in eye disease will shift even more heavily toward the leading causes of blindness in the older ages. The age-related eye diseases will rapidly become the most common causes of blindness and visual loss and, with the exception of cataract, are the more difficult to identify, diagnose, and treat. The human misery and social cost of blindness, especially in the countries that can ill afford it, are profound. To combat this problem, epidemiologic research in ophthalmology should look toward the following major areas: 1. the identification and testing of better screening modalities to determine early changes possibly amenable to preventive strategies. This includes detection of vitamin A deficiency as well. 2. the creation of uniform definitions for diseases, particularly glaucoma and early AMD, which have relevance for epidemiologic research into risk factors. 3. increased multidisciplinary research, working with investigators skilled in molecular genetics, biologic markers for age-related diseases, and those interested in new imaging and vision-testing techniques. 4. ongoing work in clinical trials of new approaches to prevent or delay the onset of vision loss from eye disease, including future vaccines for chlamydia and onchocerciasis. The major public health issue of blindness prevention will not disappear in the next century but only shift emphasis to different causes if the current programs achieve the success that is hoped. Future epidemiologic research will continue to require a concerted, sustained, and multidisciplinary effort in order to contribute to the vision research agenda in the next century.

Epidemiology of Lyme Disease

Directory of Open Access Journals (Sweden)

Dennis J White

1991-01-01

Full Text Available Investigation of the epidemiology of Lyme disease depends upon information generated from several sources. Human disease surveillance can be conducted by both passive and active means involving physicians, public health agencies and laboratories. Passive and active tick surveillance programs can document the extent of tick-borne activity, identify the geographic range of potential vector species, and determine the relative risk of exposure to Lyme disease in specific areas. Standardized laboratory services can play an important role in providing data. Epidemiologists can gain a better understanding of Lyme disease through the collection of data from such programs. The interpretation of data and provision of information to the medical and general communities are important functions of public health agencies.

Epidemiology of Gastroesophageal Reflux Disease in Asia: A Systematic Review

Science.gov (United States)

2011-01-01

Ethnic and geographical differences are important factors in studying disease frequencies, because they may highlight the environmental or genetic influences in the etiology. We retrieved the studies which have been published regarding the epidemiologic features of gastroesophageal reflux disease (GERD) in Asia, based on the definitions of GERD, study settings, publication years and geographical regions. From the population-based studies, the prevalence of symptom-based GERD in Eastern Asia was found to be 2.5%-4.8% before 2005 and 5.2%-8.5% from 2005 to 2010. In Southeast and Western Asia, it was 6.3%-18.3% after 2005, which was much higher than those in Eastern Asia. There were robust epidemiologic data of endoscopic reflux esophagitis in medical check-up participants. The prevalence of endoscopic reflux esophagitis in Eastern Asia increased from 3.4%-5.0% before 2000, to 4.3%-15.7% after 2005. Although there were only limited studies, the prevalence of extra-esophageal syndromes in Asia was higher in GERD group than in controls. The prevalence of Barrett's esophagus was 0.06%-0.84% in the health check-up participants, whereas it was 0.31%-2.00% in the referral hospital settings. In summary, the prevalence of symptom-based GERD and endoscopic reflux esophagitis has increased in Asian countries. However, the prevalence of Barrett's esophagus in Asia has not changed and also still rare. PMID:21369488

75 FR 47458 - TRICARE; Rare Diseases Definition

Science.gov (United States)

2010-08-06

... tribal governments, in aggregate or by the private sector, of $100 million or more in any one year... TRICARE; Rare Diseases Definition AGENCY: Office of the Secretary, DoD. ACTION: Final rule. SUMMARY: This final rule revises the definition of rare diseases to adopt the definition of a rare disease as...

Global epidemiology of celiac disease

Directory of Open Access Journals (Sweden)

S. V. Bykova

2018-01-01

Full Text Available The review presents the data on the prevalence of celiac disease in various world regions. The numbers of patients with celiac disease continues to rise every year. According to some authors, this is to be related not only to improvement in diagnosis, but to other extrinsic factors, as well, that require additional studies. In the 1980s the prevalence of this disease was 1.05%, and by the beginning of 2000s, it amounted to 1.99%. In particular, from 1993 to 2002 in Britain its incidence increased from 6 to 13.3 per 100,000. Both raised awareness of doctors and conduction of epidemiological studies play a decisive role in the improvement of the diagnosis of celiac disease. The information cumulated up to now makes it possible to conclude that the highest diagnostic rates of celiac disease can be found in the risk groups. They include 1st and 2nd degree relatives of patients with celiac disease, patients with autoimmune disorders (type 1 diabetes mellitus, autoimmune thyroiditis; those with clinical signs of an intestinal disorder, such as chronic diarrhea, as well as patients with anemia, osteoporosis and high transaminase levels of unknown origin. According to the Finnish epidemiological study, the prevalence of celiac disease, depending on the risk group, may vary from 6.6 to 16.3%. The guidelines by the American College of Gastroenterology, British Society of Gastroenterology, North-American Society of Pediatric Gastroenterology, and the Russian Consensus on Diagnosis and Treatment of Celiac Disease in Adults and Children all recommend thorough examination of patients from the risk groups. Active diagnosis of celiac disease (screening has been recognized as one of the approaches to primary prevention to autoimmune disorders and cancer.

O conceito de espaço na epidemiologia das doenças infecciosas The concept of space in infectious disease epidemiology

Directory of Open Access Journals (Sweden)

Luiz Jacintho da Silva

1997-10-01

Full Text Available Análise teórica da utilização do conceito de espaço na epidemiologia das doenças infecciosas. Faz-se uma breve retrospectiva do uso de diferentes conceituações de espaço e de suas implicações. Ênfase é dada à teoria dos focos naturais de Pavlovsky e às interações entre a epidemiologia e a geografia. O problema atual das infecções emergentes é visto como determinante da necessidade de se intensificarem as discussões sobre este conceito na epidemiologia das doenças infecciosas.This article analyzes how space is employed in infectious disease epidemiology, with a brief retrospective of the various definitions of space and its implications. Emphasis is given to the theory of natural foci of infectious diseases formulated by Pavlovsky and the interactions of epidemiology and geography.The current problem posed by emerging infections is seen as a determinant of the need for further discussion on the concept of space in infectious disease epidemiology.

Update on the epidemiology of the rheumatic diseases.

Science.gov (United States)

Gabriel, S E

1996-03-01

Epidemiologic studies continue to enhance our understanding of the rheumatic diseases. Such studies now indicate that 26 million American women are at risk for osteoporotic fractures. Contrary to previous recommendations, the identification and treatment of patients at risk for osteoporosis may be valuable even among very elderly people. Other epidemiologic studies suggest that the incidence of rheumatoid arthritis is decreasing and that it is a more benign disease than previously recognized. Osteoarthritis remains a leading cause of physical and work disability in North America. The roles of occupational physical activity, obesity, and highly competitive (though not low-impact) exercise as risk factors for osteoarthritis continue to be explored. Pharmacoepidemiologic research has recently demonstrated that a policy of prior authorization for prescription of nonsteroidal anti-inflammatory drugs may be highly cost effective. Finally, controlled epidemiologic studies have not confirmed an association between silicone breast implants and connective tissue diseases, a conclusion recently endorsed by the American College of Rheumatology.

Angiostrongylus spp. in the Americas: geographical and chronological distribution of definitive hosts versus disease reports.

Science.gov (United States)

Valente, Romina; Robles, Maria Del Rosario; Navone, Graciela T; Diaz, Julia I

2018-03-01

Angiostrongyliasis is an infection caused by nematode worms of the genus Angiostrongylus. The adult worms inhabit the pulmonary arteries, heart, bronchioles of the lung, or mesenteric arteries of the caecum of definitive host. Of a total of 23 species of Angiostrongylus cited worldwide, only nine were registered in the American Continent. Two species, A. cantonensis and A. costaricensis, are considered zoonoses when the larvae accidentally parasitise man. In the present study, geographical and chronological distribution of definitive hosts of Angiostrongylus in the Americas is analysed in order to observe their relationship with disease reports. Moreover, the role of different definitive hosts as sentinels and dispersers of infective stages is discussed. The study area includes the Americas. First records of Angiostrongylus spp. in definitive or accidental hosts were compiled from the literature. Data were included in tables and figures and were matched to geographic information systems (GIS). Most geographical records of Angiostrongylus spp. both for definitive and accidental hosts belong to tropical areas, mainly equatorial zone. In relation to those species of human health importance, as A. cantonensis and A. costaricensis, most disease cases indicate a coincidence between the finding of definitive host and disease record. However, in some geographic site there are gaps between report of definitive host and disease record. In many areas, human populations have invaded natural environments and their socioeconomic conditions do not allow adequate medical care. Consequently, many cases for angiostrongyliasis could have gone unreported or unrecognised throughout history and in the nowadays. Moreover, the population expansion and the climatic changes invite to make broader and more complete range of observation on the species that involve possible epidemiological risks. This paper integrates and shows the current distribution of Angiostrongylus species in America

Angiostrongylus spp. in the Americas: geographical and chronological distribution of definitive hosts versus disease reports

Science.gov (United States)

Valente, Romina; Robles, Maria del Rosario; Navone, Graciela T; Diaz, Julia I

2018-01-01

BACKGROUND Angiostrongyliasis is an infection caused by nematode worms of the genus Angiostrongylus. The adult worms inhabit the pulmonary arteries, heart, bronchioles of the lung, or mesenteric arteries of the caecum of definitive host. Of a total of 23 species of Angiostrongylus cited worldwide, only nine were registered in the American Continent. Two species, A. cantonensis and A. costaricensis, are considered zoonoses when the larvae accidentally parasitise man. OBJECTIVES In the present study, geographical and chronological distribution of definitive hosts of Angiostrongylus in the Americas is analysed in order to observe their relationship with disease reports. Moreover, the role of different definitive hosts as sentinels and dispersers of infective stages is discussed. METHODS The study area includes the Americas. First records of Angiostrongylus spp. in definitive or accidental hosts were compiled from the literature. Data were included in tables and figures and were matched to geographic information systems (GIS). FINDINGS Most geographical records of Angiostrongylus spp. both for definitive and accidental hosts belong to tropical areas, mainly equatorial zone. In relation to those species of human health importance, as A. cantonensis and A. costaricensis, most disease cases indicate a coincidence between the finding of definitive host and disease record. However, in some geographic site there are gaps between report of definitive host and disease record. In many areas, human populations have invaded natural environments and their socioeconomic conditions do not allow adequate medical care. MAIN CONCLUSIONS Consequently, many cases for angiostrongyliasis could have gone unreported or unrecognised throughout history and in the nowadays. Moreover, the population expansion and the climatic changes invite to make broader and more complete range of observation on the species that involve possible epidemiological risks. This paper integrates and shows the

Bayesian disease mapping: hierarchical modeling in spatial epidemiology

National Research Council Canada - National Science Library

Lawson, Andrew

2013-01-01

.... Exploring these new developments, Bayesian Disease Mapping: Hierarchical Modeling in Spatial Epidemiology, Second Edition provides an up-to-date, cohesive account of the full range of Bayesian disease mapping methods and applications...

Definition, classification, and epidemiology of pulmonary arterial hypertension.

Science.gov (United States)

Hoeper, Marius M

2009-08-01

Pulmonary arterial hypertension (PAH) is a distinct subgroup of pulmonary hypertension that comprises idiopathic PAH, familial/heritable forms, and PAH associated with connective tissue disease, congenital heart disease, portal hypertension, human immunodeficiency virus (HIV) infection, and some other conditions. The hemodynamic definition of PAH was recently revised: PAH is now defined by a mean pulmonary artery pressure at rest > or =25 mm Hg in the presence of a pulmonary capillary wedge pressure or =30 mm Hg during exercise) that was used in the old definition of PAH has been removed because there are no robust data that would allow defining an upper limit of normal for the pulmonary pressure during exercise. The revised classification of pulmonary hypertension still consists of five major groups: (1) PAH, (2) pulmonary hypertension due to left heart disease, (3) pulmonary hypertension due to chronic lung disease and/or hypoxia, (4) chronic thromboembolic pulmonary hypertension, and (5) miscellaneous forms. Modifications have been made in some of these groups, such as the addition of schistosomiasis-related pulmonary hypertension and pulmonary hypertension in patients with chronic hemolytic anemia to group 1.

Ongoing challenges to finding people with Parkinson's disease for epidemiological studies: a comparison of population-level case ascertainment methods.

Science.gov (United States)

Harris, M Anne; Koehoorn, Mieke; Teschke, Kay

2011-07-01

Locating Parkinson's disease cases for epidemiological studies has long been challenging. Self reports, secondary records of physician diagnosis and drug tracer methods each exhibit known disadvantages but have rarely been compared directly. Prescriptions of levodopa have in some studies been considered to comprise a reasonable proxy for Parkinson's disease diagnosis. We tested this assumption by comparing three methods of population-level case ascertainment. We compared the number of Parkinson's disease cases in British Columbia derived from self-reports in the 2001 Canadian Community Health Survey to those obtained from administrative records of filled levodopa prescriptions and to Parkinson's disease diagnoses from physician visit billing and hospital discharge records in 1996 and 2005. We directly compared a case definition based on levodopa prescriptions with a definition based on records of physician diagnosis by calculating positive predictive value and sensitivity. Crude prevalence estimates ranged from approximately 100 to 200 per 100,000. Levodopa-based case definitions overestimated prevalence, while physician- and hospital-record-based case definitions provided lower prevalence estimates compared to survey derived estimates. The proportion of levodopa users with a diagnosis of Parkinson's disease declined from 62% to 52% between 1996 and 2005. This decrease was most dramatic among women (64%-44%) and those under age 65 (54%-39%). Sex and age trends suggest increasing use of levodopa among patients with conditions other than Parkinson's disease, such as restless legs syndrome. Increased non-Parkinson's levodopa use decreases the efficiency of levodopa as a Parkinson's disease case tracer. Copyright © 2011 Elsevier Ltd. All rights reserved.

Urogenital tuberculosis: definition and classification.

Science.gov (United States)

Kulchavenya, Ekaterina

2014-10-01

To improve the approach to the diagnosis and management of urogenital tuberculosis (UGTB), we need clear and unique classification. UGTB remains an important problem, especially in developing countries, but it is often an overlooked disease. As with any other infection, UGTB should be cured by antibacterial therapy, but because of late diagnosis it may often require surgery. Scientific literature dedicated to this problem was critically analyzed and juxtaposed with the author's own more than 30 years' experience in tuberculosis urology. The conception, terms and definition were consolidated into one system; classification stage by stage as well as complications are presented. Classification of any disease includes dispersion on forms and stages and exact definitions for each stage. Clinical features and symptoms significantly vary between different forms and stages of UGTB. A simple diagnostic algorithm was constructed. UGTB is multivariant disease and a standard unified approach to it is impossible. Clear definition as well as unique classification are necessary for real estimation of epidemiology and the optimization of therapy. The term 'UGTB' has insufficient information in order to estimate therapy, surgery and prognosis, or to evaluate the epidemiology.

Epidemiology of chronic kidney disease in children

NARCIS (Netherlands)

Harambat, Jérôme; van Stralen, Karlijn J.; Kim, Jon Jin; Tizard, E. Jane

2012-01-01

In the past 30 years there have been major improvements in the care of children with chronic kidney disease (CKD). However, most of the available epidemiological data stem from end-stage renal disease (ESRD) registries and information on the earlier stages of pediatric CKD is still limited. The

[Clostridium difficile infection: epidemiology, disease burden and therapy].

Science.gov (United States)

Gulácsi, László; Kertész, Adrienne; Kopcsóné Németh, Irén; Banai, János; Ludwig, Endre; Prinz, Gyula; Reményi, Péter; Strbák, Bálint; Zsoldiné Urbán, Edit; Baji, Petra; Péntek, Márta; Brodszky, Valentin

2013-07-28

C. difficile causes 25 percent of the antibiotic associated infectious nosocomial diarrhoeas. C. difficile infection is a high-priority problem of public health in each country. The available literature of C. difficile infection's epidemiology and disease burden is limited. Review of the epidemiology, including seasonality and the risk of recurrences, of the disease burden and of the therapy of C. difficile infection. Review of the international and Hungarian literature in MEDLINE database using PubMed up to and including 20th of March, 2012. The incidence of nosocomial C. difficile associated diarrhoea is 4.1/10 000 patient day. The seasonality of C. difficile infection is unproved. 20 percent of the patients have recurrence after metronidazole or vancomycin treatment, and each recurrence increases the chance of a further one. The cost of C. difficile infection is between 130 and 500 thousand HUF (430 € and 1665 €) in Hungary. The importance of C. difficile infection in public health and the associated disease burden are significant. The available data in Hungary are limited, further studies in epidemiology and health economics are required.

Asia Pacific Consensus Statements on Crohn's disease. Part 1: Definition, diagnosis, and epidemiology: (Asia Pacific Crohn's Disease Consensus--Part 1).

Science.gov (United States)

Ooi, Choon Jin; Makharia, Govind K; Hilmi, Ida; Gibson, Peter R; Fock, Kwong Ming; Ahuja, Vineet; Ling, Khoon Lin; Lim, Wee Chian; Thia, Kelvin T; Wei, Shu-chen; Leung, Wai Keung; Koh, Poh Koon; Gearry, Richard B; Goh, Khean Lee; Ouyang, Qin; Sollano, Jose; Manatsathit, Sathaporn; de Silva, H Janaka; Rerknimitr, Rungsun; Pisespongsa, Pises; Abu Hassan, Muhamad Radzi; Sung, Joseph; Hibi, Toshifumi; Boey, Christopher C M; Moran, Neil; Leong, Rupert W L

2016-01-01

Inflammatory bowel disease (IBD) was previously thought to be rare in Asia, but emerging data indicate rising incidence and prevalence of IBD in the region. The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology with the goal of developing best management practices, coordinating research, and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis with specific relevance to the Asia-Pacific region. The present consensus statements were developed following a similar process to address the epidemiology, diagnosis, and management of Crohn's disease. The goals of these statements are to pool the pertinent literature specifically highlighting relevant data and conditions in the Asia-Pacific region relating to the economy, health systems, background infectious diseases, differential diagnoses, and treatment availability. It does not intend to be all comprehensive and future revisions are likely to be required in this ever-changing field. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Proposal for common Nordic epidemiological terms and definitions for methicillin-resistant Staphylococcus aureus (MRSA)

DEFF Research Database (Denmark)

Skov, Robert; Gudlaugsson, Olafur; Hardardottir, Hjordis

2008-01-01

The recent increase in the incidence of methicillin-resistant Staphylococcus aureus in all the Nordic countries prompted the Scandinavian Society for Antimicrobial Chemotherapy (SSAC) to create the 'SSAC Working Party on MRSA' with the objective to identify methods to keep the invasive MRSA...... infections in the Nordic countries below 1%. The lack of common definitions was recognized as a major obstacle for a joint Nordic effort to combat MRSA. The aim of this publication is to present proposals for epidemiological definitions of individual cases, for how to report MRSA frequency per country...

The Oral HIV/AIDS Research Alliance: updated case definitions of oral disease endpoints.

Science.gov (United States)

Shiboski, C H; Patton, L L; Webster-Cyriaque, J Y; Greenspan, D; Traboulsi, R S; Ghannoum, M; Jurevic, R; Phelan, J A; Reznik, D; Greenspan, J S

2009-07-01

The Oral HIV/AIDS Research Alliance (OHARA) is part of the AIDS Clinical Trials Group (ACTG), the largest HIV clinical trials organization in the world. Its main objective is to investigate oral complications associated with HIV/AIDS as the epidemic is evolving, in particular, the effects of antiretrovirals on oral mucosal lesion development and associated fungal and viral pathogens. The OHARA infrastructure comprises: the Epidemiologic Research Unit (at the University of California San Francisco), the Medical Mycology Unit (at Case Western Reserve University) and the Virology/Specimen Banking Unit (at the University of North Carolina). The team includes dentists, physicians, virologists, mycologists, immunologists, epidemiologists and statisticians. Observational studies and clinical trials are being implemented at ACTG-affiliated sites in the US and resource-poor countries. Many studies have shared end-points, which include oral diseases known to be associated with HIV/AIDS measured by trained and calibrated ACTG study nurses. In preparation for future protocols, we have updated existing diagnostic criteria of the oral manifestations of HIV published in 1992 and 1993. The proposed case definitions are designed to be used in large-scale epidemiologic studies and clinical trials, in both US and resource-poor settings, where diagnoses may be made by non-dental healthcare providers. The objective of this article is to present updated case definitions for HIV-related oral diseases that will be used to measure standardized clinical end-points in OHARA studies, and that can be used by any investigator outside of OHARA/ACTG conducting clinical research that pertains to these end-points.

Epidemiological Trends of Dengue Disease in Colombia (2000-2011): A Systematic Review

Science.gov (United States)

Villar, Luis Angel; Rojas, Diana Patricia; Besada-Lombana, Sandra; Sarti, Elsa

2015-01-01

A systematic literature review was conducted to describe the epidemiology of dengue disease in Colombia. Searches of published literature in epidemiological studies of dengue disease encompassing the terms “dengue”, “epidemiology,” and “Colombia” were conducted. Studies in English or Spanish published between 1 January 2000 and 23 February 2012 were included. The searches identified 225 relevant citations, 30 of which fulfilled the inclusion criteria defined in the review protocol. The epidemiology of dengue disease in Colombia was characterized by a stable “baseline” annual number of dengue fever cases, with major outbreaks in 2001–2003 and 2010. The geographical spread of dengue disease cases showed a steady increase, with most of the country affected by the 2010 outbreak. The majority of dengue disease recorded during the review period was among those dengue disease in Colombia may provide several avenues for future research, namely studies of asymptomatic dengue virus infection, primary versus secondary infections, and under-reporting of the disease. Improved understanding of the factors that determine disease expression and enable improvement in disease control and management is also important. PMID:25790245

Epidemiologic research using probabilistic outcome definitions.

Science.gov (United States)

Cai, Bing; Hennessy, Sean; Lo Re, Vincent; Small, Dylan S

2015-01-01

Epidemiologic studies using electronic healthcare data often define the presence or absence of binary clinical outcomes by using algorithms with imperfect specificity, sensitivity, and positive predictive value. This results in misclassification and bias in study results. We describe and evaluate a new method called probabilistic outcome definition (POD) that uses logistic regression to estimate the probability of a clinical outcome using multiple potential algorithms and then uses multiple imputation to make valid inferences about the risk ratio or other epidemiologic parameters of interest. We conducted a simulation to evaluate the performance of the POD method with two variables that can predict the true outcome and compared the POD method with the conventional method. The simulation results showed that when the true risk ratio is equal to 1.0 (null), the conventional method based on a binary outcome provides unbiased estimates. However, when the risk ratio is not equal to 1.0, the traditional method, either using one predictive variable or both predictive variables to define the outcome, is biased when the positive predictive value is value is poor (less than 0.75 in our simulation). In contrast, the POD method provides unbiased estimates of the risk ratio both when this measure of effect is equal to 1.0 and not equal to 1.0. Even when the sensitivity and positive predictive value are low, the POD method continues to provide unbiased estimates of the risk ratio. The POD method provides an improved way to define outcomes in database research. This method has a major advantage over the conventional method in that it provided unbiased estimates of risk ratios and it is easy to use. Copyright © 2014 John Wiley & Sons, Ltd.

La epidemiología ocupacional como herramienta básica para la salud de los trabajadores Occupational epidemiology as a basic tool for workers' health

Directory of Open Access Journals (Sweden)

Caristina Robaina Aguirre

2006-06-01

Full Text Available Se realizó un pequeño bosquejo del desarrollo de la Epidemiología como ciencia y su importancia en salud pública en general. Se transita por las definiciones de vieja y nueva epidemiología, de enfermedades crónicas, transmisibles y no transmisibles, del concepto de epidemiología social, etc. para posteriormente hablar de la importancia de la Epidemiología Ocupacional en la Salud PúblicaA review of the development of Epidemiology as a science, and its significance in public health in general, was made. The old and new definitions of epidemiology, of chronic, transmissible and non-transmissible diseases, of social epidemiology concept, etc., are analysed to further deal with the importance of Occupational Epidemiology in Public Health.

The failure of academic epidemiology: witness for the prosecution.

Science.gov (United States)

Shy, C M

1997-03-15

Academic epidemiology has failed to develop the scientific methods and the knowledge base to support the fundamental public health mission of preventing disease and promoting health through organized community efforts. As a basic science of public health, epidemiology should attempt to understand health and disease from a community and ecologic perspective as a consequence of how society is organized and behaves, what impact social and economic forces have on disease incidence rates, and what community actions will be effective in altering incidence rates. However, as taught in most textbooks and as widely practiced by academicians, epidemiology has become a biomedical discipline focused on the distribution and determinants of disease in groups of individuals who happen to have some common characteristics, exposures, or diseases. The ecology of human health has not been addressed, and the societal context in which disease occurs has been either disregarded or deliberately abstracted from consideration. By essentially assuming that risk factors for disease in individuals can be summed to understand the causes of disease in populations, academic epidemiology has limited itself to a narrow biomedical perspective, thereby committing the bio-medical fallacy of inferring that disease in populations can be understood by studying risk factors for disease in individuals. Epidemiology should be redefined as a study of the distribution and societal determinants of the health status of populations. This definition provides a stronger link to be the primary mission of public health and places an appropriate emphasis on the social, economic, environmental, and cultural determinants of population health. Epidemiology must cross the boundaries of other population sciences and add to its scope a macro-epidemiology, a study of causes from a truly population perspective, considering health and disease within the context of the total human environment.

Epidemiology of dengue disease in Malaysia (2000-2012): a systematic literature review.

Science.gov (United States)

Mohd-Zaki, Abdul Hamid; Brett, Jeremy; Ismail, Ellyana; L'Azou, Maïna

2014-01-01

A literature survey and analysis was conducted to describe the epidemiology of dengue disease in Malaysia between 2000 and 2012. Published literature was searched for epidemiological studies of dengue disease, using specific search strategies for each electronic database; 237 relevant data sources were identified, 28 of which fulfilled the inclusion criteria. The epidemiology of dengue disease in Malaysia was characterized by a non-linear increase in the number of reported cases from 7,103 in 2000 to 46,171 in 2010, and a shift in the age range predominance from children toward adults. The overall increase in dengue disease was accompanied by a rise in the number, but not the proportion, of severe cases. The dominant circulating dengue virus serotypes changed continually over the decade and differed between states. Several gaps in epidemiological knowledge were identified; in particular, studies of regional differences, age-stratified seroprevalence, and hospital admissions. PROSPERO #CRD42012002293.

The epidemiology of premature ejaculation.

Science.gov (United States)

Saitz, Theodore Robert; Serefoglu, Ege Can

2016-08-01

Vast advances have occurred over the past decade with regards to understanding the epidemiology, pathophysiology and management of premature ejaculation (PE); however, we still have much to learn about this common sexual problem. As a standardized evidence-based definition of PE has only recently been established, the reported prevalence rates of PE prior to this definition have been difficult to interpret. As a result, a large range of conflicting prevalence rates have been reported. In addition to the lack of a standardized definition and operational criteria, the method of recruitment for study participation and method of data collection have obviously contributed to the broad range of reported prevalence rates. The new criteria and classification of PE will allow for continued research into the diverse phenomenology, etiology and pathogenesis of the disease to be conducted. While the absolute pathophysiology and true prevalence of PE remains unclear, developing a better understanding of the true prevalence of the disease will allow for the completion of more accurate analysis and treatment of the disease.

Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review

Science.gov (United States)

El-Serag, Hashem B; Sweet, Stephen; Winchester, Christopher C; Dent, John

2014-01-01

Objective To update the findings of the 2005 systematic review of population-based studies assessing the epidemiology of gastro-oesophageal reflux disease (GERD). Design PubMed and Embase were screened for new references using the original search strings. Studies were required to be population-based, to include ≥200 individuals, to have response rates ≥50% and recall periods <12 months. GERD was defined as heartburn and/or regurgitation on at least 1 day a week, or according to the Montreal definition, or diagnosed by a clinician. Temporal and geographic trends in disease prevalence were examined using a Poisson regression model. Results 16 studies of GERD epidemiology published since the original review were found to be suitable for inclusion (15 reporting prevalence and one reporting incidence), and were added to the 13 prevalence and two incidence studies found previously. The range of GERD prevalence estimates was 18.1%–27.8% in North America, 8.8%–25.9% in Europe, 2.5%–7.8% in East Asia, 8.7%–33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in paediatric patients aged 1– 17 years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p<0.0001), particularly in North America and East Asia. Conclusions GERD is prevalent worldwide, and disease burden may be increasing. Prevalence estimates show considerable geographic variation, but only East Asia shows estimates consistently lower than 10%. PMID:23853213

Epidemiology and natural history of atopic diseases

DEFF Research Database (Denmark)

Thomsen, Simon F

2015-01-01

The atopic diseases - atopic dermatitis, asthma, and hay fever - pose a great burden to the individual and society, not least, since these diseases have reached epidemic proportions during the past decades in industrialized and, more recently, in developing countries. Whereas the prevalence...... of the atopic diseases now seems to have reached a plateau in many Western countries, they are still on the increase in the developing world. This emphasizes continuing research aimed at identifying the causes, risk factors, and natural history of these diseases. Herein, the fundamental aspects of the natural...... history and epidemiology of the atopic diseases are reviewed....

The Global Epidemiologic Transition: Noncommunicable Diseases and Emerging Health Risk of Allergic Disease in Sub-Saharan Africa

Science.gov (United States)

Atiim, George A.; Elliott, Susan J.

2016-01-01

Globally, there has been a shift in the causes of illness and death from infectious diseases to noncommunicable diseases. This changing pattern has been attributed to the effects of an (ongoing) epidemiologic transition. Although researchers have applied epidemiologic transition theory to questions of global health, there have been relatively few…

The Epidemiology of Transfusion-related Acute Lung Injury Varies According to the Applied Definition of Lung Injury Onset Time.

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Vande Vusse, Lisa K; Caldwell, Ellen; Tran, Edward; Hogl, Laurie; Dinwiddie, Steven; López, José A; Maier, Ronald V; Watkins, Timothy R

2015-09-01

Research that applies an unreliable definition for transfusion-related acute lung injury (TRALI) may draw false conclusions about its risk factors and biology. The effectiveness of preventive strategies may decrease as a consequence. However, the reliability of the consensus TRALI definition is unknown. To prospectively study the effect of applying two plausible definitions of acute respiratory distress syndrome onset time on TRALI epidemiology. We studied 316 adults admitted to the intensive care unit and transfused red blood cells within 24 hours of blunt trauma. We identified patients with acute respiratory distress syndrome, and defined acute respiratory distress syndrome onset time two ways: (1) the time at which the first radiographic or oxygenation criterion was met, and (2) the time both criteria were met. We categorized two corresponding groups of TRALI cases transfused in the 6 hours before acute respiratory distress syndrome onset. We used Cohen's kappa to measure agreement between the TRALI cases and implicated blood components identified by the two acute respiratory distress syndrome onset time definitions. In a nested case-control study, we examined potential risk factors for each group of TRALI cases, including demographics, injury severity, and characteristics of blood components transfused in the 6 hours before acute respiratory distress syndrome onset. Forty-two of 113 patients with acute respiratory distress syndrome were TRALI cases per the first acute respiratory distress syndrome onset time definition and 63 per the second definition. There was slight agreement between the two groups of TRALI cases (κ = 0.16; 95% confidence interval, -0.01 to 0.33) and between the implicated blood components (κ = 0.15, 95% confidence interval, 0.11-0.20). Age, Injury Severity Score, high plasma-volume components, and transfused plasma volume were risk factors for TRALI when applying the second acute respiratory distress syndrome onset time definition

Reconsidering the definition of Major Depression based on Collaborative Psychiatric Epidemiology Surveys.

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Rosenström, Tom; Jokela, Markus

2017-01-01

Diagnostic definitions for depressive disorders remain a debated topic, despite their central role in clinical practice and research. We use both recent evidence and nationally representative data to derive an empirically-based modification of DSM-IV/-5 Major Depressive Disorder (MDD). A modified MDD diagnosis was derived by analyzing data from Collaborative Psychiatric Epidemiology Surveys, a multistage probability sample of adults (n=20 013; age ≥ 18 years) in coterminous USA, Alaska and Hawaii. The old and the newly suggested MDD definitions were compared for their associated disability (WHO Disability Assessment Schedule and number of disability days in past month), suicide attempt, and other covariates. Our data-driven definition for major depression was "lack of interest to all or most things" plus four other symptoms from the set {weight gain, weight loss, insomnia, psychomotor retardation, fatigue, feelings of worthlessness, diminished ability to think/concentrate, suicidal ideation/attempt}. The new definition captured all the disability implied by MDD and excluded cases that showed no greater disability than the general population nor increased risk of suicide attempts. The lifetime prevalence of the new diagnosis was 14.7% (95% CI=14-15.4%) of the population, slightly less than for the old definition (16.4%; CI=15.4-17.3%). Only conservative modifications of MDD could be studied, because of restrictions in the symptom data. With only small adjusting, the new definition for major depression may be more clinically relevant than the old one, and could serve as a conservative replacement for the old definition. Copyright © 2016 Elsevier B.V. All rights reserved.

Particulate matter and heart disease: Evidence from epidemiological studies

International Nuclear Information System (INIS)

Peters, Annette

2005-01-01

The association between particulate matter and heart disease was noted in the mid-nineties of last century when the epidemiological evidence for an association between air pollution and hospital admissions due to cardiovascular disease accumulated and first hypotheses regarding the pathomechanism were formulated. Nowadays, epidemiological studies have demonstrated coherent associations between daily changes in concentrations of ambient particles and cardiovascular disease mortality, hospital admission, disease exacerbation in patients with cardiovascular disease and early physiological responses in healthy individuals consistent with a risk factor profile deterioration. In addition, evidence was found that annual average PM 2.5 exposures are associated with increased risks for mortality caused by ischemic heart disease and dysrhythmia. Thereby, evidence is suggesting not only a short-term exacerbation of cardiovascular disease by ambient particle concentrations but also a potential role of particles in defining patients' vulnerability to acute coronary events. While this concept is consistent with the current understanding of the factors defining patients' vulnerability, the mechanisms and the time-scales on which the particle-induced vulnerability might operate are unknown

[Ischemic origin of diabetic foot disease. Epidemiology, difficulties of diagnosis, options for prevention and revascularization].

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Kolossváry, Endre; Bánsághi, Zoltán; Szabó, Gábor Viktor; Járai, Zoltán; Farkas, Katalin

2017-02-01

"Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations. Available vascular centers with special expertise and diagnostic tools are the prerequisite for efficient diagnosis supporting timely recognition of peripheral arterial disease. In course of treatment of diabetic foot with ischemic origin, beyond effective medical treatment revascularization (open vascular surgery or endovascular procedures) has paramount importance for prevention of limb loss. Vascular teams of vascular specialists, vascular surgeons and interventional radiologist in dedicated centers in multidisciplinary cooperation with other professions represent public health issue in effective prevention. Orv. Hetil., 2017, 158(6), 203-211.

Merging economics and epidemiology to improve the prediction and management of infectious disease.

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Perrings, Charles; Castillo-Chavez, Carlos; Chowell, Gerardo; Daszak, Peter; Fenichel, Eli P; Finnoff, David; Horan, Richard D; Kilpatrick, A Marm; Kinzig, Ann P; Kuminoff, Nicolai V; Levin, Simon; Morin, Benjamin; Smith, Katherine F; Springborn, Michael

2014-12-01

Mathematical epidemiology, one of the oldest and richest areas in mathematical biology, has significantly enhanced our understanding of how pathogens emerge, evolve, and spread. Classical epidemiological models, the standard for predicting and managing the spread of infectious disease, assume that contacts between susceptible and infectious individuals depend on their relative frequency in the population. The behavioral factors that underpin contact rates are not generally addressed. There is, however, an emerging a class of models that addresses the feedbacks between infectious disease dynamics and the behavioral decisions driving host contact. Referred to as "economic epidemiology" or "epidemiological economics," the approach explores the determinants of decisions about the number and type of contacts made by individuals, using insights and methods from economics. We show how the approach has the potential both to improve predictions of the course of infectious disease, and to support development of novel approaches to infectious disease management.

Ecology, Epidemiology and Disease Management of Ralstonia syzygii in Indonesia.

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Safni, Irda; Subandiyah, Siti; Fegan, Mark

2018-01-01

Ralstonia solanacearum species complex phylotype IV strains, which have been primarily isolated from Indonesia, Australia, Japan, Korea, and Malaysia, have undergone recent taxonomic and nomenclatural changes to be placed in the species Ralstonia syzygii . This species contains three subspecies; Ralstonia syzygii subsp. syzygii , a pathogen causing Sumatra disease of clove trees in Indonesia, Ralstonia syzygii subsp. indonesiensis , the causal pathogen of bacterial wilt disease on a wide range of host plants, and Ralstonia syzygii subsp. celebesensis , the causal pathogen of blood disease on Musa spp. In Indonesia, these three subspecies have devastated the cultivation of susceptible host plants which have high economic value. Limited knowledge on the ecology and epidemiology of the diseases has hindered the development of effective control strategies. In this review, we provide insights into the ecology, epidemiology and disease control of these three subspecies of Ralstonia syzygii .

Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes--systematic review.

Science.gov (United States)

Ide, Mark; Papapanou, Panos N

2013-04-01

There is still debate regarding potential relationships between maternal periodontitis during pregnancy and adverse pregnancy outcomes. The aim of this systematic review was to synthesize the available epidemiological evidence on this association. Combined electronic and hand search of MEDLINE, EMBASE, WEB OF SCIENCE and Cochrane Central Register databases. Original publications reporting data from cross-sectional, case-control or prospective cohort epidemiological studies on the association between periodontal status and preterm birth, low birthweight (LBW) or preeclampsia. The search was not limited to publications in English. All selected studies provided data based on professional assessments of periodontal status, and outcome variables, including preterm birth (pregnancy loss or miscarriage, or pre-eclampsia. Pregnant women with or without periodontal disease, and with or without adverse pregnancy outcomes, assessed either during pregnancy or postpartum. No intervention studies were included. Study appraisal and synthesis methods - Publications were assessed based on predefined screening criteria including type of periodontal assessment, consistency in the timing of the periodontal assessment with respect to gestational age, examiner masking and consideration of additional exposures and confounders. Maternal periodontitis is modestly but significantly associated with LBW and preterm birth, but the use of a categorical or a continuous exposure definition of periodontitis appears to impact the findings: Although significant associations emerge from case-control and cross-sectional studies using periodontitis "case definitions," these were substantially attenuated in studies assessing periodontitis as a continuous variable. Data from prospective studies followed a similar pattern, but associations were generally weaker. Maternal periodontitis was significantly associated with pre-eclampsia. There is a high degree of variability in study populations, recruitment

Ergonomics and epidemiology in evidence based health prevention

DEFF Research Database (Denmark)

Jensen, Olaf Chresten

2009-01-01

According to the definitions, ergonomics is a natural part of the health and safety activity but it has its own research methods and causal models. Public health, occupational and clinical medicines are closely related to epidemiology and differ from ergonomics by using a disease model with a wide...... success of health effects from the clinical trials could not be obtained. It is argued that the ergonomics design, Integration and Implementation can be strengthened by adapting the epidemiological methods and causal models. The ergonomics can then contribute to a common development of public health...

Epidemiology of Dengue Disease in Malaysia (2000–2012): A Systematic Literature Review

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Mohd-Zaki, Abdul Hamid; Brett, Jeremy; Ismail, Ellyana; L'Azou, Maïna

2014-01-01

A literature survey and analysis was conducted to describe the epidemiology of dengue disease in Malaysia between 2000 and 2012. Published literature was searched for epidemiological studies of dengue disease, using specific search strategies for each electronic database; 237 relevant data sources were identified, 28 of which fulfilled the inclusion criteria. The epidemiology of dengue disease in Malaysia was characterized by a non-linear increase in the number of reported cases from 7,103 in 2000 to 46,171 in 2010, and a shift in the age range predominance from children toward adults. The overall increase in dengue disease was accompanied by a rise in the number, but not the proportion, of severe cases. The dominant circulating dengue virus serotypes changed continually over the decade and differed between states. Several gaps in epidemiological knowledge were identified; in particular, studies of regional differences, age-stratified seroprevalence, and hospital admissions. Protocol registration PROSPERO #CRD42012002293 PMID:25375211

A population-based survey of the epidemiology of symptom-defined gastroesophageal reflux disease: the Systematic Investigation of Gastrointestinal Diseases in China

Directory of Open Access Journals (Sweden)

He Jia

2010-08-01

Full Text Available Abstract Background The epidemiology of gastroesophageal reflux disease (GERD has yet to be investigated using the symptomatic threshold criteria recommended by the Montreal Definition. This study aimed to determine the prevalence of symptom-defined GERD across five regions of China, and to investigate variables associated with GERD. Methods A representative sample of 18 000 adults (aged 18-80 years were selected equally from rural and urban areas in each region (n = 1800. According to the Montreal Definition, GERD is present when mild symptoms of heartburn and/or regurgitation occur on ≥2 days a week, or moderate-to-severe symptoms of heartburn and/or regurgitation occur on ≥1 day a week. Results In total, 16 091 participants completed the survey (response rate: 89.4% and 16 078 responses were suitable for analysis. Applying the Montreal criteria, the prevalence of symptom-defined GERD was 3.1% and varied significantly (p Conclusions This population-based survey found that the prevalence of symptom-defined GERD in China was 3.1%, which is lower than that found in Western countries.

Recommendations for epidemiological studies on COPD

DEFF Research Database (Denmark)

Bakke, P S; Rönmark, E; Eagan, T

2011-01-01

of the disease and definitions of the risk factors. Few community studies have examined phenotypes of COPD and included other ways of characterising the disease beyond that of spirometry. The objective of the present Task Force report is to present recommendations for the performance of general population...... for planning and performing an epidemiological study on COPD. The main message of the paper is that thorough planning is worth half the study. It is crucial to stick to standardised methods and good quality control during sampling. We recommend collecting biological markers, depending on the specific...

The science of epidemiology and the methods needed for public health assessments: a review of epidemiology textbooks.

Science.gov (United States)

Gouda, Hebe N; Powles, John W

2014-02-10

Epidemiology is often described as 'the science of public health'. Here we aim to assess the extent that epidemiological methods, as covered in contemporary standard textbooks, provide tools that can assess the relative magnitude of public health problems and can be used to help rank and assess public health priorities. Narrative literature review. Thirty textbooks were grouped into three categories; pure, extended or applied epidemiology, were reviewed with attention to the ways the discipline is characterised and the nature of the analytical methods described. Pure texts tend to present a strict hierarchy of methods with those metrics deemed to best serve aetiological inquiry at the top. Extended and applied texts employ broader definitions of epidemiology but in most cases, the metrics described are also those used in aetiological inquiry and may not be optimal for capturing the consequences and social importance of injuries and disease onsets. The primary scientific purpose of epidemiology, even amongst 'applied' textbooks, is aetiological inquiry. Authors do not readily extend to methods suitable for assessing public health problems and priorities.

Guidance for Modifying the Definition of Diseases: A Checklist.

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Doust, Jenny; Vandvik, Per O; Qaseem, Amir; Mustafa, Reem A; Horvath, Andrea R; Frances, Allen; Al-Ansary, Lubna; Bossuyt, Patrick; Ward, Robyn L; Kopp, Ina; Gollogly, Laragh; Schunemann, Holger; Glasziou, Paul

2017-07-01

No guidelines exist currently for guideline panels and others considering changes to disease definitions. Panels frequently widen disease definitions, increasing the proportion of the population labeled as unwell and potentially causing harm to patients. We set out to develop a checklist of issues, with guidance, for panels to consider prior to modifying a disease definition. We assembled a multidisciplinary, multicontinent working group of 13 members, including members from the Guidelines International Network, Grading of Recommendations Assessment, Development and Evaluation working group, and the World Health Organisation. We used a 5-step process to develop the checklist: (1) a literature review of issues, (2) a draft outline document, (3) a Delphi process of feedback on the list of issues, (4) a 1-day face-to-face meeting, and (5) further refinement of the checklist. The literature review identified 12 potential issues. From these, the group developed an 8-item checklist that consisted of definition changes, number of people affected, trigger, prognostic ability, disease definition precision and accuracy, potential benefits, potential harms, and the balance between potential harms and benefits. The checklist is accompanied by an explanation of each item and the types of evidence to assess each one. We used a panel's recent consideration of a proposed change in the definition of gestational diabetes mellitus (GDM) to illustrate use of the checklist. We propose that the checklist be piloted and validated by groups developing new guidelines. We anticipate that the use of the checklist will be a first step to guidance and better documentation of definition changes prior to introducing modified disease definitions.

Insights from the Society of Infectious Diseases Pharmacists on antimicrobial stewardship guidelines from the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

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Drew, Richard H; White, Roger; MacDougall, Conan; Hermsen, Elizabeth D; Owens, Robert C

2009-05-01

In 2007, the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America published a document that addressed the major considerations for the justification, description, and conduct of antimicrobial stewardship programs. Our document is intended to continue the dialogue of these formalized programmatic strategies. We briefly review the guidelines, including the two primary strategies (prospective auditing with feedback, and preauthorization), and the supplemental strategies (education, information technology, transitional therapy, de-escalation or streamlining, and dose optimization). Discussions are introduced or furthered in the areas of program goals, barriers and solutions, and outcome measures. Definition and training of infectious diseases pharmacists are presented in detail. We offer keys to future success, which include continued collaboration and expanded use of information technology.

Epidemiology: Past, Present, and Future Impacts on Understanding Disease Dynamics and Improving Plant Disease Management-A Summary of Focus Issue Articles.

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Ojiambo, P S; Yuen, J; van den Bosch, F; Madden, L V

2017-10-01

Epidemiology has made significant contributions to plant pathology by elucidating the general principles underlying the development of disease epidemics. This has resulted in a greatly improved theoretical and empirical understanding of the dynamics of disease epidemics in time and space, predictions of disease outbreaks or the need for disease control in real-time basis, and tactical and strategic solutions to disease problems. Availability of high-resolution experimental data at multiple temporal and spatial scales has now provided a platform to test and validate theories on the spread of diseases at a wide range of spatial scales ranging from the local to the landscape level. Relatively new approaches in plant disease epidemiology, ranging from network to information theory, coupled with the availability of large-scale datasets and the rapid development of computer technology, are leading to revolutionary thinking about epidemics that can result in considerable improvement of strategic and tactical decision making in the control and management of plant diseases. Methods that were previously restricted to topics such as population biology or evolution are now being employed in epidemiology to enable a better understanding of the forces that drive the development of plant disease epidemics in space and time. This Focus Issue of Phytopathology features research articles that address broad themes in epidemiology including social and political consequences of disease epidemics, decision theory and support, pathogen dispersal and disease spread, disease assessment and pathogen biology and disease resistance. It is important to emphasize that these articles are just a sample of the types of research projects that are relevant to epidemiology. Below, we provide a succinct summary of the articles that are published in this Focus Issue .

Socioepidemiological screening of serologically ineligible blood donors due to Chagas disease for the definition of inconclusive cases

Directory of Open Access Journals (Sweden)

Márcia M Ferreira-Silva

2010-09-01

Full Text Available Epidemiological screening combined with serological tests has become an important tool at blood banks for the characterization of donors with or without Trypanosoma cruzi infection. Thus, the objective of the present study was to describe the sociodemographic and epidemiological characteristics of blood donors with non-negative serology for T. cruzito determine possible risk factors associated with serological ineligibility. Sociodemographic and epidemiological data were collected by analysis of patient histories and interviews. The data were analyzed descriptively using absolute and relative frequencies and odds ratio (OR evaluation. The frequency of serological ineligibility was 0.28%, with a predominance of inconclusive reactions (52% and seropositivity among first-time donors (OR = 607, donors older than 30 years (OR = 3.7, females (OR = 1.9, donors from risk areas (OR = 4 and subjects living in rural areas (OR = 1.7. The risk of seropositivity was higher among donors who had contact with the triatomine vector (OR = 11.7 and those with a family history of Chagas disease (OR = 4.8. The results demonstrate the value of detailed clinical-epidemiological screening as an auxiliary tool for serological definition that, together with more specific and more sensitive laboratory methods, will guarantee a higher efficacy in the selection of donors at blood centres.

Epidemiological features and trends of Ebola virus disease in West Africa

Directory of Open Access Journals (Sweden)

Ligui Wang

2015-09-01

Full Text Available According to a World Health Organization report, the epidemiological features of Ebola virus disease (EVD have changed significantly in West Africa. In this study, the new epidemiological features and prevalence trends for EVD in Guinea, Liberia, and Sierra Leone are described. It was predicted that the Ebola outbreak would end in June 2015.

Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases

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Gabriel, Sherine E; Michaud, Kaleb

2009-01-01

Epidemiology is the study of the distribution and determinants of disease in human populations. Over the past decade there has been considerable progress in our understanding of the fundamental descriptive epidemiology (levels of disease frequency: incidence and prevalence, comorbidity, mortality, trends over time, geographic distributions, and clinical characteristics) of the rheumatic diseases. This progress is reviewed for the following major rheumatic diseases: rheumatoid arthritis (RA), juvenile rheumatoid arthritis, psoriatic arthritis, osteoarthritis, systemic lupus erythematosus, giant cell arteritis, polymyalgia rheumatica, gout, Sjögren's syndrome, and ankylosing spondylitis. These findings demonstrate the dynamic nature of the incidence and prevalence of these conditions – a reflection of the impact of genetic and environmental factors. The past decade has also brought new insights regarding the comorbidity associated with rheumatic diseases. Strong evidence now shows that persons with RA are at a high risk for developing several comorbid disorders, that these conditions may have atypical features and thus may be difficult to diagnose, and that persons with RA experience poorer outcomes after comorbidity compared with the general population. Taken together, these findings underscore the complexity of the rheumatic diseases and highlight the key role of epidemiological research in understanding these intriguing conditions. PMID:19519924

Landscape epidemiology: An emerging perspective in the mapping and modelling of disease and disease risk factors

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Nnadi Nnaemeka Emmanuel

2011-09-01

Full Text Available Landscape epidemiology describes how the temporal dynamics of host, vector, and pathogen populations interact spatially within a permissive environment to enable transmission. It also aims at understanding the vegetation and geologic conditions that are necessary for the maintenance and transmission of a particular pathogen. The current review describes the evolution of landscape epidemiology. As a science, it also highlights the various methods of mapping and modeling diseases and disease risk factors. The key tool to characterize landscape is satellite remote sensing and these data are used as inputs to drive spatial models of transmission risk.

Kidney disease and obesity: epidemiology, mechanisms and treatment.

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Câmara, Niels Olsen Saraiva; Iseki, Kunitoshi; Kramer, Holly; Liu, Zhi-Hong; Sharma, Kumar

2017-03-01

The theme of World Kidney Day 2017 is 'kidney disease and obesity: healthy lifestyle for healthy kidneys'. To mark this event, Nature Reviews Nephrology invited five leading researchers to describe changes in the epidemiology of obesity-related kidney disease, advances in current understanding of the mechanisms and current approaches to the management of affected patients. The researchers also highlight new advances that could lead to the development of novel treatments and identify areas in which further basic and clinical studies are needed.

Major Depressive Disorder Definition, Etiology and Epidemiology: A Review

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Fatmagul Helvaci Celik

2016-03-01

Full Text Available Depression is one of the most common psychiatric disorders influencing the all population. Untreated depression may lead to early death and worsening in general health. Depression has several clinically distinct subtypes which are sometimes difficult to diagnose. Diagnosis and treatment of these disorders are of concern to physicians other than psychiatrists, because of their effect on course and prognosis of general medical diseases. This is a concise and up to date overview of the epidemiology,etiology physiopathology and diagnosis of major depressive disorder. [J Contemp Med 2016; 6(1.000: 51-66

Truth or Spin? Disease Definition in Cancer Screening.

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Reid, Lynette

2017-08-01

Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist routes to objectivity are inconsistent with the Bayesian nature of clinical reasoning; when they appeal to the sciences, they are inconsistent with what philosophy of biology tells us about its natural kinds. Proposals that we narrow the scope of our claims in the disease definition debates (proposing adoption of a specific disease paradigm for a specific context) are useful, but paradigms can still distort our reasoning in particular cases, even when we are self-conscious about their status. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The history and epidemiology of Cape St Paul wilt disease of ...

African Journals Online (AJOL)

The history of the spread of the Cape St. Paul Wilt (lethal yellowing) disease of coconut in Ghana is presented. Epidemiological studies showed that the disease starts slowly, then progresses (accelerate) rapidly before levelling off. In a farm, the disease first appears randomly on single trees, foci then develop around these ...

[Analysis of projects of infectious disease epidemiology sponsored by National Natural Science Foundation of China].

Science.gov (United States)

Jian-Ming, Wang; Yan-Kai, Xia; Hui-Juan, Zhu; Feng, Chen; Hong-Bing, Shen

2016-05-10

To analyze the projects on the infectious disease epidemiology sponsored by the National Natural Science Foundation of China (NSFC), explore the hotspot and development trend, and offer a reference for researchers in this field. Based on the NSFC database, the projects on the infectious disease epidemiology (H2609) sponsored from 1987 to 2014 were analyzed. The changes of fund numbers, amounts and research fields were described. During the study period, NSFC sponsored 373 projects, including 228 general projects (61.1%), 78 youth projects (20.9%) and 67 other projects (18.0%). The average amount of the grant was 358.2 thousand Yuan (20 thousand-8 million). The main sponsored research fields were mechanisms of pathogen and immunity (36.2%) and population-based epidemiological studies (33.0%). The top three diseases were hepatitis, HIV/AIDS and tuberculosis. The amount of funding on researches of infectious disease epidemiology has increased continuously, which has played an important role in training scientific talents in the field of prevention and control of infectious diseases.

Niewydolność serca - definicja, klasyfikacja, epidemiologia, objawy i leczenie = Heart failure - definition, classification, epidemiology, symptoms and treatment

Directory of Open Access Journals (Sweden)

Beata Kowalczyk

2017-02-01

  Streszczenie   W ciągu ostatnich 50 lat pojawiło się wiele określeń niewydolności serca. Dokonał się również znaczący postęp w postrzeganiu i leczeniu tej choroby. Skuteczność leczenia i rehabilitacji przekłada się na redukcję klasy NYHA i poprawę frakcji wyrzutowej lewej komory serca. Istotnie poprawiło się rokowanie chorych z umiarkowaną i ciężką postacią niewydolności. Kluczem do wczesnego rozpoznania niewydolności serca są jej objawy przedmiotowe i podmiotowe. Niestety pomimo ogromnego rozwoju medycyny niewydolność serca jest nadal poważnym problemem klinicznym, społecznym i ekonomicznym. Liczba zachorowań stale rośnie. W kompleksowej opiece nad pacjentem z niewydolnością serca oprócz leczenia farmakologicznego znaczącą rolę odgrywa odpowiednie przygotowanie chorego do życia z niewydolnością serca. Celem artykułu jest podsumowanie zagadnień definicji, klasyfikacji, epidemiologii, objawów i leczenia niewydolności serca.   Słowa kluczowe: niewydolność serca, definicja, klasyfikacja, epidemiologia, leczenie.     Abstract   In the last 50 years there have been many definitions of heart failure. It has been made significant progress in the perception and treatment of the disease. The effectiveness of treatment and rehabilitation translates into a reduction in NYHA class and improve the ejection fraction of the left ventricle. Significantly improved the prognosis in patients with moderate or severe heart failure. The key to early diagnosis of heart failure are its signs and symptoms. Heart failure unfortunately continues despite the enormous development of medicine is serious clinical, social and economic problem. The number of cases continues to grow. In the comprehensive care of patients with heart failure in addition to pharmacological treatment plays an important role adequate preparation of the patient to live with heart failure. Objectives of this article is a summary of issues of definition

Time for a neonatal-specific consensus definition for sepsis.

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Wynn, James L; Wong, Hector R; Shanley, Thomas P; Bizzarro, Matthew J; Saiman, Lisa; Polin, Richard A

2014-07-01

To review the accuracy of the pediatric consensus definition of sepsis in term neonates and to determine the definition of neonatal sepsis used. The review focused primarily on pediatric literature relevant to the topic of interest. Neonatal sepsis is variably defined based on a number of clinical and laboratory criteria that make the study of this common and devastating condition very difficult. Diagnostic challenges and uncertain disease epidemiology necessarily result from a variable definition of disease. In 2005, intensivists caring for children recognized that as new drugs became available, children would be increasingly studied and thus, pediatric-specific consensus definitions were needed. Pediatric sepsis criteria are not accurate for term neonates and have not been examined in preterm neonates for whom the developmental stage influences aberrations associated with host immune response. Thus, specific consensus definitions for both term and preterm neonates are needed. Such definitions are critical for the interpretation of observational studies, future training of scientists and practitioners, and implementation of clinical trials in neonates.

Costs and epidemiological changes of chronic diseases: implications and challenges for health systems.

