Janoutová, J.; Janáčková, P.; Šerý, Omar; Zeman, T.; Ambrož, P.; Kovalová, M.; Vařechová, K.; Hosák, L.; Jiřík, V.; Janout, V.
Roč. 37, č. 1 (2016), s. 1-8 ISSN 0172-780X R&D Projects: GA MZd NT14504 Institutional support: RVO:67985904 Keywords : schizophrenia * risk factors * epidemiology Subject RIV: FQ - Public Health Care, Social Medicine Impact factor: 0.918, year: 2016
This thesis explores the epidemiology and risk factors of eating disorders. It focuses on the impact of the political and cultural changes that occured in the Czech Republic in the early 1990s. The term eating disorders includes mental illnesses characterized by disturbances in eating behaviour: anorexia nervosa, bulimia nervosa and various eating disorders not otherwise specifieed. It appears that the incidence of anorexia nervosa was increasing until 1970s and remains stable since. The inci...
Full Text Available Despite only accounting for approximately 2% of all new primary cancer cases, renal cell carcinoma (RCC incidence has dramatically increased over time. Incidence rates vary greatly according to geographic areas, so that it is extremely likely that exogenous risk factors could play an important role in the development of this cancer. Several risk factors have been linked with RCC, including cigarette smoking, obesity, hypertension (and antihypertensive drugs, chronic kidney diseases (also dialysis and transplantation, as well as the use of certain analgesics. Furthermore, although RCC has not generally been considered an occupational cancer, several types of occupationally-derived exposures have been implicated in its pathogenesis. These include exposure to asbestos, chlorinated solvents, gasoline, diesel exhaust fumes, polycyclic aromatic hydrocarbons, printing inks and dyes, cadmium and lead. Finally, families with a predisposition to the development of renal neoplasms were identified and the genes involved discovered and characterized. Therefore, there are now four well-characterized, genetically determined syndromes associated with an increased incidence of kidney tumors, i.e., Von Hippel Lindau (VHL, Hereditary Papillary Renal Carcinoma (HPRC, Birt-Hogg-Dubé Syndrome (BHD, and Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC. This review will address present knowledge about the epidemiology, molecular epidemiology and risk factors of RCC.
Gonçalves, Bruna; Ferreira, Carina; Alves, Carlos Tiago; Henriques, Mariana; Azeredo, Joana; Silva, Sónia
Vulvovaginal candidiasis (VVC) is an infection caused by Candida species that affects millions of women every year. Although Candida albicans is the main cause of VVC, the identification of non-Candida albicans Candida (NCAC) species, especially Candida glabrata, as the cause of this infection, appears to be increasing. The development of VVC is usually attributed to the disturbance of the balance between Candida vaginal colonization and host environment by physiological or nonphysiological changes. Several host-related and behavioral risk factors have been proposed as predisposing factors for VVC. Host-related factors include pregnancy, hormone replacement, uncontrolled diabetes, immunosuppression, antibiotics, glucocorticoids use and genetic predispositions. Behavioral risk factors include use of oral contraceptives, intrauterine device, spermicides and condoms and some habits of hygiene, clothing and sexual practices. Despite a growing list of recognized risk factors, much remains to be elucidated as the role of host versus microorganisms, in inducing VVC and its recurrence. Thus, this review provides information about the current state of knowledge on the risk factors that predispose to VVC, also including a revision of the epidemiology and microbiology of VVC, as well as of Candida virulence factors associated with vaginal pathogenicity.
accumulation in hereditary hemochromatosis and dietary iron overload in the Black African population and membranous obstruction of the inferior cava cause the tumor in a few countries. Keywords: hepatocellular carcinoma, epidemiology, risk factors
Janoutová, Jana; Janácková, Petra; Serý, Omar; Zeman, Tomás; Ambroz, Petr; Kovalová, Martina; Varechová, Katerina; Hosák, Ladislav; Jirík, Vitezslav; Janout, Vladimír
Schizophrenia is a severe mental disorder that affects approximately one percent of the general population. The pathogenesis of schizophrenia is influenced by many risk factors, both environmental and genetic. The environmental factors include the date of birth, place of birth and seasonal effects, infectious diseases, complications during pregnancy and delivery, substance abuse and stress. At the present time, in addition to environmental factors, genetic factors are assumed to play a role in the development of the schizophrenia. The heritability of schizo- phrenia is up to 80%. If one parent suffers from the condition, the probability that it will be passed down to the offspring is 13%. If it is present in both parents, the risk is more than 20%. The opinions are varied as to the risk factors affecting the development of schizophrenia. Knowing these factors may greatly contribute to prevention of the condition.
Broeders, M. J. M.; Verbeek, A. L. M.
Breast cancer is the most common malignancy among women in the Western society. Over the past decades it has become apparent that breast cancer incidence rates are increasing steadily, whereas the mortality rates for breast cancer have remained relatively constant. Information through the media on this rising number of cases has increased breast health awareness but has also introduced anxiety in the female population. This combination of factors has made the need for prevention of breast cancer an urgent matter. Breast cancer does not seem to be a single disease entity. A specific etiologic factor may therefore have more influence on one form may therefore have more influence on one form of breast cancer than another. So far though, as shown in their summary of current knowledge on established and dubious risk factors, no risk factors have been identified that can explain a major part of the incidence. Efforts to identify other ways for primary prevention have also been discouraging, even though breast cancer is one of the most investigated tumours world-wide. Thus, at this point i time, the most important strategy to reduce breast cancer mortality is early detection through individual counselling and organised breast screening programs. The recent isolation of breast cancer susceptibility genes may introduce new ways to reduce the risk of breast cancer in a small subset of women
Background: Childhood asthma is a major public health problem in Egypt and worldwide. Epidemiologic, physiologic, and social factors appear to be associated with an increased risk of asthma. Objective: The aim of the study was to determine the most frequent risk factors of childhood asthma exacerbation and severity in ...
Epidemiologic, physiologic, and social factors appear to be associated with an increased risk of asthma. Objective: The aim of the study was to determine the most frequent risk factors of childhood asthma exacerbation and severity in our community. Methods: This cross sectional study involved 206 asthmatic children, 5 to ...
Ondrusova, M.; Ondrus, D.
Testicular cancer is a rare malignancy, that affects 1-2 % of male population. Trends of testicular cancer mortality are stable for a long period of time, even that incidence shows a rapid growth. This paper deals with national trends in testicular cancer incidence and mortality in Slovakia from 1968 to 2007 by using the join-point regression analysis to propose potential changes in health care. The authors noted a statistically significant increase in the values of incidence and improvement in mortality after 1975. Paper also deals with the etiology and risk factors of this malignancy. (author)
Elflein, H M
Amblyopia is the main cause for mostly monocular, impaired vision in childhood. Treatment and prevention of amblyopia is only effective during childhood. Ophthalmological screening of children does not yet exist in Germany. The prevalence of amblyopia in Germany is 5.6%, which is higher than in reports from studies in Australia; however, the prevalence of amblyopia is not comparable in these studies due to different definitions of amblyopia and the inclusion/exclusion criteria of the study cohorts. At present it is unknown at what age ophthalmological screening should be carried out to prevent amblyopia and the appropriate frequency of screening examinations. Amblyopia is a disorder of the visual cortex that is due to suppression and deprivation of one eye leading to unilateral visual impairment. Approximately 50% of cases of amblyopia are caused by anisometropia, 25% by strabismus and in every sixth person by a combination of both. Other causes, such as unilateral congenital cataracts are relatively rare. A variety of factors, such as ocular pathologies, premature birth, familial disposition and general diseases are associated with an increased risk for amblyopia.
Background. Impaired fasting or glucose tolerance and/or diabetes can occur with hypertension, which theoretically predicts a worse cardiovascular risk profile, and consequently requires intensive cardiovasular risk management. Objectives. To characterise the frequency of the occurence of conventional cardiovascular risk ...
Budny, Agnieszka; Kozłowski, Piotr; Kamińska, Marzena; Jankiewicz, Małgorzata; Kolak, Agnieszka; Budny, Bożena; Budny, Witold; Niemunis-Sawicka, Joanna; Szczypiór, Grzegorz; Kurniawka, Bartosz; Burdan, Franciszek
Primary liver neoplasms occurs relatively rarely in Poland. The most frequently occurring type of cancer is hepatocellular carcinoma (HCC), which globally constitutes 7% of all the occurrences of cancer. The incidence increases with age and is the highest in patients around the age of 70. It also varies significantly depending on the geographic location. The main factors that cause HCC are infection of HBV and HCV, whose genome integrates into the DNA of the host, causing mutations. The other factors include excessive alcohol consumption, contact or consumption of Aspergillus toxins as well as various metabolic disorders, such as α1-antitrypsin deficiency, hemochromatosis, tyrosinemia, porphyria, von Gierke disease and in person with gene mutation p.I148M of adiponutrin. HCC is usually detected incidentally, during ultrasound examination or during clinical diagnosis of liver failure. HCC can be diagnosed using computed tomography (CT) or magnetic resonance imaging (MRI), which is considered the most accurate diagnostic method. A core needle biopsy or the examination of the level of markers such as: alpha-fetoprotein (AFP), D-gamma-carboxy prothrombin (DCP), tumourassociated glycoprotein 72 (CA 72-4, TAG-72), are advised for a complete diagnostics.
Chughtai, Morad; Gwam, Chukwuweike U.; Mohamed, Nequesha; Khlopas, Anton; Newman, Jared M.; Khan, Rafay; Nadhim, Ali; Shaffiy, Shervin; Mont, Michael A.
Postoperative pneumonia is a common complication of surgery, and is associated with marked morbidity and mortality. Despite advances in surgical and anesthetic technique, it persists as a frequent postoperative complication. Many studies have aimed to assess its burden, as well as associated risk factors. However, this complication varies among the different surgical specialties, and there is a paucity of reports that comprehensively evaluate this complication. Therefore, the purpose of this study was to review the epidemiology and risk factors of postoperative pneumonia in the setting of: 1) general surgery; 2) cardiothoracic surgery; 3) orthopedic and spine surgery; and 4) head and neck surgery. PMID:28496546
To provide a general overview of malignant melanoma and non-melanoma skin cancer, with an emphasis on epidemiology, clinical presentation, and the multiple and varied risk factors associated with skin cancer. Peer-reviewed journal articles, government health reports, book chapters, and Web-based resources. Skin cancer is the most common carcinoma, affecting millions worldwide. Incidence is increasing yearly, making it a pre-eminent public health threat. Myriad factors increase the risk of skin cancer and may serve as important prognostic indicators for the disease. To provide nurses with a clearer understanding of the causative mechanisms of skin cancer and an improved awareness of the risk factors associated with the disease. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available The article presents current data about the risk factors of main lower limb fractures (LLFs of different localization (femur, tibia and foot. It has been shown that the most studies examine epidemiology and risk factors for hip fractures, but information about the risk factors for other LLFs is insufficient and controversial. It has been demonstrated that in addition to factors of age and sex, the road traffic accidents, sports, inadequate physical activity, injuries, falls and previous fractures play the important role in the development of LLFs. Also some diseases (systemic osteoporosis, large joints osteoarthritis, rheumatoid arthritis, dementia, epilepsy, alcoholism, parkinsonism, cancer, obesity and cataract can influence the LLFs risk. Administration of some drugs, in particular, hypnotic and sedative, as well as antidepressants, antipsychotic drugs and glucocorticoids, is the additional risk factor for LLFs. Almost all types of fractures in women are associated with low bone mineral density, which is more defined at femoral neck than at spine or peripheral skeleton, but part of fractures associated with osteoporosis is small and ranges from 10 to 44 %. The assessment of risk factors should necessarily be carried out in routine clinical practice in patients with LLFs, since it affects not only their incidence, but also the prognosis of treatment of these patients.
Full Text Available Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide and infanticide have been considered relatively rare events during the perinatal period. However, in some mental disorders (i.e. postpartum depression, bipolar disorder, postpartum psychosis, etc. have been reported a higher risk of suicidal ideation, suicide attempt or suicide. Therefore, a complete screening of mothers’ mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk and protective factors and an overview about the main clinical correlates associated with the suicidal behaviour during the pregnancy and postpartum period.
Nicolas W Shammas
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
Pereira, Duarte; Garrett, Carolina
The etiology of Parkinson's disease (PD) remains in a certain part unknown. Both genetic susceptibility and environmental factors are sometimes considered to be putative contributors to its origin. Recent epidemiologic studies have focused on the possible role of environmental risk factors present during adult life or aging, once pure genetic forms of PD are rare. The purpose of this study was to investigate possible environmental and familial risk factors for PD. We performed a hospital based case-control study using 88 PD patients with neurologist confirmed diagnostic, and 176 sex, age, and residence similar controls. Several possible risk factors were evaluated related to life style, past history, family history, occupational history and other exposures to potential neurotoxin agents. Statistical differences, using a 95% confidence interval, were observed in positive family history of PD (p = 0,002), occupation category (p = 0,001), rural living (p = 0,037), living/working near a industry (p = 0,017), exposure to pesticides, herbicides and in-secticides (p coffee consumption (p = 0,036) and tea consumption (p = 0,001). Sex and age adjusted logistic regression showed as potential risk factors, a positive family history of PD (odds ratio [OR] = 9,996; 95% confidence interval [CI] = 2,19-45,597), blue collar occupations (OR = 3,967; 95% CI = 1,670-9,426), exposure to pesticides, herbicides and insecticides (OR = 2,619 ; 95% CI = 1,170-5,862). An inverse relationship was found between tea consumption and the risk of PD (OR = 0,356; 95% CI = 0,174-0,727). The results of the study show that both familial and environmental factors may contribute to the development of PD. Like other studies suggest, PD is of unknown, but presumably multifactorial etiology.
Full Text Available Recent Italian and International epidemiological data show that invasive fungal infections (IFI, particularly aspergillosis, are still a crucial issue for patients with acute myeloid leukemia. However, in the last years the epidemiology is changing, and in order to determine the real risk of a patient and in order to improve preventive, diagnostic and therapeutic measures, it’s important to identify all the factors (e.g. age, performance status, prophylaxis that play a role in the development of IFI. Immunogenetics may potentially contribute to improve diagnosis providing new therapeutic tools, but results are limited by sample size and absence of thorough functional characterization moreover lack of replication limits translation of data to the clinical practice. Regarding candidemia an Italian study showed that the overall incidence remained unchanged between 2008 and 2010 but with an increase in the number of C. albicans aand C. glabrata infections.
Recent Italian and International epidemiological data show that invasive fungal infections (IFI, particularly aspergillosis, are still a crucial issue for patients with acute myeloid leukemia. However, in the last years the epidemiology is changing, and in order to determine the real risk of a patient and in order to improve preventive, diagnostic and therapeutic measures, it’s important to identify all the factors (e.g. age, performance status, prophylaxis that play a role in the development of IFI. Immunogenetics may potentially contribute to improve diagnosis providing new therapeutic tools, but results are limited by sample size and absence of thorough functional characterization moreover lack of replication limits translation of data to the clinical practice. Regarding candidemia an Italian study showed that the overall incidence remained unchanged between 2008 and 2010 but with an increase in the number of C. albicans aand C. glabrata infections.
Adriella Silva Oliveira
Full Text Available This study aimed to perform an integrative review of the epidemiology and the main risk factors for infection with human T lymphotropic to cells (HTLV in pregnant women from the Brazilian scientific production. The articles were extracted from databases: Literature Latin American and Caribbean Health Sciences (LILACS, Medical Literature Analysis and Retrieval System Online (MEDLINE and Scientific Electronic Library Online (SCIELO, with nine selected articles published between the years 2000-2012. Upon review of the studies it was observed that Brazil has significant prevalence of HTLV in pregnant women, demonstrating the need for adequate attention to this indicator. Some risk factors indicated by the studies analyzed were: low education, criterion race/color (infected pregnant women were mostly black, brown or indigenous majority, vertical transmission, sexual transmission, multiple pregnancies and premature sexual activity. Therefore, it is Epidemiologia e fatores de risco da infecção do vírus HTLV em gestantes important serologic screening to prevent congenital infections, as well as the introduction of new studies on the infection in Brazil. Thus, it becomes evident the need for planning and implementation of prevention and control of HTLV in the prenatal for structuring measures that minimize the appearance of new infections in pregnant women and children due to vertical transmission, the main route of transmission.
George M Varghese
Full Text Available Background & objectives: Scrub typhus is a major public health threat in South and Southeastern Asian countries including India. Understanding local patterns of disease and factors that place individuals at risk is pivotal to future preventive measures against scrub typhus. The primary aim of this study was to identify specific epidemiological and geographical factors associated with an increased risk of developing scrub typhus in this region. Methods: We mapped 709 patients from Tamil Nadu, Andhra Pradesh and Telangana who were admitted to the Christian Medical College (CMC Hospital, Vellore, Tamil Nadu, India, for the period 2006-2011, assessed seasonality using monthly counts of scrub typhus cases, and conducted a case-control study among a subset of patients residing in Vellore. Results: The geographic distribution of cases at CMC Hospital clusters around the Tamil Nadu-Andhra Pradesh border. However, distinct hotspots clearly exist distal to this area, near Madurai and the coast in Tamil Nadu, and in the Northeast of Andhra Pradesh. Seasonally, the highest numbers of cases were observed in the cooler months of the year, i.e. September to January. In the case-control analysis, cases were more likely to be agricultural laborers (OR 1.79, 95% CI 1.01 - 3.15, not wear a shirt at home (OR 4.23, 95% CI 1.12 - 16.3, live in houses adjacent to bushes or shrubs (OR 1.95, 95% CI 1.08 - 3.53, and live in a single room home (OR 1.75, 95% CI 1.02 - 3.01. On binary logistic regression, the first three of these variables were statistically significant. Interpretation & conclusions: With the growing number of cases detected in India, scrub typhus is fast emerging as a public health threat and further research to protect the population from this deadly infection is essential. Health education campaigns focusing on the agricultural workers of Southern India, especially during the cooler months of the year, can serve as an important public health measure to
Alexander N. Bogdanov
Full Text Available Epidemiology and risk factors of epilepsy, based on the follow-up of 549 children, residing in the north of Western Siberia over the course of 1995–2010 was studied. Morbidity was determined.
Burger, M.; Catto, J.W.; Dalbagni, G.; Grossman, H.B.; Herr, H.; Karakiewicz, P.; Kassouf, W.; Kiemeney, L.A.L.M.; La Vecchia, C.; Shariat, S.; Lotan, Y.
CONTEXT: Urothelial bladder cancer (UBC) is a disease of significant morbidity and mortality. It is important to understand the risk factors of this disease. OBJECTIVE: To describe the incidence, prevalence, and mortality of UBC and to review and interpret the current evidence on and impact of the
The intense differentiation of the terminal duct lobular unit associated with each full term pregnancy and release of various hormones, autocrine and paracrine growth factors during lactation may explain the protective effects the protective effects of early age at first full term pregnancy, parity and lactation of breast cancer risk ...
Full Text Available Dengue hemorrhagic fever is an infectious disease resulting spectrum of clinical manifestations that vary from the lightest, dengue fever, hemorrhagic fever and dengue fever are accompanied by shock or dengue shock syndrome. Its caused by dengue virus, transmitted by Aedes mosquitoes. The case is spread in the tropics, especially in Southeast Asia, Central America, America and the Caribbean, many causes of death in children 90% of them attacking children under 15 years old. Until now pathogenesis is unclear. There are two theories or hypotheses immuno-patogenesis DHF and DSS is still controversial which secondary infections (secondary heterologus infection and antibody-dependent enhancement. Risk factors for dengue transmission are rapid urban population growth, mobilization of the population because of improved transportation facilities and disrupted or weakened so that population control. Another risk factor is poverty which result in people not has the ability to provide a decent home and healthy, drinking water supply and proper waste disposal.
Smaoui Fourati, S; Mzid, H; Marouane, C; Kammoun, S; Messadi-Akrout, F
Despite the availability of potent drugs and the availability of vaccine, tuberculosis remains until today one of the most worrying infectious diseases because of both its morbidity and mortality. This serious health problem is further complicated by the emergence of multidrug-resistant (MDR) or extensively drug-resistant strains (XDR). The number of MDR and XDR strains has continued to increase in recent years. Therefore, it is necessary to determine the risk factors leading to the emergence of MDR-TB strains to improve its overall management. Most studies indicate that the irregular previous treatment of tuberculosis with poor adherence is the main risk factor found. Other risk factors such as digestive issues, age, sex, and immunosuppression have been reported by several studies. In Tunisia, MDR-TB prevalence remains low with 0.8% among new cases and 12% among the restatements but control of this disease is necessary and remains essentially preventive. It is based on real preventive strategies planned according to local and updated regional data. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Rita de Cassia Almeida Vieira
Full Text Available Abstract Diffuse axonal injury (DAI, a type of traumatic injury, is known for its severe consequences. However, there are few studies describing the outcomes of DAI and the risk factors associated with it. This study aimed to describe the outcome for patients with a primary diagnosis of DAI six months after trauma and to identify sociodemographic and clinical factors associated with mortality and dependence at this time point. Seventy-eight patients with DAI were recruited from July 2013 to February 2014 in a prospective cohort study. Patient outcome was analyzed using the Extended Glasgow Outcome Scale (GOS-E within six months of the traumatic injury. The mean Injury Severity Score was 35.0 (SD = 11.9, and the mean New Injury Severity Score (NISS was 46.2 (SD = 15.9. Mild DAI was observed in 44.9% of the patients and severe DAI in 35.9%. Six months after trauma, 30.8% of the patients had died, and 45.1% had shown full recovery according to the GOS-E. In the logistic regression model, the severity variables—DAI with hypoxia, as measured by peripheral oxygen saturation, and hypotension with NISS value—had a statistically significant association with patient mortality; on the other hand, severity of DAI and length of hospital stay were the only significant predictors for dependence. Therefore, severity of DAI emerged as a risk factor for both mortality and dependence.
Castro Romero, Julieta Ivone; Hernández Girón, Carlos; Madrid Marina, Vicente
Cervical cancer has been extensively studied, as well as the various risk factors for that cancer. One such factor is the prolonged use of hormonal contraceptives. To report the biological, immunological and epidemiological findings arising from the use of oral contraceptives and their relation to cervical cancer. Retrospective study based on information published in national and international literature. Controversy persists between the epidemiological data and experimental biological association between hormonal contraceptives and cancer induced by HPV. It is important to consider the biological findings because in Mexico the use of hormonal contraceptives is very broad and the number of cases of cervical cancer and only extensive epidemiological studies will clarify this controversy.
Full Text Available The incidence of fungal infections among newborn babies is increasing, owing mainly to the increased ability to care and make survive immature infants at higher specific risk for fungal infections. The risk is higher in infants with very low and extremely low birth weight, in babies receiving total parenteral nutrition, in neonates with limited barrier effect in the gut, or with central venous catheter or other devices where fungal biofilms can originate. Also neonates receiving broad spectrum antibiotics, born through caesarian section or non-breastfed can feature an increased, specific risk. Most fungal infections in neonatology occur in premature children, are of nosocomial origin, and are due to Candida species. Colonization is a preliminary step, and some factors must be considered for the diagnosis and grading process: the isolation site, the number of colonized sites, the intensity of colonization, and the Candida subspecies. The most complicated patients are at greater risk of fungal infections, and prophylaxis or pre-emptive therapy should often be considered. A consistent decisional tree in neonatology is yet to be defined, but some efforts have been made in order to identify characteristics that should guide the prophylaxis or treatment choices. A negative blood culture and the absence of symptoms aren’t enough to rule out the diagnosis of fungal infections in newborn babies. Similarly, laboratory tests have been validated only for adults. The clinical judgement is of utmost importance in the diagnostic process, and should take into account the presence of clinical signs of infection, of a severe clinical deterioration, as well as changes in some laboratory tests, and also the presence and characteristics of a pre-existing fungal colonization.http://dx.doi.org/10.7175/rhc.v14i1S.856
Zhang, Yi; Guo, Sa; Wang, Jing; Wang, Jianjun
Aim To understand the prevalence of functional constipation in pregnant women and to analyze the impact of its risk factors. Methods We searched hospital databases for women who were 37–41 weeks pregnant (1698 cases) from July 2012 to January 2014 in four hospitals in Shanghai. We reviewed factors including general data, living and eating habits, psychological history, past history of defecation in the 6 months before pregnancy and defecation after pregnancy. Data were analyzed using SPSS software. Results Pregnant women who were more than 35 years old, with a pre-pregnancy body mass index >24, who were highly educated and employed in a sedentary occupation, showed a higher prevalence of functional constipation. Multivariate logistic regression analysis indicated that the prevalence of functional constipation among pregnant women was related to age, pre-pregnancy body mass index, diet, exercise, occupation, psychological factors, threatened abortion in early pregnancy and constipation history. Conclusion The prevalence rate of functional constipation in pregnant women was significantly higher than in the general population. PMID:26208169
Farmakis, Dimitrios; Parissis, John; Lekakis, John; Filippatos, Gerasimos
Acute heart failure represents the first cause of hospitalization in elderly persons and is the main determinant of the huge healthcare expenditure related to heart failure. Despite therapeutic advances, the prognosis of acute heart failure is poor, with in-hospital mortality ranging from 4% to 7%, 60- to 90-day mortality ranging from 7% to 11%, and 60- to 90-day rehospitalization from 25% to 30%. Several factors including cardiovascular and noncardiovascular conditions as well as patient-related and iatrogenic factors may precipitate the rapid development or deterioration of signs and symptoms of heart failure, thus leading to an acute heart failure episode that usually requires patient hospitalization. The primary prevention of acute heart failure mainly concerns the prevention, early diagnosis, and treatment of cardiovascular risk factors and heart disease, including coronary artery disease, while the secondary prevention of a new episode of decompensation requires the optimization of heart failure therapy, patient education, and the development of an effective transition and follow-up plan. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Lam, W.K.; White, N.W.; Chan-Yeung, M.M. [University of Hong Kong, Hong Kong (China)
In Industrialized Countries, lung cancer is the most common form of cancer among males and it is growing among females. For both sexes, rates reflect smoking behaviours. The pattern appears to be different in Asia, particularly in China, where lung cancer rates in men reflect high smoking rates but high rates among non-smoking women appear to be related to other factors. The incidence of lung cancer is low in most African countries, but it is increasing. In addition to tobacco smoking, a number of aetiological factors have been identified for lung cancer: indoor exposure to environmental tobacco smoke, cooking oil vapour, coal burning or radon, outdoor air pollution and occupational exposure to asbestos and other carcinogens. Recent studies have shown that dietary factors may be important, with high consumption of vegetables and fruits being protective, while preserved foods and fatty foods are harmful, and certain infections such as Mycobacterium tuberculosis, human papillomavirus and Microsporum canis are associated with a high risk of lung cancer. Among non-smokers, the probable role of genetic predisposition in lung cancer by increasing the individual's susceptibility to environmental carcinogens is currently being studied actively. As the single most important cause for lung cancer is tobacco smoke and, with increased sales, a major epidemic is predicted for both Asia and Africa, all health care professionals, government health authorities and national and international health organizations must join in a concerted effort against tobacco. 135 refs.
Full Text Available The incidence and mortality rate of Clostridium difficile infection have increased remarkably in both hospital and community settings during the last two decades. The growth of infection may be caused by multiple factors including inappropriate antibiotic usage, poor standards of environmental cleanliness, changes in infection control practices, large outbreaks of C. difficile infection in hospitals, alteration of circulating strains of C. difficile, and spread of hypervirulent strains. Detection of high-risk populations could be helpful for prompt diagnosis and consequent treatment of patients suffering from C. difficile infection. Metronidazole and oral vancomycin are recommended antibiotics for the treatment of initial infection. Current treatments for C. difficile infection consist of supportive care, discontinuing the unnecessary antibiotic, and specific antimicrobial therapy. Moreover, novel approaches include fidaxomicin therapy, monoclonal antibodies, and fecal microbiota transplantation mediated therapy. Fecal microbiota transplantation has shown relevant efficacy to overcome C. difficile infection and reduce its recurrence.
María Cristina Navas Navas
Full Text Available El cáncer primario de hígado es en el mundo la quinta neoplasia más común en hombres y la octava en mujeres, con gran impacto debido a su alta mortalidad, ya que representa la tercera causa de mortalidad relacionada con cáncer en población masculina. Se ha descrito una fuerte asociación con factores de riesgo como las hepatitis virales crónicas, las hepatopatías de origen genético, el consumo de alcohol, el tabaquismo y enfermedades metabólicas, entre otras. En este artículo se analizan publicaciones originales y de revisión en las que se evalúan dichos factores y su asociación con el carcinoma hepatocelular (CHC. Además, se recopila información actualizada sobre datos epidemiológicos por regiones del mundo. Primary liver cancer is the 5th neoplasia more common among men and 8th among women worldwide. It has a great impact because of its high mortality; Liver cancer ranks third amongst the causes of cancer-related deaths in men. It has been associated with some risk factors as chronic viral hepatitis, genetic liver disease, intake of alcohol, use of tobacco, metabolic disease and others. This document corresponds to a review of original papers of evaluation of those factors and its association with liver cancer and also reviewed articles. Additionally, updated epidemiological information of liver cancer worldwide is included.
Miret, Marta; Ayuso-Mateos, José Luis; Sanchez-Moreno, Jose; Vieta, Eduard
The social and economic impact of mood disorders and suicide is extremely high and may be even higher in coming years, and yet, research in mental health is largely underfunded. This report summarizes the most recent data concerning the epidemiology and burden of depression and suicide, and underlines the most recent initiatives to identify the barriers to effective treatment and prevention of mood disorders. Global cooperation and networks of research networks are proposed. Progress in the understanding of the pathophysiology and subtypes of depression, technological advances, emphasis on early prediction of response and prevention, and a paradigm shift in drug development are crucial to overcome the current challenges posed by increasing rates of depression and suicide. Copyright © 2013 Elsevier Ltd. All rights reserved.
type II, hypertension, hyperlipidemia, and non - alcoholic fatty liver disease /steatohepatitis (NAFLD/NASH) between children with ASD and controls. For...hyperlipidemia, non - alcoholic steatoheapatitis). Despite that risk, children with ASD also were at risk of developing macronutrient and micronutrient...conditions including prevalence of otitis media, celiac disease , appendicitis, injuries, obesity and its complications (hypertension, hyperlipidemia), and
Alicia M. Montalvo, Hilary Shaefer, Belinda Rodriguez, Tan Li, Katrina Epnere, Gregory D. Myer
The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently ...
Peña Fernández, M; Bermejo Fenoll, A
An epidemiological study of dental caries amongst preschoolers (aged between 4 and 6 years) from the city of Alicante has been carried out. The influence of the socioeconomic class as well as higienic and diet habits on the appearance dental caries of deciduous teeth has been evaluated. From a total population 7,289 preschoolers, a representative sample of 1,292 children was obtained by the sampling process of a stratified randomization. A statistical significant association was found between socioeconomic class and dental caries (p less than or equal to 0.05), being the lower classes the more prone to dental caries. Higienic habits of the examined children were clearly inadequate; 75.62% of preschoolers showing dental plaque. There was a statistical significant relationship between dental plaque and caries (p less than or equal to 0.05). The ingestion of candies has been shown to be also related with dental caries. Those children who never eat candies showed a prevalence of dental caries of 30.84%, whereas the prevalence increased up to 44% in cases of frequent ingestion of sugared food.
In conclusion: Thyroid disorders are common during IFN-α therapy. Previous epidemiological data seem to be underestimated. Important risk factors for IITD development are: female sex, elevated serum TSH concentration (≥2.5 μU/mL, positive TPO-Ab and increased blood velocity in thyroid arteries.
Lijfering, Willem M.; Rosendaal, Frits R.; Cannegieter, Suzanne C.
P>Epidemiological research throughout the last 50 years has provided the long list of risk factors for venous thrombosis that are known today. Although this has advanced our current understanding about the aetiology of thrombosis, it does not give us all the answers: many people have several of
Marion, Laura L; Meeks, George Rodney
Ectopic pregnancy is directly related to tubal infection, and so prevention of chlamydia and gonorrhea must be the watchword to lower its risk and incidence. With accurate determination of very low human chorionic gonadotropin concentrations and sonography, >85% of women are diagnosed before tubal rupture, which has led to medical therapy and laparoscopic surgery with tubal preservation and the potential for future fertility. Today, early intervention saves lives and reduces morbidity, but ectopic pregnancy still accounts for 4% to 10% of pregnancy-related deaths and leads to a high incidence of ectopic site gestations in subsequent pregnancies.
Full Text Available Obesity is a public health problem that has reached epidemic proportions with an increasing worldwide prevalence. The global emergence of obesity increases the risk of developing chronic metabolic disorders. Thus, it is an economic issue that increased the costs of the comorbidities associated. Moreover, in recent years, it has been demonstrated that obesity is associated with chronic systemic inflammation, this status is conditioned by the innate immune system activation in adipose tissue that promotes an increase in the production and release of pro-inflammatory cytokines that contribute to the triggering of the systemic acute-phase response which is characterized by elevation of acute-phase protein levels. On this regard, low-grade chronic inflammation is a characteristic of various chronic diseases such as metabolic syndrome, cardiovascular disease, diabetes, hypertension, non-alcoholic fatty liver disease, and some cancers, among others, which are also characterized by obesity condition. Thus, a growing body of evidence supports the important role that is played by the inflammatory response in obesity condition and the pathogenesis of chronic diseases related.