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Arredondo, Armando; Aviles, Raul

2015-01-01

The need to integrate economic and epidemiological aspects in the clinical perspective leads to a proposal for the analysis of health disparities and to an evaluation of the health services and of the new challenges which are now being faced by health system reforms in middle income countries. To identify the epidemiological changes, the demand for health services and economic burden from chronic diseases (diabetes and hypertension) in a middle income county. We conducted longitudinal analyses of costs and epidemiological changes for diabetes and hypertension in the Mexican health system. The study population included both the insured and uninsured populations. The cost-evaluation method was used, based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2014-2016, six models were constructed according to the Box-Jenkins technique, using confidence intervals of 95%, and the Box-Pierce test. Regarding epidemiological changes expected in both diseases for 2014 vs. 2016, an increase is expected, although results predict a greater increase for diabetes, 8-12% in all three studied institutions, (p management per patient in the case of diabetes, and from $485 to $622 in patients with hypertension. Comparing financial consequences of health services required by insured and uninsured populations, the greater increase (23%) will be for the insured population (p financial requirements of both diseases will amount to 19.5% of the total budget for the uninsured and 12.5% for the insured population. If the risk factors and the different health care models remain as they currently are, the economic impact of expected epidemiological changes on the social security system will be particularly strong. Another relevant challenge is the appearance of internal competition in the use and allocation of financial resources with programs for other chronic and infectious diseases.

Epidemiology of pollution-induced airway disease in Japan

International Nuclear Information System (INIS)

Miyamoto, T.

1997-01-01

Air pollution has been implicated as one of the factors responsible for the increased incidence of allergic diseases seen over recent years. Epidemiological studies in Japan demonstrate that atopic subjects living in urban areas are more likely to suffer from the effects of air pollution, with increased coughing, sputum production, wheezing and throat irritation. Furthermore, animal studies show that high concentrations of pollutant gases can promote airway sensitization. The incidence of allergic Rhinitis and asthma have been shown to be greater in areas where there is heavy traffic and hence high levels of automobile exhaust emissions. Intranasal administration of diesel exhaust particles in mice produces a stimulatory effect on immunoglobulin E production, and a similar finding has also been shown with suspended particulate matter in air. Air pollutants, such as ozone and nitrogen dioxide (NO 2 ), have been shown to stimulate the production of granulocyte-macrophage colony stimulating factor, which may play a vital role in airway hyperreactivity and asthma. In comparative studies of asthma in urban and rural areas, history of airway infection and a younger age of onset were found to be significantly greater in urban areas. When the asthmatic patients were divided into two groups according to environmental NO 2 levels (group I: NO 2 >30 ppb, group II: NO 2 <30 ppb), no significant difference regarding the various parameters was noted between the two groups, except for a greater severity of asthma in adults in group I, and a greater severity in chrildren in group II. These studies imply that air pollution may be one reason for the increase in allergic diseases in Japan, but a definitive conclusion cannot be drawn, and further, investigation is warranted. (au)

Epidemiology of Chagas disease in Ecuador. A brief review

Directory of Open Access Journals (Sweden)

Aguilar V H Marcelo

1999-01-01

Full Text Available Chagas disease is a complex public health problem that has been underestimated in Ecuador. Here we review the relevant published information, and present unpublished and new data that help to understand the current Chagas disease epidemiological situation and its evolution in the country. Three main characteristics have been identified: (i persistence of Trypanosoma cruzi transmission in already known foci; (ii a marked endemicity in some urban areas of Guayaquil; and (iii the transformation of new Amazon foci into truly endemic areas. The situation in other suspect areas remains uncertain. Five Triatominae species have been implicated in the transmission of T. cruzi to people in Ecuador (Triatoma dimidiata, Rhodnius ecuadoriensis, R. pictipes, R. robustus and Panstrongylus geniculatus, but some others may also play a role in some areas (P. rufotuberculatus, P. howardi, T. carrioni and P. chinai. Other Triatominae reported seem to have little or no epidemiological relevance (T. venosa, T. dispar, Eratyrus mucronatus, E. cuspidatus, P. lignarius and Cavernicola pilosa. High frequency of acute cases and severe chronic disease has been observed. Although cardiomyopathy is more frequent, serious digestive disease is also present. It is estimated that around 120,000-200,000 people may be infected. 2.2 to 3.8 million people are estimated to live under transmission risk conditions.

Surgical perspectives on inflammatory bowel disease

African Journals Online (AJOL)

VikasC

Xia B, Crusius JBA, Meuwissen SGM, Pena AS. Inflammatory bowel disease: Definition, epidemiology, etiologic aspects, and immunologic studies. World J. Gastroentero 1998;4:44658. 2. Fry DR, Mahmood N, Maron DJ, Ross HM, Rombeau. J. Inflammatory bowel disease in Towsend: Sabiston. Textbook of Surgery.

78 FR 12702 - Control of Communicable Diseases: Interstate; Scope and Definitions

Science.gov (United States)

2013-02-25

... Control of Communicable Diseases: Interstate; Scope and Definitions AGENCY: Centers for Disease Control... rulemaking; withdrawal. SUMMARY: The Centers for Disease Control and Prevention (CDC) within the Department... Rulemaking (NPRM) that solicited public comment on updates to the Scope and Definitions for its regulations...

Chapter 2. Fasciola, lymnaeids and human fascioliasis, with a global overview on disease transmission, epidemiology, evolutionary genetics, molecular epidemiology and control.

Science.gov (United States)

Mas-Coma, Santiago; Valero, María Adela; Bargues, María Dolores

2009-01-01

Fascioliasis, caused by liver fluke species of the genus Fasciola, has always been well recognized because of its high veterinary impact but it has been among the most neglected diseases for decades with regard to human infection. However, the increasing importance of human fascioliasis worldwide has re-launched interest in fascioliasis. From the 1990s, many new concepts have been developed regarding human fascioliasis and these have furnished a new baseline for the human disease that is very different to a simple extrapolation from fascioliasis in livestock. Studies have shown that human fascioliasis presents marked heterogeneity, including different epidemiological situations and transmission patterns in different endemic areas. This heterogeneity, added to the present emergence/re-emergence of the disease both in humans and animals in many regions, confirms a worrying global scenario. The huge negative impact of fascioliasis on human communities demands rapid action. When analyzing how better to define control measures for endemic areas differing at such a level, it would be useful to have genetic markers that could distinguish each type of transmission pattern and epidemiological situation. Accordingly, this chapter covers aspects of aetiology, geographical distribution, epidemiology, transmission and control in order to obtain a solid baseline for the interpretation of future results. The origins and geographical spread of F. hepatica and F. gigantica in both the ruminant pre-domestication times and the livestock post-domestication period are analyzed. Paleontological, archaeological and historical records, as well as genetic data on recent dispersal of livestock species, are taken into account to establish an evolutionary framework for the two fasciolids across all continents. Emphasis is given to the distributional overlap of both species and the roles of transportation, transhumance and trade in the different overlap situations. Areas with only one Fasciola

Epidemiology of infectious diseases transmitted by drinking water in developed countries.

Science.gov (United States)

Hartemann, P; Newman, R; Foliguet, J M

1986-01-01

Research on the epidemiology of infectious diseases attributable to drinking water, common in the US during the past 20 years at least, is not yet really widespread in France. The role played by water in the transmission of certain infectious agents was important in European countries during past centuries but at present the incidence of waterborne diseases can be considered as very low. The absence of well-established data is due to the difficulty in reporting correctly a few minor outbreaks in a situation of very low endemicity. After a survey of the reported outbreaks, this paper deals with risk assessment of waterborne diseases in developed countries as well as special problems linked with proving transmission via water and with the nature of the infectious agents, and the development of monitoring methods for increasing our knowledge of this epidemiology.

Investigative workshop for mathematical modeling of Johne's disease epidemiology and immunology

Science.gov (United States)

Despite long and intensive national-level efforts for Johne’s disease (JD) control, we are still far from preventing the significant economic impact of this formidable disease. One of the major reasons for the continuing struggle with JD is that there are many unknown factors in JD epidemiology and ...

Periodontal manifestations of inflammatory bowel disease: emerging epidemiologic and biologic evidence.

Science.gov (United States)

Agossa, K; Dendooven, A; Dubuquoy, L; Gower-Rousseau, C; Delcourt-Debruyne, E; Capron, M

2017-06-01

Inflammatory bowel disease and periodontitis are both described as a disproportionate mucosal inflammatory response to a microbial environment in susceptible patients. Moreover, these two conditions share major environmental and lifestyle-related risk factors. Despite this intriguing pathogenic parallel, large-scale studies and basic research have only recently considered periodontal outcomes as relevant data. There are mounting and consistent arguments, from recent epidemiologic studies and animal models, that these two conditions might be related. This article is a comprehensive and critical up-to-date review of the current evidence and future prospects in understanding the biologic and epidemiologic relationships between periodontal status and inflammatory bowel disease. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Role of data warehousing in healthcare epidemiology.

Science.gov (United States)

Wyllie, D; Davies, J

2015-04-01

Electronic storage of healthcare data, including individual-level risk factors for both infectious and other diseases, is increasing. These data can be integrated at hospital, regional and national levels. Data sources that contain risk factor and outcome information for a wide range of conditions offer the potential for efficient epidemiological analysis of multiple diseases. Opportunities may also arise for monitoring healthcare processes. Integrating diverse data sources presents epidemiological, practical, and ethical challenges. For example, diagnostic criteria, outcome definitions, and ascertainment methods may differ across the data sources. Data volumes may be very large, requiring sophisticated computing technology. Given the large populations involved, perhaps the most challenging aspect is how informed consent can be obtained for the development of integrated databases, particularly when it is not easy to demonstrate their potential. In this article, we discuss some of the ups and downs of recent projects as well as the potential of data warehousing for antimicrobial resistance monitoring. Copyright © 2015. Published by Elsevier Ltd.

[Gender issues in the epidemiology of cardiovascular diseases].

Science.gov (United States)

Härtel, Ursula

2007-06-01

In the last decade our knowledge about sex differences in the epidemiology of cardiovascular diseases has substantially increased. However; most information relates to coronary heart disease, and relatively little information is available on other forms of heart disease or cerebrovascular diseases. In the present paper, first, the age-adjusted mortality and morbidity rates of men and women across different European countries will be described as well as differences in case-fatality after myocardial infarction. Second, gender differences regarding the impact of traditional and novel risk factors on the development of coronary heart disease will be addressed, together with recent evidence from cardiac rehabilitation research. In general, we can say that significant sex differences exist at each stage of coronary heart disease, which need to be taken into account in primary prevention, acute therapy, and long-term rehabilitation. Further research is required on other forms of cardiovascular diseases, which are more prevalent among women than among men, especially in higher age groups.

Epidemiology and natural history of gastro-oesophageal reflux disease.

Science.gov (United States)

Spechler, S J

1992-01-01

Epidemiological studies of gastro-oesophageal reflux disease (GORD) are confounded by the lack of a standardized definition and a diagnostic 'gold-standard' for the disorder. In Western countries, 20-40% of the adult population experience heartburn, which is the cardinal symptom of GORD, but only some 2% of adults have objective evidence of reflux oesophagitis. The incidence of GORD increases with age, rising dramatically after 40 years of age. There is also wide geographical variation in prevalence. Complications, including oesophageal ulcer and stricture, and Barrett's oesophagus, are found in up to 20% of patients with verified reflux oesophagitis. The signs and symptoms of GORD often wax and wane in intensity, and spontaneous remissions have been reported. In most cases, however, GORD is a chronic condition that returns shortly after discontinuing therapy. Although GORD causes substantial morbidity, the annual mortality rate due to GORD is very low (approximately 1 death per 100,000 patients), and even severe GORD has no apparent effect on longevity, although the quality of life can be significantly impaired. There are data to suggest that the use of non-steroidal anti-inflammatory drugs (NSAIDs) contributes to oesophagitis and stricture formation in patients with GORD. Although these data are not conclusive, it seems prudent, if possible, to avoid the use of NSAIDs in patients with GORD, particularly those with oesophageal stricture.

78 FR 12702 - Control of Communicable Diseases: Foreign; Scope and Definitions

Science.gov (United States)

2013-02-25

... Control of Communicable Diseases: Foreign; Scope and Definitions AGENCY: Centers for Disease Control and...; withdrawal. SUMMARY: The Centers for Disease Control and Prevention (CDC) within the Department of Health and... solicited public comment on updates to the Scope and Definitions for its regulations. DATES: The Notice of...

Epidemiological monitoring for emerging infectious diseases

Science.gov (United States)

Greene, Marjorie

2010-04-01

The Homeland Security News Wire has been reporting on new ways to fight epidemics using digital tools such as iPhone, social networks, Wikipedia, and other Internet sites. Instant two-way communication now gives consumers the ability to complement official reports on emerging infectious diseases from health authorities. However, there is increasing concern that these communications networks could open the door to mass panic from unreliable or false reports. There is thus an urgent need to ensure that epidemiological monitoring for emerging infectious diseases gives health authorities the capability to identify, analyze, and report disease outbreaks in as timely and efficient a manner as possible. One of the dilemmas in the global dissemination of information on infectious diseases is the possibility that information overload will create inefficiencies as the volume of Internet-based surveillance information increases. What is needed is a filtering mechanism that will retrieve relevant information for further analysis by epidemiologists, laboratories, and other health organizations so they are not overwhelmed with irrelevant information and will be able to respond quickly. This paper introduces a self-organizing ontology that could be used as a filtering mechanism to increase relevance and allow rapid analysis of disease outbreaks as they evolve in real time.

Below the poverty line and non-communicable diseases in Kerala: The Epidemiology of Non-communicable Diseases in Rural Areas (ENDIRA) study.

Science.gov (United States)

Menon, Jaideep; Vijayakumar, N; Joseph, Joseph K; David, P C; Menon, M N; Mukundan, Shyam; Dorphy, P D; Banerjee, Amitava

2015-01-01

India carries the greatest burden of global non-communicable diseases (NCDs). Poverty is strongly associated with NCDs but there are few prevalence studies which have measured poverty in India, particularly in rural settings. In Kerala, India, a population of 113,462 individuals was identified. The "Epidemiology of Non-communicable Diseases in Rural Areas" (ENDIRA) study was conducted via ASHAs (Accredited Social Health Activists). Standardised questionnaires were used in household interviews of individuals ≥18years during 2012 to gather sociodemographic, lifestyle and medical data for this population. The Government of Kerala definition of "the poverty line" was used. The association between below poverty line (BPL) status, NCDs and risk factors was analysed in multivariable regression models. 84,456 adults were included in the analyses (25.4% below the poverty line). The prevalence of NCDs was relatively common: myocardial infarction (MI) 1.4%, stroke 0.3%, respiratory diseases 5.0%, and cancer 1.1%. BPL status was not associated with age (p=0.96) or gender (p=0.26). Compared with those above the poverty line (APL), the BPL group was less likely to have diabetes, hypertension or dyslipidaemia (ppoverty line status. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Epidemiology of Hand, Foot and Mouth Disease in Asia

Science.gov (United States)

Koh, Wee Ming; Bogich, Tiffany; Siegel, Karen; Jin, Jing; Chong, Elizabeth Y.; Tan, Chong Yew; Chen, Mark IC; Horby, Peter

2016-01-01

Context: Hand, foot and mouth disease (HFMD) is a widespread pediatric disease caused primarily by human enterovirus 71 (EV-A71) and Coxsackievirus A16 (CV-A16). Objective: This study reports a systematic review of the epidemiology of HFMD in Asia. Data Sources: PubMed, Web of Science and Google Scholar were searched up to December 2014. Study Selection: Two reviewers independently assessed studies for epidemiologic and serologic information about prevalence and incidence of HFMD against predetermined inclusion/exclusion criteria. Data Extraction: Two reviewers extracted answers for 8 specific research questions on HFMD epidemiology. The results are checked by 3 others. Results: HFMD is found to be seasonal in temperate Asia with a summer peak and in subtropical Asia with spring and fall peaks, but not in tropical Asia; evidence of a climatic role was identified for temperate Japan. Risk factors for HFMD include hygiene, age, gender and social contacts, but most studies were underpowered to adjust rigorously for confounding variables. Both community-level and school-level transmission have been implicated, but their relative importance for HFMD is inconclusive. Epidemiologic indices are poorly understood: No supporting quantitative evidence was found for the incubation period of EV-A71; the symptomatic rate of EV-A71/Coxsackievirus A16 infection was from 10% to 71% in 4 studies; while the basic reproduction number was between 1.1 and 5.5 in 3 studies. The uncertainty in these estimates inhibits their use for further analysis. Limitations: Diversity of study designs complicates attempts to identify features of HFMD epidemiology. Conclusions: Knowledge on HFMD remains insufficient to guide interventions such as the incorporation of an EV-A71 vaccine in pediatric vaccination schedules. Research is urgently needed to fill these gaps. PMID:27273688

Landscape epidemiology of emerging infectious diseases in natural and human-altered ecosystems

Science.gov (United States)

Ross K. Meentemeyer; Sarah Haas; Tomáš Václavík

2013-01-01

A central challenge to studying emerging infectious diseases (EIDs) is a landscape dilemma: our best empirical understanding of disease dynamics occurs at local scales while pathogen invasions and management occur over broad spatial extents. The burgeoning field of landscape epidemiology integrates concepts and approaches from disease ecology with the macro-scale lens...

Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study.

Science.gov (United States)

Assiri, Abdullah; Al-Tawfiq, Jaffar A; Al-Rabeeah, Abdullah A; Al-Rabiah, Fahad A; Al-Hajjar, Sami; Al-Barrak, Ali; Flemban, Hesham; Al-Nassir, Wafa N; Balkhy, Hanan H; Al-Hakeem, Rafat F; Makhdoom, Hatem Q; Zumla, Alimuddin I; Memish, Ziad A

2013-09-01

Middle East respiratory syndrome (MERS) is a new human disease caused by a novel coronavirus (CoV). Clinical data on MERS-CoV infections are scarce. We report epidemiological, demographic, clinical, and laboratory characteristics of 47 cases of MERS-CoV infections, identify knowledge gaps, and define research priorities. We abstracted and analysed epidemiological, demographic, clinical, and laboratory data from confirmed cases of sporadic, household, community, and health-care-associated MERS-CoV infections reported from Saudi Arabia between Sept 1, 2012, and June 15, 2013. Cases were confirmed as having MERS-CoV by real-time RT-PCR. 47 individuals (46 adults, one child) with laboratory-confirmed MERS-CoV disease were identified; 36 (77%) were male (male:female ratio 3·3:1). 28 patients died, a 60% case-fatality rate. The case-fatality rate rose with increasing age. Only two of the 47 cases were previously healthy; most patients (45 [96%]) had underlying comorbid medical disorders, including diabetes (32 [68%]), hypertension (16 [34%]), chronic cardiac disease (13 [28%]), and chronic renal disease (23 [49%]). Common symptoms at presentation were fever (46 [98%]), fever with chills or rigors (41 [87%]), cough (39 [83%]), shortness of breath (34 [72%]), and myalgia (15 [32%]). Gastrointestinal symptoms were also frequent, including diarrhoea (12 [26%]), vomiting (ten [21%]), and abdominal pain (eight [17%]). All patients had abnormal findings on chest radiography, ranging from subtle to extensive unilateral and bilateral abnormalities. Laboratory analyses showed raised concentrations of lactate dehydrogenase (23 [49%]) and aspartate aminotransferase (seven [15%]) and thrombocytopenia (17 [36%]) and lymphopenia (16 [34%]). Disease caused by MERS-CoV presents with a wide range of clinical manifestations and is associated with substantial mortality in admitted patients who have medical comorbidities. Major gaps in our knowledge of the epidemiology, community prevalence

Lafora disease: epidemiology, pathophysiology and management.

LENUS (Irish Health Repository)

Monaghan, Thomas S

2010-07-01

Lafora disease is a rare, fatal, autosomal recessive, progressive myoclonic epilepsy. It may also be considered as a disorder of carbohydrate metabolism because of the formation of polyglucosan inclusion bodies in neural and other tissues due to abnormalities of the proteins laforin or malin. The condition is characterized by epilepsy, myoclonus and dementia. Diagnostic findings on MRI and neurophysiological testing are not definitive and biopsy or genetic studies may be required. Therapy in Lafora disease is currently limited to symptomatic management of the epilepsy, myoclonus and intercurrent complications. With a greater understanding of the pathophysiological processes involved, there is justified hope for future therapies.

Epidemiology in the Era of Big Data

Science.gov (United States)

Mooney, Stephen J; Westreich, Daniel J; El-Sayed, Abdulrahman M

2015-01-01

Big Data has increasingly been promoted as a revolutionary development in the future of science, including epidemiology. However, the definition and implications of Big Data for epidemiology remain unclear. We here provide a working definition of Big Data predicated on the so-called ‘3 Vs’: variety, volume, and velocity. From this definition, we argue that Big Data has evolutionary and revolutionary implications for identifying and intervening on the determinants of population health. We suggest that as more sources of diverse data become publicly available, the ability to combine and refine these data to yield valid answers to epidemiologic questions will be invaluable. We conclude that, while epidemiology as practiced today will continue to be practiced in the Big Data future, a component of our field’s future value lies in integrating subject matter knowledge with increased technical savvy. Our training programs and our visions for future public health interventions should reflect this future. PMID:25756221

Homocyst(e)ine and cardiovascular disease: a critical review of the epidemiologic evidence.

Science.gov (United States)

Eikelboom, J W; Lonn, E; Genest, J; Hankey, G; Yusuf, S

1999-09-07

To review epidemiologic studies on the association between homocyst(e)ine level and risk for cardiovascular disease and the potential benefits of homocysteine-decreasing therapies. Computerized and manual searches of the literature on total homocysteine levels and cardiovascular disease. Prospective studies and major retrospective epidemiologic studies evaluating the association between homocyst(e)ine levels and cardiovascular disease and the association between blood levels or dietary intake of folate, vitamin B6, and vitamin B12 and cardiovascular disease. Relevant data on patient population, plasma homocyst(e)ine levels, duration of follow-up, and main results were extracted from studies that met the inclusion criteria. The designs and results of studies included in this review are summarized. A formal meta-analysis was not performed because the studies were heterogeneous in method and design. Results of epidemiologic studies suggest that moderately elevated plasma or serum homocyst(e)ine levels are prevalent in the general population and are associated with an increased risk for cardiovascular disease, independent of classic cardiovascular risk factors. Simple, inexpensive, nontoxic therapy with folic acid, vitamin B6, and vitamin B12 reduces plasma homocyst(e)ine levels. Although the association between homocyst(e)ine levels and cardiovascular disease is generally strong and biologically plausible, the data from the prospective studies are less consistent. In addition, epidemiologic observations of an association between hyperhomocyst(e)inemia and cardiovascular risk do not prove the existence of a causal relation. Therefore, the effectiveness of folate, vitamin B6, and vitamin B12 in reducing cardiovascular morbidity and mortality requires rigorous testing in randomized clinical trials. Several such trials are under way; their results may greatly affect cardiovascular morbidity and mortality, given the simplicity and low cost of vitamin therapy.

Recommendations for epidemiological studies on COPD

DEFF Research Database (Denmark)

Bakke, P S; Rönmark, E; Eagan, T

2011-01-01

of the disease and definitions of the risk factors. Few community studies have examined phenotypes of COPD and included other ways of characterising the disease beyond that of spirometry. The objective of the present Task Force report is to present recommendations for the performance of general population...... for planning and performing an epidemiological study on COPD. The main message of the paper is that thorough planning is worth half the study. It is crucial to stick to standardised methods and good quality control during sampling. We recommend collecting biological markers, depending on the specific......The prevalence of chronic obstructive pulmonary disease (COPD) has been extensively studied, especially in Western Europe and North America. Few of these data are directly comparable because of differences between the surveys regarding composition of study populations, diagnostic criteria...

Epidemiology of non-tumor diseases in Chernobyl clean-up workers

International Nuclear Information System (INIS)

Buzunov, V.A.; Pirogova, E.A.; Tereshchenko, V.M.; Krasnikova, L.I.; Vojchulene, Yu.S.

2004-01-01

Epidemiological study of non-tumor diseases in Chernobyl clean-up workers was effectuated on the materials of State Registry of Ukraine for Victims of Chernobyl NPP Accident. Percent of healthy people among the clean-up workers of 1986 - 1987 decreased from 67.6% in 1988 to 9.6% in 1998, patients with chronic diseases increased from 12,8% in 1988 to 79,1% in 1998. Quantitative risk-analysis proves to possible relationship with absorbed doses prevalences of diseases of blood and hemopoietic organs, coronary hearth disease, cerebrovascular diseases, thyroid pathology. The age at the time of investigation, tobacco smoking and stress were statistically significant non-radiation factors of relative risk

Human Genome Epidemiology : A scientific foundation for using genetic information to improve health and prevent disease

Directory of Open Access Journals (Sweden)

Stefania Boccia

2005-03-01

Full Text Available

Human health is determined by the interplay of genetic factors and the environment. In this context the recent advances in human genomics are expected to play a central role in medicine and public health by providing genetic information for disease prediction and prevention.

After the completion of the human genome sequencing, a fundamental step will be represented by the translation of these discoveries into meaningful actions to improve health and prevent diseases, and the field of epidemiology plays a central role in this effort. These are some of the issues addressed by Human Genome Epidemiology –A scientific foundation for using genetic information to improve health and prevent disease, a volume edited by Prof. M. Khoury, Prof. J. Little, Prof.W. Burke and published by Oxford university Press 2004.

This book describes the important role that epidemiological methods play in the continuum from gene discovery to the development and application of genetic tests. The Authors calls this continuum human genome epidemiology (HuGE to denote an evolving field of inquiry that uses systematic applications of epidemiological methods to assess the impact of human genetic variation on health and disease.

The book is divided into four sections and it is structured to allow readers to proceed systematically from the fundamentals of genome technology and discovery, to the epidemiological approaches, to gene characterisation, to the evaluation of genetic tests and their use in health services and public health.

The household contact study design for genetic epidemiological studies of infectious diseases

Directory of Open Access Journals (Sweden)

Catherine eStein

2013-04-01

Full Text Available Most genetic epidemiological study designs fall into one of two categories: family-based and population-based (case-control. However, recent advances in statistical genetics call for study designs that combine these two approaches. We describe the household contact study design as we have applied it in our several years of study of the epidemiology of tuberculosis. Though we highlight its applicability for genetic epidemiological studies of infectious diseases, there are many facets of this design that are appealing for modern genetic studies, including the simultaneous enrollment of related and unrelated individuals, closely and distantly related individuals, collection of extensive epidemiologic and phenotypic data, and evaluation of effects of shared environment and gene by environment interaction. These study design characteristics are particularly appealing for current sequencing studies.

Interpreting predictive maps of disease: highlighting the pitfalls of distribution models in epidemiology

Directory of Open Access Journals (Sweden)

Nicola A. Wardrop

2014-11-01

Full Text Available The application of spatial modelling to epidemiology has increased significantly over the past decade, delivering enhanced understanding of the environmental and climatic factors affecting disease distributions and providing spatially continuous representations of disease risk (predictive maps. These outputs provide significant information for disease control programmes, allowing spatial targeting and tailored interventions. However, several factors (e.g. sampling protocols or temporal disease spread can influence predictive mapping outputs. This paper proposes a conceptual framework which defines several scenarios and their potential impact on resulting predictive outputs, using simulated data to provide an exemplar. It is vital that researchers recognise these scenarios and their influence on predictive models and their outputs, as a failure to do so may lead to inaccurate interpretation of predictive maps. As long as these considerations are kept in mind, predictive mapping will continue to contribute significantly to epidemiological research and disease control planning.

Microbiology and Epidemiology of Legionnaire's Disease.

Science.gov (United States)

Burillo, Almudena; Pedro-Botet, María Luisa; Bouza, Emilio

2017-03-01

Legionnaire's disease (LD) is the pneumonic form of legionellosis caused by aerobic gram-negative bacilli of the genus Legionella. Individuals become infected when they inhale aerosolized water droplets contaminated with Legionella species. Forty years after the identification of Legionella pneumophila as the cause of the 1976 pneumonia outbreak in a hotel in Philadelphia, we have non-culture-based diagnostic tests, effective antibiotics, and preventive measures to handle LD. With a mortality rate still around 10%, underreporting, and sporadic outbreaks, there is still much work to be done. In this article, the authors review the microbiology, laboratory diagnosis, and epidemiology of LD. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of the Paris definition of early Crohn's disease for disease-modification trials: results of an international expert opinion process.

Science.gov (United States)

Peyrin-Biroulet, Laurent; Billioud, Vincent; D'Haens, Geert; Panaccione, Remo; Feagan, Brian; Panés, Julian; Danese, Silvio; Schreiber, Stefan; Ogata, Haruhiko; Hibi, Toshifumi; Higgins, Peter D R; Beaugerie, Laurent; Chowers, Yehuda; Louis, Edouard; Steinwurz, Flávio; Reinisch, Walter; Rutgeerts, Paul; Colombel, Jean-Frédéric; Travis, Simon; Sandborn, William J

2012-12-01

We report the findings and outputs of an international expert opinion process to develop a definition of early Crohn's disease (CD) that could be used in future disease-modification trials. Nineteen experts on inflammatory bowel diseases held an international expert opinion meeting to discuss and agree on a definition for early CD to be used in disease-modification trials. The process included literature searches for the relevant basic-science and clinical evidence. A published preliminary definition of early CD was used as the basis for development of a proposed definition that was discussed at the expert opinion meeting. The participants then derived a final definition, based on best current knowledge, that it is hoped will be of practical use in disease-modification trials in CD.

Toward an Inclusive, Congruent, and Precise Definition of Autoinflammatory Diseases.

Science.gov (United States)

Wekell, Per; Berg, Stefan; Karlsson, Anna; Fasth, Anders

2017-01-01

Autoinflammatory disease was introduced as a concept in 1999, demarcating an entirely new group of diseases in clinical, immunological, and conceptual terms. During recent years, the preconditions for the definition of autoinflammatory conditions have changed. This includes the recent discovery of a number of monogenic autoinflammatory conditions with complex phenotypes that combine autoinflammation with defects of the adaptive and/or innate immune system, resulting in the occurrence of infection, autoimmunity, and/or uncontrolled hyperinflammation in addition to autoinflammation. Further, there are strong indications that classical IL-1-driven autoinflammatory diseases are associated with activation of adaptive immunity. As suggested by this development, we are of the opinion that an all-encompassing definition of autoinflammatory diseases should regard autoinflammatory conditions and innate dysregulation as inseparable and integral parts of the immune system as a whole. Hence, in this article, we try to advance the conceptual understanding of autoinflammatory disease by, proposing a modification of the definition by Daniel Kastner et al., which allows for a congruent and precise description of conditions that expand the immunological spectrum of autoinflammatory disease.

The Oslo definitions for coeliac disease and related terms

Science.gov (United States)

Ludvigsson, Jonas F; Leffler, Daniel A; Bai, Julio; Biagi, Federico; Fasano, Alessio; Green, Peter HR; Hadjivassiliou, Marios; Kaukinen, Katri; Kelly, Ciaran; Leonard, Jonathan N; Lundin, Knut E; Murray, Joseph A; Sanders, David S; Walker, Marjorie M; Zingone, Fabiana; Ciacci, Carolina

2012-01-01

Background The literature suggests a lack of consensus on the use of terms related to coeliac disease (CD) and gluten. Methods A multi-disciplinary task force of 16 physicians from 7 countries used the electronic database PubMed to review the literature with regards to CD-related terms up to January 2011. Teams of physicians then suggested a definition for each term, followed by feedback of these definitions through a web survey on definitions, discussions during a meeting in Oslo, and phone conferences. We evaluated the following terms (in alphabetical order): Coeliac disease and the following descriptors of CD: asymptomatic, atypical, classical, latent, non-classical, overt, paediatric classical, potential, refractory, silent, subclinical, symptomatic, typical, CD serology, CD autoimmunity, genetically at risk of CD, dermatitis herpetiformis, gluten, gluten ataxia, gluten intolerance, gluten sensitivity, and gliadin-specific antibodies. Results CD was defined as “a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals”. Classical CD was defined as “CD presenting with signs and symptoms of malabsorption. Diarrhoea, steatorrhoea, weight loss or growth failure is required.” We suggest that “gluten-related disorders” is the umbrella term for all diseases triggered by gluten and that the term gluten intolerance is not to be used. Other definitions are presented in the paper. Conclusion This paper presents the Oslo definitions for CD-related terms. PMID:22345659

Costs and epidemiological changes of chronic diseases: implications and challenges for health systems.

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Armando Arredondo

Full Text Available The need to integrate economic and epidemiological aspects in the clinical perspective leads to a proposal for the analysis of health disparities and to an evaluation of the health services and of the new challenges which are now being faced by health system reforms in middle income countries.To identify the epidemiological changes, the demand for health services and economic burden from chronic diseases (diabetes and hypertension in a middle income county.We conducted longitudinal analyses of costs and epidemiological changes for diabetes and hypertension in the Mexican health system. The study population included both the insured and uninsured populations. The cost-evaluation method was used, based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2014-2016, six models were constructed according to the Box-Jenkins technique, using confidence intervals of 95%, and the Box-Pierce test.Regarding epidemiological changes expected in both diseases for 2014 vs. 2016, an increase is expected, although results predict a greater increase for diabetes, 8-12% in all three studied institutions, (p < .05. Indeed, in the case of diabetes, the increase was 41469 cases for uninsured population (SSA and 65737 for the insured population (IMSS and ISSSTE. On hypertension cases the increase was 38109 for uninsured vs 62895 for insured. Costs in US$ ranged from $699 to $748 for annual case management per patient in the case of diabetes, and from $485 to $622 in patients with hypertension. Comparing financial consequences of health services required by insured and uninsured populations, the greater increase (23% will be for the insured population (p < .05. The financial requirements of both diseases will amount to 19.5% of the total budget for the uninsured and 12.5% for the insured population.If the risk factors and the different health care models remain as they currently are, the economic

Commentary: Epidemiology in the era of big data.

Science.gov (United States)

Mooney, Stephen J; Westreich, Daniel J; El-Sayed, Abdulrahman M

2015-05-01

Big Data has increasingly been promoted as a revolutionary development in the future of science, including epidemiology. However, the definition and implications of Big Data for epidemiology remain unclear. We here provide a working definition of Big Data predicated on the so-called "three V's": variety, volume, and velocity. From this definition, we argue that Big Data has evolutionary and revolutionary implications for identifying and intervening on the determinants of population health. We suggest that as more sources of diverse data become publicly available, the ability to combine and refine these data to yield valid answers to epidemiologic questions will be invaluable. We conclude that while epidemiology as practiced today will continue to be practiced in the Big Data future, a component of our field's future value lies in integrating subject matter knowledge with increased technical savvy. Our training programs and our visions for future public health interventions should reflect this future.

Definition, epidemiology and registries of pulmonary hypertension.

Science.gov (United States)

Awdish, R; Cajigas, H

2016-05-01

Pulmonary arterial hypertension (PAH) is a subcategory of pulmonary hypertension (PH) that comprises a group of disorders with similar pulmonary vascular pathology. Though PH is common, the estimated incidence of IPAH is 1-3 cases per million, making it a rare disease. The hemodynamic definition of PAH is a mean pulmonary artery pressure at rest >OR = 25 mm Hg in the presence of a pulmonary capillary wedge pressure disease that exhibits clinical overlap with a common syndrome necessitated the creation of registries. These registries have been indispensable in the characterization and mapping of the natural history of the disease. Equations and risk calculators derived from registries have given clinicians a basis for risk stratification and prognostication. The sequential accumulation of data since the registries began in the 1980s allows for comparisons to be made. Patients who are differentiated by treatment eras and environments can be contrasted. Variability among inclusion criteria similarly allows for comparisons of these subpopulations. This article provides an overview of available registries, highlights insights provided by each and discusses key issues around the interpretation and extrapolation of data from PAH registries. Registries have allowed us to appreciate the improvement in survival afforded by modern therapy and enhanced detection of this disease. Moving forward, a more global approach to registries is needed, as is enhanced collaboration and centralization.

Molecular Infectious Disease Epidemiology: Survival Analysis and Algorithms Linking Phylogenies to Transmission Trees

Science.gov (United States)

Kenah, Eben; Britton, Tom; Halloran, M. Elizabeth; Longini, Ira M.

2016-01-01

Recent work has attempted to use whole-genome sequence data from pathogens to reconstruct the transmission trees linking infectors and infectees in outbreaks. However, transmission trees from one outbreak do not generalize to future outbreaks. Reconstruction of transmission trees is most useful to public health if it leads to generalizable scientific insights about disease transmission. In a survival analysis framework, estimation of transmission parameters is based on sums or averages over the possible transmission trees. A phylogeny can increase the precision of these estimates by providing partial information about who infected whom. The leaves of the phylogeny represent sampled pathogens, which have known hosts. The interior nodes represent common ancestors of sampled pathogens, which have unknown hosts. Starting from assumptions about disease biology and epidemiologic study design, we prove that there is a one-to-one correspondence between the possible assignments of interior node hosts and the transmission trees simultaneously consistent with the phylogeny and the epidemiologic data on person, place, and time. We develop algorithms to enumerate these transmission trees and show these can be used to calculate likelihoods that incorporate both epidemiologic data and a phylogeny. A simulation study confirms that this leads to more efficient estimates of hazard ratios for infectiousness and baseline hazards of infectious contact, and we use these methods to analyze data from a foot-and-mouth disease virus outbreak in the United Kingdom in 2001. These results demonstrate the importance of data on individuals who escape infection, which is often overlooked. The combination of survival analysis and algorithms linking phylogenies to transmission trees is a rigorous but flexible statistical foundation for molecular infectious disease epidemiology. PMID:27070316

Epidemiology of Inflammatory Bowel Diseases in Iran and Asia; A Mini Review

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Ali Reza Safarpour

2013-06-01

Full Text Available The prevalence of inflammatory bowel diseases (IBDs is set to stabilize in Western Europe and North America, as opposed to its increasing trend in developing countries in Asia. The epidemiology of IBDs in areas where the incidence and prevalence are relatively low provides an opportunity for researchers to determine the unknown aspects of them. In this review article, the PubMed and MEDLINE databases were searched from 1970 to 2012 and the epidemiological aspects assessed in Iranian articles were compared with identical subjects in other Asian countries. During this period, there were 21 documented articles on IBD epidemiology in Iran and 52 in Asia. According to the present review, CTLA-gene polymorphism and male/female ratio in ulcerative colitis (UC, incidence of extra-intestinal manifestations, extent of intestinal involvement, and family history in both UC and Crohn’s disease (CD seemed to be different between Asia and Iran. In contrast, the incidence of primary sclerosing cholangitis in IBD patients and association between NO2/CARD15 mutation and CD as C3435-T allele and UC were nearly the same. The rate of IBD has increased significantly in Iran, as has that of other Asian countries during the last decade. A thorough, well-designed, population-based, multi-regional epidemiologic study seems mandatory due to the substantial demographic and characteristic variability in IBD patients in our region.

Epidemiologic study of Phenylketonuria disease in Lorestan province

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Azita Zafar Mohtashami

2016-12-01

Full Text Available Background : Phenylketonuria (PKU is a metabolic disease with autosomal recessive pattern of inheritance caused by a deficiency or absence of the enzyme phenylalanine hydroxylase in the liver. Phenylketonuria incidence is 1 in 10,000 births. This study aimed to determine the epidemiological characteristics of phenylketonuria in Lorestan province. Materials and Methods: All 81 phenylketonuria patients known in Lorestan province up to winter 2014 were considered in this descriptive epidemiologic study. Based on the goals and variables of the study, a complete questionnaire was developed to collect data through interviews with parents and the records and they were analyzed by use of SPSS v.16 software with preparing tables and graphs and using chi-square and t-test. Results: Results showed that phenylketonuria prevalence is 4.3 out of 100,000 people in Lorestan province. Twenty of the patients (24.7% were identified through screening and 61 patients (75.3% through other methods. Forty-six of the samples (56.8% were female and 35 cases (43.2% were male. Nearly 75% of PKU patients had a positive history of consanguinity marriage in their parents. The prevalence of the disease was significantly different from other cities. Conclusion: Neonatal screening for phenylketonuria is necessary and should be done within 3-5 days of birth. In families with children suffering from PKU, prenatal diagnosis is necessary for other pregnancies.

Global foot-and-mouth disease research update and gap analysis: 2 - epidemiology, wildlife and economics

Science.gov (United States)

In 2014, the Global Foot-and-mouth disease Research ings in the fields of (i) epidemiology, (ii) wildlife and (iii) Alliance (GFRA) conducted a gap analysis of foot-and- economics. Although the three sections, epidemiology, wildlife and economics are presented as separate entities, the fields are ...

History and philosophy of modern epidemiology

DEFF Research Database (Denmark)

Andersen, Hanne

2012-01-01

Epidemiological studies of chronic diseases began around the mid-20th century. Contrary to the infectious disease epidemiology which had prevailed at the beginning of the 20th century and which had focused on single agents causing individual diseases, the chronic disease epidemiology which emerge...

Molecular epidemiology of human oral Chagas disease outbreaks in Colombia.

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Juan David Ramírez

Full Text Available BACKGROUND: Trypanosoma cruzi, the causative agent of Chagas disease, displays significant genetic variability revealed by six Discrete Typing Units (TcI-TcVI. In this pathology, oral transmission represents an emerging epidemiological scenario where different outbreaks associated to food/beverages consumption have been reported in Argentina, Bolivia, Brazil, Ecuador and Venezuela. In Colombia, six human oral outbreaks have been reported corroborating the importance of this transmission route. Molecular epidemiology of oral outbreaks is barely known observing the incrimination of TcI, TcII, TcIV and TcV genotypes. METHODOLOGY AND PRINCIPAL FINDINGS: High-throughput molecular characterization was conducted performing MLMT (Multilocus Microsatellite Typing and mtMLST (mitochondrial Multilocus Sequence Typing strategies on 50 clones from ten isolates. Results allowed observing the occurrence of TcI, TcIV and mixed infection of distinct TcI genotypes. Thus, a majority of specific mitochondrial haplotypes and allelic multilocus genotypes associated to the sylvatic cycle of transmission were detected in the dataset with the foreseen presence of mitochondrial haplotypes and allelic multilocus genotypes associated to the domestic cycle of transmission. CONCLUSIONS: These findings suggest the incrimination of sylvatic genotypes in the oral outbreaks occurred in Colombia. We observed patterns of super-infection and/or co-infection with a tailored association with the severe forms of myocarditis in the acute phase of the disease. The transmission dynamics of this infection route based on molecular epidemiology evidence was unraveled and the clinical and biological implications are discussed.

[Eco-epidemiology: towards epidemiology of complexity].

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Bizouarn, Philippe

2016-05-01

In order to solve public health problems posed by the epidemiology of risk factors centered on the individual and neglecting the causal processes linking the risk factors with the health outcomes, Mervyn Susser proposed a multilevel epidemiology called eco-epidemiology, addressing the interdependence of individuals and their connection with molecular, individual, societal, environmental levels of organization participating in the causal disease processes. The aim of this epidemiology is to integrate more than a level of organization in design, analysis and interpretation of health problems. After presenting the main criticisms of risk-factor epidemiology focused on the individual, we will try to show how eco-epidemiology and its development could help to understand the need for a broader and integrative epidemiology, in which studies designed to identify risk factors would be balanced by studies designed to answer other questions equally vital to public health. © 2016 médecine/sciences – Inserm.

Severe chronic allergic (and related) diseases

DEFF Research Database (Denmark)

Bousquet, J; Anto, J M; Demoly, P

2012-01-01

-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic...... and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness...... and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies....

78 FR 12621 - Control of Communicable Diseases: Interstate; Scope and Definitions

Science.gov (United States)

2013-02-25

... Control of Communicable Diseases: Interstate; Scope and Definitions AGENCY: Centers for Disease Control... effective date of Direct Final Rule. SUMMARY: The Centers for Disease Control and Prevention (CDC) within... Disease [[Page 12622

Epidemiology of invasive meningococcal disease in the Netherlands, 1960-2012: an analysis of national surveillance data

NARCIS (Netherlands)

Bijlsma, Merijn W.; Bekker, Vincent; Brouwer, Matthijs C.; Spanjaard, Lodewijk; van de Beek, Diederik; van der Ende, Arie

2014-01-01

Epidemiological data for invasive meningococcal disease is essential for public health policy and vaccine development. We analysed national surveillance data from the Netherlands for PorA coverage of two PorA-based meningococcal serogroup B vaccines to describe the epidemiology of invasive

Spatio-temporal epidemiology of human West Nile virus disease in South Dakota.

Science.gov (United States)

Wimberly, Michael C; Giacomo, Paolla; Kightlinger, Lon; Hildreth, Michael B

2013-10-29

Despite a cold temperate climate and low human population density, the Northern Great Plains has become a persistent hot spot for human West Nile virus (WNV) disease in North America. Understanding the spatial and temporal patterns of WNV can provide insights into the epidemiological and ecological factors that influence disease emergence and persistence. We analyzed the 1,962 cases of human WNV disease that occurred in South Dakota from 2002-2012 to identify the geographic distribution, seasonal cycles, and interannual variability of disease risk. The geographic and seasonal patterns of WNV have changed since the invasion and initial epidemic in 2002-2003, with cases shifting toward the eastern portion of South Dakota and occurring earlier in the transmission season in more recent years. WNV cases were temporally autocorrelated at lags of up to six weeks and early season cumulative case numbers were correlated with seasonal totals, indicating the possibility of using these data for short-term early detection of outbreaks. Epidemiological data are likely to be most effective for early warning of WNV virus outbreaks if they are integrated with entomological surveillance and environmental monitoring to leverage the strengths and minimize the weaknesses of each information source.

Case definition terminology for paratuberculosis (Johne's disease).

Science.gov (United States)

Whittington, R J; Begg, D J; de Silva, K; Purdie, A C; Dhand, N K; Plain, K M

2017-11-09

Paratuberculosis (Johne's disease) is an economically significant condition caused by Mycobacterium avium subsp. paratuberculosis. However, difficulties in diagnosis and classification of individual animals with the condition have hampered research and impeded efforts to halt its progressive spread in the global livestock industry. Descriptive terms applied to individual animals and herds such as exposed, infected, diseased, clinical, sub-clinical, infectious and resistant need to be defined so that they can be incorporated consistently into well-understood and reproducible case definitions. These allow for consistent classification of individuals in a population for the purposes of analysis based on accurate counts. The outputs might include the incidence of cases, frequency distributions of the number of cases by age class or more sophisticated analyses involving statistical comparisons of immune responses in vaccine development studies, or gene frequencies or expression data from cases and controls in genomic investigations. It is necessary to have agreed definitions in order to be able to make valid comparisons and meta-analyses of experiments conducted over time by a given researcher, in different laboratories, by different researchers, and in different countries. In this paper, terms are applied systematically in an hierarchical flow chart to enable classification of individual animals. We propose descriptive terms for different stages in the pathogenesis of paratuberculosis to enable their use in different types of studies and to enable an independent assessment of the extent to which accepted definitions for stages of disease have been applied consistently in any given study. This will assist in the general interpretation of data between studies, and will facilitate future meta-analyses.

Extraintestinal manifestations of inflammatory bowel disease: epidemiology, diagnosis, and management

DEFF Research Database (Denmark)

Larsen, Signe; Bendtzen, Klaus; Nielsen, Ole Haagen

2010-01-01

Abstract Extraintestinal manifestations occur rather frequently in inflammatory bowel disease (IBD), e.g. ulcerative colitis (UC) and Crohn's disease (CD). The present paper provides an overview of the epidemiology, clinical characteristics, diagnostic process, and management of rheumatic......, metabolic, dermatologic (mucocutaneous), ophthalmologic, hepatobiliary, hematologic, thromboembolic, urinary tract, pulmonary, and pancreatic extraintestinal manifestations related to IBD. Articles were identified through search of the PubMed and Embase databases, the Cochrane Library, and the web sites......', 'thromboembolism', and 'treatment'. The search was performed on English-language reviews, practical guidelines, letters, and editorials. Articles were selected based on their relevance, and additional papers were retrieved from their reference lists. Since some of the diseases discussed are uncommon, valid...

Value of first trimester epidemiologic and sonographic markers as chromosome-diseases risk indicators

International Nuclear Information System (INIS)

Llanusa Ruiz, Celia; Nodarse Rodriguez, Alfredo; Vazquez, Yovany Enrique; Carrillo Bermudez, Lourdes; Sanchez Lombana, Rita

2009-01-01

Prenatal screening of chromosomal anomalies using epidemiological and sonographic markers during the first trimester, allow identifying pregnant with high risk of chromosome disease; we offer the cytogenetics prenatal diagnosis as option

HLA-Cw Allele Frequency in Definite Meniere’s Disease Compared to Probable Meniere’s Disease and Healthy Controls in an Iranian Sample

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Sasan Dabiri

2016-05-01

Full Text Available Introduction Several lines of evidence support the contribution of autoimmune mechanisms in the pathogenesis of Meniere’s disease. The aim of this study was determining the association between HLA-Cw Alleles in patients with definite Meniere’s disease and patients with probable Meniere’s disease and a control group.  Materials and Methods: HLA-Cw genotyping was performed in 23 patients with definite Meniere’s disease, 24 with probable Meniere’s disease, and 91 healthy normal subjects, using sequence specific primers polymerase chain reaction technique. The statistical analysis was performed using stata 8 software.  Results: There was a significant association between HLA-Cw*04 and HLA-Cw*16 in both definite and probable Meniere’s disease compared to normal healthy controls. We observed a significant difference in HLA-Cw*12 frequencies between patients with definite Meniere’s disease compared to patients with probable Meniere’s disease (P=0.04. The frequency of HLA-Cw*18 is significantly higher in healthy controls (P=0.002.  Conclusion: Our findings support the rule of HLA-Cw Alleles in both definite and probable Meniere’s disease. In addition, differences in HLA-Cw*12 frequency in definite and probable Meniere’s disease in our study’s population might indicate distinct immune and inflammatory mechanisms involved in each condition.

Lexis diagram and illness-death model: simulating populations in chronic disease epidemiology.

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Ralph Brinks

Full Text Available Chronic diseases impose a tremendous global health problem of the 21st century. Epidemiological and public health models help to gain insight into the distribution and burden of chronic diseases. Moreover, the models may help to plan appropriate interventions against risk factors. To provide accurate results, models often need to take into account three different time-scales: calendar time, age, and duration since the onset of the disease. Incidence and mortality often change with age and calendar time. In many diseases such as, for example, diabetes and dementia, the mortality of the diseased persons additionally depends on the duration of the disease. The aim of this work is to describe an algorithm and a flexible software framework for the simulation of populations moving in an illness-death model that describes the epidemiology of a chronic disease in the face of the different times-scales. We set up a discrete event simulation in continuous time involving competing risks using the freely available statistical software R. Relevant events are birth, the onset (or diagnosis of the disease and death with or without the disease. The Lexis diagram keeps track of the different time-scales. Input data are birth rates, incidence and mortality rates, which can be given as numerical values on a grid. The algorithm manages the complex interplay between the rates and the different time-scales. As a result, for each subject in the simulated population, the algorithm provides the calendar time of birth, the age of onset of the disease (if the subject contracts the disease and the age at death. By this means, the impact of interventions may be estimated and compared.

Ultraviolet radiation and autoimmune disease: insights from epidemiological research

International Nuclear Information System (INIS)

Ponsonby, Anne-Louise; McMichael, Anthony; Mei, Ingrid van der

2002-01-01

This review examines the epidemiological evidence that suggests ultraviolet radiation (UVR) may play a protective role in three autoimmune diseases: multiple sclerosis, insulin-dependent diabetes mellitus and rheumatoid arthritis. To date, most of the information has accumulated from population studies that have studied the relationship between geography or climate and autoimmune disease prevalence. An interesting gradient of increasing prevalence with increasing latitude has been observed for at least two of the three diseases. This is most evident for multiple sclerosis, but a similar gradient has been shown for insulin-dependent diabetes mellitus in Europe and North America. Seasonal influences on both disease incidence and clinical course and, more recently, analytical studies at the individual level have provided further support for a possible protective role for UVR in some of these diseases but the data are not conclusive. Organ-specific autoimmune diseases involve Th1 cell-mediated immune processes. Recent work in photoimmunology has shown ultraviolet B (UVB) can specifically attenuate these processes through several mechanisms which we discuss. In particular, the possible contribution of an UVR-induced increase in serum vitamin D (1,25(OH) 2 D 3 ) levels in the beneficial immunomodulation of these diseases is discussed

Basic concepts of epidemiology

International Nuclear Information System (INIS)

Savitz, D.A.

1984-01-01

Epidemiology can be defined simply as the science of the distribution and determinants of disease in human populations. As a descriptive tool, epidemiology can aid health care service providers, for example, in allocation of resources. In its analytic capacity, the epidemiologic approach can help identify determinants of disease through the study of human populations. Epidemiology is primarily an observational rather than experimental methodology, with corresponding strengths and limitations. Relative to other approaches for assessing disease etiology and impacts of potential health hazards, epidemiology has a rather unique role that is complementary to, but independent of, both basic biologic sciences and clinical medicine. Experimental biologic sciences such as toxicology and physiology provide critical information on biologic mechanisms of disease required for causal inference. Clinical medicine often serves as the warning system that provides etiologic clues to be pursued through systematic investigation. The advantage of the epidemiologic approach is its reliance on human field experience, that is, the real world. While laboratory experimentation is uniquely well suited to defining potential hazards, it can neither determine whether human populations have actually been affected nor quantify that effect. Building all the complexities of human behavior and external factors into a laboratory study or mathematical model is impossible. By studying the world as it exists, epidemiology examines the integrated, summarized product of the myriad factors influencing health

Epidemiology of inflammatory bowel diseases from west to east.

Science.gov (United States)

Vegh, Zsuzsanna; Kurti, Zsuzsanna; Lakatos, Peter L

2017-02-01

The incidence and prevalence of inflammatory bowel disease (IBD) show considerable variation over time and across geographical regions. The first studies on the epidemiology of IBD were mainly from traditionally high-incidence areas, such as North America, and northern and western Europe. In the last two decades, more and more studies have been published from Eastern European and Asian countries with increasing incidence rates from some regions. According to recent studies, the high incidence and prevalence of IBD in some Western countries is plateauing and in some Eastern countries increasing incidences have been reported. In the era of new multicenter epidemiological studies with common methodology the direct comparison of incidences and prevalences has became possible. In the present review we summarized the currently available literatures on west-east differences in the incidences and prevalences of IBD. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Gastric cancer: a primer on the epidemiology and biology of the disease and an overview of the medical management of advanced disease.

Science.gov (United States)

Shah, Manish A; Kelsen, David P

2010-04-01

Gastric cancer is a cause of significant morbidity and cancer-related mortality worldwide. Despite recent advances in targeted therapy and understanding of the biology and development of the malignancy, progress in the treatment of gastric cancer has been limited. Most newly diagnosed patients will present with incurable disease, and have a median survival of less than 1 year. Although the disease has widespread ethnic and epidemiologic differences, medical management of gastric cancer does not distinguish among the various disease subtypes. The recent report of the ToGA phase III study has validated Her2 as a molecular target in this disease, supporting the concept that a greater understanding of the biology of gastric cancer subsets may improve treatment selection and overall outcome of individual patients. This article summarizes the epidemiology and ethnic variation of this disease to crystalize subtypes of gastric cancer in the context of current and future medical management of advanced disease.

78 FR 12622 - Control of Communicable Diseases: Foreign; Scope and Definitions

Science.gov (United States)

2013-02-25

... Control of Communicable Diseases: Foreign; Scope and Definitions AGENCY: Centers for Disease Control and... of direct final rule. SUMMARY: The Centers for Disease Control and Prevention (CDC) within the... INFORMATION CONTACT: For questions concerning this notice: Ashley A. Marrone, JD, Centers for Disease Control...

Simulating Nationwide Pandemics: Applying the Multi-scale Epidemiologic Simulation and Analysis System to Human Infectious Diseases

Energy Technology Data Exchange (ETDEWEB)

Dombroski, M; Melius, C; Edmunds, T; Banks, L E; Bates, T; Wheeler, R

2008-09-24

This study uses the Multi-scale Epidemiologic Simulation and Analysis (MESA) system developed for foreign animal diseases to assess consequences of nationwide human infectious disease outbreaks. A literature review identified the state of the art in both small-scale regional models and large-scale nationwide models and characterized key aspects of a nationwide epidemiological model. The MESA system offers computational advantages over existing epidemiological models and enables a broader array of stochastic analyses of model runs to be conducted because of those computational advantages. However, it has only been demonstrated on foreign animal diseases. This paper applied the MESA modeling methodology to human epidemiology. The methodology divided 2000 US Census data at the census tract level into school-bound children, work-bound workers, elderly, and stay at home individuals. The model simulated mixing among these groups by incorporating schools, workplaces, households, and long-distance travel via airports. A baseline scenario with fixed input parameters was run for a nationwide influenza outbreak using relatively simple social distancing countermeasures. Analysis from the baseline scenario showed one of three possible results: (1) the outbreak burned itself out before it had a chance to spread regionally, (2) the outbreak spread regionally and lasted a relatively long time, although constrained geography enabled it to eventually be contained without affecting a disproportionately large number of people, or (3) the outbreak spread through air travel and lasted a long time with unconstrained geography, becoming a nationwide pandemic. These results are consistent with empirical influenza outbreak data. The results showed that simply scaling up a regional small-scale model is unlikely to account for all the complex variables and their interactions involved in a nationwide outbreak. There are several limitations of the methodology that should be explored in future

Modelling the epidemiology of infectious diseases for decision analysis: a primer.

Science.gov (United States)

Jit, Mark; Brisson, Marc

2011-05-01

The number of economic evaluations related to infectious disease topics has increased over the last 2 decades. However, many such evaluations rely on models that do not take into account unique features of infectious diseases that can affect the estimated value of interventions against them. These include their transmissibility from infected to susceptible individuals, the possibility of acquiring natural immunity following recovery from infection and the uncertainties that arise as a result of their complex natural history and epidemiology. Modellers conducting economic evaluations of infectious disease interventions need to know the main features of different types of infectious disease models, the situations in which they should be applied and the effects of model choices on the cost effectiveness of interventions.

Histologic definition of gastro-esophageal reflux disease.

Science.gov (United States)

Chandrasoma, Parakrama T

2013-07-01

To review recent data supporting the development of new histology-based definitions of gastro-esophageal reflux disease (GERD). Three precisely definable columnar epithelial types--cardiac, oxyntocardiac and intestinal--may be interposed between esophageal squamous epithelium and gastric oxyntic (acid secreting) mucosa. This enables definition of a new histologic concept: the squamo-oxyntic gap. The squamo-oxyntic gap is zero or very small in autopsies performed on patients without evidence of GERD. The gap progressively increases in length with the severity of GERD, indicating that the squamo-oxyntic gap is a marker for chronic GERD. The distal part of the gap lines gastric-type rugal folds and, therefore, is distal to the present endoscopic definition of the gastro-esophageal junction. I contend that this distal gap segment (which has esophageal submucosal glands) is actually the dilated distal esophagus; this is the pathologic correlate of destruction of the abdominal segment of the lower esophageal sphincter. The dilated distal esophagus is mistaken for 'gastric cardia' by present endoscopic definitions. I believe that these data support the adoption of novel histologic definitions of GERD as follows: the presence of any squamo-oxyntic gap defines GERD; the length of the gap is a measure of severity of chronic GERD; and the presence of intestinal metaplasia in the gap defines Barrett esophagus and cancer risk.

[Epidemiology of nosocomial infections in neonates].

Science.gov (United States)

Lachassinne, E; Letamendia-Richard, E; Gaudelus, J

2004-03-01

Epidemiology of nosocomial infections in neonates has to be described according to our definitions (early onset GBS diseases excluded) and according to levels of care. Nosocomial risk exists in maternity departments (3% in postnatal beds), incidence rates are 7.5-12.7% or 1.3-8.5 per 1000 days in neonatal care units and 14.2% or 11.7 per 1000 days in neonatal intensive care units (NICU). Gram-positive cocci bloodstream infections are the most common nosocomial infections in NICU but viral gastroenteritis are more frequent in neonatal care units. Risk factors are low birthweight, small gestational age and intravascular catheter in NICU, and for viral nosocomial infections, visits and winter outbreaks.

A Comprehensive Review of Sex Disparities in Symptoms, Pathophysiology, and Epidemiology of Dry Eye Syndrome.

Science.gov (United States)

Rapoport, Yuna; Singer, Jason M; Ling, Jeanie D; Gregory, Anthony; Kohanim, Sahar

2016-01-01

The etiology, frequency, manifestation, and treatment of dry eye syndrome are commonly influenced by sex and gender. This study aims to review the differences in epidemiology, pathophysiology, and associated diseases between the sexes. The terms men and male and women and female are used interchangeably throughout the review to refer to biological sex. There are numerous objective and subjective markers of dry eye syndrome but not one diagnostic criterion. There are numerous associated conditions with dry eye syndrome varying from autoimmune to allergic. Large epidemiologic studies reviewed suggest that there does indeed exist a difference between dry eye symptoms between men and women, with women having dry eye signs and reporting dry eye symptoms more often than men. The increased prevalence in women could be correlated to an increased association with certain systemic diseases, specifically autoimmune diseases, and to hormonal variations. Several studies found equivocal data about prevalence of dry eye symptoms between men and women. Interpreting studies that investigate epidemiology, pathogenesis, and treatment of dry-eye conditions is complicated by the lack of universally adapted diagnostic criteria and standardized, specific diagnostic tests, and inter-study variability in the definition of dry eye syndrome.

77 FR 75880 - Control of Communicable Diseases: Interstate; Scope and Definitions

Science.gov (United States)

2012-12-26

... definitions related to the control of communicable diseases and add more current medical terminology where... definitions for interstate quarantine regulations to reflect modern terminology and plain language used by..., under section 70.1, to reflect modern terminology and plain language commonly used by private sector...

The epidemiology of cardiovascular diseases in sub-Saharan Africa: the Global Burden of Diseases, Injuries and Risk Factors 2010 Study.

Science.gov (United States)

Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George

2013-01-01

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years. © 2013.

The Epidemiology of Cardiovascular Diseases in Sub-Saharan Africa: The Global Burden of Diseases, Injuries and Risk Factors 2010 Study

Science.gov (United States)

Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George

2014-01-01

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years. PMID:24267430

A clinical review of recent findings in the epidemiology of inflammatory bowel disease

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Ponder A

2013-07-01

Full Text Available Alexis Ponder, Millie D LongDepartment of Medicine, University of North Carolina, Chapel Hill, NC, USAAbstract: Inflammatory bowel diseases (IBD, including both Crohn’s disease and ulcerative colitis, are disorders of chronic inflammation of the gastrointestinal tract marked by episodes of relapse and remission. Over the past several decades, advances have been made in understanding the epidemiology of IBD. The incidence and prevalence of both Crohn’s disease and ulcerative colitis have been increasing worldwide across pediatric and adult populations. As IBD is thought to be related to a combination of individual genetic susceptibility, environmental triggers, and alterations in the gut microbiome that stimulate an inflammatory response, understanding the potentially modifiable environmental risk factors associated with the development or the course of IBD could impact disease rates or management in the future. Current hypotheses as to the development of IBD are reviewed, as are a host of environmental cofactors that have been investigated as both protective and inciting factors for IBD onset. Such environmental factors include breast feeding, gastrointestinal infections, urban versus rural lifestyle, medication exposures, stress, smoking, and diet. The role of these factors in disease course is also reviewed. Looking forward, there is still much to be learned about the etiology of IBD and how specific environmental exposures intimately impact the development of disease and also the potential for relapse.Keywords: clinical epidemiology, inflammatory bowel disease, environmental risk factors

Epidemiology of IBD

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... IBD? Projects and Partners Data and Statistics Resources Epidemiology of the IBD Recommend on Facebook Tweet Share ... 5:1424-9. 2 Loftus EV, Jr. Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental ...

Strengthening epidemiologic investigation of infectious diseases in Korea: lessons from the Middle East Respiratory Syndrome outbreak

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Changhwan Lee

2015-09-01

Full Text Available The recent outbreak of Middle East Respiratory Syndrome (MERS coronavirus infection in Korea resulted in large socioeconomic losses. This provoked the Korean government and the general public to recognize the importance of having a well-established system against infectious diseases. Although epidemiologic investigation is one of the most important aspects of prevention, it has been pointed out that much needs to be improved in Korea. We review here the current status of the Korean epidemiologic service and suggest possible supplementation measures. We examine the current national preventive infrastructure, including human resources such as Epidemic Intelligence Service officers, its governmental management, and related policies. In addition, we describe the practical application of these resources to the recent MERS outbreak and the progress in preventive measures. The spread of MERS demonstrated that the general readiness for emerging infectious diseases in Korea is considerably low. We believe that it is essential to increase society’s investment in disease prevention. Fostering public health personnel, legislating management policies, and establishing research centers for emerging infectious diseases are potential solutions. Evaluating international preventive systems, developing cooperative measures, and initiating improvements are necessary. We evaluated the Korean epidemiologic investigation system and the public preventive measures against infectious diseases in light of the recent MERS outbreak. We suggest that governmental authorities in Korea enforce preventive policies, foster the development of highly qualified personnel, and increase investment in the public health domain of infectious disease prevention.

Definition and classification of chronic kidney disease : A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)

NARCIS (Netherlands)

Levey, Andrew S.; Eckardt, Kai Uwe; Tsukamoto, Yusuke; Levin, Adeera; Coresh, Josef; Rossert, Jerome; de Zeeuw, Dick; Hostetter, Thomas H.; Lameire, Norbert; Eknoyan, Garabed

Chronic kidney disease (CKD) is a worldwide public health problem, with adverse outcomes of kidney failure, cardiovascular disease (CVD), and premature death. A simple definition and classification of kidney disease is necessary for international development and implementation of clinical practice

Epidemiology and the Tobacco Epidemic: How Research on Tobacco and Health Shaped Epidemiology.

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Samet, Jonathan M

2016-03-01

In this article, I provide a perspective on the tobacco epidemic and epidemiology, describing the impact of the tobacco-caused disease epidemic on the field of epidemiology. Although there is an enormous body of epidemiologic evidence on the associations of smoking with health, little systematic attention has been given to how decades of research have affected epidemiology and its practice. I address the many advances that resulted from epidemiologic research on smoking and health, such as demonstration of the utility of observational designs and important parameters (the odds ratio and the population attributable risk), guidelines for causal inference, and systematic review approaches. I also cover unintended and adverse consequences for the field, including the strategy of doubt creation and the recruitment of epidemiologists by the tobacco industry to serve its mission. The paradigm of evidence-based action for addressing noncommunicable diseases began with the need to address the epidemic of tobacco-caused disease, an imperative for action documented by epidemiologic research. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Molecular Epidemiology of Heart Failure

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J. Gustav Smith, MD, PhD

2017-12-01

Full Text Available Heart failure (HF is the end-stage of all heart disease and arguably constitutes the greatest unmet therapeutic need in cardiovascular medicine today. Classic epidemiological studies have established clinical risk factors for HF, but the cause remains poorly understood in many cases. Biochemical analyses of small case-control series and animal models have described a plethora of molecular characteristics of HF, but a single unifying pathogenic theory is lacking. Heart failure appears to result not only from cardiac overload or injury but also from a complex interplay among genetic, neurohormonal, metabolic, inflammatory, and other biochemical factors acting on the heart. Recent development of robust, high-throughput tools in molecular biology provides opportunity for deep molecular characterization of population-representative cohorts and HF cases (molecular epidemiology, including genome sequencing, profiling of myocardial gene expression and chromatin modifications, plasma composition of proteins and metabolites, and microbiomes. The integration of such detailed information holds promise for improving understanding of HF pathophysiology in humans, identification of therapeutic targets, and definition of disease subgroups beyond the current classification based on ejection fraction which may benefit from improved individual tailoring of therapy. Challenges include: 1 the need for large cohorts with deep, uniform phenotyping; 2 access to the relevant tissues, ideally with repeated sampling to capture dynamic processes; and 3 analytical issues related to integration and analysis of complex datasets. International research consortia have formed to address these challenges and combine datasets, and cohorts with up to 1 million participants are being collected. This paper describes the molecular epidemiology of HF and provides an overview of methods and tissue types and examples of published and ongoing efforts to systematically evaluate molecular

Recent trends in coronary heart disease epidemiology in India.

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Gupta, Rajeev

2008-01-01

Coronary heart disease (CHD) is epidemic in India and one of the major causes of disease-burden and deaths. Mortality data from the Registrar General of India shows that cardiovascular diseases are a major cause of death in India now. Studies to determine the precise causes of death in urban Chennai and rural areas of Andhra Pradesh have revealed that cardiovascular diseases cause about 40% of the deaths in urban areas and 30% in rural areas. Analysis of cross-sectional CHD epidemiological studies performed over the past 50 years reveals that this condition is increasing in both urban and rural areas. The adult prevalence has increased in urban areas from about 2% in 1960 to 6.5% in 1970, 7.0% in 1980, 9.7% in 1990 and 10.5% in 2000; while in rural areas, it increased from 2% in 1970, to 2.5% in 1980, 4% in 1990, and 4.5% in 2000. In terms of absolute numbers this translates into 30 million CHD patients in the country. The disease occurs at a much younger age in Indians as compared to those in North America and Western Europe. Rural-urban differences reveal that risk factors like obesity, truncal obesity, hypertension, high cholesterol, low HDL cholesterol and diabetes are more in urban areas. Case-control studies also confirm the importance of these risk factors. The INTERHEART-South Asia study identified that eight established coronary risk factors--abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, low fruit and vegetable consumption, and lack of physical activity--accounted for 89% of the cases of acute myocardial infarction in Indians. There is epidemiological evidence that all these risk factors are increasing. Over the past fifty years prevalence of obesity, hypertension, hypercholesterolemia, and diabetes have increased significantly in urban (R2 0.45-0.74) and slowly in rural areas (R2 0.19-0.29). There is an urgent need for development and implementation of suitable primordial, primary, and secondary prevention

Epidemiological methods: a brief review

International Nuclear Information System (INIS)

Winkelstein, W. Jr.

1983-01-01

Epidemiology, the study of disease distributions in populations and the factors which influence these distributions, is an observational science, i.e., its data base consists of measurements made on free living individuals characterized by presence or absence of disease states and putative risk factors. Epidemiological studies are usually classified as descriptive or analytical. Descriptive studies are primarily used for planning and evaluating health programs or to generate etiological hypotheses. Analytical studies are primarily used for testing etiological hypotheses. Analytical studies are designed either as cohort investigations in which populations with and without a putative risk factor are followed through time to ascertain their differential incidence of disease, or case-control investigations in which the history of exposure to a putative risk factor is compared among persons with a disease and appropriate controls free of disease. Both descriptive and analytical epidemiological studies have been applied to health physics problems. Examples of such problems and the epidemiological methods used to explore them will be presented

International consensus for a definition of disease flare in lupus.

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Ruperto, N; Hanrahan, L M; Alarcón, G S; Belmont, H M; Brey, R L; Brunetta, P; Buyon, J P; Costner, M I; Cronin, M E; Dooley, M A; Filocamo, G; Fiorentino, D; Fortin, P R; Franks, A G; Gilkeson, G; Ginzler, E; Gordon, C; Grossman, J; Hahn, B; Isenberg, D A; Kalunian, K C; Petri, M; Sammaritano, L; Sánchez-Guerrero, J; Sontheimer, R D; Strand, V; Urowitz, M; von Feldt, J M; Werth, V P; Merrill, J T

2011-04-01

The Lupus Foundation of America (LFA) convened an international working group to obtain a consensus definition of disease flare in lupus. With help from the Paediatric Rheumatology International Trials Organization (PRINTO), two web-based Delphi surveys of physicians were conducted. Subsequently, the LFA held a second consensus conference followed by a third Delphi survey to reach a community-wide agreement for flare definition. Sixty-nine of the 120 (57.5%) polled physicians responded to the first survey. Fifty-nine of the responses were available to draft 12 preliminary statements, which were circulated in the second survey. Eighty-seven of 118 (74%) physicians completed the second survey, with an agreement of 70% for 9/12 (75%) statements. During the second conference, three alternative flare definitions were consolidated and sent back to the international community. One hundred and sixteen of 146 (79.5%) responded, with agreement by 71/116 (61%) for the following definition: "A flare is a measurable increase in disease activity in one or more organ systems involving new or worse clinical signs and symptoms and/or laboratory measurements. It must be considered clinically significant by the assessor and usually there would be at least consideration of a change or an increase in treatment." The LFA proposes this definition for lupus flare on the basis of its high face validity.

Diabetic Kidney Disease: From Epidemiology to Clinical Perspectives

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Cheol Whee Park

2014-08-01

Full Text Available With worldwide epidemic of diabetes mellitus, diabetic nephropathy which is one of the major causes of microvascular complication has become a serious concern in Korea as well as the rest of the world. In view of its significance, there is an urgent and paramount need for proper managements that could either deter or slow the progression of diabetic nephropathy. Despite advances in care, ever increasing number of patients suffering from diabetic kidney disease and from end-stage renal disease implies that the current management is not adequate in many aspects. The reasons for these inadequacies compromise lack of early diagnosis, failure to intervene with timely and aggressive manner, and lack of understanding on the kind of interventions required. Another issue equally important for the adequate care of patients with diabetic nephropathy is an understanding of past, present and future epidemiology of diabetic nephropathy which serves, especially in Korea, as a material determining standard diagnosis and treatment and a national health-policy decision.

Molecular pathological epidemiology of epigenetics: emerging integrative science to analyze environment, host, and disease.

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Ogino, Shuji; Lochhead, Paul; Chan, Andrew T; Nishihara, Reiko; Cho, Eunyoung; Wolpin, Brian M; Meyerhardt, Jeffrey A; Meissner, Alexander; Schernhammer, Eva S; Fuchs, Charles S; Giovannucci, Edward

2013-04-01

Epigenetics acts as an interface between environmental/exogenous factors, cellular responses, and pathological processes. Aberrant epigenetic signatures are a hallmark of complex multifactorial diseases (including neoplasms and malignancies such as leukemias, lymphomas, sarcomas, and breast, lung, prostate, liver, and colorectal cancers). Epigenetic signatures (DNA methylation, mRNA and microRNA expression, etc) may serve as biomarkers for risk stratification, early detection, and disease classification, as well as targets for therapy and chemoprevention. In particular, DNA methylation assays are widely applied to formalin-fixed, paraffin-embedded archival tissue specimens as clinical pathology tests. To better understand the interplay between etiological factors, cellular molecular characteristics, and disease evolution, the field of 'molecular pathological epidemiology (MPE)' has emerged as an interdisciplinary integration of 'molecular pathology' and 'epidemiology'. In contrast to traditional epidemiological research including genome-wide association studies (GWAS), MPE is founded on the unique disease principle, that is, each disease process results from unique profiles of exposomes, epigenomes, transcriptomes, proteomes, metabolomes, microbiomes, and interactomes in relation to the macroenvironment and tissue microenvironment. MPE may represent a logical evolution of GWAS, termed 'GWAS-MPE approach'. Although epigenome-wide association study attracts increasing attention, currently, it has a fundamental problem in that each cell within one individual has a unique, time-varying epigenome. Having a similar conceptual framework to systems biology, the holistic MPE approach enables us to link potential etiological factors to specific molecular pathology, and gain novel pathogenic insights on causality. The widespread application of epigenome (eg, methylome) analyses will enhance our understanding of disease heterogeneity, epigenotypes (CpG island methylator

Asthma: epidemiology of disease control in Latin America ? short review

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Sol?, Dirceu; Aranda, Carolina Sanchez; Wandalsen, Gustavo Falbo

2017-01-01

Asthma is reported as one of the most common chronic diseases in childhood, impairing the quality of life of patients and their families and incurring high costs to the healthcare system and society. Despite the development of new drugs and the availability of international treatment guidelines, asthma is still poorly controlled, especially in Latin America. Original and review articles on asthma control or epidemiology with high levels of evidence have been selected for analysis among those ...

Geographic variations in epidemiology of two autoimmune bullous diseases: pemphigus and bullous pemphigoid.

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Alpsoy, Erkan; Akman-Karakas, Ayse; Uzun, Soner

2015-05-01

Autoimmune bullous diseases are rare, organ-specific, a group of blistering disease of skin and mucous membranes. Recent studies suggest that the frequency of the autoimmune bullous diseases has been increasing. Pemphigus vulgaris and bullous pemphigoid are the most frequently reported autoimmune bullous diseases. High incidence of autoimmune bullous diseases in some ethnic groups such as pemphigus in Ashkenazi Jewish, or in some regions such as pemphigus foliaceus in Brazil has been shown to be related to genetic and environmental factors, respectively. Pemphigus has been reported more frequently in the female gender. Although it is most frequently diagnosed between the ages 50 and 60 in European countries, in the remaining countries in the world, it is seen between the ages of 30 and 50. Bullous pemphigoid is generally seen above 70 years of age. Although overall incidence is slightly higher in females, after the age of 80 years it is more frequent in males. Both pemphigus vulgaris and bullous pemphigoid has a chronic course with recurrences. Mortality risk of the patients with bullous pemphigoid was found at least 2 times higher and the mortality risk of the patients with pemphigus was found approximately 3 times higher than that of the general population. In this review, the results obtained from the epidemiological studies were analyzed according to geographic regions, and especially epidemiologic features of two prevalent autoimmune bullous diseases, pemphigus and bullous pemphigoid have been discussed.

The epidemiology of invasive pneumococcal disease in the Canadian North from 1999 to 2010

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Melissa Helferty

2013-08-01

Full Text Available Introduction . The International Circumpolar Surveillance network is a population-based surveillance system that collects data on invasive pneumococcal disease (IPD in Northern Canada. A 7-valent pneumococcal conjugate vaccine was first introduced in some regions of Northern Canada in 2002, followed by 10-valent (2009 and 13-valent (PCV-13 vaccines (2010. A 23-valent polysaccharide (PPV-23 vaccine was first introduced in 1988 for special populations and adults aged 65 years and older. To describe the epidemiology in the context of pneumococcal vaccination programs, we analysed surveillance data from Northern Canada from 1999 to 2010. Methods . A standardized case report form capturing demographic and clinical information was completed for all IPD cases in Northern Canada meeting the national case definition. Isolates were sent to a reference laboratory for confirmation, serotyping and antimicrobial resistance testing. Both laboratory and epidemiological data were sent to the Public Health Agency of Canada for analysis. Population denominators were obtained from Statistics Canada. Results . From 1999 to 2010, 433 IPD cases were reported (average 36 cases per year. Incidence was greatest among infants aged <2 years and among those aged 65 years and older, with an average annual incidence of 133 and 67 cases per 100,000 population, respectively. After a peak in incidence in 2008, rates among infants have declined. Incidence rates varied from 2 to 16 times greater, depending on the year, among Aboriginals compared to non-Aboriginals. Hospitalization was reported in 89% of all cases and the case fatality ratio was 6.0%. Clinical manifestations varied, with some patients reporting >1 manifestation. Pneumonia was the most common (70%, followed by bacteremia/septicaemia (30% and meningitis (8%. Approximately, 42% of cases aged <2 years in 2009 and 2010 had serotypes covered by the PCV-13. In addition, the majority (89% of serotypes isolated in cases

Pregnancy after definitive treatment for Graves' disease--does treatment choice influence outcome?

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Elston, Marianne S; Tu'akoi, Kelson; Meyer-Rochow, Goswin Y; Tamatea, Jade A U; Conaglen, John V

2014-08-01

Women requiring thyroid hormone replacement after definitive therapy (surgery or radioiodine) for Graves' disease who later conceive require an early increase in levothyroxine dose and monitoring of thyroid hormone levels throughout pregnancy. In addition, as TSH receptor antibodies (TRAb) can cross the placenta and affect the fetus, measurement of these antibodies during pregnancy is recommended. To review the management of pregnancies following definitive treatment for Graves' disease in order to assess the rates of maternal hypothyroidism and TRAb measurement. Retrospective chart review of women who had undergone definitive treatment for Graves' disease at a tertiary hospital and subsequently had one or more pregnancies. A total of 29 women were identified, each of whom had at least one pregnancy since receiving definitive treatment for Graves' disease: there were a total of 49 pregnancies (22 in the surgical group and 27 in the radioiodine group). Both groups had high rates of hypothyroidism documented during pregnancy (47 and 50%, respectively). The surgical group was more likely to be euthyroid around the time of conception. Less than half of the women were referred to an endocrinologist or had TRAb measured during pregnancy. Neonatal thyroid function was measured in one-third of live births. One case of neonatal thyrotoxicosis was identified. Adherence to the current American Thyroid Association guidelines is poor. Further education of both patients and clinicians is important to ensure that treatment of women during pregnancy after definitive treatment follows the currently available guidelines. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies: Proposed standards from the Joint EU/USA Periodontal Epidemiology Working Group.

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Holtfreter, Birte; Albandar, Jasim M; Dietrich, Thomas; Dye, Bruce A; Eaton, Kenneth A; Eke, Paul I; Papapanou, Panos N; Kocher, Thomas

2015-05-01

Periodontal diseases are common and their prevalence varies in different populations. However, prevalence estimates are influenced by the methodology used, including measurement techniques, case definitions, and periodontal examination protocols, as well as differences in oral health status. As a consequence, comparisons between populations are severely hampered and inferences regarding the global variation in prevalence can hardly be drawn. To overcome these limitations, the authors suggest standardized principles for the reporting of the prevalence and severity of periodontal diseases in future epidemiological studies. These principles include the comprehensive reporting of the study design, the recording protocol, and specific subject-related and oral data. Further, a range of periodontal data should be reported in the total population and within specific age groups. Periodontal data include the prevalence and extent of clinical attachment loss (CAL) and probing depth (PD) on site and tooth level according to specific thresholds, mean CAL/PD, the CDC/AAP case definition, and bleeding on probing. Consistent implementation of these standards in future studies will ensure improved reporting quality, permit meaningful comparisons of the prevalence of periodontal diseases across populations, and provide better insights into the determinants of such variation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The epidemiology and the pathogenesis of inflammatory bowel disease

International Nuclear Information System (INIS)

Karlinger, Kinga; Gyoerke, Tamas; Makoe, Erno; Mester, Adam; Tarjan, Zsolt

2000-01-01

The etiology of inflammatory bowel disease (IBD) is still unknown. However, a satisfactory solution cannot be far away. IBD actually encompasses two diseases, i.e. Crohn's disease (CD) and ulcerous colitis (UC). These diseases resemble each other so closely that they cannot be distinguished even pathologically, but differ from each other sufficiently to regard them as independent entities. Epidemiological observations may be helpful in identifying the true causative factors of this evasive disease. Geographically, the prevalence of the disease has a slope from North to South and, to a lesser degree, from West to East. The Western-Eastern discrepancy can be attributed to a difference in Western life styles. The incidence of the disease has been increasing world-wide of late, but its spread has been slowing down in highly affected countries. Racial and ethnic relations in different populations and immigration studies offer interesting data which can reflect genetic, inherited, environmental and behavioural factors. The disease seems to have a characteristic racial-ethnic distribution: the Jewish population is highly susceptible everywhere, but its prevalence in that population nears that of the domestic society in which they live. In Hungary, the Roma (Gypsies) have a considerably lower prevalence than the average population. This can be attributed to a genetic or environmental influence. According to age, the onset of the disease occurs more often in the second or the third decade of life, but there also is another peak in the 60s. Regarding sexual distribution, there is a slight preponderance of colitis ulcerosa in men and of Crohn's disease in women. It may correspond to the stronger auto-immune affection in the process of Crohn's disease. Environmental factors and behavioural influences also are investigated. Diet, the role of the early ages, smoking habits and the influence of hormonal status and drugs are viewed as useful contributing factors in the

Epidemiological survey of graves' disease in Tianjin area

International Nuclear Information System (INIS)

Gao Shuo; Fang Peihua; Lai Zemin; Chen Bingzhong; Lu Tizhang; Zhou Yinbao; Tan Jian; Ni Xiaoyan

2002-01-01

Objective: To study the incidence of Graves' disease and associated factors. Methods: From 1997.4 to 1999.12, by using cluster and stratified sampling, total of 31530 people aged 6 years and over were surveyed epidemiologically for Graves' disease in five districts and one county of Tianjin area where the study subjects had been resided for at least one year. The researching team consisted of endocrinologists, epidemiologists and technicians and was divided into three branches, they served as investigators, professional experts and technicians, respectively. The serum thyroid hormones, thyroid antibodies, iodine in table salt, urine iodine and B-US were examined for the suspected cases, the final diagnoses were concluded by the professional experts. Results: Eighty-nine patients with Graves' disease were confirmed, 26 (0.166%) of them were males and 63(0.397%) of them were females, the total incidence was 0.282%. The incidence significantly associated with sex (female higher than male, P<0.001), age (50-60 group for male and 30-40 group for female higher than others, P<0.001) and family history (the patients with vs without family history, P<0.001). The survey showed an ascending trend of incidence of Graves' disease, along with decreasing of goiter rate and increasing of iodine contents in table salt and in urine. Further research work should be pursued. Conclusion: This study may provide some theoretical basis for prevention and treatment of Graves' disease

[Epidemiology of imported infectious diseases in China, 2013-2016].

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Wang, Y L; Wang, X; Ren, R Q; Zhou, L; Tu, W W; Ni, D X; Li, Q; Feng, Z J; Zhang, Y P

2017-11-10

Objective: To describe the epidemic of imported infectious diseases in China between 2013 and 2016, including the kinds of infectious diseases, affected provinces, source countries and the epidemiological characteristics, and provide scientific information for the prevention and control of imported infectious diseases. Methods: Data of cases of imported infectious diseases in China from 2013 to 2016 were collected from national information reporting system of infectious diseases, Microsoft Excel 2010 and SPSS 18.0 were used to conduct data cleaning and analysis. Results: From 2013 to 2016, a total of 16 206 imported cases of infectious diseases were reported in China. Of all the cases, 83.12% (13 471 cases) were malaria cases, followed by dengue fever (2 628 cases, 16.22%). The majority of the imported cases were males (14 522 cases, 89.61%). Most cases were aged 20-50 years. Except Zika virus disease and yellow fever, which were mainly reported before and after spring festival, other imported infectious diseases mainly occurred in summer and autumn. The epidemic in affected provinces varied with the types of infectious diseases, and Yunnan reported the largest case number of imported infectious diseases, followed by Jiangsu, Guangxi and Guangdong. The imported cases were mainly from Asian countries, such as Burma, and African countries, such as Angola, Equatorial Guinea and Ghana, which also varied with the types of infectious diseases. Conclusions: We should pay more attention to imported infectious diseases and strengthen the prevention and control measures in our country. In order to reduce the incidence of imported infectious diseases, the health education should be enforced for persons who plan to travel abroad and the active surveillance should be strengthened for returned travelers.

Some considerations concerning the challenge of incorporating social variables into epidemiological models of infectious disease transmission.

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Barnett, Tony; Fournié, Guillaume; Gupta, Sunetra; Seeley, Janet

2015-01-01

Incorporation of 'social' variables into epidemiological models remains a challenge. Too much detail and models cease to be useful; too little and the very notion of infection - a highly social process in human populations - may be considered with little reference to the social. The French sociologist Émile Durkheim proposed that the scientific study of society required identification and study of 'social currents'. Such 'currents' are what we might today describe as 'emergent properties', specifiable variables appertaining to individuals and groups, which represent the perspectives of social actors as they experience the environment in which they live their lives. Here we review the ways in which one particular emergent property, hope, relevant to a range of epidemiological situations, might be used in epidemiological modelling of infectious diseases in human populations. We also indicate how such an approach might be extended to include a range of other potential emergent properties to represent complex social and economic processes bearing on infectious disease transmission.

Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference.

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Khemani, Robinder G; Smith, Lincoln S; Zimmerman, Jerry J; Erickson, Simon

2015-06-01

Although there are similarities in the pathophysiology of acute respiratory distress syndrome in adults and children, pediatric-specific practice patterns, comorbidities, and differences in outcome necessitate a pediatric-specific definition. We sought to create such a definition. A subgroup of pediatric acute respiratory distress syndrome investigators who drafted a pediatric-specific definition of acute respiratory distress syndrome based on consensus opinion and supported by detailed literature review tested elements of the definition with patient data from previously published investigations. International PICUs. Children enrolled in published investigations of pediatric acute respiratory distress syndrome. None. Several aspects of the proposed pediatric acute respiratory distress syndrome definition align with the Berlin Definition of acute respiratory distress syndrome in adults: timing of acute respiratory distress syndrome after a known risk factor, the potential for acute respiratory distress syndrome to coexist with left ventricular dysfunction, and the importance of identifying a group of patients at risk to develop acute respiratory distress syndrome. There are insufficient data to support any specific age for "adult" acute respiratory distress syndrome compared with "pediatric" acute respiratory distress syndrome. However, children with perinatal-related respiratory failure should be excluded from the definition of pediatric acute respiratory distress syndrome. Larger departures from the Berlin Definition surround 1) simplification of chest imaging criteria to eliminate bilateral infiltrates; 2) use of pulse oximetry-based criteria when PaO2 is unavailable; 3) inclusion of oxygenation index and oxygen saturation index instead of PaO2/FIO2 ratio with a minimum positive end-expiratory pressure level for invasively ventilated patients; 4) and specific inclusion of children with preexisting chronic lung disease or cyanotic congenital heart disease. This

COPD in Taiwan: a National Epidemiology Survey

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Cheng SL

2015-11-01

Full Text Available Shih-Lung Cheng,1,2 Ming-Cheng Chan,3 Chin-Chou Wang,4 Ching-Hsiung Lin,5 Hao-Chien Wang,6 Jeng-Yuan Hsu,3 Liang-Wen Hang,7,8 Chee-Jen Chang,9 Diahn-Warng Perng,10,* Chong-Jen Yu6,* On behalf of the Taiwan COPD Consortium 1Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, 2Department of Chemical Engineering and Materials Science, Yuan Ze University, Chung-Li City, Taoyuan County, 3Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 4Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 5Division of Chest Medicine, Changhua Christian Hospital, Changhua City, Changhua County, 6Department of Internal Medicine, National Taiwan University Hospital, Taipei, 7Department of Pulmonary and Critical Care Medicine, Sleep Medicine Center, China Medical University Hospital, 8Department of Respiratory Therapy, College of Health Care, China Medical University, Taichung, 9Biostatistical Center for Clinical Research, Chang Gung Memorial Hospital, Linkou Branch, Guishan Township, Taoyuan County, 10Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China *These authors contributed equally to this work Objectives: To determine the prevalence of COPD in Taiwan and to document the disease characteristics and associated risk factors.Methods: We conducted a random cross-sectional national survey of adults older than 40 years in Taiwan. Respiratory health screening questions identified subjects with diagnosed COPD or whose reported symptoms also fulfilled an epidemiological case definition; these were eligible to complete the survey, which also included indices of symptom severity and disability and questions on comorbidities, medical treatments, smoking habits, and occupations potentially harmful to respiratory health. Subjects with diagnosed COPD were subdivided by smoking status. Subjects who fulfilled the case definition

The epidemiological modelling of dysthymia: application for the Global Burden of Disease Study 2010.

Science.gov (United States)

Charlson, Fiona J; Ferrari, Alize J; Flaxman, Abraham D; Whiteford, Harvey A

2013-10-01

In order to capture the differences in burden between the subtypes of depression, the Global Burden of Disease 2010 Study for the first time estimated the burden of dysthymia and major depressive disorder separately from the previously used umbrella term 'unipolar depression'. A global summary of epidemiological parameters are necessary inputs in burden of disease calculations for 21 world regions, males and females and for the year 1990, 2005 and 2010. This paper reports findings from a systematic review of global epidemiological data and the subsequent development of an internally consistent epidemiological model of dysthymia. A systematic search was conducted to identify data sources for the prevalence, incidence, remission and excess-mortality of dysthymia using Medline, PsycINFO and EMBASE electronic databases and grey literature. DisMod-MR, a Bayesian meta-regression tool, was used to check the epidemiological parameters for internal consistency and to predict estimates for world regions with no or few data. The systematic review identified 38 studies meeting inclusion criteria which provided 147 data points for 30 countries in 13 of 21 world regions. Prevalence increases in the early ages, peaking at around 50 years. Females have higher prevalence of dysthymia than males. Global pooled prevalence remained constant across time points at 1.55% (95%CI 1.50-1.60). There was very little regional variation in prevalence estimates. There were eight GBD world regions for which we found no data for which DisMod-MR had to impute estimates. The addition of internally consistent epidemiological estimates by world region, age, sex and year for dysthymia contributed to a more comprehensive estimate of mental health burden in GBD 2010. © 2013 Elsevier B.V. All rights reserved.

Global epidemiology of phytoplasma diseases of economic importance in Southeast Europe

OpenAIRE

Mitrev, Sasa

2007-01-01

The network ‘Global epidemiology of phytoplasma diseases of economic importance in Southeast Europe’ will coordinate the efforts of plant pathologists, microbiologists and entomologists of Southeast European countries to better monitor phytoplasma strains propagation through nurseries and insect vectors, at the European scale. This will be investigated both in plants and insects using up to date molecular typing tools and real-time PCR detection technology. In addition, the network will initi...

Development and application of Human Genome Epidemiology

Science.gov (United States)

Xu, Jingwen

2017-12-01

Epidemiology is a science that studies distribution of diseases and health in population and its influencing factors, it also studies how to prevent and cure disease and promote health strategies and measures. Epidemiology has developed rapidly in recent years and it is an intercross subject with various other disciplines to form a series of branch disciplines such as Genetic epidemiology, molecular epidemiology, drug epidemiology and tumor epidemiology. With the implementation and completion of Human Genome Project (HGP), Human Genome Epidemiology (HuGE) has emerged at this historic moment. In this review, the development of Human Genome Epidemiology, research content, the construction and structure of relevant network, research standards, as well as the existing results and problems are briefly outlined.

Epidemiology of oral diseases in individuals between the ages of 35 and 44 years:an epidemiological scenario of the worker

Directory of Open Access Journals (Sweden)

Érica Silva Carvalho

2010-04-01

Full Text Available Objectives: To review epidemiological studies on oral diseases, specifically caries, periodontal disease and oral cancer, in the age group between 35 and 44 years. Methods: The strategy used to identify the articles was to search the PubMed database using the following key words: dental health surveys, epidemiology, caries, periodotitis, cancer, always with Boolean operator, and without limitation of language. The exclusion criteria were as follows: articles published over 10 years ago, articles that did not deal with adults from 35 to 44 years old and articles that did not cover the issue proposed. Results: On dental caries 7.071 articles were found, from which 6.992 articles were excluded, leaving 79. In the criteria complete articles, of the 19 articles selected, 8 were coherent with the objectives of the study. On periodontal disease, 1.554 articles were found and 872 articles were excluded. After evaluating the complete articles, 6 articles were selected. With regard to the subject oral cancer, 573 articles were found and 3 articles suited the study. Conclusion: It may be considered that caries disease increases with age and that dental loss prevails in DMFT in adults. In adults the prevalence of calculus and shallow pockets prevails and the need for dentures is higher in elderly people although it is significant in adults etween the ages of 35 and 44 years. There is a higher incidence of oral cancer in men with a synergism in alcoholic smokers. During the search in the database, it was observed that the number of researches is lower among adults.

The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report.

Science.gov (United States)

Levey, Andrew S; de Jong, Paul E; Coresh, Josef; El Nahas, Meguid; Astor, Brad C; Matsushita, Kunihiro; Gansevoort, Ron T; Kasiske, Bertram L; Eckardt, Kai-Uwe

2011-07-01

The definition and classification for chronic kidney disease was proposed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) in 2002 and endorsed by the Kidney Disease: Improving Global Outcomes (KDIGO) in 2004. This framework promoted increased attention to chronic kidney disease in clinical practice, research and public health, but has also generated debate. It was the position of KDIGO and KDOQI that the definition and classification should reflect patient prognosis and that an analysis of outcomes would answer key questions underlying the debate. KDIGO initiated a collaborative meta-analysis and sponsored a Controversies Conference in October 2009 to examine the relationship of estimated glomerular filtration rate (GFR) and albuminuria to mortality and kidney outcomes. On the basis of analyses in 45 cohorts that included 1,555,332 participants from general, high-risk, and kidney disease populations, conference attendees agreed to retain the current definition for chronic kidney disease of a GFR 30 mg/g, and to modify the classification by adding albuminuria stage, subdivision of stage 3, and emphasizing clinical diagnosis. Prognosis could then be assigned based on the clinical diagnosis, stage, and other key factors relevant to specific outcomes. KDIGO has now convened a workgroup to develop a global clinical practice guideline for the definition, classification, and prognosis of chronic kidney disease.

Issues in epidemiological studies of radiofrequency workers

International Nuclear Information System (INIS)

Hocking, B.

1985-01-01

The paper reviews some of the issues in a proposed epidemiological study of radiofrequency workers. First a few other epidemiological studies are discussed to illustrate some of the common problems such as inadequate definition of effects and/or exposure. Then technical problems in determining dosage and responses as well as study design are reviewed, and finally the administrative aspects of ethics, industrial relations and costs are considered

Contesting lifestyle risk and gendering coronary candidacy: lay epidemiology of heart disease in Finland in the 1970s.

Science.gov (United States)

Jauho, Mikko

2017-09-01

This study addresses two issues currently under critical discussion in the epidemiology of cardiovascular diseases (CVD), the relative neglect of women and the individualised nature of key risk factors. It focuses on the North Karelia project (NKP), a community programme aimed at coronary heart disease (CHD) prevention in a predominantly rural Finnish region in the early 1970s, that is, during a period when the epidemiological understanding of CVD still was relatively new and actively promoted. Adopting the notions of lay epidemiology and coronary candidacy, culturally mediated explanatory models lay people use to assess who is likely to develop heart disease and why, the study shows that locals targeted by the project critically engaged with both of these bias. Based on the rich materials resulting from project activities the study shows, first, how many locals subsumed the individualised and lifestyle-based approach to CHD prevention promoted by NKP under a more general framework emphasising the health effects of ongoing structural changes in the area, and second, how women constructed themselves as viable coronary candidates. The case supports the position in the current discussions on lay expertise that wants to integrate lay experiences more firmly into epidemiological studies and public health. © 2017 Foundation for the Sociology of Health & Illness.

Development of a foundation for a case definition of post-treatment Lyme disease syndrome.

Science.gov (United States)

Aucott, John N; Crowder, Lauren A; Kortte, Kathleen B

2013-06-01

The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of definition of PTLDS allows for identification of those patients who are treated for early Lyme disease and have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

The role of diseases, risk factors and symptoms in the definition of multimorbidity

DEFF Research Database (Denmark)

Willadsen, Tora Grauers; Bebe, Anna; Køster-Rasmussen, Rasmus

2016-01-01

until October 2013. One author extracted the information. Ambiguities were resolved, and consensus reached with one co-author. Outcome measures were: cut-off point for the number of conditions included in the definitions of multimorbidity; setting; data sources; number, kind, duration, and severity......Objective is to explore how multimorbidity is defined in the scientific literature, with a focus on the roles of diseases, risk factors, and symptoms in the definitions. DESIGN: Systematic review. METHODS: MEDLINE (PubMed), Embase, and The Cochrane Library were searched for relevant publications up......%). Sources of data were primarily self-reports (56 articles, 42%). Out of the 163 articles selected, 115 had individually constructed multimorbidity definitions, and in these articles diseases occurred in all definitions, with diabetes as the most frequent. Risk factors occurred in 98 (85%) and symptoms...

Analyzing differences in operational disease definitions using ontological modeling

NARCIS (Netherlands)

Peelen, Linda; Klein, Michel C.A.; Schlobach, Stefan; De Keizer, Nicolette F.; Peek, Niels

2007-01-01

In medicine, there are many diseases which cannot be precisely characterized but are considered as natural kinds. In the communication between health care professionals, this is generally not problematic. In biomedical research, however, crisp definitions are required to unambiguously distinguish

Liver transplant for cholestatic liver diseases.

Science.gov (United States)

Carrion, Andres F; Bhamidimarri, Kalyan Ram

2013-05-01

Cholestatic liver diseases include a group of diverse disorders with different epidemiology, pathophysiology, clinical course, and prognosis. Despite significant advances in the clinical care of patients with cholestatic liver diseases, liver transplant (LT) remains the only definitive therapy for end-stage liver disease, regardless of the underlying cause. As per the United Network for Organ Sharing database, the rate of cadaveric LT for cholestatic liver disease was 18% in 1991, 10% in 2000, and 7.8% in 2008. This review summarizes the available evidence on various common and rare cholestatic liver diseases, disease-specific issues, and pertinent aspects of LT. Copyright © 2013 Elsevier Inc. All rights reserved.

[Relations between official and private veterinary services in epidemiology and the control of contagious diseases].

Science.gov (United States)

Moura, J A; Bedoya, M; Agudelo, M P

2004-04-01

Growing budget restrictions in many countries have meant that official Veterinary Services cannot assume responsibility for any new activities. The natural reaction is to turn to private veterinary services to provide the support needed to strengthen the control and surveillance of priority diseases and thereby support the development of the livestock sector and the establishment of safe international trade. In this context, official Veterinary Services must work together with private veterinarians, delegating various technical animal health activities, so that they may focus their efforts on those tasks that cannot be delegated: standardisation, control, auditing, general system co-ordination, epidemiological surveillance, etc., as well as organising veterinary policy in order to make best use of budget resources. For these relations to be efficient, a dynamic, two-way epidemiological information mechanism must be created, whereby private veterinarians periodically keep governments informed, on the basis of an agreed methodology. Moreover, the official Veterinary Services must systematically transmit information on List A and B diseases of the OIE (World organisation for animal health), and perform detailed analyses of epidemiologically significant events. The article proposes the establishment of relations between public and private veterinary services as a way in which to provide the livestock sector with the health and hygiene conditions that are necessary for effective disease control, which in turn provides greater security for international trade and increased consumer protection.

Review: Epidemiological evidence of groundwater contribution to global enteric disease, 1948-2015

Science.gov (United States)

Murphy, Heather M.; Prioleau, Morgan D.; Borchardt, Mark A.; Hynds, Paul D.

2017-06-01

Globally, approximately 2.2 billion people rely on groundwater for daily consumption. It is widely accepted that groundwater is more pristine than surface water but while this assumption is frequently the case, groundwater is not ubiquitously free of contaminants; accordingly, this presumption can result in an unfounded and potentially hazardous sense of security among owners, operators and users. The current paper presents a review of published literature providing epidemiological evidence of the contribution of groundwater to global human enteric infection. An emphasis is placed on enteric pathogens transmitted via the faecal-oral route, and specifically those associated with acute gastrointestinal illness (AGI). The review identified 649 published groundwater outbreaks globally between 1948 and 2013 and several epidemiological studies that show there is an increased risk of AGI associated with the consumption of untreated groundwater. The review identified that the following five pathogens were responsible for most outbreaks: norovirus, Campylobacter, Shigella, Hepatitis A and Giardia. Crudely, the authors estimate that between 35.2 and 59.4 million cases of AGI per year globally could be attributable to the consumption of groundwater. Although groundwater is frequently presumed to be a microbiologically safe source of water for consumption, this review demonstrates that consumers served by an untreated groundwater supply remain at risk to enteric disease. The authors conclude that collaboration between microbiologists, hydrogeologists and epidemiologists is needed to better understand pathogen occurrence, persistence, detection and transport in groundwater as well as build stronger epidemiological evidence documenting the true magnitude of disease associated with groundwater globally.

Paula Coutinho's outstanding contribution to the definition of Machado-Joseph disease.

Science.gov (United States)

Garcia, Bruno Carniatto Marques; Germiniani, Francisco Manoel Branco; Marques, Paula; Sequeiros, Jorge; Teive, Hélio Afonso Ghizoni

2017-10-01

Machado-Joseph disease, also known as spinocerebellar ataxia type 3, is the most common form of autosomal dominant ataxia in the world. Paula Coutinho, a highly-regarded Portuguese neurologist worldwide, had a seminal participation in the definition of this disease, more than 40 years ago.

Alzheimer’s disease is not “brain aging”: neuropathological, genetic, and epidemiological human studies

Science.gov (United States)

Head, Elizabeth; Schmitt, Frederick A.; Davis, Paulina R.; Neltner, Janna H.; Jicha, Gregory A.; Abner, Erin L.; Smith, Charles D.; Van Eldik, Linda J.; Kryscio, Richard J.; Scheff, Stephen W.

2011-01-01

Human studies are reviewed concerning whether “aging”-related mechanisms contribute to Alzheimer’s disease (AD) pathogenesis. AD is defined by specific neuropathology: neuritic amyloid plaques and neocortical neurofibrillary tangles. AD pathology is driven by genetic factors related not to aging per se, but instead to the amyloid precursor protein (APP). In contrast to genes involved in APP-related mechanisms, there is no firm connection between genes implicated in human “accelerated aging” diseases (progerias) and AD. The epidemiology of AD in advanced age is highly relevant but deceptively challenging to address given the low autopsy rates in most countries. In extreme old age, brain diseases other than AD approximate AD prevalence while the impact of AD pathology appears to peak by age 95 and decline thereafter. Many distinct brain diseases other than AD afflict older human brains and contribute to cognitive impairment. Additional prevalent pathologies include cerebrovascular disease and hippocampal sclerosis, both high-morbidity brain diseases that appear to peak in incidence later than AD chronologically. Because of these common brain diseases of extreme old age, the epidemiology differs between clinical “dementia” and the subset of dementia cases with AD pathology. Additional aging-associated mechanisms for cognitive decline such as diabetes and synapse loss have been linked to AD and these hypotheses are discussed. Criteria are proposed to define an “aging-linked” disease, and AD fails all of these criteria. In conclusion, it may be most fruitful to focus attention on specific pathways involved in AD rather than attributing it to an inevitable consequence of aging. PMID:21516511

Scale-dependent approaches to modeling spatial epidemiology of chronic wasting disease.

Science.gov (United States)

Conner, Mary M.; Gross, John E.; Cross, Paul C.; Ebinger, Michael R.; Gillies, Robert; Samuel, Michael D.; Miller, Michael W.

2007-01-01

This e-book is the product of a second workshop that was funded and promoted by the United States Geological Survey to enhance cooperation between states for the management of chronic wasting disease (CWD). The first workshop addressed issues surrounding the statistical design and collection of surveillance data for CWD. The second workshop, from which this document arose, followed logically from the first workshop and focused on appropriate methods for analysis, interpretation, and use of CWD surveillance and related epidemiology data. Consequently, the emphasis of this e-book is on modeling approaches to describe and gain insight of the spatial epidemiology of CWD. We designed this e-book for wildlife managers and biologists who are responsible for the surveillance of CWD in their state or agency. We chose spatial methods that are popular or common in the spatial epidemiology literature and evaluated them for their relevance to modeling CWD. Our opinion of the usefulness and relevance of each method was based on the type of field data commonly collected as part of CWD surveillance programs and what we know about CWD biology, ecology, and epidemiology. Specifically, we expected the field data to consist primarily of the infection status of a harvested or culled sample along with its date of collection (not date of infection), location, and demographic status. We evaluated methods in light of the fact that CWD does not appear to spread rapidly through wild populations, relative to more highly contagious viruses, and can be spread directly from animal to animal or indirectly through environmental contamination.

Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study.

NARCIS (Netherlands)

van Ingen, Jakko; Kohl, Thomas A; Kranzer, Katharina; Hasse, Barbara; Keller, Peter M; Katarzyna Szafrańska, Anna; Hillemann, Doris; Chand, Meera; Schreiber, Peter Werner; Sommerstein, Rami; Berger, Christoph; Genoni, Michele; Rüegg, Christian; Troillet, Nicolas; Widmer, Andreas F; Becker, Sören L; Herrmann, Mathias; Eckmanns, Tim; Haller, Sebastian; Höller, Christiane; Debast, Sylvia B; Wolfhagen, Maurice J; Hopman, Joost; Kluytmans, Jan; Langelaar, Merel; Notermans, Daan W; Ten Oever, Jaap; van den Barselaar, Peter; Vonk, Alexander B A; Vos, Margreet C; Ahmed, Nada; Brown, Timothy; Crook, Derrick; Lamagni, Theresa; Phin, Nick; Smith, E Grace; Zambon, Maria; Serr, Annerose; Götting, Tim; Ebner, Winfried; Thürmer, Alexander; Utpatel, Christian; Spröer, Cathrin; Bunk, Boyke; Nübel, Ulrich; Bloemberg, Guido V; Böttger, Erik C; Niemann, Stefan; Wagner, Dirk; Sax, Hugo

2017-01-01

Since 2013, over 100 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notified in Europe and the USA, linked to contaminated heater-cooler units (HCUs) used during cardiac surgery. We did a molecular epidemiological investigation to establish the source of

Definition of chronic kidney disease and measurement of kidney function in original research papers: a review of the literature.

Science.gov (United States)

Anderson, Jocelyn; Glynn, Liam G

2011-09-01

Over the past decade, chronic kidney disease (CKD) has become an area of intensive clinical and epidemiological research. Despite the clarity provided by the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines, there appears to be within the CKD research literature significant disagreement on how to define CKD and measure kidney function. The objectives of this study were to investigate the variety of methods used to define CKD and to measure kidney function in original research papers as well as to investigate whether the quality of the journal had any effect on the quality of the methodology used. This was a descriptive review and not a meta-analysis. Information was extracted from each article including publication details (including the journal's impact factor), definition of CKD, method used to estimate kidney function and quantity of serum creatinine readings used to define CKD. An electronic search of MEDLINE through OVID was completed using the search term CKD. The search was limited to articles in English published in 2009. Studies were included in the review only if they were original research articles including patients with CKD. Articles were excluded if they reported data from a paediatric population, a population solely on dialysis or if there was no full-text access through OVID. Each article was assessed for quality with respect to using KDOQI CKD definition criteria. A description of the pooled data was completed and chi-square tests were used to investigate the relation between article quality and journal quality. Analysis was carried out using SPSS (15.0) and a P-value of definitions are being used in original research articles to define CKD and measure kidney function which calls into question the validity and reliability of such research findings and associated clinical guidelines. International consensus is urgently required to improve validity and generalizability of CKD research findings.

The epidemiologic study of children diseases under one year in Tehran

Directory of Open Access Journals (Sweden)

Babaeei Gh

2001-07-01

Full Text Available Infant mortality and morbidity present important challenges to those concerned with community health. We did this research to study epidemiology of diseases of infancy in city of Tehran. During 15 days, of 6395 deliveries in Tehran hospitals a cohort of 6267 live births entered this study. Follow up data were gathered in 1st, 3rd, 6th and 12th months of birth. In this period, 5382 occurrence of disease were reported. The most frequent were cardiopulmonary (52.3% and Gastrointestinal (26.6% diseases. Most of the events were seen in 6-12 months age group (30.5%. The lowest frequencies of infant diseases were seen in 19-35 years of maternal age (15.3%, as compared with >35 (35.4% and <19 (49.3% groups. Mortality ratio was 32/1000 live birth (198 death. The most common causes of death were cardiopulmonary (38%, infectious (21% and gastrointestinal (18% diseases. Control of infectious disease, development of educational programs for breast feeding and planning of proper age and interval of pregnancy are effective measures for reducing infant mortality and morbidity.

The Application of Contagious Disease Epidemiological Models to Known Population Structure and Movement

Science.gov (United States)

2016-03-01

concept model ( Ebola ) • Time-varying disease transmission rate () Influenza model • Population structure represented via finite scale-free network...I N S T I T U T E F O R D E F E N S E A N A L Y S E S The Application of Contagious Disease Epidemiological Models to Known Population Structure ...Known Population Structure and Movement Julia K. Burr Robert L. Cubeta Lucas A. LaViolet Carl A. Curling This page is intentionally blank. iii

Sensitivity and Specificity of Suspected Case Definition Used during West Africa Ebola Epidemic.

Science.gov (United States)

Hsu, Christopher H; Champaloux, Steven W; Keïta, Sakoba; Martel, Lise; Bilivogui, Pepe; Knust, Barbara; McCollum, Andrea M

2018-01-01

Rapid early detection and control of Ebola virus disease (EVD) is contingent on accurate case definitions. Using an epidemic surveillance dataset from Guinea, we analyzed an EVD case definition developed by the World Health Organization (WHO) and used in Guinea. We used the surveillance dataset (March-October 2014; n = 2,847 persons) to identify patients who satisfied or did not satisfy case definition criteria. Laboratory confirmation determined cases from noncases, and we calculated sensitivity, specificity and predictive values. The sensitivity of the defintion was 68.9%, and the specificity of the definition was 49.6%. The presence of epidemiologic risk factors (i.e., recent contact with a known or suspected EVD case-patient) had the highest sensitivity (74.7%), and unexplained deaths had the highest specificity (92.8%). Results for case definition analyses were statistically significant (pdefinition used in Guinea contributed to improved overall sensitivity and specificity.

Classification and prediction of river network ephemerality and its relevance for waterborne disease epidemiology

Science.gov (United States)

Perez-Saez, Javier; Mande, Theophile; Larsen, Joshua; Ceperley, Natalie; Rinaldo, Andrea

2017-12-01

The transmission of waterborne diseases hinges on the interactions between hydrology and ecology of hosts, vectors and parasites, with the long-term absence of water constituting a strict lower bound. However, the link between spatio-temporal patterns of hydrological ephemerality and waterborne disease transmission is poorly understood and difficult to account for. The use of limited biophysical and hydroclimate information from otherwise data scarce regions is therefore needed to characterize, classify, and predict river network ephemerality in a spatially explicit framework. Here, we develop a novel large-scale ephemerality classification and prediction methodology based on monthly discharge data, water and energy availability, and remote-sensing measures of vegetation, that is relevant to epidemiology, and maintains a mechanistic link to catchment hydrologic processes. Specifically, with reference to the context of Burkina Faso in sub-Saharan Africa, we extract a relevant set of catchment covariates that include the aridity index, annual runoff estimation using the Budyko framework, and hysteretical relations between precipitation and vegetation. Five ephemerality classes, from permanent to strongly ephemeral, are defined from the duration of 0-flow periods that also accounts for the sensitivity of river discharge to the long-lasting drought of the 70's-80's in West Africa. Using such classes, a gradient-boosted tree-based prediction yielded three distinct geographic regions of ephemerality. Importantly, we observe a strong epidemiological association between our predictions of hydrologic ephemerality and the known spatial patterns of schistosomiasis, an endemic parasitic waterborne disease in which infection occurs with human-water contact, and requires aquatic snails as an intermediate host. The general nature of our approach and its relevance for predicting the hydrologic controls on schistosomiasis occurrence provides a pathway for the explicit inclusion of

Epidemiology, classification, and modifiable risk factors of peripheral arterial disease

Directory of Open Access Journals (Sweden)

Nicolas W Shammas

2007-05-01

Full Text Available Nicolas W ShammasMidwest Cardiovascular Research Foundation, Cardiovascular Medicine, PC, Davenport, IA, USAAbstract: Peripheral arterial disease (PAD is part of a global vascular problem of diffuse atherosclerosis. PAD patients die mostly of cardiac and cerebrovascular-related events and much less frequently due to obstructive disease of the lower extremities. Aggressive risk factors modification is needed to reduce cardiac mortality in PAD patients. These include smoking cessation, reduction of blood pressure to current guidelines, aggressive low density lipoprotein lowering, losing weight, controlling diabetes and the use of oral antiplatelet drugs such as aspirin or clopidogrel. In addition to quitting smoking and exercise, cilostazol and statins have been shown to reduce claudication in patients with PAD. Patients with critical rest limb ischemia or severe progressive claudication need to be treated with revascularization to minimize the chance of limb loss, reduce symptoms, and improve quality of life.Keywords: peripheral arterial disease, epidemiology, risk factors, classification

Epidemiology of the Emergent Disease Paridae pox in an Intensively Studied Wild Bird Population

Science.gov (United States)

Lachish, Shelly; Lawson, Becki; Cunningham, Andrew A.; Sheldon, Ben C.