MacIntyre, Norma J; Dewan, Neha
Literature Review. For optimal Distal Radius Fracture (DRF) rehabilitation and fracture prevention, it is important to understand the epidemiology and factors predictive of injury, chronic pain, chronic disability, and subsequent fracture. To summarize the literature reporting on DRF epidemiology, risk factors, and prognostic factors. Literature synthesis. Although incidence varies globally, DRFs are common across the lifespan and appear to be on the rise. Risk of DRF is determined by personal factors (age, sex/gender, lifestyle, health condition) and environmental factors (population density, climate). For example, age and sex influence risk such that DRF is most common in boys/young men and older women. The most common causes of DRF in the pediatric and young adult age groups include playing/sporting activities and motor vehicle accidents. In contrast, the most common mechanism of injury in older adults is a low-energy trauma because of a fall from a standing height. Poorer health outcomes are associated with older age, being female, poor bone healing (or having an associated fracture of the ulnar styloid), having a compensated injury, and a lower socioeconomic status. Risk stratification according to predictors of chronic pain and disability enable therapists to identify those patients who will benefit from advocacy for more comprehensive assessment, targeted interventions, and tailored educational strategies. The unique opportunity for secondary prevention of osteoporotic fracture after DRF has yet to be realized by treating therapists in the orthopedic community. V. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
Full Text Available BACKGROUND: Rates of diseases and injuries and the effects of their risk factors can have substantial subnational heterogeneity, especially in middle-income countries like Mexico. Subnational analysis of the burden of diseases, injuries, and risk factors can improve characterization of the epidemiological transition and identify policy priorities. METHODS AND FINDINGS: We estimated deaths and loss of healthy life years (measured in disability-adjusted life years [DALYs] in 2004 from a comprehensive list of diseases and injuries, and 16 major risk factors, by sex and age for Mexico and its states. Data sources included the vital statistics, national censuses, health examination surveys, and published epidemiological studies. Mortality statistics were adjusted for underreporting, misreporting of age at death, and for misclassification and incomparability of cause-of-death assignment. Nationally, noncommunicable diseases caused 75% of total deaths and 68% of total DALYs, with another 14% of deaths and 18% of DALYs caused by undernutrition and communicable, maternal, and perinatal diseases. The leading causes of death were ischemic heart disease, diabetes mellitus, cerebrovascular disease, liver cirrhosis, and road traffic injuries. High body mass index, high blood glucose, and alcohol use were the leading risk factors for disease burden, causing 5.1%, 5.0%, and 7.3% of total burden of disease, respectively. Mexico City had the lowest mortality rates (4.2 per 1,000 and the Southern region the highest (5.0 per 1,000; under-five mortality in the Southern region was nearly twice that of Mexico City. In the Southern region undernutrition and communicable, maternal, and perinatal diseases caused 23% of DALYs; in Chiapas, they caused 29% of DALYs. At the same time, the absolute rates of noncommunicable disease and injury burdens were highest in the Southern region (105 DALYs per 1,000 population versus 97 nationally for noncommunicable diseases; 22 versus
Moukaddem, Afaf; Chaaya, Monique; Slim, Zeinab F N; Jaffa, Miran; Sibai, Abla Mehio; Uthman, Imad
To investigate the epidemiology of fibromyalgia (FM) and assess its risk factors. Using data from the 2009 Community Oriented Program for Control of Rheumatic Diseases (COPCORD) study conducted in Lebanon, a population-based case control study was performed. The sample included 34 FM patients, frequency matched with 136 controls free from any musculoskeletal complaints and randomly sampled from the population. The controls were frequency matched with cases by age and gender. The 34 female FM cases were prevalent cases which existed for a long period of time and all those who consulted a doctor were previously misdiagnosed. Family history of joint problems (OR = 4.93, 95% CI: 1.56-15.58) and working status (OR = 2.69, 95% CI: 1.04-6.93) were significant risk factors for FM, after adjusting for body mass index, distress level, smoking status and residence location. This was the first study to address the epidemiology of FM in Lebanon and the region. The chronic nature of FM that is characterized by frequent bouts of intense disabling pain and symptoms constitutes a significant health and economic burden. Clustering of cases in coastal areas was partially explained by other factors such as body mass index, distress level, smoking and work status. The high burden of FM found in our study calls for further investigation of potential risk factors of this condition. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
Zagdańska, Marta; Kiejna, Andrzej
The aim of this study was to identify risk factors and estimate prevalence of depressive episodes among Wroclaw's universities students. Polish adaptation of the Composite International Diagnostic Interview (CIDI) was implemented to gather epidemiological data from 370 students of public universities in Wroclaw. Proportional stratified sampling was performed to obtain distinct, independent strata representing sex, year of study and educational profiles. Randomisation was ensured by recruitment procedures. Prevalence of depressive episodes among students in Wroclaw is high - 14.7% throughout life, 9.8% within 12 months prior to the interview. High prevalence of severe and moderate depressive episodes seems to be worrisome (respectively 5.1% and 6.6% throughout life, 3.8% and 3.9% within 12 months prior to the study). Year of study, profile and lack of partner relationship remain risk factor for depression. High prevalence of depressive episodes indicates the need for prevention and therapy based on epidemiological data and tailored to the students' needs. Depression among students requires further epidemiological studies.
Shaukat, Uzma; Ismail, Muhammad; Mehmood, Nasir
Occurrence of breast cancer is related to genetic as well as cultural, environmental and life-style factors. Variations in diversity of these factors among different ethnic groups and geographical areas emphasize the immense need for studies in all racial-ethnic populations. The incidence of breast cancer in Pakistan is highest in Asians after Jews in Israel and 2.5 times higher than that in neighboring countries like Iran and India, accounting for 34.6% of female cancers. The Pakistani population is deficient in information regarding breast cancer etiology and epidemiology, but efforts done so far had suggested consanguinity as a major risk factor for frequent mutations leading to breast cancer and has also shed light on genetic origins in different ethnic groups within Pakistan. World-wide research efforts on different ethnicities have enhanced our understanding of genetic predisposition to breast cancer but despite these discoveries, 75% of the familial risk of breast cancer remains unexplained, highlighting the fact that the majority of breast cancer susceptibility genes remain unidentified. For this purpose Pakistani population provides a strong genetic pool to elucidate the genetic etiology of breast cancer because of cousin marriages. In this review, we describe the known breast cancer predisposition factors found in the local Pakistani population and the epidemiological research work done to emphasize the importance of exploring factors/variants contributing to breast cance, in order to prevent, cure and decrease its incidence in our country.
Tien, A Y; Anthony, J C
Clinical and laboratory studies link alcohol and other drug use to the occurrence of psychotic experiences, but epidemiologic evidence has been lacking. In this study, the quantitative relationships between alcohol or other drug use and psychotic experiences were examined by analysis of prospective data from 4994 adult household residents sampled in a multisite survey of mental disorders in the population, the NIMH Epidemiologic Catchment Area Program. After control for sociodemographic factors and preexisting psychiatric conditions, the risk for onset of self-reported delusions or hallucinations was observed to be greater for daily users of marijuana or cocaine and for users of anxiolytics or sympathomimetics compared with nonusers. After control for daily cocaine use and alcohol disorder, the risk of onset of psychotic experiences for daily users of marijuana was double that for nonusers. Alcohol disorder in men was associated with eightfold risk and in women with threefold risk. Baseline depressive episodes, manic episodes, agoraphobia, and obsessive-compulsive disorder also were associated with increased risk of onset of psychotic experiences.
Joseph, Philip; Leong, Darryl; McKee, Martin; Anand, Sonia S; Schwalm, Jon-David; Teo, Koon; Mente, Andrew; Yusuf, Salim
Current global health policy goals include a 25% reduction in premature mortality from noncommunicable diseases by 2025. In this 2-part review, we provide an overview of the current epidemiological data on cardiovascular diseases (CVD), its risk factors, and describe strategies aimed at reducing its burden. In part 1, we examine the global epidemiology of cardiac conditions that have the greatest impact on CVD mortality; the predominant risk factors; and the impact of upstream, societal health determinants (eg, environmental factors, health policy, and health systems) on CVD. Although age-standardized mortality from CVD has decreased in many regions of the world, the absolute number of deaths continues to increase, with the majority now occurring in middle- and low-income countries. It is evident that multiple factors are causally related to CVD, including traditional individual level risk factors (mainly tobacco use, lipids, and elevated blood pressure) and societal level health determinants (eg, health systems, health policies, and barriers to CVD prevention and care). Both individual and societal risk factors vary considerably between different regions of the world and economic settings. However, reliable data to estimate CVD burden are lacking in many regions of the world, which hampers the establishment of nationwide prevention and management strategies. A 25% reduction in premature CVD mortality globally is feasible but will require better implementation of evidence-based policies (particularly tobacco control) and integrated health systems strategies that improve CVD prevention and management. In addition, there is a need for better health information to monitor progress and guide health policy decisions. © 2017 American Heart Association, Inc.
Soriano, Joan B; Rodríguez-Roisin, Roberto
Chronic obstructive pulmonary disease (COPD) has been a major public health problem during the 20th century, and will remain a challenge for the foreseeable future. Worldwide, COPD is in the spotlight, because its high prevalence, morbidity, and mortality create formidable challenges for healthcare systems. However, there remain many ongoing, contentious issues in COPD, including the definition and staging of COPD itself. Similarly, it appears that there is no consensus as yet on how, when, and where spirometry and other tools (symptoms assessment, imaging, biomarkers, and so on) should be conducted and implemented to screen, label, and treat for COPD, if any. Our current knowledge on the epidemiology, risk factors, and clinical presentation of COPD has been reasonably well documented in several previous reviews. We aim to summarize new developments surrounding the epidemiology of COPD, both at the population and at the clinical level, in comparison with other major burden contributors, while debating old and novel risk factors. Cigarette smoking is the principal causal factor, but other factors play a role in causing and triggering COPD. Likely, the clinical presentation of COPD and its contributing phenotypes within the remainder of the 21st century will be different than the "blue bloaters" and "pink puffers" observed one or two generations ago. Hopefully, the COPD clinical course will shift to better outcomes and prognosis than in the past.
Jervis-Bardy, Jake; Sanchez, L; Carney, A S
Otitis media represents a major health concern in Australian Indigenous children ('Indigenous children'), which has persisted, despite public health measures, for over 30 years. Global searches were performed to retrieve peer-reviewed and 'grey' literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012. In Indigenous children, the prevalence of otitis media subtypes is 7.1-12.8 per cent for acute otitis media, 10.5-30.3 per cent for active chronic otitis media and 31-50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media. Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.
Demirdag, Kutbettin; Hosoglu, Salih
Increased production of extended-spectrum β-lactamases (ESBLs) has become an important issue for treatment of severe Klebsiella pneumoniae (K. pneumoniae) infections. This study aimed to evaluate risk factors of infection from ESBL-producing K. pneumoniae (ESBL-KP). Risk factors were evaluated using a retrospective case control design. Fifty-two patients admitted to Firat University Hospital (FUH) with invasive infections from ESBL-KP were employed as cases. Patients admitted to FUH with non-ESBL-producing K. pneumoniae invasive infection were chosen as controls. Potential risk factors of the cases and controls were evaluated using hospital charts. Pulsed-field Gel Electrophoresis (PFGE) was used to show the relatedness of ESBL-KP strains. In univariate analysis, the following factors were found significant for ESBL-KP: pre-infection hospital stay, nosocomial origin, central venous catheterization, surgical intervention, antibiotic use longer than one week, and previous hospitalization. In contrast, stepwise logistic regression analysis showed that two variables, previous antibiotic use (p = 0.000) and surgical intervention (p = 0.006), remained significantly associated with risk for infection with an ESBL-KP. Molecular epidemiology identified several clusters among the ESBL-producing isolates. Antibiotic use and surgical intervention were significant associated factors for infections with ESBL-KP.
Lauritzen, J B
have a high risk of hip fracture (annual rate of 5-6%), and the incidence of falls is about 1,500 falls/1,000 persons/year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 290 falls/1,000 persons/year and about......%, corresponding to 9 out of 247 residents saved from sustaining a hip fracture. The review points to the essentials of the development of hip fracture, which constitutes; risk of fall, type of fall, type of impact, energy absorption, and lastly bone strength, which is the ultimate and last permissive factor......The present review summarizes the pathogenic mechanisms leading to hip fracture based on epidemiological, experimental, and controlled studies. The estimated lifetime risk of hip fracture is about 14% in postmenopausal women and 6% in men. The incidence of hip fractures increases exponentially...
Recurrence after inguinal hernia surgery is a considerable clinical problem, and several risk factors of recurrence such as surgical technique, re-recurrence, and family history have been identified. Non-technical patient related factors that influence the risk of recurrence after inguinal hernia surgery are sparsely studied. The purpose of the studies included in this PhD thesis, was to describe the epidemiologic characteristics of inguinal hernia occurrence and recurrence, as well as investigating the patient related risk factors leading to recurrence after inguinal hernia surgery. Four studies were included in this thesis. Study 1: The study was a nationwide register-based study combining the Civil Registration System and the Danish National Hospital Register during a five-year period. We included a total of 46,717 persons operated for a groin hernia from the population of 5,639,885 people (2,799,105 males, 2,008,780 females). We found that 97% of all groin hernia repairs were inguinal hernias and 3% femoral hernias. Data showed that inguinal hernia surgery peaked during childhood and old age, whereas femoral hernia surgery increased throughout life. Study 2: Using data from the Danish Hernia Database (DHDB), we included all male patients operated for elective primary inguinal hernia during a 15-year period (n = 85,314). The overall inguinal hernia reoperation rate was 3.8%, and subdivided into indirect inguinal hernias and direct inguinal hernias, the reoperation rates were 2.7% and 5.2%, respectively (p thesis have studies the natural history of groin hernias on a nationwide basis; have identified the epidemiologic distribution of groin hernias and the non-technical risk factors associated with recurrence. Data showed that non-technical patient-related risk factors have great impact on the risk of recurrence after inguinal hernia surgery. The reason to why inguinal hernias recur is most likely multifactorial and lies in the span of technical and non
Marín Martínez, Elena M; Aller García, Ana Isabel; Martín-Mazuelos, Estrella
Invasive fungal infection (IFI) has increased in recent years due to there being a greater number of risk factors. IFI caused by Candida is the most frequent, and although Candida albicans is the most isolated species, there is currently a decrease of C. albicans and an increase of other species of the genus. To analyse the epidemiology, risk factors, and antifungal susceptibility of blood culture isolates of non-C.albicans Candida species in our hospital in the last 12years. A retrospective study was conducted on 107 patients with candidaemia admitted to our hospital. Candida isolates susceptibility to fluconazole, itraconazole, voriconazole, amphotericinB, 5-fluorocytosine, caspofungin, micafungin, and anidulafungin was determined by means of a microdilution technique (Sensititre Yeast One; Izasa, Spain). From a total of 109 strains, 59 belonged to non-C. albicans Candida species: 25 Candida parapsilosis complex, 14 Candida glabrata complex, 13 Candida tropicalis, 4 Candida krusei, 1 Candida lipolytica, 1 Candida membranaefaciens, and 1 Candida pulcherrima. The most common risk factor in adults and children was catheter use. It was observed that 8.5% of those non-C.albicans strains were resistant to fluconazole. The results of this work confirm that it is necessary to know the epidemiology of non-C.albicans Candida species, the in vitro susceptibility of the species involved, and the main risk factors, especially in patients with predisposing conditions. Copyright © 2016 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.
Kyari, Fatima; Abdull, Mohammed M; Bastawrous, Andrew; Gilbert, Clare E; Faal, Hannah
The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa. Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition. Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma.
Kyari, Fatima; Abdull, Mohammed M.; Bastawrous, Andrew; Gilbert, Clare E.; Faal, Hannah
Purpose: The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. Methods: Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa. Results: Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition. Conclusion: Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma. PMID:23741130
Victor O. Akinseye
Full Text Available Bovine brucellosis is endemic in Nigeria; however, limited data exist on nationwide studies and risk factors associated with the disease. Using a cross-sectional sero-epidemiological survey, we determined the prevalence of and risk factors for brucellosis in slaughtered cattle in three geographical regions of Nigeria. Serum samples from randomly selected unvaccinated cattle slaughtered over a period of 3 years (between December 2010 and September 2013 from northern, southern and south-western Nigeria were tested for antibodies to Brucella abortus using the Rose Bengal test. Data associated with risk factors of brucellosis were analysed by Stata Version 12. In all, 8105 cattle were screened. An overall seroprevalence of 3.9% (315/8105 was recorded by the Rose Bengal test, with 3.8%, 3.4% and 4.0% from the northern, southern and south-western regions, respectively. Bivariate analysis showed that cattle screened in northern Nigeria were less likely to be seropositive for antibodies to Brucella spp. than those from south-western Nigeria (odds ratio = 0.94; 95% confidence interval: 0.73–1.22. However, logistic regression analysis revealed that breed ( p = 0.04 and sex ( p £ 0.0001 of cattle were statistically significant for seropositivity to Brucella spp. The study found that brucellosis was endemic at a low prevalence among slaughtered cattle in Nigeria, with sex and breed of cattle being significant risk factors. Considering the public health implications of brucellosis, we advocate coordinated surveillance for the disease among diverse cattle populations in Nigeria, as is carried out in most developed countries. Keywords: Bovine brucellosis, RBT, Epidemiology, Public Health, Nigeria
Hegazi, Refaat; El-Gamal, Mohamed; Abdel-Hady, Nagy; Hamdy, Osama
Diabetes is a fast-growing health problem in Egypt with a significant impact on morbidity, mortality, and health care resources. Currently, the prevalence of type 2 diabetes (T2D) in Egypt is around 15.6% of all adults aged 20 to 79. To describe the epidemiology, principal causes, associated risk factors, cultural aspects, and challenges that may contribute to the rapid rise in T2D in Egypt. Review of papers in PubMed and relevant gray literature. The International Diabetes Federation (IDF) has identified Egypt as the ninth leading country in the world for the number of patients with T2D. The prevalence of T2D in Egypt was almost tripled over the last 2 decades. This sharp rise could be attributed to either an increased pattern of the traditional risk factors for T2D such as obesity and physical inactivity and change in eating pattern or other risk factors unique to Egypt. These include increased exposure to environmental risk factors like pesticides and increased prevalence of chronic hepatitis C. Prevention, early identification, and effective intervention are integral components of effective T2D care in Egypt. These strategies may reduce the expanding economic burden associated with T2D care. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Portela de Santana, M L; da Costa Ribeiro Junior, H; Mora Giral, M; Raich, R M
Currently, there is a higher occurrence of biopsychosocial diseases, especially eating disorders, involving different body systems and aspects related to the individual and their social relations. Addressing current and relevant issues about the prevalence, incidence and risk factors for anorexia and bulimia nervosa in adolescence. Search the databases: MEDLINE, SciELO and LILACS for studies published on the epidemiology and risk factors for eating disorders in adolescence. The highest incidence of anorexia and bulimia nervosa among girls in the middle and final phase of adolescence. Factors that increase the risk for the onset of eating disorders in adolescents are: genetics, body changes during puberty, the vulnerability of adolescents to the ideals of thinness, social pressures to be thin, body image dissatisfaction, restrictive diet, depression and low self-esteem. However, it is suggested that in different cultures, eating disorders may come from a number of conditions unrelated to compensatory behaviors or weight, but the shape of the body. Several factors determine the occurrence of anorexia and bulimia nervosa in adolescence, however, there is no consensus how these factors interact in this complex process, which indicates the need for further investigations.
Full Text Available Objective: To review what is known at present with respect to incidence, survival, risk factors and prevalence among the elderly stroke patients in the Nordic countries.Method: This article is based mainly on literature identified through search engines (Mc Master Plus, Cochrane Library, Medline and PubMed, restricted to first-ever stroke in Nordic population-based studies and having applied to the standard WHO definition, a prospective study design and no upper age limit.Results: Data from the Nordic countries show an incidence rate of 1250 to 1796/100 000 in the age group 75-84, and 1628 to 2234 in those above 85 years. The incidence rates are higher among men, but women are expected to contribute more to incident cases due to their higher life expectancy. If the age-specific incidence of stroke remains stable, the proportion of stroke patients aged 80 years and older may reach 50% in a few decades. The elderly stroke patients have a higher 30-days case fatality, and a higher risk of dependency. Better treatment of stroke patients has improved the survival over the last two decades. The prevalence is expected to increase due to the decrease in lethality, a slower fall in incidence and a higher proportion of elderly. Cardiovascular risk factors increase with age. Hypertension is a major risk factor for stroke mortality in the elderly. Cardioembolic stroke due to atrial fibrillation is the most common stroke subtype in the elderly. Lifestyle risk factors are less prevalent in the older stroke patients.Conclusion: The growing proportion of elderly stroke patients is a major challenge for future stroke care. The elderly stroke patients have a different risk factor profile compared to younger stroke patients. Treatment should focus on regaining independency. The age-specific epidemiology of stroke needs to be studied further in large studies in order to plan for future health care.
Bao, Yu-Shi; Song, Li-Ting; Zhong, Di; Song, A-Xia; Jia, Xi-Bei; Liu, Rui-Chan; Xie, Ru-Juan; Na, Shi-Ping
There is growing evidence for an association between chronic renal disease (CKD) and adverse cerebrovascular events because of the overlap of several risk factors. The purpose of this study is to examine the epidemiology of CKD and the characteristics of risk factors for CKD in the population with ischaemic stroke. This retrospective study included 571 patients with ischaemic stroke. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease (MDRD) study equation. Renal function was assessed according to the Kidney Disease Outcomes Quality Initiative (K/DOQI)-CKD classification. Study demonstrated that the major factors associated with CKD in the ischaemic stroke patients were age, diabetes mellitus, hypertension, systolic blood pressure, LDL cholesterol and serum uric acid. Diabetes mellitus (OR 4·146, 95% CI 1·047-16·418, P = 0·043), hypertension and diabetes mellitus (OR 3·574, 95% CI 1·248-10·234, P = 0·018), serum uric acid (OR 1·010, 95% CI 1·006-1·013, P ischaemic stroke. The patients with ischaemic stroke may be considered as a high-risk population for CKD and be aggressively managed for CKD prevention. The high prevalence of CKD in population with ischaemic stroke prompts the need for greater public awareness about risks of CKD. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
Dang, T T; Majumdar, S R; Marrie, T J; Eurich, D T
Community-acquired pneumonia (CAP) is one of the most common reasons for physician visits and hospitalizations in North America. Rates of CAP increase with age and CAP is associated with significant morbidity and mortality, especially in the elderly. Though there is much written about the epidemiology and risk factors of incident (first episode) pneumonia, much less is known about recurrent pneumonia. Rates of recurrent pneumonia within 3-5-years of an episode of CAP are 9-12% with a median time to recurrence of 123-317 days and mortality ranging from 4 to 10%. Age ≥65-years-old and impaired functional status are the only patient characteristics that are independently associated with increased risk of recurrence. In terms of modifiable risk factors, only the use of proton-pump inhibitors and systemic and inhaled corticosteroids have consistently been associated with increased risk of recurrent pneumonia, while angiotensin-converting enzyme (ACE) inhibitors may exert a protective effect. Many chronic medical conditions typically associated with increased incident pneumonia-such as chronic obstructive pulmonary disease (COPD), neurological disease (resulting in dysphagia or silent aspiration), and heart failure-were not associated with increased risk of recurrent pneumonia. However, those who are immune-suppressed (e.g., immunoglobulin deficiencies) may be at increased risk of recurrent pneumonia. In summary, among those who survive an episode of pneumonia, recurrence is not uncommon, particularly in the elderly. Following recovery from an episode of pneumonia, patients should be evaluated for risk factors that would predispose to a second episode including seeking evidence of immunosuppression in younger patients and medication optimization, particularly in the elderly.
Boedeker, Wolfgang; Backhaus, Thomas
The analysis of combined effects of substances or risk factors has been a subject to science for more than a century. With different goals, combined effect analysis was addressed in almost all experimental biosciences. The major theoretical foundation can be traced back to two distinct origins. First, to the work by the pharmacologist Loewe on the concept of concentration additivity and second to the biometrician Bliss and the concept of independent action. In the search for a general solution and a unified terminology the interrelations of the concepts have extensively been studied and experimental findings reviewed. Meanwhile there seems to be consensus in experimental sciences that each concept has its role in predicting combined effect of agents and both are used for hazard und risk management. In contrast, epidemiologists describe combined effects mainly in terms of interactions in regression models. Although this approach started from a probabilistic model equivalent to the concept of independent action this origin is rarely acknowledged and effect summation is usually the preferred concept nowadays. Obscure biological meaning, the scale dependency of interaction terms as well as unavoidable residual confounding are taken as reasons why no new insights in combined effect analysis are likely to occur from epidemiology. In this paper we sketch the history of ideas and the state of the arts in combined effect analysis. We point to differences and common grounds in experimental biosciences and epidemiology.
Full Text Available Objective. Kuwait is among the countries with the highest obesity rates worldwide; however, little is known about the state of obesity epidemiology research in Kuwait. In this paper, we therefore review the findings and methodology of studies on the prevalence, trends and risk factors of obesity in Kuwait. Methods. The PubMed database was searched using the keyword combination: obesity and adults and Kuwait. Out of 111 articles, 39 remained after abstract review, and 18 were selected after full-text review. Results. The studies were all cross-sectional and published in the last fifteen years (1997–2012. The sample size ranged from 177 to 38,611 individuals. Only 30% of studies used random sampling. The prevalence (BMI ≥ 30 in studies with a nationally representative sample ranged from 24% to 48% overall and in adults >50 years was greater than 52%. Rates were significantly higher in women than those in men. Studies that examined trends showed an increase in obesity prevalence between 1980 and 2009. Multiple risk factors including sociocultural factors were investigated in the studies; however, factors were only crudely assessed. Conclusion. There is a need for future studies, particularly surveillance surveys and prospective cohort studies utilizing advanced methods, to monitor trends and to comprehensively assess the factors contributing to the obesity epidemic in Kuwait.
Wang, Jintang; Chen, Zheng; Song, Yuetao
Falls are a common and serious problem for aged people, causing an enormous amount of morbidity, mortality and burden to both the immediate family and the society in terms of healthcare utilization and costs. In the Chinese mainland, epidemiological data indicates a predilection for single falls, with women more at risk than men. A variety of risk factors such as weakness, unsteady gait, mental confusion and use of certain medications are associated with falls in the elderly. Addressing these risk factors can be expected to reduce rates of falling. Targeted fall risk assessments are the most effective preventive procedures, and include a plethora of assessment instruments that have been developed and designed for different purposes over the decades. Strategies for control of elderly falls have been established differently, taking into account the complex physiological and pathological conditions of the elderly. The optimal approach involves interdisciplinary assessments, physical exercise, medical intervention, environmental inspection and hazard abatement. In China, the 25 million falls suffered annually by the estimated 20 million elderly population exacts direct medical costs of about 5 billion yuan and social costs of 60-80 billion yuan. Fall-prevention strategies will thus have profound social and economic benefits. Copyright © 2010 Elsevier B.V. All rights reserved.
Eslick, G D; Talley, N J
Data on the population epidemiology of dysphagia are scarce. Little is known about the prevalence, risk factors and impact on quality of life of dysphagia in the general community. To determine the magnitude and impact of dysphagia in the general community. A random sample of 1000 individuals of Sydney, Australia, were mailed a validated self-report questionnaire to assess dysphagia. Measured were dysphagia symptoms, potential mechanisms, risk factors, psychological disorders, quality of life and demographics. The response rate of included subjects (n = 926) was 73% (n = 672). Dysphagia ever was reported by 16% (n = 110). Multiple logistic regression analysis found that odynophagia was independently associated with gastro-oesophageal reflux disease (GERD) (OR = 3.41, 95% CI: 1.16-10.04). Intermittent dysphagia was independently associated with GERD (OR = 2.96, 95% CI: 1.76-4.98) and anxiety (OR = 1.09, 95% CI: 1.01-1.19). The presence of progressive dysphagia was independently associated with depression (OR = 1.34, 95% CI: 1.07-1.67). Progressive dysphagia was independently associated with reduced 'general health' (OR = 0.95, 95% CI: 0.90-0.99), while intermittent dysphagia was associated with a reduction in the 'role physical' subscale (OR = 0.98, 95% CI: 0.97-0.99). Dysphagia is remarkably common in the general population. GERD is a risk factor for dysphagia as well as odynophagia. Intermittent dysphagia was associated with anxiety, while progressive dysphagia was associated with depression.
Chen, Jichang; Jiang, Yongjiang; Wei, Ba; Ding, Yanling; Xu, Shaolin; Qin, Peixu; Fu, Jinjian
The prevalence and clinical characteristics of neonatal candidemia are poorly understood in western China. The aim of our study was to evaluate the epidemiological features of neonatal candidemia in the Liuzhou Maternity and Child Healthcare Hospital. A retrospective case-control study was conducted between January 2012 and November 2015. Electronic databases were reviewed and data on Candida species were isolated from blood cultures and candidemia incidence, risk factors, and mortality were extracted. Univariate and multivariate logistic regression analysis were performed to identify risk factors associated with candidemia. During the 4-year period, candidemia was identified in 69 newborns, for an incidence rate of 13.6 per 1000 admissions. Prolonged antibiotic therapy duration [odds ratio (OR), 95% confidence incidence (95% CI) = 1.06, 1.01-1.10], total parenteral nutrition [OR, 95% CI = 6.03, 2.10-17.30] and neurodevelopmental impairment (OR, 95% CI = 7.34, 1.18-45.80) were all associated with increased odds of candidemia development in infants (P value was 0.010, 0.001, 0.033, respectively). The overall mortality rate was 7.2% in the candidemia group. Prolonged duration of antibiotic therapy, presence of total parenteral nutrition and neurodevelopmental impairment were the major risk factors associated with neonatal candidemia. This study highlights the importance of the early detection, diagnosis and treatment of neonatal candidemia.
OBJECTIVES To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. METHODS A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. RESULTS During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. CONCLUSIONS Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning. PMID:28882026
than single solutions, are strongly indicated in early rather than late adulthood.Keywords: epidemiology, disability, hip fractures, injury, prevention, risk factors
Lew Kan Sprenger
Full Text Available This study aimed to investigate the frequency of geohelminthic contamination of public parks and squares in Curitiba, state of Paraná, Brazil, between August and December 2010. A total of 345 samples were collected from 69 sandboxes in different areas and were tested using the Faust, Lutz and Baermann parasitological techniques. Potential risk factors associated with soil contamination were also analyzed. A total of 36% of the samples (124/345 were positive for helminths and 65.2% of the areas (45/69 were classified as contaminated in one or more samples. The most commonly identified parasite eggs were Ancylostoma sp. (14.5%; 50/345; followed by Toxocara sp. (9.6%; 33/345 and the Strongyloidea superfamily (excluding hookworms (2.3%; 8/345. The analysis on the epidemiological risk factors indicated that the presence of dogs and feces in the sandboxes increased the chances of contamination of the site. Use of fences had a protective positive impact that reduced soil contamination. Health education programs should be applied within the community to minimize the risk of human contact with dogs' feces. Use of fencing in these areas is highly recommended to prevent or reduce the users' contact with animal excrement.
Akinseye, Victor O; Adesokan, Hezekiah K; Ogugua, Akwoba J; Adedoyin, Folashade J; Otu, Patricia I; Kwaghe, Ayi V; Kolawole, Noah O; Okoro, Oyinye J; Agada, Charity A; Tade, Adeniyi O; Faleke, Olufemi O; Okeke, Anyanwu L; Akanbi, Ibikunle M; Ibitoye, Mofoluwake M; Dipeolu, Morenike O; Dale, Emma J; Lorraine, Perrett; Taylor, Andrew V; Awosanya, Emmanuel A; Cadmus, Eniola O; Stack, Judy A; Cadmus, Simeon I
Bovine brucellosis is endemic in Nigeria; however, limited data exist on nationwide studies and risk factors associated with the disease. Using a cross-sectional sero-epidemiological survey, we determined the prevalence of and risk factors for brucellosis in slaughtered cattle in three geographical regions of Nigeria. Serum samples from randomly selected unvaccinated cattle slaughtered over a period of 3 years (between December 2010 and September 2013) from northern, southern and south-western Nigeria were tested for antibodies to Brucella abortus using the Rose Bengal test. Data associated with risk factors of brucellosis were analysed by Stata Version 12. In all, 8105 cattle were screened. An overall seroprevalence of 3.9% (315/8105) was recorded by the Rose Bengal test, with 3.8%, 3.4% and 4.0% from the northern, southern and south-western regions, respectively. Bivariate analysis showed that cattle screened in northern Nigeria were less likely to be seropositive for antibodies to Brucella spp. than those from south-western Nigeria (odds ratio = 0.94; 95% confidence interval: 0.73-1.22). However, logistic regression analysis revealed that breed ( p = 0.04) and sex ( p £ 0.0001) of cattle were statistically significant for seropositivity to Brucella spp. The study found that brucellosis was endemic at a low prevalence among slaughtered cattle in Nigeria, with sex and breed of cattle being significant risk factors. Considering the public health implications of brucellosis, we advocate coordinated surveillance for the disease among diverse cattle populations in Nigeria, as is carried out in most developed countries.
Dilillo, Dario; Mauri, Silvia; Mantegazza, Cecilia; Fabiano, Valentina; Mameli, Chiara; Zuccotti, Gian Vincenzo
Epidemiological data suggests suicide is uncommon in childhood but becomes an extremely serious issue among adolescents. Several risk factors have been identified and include the presence of psychiatric illness, a previous suicide attempt, family factors, substance abuse, sexual and physical abuse, disorders in gender identity or bullying. Pediatricians have a primary role in searching for these risk factors, recognizing them and acting synergistically with other specialists to prevent and tr...
Montalvo, Alicia M; Shaefer, Hilary; Rodriguez, Belinda; Li, Tan; Epnere, Katrina; Myer, Gregory D
The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002) and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce the increase risk of injury during CrossFit.
Full Text Available Objective To investigate the epidemiological features and its potential related risk factors of adult rumination syndrome (ARS in Chinese naval servicemen, and to provide clinical basis for diagnosis and treatment of ARS. Methods A randomized cluster sampling method was used. Investigation and diagnosis were made according to the Rome Ⅲ Modular Questionnaire from November 2006 to April 2007, and 8600 cases were collected from naval forces. Results 7454 valid questionnaires were retrieved. The overall incidence of ARS was 2.32% (176/7574, male>female. The median age, age of conscription and length of military service were 23, 18 and 4 years respectively. The ARS was most common in unmarried people, who were 21-25 years old holding a high school diploma, with a 1-4 years military service. The incidence of ARS was different between groups with different gender, age, years of military service and marital status (P＜0.05. No significant difference in the incidence between those with different education levels or blood types. The differences between individuals in ARS group and healthy controls were related to habit of overeating (P=0.0000, picky eating (P=0.0001, addiction to spicy food (P=0.0000, eating hard dry food (P=0.0001, and eating fruits (P=0.0188. Conclusion The overall incidence of ARS in naval force is 2.32%, and it is prevalent in young man. The body weight is an independent risk factor for ARS.
Full Text Available Saïd C Azoury,1 Norma Elizabeth Farrow,2 Qing L Hu,2 Kevin C Soares,1 Caitlin W Hicks,1 Faris Azar,1 Nelson Rodriguez-Unda,3 Katherine E Poruk,1 Peter Cornell,1 Karen K Burce,1 Carisa M Cooney,3 Hien T Nguyen,1 Frederic E Eckhauser1 1Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; 2School of Medicine, Johns Hopkins University, Baltimore, MD, USA; 3Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA Abstract: Surgical site infections (SSIs complicate the postoperative course of a significant proportion of general abdominal surgical patients and are associated with excessive health care costs. SSIs increase postoperative morbidity and mortality, and may require hospital admission, intravenous antibiotics, and even surgical reintervention. Risks associated with SSIs are related to both host and perioperative factors. However, a vast majority of these infections are preventable. More recently, quality initiative programs such as American College of Surgeons National Surgical Quality Improvement Program are expanding their roles to help better monitor adherence to improvement measures. Indeed, standardizing preoperative antibiotic prophylaxis timing is perhaps the most persuasive example and this has been integral to reducing postoperative SSI rates. Herein, the authors provide an update on the epidemiology, risk factors, identification, and management of wound infections following abdominal surgery. Keywords: surgical site infection, diagnosis, treatment, prevention
Isgren, Cajsa M.; Upjohn, Melissa M.; Fernandez-Fuente, Marta; Massey, Claire; Pollott, Geoff; Verheyen, Kristien L. P.; Piercy, Richard J.
Background Exertional rhabdomyolysis syndrome is recognised in many athletic horse breeds and in recent years specific forms of the syndrome have been identified. However, although Standardbred horses are used worldwide for racing, there is a paucity of information about the epidemiological and performance-related aspects of the syndrome in this breed. The objectives of this study therefore were to determine the incidence, risk factors and performance effects of exertional rhabdomyolysis syndrome in Standardbred trotters and to compare the epidemiology and genetics of the syndrome with that in other breeds. Methodology/Principal Findings A questionnaire-based case-control study (with analysis of online race records) was conducted following identification of horses that were determined susceptible to exertional rhabdomyolysis (based on serum biochemistry) from a total of 683 horses in 22 yards. Thirty six exertional rhabdomyolysis-susceptible horses were subsequently genotyped for the skeletal muscle glycogen synthase (GYS1) mutation responsible for type 1 polysaccharide storage myopathy. A total of 44 susceptible horses was reported, resulting in an annual incidence of 6.4 (95% CI 4.6–8.2%) per 100 horses. Female horses were at significantly greater risk than males (odds ratio 7.1; 95% CI 2.1–23.4; p = 0.001) and nervous horses were at a greater risk than horses with calm or average temperaments (odds ratio 7.9; 95% CI 2.3–27.0; p = 0.001). Rhabdomyolysis-susceptible cases performed better from standstill starts (p = 0.04) than controls and had a higher percentage of wins (p = 0.006). All exertional rhabdomyolysis-susceptible horses tested were negative for the R309H GYS1 mutation. Conclusions/Significance Exertional rhabdomyolysis syndrome in Standardbred horses has a similar incidence and risk factors to the syndrome in Thoroughbred horses. If the disorder has a genetic basis in Standardbreds, improved performance in susceptible animals may
Cajsa M Isgren
Full Text Available BACKGROUND: Exertional rhabdomyolysis syndrome is recognised in many athletic horse breeds and in recent years specific forms of the syndrome have been identified. However, although Standardbred horses are used worldwide for racing, there is a paucity of information about the epidemiological and performance-related aspects of the syndrome in this breed. The objectives of this study therefore were to determine the incidence, risk factors and performance effects of exertional rhabdomyolysis syndrome in Standardbred trotters and to compare the epidemiology and genetics of the syndrome with that in other breeds. METHODOLOGY/PRINCIPAL FINDINGS: A questionnaire-based case-control study (with analysis of online race records was conducted following identification of horses that were determined susceptible to exertional rhabdomyolysis (based on serum biochemistry from a total of 683 horses in 22 yards. Thirty six exertional rhabdomyolysis-susceptible horses were subsequently genotyped for the skeletal muscle glycogen synthase (GYS1 mutation responsible for type 1 polysaccharide storage myopathy. A total of 44 susceptible horses was reported, resulting in an annual incidence of 6.4 (95% CI 4.6-8.2% per 100 horses. Female horses were at significantly greater risk than males (odds ratio 7.1; 95% CI 2.1-23.4; p = 0.001 and nervous horses were at a greater risk than horses with calm or average temperaments (odds ratio 7.9; 95% CI 2.3-27.0; p = 0.001. Rhabdomyolysis-susceptible cases performed better from standstill starts (p = 0.04 than controls and had a higher percentage of wins (p = 0.006. All exertional rhabdomyolysis-susceptible horses tested were negative for the R309H GYS1 mutation. CONCLUSIONS/SIGNIFICANCE: Exertional rhabdomyolysis syndrome in Standardbred horses has a similar incidence and risk factors to the syndrome in Thoroughbred horses. If the disorder has a genetic basis in Standardbreds, improved performance in susceptible animals may be
Alicia M. Montalvo, Hilary Shaefer, Belinda Rodriguez, Tan Li, Katrina Epnere, Gregory D. Myer
Full Text Available The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002 and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p < 0.001 than non-competitors. Athletes who reported injury also reported significantly higher values for the following risk factors: years of participation (2.7 ± 1.8 v 1.8 ± 1.5, p = 0.001, weekly athlete training hours (7.3 ± 3.8 v 4.9 ± 2.1, p = 0.020, weekly athlete-exposures (6.4 ± 3.8 v 4.7 ± 2.1, p = 0.003, height (1.72 ± 0.09 m v 1.68 ± 0.01 m, p = 0.011, and body mass (78.24 ± 16.86 kg v 72.91 ± 14.77 kg, p = 0.037. Injury rates during CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce
Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that have been associated with an increased risk of developing nonalcoholic fatty liver disease (NAFLD). Insulin resistance and central obesity are the key components of MetS, ultimately leading to liver fat accumulation and the subsequent development of necroinflammatory liver injury. However, the origin and nature of the metabolic stressors responsible for stimulating the progression of simple steatosis to nonalcoholic steatohepatitis (NASH) remain to be clearly identified. In addition, epidemiologic research on the association between MetS and NAFLD has provided only limited information to guide the development of targeted interventions, in particular, nutrition and pharmacologic prevention programs. This review summarizes the evidence supporting the proposal that NAFLD is not invariably associated with the presence of MetS, and mechanisms other than insulin resistance may contribute to the chronic inflammatory processes that underpin the development of liver fat accumulation and the subsequent architectural distortion of the liver. A special focus is given to increased hemoglobin as a risk factor for the development of NAFLD in the absence of MetS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Full Text Available Background: The increasing prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP poses an immediate threat to treatment worldwide. This retrospective study assessed the molecular epidemiology and determined the risk factors for and outcomes of CRKP infections in a general teaching hospital in Shanghai, China.Methods: From January 2013 to July 2015, 100 consecutive unique CRKP isolates isolated from hospitalized patients were collected. Isolates were screened for antibiotic resistance genes by polymerase chain reaction and molecular typing was performed by pulsed-field gel electrophoresis (PFGE. Patients infected with CRKP comprised the case group and were compared to the control group of patients infected with carbapenem-susceptible Klebsiella pneumoniae. Therapeutic effects were compared in the CRKP infection group.Results: Among the 100 CRKP isolates, the percentages of multidrug-resistant, extensively drug-resistant (XDR, and pandrug-resistant were 50.0, 50.0, and 0%, respectively. All the CRKP isolates produced KPC-2 and could be divided into 18 PFGE clusters (A–O and 70 subtypes. No dominant intra-hospital PFGE type was detected using a cutoff of 80% similarity. The ratio of CRKP infection to colonization was 51 to 49. Risk factors correlated with CRKP infection included pulmonary disease (p = 0.038, ICU stay (p = 0.002, invasive ventilation (p = 0.009, blood transfusion (p = 0.028, parenteral nutrition (p = 0.004, sputum suction (p = 0.006, medical history of previous hospitalization (p = 0.022, exposure to antibiotics 90 days before infection (p = 0.030, and antibiotic exposure during hospital stay including carbapenems (p = 0.013, enzyme inhibitors (p = 0.021, nitroimidazoles (p = 0.029, and glycopeptides (p = 0.000. Multivariable analysis showed that sputum suction (odds ratio 3.090, 95% confidence intervals 1.004–9.518, p = 0.049 was an independent risk factor for CRKP infections. Patients infected with CRKP with longer
Full Text Available Abstract Background Lung cancer aetiology and clinical aspects have been mainly studied in men, although specific risk factors probably exist in women. Here we present the rationale, design and organization of the WELCA study (Women Epidemiology Lung CAncer that has been launched to investigate lung cancer in women, focusing particularly on hormonal and occupational factors. Methods/Design WELCA is a population based case-control study and planned to recruit 1000 cases and 1000 controls in three years, based on study power calculation. Eligible cases are female patients newly diagnosed with lung cancer, living in Paris and the Ile de France area and aged up to 75 years. Almost all Parisian pneumology and oncology clinical departments are involved. The control group is a random sample of the population living in the same area, frequency-matched on age and additionally stratified on the distribution of socio-professional categories of women residing there. After acquisition of written consent, research nurses administer standardized computer assisted questionnaires to all the subjects in face-to-face interviews and acquire anthropometric measures. Besides usual socio-demographic characteristics, information is gathered about menstrual and reproductive factors, hormonal treatments, lifestyle and leisure characteristics, occupational history, personal and familial medical history. Biological samples are also collected, in order to establish a biobank for molecular epidemiology studies. Molecular characteristics of the tumours will be obtained and patients will be followed up for five years. Discussion The WELCA study aims to answer key questions in lung cancer aetiology and clinical characteristics specifically in women. The role of hormonal impregnation is investigated, and the interactions with cigarette smoking or body mass index (BMI will be analyzed in detail. The occupational history of the subjects is carefully reconstructed, focusing in
Jiménez de Domingo, Ana; Rubio García, Elena; Marañon Pardillo, Rafael; Arias Constanti, Vanessa; Frontado Haiek, Luis Alberto; Soriano Arola, Marta; Ripoll Oliveras, Francesc; Remón García, Cristina; Estopiña Ferrer, Gloria; Lorente Romero, Jorge
To describe the epidemiological characteristics of unintentional injuries due to falls in children under one year and to analyse the risk factors associated with severe injuries. This multicentre, observational and cross-sectional study included all children less than one year treated for unintentional fall in the Emergency Departments of 8 Spanish Hospitals, belonging to the «Unintentional Paediatric Injury Workshop» of the Spanish Paediatric Emergency Society, between March 1st, 2014 and February 28th, 2015. Out of 289,887 emergency department cases, 1,022 were due to unintentional falls. The median age was 8 months and 52.5% were males. Fall injuries were more frequent among children aged 9-12 months (37.6%), and 83.5% occurred at home. The most common mechanism was fall from nursery equipment (69.4%), and 47.8% occurred from a height under 50cm. More than two-thirds (68%) of falls were witnessed, but in half of the cases (329) the caregiver was not in area. Serious injuries were seen in 12% of cases. In this study, a fall height greater than 50cm, falls in the street, from the arms of the carer, and from the stairs were identified as independent risk factors for worse outcomes. The most serious injuries occur in children 50cm, though not related to unwitnessed falls. Because the most common serious injury mechanism is the fall from the arms of the carer, from stairs, and falls in the street, these facts should be highlighted in order to avoid morbidity. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
Rostad, Christina A; Wehrheim, Karla; Kirklin, James K; Naftel, David; Pruitt, Elizabeth; Hoffman, Timothy M; L'Ecuyer, Thomas; Berkowitz, Katie; Mahle, William T; Scheel, Janet N
Bacterial infections represent a major cause of morbidity and mortality in heart transplant recipients. However, data describing the epidemiology and outcomes of these infections in children are limited. We analyzed the Pediatric Heart Transplant Study database of patients transplanted between 1993 and 2014 to determine the etiologies, risk factors and outcomes of children with bacterial infections post-heart transplantation. Of 4,458 primary transplants in the database, there were 4,815 infections that required hospitalization or intravenous therapy, 2,047 (42.51%) of which were bacterial. The risk of bacterial infection was highest in the first month post-transplant, and the bloodstream was the most common site (24.82%). In the early post-transplant period (transplant), coagulase-negative staphylococci were the most common pathogens (16.97%), followed by Enterobacter sp (11.99%) and Pseudomonas sp (11.62%). In the late post-transplant period, community-acquired pathogens Streptococcus pneumoniae (6.27%) and Haemophilus influenzae (2.82%) were also commonly identified. Patients' characteristics independently associated with acquisition of bacterial infection included younger age (p transplant. Overall mortality post-bacterial infection was 33.78%, and previous cardiac surgery (p heart transplant recipients and were associated with high mortality rates. The risk of acquiring a bacterial infection was highest in the first month post-transplant, and a large proportion of the infections were caused by multidrug-resistant pathogens. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Matsumoto, Hisako; Izuhara, Yumi; Niimi, Akio; Tabara, Yasuharu; Nagasaki, Tadao; Kanemitsu, Yoshihiro; Murase, Kimihiko; Oguma, Tsuyoshi; Ito, Isao; Muro, Shigeo; Sekine, Akihiro; Matsuda, Fumihiko; Kosugi, Shinji; Nakayama, Takeo; Chin, Kazuo; Mishima, Michiaki
Chronic cough hypersensitivity, a potentially important concept of chronic or prolonged cough, is featured by heightened cough response to low-intensity stimuli, which may be generated in the absence of airflow limitations or allergic conditions. However, there is little epidemiological evidence to support this. In this large-scale community survey, we aimed to determine risks and cough-aggravating factors of prolonged cough while focusing on serum IgE levels. Prevalence of prolonged cough, defined as cough lasting 3 weeks or longer, was determined in 9,804 residents from a baseline measurement of the Nagahama Cohort Study, conducted from 2008 to 2010. Risk assessment of prolonged cough was confined to subjects without asthma (n = 9,402). A follow-up measurement of the Nagahama Study was successively conducted from 2013 to 2015, recruiting the same residents living in Nagahama City, Japan (n = 8,292). Validation analysis was performed in the follow-up measurement. In a baseline measurement, prolonged cough was reported by 9.5% of subjects without asthma and 32.3% of subjects with asthma. In subjects without asthma, various cough-aggravating factors were associated with prolonged cough. On the multivariate analysis, several cough-aggravating factors, including nighttime or early morning, weather, pollen season, and common cold, were associated with prolonged cough, independent of female sex, younger age, chronic obstructive pulmonary disease, postnasal drip, daytime sputum, and lower serum total IgE. Serum-specific IgE levels against Japanese cedar pollen were significantly higher in subjects who responded "yes" to "cough in the pollen season" than in those who did not respond, whereas, among subjects who responded "yes" to "cough in the pollen season," prolonged coughers showed lower serum IgE levels against Japanese cedar pollen than temporal coughers. Validation analysis in a follow-up measurement confirmed the associations between prolonged cough and
Freire, Maristela P; Pierrotti, Ligia C; Zerati, Antônio E; Araújo, Pedro H X N; Motta-Leal-Filho, J M; Duarte, Laiane P G; Ibrahim, Karim Y; Souza, Antonia A L; Diz, Maria P E; Pereira, Juliana; Hoff, Paulo M; Abdala, Edson
To describe the epidemiology of infections related to the use of implantable central venous access devices (CVADs) in cancer patients and to evaluate measures aimed at reducing the rates of such infections. Prospective cohort study. Referral hospital for cancer in São Paulo, Brazil. We prospectively evaluated all implantable CVADs employed between January 2009 and December 2011. Inpatients and outpatients were followed until catheter removal, transfer to another facility, or death. Outcome measures were bloodstream infection and pocket infection. We also evaluated the effects that the creation of a multidisciplinary team for CVAD care, avoiding in-hospital implantation of CVADs, and limiting CVAD insertion in neutropenic patients have on the rates of such infections. During the study period, 966 CVADs (mostly venous ports) were implanted in 933 patients, for a combined total of 243,792 catheter-days. We identified 184 episodes of infection: 154 (84%) were bloodstream infections, 21 (11%) were pocket infections, and 9 (5%) were surgical site infections. During the study period, the rate of CVAD-related infection dropped from 2.2 to 0.24 per 1,000 catheter-days ([Formula: see text]). Multivariate analysis revealed that relevant risk factors for such infection include surgical reintervention, implantation in a neutropenic patient, in-hospital implantation, use of a cuffed catheter, and nonchemotherapy indication for catheter use. Establishing a multidisciplinary team specifically focused on CVAD care, together with systematic reporting of infections, appears to reduce the rates of infection related to the use of these devices.
Full Text Available Hepatitis E Virus (HEV in pregnant women is more severe, often leading to fulminates hepatic failure, death in mother, abortion and death of infants. The aim of this study was to determine the Sero-epidemiology and risk factors of anti-HEV IgG antibodies in pregnant women in East Azerbaijan of Iran because the prevalence in Iranian pregnant women is almost unclear. We performed a descriptive, Cross-Sectional study to determine the frequency of anti-HEV IgG antibodies was evaluated using enzyme-linked immunosorbent assay (ELISA on 321 pregnant women referred to Alzahra health centers of Tabriz for pursuing pregnancy. Only ten (3.1% of 321 cases had positive results for anti-HEV IgG. Multivariate analysis of socio-demographic and behavioral characteristics of the pregnant women showed that HEV was associated with availability of potable water at home (p=0.007. The Seroprevalence anti-HEV IgG is low in the pregnant women; maybe it is related to the availability of potable water at home or high level of higen.
Andrist, Claude A; van den Borne, Bart H P; Bigler, Lotti M; Buchwalder, Theres; Roth, Beatrice A
In Switzerland, group-housing for breeding rabbit does is not explicitly required by law, but label programmes, as well as the general public and animal welfare groups, are advocating it. Although group-housing is of great benefit to the gregariously living rabbits, the establishment of a social hierarchy within the group might lead to stress and lesions. In the present epidemiological study, lesions were scored twice on 30% of the breeding does on all 28 commercial Swiss farms with group-housed breeding does. Additionally, a detailed questionnaire was filled out with all producers to determine risk factors potentially associated with lesions. Data were analysed using hierarchical proportional odds models. About 33% of the does examined had lesions, including wounds that were almost healed and small scratches. Severe lesions were counted on 9% of the animals. Differences between seasons in lesions score were identified, with the extent of lesions being higher in summer than in spring. Fewer lesions occurred on farms on which mastitis was more common. More lesions were found on farms where the does were isolated between littering and artificial insemination than on farms without isolation. According to the producers, most of the aggression occurred directly after the isolation phase when the does were regrouped again. We conclude that lesions in group-housed breeding does might be reduced by appropriate reproductive management. Copyright © 2012 Elsevier B.V. All rights reserved.
Tong, Louis; Saw, Seang-Mei; Carkeet, Andrew; Chan, Wai-Ying; Wu, Hui-Min; Tan, Donald
This study examined the prevalence rate of astigmatism and its epidemiological risk factors in Singapore school children. In a study of school children aged 7 to 9 years old in two schools in Singapore in 1999, a detailed questionnaire was administered to parents regarding reading or close-work habits, past history of close-work, family history, and socioeconomic factors. Cycloplegic refraction was performed five times in each eye. Defining astigmatism as worse than or equal to 0.5, 0.75, and 1 D cylinder in the right eye, the prevalence of astigmatism was calculated. The study population consisted of 1028 children. The prevalence rate of astigmatism (worse than or equal to 1 D cylinder) was 19.2% (95% confidence interval, 16.8 to 21.6). This was not different between genders, ethnic groups, or age (p > 0.05). With-the-rule astigmatism was more common than against-the-rule astigmatism. The prevalence of astigmatism and myopia was 9.8% (95% confidence interval, 8.0 to 11.6). A high AC/A ratio was associated (p = 0.003) with astigmatism, even after exclusion of myopic children. On vectorial analysis, J0 and J45 were associated with the number of hours of playing video games, whereas J45 was also associated with computer use. Only J45 was associated to male gender, a high AC/A ratio, and a family history of myopia. The prevalence rate of astigmatism (> or = 1 D) was 19%. Playing video games and computer use may be associated with astigmatism severity, although the presence of astigmatism (> or = 1 D) was not associated with any nearwork factors. A family history of myopia was associated with oblique astigmatism severity. A high AC/A ratio is associated with astigmatism, and this requires further investigation.
Zhao, Kun; Song, Gui-Hua; Gu, Hua-Qian; Liu, Shuang; Zhang, Yan; Guo, Yan-Rong
To study the epidemiological features, treatment status, and risk factors for asthma in children in Zhengzhou, China. Questionnaires for primary screening were issued using the method of multi-stage stratified sampling. Suspected asthmatic children were given a second questionnaire, physical examination, medical history review, and auxiliary examination to confirm the diagnosis. Age- and sex-matched non-asthmatic children were randomly recruited to the control group. The number of valid questionnaires was 10 616 (5 444 males and 5 172 females). There were 308 confirmed asthma cases and the overall prevalence was 2.90%. The prevalence in boys was higher than that in girls (3.4% vs 2.4%). The prevalence in children under 3 years of age was 10.2%, which was higher than that in other age groups. The top three triggers for asthma attack in children were respiratory infection (94.2%), weather changes (89.0%), and exercise (35.1%). The most common asthma attack was moderate (71.8%), followed by mild (22.7%). Inhaled corticosteroids, systemic corticosteroids, and antibiotics were applied to 94.8% (292 cases), 74.7% (230 cases), and 90.9% (280 cases) of all patients, respectively. Multivariate logistic regression analysis indicated the following major risk factors for asthma: history of allergic rhinitis (OR=150.285, 95% CI: 31.934-707.264), history of eczema (OR=10.600, 95% CI: 1.054-106.624), history of atopic dermatitis (OR=31.368, 95% CI: 3.339-294.683), food allergies (OR=27.373, 95% CI: 2.670-280.621), method of birth (OR=2.853, 95% CI: 1.311-6.208), age of first antibiotic use (OR=0.384, 95% CI: 0.172-0.857), frequency of antibiotic use within 1 year of age (OR=9.940, 95% CI: 6.246-15.820), use of wall decorating materials (OR=2.108, 95% CI: 1.464-3.036), and use of heat supply in winter (OR=6.046, 95% CI: 1.034-35.362). The prevalence of childhood asthma is associated with age and gender in Zhengzhou. Most asthma attacks are moderate, often triggered by
Mensah, George A
Reliable data on risk factor levels, exposure history, and population distribution can help inform policies and programs for disease prevention and control. With rare exception however, ideal local data on major risk factors and causes of death and disease burden have been scarce in sub-Saharan Africa (SSA). Basic community surveys in some countries and recent systematic analysis of disease burden attributable to 67 risk factors and risk factor clusters in 21 regions of the world provide an opportunity to examine and relate diabetes and cardiovascular risk factors to mortality and burden in SSA. Rising body mass index, especially in women in Southern Africa; and rising systolic blood pressure in East Africa for both sexes, and in West Africa for women are the major cardiometabolic risk factors. Harmful use of alcohol, especially in Southern SSA, tobacco use, and physical inactivity are also important. Improving vital registration and risk factor surveillance remain major challenges. © 2013.
Chen, Jichang; Jiang, Yongjiang; Wei, Ba; Ding, Yanling; Xu, Shaolin; Qin, Peixu; Fu, Jinjian
Abstract Background The prevalence and clinical characteristics of neonatal candidemia are poorly understood in western China. The aim of our study was to evaluate the epidemiological features of neonatal candidemia in the Liuzhou Maternity and Child Healthcare Hospital. Methods A retrospective case-control study was conducted between January 2012 and November 2015. Electronic databases were reviewed and data on Candida species were isolated from blood cultures and candidemia incidence, risk ...
Wobeser, Wendy L.; Yuan, Lilian; Naus, Monika; Corey, Paul; Edelson, Jeff; Heywood, Neil; Holness, D. Linn
Background Many people immigrating to Canada come from countries with a high burden of tuberculosis. The aim of this study was to develop a detailed epidemiologic profile of foreign-born people with tuberculosis living in Ontario. Methods In this population-based case-control study, cases of tuberculosis diagnosed in 1994-1995 were identified from the database of the Ontario Reportable Disease Information Service and were considered eligible for analysis if a record of landing (receipt of permission to establish residence in Canada) from the period 1986-1995 was found in the Citizenship and Immigration Canada (CIC) database, if the person was at least 11 years of age at the time their visa was issued, and if the person had not been diagnosed with tuberculosis before becoming legally landed in Canada. Control subjects, who met the same criteria as the case subjects but who did not have tuberculosis in 1994-1995, were identified from a CIC database for landed immigrants. Results A total of 1341 cases of tuberculosis in foreign-born people were reported in Ontario in 1994-1995. A record of landing was found in CIC databases for 1099 of these people, 224 of whom were not legally landed at the time of diagnosis. In total, 602 cases met the inclusion criteria. The 2 strongest determinants of risk among those who had become landed within the preceding 10 years were referral for medical surveillance by immigration officials (odds ratio [OR] 3.8, 95% confidence interval [CI] 2.6-6.0) and world region of origin (Somalia [OR 67.7, 95% CI 31.3-154.9], Vietnam [OR 25.0, 95% CI 12.5-50.0], the Philippines [OR 11.9, 95% CI 6.0-23.3], other sub-Saharan African countries [OR 11.6, 95% CI 5.7-23.2], India [OR 9.7, 95% CI 4.9-18.9], China [OR 6.1, 95% CI 3.1-12.1], other Asian countries [OR 4.7, 95% CI 2.4-9.1], the Middle East [OR 4.1, 95% CI 2.0-8.3], Latin America [OR 1.9, 95% CI 0.9-3.8), and the former socialist countries of Europe [OR 1.8, 95% CI 0.8-3.8]; the reference
Jonsson, Anders; Bonander, Carl; Nilson, Finn; Huss, Fredrik
Residential fires represent the largest category of fatal fires in Sweden. The purpose of this study was to describe the epidemiology of fatal residential fires in Sweden and to identify clusters of events. Data was collected from a database that combines information on fatal fires with data from forensic examinations and the Swedish Cause of Death-register. Mortality rates were calculated for different strata using population statistics and rescue service turnout reports. Cluster analysis was performed using multiple correspondence analysis with agglomerative hierarchical clustering. Male sex, old age, smoking, and alcohol were identified as risk factors, and the most common primary injury diagnosis was exposure to toxic gases. Compared to non-fatal fires, fatal residential fires more often originated in the bedroom, were more often caused by smoking, and were more likely to occur at night. Six clusters were identified. The first two clusters were both smoking-related, but were separated into (1) fatalities that often involved elderly people, usually female, whose clothes were ignited (17% of the sample), (2) middle-aged (45-64years old), (often) intoxicated men, where the fire usually originated in furniture (30%). Other clusters that were identified in the analysis were related to (3) fires caused by technical fault, started in electrical installations in single houses (13%), (4) cooking appliances left on (8%), (5) events with unknown cause, room and object of origin (25%), and (6) deliberately set fires (7%). Fatal residential fires were unevenly distributed in the Swedish population. To further reduce the incidence of fire mortality, specialized prevention efforts that focus on the different needs of each cluster are required. Cooperation between various societal functions, e.g. rescue services, elderly care, psychiatric clinics and other social services, with an application of both human and technological interventions, should reduce residential fire
Riman, Tomas; Nilsson, Staffan; Persson, Ingemar R
Ovarian cancer is the leading cause of mortality related to gynecologic malignancies in Sweden but there is no current screening program. Based upon epidemiological research there is evidence that certain reproductive factors are associated with ovarian cancer risk. Most studies generally indicate that each childbirth incurs a 15-20% risk reduction. Women who have used oral contraceptives for 5 years or longer experience about half the risk of ovarian cancer compared with never users. Breastfeeding seems to be protective while age at menarche and at menopause are less consistent risk predictors. Tubal ligation and hysterectomy seem to reduce ovarian cancer risk by up to 80%. Although some studies found endometriosis, polycystic ovarian syndrome (PCOS) and pelvic inflammatory disease (PID) to be positively related to ovarian cancer, the role of these factors is not yet established. Most recent studies observed an approximately 50% ovarian cancer risk increase among ever users of hormone replacement therapy (HRT) compared with never users, and the risk increased further with long-term use. There is less information concerning separate estrogen and progestin effects of HRT and ovarian cancer risk. Although the cause of ovarian cancer remains obscure, hypotheses relating to "incessant" ovulation, excessive gonadotropin secretion, retrograde carcinogen transportation, apoptosis and estrogen/progestin imbalance have been invoked as etiological explanations. All these hypotheses find various epidemiological support. The aim of this review is to summarize the epidemiological findings on reproductive factors and ovarian cancer risk. These findings are considered in the context of etiologic hypotheses and some new research areas are suggested.
Bassig, B. A.; Zhang, Y.; Zheng, T.; Lan, Q.; Rothman, N.
The incidence rates of non-Hodgkin lymphoma (NHL) have steadily increased over the last several decades in the United States, and the temporal trends in incidence can only be partially explained by the HIV epidemic. In 1992, an international workshop sponsored by the United States National Cancer Institute concluded that there was an “emerging epidemic” of NHL and emphasized the need to investigate the factors responsible for the increasing incidence of this disease. Over the past two decades, numerous epidemiological studies have examined the risk factors for NHL, particularly for putative environmental and lifestyle risk factors, and international consortia have been established in order to investigate rare exposures and NHL subtype-specific associations. While few consistent risk factors for NHL aside from immunosuppression and certain infectious agents have emerged, suggestive associations with several lifestyle and environmental factors have been reported in epidemiologic studies. Further, increasing evidence has suggested that the effects of these and other exposures may be limited to or stronger for particular NHL subtypes. This paper examines the progress that has been made over the last twenty years in elucidating the etiology of NHL, with a primary emphasis on lifestyle factors and environmental exposures.
Full Text Available Since the territory is divided with the province of Banten, in West Java there are five regencies that defined as malaria endemic area, there are Ciamis, Tasikmalaya, Garut, Cianjur and Sukabumi. Sufferer, concentrated in southern coastal areas (Indonesian Ocean starting from the beach of Kalipucang at Ciamis up to coast of Cikakak at Sukabumi which borders the province of Banten and also mountain and plantations areas. Malaria morbidity incidence risk factors is differ in each of these endemic areas. In general is the presence of malaria patients without symptoms who can be a source of infection that so difficult to know its existence. Still the number of standing water that can become mosqui-to breeding places of Anopheles spp, such as fish pond, small puddle on the riverside, shrimp pond, mangrove forests that potentially at the beginning of the rainy season, the fields during rice that potential when the rice growing and the river that potential in the dry season. The existence of high population mobility and also the number of vegetation in the surrounding residential population and the existence of cattle are placed close to settle-ments.
Bager, Cecilie Liv; Willumsen, Nicholas; Kehlet, Stephanie Nina
were elevated prior to diagnosis of solid cancers in a large prospective study. Methods: Between 1999 and 2001, 5,855 postmenopausal Danish women ages 48 to 89 years enrolled in the Prospective Epidemiologic Risk Factor study. Baseline demographics and serum were collected at the time of registration...
Jabbarvand, Mahmoud; Hashemian, Hesam; Khodaparast, Mehdi; Jouhari, Mohammadkarim; Tabatabaei, Ali; Rezaei, Shadi
To report the incidence of endophthalmitis after senile cataract surgery and to describe the epidemiology and main risk factors. Retrospective, single-center, cross-sectional descriptive study. Patients who underwent cataract surgery in Farabi Eye Hospital from 2006 through 2014. All patients were evaluated retrospectively to compare risk factors, epidemiologic factors, and prophylaxis methods related to endophthalmitis. Patient records were used to gather the data. Epidemiologic factors, systemic diseases, other ocular pathologic characteristics, complications during the surgery, technique of cataract surgery, intraocular lens type, method of antibiotic prophylaxis, surgeon experience, vitreous culture, and vision outcome were evaluated in these patients. One hundred twelve endophthalmitis cases among 480 104 operations reported, equaling an incidence of 0.023%. Patients with diabetes mellitus (14.3%) and of older age (mean age, 81 years), perioperative communication with the vitreous (17.9%), extracapsular cataract surgery procedure (11%), and surgery on the left eye (58.9% vs. 41.1% for right eye; P = 0.03) showed a statistically significant association with endophthalmitis. Short-term treatment with topical or systemic preoperative antibiotics or postoperative subconjunctival injection was associated with a 40% to 50% reduced odds of endophthalmitis compared with no prophylaxis (P = 0.2). No cases of endophthalmitis were observed among the 25 920 patients who received intracameral cefuroxime, suggesting that this approach to antibiotic prophylaxis may be far more effective than traditional topical or subconjunctival approaches. The incidence of endophthalmitis after cataract surgery in our center was 0.023%, comparable with that of other previously published international studies. Older rural patients with immune suppressive diseases, such as diabetes mellitus, are particularly more prone to endophthalmitis. Vitreous loss at the time of surgery was
Luna, J; Logroscino, G; Couratier, P; Marin, B
Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease with a fatal outcome. This review aims to report key epidemiological features of ALS in relation to the hypothesis of variation between populations, to summarize environmental hypothesis and to highlight current issues that deserve much considerations. Epidemiological ALS studies have shown a variation of incidence, mortality and prevalence between geographical areas and different populations. These data could support the notion that genetic factors, especially populations' ancestries, along with environmental and lifestyle factors, play a significant role in the occurrence of the disease. To date, there is no strong evidence to confirm an association between a particular environmental factor and ALS. Physical activity (PA) has been extensively evaluated. Recent studies support with the best evidence level that PA in general population is not a risk factor for ALS. However, further research is needed to clarify the association of PA in some occupations and some athletic activities. Epidemiological research based on multicenter international collaboration is essential to provide new data on ALS especially in some regions of the world that are to date poorly represented in the ALS literature. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Witt, Katrina; Lichtenstein, Paul; Fazel, Seena
Violence risk assessment in schizophrenia relies heavily on criminal history factors. To investigate which criminal history factors are most strongly associated with violent crime in schizophrenia. A total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification. Over a mean follow-up of 12.0 years, 17.3% of men (n = 1535) and 5.7% of women (n = 281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder. Clinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance. © The Royal College of Psychiatrists 2015.
Full Text Available This paper deals with the subject of injury in alpine skiing and snowboarding and the aim was to define the characteristics of injuries and the risk factors as the basis for establishing preventive measures. The types of injuries and risk factors were analyzed by examining previous papers. During the last thirty years, the number of injuries has generally decreased by 50-70%. The changes were recorded in the types of injuries, and the number of certain injuries increased. It was found that there was a mutual difference in the number and structure of the injuries of skiers and snowboarders. Injuries can be classified topologically and according to risk factors. The risk factors may be manifold: the characteristics of the equipment, the characteristics of the trail and snow surface, protective equipment, age, gender, physical fitness, risky behaviours, time of day, skiing discipline, climate factors, the presence of other skiers and others. By the analysis of these factors it was concluded that there were three entities in the implementation of security measures: the state that stipulates laws (relevant ministries, owners or organizers who provide services in skiing (ski centres, ski services, ski schools, clubs and skiers and snowboarders themselves.
Kongsted, Hanne; Toft, Nils; Nielsen, Jens Peter
, which is un-responsive to antibiotics and not associated with known pathogens. The aetiology behind the syndrome is unknown, and specific risk factors predisposing piglets to develop NNPDS also remain to be determined. The study evaluated sow and piglet-level risk factors for developing NNPDS......-65%) of piglets born by mature sows. In total of 26% of piglets had liquid faeces on the day of birth. Approximately half of these piglets developed NNPDS. In the majority of cases (50-70% of cases within herds) symptoms started on the second or third day of life. Piglets in Herd 1 had 12.8 times higher...... probability of developing NNPDS than piglets in Herd 4. First parity piglets had a 4.1 higher probability of developing NNPDS than piglets born by mature sows. Birth weight and faecal consistency on the day of birth were minor risk factors, each significant within one herd. Conclusions: The most important...