2012-01-01

Paridae pox, a novel avipoxvirus infection, has recently been identified as an emerging infectious disease affecting wild tit species in Great Britain. The incursion of Paridae pox to a long-term study site where populations of wild tits have been monitored in detail for several decades provided a unique opportunity to obtain information on the local-scale epidemiological characteristics of this novel infection during a disease outbreak. Using captures of >8000 individual birds, we show that, within two years of initial emergence, Paridae pox had become established within the population of great tits (Parus major) reaching relatively high peak prevalence (10%), but was far less prevalent (<1%) in sympatric populations of several other closely related, abundant Paridae species. Nonlinear smoothing models revealed that the temporal pattern of prevalence among great tits was characterised by within-year fluctuations indicative of seasonal forcing of infection rates, which was likely driven by multiple environmental and demographic factors. There was individual heterogeneity in the course of infection and, although recovery was possible, diseased individuals were far less likely to be recaptured than healthy individuals, suggesting a survival cost of infection. This study demonstrates the value of long-term monitoring for obtaining key epidemiological data necessary to understand disease dynamics, spread and persistence in natural populations. PMID:23185230

Epidemiology of the emergent disease Paridae pox in an intensively studied wild bird population.

Directory of Open Access Journals (Sweden)

Shelly Lachish

Full Text Available Paridae pox, a novel avipoxvirus infection, has recently been identified as an emerging infectious disease affecting wild tit species in Great Britain. The incursion of Paridae pox to a long-term study site where populations of wild tits have been monitored in detail for several decades provided a unique opportunity to obtain information on the local-scale epidemiological characteristics of this novel infection during a disease outbreak. Using captures of >8000 individual birds, we show that, within two years of initial emergence, Paridae pox had become established within the population of great tits (Parus major reaching relatively high peak prevalence (10%, but was far less prevalent (<1% in sympatric populations of several other closely related, abundant Paridae species. Nonlinear smoothing models revealed that the temporal pattern of prevalence among great tits was characterised by within-year fluctuations indicative of seasonal forcing of infection rates, which was likely driven by multiple environmental and demographic factors. There was individual heterogeneity in the course of infection and, although recovery was possible, diseased individuals were far less likely to be recaptured than healthy individuals, suggesting a survival cost of infection. This study demonstrates the value of long-term monitoring for obtaining key epidemiological data necessary to understand disease dynamics, spread and persistence in natural populations.

Current practice of epidemiology in Africa: highlights of the 3rd conference of the African epidemiological association and 1st conference of the Cameroon society of epidemiology, Yaoundé, Cameroon, 2014.

Science.gov (United States)

Nkwescheu, Armand Seraphin; Fokam, Joseph; Tchendjou, Patrice; Nji, Akindeh; Ngouakam, Hermann; Andre, Bita Fouda; Joelle, Sobngwi; Uzochukwu, Benjamin; Akinroye, Kingsley; Mbacham, Wilfred; Colizzi, Vittorio; Leke, Rose; Victora, Cesar

2015-01-01

As the study of disease occurrence and health indicators in human populations, Epidemiology is a dynamic field that evolves with time and geographical context. In order to update African health workers on current epidemiological practices and to draw awareness of early career epidemiologists on concepts and opportunities in the field, the 3(rd) African Epidemiology Association and the 1st Cameroon Society of Epidemiology Conference was organized in June 2-6, 2014 at the Yaoundé Mont Febe Hotel, in Cameroon. Under the theme«Practice of Epidemiology in Africa: Stakes, Challenges and Perspectives», the conference attracted close to five hundred guest and participants from all continents. The two main programs were the pre-conference course for capacity building of African Early Career epidemiologists, and the conference itself, providing a forum for scientific exchanges on recent epidemiological concepts, encouraging the use of epidemiological methods in studying large disease burden and neglected tropical diseases; and highlighting existing opportunities.

Methodology in the epidemiological research of respiratory diseases and environmental pollution

Directory of Open Access Journals (Sweden)

Simón Barquera

2002-02-01

Full Text Available There are complex and diverse methodological problems involved in the clinical and epidemiological study of respiratory diseases and their etiological factors. The association of urban growth, industrialization and environmental deterioration with respiratory diseases makes it necessary to pay more attention to this research area with a multidisciplinary approach. Appropriate study designs and statistical techniques to analyze and improve our understanding of the pathological events and their causes must be implemented to reduce the growing morbidity and mortality through better preventive actions and health programs. The objective of the article is to review the most common methodological problems in this research area and to present the most available statistical tools used.

Methodology in the epidemiological research of respiratory diseases and environmental pollution

Directory of Open Access Journals (Sweden)

Barquera Simón

2002-01-01

Full Text Available There are complex and diverse methodological problems involved in the clinical and epidemiological study of respiratory diseases and their etiological factors. The association of urban growth, industrialization and environmental deterioration with respiratory diseases makes it necessary to pay more attention to this research area with a multidisciplinary approach. Appropriate study designs and statistical techniques to analyze and improve our understanding of the pathological events and their causes must be implemented to reduce the growing morbidity and mortality through better preventive actions and health programs. The objective of the article is to review the most common methodological problems in this research area and to present the most available statistical tools used.

The epidemiology and the pathogenesis of inflammatory bowel disease

Energy Technology Data Exchange (ETDEWEB)

Karlinger, Kinga E-mail: karlking@radi.sote.hu; Gyoerke, Tamas; Makoe, Erno; Mester, Adam; Tarjan, Zsolt

2000-09-01

The etiology of inflammatory bowel disease (IBD) is still unknown. However, a satisfactory solution cannot be far away. IBD actually encompasses two diseases, i.e. Crohn's disease (CD) and ulcerous colitis (UC). These diseases resemble each other so closely that they cannot be distinguished even pathologically, but differ from each other sufficiently to regard them as independent entities. Epidemiological observations may be helpful in identifying the true causative factors of this evasive disease. Geographically, the prevalence of the disease has a slope from North to South and, to a lesser degree, from West to East. The Western-Eastern discrepancy can be attributed to a difference in Western life styles. The incidence of the disease has been increasing world-wide of late, but its spread has been slowing down in highly affected countries. Racial and ethnic relations in different populations and immigration studies offer interesting data which can reflect genetic, inherited, environmental and behavioural factors. The disease seems to have a characteristic racial-ethnic distribution: the Jewish population is highly susceptible everywhere, but its prevalence in that population nears that of the domestic society in which they live. In Hungary, the Roma (Gypsies) have a considerably lower prevalence than the average population. This can be attributed to a genetic or environmental influence. According to age, the onset of the disease occurs more often in the second or the third decade of life, but there also is another peak in the 60s. Regarding sexual distribution, there is a slight preponderance of colitis ulcerosa in men and of Crohn's disease in women. It may correspond to the stronger auto-immune affection in the process of Crohn's disease. Environmental factors and behavioural influences also are investigated. Diet, the role of the early ages, smoking habits and the influence of hormonal status and drugs are viewed as useful contributing factors in

Epidemiology and Management of Otitis Media in Children.

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Giebink, G. Scott; Daly, Kathy

1990-01-01

This article focuses on definitions of middle ear inflammation (otitis media), the epidemiology of this disorder, brief considerations of pathophysiology and management, and possible future therapies. (DB))

Understanding disease control: influence of epidemiological and economic factors.

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Katarzyna Oleś

Full Text Available We present a model of disease transmission on a regular and small world network and compare different control options. Comparison is based on a total cost of epidemic, including cost of palliative treatment of ill individuals and preventive cost aimed at vaccination or culling of susceptible individuals. Disease is characterized by pre-symptomatic phase, which makes detection and control difficult. Three general strategies emerge: global preventive treatment, local treatment within a neighborhood of certain size and only palliative treatment with no prevention. While the choice between the strategies depends on a relative cost of palliative and preventive treatment, the details of the local strategy and, in particular, the size of the optimal treatment neighborhood depend on the epidemiological factors. The required extent of prevention is proportional to the size of the infection neighborhood, but depends on time till detection and time till treatment in a non-nonlinear (power law. The optimal size of control neighborhood is also highly sensitive to the relative cost, particularly for inefficient detection and control application. These results have important consequences for design of prevention strategies aiming at emerging diseases for which parameters are not nessecerly known in advance.

Foot-and-mouth disease in pigs: current epidemiological situation and control methods.

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León, Emilio A

2012-03-01

Foot-and-mouth disease (FMD) is the paradigm of a transboundary animal disease. Beyond any doubt, it is the most serious challenge for livestock's health. Official Veterinary Services from free countries invest considerable amount of money to prevent its introduction, whereas those from endemic countries invest most of their resources in the control of the disease. A very important volume of scientific production is developed every year in different aspects of FMD, and for that reason, the current knowledge makes the diagnosis of the disease easier to a great extent. However, FMD is still endemic in about two-thirds of the countries, and periodically re-emergent in several countries. This paper is a review of recent publications, focusing mainly on control measures and current world epidemiological situation, emphasizing primarily pigs. © 2012 Blackwell Verlag GmbH.

Low doses of ionizing radiation and risk of cardiovascular disease: A review of epidemiological studies

International Nuclear Information System (INIS)

Metz-Flamant, C.; Bonaventure, A.; Tirmarche, M.; Laurier, D.; Bernier, M.O.; Milliat, F.

2009-01-01

Background While cardiovascular risks associated with high level of ionizing radiation are well-established, long-term effects of low and medium levels of exposure, between 0 and 5 gray (Gy), on the cardiovascular system are debated. Methods Available literature was reviewed considering various populations, such as survivors of atomic bombs, nuclear workers, Chernobyl liquidators, radiologists and radiological technologists and patients exposed for medical reasons. Results A significant increased risk of cardiovascular diseases associated with low doses of ionizing radiation was observed in 13 studies among the 27 analyzed. The ischemic heart diseases risk was detailed in 16 studies and seven of them showed a significant increase. The cerebrovascular risk was significantly increased in five studies among the 12 considered. Conclusion Some epidemiological and experimental data are clearly in favour of an increased cardiovascular risk associated with exposure to low doses. However, given the multi-factorial origin of cardiovascular diseases and the lack of a clear pathophysiologic mechanism, epidemiological results have to be carefully interpreted. Further research should be conducted in this area. (authors)

Epidemiologic studies of fatal and nonfatal cardiovascular disease and ETS exposure from spousal smoking.

OpenAIRE

Thun, M; Henley, J; Apicella, L

1999-01-01

This article reviews the epidemiologic studies of the association of ischemic heart disease risk and environmental tobacco smoke (ETS) exposure from a spouse who smokes. Seventeen studies (nine cohort, eight case-control) comprising more than 485,000 lifelong nonsmokers and 7,345 coronary heart disease (CHD) events were included in a meta-analysis. Together, these studies include 36% more CHD events and 58% more study subjects than were available for review by the U. S. Occupational Safety an...

Relationship between Periodontal Diseases and Preterm Birth: Recent Epidemiological and Biological Data

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Huck, O.; Tenenbaum, H.; Davideau, J.-L.

2011-01-01

For ten years, the incidence of preterm birth does not decrease in developed countries despite the promotion of public health programs. Many risk factors have been identified including ethnicity, age, tobacco, and infection. However, almost 50% of preterm birth causes remain unknown. The periodontal diseases are highly prevalent inflammatory and infectious diseases of tooth supporting tissues leading to an oral disability. They influence negatively general health worsening cardiovascular diseases and diabetes. Periodontal diseases have been also suspected to increase the rate of preterm birth, but data remain contradictory. The objective of this review is to present the principal results of epidemiological, biological, and interventional studies on the link between periodontal diseases and preterm birth. The conclusions of this work underline the importance for the physician/obstetrician to identify women at risk for preterm birth and to address these patients to dentist for periodontal examination and treatment in order to limit adverse pregnancy outcomes. PMID:22132334

Relationship between Periodontal Diseases and Preterm Birth: Recent Epidemiological and Biological Data

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O. Huck

2011-01-01

Full Text Available For ten years, the incidence of preterm birth does not decrease in developed countries despite the promotion of public health programs. Many risk factors have been identified including ethnicity, age, tobacco, and infection. However, almost 50% of preterm birth causes remain unknown. The periodontal diseases are highly prevalent inflammatory and infectious diseases of tooth supporting tissues leading to an oral disability. They influence negatively general health worsening cardiovascular diseases and diabetes. Periodontal diseases have been also suspected to increase the rate of preterm birth, but data remain contradictory. The objective of this review is to present the principal results of epidemiological, biological, and interventional studies on the link between periodontal diseases and preterm birth. The conclusions of this work underline the importance for the physician/obstetrician to identify women at risk for preterm birth and to address these patients to dentist for periodontal examination and treatment in order to limit adverse pregnancy outcomes.

The Line-drawing Problem in Disease Definition.

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Rogers, Wendy A; Walker, Mary Jean

2017-08-01

Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within "dysfunction-requiring" accounts of disease, such as those of Christopher Boorse and Jerome Wakefield. We then provide several detailed examples to establish that biological dysfunction cannot provide a boundary. We examine potential ways of resolving the line-drawing problem, either by dropping one of the claims that generates it, or by appealing to additional criteria. We argue that two of these options are plausible, and that each of these can be applied with regard to different diseases. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

WHO - IPHECA: Epidemiological aspects

International Nuclear Information System (INIS)

Souchkevitch, G.

1996-01-01

In May 1991 the World Health Assembly endorsed the establishment of the International Programme on the Health Effects of the Chernobyl Accident (IPHECA) under the auspices of WHO. Five pilot projects have been carried out within IPHECA in the study territories of Belarus, Russian Federation and Ukraine in a period from 1991 to 1994. This pilot projects dealt with the detection and treatment of leukaemia and related diseases (Haematology Project), thyroid disorders (Thyroid project), brain damage during exposure 'in-utero' (Brain Damage 'in-Utero' project) and with the development of the Chernobyl registries (Epidemiological Registry Project). A fifth pilot project on oral health was performed only in Belarus. Epidemiological investigations have been an important component of all IPHECA pilot projects. Within 'Epidemiological Registry' Project such investigations have been the principal activity. But with respect to other IPHECA projects it was carried out in addition to main objectives relating to medical monitoring, early diagnosis and treatment of specific diseases included in project protocols. To support the epidemiological investigations within IPHECA, WHO supplied 41 computers in Belarus, Russian Federation and Ukraine and provided training for specialists from these countries in internationally recognized centres. The training programmes and host countries were as follows: standardization of epidemiological investigations (United Kingdom), radiation epidemiology (Russia), development of software (United Kingdom), principles of epidemiological investigations (The Czech Republic), cohort investigations (Japan)

WHO - IPHECA: Epidemiological aspects

Energy Technology Data Exchange (ETDEWEB)

Souchkevitch, G [World Health Organization, Geneva (Swaziland)

1996-07-01

In May 1991 the World Health Assembly endorsed the establishment of the International Programme on the Health Effects of the Chernobyl Accident (IPHECA) under the auspices of WHO. Five pilot projects have been carried out within IPHECA in the study territories of Belarus, Russian Federation and Ukraine in a period from 1991 to 1994. This pilot projects dealt with the detection and treatment of leukaemia and related diseases (Haematology Project), thyroid disorders (Thyroid project), brain damage during exposure 'in-utero' (Brain Damage 'in-Utero' project) and with the development of the Chernobyl registries (Epidemiological Registry Project). A fifth pilot project on oral health was performed only in Belarus. Epidemiological investigations have been an important component of all IPHECA pilot projects. Within 'Epidemiological Registry' Project such investigations have been the principal activity. But with respect to other IPHECA projects it was carried out in addition to main objectives relating to medical monitoring, early diagnosis and treatment of specific diseases included in project protocols. To support the epidemiological investigations within IPHECA, WHO supplied 41 computers in Belarus, Russian Federation and Ukraine and provided training for specialists from these countries in internationally recognized centres. The training programmes and host countries were as follows: standardization of epidemiological investigations (United Kingdom), radiation epidemiology (Russia), development of software (United Kingdom), principles of epidemiological investigations (The Czech Republic), cohort investigations (Japan)

Transmission and epidemiology of zoonotic protozoal diseases of companion animals.

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Esch, Kevin J; Petersen, Christine A

2013-01-01

Over 77 million dogs and 93 million cats share our households in the United States. Multiple studies have demonstrated the importance of pets in their owners' physical and mental health. Given the large number of companion animals in the United States and the proximity and bond of these animals with their owners, understanding and preventing the diseases that these companions bring with them are of paramount importance. Zoonotic protozoal parasites, including toxoplasmosis, Chagas' disease, babesiosis, giardiasis, and leishmaniasis, can cause insidious infections, with asymptomatic animals being capable of transmitting disease. Giardia and Toxoplasma gondii, endemic to the United States, have high prevalences in companion animals. Leishmania and Trypanosoma cruzi are found regionally within the United States. These diseases have lower prevalences but are significant sources of human disease globally and are expanding their companion animal distribution. Thankfully, healthy individuals in the United States are protected by intact immune systems and bolstered by good nutrition, sanitation, and hygiene. Immunocompromised individuals, including the growing number of obese and/or diabetic people, are at a much higher risk of developing zoonoses. Awareness of these often neglected diseases in all health communities is important for protecting pets and owners. To provide this awareness, this review is focused on zoonotic protozoal mechanisms of virulence, epidemiology, and the transmission of pathogens of consequence to pet owners in the United States.

Epidemiological Characteristics of Dengue Disease in Latin America and in the Caribbean: A Systematic Review of the Literature

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Jaime Rafael Torres

2017-01-01

Full Text Available Dengue, an important mosquito-borne virus transmitted mainly by Aedes aegypti, is a major public health issue in Latin America and the Caribbean. National epidemiological surveillance systems, usually based on passive detection of symptomatic cases, while underestimating the true burden of dengue disease, can provide valuable insight into disease trends and excess reporting and potential outbreaks. We carried out a systematic review of the literature to characterize the recent epidemiology of dengue disease in Latin America and the English-speaking and Hispanic Caribbean Islands. We identified 530 articles, 60 of which met criteria for inclusion. In general, dengue seropositivity across the region was high and increased with age. All four virus serotypes were reported to circulate in the region. These observations varied considerably between and within countries and over time, potentially due to climatic factors (temperature, rainfall, and relative humidity and their effect on mosquito densities and differences in socioeconomic factors. This review provides important insight into the major epidemiological characteristics of dengue in distinct regions of Latin America and the Caribbean, allowing gaps in current knowledge and future research needs to be identified.

From biological anthropology to applied public health: epidemiological approaches to the study of infectious disease.

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Albalak, Rachel

2009-01-01

This article describes two large, multisite infectious disease programs: the Tuberculosis Epidemiologic Studies Consortium (TBESC) and the Emerging Infections Programs (EIPs). The links between biological anthropology and applied public health are highlighted using these programs as examples. Funded by the Centers for Disease Control and Prevention (CDC), the TBESC and EIPs conduct applied public health research to strengthen infectious disease prevention and control efforts in the United States. They involve collaborations among CDC, public health departments, and academic and clinical institutions. Their unique role in national infectious disease work, including their links to anthropology, shared elements, key differences, strengths and challenges, is discussed.

Epidemiological, Clinical and Entomological Characteristics of Yellow Fever Outbreak in Darfur 2012

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Hamdi Abdulwahab Alhakimi

2015-03-01

Full Text Available The study aims at analyzing the epidemiological, clinical and entomological characteristics of Darfur yellow fever epidemic. It is a descriptive, cross-sectional study. According to operational case definition, suspected yellow fever cases are included in case spread sheet with variables like age, sex, locality, occupation, status of vaccination, onset of symptoms, presenting symptoms, date of blood sampling and confirmation of diagnosis either by laboratory results or epidemiological link. Data about important entomological indices were collected by surveys conducted in 17 localities of 3 Darfur states (Central, West and south Darfur. All Darfur states (especially Central Darfur have been affected by Yellow Fever outbreak. There is a need to review the non-specific case definition of Yellow Fever which seems to overwhelm the system during outbreaks with cases of other endemic diseases. The significant risk factors of this outbreak included male sex, adult age, outdoor occupation and traditional mining. The fatality rate was significantly associated with vaccination status. The highest fatality rate was recorded by children less than 2 years old (42.9%. Generally, increase in certain entomological indices was followed by increase in number of reported cases 7 days later. Central Darfur state was significantly higher in most studied entomological indices.

Epidemiological, Clinical and Entomological Characteristics of Yellow Fever Outbreak in Darfur 2012.

Science.gov (United States)

Alhakimi, Hamdi Abdulwahab; Mohamed, Omima Gadalla; Khogaly, Hayat Salah Eldin; Arafa, Khalid Ahmad Omar; Ahmed, Waled Amen

2015-01-01

The study aims at analyzing the epidemiological, clinical and entomological characteristics of Darfur yellow fever epidemic. It is a descriptive, cross-sectional study. According to operational case definition, suspected yellow fever cases are included in case spread sheet with variables like age, sex, locality, occupation, status of vaccination, onset of symptoms, presenting symptoms, date of blood sampling and confirmation of diagnosis either by laboratory results or epidemiological link. Data about important entomological indices were collected by surveys conducted in 17 localities of 3 Darfur states (Central, West and south Darfur). All Darfur states (especially Central Darfur) have been affected by Yellow Fever outbreak. There is a need to review the non-specific case definition of Yellow Fever which seems to overwhelm the system during outbreaks with cases of other endemic diseases. The significant risk factors of this outbreak included male sex, adult age, outdoor occupation and traditional mining. The fatality rate was significantly associated with vaccination status. The highest fatality rate was recorded by children less than 2 years old (42.9%). Generally, increase in certain entomological indices was followed by increase in number of reported cases 7 days later. Central Darfur state was significantly higher in most studied entomological indices.

Homozygous familial hypercholesterolemia (HoFH in Germany: an epidemiological survey

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Walzer S

2013-05-01

Full Text Available S Walzer,1 K Travers,2 S Rieder,3 E Erazo-Fischer,3 D Matusiewicz41MArS Market Access and Pricing Strategy UG (hb, Weil am Rhein, Germany; 2United Biosource Corporation, Lexington, USA; 3Alcimed GmbH, Cologne, Germany; 4Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Essen, GermanyIntroduction: In Europe a disease is recognized as rare if less than 1 in 2000 people suffer from the specific disease. In patients with familial homozygous hypercholesterolemia (HoFH the accumulation of low-density lipoprotein cholesterol (LDL-C leads to generalized atherosclerosis due to an insufficient functioning of the LDL-C receptors. Patients die early sometimes even in the mid-30s, from myocardial infarction or stroke. For the German population, insufficient epidemiological evidence exists.Methods: A systematic literature search in EMBASE and Medline was performed in conjunction with a targeted manual search for epidemiological HoFH studies. Additionally a nationwide survey was conducted in Germany in all identified apheresis- and lipid centers. The purpose of the survey was the validation of the systematic literature search results based on empirical (practice data.Results: In total 961 publications were found, 874 were excluded based on pre-defined exclusion criteria leaving only 87 for further review. After review of the identified abstracts (n = 87 23 publications were identified as epidemiological studies. Only one publication was found which reported a prevalence of 1:1,000,000. The qualitative survey among 187 physicians in Germany also revealed a low prevalence: 95 HoFH patients were identified in 35 centers.Conclusion: The estimated frequency of homozygous familial hypercholesterolemia patients in Germany is around 95 (1:860,000 and the disease should be recognized as rare according to the definition of the European Medical Agency.Keywords: epidemiology, homozygous

Epidemiology, Policy, and Racial/Ethnic Minority Health Disparities

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Carter-Pokras, Olivia; Offutt-Powell, Tabatha; Kaufman, Jay S.; Giles, Wayne; Mays, Vickie

2013-01-01

Purpose Epidemiologists have long contributed to policy efforts to address health disparities. Three examples illustrate how epidemiologists have addressed health disparities in the U.S. and abroad through a “social determinants of health” lens. Methods To identify examples of how epidemiologic research has been applied to reduce health disparities, we queried epidemiologists engaged in disparities research in the U.S., Canada, and New Zealand, and drew upon the scientific literature. Results Resulting examples covered a wide range of topic areas. Three areas selected for their contributions to policy were: 1) epidemiology's role in definition and measurement, 2) the study of housing and asthma, and 3) the study of food policy strategies to reduce health disparities. While epidemiologic research has done much to define and quantify health inequalities, it has generally been less successful at producing evidence that would identify targets for health equity intervention. Epidemiologists have a role to play in measurement and basic surveillance, etiologic research, intervention research, and evaluation research. However, our training and funding sources generally place greatest emphasis on surveillance and etiologic research. Conclusions: The complexity of health disparities requires better training for epidemiologists to effectively work in multidisciplinary teams. Together we can evaluate contextual and multilevel contributions to disease and study intervention programs in order to gain better insights into evidenced-based health equity strategies. PMID:22626003

Epidemiology of Dyslipidemia in the Asia Pacific Region

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Chao-Feng Lin

2018-03-01

Full Text Available Summary: Dyslipidemia, including high levels of total cholesterol, low-density lipoprotein cholesterol, and triglyceride, and low levels of high-density lipoprotein cholesterol, is a major risk factor of atherosclerosis that leads to various cardiovascular diseases. This article compares the epidemiology of dyslipidemia among countries of the Asia Pacific region, including Australia, China, Indonesia, Japan, Korea, Malaysia, New Zealand, Singapore, Thailand, and Taiwan, based on public-accessible data from websites. Sources of lipid management guidelines of the countries are also summarized. Before comparing the data from each of the countries, the readers should pay attention to the impact of lipid testing methods, medication use, the year of data acquisition, the age range of the examinees, and the definition of dyslipidemia in each country. Apart from the mentioned factors that may affect the epidemiology data, some of the countries have unique features. For example, substantial ethnic differences existed in Indonesia and Malaysia; whereas the reports from China and Thailand exhibited significant regional variations. However, a common feature is that the levels of serum lipids change with age, and men and women may have quite different levels of serum lipids even of the same age range. Nevertheless, there is a lot of room for improvement in the awareness, treatment, and control rate of dyslipidemia. To reduce the prevalence of dyslipidemia and promote cardiovascular health, the epidemiological surveys of dyslipidemia and implementation of management guidelines according to their own national conditions are encouraged. Keywords: Asia Pacific region, dyslipidemia, epidemiology

Solvents and Parkinson disease: A systematic review of toxicological and epidemiological evidence

Energy Technology Data Exchange (ETDEWEB)

Lock, Edward A., E-mail: e.lock@ljmu.ac.uk [Liverpool John Moores University, School of Pharmacy and Biomolecular Sciences, Byrom Street, Liverpool (United Kingdom); Zhang, Jing [University of Washington, Department of Pathology, School of Medicine, Seattle, WA (United States); Checkoway, Harvey [University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA (United States)

2013-02-01

Parkinson disease (PD) is a debilitating neurodegenerative motor disorder, with its motor symptoms largely attributable to loss of dopaminergic neurons in the substantia nigra. The causes of PD remain poorly understood, although environmental toxicants may play etiologic roles. Solvents are widespread neurotoxicants present in the workplace and ambient environment. Case reports of parkinsonism, including PD, have been associated with exposures to various solvents, most notably trichloroethylene (TCE). Animal toxicology studies have been conducted on various organic solvents, with some, including TCE, demonstrating potential for inducing nigral system damage. However, a confirmed animal model of solvent-induced PD has not been developed. Numerous epidemiologic studies have investigated potential links between solvents and PD, yielding mostly null or weak associations. An exception is a recent study of twins indicating possible etiologic relations with TCE and other chlorinated solvents, although findings were based on small numbers, and dose–response gradients were not observed. At present, there is no consistent evidence from either the toxicological or epidemiologic perspective that any specific solvent or class of solvents is a cause of PD. Future toxicological research that addresses mechanisms of nigral damage from TCE and its metabolites, with exposure routes and doses relevant to human exposures, is recommended. Improvements in epidemiologic research, especially with regard to quantitative characterization of long-term exposures to specific solvents, are needed to advance scientific knowledge on this topic. -- Highlights: ► The potential for organic solvents to cause Parkinson's disease has been reviewed. ► Twins study suggests etiologic relations with chlorinated solvents and Parkinson's. ► Animal studies with TCE showed potential to cause damage to dopaminergic neurons. ► Need to determine if effects in animals are relevant to human

Solvents and Parkinson disease: A systematic review of toxicological and epidemiological evidence

International Nuclear Information System (INIS)

Lock, Edward A.; Zhang, Jing; Checkoway, Harvey

2013-01-01

Parkinson disease (PD) is a debilitating neurodegenerative motor disorder, with its motor symptoms largely attributable to loss of dopaminergic neurons in the substantia nigra. The causes of PD remain poorly understood, although environmental toxicants may play etiologic roles. Solvents are widespread neurotoxicants present in the workplace and ambient environment. Case reports of parkinsonism, including PD, have been associated with exposures to various solvents, most notably trichloroethylene (TCE). Animal toxicology studies have been conducted on various organic solvents, with some, including TCE, demonstrating potential for inducing nigral system damage. However, a confirmed animal model of solvent-induced PD has not been developed. Numerous epidemiologic studies have investigated potential links between solvents and PD, yielding mostly null or weak associations. An exception is a recent study of twins indicating possible etiologic relations with TCE and other chlorinated solvents, although findings were based on small numbers, and dose–response gradients were not observed. At present, there is no consistent evidence from either the toxicological or epidemiologic perspective that any specific solvent or class of solvents is a cause of PD. Future toxicological research that addresses mechanisms of nigral damage from TCE and its metabolites, with exposure routes and doses relevant to human exposures, is recommended. Improvements in epidemiologic research, especially with regard to quantitative characterization of long-term exposures to specific solvents, are needed to advance scientific knowledge on this topic. -- Highlights: ► The potential for organic solvents to cause Parkinson's disease has been reviewed. ► Twins study suggests etiologic relations with chlorinated solvents and Parkinson's. ► Animal studies with TCE showed potential to cause damage to dopaminergic neurons. ► Need to determine if effects in animals are relevant to human exposure

Detection and typing of Xylella fastidiosa from glassy-winged sharpshooter for Pierce’s disease epidemiology

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Epidemiology of Pierce’s disease of grape, caused by the bacterial pathogen Xylella fastidiosa (Xf), is largely dependent on populations of insect vectors such as the invasive glassy-winged sharpshooter (GWSS) (Homalodisca vitripennis). In the grape-growing regions of the southern San Joaquin Valley...

Clinical epidemiology of human AE in Europe.

Science.gov (United States)

Vuitton, D A; Demonmerot, F; Knapp, J; Richou, C; Grenouillet, F; Chauchet, A; Vuitton, L; Bresson-Hadni, S; Millon, L

2015-10-30

This review gives a critical update of the situation regarding alveolar echinococcosis (AE) in Europe in humans, based on existing publications and on findings of national and European surveillance systems. All sources point to an increase in human cases of AE in the "historic endemic areas" of Europe, namely Germany, Switzerland, Austria and France and to the emergence of human cases in countries where the disease had never been recognised until the end of the 20th century, especially in central-eastern and Baltic countries. Both increase and emergence could be only due to methodological biases; this point is discussed in the review. One explanation may be given by changes in the animal reservoir of the parasite, Echinococcus multilocularis (increase in the global population of foxes in Europe and its urbanisation, as well as a possible increased involvement of pet animals as definitive infectious hosts). The review also focuses onto 2 more original approaches: (1) how changes in therapeutic attitudes toward malignant and chronic inflammatory diseases may affect the epidemiology of AE in the future in Europe, since a recent survey of such cases in France showed the emergence of AE in patients with immune suppression since the beginning of the 21st century; (2) how setting a network of referral centres in Europe based on common studies on the care management of patients might contribute to a better knowledge of AE epidemiology in the future. Copyright © 2015. Published by Elsevier B.V.

Enterovirus D68 disease and molecular epidemiology in Australia.

Science.gov (United States)

Levy, Avram; Roberts, Jason; Lang, Jurissa; Tempone, Simone; Kesson, Alison; Dofai, Alfred; Daley, Andrew J; Thorley, Bruce; Speers, David J

2015-08-01

Enterovirus D68 (EV-D68) has received considerable recent attention as a cause of widespread respiratory illness. Neurological syndromes such as acute flaccid paralysis following EV-D68 infection have also been reported in a small number of cases. To summarize the clinical and epidemiological characteristics of laboratory confirmed EV-D68 cases in Australia. We combined EV-D68 data acquired through laboratory surveillance in Western Australia with cases from national enterovirus surveillance and regional acute flaccid paralysis (AFP) surveillance. Clinical data was obtained for EV-D68 cases and capsid protein sequences were used for phylogenetic analysis. Sporadic cases of EV-D68 were recorded in Australia since 2008, with peaks in activity during 2011 and 2013. EV-D68 was primarily associated with respiratory disease, but was also detected in cerebrospinal fluid of one patient and faeces of two patients presenting with AFP. EV-D68 has been circulating in Western Australia and is likely to have also been present in the wider region for a number of years, causing primarily respiratory disease. Detection of EV-D68 in cerebrospinal fluid of one patient and in faeces of two AFP cases reinforces the association between EV-D68 and neurological disease. Copyright © 2015 Elsevier B.V. All rights reserved.

Materials of VII congress of hygienists, sanitarians, epidemiologists and infectious diseases specialists of the republic of Uzbekistan 'Actual problems of hygiene, toxicology, epidemiology and infectious diseases in the republic of Uzbekistan'

International Nuclear Information System (INIS)

Iskandarov, T.I.; Kamil'dzhanov, A.Kh.

2000-01-01

The VII congress of hygienists, sanitarians, epidemiologists and infectious diseases specialists of the republic of Uzbekistan 'Actual problems of hygiene, toxicology, epidemiology and infectious diseases in the republic of Uzbekistan' was held on 2000 in Tashkent, Uzbekistan. Specialists discussed various aspects of actual problems of hygiene, toxicology, epidemiology and infectious diseases . They discussed also some aspects of radiology and nuclear medicine, radiation protection and dosimetry, radiation and other environmental pollutant effect on living organisms and biological materials. More than 100 talks were presented in the meeting. (k.m.)

Development of the Paris Definition of Early Crohn's Disease for Disease-Modification Trials: Results of an International Expert Opinion Process

NARCIS (Netherlands)

Peyrin-Biroulet, Laurent; Billioud, Vincent; D'Haens, Geert; Panaccione, Remo; Feagan, Brian; Panés, Julian; Danese, Silvio; Schreiber, Stefan; Ogata, Haruhiko; Hibi, Toshifumi; Higgins, Peter D. R.; Beaugerie, Laurent; Chowers, Yehuda; Louis, Edouard; Steinwurz, Flávio; Reinisch, Walter; Rutgeerts, Paul; Colombel, Jean-Frédéric; Travis, Simon; Sandborn, William J.

2012-01-01

We report the findings and outputs of an international expert opinion process to develop a definition of early Crohn's disease (CD) that could be used in future disease-modification trials. Nineteen experts on inflammatory bowel diseases held an international expert opinion meeting to discuss and

Asthma: epidemiology of disease control in Latin America - short review.

Science.gov (United States)

Solé, Dirceu; Aranda, Carolina Sanchez; Wandalsen, Gustavo Falbo

2017-01-01

Asthma is reported as one of the most common chronic diseases in childhood, impairing the quality of life of patients and their families and incurring high costs to the healthcare system and society. Despite the development of new drugs and the availability of international treatment guidelines, asthma is still poorly controlled, especially in Latin America. Original and review articles on asthma control or epidemiology with high levels of evidence have been selected for analysis among those published in PubMed referenced journals during the last 20 years, using the following keywords: "asthma control" combined with "Latin America", " epidemiology", "prevalence", "burden", "mortality", "treatment and unmet needs", "children", "adolescents", and "infants". There was a high prevalence and severity of asthma during the period analyzed, especially in children and adolescents. Wheezing in infants was a significant reason for seeking medical care in Latin American health centers. Moreover, the frequent use of quick-relief bronchodilators and oral corticosteroids by these patients indicates the lack of a policy for providing better care for asthmatic patients, as well as poor asthma control. Among adults, studies document poor treatment and control of the disease, as revealed by low adherence to routine anti-inflammatory medications and high rates of emergency care visits and hospitalization. In conclusion, although rare, studies on asthma control in Latin America repeatedly show that patients are inadequately controlled and frequently overestimate their degree of asthma control according to the criteria used by international asthma treatment guidelines. Additional education for doctors and patients is essential for adequate control of this illness, and therefore also for reduction of the individual and social burden of asthma.

[Epidemiology of cerebrovascular disease in Spain].

Science.gov (United States)

Brea, Angel; Laclaustra, Martín; Martorell, Esperanza; Pedragosa, Angels

2013-01-01

In Spain, cerebrovascular disease (CVD) is a very common cause of morbidity and hospitalization. They are the second leading cause of mortality in the general population, and the first in women. They also constitute a very high social spending, which is estimated to increase in coming years, due to the aging of our population. Data from the Hospital Morbidity Survey of the National Statistics Institute recorded, in 2011, 116,017 strokes and 14,933 transient ischemic attacks, corresponding, respectively, to an incidence of 252 and 32 events per 100,000 people. In 2002, the cost of hospitalization for each stroke was estimated at €3,047. The amount of total cost health care throughout the life of a stroke patient is calculated at €43,129. Internationally, the direct costs of stroke constitute 3% of national health spending, this being similar amount in different countries around us. Hypertension was the cardiovascular risk factor (CVRF) more prevalent in both ischemic and hemorrhagic strokes, followed by dyslipidemia and diabetes mellitus. Peripheral arterial disease and hypertension were more frequently associated with atherothrombotic events, atrial fibrillation with cardioembolic strokes, and obesity and high blood pressure to lacunar infarcts. In Spain, as showing several studies, we are far from optimal control of CVRF, especially in secondary prevention of stroke. According to the ICTUSCARE study, achieving recommended values was 17.6% in the case of hypertension, 29.8% in LDL-cholesterol, 74.9% of smoking, and 50.2% in diabetes mellitus. In this review, we analyze in detail the epidemiology, prevention and costs originated by CVD. Copyright © 2013 Elsevier España, S.L. y SEA. All rights reserved.

Invasive meningococcal disease epidemiology and control measures: a framework for evaluation

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Coudeville L

2007-06-01

Full Text Available Abstract Background Meningococcal disease can have devastating consequences. As new vaccines emerge, it is necessary to assess their impact on public health. In the absence of long-term real world data, modeling the effects of different vaccination strategies is required. Discrete event simulation provides a flexible platform with which to conduct such evaluations. Methods A discrete event simulation of the epidemiology of invasive meningococcal disease was developed to quantify the potential impact of implementing routine vaccination of adolescents in the United States with a quadrivalent conjugate vaccine protecting against serogroups A, C, Y, and W-135. The impact of vaccination is assessed including both the direct effects on individuals vaccinated and the indirect effects resulting from herd immunity. The simulation integrates a variety of epidemiologic and demographic data, with core information on the incidence of invasive meningococcal disease and outbreak frequency derived from data available through the Centers for Disease Control and Prevention. Simulation of the potential indirect benefits of vaccination resulting from herd immunity draw on data from the United Kingdom, where routine vaccination with a conjugate vaccine has been in place for a number of years. Cases of disease are modeled along with their health consequences, as are the occurrence of disease outbreaks. Results When run without a strategy of routine immunization, the simulation accurately predicts the age-specific incidence of invasive meningococcal disease and the site-specific frequency of outbreaks in the Unite States. 2,807 cases are predicted annually, resulting in over 14,000 potential life years lost due to invasive disease. In base case analyses of routine vaccination, life years lost due to infection are reduced by over 45% (to 7,600 when routinely vaccinating adolescents 12 years of age at 70% coverage. Sensitivity analyses indicate that herd immunity plays

Worldwide Report, Epidemiology, No. 327

National Research Council Canada - National Science Library

1983-01-01

Partial Contents: Epidemiology, Human Diseases, Health, Malaria, AIDS, Homosexual Male, Medical Administration, Rabies, Tuberculosis, Encephalitis Statistics, Gastroenteritie, Mystery Diseases, Children, Epidemics...

EULAR definition of erosive disease in light of the 2010 ACR/EULAR rheumatoid arthritis classification criteria.

Science.gov (United States)

van der Heijde, Désirée; van der Helm-van Mil, Annette H M; Aletaha, Daniel; Bingham, Clifton O; Burmester, Gerd R; Dougados, Maxime; Emery, Paul; Felson, David; Knevel, Rachel; Kvien, Tore K; Landewé, Robert B M; Lukas, Cédric; McInnes, Iain; Silman, Alan J; Smolen, Josef S; Stanislawska-Biernat, Ewa; Zink, Angela; Combe, Bernard

2013-04-01

The aim of this report was to propose a definition for erosive disease in the context of inflammatory arthritis in light of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria for use in clinical practice and studies. A EULAR task force was formed including 16 rheumatologists and one rheumatology fellow. The process was both evidence based and consensus based, and included, between March 2010 and April 2012, analyses of data from two cohorts, two face-to-face meetings, one online voting and one teleconference. The Leiden Early Arthritis Cohort and the French ESPOIR cohort were used for the evidence-based part. The outcome measures, which were initiation of methotrexate therapy, or any disease-modifying antirheumatic drug therapy within the first year of disease and arthritis persistency over 5 years, were studied with the aim to give the best definition of erosive disease. A decision was made to select a definition with a high specificity and focus on patients who did not otherwise fulfil the 2010 ACR/EULAR RA criteria (definition was selected: erosive disease for use in the 2010 ACR/EULAR RA classification criteria is defined when an erosion (defined as a cortical break) is seen in at least three separate joints at any of the following sites: the proximal interphalangeal, the metacarpophalangeal, the wrist (counted as one joint) and the metatarsophalangeal joints on radiographs of both hands and feet. A highly specific definition for erosive disease has thus been formulated.

Case definition and classification of leukodystrophies and leukoencephalopathies

NARCIS (Netherlands)

Vanderver, Adeline; Prust, Morgan; Tonduti, Davide; Mochel, Fanny; Hussey, Heather M.; Helman, Guy; Garbern, James; Eichler, Florian; Labauge, Pierre; Aubourg, Patrick; Rodriguez, Diana; Patterson, Marc C.; van Hove, Johan L. K.; Schmidt, Johanna; Wolf, Nicole I.; Boespflug-Tanguy, Odile; Schiffmann, Raphael; van der Knaap, Marjo S.

2015-01-01

An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Thirteen experts at multiple institutions participated in iterative

Case definition and classification of leukodystrophies and leukoencephalopathies

NARCIS (Netherlands)

Vanderver, A.; Prust, M.; Tonduti, D.; Mochel, F.; Hussey, H.M.; Helman, G.; Garbern, J.; Eichler, F.; Labauge, P.; Aubourg, P.; Rodriguez, D.; Patterson, M.C.; van Hove, J.LK.; Schmidt, J; Wolf, N.I.; Boespflug-Tanguy, O.; Schiffmann, R.; van der Knaap, M.S.

2015-01-01

Objective: An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Method: Thirteen experts at multiple institutions participated

The epidemiology of pneumococcal carriage and infections in Malaysia.

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Le, Cheng-Foh; Jefferies, Johanna M; Yusof, Mohd Yasim Mohd; Sekaran, Shamala Devi; Clarke, Stuart C

2012-06-01

In Malaysia, various aspects of the epidemiology of pneumococcal carriage and disease remain largely unclear due to the lack of supporting data. Although a number of relevant studies have been documented, their individual discrete findings are not sufficient to inform experts on pneumococcal epidemiology at a national level. Therefore, in this review we aim to bring together and systematically evaluate the key information regarding pneumococcal disease epidemiology in Malaysia and provide a comprehensive overview of the data. Major aspects discussed include pneumococcal carriage, disease incidence and prevalence, age factors, invasiveness of pneumococci, serotypes, molecular epidemiology and antibiotic susceptibility. Penicillin resistance is increasingly prevalent and studies suggest that the majority of pneumococcal serotypes causing pneumococcal disease in Malaysia are covered by currently available conjugate vaccines. Continued surveillance is needed to provide a better understanding of pneumococcal epidemiology in Malaysia.

The definition, classification, and prognosis of chronic kidney disease : a KDIGO Controversies Conference report

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Levey, Andrew S.; de Jong, Paul E.; Coresh, Josef; El Nahas, Meguid; Astor, Brad C.; Matsushita, Kunihiro; Gansevoort, Ron T.; Kasiske, Bertram L.; Eckardt, Kai-Uwe

The definition and classification for chronic kidney disease was proposed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) in 2002 and endorsed by the Kidney Disease: Improving Global Outcomes (KDIGO) in 2004. This framework promoted increased attention to

Using epidemiological information to develop effective integrated virus disease management strategies.

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Jones, Roger A C

2004-03-01

Virus diseases cause serious losses in yield and quality of cultivated plants worldwide. These losses and the resulting financial damage can be limited by controlling epidemics using measures that minimise virus infection sources or suppress virus spread. For each combination of virus, cultivated plant and production system, there is an 'economic threshold' above which the financial damage is sufficient to justify using such measures. However, individual measures used alone may bring only small benefits and they may become ineffective, especially over the long term. When diverse control measures that act in different ways are combined and used together, their effects are complementary resulting in far more effective overall control. Such experiences have led to the development of integrated management concepts for virus diseases that combine available host resistance, cultural, chemical and biological control measures. Selecting the ideal mix of measures for each pathosystem and production situation requires detailed knowledge of the epidemiology of the causal virus and the mode of action of each individual control measure so that diverse responses can be devised to meet the unique features of each of the different scenarios considered. The strategies developed must be robust and necessitate minimal extra expense, labour demands and disruption to standard practices. Examples of how epidemiological information can be used to develop effective integrated disease management (IDM) strategies for diverse situations are described. They involve circumstances where virus transmission from plant-to-plant occurs in four different ways: by contact, non-persistently or persistently by insect vectors, and by root-infecting fungi. The examples are: Subterranean clover mottle virus (SCMoV) (contact-transmitted) and Bean yellow mosaic virus (BYMV) (non-persistently aphid-transmitted) in annually self-regenerating clover pasture; three seed-borne viruses (all non-persistently aphid

Multi-agent systems in epidemiology: a first step for computational biology in the study of vector-borne disease transmission

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Guégan Jean-François

2008-10-01

Full Text Available Abstract Background Computational biology is often associated with genetic or genomic studies only. However, thanks to the increase of computational resources, computational models are appreciated as useful tools in many other scientific fields. Such modeling systems are particularly relevant for the study of complex systems, like the epidemiology of emerging infectious diseases. So far, mathematical models remain the main tool for the epidemiological and ecological analysis of infectious diseases, with SIR models could be seen as an implicit standard in epidemiology. Unfortunately, these models are based on differential equations and, therefore, can become very rapidly unmanageable due to the too many parameters which need to be taken into consideration. For instance, in the case of zoonotic and vector-borne diseases in wildlife many different potential host species could be involved in the life-cycle of disease transmission, and SIR models might not be the most suitable tool to truly capture the overall disease circulation within that environment. This limitation underlines the necessity to develop a standard spatial model that can cope with the transmission of disease in realistic ecosystems. Results Computational biology may prove to be flexible enough to take into account the natural complexity observed in both natural and man-made ecosystems. In this paper, we propose a new computational model to study the transmission of infectious diseases in a spatially explicit context. We developed a multi-agent system model for vector-borne disease transmission in a realistic spatial environment. Conclusion Here we describe in detail the general behavior of this model that we hope will become a standard reference for the study of vector-borne disease transmission in wildlife. To conclude, we show how this simple model could be easily adapted and modified to be used as a common framework for further research developments in this field.

Incidence of diseases primarily affecting the skin by age group: population-based epidemiologic study in Olmsted County, Minnesota, and comparison with age-specific incidence rates worldwide.

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Wessman, Laurel L; Andersen, Louise K; Davis, Mark D P

2018-01-29

Understanding the effects of age on the epidemiology of diseases primarily affecting the skin is important to the practice of dermatology, both for proper allocation of resources and for optimal patient-centered care. To fully appreciate the effect that age may have on the population-based calculations of incidence of diseases primarily affecting the skin in Olmsted County, Minnesota, and worldwide, we performed a review of all relevant Rochester Epidemiology Project-published data and compared them to similar reports in the worldwide English literature. Using the Rochester Epidemiology Project, population-based epidemiologic studies have been performed to estimate the incidence of specific skin diseases over the past 50 years. In older persons (>65 years), nonmelanoma skin cancer, lentigo maligna, herpes zoster, delusional infestation, venous stasis syndrome, venous ulcer, and burning mouth syndrome were more commonly diagnosed. In those younger than 65 years, atypical nevi, psoriatic arthritis, pityriasis rosea, herpes progenitalis, genital warts, alopecia areata, hidradenitis suppurativa, infantile hemangioma, Behçet's disease, and sarcoidosis (isolated cutaneous, with sarcoidosis-specific cutaneous lesions and with erythema nodosum) had a higher incidence. Many of the incidence rates by age group of diseases primarily affecting the skin derived from the Rochester Epidemiology Project were similar to those reported elsewhere. © 2018 The International Society of Dermatology.

Epidemiological characteristics of chronic kidney disease of non-traditional causes in women of agricultural communities of El Salvador.

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Orantes Navarro, Carlos M; Herrera Valdés, Raúl; López, Miguel Almaguer; Calero, Denis J; Fuentes de Morales, Jackeline; Alvarado Ascencio, Nelly P; Vela Parada, Xavier F; Zelaya Quezada, Susana M; Granados Castro, Delmy V; Orellana de Figueroa, Patricia

2015-01-01

In El Salvador end-stage renal disease (ESRD) was the first cause of hospital mortality overall, the first cause of hospital deaths in men, and the fifth cause of hospital mortality in women in 2013. In agricultural communities, chronic kidney disease (CKD) occurs predominantly in male agricultural workers, but it also affects women to a lesser degree, even those who are not involved in agricultural work. Internationally, most epidemiological CKD studies emphasize men and no epidemiological studies focused exclusively on women. To describe the epidemiological characteristics of CKD in females in agricultural communities of El Salvador. A cross-sectional epidemiological study was carried out in 2009 - 2011 based on active screening for CKD and risk factors in women aged ≥ 18 years in 3 disadvantaged populations of El Salvador: Bajo Lempa (Usulután Department), Guayapa Abajo (Ahuachapán Department), and Las Brisas (San Miguel Department). Epidemiological and clinical data were gathered through personal history, as well as urinalysis for renal damage markers, determinations of serum creatinine and glucose, and estimation of glomerular filtration rates. CKD cases were confirmed at 3 months. Prevalence of CKD was 13.9% in 1,412 women from 1,306 families studied. Chronic kidney disease of nontraditional causes (CKDu), not attributed to diabetes mellitus, hypertension, or proteinuric primary glomerulopathy (proteinuria > 1 g/L) was 6.6%. Prevalence of chronic renal failure was 6.8%. Prevalence of renal damage markers was 9.8% (microalbuminuria (30 - 300 mg/L) 5.7%; macroalbuminuria (> 300 mg/L) 2%; and hematuria, 2.1%. Prevalence of chronic kidney disease risk factors was: diabetes mellitus, 9.3%; hypertension, 23%; family history of CKD, 16%; family history of diabetes mellitus (DM), 18.7%; family history of hypertension (HT), 31.9%; obesity, 21%; central obesity, 30.7%; NSAID use, 84.3%; agricultural occupation, 15.2%; and contact with agrochemicals, 33.1%. CKD in

Ozone Atmospheric Pollution and Alzheimer's Disease: From Epidemiological Facts to Molecular Mechanisms.

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Croze, Marine L; Zimmer, Luc

2018-01-01

Atmospheric pollution is a well-known environmental hazard, especially in developing countries where millions of people are exposed to airborne pollutant levels above safety standards. Accordingly, several epidemiological and animal studies confirmed its role in respiratory and cardiovascular pathologies and identified a strong link between ambient air pollution exposure and adverse health outcomes such as hospitalization and mortality. More recently, the potential deleterious effect of air pollution inhalation on the central nervous system was also investigated and mounting evidence supports a link between air pollution exposure and neurodegenerative pathologies, especially Alzheimer's disease (AD). The focus of this review is to highlight the possible link between ozone air pollution exposure and AD incidence. This review's approach will go from observational and epidemiological facts to the proposal of molecular mechanisms. First, epidemiological and postmortem human study data concerning residents of ozone-severely polluted megacities will be presented and discussed. Then, the more particular role of ozone air pollution in AD pathology will be described and evidenced by toxicological studies in rat or mouse with ozone pollution exposure only. The experimental paradigms used to reproduce in rodent the human exposure to ozone air pollution will be described. Finally, current insights into the molecular mechanisms through which ozone inhalation can affect the brain and play a role in AD development or progression will be recapitulated.

Mapping epidemiology's past to inform its future: metaknowledge analysis of epidemiologic topics in leading journals, 1974-2013.

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Trinquart, Ludovic; Galea, Sandro

2015-07-15

An empiric perspective on what epidemiology has studied over time might inform discussions about future directions for the discipline. We aimed to identify the main areas of epidemiologic inquiry and determine how they evolved over time in 5 high-impact epidemiologic journals. We analyzed the titles and abstracts of 20,895 articles that were published between 1974 and 2013. In 5 time periods that reflected approximately equal numbers of articles, we identified the main topics by clustering terms based on co-occurrence. Infectious disease and cardiovascular disease epidemiology were the prevailing topics over the 5 periods. Cancer epidemiology was a major topic from 1974 to 2001 but disappeared thereafter. Nutritional epidemiology gained relative importance from 1974 to 2013. Environmental epidemiology appeared during 1996-2001 and continued to be important, whereas 2 clusters related to methodology and meta-analysis in genetics appeared during 2008-2013. Several areas of epidemiology, including injury or psychiatric epidemiology, did not make an appearance as major topics at any time. In an ancillary analysis of 6 high-impact general medicine journals, we found patterns of epidemiologic articles that were overall consistent with the findings in epidemiologic journals. This metaknowledge investigation allowed identification of the dominant topics in and conversely those that were absent from 5 major epidemiologic journals. We discuss implications for the field. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Diagnosis and epidemiology of respiratory system diseases due to plant dusts

Energy Technology Data Exchange (ETDEWEB)

Goscicki, J.W.; Indulski, J.A.

1981-01-01

Of the respiratory tract diseases - byssinosis - i.e. the disease diagnosed in textile industry workers has aroused interest and controversies for many years. In Western Europe Countries the USA, Egypt and Pakistan this disease was diagnosed in more than half of the workers employed at cotton processing. Epidemiological data imply that in Eastern and Middle Europe few authors diagnose byssinosis in the population exposed to vegetable dusts. In the Soviet Union, the greatest cotton producer in the world, processing the greatest amounts of this raw material in the textile industry, medical examinations carried out in different centres did not show byssinosis symptoms in textile workers, that would apply to Schilling's criteria. Vegetable dusts inherent in agricultural and food industry largely promote the occurrence of nonspecific respiratory tract diseases. They are diagnosed as chronic bronchitis, which at dusted workstations are the mean cause of sickness absenteeism. The preventive activities aimed at the reduction of hazardous effects of dust upon organism would consist mostly in application of technical measures, i.e. technological processes hermetization and ventilation and only in scarce cases - in the use of good antidust personal protective measures.

Preclinical Alzheimer's disease: Definition, natural history, and diagnostic criteria.

Science.gov (United States)

Dubois, Bruno; Hampel, Harald; Feldman, Howard H; Scheltens, Philip; Aisen, Paul; Andrieu, Sandrine; Bakardjian, Hovagim; Benali, Habib; Bertram, Lars; Blennow, Kaj; Broich, Karl; Cavedo, Enrica; Crutch, Sebastian; Dartigues, Jean-François; Duyckaerts, Charles; Epelbaum, Stéphane; Frisoni, Giovanni B; Gauthier, Serge; Genthon, Remy; Gouw, Alida A; Habert, Marie-Odile; Holtzman, David M; Kivipelto, Miia; Lista, Simone; Molinuevo, José-Luis; O'Bryant, Sid E; Rabinovici, Gil D; Rowe, Christopher; Salloway, Stephen; Schneider, Lon S; Sperling, Reisa; Teichmann, Marc; Carrillo, Maria C; Cummings, Jeffrey; Jack, Cliff R

2016-03-01

During the past decade, a conceptual shift occurred in the field of Alzheimer's disease (AD) considering the disease as a continuum. Thanks to evolving biomarker research and substantial discoveries, it is now possible to identify the disease even at the preclinical stage before the occurrence of the first clinical symptoms. This preclinical stage of AD has become a major research focus as the field postulates that early intervention may offer the best chance of therapeutic success. To date, very little evidence is established on this "silent" stage of the disease. A clarification is needed about the definitions and lexicon, the limits, the natural history, the markers of progression, and the ethical consequence of detecting the disease at this asymptomatic stage. This article is aimed at addressing all the different issues by providing for each of them an updated review of the literature and evidence, with practical recommendations. Copyright © 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Distantiae transmission of Trypanosoma cruzi: a new epidemiological feature of acute Chagas disease in Brazil.

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Samanta Cristina das Chagas Xavier

2014-05-01

Full Text Available BACKGROUND: The new epidemiological scenario of orally transmitted Chagas disease that has emerged in Brazil, and mainly in the Amazon region, needs to be addressed with a new and systematic focus. Belém, the capital of Pará state, reports the highest number of acute Chagas disease (ACD cases associated with the consumption of açaí juice. METHODOLOGY/PRINCIPAL FINDINGS: The wild and domestic enzootic transmission cycles of Trypanosoma cruzi were evaluated in the two locations (Jurunas and Val-de Cães that report the majority of the autochthonous cases of ACD in Belém city. Moreover, we evaluated the enzootic cycle on the three islands that provide most of the açaí fruit that is consumed in these localities. We employed parasitological and serological tests throughout to evaluate infectivity competence and exposure to T. cruzi. In Val-de-Cães, no wild mammal presented positive parasitological tests, and 56% seroprevalence was observed, with low serological titers. Three of 14 triatomines were found to be infected (TcI. This unexpected epidemiological picture does not explain the high number of autochthonous ACD cases. In Jurunas, the cases of ACD could not be autochthonous because of the absence of any enzootic cycle of T. cruzi. In contrast, in the 3 island areas from which the açaí fruit originates, 66.7% of wild mammals and two dogs displayed positive hemocultures, and 15.6% of triatomines were found to be infected by T. cruzi. Genotyping by mini-exon gene and PCR-RFLP (1f8/Akw21I targeting revealed that the mammals and triatomines from the islands harbored TcI and Trypanosoma rangeli in single and mixed infections. CONCLUSION/SIGNIFICANCE: These findings show that cases of Chagas disease in the urban area of Belém may be derived from infected triatomines coming together with the açaí fruits from distant islands. We term this new epidemiological feature of Chagas disease as "Distantiae transmission".

Participatory epidemiology: the contribution of participatory research to epidemiology

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Mario Bach

2017-02-01

Full Text Available Abstract Background Epidemiology has contributed in many ways to identifying various risk factors for disease and to promoting population health. However, there is a continuing debate about the ability of epidemiology not only to describe, but also to provide results which can be better translated into public health practice. It has been proposed that participatory research approaches be applied to epidemiology as a way to bridge this gap between description and action. A systematic account of what constitutes participatory epidemiology practice has, however, been lacking. Methods A scoping review was carried out focused on the question of what constitutes participatory approaches to epidemiology for the purpose of demonstrating their potential for advancing epidemiologic research. Relevant databases were searched, including both the published and non-published (grey literature. The 102 identified sources were analyzed in terms of comparing common epidemiologic approaches to participatory counterparts regarding central aspects of the research process. Exemplary studies applying participatory approaches were examined more closely. Results A highly diverse, interdisciplinary body of literature was synthesized, resulting in a framework comprised of seven aspects of the research process: research goal, research question, population, context, data synthesis, research management, and dissemination of findings. The framework specifies how participatory approaches not only differ from, but also how they can enhance common approaches in epidemiology. Finally, recommendations for the further development of participatory approaches are given. These include: enhancing data collection, data analysis, and data validation; advancing capacity building for research at the local level; and developing data synthesis. Conclusion The proposed framework provides a basis for systematically developing the emergent science of participatory epidemiology.

The role of diseases, risk factors and symptoms in the definition of multimorbidity – a systematic review

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Willadsen, Tora Grauers; Bebe, Anna; Køster-Rasmussen, Rasmus; Jarbøl, Dorte Ejg; Guassora, Ann Dorrit; Waldorff, Frans Boch; Reventlow, Susanne; Olivarius, Niels de Fine

2016-01-01

Objective is to explore how multimorbidity is defined in the scientific literature, with a focus on the roles of diseases, risk factors, and symptoms in the definitions. Design: Systematic review. Methods: MEDLINE (PubMed), Embase, and The Cochrane Library were searched for relevant publications up until October 2013. One author extracted the information. Ambiguities were resolved, and consensus reached with one co-author. Outcome measures were: cut-off point for the number of conditions included in the definitions of multimorbidity; setting; data sources; number, kind, duration, and severity of diagnoses, risk factors, and symptoms. We reviewed 163 articles. In 61 articles (37%), the cut-off point for multimorbidity was two or more conditions (diseases, risk factors, or symptoms). The most frequently used setting was the general population (68 articles, 42%), and primary care (41 articles, 25%). Sources of data were primarily self-reports (56 articles, 42%). Out of the 163 articles selected, 115 had individually constructed multimorbidity definitions, and in these articles diseases occurred in all definitions, with diabetes as the most frequent. Risk factors occurred in 98 (85%) and symptoms in 71 (62%) of the definitions. The severity of conditions was used in 26 (23%) of the definitions, but in different ways. The definition of multimorbidity is heterogeneous and risk factors are more often included than symptoms. The severity of conditions is seldom included. Since the number of people living with multimorbidity is increasing there is a need to develop a concept of multimorbidity that is more useful in daily clinical work. Key pointsThe increasing number of multimorbidity patients challenges the healthcare system. The concept of multimorbidity needs further discussion in order to be implemented in daily clinical practice.Many definitions of multimorbidity exist and most often a cut-off point of two or more is applied to a range of 4–147 different conditions.Diseases

Severe Chronic Upper Airway Disease (SCUAD) in children. Definition issues and requirements.

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Karatzanis, A; Kalogjera, L; Scadding, G; Velegrakis, S; Kawauchi, H; Cingi, C; Prokopakis, E

2015-07-01

Upper airway diseases are extremely common, and a significant proportion of patients are not adequately controlled by contemporary treatment algorithms. The term SCUAD (Severe Chronic Upper Airway Disease) has been previously introduced to describe such cases. However, this term has not been adequately focused on children. This study aims to address the necessity of the term, as well as further details specifically for children. For this purpose, a review was performed of the current literature, with specific focus on issues regarding SCUAD in children. Paediatric SCUAD represents a heterogeneous group of patients and has significant clinical and socioeconomic implications. Relevant literature is generally lacking and questions regarding definition and pathogenesis remain unanswered. Accurate definition and acknowledgement of paediatric SCUAD cases may lead to better design of future clinical and molecular research protocols. This may provide improved understanding of the underlying disease processes, more accurate data regarding socioeconomic burden, and, above all, more successful treatment and prevention strategies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method

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Lázzari Julio O.

1998-01-01

Full Text Available An electrocardiographic recording method with an associated reading guide, designed for epidemiological studies on Chagas' disease, was tested to assess its diagnostic reproducibility. Six cardiologists from five countries each read 100 electrocardiographic (ECG tracings, including 30 from chronic chagasic patients, then reread them after an interval of 6 months. The readings were blind, with the tracings numbered randomly for the first reading and renumbered randomly for the second reading. The physicians, all experienced in interpreting ECGs from chagasic patients, followed printed instructions for reading the tracings. Reproducibility of the readings was evaluated using the kappa (k index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (k = 0.66; SE 0.02. While the interpretations of some categories of ECG abnormalities were highly reproducible, others, especially those having a low prevalence, showed lower levels of concordance. Intraobserver concordance was uniformly higher than interobserver concordance. The findings of this study justify the use by specialists of the recording of readings method proposed for epidemiological studies on Chagas' disease, but warrant caution in the interpretation of some categories of electrocardiographic alterations.

Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method

Directory of Open Access Journals (Sweden)

Julio O. Lázzari

1998-11-01

Full Text Available An electrocardiographic recording method with an associated reading guide, designed for epidemiological studies on Chagas' disease, was tested to assess its diagnostic reproducibility. Six cardiologists from five countries each read 100 electrocardiographic (ECG tracings, including 30 from chronic chagasic patients, then reread them after an interval of 6 months. The readings were blind, with the tracings numbered randomly for the first reading and renumbered randomly for the second reading. The physicians, all experienced in interpreting ECGs from chagasic patients, followed printed instructions for reading the tracings. Reproducibility of the readings was evaluated using the kappa (k index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (k = 0.66; SE 0.02. While the interpretations of some categories of ECG abnormalities were highly reproducible, others, especially those having a low prevalence, showed lower levels of concordance. Intraobserver concordance was uniformly higher than interobserver concordance. The findings of this study justify the use by specialists of the recording of readings method proposed for epidemiological studies on Chagas' disease, but warrant caution in the interpretation of some categories of electrocardiographic alterations.

[Important vector-borne infectious diseases among humans in Germany. Epidemiological aspects].

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Frank, C; Faber, M; Hellenbrand, W; Wilking, H; Stark, K

2014-05-01

Vector-borne infections pathogenic to humans play an important role in Germany. The relevant zoonotic pathogens are either endemic throughout Germany (e.g. Borrelia burgdorferi sensu latu) or only in specific regions, e.g. tick-borne encephalitis (TBE) virus and hantavirus. They cause a substantial burden of disease. Prevention and control largely rely on public advice and the application of personal protective measures (e.g. TBE virus vaccination and protection against vectors). High quality surveillance and targeted epidemiological studies are fundamental for the evaluation of temporal and spatial risks of infection and the effectiveness of preventive measures. Aside from endemic pathogens, vector-borne infections acquired abroad, mostly transmitted by mosquitoes, have to be systematically and intensively monitored as well, to assess the risk of infection for German residents traveling abroad and to adequately evaluate the risk of autochthonous transmission. Related issues, such as invasive species of mosquitoes in Germany and climate change, have to be taken into consideration. Such pathogens include West Nile, dengue and chikungunya viruses, as well as malaria parasites (Plasmodium species). The article presents an overview of the epidemiological situation of selected relevant vector-borne infections in Germany.

Clinical disease registries in acute myocardial infarction.

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Ashrafi, Reza; Hussain, Hussain; Brisk, Robert; Boardman, Leanne; Weston, Clive

2014-06-26

Disease registries, containing systematic records of cases, have for nearly 100 years been valuable in exploring and understanding various aspects of cardiology. This is particularly true for myocardial infarction, where such registries have provided both epidemiological and clinical information that was not readily available from randomised controlled trials in highly-selected populations. Registries, whether mandated or voluntary, prospective or retrospective in their analysis, have at their core a common study population and common data definitions. In this review we highlight how registries have diversified to offer information on epidemiology, risk modelling, quality assurance/improvement and original research-through data mining, transnational comparisons and the facilitation of enrolment in, and follow-up during registry-based randomised clinical trials.

Clostridium difficile in Crete, Greece: epidemiology, microbiology and clinical disease.

Science.gov (United States)

Samonis, G; Vardakas, K Z; Tansarli, G S; Dimopoulou, D; Papadimitriou, G; Kofteridis, D P; Maraki, S; Karanika, M; Falagas, M E

2016-01-01

We studied the epidemiology and microbiology of Clostridium difficile and the characteristics of patients with C. difficile infection (CDI) in Crete in three groups of hospitalized patients with diarrhoea: group 1 [positive culture and positive toxin by enzyme immunoassay (EIA)]; group 2 (positive culture, negative toxin); group 3 (negative culture, negative toxin). Patients in group 1 were designated as those with definitive CDI (20 patients for whom data was available) and matched with cases in group 2 (40 patients) and group 3 (40 patients). C. difficile grew from 6% (263/4379) of stool specimens; 14·4% of these had positive EIA, of which 3% were resistant to metronidazole. Three isolates had decreased vancomycin susceptibility. Patients in groups 1 and 2 received more antibiotics (P = 0·03) and had more infectious episodes (P = 0·03) than patients in group 3 prior to diarrhoea. Antibiotic administration for C. difficile did not differ between groups 1 and 2. Mortality was similar in all three groups (10%, 12·5% and 5%, P = 0·49). CDI frequency was low in the University Hospital of Crete and isolates were susceptible to metronidazole and vancomycin.

Epidemiologic patterns of Ross River virus disease in Queensland, Australia, 2001-2011.

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Yu, Weiwei; Mengersen, Kerrie; Dale, Pat; Mackenzie, John S; Toloo, Ghasem Sam; Wang, Xiaoyu; Tong, Shilu

2014-07-01

Ross River virus (RRV) infection is a debilitating disease that has a significant impact on population health, economic productivity, and tourism in Australia. This study examined epidemiologic patterns of RRV disease in Queensland, Australia, during January 2001-December 2011 at a statistical local area level. Spatio-temporal analyses were used to identify the patterns of the disease distribution over time stratified by age, sex, and space. The results show that the mean annual incidence was 54 per 100,000 persons, with a male:female ratio of 1:1.1. Two space-time clusters were identified: the areas adjacent to Townsville, on the eastern coast of Queensland, and the southeast areas. Thus, although public health intervention should be considered across all areas in which RRV occurs, it should specifically focus on high-risk regions, particularly during summer and autumn to reduce the social and economic impacts of RRV infection. © The American Society of Tropical Medicine and Hygiene.

How to make epidemiological training infectious.

Directory of Open Access Journals (Sweden)

Steve E Bellan

Full Text Available Modern infectious disease epidemiology builds on two independently developed fields: classical epidemiology and dynamical epidemiology. Over the past decade, integration of the two fields has increased in research practice, but training options within the fields remain distinct with few opportunities for integration in the classroom. The annual Clinic on the Meaningful Modeling of Epidemiological Data (MMED at the African Institute for Mathematical Sciences has begun to address this gap. MMED offers participants exposure to a broad range of concepts and techniques from both epidemiological traditions. During MMED 2010 we developed a pedagogical approach that bridges the traditional distinction between classical and dynamical epidemiology and can be used at multiple educational levels, from high school to graduate level courses. The approach is hands-on, consisting of a real-time simulation of a stochastic outbreak in course participants, including realistic data reporting, followed by a variety of mathematical and statistical analyses, stemming from both epidemiological traditions. During the exercise, dynamical epidemiologists developed empirical skills such as study design and learned concepts of bias while classical epidemiologists were trained in systems thinking and began to understand epidemics as dynamic nonlinear processes. We believe this type of integrated educational tool will prove extremely valuable in the training of future infectious disease epidemiologists. We also believe that such interdisciplinary training will be critical for local capacity building in analytical epidemiology as Africa continues to produce new cohorts of well-trained mathematicians, statisticians, and scientists. And because the lessons draw on skills and concepts from many fields in biology--from pathogen biology, evolutionary dynamics of host--pathogen interactions, and the ecology of infectious disease to bioinformatics, computational biology, and

Epidemiology of dry eye disease in Africa: The sparse information, gaps and opportunities.

Science.gov (United States)

Osae, A E; Gehlsen, U; Horstmann, J; Siebelmann, S; Stern, M E; Kumah, D B; Steven, P

2017-04-01

Dry eye disease (DED) is an increasingly significant clinical problem in developing countries and/or emerging economies. Existing studies on DED conducted in these areas have largely reported on associations between DED and infectious disease (trachoma) and malnutrition (hypovitaminosis A), but current trends of industrialization, urbanization, and modernization in these areas could result in a shift to other forms of DED. Herein, we review the epidemiology of DED in these geographic areas, highlighting potential causes and risk factors of DED while presenting information on diagnostic tools and algorithms and insight into some treatment modalities of DED that could prove useful to clinicians and investigators in these regions. Copyright © 2017 Elsevier Inc. All rights reserved.

Two different epidemiological scenarios of border disease in the populations of Pyrenean chamois (Rupicapra p. pyrenaica after the first disease outbreaks.

Directory of Open Access Journals (Sweden)

Laura Fernández-Sirera

Full Text Available Since 2001 several outbreaks of a new disease associated with Border disease virus (BDV infection have caused important declines in Pyrenean chamois (Rupicapra pyrenaica populations in the Pyrenees. The goal of this study was to analyze the post-outbreak BDV epidemiology in the first two areas affected by disease with the aim to establish if the infection has become endemic. We also investigated if BDV infected wild and domestic ruminants sharing habitat with chamois. Unexpectedly, we found different epidemiological scenarios in each population. Since the disease outbreaks, some chamois populations recuperated quickly, while others did not recover as expected. In chamois from the first areas, prevalence was high (73.47% and constant throughout the whole study period and did not differ between chamois born before and after the BDV outbreak; in all, BDV was detected by RT-PCR in six chamois. In the other areas, prevalence was lower (52.79% and decreased during the study period; as well, prevalence was significantly lower in chamois born after the disease outbreak. No BDV were detected in this population. A comparative virus neutralisation test performed with four BDV strains and one Bovine viral diarrhoea virus (BVDV strain showed that all the chamois had BDV-specific antibodies. Pestivirus antibodies were detected in all the rest of analyzed species, with low prevalence values in wild ruminants and moderate values in domestic ruminants. No viruses were detected in these species. These results confirm the hypothesis that outbreaks of BDV infection only affect the Pyrenean chamois, although other wild ruminants can occasionally be infected. In conclusion, two different scenarios have appeared since the first border disease outbreaks in Pyrenean chamois: on the one hand frequent BDV circulation with possible negative impact on population dynamics in some areas and on the other, lack of virus circulation and quick recovery of the chamois population.

Cancer Epidemiology Cohorts

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Cohort studies are fundamental for epidemiological research by helping researchers better understand the etiology of cancer and provide insights into the key determinants of this disease and its outcomes.

International biological engagement programs facilitate Newcastle disease epidemiological studies

Directory of Open Access Journals (Sweden)

Patti J. Miller

2015-10-01

Full Text Available Infections of poultry species with virulent strains of Newcastle disease virus (NDV cause Newcastle disease (ND, one of the most economically significant and devastating diseases for poultry producers worldwide. Biological engagement programs (BEP between the Southeast Poultry Research Laboratory (SEPRL of the United States Department of Agriculture and laboratories from Russia, Pakistan, Ukraine, Kazakhstan and Indonesia collectively have produced a better understanding of the genetic diversity and evolution of the viruses responsible for ND, which is crucial for the control of the disease. The data from Kazakhstan, Russia and Ukraine identified possible migratory routes for birds that may carry both virulent NDV (vNDV and NDV of low virulence into Europe. In addition, related NDV strains were isolated from wild birds in Ukraine and Nigeria, and from birds in continental USA, Alaska, Russia, and Japan, identifying wild birds as a possible mechanism of intercontinental spread of NDV of low virulence. More recently, the detection of new sub-genotypes of vNDV suggests that a new, fifth, panzootic of ND has already originated in Southeast Asia, extended to the Middle East, and is now entering into Eastern Europe. Despite expected challenges when multiple independent laboratories interact, many scientists from the collaborating countries have successfully been trained by SEPRL on molecular diagnostics, best laboratory practices, and critical biosecurity protocols, providing our partners the capacity to further train other employees and to identify locally the viruses that cause this OIE listed disease. These and other collaborations with partners in Mexico, Bulgaria, Israel, and Tanzania have allowed SEPRL scientists to engage in field studies, to elucidate more aspects of ND epidemiology in endemic countries, and to understand the challenges that the scientists and field veterinarians in these countries face on a daily basis. Finally, new viral

International Biological Engagement Programs Facilitate Newcastle Disease Epidemiological Studies

Science.gov (United States)

Miller, Patti J.; Dimitrov, Kiril M.; Williams-Coplin, Dawn; Peterson, Melanie P.; Pantin-Jackwood, Mary J.; Swayne, David E.; Suarez, David L.; Afonso, Claudio L.

2015-01-01

Infections of poultry species with virulent strains of Newcastle disease virus (NDV) cause Newcastle disease (ND), one of the most economically significant and devastating diseases for poultry producers worldwide. Biological engagement programs between the Southeast Poultry Research Laboratory (SEPRL) of the United States Department of Agriculture and laboratories from Russia, Pakistan, Ukraine, Kazakhstan, and Indonesia collectively have produced a better understanding of the genetic diversity and evolution of the viruses responsible for ND, which is crucial for the control of the disease. The data from Kazakhstan, Russia, and Ukraine identified possible migratory routes for birds that may carry both virulent NDV (vNDV) and NDV of low virulence into Europe. In addition, related NDV strains were isolated from wild birds in Ukraine and Nigeria, and from birds in continental USA, Alaska, Russia, and Japan, identifying wild birds as a possible mechanism of intercontinental spread of NDV of low virulence. More recently, the detection of new sub-genotypes of vNDV suggests that a new, fifth, panzootic of ND has already originated in Southeast Asia, extended to the Middle East, and is now entering into Eastern Europe. Despite expected challenges when multiple independent laboratories interact, many scientists from the collaborating countries have successfully been trained by SEPRL on molecular diagnostics, best laboratory practices, and critical biosecurity protocols, providing our partners the capacity to further train other employes and to identify locally the viruses that cause this OIE listed disease. These and other collaborations with partners in Mexico, Bulgaria, Israel, and Tanzania have allowed SEPRL scientists to engage in field studies, to elucidate more aspects of ND epidemiology in endemic countries, and to understand the challenges that the scientists and field veterinarians in these countries face on a daily basis. Finally, new viral characterization tools

International Biological Engagement Programs Facilitate Newcastle Disease Epidemiological Studies.

Science.gov (United States)

Miller, Patti J; Dimitrov, Kiril M; Williams-Coplin, Dawn; Peterson, Melanie P; Pantin-Jackwood, Mary J; Swayne, David E; Suarez, David L; Afonso, Claudio L

2015-01-01

Infections of poultry species with virulent strains of Newcastle disease virus (NDV) cause Newcastle disease (ND), one of the most economically significant and devastating diseases for poultry producers worldwide. Biological engagement programs between the Southeast Poultry Research Laboratory (SEPRL) of the United States Department of Agriculture and laboratories from Russia, Pakistan, Ukraine, Kazakhstan, and Indonesia collectively have produced a better understanding of the genetic diversity and evolution of the viruses responsible for ND, which is crucial for the control of the disease. The data from Kazakhstan, Russia, and Ukraine identified possible migratory routes for birds that may carry both virulent NDV (vNDV) and NDV of low virulence into Europe. In addition, related NDV strains were isolated from wild birds in Ukraine and Nigeria, and from birds in continental USA, Alaska, Russia, and Japan, identifying wild birds as a possible mechanism of intercontinental spread of NDV of low virulence. More recently, the detection of new sub-genotypes of vNDV suggests that a new, fifth, panzootic of ND has already originated in Southeast Asia, extended to the Middle East, and is now entering into Eastern Europe. Despite expected challenges when multiple independent laboratories interact, many scientists from the collaborating countries have successfully been trained by SEPRL on molecular diagnostics, best laboratory practices, and critical biosecurity protocols, providing our partners the capacity to further train other employes and to identify locally the viruses that cause this OIE listed disease. These and other collaborations with partners in Mexico, Bulgaria, Israel, and Tanzania have allowed SEPRL scientists to engage in field studies, to elucidate more aspects of ND epidemiology in endemic countries, and to understand the challenges that the scientists and field veterinarians in these countries face on a daily basis. Finally, new viral characterization tools

Nonalcoholic fatty liver disease and sarcopenia in a Western population (NHANES III): The importance of sarcopenia definition.

Science.gov (United States)

Peng, Tao-Chun; Wu, Li-Wei; Chen, Wei-Liang; Liaw, Fang-Yih; Chang, Yaw-Wen; Kao, Tung-Wei

2017-12-08

Recent epidemiological studies have shown that sarcopenia is associated with non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis in an Asian population. We investigated whether NAFLD is associated with a higher risk of sarcopenia using a different definition in elderly patients. A population-based cross-sectional survey of US patients was conducted, involving 2551 participants aged 60-75 years. NAFLD was measured by ultrasound. Sarcopenia was defined by both a low muscle mass and poor muscle function. In addition, the skeletal muscle index (SMI) was calculated as the absolute muscle mass (kilograms) divided by height 2 (meters) or total body mass (kilograms). A multivariable logistic regression was conducted to estimate the relationship between sarcopenia and NAFLD in the elderly. After adjusting for age, sex, and race/ethnicity, severe hepatic steatosis was associated with a decreased risk of sarcopenia as defined by the height-adjusted SMI (odds ratio (OR) 0.63; 95% confidence interval (CI) 0.46-0.87). In contrast, severe hepatic steatosis was associated with an increased risk of sarcopenia as defined by the weight-adjusted SMI (OR 1.73; 95% CI 1.31-2.28). These significant associations remained after further adjustments for other potential confounding variables. NAFLD is associated with a lower risk of sarcopenia when using the height-adjusted SMI. In contrast, it showed the opposite result when using the weight-adjusted SMI. The definition of sarcopenia may be an important factor when examining its relationship with NAFLD. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Development and validation of a self-reported periodontal disease measure among Jordanians.

Science.gov (United States)

Khader, Yousef; Alhabashneh, Rola; Alhersh, Fadi

2015-08-01

The development of self-reported measures of periodontal disease would be of great benefit to facilitate epidemiological studies of periodontal disease on a larger scale, and to allow for surveillance of the periodontal condition of populations over time. To develop a culturally adapted self-reported measure of periodontal disease, test its predictive and discriminative validity and establish a cut-off value for this measure to diagnose periodontal disease. A total of 288 Jordanian adults completed the questionnaire assessing self-reported periodontal health (18 questions) and underwent periodontal examination. Of the 18 questions, six were significantly associated with at least one clinical definition of periodontitis and were used to constitute the self-reported periodontal disease measure. Receiver-operating characteristics (ROC) curve analyses were used to examine the overall discriminatory power, sensitivity and specificity, and corresponding cut-off points of the self-reported periodontal disease measure. ROC analysis showed that the self-reported periodontal disease measure had an excellent performance to discriminate between those with and without periodontal disease, regardless of the clinical definition used. A score of 2, on a scale of 0 to 6, had the highest sensitivity and specificity to detect periodontal disease when defined by all study criteria. Significant associations were observed between self-reported periodontal disease measures and all clinical definitions in the regression analysis (the odds ratio ranged from 8.31 to 18.96), according to the clinical definition to be predicted. Self-reported periodontal disease measures have excellent predictive and discriminative validity when tested against clinical definitions, and severity and extent of periodontal disease. © 2015 FDI World Dental Federation.

About the Epidemiology and Genomics Research Program

Science.gov (United States)

Epidemiology is the scientific study of the causes and distribution of disease in populations. NCI-funded epidemiology research is conducted through research at institutions in the United States and internationally.

The European concerted action on air pollution epidemiology

Energy Technology Data Exchange (ETDEWEB)

Ackermann-Liebrich, U. [Basel Univ. (Switzerland). Inst. for Social and Preventive Medicine

1995-12-31

The European Concerted Action on Air Pollution Epidemiology was started in 1990 with the aim of bringing together European researchers in the field and improving research through collaboration and by preparing documents which would help to this end and by organizing workshops. A further aim was to stimulate cooperative research. Air pollution epidemiology investigates human effects of community air pollution by epidemiological methods. Epidemiology in general investigates the distribution and determinants of health-related states and events in populations. Diseases in which air pollution may play a significant role are mainly diseases of the respiratory system, for example chronic non-specific lung disease and lung cancer. Most diseases caused by air pollution can also be caused by other factors. Air pollution epidemiology is therefore specific in the expo variable (community air pollution) rather than in the type of health effects being studied. Air pollution epidemiology is beset with some specially challenging difficulties: ubiquitous exposure and as a consequence limited heterogeneity in exposure, low relative risks, few or specific health end points, and strong confounding. Further on the exposure-effect relationship is complicated by assumptions inherent to different study designs which relate to the exposure duration necessary to produce a certain health effect. In reports and workshops the concerted action tries to propose strategies to deal with these problems. (author)

The European concerted action on air pollution epidemiology

Energy Technology Data Exchange (ETDEWEB)

Ackermann-Liebrich, U [Basel Univ. (Switzerland). Inst. for Social and Preventive Medicine

1996-12-31

The European Concerted Action on Air Pollution Epidemiology was started in 1990 with the aim of bringing together European researchers in the field and improving research through collaboration and by preparing documents which would help to this end and by organizing workshops. A further aim was to stimulate cooperative research. Air pollution epidemiology investigates human effects of community air pollution by epidemiological methods. Epidemiology in general investigates the distribution and determinants of health-related states and events in populations. Diseases in which air pollution may play a significant role are mainly diseases of the respiratory system, for example chronic non-specific lung disease and lung cancer. Most diseases caused by air pollution can also be caused by other factors. Air pollution epidemiology is therefore specific in the expo variable (community air pollution) rather than in the type of health effects being studied. Air pollution epidemiology is beset with some specially challenging difficulties: ubiquitous exposure and as a consequence limited heterogeneity in exposure, low relative risks, few or specific health end points, and strong confounding. Further on the exposure-effect relationship is complicated by assumptions inherent to different study designs which relate to the exposure duration necessary to produce a certain health effect. In reports and workshops the concerted action tries to propose strategies to deal with these problems. (author)

Puffy skin disease (PSD) in rainbow trout, Oncorhynchus mykiss (Walbaum): a case definition.

Science.gov (United States)

Maddocks, C E; Nolan, E T; Feist, S W; Crumlish, M; Richards, R H; Williams, C F

2015-07-01

Puffy skin disease (PSD) is a disease that causes skin pathology in rainbow trout, Oncorhynchus mykiss (Walbaum). Incidence of PSD in UK fish farms and fisheries has increased sharply in the last decade, with growing concern from both industry sectors. This paper provides the first comprehensive case definition of PSD, combining clinical and pathological observations of diseased rainbow trout from both fish farms and fisheries. The defining features of PSD, as summarized in the case definition, were focal lateral flank skin lesions that appeared as cutaneous swelling with pigment loss and petechiae. These were associated with lethargy, poor body condition, inappetance and low level mortality. Epidermal hyperplasia and spongiosis, oedema of the dermis stratum spongiosum and a mild diffuse inflammatory cellularity were typical in histopathology of skin. A specific pathogen or aetiology was not identified. Prevalence and severity of skin lesions was greatest during late summer and autumn, with the highest prevalence being 95%. Atypical lesions seen in winter and spring were suggestive of clinical resolution. PSD holds important implications for both trout aquaculture and still water trout fisheries. This case definition will aid future diagnosis, help avoid confusion with other skin conditions and promote prompt and consistent reporting. © 2014 John Wiley & Sons Ltd.

Developing a New Definition and Assessing New Clinical Criteria for Septic Shock For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

NARCIS (Netherlands)

Shankar-Hari, Manu; Phillips, Gary S.; Levy, Mitchell L.; Seymour, Christopher W.; Liu, Vincent X.; Deutschman, Clifford S.; Angus, Derek C.; Rubenfeld, Gordon D.; Singer, Mervyn; Angus, Derek; Annane, Djilalli; Bauer, Michael; Bellomo, Rinaldo; Bernard, Gordon; Chiche, Jean-Daniel; Coopersmith, Craig; Deutschman, Cliff; Hotchkiss, Richard; Levy, Mitchell; Marshall, John; Martin, Greg; Opal, Steve; Rubenfeld, Gordon; Seymour, Christopher; van der Poll, Tom; Vincent, Jean-Louis

2016-01-01

IMPORTANCE Septic shock currently refers to a state of acute circulatory failure associated with infection. Emerging biological insights and reported variation in epidemiology challenge the validity of this definition. OBJECTIVE To develop a new definition and clinical criteria for identifying

Snippets from the past: the evolution of Wade Hampton Frost's epidemiology as viewed from the American Journal of Hygiene/Epidemiology.

Science.gov (United States)

Morabia, Alfredo

2013-10-01

Wade Hampton Frost, who was a Professor of Epidemiology at Johns Hopkins University from 1919 to 1938, spurred the development of epidemiologic methods. His 6 publications in the American Journal of Hygiene, which later became the American Journal of Epidemiology, comprise a 1928 Cutter lecture on a theory of epidemics, a survey-based study of tonsillectomy and immunity to Corynebacterium diphtheriae (1931), 2 papers from a longitudinal study of the incidence of minor respiratory diseases (1933 and 1935), an attack rate ratio analysis of the decline of diphtheria in Baltimore (1936), and a 1936 lecture on the age, time, and cohort analysis of tuberculosis mortality. These 6 American Journal of Hygiene /American Journal of Epidemiology papers attest that Frost's personal evolution mirrored that of the emerging "early" epidemiology: The scope of epidemiology extended beyond the study of epidemics of acute infectious diseases, and rigorous comparative study designs and their associated quantitative methods came to light.

Epidemiology and introduction to the clinical presentation of Wilson disease.

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Lo, Christine; Bandmann, Oliver

2017-01-01

Our understanding of the epidemiology of Wilson disease has steadily grown since Sternlieb and Scheinberg's first prevalence estimate of 5 per million individuals in 1968. Increasingly sophisticated genetic techniques have led to revised genetic prevalence estimates of 142 per million. Various population isolates exist where the prevalence of Wilson disease is higher still, the highest being 885 per million from within the mountainous region of Rucar in Romania. In Sardinia, where the prevalence of Wilson disease has been calculated at 370 per million births, six mutations account for around 85% of Wilson disease chromosomes identified. Significant variation in the patterns of presentation may however exist, even between individuals carrying the same mutations. At either extremes of presentation are an 8-month-old infant with abnormal liver function tests and individuals diagnosed in their eighth decade of life. Three main patterns of presentation have been recognized - hepatic, neurologic, and psychiatric - prompting their presentation to a diverse range of specialists. Deviations in the family history from the anticipated autosomal-recessive mode of inheritance, with apparent "pseudodominance" and mechanisms of inheritance that include uniparental isodisomy (the inheritance of both chromosomal copies from a single parent), may all further cloud the diagnosis. It can therefore take the efforts of an astute clinician with a high clinical index of suspicion to clinch the diagnosis of this eminently treatable condition. © 2017 Elsevier B.V. All rights reserved.

New Perspectives on Dry Eye Definition and Diagnosis: A Consensus Report by the Asia Dry Eye Society.

Science.gov (United States)

Tsubota, Kazuo; Yokoi, Norihiko; Shimazaki, Jun; Watanabe, Hitoshi; Dogru, Murat; Yamada, Masakazu; Kinoshita, Shigeru; Kim, Hyo-Myung; Tchah, Hung-Won; Hyon, Joon Young; Yoon, Kyung-Chul; Seo, Kyoung Yul; Sun, Xuguang; Chen, Wei; Liang, Lingyi; Li, Mingwu; Liu, Zuguo

2017-01-01

For the last 20 years, a great amount of evidence has accumulated through epidemiological studies that most of the dry eye disease encountered in daily life, especially in video display terminal (VDT) workers, involves short tear film breakup time (TFBUT) type dry eye, a category characterized by severe symptoms but minimal clinical signs other than short TFBUT. An unstable tear film also affects the visual function, possibly due to the increase of higher order aberrations. Based on the change in the understanding of the types, symptoms, and signs of dry eye disease, the Asia Dry Eye Society agreed to the following definition of dry eye: "Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The definition stresses instability of the tear film as well as the importance of visual impairment, highlighting an essential role for TFBUT assessment. This paper discusses the concept of Tear Film Oriented Therapy (TFOT), which evolved from the definition of dry eye, emphasizing the importance of a stable tear film. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

Retrospective study of epidemiological, clinicopathological and ...

African Journals Online (AJOL)

Retrospective study of epidemiological, clinicopathological and biological profils of 62 colorectal cancers cases in Jijel provence (Algeria) ... Our results were often compatible with the available literature and may provide reliable and relevant data on this disease. Key words: Colorectal cancer; Epidemiology; Therapy; ...

Proposing a Novel, Three-level Definition of Periodontitis 
using Probing Depth, Clinical Attachment Loss and Bleeding on Probing: Analysis of a Rural Chinese Population.

Science.gov (United States)

Pei, Xi Yan; He, Lu; Ouyang, Xiang Ying

To propose a novel, three-level (severe, moderate, mild) case definition using probing depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP) for epidemiologic studies on periodontitis. Case definitions (DEF) 1-30 with PD, CAL and BOP were made. Based on data from epidemiologic research in Chengde (Hebei Province, China) in 1992, prevalence of periodontitis by DEF1-30 was calculated and compared with a reference (definitions by Centers for Disease Control and Prevention/American Academy of Periodontology in 2012). Sensitivity, specificity, Youden Index, Cohen's kappa coefficient (CKC) and the area under the receiver operator characteristic curve (AUC) were calculated for the definitions selected. DEF1 and DEF18 for periodontitis, DEF2, DEF3, DEF19 for moderate and severe periodontitis, and DEF5, DEF13, DEF14, DEF21 and DEF25 for severe periodontitis, which were similar for estimation of periodontitis prevalence compared with the reference, were selected. DEF18 for periodontitis, DEF19 for moderate and severe periodontitis, and DEF5 for severe periodontitis were selected because they showed higher values for the Youden Index, CKC and AUC, and formed a three-level definition. A novel three-level case classification of periodontitis using three parameters of PD, CAL and BOP was proposed. The estimated periodontitis prevalence according to the novel proposed definition is close to the prevalence according to the CDC/AAP definition.

Salmonella epidemiology: A whirlwind of change.

Science.gov (United States)

Besser, John M

2018-05-01

The field of infectious disease epidemiology for Salmonella and other enteric pathogens is undergoing some of the most profound changes since the time of Kauffman and White. Rapid advances in "big data" technologies such as genomics and metagenomics are making it possible to monitor and control salmonellosis in new and exciting ways. Epidemiological methods are becoming increasingly robust through the routine use of standardized hypothesis-generating questionnaires, iterative open-ended interviewing, informational trace-backs and new modeling techniques for describing the attribution of disease to food sources. In addition, Salmonella epidemiology is facing important challenges and new opportunities due to the rapid adoption of culture independent diagnostic test panels by clinical laboratories. Where is this unprecedented wave of change taking us? This chapter will examine emerging trends in Salmonella epidemiology, and take a peek into the not-so-distant future. Published by Elsevier Ltd.

The role of geographic information systems inwildlife epidemiology: models of chronic wasting disease in Colorado mule deer

OpenAIRE

Farnsworth, Matthew L.; Hoeting, Jennifer A.; Hobbs, N. Thompson; Conner, Mary M.; Burnham, Kenneth P.; Wolfe, Lisa L.; Williams, Elizabeth S.; Theobald, David M.; Miller, Michael W.

2007-01-01

The authors present findings from two landscape epidemiology studies of chronic wasting disease (CWD) in northern Colorado mule deer (Odocoileus hemionus). First, the effects of human land use on disease prevalence were explored by formulating a set of models estimating CWD prevalence in relation to differences in human land use, sex and geographic location. Prevalence was higher in developed areas and among male deer suggesting that anthropogenic influences (changes in land use), differences...

The burden and recent epidemiological changes of the main chronic liver diseases in a Greek referral tertiary centre.

Science.gov (United States)

Giannousis, Ioannis P; Papatheodoridis, George V; Deutsch, Melanie J; Manolakopoulos, Spilios G; Manesis, Emanuel K; Koskinas, John S; Archimandritis, Athanasios J

2010-02-01

To investigate the burden and recent epidemiological changes of the main chronic liver diseases in a Greek referral tertiary centre. We evaluated the main epidemiological characteristics of 1080 consecutive adult patients, seen at our outpatient liver clinic between 2002 and 2007, with chronic hepatitis B (HBV) and/or C (HCV) virus infection, alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD). Our patient population was divided into two groups in relation to the time of the first visit (period A: 2002-2004, period B: 2005-2007). Among our patient population, 86.1% had chronic HBV and/or HCV infection (chronic HCV alone: 44.9%), 9.2% NAFLD and 4.8% ALD. From period A to B, there was a decrease in chronic HBV cases (44.0 vs. 37.8%, P = 0.045) with immigrants being responsible for 35.5% of them and being more frequent in period B than A (39.7 vs. 30.5%, P = 0.046). In chronic hepatitis B, hepatitis B e antigen-positive patients, who were more frequent immigrants compared with hepatitis B e antigen-negative patients (65.5 vs. 29.5%, P = 0.001), increased from period A to B (8.0 vs. 17.6%, P = 0.045). Intravenous drug use was reported by 41.2% of HCV patients with its proportion increasing from period A to B (32.5 vs. 47.4%, P = 0.002). Decompensated cirrhosis was present in 67, 10, 11 and 3% of patients with ALD, HBV, HCV and NAFLD, respectively. At Greek tertiary centres, chronic viral hepatitis remains responsible for most chronic liver disease cases, but its epidemiology is changing owing to immigrants and intravenous drug users.

Epidemiological studies on syncope

DEFF Research Database (Denmark)

Ruwald, Martin Huth

2013-01-01

of the patients play an essential role. In epidemiology these factors have major impact on the outcome of the patients. Until recently, even the definition of syncope differed from one study to another which has made literature reviews difficult. Traditionally the data on epidemiology of syncope has been taken...... from smaller studies from different clinical settings with wide differences in patient morbidity. Through the extensive Danish registries we examined the characteristics and prognosis of the patients hospitalized due to syncope in a nationwide study. The aims of the present thesis were to investigate......, prevalence and cardiovascular factors associated with the risk of syncope, 4) the prognosis in healthy individuals discharged after syncope, and 5) the prognosis of patients after syncope and evaluation of the CHADS2 score as a tool for short- and long-term risk prediction. The first studies of the present...

Epidemiologic Patterns of Ross River Virus Disease in Queensland, Australia, 2001–2011

Science.gov (United States)

Yu, Weiwei; Mengersen, Kerrie; Dale, Pat; Mackenzie, John S.; Toloo, Ghasem (Sam); Wang, Xiaoyu; Tong, Shilu

2014-01-01

Ross River virus (RRV) infection is a debilitating disease that has a significant impact on population health, economic productivity, and tourism in Australia. This study examined epidemiologic patterns of RRV disease in Queensland, Australia, during January 2001–December 2011 at a statistical local area level. Spatio-temporal analyses were used to identify the patterns of the disease distribution over time stratified by age, sex, and space. The results show that the mean annual incidence was 54 per 100,000 persons, with a male:female ratio of 1:1.1. Two space-time clusters were identified: the areas adjacent to Townsville, on the eastern coast of Queensland, and the southeast areas. Thus, although public health intervention should be considered across all areas in which RRV occurs, it should specifically focus on high-risk regions, particularly during summer and autumn to reduce the social and economic impacts of RRV infection. PMID:24799374

Epidemiology of allergic diseases of the respiratory passages in the Kazakh SSR

Energy Technology Data Exchange (ETDEWEB)

Moshkevich, V.S.

1985-01-01

Over a period of 20 years, the authors have been studying the distribution, aetiology and causes of increasing incidence of allergic respiratory diseases in various climatogeographic zones of the Kazakh SSR. Large groups of people living in towns and in the country were examined by various methods. The number of patients seeking advice in health service establishments because of allergic rhinitis and bronchial asthma was found to increase every year. A number of factors influencing the incidence of disease were pointed out, such as the character of diet, duration of the person's stay, vaccination against brucellosis, pollution of the atmosphere, local flora, climate, and other factors. Morbidity also depended on the methods of studying the epidemiology of respiratory allergoses. The obtained results will help health service authorities in taking specific measures to reduce morbidity from the mentioned pathological condition.

Update on epidemiology and control of Foot and Mouth Disease - A menace to international trade and global animal enterprise

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P. M. Depa

Full Text Available Foot and mouth disease (FMD is one of the most economically and socially devastating disease affecting animal agriculture throughout the world. This review describes economic impact of disease outbreaks, an update of recent findings in epidemiology of FMD both at International and national level and control of this disease. The etiological agent (FMD virus is examined in detail at genetic and molecular characterization level and in terms of antigenic diversity. [Vet World 2012; 5(11.000: 694-704

A Disease Register for ME/CFS: Report of a Pilot Study

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Featherstone Valerie

2011-05-01

Full Text Available Abstract Background The ME/CFS Disease Register is one of six subprojects within the National ME/CFS Observatory, a research programme funded by the Big Lottery Fund and sponsored by Action for ME. A pilot study in East Anglia, East Yorkshire, and London aimed to address the problem of identifying representative groups of subjects for research, in order to be able to draw conclusions applicable to the whole ME/CFS population. While not aiming for comprehensive population coverage, this pilot register sought to recruit participants with ME/CFS in an unbiased way from a large population base. Those recruited are constituting a cohort for long-term follow-up to shed light on prognosis, and a sampling frame for other studies. Findings Patients with unidentified chronic fatigue were identified in GP databases using a READ-code based algorithm, and conformity to certain case definitions for ME/CFS determined. 29 practices, covering a population aged 18 to 64 of 143,153, participated. 510 patients with unexplained chronic fatigue were identified. 265 of these conformed to one or more case definitions. 216 were invited to join the register; 160 agreed. 96.9% of participants conformed to the CDC 1994 (Fukuda definition; the Canadian definition defined more precisely a subset of these. The addition of an epidemiological case definition increased case ascertainment by approximately 4%. A small-scale study in a specialist referral service in East Anglia was also undertaken. There was little difference in pattern of conformity to case definitions, age or sex among disease register participants compared with subjects in a parallel epidemiological study who declined to participate. One-year follow-up of 50 subjects showed little change in pain or fatigue scores. There were some changes in conformity to case definitions. Conclusions Objective evaluation indicated that the aim of recruiting participants with ME/CFS to a Disease Register had been fulfilled, and

A Disease Register for ME/CFS: Report of a Pilot Study.

Science.gov (United States)

Pheby, Derek; Lacerda, Eliana; Nacul, Luis; Drachler, Maria de Lourdes; Campion, Peter; Howe, Amanda; Poland, Fiona; Curran, Monica; Featherstone, Valerie; Fayyaz, Shagufta; Sakellariou, Dikaios; Leite, José Carlos de Carvalho

2011-05-09

The ME/CFS Disease Register is one of six subprojects within the National ME/CFS Observatory, a research programme funded by the Big Lottery Fund and sponsored by Action for ME. A pilot study in East Anglia, East Yorkshire, and London aimed to address the problem of identifying representative groups of subjects for research, in order to be able to draw conclusions applicable to the whole ME/CFS population.While not aiming for comprehensive population coverage, this pilot register sought to recruit participants with ME/CFS in an unbiased way from a large population base. Those recruited are constituting a cohort for long-term follow-up to shed light on prognosis, and a sampling frame for other studies. Patients with unidentified chronic fatigue were identified in GP databases using a READ-code based algorithm, and conformity to certain case definitions for ME/CFS determined. 29 practices, covering a population aged 18 to 64 of 143,153, participated.510 patients with unexplained chronic fatigue were identified. 265 of these conformed to one or more case definitions. 216 were invited to join the register; 160 agreed. 96.9% of participants conformed to the CDC 1994 (Fukuda) definition; the Canadian definition defined more precisely a subset of these. The addition of an epidemiological case definition increased case ascertainment by approximately 4%. A small-scale study in a specialist referral service in East Anglia was also undertaken.There was little difference in pattern of conformity to case definitions, age or sex among disease register participants compared with subjects in a parallel epidemiological study who declined to participate.One-year follow-up of 50 subjects showed little change in pain or fatigue scores. There were some changes in conformity to case definitions. Objective evaluation indicated that the aim of recruiting participants with ME/CFS to a Disease Register had been fulfilled, and confirmed the feasibility of our approach to case identification

The Epidemiology of African Swine Fever in "Nonendemic" Regions of Zambia (1989-2015): Implications for Disease Prevention and Control.

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Simulundu, Edgar; Lubaba, Caesar H; van Heerden, Juanita; Kajihara, Masahiro; Mataa, Liywalii; Chambaro, Herman Moses; Sinkala, Yona; Munjita, Samuel Munalula; Munang'andu, Hetron Mweemba; Nalubamba, King Shimumbo; Samui, Kenny; Pandey, Girja Shanker; Takada, Ayato; Mweene, Aaron S

2017-08-23

African swine fever (ASF) is a highly contagious and deadly viral hemorrhagic disease of swine. In Zambia, ASF was first reported in 1912 in Eastern Province and is currently believed to be endemic in that province only. Strict quarantine measures implemented at the Luangwa River Bridge, the only surface outlet from Eastern Province, appeared to be successful in restricting the disease. However, in 1989, an outbreak occurred for the first time outside the endemic province. Sporadic outbreaks have since occurred almost throughout the country. These events have brought into acute focus our limited understanding of the epidemiology of ASF in Zambia. Here, we review the epidemiology of the disease in areas considered nonendemic from 1989 to 2015. Comprehensive sequence analysis conducted on genetic data of ASF viruses (ASFVs) detected in domestic pigs revealed that p72 genotypes I, II, VIII and XIV have been involved in causing ASF outbreaks in swine during the study period. With the exception of the 1989 outbreak, we found no concrete evidence of dissemination of ASFVs from Eastern Province to other parts of the country. Our analyses revealed a complex epidemiology of the disease with a possibility of sylvatic cycle involvement. Trade and/or movement of pigs and their products, both within and across international borders, appear to have been the major factor in ASFV dissemination. Since ASFVs with the potential to cause countrywide and possibly regional outbreaks, could emerge from "nonendemic regions", the current ASF control policy in Zambia requires a dramatic shift to ensure a more sustainable pig industry.

Epidemiology, management and outcomes of Graves' disease-real life data.

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Hussain, Y S; Hookham, J C; Allahabadia, A; Balasubramanian, S P

2017-06-01

Treatment options in Graves' disease are clearly defined, but management practices and the perceptions of success are varied. The outcomes of treatment in large consecutive cohorts of Graves' disease have not been well characterised. The study describes the epidemiology, management strategies and medium term outcomes following anti-thyroid drug treatment, radio-iodine ablation and surgery in Graves' disease. All patients (n = 659) who received treatment for a new diagnosis of Graves' disease in secondary care over a 5 year period were included with a median (interquartile range) follow-up of 42.9 (29-57.5) months. The age adjusted incidence of adult onset Graves' disease in Sheffield, UK was 24.8 per 100,000 per year. Excluding 35 patients lost to follow-up, 93.1% (n = 581) were controlled on anti-thyroid drug treatment. Of these, 73.6% went into remission following withdrawal of anti-thyroid drugs; 5.2% were still undergoing initial therapy; 13.3% lost control whilst on anti-thyroid drugs; and 7.9% went on to have either surgery or radio-iodine ablation whilst controlled on anti-thyroid drugs. Of the 428 patients who achieved remission, 36.7% relapsed. Of 144 patients who had radio-iodine ablation treatment, 5.6% relapsed and needed further treatment. Of 119 patients having surgery, 5.2% had long-term hypoparathyroidism and none had documented long-term recurrent laryngeal nerve palsy. In the follow-up, 39.9% of patients underwent surgery or radio-iodine ablation with little morbidity. Up to two-thirds of patients who achieved remission did not relapse. Data on effectiveness and risks of treatments for Graves' disease presented in this study will help clinicians and patients in decision making.

Epidemiological aspects of bovine trypanosomosis in an endemic focus of eastern Zambia: The role of trypanosome strain variability in disease pattern

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Justin Masumu

2012-06-01

Full Text Available Bovine trypanosomosis displays various epidemiological aspects in various areas. In some instances the disease has a high prevalence in animals with high impact on production whereas in other cases the disease has a low impact on production despite a high level of infection in animals. In addition epidemiological changes are frequently observed in various areas and are related to many factors including the vectors, the host, the parasites, the environment as well as the livestock management. However the implication of these factors in these changes is not fully elucidated. In eastern Zambia, factors predicting the establishment of severe infection in cattle are all present. However trypanosomosis occurring in cattle in this area has a low impact on livestock production. Several studies on the characterisation of trypanosome strains circulating in domestic and wild animals have been conducted in order to clarify the epidemiology of this disease in this area. These studies aimed at evaluating genetic and biological characteristics of these strains including their virulence profiles, their transmissibility by tsetse flies, their resistance to drugs and interference between different strains. In this review these findings are analysed in order to elucidate the implication of trypanosome strain variability in the distribution and the expression of this disease in the study area. The evolutionary trends of the situation occurring in this study area are also explained. Use of these findings is the context of disease control in the study area is further discussed.

Ebola virus disease outbreak; the role of field epidemiology training programme in the fight against the epidemic, Liberia, 2014.

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Lubogo, Mutaawe; Donewell, Bangure; Godbless, Lucas; Shabani, Sasita; Maeda, Justin; Temba, Herilinda; Malibiche, Theophil C; Berhanu, Naod

2015-01-01

The African Field Epidemiology Network (AFENET) is a public health network established in 2005 as a non-profit networking alliance of Field Epidemiology and Laboratory Training Programs (FELTPs) and Field Epidemiology Training Programs (FETPs) in Africa. AFENET is dedicated to supporting Ministries of Health in Africa build strong, effective and sustainable programs and capacity to improve public health systems by partnering with global public health experts. The Network's goal is to strengthen field epidemiology and public health laboratory capacity to contribute effectively to addressing epidemics and other major public health problems in Africa. The goal for the establishment of FETP and FELTP was and still is to produce highly competent multi-disciplinary public health professionals who would assume influential posts in the public health structures and tackle emerging and re-emerging communicable and non-communicable diseases. AFENET currently networks 12 FELTPs and FETPs in sub-Saharan Africa with operations in 20 countries. During the Ebola Virus Disease (EVD) outbreak in West Africa, African Union Support for the Ebola Outbreak in West Africa (ASEOWA) supported FETP graduates from Uganda, Zimbabwe, Ethiopia and Tanzania for the investigation and control of the EVD outbreak in Liberia. The graduates were posted in different counties in Liberia where they lead teams of other experts conduct EVD outbreak investigations, Infection Control and Prevention trainings among health workers and communities, Strengthening integrated disease surveillance, developing Standard Operating Procedures for infection control and case notification in the Liberian setting as well as building capacity of local surveillance officers' conduct outbreak investigation and contact tracing. The team was also responsible for EVD data management at the different Counties in Liberia. The FETP graduates have been instrumental in the earlier successes registered in various counties in Liberia

Accuracy of Zika virus disease case definition during simultaneous Dengue and Chikungunya epidemics.

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Braga, José Ueleres; Bressan, Clarisse; Dalvi, Ana Paula Razal; Calvet, Guilherme Amaral; Daumas, Regina Paiva; Rodrigues, Nadia; Wakimoto, Mayumi; Nogueira, Rita Maria Ribeiro; Nielsen-Saines, Karin; Brito, Carlos; Bispo de Filippis, Ana Maria; Brasil, Patrícia

2017-01-01

Zika is a new disease in the American continent and its surveillance is of utmost importance, especially because of its ability to cause neurological manifestations as Guillain-Barré syndrome and serious congenital malformations through vertical transmission. The detection of suspected cases by the surveillance system depends on the case definition adopted. As the laboratory diagnosis of Zika infection still relies on the use of expensive and complex molecular techniques with low sensitivity due to a narrow window of detection, most suspected cases are not confirmed by laboratory tests, mainly reserved for pregnant women and newborns. In this context, an accurate definition of a suspected Zika case is crucial in order for the surveillance system to gauge the magnitude of an epidemic. We evaluated the accuracy of various Zika case definitions in a scenario where Dengue and Chikungunya viruses co-circulate. Signs and symptoms that best discriminated PCR confirmed Zika from other laboratory confirmed febrile or exanthematic diseases were identified to propose and test predictive models for Zika infection based on these clinical features. Our derived score prediction model had the best performance because it demonstrated the highest sensitivity and specificity, 86·6% and 78·3%, respectively. This Zika case definition also had the highest values for auROC (0·903) and R2 (0·417), and the lowest Brier score 0·096. In areas where multiple arboviruses circulate, the presence of rash with pruritus or conjunctival hyperemia, without any other general clinical manifestations such as fever, petechia or anorexia is the best Zika case definition.

Epidemiological aspects of retrovirus (HTLV infection among Indian populations in the Amazon Region of Brazil

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Ricardo Ishak

Full Text Available HTLV was initially described in association with a form of leukemia in Japan and a neurological disease in the Caribbean. It was soon shown that HTLV-II was endemic among Amerindians and particularly among Brazilian Indians. The Amazon Region of Brazil is presently the largest endemic area for this virus and has allowed several studies concerning virus biology, the search for overt disease, epidemiological data including detailed demographic data on infected individuals, clear-cut geographic distribution, definition of modes of transmission and maintenance within small, epidemiologically-closed groups, and advances in laboratory diagnosis of the infection. A new molecular subtype named HTLV-IIc was further described on the basis of genome sequencing and phylogenetic analysis. This subtype is present in other areas of Brazil, indicating that the virus is additionally both a valuable marker for tracing past human migration routes in the Americas and a probable marker for social habits of the present human population. HIV, the other human retrovirus, is still not prevalent among indigenous communities in the Brazilian Amazon, but these groups are also easy targets for the virus.

Epidemiology of gastroesophageal reflux disease: A general population-based study in Xi’an of Northwest China

OpenAIRE

Wang, Jin-Hai; Luo, Jin-Yan; Dong, Lei; Gong, Jun; Tong, Ming

2004-01-01

AIM: Gastroesophageal reflux disease (GERD) is a common disorder in the Western population, but detailed population-based data in China are limited. The aim of this study was to understand the epidemiology of symptomatic gastroesophageal reflux (SGER) in adults of Xi’an, a northwestern city of China, and to explore the potential risk factors of GERD.

Epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia: a systematic review protocol.