Type 2 diabetes is a disease with increasing prevalence. Better knowledge of risk factors may form the bases for specific interventions and preventive measures. The aim of this thesis was to contribute to the knowledge on type 2 diabetes, by examining family history of diabetes and other risk factors with emphasis on psychological exposures. The studies are based on the cohort of the Stockholm Diabetes Prevention Program (SDPP) in which 12,952 men and 19,416 women 35-56 years old were s...
Maniam, T; Marhani, Midin; Firdaus, M; Kadir, A B; Mazni, M J; Azizul, A; Salina, A A; Fadzillah, A R; Nurashikin, I; Ang, K T; Jasvindar, K; Noor Ani, A
This is an epidemiological study to determine the prevalence of suicidal behavior and its association with generalised anxiety disorder (GAD) and major depressive disorder (MDD) in a nationally representative sample. Suicidal ideation, plans and attempts were assessed in face-to-face interviews of respondents selected by a multistage probability sampling using items on suicidality from the WHO SUPRE-MISS questionnaire. The Mini International Neuropsychiatric Interview (MINI) was used to generate DSM-IV diagnoses of GAD and MDD. A total of 19309 subjects were studied. Multivariate regression analysis was conducted controlling for demographic characteristics such as age, gender and ethnicity. The prevalence estimates for suicide ideation, plans and attempts were 1.7% (95% CI: 1.4-1.9), 0.9% (CI: 0.7-1.1) and 0.5% (CI: 0.4-0.7) respectively. Younger people (16-24 years) had higher risk of suicidal behavior (OR: 2.6, CI: 1.08-6.2). Females (OR: 1.6, CI: 1.2-2.1) and Indians (OR: 3.3, CI: 2.2-4.9) also had higher risk. The prevalence of suicidal behavior in Malaysia is low, but it broadly corresponds to the pattern described in other countries. This national study confirms that Malaysians of Indian descent have much higher rates of suicidal behavior than other groups. The younger age group, females and the Indian ethnic group would need focused preventive efforts. © 2014.
Bissell, Benjamin T; Johnson, Robert J; Shafritz, Adam B; Chase, Derek C; Ettlinger, Carl F
The incidence of humerus fractures while participating in snowboarding and skiing is undefined. Very little is known about the risk factors associated with these fractures. Snowboarders are at increased risk for sustaining humerus fractures when compared with skiers. In addition, the types of fractures, laterality, and risk factors differ between the 2 groups. Case-control study; Level of evidence, 3. At a major ski area clinic, 318 humerus fractures were evaluated over 34 seasons. Radiographs were classified according to the AO and Neer systems. Patient data were analyzed and compared with that of a control population of uninjured skiers and snowboarders to determine incidence and risk factors. The incidence of humerus fractures among snowboarders (0.062 per 1000 snowboarder days) was significantly higher than that of skiers (0.041 per 1000, P Jumping was involved in 28.3% of humerus fractures among snowboarders and in 5.4% among skiers. Skiers with humerus fractures were more skilled, older, and fell less frequently than controls. Snowboarders were less skilled, younger, and fell at a similar rate compared with controls. Snowboarders are at significantly higher risk of sustaining humerus fractures than skiers. In skiers, humerus fractures show no laterality and most often involve the proximal humerus. In contrast, snowboarders more often fracture the left humerus at the diaphysis.
S.A. de Man (Stella)
textabstractThe studies on physical fitness in children as descnbed in this thesis address the following questions: (1) is there a relation between physical fitness and cardiovascular risk factors, notably blood pressure and serum lipids and lipoproteins, at a young age? (2) what is the effect of
Lisandro Alberto Encalada Mena
Full Text Available High seroprevalence in Yucatan and proximity to the state of Campeche make it necessary to determine the seroprevalence and risk factors of bovine respiratory syncytial virus (VRSB in the state of Campeche, Mexico. Thus the objective of the present work was to determine the seroprevalence and risk factors bovine respiratory syncytial virus (BRSV of the state of Campeche, Mexico. The sampled of 36 cattle herds (842 sera were analyzed by indirect ELISA kit, in the 11 municipalities of Campeche. A survey to obtain risk factors (sex, age of animals, number of animals grazing density, management system, presence of sheep on the farm and access to the roadside was applied and calculated X2 for each variable considered. Of the total number of samples analyzed (842, 273 were positive (32.47%. The prevalence ranges found ranged from 0% to 84%, so in 9 of the herds there were no positive samples, indicating a 75% (27/36 of dispersion of this virus. X2 analysis indicated that all variables were significant and are risk factors regarding with respect to the variable seroprevalence of BRSV. The results indicate a wide circulation of BRSV and we suggest implement recommendations that will enable a lower spread of this virus in the cattle population.
Neergaard, Jesper; Dragsbæk, K.; Christiansen, C.
cognitive impairment (OCI), who were most likely to progress to dementia and to identify the risk factors associated with progression. Design: Prospective cohort study. Setting: Population-based. Participants: 5,380 elderly women from Denmark. Measurements: The Short Blessed Test and a category fluency test...... with animal naming, was used to assess cognitive function, and to classify them into different groups of OCI. Results: OCI was identified in 852 subjects at baseline. The risk of dementia was elevated for OCI subjects as compared to subjects with normal cognition (HR 1.46[1.19-1.79]). The courses of OCI were...... predictor of conversion to dementia, additionally several modifiable risk factors were associated with progression....
Hoff, Ana O; Toth, Bela; Hu, Mimi; Hortobagyi, Gabriel N; Gagel, Robert F
Osteonecrosis of the jaw (ONJ), previously an entity associated with radiation therapy to the head and neck, has been observed in patients treated with bisphosphonates. Patients with metastatic breast cancer and myelomatous bone disease, commonly treated with high-potency nitrogen-containing bisphosphonates for a prolonged period of time, have the greatest risk of ONJ development. The reported frequency of ONJ ranges from 0.6% to 6.2% in breast cancer and from 1.7% to 15% in patients with multiple myeloma. Osteonecrosis of the jaw has also been observed in patients with other cancers such as prostate cancer and in benign bone disorders such as osteoporosis and Paget's disease in which the incidence is low. Risk factors associated with the development of ONJ include dental extractions, length of bisphosphonate treatment, and the type of bisphosphonate used. In this review, we summarize the reported incidence and risk factors associated with ONJ. © 2010 New York Academy of Sciences.
Ko, Yanna; Butcher, Rhys; Leong, Rupert W
Inflammatory bowel diseases (IBD) are idiopathic chronic diseases of the gastrointestinal tract well known to be associated with both genetic and environmental risk factors. Permissive genotypes may manifest into clinical phenotypes under certain environmental influences and these may be best studied from migratory studies. Exploring differences between first and second generation migrants may further highlight the contribution of environmental factors towards the development of IBD. There are few opportunities that have been offered so far. We aim to review the available migration studies on IBD, evaluate the known environmental factors associated with IBD, and explore modern migration patterns to identify new opportunities and candidate migrant groups in IBD migration research.
Ahmadi, Batoul; Alimohammadian, Masoomeh; Yaseri, Mehdi; Majidi, Azam; Boreiri, Majid; Islami, Farhad; Poustchi, Hossein; Derakhshan, Mohammad H; Feizesani, Akabar; Pourshams, Akram; Abnet, Christian C; Brennan, Paul; Dawsey, Sanford M; Kamangar, Farin; Boffetta, Paolo; Sadjadi, Alireza; Malekzadeh, Reza
Advances in medicine and health policy have resulted in growing of older population, with a concurrent rise in multimorbidity, particularly in Iran, as a country transitioning to a western lifestyle, and in which the percent of the population over the age of 60 years is increasing. This study aims to assess multimorbidity and the associated risk factors in Iran. We used data from 50,045 participants (age 40-75 y) in the Golestan Cohort Study, including data on demographics, lifestyle habits, socioeconomic status, and anthropometric indices. Multimorbidity was defined as the presence of 2 or more out of 8 self-reported chronic conditions, including cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, liver disease, gastroesophageal reflux disease, tuberculosis, and cancer. Multivariate logistic regression models were used to examine the associations between multiple different factors and the risk factors. Multimorbidity prevalence was 19.4%, with the most common chronic diseases being gastroesophageal reflux disease (76.7%), cardiovascular diseases (72.7%), diabetes (25.3%), and chronic obstructive pulmonary disease (21.9%). The odds of multimorbidity was 2.56-fold higher at the age of >60 years compared with that at <50 years (P < 0.001), and 2.11-fold higher in women than in men (P < 0.001). Other factors associated with higher risk of multimorbidity included non-Turkmen ethnicity, low education, unemployment, low socioeconomic status, physical inactivity, overweight, obesity, former smoking, opium and alcohol use, and poor oral health. Apart from advanced age and female sex, the most important potentially modifiable lifestyle factors, including excess body weight and opium use, and opium user, are associated with multimorbidity. Policies aiming at controlling multimorbidity will require a multidimensional approach to reduce modifiable risk factors in the younger population in developing countries alongside
Onishchenko, G G; Rakhmanin, Iu A; Tutel'ian, V A
In the article there are adduced the practical aspects of realization of a concept of risk evaluation of the adverse environment factors influencing the health of the Russian population by the State Service of Sanitary and Epidemiological Surveillance. Epidemiological data on the influence of the most spread free air contaminants is summarized and a matter of monitoring food products safety is considered. There are outlined arrangements for the successful application of the evaluation of risk of the different environment factors influencing the populations health to practical activities of the State Service of Sanitary and Epidemiological Surveillance of Russia.
Magnussen, Christina; Niiranen, Teemu J; Ojeda, Francisco M
BACKGROUND: Atrial fibrillation (AF) is a common cardiac disease in aging populations with high comorbidity and mortality. Sex differences in AF epidemiology are insufficiently understood. METHODS: In N=79 793 individuals without AF diagnosis at baseline (median age, 49.6 years; age range, 24...... without AF. Multivariable-adjusted models showed sex differences for the association of body mass index and AF (hazard ratio per standard deviation increase, 1.18; 95% confidence interval [CI], 1.12-1.23 in women versus 1.31; 95% CI 1.25-1.38 in men; interaction P value of 0.001). Total cholesterol...... was inversely associated with incident AF with a greater risk reduction in women (hazard ratio per SD, 0.86; 95% CI, 0.81-0.90 versus 0.92; 95% CI, 0.88-0.97 in men; interaction P value of 0.023). No sex differences were seen for C-reactive protein and N-terminal pro B-type natriuretic peptide. The population...
Full Text Available BACKGROUND Ectopic pregnancies are increasing in number and proportions. Real increase and better detection methods are contributing for this rise. All the cases diagnosed now are not surgical emergencies. Medical management and expectant line of management are possible. Revised clinical guidelines are there for the selection of cases for nonsurgical management. Knowledge about the risk factors is good for prophylaxis and to have a high suspicion about ectopic pregnancy in high-risk individuals. Knowing the success rate is absolutely essential for counselling before starting the therapy. Aim of the study- 1. To study the risk factor profile of ectopic pregnancies and to compare them with the old data of the study setting. 2. To follow up the cases receiving nonsurgical treatment and to assess the success rate. MATERIALS AND METHODS Study Setting- Department of Obstetrics and Gynaecology, Government Medical College, Kottayam. It is a tertiary care centre with 1500 beds and catering for the population of five districts of Kerala. Study Design- Observational Study Study Period- This study was completed by eighteen months from April 2014 to September 2015. RESULTS 219 cases of ectopic pregnancies were diagnosed during the study period. The ratio of this number with the total number of deliveries during that period is 3.48% and this is three times higher than that of the ratio twenty years ago (1.23%. Risk factor profile is also showing changes over this period. 15.1% had medical treatment and 11% had expectant line of therapy. Success rates are 87.87% and 95.65%, respectively. CONCLUSIONS Incidence and detection of ectopic pregnancies are increasing and the risk factor profile is changing. In properly selected cases, the success of nonsurgical management is excellent.
Ayoola, Modupe Comfort; Ogugua, Akwoba Joseph; Akinseye, Victor Oluwatoyin; Joshua, Tunde Olu; Banuso, Morenikeji Folusho; Adedoyin, Folashade Julianah; Adesokan, Hezekiah Kehinde; Omobowale, Temidayo Olutayo; Abiola, John Olusoji; Otuh, Patricia Ihuaku; Nottidge, Helen Oyebukola; Dale, Emma-Jane; Perrett, Lorraine; Taylor, Andrew; Stack, Judy; Cadmus, Simeon Idowu Babalola
In Nigeria, there is limited information on brucellosis particularly in dogs, despite its public health implications. We undertook a sero-epidemiological survey of brucellosis in dogs to determine the prevalence of the disease and associated risk factors for its occurrence in Nigeria. A cross-sectional study was conducted to screen dogs in south-western Nigeria for antibodies to Brucella sp using the rapid slide agglutination test (RSA) and Rose Bengal test (RBT), with positive samples confirmed respectively by serum agglutination test (SAT) and competitive enzyme linked immunosorbent assay (cELISA). Data were analyzed with STATA-12. From the 739 dog sera tested, 81 (10.96%) were positive by RSA and 94 (12.72%) by RBT; these were corroborated with SAT (4/81; 4.94%) and cELISA (1/94; 1.06%), respectively. Logistic regression identified location (OR=0.04; 95% CI: 0.02-0.09), breed (OR=1.71; 95% CI: 1.34-2.19), age (OR=0.10; 95% CI: 0.04-0.30) and management system (OR=8.51; 95% CI: 1.07-68.05) as risk factors for Brucella infection by RSA. However, location (OR=10.83; 95% CI: 5.48-21.39) and history of infertility (OR=2.62; 95% CI: 1.41-4.84) were identified as risk factors using RBT. Given the 10.96% to 12.72% seroprevalence of brucellosis recorded in this study, we advocate control of the disease in dogs, and public health education for those at risk of infection. Again, further studies are required to elucidate the role of dogs in the epidemiology of brucellosis in Nigeria considering the conducive human-animal interface and ecological factors responsible for the transmission of the disease.
Full Text Available BACKGROUND: Elucidating the role of the underlying risk factors for severe outcomes of the 2009 A/H1N1 influenza pandemic could be crucial to define priority risk groups in resource-limited settings in future pandemics. METHODS: We use individual-level clinical data on a large series of ARI (acute respiratory infection hospitalizations from a prospective surveillance system of the Mexican Social Security medical system to analyze clinical features at presentation, admission delays, selected comorbidities and receipt of seasonal vaccine on the risk of A/H1N1-related death. We considered ARI hospitalizations and inpatient-deaths, and recorded demographic, geographic, and medical information on individual patients during August-December, 2009. RESULTS: Seasonal influenza vaccination was associated with a reduced risk of death among A/H1N1 inpatients (OR = 0.43 (95% CI: 0.25, 0.74 after adjustment for age, gender, geography, antiviral treatment, admission delays, comorbidities and medical conditions. However, this result should be interpreted with caution as it could have been affected by factors not directly measured in our study. Moreover, the effect of antiviral treatment against A/H1N1 inpatient death did not reach statistical significance (OR = 0.56 (95% CI: 0.29, 1.10 probably because only 8.9% of A/H1N1 inpatients received antiviral treatment. Moreover, diabetes (OR = 1.6 and immune suppression (OR = 2.3 were statistically significant risk factors for death whereas asthmatic persons (OR = 0.3 or pregnant women (OR = 0.4 experienced a reduced fatality rate among A/H1N1 inpatients. We also observed an increased risk of death among A/H1N1 inpatients with admission delays >2 days after symptom onset (OR = 2.7. Similar associations were also observed for A/H1N1-negative inpatients. CONCLUSIONS: Geographical variation in identified medical risk factors including prevalence of diabetes and immune suppression may in part
Zöller, Bengt; Li, Xinjun; Sundquist, Jan; Sundquist, Kristina
Our aims were to investigate possible associations between hospitalisation for venous thromboembolism (VTE) and socioeconomic and occupational factors. A nationwide database was constructed by linking Swedish census data to the Hospital Discharge Register (1990-2007). Hospital diagnoses of VTE were based on the International Classification of Diseases. Standardised incidence ratios were calculated for different socioeconomic and occupational groups. A total of 43063 individuals aged >20 years were hospitalised for VTE. Individuals with >12 years of education were at lower risk for VTE. Blue-collar workers, farmers, and non-employed individuals had higher risks for VTE, and white collar workers and professionals lower risks. In males and/or females, risks for VTE were increased for assistant nurses; farmers; miners and quarry workers; mechanics, iron and metalware workers; wood workers; food manufacture workers; packers; loaders and warehouse workers; public safety and protection workers; cooks and stewards; home helpers; building caretakers; and cleaners. Decreased risks were observed for technical, chemical, physical, and biological workers; physicians; dentists; nurses; other health and medical workers; teachers, religious, juridical, and other social science-related workers; artistic workers; clerical workers; sale agents; and fishermen, whalers and sealers. High educational level and several occupations requiring high levels of education were protective against VTE, while the risks for VTE were increased for farmers, blue-collar workers and non-employed individuals. The mechanisms are unknown but it might involve persistent psychosocial stress related to low socioeconomic and occupational status. Copyright © 2011 Elsevier Ltd. All rights reserved.
Mustanski, Brian S.; Newcomb, Michael E.; Bois, Steve Nicholas Du; Garcia, Steve C.; Grov, Christian
Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the U.S. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. We conclude that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, we suggest that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors. PMID:21409715
Ogugua Akwoba Joseph
Full Text Available Objective: To investigate risk factors responsible for the epidemiology of brucellosis among cattle slaughtered in Nigeria in a bid to implement control strategies. Methods: This was a cross-sectional and sero-epidemiological survey of bovine brucellosis in two metropolitan abattoirs in Southwestern Nigeria. Between March and August 2013, cattle were screened for antibodies to Brucella spp. by using Rose Bengal test (RBT, and positive samples were subjected to competitive ELISA (cELISA. Parameters of individual animal were also obtained. Data were analyzed by using STATA version 12 and Chi-square; and logistic regression statistics were used to test association. Results: Overall, 2 480 cattle (1 241 in Oyo; 1 239 in Lagos were screened. Analysis using RBT revealed a total sero-prevalence of 4.9% (121/2 480, with 7.8% and 1.9% from Oyo and Lagos States respectively. The cELISA result supported 77.7% (94/121 (90.7% in Oyo; 25.0% in Lagos of the total RBT positive samples. Logistic regression analysis showed that only sex (P ≤ 0.001 and location (P = 0.001 of animal screened had statistically significant effects on seropositivity to Brucella abortus antibodies. Conclusions: Our findings reveal low sero-prevalence of brucellosis among slaughtered cattle in Southwestern Nigeria. Sex and location of abattoirs where animals are slaughtered are major risk factors to be considered in the epidemiology of the disease. Therefore, to promote public health, trade cattle meant for slaughter in Nigeria and African countries where brucellosis is endemic, should be monitored, and positive animals be excluded from the food chain.
Keski-Rahkonen, Anna; Mustelin, Linda
Eating disorders - anorexia nervosa, bulimia nervosa, and binge eating disorder - affect numerous Europeans. This narrative review summarizes European studies on their prevalence, incidence, comorbidity, course, consequences, and risk factors published in 2015 and the first half of 2016. Anorexia nervosa is reported by eating disorder eating disorders by 2-3% of women in Europe. Of men, 0.3-0.7% report eating disorders. Incidences of anorexia appear stable, whereas bulimia may be declining. Although the numbers of individuals receiving treatment have increased, only about one-third is detected by healthcare. Over 70% of individuals with eating disorders report comorbid disorders: anxiety disorders (>50%), mood disorders (>40%), self-harm (>20%), and substance use (>10%) are common. The long-term course of anorexia nervosa is favorable for most, but a substantial minority of eating disorder patients experience longstanding symptoms and somatic problems. The risk of suicide is elevated. Parental psychiatric disorders, prenatal maternal stress, various family factors, childhood overweight, and body dissatisfaction in adolescence increase the risk of eating disorders. Eating disorders are relatively common disorders that are often overlooked, although they are associated with high comorbidity and serious health consequences.
Theonys Diógenes Freitas
Full Text Available The aim of this investigation was to conduct an epidemiological study and identify risk factors associated with the occurrence of paratuberculosis (Johne’s disease in dairy goats within the semiarid region of Paraíba State. The study was done during the period of March 2009 to July 2011, during which 727 female goats from 86 flocks from the city of Monteiro, Paraíba were investigated. For the serological diagnosis of Mycobacterium avium subsp. paratuberculosis (Map infection indirect ELISA tests (screening and confirmatory were performed. Of the 727 animals used six (0.82% were seropositive at the confirmatory test after screening, and of the 86 flocks six (6.97% presented at least one seropositive animal. In positive flocks the frequency of reactive animals ranged from 5.26% to 16.60%. Risk factors identified were production system (weaning and reproduction (odds ratio = 36.0; 95% CI = 2.6 –486.1; p < 0,001 and absence of technical infrastructure (odds ratio = 54.0; 95% CI = 4.5 –642.9; p < 0,001. It was concluded that Mycobacterium avium subsp. paratuberculosis is present in dairy goat flocks in the region; however, its influence on decrease productivity as well as the risk of transmission to humans through animal products must totally evaluated. Based on the analysis of risk factors, improvements are recommended for the technical infrastructure and the management of breeding goats.
Patten, Scott B; Williams, Jeanne V A; Lavorato, Dina H; Campbell, Norman R C; Eliasziw, Michael; Campbell, Tavis S
To determine whether major depression (MD) leads to an increased risk of new-onset high blood pressure diagnoses. The data source was the Canadian National Population Health Survey (NPHS). The NPHS included a short-form version of the Composite International Diagnostic Interview (CIDI-SF) to assess MD and collected self-report data about professionally diagnosed high blood pressure and the use of antihypertensive medications. The analysis included 12,270 respondents who did not report high blood pressure or the use of antihypertensive medications at a baseline interview conducted in 1994. Proportional hazards models were used to compare the incidence of high blood pressure in respondents with and without MD during 10 years of subsequent follow-up. After adjustment for age, the risk of developing high blood pressure was elevated in those with MD. The hazard ratio was 1.6 (95% Confidence Interval = 1.2-2.1), p = .001, indicating a 60% increase in risk. Adjustment for additional covariates did not alter the association. MD may be a risk factor for new-onset high blood pressure. Epidemiologic data cannot definitely confirm a causal role, and the association may be due to shared etiologic factors. However, the increased risk may warrant closer monitoring of blood pressure in people with depressive disorders.
Ghias, M.; Pervaiz, M.K.
Hepatitis C virus (HCV) is one of the major health issues in Punjab, Pakistan. About 3% of the world population have been infected by hepatitis C virus. The objective of this study was to find out significantly associated factors with Hepatitis C in the region. Demographic, socio-economic and clinical factors were taken in consideration to determine the predictive strength of these associated factors by the logistic regression model approach. This was a hospital based case-control study of 400 patients; out of which 119 were controlled patients (HCV negative) while 281 were cases (HCV positive). Patients admitted in gastroenterology wards of Jinnah, Shaikh Zayed, and Mayo hospitals in Lahore city were interviewed to gather risk factors information. Data was collected in six months starting from April 2006 to September 2006. results from multiple linear logistic regression model for overall data showed that age (OR=1.035, p=0.001), history of blood transfusion (OR=9.204, p=0.004), history of hospitalization (OR=2.979, p=0.043), Tattooing (OR=27.484, p=0.013), family history of hepatitis (OR=4.069, p=0.000), surgical operation (OR=4.290, p=0.030) were found to have significant and positively association with Hepatitis C. Hence our estimated logit model can be used to predict the chance of hepatitis C under the presence or absence of certain significant factors. (author)
Schuster, Jennifer E.; Khuri-Bulos, Najwa; Faouri, Samir; Shehabi, Asem; Johnson, Monika; Wang, Li; Fonnesbeck, Christopher; Williams, John V.; Halasa, Natasha
Background Human metapneumovirus (HMPV) is a leading cause of acute respiratory tract infection (ARTI) in young children. Our objectives were to define HMPV epidemiology and circulating strains and determine markers of severe disease in Jordanian children. Methods We conducted a prospective study March 16, 2010-March 31, 2013 using quantitative RT-PCR to determine the frequency of HMPV infection among children <2 years old admitted with fever and/or acute respiratory illness to a major government hospital in Amman, Jordan. Results HMPV was present in 273/3168 (8.6%) of children presenting with ARTI. HMPV A2, B1, and B2, but not A1, were detected during the 3-year period. HMPV-infected children were older and more likely to be diagnosed with bronchopneumonia than HMPV-negative children. HMPV-infected children with lower respiratory tract infection (LRTI) had higher rates of cough and shortness of breath than children with LRTI infected with other or no identifiable viruses. Symptoms and severity were not different between children with HMPV only compared with HMPV co-infection. Children with HMPV subgroup A infection were more likely to require supplemental oxygen. In a multivariate analysis, HMPV subgroup A and age <6 months were independently associated with supplemental oxygen requirement. Conclusions HMPV is a leading cause of acute respiratory tract disease in Jordanian children <2 years old. HMPV A and young age were associated with severe disease. Ninety percent of HMPV-infected hospitalized children were full-term and otherwise healthy, in contrast to high-income nations; thus, factors contributing to disease severity likely vary depending on geographic and resource differences. PMID:26372450
Fill, M A; Sizemore, L A; Rickles, M; Cooper, K C; Buecker, C M; Mullins, H L; Hofmeister, M G; Abara, W E; Foster, M A; Asher, A K; Schaffner, W; Dunn, J R; Jones, T F; Wester, C
To understand increasing rates of hepatitis C virus (HCV) infection in Tennessee, we conducted testing, risk factor analysis and a nested case-control study among persons who use drugs. During June-October 2016, HCV testing with risk factor assessment was conducted in sexually transmitted disease clinics, family planning clinics and an addiction treatment facility in eastern Tennessee; data were analysed by using multivariable logistic regression. A nested case-control study was conducted to assess drug-using risks and behaviours among persons who reported intranasal or injection drug use (IDU). Of 4753 persons tested, 397 (8.4%) were HCV-antibody positive. HCV infection was significantly associated with a history of both intranasal and IDU (adjusted odds ratio (aOR) 35.4, 95% confidence interval (CI) 24.1-51.9), IDU alone (aOR 52.7, CI 25.3-109.9), intranasal drug use alone (aOR 2.6, CI 1.8-3.9) and incarceration (aOR 2.7, CI 2.0-3.8). By 4 October 2016, 574 persons with a reported history of drug use; 63 (11%) were interviewed further. Of 31 persons who used both intranasal and injection drugs, 26 (84%) reported previous intranasal drug use, occurring 1-18 years (median 5.5 years) before their first IDU. Our findings provide evidence that reported IDU, intranasal drug use and incarceration are independent indicators of risk for past or present HCV infection in the study population.
Milligan, Ki Lee; Matsui, Elizabeth; Sharma, Hemant
Asthma is the most commonly reported chronic condition of childhood in developed countries, with 6.5 million children affected in the USA. A disparate burden of childhood asthma is seen among socioeconomically disadvantaged youth, often concentrated in urban areas with high poverty rates. Host factors that predispose a child to asthma include atopy, male gender, parental history of asthma, and also race, ethnicity, and genetic and epigenetic susceptibilities. Environmental factors, such as improved hygiene, ambient air pollution, and early life exposures to microbes and aeroallergens, also influence the development of asthma. With greater than 90% of time spent indoors, home exposures (such as cockroach, rodent, and indoor air pollution) are highly relevant for urban asthma. Morbidity reduction may require focused public health initiatives for environmental intervention in high priority risk groups and the addition of immune modulatory agents in children with poorly controlled disease.
Gudjonsson, Gisli H; Sigurdsson, Jon Fridrik; Sigfusdottir, Inga Dora; Young, Susan
The objective was to disentangle the relationship between offending, ADHD, and comorbid risk factors. A total of 11,388 students in further education completed a questionnaire, which measured nonviolent and violent delinquency, current ADHD symptoms, conduct disorder, substance use, association with delinquent peers, emotional lability, anger problems, violent attitudes, and low self-esteem. The nonviolent and violent delinquency measures correlated significantly with all the predictor measures, with small to large effect sizes. Multiple regressions showed that after controlling for age and gender, ADHD contributed 8.2% and 8.8% to the variance in nonviolent and violent delinquency, respectively, but these effects were largely mediated by the comorbid measures, particularly substance use, association with delinquent peers, and conduct disorder. The relationship between ADHD symptoms and offending among young people is largely explained indirectly by comorbid factors. A key prevention is to address substance use problems and association with delinquent peers.
Ofori, Emmanuel; Ramai, Daryl; Dhawan, Monica; Mustafa, Fareeza; Gasperino, James; Reddy, Madhavi
The epidemiological landscape of Clostridium difficile infection (CDI) has changed over the past 30 years. To review studies of CDI in the community setting. Electronic databases including PubMed, MEDLINE, Embase, Google Scholar, Scopus, ClinicalTrials.gov, and Cochrane Databases were searched for human studies performed between 2000 and 2017 that assessed the epidemiology, risk factors, ribotypes, hospital and intensive care unit outcomes, and management of community-acquired CDI. We also manually searched references to identify additional relevant studies. In total, 39 articles met our inclusion criteria. The incidence of community acquired CDI has almost doubled in the past decade. Approximately half of all cases of CDI are attributed to community origin. Individuals who are younger, female, in the presence of infants, frequently use proton pump inhibitors or specific classes of antibiotics, or live near farms and livestock are at higher risk for community-acquired CDI. Additionally, about 40% of all community-acquired cases require hospitalization, where severity has been linked to hypervirulent ribotypes 027 and 078 with poor outcomes. Emerging data on treatment paradigms have led to the revision of clinical guidelines and two potential vaccines in phase three clinical trials. However, ribotype specific response to current treatment strategies is lacking. Community-acquired CDI represents a growing public health threat and burden on healthcare systems. A multidisciplinary approach will be required to stem the tides. Copyright © 2018. Published by Elsevier Ltd.
Mamidala, Madhu Poornima; Polinedi, Anupama; Kumar, P T V Praveen; Rajesh, N; Vallamkonda, Omsai Ramesh; Udani, Vrajesh; Singhal, Nidhi; Rajesh, Vidya
Globalization and women empowerment have led to stressful life among Indian women. This stress impairs women's hormonal makeup and menstrual cycle, leading to infertility. National Family Health Survey-3 (NFHS-3) reports a decline in fertility status in India, indicating a rise in various infertility treatments involving hormonal interventions. No studies are available from India on the risk association link between maternal hormonal treatments and ASD. Hence, this study explores the association of maternal hormonal interventions with risk for ASD. Parents of 942 children (471 ASD and 471 controls) across 9 cities in India participated in the questionnaire-based study. The questionnaire was pilot tested and validated for its content and reliability as a psychometric instrument. Data collection was done at 70 centres through direct interaction with parents and with the help of trained staff. Statistical analysis of data was carried out using SAS 9.1.3. Out of the 471 ASD cases analysed, 58 mothers had undergone hormonal interventions (12.3 percent) while there were only 22 mothers among controls who underwent hormonal interventions (4.6 percent). According to logistic regression analysis maternal hormonal intervention (OR=2.24) was a significant risk factor for ASD.
Bhattarai, Manjula; Baniya, Jagat Bahadur; Aryal, Nirmal; Shrestha, Bimal; Rauniyar, Ramanuj; Adhikari, Anurag; Koirala, Pratik; Oli, Pardip Kumar; Pandit, Ram Deo; Stein, David A; Gupta, Birendra Prasad
HBV and HCV infections are widespread among the HIV-infected individuals in Nepal. The goals of this study were to investigate the epidemiological profile and risk factors for acquiring HBV and/or HCV coinfection in disadvantaged HIV-positive population groups in Nepal. We conducted a retrospective study on blood samples from HIV-positive patients from the National Public Health Laboratory at Kathmandu to assay for HBsAg, HBeAg, and anti-HCV antibodies, HIV viral load, and CD4+ T cell count. Among 579 subjects, the prevalence of HIV-HBV, HIV-HCV, and HIV-HBV-HCV coinfections was 3.62%, 2.93%, and 0.34%, respectively. Multivariate regression analysis indicated that spouses of HIV-positive migrant labourers were at significant risk for coinfection with HBV infection, and an age of >40 years in HIV-infected individuals was identified as a significant risk factor for HCV coinfection. Overall our study indicates that disadvantaged population groups such as intravenous drug users, migrant workers and their spouses, female sex workers, and men who have sex with HIV-infected men are at a high and persistent risk of acquiring viral hepatitis. We conclude that Nepalese HIV patients should receive HBV and HCV diagnostic screening on a regular basis.
Dora E Corzo-Leon
Full Text Available Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI.To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City.Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010.All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis.CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days. C. albicans was the predominant species (46%, followed by C. tropicalis (26%. C. glabrata was isolated from patients with diabetes (50%, and elderly patients. Sixty-four patients (86% received antifungals. Amphotericin-B deoxycholate (AmBD was the most commonly used agent (66%. Overall mortality rate reached 46%, and risk factors for death were APACHE II score ≥ 16 (OR = 6.94, CI95% = 2.34-20.58, p<0.0001, and liver disease (OR = 186.11, CI95% = 7.61-4550.20, p = 0.001. Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed.The cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI.
Primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC) are chronic cholestatic liver diseases of unknown etiology. True population-based epidemiological studies are scarce, especially in PSC. There is a need for large population-based studies combining meticulous case-finding and
Jennifer L Foltz
Full Text Available Nodding Syndrome (NS, an unexplained illness characterized by spells of head bobbing, has been reported in Sudan and Tanzania, perhaps as early as 1962. Hypothesized causes include sorghum consumption, measles, and onchocerciasis infection. In 2009, a couple thousand cases were reportedly in Northern Uganda.In December 2009, we identified cases in Kitgum District. The case definition included persons who were previously developmentally normal who had nodding. Cases, further defined as 5- to 15-years-old with an additional neurological deficit, were matched to village controls to assess risk factors and test biological specimens. Logistic regression models were used to evaluate associations.Surveillance identified 224 cases; most (95% were 5-15-years-old (range = 2-27. Cases were reported in Uganda since 1997. The overall prevalence was 12 cases per 1,000 (range by parish = 0·6-46. The case-control investigation (n = 49 case/village control pairs showed no association between NS and previously reported measles; sorghum was consumed by most subjects. Positive onchocerciasis serology [age-adjusted odds ratio (AOR1 = 14·4 (2·7, 78·3], exposure to munitions [AOR1 = 13·9 (1·4, 135·3], and consumption of crushed roots [AOR1 = 5·4 (1·3, 22·1] were more likely in cases. Vitamin B6 deficiency was present in the majority of cases (84% and controls (75%.NS appears to be increasing in Uganda since 2000 with 2009 parish prevalence as high as 46 cases per 1,000 5- to 15-year old children. Our results found no supporting evidence for many proposed NS risk factors, revealed association with onchocerciasis, which for the first time was examined with serologic testing, and raised nutritional deficiencies and toxic exposures as possible etiologies.