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van Netten, Jaap J; Baba, Mendel; Lazzarini, Peter A

2017-05-18

Diabetic foot disease is associated with major morbidity, mortality, costs, and reduction of a person's quality of life. Investigating the epidemiology of diabetic foot disease is the backbone of diabetic foot research and clinical practice, yet the full burden of diabetic foot disease in Australia is unknown. This study aims to describe the protocol for a systematic review of the epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia. The systematic review will be performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed and EMBASE will be searched for publications in any language and without restrictions to date. Two independent investigators will screen publications for eligibility, with publications reporting Australian population-based incidence or prevalence of diabetic foot disease or diabetes-related lower-extremity amputation to be included. Additionally, a forward literature search will be performed in Google Scholar, and a grey literature search will be performed to identify government publications. Quality assessment will be performed using customised checklists. The summary statistic used for each study will be an incidence or prevalence proportion of diabetic foot disease or diabetes-related lower-extremity amputation. The standard error for each proportion will be calculated. A meta-analysis will be performed when three or more publications of adequate quality, reporting on similar outcomes and in similar populations, are identified. The results of this systematic review can be used to adequately inform stakeholders in the field of diabetic foot disease on the extent of the problem in incidence and prevalence of diabetic foot disease in Australia, and to help guide appropriate use of resources to reduce the burden of this disease. PROSPERO CRD42016050740.

The Emergence and Epidemiology of Haff Disease in China

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Thomas Y. K. Chan

2016-12-01

Full Text Available Haff disease is a rare syndrome of unexplained myalgia and rhabdomyolysis occurring within 24 h of consumption of certain types of cooked freshwater fish or crustacean. It is caused by a yet unidentified heat-stable toxin. In the present review of published case studies and official press releases, the main objective is to report the emergence and epidemiology of Haff disease in China. Haff disease first occurred in Beijing in 2000 and in Lianzhou and Liannan, Guangdong Province in 2009. Subsequent outbreaks mostly occurred in the Jiangsu Province—Nanjing, Yangzhou, Huai’an, and Yancheng. Isolated outbreaks occurred in other cities since 2010—Shijiazhuang, Yueyang, Shanghai, Wuhu, Baoding, Shenzhen, and Hong Kong (imported cases from Shenzhen. Outbreaks occurred predominately in the summer. Crayfish accounted for almost all the outbreaks. Two large outbreaks occurred in Lianzhou and Liannan in 2009 (n = 54 after eating pomfrets and in Nanjing in 2010 (n = 42 after eating crayfish. Other reports or outbreaks involved only 1–9 subjects (median 2 subjects. Variability in individual susceptibility and attack rates were noted, with many subjects remaining asymptomatic despite sharing the same seafood meal as the index cases. Adults were predominately involved. Symptoms occurred within 3–20 h of seafood ingestion, including myalgia, weakness, and, less frequently, nausea, vomiting, abdominal pain, and diarrhea. Myalgia and muscle weakness should normally subside within 2–3 days. Serum creatine phosphokinase became normal within 5–6 days. Abnormal renal function was uncommon. Serious complications (renal failure, multi-organ failure, and prolonged myopathy and death were rare. In any subjects with unexplained myalgia and rhabdomyolysis, seafood consumption should be included in the history. All suspected cases of Haff disease, including milder presentations, should be reported to public health authorities.

Analysis of the epidemiological dynamics during the 1982-1983 epidemic of foot-and-mouth disease in Denmark based on molecular high-resolution strain identification

DEFF Research Database (Denmark)

Christensen, Laurids Siig; Normann, Preben; Thykier-Nielsen, Søren

2005-01-01

An epidemic of foot-and-mouth disease (FMD) causing a total of 23 cases in 1982-1983, primarily on the island of Funen, Denmark, was subjected to molecular epidemiological investigations. In an attempt to exploit the quasi-species nature of foot-and-mouth disease virus strains for molecular high......-resolution strain identification in order to analyse the dynamics of this epidemic, full-length VP1 coding regions were sequenced for 17 isolates collected at different farms during the epidemic. The sequence information together with epidemiological information gathered during the epidemic suggests......, and the prerequisite of co- or superinfection of animals with variant strains in turn implies that they have a common source or epidemiologically related sources originating from an area with endemic FMD....

High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy.

Science.gov (United States)

Penny, Hugo A; Mooney, Peter D; Burden, Mitchell; Patel, Nisha; Johnston, Alexander J; Wong, Simon H; Teare, Julian; Sanders, David S

2016-06-01

Celiac disease remains underdiagnosed at endoscopy. We aimed to assess the utility of I-Scan (virtual chromo-endoscopy) to improve sensitivity of endoscopy to detect markers of villous atrophy in this condition. Patients from 2 UK hospitals were studied in 3 groups. Group 1: standard high definition, white light endoscopy (WLE); Group 2: WLE plus I-Scan; Group 3: non-high definition control group. The presence of endoscopic markers was recorded. At least 4 duodenal biopsies were taken from all patients. Serology was performed concurrently and observations were compared with histology. 758 patients (62% female, mean age 52) were recruited (Group 1: 230; Group 2: 228; Group 3: 300). 135 (17.8%) new diagnoses of coeliac disease were made (21 Group 1; 24 Group 2; 89 Group 3). The sensitivity for detection of endoscopic markers of villous atrophy was significantly higher in both Group 1 (85.7%, p=0.0004) and Group 2 (75%, p=0.005) compared to non-high definition controls (41.6%). There was no significant difference between high definition only and I-Scan groups (p=0.47). In non-high definition endoscopy a missed diagnosis was associated with lesser degrees of villous atrophy (p=0.019) and low tTG titre (p=0.007). High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Bacterial meningitis: epidemiology, herd protection, clinical characteristics, and risk assessment

NARCIS (Netherlands)

Bijlsma, M.W.

2016-01-01

This thesis studied the epidemiology of community-acquired bacterial meningitis after the nationwide implementation of paediatric conjugate vaccines, as well as the long-term epidemiology of invasive meningococcal disease and neonatal group B streptococcal disease in the Netherlands. Furthermore,

Epidemiological profile of colombian patients with rheumatoid arthritis in a specialized care clinic.

Science.gov (United States)

Bautista-Molano, Wilson; Fernández-Avila, Daniel; Jiménez, Ruth; Cardozo, Rosa; Marín, Andrés; Soler, María Del Pilar; Gómez, Olga; Ruiz, Oscar

Few studies report the epidemiological profile of RA patients attending clinics for comprehensive care. We describe the clinical, socio-demographic characteristics and comorbidities of a cohort of patients with RA. Cross-sectional study in a cohort of patients according to ACR criteria/EULAR 2010 classification who have entered to the AR clinic since October 2012 until May 2014, referred from primary care. Frequencies for socio-demographic, comorbidity, state of disease activity, functional status, biomarkers and therapeutic modalities variables are described. In total, 1652 patients were included with a mean age of 58 years and a duration of 9 years. Rheumatoid factor was positive in 80% and anti-citrullinated peptide antibody in 63% of patients. In total, 43.6% of patients had comorbidities: Hypertension (20.4%), osteoporosis (17.3%) and Sjögren's syndrome (10.4%). Fifty percent of the patients had moderate and high disease activity level measured by DAS-28 score, and the mean HAQ score was 0.64 (DS 1.12). Seventy three percent of patients were treated with oral disease modified anti rheumatic treatment and 63.6% of them were with methotrexate. 42.4% of the patients were treated with glucocorticoids (mean dose 6.3mg). The epidemiological behavior of a group of RA patients is reported. The presence of comorbidities is significant affecting the risk of morbidity and mortality in these patients. The definition of the epidemiological profile of this population will allow the design of research questions to resolve outstanding problems in the clinical context of this pathology. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Epidemiology and the control of disease in China, with emphasis on the Chinese Biobank Study.

Science.gov (United States)

Li, L; Guo, Y; Chen, Z; Chen, J; Peto, R

2012-03-01

Similar to many other developing countries, China is facing a double burden of disease as a result of epidemiological transition. Non-communicable diseases (NCDs) represent a major challenge, having an adverse effect on the health of the Chinese population and increasing the economic burden of health care. In today's era of evidence-based medicine and decision making, China, as a developing country, has a lack of local scientific evidence which will affect the effectiveness of NCD prevention and control. As such, and on the basis of decades of cooperation and trust with the University of Oxford, the Chinese Biobank Study [Kadoorie Study of Chronic Disease in China (KSCDC)] was commenced in 2004. KSCDC, an international prospective project, aims to establish the basis of a blood-based health database, using genetic, environmental and lifestyle aspects to investigate and understand the causes, risk factors, pathogenesis, prevalence patterns and trends of major chronic diseases in China (such as stroke, coronary heart disease, cancer, diabetes, hypertension, chronic obstructive pulmonary disease etc.). This study has a duration of 15-20 years, and will provide scientific evidence for strategic planning of NCD prevention and control, and development of new treatment and intervention approaches. In total, approximately 510,000 adults aged 30-79 years have been recruited from the general population in 10 geographically defined regions (five rural and five urban) of China, with differing disease profiles and differing risk exposures. Extensive data collection has been undertaken with questionnaires, physical measurements, and collection and storage of blood samples. KSCDC is a multi-factor, multi-disease, multi-disciplinary large-scale chronic disease epidemiological study, and is also one of the largest long-term blood-based population cohort studies ever conducted in the world. It is worth mentioning that all gene specimens are kept in China, and all associated

Characteristics of fatal abusive head trauma among children in the USA: 2003-2007: an application of the CDC operational case definition to national vital statistics data.

Science.gov (United States)

Parks, Sharyn E; Kegler, Scott R; Annest, Joseph L; Mercy, James A

2012-06-01

In March of 2008, an expert panel was convened at the Centers for Disease Control and Prevention to develop code-based case definitions for abusive head trauma (AHT) in children under 5 years of age based on the International Classification of Diseases, 10th Revision (ICD-10) nature and cause of injury codes. This study presents the operational case definition and applies it to US death data. National Center for Health Statistics National Vital Statistics System data on multiple cause-of-death from 2003 to 2007 were examined. Inspection of records with at least one ICD-10 injury/disease code and at least one ICD-10 cause code from the AHT case definition resulted in the identification of 780 fatal AHT cases, with 699 classified as definite/presumptive AHT and 81 classified as probable AHT. The fatal AHT rate was highest among children age definition can help to identify population subgroups at higher risk for AHT defined by year and month of death, age, sex and race/ethnicity. This type of definition may be useful for various epidemiological applications including research and surveillance. These activities can in turn inform further development of prevention activities, including educating parents about the dangers of shaking and strategies for managing infant crying.

[Multiple sclerosis epidemiological situation update: pertinence and set-up of a population based registry of new cases in Catalonia].

Science.gov (United States)

Otero, S; Batlle, J; Bonaventura, I; Brieva, Ll; Bufill, E; Cano, A; Carmona, O; Escartín, A; Marco, M; Moral, E; Munteis, E; Nos, C; Pericot, I; Perkal, H; Ramió-Torrentà, Ll; Ramo-Tello, C; Saiz, A; Sastre-Garriga, J; Tintoré, M; Vaqué, J; Montalban, X

2010-05-16

The first epidemiological studies on multiple sclerosis (MS) around the world pictured a north to south latitudinal gradient that led to the first genetic and environmental pathogenic hypothesis. MS incidence seems to be increasing during the past 20 years based on recent data from prospective studies performed in Europe, America and Asia. This phenomenon could be explained by a better case ascertainment as well as a change in causal factors. The few prospective studies in our area together with the increase in the disease in other regions, justifies an epidemiological MS project in order to describe the incidence and temporal trends of MS. A prospective multicenter MS registry has been established according to the actual requirements of an epidemiological surveillance system. Case definition is based on the fulfillment of the McDonald diagnostic criteria. The registry setting is the geographical area of Cataluna (northeastern Spain), using a wide network of hospitals specialized in MS management. Recent epidemiological studies have described an increase in MS incidence. In order to contrast this finding in our area, we consider appropriate to set up a population based registry.

Epidemiology and control of schistosomiasis: present situation and priorities for further research. Scientific Working Group on Schistosomiasis.

Science.gov (United States)

1978-01-01

The article highlights specific aspects of the epidemiology of schistosomiasis where insufficient data are available on which to base appropriate control strategies. Emphasis is placed on the part that immunological techniques might play in improving the baseline epidemiological data. A study of acquired resistance to the disease is also important in relation to epidemiology and control. The clinical manifestations of the disease vary in different areas and further study of the relation between the clinical and pathological manifestations are therefore required. In relation to the intermediate host, the main priority for research concerns the definition of the location and time-patterns of transmission foci within any particular area: variations in transmission are of particular importance in relation to man-made water resources. Although chemotherapy will play an increasing role in control, its importance will depend on local conditions: coordinated and standardized trials are required of chemotherapeutic agents in different regions and in various defined groups of subjects. The effects of chemotherapy on immunity to reinfection and on immunopathology also require study. With all types of snail control-chemical, ecological, and biological-cost-effectiveness aspects are important. With chemicals, it is important to bear in mind other possible effects on the environment. In the field of water supplies and sanitation, several aspects are important in relation to schistosomiasis transmission and community involvement should be encouraged.

Chronic kidney disease of unknown etiology in agricultural communities.

Science.gov (United States)

Almaguer, Miguel; Herrera, Raúl; Orantes, Carlos M

2014-04-01

In recent years, Central America, Egypt, India and Sri Lanka have reported a high prevalence of chronic kidney disease of unknown etiology in agricultural communities, predominantly among male farmworkers. This essay examines the disease's case definitions, epidemiology (disease burden, demographics, associated risk factors) and causal hypotheses, by reviewing published findings from El Salvador, Nicaragua, Costa Rica, Sri Lanka, Egypt and India. The range of confirmed chronic kidney disease prevalence was 17.9%-21.1%. Prevalence of reduced glomerular filtration (homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved. Further etiological research is needed, plus interventions to reduce preventable risk factors.

Alzheimer disease: epidemiology, diagnostic criteria, risk factors and biomarkers.

Science.gov (United States)

Reitz, Christiane; Mayeux, Richard

2014-04-15

The global prevalence of dementia is as high as 24 million, and has been predicted to quadruple by the year 2050. In the US alone, Alzheimer disease (AD) - the most frequent cause of dementia characterized by a progressive decline in cognitive function in particular the memory domain - causes estimated health-care costs of $ 172 billion per year. Key neuropathological hallmarks of the AD brain are diffuse and neuritic extracellular amyloid plaques - often surrounded by dystrophic neurites - and intracellular neurofibrillary tangles. These pathological changes are frequently accompanied by reactive microgliosis and loss of neurons, white matter and synapses. The etiological mechanisms underlying these neuropathological changes remain unclear, but are probably caused by both environmental and genetic factors. In this review article, we provide an overview of the epidemiology of AD, review the biomarkers that may be used for risk assessment and in diagnosis, and give suggestions for future research. Copyright © 2014 Elsevier Inc. All rights reserved.

The epidemiology of endometriosis.

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Cramer, Daniel W; Missmer, Stacey A

2002-03-01

Advances in understanding the epidemiology of endometriosis have lagged behind other diseases because of methodologic problems related to disease definition and control selection. Nevertheless, a better picture of the epidemiology of endometriosis has emerged over the past few decades. Prevalence estimates of the disease in clinic populations vary from about a 4% occurrence of largely asymptomatic endometriosis found in women undergoing tubal ligation to 50% of teenagers with intractable dysmenorrhea. General population incidence during the 1970s in this country has been suggested to be 1.6 per 1000 white females aged 15-49, while a more current study based upon hospital discharges finds endometriosis as a first listed diagnosis in 1.3 per 1000 discharges in women aged 15-44. There is a clinical impression that blacks have lower rates of endometriosis and Orientals have higher rates than whites. A variety of personal risk factors for endometriosis have also been described. Women with endometriosis may be taller and thinner. Menstrual factors reported to increase risk include dysmenorrhea, early menarche, and shorter cycle lengths. There is support for the idea that lifestyle exposures that might raise or lower estrogen levels could affect risk, including a decreased risk associated with smoking and exercise and an increased risk associated with caffeine or alcohol use. These risk factors appear to be compatible with the central importance of retrograde menstruation influenced by outflow obstruction that might affect its amount, immune factors that might affect its ability to be cleared, or hormonal stimuli that might affect its growth. In this model, dysmenorrhea could be either a disease symptom or a manifestation of outflow obstruction. Nulliparity could be either a consequence of disease or a cause since nulliparous women would not have the benefit of cervical dilation associated with labor and delivery. Since there is evidence that family history is a risk

Changing spatial epidemiology of pertussis in continental USA.

Science.gov (United States)

Choisy, Marc; Rohani, Pejman

2012-11-22

Prediction and control of the geographical spread of emerging pathogens has become a central public health issue. Because these infectious diseases are by definition novel, there are few data to characterize their dynamics. One possible solution to this problem is to apply lessons learnt from analyses of historical data on familiar and epidemiologically similar pathogens. However, the portability of the spatial ecology of an infectious disease in a different epoch to other infections remains unexamined. Here, we study this issue by taking advantage of the recent re-emergence of pertussis in the United States to compare its spatial transmission dynamics throughout the 1950s with the past decade. We report 4-year waves, sweeping across the continent in the 1950s. These waves are shown to emanate from highly synchronous foci in the northwest and northeast coasts. In contrast, the recent resurgence of the disease is characterized by 5.5-year epidemics with no particular spatial structure. We interpret this to be the result of dramatic changes in patterns of human movement over the second half of the last century, together with changing age distribution of pertussis. We conclude that extrapolation regarding the spatial spread of contemporaneous pathogens based on analyses of historical incidence may be potentially very misleading.

[Epidemiological transition of mycosis diseases in sub-Saharan Africa: from surface to depth].

Science.gov (United States)

Chandenier, J; Desoubeaux, G

2015-02-01

Fungi are schematically responsible for three distinct kinds of infections: superficial mycoses, subcutaneous and deep ones. The current socio-epidemiological transition observed in sub-Saharan Africa does not actually lead to similar consequences regarding these three categories of fungal entities. For instance, it has long been known that superficial mycoses are very prevalent in tropical areas, since they are partly due to the warm climate and the promiscuity. They are mostly caused by dermatophytic fungi or Malassezia sp. (Pityriasis versicolor). Subcutaneous mycoses are rarer, and usually due to dimorphic fungi which are accidentally inoculated into the body after a skin injury or a trauma. Sometimes very spectacular, the clinical outcome is then described as chronic. Thus, chromoblastomycosis, rhinoentomophtoromycosis or mycetoma are some examples of subcutaneous mycoses which remain well-known by practitioners of endemic countries. Deep mycoses (or invasive / systemic mycoses) are defined by fungal infections of deep anatomical sites that should be normally sterile. By contrast with the other entities mentioned above, the outcome may be rapidly fatal for the patient. One of the most outstanding examples was the great increasing of cryptococcal meningitis during the HIV outbreak in the 80'. A few other similar mycoses may be feared in a near future, since they usually occur in contexts of important immunosuppression which are about to be definitely experienced in Africa: overall increase of chronic diseases like diabetes, lengthening life expectancy and its associated diseases, widespread medical practices which were only seen in advanced intensive care units, onco-haematology departments or graft centers so far. Thus, the deep mycoses will inevitably increase in Africa, as they did in all developed countries over the last two decades. The consequences will not only be limited to the clinical management as described above: the diagnostic approach is also

S3 guidelines for diagnostics and treatment of peripheral arterial occlusive disease

International Nuclear Information System (INIS)

Huppert, P.; Tacke, J.; Lawall, H.

2010-01-01

This report summarizes the most important aspects of the new German S3 guidelines for the diagnostics and treatment of peripheral arterial occlusive disease (PAOD) from March 2009. The guidelines include definitions and epidemiology of peripheral arterial occlusive disease, diagnostic methods including clinical and technical procedures as well as imaging methods, treatment by non-invasive, interventional and surgical methods and patient care during follow-up. In key messages recommendations are given which are graded corresponding to the scientific evidence concluded from the literature. (orig.) [de

Livestock associated epidemiological information profiling in New Sandwip Island (Jahajerchar of the Meghna estuary, Noakhali using participatory disease searching tool

Directory of Open Access Journals (Sweden)

SK Shaheenur Islam

2017-09-01

Conclusion: This place is potential for sheep and buffalo raising rather than cattle. The study has validated the significance of accepting participatory disease searching tool in order to capture voluntarily submitted epidemiological data towards establishing a cost effective, unique national disease surveillance system in Bangladesh. [J Adv Vet Anim Res 2017; 4(3.000: 267-273

Accuracy of Zika virus disease case definition during simultaneous Dengue and Chikungunya epidemics.

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José Ueleres Braga

Full Text Available Zika is a new disease in the American continent and its surveillance is of utmost importance, especially because of its ability to cause neurological manifestations as Guillain-Barré syndrome and serious congenital malformations through vertical transmission. The detection of suspected cases by the surveillance system depends on the case definition adopted. As the laboratory diagnosis of Zika infection still relies on the use of expensive and complex molecular techniques with low sensitivity due to a narrow window of detection, most suspected cases are not confirmed by laboratory tests, mainly reserved for pregnant women and newborns. In this context, an accurate definition of a suspected Zika case is crucial in order for the surveillance system to gauge the magnitude of an epidemic.We evaluated the accuracy of various Zika case definitions in a scenario where Dengue and Chikungunya viruses co-circulate. Signs and symptoms that best discriminated PCR confirmed Zika from other laboratory confirmed febrile or exanthematic diseases were identified to propose and test predictive models for Zika infection based on these clinical features.Our derived score prediction model had the best performance because it demonstrated the highest sensitivity and specificity, 86·6% and 78·3%, respectively. This Zika case definition also had the highest values for auROC (0·903 and R2 (0·417, and the lowest Brier score 0·096.In areas where multiple arboviruses circulate, the presence of rash with pruritus or conjunctival hyperemia, without any other general clinical manifestations such as fever, petechia or anorexia is the best Zika case definition.

Epidemiology of infectious meningitis in the State of Amazonas, Brazil

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Maria das Graças Gomes Saraiva

2015-06-01

Full Text Available INTRODUCTION: In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS: Since the 1970s, the (currently named Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS: The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV and varicella zoster virus (VZV prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS, cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS: Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.

Herd-level interpretation of test results for epidemiologic studies of animal diseases

DEFF Research Database (Denmark)

Christensen, Jette; Gardner, Ian A.

2000-01-01

Correct classification of the true status of herds is an important component of epidemiologic studies and animal disease-control programs. We review theoretical aspects of herd-level testing through consideration of test performance (herd-level sensitivity, specificity and predictive values......), the factors affecting these estimates, and available software for calculations. We present new aspects and considerations concerning the effect of precision and bias in estimation of individual-test performance on herd-test performance and suggest methods (pooled testing, targeted sampling of subpopulations...... with higher prevalence, and use of combinations of tests) to improve herd-level sensitivity when the expected within-herd prevalence is low....

Epidemiology and Anthropology: an integrated approach dealing with bio-socio-cultural aspects as strategy for the control of endemic diseases

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Constança Simões Barbosa

1998-01-01

Full Text Available The control of endemic diseases has not attained the desired level of effectiveness in spite of the use of modern efficient thecnologies. The classic interventionist approach for the control of schistosomiasis is centered on systemic control of the snail hosts combined to large scale medical treatment and is usually carried out without social preocupation due to the assisted communities. It is easy to understand the interest and the ethical compromise of public health research while producing studies in which the biological and social determinants as well as the cultural components should be considered and also encompass the historical dimensions and symbolic representations. In face of the recent political decision in favor of decentralizations of health administration to municipal level, we suggest, in the present paper, an integrated approach for the epidemiological diagnosis of an endemic situation at local level. Theoretical and methodological aspects from both, epidemiology and anthropology are discussed. Epidemiological methods can be used to detect the dependent variables (those related to the human infection and the independent variables (demographic, economic, sanitary and social. Another methodological approach of anthropological /etnographic nature can be conducted in order to make an articulation of the knowledge on the various dimensions or determinant levels of the disease. Mutual comprehension, between researchers and the people under investigation, on the dynamic transmission process would be relevant for a joint construction, at local level, of programmed actions for the control of endemic diseases. This would extend reflections on the health/disease process as a whole.

A comparison of estimated glomerular filtration rates using Cockcroft-Gault and the Chronic Kidney Disease Epidemiology Collaboration estimating equations in HIV infection

DEFF Research Database (Denmark)

Mocroft, A; Nielsen, Lene Ryom; Reiss, P

2014-01-01

The aim of this study was to determine whether the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)- or Cockcroft-Gault (CG)-based estimated glomerular filtration rates (eGFRs) performs better in the cohort setting for predicting moderate/advanced chronic kidney disease (CKD) or end...

Cachexia: common, deadly, with an urgent need for precise definition and new therapies.

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Lainscak, Mitja; Filippatos, Gerasimos S; Gheorghiade, Mihai; Fonarow, Gregg C; Anker, Stefan D

2008-06-02

Cachexia--sometimes also referred to as wasting disease, malnutrition, or hypercatabolism--has been described for centuries and has always raised ominous thoughts that "the end is near." The disease is encountered in many malignant and nonmalignant chronic, ultimately fatal, illnesses. Yet, although cachexia is a deadly syndrome, little is known about its pathophysiology, and the debate regarding its definition is ongoing. Thus, the data on epidemiology can be contested, but a few things are certain: Cachexia is associated with exceedingly high mortality once the syndrome has fully developed, irrespective of the definition we apply, and it is associated with weakness, weight loss, muscle wasting, and inflammation. It is not simply an ancillary event, and it may contribute to the death of the patient either through effects on neuroendocrine and immune defense mechanisms or through protein calorie malnutrition. The therapeutic standard of care for cachexia remains undefined to date, with a few exceptions. Among the recognized approaches, exogenous oral amino acid supplementation appears very promising. Further research efforts are needed and they are ongoing.

Remission Time after Rituximab Treatment for Autoimmune Bullous Disease: A Proposed Update Definition.

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Iranzo, Pilar; Pigem, Ramon; Giavedoni, Priscila; Alsina-Gibert, Mercè

2015-01-01

A therapeutic endpoint is a very important tool to evaluate response in clinical trials. In 2005, a consensus statement identified two late endpoints of disease activity in pemphigus: complete remission off therapy and complete remission on therapy, both definitions applying to patients without lesions for at least 2 months. The same period of time was considered for partial remission off/on therapy. These definitions were later applied to bullous pemphigoid and are considered in most studies on autoimmune bullous disease. These endpoints were established for different adjuvant agents, but at that moment, rituximab was not considered. Rituximab is known for the long duration of its effect, and in most studies relapses have been reported later than 6 months after treatment. In our opinion, time to remission after rituximab treatment should be redefined. © 2015 S. Karger AG, Basel.

The role of epigenetics in genetic and environmental epidemiology.

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Ladd-Acosta, Christine; Fallin, M Daniele

2016-02-01

Epidemiology is the branch of science that investigates the causes and distribution of disease in populations in order to provide preventative measures and promote human health. The fields of genetic and environmental epidemiology primarily seek to identify genetic and environmental risk factors for disease, respectively. Epigenetics is emerging as an important piece of molecular data to include in these studies because it can provide mechanistic insights into genetic and environmental risk factors for disease, identify potential intervention targets, provide biomarkers of exposure, illuminate gene-environment interactions and help localize disease-relevant genomic regions. Here, we describe the importance of including epigenetics in genetic and environmental epidemiology studies, provide a conceptual framework when considering epigenetic data in population-based studies and touch upon the many challenges that lie ahead.

Child and Adolescent Mortality Across Malaysia's Epidemiological Transition: A Systematic Analysis of Global Burden of Disease Data.

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Abdul-Razak, Suraya; Azzopardi, Peter S; Patton, George C; Mokdad, Ali H; Sawyer, Susan M

2017-10-01

A rapid epidemiological transition in developing countries in Southeast Asia has been accompanied by major shifts in the health status of children and adolescents. In this article, mortality estimates in Malaysian children and adolescents from 1990 to 2013 are used to illustrate these changes. All-cause and cause-specific mortality estimates were obtained from the 2013 Global Burden of Disease Study. Data were extracted from 1990 to 2013 for the developmental age range from 1 to 24 years, for both sexes. Trends in all-cause and cause-specific mortality for the major epidemiological causes were estimated. From 1990 to 2013, all-cause mortality decreased in all age groups. Reduction of all-cause mortality was greatest in 1- to 4-year-olds (2.4% per year reduction) and least in 20- to 24-year-olds (.9% per year reduction). Accordingly, in 2013, all-cause mortality was highest in 20- to 24-year-old males (129 per 100,000 per year). In 1990, the principal cause of death for 1- to 9-year boys and girls was vaccine preventable diseases. By 2013, neoplasms had become the major cause of death in 1-9 year olds of both sexes. The major cause of death in 10- to 24-year-old females was typhoid in 1990 and neoplasms in 2013, whereas the major cause of death in 10- to 24-year-old males remained road traffic injuries. The reduction in mortality across the epidemiological transition in Malaysia has been much less pronounced for adolescents than younger children. The contribution of injuries and noncommunicable diseases to adolescent mortality suggests where public health strategies should focus. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Epidemiological causality.

Science.gov (United States)

Morabia, Alfredo

2005-01-01

Epidemiological methods, which combine population thinking and group comparisons, can primarily identify causes of disease in populations. There is therefore a tension between our intuitive notion of a cause, which we want to be deterministic and invariant at the individual level, and the epidemiological notion of causes, which are invariant only at the population level. Epidemiologists have given heretofore a pragmatic solution to this tension. Causal inference in epidemiology consists in checking the logical coherence of a causality statement and determining whether what has been found grossly contradicts what we think we already know: how strong is the association? Is there a dose-response relationship? Does the cause precede the effect? Is the effect biologically plausible? Etc. This approach to causal inference can be traced back to the English philosophers David Hume and John Stuart Mill. On the other hand, the mode of establishing causality, devised by Jakob Henle and Robert Koch, which has been fruitful in bacteriology, requires that in every instance the effect invariably follows the cause (e.g., inoculation of Koch bacillus and tuberculosis). This is incompatible with epidemiological causality which has to deal with probabilistic effects (e.g., smoking and lung cancer), and is therefore invariant only for the population.

Epidemiology of whooping cough & typing of Bordetella pertussis.

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Hegerle, Nicolas; Guiso, Nicole

2013-11-01

Bordetella pertussis is a Gram-negative human-restricted bacterium that evolved from the broad-range mammalian pathogen, Bordetella bronchiseptica. It causes whooping cough or pertussis in humans, which is the most prevalent vaccine-preventable disease worldwide. The introduction of the pertussis whole-cell vaccination for young children, followed by the introduction of the pertussis acellular vaccination (along with booster vaccination) for older age groups, has affected the bacterial population and epidemiology of the disease. B. pertussis is relatively monomorphic worldwide, but nevertheless, different countries are facing different epidemiological evolutions of the disease. Although it is tempting to link vaccine-driven phenotypic and genotypic evolution of the bacterium to epidemiology, many other factors should be considered and surveillance needs to continue, in addition to studies investigating the impact of current clinical isolates on vaccine efficacy.

Global Foot-and-Mouth Disease Research Update and Gap Analysis: 2 - Epidemiology, Wildlife and Economics.

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Knight-Jones, T J D; Robinson, L; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

2016-06-01

We assessed knowledge gaps in foot-and-mouth disease (FMD) research, and in this study, we consider (i) epidemiology, (ii) wildlife and (iii) economics. The study took the form of a literature review (2011-2015) combined with research updates collected in 2014 from 33 institutes from across the world. Findings were used to identify priority areas for future FMD research. During 2011-2015, modelling studies were dominant in the broad field of epidemiology; however, continued efforts are required to develop robust models for use during outbreaks in FMD-free countries, linking epidemiologic and economics models. More guidance is needed for both the evaluation and the setting of targets for vaccine coverage, population immunity and vaccine field efficacy. Similarly, methods for seroprevalence studies need to be improved to obtain more meaningful outputs that allow comparison across studies. To inform control programmes in endemic countries, field trials assessing the effectiveness of vaccination in extensive smallholder systems should be performed to determine whether FMD can be controlled with quality vaccines in settings where implementing effective biosecurity is challenging. Studies need to go beyond measuring only vaccine effects and should extend our knowledge of the impact of FMD and increase our understanding of how to maximize farmer participation in disease control. Where wildlife reservoirs of virus exist, particularly African Buffalo, we need to better understand when and under what circumstances transmission to domestic animals occurs in order to manage this risk appropriately, considering the impact of control measures on livelihoods and wildlife. For settings where FMD eradication is unfeasible, further ground testing of commodity-based trade is recommended. A thorough review of global FMD control programmes, covering successes and failures, would be extremely valuable and could be used to guide other control programmes. © 2016 Blackwell Verlag GmbH.

[Epidemiologic findings of the etiology of psychogenic diseases].

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Franz, M; Schellberg, D; Schepank, H

1993-01-01

In an epidemiological longitudinal field study, a sample of high risk probands suffering from medium psychogenic impairment was investigated with regard to the etiological relevancy of factors influencing psychogenic disorders (psychoneuroses, character neuroses, psychosomatic and/or psychosomatic functional diseases). The study focused the question of the etiological impact of personality, life events, and social support. With theoretical reference to the psychodynamic concept of personality trained physicians and psychologists investigated 240 probands in a half standardized psychodynamic interview which included psychometric and social empiric instruments. Expert ratings and self ratings were used to assess the current psychogenic impairment. The impact of the constructs personality, critical life events, and social support on psychogenic impairment was specified in two path models. In both models psychodynamic personality variables had the highest impact on the criterium. Psychodynamically consistent, the ability to establish mature object relations and the maturity of ego functions was inversely related to the degree of psychogenic impairment, whereas an immature organisation of defense mechanisms exerted an aggravating influence on the severity of impairment. The present path analyses altogether point to a possible central etiological impact of personality and/or psychodynamic variables on the severity of psychogenic impairment.

World Health Organization definition of myocardial infarction: 2008-09 revision.

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Mendis, Shanthi; Thygesen, Kristian; Kuulasmaa, Kari; Giampaoli, Simona; Mähönen, Markku; Ngu Blackett, Kathleen; Lisheng, Liu

2011-02-01

WHO has played a leading role in the formulation and promulgation of standard criteria for the diagnosis of coronary heart disease and myocardial infarction since early 1970s. The revised definition takes into consideration the following: well-resourced settings can use the ESC/ACC/AHA/WHF definition, which has new biomarkers as a compulsory feature; in resource-constrained settings, a typical biomarker pattern cannot be made a compulsory feature as the necessary assays may not be available; the definition must also have provision for diagnosing non-fatal events with incomplete information on cardiac biomarkers and the ECG; to facilitate epidemiologic monitoring definition must recognize fatal events with incomplete or no information on cardiac biomarkers and/or ECG and/or autopsy and/or coronary angiography. Category A definition is the same as ESC/ACC/AHA/WHF definition of MI, and can be applied to settings with no resource constraints. Category B definition of MI is to be applied whenever there is incomplete information on cardiac bio-markers together with symptoms of ischaemia and the development of unequivocal pathological Q waves. Category C definition (probable MI) is to be applied when individuals with MI may not satisfy Category A or B definitions because of delayed access to medical services and/or unavailability of electrocardiography and/or laboratory assay of cardiac biomarkers. In these situations, the term probable MI should be used when there is either ECG changes suggestive of MI or incomplete information on cardiac biomarkers in a person with symptoms of ischaemia with no evidence of a non-coronary reason. This article presents the 2008-09 revision of the World Health Organization (WHO) definition of myocardial infarction (MI) developed at a WHO expert consultation.

Variations in Definitions and Outcome Measures in Gastroesophageal Reflux Disease: A Systematic Review

NARCIS (Netherlands)

Singendonk, Maartje M. J.; Brink, Anna J.; Steutel, Nina F.; van Etten-Jamaludin, Faridi S.; van Wijk, Michiel P.; Benninga, Marc A.; Tabbers, Merit M.

2017-01-01

CONTEXT: Gastroesophageal reflux (GER) is defined as GER disease (GERD) when it leads to troublesome symptoms and/or complications. We hypothesized that definitions and outcome measures in randomized controlled trials (RCTs) on pediatric GERD would be heterogeneous. OBJECTIVES: Systematically assess

A Systematic Bayesian Integration of Epidemiological and Genetic Data

Science.gov (United States)

Lau, Max S. Y.; Marion, Glenn; Streftaris, George; Gibson, Gavin

2015-01-01

Genetic sequence data on pathogens have great potential to inform inference of their transmission dynamics ultimately leading to better disease control. Where genetic change and disease transmission occur on comparable timescales additional information can be inferred via the joint analysis of such genetic sequence data and epidemiological observations based on clinical symptoms and diagnostic tests. Although recently introduced approaches represent substantial progress, for computational reasons they approximate genuine joint inference of disease dynamics and genetic change in the pathogen population, capturing partially the joint epidemiological-evolutionary dynamics. Improved methods are needed to fully integrate such genetic data with epidemiological observations, for achieving a more robust inference of the transmission tree and other key epidemiological parameters such as latent periods. Here, building on current literature, a novel Bayesian framework is proposed that infers simultaneously and explicitly the transmission tree and unobserved transmitted pathogen sequences. Our framework facilitates the use of realistic likelihood functions and enables systematic and genuine joint inference of the epidemiological-evolutionary process from partially observed outbreaks. Using simulated data it is shown that this approach is able to infer accurately joint epidemiological-evolutionary dynamics, even when pathogen sequences and epidemiological data are incomplete, and when sequences are available for only a fraction of exposures. These results also characterise and quantify the value of incomplete and partial sequence data, which has important implications for sampling design, and demonstrate the abilities of the introduced method to identify multiple clusters within an outbreak. The framework is used to analyse an outbreak of foot-and-mouth disease in the UK, enhancing current understanding of its transmission dynamics and evolutionary process. PMID:26599399

Toward a functional definition of a "rare disease" for regulatory authorities and funding agencies.

Science.gov (United States)

Clarke, Joe T R; Coyle, Doug; Evans, Gerald; Martin, Janet; Winquist, Eric

2014-12-01

The designation of a disease as "rare" is associated with some substantial benefits for companies involved in new drug development, including expedited review by regulatory authorities and relaxed criteria for reimbursement. How "rare disease" is defined therefore has major financial implications, both for pharmaceutical companies and for insurers or public drug reimbursement programs. All existing definitions are based, somewhat arbitrarily, on disease incidence or prevalence. What is proposed here is a functional definition of rare based on an assessment of the feasibility of measuring the efficacy of a new treatment in conventional randomized controlled trials, to inform regulatory authorities and funding agencies charged with assessing new therapies being considered for public funding. It involves a five-step process, involving significant negotiations between patient advocacy groups, pharmaceutical companies, physicians, and public drug reimbursement programs, designed to establish the feasibility of carrying out a randomized controlled trial with sufficient statistical power to show a clinically significant treatment effect. The steps are as follows: 1) identification of a specific disease, including appropriate genetic definition; 2) identification of clinically relevant outcomes to evaluate efficacy; 3) establishment of the inherent variability of measurements of clinically relevant outcomes; 4) calculation of the sample size required to assess the efficacy of a new treatment with acceptable statistical power; and 5) estimation of the difficulty of recruiting an adequate sample size given the estimated prevalence or incidence of the disorder in the population and the inclusion criteria to be used. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches

Science.gov (United States)

de Noya, Belkisyolé Alarcón; Díaz-Bello, Zoraida; Colmenares, Cecilia; Ruiz-Guevara, Raiza; Mauriello, Luciano; Muñoz-Calderón, Arturo; Noya, Oscar

2015-01-01

Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred in Venezuela and largest recorded outbreak at that time. Since then, 10 outbreaks (four in Caracas) with 249 cases (73.5% children) and 4% mortality have occurred. The absence of contact with the vector and of traditional cutaneous and Romana’s signs, together with a florid spectrum of clinical manifestations during the acute phase, confuse the diagnosis of orally transmitted Chagas disease with other infectious diseases. The simultaneous detection of IgG and IgM by ELISA and the search for parasites in all individuals at risk have been valuable diagnostic tools for detecting acute cases. Follow-up studies regarding the microepidemics primarily affecting children has resulted in 70% infection persistence six years after anti-parasitic treatment. Panstrongylus geniculatus has been the incriminating vector in most cases. As a food-borne disease, this entity requires epidemiological, clinical, diagnostic and therapeutic approaches that differ from those approaches used for traditional direct or cutaneous vector transmission. PMID:25946155

Definition of drug-resistant epilepsy: is it evidence based?

Science.gov (United States)

Wiebe, Samuel

2013-05-01

Clinical case definitions are the cornerstone of clinical communication and of clinical and epidemiologic research. The ramifications of establishing a case definition are extensive, including potentially large changes in epidemiologic estimates of frequency, and decisions for clinical management. Yet, defining a condition entails numerous challenges such as defining the scope and purpose, incorporating the strongest evidence base with clinical expertise, accounting for patients' values, and considering impact on care. The clinical case definition of drug-resistant epilepsy, in addition, must address what constitutes an adequate intervention for an individual drug, what are the outcomes of relevance, what period of observation is sufficient to determine success or failure, how many medications should be tried, whether seizure frequency should play a role, and what is the role of side effects and tolerability. On the other hand, the principles of evidence-based medicine (EBM) aim at providing a systematic approach to incorporating the best available evidence into the process of clinical decision for individual patients. The case definition of drug-resistant epilepsy proposed by the the International League Against Epilepsy (ILAE) in 2009 is evaluated in terms of the principles of EBM as well as the stated goals of the authors of the definition. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Clinical epidemiology.

Science.gov (United States)

Martin, S W; Bonnett, B

1987-06-01

Rational clinical practice requires deductive particularization of diagnostic findings, prognoses, and therapeutic responses from groups of animals (herds) to the individual animal (herd) under consideration This process utilizes concepts, skills, and methods of epidemiology, as they relate to the study of the distribution and determinants of health and disease in populations, and casts them in a clinical perspective.We briefly outline diagnostic strategies and introduce a measure of agreement, called kappa, between clinical diagnoses. This statistic is useful not only as a measure of diagnostic accuracy, but also as a means of quantifying and understanding disagreement between diagnosticians. It is disconcerting to many, clinicians included, that given a general deficit of data on sensitivity and specificity, the level of agreement between many clinical diagnoses is only moderate at best with kappa values of 0.3 to 0.6.Sensitivity, specificity, pretest odds, and posttest probability of disease are defined and related to the interpretation of clinical findings and ancillary diagnostic test results. An understanding of these features and how they relate to ruling-in or ruling-out a diagnosis, or minimizzing diagnostic errors will greatly enhance the diagnostic accuracy of the practitioner, and reduce the frequency of clinical disagreement. The approach of running multiple tests on every patient is not only wasteful and expensive, it is unlikely to improve the ability of the clinician to establish the correct diagnosis.We conclude with a discussion of how to decide on the best therapy, a discussion which centers on, and outlines the key features of, the well designed clinical trial. Like a diagnosis, the results from a clinical trial may not always be definitive, nonetheless it is the best available method of gleaning information about treatment efficacy.

Definition and initial validation of a Lupus Low Disease Activity State (LLDAS).

Science.gov (United States)

Franklyn, Kate; Lau, Chak Sing; Navarra, Sandra V; Louthrenoo, Worawit; Lateef, Aisha; Hamijoyo, Laniyati; Wahono, C Singgih; Chen, Shun Le; Jin, Ou; Morton, Susan; Hoi, Alberta; Huq, Molla; Nikpour, Mandana; Morand, Eric F

2016-09-01

Treating to low disease activity is routine in rheumatoid arthritis, but no comparable goal has been defined for systemic lupus erythematosus (SLE). We sought to define and validate a Lupus Low Disease Activity State (LLDAS). A consensus definition of LLDAS was generated using Delphi and nominal group techniques. Criterion validity was determined by measuring the ability of LLDAS attainment, in a single-centre SLE cohort, to predict non-accrual of irreversible organ damage, measured using the Systemic Lupus International Collaborating Clinics Damage Index (SDI). Consensus methodology led to the following definition of LLDAS: (1) SLE Disease Activity Index (SLEDAI)-2K ≤4, with no activity in major organ systems (renal, central nervous system (CNS), cardiopulmonary, vasculitis, fever) and no haemolytic anaemia or gastrointestinal activity; (2) no new lupus disease activity compared with the previous assessment; (3) a Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI physician global assessment (scale 0-3) ≤1; (4) a current prednisolone (or equivalent) dose ≤7.5 mg daily; and (5) well tolerated standard maintenance doses of immunosuppressive drugs and approved biological agents. Achievement of LLDAS was determined in 191 patients followed for a mean of 3.9 years. Patients who spent greater than 50% of their observed time in LLDAS had significantly reduced organ damage accrual compared with patients who spent less than 50% of their time in LLDAS (p=0.0007) and were significantly less likely to have an increase in SDI of ≥1 (relative risk 0.47, 95% CI 0.28 to 0.79, p=0.005). A definition of LLDAS has been generated, and preliminary validation demonstrates its attainment to be associated with improved outcomes in SLE. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies.

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Pimpin, Laura; Cortez-Pinto, Helena; Negro, Francesco; Corbould, Emily; Lazarus, Jeffrey V; Webber, Laura; Sheron, Nick

2018-05-16

The burden of liver disease in Europe continues to grow. We aimed to describe the epidemiology of liver diseases and their risk factors in European countries, and identify public health interventions that could impact on these risk factors to reduce the burden of liver disease. As part of the HEPAHEALTH project, commissioned by EASL, we extracted information on historical and current prevalence and mortality from national and international literature and databases on liver disease in 35 countries in the WHO European region, as well as historical and recent prevalence data on their main determinants; alcohol consumption, obesity and hepatitis B and C virus infections. We extracted information from peer-reviewed and grey literature to identify public health interventions targeting these risk factors. The epidemiology of liver disease is diverse and countries cluster with similar pictures, although the exact composition of diseases and the trends in risk factors which drive them is varied. Prevalence and mortality data indicate that increasing cirrhosis and liver cancer may be linked to dramatic increases in harmful alcohol consumption in Northern European countries, and viral hepatitis epidemics in Eastern and Southern European countries. Countries with historically low levels of liver disease may experience an increase in non-alcoholic fatty liver disease in the future, given the rise of obesity across the majority of European countries. Interventions exist for curbing harmful alcohol use, reducing obesity, preventing or treating viral hepatitis, and screening for liver disease at an early stage. Liver disease in Europe is a serious issue, with increasing cirrhosis and liver cancer. The public health and hepatology communities are uniquely placed to implement measures aimed at reducing their causes: harmful alcohol consumption, child and adult obesity prevalence and chronic infection with hepatitis viruses, which will in turn reduce the burden of liver disease. The

Hypertension with diabetes mellitus: significance from an epidemiological perspective for Japanese.

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Tatsumi, Yukako; Ohkubo, Takayoshi

2017-09-01

The prevalence of both hypertension and diabetes mellitus is increasing worldwide. Both diseases lead to severe complications such as cardiovascular and chronic kidney diseases, which increase the risk of death over a long period of time. Therefore, the prevention and aggravation of hypertension and diabetes mellitus are major challenges. Because few review articles have focused on the epidemiological perspective of hypertension and diabetes mellitus, we reviewed major observational studies mainly from Japan and from Western countries that have reported on the prevalence of hypertension and diabetes mellitus, the binominal risk of hypertension and diabetes mellitus, and the risk of their coexistence. Our investigation found that approximately 50% of diabetic patients had hypertension, and approximately 20% of hypertensive patients had diabetes mellitus. Those with either hypertension or diabetes mellitus had a 1.5- to 2.0-fold higher risk of having both conditions. These results were similar for both Japan and Western countries. Although comparing the results between Japan and Western countries was difficult because the risks were estimated using widely varying statistical analyses, it was revealed that the coexistence of hypertension and diabetes mellitus certainly increased the risk of complications regardless of the country. The definition, prevalence and medical treatment of hypertension and diabetes mellitus will change in the future. For early intervention based on the latest evidence to prevent severe complications, it is important to accumulate epidemiological knowledge of hypertension and diabetes mellitus and to update the evidence for both Japan and other countries.

Epidemiology of Tropical Neglected Diseases in Ecuador in the Last 20 Years

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Cartelle Gestal, Monica; Holban, Alina Maria; Escalante, Santiago; Cevallos, Marcelo

2015-01-01

Background Tropical and zoonotic diseases are major problems in developing countries like Ecuador. Poorly designed houses, the high proportion of isolated indigenous population and under developed infrastructure represent a fertile environment for vectors to proliferate. Control campaigns in Ecuador over the years have had varying success, depending on the disease and vectors targeted. Aims In our study we analyse the current situation of some neglected diseases in Ecuador and the efficiency of the control campaigns (by measuring changes in numbers of cases reported) that the Ecuadorian government has been running to limit the spread of these infectious and parasitic diseases. Results Our study reveals that Brucellosis, Chagas Disease, Rabies and Onchocerciasis have been controlled, but small outbreaks are still detected in endemic areas. Leptospirosis and Echinococcosis have been increasing steadily in recent years in Ecuador since the first records. The same increase has been reported world-wide also. Better diagnosis has resulted in a higher number of cases being identified, particularly with regard to the linking of outdoor activities and contact with farm animals as contributing vectors. Improvements in diagnosis are due to regular professional training, implementation of automatized systems, establishing diagnosis protocols and the creation of an epidemiological vigilance network that acts as soon as a case is reported. Conclusion Control campaigns performed in Ecuador have been successful in recent years, although natural phenomena limit their efficiency. Leptospirosis and Echinococcosis infections remain a growing problem in Ecuador as it is worldwide. PMID:26394405

Epidemiology of Tropical Neglected Diseases in Ecuador in the Last 20 Years.

Science.gov (United States)

Cartelle Gestal, Monica; Holban, Alina Maria; Escalante, Santiago; Cevallos, Marcelo

2015-01-01

Tropical and zoonotic diseases are major problems in developing countries like Ecuador. Poorly designed houses, the high proportion of isolated indigenous population and under developed infrastructure represent a fertile environment for vectors to proliferate. Control campaigns in Ecuador over the years have had varying success, depending on the disease and vectors targeted. In our study we analyse the current situation of some neglected diseases in Ecuador and the efficiency of the control campaigns (by measuring changes in numbers of cases reported) that the Ecuadorian government has been running to limit the spread of these infectious and parasitic diseases. Our study reveals that Brucellosis, Chagas Disease, Rabies and Onchocerciasis have been controlled, but small outbreaks are still detected in endemic areas. Leptospirosis and Echinococcosis have been increasing steadily in recent years in Ecuador since the first records. The same increase has been reported world-wide also. Better diagnosis has resulted in a higher number of cases being identified, particularly with regard to the linking of outdoor activities and contact with farm animals as contributing vectors. Improvements in diagnosis are due to regular professional training, implementation of automatized systems, establishing diagnosis protocols and the creation of an epidemiological vigilance network that acts as soon as a case is reported. Control campaigns performed in Ecuador have been successful in recent years, although natural phenomena limit their efficiency. Leptospirosis and Echinococcosis infections remain a growing problem in Ecuador as it is worldwide.

A Computable Definition of Sepsis Facilitates Screening and Performance Improvement Tracking.

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Alessi, Lauren J; Warmus, Holly R; Schaffner, Erin K; Kantawala, Sajel; Carcillo, Joseph; Rosen, Johanna; Horvat, Christopher M

2018-03-01

Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control. The performance of a screening tool was evaluated in the emergency department. During the "do" phase, a novel inpatient workflow is being piloted, which involves regular sepsis screening by nurses using the tool, and a regimented response to high risk patients. Screening tool use in the emergency department reduced time to antibiotics (Fig. 1). Of the 6,159 admissions, EHR definitions identified 1,433 (23.3%) between July and December 2016 with sepsis, of which 159 (11.1%) had septic shock. Hospital mortality for all sepsis patients was 2.2% and 15.7% for septic shock (Table 1). These findings approximate epidemiologic studies of sepsis and severe sepsis, which report a prevalence range of 0.45-8.2% and mortality range of 8.2-25% (Table 2). 1-5 . Implementation of a sepsis screening tool is associated with improved performance. The prevalence of sepsis conditions identified with electronic definitions approximates the epidemiologic landscape characterized by other point-prevalence and administrative studies, providing face validity to this approach, and proving useful for tracking performance improvement.

Chronic Respiratory Diseases in the Regions of Northern Russia: Epidemiological Distinctions in the Results of a National Population Study.

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Gambaryan, Marine H; Shalnova, Svetlana A; Deev, Alexander D; Drapkina, Oxana M

2017-07-26

The aim of the study is to investigate the epidemiological situation regarding chronic respiratory diseases in populations that inhabit different climatic-geographical regions of Russia, and to develop targeted programs for prevention of these diseases. (1) a comparative analysis of the standardized mortality data in Russia and other selected regions of the Russian North using the European standard for respiratory diseases, in a population aged 25-64; and (2) data from a randomized cross-sectional epidemiological study, with subjects from three different climatic-geographical regions of Russia. (1) the respiratory disease-related mortality rates in the majority of Russian Northern regions were much higher compared to the national average. Although death rates from chronic lower respiratory diseases were higher among the Northern regions and in the whole of Russia relative to the countries of European Union (EU), the cause of death in the populations of the Northern regions tend to be lower respiratory infections and pneumonia; and (2) despite the absence of any significant differences in the prevalence of smoking, the prevalence of chronic respiratory diseases (COPD) is significantly higher in Far North Yakutsk compared to the other two regions in this study-Chelyabinsk and Vologda. The status of hyperborean had the highest chance of a significant contribution to COPD and cardiorespiratory pathology among all other risk factors. The results revealed a need for effective targeted strategies for primary and secondary prevention of chronic respiratory diseases for the populations of the Northern regions of Russia. The revealed regional distinctions regarding the prevalence of, and mortality from, chronic respiratory diseases should be taken into consideration when designing integrated programs for chronic non-communicable disease prevention in these regions.

Universal MI definition update for cardiovascular disease.

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White, Harvey; Thygesen, Kristian; Alpert, Joseph S; Jaffe, Allan

2014-01-01

The new third universal definition of myocardial infarction (MI) is based on troponin elevation together with ischemic symptoms, ischemic ECG changes, and imaging evidence. MIs are classified into five types as to whether they are spontaneous, secondary to imbalance between coronary artery blood supply and demand, related to sudden death, or related to revascularization procedures. The definition is based on a rise and/or fall in troponin levels occurring in a clinical setting. There have been modifications over previous definitions with adding intracoronary thrombus as a criterion, adding a new type of MI type 4c, and raising the cutpoint for the diagnosis of MI related to percutaneous coronary intervention to five times the 99(th) percentile upper reference limit and requiring evidence of ischemia or angiographic complications. In clinical practice, trials, and registries, different definitions are used. There is a need for consistency with regard to the definition of MI and the universal definition should be implemented.

Review Article: The Role of Molecular Pathological Epidemiology in the Study of Neoplastic and Non-neoplastic Diseases in the Era of Precision Medicine.

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Ogino, Shuji; Nishihara, Reiko; VanderWeele, Tyler J; Wang, Molin; Nishi, Akihiro; Lochhead, Paul; Qian, Zhi Rong; Zhang, Xuehong; Wu, Kana; Nan, Hongmei; Yoshida, Kazuki; Milner, Danny A; Chan, Andrew T; Field, Alison E; Camargo, Carlos A; Williams, Michelle A; Giovannucci, Edward L

2016-07-01

Molecular pathology diagnostics to subclassify diseases based on pathogenesis are increasingly common in clinical translational medicine. Molecular pathological epidemiology (MPE) is an integrative transdisciplinary science based on the unique disease principle and the disease continuum theory. While it has been most commonly applied to research on breast, lung, and colorectal cancers, MPE can investigate etiologic heterogeneity in non-neoplastic diseases, such as cardiovascular diseases, obesity, diabetes mellitus, drug toxicity, and immunity-related and infectious diseases. This science can enhance causal inference by linking putative etiologic factors to specific molecular biomarkers as outcomes. Technological advances increasingly enable analyses of various -omics, including genomics, epigenomics, transcriptomics, proteomics, metabolomics, metagenomics, microbiome, immunomics, interactomics, etc. Challenges in MPE include sample size limitations (depending on availability of biospecimens or biomedical/radiological imaging), need for rigorous validation of molecular assays and study findings, and paucities of interdisciplinary experts, education programs, international forums, and standardized guidelines. To address these challenges, there are ongoing efforts such as multidisciplinary consortium pooling projects, the International Molecular Pathological Epidemiology Meeting Series, and the Strengthening the Reporting of Observational Studies in Epidemiology-MPE guideline project. Efforts should be made to build biorepository and biobank networks, and worldwide population-based MPE databases. These activities match with the purposes of the Big Data to Knowledge (BD2K), Genetic Associations and Mechanisms in Oncology (GAME-ON), and Precision Medicine Initiatives of the United States National Institute of Health. Given advances in biotechnology, bioinformatics, and computational/systems biology, there are wide open opportunities in MPE to contribute to public

Epidemiology of foodborne diseases: a worldwide review.