Walker, Martin; Hall, Andrew; Basáñez, María-Gloria
Much of our current understanding of the epidemiology of Ascaris lumbricoides infections in humans has been acquired by analyzing worm count data. These data are collected by treating infected individuals with anthelmintics so that worms are expelled intact from the gastrointestinal tract. Analysis of such data established that individuals are predisposed to infection with few or many worms and members of the same household tend to harbor similar numbers of worms. These effects, known respectively as individual predisposition and household clustering, are considered characteristic of the epidemiology of ascariasis. The mechanisms behind these phenomena, however, remain unclear. In particular, the impact of heterogeneous individual exposures to infectious stages has not been thoroughly explored. Bayesian methods were used to fit a three-level hierarchical statistical model to A. lumbricoides worm counts derived from a three-round chemo-expulsion study carried out in Dhaka, Bangladesh. The effects of individual predisposition, household clustering and household covariates of the numbers of worms per host (worm burden) were considered simultaneously. Individual predisposition was found to be of limited epidemiological significance once household clustering had been accounted for. The degree of intra-household variability among worm burdens was found to be reduced by approximately 58% when household covariates were included in the model. Covariates relating to decreased affluence and quality of housing construction were associated with a statistically significant increase in worm burden. Heterogeneities in the exposure of individuals to infectious eggs have an important role in the epidemiology of A. lumbricoides infection. The household covariates identified as being associated with worm burden provide valuable insights into the source of these heterogeneities although above all emphasize and reiterate that infection with A. lumbricoides is inextricably associated
Luo, Kai-Wei; Gao, Li-Dong; Hu, Shi-Xiong; Zhang, Hong; Deng, Zhi-Hong; Huang, Wei; Sun, Qian-Lai; Zhang, Fan; Zhang, Si-Yu; Chen, Yu
Hand, foot, and mouth disease (HFMD) is an arising public health problem in Asia, including China. Epidemiological data is necessary to enable judicious public health responses and interventions. We analyzed the epidemiological and laboratory data of 759,301 HFMD cases reported to the Hunan Provincial Center for Disease Control and Prevention from 1 January 2009 to 31 December 2014. Univariate and multivariable conditional logistic regression analyses were used to identify risk factors of fatality in HFMD. The incidence of HFMD was highest among children aged 1-3 years, compared with other age groups. Of the total HFMD cases, 7,222 (0.95%) were considered severe and 338 (0.04%) were fatal. Enterovirus-A71 was the major cause of severe and fatal cases (65.75% and 88.78%, respectively). For severe cases, the median time from symptom onset to diagnosis was 0.5 days (interquartile range [IQR] 0-1.5 days); the median time from diagnosis to severe illness was 2 days (IQR 1-3 days). For fatal cases, the median time from symptom onset to diagnosis was 0.5 days (IQR 0-1.5 days); the median time from diagnosis to death was 1.5 days (IQR 0.5-2.5 days). In multivariable analysis, the abuse of antibiotic, glucocorticoid and pyrazolone in village clinics at basic medical institutions were identified as independent risk factors for HFMD fatal cases. In conclusion, our results suggest that the future direction to control and respond to HFMD is intensive surveillance of enterovirus-A71 and improving the ability to diagnose disease and treat patients, especially in basic medical institutions.
Chun Wei Li
Full Text Available The prevalence of allergic rhinitis (AR in China has increased with an apparent geographic variation. The current study aims to investigate the AR prevalence/classification, diagnosis/treatment conditions, trigger factors, and risk factors in the general population of Guangzhou, the third biggest city in China. A cross-sectional survey was performed in the citizens in Guangzhou from December 2009 to March 2010 by using a stratified multistage cluster sampling method. All subjects were asked to complete a comprehensive questionnaire via a face to face interview. A total of 9,899 questionnaires were valid. The prevalence rate of AR in the general population of Guangzhou was 6.24%, with a significant higher prevalence in urban area (8.32% versus rural area (3.43%. Among the AR subjects, most (87% were diagnosed with intermittent AR and 87% suffered from moderate-severe symptoms. High percentages of the AR patients did not have previously physician-based diagnosis (34% or specific medical treatment (55%. Morning time, winter season, and cold air were the most common trigger factors of AR. Family history of AR, current living place, living place during babyhood, smoking, home renovation, and pet ownership were the significant risk factors associated with AR prevalence in the population. The study demonstrated comprehensive epidemiological and clinical information about the AR in Guangzhou population. Change of living environment and lifestyles had strong impacts on the prevalence of AR. Public health policies should help the patients benefit from a proper diagnosis/treatment and specifically target the local risk factors, in order to control the AR incidence.
Cortés, Jorge Alberto; Reyes, Patricia; Gómez, Carlos Hernando; Cuervo, Sonia Isabel; Rivas, Pilar; Casas, Christian A; Sánchez, Ricardo
Bloodstream infection by Candida species has a high mortality in Latin American countries. The aim of this study was to describe the characteristics of patients with documented bloodstream infections caused by Candida species in third level hospitals and determine the risk factors for in-hospital-mortality. Patients from seven tertiary-care hospitals in Bogotá, Colombia, with isolation of a Candida species from a blood culture were followed prospectively from March 2008 to March 2009. Epidemiologic information, risk factors, and mortality were prospectively collected. Isolates were sent to a reference center, and fluconazole susceptibility was tested by agar-based E-test. The results of susceptibility were compared by using 2008 and 2012 breakpoints. A multivariate analysis was used to determinate risk factors for mortality. We identified 131 patients, with a median age of 41.2 years. Isolates were most frequently found in the intensive care unit (ICU). Candida albicans was the most prevalent species (66.4% of the isolates), followed by C. parapsilosis (14%). Fluconazole resistance was found in 3.2% and 17.6% of the isolates according to the 2008 and 2012 breakpoints, respectively. Fluconazole was used as empirical antifungal therapy in 68.8% of the cases, and amphotericin B in 22%. Hospital crude mortality rate was 35.9%. Mortality was associated with age and the presence of shock at the time of Candida detection. Fluconazole therapy was a protective factor for mortality. Candidemia is associated with a high mortality rate. Age and shock increase mortality, while the use of fluconazole was shown to be a protective factor. A higher resistance rate with new breakpoints was noted. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.
Gawlik, Kate Sustersic; Melnyk, Bernadette Mazurek; Tan, Alai
To present nationally representative data on the prevalence of "social" smoking and its relationship to cardiovascular health. A population-based, cross-sectional survey on cardiovascular health and its risk factors across the United States. Million Hearts ® cardiovascular screenings that took place in community settings. De-identified data were collected on a convenient sample of 39, 555 participants. Reported smoking status, blood pressure, and total cholesterol. The prevalence of current smoking, social smoking, and non-smoking were cross-tabulated and stratified by sample characteristics. The adjusted estimates were derived from multiple logistic regression models, adjusting for demographics and other biometric measures. Ten percent identified as social smokers. Social smokers were more likely to be aged between 21 and 40, male, and Hispanic. Social smokers had significantly higher risks of having hypertension (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.80-2.41) and elevated cholesterol (OR: 1.53, 95% CI: 1.33-1.75) than non-smokers. There was no significant difference between social smokers and current smokers (OR = 0.94, 95% CI = 0.80-1.14 for hypertension and OR = 0.95, 95% CI = 0.81-1.11 for elevated cholesterol). This is the first population health study to compare the blood pressure and cholesterol levels of people who self-identify as current verses social smokers. Although previous smoking behavior was not controlled for in the analysis, this study demonstrates there is no significant difference in the prevalence of elevated blood pressure or cholesterol among the 2 smoking groups.
Schmidt, Sigrun A J; Vestergaard, Mogens; Baggesen, Lisbeth M; Pedersen, Lars; Schønheyder, Henrik C; Sørensen, Henrik T
Herpes zoster (HZ) is a vaccine-preventable disease caused by reactivation of the varicella-zoster virus. Unfortunately, formulation of recommendations on routine immunization is hampered by a lack of data on disease burden, since most countries do not record cases of HZ in the general population. We developed and validated an algorithm to identify HZ based on routinely collected registry data and used it to quantify HZ occurrence and risk factors in Denmark prior to marketing of the HZ vaccine. We included patients aged ≥40years with a first-time systemic Acyclovir, Valacyclovir, or Famciclovir prescription or a hospital-based HZ diagnosis in the Danish nationwide health registries during 1997-2013. In a validation substudy (n=176), we computed the proportion of persons with HZ among patients who redeemed antiviral prescriptions. In a cohort study, we computed age-specific rates of HZ (45,297,258 person-years). In a case-control study, we then computed odds ratios (ORs) for common chronic diseases and immunosuppressive factors among HZ cases (n=189,025) vs. matched population controls (n=945,111). Medical record review confirmed HZ in 87% (95% confidence interval: 79-93%) of persons ≥40years who dispensed antivirals at doses recommended for HZ. HZ rates increased from 2.15/1000 person-years in 40-year-olds to 9.45/1000 person-years in 95-year-olds. Rates were highest in women. HZ was diagnosed during hospitalization among 3.5%. As expected, persons with severe immunosuppressive conditions had the highest ORs of HZ (between 1.82 and 4.12), but various autoimmune diseases, asthma, chronic kidney disease, and inhaled glucocorticoids were also associated with increased ORs (between 1.06 and 1.64). This algorithm is a valid tool for identifying HZ in routine healthcare data. It shows that HZ is common in Denmark, especially in patients with certain chronic conditions. Prioritized vaccination of such high-risk patients might be an option in countries considering
Ceravolo, Roberto; Frosini, Daniela; Rossi, Carlo; Bonuccelli, Ubaldo
There is increasing awareness that impulse control disorders (ICDs), including pathological gambling, hyper-sexuality, compulsive eating and buying, can occur as a complication of Parkinson's disease (PD). In addition, other impulsive or compulsive disorders have been reported to occur, including dopamine dysregulation syndrome (DDS) and punding. Case reports and prospective studies have reported an association between ICDs and the use of dopamine receptor agonists at higher doses, and DDS has been associated with L-dopa at higher doses or short-acting dopamine receptor agonists. Risk factors for ICDs include male sex, younger age or younger age at PD onset, a pre-PD history of ICD symptoms, history of substance use or bipolar disorder, and a personality profile characterized by impulsiveness. The management of clinically significant ICD symptoms should consist of modifications to dopamine replacement therapy, particularly dopamine receptor agonists, which is usually associated with an improvement of ICDs. There is no empirical evidence supporting the use of psychiatric drugs for ICDs in PD. Functional neuroimaging studies such as functional MRI and PET can investigate in vivo the neurobiological basis of these pathological behaviours. Copyright 2009 Elsevier Ltd. All rights reserved.
Tadec, Laurent; Talarmin, Jean-Philippe; Gastinne, Thomas; Bretonnière, Cédric; Miegeville, Michel; Le Pape, Patrice; Morio, Florent
Candidemia remains a major cause of disease worldwide and is associated with a high mortality rate. We conducted a retrospective study of candidemia at Nantes Hospital, France, between 2004 and 2010. A total of 191 episodes (n = 188 patients) were reviewed. Incidence, demographics, risk factors, antifungal management, species identification, in vitro susceptibility and 12 weeks survival were analysed. Global incidence of candidemia was 0.37‰ admissions. Higher incidences were observed in haematology (6.65‰) and intensive care units (2‰). Central venous catheter and antibiotic exposure were the most frequent risk factors (77% and 76% respectively). Candida albicans was the predominant species (51.8%) followed by C. parapsilosis (14.5%), C. glabrata (9.8%), C. tropicalis (9.8%) and C. krusei (4.1%). However, species distribution differed significantly between medical units with frequency of C. tropicalis being higher in haematology compared to other medical units. Fluconazole and caspofungin were the main antifungals given as first-line therapy. Although not significant, 12 weeks mortality rate was 30.9%, being higher for C. tropicalis (44.4%) than for C. parapsilosis (16%). Acquired azole or echinocandin resistance was noted in some isolates, underlining the need for systematic antifungal susceptibility testing in patients with candidemia. These epidemiological findings will be of interest for antifungal stewardship at our hospital. © 2016 Blackwell Verlag GmbH.
Nieuwenhuijsen, Mark J; Dadvand, Payam; Grellier, James; Martinez, David; Vrijheid, Martine
Various epidemiological studies have suggested associations between environmental exposures and pregnancy outcomes. Some studies have tempted to combine information from various epidemiological studies using meta-analysis. We aimed to describe the methodologies used in these recent meta-analyses of environmental exposures and pregnancy outcomes. Furthermore, we aimed to report their main findings. We conducted a bibliographic search with relevant search terms. We obtained and evaluated 16 recent meta-analyses. The number of studies included in each reported meta-analysis varied greatly, with the largest number of studies available for environmental tobacco smoke. Only a small number of the studies reported having followed meta-analysis guidelines or having used a quality rating system. Generally they tested for heterogeneity and publication bias. Publication bias did not occur frequently.The meta-analyses found statistically significant negative associations between environmental tobacco smoke and stillbirth, birth weight and any congenital anomalies; PM2.5 and preterm birth; outdoor air pollution and some congenital anomalies; indoor air pollution from solid fuel use and stillbirth and birth weight; polychlorinated biphenyls (PCB) exposure and birth weight; disinfection by-products in water and stillbirth, small for gestational age and some congenital anomalies; occupational exposure to pesticides and solvents and some congenital anomalies; and agent orange and some congenital anomalies. The number of meta-analyses of environmental exposures and pregnancy outcomes is small and they vary in methodology. They reported statistically significant associations between environmental exposures such as environmental tobacco smoke, air pollution and chemicals and pregnancy outcomes.
Nieuwenhuijsen Mark J
Full Text Available Abstract Background Various epidemiological studies have suggested associations between environmental exposures and pregnancy outcomes. Some studies have tempted to combine information from various epidemiological studies using meta-analysis. We aimed to describe the methodologies used in these recent meta-analyses of environmental exposures and pregnancy outcomes. Furthermore, we aimed to report their main findings. Methods We conducted a bibliographic search with relevant search terms. We obtained and evaluated 16 recent meta-analyses. Results The number of studies included in each reported meta-analysis varied greatly, with the largest number of studies available for environmental tobacco smoke. Only a small number of the studies reported having followed meta-analysis guidelines or having used a quality rating system. Generally they tested for heterogeneity and publication bias. Publication bias did not occur frequently. The meta-analyses found statistically significant negative associations between environmental tobacco smoke and stillbirth, birth weight and any congenital anomalies; PM2.5 and preterm birth; outdoor air pollution and some congenital anomalies; indoor air pollution from solid fuel use and stillbirth and birth weight; polychlorinated biphenyls (PCB exposure and birth weight; disinfection by-products in water and stillbirth, small for gestational age and some congenital anomalies; occupational exposure to pesticides and solvents and some congenital anomalies; and agent orange and some congenital anomalies. Conclusions The number of meta-analyses of environmental exposures and pregnancy outcomes is small and they vary in methodology. They reported statistically significant associations between environmental exposures such as environmental tobacco smoke, air pollution and chemicals and pregnancy outcomes.
Full Text Available We conducted a prospective study to assess the risk factors, molecular epidemiology and outcome of bloodstream infection (BSI due to Enterococcus faecium in hospitalized cancer patients. Between 2006 and 2012, a significant increase in vancomycin-susceptible E. faecium BSI was observed among cancer patients. Comparison of 54 episodes of BSI due to E. faecium with 38 episodes of BSI due to E. faecalis showed that previous use of carbapenems was the only independent risk factor for E. faecium acquisition (OR 10.24; 95% CI, 1.35-77.66. All E. faecium isolates were susceptible to glycopeptides, whereas 97% showed high-level resistance to ampicillin and ciprofloxacin. All 30 isolates available for genotyping belonged to the hospital-associated E. faecium lineages 17, 18 and 78. After 2009, most of the isolates belonged to ST117 (lineage 78. Patients with E. faecium BSI were more likely to receive inadequate initial empirical antibiotic therapy than patients with E. faecalis BSI, and time to adequate empirical antibiotic therapy was also longer in the former group. No significant differences were found between the two groups regarding early and overall case-fatality rates. Independent risk factors for overall case-fatality were current corticosteroids (OR 4.18; 95% CI, 1.34-13.01 and intensive care unit admission (OR 9.97; 95% CI, 1.96-50.63. The emergence of E. faecium among cancer patients is a concern since there are limited treatment options and it may presage the emergence of vancomycin-resistant enterococci. A rationale approach that combines infection control with antimicrobial stewardship.
Lau, Colleen L; Watson, Conall H; Lowry, John H; David, Michael C; Craig, Scott B; Wynwood, Sarah J; Kama, Mike; Nilles, Eric J
Leptospirosis is an important zoonotic disease in the Pacific Islands. In Fiji, two successive cyclones and severe flooding in 2012 resulted in outbreaks with 576 reported cases and 7% case-fatality. We conducted a cross-sectional seroprevalence study and used an eco-epidemiological approach to characterize risk factors and drivers for human leptospirosis infection in Fiji, and aimed to provide an evidence base for improving the effectiveness of public health mitigation and intervention strategies. Antibodies indicative of previous or recent infection were found in 19.4% of 2152 participants (81 communities on the 3 main islands). Questionnaires and geographic information systems data were used to assess variables related to demographics, individual behaviour, contact with animals, socioeconomics, living conditions, land use, and the natural environment. On multivariable logistic regression analysis, variables associated with the presence of Leptospira antibodies included male gender (OR 1.55), iTaukei ethnicity (OR 3.51), living in villages (OR 1.64), lack of treated water at home (OR 1.52), working outdoors (1.64), living in rural areas (OR 1.43), high poverty rate (OR 1.74), living district (OR 1.04 per head/sqkm), and high maximum rainfall in the wettest month (OR 1.003 per mm). Risk factors and drivers for human leptospirosis infection in Fiji are complex and multifactorial, with environmental factors playing crucial roles. With global climate change, severe weather events and flooding are expected to intensify in the South Pacific. Population growth could also lead to more intensive livestock farming; and urbanization in developing countries is often associated with urban and peri-urban slums where diseases of poverty proliferate. Climate change, flooding, population growth, urbanization, poverty and agricultural intensification are important drivers of zoonotic disease transmission; these factors may independently, or potentially synergistically, lead to
Conceição, Luciana Domingues; da Silveira, Isadora Augusta; Nascimento, Gustavo Giacomelli; Lund, Rafael Guerra; da Silva, Ricardo Henrique Alves; Leite, Fábio Renato Manzolli
The etiology and epidemiology of maxillofacial injuries varies widely in different regions of the world due to socioeconomic status, cultural aspects in addition to road traffic and drug consumption. The aim of this study is to determine major causes and epidemiological characteristics of maxillofacial trauma in a 5-year period. Reports of corporal trauma (n = 25,632) from 2007 to 2011 in the Department of Forensic Medicine were analyzed as to the presence of maxillofacial injuries. Data were submitted to Chi square test and to multivariate Poisson regression. 3262 reports referred maxillofacial trauma. The majority were men (55.8%), single (68.9%), most of them white (75.7%). The average age was 28.9 years (SD = 8.42), and victims with age between 16 and 30 years old were the most affected (48.0%). Women comprised 44% of total sample, 67.8% (971) were single, 76% (1.076) white and 46% (691) aged between 16 and 30 years old. Middle third injuries were associated after adjustment with females (PR 1.05; 95% CI 1.01-1.11), non-white subjects (PR 1.06; 95% CI 1.01-1.12) and physical aggression (PR 1.07; 95% CI 1.02-1.13). Injuries in the oral region was more prevalent in men (PR 1.24; 95% CI 1.09-1.41), in those aged between 16 and 30 (PR 1.97; 95% CI 1.48-2.61) and in subjects with injuries caused by traffic accident (PR 1.21; 95% CI 1.02-1.44). The presence of injuries in the lower third of face remained associated in the final model only with traffic accident (PR 1.75; 95% CI 1.43-2.15). Health care practitioners must recognize vulnerable population and most prevalent sites of lesion to identify cases of violence.
Li, Kun; Zhang, Lihong; Zhang, Hui; Lei, Zhixin; Luo, Houqiang; Mehmood, Khalid; Shahzad, Muhammad; Lan, Yanfang; Wang, Meng; Li, Jiakui
and breed dog) were not significant (P>0.05). The present results reported the prevalence and associated risk factors of E. granulosus in yaks, Tibetan pigs and native Tibetans. These findings could have important epidemiological significance and a direct influence on the remote plateau. Copyright © 2017 Elsevier B.V. All rights reserved.
Jackson, K; Kelty, E; Tennant, M
Peripheral dental caries is defined as macroscopic destruction of the calcified dental tissues and can cause considerable dental pathology and pain. It appears to occur at a high prevalence in Western Australian horses. At present, risk factors for the condition are poorly understood, making treatment and prevention difficult. To assess the prevalence of and potential risk factors for peripheral caries in Western Australian horses. Cross-sectional, epidemiological study. A survey of 500 Western Australian horses was administered in two sections. The first section was completed by the owner and referred to the horse's signalment, diet and husbandry conditions. The second section was completed by veterinarians and focused on the horse's oral health. A multivariable logistic regression model was used to assess risk factors associated with peripheral caries. Peripheral caries was present in 58.8% (95% confidence interval [CI] 54.5-63.1%) of surveyed horses. Breed was significantly associated with peripheral caries, with Warmbloods (odds ratio [OR] 0.44, 95% CI 0.24-0.82; P = 0.009) and Western breeds (OR 0.38, 95% CI 0.19-0.78; P = 0.008) being less likely to have peripheral caries than Thoroughbreds. Dietary risk factors included oaten hay (OR 2.90, 95% CI 1.87-4.53; Pcaries than horses without access to grazing (OR 0.31, 95% CI 0.15-0.66; P = 0.002), as were horses on groundwater compared with horses on rainwater (OR 3.35, 95% CI 1.65-6.78; P = 0.001), drinking water (OR 2.03, 95% CI 1.14-3.62; P = 0.016) or dam water (OR 3.53, 95% CI 1.08-11.53; P = 0.037). Peripheral caries was positively correlated with periodontal disease (OR 4.53, 95% CI 2.91-7.06; Pcaries. Management factors that may help to prevent or reduce peripheral caries include more access to quality pasture, use of groundwater, feeding on meadow hay and avoidance of oaten hay. © 2017 EVJ Ltd.
Lucena, A; Dalla Costa, L M; Nogueira, K S; Matos, A P; Gales, A C; Paganini, M C; Castro, M E S; Raboni, S M
Metallo-β-lactamases (MBLs) have emerged as one of the most important bacterial resistance mechanisms because of their ability to hydrolyse virtually all β-lactam agents. MBL-producing Pseudomonas aeruginosa (MBL-PA) are an important cause of nosocomial infections, particularly in intensive care units (ICUs), where they are associated with serious infections and present a significant clinical risk. To assess the molecular epidemiology, risk factors and outcomes of nosocomial infections caused by MBL-PA in a teaching hospital in Southern Brazil. From January 2001 to December 2008, 142 carbapenem-resistant P. aeruginosa strains were isolated from distinct clinical samples from hospitalized patients. These isolates were screened for MBLs, and underwent polymerase chain reaction, sequencing and pulsed-field gel electrophoresis (PFGE). Patients infected with carbapenem-resistant MBL-PA were considered as cases, and patients infected with non-MBL-PA were considered as controls. Eighty-four of 142 patients with positive carbapenem-resistant P. aeruginosa cultures met the criteria of the Centers for Disease Control and Prevention for infection. Fifty-eight patients were infected with MBL-PA (69%) and 26 patients were infected with non-MBL-PA (31%). Multi-variate analysis revealed that ICU stay [P = 0.003, odds ratio (OR) 4.01, 95% confidence interval (CI) 1.15-14.01] and urinary tract infection (P = 0.001, OR 9.67, 95% CI 1.72-54.48) were important risk factors for MBL-PA infection. Patients infected with MBL-PA showed faster onset of infection (P = 0.002) and faster progression to death (P = 0.04). These results showed the severity of MBL-PA infections, and demonstrated the urgent need for strategies to improve infection control measures to prevent an increase in these nosocomial infections. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Weng, Hsin-Yi; Kass, Philip H; Hart, Lynette A; Chomel, Bruno B
This retrospective study of 259 Taiwanese dog owners in 2004 addressed one of the major contributors to dog overpopulation in Taiwan: unsuccessful dog ownership. We found an inverse association between age of the dog at acquisition and risk of unsuccessful dog ownership: the younger the dog at acquisition the higher the risk. The incidence-proportion ratios (IPRs) of unsuccessful dog ownership for the owners who had a history of pet abandonment or losing a pet compared with those without such a history were 1.8 (95% confidence interval (CI)=1.1, 3.0) and 2.1 (95% CI=1.3, 3.3), respectively. Soiling (IPR=2.0, 95% CI=1.3, 3.1) and barking (IPR=1.6, 95% CI=1.0, 2.6) problems had the strongest effects on unsuccessful dog ownership among the post-acquisition variables studied. Preventing owners with a history of unsuccessful dog ownership from acquiring dogs was predicted to yield the largest reduction of risk of unsuccessful dog ownership among the investigated variables (population attributable fraction=33%, 95% CI=11%, 50%).
Disorder , ADHD = Attention Deficit Hyperactivity Disorder Table 12: Impact of Comorbid Conditions on Medication Days per Year in Children with Autism...and/or attention deficit hyperactivity disorder . J Int Neuropsychol Soc. 2007;13(2)246-256. Maayan L, Correll CU. Weight gain and metabolic risks...Anxiety Disorders 14.2 13.4 16.7 17.6 38.2 ASD and Attention Deficit Disorders 15.3 19.3 19.2 17.0 29.3 ASD and Delirium/Dementia 14.6
Conclusions: Hip fractures in the elderly population are on a rising trend especially in the Indian subcontinent due to a number of factors both hereditary and acquired. Simple measures like routine usage of bedside railing, wall-side railings at an appropriate height, high friction tiles inside rooms and washrooms, and adequate lighting indoors can play a significant role in reducing falls and hip fractures among the elderly.
Maldonado, Natalia; Castro, Bibiana; Berrio, Indira; Manjarrés, Miguel; Robledo, Carlos; Robledo, Jaime
Carbapenems resistance is a growing phenomenon and a threat to public health because of the reduced therapeutic options for resistant infections. A retrospective case-control study was conducted in 2 tertiary-care hospitals in Medellín, Colombia. Fifty patients infected with ertapenem-resistant enterobacteriaceae were compared with a control group consisting of 100 patients with infections caused by ertapenem susceptible enterobacteriaceae. A multivariate logistic regression model was used to identify factors that best explain ertapenem-resistant enterobacteriaceae infections. The factors associated with ertapenem-resistant enterobacteriaceae infections were prior exposure to carbapenems (adjusted OR 3.43; 95% IC 1.08-10.87) and prior exposure to cefepime (adjusted OR 6.46; 95% IC 1.08-38.38). Prior exposure to antibiotics is the factor that best explains the ertapenem-resistant enterobacteriaceae infection in this population, highlighting the importance of antimicrobial stewardship programs in hospitals. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
Chen, Luke F.; Arduino, Jean Marie; Sheng, Shubin; Muhlbaier, Lawrence H.; Kanafani, Zeina A.; Harris, Anthony D.; Fraser, Thomas G.; Allen, Keith; Corey, G. Ralph; Fowler, Vance G.
Background Major postoperative infections (MPIs) are poorly understood complications of cardiac surgery. We examined the epidemiology, microbiology, and outcome of MPIs occurring after cardiac surgery. Methods The study cohort was drawn from the Society of Thoracic Surgeon National Cardiac Database and comprised adults who underwent cardiac surgery at 5 tertiary hospitals between 2000 and 2004. We studied the incidence, microbiology, and risk factors of MPI (bloodstream or chest wound infections within 30 days after surgery), as well as 30-day mortality. We used multivariate regression analyses to evaluate the risk of MPI and mortality. Results MPI was identified in 341 of 10,522 patients (3.2%). Staphylococci were found in 52.5% of these patients, gram-negative bacilli (GNB) in 24.3%, and other pathogens in 23.2%. High body mass index, previous coronary bypass surgery, emergency surgery, renal impairment, immunosuppression, cardiac failure, and peripheral/cerebrovascular disease were associated with the development of MPI. Median postoperative duration of hospitalization (15 days vs 6 days) and mortality (8.5% vs 2.2%) were higher in patients with MPIs. Compared with uninfected individuals, odds of mortality were higher in patients with S aureus MPIs (adjusted odds ratio, 3.7) and GNB MPIs (adjusted odds ratio, 3.0). Conclusions Staphylococci accounted for the majority of MPIs after cardiac surgery. Mortality was higher in patients with Staphylococcus aureus- and GNB-related MPIs than in patients with MPIs caused by other pathogens and uninfected patients. Preventive strategies should target likely pathogens and high-risk patients undergoing cardiac surgery. PMID:22609237
Full Text Available Abstract Background The incidence of community-associated methicillin-resistant Staphylococcus aureus (MRSA has risen dramatically in the U.S., particularly among children. Although Streptococcus pneumoniae colonization has been inversely associated with S. aureus colonization in unvaccinated children, this and other risk factors for S. aureus carriage have not been assessed following widespread use of the heptavalent pneumococcal conjugate vaccine (PCV7. Our objectives were to (1 determine the prevalence of S. aureus and MRSA colonization in young children in the context of widespread use of PCV7; and (2 examine risk factors for S. aureus colonization in the post-PCV7 era, including the absence of vaccine-type S. pneumoniae colonization. Methods Swabs of the anterior nares (S. aureus were obtained from children enrolled in an ongoing study of nasopharyngeal pneumococcal colonization of healthy children in 8 Massachusetts communities. Children 3 months to S. aureus was identified and antibiotic susceptibility testing was performed. Epidemiologic risk factors for S. aureus colonization were collected from parent surveys and chart reviews, along with data on pneumococcal colonization. Multivariate mixed model analyses were performed to identify factors associated with S. aureus colonization. Results Among 1,968 children, the mean age (SD was 2.7 (1.8 years, 32% received an antibiotic in the past 2 months, 2% were colonized with PCV7 strains and 24% were colonized with non-PCV7 strains. The prevalence of S. aureus colonization remained stable between 2003–04 and 2006–07 (14.6% vs. 14.1%, while MRSA colonization remained low (0.2% vs. 0.9%, p = 0.09. Although absence of pneumococcal colonization was not significantly associated with S. aureus colonization, age (6–11 mo vs. ≥5 yrs, OR 0.39 [95% CI 0.24–0.64]; 1–1.99 yrs vs. ≥5 yrs, OR 0.35 [0.23–0.54]; 2–2.99 yrs vs. ≥5 yrs, OR 0.45 [0.28–0.73]; 3–3.99 yrs vs. ≥5 yrs, OR 0
Full Text Available Cleft lip with or without cleft palate is the most occurring craniofacial anomaly in human, resulting from a complex etiology involving multiple genetic and environmental factors. The defect carries lifelong morbidity and economic burden. Children with clefts will require continuous medical interventions for at least the first 18 years of life, affecting many aspects of their lives. The extent and complexity of clefts vary infinitely, later determining individual management and outcome. Identification and classification play significant roles in initial assessment of these unique cleft cases, which affect options for following correctional attempts. Some classifications even allow measurement of progress after anatomical repositioning, and success rate after surgical repairs. The challenge of developing one such widely inclusive classification is discussed. (Med J Indones 2008; 17: 226-39Keywords: Cleft lip, cleft palate, congenital anomaly, cleft classfications
Wang, Hao; Wang, Jing; Liu, Miao-Miao; Wang, Da; Liu, Yu-Qin; Zhao, Yang; Huang, Mei-Meng; Liu, Yang; Sun, Jing; Dong, Guang-Hui
Abstract Background Obesity increases the risk of many diseases. However, there has been little literature about the epidemiology of obesity classified by body mass index (BMI) or waist (abdominal obesity) among urban Chinese adults. This study is to fill the gap by assessing the prevalence of obesity and associated risk factors among urban Chinese adults. Methods A representative sample of 25,196 urban adults aged 18 to 74 years in Northeast China was selected and measurements of height, wei...
Chua, Jacqueline; Lim, Blanche; Fenwick, Eva K; Gan, Alfred Tau Liang; Tan, Ava Grace; Lamoureux, Ecosse; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Yin; Cheng, Ching-Yu
To determine the prevalence, risk factors, and impact of undiagnosed visually significant cataract in an Asian population. The Singapore Epidemiology of Eye Diseases is a population-based study where 8,697 adults of Malay, Indian, and Chinese ethnicities aged > 40 years were invited for an eye examination, including lens photograph, to establish cataract diagnosis. Visually significant cataract was defined by Wisconsin Cataract Grading System and a best-corrected visual acuity educational attainment, in employment, and without a history of diabetes (all P<0.05). In those with undiagnosed visually significant cataract, half had bilateral visual impairment, which was significantly associated with 24.8% poorer visual functioning compared to those with unilateral visual impairment (P<0.001). Two-thirds of Singaporean adults with visually significant cataract were previously undiagnosed. Half of these cases had bilateral visual impairment and substantially reduced quality of life. Public health strategies targeting elderly patients, such as regular screening for visual impairment and timely referral to ophthalmologists in order to prevent progression to bilateral visual impairment when visual function is compromised are warranted.
Full Text Available Background: Prevalence of End Stage Renal Disease (ESRD is increasing in the world. Because of clinical importance of ESRD and absence of significant data, we studied the epidemiology of end stage renal failure in patients under hemodialysis in Lorestan province. Material and methods: This descriptive cross sectional study was carried out between January 2012 and January 2013 in dialysis centers of Lorestan university of medical sciences .Subject were selected by census method and data galhered using a questionnaire. At the end, collected data were analyzed by SPSS software, descriptive statistics and Chi-square test. Results: All the patients under hemodialysis were 318 cases, 182 out of them (57.2% and 136(42.8% were male and female respectively. The mean age of the subjects was 53.2± 16.4 years. The cause of renal failure in 38.1% of the patients were hypertension, diabetes (19.2% and unknown factors (27.4%. As well as 5.97% of the patients infected by HCV, HBV or HIV . A significant statistical difference was observed between causes of chronic renal failure and different ages of the subjects (p=0.002. Conclusion: Augmentation of screening programs and especially, early referral of high risk subjects to nephrologists is recommended for prevention of end stage renal disease.