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Todd, E C

1997-01-01

Acute foodborne disease infections and intoxications are much more of a concern to governments and the food industry today than a few decades ago. Some of the factors that have led to this include the identification of new agents that have caused life-threatening conditions; the finding that traditional agents are being associated with foods that were of no concern previously: an increasing number of large outbreaks being reported; the impact of foodborne disease on children, the aging population and the immunocompromised; migrant populations demanding their traditional foods in the countries of settlement; the ease of worldwide shipment of fresh and frozen food; and the development of new food industries, including aquaculture. However, to meaningfully monitor increases or decreases in foodborne disease requires an effective surveillance system at the local, national and international levels. To date, resources have been limited for most countries and regions to do this, and our current knowledge is based, for the most part, on passive reporting mechanisms. Laboratory isolation data and reports of notifiable diseases have some value in observing timely changes in case numbers of some enteric diseases, but they usually do not indicate the reasons for these trends. Special epidemiological studies are useful for the area covered, but it is often questionable whether they can be extrapolated to other areas or countries. Outbreak investigations tell us that a certain set of circumstances led to illness and that another outbreak may occur under similar but not necessarily identical conditions. Control programmes have often been triggered by the conclusions from investigations of specific outbreaks. Unfortunately, the agent/ food combination leading to illness in many of the reported incidents were not predicted from existing databases, and no doubt foodborne agents will continue to surprise food control agencies in the foreseeable future. Nevertheless, data from around

Current epidemiology and accessibility to diet compliance in adult celiac disease Epidemiología actual y accesibilidad al seguimiento de la dieta de la enfermedad celiaca del adulto

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F. Casellas

2006-06-01

Full Text Available Background: the widespread of serologic diagnosis for celiac disease has brought about an epidemiologic shift. Little up-to-date information is available on relevant epidemiologic issues regarding diagnosis, information, and therapy. Objective: to examine forms of presentation, diagnostic difficulties, follow-up, information sources, and treatment-related issues regarding celiac disease. Method: a cross-sectional observational study using a self-completed questionnaire. Results: seventy-three adult patients were included; 15.0% of cases were diagnosed over 60 years of age. Most were non-smokers (91.8%. The rate of first-degree relatives with celiac sprue was 10.9%. The disease had a classic presentation in only 54.7% of cases. A functional gastrointestinal disorder was initially suspected in 42.4% of patients. Diet adherence is adequate, with unintentional lack of compliance in 15.5% of patients. Diet results in absent or improved symptoms in virtually all patients, but most of them consider compliance a challenge. Forty percent had difficulty finding gluten-free food, and 50.8% had problems in labelling recognition. Conclusions: celiac disease presents at any age, has a great variety of manifestations, and responds very well to gluten-free diet. It is crucial that patients be highly motivated and informed, and that they know for certain which foods and manufactured products are to be to used. Therefore, adequate control will result from coordination and cooperation regarding all resources involved, including medical care, and information provided by associations and other sources such as the Web.

New variant of Creutzfeldt-Jakob (vCJD) disease and other human prion diseases under epidemiological surveillance in Brazil

OpenAIRE

Gattás, Vera Lúcia; Lima Neto, Antonio Silva; Dimech, George Santiago; Mancini, Denise; Cantarino, Ligia Maria; Marins, José Ricardo Pio; Luna, Expedito José Albuquerque

2007-01-01

Abstract To increase the timeliness of detection of human cases of the new variant of Creutzfeldt-Jakob disease (vCJD) and to reduce the risk of transmission, the Brazilian Ministry of Health has established and standardized rules and control measures. These include the definition of criteria for suspect cases, reporting, monitoring, and control measures for illness prevention and transmission. Guidelines to be used by the team of health care staff were published and distributed to health wor...

Epidemiology: Then and Now.

Science.gov (United States)

Kuller, Lewis H

2016-03-01

Twenty-five years ago, on the 75th anniversary of the Johns Hopkins Bloomberg School of Public Health, I noted that epidemiologic research was moving away from the traditional approaches used to investigate "epidemics" and their close relationship with preventive medicine. Twenty-five years later, the role of epidemiology as an important contribution to human population research, preventive medicine, and public health is under substantial pressure because of the emphasis on "big data," phenomenology, and personalized medical therapies. Epidemiology is the study of epidemics. The primary role of epidemiology is to identify the epidemics and parameters of interest of host, agent, and environment and to generate and test hypotheses in search of causal pathways. Almost all diseases have a specific distribution in relation to time, place, and person and specific "causes" with high effect sizes. Epidemiology then uses such information to develop interventions and test (through clinical trials and natural experiments) their efficacy and effectiveness. Epidemiology is dependent on new technologies to evaluate improved measurements of host (genomics), epigenetics, identification of agents (metabolomics, proteomics), new technology to evaluate both physical and social environment, and modern methods of data collection. Epidemiology does poorly in studying anything other than epidemics and collections of numerators and denominators without specific hypotheses even with improved statistical methodologies. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Epidemiology and control of malaria and other arthropod born diseases

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F. J. López-Antuñano

1992-01-01

Full Text Available Malaria and other arthropod born diseases remain a serious public health problem affecting the lives and health of certain social groups when the two basic strategies to control fail due to : (1 the lack of effective chemoprophylaxis/chemotherapy or the rapid development of drug resistance of the infectious agents and (2 the ineffectiveness of pesticides or the arthropod vectors develop resistance to them. These situations enhances the need for the design and implementation of other alternatives for sustainable health programmes. The application of the epidemiological methods is essential not only for analyzing the relevant data for the understanding of the biological characteristics of the infectious agents, their reservoirs and vectors and the methods for their control, but also for the assessment of the human behaviour, the environmental, social and economic factors involved in disease transmission and the capacity of the health systems to implement interventions for both changes in human behaviour and environmental management to purpose guaranteed prevention and control of malaria and other arthropod born diseases with efficiency, efficacy and equity. This paper discuss the evolution of the malaria arthropod diseases programmes in the American Region and the perspectives for their integration into health promotion programs and emphasis is made in the need to establish solid basis in the decision-making process for the selection of intervention strategies to remove the risk factors determining the probability to get sick or die from ABDs. The implications of the general planning and the polices to be adopted in an area should be analyzed in the light of programme feasibility at the local level, in the multisectoral context specific social groups and taking in consideration the principles of stratification and equity

Clinical and epidemiological features of typhoid fever in Pemba, Zanzibar: assessment of the performance of the WHO case definitions.

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Thriemer, Kamala; Ley, Benedikt; Ley, Benedikt B; Ame, Shaali S; Deen, Jaqueline L; Pak, Gi Deok; Chang, Na Yoon; Hashim, Ramadhan; Schmied, Wolfgang Hellmut; Busch, Clara Jana-Lui; Nixon, Shanette; Morrissey, Anne; Puri, Mahesh K; Ochiai, R Leon; Wierzba, Thomas; Clemens, John D; Ali, Mohammad; Jiddawi, Mohammad S; von Seidlein, Lorenz; Ali, Said M

2012-01-01

The gold standard for diagnosis of typhoid fever is blood culture (BC). Because blood culture is often not available in impoverished settings it would be helpful to have alternative diagnostic approaches. We therefore investigated the usefulness of clinical signs, WHO case definition and Widal test for the diagnosis of typhoid fever. Participants with a body temperature ≥37.5°C or a history of fever were enrolled over 17 to 22 months in three hospitals on Pemba Island, Tanzania. Clinical signs and symptoms of participants upon presentation as well as blood and serum for BC and Widal testing were collected. Clinical signs and symptoms of typhoid fever cases were compared to other cases of invasive bacterial diseases and BC negative participants. The relationship of typhoid fever cases with rainfall, temperature, and religious festivals was explored. The performance of the WHO case definitions for suspected and probable typhoid fever and a local cut off titre for the Widal test was assessed. 79 of 2209 participants had invasive bacterial disease. 46 isolates were identified as typhoid fever. Apart from a longer duration of fever prior to admission clinical signs and symptoms were not significantly different among patients with typhoid fever than from other febrile patients. We did not detect any significant seasonal patterns nor correlation with rainfall or festivals. The sensitivity and specificity of the WHO case definition for suspected and probable typhoid fever were 82.6% and 41.3% and 36.3 and 99.7% respectively. Sensitivity and specificity of the Widal test was 47.8% and 99.4 both forfor O-agglutinin and H- agglutinin at a cut-off titre of 1:80. Typhoid fever prevalence rates on Pemba are high and its clinical signs and symptoms are non-specific. The sensitivity of the Widal test is low and the WHO case definition performed better than the Widal test.

An Ontology to Improve Transparency in Case Definition and Increase Case Finding of Infectious Intestinal Disease: Database Study in English General Practice.

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de Lusignan, Simon; Shinneman, Stacy; Yonova, Ivelina; van Vlymen, Jeremy; Elliot, Alex J; Bolton, Frederick; Smith, Gillian E; O'Brien, Sarah

2017-09-28

Infectious intestinal disease (IID) has considerable health impact; there are 2 billion cases worldwide resulting in 1 million deaths and 78.7 million disability-adjusted life years lost. Reported IID incidence rates vary and this is partly because terms such as "diarrheal disease" and "acute infectious gastroenteritis" are used interchangeably. Ontologies provide a method of transparently comparing case definitions and disease incidence rates. This study sought to show how differences in case definition in part account for variation in incidence estimates for IID and how an ontological approach provides greater transparency to IID case finding. We compared three IID case definitions: (1) Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) definition based on mapping to the Ninth International Classification of Disease (ICD-9), (2) newer ICD-10 definition, and (3) ontological case definition. We calculated incidence rates and examined the contribution of four supporting concepts related to IID: symptoms, investigations, process of care (eg, notification to public health authorities), and therapies. We created a formal ontology using ontology Web language. The ontological approach identified 5712 more cases of IID than the ICD-10 definition and 4482 more than the RCGP RSC definition from an initial cohort of 1,120,490. Weekly incidence using the ontological definition was 17.93/100,000 (95% CI 15.63-20.41), whereas for the ICD-10 definition the rate was 8.13/100,000 (95% CI 6.70-9.87), and for the RSC definition the rate was 10.24/100,000 (95% CI 8.55-12.12). Codes from the four supporting concepts were generally consistent across our three IID case definitions: 37.38% (3905/10,448) (95% CI 36.16-38.5) for the ontological definition, 38.33% (2287/5966) (95% CI 36.79-39.93) for the RSC definition, and 40.82% (1933/4736) (95% CI 39.03-42.66) for the ICD-10 definition. The proportion of laboratory results associated with a positive test

Epidemiology: past, present and future.

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Kesteloot, H

2004-01-01

Epidemiology in the past was concerned essentially by the study of infectious diseases which were the cause of huge mortalities especially since urbanisation was initiated. Epidemics of pest, typhus, cholera, influenza a.o. were common. The epidemics were halted by better hygiene, vaccination and antibiotics. Since the second world war epidemiology was dominated by an "epidemic" of new chronic diseases, especially heart disease and cancer. This was due to an increase in life span and to an increase in smoking habits and in the intake of saturated fat and a too small intake of fruit and vegetables combined with a too high intake of salt (NaCl). Gradually epidemiology evolved as the study of the causes, the distribution, the risk factors and the prevention of chronic diseases, but also including accidents, suicide, depression a.o., diseases with a mass occurrence at the population level. The importance of nutrition as a determinant of health gradually became recognized, but remains undervalued by the medical profession. Mortality at the population level follows some simple mathematical laws and can be represented accurately (r2>0.99) between the ages of 35 and 84 year by either Gompertz equations (ln mortality versus age) or by a polynomial equation (ln mortality versus age, age2). This is valid for all populations and both sexes and remains valid at times of great and rapid changes in mortality. This shows that measures for prevention should be directed towards the total population. The future of epidemiology should be directed towards the slowing of the ageing process at the population level by a healthy life style consisting of: not smoking, avoiding obesity, a fair amount of physical activity and a healthy nutrition i.e little salt, little saturated fat, an adequate amount of omega-3 fatty acids and a large amount of fruit and vegetables, with an occasional glass of red wine. This contains the secret of a long and healthy life. Conceptually it will be important

The Current Status of the Disease Caused by Enterovirus 71 Infections: Epidemiology, Pathogenesis, Molecular Epidemiology, and Vaccine Development.

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Chang, Ping-Chin; Chen, Shou-Chien; Chen, Kow-Tong

2016-09-09

Enterovirus 71 (EV71) infections have a major public health impact in the Asia-Pacific region. We reviewed the epidemiology, pathogenesis, and molecular epidemiology of EV71 infection as well as EV71 vaccine development. Previous studies were found using the search terms "enterovirus 71" and "epidemiology" or "pathogenesis" or "molecular epidemiology" or "vaccine" in Medline and PubMed. Articles that were not published in the English language, manuscripts without an abstract, and opinion articles were excluded from the review. The reported epidemiology of cases caused by EV71 infection varied from country to country; seasonal variations in incidence were observed. Most cases of EV71 infection that resulted in hospitalization for complications occurred in children less than five years old. The brainstem was the most likely major target of EV71 infection. The emergence of the EV71 epidemic in the Asia-Pacific region has been associated with the circulation of different genetic lineages (genotypes B3, B4, C1, C2, and C4) that appear to be undergoing rapid evolutionary changes. The relationship between the gene structure of the EV71 virus and the factors that ensure its survival, circulation, and evasion of immunity is still unknown. EV71 infection has emerged as an important global public health problem. Vaccine development, including the development of inactivated whole-virus live attenuated, subviral particles, and DNA vaccines, has been progressing.

Epidemiology of serogroup B invasive meningococcal disease in Ontario, Canada, 2000 to 2010

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Dang Vica

2012-08-01

Full Text Available Abstract Background Invasive meningococcal disease (IMD caused by serogroup B is the last major serogroup in Canada to become vaccine-preventable. The anticipated availability of vaccines targeting this serogroup prompted an assessment of the epidemiology of serogroup B disease in Ontario, Canada. Methods We retrieved information on confirmed IMD cases reported to Ontario’s reportable disease database between January 1, 2000 and December 31, 2010 and probabilistically-linked these cases to Public Health Ontario Laboratory records. Rates were calculated with denominator data obtained from Statistics Canada. We calculated a crude number needed to vaccinate using the inverse of the infant ( Results A total of 259 serogroup B IMD cases were identified in Ontario over the 11-year period. Serogroup B was the most common cause of IMD. Incidence ranged from 0.11 to 0.27/100,000/year, and fluctuated over time. Cases ranged in age from 13 days to 101 years; 21.4% occurred in infants, of which 72.7% were Conclusions Although rare, the proportion of IMD caused by serogroup B has increased and currently causes most IMD in Ontario, with infants having the highest risk of disease. Although serogroup B meningococcal vaccines are highly anticipated, our findings suggest that decisions regarding publicly funding serogroup B meningococcal vaccines will be difficult and may not be based on disease burden alone.

Determination of neuronal antibodies in suspected and definite Creutzfeldt-Jakob disease

OpenAIRE

Grau-Rivera, O.; Sánchez del Valle Díaz, Raquel; Saiz Hinajeros, Albert; Molinuevo, José L.; Bernabé, Reyes; Munteis, Elvira; Pujadas, Francesc; Salvador, Antoni; Saura, Júlia; Ugarte, Antonio; Titulaer, Maarten; Dalmau Obrador, Josep; Graus Ribas, Francesc

2014-01-01

IMPORTANCE Creutzfeldt-Jakob disease (CJD) and autoimmune encephalitis with antibodies against neuronal surface antigens (NSA-abs) may present with similar clinical features. Establishing the correct diagnosis has practical implications in the management of care for these patients. OBJECTIVE To determine the frequency of NSA-abs in the cerebrospinal fluid of patients with suspected CJD and in patients with pathologically confirmed (ie, definite) CJD. DESIGN, SETTING, AND PARTICIPANTS A mixed ...

[Cost estimation of an epidemiological surveillance network for animal diseases in Central Africa: a case study of the Chad network].

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Ouagal, M; Berkvens, D; Hendrikx, P; Fecher-Bourgeois, F; Saegerman, C

2012-12-01

In sub-Saharan Africa, most epidemiological surveillance networks for animal diseases were temporarily funded by foreign aid. It should be possible for national public funds to ensure the sustainability of such decision support tools. Taking the epidemiological surveillance network for animal diseases in Chad (REPIMAT) as an example, this study aims to estimate the network's cost by identifying the various costs and expenditures for each level of intervention. The network cost was estimated on the basis of an analysis of the operational organisation of REPIMAT, additional data collected in surveys and interviews with network field workers and a market price listing for Chad. These costs were then compared with those of other epidemiological surveillance networks in West Africa. The study results indicate that REPIMAT costs account for 3% of the State budget allocated to the Ministry of Livestock. In Chad in general, as in other West African countries, fixed costs outweigh variable costs at every level of intervention. The cost of surveillance principally depends on what is needed for surveillance at the local level (monitoring stations) and at the intermediate level (official livestock sectors and regional livestock delegations) and on the cost of the necessary equipment. In African countries, the cost of surveillance per square kilometre depends on livestock density.

[Epidemiological risk of introduction of dangerous and exotic infectious diseases on the territory of the XXII Olympic Winter Games and XI Paralympic Winter Games 2014 in Sochi].

Science.gov (United States)

Kuz'kin, B P; Ezhlova, E B; Kulichenko, A N; Maletskaia, O V; Demina, Iu V; Taran, T V; Pakskina, N D; Kharchenko, T V; Grizhebovskiĭ, G M; Savel'ev, V N; Orobeĭ, V G; Klindukhov, V P; Grechanaia, T V; Tesheva, S Ch; Brukhanova, G D

2015-01-01

To assess the epidemiological risk of introduction of serious infectious diseases in the pre-Olympic period defined list of dangerous and exotic infections and held assessment of potential danger threatening. Initial external information to assess the potential risk of skidding were reports, forecasts, posted on the official websites. The risk of skidding and epidemiological complications conditionally designated as high, moderate and minimal risk importation of measles virus-Rate was considered as high. In confirmation of the forecast for the period of the Olympic Games in Sochi have been registered about 100 cases of measles. Moderate risk of importation was determined for poliomyelitis due to wild poliovirus, Lassa fever, cholera, plague, and the minimal--for Dengue fever, yellow fever, the Middle East and respiratory syndrome, diseases caused by viruses Marburg and Ebola. Based on of analysis of previous Olympic Games and subsequent co-events related to the activity of the infectious diseases in the world, mate-cluded that even a slight risk of importation of infectious diseases requires maximum alertness and readiness to conduct adequate epidemiological issues incorporated.

Epidemiological review of human and animal fascioliasis in Egypt.

Science.gov (United States)

Soliman, Maha F M

2008-06-01

One of the neglected food-borne-diseases in the international public health arena is fascioliasis. It is a serious infectious parasitic disease infecting humans and animals worldwide and tops all the zoonotic helminthes. Human cases are being increasingly reported from Europe, the Americas, Oceania, Africa and Asia. Hence, human fascioliasis is considered now as a zoonosis of major global and regional importance. In Egypt, animal and human fascioliasis is an endemic clinical and epidemiological health problem. Doubtless, understanding the epidemiology of the parasitic diseases and factors affecting their incidence provides the foundation upon which effective prevention and control programs should be established. This article reviews the history, life cycles, transmission, incidence, geographical distribution, and environmental and human determinants that contribute to the epidemiological picture of fascioliasis with special reference to Egypt.

Is It Time to Change the Definition of Acute Exacerbation of Chronic Obstructive Pulmornary Disease? What Do We Need to Add?

Science.gov (United States)

Montes de Oca, Maria; Laucho-Contreras, Maria Eugenia

2018-06-14

Acute exacerbations in chronic obstructive pulmonary disease (AECOPD) are associated with increased mortality, rate of hospitalization, use of healthcare resources, and have a negative impact on disease progression, quality of life and lung function of patients with chronic obstructive pulmonary disease (COPD). There is an imperative need to homogenize the definition of AECOPD because the incidence of exacerbations has a significant influence or implication on treatment decision making, particularly in pharmacotherapy and could impact the outcome or change the statistical significance of a therapeutic intervention in clinical trials. In this review, using PubMed searches, we have analyzed the weaknesses and strengths of the different used AECOPD definitions (symptom-based, healthcare-based definition or the combinations of both), as well as the findings of the studies that have assessed the relationship of different biomarkers with the diagnosis, etiology and differential diagnosis of AECOPD and the progress towards the development of a more precise definition of COPD exacerbation. Finally, we have proposed a simple definition of AECOPD, which must be validated in future clinical trials to define its accuracy and usefulness in daily practice.

Much Ado About the New Definitions of Sepsis

Directory of Open Access Journals (Sweden)

Copotoiu Sanda-Maria

2016-04-01

Full Text Available Following the publication of the new definition of sepsis (Sepsis-3, a plethora of articles have been published in medical journals. Recognizing the epidemiological importance of the previous definitions, first issued in 1992 (Sepsis-1, and subsequently revised in 2001 (Sepsis-2, the most recent opinion emphasizes the failure “to provide adequate groups of patients with homogenous aetiologies, presentations and outcomes”, and blamed one of the causes “for the failure of several randomized controlled trials (RCTs, that tested the efficacy of adjuvant sepsis therapies”. This review summarizes the recent advances in sepsis definition.

A review of the epidemiologic literature on the role of environmental arsenic exposure and cardiovascular diseases

International Nuclear Information System (INIS)

Wang, C.-H.; Hsiao, C.K.; Chen, C.-L.; Hsu, L.-I; Chiou, H.-Y.; Chen, S.-Y.; Hsueh, Y.-M.; Wu, M.-M.; Chen, C.-J.

2007-01-01

Cardiovascular disease is the leading cause of mortality worldwide. Arsenic is a ubiquitous metalloid in the crust of the earth. Chronic arsenic poisoning is becoming an emerging epidemic in Asia. Epidemiological studies have shown that chronic arsenic poisoning through ingestion of arsenic-contaminated water is associated with various cardiovascular diseases in dose-response relationships. These cardiovascular disorders include carotid atherosclerosis detected by ultrasonography, impaired microcirculation, prolonged QT interval and increased QT dispersion in electrocardiography, and clinical outcomes such as hypertension, blackfoot disease (a unique peripheral vascular disease endemic in southwestern Taiwan), coronary artery disease and cerebral infarction. Chronic arsenic poisoning is an independent risk factor for cardiovascular disease. The adverse cardiovascular effects of long-term arsenic exposure may be persistent and/or irreversible. Arsenic-induced cardiovascular diseases in human population may result from the interaction among genetic, environment and nutritional factors. The major adverse cardiovascular effect of chronic arsenic poisoning has been established qualitatively and quantitatively in the high arsenic exposure areas, but the low-dose effect of arsenic on cardiovascular diseases remains to be explored. Cardiovascular death is the major cause of mortality worldwide, and a small increased risk may imply a large quantity of excess mortality

Genesis of Preeclampsia: An Epidemiological Approach

Science.gov (United States)

Salvador-Moysén, Jaime; Martínez-López, Yolanda; Ramírez-Aranda, José M.; Aguilar-Durán, Marisela; Terrones-González, Alberto

2012-01-01

There are analyzed some of the main aspects related to the causality of preeclampsia, privileging two types of models: the clinic model and the epidemiologic model, first one represented by the hypothesis of the reduced placental perfusion and the second one considering the epidemiologic findings related to the high levels of psychosocial stress and its association with preeclampsia. It is reasoned out the relevance of raising the causality of the disease from an interdisciplinary perspective, integrating the valuable information generated from both types, clinical and epidemiologic, and finally a tentative explanatory model of preeclampsia is proposed, the subclinical and sociocultural aspects that predispose and trigger the disease are emphasized making aspects to stand out: the importance of reduced placental perfusion as an indicator of individual risk, and the high levels of physiological stress, as a result of the unfavorable conditions of the psychosocial surroundings (indicator of population risk) of the pregnant women. PMID:22462008

Fertility and pregnancy: an epidemiologic perspective

National Research Council Canada - National Science Library

Wilcox, Allen J

2010-01-01

.... Weaving together history, biology, obstetrics, pediatrics, demography, infectious diseases, molecular genetics, and evolutionary biology, Allen Wilcox brings a fresh coherence to the epidemiologic...

Demography, maternal health and the epidemiology of malaria and other major infectious diseases in the rural department Tsamba-Magotsi, Ngounie Province, in central African Gabon

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R. Zoleko Manego

2017-01-01

Full Text Available Abstract Background Sub-Saharan Africa is undergoing an epidemiological transition from a predominance of infectious diseases to non-communicable and lifestyle related conditions. However, the pace of this transition and the pattern of disease epidemiology are uneven between affluent urban and rural poor populations. To address this question for a remote rural region located in the central African rainforest region of Gabon, this study was conducted to assess reasons for health care attendance and to characterize the epidemiology of malaria and other major infectious diseases for the department of Tsamba Magotsi. Methods Major causes for health care attendance were collected from local hospital records. Cross sectional population based surveys were performed for the assessment of local malaria epidemiology. Pregnant women attending antenatal care services were surveyed as a sentinel population for the characterization of chronic viral and parasitic infections in the community. Results Infectious diseases were responsible for 71% (7469 of a total of 10,580 consultations at the formal health care sector in 2010. Overall, malaria – defined by clinical syndrome – remained the most frequent cause for health care attendance. A cross sectional malaria survey in 840 asymptomatic individuals residing in Tsamba Magotsi resulted in a Plasmodium spp. infection prevalence of 37%. The infection rate in 2–10 year old asymptomatic children – a standard measure for malaria endemicity – was 46% (100 of 217 with P. falciparum as predominant species (79%. Infection with other plasmodial species (P. ovale and P. malariae presented most commonly as coinfections (23.2%. Prevalence of HIV, HBV, and syphilis were 6.2, 7.3, and 2.5%, respectively, in cross-sectional assessments of antenatal care visits of pregnant women. Urogenital schistosomiasis and the filarial pathogens Loa loa and Mansonella perstans are highly prevalent chronic parasitic infections

Clinical and epidemiological aspects of feline leishmaniasis in Brazil

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Luiz da Silveira Neto

2015-06-01

Full Text Available Tegumentary and visceral leishmaniasis are severe and unfortunately common parasitic diseases in Brazil. Among domestic animals, dogs are considered the main urban reservoir of the protozoan parasites, however, there is evidence that infected cats can also contribute towards the disease pool. The number of cats diagnosed with leishmaniasis has greatly increased in the last few years, highlighting the importance of thorough investigations on the role of the cat in the epidemiological cycle of the disease and in public health related issues. The main clinical manifestations of leishmaniasis suffered by cats, even when infected with Leishmania chagasi, a viscerotropic species, are skin abnormalities, which can be confounded with multiple other diseases. Indirect ELISA should be used as a screening test in epidemiological investigations for being a sensitive technique, followed by more specific laboratory tests. The standardization and validation of rapid, economical and reproducible diagnostic methods, to be employed in epidemiological surveillance, are still required

Epidemiology of Epidemic Ebola Virus Disease in Conakry and Surrounding Prefectures, Guinea, 2014-2015.

Science.gov (United States)

Rico, Adriana; Brody, Debra; Coronado, Fátima; Rondy, Marc; Fiebig, Lena; Carcelen, Andrea; Deyde, Varough M; Mesfin, Samuel; Retzer, Kyla D; Bilivogui, Pepe; Keita, Sakoba; Dahl, Benjamin A

2016-02-01

In 2014, Ebola virus disease (EVD) in West Africa was first reported during March in 3 southeastern prefectures in Guinea; from there, the disease rapidly spread across West Africa. We describe the epidemiology of EVD cases reported in Guinea's capital, Conakry, and 4 surrounding prefectures (Coyah, Dubreka, Forecariah, and Kindia), encompassing a full year of the epidemic. A total of 1,355 EVD cases, representing ≈40% of cases reported in Guinea, originated from these areas. Overall, Forecariah had the highest cumulative incidence (4× higher than that in Conakry). Case-fatality percentage ranged from 40% in Conakry to 60% in Kindia. Cumulative incidence was slightly higher among male than female residents, although incidences by prefecture and commune differed by sex. Over the course of the year, Conakry and neighboring prefectures became the EVD epicenter in Guinea.

Recent advances and perspectives in molecular epidemiology of Taenia solium cysticercosis.

Science.gov (United States)

Ito, Akira; Yanagida, Tetsuya; Nakao, Minoru

2016-06-01

Cysticercosis caused by accidental ingestion of eggs of Taenia solium is spreading all over the world through globalization and is one of the most neglected, neglected tropical diseases (NTDs) or neglected zoonotic diseases (NZDs). In the present study, the reason why T. solium cysticercosis has been neglected is discussed at first, and followed with an overview on the most recent advances and perspectives in molecular approaches for epidemiology of T. solium taeniasis/cysticercosis, since although taeniasis does not constitute recognized zoonoses, transmission and complete development are dependent on human definitive hosts. Main topics are discussions on (1) the two, Asian and Afro/American, genotypes of T. solium, (2) comparative analysis of mitochondrial (haploid) and nuclear (diploid) genes, and (3) the presence of hybrids of these two genotypes which indicates out-crossing of two genotypes in hermaphrodite tapeworms in Madagascar. Additional topics are on (4) the usefulness of phylogeographic analyses to discuss where the infection was acquired from, and (5) miscellaneous unsolved topics around these genetic diversity of T. solium. Copyright © 2015 Elsevier B.V. All rights reserved.

COELIAC DISEASE IN CENTRAL AND SOUTH AMERICA: time for a concerted approach to its epidemiology

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Affifa FARRUKH

2015-06-01

Full Text Available Central and South America offer an opportunity to resolve some of the current controversies that surround the epidemiology of celiac disease. Through a concerted action which brings together clinicians, researchers and patients there is an opportunity to establish robust data sets which will allow detailed analysis of environmental and genetic factors. In this review available data from the continent together with data from Spain and Italy are drawn together to give a current picture in the hope that it will stimulate further research.

Mathematical epidemiology

CERN Document Server

Driessche, Pauline; Wu, Jianhong

2008-01-01

Based on lecture notes of two summer schools with a mixed audience from mathematical sciences, epidemiology and public health, this volume offers a comprehensive introduction to basic ideas and techniques in modeling infectious diseases, for the comparison of strategies to plan for an anticipated epidemic or pandemic, and to deal with a disease outbreak in real time. It covers detailed case studies for diseases including pandemic influenza, West Nile virus, and childhood diseases. Models for other diseases including Severe Acute Respiratory Syndrome, fox rabies, and sexually transmitted infections are included as applications. Its chapters are coherent and complementary independent units. In order to accustom students to look at the current literature and to experience different perspectives, no attempt has been made to achieve united writing style or unified notation. Notes on some mathematical background (calculus, matrix algebra, differential equations, and probability) have been prepared and may be downlo...

MICROBIOLOGICAL MONITORING OF YERSINIA AS THE BASIS OF SANITARY AND EPIDEMIOLOGICAL SURVELLANCE OF YERSINIOSIS IN ORGANIZED GROUРS

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A. L. Panin

2013-01-01

Full Text Available Abstract. Practical decision of infectology problem depends on the correct assessment of the main concepts of epidemiology and microbiology. The feasibility of attracting the attention of specialists in related disciplines to the problem of microbiological monitoring is discussed. In connection with the capabilities of highly sensitive molecular methods and mathematical modeling on the example of microbiological monitoring of Yersinia was made attempt to analyse mod- ern opportunities of bacteriology and to enter a predictive component as an important element of purposeful activity into monitoring definition. Yersiniosis are one of the most urgent infectious diseases. A variety of biological properties of Yersinia, their various epidemiological importance (Yersinia spp. enter into I, III and the IV groups of virulence, group incidence of Yersiniosis in the organized groups, mobility of genes of a virulence and change of pathogenic properties of Yersinia from strain to strain cause need of carrying out microbiological monitoring with a predictive component in new social and biological conditions. 

Epidemiological studies on syncope--a register based approach

DEFF Research Database (Denmark)

Ruwald, Martin Huth

2013-01-01

of the patients play an essential role. In epidemiology these factors have major impact on the outcome of the patients. Until recently, even the definition of syncope, differed from one study to another which has made literature reviews difficult. Traditionally the data on epidemiology of syncope has been taken......: 1) the use, validity and accuracy of the ICD-10 diagnosis of syncope R55.9 in the National Patient Registry for the use of this diagnosis in the epidemiology of syncope, 2) diagnostics used and etiology of a random selection of patients who had a discharge diagnosis of R55.9, 3) the incidence...... thesis demonstrated that the ICD-10 discharge diagnosis could reliably identify a cohort of patients admitted for syncope and that the discharge code carried a high number of unexplained cases despite use of numerous tests. The last studies showed that syncope is a common cause for hospital contact...

Measuring chronic liver disease mortality using an expanded cause of death definition and medical records in Connecticut, 2004.

Science.gov (United States)

Ly, Kathleen N; Speers, Suzanne; Klevens, R Monina; Barry, Vaughn; Vogt, Tara M

2014-10-16

Chronic liver disease (CLD) is a leading cause of death and is defined based on a specific set of underlying cause-of-death codes on death certificates. This conventional approach to measuring CLD mortality underestimates the true mortality burden because it does not consider certain CLD conditions like viral hepatitis and hepatocellular carcinoma. We measured how much the conventional CLD mortality case definition will underestimate CLD mortality and described the distribution of CLD etiologies in Connecticut. We used 2004 Connecticut death certificates to estimate CLD mortality two ways. One way used the conventional definition and the other used an expanded definition that included more conditions suggestive of CLD. We compared the number of deaths identified using this expanded definition with the number identified using the conventional definition. Medical records were reviewed to confirm CLD deaths. Connecticut had 29 314 registered deaths in 2004. Of these, 282 (1.0%) were CLD deaths identified by the conventional CLD definition while 616 (2.1%) were CLD deaths defined by the expanded definition. Medical record review confirmed that most deaths identified by the expanded definition were CLD-related (550/616); this suggested a 15.8 deaths/100 000 population mortality rate. Among deaths for which hepatitis B, hepatitis C and alcoholic liver disease were identified during medical record review, only 8.6%, 45.4% and 36.5%, respectively, had that specific cause-of-death code cited on the death certificate. An expanded CLD mortality case definition that incorporates multiple causes of death and additional CLD-related conditions will better estimate CLD mortality. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Extended Spectrum Beta-lactamases: Definition, Classification and Epidemiology.

Science.gov (United States)

Ghafourian, Sobhan; Sadeghifard, Nourkhoda; Soheili, Sara; Sekawi, Zamberi

2015-01-01

Extended spectrum beta-lactamases (ESBLs) are defined as enzymes produced by certain bacteria that are able to hydrolyze extended spectrum cephalosporin. They are therefore effective against beta-lactam antibiotics such as ceftazidime, ceftriaxone, cefotaxime and oxyimino-monobactam. The objective of the current review is to provide a better understanding of ESBL and the epidemiology of ESBL producing organisms which are among those responsible for antibiotic resistant strains. Globally, ESBLs are considered to be problematic, particularly in hospitalized patients. There is an increasing frequency of ESBL in different parts of the world. The high risk patients are those contaminated with ESBL producer strains as it renders treatment to be ineffective in these patients. Thus, there an immediate needs to identify EBSL and formulate strategic policy initiatives to reduce their prevalence.

Physical disease and resilient outcomes: a systematic review of resilience definitions and study methods.

Science.gov (United States)

Johnston, Marjorie C; Porteous, Terry; Crilly, Michael A; Burton, Christopher D; Elliott, Alison; Iversen, Lisa; McArdle, Karen; Murray, Alison; Phillips, Louise H; Black, Corri

2015-01-01

Findings from physical disease resilience research may be used to develop approaches to reduce the burden of disease. However, there is no consensus on the definition and measurement of resilience in the context of physical disease. The aim was to summarize the range of definitions of physical disease resilience and the approaches taken to study it in studies examining physical disease and its relationship to resilient outcomes. Electronic databases were searched from inception to March 2013 for studies in which physical disease was assessed for its association with resilient outcomes. Article screening, data extraction, and quality assessment were carried out independently by 2 reviewers, with disagreements being resolved by a third reviewer. The results were combined using a narrative technique. Of 2280 articles, 12 met the inclusion criteria. Of these studies, 1 was of high quality, 9 were of moderate quality, and 2 were low quality. The common findings were that resilience involves maintaining healthy levels of functioning following adversity and that it is a dynamic process not a personality trait. Studies either assessed resilience based on observed outcomes or via resilience measurement scales. They either considered physical disease as an adversity leading to resilience or as a variable modifying the relationship between adversity and resilience. This work begins building consensus as to the approach to take when defining and measuring physical disease resilience. Resilience should be considered as a dynamic process that varies across the life-course and across different domains, therefore the choice of a resilience measure should reflect this. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Diagnosis of Cognitive Impairment Compatible with Early Diagnosis of Alzheimer's Disease. A Bayesian Network Model based on the Analysis of Oral Definitions of Semantic Categories.

Science.gov (United States)

Guerrero, J M; Martínez-Tomás, R; Rincón, M; Peraita, H

2016-01-01

Early detection of Alzheimer's disease (AD) has become one of the principal focuses of research in medicine, particularly when the disease is incipient or even prodromic, because treatments are more effective in these stages. Lexical-semantic-conceptual deficit (LSCD) in the oral definitions of semantic categories for basic objects is an important early indicator in the evaluation of the cognitive state of patients. The objective of this research is to define an economic procedure for cognitive impairment (CI) diagnosis, which may be associated with early stages of AD, by analysing cognitive alterations affecting declarative semantic memory. Because of its low cost, it could be used for routine clinical evaluations or screenings, leading to more expensive and selective tests that confirm or rule out the disease accurately. It should necessarily be an explanatory procedure, which would allow us to study the evolution of the disease in relation to CI, the irregularities in different semantic categories, and other neurodegenerative diseases. On the basis of these requirements, we hypothesise that Bayesian networks (BNs) are the most appropriate tool for this purpose. We have developed a BN for CI diagnosis in mild and moderate AD patients by analysing the oral production of semantic features. The BN causal model represents LSCD in certain semantic categories, both of living things (dog, pine, and apple) and non-living things (chair, car, and trousers), as symptoms of CI. The model structure, the qualitative part of the model, uses domain knowledge obtained from psychology experts and epidemiological studies. Further, the model parameters, the quantitative part of the model, are learnt automatically from epidemiological studies and Peraita and Grasso's linguistic corpus of oral definitions. This corpus was prepared with an incidental sampling and included the analysis of the oral linguistic production of 81 participants (42 cognitively healthy elderly people and 39

How much, how long, what, and where: air pollution exposure assessment for epidemiologic studies of respiratory disease.

Science.gov (United States)

Brauer, Michael

2010-05-01

Epidemiology has played an important role in the understanding of air pollution as a risk factor for respiratory disease and in the evidence base for air quality standards. With the widespread availability of genetic information and increasingly sophisticated measurements of molecular markers of adverse effects, there is a need for more specific and precise assessment of exposure to maximize the potential information to be derived from epidemiologic studies. Here advances in air pollution exposure assessment and their applications to studies of respiratory disease are reviewed, with a focus on recent studies of traffic-related air pollution and asthma. Although continuous measurements of personal exposures for all study subjects for a complete study period might be considered the desired "gold standard" for exposure, this is rarely, if ever, achieved due to feasibility constraints. Given this, exposure is typically estimated using models. Recent applications of geospatial (e.g., land use regression) models to studies of respiratory disease have made possible new study designs focused on spatial variability in exposure within urban areas and have provided new insights into the potential role of traffic-related air pollution (TRAP) as a risk factor for the development of childhood asthma. Substantial uncertainty remains, however, regarding what agent(s) within TRAP might be responsible for the observed associations. Future research will require increasing the specificity of exposure assessment to identify the potential roles of individual air pollution components, to elucidate potential mechanisms, and to facilitate studies of mixtures and gene-air pollution interactions.

Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project

Energy Technology Data Exchange (ETDEWEB)

Mahomed, Nasreen [University of the Witwatersrand, Department of Radiology, Johannesburg (South Africa); University of the Witwatersrand, Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg (South Africa); Fancourt, Nicholas [Johns Hopkins Bloomberg School of Public Health, Baltimore (United States); Murdoch Children' s Research Institute, Melbourne (Australia); De Campo, John; De Campo, Margaret [Murdoch Children' s Research Institute, Melbourne (Australia); Melbourne University, Melbourne (Australia); Akano, Aliu [Department of Radiology National Hospital, Abuja (Nigeria); Medical Research Council, Gambia (South Africa); Cherian, Thomas [World Health Organization, Geneva (Switzerland); Cohen, Olivia G. [Johns Hopkins Bloomberg School of Public Health, Baltimore (United States); World Health Organization, Geneva (Switzerland); Greenberg, David [Soroka University Medical Center, Beer-Sheva (Israel); Lacey, Stephen [Murdoch Children' s Research Institute, Melbourne (Australia); Kohli, Neera [King George Medical University, Lucknow (India); Lederman, Henrique M. [Paulista School of Medicine, Hospital Sao Paulo, Sao Paulo (Brazil); Madhi, Shabir A. [University of the Witwatersrand, Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg (South Africa); University of the Witwatersrand, Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Johannesburg (South Africa); Manduku, Veronica [Kenya Medical Research Institute (KEMRI), Nairobi (Kenya); McCollum, Eric D. [Johns Hopkins School of Medicine, Eudowood Division of Pediatric Respiratory Sciences, Baltimore (United States); Johns Hopkins Bloomberg School of Public Health, Baltimore (United States); Park, Kate [Oxford University Hospitals NHS Foundation Trust, Oxford (United Kingdom); Ribo-Aristizabal, Jose Luis [Hospital Sant Joan de Deu, Barcelona (Spain); Bar-Zeev, Naor [University of Malawi, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre (Malawi); University of Liverpool, Centre for Global Vaccine Research, Liverpool (United Kingdom); O' Brien, Katherine L. [Johns Hopkins Bloomberg School of Public Health, Baltimore (United States); Mulholland, Kim [Murdoch Children' s Research Institute, Melbourne (Australia); London School of Hygiene and Tropical Medicine, London (United Kingdom)

2017-10-15

Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs. (orig.)

Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project.

Science.gov (United States)

Mahomed, Nasreen; Fancourt, Nicholas; de Campo, John; de Campo, Margaret; Akano, Aliu; Cherian, Thomas; Cohen, Olivia G; Greenberg, David; Lacey, Stephen; Kohli, Neera; Lederman, Henrique M; Madhi, Shabir A; Manduku, Veronica; McCollum, Eric D; Park, Kate; Ribo-Aristizabal, Jose Luis; Bar-Zeev, Naor; O'Brien, Katherine L; Mulholland, Kim

2017-10-01

Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs.

Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project

International Nuclear Information System (INIS)

Mahomed, Nasreen; Fancourt, Nicholas; De Campo, John; De Campo, Margaret; Akano, Aliu; Cherian, Thomas; Cohen, Olivia G.; Greenberg, David; Lacey, Stephen; Kohli, Neera; Lederman, Henrique M.; Madhi, Shabir A.; Manduku, Veronica; McCollum, Eric D.; Park, Kate; Ribo-Aristizabal, Jose Luis; Bar-Zeev, Naor; O'Brien, Katherine L.; Mulholland, Kim

2017-01-01

Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs. (orig.)

The French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort study.

Science.gov (United States)

Stengel, Bénédicte; Combe, Christian; Jacquelinet, Christian; Briançon, Serge; Fouque, Denis; Laville, Maurice; Frimat, Luc; Pascal, Christophe; Herpe, Yves-Edouard; Deleuze, Jean-François; Schanstra, Joost; Pisoni, Ron L; Robinson, Bruce M; Massy, Ziad A

2014-08-01

While much has been learned about the epidemiology and treatment of end-stage renal disease (ESRD) in the last 30 years, chronic kidney disease (CKD) before the end-stage has been less investigated. Not enough is known about factors associated with CKD progression and complications, as well as its transition to ESRD. We designed the CKD-renal epidemiology and information network (REIN) cohort to provide a research platform to address these key questions and to assess clinical practices and costs in patients with moderate or advanced CKD. A total of 46 clinic sites and 4 renal care networks participate in the cohort. A stratified selection of clinic sites yields a sample that represents a diversity of settings, e.g. geographic region, and public versus for-profit and non-for-profit private clinics. In each site, 60-90 patients with CKD are enrolled at a routine clinic visit during a 12-month enrolment phase: 3600 total, including 1800 with Stage 3 and 1800 with Stage 4 CKD. Follow-up will continue for 5 years, including after initiation of renal replacement therapy. Data will be collected from medical records at inclusion and at yearly intervals, as well as from self-administered patient questionnaires and provider-level questionnaires. Patients will also be interviewed at baseline, and at 1, 3 and 5 years. Healthcare costs will also be determined. Blood and urine samples will be collected and stored for future studies on all patients at enrolment and at study end, and at 1 and 3 years in a subsample of 1200. The CKD-REIN cohort will serve to improve our understanding of the biological, clinical and healthcare system determinants associated with CKD progression and adverse outcomes as well as of international variations in collaboration with the CKD Outcome and Practice Pattern Study (CKDopps). It will foster CKD epidemiology and outcomes research and provide evidence to improve the health and quality of life of patients with CKD and the performances of the

Methodologic assessment of radiation epidemiology studies

International Nuclear Information System (INIS)

Beebe, G.W.

1983-01-01

Epidemiologic studies of the late effects of ionizing radiation have utilized the entire spectrum of situations in which man has been exposed. These studies have provided insights into the dependence of human effects upon not only dose to target tissues but also other dimensions of exposure, host characteristics, and time following exposure. Over the past three decades studies have progressed from the mere identification of effects to their measurement. Because investigators of human effects have no control over the exposure situation, validity must be sought in the consistency of findings among independent studies and with accepted biologic principles. Because exposure may be confounded with factors that are hidden from view, bias may enter into any study of human exposure. Avoidance of bias and attainment of sufficient power to detect relationships that are real are methodologic challenges. Many methodologic issues, e.g., those associated with the definition and measurement of specific end-points, or with the selection of appropriate controls, permeate epidemiologic work in all fields. Others, especially those concerned with the measurement of exposure, the patterning of events in time after exposure, and the prediction of events beyond the scope of existing observations give radiation epidemiology its distinctive character

Behçet's disease

Directory of Open Access Journals (Sweden)

Saadoun David

2012-04-01

Full Text Available Abstract Definition of the disease Behçet disease (BD is a chronic, relapsing, multisystemic disorder characterized by mucocutaneous, ocular, vascular and central nervous system manifestations. Epidemiology BD seems to cluster along the ancient Silk Road, which extends from eastern Asia to the Mediterranean basin. European cases are often described, not exclusively in the migrant population. Clinical description The clinical spectrum includes oral and genital ulcerations, uveitis, vascular, neurological, articular, renal and gastrointestinal manifestations. Etiology The etiopathogenesis of the disease remains unknown, although genetic predisposition, environmental factors and immunological abnormalities have been implicated. Diagnostic methods Diagnosis is only based on clinical criteria. Differrential diagnosis It depends on the clinical presentation of BD, but sarcoidosis, multiple sclerosis, Crohn’s disease, Takayasu’s arteritis, polychondritis or antiphospholipid syndrome need to be considered. Management Treatment is symptomatic using steroids and immunomodulatory therapy. It is efficient depending on the rapidity of initiation, the compliance, and the duration of therapy. Prognosis The prognosis is severe due to the ocular, neurological and arterial involvement.

Histopathologic reproducibility of thyroid disease in an epidemiologic study

International Nuclear Information System (INIS)

Ron, E.; Griffel, B.; Liban, E.; Modan, B.

1986-01-01

An investigation of the long-term effects of childhood scalp irradiation demonstrated a significantly increased risk of thyroid tumors in the irradiated population. Because of the complexity of thyroid cancer diagnosis, a histopathologic slide review of 59 of the 68 patients (irradiated and nonirradiated) with thyroid disease was undertaken. The review revealed 90% agreement (kappa = +0.85, P less than 0.01) between the original and review diagnosis. Four of 27 cases previously diagnosed as malignant were reclassified as benign, yielding a cancer misdiagnosis rate of 14.8%. All four of the misdiagnosed cancers were of follicular or mixed papillary-follicular type. As a result of the histologic review, the ratio of malignant to benign tumors decreased from 2.55 to 1.75. Since disagreement in diagnosis was similar in the irradiated and nonirradiated groups, the relative risk of radiation-associated neoplasms did not change substantially. The histopathologic review shows that although there were some problems in diagnostic reproducibility, they were not statistically significant and did not alter our previous conclusions regarding radiation exposure. However, a 15% reduction in the number of malignancies might affect epidemiologic studies with an external comparison as well as geographic or temporal comparisons

Emergency general surgery: definition and estimated burden of disease.

Science.gov (United States)

Shafi, Shahid; Aboutanos, Michel B; Agarwal, Suresh; Brown, Carlos V R; Crandall, Marie; Feliciano, David V; Guillamondegui, Oscar; Haider, Adil; Inaba, Kenji; Osler, Turner M; Ross, Steven; Rozycki, Grace S; Tominaga, Gail T

2013-04-01

Acute care surgery encompasses trauma, surgical critical care, and emergency general surgery (EGS). While the first two components are well defined, the scope of EGS practice remains unclear. This article describes the work of the American Association for the Surgery of Trauma to define EGS. A total of 621 unique International Classification of Diseases-9th Rev. (ICD-9) diagnosis codes were identified using billing data (calendar year 2011) from seven large academic medical centers that practice EGS. A modified Delphi methodology was used by the American Association for the Surgery of Trauma Committee on Severity Assessment and Patient Outcomes to review these codes and achieve consensus on the definition of primary EGS diagnosis codes. National Inpatient Sample data from 2009 were used to develop a national estimate of EGS burden of disease. Several unique ICD-9 codes were identified as primary EGS diagnoses. These encompass a wide spectrum of general surgery practice, including upper and lower gastrointestinal tract, hepatobiliary and pancreatic disease, soft tissue infections, and hernias. National Inpatient Sample estimates revealed over 4 million inpatient encounters nationally in 2009 for EGS diseases. This article provides the first list of ICD-9 diagnoses codes that define the scope of EGS based on current clinical practices. These findings have wide implications for EGS workforce training, access to care, and research.

The effects of clinical, epidemiological and economic aspects of changes in classification criteria of selected rheumatic diseases

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Aleksander J. Owczarek

2014-06-01

Full Text Available The paper presents the epidemiology and socio-economic aspects of the three most common rheumatic diseases: rheumatoid arthritis (RA, systemic lupus erythematosus (SLE and scleroderma. The incidence of rheumatic diseases in a population is estimated at 4–5%. Prevalence rate for RA in Poland is 0.45% of the adult population and is similar to the rate reported in the EU (0.49%. It is estimated that the average incidence of SLE is 40–55 per 100 thousand and that the annual incidence of systemic sclerosis is 19–35 cases per million (depending on the country. Nearly 18% of all hospital admissions in Poland are associated with rheumatic diseases. The introduction of new classification criteria for rheumatoid arthritis, allowing classification of the early forms of the disease and their use in clinical practice will probably change the assessment of incidence of this disease in the population.

Pathogenesis of Helicobacter pylori-Related Gastroduodenal Diseases from Molecular Epidemiological Studies.

Science.gov (United States)

Yamaoka, Yoshio

2012-01-01

Helicobacter pylori is a major human pathogen that infects the stomach and produces inflammation that is responsible for various gastroduodenal diseases. Despite the high prevalence of H. pylori infections in Africa and South Asia, the incidence of gastric cancer in these areas is much lower than in other countries. The incidence of gastric cancer also tends to decrease from north to south in East Asia. Data from molecular epidemiological studies show that this variation in different geographic areas could be explained in part by different types of H. pylori virulence factors, especially CagA, VacA, and OipA. H. pylori infection is thought to be involved in both gastric cancer and duodenal ulcer, which are at opposite ends of the disease spectrum. This discrepancy can also be explained in part by another H. pylori factor, DupA, as well as by CagA typing (East Asian type versus Western type). H. pylori has a genome of approximately 1,600 genes; therefore, there might be other novel virulence factors. Because genome wide analyses using whole-genome sequencing technology give a broad view of the genome of H. pylori, we hope that next-generation sequencers will enable us to efficiently investigate novel virulence factors.

Pathogenesis of Helicobacter pylori-Related Gastroduodenal Diseases from Molecular Epidemiological Studies

Directory of Open Access Journals (Sweden)

Yoshio Yamaoka

2012-01-01

Full Text Available Helicobacter pylori is a major human pathogen that infects the stomach and produces inflammation that is responsible for various gastroduodenal diseases. Despite the high prevalence of H. pylori infections in Africa and South Asia, the incidence of gastric cancer in these areas is much lower than in other countries. The incidence of gastric cancer also tends to decrease from north to south in East Asia. Data from molecular epidemiological studies show that this variation in different geographic areas could be explained in part by different types of H. pylori virulence factors, especially CagA, VacA, and OipA. H. pylori infection is thought to be involved in both gastric cancer and duodenal ulcer, which are at opposite ends of the disease spectrum. This discrepancy can also be explained in part by another H. pylori factor, DupA, as well as by CagA typing (East Asian type versus Western type. H. pylori has a genome of approximately 1,600 genes; therefore, there might be other novel virulence factors. Because genome wide analyses using whole-genome sequencing technology give a broad view of the genome of H. pylori, we hope that next-generation sequencers will enable us to efficiently investigate novel virulence factors.

Epidemiological study of Paget's disease of bone in a zone of the Province of Salamanca (spain)

International Nuclear Information System (INIS)

Mironon-Canelo, J.A.; Del Pino-Montes, J.; Vicente-Arroyo, M.; Saenz-Gonzalez, M.C.

1997-01-01

Bone Paget's disease is heterogeneously distributed and several foci of high prevalence have been reported in Spain. The aim of the present work was to determine the prevalence of the disease in a zone situated in the northwestern sector of the Province of Salamanca (Spain) using a cross sectional epidemiological study. Sample choice was based on a stratified sampling according to the residence, age and sex of the inhabitants of the zone. A sampling error of 5% and a confidence level of 95% were considered; these afforded a sample of 378 units. Final choice of the subjects was based on a random pathway method. Data collection was accomplished with a personal interview using a 31-item questionnaire and analytical screening (AP and GGT). The field work was carried out over a one-year period. The data were input onto a calculation sheet for analysis and epidemiological interpretation. Finally, clinico-radiological confirmation of the cases deemed positive in the screening was accomplished. The prevalence of PBD in the zone studied is 5.7% (95% CI: 4.5-6.9). The highest percentage of patients lies within the age group between 70-79 years; most of these patients were women. The mean residence time in the zone was 66 years. According to the findings, this geographic zone has a high prevalence of PBD

[The French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort study: To better understand chronic kidney disease].

Science.gov (United States)

Stengel, Bénédicte; Combe, Christian; Jacquelinet, Christian; Briançon, Serge; Fouque, Denis; Laville, Maurice; Frimat, Luc; Pascal, Christophe; Herpe, Yves-Édouard; Morel, Pascal; Deleuze, Jean-François; Schanstra, Joost P; Pisoni, Ron L; Robinson, Bruce M; Massy, Ziad A

2016-04-01

Preserving kidney function and improving the transition from chronic kidney disease to end stage is a research and healthcare challenge. The national Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort was established to identify the determinants, biomarkers and practice patterns associated with chronic kidney disease outcomes. The study will include more than 3000 adult patients with moderate to advanced chronic kidney disease from a representative sample of 40 nephrology clinics with respect to regions and legal status, public or private. Patients are recruited during a routine visit and followed for 5 years, before and after starting renal replacement therapy. Patient-level clinical, biological, and lifestyle data are collected annually, as well as provider-level data on clinical practices, coordinated with the International Chronic Kidney Disease Outcomes and Practice Pattern Study. Blood and urine samples are stored in a biobank. Major studied outcomes include survival, patient-reported outcomes, disease progression and hospitalizations. More than 13,000 eligible patients with chronic kidney disease were identified, 60% with stage 3 and 40% with stage 4. Their median age is 72 years [interquartile range, 62-80 years], 60% are men and 38% have diabetes. By the end of December 2015, 2885 patients were included. The CKD-REIN cohort will serve to improve our understanding of chronic kidney disease and provide evidence to improve patient survival and quality of life as well as health care system performances. Copyright © 2016 Association Société de néphrologie. All rights reserved.

[Sex- and gender-sensitive research in epidemiology and medicine: how can this be achieved? Aims and first results of the network "Sex-/Gender-Sensitive Research in Epidemiology, Neurosciences and Genetics/Cancer Research"].

Science.gov (United States)

Jahn, I; Gansefort, D; Kindler-Röhrborn, A; Pfleiderer, B

2014-09-01

It is considered general knowledge among physicians and epidemiologists that biological and social aspects associated with being male or female have a strong influence on health and disease. Integrating these aspects into research is necessary to counteract the problems--including ethical problems--resulting from a different evidence basis for men and women. From January 2011 to June 2014 the Federal Ministry of Education and Research supported the network "Sex-/Gender-Sensitive Research in Epidemiology, Neuroscience and Genetics/Cancer Research" with three subprojects, which aimed to promote gender-sensitive research practices. The concepts and results are presented in this article. The subproject gathered data (literature analyses, questionnaires) and offered programs for young scientists. Experiences and results were collected and generalized, for instance, in the form of definitions of terms. 50 young scientists have taken part in the training program, identifying associations and barriers in sex-/gender-sensitive research. Among others, a working definition for "sex-/gender-sensitive research" was developed, as well as definitions for the terms "sex-specific" (for biological characteristics that are specific to men or women) and "sex-/gender-dependent" or "sex-/gender-associated" (for biological and social factors, for which the extent of occurrence differs between the sexes). The concepts realized by the network are well suited to stimulate further development and discussions. The definition of terms is an important base for a productive and high-yielding interdisciplinary collaboration.

Is the red fox (Vulpes vulpes) a competent definitive host for Taenia multiceps?