Mohammod Jobayer Chisti MBBS, MMed, PhD
Full Text Available We aimed to evaluate sociodemographic, epidemiological, and clinical risk factors for pulmonary tuberculosis (PTB in children presenting with severe acute malnutrition (SAM and pneumonia. Children aged 0 to 59 months with SAM and radiologic pneumonia from April 2011 to July 2012 were studied in Bangladesh. Children with confirmed PTB (by culture and/or X-pert MTB/RIF (cases = 27 and without PTB (controls = 81; randomly selected from 378 children were compared. The cases more often had the history of contact with active PTB patient (P < .01 and exposure to cigarette smoke (P = .04 compared with the controls. In logistic regression analysis, after adjusting for potential confounders, the cases were independently associated with working mother (P = .05 and positive tuberculin skin test (TST; P = .02. Thus, pneumonia in SAM children is a common presentation of PTB and further highlights the importance of the use of simple TST and/or history of contact with active TB patients in diagnosing PTB in such children, especially in resource-limited settings.
Kelly, K J; Pearson, M L; Kurup, V P; Havens, P L; Byrd, R S; Setlock, M A; Butler, J C; Slater, J E; Grammer, L C; Resnick, A
Anaphylactic reactions (ARs) in high-risk pediatric patients undergoing general anesthesia, especially those with spina bifida, have been attributed to anesthetics, muscle relaxants, antimicrobials, ethylene oxide, and latex. To identify risk factors for AR during general anesthesia and to investigate the role of latex allergy, we studied epidemiologic and immunologic characteristics of patients with ARs during general anesthesia during a 13-month cluster of such reactions at Children's Hospital of Wisconsin (case patients). Patients with AR were compared with patients with spina bifida undergoing uneventful general anesthesia during the same period (control patients). For each case patient and control patient, we conducted a chart review; a parental interview; skin prick testing with latex, anesthetics, aeroallergens, and banana extract; ELISA and RAST for latex-specific IgE; a total serum IgE; and an ELISA for IgE antibody to ethylene oxide. Anaphylactic reactions occurred exclusively in patients with spina bifida (n = 10) or patients with a congenital urinary tract anomaly (n = 1). Case-patients were more likely than control patients to have a history of asthma (p = 0.002), rubber contact allergy (p = 0.001), food allergy (p = 0.001), rash caused by adhesive tape (p = 0.05), daily rectal disimpaction (p < 0.001), nine or more prior surgical procedures (p < 0.002), latex-specific IgE (p = 0.027), or elevated total serum IgE levels (p = 0.002). Multivariate analysis identified non-white race, rubber contact allergy, history of food allergy, and nine or more surgical procedures as significant independent risk factors. Logistic model equation identified the predicted probability of AR with a sensitivity, specificity, and positive predictive value of 82%, 97%, and 82%, respectively. These findings demonstrate that atopy, especially symptomatic latex allergy, is associated with AR during anesthesia in patients with spina bifida. Until a standardized latex test is
Leung, Ting Fan; Yung, Edmund; Wong, Yun Sze; Lam, Christopher W K; Wong, Gary W K
The epidemiology of adverse food reactions (AFRs), including the potentially life-threatening food allergy (FA), in Asia is unclear. AFR is believed to be less prevalent than in Caucasians. This study determines the prevalence, clinical features and risk factors for parent-reported AFR in Chinese pre-school children in Hong Kong. Children aged 2-7 yr living in Hong Kong were recruited through local nurseries and kindergartens to ascertain the occurrence and clinical spectrum of AFR and other atopic disorders. Subjects' parents answered a self-administered questionnaire that was modified and validated based on the International Study of Asthma and Allergy in Childhood. A total of 3827 children from 21 nurseries and kindergartens returned the study questionnaires, and information on AFR was analyzable for 3677 (96.1%) children. The prevalence rates of parent-reported AFR and parent-reported, doctor-diagnosed AFR were 8.1% and 4.6%, respectively, whereas 5.0% of pre-schoolers had doctor-diagnosed asthma. The six leading causes of AFR were shellfish (15.8%), egg (9.1%), peanut (8.1%), beef (6.4%), cow's milk (5.7%), and tree nuts (5.0%). When compared with children born and raised in Hong Kong, children born in mainland China (n = 253) had less parent-reported AFR (4.0% vs. 6.7%; p = 0.016). On logistic regression, parent-reported AFR was associated with younger age (p = 0.010), born in mainland China (p = 0.038), and AFR history in father (p = 0.001), mother (p Hong Kong pre-school children, and prevalence rates are comparable to the Caucasians.
Christiansen, Erik; Stenager, Elsebeth; Bilenberg, Niels
to level of evidence (LoE). Methods: We searched PubMed and psycINFO in order to identify relevant individual studies. Results: We included 36 studies of children and youth on suicidal behaviour and ideation-many rank low on LoE. For suicide, cohort design was often used, and mental illness (depression......Introduction: Many different epidemiology study designs have been used to analyse risk factors for suicide behaviour. The purpose of this study was to obtain an insight into the current study design used in research on youths' risk factors for suicide behaviour and to rank the studies according......, substance abuse and severity of mental illness) was the most common risk factor. Cohort studies are ranked 2b, which is high according to LoE. For suicide attempts, survey was often used, and psychopathology, substance abuse and being exposed to suicidal behaviour were the most common risk factors...
Helweg-Larsen, K; Banner, Jytte; Oyen, N
The aim of the study was to investigate the effect of infection on sudden infant death syndrome (SIDS) and to analyse whether modifiable risk factors of SIDS, prone sleeping, covered head and smoking act as effect modifiers. In a consecutive multicentre case-control study of SIDS in Denmark, Norway......, prone sleeping, head covered or parental smoking, was far greater than the sum of each individual factor. These risk factors thus modify the dangerousness of infection in infancy....
Hemminki, K; Pershagen, G
Epidemiological studies on the effect of urban air pollution on lung cancer were surveyed. Overall, the studies from many countries point to a smoking-adjusted risk in urban areas over countryside areas that is higher by a factor of up to 1.5. The extent to which urban air pollution contributes to this excess remains unknown. Studies on diesel-exposed occupational groups show that urban air pollution may have a causative role in lung cancer. Model calculations on unit risk factors of known hu...
Background Human brucellosis incidence in China has been increasing dramatically since 1999. However, epidemiological features and potential factors underlying the re-emergence of the disease remain less understood. Methods Data on human and animal brucellosis cases at the county scale were collected for the year 2004 to 2010. Also collected were environmental and socioeconomic variables. Epidemiological features including spatial and temporal patterns of the disease were characterized, and the potential factors related to the spatial heterogeneity and the temporal trend of were analysed using Poisson regression analysis, Granger causality analysis, and autoregressive distributed lag (ADL) models, respectively. Results The epidemic showed a significantly higher spatial correlation with the number of sheep and goats than swine and cattle. The disease was most prevalent in grassland areas with elevation between 800–1,600 meters. The ADL models revealed that local epidemics were correlated with comparatively lower temperatures and less sunshine in winter and spring, with a 1–7 month lag before the epidemic peak in May. Conclusions Our findings indicate that human brucellosis tended to occur most commonly in grasslands at moderate elevation where sheep and goats were the predominant livestock, and in years with cooler winter and spring or less sunshine. PMID:24238301
Full Text Available Abstract Background Hepatitis B is one of the most common infectious diseases in China. The aim of this study was to determine the prevalence of hepatitis B surface antigen (HBsAg among the general population and the risk factors associated with HBV infection in Anhui province, China. Methods A provincial serosurvey was conducted in four cities, and selected through stratified clustering sampling. Data on demographics, immunization history, medical history, family medical history, and life history were collected, along with serum tested for HBsAg. Completed surveys were analysed from 8,875 participants. Results Overall prevalence of HBsAg was 7.44%. Using multivariate analysis, older age was a risk factor for HBsAg infection among children younger than 15 years. Among adults 15-59 years old, the risk factors were male gender, a history of surgical operations, at least one HBsAg-positive family member, and non-vaccination. For adults older than 59 years, the risk factor was a blood transfusion history. Conclusions Though Anhui province has already reached the national goal of reducing HBsAg prevalence to less than 1% among children younger than 5 years, there are still several risk factors for HBsAg infection among the older population. Immunization programs should continue to focus on adults, and interventions should be taken to reduce risk factors associated with being infected with Hepatitis B.
Alvarez, Karina; Loehr, Laura; Folsom, Aaron R.; Newman, Anne B.; Weissfeld, Lisa A.; Wunderink, Richard G.; Kritchevsky, Stephen B.; Mukamal, Kenneth J.; London, Stephanie J.; Harris, Tamara B.; Bauer, Doug C.; Angus, Derek C.
Background: Preventing pneumonia requires better understanding of incidence, mortality, and long-term clinical and biologic risk factors, particularly in younger individuals. Methods: This was a cohort study in three population-based cohorts of community-dwelling individuals. A derivation cohort (n = 16,260) was used to determine incidence and survival and develop a risk prediction model. The prediction model was validated in two cohorts (n = 8,495). The primary outcome was 10-year risk of pneumonia hospitalization. Results: The crude and age-adjusted incidences of pneumonia were 6.71 and 9.43 cases/1,000 person-years (10-year risk was 6.15%). The 30-day and 1-year mortality were 16.5% and 31.5%. Although age was the most important risk factor (range of crude incidence rates, 1.69-39.13 cases/1,000 person-years for each 5-year increment from 45-85 years), 38% of pneumonia cases occurred in adults risk of pneumonia, reduced lung function was the most important risk factor (relative risk = 6.61 for severe reduction based on FEV1 by spirometry). A clinical risk prediction model based on age, smoking, and lung function predicted 10-year risk (area under curve [AUC] = 0.77 and Hosmer-Lemeshow [HL] C statistic = 0.12). Model discrimination and calibration were similar in the internal validation cohort (AUC = 0.77; HL C statistic, 0.65) but lower in the external validation cohort (AUC = 0.62; HL C statistic, 0.45). The model also calibrated well in blacks and younger adults. C-reactive protein and IL-6 were associated with higher pneumonia risk but did not improve model performance. Conclusions: Pneumonia hospitalization is common and associated with high mortality, even in younger healthy adults. Long-term risk of pneumonia can be predicted in community-dwelling adults with a simple clinical risk prediction model. PMID:23744106
Finley, Brent L; Benson, Stacey M; Marsh, Gary M
Due to some historical (and inaccurate) reports that asbestos might be present in some cosmetic talc products, questions are occasionally raised regarding the potential pleural mesothelioma risks associated with cosmetic talc products. Our objective was to determine the incidence of pleural mesothelioma of individuals exposed to cosmetic talc. We conducted a systematic review of the epidemiological literature for cosmetic talc miners and millers and found three occupational cohort studies that evaluated pleural mesothelioma incidence in workers in Italy, Norway, France, and Austria. We conducted a second literature review to evaluate the incidence and mortality of pleural mesothelioma among patients who received talc pleurodesis treatments before 1965 and found retrospective clinical studies including over 300 patients with follow-up ranging from 14 to 40 years. There were no mesotheliomas reported in any of the cosmetic talc miner and miller cohorts. A pooled analysis of data from the cohort mortality studies indicated that four mesothelioma deaths would have been expected from the 90,022 person-years of observation, and this was associated with 84% and 67% statistical power to observe a 3-fold or 2.5-fold increase in pleural mesothelioma mortality, respectively. None of the patients who received talc pleurodesis treatments developed mesothelioma. We conclude that there is no epidemiological evidence to support the hypothesis that exposure to cosmetic talc is associated with the development of pleural mesothelioma.
Dennery, M.; Dupont, M.A.
This article deals with the development of risk management in the gas sector business: why a risk factor legal mention must precede any published financial information? Do gas companies have to face new risks? Is there specific risks bound to gas activities? Why companies want to master their risks? Is it mandatory or just a new habit? Do they expect a real benefit in return? These are the risk management questions that are analyzed in this article which is based on the public communication of 15 gas companies randomly selected over the world. The information comes from their annual reports or from documents available on their web sites. The intention of this document is not to be exhaustive or to make statistics but only to shade light on the risk factors of the gas sector. (J.S.)
Ding, Xiurong; Yan, Donghui; Sun, Wei; Zeng, Zhaoyin; Su, Ruirui; Su, Jianrong
Nosocomial candidemia extends the length of hospital stay, increases the costs of medical care, and is associated with a high mortality rate. Epidemiological data that assist in the choice of initial therapy may help to improve the prognosis. The present study was undertaken to investigate the epidemiology of nosocomial candidemia and identify risk factors for nosocomial candidemia caused by C. albicans and non-albicans Candida species (NAC). A retrospective chart review was undertaken to analyze cases of nosocomial candidemia treated at the Beijing Friendship Hospital between January 2008 and December 2012. All cases of candidemia were identified using the previously published criteria. Among 106 patients analyzed, 53.8% had nosocomial candidemia caused by NAC. Candida albicans was the most common causative agent, accounting for 46.2% of all cases, followed by C. glabrata (25.5%), C. tropicalis (15.1%), C. parapsilosis (10.4%) and C. Krusei (0.9%). Comparison of nosocomial C. albicans and NAC candidemia by multivariate logistic regression showed that factors independently associated with nosocomial NAC candidemia included exposure to azole agents (odds ratio [OR]: 3.359; 95% confidence interval [CI]: 1.136-10.154; P = .031) and artificial surgical implants (OR: 37.519; 95% CI: 2.5-562.998; P = .009). A significant risk factor for nosocomial C. albicans candidemia was cancer surgery (OR: 0.075; 95% CI: 0.013-0.437; P = .004). Clinical and epidemiological differences in the risk factors between nosocomial candidemia caused by C. albicans and NAC should be considered when selecting an initial antifungal regimen for the treatment of adult patients. This should be undertaken before the availability of species identification and/or antifungal susceptibility results. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Sibonga, Jean; Amin, Shreyasee
AIM 1: To investigate the risk of microgravity exposure on long-term changes in bone health and fracture risk. compare data from crew members ("observed") with what would be "expected" from Rochester Bone Health Study. AIM 2: To provide a summary of current evidence available on potential risk factors for bone loss, recovery & fracture following long-duration space flight. integrative review of all data pre, in-, and post-flight across disciplines (cardiovascular, nutrition, muscle, etc.) and their relation to bone loss and recovery
The results of several major epidemiology studies on populations with particular exposure to ionizing radiation should become available during the first years of the 21. century. These studies are expected to provide answers to a number of questions concerning public health and radiation protection. Most of the populations concerned were accidentally exposed to radiation in ex-USSR or elsewhere or in a nuclear industrial context. The results will complete and test information on risk coming from studies among survivors of the Hiroshima and Nagasaki atomic bombs, particularly studies on the effects of low dose exposure and prolonged low-dose exposure, of different types of radiation, and environmental and host-related factors which could modify the risk of radiation-induced effects. These studies are thus important to assess the currently accepted scientific evidence on radiation protection for workers and the general population. In addition, supplementary information on radiation protection could be provided by formal comparisons and analyses combining data from populations with different types of exposure. Finally, in order to provide pertinent information for public health and radiation protection, future epidemiology studies should be targeted and designed to answer specific questions, concerning, for example, the risk for specific populations (children, patients, people with genetic predisposition). An integrated approach, combining epidemiology and studies on the mechanisms of radiation induction should provide particularly pertinent information. (author)
Heiervang, Einar; Stormark, Kjell M; Lundervold, Astri J
OBJECTIVE: The Bergen Child Study is a longitudinal study of child mental health from the city of Bergen, Norway. We present methods and results from the first wave of the study, focusing on prevalence of disorders, associations with risk factors, and the use of services. METHOD: The target popul...
Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn
The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute...
The aim of the research program we are developing is to define molecular markers and their interaction with other risk factors as risk indicators for development of breast cancer among women with benign breast disease (BBD...
Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs); however, SSI after hepatobiliary and pancreatic surgery (HBPS) has not been well investigated in a large cohort of patients. This study analyzed the factors associated with SSI following HBPS in Japan, using a Japanese national database. Data on HBPS performed between 2012 and 2014 were extracted from a national monitoring system for HAI: The Japan Nosocomial Infections Surveillance. Using multivariate logistic regression, I assessed the factors associated with SSI. The cumulative incidence of SSI following HBPS was 15.6% (2873/18,398). The incidence of SSI after pancreatoduodenectomy was 28.0%, which was significantly higher than that after liver resection and other types of HBPS (8.8 and 15.5%, respectively). Among the four traditional risk factors, the American Society of Anesthesiologists score was ineffective for predicting SSI in the final model of all three types of surgery. Additional risk factors were identified, including age and male gender. The incidence of and factors associated with SSI after the three types of HBPS analyzed differed significantly. To accurately compare hospital performance in relation to SSI following HBPS, the operative procedure category in the surveillance system must be divided into three types.
Wang, Hai-Yan; Qiao, Jie; Sun, Xiao-Xi; Wang, Shu-Yu; Liang, Xiao-Yan; Sun, Yun; Liu, Feng-Hua
Background: A higher frequency of spontaneous miscarriage has been observed in infertile couples, and there is a higher prevalence of infertility among patients with a history of recurrent spontaneous miscarriages (RSMs; ?2 miscarriages). This study aimed to determine the proportion of infertile patients with RSM and examine risk factors associated in patients with RSM being treated with assisted reproductive technologies. Methods: This cross-sectional observational study was conducted at six...
Berenger, B M; Doucette, K; Smith, S W
Bloodstream infections (BSIs) are a leading cause of morbidity and mortality in solid organ transplantation (SOT). We sought to determine the types of nosocomial BSIs and risk factors for them in SOT. Prospectively collected databases of all SOT and nosocomial BSIs occurring at our institution for a 10-year period were reviewed. From 2003-2012, we observed 157 nosocomial BSI episodes in 2257 SOTs, the majority of which were caused by staphylococci and enterococci (67.5%). The most common sources of BSI were central line, organ space, respiratory, and gastrointestinal. Kidney transplant patients had the lowest risk of acquiring a BSI compared with other SOT types. Lung transplant patients were at increased risk of methicillin-resistant Staphylococcus aureus BSI and heart transplant patients were at increased risk of a Candida albicans BSI, when compared to other organ transplant types. When coagulase-negative Staphylococcus (CoNS) or C. albicans was isolated, the central line was most often the source. The implementation of central-line bundles during the study period correlated temporally with a decreased rate of CoNS BSI. Over the 10-year period, vancomycin-resistant enterococci became the most common enterococcal BSI. Donor-positive cytomegalovirus status was associated with an increased risk of BSI, when compared to donor-negative patients. This study demonstrates the common sources, risk factors, and causative organisms of BSI, which can guide empiric antibiotic choices, and highlights areas where preventative interventions could be targeted to prevent nosocomial BSI in SOT. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Kawasaki, Takayuki; Ota, Chihiro; Urayama, Shingo; Maki, Nobukazu; Nagayama, Masataka; Kaketa, Takefumi; Takazawa, Yuji; Kaneko, Kazuo
The incidence of reinjuries due to glenohumeral instability and the major risk factors for primary anterior shoulder dislocation in youth rugby players have been unclear. The purpose of this study was to investigate the incidence, mechanisms, and intrinsic risk factors of shoulder dislocation in elite high-school rugby union teams during the 2012 season. A total of 378 male rugby players from 7 high-school teams were investigated by use of self-administered preseason and postseason questionnaires. The prevalence of a history of shoulder dislocation was 14.8%, and there were 21 events of primary shoulder dislocation of the 74 overall shoulder injuries that were sustained during the season (3.2 events per 1000 player-hours of match exposure). During the season, 54.3% of the shoulders with at least one episode of shoulder dislocation had reinjury. This study also indicated that the persistence of glenohumeral instability might affect the player's self-assessed condition, regardless of the incidence during the current season. By a multivariate logistic regression method, a history of shoulder dislocation on the opposite side before the season was found to be a risk factor for contralateral primary shoulder dislocation (odds ratio, 3.56; 95% confidence interval, 1.27-9.97; P = .02). High-school rugby players with a history of shoulder dislocation are not playing at full capacity and also have a significant rate of reinjury as well as a high risk of dislocating the other shoulder. These findings may be helpful in deciding on the proper treatment of primary anterior shoulder dislocation in young rugby players. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
Leung, T F; Lam, D S Y; Miu, T Y; Hon, K L; Chau, C S K; Ku, S W; Lee, R S Y; Chow, P Y; Chiu, W K; Ng, D K K
Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infection in young children. However, there are limited data on severe RSV infection requiring pediatric intensive care unit (PICU) admission. This retrospective study described features of RSV-associated PICU admissions in Hong Kong and investigated factors for mortality and duration of PICU stay. Children with laboratory-confirmed RSV infection and admitted to the PICUs of all eight government hospitals in Hong Kong between January 2009 and June 2011 were identified from computerized auditing systems and PICU databases. RSV in respiratory samples was detected by direct immunofluorescence and/or viral culture. The relationships between mortality and PICU duration and demographic and clinical factors were analyzed. A total of 118 (2.4 %) PICU admissions were identified among 4,912 RSV-positive pediatric cases in all hospitals. Sixty-five (55.6 %) patients were infants. PICU admissions were higher between October and March. Eight (6.8 %) patients died, but only two were infants. RSV-associated mortality was related to prior sick contact, presence of older siblings, neurodevelopmental conditions, chromosomal and genetic diseases, and bacterial co-infections, but none was significant following logistic regression analyses (odds ratio 9.36, 95 % confidence interval 0.91-96.03 for prior sick contact, p = 0.060). Chronic lung disease was the only risk factor for the duration of PICU admission (β = 0.218, p = 0.017). The majority of RSV-infected children do not require PICU support. There is winter seasonality for RSV-associated PICU admission in Hong Kong. Prior sick contact is the only risk factor for RSV-associated mortality, whereas the presence of chronic lung disease is associated with longer PICU stay. The current risk-based approach of RSV prophylaxis may not be effective in reducing severe RSV infections.
Dizbay, Murat; Guzel Tunccan, Ozlem; Karasahin, Omer; Aktas, Firdevs
Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study. The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed. A total of 720 patients were included in the study. Carbapenem resistance among Klebsiella spp. were significantly increased between 2003 and 2007 (pKlebsiella spp. infections. In a multivariate analysis, prior use of imipenem (OR 3.35; CI 1.675-6.726, p<0.001), stay in ICU (OR 3.36; 95% CI 1.193-9.508; p=0.022), receiving H2 receptor antagonist (OR 4.49; 95% CI 1.011-19.951; p=0.048) were independently associated with carbapenem resistance. Respiratory tract infections were the most seen nosocomial infection. Attack mortality rate was significantly higher in patients infected with CRK strains (p<0.001). CRK strains showed significantly higher resistance rates to other antibiotics. In conclusion, the emergence and rapid spread of CRK strains in our hospital is worrisome. The patients in ICU are most important risk group for the acquisition of CRK strains. High resistant rates to other antibiotics except than colistin and tigecycline limits therapeutic options, and increases mortality rates.
The identification and quantification of risk factors that are characterized by low exposure levels, moderately increased risks, and unspecific exposure-disease relations is a major challenge facing risk assessment today. Occupational epidemiological studies can play a role in addressing this
Matsudaira, Ko; Kawaguchi, Mika; Isomura, Tatsuya; Arisaka, Mayumi; Fujii, Tomoko; Takeshita, Katsushi; Kitagawa, Tomoaki; Miyoshi, Kota; Konishi, Hiroaki
Two-year, prospective cohort data collected for the Japan epidemiological research of Occupation-related Back pain study were used for the analysis. To identify potential risk factors for the development of new-onset sciatica in initially symptom-free Japanese workers with no history of sciatica. Although the associations between individual and occupational factors and cases of new-onset sciatica are established, the effect of psychosocial factors on the development of sciatica has still not been adequately clarified. In total, 5310 participants responded to a self-administered baseline questionnaire (response rate: 86.5%). Furthermore, 3194 (60.2%) completed both 1- and 2-year follow-up questionnaires. The baseline questionnaire assessed individual characteristics, ergonomic work demands, and work-related psychosocial factors. The outcome of interest was new-onset sciatica with or without low back pain during the 2-year follow-up period. Incidence was calculated for participants who reported no low back pain in the preceding year and no history of lumbar radicular pain (sciatica) at baseline. Logistical regression assessed risk factors associated with new-onset sciatica. Of 765 eligible participants, 141 (18.4%) reported a new episode of sciatica during the 2-year follow-up. In crude analysis, significant associations were found between new-onset sciatica and age and obesity. In adjusted analysis, significant associations were found for obesity and mental workload in a qualitative aspect after controlling for age and sex. Consequently, in multivariate analysis with all the potential risk factors, age and obesity remained statistically significant (odds ratios: 1.59, 95% confidence interval: 1.01-2.52; odds ratios: 1.77, 95% confidence interval: 1.17-2.68, respectively). In previously asymptomatic Japanese workers, the risk of developing new-onset sciatica is mediated by individual factors. Our findings suggest that the management of obesity may prevent new
Al-Areeqi, Mona A; Sady, Hany; Al-Mekhlafi, Hesham M; Anuar, Tengku Shahrul; Al-Adhroey, Abdulelah H; Atroosh, Wahib M; Dawaki, Salwa; Elyana, Fatin Nur; Nasr, Nabil A; Ithoi, Init; Lau, Yee-Ling; Surin, Johari
To investigate the molecular epidemiology of Entamoeba histolytica, E. dispar and E. moshkovskii infections among rural communities in Yemen. In a community-based study, faecal samples were collected from 605 participants and examined by wet mount, formalin-ether sedimentation, trichrome staining and nested multiplex PCR techniques. Demographic, socio-economic and environmental information was collected using a pre-tested questionnaire. Overall, 324 (53.6%) of the samples were positive for Entamoeba cysts and/or trophozoites by microscopic examination. Molecular analysis revealed that 20.2%, 15.7% and 18.2% of the samples were positive for E. histolytica, E. dispar and E. moshkovskii, respectively. Multivariate analysis showed different sets of species-specific risk factors among these communities. Educational level was identified as the significant risk factor for E. histolytica; age and gender were the significant risk factors for E. moshkovskii; and sources of drinking water and consumption of unwashed vegetables were the significant risk factors for E. dispar. Moreover, living in coastal/foothill areas and presence of other infected family members were risk factors for both E. histolytica and E. moshkovskii infections. The study reveals that Entamoeba spp. infection is highly prevalent among rural communities in Yemen, with E. histolytica, E. dispar and E. moshkovskii differentiated for the first time. Identifying and treating infected family members, providing health education pertinent to good personal and food hygiene practices and providing clean drinking water should be considered in developing a strategy to control intestinal parasitic infections in these communities, particularly in the coastal/foothill areas of the country. © 2017 John Wiley & Sons Ltd.
Guwatudde, David; Mutungi, Gerald; Wesonga, Ronald; Kajjura, Richard; Kasule, Hafisa; Muwonge, James; Ssenono, Vincent; Bahendeka, Silver K.
Background Hypertension is an important contributor to global burden of disease and mortality, and is a growing public health problem in sub-Saharan Africa. However, most sub-Saharan African countries lack detailed countrywide data on hypertension and other non-communicable diseases (NCD) risk factors that would provide benchmark information for design of appropriate interventions. We analyzed blood pressure data from Uganda’s nationwide NCD risk factor survey conducted in 2014, to describe the prevalence and distribution of hypertension in the Ugandan population, and to identify the associated factors. Methods The NCD risk factor survey drew a countrywide sample stratified by the four regions of the country, and with separate estimates for rural and urban areas. The World Health Organization’s STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. Prevalence rate ratios (PRR) using modified Poison regression modelling was used to identify factors associated with hypertension. Results Of the 3906 participants, 1033 were classified as hypertensive, giving an overall prevalence of 26.4%. Prevalence was highest in the central region at 28.5%, followed by the eastern region at 26.4%, western region at 26.3%, and northern region at 23.3%. Prevalence in urban areas was 28.9%, and 25.8% in rural areas. The differences between regions, and between rural-urban areas were not statistically significant. Only 7.7% of participants with hypertension were aware of their high blood pressure. The prevalence of pre-hypertension was also high at 36.9%. The only modifiable factor found to be associated with hypertension was higher body mass index (BMI). Compared to participants with BMI less than 25 kg/m2, prevalence was significantly higher among participants with BMI between 25 to 29.9 kg/m2 with an adjusted PRR = 1.46 [95% CI = 1.25–1.71], and even higher among obese participants (BMI ≥ 30 kg/m2) with an
Espinoza Espinoza, Sebastián Eduardo; Vivaceta De la Fuente, Anibal Enrique; Machuca Contreras, Constanza Andrea
To describe and relate the main environmental risk factors in the emergency process after a large urban fire in Valparaiso, Chile, in April 2014. An observational, cross-sectional descriptive study was performed. All 243 reports from an ad hoc web/mobile website created on the Ushahidi/Crowdmap platform were reviewed. Reports were recorded in a new database with dichotomist variables based on either the presence or absence of the relevant category in each report. Almost one-third of the reports presented data about garbage (30%) and chemical toilets (29%). Reports related to water, infrastructural damage, and garbage had significant associations with 4 categories by chi-square test. In the logistic regression model for chemical toilets, only the variable of water was significant (P value=0.00; model P value: 0.00; R2: 11.7%). The "garbage" category confirmed infrastructural damage (P value: 0.00), water (P value: 0.028), and vectors (P value: 0.00) as predictors (model P value: 0.00; R2: 23.09%). Statistically significant evidence was found for the statistical dependence of 7 out of 10 studied variables. The most frequent environmental risk factors in the reports were garbage, chemical toilets, and donation centers. The highest correlation found was for damaged infrastructure, vectors, and garbage. (Disaster Med Public Health Preparedness. 2017;11:239-243).
Full Text Available ObjectiveTo investigate the prevalence and major risk factors for fatty liver disease among adult residents in Yan’an, Shanxi Province, China．MethodsThe study enrolled healthy adults who had physical examination with complete clinical records in our hospital from February 2011 to March 2013. All participants underwent anthropometric measurement (height, weight, and blood pressure, biochemical and immunological tests (liver and renal function; blood glucose, lipids, and uric acid ［UA］; viral markers, and ultrasound examination. Data analysis was performed using the t test, χ2 test, and logistic regression analysis. ResultsA total of 6236 adult residents participated in the survey, who accounted for approximately 3.76/1000 of the total population in Yan’an. There were 3532 males and 2704 females, with a mean age of 49.27±12.93 years. Fatty liver disease was detected with ultrasound examination in 1602 participants (2568%, among whom alcoholic, suspected alcoholic, and nonalcoholic forms accounted for 4.55%, 7.08%, and 88.37%, respectively. The fatty liver group had a significantly higher prevalence of obesity, hypertension, hyperuricemia, higher-than-normal fasting serum glucose (FSG level, diabetes mellitus, and dyslipidemia than the non-fatty-liver group (P＜0.001. Multiple regression analysis showed that age, gender (male, drinking, waist circumference, body mass index, high-density lipoprotein cholesterol (HDL-C, low-density lipoprotein cholesterol (LDL-C, triglyceride (TG, UA, FSG, diabetes mellitus, and hypertension were influential factors for fatty liver disease, of which HDL-C was a protective factor. Compared with the normal FSG group, the impaired fasting glycaemia and diabetes groups were at an increased risk for fatty liver disease by 1.584-and 2.638-fold, respectively (P＜0.001. The risk increased by1.627-, 1.796-, 9.544-fold, respectively, in the overweight, grade I obesity, and grade Ⅱ obesity groups versus the
Background Obesity increases the risk of many diseases. However, there has been little literature about the epidemiology of obesity classified by body mass index (BMI) or waist (abdominal obesity) among urban Chinese adults. This study is to fill the gap by assessing the prevalence of obesity and associated risk factors among urban Chinese adults. Methods A representative sample of 25,196 urban adults aged 18 to 74 years in Northeast China was selected and measurements of height, weight and waist circumference (WC) were taken from 2009–2010. Definitions of overweight and obesity by the World Health Organization (WHO) were used. Results The overall prevalence rates of general obesity and overweight classified by BMI were 15.0% (15.7% for men and 14.3% for women, pmen and 17.7% for women, pobesity was 37.6% (31.1% for men and women 43.9% for women, pobesity, alcohol drinking, or former cigarette smoking were at high risk of obesity classified by BMI or WC, whereas those with a higher level of education, higher family income, or a healthy and balanced diet were at low risk of obesity. Analysis stratified by gender showed that men with a higher level education level, a white-collar job, a cadre job, or higher family income were the high risk group, and women with a higher level of education or higher family income were the low risk group. Conclusions Obesity and overweight have become epidemic in urban populations in China; associations of risk factors with obesity differ between men and women. PMID:23146089
Hawton, Keith; Linsell, Louise; Adeniji, Tunde; Sariaslan, Amir; Fazel, Seena
Self-harm and suicide are common in prisoners, yet robust information on the full extent and characteristics of people at risk of self-harm is scant. Furthermore, understanding how frequently self-harm is followed by suicide, and in which prisoners this progression is most likely to happen, is important. We did a case-control study of all prisoners in England and Wales to ascertain the prevalence of self-harm in this population, associated risk factors, clustering effects, and risk of subsequent suicide after self-harm. Records of self-harm incidents in all prisons in England and Wales were gathered routinely between January, 2004, and December, 2009. We did a case-control comparison of prisoners who self-harmed and those who did not between January, 2006, and December, 2009. We also used a Bayesian approach to look at clustering of people who self-harmed. Prisoners who self-harmed and subsequently died by suicide in prison were compared with other inmates who self-harmed. 139,195 self-harm incidents were recorded in 26,510 individual prisoners between 2004 and 2009; 5-6% of male prisoners and 20-24% of female inmates self-harmed every year. Self-harm rates were more than ten times higher in female prisoners than in male inmates. Repetition of self-harm was common, particularly in women and teenage girls, in whom a subgroup of 102 prisoners accounted for 17,307 episodes. In both sexes, self-harm was associated with younger age, white ethnic origin, prison type, and a life sentence or being unsentenced; in female inmates, committing a violent offence against an individual was also a factor. Substantial evidence was noted of clustering in time and location of prisoners who self-harmed (adjusted intra-class correlation 0·15, 95% CI 0·11-0·18). 109 subsequent suicides in prison were reported in individuals who self-harmed; the risk was higher in those who self-harmed than in the general prison population, and more than half the deaths occurred within a month of self
Hawton, Keith; Linsell, Louise; Adeniji, Tunde; Sariaslan, Amir; Fazel, Seena
Summary Background Self-harm and suicide are common in prisoners, yet robust information on the full extent and characteristics of people at risk of self-harm is scant. Furthermore, understanding how frequently self-harm is followed by suicide, and in which prisoners this progression is most likely to happen, is important. We did a case-control study of all prisoners in England and Wales to ascertain the prevalence of self-harm in this population, associated risk factors, clustering effects, and risk of subsequent suicide after self-harm. Methods Records of self-harm incidents in all prisons in England and Wales were gathered routinely between January, 2004, and December, 2009. We did a case-control comparison of prisoners who self-harmed and those who did not between January, 2006, and December, 2009. We also used a Bayesian approach to look at clustering of people who self-harmed. Prisoners who self-harmed and subsequently died by suicide in prison were compared with other inmates who self-harmed. Findings 139 195 self-harm incidents were recorded in 26 510 individual prisoners between 2004 and 2009; 5–6% of male prisoners and 20–24% of female inmates self-harmed every year. Self-harm rates were more than ten times higher in female prisoners than in male inmates. Repetition of self-harm was common, particularly in women and teenage girls, in whom a subgroup of 102 prisoners accounted for 17 307 episodes. In both sexes, self-harm was associated with younger age, white ethnic origin, prison type, and a life sentence or being unsentenced; in female inmates, committing a violent offence against an individual was also a factor. Substantial evidence was noted of clustering in time and location of prisoners who self-harmed (adjusted intra-class correlation 0·15, 95% CI 0·11–0·18). 109 subsequent suicides in prison were reported in individuals who self-harmed; the risk was higher in those who self-harmed than in the general prison population, and more than
Om Narayan Yadav
Full Text Available BACKGROUND Type 2 diabetes mellitus is a chronic, debilitating disease characterised by insulin resistance, impaired insulin secretion and hyperglycaemia. It is the most prevalent metabolic condition and one amongst major health and socioeconomic problems worldwide. It represents more than 90% of total prevalence of diabetes in the world and is responsible for 9% of the global mortality corresponding to four million deaths per year. The aim of the study is to- 1. Determine the prevalence of diabetes mellitus type 2 in a rural population of age 30 years and above. 2. Study the association of various risk factors with diabetes mellitus type 2. MATERIALS AND METHODS A community-based cross-sectional study was carried out in population 30 years and above at Hazipur village in the district of Katihar in Bihar. During the study period of 1 st January to 31 st December 2015, in which 910 persons aged 30 years or more living in this village were included in study. RESULTS Total sample size in this study was 910 and out of this, 37 (4.06% were found to have type 2 diabetes mellitus. The prevalence of type 2 diabetes was 45.94% among sedentary and only 13.52% among heavy worker subjects. According to literacy of subjects, the prevalence among illiterate, primary, middle, secondary, higher secondary and above was 24.33%, 32.43%, 16.22%, 13.51% and 13.51%, respectively. Among vegetarians and non-vegetarians, the prevalence was 18.91% and 81.09%, respectively. Among subjects with type 2 DM, 54.06% were overweight and 72.97% were hypertensive. Smoking habit was found among 54.05% subjects. CONCLUSION This study shows that the prevalence of diabetes is high in the subjects having sedentary lifestyle, poor literacy status, overweight, non-vegetarians, hypertension and smoking habit. Control of type 2 diabetes mellitus mandates lifestyle modification and control of risk factors.
Fasolo, Adriano; Capuzzo, Cristina; Fornea, Michela; Franch, Antonella; Birattari, Federica; Carito, Giuseppe; Cucco, Flavio; Prosdocimo, Giovanni; Sala, Michele; Delle Noci, Nicola; Primavera, Vito; Frigo, Anna Chiara; Grigoletto, Francesco; Ponzin, Diego
To evaluate corneal graft survival over a 5-year period and to investigate whether factors related to the donor, eye bank practices, the recipient, surgery, and postoperative course influenced the outcome. Nine hundred ninety-eight patients were randomly selected and monitored in the subsequent 3 years from a cohort of 4500 recipients who underwent penetrating keratoplasty between 2001 and 2004. Cox univariate regression analysis was used to select variables to be included in a multivariate Cox proportional hazards model with a backward selection procedure to identify potential risk factors for graft failure. Graft survival curves were obtained from Kaplan-Meier estimates. Ectasia/thinning was the most common indication (49.1%), followed by regraft (16.1%) and pseudophakic corneal edema (PCE) (9.4%). The overall rate of graft failure was 10.7% with 6 cases of primary graft failure. Adverse reactions and complications (other than graft failure) were reported in 2.7% of patients in the first postoperative week and in 22.8% during the full follow-up period. The probability of 5-year survival was 83.0%, best in eyes with ectasia/thinning (96.0%) and less favorable in PCE (67.0%) and regraft (64.0%). Multivariate analyses showed the following variables to be linked to an increased risk of graft failure: regraft for any reason, all clinical indication except PCE, history of ocular inflammation/infection, pseudophakic/aphakic eye, vitrectomy, graft Descemet folds, adverse reactions/complications, and surgeons' low caseload. Penetrating keratoplasty shows an overall positive prognosis in the long-term. However, the probability of graft survival is largely dependent on the preoperative clinical condition and the lack of complications during follow-up.
Full Text Available The amebic liver abscess is uncommon in developed countries like Spain, but the incidence is increasing probably due to the migratory movements of the population. We report a case of an amebic abscess, initially unsuspected due to the absence of epidemiologic risk factors and the negative serology for amebiasis, in the early stages of the disease.El absceso hepático amebiano es infrecuente en países desarrollados, como lo es el caso de España, pero su incidencia está aumentando, posiblemente en relación con los movimientos migratorios de la población. Presentamos un caso de absceso hepático amebiano, no sospechado inicialmente, debido a la ausencia de antecedentes epidemiológicos y a la negatividad de las pruebas serológicas en las fases iniciales de enfermedad.
Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George
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
Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George
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.
Full Text Available BACKGROUND Many of the ovarian tumours traditionally thought to be of ovarian origin is now thought to primarily originate in other pelvic organs and ovarian involvement is actually secondary. MATERIALS AND METHODS A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode, over a period of 10 months from January 2013 to October 2013. All cases of carcinoma ovary operated and specimen submitted for histopathology examination with no gross involvement of fallopian tubes were included in the study. All cases where specimen showed gross involvement of fallopian tubes or adherence of the fallopian tubes to the ovary were excluded. Bilateral salpingectomy specimens from women undergoing surgery for reasons other than ovarian, tubal or peritoneal malignancy were taken as controls. General information regarding the patients was collected. Investigation results were analysed. Histopathology examination of the specimen was done. Fallopian tube was examined by SEE-FIM (sectioning and extensive examination of fimbrial end protocol and was submitted for p53 and Ki67 studies. RESULTS Pain was the most common presenting symptom. Ultrasound was suggestive of ovarian malignancy in majority. Tubal involvement was noted in 35% cases and 27% controls. 61% of cases were above 45 years of age. 60% of cases had not undergone tubal ligation. Family history of malignancy was more among cases. CONCLUSION Fallopian tube mucosal involvement was noted in 35% of cases and 30% of controls. These lesions can be considered as precursor lesions in carcinoma ovary. However, further studies with larger sample size is needed. Tubal ligation not done was found to be a significant risk factor for ovarian carcinoma. Age of menopause above 48 years and family history of malignancy were associated with increased risks. Incidence of ovarian carcinoma showed an increase with increasing age.
Santos, Luzia Michelle; Bernardino, Italo M; Ferreira Porto, Alysson Vinicius; Nórbrega Barbosa, Kevan Guilherme; Marques da Nóbrega, Lorena; d'Avila, Sérgio
The aim of the present study was to characterize the profile of victims of interpersonal physical violence (IPV) caused by a knife or other sharp instrument, identify the factors associated with maxillofacial trauma, and examine the incidence of maxillofacial trauma over time. In a retrospective cohort study, we evaluated 569 medicolegal and social records of IPV victims by knife or other sharp instruments treated at a forensic medicine and dentistry center in Brazil during a 4-year consecutive period. The variables investigated were related to the sociodemographic characteristics of the victims, circumstances of the aggression, and trauma patterns. Descriptive and multivariate statistics through Poisson regression and trend analysis with the creation of polynomial regression models were used. The cumulative incidence of oral-maxillofacial trauma was 19.3%. The mean age of the victims was 31.29 ± 13.82 years. Cases of trauma affecting more than one region of the face prevailed (45.5%). Based on the final Poisson regression model, unemployed people were more likely to exhibit maxillofacial trauma (relative risk [RR] 1.86; 95% confidence interval [CI] 1.03-3.35; P = .039). In addition, individuals were more likely to experience maxillofacial trauma on Wednesdays (RR 1.85; 95% CI 1.01-3.37; P = .045). The trend analysis revealed a significant increase in oral-maxillofacial injuries over time (P maxillofacial trauma was high, and the main factors associated with trauma were the victim's employment status and day of occurrence. Future studies will focus on assessing the effect of maxillofacial trauma on the quality of life and well-being of violence victims. Copyright © 2018. Published by Elsevier Inc.
Elmi, Asha A; Bansal, Devendra; Acharya, Anushree; Skariah, Sini; Dargham, Soha R; Abu-Raddad, Laith J; Mohamed-Nady, Nady; Amuna, Paul; Al-Thani, Asma A J; Sultan, Ali A
Human Papillomavirus (HPV) infections are known to cause cervical cancer worldwide, however, limited information is currently available on prevalence, types distribution and risk factors for HPV infection in the Arab countries. We conducted a cross-sectional observational study exclusively of women of Arabic origin residing in Qatar (n = 406) who were selected from the Women's Hospital at Hamad Medical Corporation (HMC) and Health Centers of the Primary Health Care Corporation in Doha, Qatar over the period March 2013 to August 2014. Socio-demographic, behavioral and clinical data were collected. Four hundred and six cervical smears and 292 blood samples were included in the study. HPV typing was done using HPV type-specific primers-based real-time PCR, and Sanger sequencing. HPV-IgG and IgM were quantified using ELISA assays. The prevalence of HPV infection amongst Qatari and non-Qatari Arab women were 9.8% and 6.1%, respectively and 7.6% and 16.7% in women with normal and abnormal cytology, respectively. HPV 81 was the most commonly found genotype in women with normal cytology (34.5%), whereas HPV 81, 16 and 59 in women with abnormal cytology (25.0% each). All the HPV DNA positive women were seronegative and HPV-IgG prevalence was higher in Qatari women than in non-Qatari Arab women. None of the studied factors had any significant association with HPV-DNA positivity or HPV-IgG seropositivity. The overall identified HPV DNA prevalence and HPV seroprevalence among Arab women in Qatar were on the low side compared to global levels.
Full Text Available PURPOSE: The purpose of this study was to describe the epidemiology of cervical spine injury in the patients with cervical trauma and analyze its associated risk factors during the special heating season in North China. METHODS: This cross-sectional study investigated predictors for cervical spine injury in cervical trauma patients using retrospectively collected data of Hebei Provincial Orthopaedic Hospital from 11/2011 to 02/2012, and 11/2012 to 02/2013. Binary logistic regression analysis was used to determine risk factors for cervical fractures/dislocations or cord injury. RESULTS: A total of 106 patients were admitted into this study. Of all, 34 patients (32.1% were treated from 11/2011 to 02/2012 and 72 patients (67.9% from 11/2012 to 02/2013. The mean age was 41.9±13.3 years old; 85 patients (80.2% were male and 82 (77.4% from rural areas. Eighty patients (75.5% were caused by fall including 45 (42.5% by severe fall (>2 m. Sixty-five patients (61.3% of all suffered injuries to other body regions and 32 (30.2% got head injury. Thirty-one patients (29.2% sustained cervical cord injury with cervical fractures/dislocations. Twenty-six (83.9% of cervical cord injury patients were from rural areas and 24 (77.4% of those resulted from fall including 15 (48.4% from severe fall (>2 m. Logistic regression displayed that age (OR, 1.47; 95% CI, 1.05-2.07, head injury (OR, 5.63; 95% CI, 2.23-14.26, were risk factors for cervical cord injury and snowing (OR, 8.25; 95% CI, 2.26-30.15 was a risk factor for cervical spine injury due to severe fall (>2 m. CONCLUSIONS: The elder male patients and patients with head trauma are high-risk population for cervical cord injury. As a seasonal factor, snowing during heating season is of note a risk factor for cervical spine injury resulting from severe fall (>2 m in the patients with cervical trauma in North China.
Murray, Gerard M; More, Simon J; Sammin, Dónal; Casey, Mìcheàl J; McElroy, Máire C; O'Neill, Rónan G; Byrne, William J; Earley, Bernadette; Clegg, Tracy A; Ball, Hywel; Bell, Colin J; Cassidy, Joseph P
We examined the pathogens, morphologic patterns, and risk factors associated with bovine respiratory disease (BRD) in 136 recently weaned cattle ("weanlings"), 6-12 mo of age, that were submitted for postmortem examination to regional veterinary laboratories in Ireland. A standardized sampling protocol included routine microbiologic investigations as well as polymerase chain reaction and immunohistochemistry. Lungs with histologic lesions were categorized into 1 of 5 morphologic patterns of pneumonia. Fibrinosuppurative bronchopneumonia (49%) and interstitial pneumonia (48%) were the morphologic patterns recorded most frequently. The various morphologic patterns of pulmonary lesions suggest the involvement of variable combinations of initiating and compounding infectious agents that hindered any simple classification of the etiopathogenesis of the pneumonias. Dual infections were detected in 58% of lungs, with Mannheimia haemolytica and Histophilus somni most frequently recorded in concert. M. haemolytica (43%) was the most frequently detected respiratory pathogen; H. somni was also shown to be frequently implicated in pneumonia in this age group of cattle. Bovine parainfluenza virus 3 (BPIV-3) and Bovine respiratory syncytial virus (16% each) were the viral agents detected most frequently. Potential respiratory pathogens (particularly Pasteurella multocida, BPIV-3, and H. somni) were frequently detected (64%) in lungs that had neither gross nor histologic pulmonary lesions, raising questions regarding their role in the pathogenesis of BRD. The breadth of respiratory pathogens detected in bovine lungs by various detection methods highlights the diagnostic value of parallel analyses in respiratory disease postmortem investigation.
Hunt, Kenneth J; George, Elizabeth; Harris, Alex H S; Dragoo, Jason L
To describe the incidence and risk factors for high ankle sprains (ie, syndesmosis injuries) among National Collegiate Athletic Association (NCAA) football players. Descriptive epidemiologic study. Data were examined from the NCAA's Injury Surveillance System (ISS) for 5 football seasons (from 2004-2005 to 2008-2009). All NCAA men's football programs participating in the ISS. No additional risk factors were introduced as a result of this analysis. For partial and complete syndesmosis injuries, outcome measures included incidence, time lost from participation, and requirement for surgical repair. The overall incidence of high ankle sprains in NCAA football players was 0.24 per 1000 athlete exposures, accounting for 24.6% of all ankle sprains. Athletes were nearly 14 times more likely to sustain the injury during games compared with practice; complete syndesmosis injuries resulted in significantly greater time lost compared with partial injuries (31.3 vs 15.8 days). Less than 3% of syndesmosis injuries required surgical intervention. There was a significantly higher injury incidence on artificial surfaces compared with natural grass. The majority of injuries (75.2%) occurred during contact with another player. Our data suggest a significantly higher incidence of syndesmosis injuries during games, during running plays, and to running backs and interior defensive linemen. The wide range in time lost from participation for complete syndesmosis injuries underscores the need for improved understanding of injury mechanism and classification of injury severity such that prevention, safe return to play protocols, and outcomes can be further improved.
Tao, Z L
Most epidemiological studies of eating disorders have been carried out in North America and Western Europe. There are few exploratory studies in China on the prevalence of eating disorders and influential factors that cause eating disorders. A survey of school and college students aged between 12 and 25 in two cities in China had 1199 participants (95.8% response rate), 767 were female (63.9%) and 432 male (36.1%) Subjects completed questionnaires including the Eating Attitude Test (EAT-26). 9.9% of the females and 2.0% of the males showed high risk scores (EAT ≥ 20) regardless of whether their weight was normal or they were underweight. Such high risk groups showed a significantly higher degree of psychological characteristics relevant to eating disorders in both female and male subjects. Both Chinese females and a group of Chinese males may be at high risk for eating disorders. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.
Nakayama, Kunio; Morimoto, Kanehisa
To investigate the association among symptoms of sick building syndrome (SBS). Self-reported questionnaire and indoor environmental surveys of newly build dwellings in Japan were conducted. The questionnaire included items on symptoms of SBS and lifestyle, and an indoor environmental survey (i.e., mold, mites, and volatile organic compounds (VOC)) was conducted in family rooms of dwellings in Japan (Sapporo, Fukushima, Nagoya, Osaka, Okayama, and Kitakyusyu), from 2004 to 2007. Data from Osaka in 2004 indicated significant odds ratios for symptoms of SBS for questionnaire items on renovation, air freshener, carpet, use of benzin, use of thinner, use of coating materials, moldiness, smell of house, and feeling of having insufficient sleeping hours. Significant odds ratios were noted for total CFU, Auerbasidum genus, Alternaria alternata, Aspergillus sp., Aureobasidium pullulans, Cladosporium cladosporioides, Fusarium sp., Penicillium sp., Rhodotorula minuta, and Wallemia sebi. Concerning concentrations of VOCs, TVOC, limonene, o,m-tolualdehyde, 2-pentanone, tetrachloroethylene, n-decane, and n-heptane are significantly higher in those who have symptoms of SBS. Significant odds ratios were indicated for questionnaire items on smell of house, stuffiness, moldiness, fustiness, dampness, water leakage, and feeling of having insufficient sleeping hours from data of six areas in Japan in 2004. Continuous data analysis of Osaka from 2004 to 2006 suggested that improvement of symptoms of SBS might be due to lifestyle modification. Mites, molds, VOCs, renovation, moldiness, stuffiness, feeling of having insufficient sleeping hours, carpet use, benzin, thinner, and coating materials, increase the risk of developing symptoms of SBS, whereas modification of lifestyle and ways of living factors might alleviate them.
Nóbrega, Marcus Vinícius Dantas da; Reis, Ricardo Coelho; Aguiar, Isabel Cristina Veras; Queiroz, Timóteo Vasconcelos; Lima, Ana Claudia Feitosa; Pereira, Eanes Delgado Barros; Ferreira, Raquel Feijó de Araújo
Tetanus, an acute infectious disease, is highly prevalent worldwide, especially in developing countries. Due to respiratory failure and hemodynamic instability associated with dysautonomia, severe cases require intensive care, but little has been published regarding the management in the Intensive Care Unit. To draw a 10-year clinical-epidemiological profile of Intensive Care Unit patients with severe tetanus, observe their evolution in the Intensive Care Unit and identify risk factors for mortality. In this retrospective study, we used a standardized questionnaire to collect information from the records of patients with severe tetanus admitted to the intensive care unit of a referral hospital for infectious and contagious diseases in Northeastern Brazil. The initial sample included 144 patients, of whom 29 were excluded due to incomplete information, leaving a cohort of 115 subjects. The average age was 49.6±15.3 years, most patients had no (or incomplete) vaccination against tetanus, and most were male. The main intensive care-related complications were pneumonia (84.8%) and dysautonomia (69.7%). Mortality (44.5%) was higher than expected from the mean APACHE II score (11.8), with shock/multiple organ failure as the main cause of death (72.9%). The independent factors most predictive of mortality were APACHE II score, dysautonomia, continuous neuromuscular blockade and age. A high mortality rate was observed in our cohort of Intensive Care Unit patients with severe tetanus and a number of risk factors for mortality were identified. Our results provide important insights for the development of intervention protocols capable of reducing complications and mortality in this patient population. Copyright © 2016 Sociedade Brasileira de Infectologia. All rights reserved.
Jorge Alberto Cortés
Conclusions: Candidemia is associated with a high mortality rate. Age and shock increase mortality, while the use of fluconazole was shown to be a protective factor. A higher resistance rate with new breakpoints was noted.
Full Text Available Background and Aim: Sudden Sensorineural Hearing Loss (SSNHL is an emergency situation, and is one of the most controversial subjects in domain of otolaryngology. In this article, we have analyzed some Epidemiologic Characteristics, clinical features, audiological Characteristics, and other findings in routine serological tests and MRI of 48 cases with SSNHL ,who came or were referred to us in the past 2 years. Study design: Cross sectional. Materials and Methods: In 48 patients with chief complaint of SSNHL, from June 2003 to Feb. 2005, who were admitted in clinic of otolaryngology- in Kashani Hospital -Isfahan- Iran, physical examination and history taking, audiological evaluation, MRI,and serological tests were performed in a similar way , and data were analyzed by SPSS software. Results: From 48 cases(M:28 ,F:20 with mean age of 40.9(+/-15.9 years, left ear was involved in 26 cases (54.1% ,and right ear in 19 cases (39.5% ,and in 3 cases (6.3%,both sides were involved. The severity of hearing loss was “subjectively” HIGH in 78% of patients, and the mean threshold of hearing had been calculated as 69 dB. The most common pattern in pure tone audiometry curves ,was ‘flat pattern’(75% ,and then ,’down sloping pattern’(16%.The most adjunctive clinical symptom was “tinnitus”(in 78.7%, and 40% of patients had “true vertigo”. 44.4% of our patients had some evidences of upper respiratory tract infections (URIs during recent 2 weeks. Positive family history, smoking, alcohol intake ,oral contraceptive and ototoxic drugs consumption were uncommon. 24% of cases (11 of 39 had increased ESR, and 100% of 39 patients had negative VDRL. Diabetes mellitus was the most common underlying disease (in 6 cases.From 20 patients ,who were succeeded to perform brain and ear MRI, 2 cases had tumor in internal auditory canal and cerebellopontine angle. Conclusion: SSNHL has some limitations in being studied histopathologically or in the form of
Conclusions: Compared to patients with only a SSM, the conditions of patients with RSM are more complicated. To increase the success rate of assisted reproductive technology, factors including uterus cavity adhesion, cervical relaxation, endocrine disorders, and immune disorders should be treated before assisted reproduction is initiated. These data may provide treatment guidance for infertile patients with a history of RSM.
... have been shown to reduce the risk of breast cancer in women at high risk. SERMS may cause side effects , such as hot flashes , so they are not often used for prevention of cancer. See the PDQ summary on Breast Cancer Prevention for more information. Finasteride has been ...
Stirnadel Heide A
Full Text Available Abstract Background Cardiovascular diseases and their associated risk factors remain the main cause of mortality in western societies. In order to assess the prevalence of cardiovascular risk factors (CVRFs in the Caucasian population of Lausanne, Switzerland, we conducted a population-based study (Colaus Study. A secondary aim of the CoLaus study will be to determine new genetic determinants associated with CVRFs. Methods Single-center, cross-sectional study including a random sample of 6,188 extensively phenotyped Caucasian subjects (3,251 women and 2,937 men aged 35 to 75 years living in Lausanne, and genotyped using the 500 K Affymetrix chip technology. Results Obesity (body mass index ≥ 30 kg/m2, smoking, hypertension (blood pressure ≥ 140/90 mmHg and/or treatment, dyslipidemia (high LDL-cholesterol and/or low HDL-cholesterol and/or high triglyceride levels and diabetes (fasting plasma glucose ≥ 7 mmol/l and/or treatment were present in 947 (15.7%, 1673 (27.0%, 2268 (36.7%, 2113 (34.2% and 407 (6.6% of the participants, respectively, and the prevalence was higher in men than in women. In both genders, the prevalence of obesity, hypertension and diabetes increased with age. Conclusion The prevalence of major CVRFs is high in the Lausanne population in particular in men. We anticipate that given its size, the depth of the phenotypic analysis and the availability of dense genome-wide genetic data, the CoLaus Study will be a unique resource to investigate not only the epidemiology of isolated, or aggregated CVRFs like the metabolic syndrome, but can also serve as a discovery set, as well as replication set, to identify novel genes associated with these conditions.
Corcione, Silvia; Angilletta, Roberto; Raviolo, Stefania; Filippini, Claudia; Fossati, Lucina; Di Perri, Giovanni; Cavallo, Rossana; De Rosa, Francesco Giuseppe
The incidence of C. difficile infection (CDI) and of bloodstream infection (BSI) caused by Candida spp., ESBL-E-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing K. pneumoniae (CP-Kp) is associated with high mortality. We conducted a single centre retrospective study on patients admitted to Molinette Hospital, Turin, Italy, from January 2013 to April 2015 with CDI or BSI caused by Candida, ESBL-E or CP-Kp. For each patient demographic, clinical and microbiological data were collected. Aims of this study were to describe epidemiology and to evaluate risk factors for in-hospital mortality in this group of patients. Seven hundred-eighty six cases were analyzed: 398 CDI, 137 candidemia, 125 ESBL-E BSI and 126 CP-Kp BSI. CDI, candidemia and ESBL-E BSI were more frequently reported in internal medicine wards (IMW), whilst CP-Kp were more described in intensive care unit (ICU). Sixty-six percent of patients had a previous hospitalization and the majority of patients had several medical comorbidities. In-hospital death occurred in 23.4%. Independent risk factors for mortality were antibiotic therapy before hospital admission, cardiovascular diseases, neutropenia, urinary catheter, total parenteral nutrition, SIRS and higher creatinine levels at diagnosis. Previous abdominal surgery, inflammatory bowel disease, higher serum albumin levels at the admission and fever at diagnosis were significantly associated with survival. Our data showed that CDI, ESBL-E BSI and candidemia are more frequent in frail patients, admitted to IMW, with chronic comorbidities and broad exposure to antibiotic therapies, with the exception for CP-Kp BSI, still more common in the ICU. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Gansevoort, Ron T.; Correa-Rotter, Ricardo; Hemmelgarn, Brenda R.; Jafar, Tazeen H.; Heerspink, Hiddo J. Lambers; Mann, Johannes F.; Matsushita, Kunihiro; Wen, Chi Pang
Since the first description of the association between chronic kidney disease and heart disease, many epidemiological studies have confirmed and extended this finding. As chronic kidney disease progresses, kidney-specific risk factors for cardiovascular events and disease come into play. As a
Reza Jafarzadeh Esfehani
Full Text Available Background & aim: Female sexual function (FSD is a multifactorial phenomenon. Sexual function is influenced by different personal and environmental factors. This study aimed to evaluate FSD and its contributing factors using female sexual function index (FSFI. Methods:This descriptive cross-sectional study was conducted on 264 women referring to 11 health centers of Sabzevar, Iran during October 2012 to January 2013 using a convenience sampling. Data were collected using a validated Persian version of FSFI containing six domains of sexual desire, lubrication, sexual arousal, sexual satisfaction, orgasm and sexual pain as well as demographic questionnaire. A total score of Results: The mean age of women enrolled in this study was 32.2±10.27 years . Considering the cut-off point of sexual dysfunction at 28, 62.1% of the study population had FSD. Highest rate of FSD was estimated at 49.2%, Age was associated with a significant decline in total scores of FSFI (P=0.042. Moreover, a significant correlation was observed between duration of marriage and total scores of FSFI (P
Full Text Available The report of World Health Organization (WHO shows that India tops the world with largest number of diabetic subjects. This increase is attributed to the rapid epidemiological transition accompanied by urbanization and changes in the life style, which is occurring in India. A cross-sectional descriptive study was conducted in the Department of Biochemistry of Calcutta National Medical College among the patients who were doing first time blood examination for diagnosis of diabetes. The objective of this study was to assess socio-demographic profile and risk factors associated with the diabetic patients. Prevalence of diabetes was more (63.6% among those who had BMI (Body Mass Index 25 or more, where as the proportion of diabetes was less among the persons having BMI less than 18.5. This association was found to be statistically significant (χ2 = 32.78, df = 2 p = 0.0001. Prevalence of diabetes was also high among persons consuming tobacco (34.5% (χ2 = 14.76, df = 1, p = 0.0001 and animal protein (51.5% (χ2 = 55.65, df = 1, p = 0.0001. Lifestyle modifications, reduction of body weight, increasing physical activity are some of the important primary preventive measures to halt the upward trend of diabetes epidemic in India.
Full Text Available The report of World Health Organization (WHO shows that India tops the world with largest number of diabetic subjects. This increase is attributed to the rapid epidemiological transition accompanied by urbanization and changes in the life style, which is occurring in India. A cross-sectional descriptive study was conducted in the Department of Biochemistry of Calcutta National Medical College among the patients who were doing first time blood examination for diagnosis of diabetes. The objective of this study was to assess socio-demographic profile and risk factors associated with the diabetic patients. Prevalence of diabetes was more (63.6% among those who had BMI (Body Mass Index 25 or more, where as the proportion of diabetes was less among the persons having BMI less than 18.5. This association was found to be statistically significant (χ2 = 32.78, df = 2 p = 0.0001. Prevalence of diabetes was also high among persons consuming tobacco (34.5% (χ2 = 14.76, df = 1, p = 0.0001 and animal protein (51.5% (χ2 = 55.65, df = 1, p = 0.0001. Lifestyle modifications, reduction of body weight, increasing physical activity are some of the important primary preventive measures to halt the upward trend of diabetes epidemic in India.
Saha, Shampa; Hasan, Md; Kim, Lindsay; Farrar, Jennifer L; Hossain, Belal; Islam, Maksuda; Ahmed, Asm Nawshad Uddin; Amin, M Ruhul; Hanif, Mohammed; Hussain, Manzoor; El-Arifeen, Shams; Whitney, Cynthia G; Saha, Samir K
Pneumonia is the leading infectious cause of morbidity and mortality in young children in Bangladesh. We present the epidemiology of pneumonia in Bangladeshi children factors associated with disease severity and mortality. Children aged 2-59 months admitted to three Bangladeshi hospitals with pneumonia (i.e., cough or difficulty breathing and age-specific tachypnea without danger signs) or severe pneumonia (i.e., cough or difficulty breathing and ≥1 danger signs) were included. Demographic, clinical, laboratory, and vaccine history data were collected. We assessed associations between characteristics and pneumonia severity and mortality using multivariable logistic regression. Among 3639 Bangladeshi children with pneumonia, 61% had severe disease, and 2% died. Factors independently associated with severe pneumonia included ages 2-5 months (adjusted odds ratio [aOR] 1.60 [95% CI: 1.26-2.01]) and 6-11 months (aOR 1.31 [1.10-1.56]) relative to 12-59 months, low weight for age (aOR 1.22 [1.04-1.42]), unsafe drinking water source (aOR 2.00 [1.50-2.69]), higher paternal education (aOR 1.34 [1.15-1.57]), higher maternal education (aOR 0.74 [0.64-0.87]), and being fully vaccinated for age with pentavalent vaccination (aOR 0.64 [0.51-0.82]). Increased risk of pneumonia mortality was associated with age factors for severe pneumonia and mortality included low weight for age and access to safe drinking water. Improving vaccination status could decrease disease severity.
... prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk factors ... do smoke, quit. Controlling your cholesterol through diet, exercise, and medicines . Controlling high blood pressure through diet, ...
Full Text Available It is commonly assumed that sexual risk factors for heterosexual HIV transmission in sub-Saharan Africa, such as multi-partner sex, paid sex and co-infections, become less important as HIV epidemics mature and prevalence increases.We conducted a systematic review of 68 African epidemiological studies from 1986 to 2006 involving 17,000 HIV positive adults and 73,000 controls. We used random-effects methods and stratified results by gender, time, background HIV prevalence rates and other variables. The number of sex partners, history of paid sex, and infection with herpes simplex virus (HSV-2 or other sexually-transmitted infections (STIs each showed significant associations with HIV infection. Among the general population, the odds ratio (OR of HIV infection for women reporting 3+ sex partners versus 0-2 was 3.64 (95%CI [2.87-4.62], with similar risks for men. About 9% of infected women reported ever having been paid for sex, versus 4% of control women (OR = 2.29, [1.45-3.62]. About 31% of infected men reported ever paying for sex versus 18% of uninfected men (OR = 1.75, [1.30-2.36]. HSV-2 infection carried the largest risk of HIV infection: OR = 4.62, [2.85-7.47] in women, and OR = 6.97, [4.68-10.38] in men. These risks changed little over time and stratification by lower and higher HIV background prevalence showed that risk ratios for most variables were larger in high prevalence settings. Among uninfected controls, the male-female differences in the number of sex partners and in paid sex were more extreme in the higher HIV prevalence settings than in the lower prevalence settings.Multi-partner sex, paid sex, STIs and HSV-2 infection are as important to HIV transmission in advanced as in early HIV epidemics. Even in high prevalence settings, prevention among people with high rates of partner change, such as female sex workers and their male clients, is likely to reduce transmission overall.
Fotini K Kavvoura
Full Text Available Epidemiological studies may be subject to selective reporting, but empirical evidence thereof is limited. We empirically evaluated the extent of selection of significant results and large effect sizes in a large sample of recent articles.We evaluated 389 articles of epidemiological studies that reported, in their respective abstracts, at least one relative risk for a continuous risk factor in contrasts based on median, tertile, quartile, or quintile categorizations. We examined the proportion and correlates of reporting statistically significant and nonsignificant results in the abstract and whether the magnitude of the relative risks presented (coined to be consistently > or =1.00 differs depending on the type of contrast used for the risk factor. In 342 articles (87.9%, > or =1 statistically significant relative risk was reported in the abstract, while only 169 articles (43.4% reported > or =1 statistically nonsignificant relative risk in the abstract. Reporting of statistically significant results was more common with structured abstracts, and was less common in US-based studies and in cancer outcomes. Among 50 randomly selected articles in which the full text was examined, a median of nine (interquartile range 5-16 statistically significant and six (interquartile range 3-16 statistically nonsignificant relative risks were presented (p = 0.25. Paradoxically, the smallest presented relative risks were based on the contrasts of extreme quintiles; on average, the relative risk magnitude was 1.41-, 1.42-, and 1.36-fold larger in contrasts of extreme quartiles, extreme tertiles, and above-versus-below median values, respectively (p < 0.001.Published epidemiological investigations almost universally highlight significant associations between risk factors and outcomes. For continuous risk factors, investigators selectively present contrasts between more extreme groups, when relative risks are inherently lower.
Kok, V C; Horng, J-T; Wang, M N; Chen, Z-Y; Kuo, J-T; Hung, G-D
Is gout a risk factor for future osteoporosis? This large population-based study comprising two matched groups of individuals with and without gout demonstrates that patients with gout have a 20% increase in the risk of developing osteoporosis in future through an 8-year follow-up. To examine if gout is associated with an increased risk of osteoporosis. We conducted a nationwide population-based retrospective matched-cohort study. Two matched cohorts (n = 36,458 with gout and 71,602 without gout) assembled and recruited from the Longitudinal Health Insurance Dataset containing 1 million subjects. Exclusion criteria were missing data, age < 20 years, short follow-up period, and pre-existing osteoporosis. Both cohorts were followed up until incident osteoporosis, death, or the end of the study. Person-year data and incidence rates were evaluated. A multivariable Cox model was used to derive an adjusted hazard ratio (aHR) after controlling for socioeconomic proxy, geographical difference, glucocorticoid and allopurinol exposure, various prespecified medical conditions, and comorbidities. Men comprised 72.8% of the cohorts. With a follow-up of 183,729 and 359,900 person-years for the gout and non-gout cohorts, 517 and 811 incidents of osteoporosis occurred, respectively, after excluding osteoporosis incidents in the first 3 years of follow-up. The cumulative incidence of osteoporosis was statistically higher in the gout cohort than in the non-gout cohort, at 3.3 versus 2.1% (P = 0.0036, log-rank). Our Cox model showed a 1.2-fold increase in the incidence of osteoporosis in the gout cohort, with an aHR of 1.2 (95% confidence interval, 1.06-1.35). This first population-based epidemiologic study supports the hypothesis that compared with individuals without gout; those with gout have a modest increase in the risk of developing osteoporosis in future.