Science.gov (United States)

Varcasia, Antonio; Tamponi, Claudia; Tosciri, Gabriele; Pipia, Anna Paola; Dore, Francesco; Schuster, Rolf Karl; Kandil, Omnia Mohamed; Manunta, Maria Lucia; Scala, Antonio

2015-09-25

Shepherd and stray dogs are thought to represent the primary definitive hosts of Coenurosis by Taenia multiceps, due to their feeding habits which translate into high chances of coming into contact with infected intermediate hosts. Nonetheless, little attention has been paid to the role of the red fox (Vulpes vulpes) in the epidemiology of coenurosis. In fact a knowledge gap exists on the role played by red foxes in the epidemiology of Taenia multiceps and the capability of this parasite to produce fertile and viable eggs in this wild canid, i.e. on the occurrence of a sylvatic cycle. This study investigates the role of the red fox (Vulpes vulpes) in the epidemiology of T. multiceps and related metacestodoses. The small intestine of 63 red foxes was macroscopically examined for the presence of cestodes. Adult parasites were identified morphologically as being T. multiceps. Tapeworm eggs were counted and stored at 4 °C in physiological saline solution prior to experimental infection of four sheep and one goat. Sheep were inoculated orally on Day 0 with 3000 (sheep 1), 5000 (sheep 2 and 3) or 7000 eggs (sheep 4), while the goat was infected with 5000 eggs of T. multiceps. The animals were followed-up regularly by MRI and underwent surgical treatment between days 180 to day 240 post infection. Collected coenuri were identified using morphological and molecular methods. A total of 6.3 % of red foxes were found infected with T. multiceps and the eggs obtained from the worms were determined to have a viability of 45.4 %. Two of the challenged sheep and the goat developed disease compatible with T. multiceps. Morphometrical features of the cysts were consistent with those of T. multiceps; nucleotide amplification and sequencing of mitochondrial genes (i.e., cox1 and Nd1) from the metacestode material confirmed the identification. The present study is the first to provide evidence of the role of the red fox as a competent definitive host for T. multiceps, thus changing

European monitoring systems and data for assessing environmental and climate impacts on human infectious diseases.

Science.gov (United States)

Nichols, Gordon L; Andersson, Yvonne; Lindgren, Elisabet; Devaux, Isabelle; Semenza, Jan C

2014-04-09

Surveillance is critical to understanding the epidemiology and control of infectious diseases. The growing concern over climate and other drivers that may increase infectious disease threats to future generations has stimulated a review of the surveillance systems and environmental data sources that might be used to assess future health impacts from climate change in Europe. We present an overview of organizations, agencies and institutions that are responsible for infectious disease surveillance in Europe. We describe the surveillance systems, tracking tools, communication channels, information exchange and outputs in light of environmental and climatic drivers of infectious diseases. We discuss environmental and climatic data sets that lend themselves to epidemiological analysis. Many of the environmental data sets have a relatively uniform quality across EU Member States because they are based on satellite measurements or EU funded FP6 or FP7 projects with full EU coverage. Case-reporting systems for surveillance of infectious diseases should include clear and consistent case definitions and reporting formats that are geo-located at an appropriate resolution. This will allow linkage to environmental, social and climatic sources that will enable risk assessments, future threat evaluations, outbreak management and interventions to reduce disease burden.

Epidemiology of Alzheimer disease.

Science.gov (United States)

Mayeux, Richard; Stern, Yaakov

2012-08-01

The global prevalence of dementia has been estimated to be as high as 24 million, and is predicted to double every 20 years until at least 2040. As the population worldwide continues to age, the number of individuals at risk will also increase, particularly among the very old. Alzheimer disease is the leading cause of dementia beginning with impaired memory. The neuropathological hallmarks of Alzheimer disease include diffuse and neuritic extracellular amyloid plaques in brain that are frequently surrounded by dystrophic neurites and intraneuronal neurofibrillary tangles. The etiology of Alzheimer disease remains unclear, but it is likely to be the result of both genetic and environmental factors. In this review we discuss the prevalence and incidence rates, the established environmental risk factors, and the protective factors, and briefly review genetic variants predisposing to disease.

Basic definitions for discrete modeling of computer worms epidemics

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Pedro Guevara López

2015-01-01

Full Text Available The information technologies have evolved in such a way that communication between computers or hosts has become common, so much that the worldwide organization (governments and corporations depends on it; what could happen if these computers stop working for a long time is catastrophic. Unfortunately, networks are attacked by malware such as viruses and worms that could collapse the system. This has served as motivation for the formal study of computer worms and epidemics to develop strategies for prevention and protection; this is why in this paper, before analyzing epidemiological models, a set of formal definitions based on set theory and functions is proposed for describing 21 concepts used in the study of worms. These definitions provide a basis for future qualitative research on the behavior of computer worms, and quantitative for the study of their epidemiological models.

Molecular Epidemiology of Bovine Tuberculosis and most Common ...

African Journals Online (AJOL)

Even though tuberculosis is endemic in Nigeria, information on the epidemiology of the disease especially bovine tuberculosis is still very scanty. Variable Number of Tandem Repeat (VNTR) was carried out on 113 tissue samples to have an idea of not only the epidemiology of bovine tuberculosis but also the most common ...

Limit of probability of causation in the compensation of radiation induced malignant diseases

International Nuclear Information System (INIS)

Sun Shiquan

1989-01-01

Etiological relationship between previous radiation exposure and malignant diseases concerned could be estimated from NIH Epidemiological Tables expressed as Probability of Causation (PC). But the limit of PC in the compensation of radiation induced malignant diseases has not been decided definitely. In this paper PC calculations were made for populations of occupational exposure with typical distribution of individual doses and levels of exposure. The results show that it is feasible to choice PC ≥ 50% as a limit of compensation for leukemia and radon induced lung cancer. Some lenient limits may be taken for other radiation related solid carcinomas

WIN EPISCOPE 2.0: improved epidemiological software for veterinary medicine

NARCIS (Netherlands)

Thrusfield, M.; Ortega, C.; Blas, de I.; Noordhuizen, J.P.; Frankena, K.

2001-01-01

Recent changes in veterinary medicine have required quantitative epidemiological techniques for designing field surveys, identifying risk factors for multifactorial diseases, and assessing diagnostic tests. Several relevant techniques are brought together in the package of veterinary epidemiological

Epidemiology of Alzheimer Disease

Science.gov (United States)

Mayeux, Richard; Stern, Yaakov

2012-01-01

The global prevalence of dementia has been estimated to be as high as 24 million, and is predicted to double every 20 years until at least 2040. As the population worldwide continues to age, the number of individuals at risk will also increase, particularly among the very old. Alzheimer disease is the leading cause of dementia beginning with impaired memory. The neuropathological hallmarks of Alzheimer disease include diffuse and neuritic extracellular amyloid plaques in brain that are frequently surrounded by dystrophic neurites and intraneuronal neurofibrillary tangles. The etiology of Alzheimer disease remains unclear, but it is likely to be the result of both genetic and environmental factors. In this review we discuss the prevalence and incidence rates, the established environmental risk factors, and the protective factors, and briefly review genetic variants predisposing to disease. PMID:22908189

Incidence, risk factors and clinical epidemiology of melioidosis: a complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia

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Vijayalakshmi Natesan

2010-10-01

Full Text Available Abstract Background Melioidosis, a severe and fatal infectious disease caused by Burkholderia pseudomallei, is believed to an emerging global threat. However, data on the natural history, risk factors, and geographic epidemiology of the disease are still limited. Methods We undertook a retrospective analysis of 145 confirmed cases extracted from a hospital-based Melioidosis Registry set up from 2005 in Hospital Sultanah Bahiyah, Alor Setar, Kedah state, Malaysia, in order to provide a first description of the contemporary incidence, risk factors, and clinical epidemiology of the disease in this putatively high risk region of the country. Results The incidence of melioidosis in Alor Setar is remarkably high at 16.35 per 100,000 population per year. The mean age of patients was 50.40 years, with infection varying nonlinearly with age. Males (75.2%; P 2 = 30.57, P Conclusions Melioidosis represents a complex socio-ecological public health problem in Kedah, being strongly related with age, occupation, rainfall and predisposing chronic diseases, such as diabetes mellitus. Among cases, bacteremic patients were associated with significantly high mortality despite provision of the recommended antibacterial therapy. The burden of this disease is likely to grow in this region unless better informed interventions targeted at high-risk groups and associated diseases are urgently implemented.

Genetic epidemiology of Scheuermann's disease

DEFF Research Database (Denmark)

Damborg, Frank; Engell, Vilhelm; Nielsen, Jan

2011-01-01

The genetic/environmental etiology of Scheuermann's disease is unclear. We estimated the heritability of the disease using an etiological model adjusted for sex and time of diagnosis, and examined whether the prevalence of Scheuermann's disease was constant over time.......The genetic/environmental etiology of Scheuermann's disease is unclear. We estimated the heritability of the disease using an etiological model adjusted for sex and time of diagnosis, and examined whether the prevalence of Scheuermann's disease was constant over time....

Definition of treatment response in rheumatoid arthritis based on the simplified and the clinical disease activity index.

Science.gov (United States)

Aletaha, Daniel; Martinez-Avila, Jose; Kvien, Tore K; Smolen, Josef S

2012-07-01

The simplified disease activity index (SDAI) and the clinical disease activity index (CDAI) are established instruments to measure disease activity in rheumatoid arthritis (RA). To date, no validated response definitions for the SDAI and CDAI are available. The authors aimed to define minor, moderate and major response criteria for the SDAI. The authors used data from two clinical trials on infliximab versus methotrexate in early (ASPIRE) or established (ATTRACT) RA, and identified the three SDAI cutpoints based on the best agreement (by κ statistics) with the American College of Rheumatology (ACR)20/50/70 responses. Cutpoints were then tested for different aspects of validity in the trial datasets and in a Norwegian disease modifying antirheumatic drug prescription dataset (NOR-DMARD). Based on agreement with the ACR response, the minor, moderate and major responses were identified as SDAI 50%, 70% and 85% improvement. These cutpoints had good face validity concerning the disease activity states achieved by the different response definitions. Construct validity was shown by a clear association of increasing SDAI response categories with increasing levels of functional improvement, achievement of better functional states and lower annual radiographic progression. Across SDAI 50/70/85, the sensitivities regarding a patient-perceived improvement decreased (73%/39%/22%) and the specificities increased (61%/89%/96%) in a meaningful way. Further, the cutpoints discriminated the different treatment arms in ASPIRE and ATTRACT. The same cutpoints were used for the CDAI, with similar results in the validation analyses. These new response criteria expand the usefulness of the SDAI and CDAI for their use as endpoints in clinical trials beyond the definition of disease activity categories.

New variant of Creutzfeldt-Jakob (vCJD disease and other human prion diseases under epidemiological surveillance in Brazil

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Vera Lúcia Gattás

Full Text Available Abstract To increase the timeliness of detection of human cases of the new variant of Creutzfeldt-Jakob disease (vCJD and to reduce the risk of transmission, the Brazilian Ministry of Health has established and standardized rules and control measures. These include the definition of criteria for suspect cases, reporting, monitoring, and control measures for illness prevention and transmission. Guidelines to be used by the team of health care staff were published and distributed to health workers. A detailed proposal for a simplified system of surveillance for prion diseases was developed and mandatory reporting introduced. Additional effort is necessary to increase vCJD case detection, thus making it necessary to establish a partnership with health care services for best identification of suspected cases and dissemination of information to all involved in the service dealing with vCJD investigation.

Epidemiology and treatment of extramammary Paget disease in the Netherlands.

Science.gov (United States)

Siesling, S; Elferink, M A G; van Dijck, J A A M; Pierie, J P E N; Blokx, W A M

2007-10-01

To determine the incidence of EMPD and to describe its epidemiology, treatment, survival and the risk of developing other malignancies. All cases of EMPD, diagnosed between 1989 and 2001, were selected from the Netherlands Cancer Registry. In total, 178 cases of invasive and 48 cases of in situ EMPD had been registered. The overall relative 5-year survival for invasive tumours was 72%. Most patients with invasive as well as in situ cancer underwent surgery. Other malignancies were found in 32% of patients with invasive EMPD and 35% of patients with in situ EMPD. Patients had an increased risk of developing a second primary cancer (standardized incidence ratio: 1.7; 95% confidence interval 1.2-2.4). The most frequent localizations of the other cancers were the colorectum, the prostate, the breast and the extragenital skin. For EMPD, which is a rare disease in the Netherlands, there are no clear diagnostic and treatment guidelines. The prognosis is fairly good. A thorough search for other tumours is recommended for these patients.

Disease Definition for Schizophrenia by Functional Connectivity Using Radiomics Strategy.

Science.gov (United States)

Cui, Long-Biao; Liu, Lin; Wang, Hua-Ning; Wang, Liu-Xian; Guo, Fan; Xi, Yi-Bin; Liu, Ting-Ting; Li, Chen; Tian, Ping; Liu, Kang; Wu, Wen-Jun; Chen, Yi-Huan; Qin, Wei; Yin, Hong

2018-02-17

Specific biomarker reflecting neurobiological substrates of schizophrenia (SZ) is required for its diagnosis and treatment selection of SZ. Evidence from neuroimaging has implicated disrupted functional connectivity in the pathophysiology. We aimed to develop and validate a method of disease definition for SZ by resting-state functional connectivity using radiomics strategy. This study included 2 data sets collected with different scanners. A total of 108 first-episode SZ patients and 121 healthy controls (HCs) participated in the current study, among which 80% patients and HCs (n = 183) and 20% (n = 46) were selected for training and testing in intra-data set validation and 1 of the 2 data sets was selected for training and the other for testing in inter-data set validation, respectively. Functional connectivity was calculated for both groups, features were selected by Least Absolute Shrinkage and Selection Operator (LASSO) method, and the clinical utility of its features and the generalizability of effects across samples were assessed using machine learning by training and validating multivariate classifiers in the independent samples. We found that the accuracy of intra-data set training was 87.09% for diagnosing SZ patients by applying functional connectivity features, with a validation in the independent replication data set (accuracy = 82.61%). The inter-data set validation further confirmed the disease definition by functional connectivity features (accuracy = 83.15% for training and 80.07% for testing). Our findings demonstrate a valid radiomics approach by functional connectivity to diagnose SZ, which is helpful to facilitate objective SZ individualized diagnosis using quantitative and specific functional connectivity biomarker.

Causal diagrams in systems epidemiology

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Joffe Michael

2012-03-01

Full Text Available Abstract Methods of diagrammatic modelling have been greatly developed in the past two decades. Outside the context of infectious diseases, systematic use of diagrams in epidemiology has been mainly confined to the analysis of a single link: that between a disease outcome and its proximal determinant(s. Transmitted causes ("causes of causes" tend not to be systematically analysed. The infectious disease epidemiology modelling tradition models the human population in its environment, typically with the exposure-health relationship and the determinants of exposure being considered at individual and group/ecological levels, respectively. Some properties of the resulting systems are quite general, and are seen in unrelated contexts such as biochemical pathways. Confining analysis to a single link misses the opportunity to discover such properties. The structure of a causal diagram is derived from knowledge about how the world works, as well as from statistical evidence. A single diagram can be used to characterise a whole research area, not just a single analysis - although this depends on the degree of consistency of the causal relationships between different populations - and can therefore be used to integrate multiple datasets. Additional advantages of system-wide models include: the use of instrumental variables - now emerging as an important technique in epidemiology in the context of mendelian randomisation, but under-used in the exploitation of "natural experiments"; the explicit use of change models, which have advantages with respect to inferring causation; and in the detection and elucidation of feedback.

Causal diagrams in systems epidemiology.

Science.gov (United States)

Joffe, Michael; Gambhir, Manoj; Chadeau-Hyam, Marc; Vineis, Paolo

2012-03-19

Methods of diagrammatic modelling have been greatly developed in the past two decades. Outside the context of infectious diseases, systematic use of diagrams in epidemiology has been mainly confined to the analysis of a single link: that between a disease outcome and its proximal determinant(s). Transmitted causes ("causes of causes") tend not to be systematically analysed.The infectious disease epidemiology modelling tradition models the human population in its environment, typically with the exposure-health relationship and the determinants of exposure being considered at individual and group/ecological levels, respectively. Some properties of the resulting systems are quite general, and are seen in unrelated contexts such as biochemical pathways. Confining analysis to a single link misses the opportunity to discover such properties.The structure of a causal diagram is derived from knowledge about how the world works, as well as from statistical evidence. A single diagram can be used to characterise a whole research area, not just a single analysis - although this depends on the degree of consistency of the causal relationships between different populations - and can therefore be used to integrate multiple datasets.Additional advantages of system-wide models include: the use of instrumental variables - now emerging as an important technique in epidemiology in the context of mendelian randomisation, but under-used in the exploitation of "natural experiments"; the explicit use of change models, which have advantages with respect to inferring causation; and in the detection and elucidation of feedback.

Epidemiology of systemic mastocytosis in Denmark

DEFF Research Database (Denmark)

Cohen, Sarah; Hoffmann, Stine Skovbo; Vestergaard, Hanne

2014-01-01

Mastocytosis is a heterogeneous group of diseases characterized by abnormal proliferation of mast cells. Systemic mastocytosis (SM), in which abnormal mast cells are present in tissues beyond the skin, is divided into seven subcategories with varying degrees of severity and prognosis. Very little......%), followed by SM with subtype unknown (n = 61; 11%), SM with associated clonal haematological non-mast cell lineage disease (n = 24; 4%), aggressive SM (n = 8; 2%), and mast cell leukaemia (n = 5; 1%). The incidence rate for SM (all subtypes including urticaria pigmentosa) was 0_89 per 100 000 per year...... to be overall relatively rare with notable variation by subtype for patient characteristics, survival and epidemiological measures. Keywords: aggressive systemic mastocytosis, indolent systemic mastocytosis, urticaria pigmentosa, epidemiology, Denmark....

Tick-borne pathogen – Reversed and conventional discovery of disease

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Ellen eTijsse Klasen

2014-07-01

Full Text Available Molecular methods have increased the number of known microorganisms associated with ticks significantly. Some of these newly identified microorganisms are readily linked to human disease while others are yet unknown to cause human disease. The face of tick-borne disease discovery has changed with more diseases now being discovered in a ‘reversed way’, detecting disease cases only years after the tick-borne microorganism was first discovered. Compared to the conventional discovery of infectious diseases, this order of discoveries presents researchers with new challenges. Especially estimating public health risks of such agents is challenging, as case definitions and diagnostic procedures may initially be missing. We discuss the advantages and shortcomings of molecular methods, serology, epidemiological studies that might be used to study some fundamental questions regarding newly identified tick-borne diseases. With increased tick-exposure and improved detection methods, more tick-borne microorganisms will be added to the list of pathogens causing disease in humans in future.

Epidemiology of Epidemic Ebola Virus Disease in Conakry and Surrounding Prefectures, Guinea, 2014–2015

Science.gov (United States)

Brody, Debra; Coronado, Fátima; Rondy, Marc; Fiebig, Lena; Carcelen, Andrea; Deyde, Varough M.; Mesfin, Samuel; Retzer, Kyla D.; Bilivogui, Pepe; Keita, Sakoba; Dahl, Benjamin A.

2016-01-01

In 2014, Ebola virus disease (EVD) in West Africa was first reported during March in 3 southeastern prefectures in Guinea; from there, the disease rapidly spread across West Africa. We describe the epidemiology of EVD cases reported in Guinea’s capital, Conakry, and 4 surrounding prefectures (Coyah, Dubreka, Forecariah, and Kindia), encompassing a full year of the epidemic. A total of 1,355 EVD cases, representing ≈40% of cases reported in Guinea, originated from these areas. Overall, Forecariah had the highest cumulative incidence (4× higher than that in Conakry). Case-fatality percentage ranged from 40% in Conakry to 60% in Kindia. Cumulative incidence was slightly higher among male than female residents, although incidences by prefecture and commune differed by sex. Over the course of the year, Conakry and neighboring prefectures became the EVD epicenter in Guinea. PMID:26812047

Epidemiology of disorders and distortion of the internal picture of disease in patients with macrosocial disadjustments

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Oleg Vladimirovich Potapov

2013-01-01

Full Text Available The paper presents the results of an investigation of 569 patients with macrosocial disadjustments. The latter were diagnosed in 71.1% of the examinees from a sample of 800 people from different socially disadapted population groups (unemployed miners, police officers on 6-month business to Chechnya, and migrants. The epidemiological and syndrome characteristics and the results of examining some aspects of the internal picture of disease, such as protective mechanisms, coping strategies, and aggravational and dissimulative tendencies, are given.

Population-Based Study of the Epidemiology of Herpes Zoster in Korea

OpenAIRE

Kim, You Jeong; Lee, Chang Nam; Lim, Chi-Yeon; Jeon, Woo Seok; Park, Young Min

2014-01-01

General epidemiological data regarding herpes zoster (HZ) are necessary for treatment and prevention of this disease. In addition, epidemiological data can play an important role in evaluating the efficacy and impact of vaccination. Though several epidemiological studies of HZ in Korea have been conducted, they usually depend on hospital-based data and may not be representative of HZ characteristics all over Korea. The purpose of this study was to evaluate the incidence and other epidemiologi...

Incidence, epidemiology and clinical features of Kawasaki disease in Catalonia, Spain.

Science.gov (United States)

Sánchez-Manubens, Judith; Antón, Jordi; Bou, Rosa; Iglesias, Estíbaliz; Calzada-Hernandez, Joan

2016-01-01

To assess the incidence, epidemiology and clinical features of Kawasaki disease (KD) in Catalonia (northeast region of Spain). This was an observational population-based study including all Paediatric Units in Catalonia, under both public and private management. Retrospective data retrieval was performed for 10 years (2004-2013). A 12-month (March 2013 to March 2014) prospective collection of new cases of KD was carried out to determine the incidence of KD. Data from 399 patients over the 10-year study period was analysed, revealing that 233 (58.4%) had complete KD, 159 (39.8) incomplete KD and 7 (1.7%) were considered atypical KD. Mean annual incidence was 3.5/105 children 10(th) day of illness, ages 8 yo and the presence of sterile piuria, aseptic meningitis, abdominal pain and uveitis at diagnosis were found to have higher risk of coronary aneurisms (CAA) (pIncidence, clinical features and treatment plans in our cohort are similar to those described in other European studies.

Panel 1: Epidemiology and Diagnosis.

Science.gov (United States)

Homøe, Preben; Kværner, Kari; Casey, Janet R; Damoiseaux, Roger A M J; van Dongen, Thijs M A; Gunasekera, Hasantha; Jensen, Ramon G; Kvestad, Ellen; Morris, Peter S; Weinreich, Heather M

2017-04-01

Objective To create a literature review between 2011 and June 1, 2015, on advances in otitis media (OM) epidemiology and diagnosis (including relevant audiology studies). Data Sources Electronic search engines (PubMed, EMBASE, and Cochrane Library) with a predefined search strategy. Review Methods Articles with appropriate epidemiologic methodology for OM, including acute mastoiditis and eustachian tube dysfunction. Items included OM worldwide and in high-risk populations, OM-related hearing loss, news in OM diagnostics, prenatal risk factors and comorbidities, postnatal risk factors, genetics, microbiological epidemiology, guidelines, and quality of life. Conclusions Diagnostic evidence and genetic studies are increasing; guidelines are introduced worldwide; and there is evidence of benefit of pneumococcal conjugate vaccines. New risk factors and comordities are identified in the study period, and quality of life is affected in children and their families. Implications for Practice Chronic suppurative OM occurs worldwide and contributes to lifelong hearing loss. Uniform definitions are still lacking and should be provided. An association between HIV and chronic suppurative OM has been found. Tympanometry is recommended for diagnosis, with or without pneumatic otoscopy. Video otoscopy, algorithms, and validated questionnaires may assist clinicians. Childhood obesity is associated with OM. Heritability accounts for 20% to 50% of OM diagnoses. OM-prone children seem to produce weaker immunologic responses to pneumococcal conjugate vaccines. Clinicians tend to individualize treatment without adhering to guidelines.

Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data

NARCIS (Netherlands)

Waldinger, Marcel D.; Zwinderman, Aeilko H.; Olivier, Berend; Schweitzer, Dave H.

2005-01-01

Introduction. Consensus on a definition of premature ejaculation has not yet been reached because of debates based on subjective authority opinions and nonstandardized assessment methods to measure ejaculation time and ejaculation control. Aim. To provide a definition for lifelong premature

Epidemiology of chlamydial infection and disease in a free-ranging koala (Phascolarctos cinereus population.

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Sharon Nyari

Full Text Available Chlamydial disease continues to be one of the main factors threatening the long-term survival of the koala (Phascolarctos cinereus. Despite this, large epidemiological studies of chlamydial infection and disease in wild koala populations are lacking. A better understanding of the prevalence, transmission and pathogenesis is needed to improve control measures, such as the development of vaccines. We investigated the prevalence of Chlamydia pecorum infection and disease in 160 koalas in a peri-urban wild population in Queensland, Australia and found that 31% of koalas were Chlamydia PCR positive and 28% had clinically detectable chlamydial disease. Most infections were at the urogenital site (27%; both males and females with only 14% at the ocular site. Interestingly, we found that 27% (4/15 of koalas considered to be sexually immature (9-13 months were already infected with C. pecorum, suggesting that a significant percentage of animals are infected directly from their mother. Ocular infection levels were less prevalent with increasing age (8% in koalas older than 4 years, whereas the prevalence of urogenital tract infections remained high into older age (26% in koalas older than 4 years, suggesting that, after mother-to-young transmission, C. pecorum is predominantly a sexually transmitted infection. While 28% of koalas in this population had clinically detectable chlamydial disease (primarily urogenital tract disease, many PCR positive koalas had no detectable disease and importantly, not all diseased animals were PCR positive. We also observed higher chlamydial loads in koalas who were C. pecorum infected without clinical disease than in koalas who were C. pecorum infected with clinical disease. These results shed light on the potential mechanisms of transmission of C. pecorum in koalas and also guide future control measures, such as vaccination.

Epidemiology of chlamydial infection and disease in a free-ranging koala (Phascolarctos cinereus) population.

Science.gov (United States)

Nyari, Sharon; Waugh, Courtney A; Dong, Jianbao; Quigley, Bonnie L; Hanger, Jonathan; Loader, Joanne; Polkinghorne, Adam; Timms, Peter

2017-01-01

Chlamydial disease continues to be one of the main factors threatening the long-term survival of the koala (Phascolarctos cinereus). Despite this, large epidemiological studies of chlamydial infection and disease in wild koala populations are lacking. A better understanding of the prevalence, transmission and pathogenesis is needed to improve control measures, such as the development of vaccines. We investigated the prevalence of Chlamydia pecorum infection and disease in 160 koalas in a peri-urban wild population in Queensland, Australia and found that 31% of koalas were Chlamydia PCR positive and 28% had clinically detectable chlamydial disease. Most infections were at the urogenital site (27%; both males and females) with only 14% at the ocular site. Interestingly, we found that 27% (4/15) of koalas considered to be sexually immature (9-13 months) were already infected with C. pecorum, suggesting that a significant percentage of animals are infected directly from their mother. Ocular infection levels were less prevalent with increasing age (8% in koalas older than 4 years), whereas the prevalence of urogenital tract infections remained high into older age (26% in koalas older than 4 years), suggesting that, after mother-to-young transmission, C. pecorum is predominantly a sexually transmitted infection. While 28% of koalas in this population had clinically detectable chlamydial disease (primarily urogenital tract disease), many PCR positive koalas had no detectable disease and importantly, not all diseased animals were PCR positive. We also observed higher chlamydial loads in koalas who were C. pecorum infected without clinical disease than in koalas who were C. pecorum infected with clinical disease. These results shed light on the potential mechanisms of transmission of C. pecorum in koalas and also guide future control measures, such as vaccination.

TFOS DEWS II Epidemiology Report

NARCIS (Netherlands)

Stapleton, Fiona; Alves, Monica; Bunya, Vatinee Y.; Jalbert, Isabelle; Lekhanont, Kaevalin; Malet, Florence; Na, Kyung-Sun; Schaumberg, Debra; Uchino, Miki; Vehof, Jelle; Viso, Eloy; Vitale, Susan; Jones, Lyndon

The subcommittee reviewed the prevalence, incidence, risk factors, natural history, morbidity and questionnaires reported in epidemiological studies of dry eye disease (DED). A meta-analysis of published prevalence data estimated the impact of age and sex. Global mapping of prevalence was

Cardiovascular magnetic resonance in pericardial diseases

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Francone Marco

2009-05-01

Full Text Available Abstract The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the epidemiology of constrictive pericarditis has been noted. Accurate decision making is crucial taking into account the significant morbidity and mortality caused by complicated pericardial diseases, and the potential benefit of therapeutic interventions. Imaging herein has an important role, and cardiovascular magnetic resonance (CMR is definitely one of the most versatile modalities to study the pericardium. It fuses excellent anatomic detail and tissue characterization with accurate evaluation of cardiac function and assessment of the haemodynamic consequences of pericardial constraint on cardiac filling. This review focuses on the current state of knowledge how CMR can be used to study the most common pericardial diseases.

Implications of host genetic variation on the risk and prevalence of infectious diseases transmitted through the environment.

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Doeschl-Wilson, Andrea B; Davidson, R; Conington, J; Roughsedge, T; Hutchings, M R; Villanueva, B

2011-07-01

Previous studies have shown that host genetic heterogeneity in the response to infectious challenge can affect the emergence risk and the severity of diseases transmitted through direct contact between individuals. However, there is substantial uncertainty about the degree and direction of influence owing to different definitions of genetic variation, most of which are not in line with the current understanding of the genetic architecture of disease traits. Also, the relevance of previous results for diseases transmitted through environmental sources is unclear. In this article a compartmental genetic-epidemiological model was developed to quantify the impact of host genetic diversity on epidemiological characteristics of diseases transmitted through a contaminated environment. The model was parameterized for footrot in sheep. Genetic variation was defined through continuous distributions with varying shape and degree of dispersion for different disease traits. The model predicts a strong impact of genetic heterogeneity on the disease risk and its progression and severity, as well as on observable host phenotypes, when dispersion in key epidemiological parameters is high. The impact of host variation depends on the disease trait for which variation occurs and on environmental conditions affecting pathogen survival. In particular, compared to homogeneous populations with the same average susceptibility, disease risk and severity are substantially higher in populations containing a large proportion of highly susceptible individuals, and the differences are strongest when environmental contamination is low. The implications of our results for the recording and analysis of disease data and for predicting response to selection are discussed.

Novel Methods in Disease Biogeography: A Case Study with Heterosporosis

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Luis E. Escobar

2017-07-01

Full Text Available Disease biogeography is currently a promising field to complement epidemiology, and ecological niche modeling theory and methods are a key component. Therefore, applying the concepts and tools from ecological niche modeling to disease biogeography and epidemiology will provide biologically sound and analytically robust descriptive and predictive analyses of disease distributions. As a case study, we explored the ecologically important fish disease Heterosporosis, a relatively poorly understood disease caused by the intracellular microsporidian parasite Heterosporis sutherlandae. We explored two novel ecological niche modeling methods, the minimum-volume ellipsoid (MVE and the Marble algorithm, which were used to reconstruct the fundamental and the realized ecological niche of H. sutherlandae, respectively. Additionally, we assessed how the management of occurrence reports can impact the output of the models. Ecological niche models were able to reconstruct a proxy of the fundamental and realized niche for this aquatic parasite, identifying specific areas suitable for Heterosporosis. We found that the conceptual and methodological advances in ecological niche modeling provide accessible tools to update the current practices of spatial epidemiology. However, careful data curation and a detailed understanding of the algorithm employed are critical for a clear definition of the assumptions implicit in the modeling process and to ensure biologically sound forecasts. In this paper, we show how sensitive MVE is to the input data, while Marble algorithm may provide detailed forecasts with a minimum of parameters. We showed that exploring algorithms of different natures such as environmental clusters, climatic envelopes, and logistic regressions (e.g., Marble, MVE, and Maxent provide different scenarios of potential distribution. Thus, no single algorithm should be used for disease mapping. Instead, different algorithms should be employed for a more

Epidemiology of pituitary pars intermedia dysfunction: A systematic literature review of clinical presentation, disease prevalence and risk factors.

Science.gov (United States)

Ireland, J L; McGowan, C M

2018-05-01

Pituitary pars intermedia dysfunction (PPID) is caused by an age-related degenerative disease of dopaminergic neurones. Despite its importance in equine practice, available information regarding its epidemiology is limited. This systematic review aimed to assess published literature to evaluate available evidence regarding the clinical presentation, prevalence and risk factors for PPID in horses and ponies. Electronic database searches were undertaken using a range of terms, and English language publications published prior to August 2016 were included. Both authors independently reviewed screened papers for inclusion, extracted data, and assessed the quality of reporting using predefined criteria. Data were extracted using modified critically appraised topic data collection forms. Meta-analysis was not undertaken due to marked between-study variations. Following removal of duplicate records, of 358 published papers yielded by the search, 97 abstracts were screened for eligibility and 29 publications meeting inclusion criteria were included in the review. Most studies reviewed were case series or cross-sectional studies, with considerable variation in study populations and PPID case definition. Hypertrichosis and/or other hair coat abnormalities, laminitis and epaxial muscle wastage or muscle atrophy are the most frequently reported clinical signs, with prevalence of these signs increasing with increasing horse age. The most robust prevalence estimates for PPID were 21.2% in horses and ponies aged ≥15 years and 2.9% amongst the general equine population. Findings regarding breed and sex predispositions were equivocal and only increasing age has been identified as a significant risk factor for PPID. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Epidemiological Study of Huntington's Disease in the Province of Ferrara, Italy.

Science.gov (United States)

Carrassi, Erika; Pugliatti, Maura; Govoni, Vittorio; Sensi, Mariachiara; Casetta, Ilaria; Granieri, Enrico

2017-01-01

Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder caused by the abnormal expansion of CAG triplet repeat. We aimed to reappraise HD epidemiology in a northern Italian population, in relation to introduction of genetic testing. Through ICD-9M code 333.4 and medical fare exemption code RF0080, HD cases were identified from administrative health data and medical records from the Units of Neurology and Genetics, Ferrara University Hospital, and from other provincial neurological structures. HD mean annual incidence rate in 1990-2009 was 0.3 per 100,000 (95% CI 0.2-0.5). All incident cases were found to have symptoms of the disease's classic form, and neither juvenile nor the rigid Westphal variant was detected. The mean (SD) age at onset was 50.2 (12.7 years; range 32-82 years), 54.9 (14.6) for men and 45.8 (9.4) for women. On prevalence day, December 31, 2014, HD prevalence was 4.2 per 100,000 (95% CI 2.4-7.0), with a male:female ratio of 1:2. The prevalence and incidence of HD in our population were lower than the prevalence and incidence reported for other European and Italian populations, but higher compared to those of Asia, Africa, and Eastern Europe. Compared to previous studies, HD incidence and prevalence did not change significantly. © 2017 S. Karger AG, Basel.

Global epidemiology of hyperthyroidism and hypothyroidism.

Science.gov (United States)

Taylor, Peter N; Albrecht, Diana; Scholz, Anna; Gutierrez-Buey, Gala; Lazarus, John H; Dayan, Colin M; Okosieme, Onyebuchi E

2018-05-01

Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. Hypothyroidism and hyperthyroidism are common conditions with potentially devastating health consequences that affect all populations worldwide. Iodine nutrition is a key determinant of thyroid disease risk; however, other factors, such as ageing, smoking status, genetic susceptibility, ethnicity, endocrine disruptors and the advent of novel therapeutics, including immune checkpoint inhibitors, also influence thyroid disease epidemiology. In the developed world, the prevalence of undiagnosed thyroid disease is likely falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. However, continued vigilance against iodine deficiency remains essential in developed countries, particularly in Europe. In this report, we review the global incidence and prevalence of hyperthyroidism and hypothyroidism, highlighting geographical differences and the effect of environmental factors, such as iodine supplementation, on these data. We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.

Descriptive and analytic epidemiology. Bridges to cancer control

International Nuclear Information System (INIS)

Mettlin, C.

1988-01-01

Epidemiology serves as a bridge between basic science and cancer control. The two major orientations of epidemiology are descriptive and analytic. The former is useful in assessing the scope and dimensions of the cancer problem and the latter is used to assess environmental and lifestyle sources of cancer risk. A recent development in descriptive epidemiology is the use of functional measures of disease such as lost life expectancy. In analytical epidemiology, there is new or renewed interest in several lifestyle factors including diet and exercise as well as environmental factors such as involuntary tobacco exposure and radon in dwellings. Review of the evidence should consider the strengths and weaknesses of different research procedures. Each method is inconclusive by itself but, the different research designs of epidemiology collectively may represent a hierarchy of proof. Although the roles of many factors remain to be defined, the aggregate epidemiologic data continue to demonstrate the special importance of personal behavior and lifestyle in affecting cancer risk

Clinical and epidemiological profile of patients with valvular heart disease admitted to the emergency department

Energy Technology Data Exchange (ETDEWEB)

Moraes, Ricardo Casalino Sanches de [Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Katz, Marcelo [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Tarasoutchi, Flávio [Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil)

2014-07-01

To evaluate the clinical and epidemiological profile of patients with valvular heart disease who arrived decompensated at the emergency department of a university hospital in Brazil. A descriptive analysis of clinical and echocardiographic data of 174 patients with severe valvular disease, who were clinically decompensated and went to the emergency department of a tertiary cardiology hospital, in the State of São Paulo, in 2009. The mean age of participants was 56±17 years and 54% were female. The main cause of valve disease was rheumatic in 60%, followed by 15% of degenerative aortic disease and mitral valve prolapse in 13%. Mitral regurgitation (27.5%) was the most common isolated valve disease, followed by aortic stenosis (23%), aortic regurgitation (13%) and mitral stenosis (11%). In echocardiographic data, the mean left atrial diameter was 48±12mm, 38±12mm for the left ventricular systolic diameter, and 54±12mm for the diastolic diameter; the mean ejection fraction was 56±13%, and the mean pulmonary artery pressure was 53±16mmHg. Approximately half of patients (44%) presented atrial fibrillation, and over one third of them (37%) had already undergone another cardiac surgery. Despite increased comorbidities and age-dependent risk factors commonly described in patients with valvular heart disease, the clinical profile of patients arriving at the emergency department represented a cohort of rheumatic patients in more advanced stages of disease. These patients require priority care in high complexity specialized hospitals.

Clinical and epidemiological profile of patients with valvular heart disease admitted to the emergency department

International Nuclear Information System (INIS)

Moraes, Ricardo Casalino Sanches de; Katz, Marcelo; Tarasoutchi, Flávio

2014-01-01

To evaluate the clinical and epidemiological profile of patients with valvular heart disease who arrived decompensated at the emergency department of a university hospital in Brazil. A descriptive analysis of clinical and echocardiographic data of 174 patients with severe valvular disease, who were clinically decompensated and went to the emergency department of a tertiary cardiology hospital, in the State of São Paulo, in 2009. The mean age of participants was 56±17 years and 54% were female. The main cause of valve disease was rheumatic in 60%, followed by 15% of degenerative aortic disease and mitral valve prolapse in 13%. Mitral regurgitation (27.5%) was the most common isolated valve disease, followed by aortic stenosis (23%), aortic regurgitation (13%) and mitral stenosis (11%). In echocardiographic data, the mean left atrial diameter was 48±12mm, 38±12mm for the left ventricular systolic diameter, and 54±12mm for the diastolic diameter; the mean ejection fraction was 56±13%, and the mean pulmonary artery pressure was 53±16mmHg. Approximately half of patients (44%) presented atrial fibrillation, and over one third of them (37%) had already undergone another cardiac surgery. Despite increased comorbidities and age-dependent risk factors commonly described in patients with valvular heart disease, the clinical profile of patients arriving at the emergency department represented a cohort of rheumatic patients in more advanced stages of disease. These patients require priority care in high complexity specialized hospitals

Epidemiology of transmissible diseases: Array hybridization and next generation sequencing as universal nucleic acid-mediated typing tools.

Science.gov (United States)

Michael Dunne, W; Pouseele, Hannes; Monecke, Stefan; Ehricht, Ralf; van Belkum, Alex

2017-09-21

The magnitude of interest in the epidemiology of transmissible human diseases is reflected in the vast number of tools and methods developed recently with the expressed purpose to characterize and track evolutionary changes that occur in agents of these diseases over time. Within the past decade a new suite of such tools has become available with the emergence of the so-called "omics" technologies. Among these, two are exponents of the ongoing genomic revolution. Firstly, high-density nucleic acid probe arrays have been proposed and developed using various chemical and physical approaches. Via hybridization-mediated detection of entire genes or genetic polymorphisms in such genes and intergenic regions these so called "DNA chips" have been successfully applied for distinguishing very closely related microbial species and strains. Second and even more phenomenal, next generation sequencing (NGS) has facilitated the assessment of the complete nucleotide sequence of entire microbial genomes. This technology currently provides the most detailed level of bacterial genotyping and hence allows for the resolution of microbial spread and short-term evolution in minute detail. We will here review the very recent history of these two technologies, sketch their usefulness in the elucidation of the spread and epidemiology of mostly hospital-acquired infections and discuss future developments. Copyright © 2017 Elsevier B.V. All rights reserved.

Epidemiology of bacterial zoonoses in Nigeria | Adesiji | Nigerian ...

African Journals Online (AJOL)

This paper dicusses the epidemiology and epizootiology of bacterial zoonotic diseases in Nigeria. Six diseases are discussed including anthrax, brucellosis, bovine tuberculosis, campylobacteriosis leptospirosis, salmonellosis and tetanus. All axcept anthrax are enzootic and endemic in the country, and have been ...

Statistical significance of epidemiological data. Seminar: Evaluation of epidemiological studies

International Nuclear Information System (INIS)

Weber, K.H.

1993-01-01

In stochastic damages, the numbers of events, e.g. the persons who are affected by or have died of cancer, and thus the relative frequencies (incidence or mortality) are binomially distributed random variables. Their statistical fluctuations can be characterized by confidence intervals. For epidemiologic questions, especially for the analysis of stochastic damages in the low dose range, the following issues are interesting: - Is a sample (a group of persons) with a definite observed damage frequency part of the whole population? - Is an observed frequency difference between two groups of persons random or statistically significant? - Is an observed increase or decrease of the frequencies with increasing dose random or statistically significant and how large is the regression coefficient (= risk coefficient) in this case? These problems can be solved by sttistical tests. So-called distribution-free tests and tests which are not bound to the supposition of normal distribution are of particular interest, such as: - χ 2 -independence test (test in contingency tables); - Fisher-Yates-test; - trend test according to Cochran; - rank correlation test given by Spearman. These tests are explained in terms of selected epidemiologic data, e.g. of leukaemia clusters, of the cancer mortality of the Japanese A-bomb survivors especially in the low dose range as well as on the sample of the cancer mortality in the high background area in Yangjiang (China). (orig.) [de

New developments in epidemiology, diagnosis, and treatment of fascioliasis.

Science.gov (United States)

Cabada, Miguel M; White, A Clinton

2012-10-01

This review focuses on the recent developments in the epidemiology, burden of disease, diagnostic tests, and treatment of fascioliasis. Recent epidemiologic data suggest that either the endemic areas are expanding or disease is being recognized in areas where it was not previously observed. In addition, recent data highlight the effects of fascioliasis on childhood anemia and nutrition. Diagnosis remains problematic, but newer diagnostic tests including antibody, antigen, and DNA detection tests may facilitate earlier diagnosis. Recent studies suggest that point-of-care testing may soon be possible. Treatment with triclabendazole is effective, but resistance is emerging in livestock and may pose a threat for patients. Fascioliasis continues to emerge as an important neglected disease, with new studies highlighting the under-recognized burden of disease. Further studies are needed on burden of disease, improved diagnosis, and alternative to triclabendazole treatment.

Health Care and the Social Construction of AIDS: Impact of Disease Definitions on Psychosocial Adaptation and Economic Circumstances.

Science.gov (United States)

Crystal, Stephen; Jackson, Marguerite

As with other illnesses, Acquired Immune Deficiency Syndrome (AIDS) is a socially constructed phenomenon, not simply a biological entity. Biologically, Human Immunodeficiency Virus (HIV) infection causes immunosuppression, which in turn causes a spectrum of disease states. The official definition of AIDS by the Centers for Disease Control requires…

Epidemiological Study of Heart Failure in China

Directory of Open Access Journals (Sweden)

Yang Guo

2015-10-01

Full Text Available Heart failure (HF is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. HF is one of the most important and severe end stages of many cardiovascular diseases. Epidemiological studies of HF have focused mainly on the prevalence, incidence, mortality, fatality, and distribution and temporal trends of these indicators among different populations. This review highlights important epidemiological studies of HF in China.

Association of Helicobacter pylori infection with chronic atrophic gastritis: Meta-analyses according to type of disease definition.

Science.gov (United States)

Weck, Melanie N; Brenner, Hermann

2008-08-15

Helicobacter pylori is a major risk factor for chronic atrophic gastritis (CAG). A large variety of definitions of CAG have been used in epidemiologic studies in the past. The aim of this work was to systematically review and summarize estimates of the association between H. pylori infection and CAG according to the various definitions of CAG. Articles on the association between H. pylori infection and CAG published until July 2007 were identified. Separate meta-analyses were carried out for studies defining CAG based on gastroscopy with biopsy, serum pepsinogen I (PG I) only, the pepsinogen I/pepsinogen II ratio (PG I/PG II ratio) only, or a combination of PG I and the PG I/PG II ratio. Numbers of identified studies and summary odds ratios (OR) (95% confidence intervals) were as follows: gastroscopy with biopsy: n = 34, OR = 6.4 (4.0-10.1); PG I only: n = 13, OR = 0.9 (0.7-1.2); PG I/PG II ratio: n = 8, OR = 7.2 (3.1-16.8); combination of PG I and the PG I/PG II ratio: n = 20, OR = 5.7 (4.4-7.5). Studies with CAG definitions based on gastroscopy with biopsy or the PG I/PG II ratio (alone or in combination with PG I) yield similarly strong associations of H. pylori with CAG. The association is missed entirely in studies where CAG is defined by PG I only. (c) 2008 Wiley-Liss, Inc.

Evolution of the clinical and epidemiological knowledge about Chagas disease 90 years after its discovery

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Prata Aluízio

1999-01-01

Full Text Available Three different periods may be considered in the evolution of knowledge about the clinical and epidemiological aspects of Chagas disease since its discovery: (a early period concerning the studies carried out by Carlos Chagas in Lassance with the collaboration of other investigators of the Manguinhos School. At that time the disease was described and the parasite, transmitters and reservoirs were studied. The coexistence of endemic goiter in the same region generated some confusion about the clinical forms of the disease; (b second period involving uncertainty and the description of isolated cases, which lasted until the 1940 decade. Many acute cases were described during this period and the disease was recognized in many Latin American countries. Particularly important were the studies of the Argentine Mission of Regional Pathology Studies, which culminated with the description of the Romaña sign in the 1930 decade, facilitating the diagnosis of the early phase of the disease. However, the chronic phase, which was the most important, continued to be difficult to recognize; (c period of consolidation of knowledge and recognition of the importance of Chagas disease. Studies conducted by Laranja, Dias and Nóbrega in Bambuí updated the description of Chagas heart disease made by Carlos Chagas and Eurico Villela. From then on, the disease was more easily recognized, especially with the emphasis on the use of a serologic diagnosis; (d period of enlargement of knowledges on the disease. The studies on denervation conducted in Ribeirão Preto by Fritz Köberle starting in the 1950 decade led to a better understanding of the relations between Chagas disease and megaesophagus and other visceral megas detected in endemic areas.

Diverticular Disease: Epidemiology and Management

Directory of Open Access Journals (Sweden)

Adam V Weizman

2011-01-01

Full Text Available Diverticular disease of the colon is among the most prevalent conditions in western society and is among the leading reasons for outpatient visits and causes of hospitalization. While previously considered to be a disease primarily affecting the elderly, there is increasing incidence among individuals younger than 40 years of age. Diverticular disease most frequently presents as uncomplicated diverticulitis, and the cornerstone of management is antibiotic therapy and bowel rest. Segmental colitis associated with diverticula shares common histopathological features with inflammatory bowel disease and may benefit from treatment with 5-aminosalicylates. Surgical management may be required for patients with recurrent diverticulitis or one of its complications including peridiverticular abscess, perforation, fistulizing disease, and strictures and/or obstruction.

Diverticular disease: Epidemiology and management

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Weizman, Adam V; Nguyen, Geoffrey C

2011-01-01

Diverticular disease of the colon is among the most prevalent conditions in western society and is among the leading reasons for outpatient visits and causes of hospitalization. While previously considered to be a disease primarily affecting the elderly, there is increasing incidence among individuals younger than 40 years of age. Diverticular disease most frequently presents as uncomplicated diverticulitis, and the cornerstone of management is antibiotic therapy and bowel rest. Segmental colitis associated with diverticula shares common histopathological features with inflammatory bowel disease and may benefit from treatment with 5-aminosalicylates. Surgical management may be required for patients with recurrent diverticulitis or one of its complications including peridiverticular abscess, perforation, fistulizing disease, and strictures and/or obstruction. PMID:21876861

Standard epidemiological methods to understand and improve Apis mellifera health

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Lengerich, Eugene; Spleen, Angela; Dainat, Benjamin; Cresswell, James; Baylis , Kathy; Nguyen, Bach Kim; Soroker, Victoria; Underwood, Robyn; Human, Hannelie; Le Conte, Yves; Saegerman, Claude

2013-01-01

In this paper, we describe the use of epidemiological methods to understand and reduce honey bee morbidity and mortality. Essential terms are presented and defined and we also give examples for their use. Defining such terms as disease, population, sensitivity, and specificity, provides a framework for epidemiological comparisons. The term population, in particular, is quite complex for an organism like the honey bee because one can view “epidemiological unit” as individual bees, colonies, ap...

[Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?].

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Lozano-Álvarez, C; Pérez-Prieto, D; Saló-Bru, G; Molina, A; Lladó, A; Cáceres, E; Ramírez, M

2014-01-01

To evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. A total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. The mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β=14.146; 95% CI: 9.09 - 29.58; P<.01 and β=0.334; 95% CI: 0.40 - 0.98, P<.05, respectively), and change in quality of life (β=-8.568; 95% CI: -14.88 - -2.26; p<.01 and β=-0.228, IC 95% CI: -0.40 - -0.06, P<.05, respectively). Based on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

Using whole genome sequencing to study American foulbrood epidemiology in honeybees.

Directory of Open Access Journals (Sweden)

Joakim Ågren

Full Text Available American foulbrood (AFB, caused by Paenibacillus larvae, is a devastating disease in honeybees. In most countries, the disease is controlled through compulsory burning of symptomatic colonies causing major economic losses in apiculture. The pathogen is endemic to honeybees world-wide and is readily transmitted via the movement of hive equipment or bees. Molecular epidemiology of AFB currently largely relies on placing isolates in one of four ERIC-genotypes. However, a more powerful alternative is multi-locus sequence typing (MLST using whole-genome sequencing (WGS, which allows for high-resolution studies of disease outbreaks. To evaluate WGS as a tool for AFB-epidemiology, we applied core genome MLST (cgMLST on isolates from a recent outbreak of AFB in Sweden. The high resolution of the cgMLST allowed different bacterial clones involved in the disease outbreak to be identified and to trace the source of infection. The source was found to be a beekeeper who had sold bees to two other beekeepers, proving the epidemiological link between them. No such conclusion could have been made using conventional MLST or ERIC-typing. This is the first time that WGS has been used to study the epidemiology of AFB. The results show that the technique is very powerful for high-resolution tracing of AFB-outbreaks.

The effect of neighbourhood definitions on spatio-temporal models of disease outbreaks: Separation distance versus range overlap.

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Laffan, Shawn W; Wang, Zhaoyuan; Ward, Michael P

2011-12-01

The definition of the spatial relatedness between infectious and susceptible animal groups is a fundamental component of spatio-temporal modelling of disease outbreaks. A common neighbourhood definition for disease spread in wild and feral animal populations is the distance between the centroids of neighbouring group home ranges. This distance can be used to define neighbourhood interactions, and also to describe the probability of successful disease transmission. Key limitations of this approach are (1) that a susceptible neighbour of an infectious group with an overlapping home range - but whose centroid lies outside the home range of an infectious group - will not be considered for disease transmission, and (2) the degree of overlap between the home ranges is not taken into account for those groups with centroids inside the infectious home range. We assessed the impact of both distance-based and range overlap methods of disease transmission on model-predicted disease spread. Range overlap was calculated using home ranges modelled as circles. We used the Sirca geographic automata model, with the population data from a nine-county study area in Texas that we have previously described. For each method we applied 100 model repetitions, each of 100 time steps, to 30 index locations. The results show that the rate of disease spread for the range-overlap method is clearly less than the distance-based method, with median outbreaks modelled using the latter being 1.4-1.45 times larger. However, the two methods show similar overall trends in the area infected, and the range-overlap median (48 and 120 for cattle and pigs, respectively) falls within the 5th-95th percentile range of the distance-based method (0-96 and 0-252 for cattle and pigs, respectively). These differences can be attributed to the calculation of the interaction probabilities in the two methods, with overlap weights generally resulting in lower interaction probabilities. The definition of spatial

Strategies for Advancing Disease Definition Using Biomarkers and Genetics: The Bipolar and Schizophrenia Network for Intermediate Phenotypes.

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Tamminga, Carol A; Pearlson, Godfrey D; Stan, Ana D; Gibbons, Robert D; Padmanabhan, Jaya; Keshavan, Matcheri; Clementz, Brett A

2017-01-01

It is critical for psychiatry as a field to develop approaches to define the molecular, cellular, and circuit basis of its brain diseases, especially for serious mental illnesses, and then to use these definitions to generate biologically based disease categories, as well as to explore disease mechanisms and illness etiologies. Our current reliance on phenomenology is inadequate to support exploration of molecular treatment targets and disease formulations, and the leap directly from phenomenology to disease biology has been limiting because of broad heterogeneity within conventional diagnoses. The questions addressed in this review are formulated around how we can use brain biomarkers to achieve disease categories that are biologically based. We have grouped together a series of vignettes as examples of early approaches, all using the Bipolar and Schizophrenia Network on Intermediate Phenotypes (BSNIP) biomarker database and collaborators, starting off with describing the foundational statistical methods for these goals. We use primarily criterion-free statistics to identify pertinent groups of involved genes related to psychosis as well as symptoms, and finally, to create new biologically based disease cohorts within the psychopathological dimension of psychosis. Although we do not put these results forward as final formulations, they represent a novel effort to rely minimally on phenomenology as a diagnostic tool and to fully embrace brain characteristics of structure, as well as molecular and cellular characteristics and function, to support disease definition in psychosis. Copyright © 2016. Published by Elsevier Inc.

Rotavirus epidemiology and vaccine demand: considering Bangladesh chapter through the book of global disease burden.

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Mahmud-Al-Rafat, Abdullah; Muktadir, Abdul; Muktadir, Hasneen; Karim, Mahbubul; Maheshwari, Arpan; Ahasan, Mohammad Mainul

2018-02-01

Rotavirus is the major cause of gastroenteritis in children throughout the world. Every year, a large number of children aged rotavirus-related diarrhoeal diseases. Though these infections are vaccine-preventable, the vast majority of children in low-income countries suffer from the infection. The situation leads to severe economic loss and constitutes a major public health problem. We searched electronic databases including PubMed and Google scholar using the following words: "features of rotavirus," "epidemiology of rotavirus," "rotavirus serotypes," "rotavirus in Bangladesh," "disease burden of rotavirus," "rotavirus vaccine," "low efficacy of rotavirus vaccine," "inactivated rotavirus vaccine". Publications until July 2017 have been considered for this work. Currently, two live attenuated vaccines are available throughout the world. Many countries have included rotavirus vaccines in national immunization program to reduce the disease burden. However, due to low efficacy of the available vaccines, satisfactory outcome has not yet been achieved in developing countries such as Bangladesh. Poor economic, public health, treatment, and sanitation status of the low-income countries necessitate the need for the most effective rotavirus vaccines. Therefore, the present scenario demands the development of a highly effective rotavirus vaccine. In this regard, inactivated rotavirus vaccine concept holds much promise for reducing the current disease burden. Recent advancements in developing an inactivated rotavirus vaccine indicate a significant progress towards disease prophylaxis and control.

Epidemiology of idiopathic pulmonary fibrosis

Directory of Open Access Journals (Sweden)

Ley B

2013-11-01

Full Text Available Brett Ley, Harold R Collard Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, USA Abstract: Idiopathic pulmonary fibrosis is a chronic fibrotic lung disease of unknown cause that occurs in adults and has a poor prognosis. Its epidemiology has been difficult to study because of its rarity and evolution in diagnostic and coding practices. Though uncommon, it is likely underappreciated both in terms of its occurrence (ie, incidence, prevalence and public health impact (ie, health care costs and resource utilization. Incidence and mortality appear to be on the rise, and prevalence is expected to increase with the aging population. Potential risk factors include occupational and environmental exposures, tobacco smoking, gastroesophageal reflux, and genetic factors. An accurate understanding of its epidemiology is important, especially as novel therapies are emerging. Keywords: idiopathic pulmonary fibrosis, epidemiology, incidence, prevalence, mortality, risk factors

Listeriosis in Mexico: Clinical and epidemiological importance

Directory of Open Access Journals (Sweden)

Gloria Castañeda-Ruelas

2014-11-01

Full Text Available Listeriosis is caused by Listeria monocytogenes, an important food-borne disease due to its clinical forms, high mortality rate, and the economic impact in both clinical and food production industries. In Mexico, the lack of epidemiological surveillance systems leads to the need of accurate data on the incidence of listeriosis and its association with food-borne disease. In this paper, we present data about the presence of this bacterium in food, reports related to clinical cases of listeriosis, and information of diseases in which L. monocytogenes may be involved. However, in most of these cases the etiology was not established. Given this, there´s a need to inform and warn the appropriate entities, to define strategies for the mandatory search of L. monocytogenes through the whole food production chain and clinical suspects, for the epidemiological importance and control of listeriosis in Mexico.