It is no longer reasonable to divide cancers into those that are genetic in origin and those that are environmental in origin. With rare exception, carcinogenesis involves environmental factors that directly or indirectly exert a change in the cell's genome. Virtually all causes of cancer are multifactorial, sometimes involving an inherited predisposition to the carcinogenic effects of environmental factors, which include chemicals, ionizing radiation, and oncogenic virus. Carcinogenesis is a multistep process including induction, promotion, and progression. Initiation requires an irreversible change in the cellular genome, whereas promotion is commonly associated with prolonged and reversible exposure. Tumor progression results in genotypic and phenotypic changes associated with tumor growth, invasion, and metastasis. Most information on human cancer risk is based on epidemiologic studies involving both exposed and unexposed individuals. The quality of such studies depends on their ability to assess the strength of any association of exposure and disease and careful attention to any potential bias. Few cancers are inherited in a Mendelian fashion. Several preneoplastic conditions, however, are clearly inherited and several malignancies demonstrate weak familial patterns. Environmental factors may exert their effect on DNA in a random fashion, but certain consistent changes, including specific translocations of genetic information, are often found. Currently, there is great interest in the close proximity of certain oncogenes governing growth control to the consistent chromosomal changes observed. Such changes may represent a final common pathway of action for environmental carcinogens. Sufficient laboratory and epidemiologic evidence exists to establish a causal association of several chemical agents with cancer
The hazard and exposures from radiation are known with reasonable accuracy. However, at 'low levels' uncertainty persists as to whether the dose response relationship is linear and whether there is a dose threshold, below which there is no risk. Some have proposed that 'low' exposures to radiation may be beneficial, a hypothesis referred to as 'hormesis'. Over recent decades, various expert groups have adopted linear no-threshold dose-response models for radiation and cancer, based on review of epidemiological and biological evidence. The unexpected epidemic of thyroid cancer among children following the Chernobyl disaster was noticed. The research with epidemiological data and knowledge of the radionuclides to which the children were exposed is needed. Currently a debate concerning potential risks of high frequency electromagnetic radiation from mobile phones illustrates another need for further research
Cardiovascular risk factors are prevalent among relatively young adult, clinically stable outpatients attending clinics across the UAE. These findings support targeted screening of outpatients visiting a general practitioner, which may provide opportunity for early discovery and ongoing management of risk factors, including recommending lifestyle changes. The ACE trial is registered under NCT01243138.
Di Bella, Stefano; Friedrich, Alexander W.; Garcia-Almodovar, Esther; Gallone, Maria Serena; Taglietti, Fabrizio; Topino, Simone; Galati, Vincenzo; Johnson, Emma; D'Arezzo, Silvia; Petrosillo, Nicola
Background: HIV infection is a risk factor for Clostridium difficile infection (CDI) yet the immune deficiency predisposing to CDI is not well understood, despite an increasing incidence of CDI among such individuals. We aimed to estimate the incidence and to evaluate the risk factors of CDI among
Mullooly, Maeve; Khodr, Zeina G; Dallal, Cher M; Nyante, Sarah J; Sherman, Mark E; Falk, Roni; Liao, Linda M; Love, Jeffrey; Brinton, Louise A; Gierach, Gretchen L
Comparing risk factor associations between invasive breast cancers and possible precursors may further our understanding of factors related to initiation versus progression. Accordingly, among 190,325 postmenopausal participants in the National Institutes of Health-AARP Diet and Health Study (1995-2011), we compared the association between risk factors and incident ductal carcinoma in situ (DCIS; n = 1,453) with that of risk factors and invasive ductal carcinomas (n = 7,525); in addition, we compared the association between risk factors and lobular carcinoma in situ (LCIS; n = 186) with that of risk factors and invasive lobular carcinomas (n = 1,191). Hazard ratios and 95% confidence intervals were estimated from multivariable Cox proportional hazards regression models. We used case-only multivariable logistic regression to test for heterogeneity in associations. Younger age at menopause was associated with a higher risk of DCIS but lower risks of LCIS and invasive ductal carcinomas (P for heterogeneity factor associations are similar for in situ and invasive cancers and may influence early stages of tumorigenesis. The differential associations observed for various factors may provide important clues for understanding the etiology of certain breast cancers. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
... are here: Home For Patients Risk Factors Risk Factors for Scleroderma The cause of scleroderma is still ... Scientists are working diligently to understand what biological factors contribute to scleroderma pathogenesis. Genetic Risk Scleroderma does ...
Bongers, P.M.; IJmker, S.; Heuvel, S. van den; Blatter, B.M.
Work related neck and upper limb symptoms have a multi-factorial origin. Possible risk factors are of a physical, psychosocial or personal origin. These factors can reinforce each other and their influence can also be mediated by cultural or societal factors. Initially, most research on neck and
Paulie Marcelly Ribeiro dos Santos Carvalho
Full Text Available Data are limited in Brazil on hepatitis B infection among homeless individuals, a marginalized population with high risk of sexually transmissible infections (STI, including hepatitis B. The aim of this study was to investigate hepatitis B epidemiology in homeless persons lodged in a public shelter in Goiânia, Central Brazil. From August 2014 to June 2015, 353 individuals were interviewed and tested for markers of HBV infection. Overall HBV prevalence was 21.8% (95%CI: 17,82-26,41, and 19,5% (95%CI: 15,75-24,0 showed a serological profile of previous HBV vaccination. Older individuals (> 50 years, blacks, and homosexuals or bisexuals showed increased exposure to HBV. The low frequency of individuals immunized against HBV, high social vulnerability, and risk behaviors emphasize the need for health services administrators to provide more opportunities for HBV vaccination in this target population.
Hemant J. Pawar
Full Text Available Background: The 'organ distribution' of cancer is often strikingly dissimilar in different groups of population and varies greatly from one community to another and also differs in different communities in the same geographical location, depending on the practices, lifestyles and the influence of deleterious habits like use of tobacco and or alcohol of the people. Among various cancers affecting the human body, oral cancer accounts for nearly one third of it. Objectives: i To find out the relative frequency of oral cancer in relation to other sites from Hospital Based Cancer Registry (HBCR ii To find out the various risk factors associated with oral cancer and iii To recommend appropriate preventive measures. Methodology: A hospital based retrospective cross sectional study was conducted through case records of oral cancer patients who reported in the year 2013 to Pravara Rural HBCR, Department of Radiotherapy and Oncology, Rural Medical College and Pravara Rural Hospital, Loni, Maharashtra state, India. The case files and registers of oral cancer cases were reviewed to collect personal and clinical data about sex, age, occupation, marital status, education, socioeconomic status, habits like tobacco chewing and cigarette smoking. A predesigned performa (a core form by HBCR programme was used to collect the data. The statistical analysis was done using SYSTAT for Windows version 12 and categorical data was analysed by using Chi-square test. Results: In all1328 patients of all cancers visited the hospital during the period January 2013 to December 2013. Out of these, 349 (26.28% were of oral cancer cases. The sex wise distribution revealed 256 (73.25% among males and 93(26.65% among females. Mean age of the patients was 54.98 years, ranging from 15- 78 years, 31.23% were more than 65 years of age. The most oral cancer sites among the males and females were those of tongue (37.82% and buccal mucosa (32.95% respectively. Tobacco related cancer
Bongers, P.M.; Kremer, A.M.; Laak, J. ter
Background: In 1993, an extensive review on the role of psychosocial factors in the development of musculoskeletal problems was published by Bongers et al (1993). Since then, additional reviews on this topic have been published; however, none of these focussed on upper limb problems. Methods: In
Porter, C K; Welsh, M; Riddle, M S; Nieh, C; Boyko, E J; Gackstetter, G; Hooper, T I
Crohn's disease (CD) and ulcerative colitis (UC) are two pathotypes of inflammatory bowel disease (IBD) with unique pathology, risk factors and significant morbidity. To estimate incidence and identify IBD risk factors in a US military population, a healthy subset of the US population, using information from the Millennium Cohort Study. Incident IBD was identified from medical encounters from 2001 to 2009 or by self-report. Our primary risk factor of interest, infectious gastroenteritis, was identified from medical encounters and self-reported post-deployment health assessments. Other potential risk factors were assessed using self-reported survey responses and military personnel files. Hazard ratios were estimated using Cox proportional hazards analysis. We estimated 23.2 and 21.9 diagnoses per 100 000 person-years, respectively, for CD and UC. For CD, significant risk factors included [adjusted hazard ratio (aHR), 95% confidence interval]: current smoking (aHR: 2.7, 1.4-5.1), two life stressors (aHR: 2.8, 1.4-5.6) and prior irritable bowel syndrome (aHR: 4.7, 1.5-15.2). There was no significant association with prior infectious gastroenteritis. There was an apparent dose-response relationship between UC risk and an increasing number of life stressors. In addition, antecedent infectious gastroenteritis was associated with almost a three-fold increase in UC risk (aHR: 2.9, 1.4-6.0). Moderate alcohol consumption (aHR: 0.4, 0.2-0.6) was associated with lower UC risk. Stressful conditions and the high risk of infectious gastroenteritis in deployment operations may play a role in the development of IBD in military populations. However, observed differences in risk factors for UC and CD warrant further investigation. © 2017 John Wiley & Sons Ltd.
Laursen, Thomas Munk
This Ph.D. thesis summarizes the results from 3 cohort studies describing risk factors for and mortality of major psychiatric disorders with focus on comparison between schizophrenia and bipolar affective disorder. Furthermore, the results are evaluated in the context of the dichotomization...... and followed over several decades. Survival analysis techniques were applied to identify risk factors and mortality rates. The results demonstrated an overlap in risk factors for schizophrenia and bipolar affective disorder. Excess mortality (compared to persons never admitted with a psychiatric disorder......), and environmental factors act (or interact) with this predisposition. However, large differences in gender distribution and age at onset are present, and differences and similarities between the disorders should be further examined before the Kraepelinian dichotomization can be disregarded....
Haffner, Johann; Esther, Cornelia; Münch, Horst; Parzer, Peter; Raue, Britta; Steen, Rainer; Klett, Martin; Resch, Franz
Behavioral and emotional problems based on parents information from the Child Behavior Checklist (CBCL) were investigated in a large epidemiological sample of 4363 six year old pre-school children from the area of Heidelberg and Rhein-Neckar county. An overview about symptom frequencies of boys and girls is given, taking age specific evaluations into account. Considering symptoms and syndromes, externalizing and attention problems show high prevalence, especially for boys. Family problems are the most important predictors of child global symptomatology, explaining about 10% of variance of the CBCL total score. Other factors like gender, chronical illness, adverse living conditions, family constellation or amount of TV consumption prove as additional independent predictors. An overall model explains about 20% of variance of child symptomatology. Results are discussed from the view of normal child development, developmental psychopathology, changing norms and altered socio-cultural conditions.
Belo, Elsia Nascimento; Orellana, Jesem Douglas Yamall; Levino, Antônio; Basta, Paulo Cesar
To describe the epidemiological situation and the incidence of tuberculosis and to investigate the factors associated with treatment default in the Amazonian municipalities located in the northern Brazilian international border. This retrospective study employed sociodemographic, clinical, and epidemiological tuberculosis data recorded in the Brazilian Notifiable Diseases Information System (SINAN) between 2001 and 2010. Logistic regression was used to identify factors associated with treatment default. Tuberculosis affected mostly indigenous peoples (51.9%), males (57.9%), and people aged 25-44 years (31.4%). The predominant clinical presentation was pulmonary (89.7%), yet in 24.5% of the cases the patients did not undergo sputum smear microscopy, and only half received supervised treatment. In 70.0% of the cases notified, patients were discharged as cured. Treatment default was recorded in 10.0% of the patients. Of all deaths, 4.1% were by tuberculosis and other causes, and 1.7% by multidrug-resistant tuberculosis. The average incidence by race/color was greater among indigenous peoples, ranging from 202.3/100 000 in 2001 to 65.6/100 000 in 2010. Treatment default was associated with failure to perform the follow-up smear at the second, fourth, and sixth months (OR = 11.9, 95%CI: 7.4-19.0); with resuming treatment after default (OR = 3.0, 95%CI: 1.5-5.9); and with living in specific subregions, particularly the Alto Solimões region (OR = 6.7, 95%CI: 4.6-9.8). The present results show a high incidence of tuberculosis in the Amazon portion of the northern Brazilian international border, especially among indigenous peoples. Considering the socio-cultural specificities of these populations and the poor tuberculosis control in this area, the authors of the study conclude that the integration of different national health systems is both necessary and urgent.
M. L. Portela de Santana; H. da Costa Ribeiro Junior; M. Mora Giral; R. M.ª Raich
Introducción: En la actualidad, existe la mayor ocurrencia de enfermedades de origen biopsicosocial, en especial los trastornos alimentarios, que involucran diferentes sistemas del cuerpo y los aspectos inherentes a la persona y sus relaciones sociales. Objetivo: Abordar temas actuales y relevantes acerca de la prevalencia, la incidencia y los factores de riesgo de anorexia y bulimia nerviosa en la adolescencia. Métodos: Búsqueda en las bases de datos MEDLINE, SciELO y LILACS de estudios publ...
Shah, Naman K; Poole, Charles; MacDonald, Pia D M; Srivastava, Bina; Schapira, Allan; Juliano, Jonathan J; Anvikar, Anup; Meshnick, Steven R; Valecha, Neena; Mishra, Neelima
To characterise the epidemiology of Plasmodium falciparum gametocytemia and determine the prevalence, age structure and the viability of a predictive model for detection. We collected data from 21 therapeutic efficacy trials conducted in India during 2009-2010 and estimated the contribution of each age group to the reservoir of transmission. We built a predictive model for gametocytemia and calculated the diagnostic utility of different score cut-offs from our risk score. Gametocytemia was present in 18% (248/1 335) of patients and decreased with age. Adults constituted 43%, school-age children 45% and under fives 12% of the reservoir for potential transmission. Our model retained age, sex, region and previous antimalarial drug intake as predictors of gametocytemia. The area under the receiver operator characteristic curve was 0.76 (95%CI:0.73,0.78), and a cut-off of 14 or more on a risk score ranging from 0 to 46 provided 91% (95%CI:88,95) sensitivity and 33% (95%CI:31,36) specificity for detecting gametocytemia. Gametocytemia was common in India and varied by region. Notably, adults contributed substantially to the reservoir for potential transmission. Predictive modelling to generate a clinical algorithm for detecting gametocytemia did not provide sufficient discrimination for targeting interventions. © 2013 Blackwell Publishing Ltd.
Yende, Sachin; Alvarez, Karina; Loehr, Laura; Folsom, Aaron R; Newman, Anne B; Weissfeld, Lisa A; Wunderink, Richard G; Kritchevsky, Stephen B; Mukamal, Kenneth J; London, Stephanie J; Harris, Tamara B; Bauer, Doug C; Angus, Derek C
Preventing pneumonia requires better understanding of incidence, mortality, and long-term clinical and biologic risk factors, particularly in younger individuals. This was a cohort study in three population-based cohorts of community-dwelling individuals. A derivation cohort (n = 16,260) was used to determine incidence and survival and develop a risk prediction model. The prediction model was validated in two cohorts (n = 8,495). The primary outcome was 10-year risk of pneumonia hospitalization. The crude and age-adjusted incidences of pneumonia were 6.71 and 9.43 cases/1,000 person-years (10-year risk was 6.15%). The 30-day and 1-year mortality were 16.5% and 31.5%. Although age was the most important risk factor (range of crude incidence rates, 1.69-39.13 cases/1,000 person-years for each 5-year increment from 45-85 years), 38% of pneumonia cases occurred in adults < 65 years of age. The 30-day and 1-year mortality were 12.5% and 25.7% in those < 65 years of age. Although most comorbidities were associated with higher risk of pneumonia, reduced lung function was the most important risk factor (relative risk = 6.61 for severe reduction based on FEV1 by spirometry). A clinical risk prediction model based on age, smoking, and lung function predicted 10-year risk (area under curve [AUC] = 0.77 and Hosmer-Lemeshow [HL] C statistic = 0.12). Model discrimination and calibration were similar in the internal validation cohort (AUC = 0.77; HL C statistic, 0.65) but lower in the external validation cohort (AUC = 0.62; HL C statistic, 0.45). The model also calibrated well in blacks and younger adults. C-reactive protein and IL-6 were associated with higher pneumonia risk but did not improve model performance. Pneumonia hospitalization is common and associated with high mortality, even in younger healthy adults. Long-term risk of pneumonia can be predicted in community-dwelling adults with a simple clinical risk prediction model.
Conclusion: Bitter taste is a common symptom in hospitalized patients, especially in patients with gastroesophageal reflux and liver and gallbladder diseases and the link to smoking, dietary and emotional stress. It is found that smoking is a sole risk factor for the manifestation of bitter taste.
Menotti, A.; Puddu, P.E.; Lanti, M.; Kromhout, D.; Tolonen, H.; Parapid, B.
Objectives: The relationships were explored of some cardiovascular risk factors to typical (TYP) and atypical (ATYP) fatal coronary events (CHD). Material and methods: Thirteen cohorts of 40-59 year-old men of the Seven Countries Study were followed-up for 40 years (N = 9704 heart disease free
Marcus Vinícius Dantas da Nóbrega
Conclusion: A high mortality rate was observed in our cohort of Intensive Care Unit patients with severe tetanus and a number of risk factors for mortality were identified. Our results provide important insights for the development of intervention protocols capable of reducing complications and mortality in this patient population.
May H. Yang
Full Text Available To examine whether behavioral risk factors associated with diabetes (diet, BMI, waist circumference, physical activity, and sleep duration are also related to both prediabetes and insulin resistance (IR, we used data from Boston Area Community Health (BACH Survey (2010–2012, n=3155. Logistic and linear regression models were used to test the association of lifestyle factors with prediabetes status, insulin resistance, and prediabetes or insulin resistance. All regression models were stratified by education and income levels (to examine whether risk factors had differential effects across socioeconomic factors and adjusted for age, gender, race/ethnicity, family history of diabetes, and smoking status. We found that large waist circumference was consistently associated with higher levels of insulin resistance (IR and increased odds of prediabetes. While the association between large waist circumference and IR was consistent across all levels of SES (P<0.001, the association between large waist circumference and prediabetes was only statistically significant in the highest socioeconomic strata with odds ratios of 1.68 (95% CI 1.07–2.62 and 1.88 (95% CI 1.22–2.92 for postgraduate degree and income strata, respectively. There was no association between diet, physical activity, sleep duration, and the presence of multiple risk factors and prediabetes or IR within SES strata.
... risk factors are unique to women. These include: Menopause Use of hormonal birth control (certain types of combination pills, patches, ... risk factors are unique to women. These include: Menopause Use of hormonal birth control (certain types of combination pills, patches, ...
... Brain cells can die, causing lasting damage. Risk factors are things that increase your chance of getting ... disease or condition. This article discusses the risk factors for stroke and things you can do to ...
Marlon Cezar Cominetti
Full Text Available INTRODUCTION: This work was an epidemiological investigation of the risk of Trypanosoma cruzi transmission in the rural Quilombola community of Furnas do Dionízio, State of Mato Grosso do Sul, Brazil. METHODS: Of the 71 animals examined, seven were captured (two opossums, Didelphis albiventris; four rats, Rattus rattus; and one nine-banded armadillo, Dasypus novemcinctus and 64 were domestic (one canine, Canis familiaris; five pigs, Sus scrofa; two bovines, Bos taurus; five caprines, Capra sp.; and 51 ovines, Ovis aries. Parasitological tests were performed to detect parasites in the blood and to identify the morphology of flagellates. These methods included fresh examinations, buffy coat tests and blood cultures. Molecular analysis of DNA for identification of trypanosomatids was performed by polymerase chain reaction (PCR with primers S35 and S36. RESULTS: The parasitological tests showed flagellates in an opossum and two cattle. The molecular tests showed DNA from T. cruzi in an opossum and a pig. Triatoma sordida was the only triatomine species found in the community, and it colonized households (four specimens and the surrounding areas (124 specimens. Twenty-three specimens tested positive for flagellates, which were subsequently identified as T. cruzi by PCR. CONCLUSIONS: Data analysis demonstrated that T. cruzi has a peridomestic life cycle that involves both domestic and wild mammals.
Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control.
Full Text Available In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities.We reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10 and Matola (n = 3 cities and neighbouring Boane district (n = 1 between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819 were from Maputo City. Dogs were responsible for 97.8% (801/819 of all animal bites, but only 27.0% (126/467 were immunized. Factors significantly associated with human rabies were: age <15 years (p = 0.05, bite by stray dog (p = 0.002, deep wound (p = 0.02, bite in the head (p = 0.001, bite by unimmunized dog (p = 0.01, no use of soap and water (p = 0.001, and no post-exposure prophylaxis (p = 0.01.Implementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures.
Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control
Salomão, Cristolde; Nacima, Amílcar; Cuamba, Lutero; Gujral, Lorna; Amiel, Olga; Baltazar, Cynthia; Cliff, Julie
Background In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities. Methodology/Principal findings We reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and neighbouring Boane district (n = 1) between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized. Factors significantly associated with human rabies were: age <15 years (p = 0.05), bite by stray dog (p = 0.002), deep wound (p = 0.02), bite in the head (p = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p = 0.001), and no post-exposure prophylaxis (p = 0.01). Conclusions/Significance Implementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures. PMID:28742094
Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control.
Salomão, Cristolde; Nacima, Amílcar; Cuamba, Lutero; Gujral, Lorna; Amiel, Olga; Baltazar, Cynthia; Cliff, Julie; Gudo, Eduardo Samo
In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities. We reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and neighbouring Boane district (n = 1) between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized. Factors significantly associated with human rabies were: age dog (p = 0.002), deep wound (p = 0.02), bite in the head (p = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p = 0.001), and no post-exposure prophylaxis (p = 0.01). Implementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures.
Alexopoulos, Evangelos C; Malli, Foteini; Mitsiki, Eirini; Bania, Eleni G; Varounis, Christos; Gourgoulianis, Konstantinos I
COPD exacerbations and hospitalizations have been associated with poor prognosis for the COPD patient. To evaluate the frequency and risk factors of COPD exacerbations, hospitalizations, and admissions to intensive care units (ICUs) in Greece by a nationwide cross-sectional study. A nationwide observational, multicenter, cross-sectional study was conducted in the clinical practice setting of respiratory medicine physicians over a 6 month-period (October 2010 to March 2011). A total of 6,125 COPD patients were recruited by 199 respiratory physicians. Participants had a median age of 68.0 years, 71.3% were males, and 71.8% suffered from comorbidities. The median disease duration was 10.0 years. Of the patients, 45.3% were classified as having GOLD (Global initiative for chronic Obstructive Lung Disease) stage III or IV COPD. Patients with four or more comorbidities had 78.5% and threefold-higher than expected number of exacerbations and hospitalizations, respectively, as well as fivefold-higher risk of admission to the ICU compared to those with no comorbidities. Obese patients had 6.2% fewer expected exacerbations compared to those with a normal body mass index. Patients with GOLD stage IV had 74.5% and fivefold-higher expected number of exacerbations and hospitalizations, respectively, and nearly threefold-higher risk of admission to the ICU compared to stage I patients. An additional risk factor for exacerbations and hospitalizations was low compliance with treatment: 45% of patients reported forgetting to take their medication, and 81% reported a preference for a treatment with a lower dosing frequency. Comorbidities, disease severity, and compliance with treatment were identified as the most notable risk factors for exacerbations, hospitalizations, and ICU admissions. The results point to the need for a multifactorial approach for the COPD patient and for the development of strategies that can increase patient compliance with treatment.
Lee, Kyung Suk; Oh, In-Hwan; Choi, Sun Hee; Rha, Yeong-Ho
Background Atopic dermatitis (AD) is a common chronic inflammatory skin disease, but only few studies involved samples of children and adolescents that are representative of the entire Korean population. This study aimed to estimate the prevalence and risk factors of AD among children and adolescents in Korea by using nationally representative data. Methods We used data from the fifth Korean National Health and Nutrition Examination Survey in 2010 and retrospectively evaluated 2,116 children ...
Mohammad Shadab Alam
Results and Conclusion: HNC accounts for 21.2% of total body malignancy and 47% of all malignancies in males and 2.5% in females. Squamous cell carcinoma was the most common histological type (97%. Maximum incidence of HNC (>60% was in 40–60 year of age. Male:female ratio was 16:1. Oral cancers were most common HNC in patients below 40 year age group, whereas carcinoma oropharynx and larynx were more common in patients above 40 year age group. Tobacco smoking was a most prevalent risk factor for carcinoma oropharynx, larynx, and hypopharynx. Tobacco chewing was a most prevalent risk factor in females, young males, and carcinoma buccal mucosa patients. Habit of tobacco consumption in HNC patients was much higher than their normal counterpart. Alcohols drinking alone was observed in <1% patient as a risk factor. In oral tongue cancer, smoking and tobacco chewing were equally prevalent. Habit of tobacco chewing and alcohol were significantly higher in carcinoma buccal mucosa than other HNC suggesting synergistic effect specific to this site.
Full Text Available Evangelos C Alexopoulos,1 Foteini Malli,2 Eirini Mitsiki,3 Eleni G Bania,2 Christos Varounis,3 Konstantinos I Gourgoulianis1 1School of Social Sciences, Hellenic Open University, Patras, 2Respiratory Medicine Department, University of Thessaly Medical School, University Hospital of Larissa, Larissa, 3Medical Department, Novartis Hellas, Athens, Greece Background: COPD exacerbations and hospitalizations have been associated with poor prognosis for the COPD patient.Objective: To evaluate the frequency and risk factors of COPD exacerbations, hospitalizations, and admissions to intensive care units (ICUs in Greece by a nationwide cross-sectional study.Materials and methods: A nationwide observational, multicenter, cross-sectional study was conducted in the clinical practice setting of respiratory medicine physicians over a 6 month-period (October 2010 to March 2011. A total of 6,125 COPD patients were recruited by 199 respiratory physicians.Results: Participants had a median age of 68.0 years, 71.3% were males, and 71.8% suffered from comorbidities. The median disease duration was 10.0 years. Of the patients, 45.3% were classified as having GOLD (Global initiative for chronic Obstructive Lung Disease stage III or IV COPD. Patients with four or more comorbidities had 78.5% and threefold-higher than expected number of exacerbations and hospitalizations, respectively, as well as fivefold-higher risk of admission to the ICU compared to those with no comorbidities. Obese patients had 6.2% fewer expected exacerbations compared to those with a normal body mass index. Patients with GOLD stage IV had 74.5% and fivefold-higher expected number of exacerbations and hospitalizations, respectively, and nearly threefold-higher risk of admission to the ICU compared to stage I patients. An additional risk factor for exacerbations and hospitalizations was low compliance with treatment: 45% of patients reported forgetting to take their medication, and 81% reported a
Epidemiological studies have identified several modifiable risk factors for colorectal neoplasms in the general population. However, associations between modifiable risk factors, including body mass index (BMI), smoking, alcohol consumption and dietary patterns, and colorectal neoplasms in two
Şevik, Murat; Avcı, Oğuzhan; İnce, Ömer Barış
Enzootic bovine leukosis (EBL) which is caused by bovine leukaemia virus (BLV) has an important economic impact on dairy herds due to reduced milk production and restrictions on livestock exports. This study was conducted to determine the BLV infection status in Central Anatolia Region of Turkey, an important milk production centre, and to examine the risk factors such as purchasing cattle, increasing cattle age, cattle breed and herd size associated with transmission of BLV infection. To estimate the rate of BLV infection, a survey for specific antibodies in 28,982 serum samples from animals belonging to 1116 different herds situated in Central Anatolia Region of Turkey were tested from January 2006 to December 2013. A generalized mixed linear model was used to evaluate the risk factors that influenced BLV seroprevalence. Antibodies against BLV were detected in 431 (2.28 %) of 18,822 Holstein and 29 (0.28 %) of 10,160 Brown Swiss cows. Among 1116 herds, 132 herds (11.82 %) had one or more positive animals. Also results of our study show that the prevalence of BLV infection increased from 2006 to 2011, and it tends to reduce with BLV control programme. Furthermore, we found positive associations between percentage of seropositive animal and increasing cattle age, herd size, cattle breed and purchased cattle. Age-specific prevalence showed that BLV prevalence increased with age. These factors should be taken into consideration for control of BLV infection.
Bouglé, Adrien; Bombled, Camille; Margetis, Dimitri; Lebreton, Guillaume; Vidal, Charles; Coroir, Marine; Hajage, David; Amour, Julien
Ventilator-associated pneumonia (VAP) is frequent in Intensive Care Unit (ICU) patients. In the specific case of patients treated with Veno-Arterial Extracorporeal Membrane Oxygenation Support (VA-ECMO), VAP treatment failures (VAP-TF) have been incompletely investigated. To investigate the risk factors of treatment failure (VAP-TF) in a large cohort of ICU patients treated with VA-ECMO, we conducted a retrospective study in a Surgical ICU about patients assisted with VA-ECMO between January 1, 2013, and December 31, 2014. Diagnosis of VAP was confirmed by a positive quantitative culture of a respiratory sample. VAP-TF was defined as composite of death attributable to pneumonia and relapse within 28 days of the first episode. In total, 152 patients underwent ECMO support for > 48h. During the VA-ECMO support, 85 (55.9%) patients developed a VAP, for a rate of 60.6 per 1000 ECMO days. The main pathogens identified were Pseudomonas aeruginosa and Enterobacteriaceae. VAP-TF occurred in 37.2% of patients and was associated with an increased 28-day mortality (Hazard Ratio 3.05 [1.66; 5.63], P<0.001), and VA-ECMO assistance duration (HR 1.47 [1.05-2.05], P = 0.025). Risk factors for VAP-TF were renal replacement therapy (HR 13.05 [1.73; 98.56], P = 0.013) and documentation of Pseudomonas aeruginosa (HR 2.36 [1.04; 5.35], P = 0.04). VAP in patients treated with VA-ECMO is associated with an increased morbidity and mortality. RRT and infection by Pseudomonas aeruginosa appear as strong risks factors of treatment failure. Further studies seem necessary to precise the best antibiotic management in these patients.
Li, Ding; Xia, Rui; Zhang, Qing; Bai, Changsen; Li, Zheng; Zhang, Peng
Candidemia is the worldwide life-threaten disease, especially in cancer patients. This study was aimed to identify and evaluate the risk factors of candidemia in cancer patients, which will prompt the improvement on current therapeutic strategies and prognosis. A retrospective, case-control study was conducted from inpatients of Tianjin Medical University Cancer Institute and Hospital, during 2006 to 2013. Analyses were performed between cancer patients with candidemia as study case, and patients with bacterial bloodstream infections as control. Each case was matched up with two controls, for gender and inpatient duration. Candida species, clinical characteristics, risk factors and outcomes were reviewed in details. Total number of 80 cases and 160 controls were enrolled and analyzed in this study. Candida albicans was identified as the most prevalent species and account for 55.0% candidemia, followed by Candida parapsilosis complex (21.3%), Candida tropicalis (8.8%), Candida glabrata complex (7.5%), Candida lusitaniae (3.8%), and Candida famata (3.8%). The crude mortality at 30-days of candidemia was up to 30.0%, which is significantly higher than bacterial bloodstream infections (p = 0.006). Logistical analysis demonstrated that total parenteral nutrition >5 days (p = 0.036), urinary catheter >2 days (p = 0.001), distant organ metastasis of cancer (p = 0.002) and gastrointestinal cancer (p = 0.042) were the independent risk factors for candidemia. Candidemia showed significant higher mortality than bacterial bloodstream infections, C. albicans was cited as the primary pathogen. Total parenteral nutrition, urinary catheter, distant organ metastasis of cancer and gastrointestinal cancer are independent predictors for candidemia, this findings provides potential therapeutic targets for improving the outcome.
Background: Many burns are preventable but there is no published local prospective data on the epidemiological pattern of burns that would form the basis of care and formulation of burn prevention strategies. Objectives: To determine the epidemiological pattern of burns and assess the awareness of burn risk and ...
Zoffi Roberto S. Gerber
Full Text Available OBJETIVO: Obter um perfil dos fatores de risco coronário em uma amostra populacional pediátrica da cidade de Bento Gonçalves, RS, no período de maio/90 a junho/91. MÉTODOS: Foram estudados 1501 escolares de 6 a 16 anos incompletos, visando a detecção dos níveis séricos de colesterol total, lipoproteínas, triglicerídeos, bem como a avaliação da pressão arterial e da história familiar de doença cardiovascular isquêmica e obesidade. RESULTADOS: Foram detectadas 420 (27,98% crianças com hipercolesterolemia, sendo que 75 (5% apresentavam hipertensão arterial sistólica e 48 (3,20% hipertensão arterial diastólica. A história familiar foi importante quando positiva, porém, sua ausência não excluia a presença de fatores de risco para a aterosclerose. A hipertrigliceridemia foi encontrada em 136 (9,06% escolares e a LDL-colesterol elevada em 155 (10,33%, mostrando forte associação com hipercolesterolemia. Apresentaram índice de massa corporal acima de percentil 95, não mostrando uma maior prevalência de hipercolesterolemia, 111 crianças. CONCLUSÃO: Os fatores de risco para a aterosclerose estão presentes na infância e deveriam ser pesquisados independentemente do nível socioeconômico, da história familiar, da idade e do sexo, devendo o pediatra ser um dos responsáveis por esta investigação.PURPOSE: To obtain a profile of risk factors for coronary atherosclerosis in a pediatric population from Bento Gonçalves, Rio Grande do Sul, from May 1990 to June 1991. METHODS: One thousand five hundred and one children with ages from 6 to 15 years were studied to assess serum cholesterol levels and their association with other risk factors, such as arterial hypertension, obesity and family history of cardiovascular disease. RESULTS: Four hundred and twenty (27.98% children showed cholesterol levels over 180mg%; 75 (5% had systolic hypertension and 48 (3.20% diastolic hypertension. The family history was important to search
Biological, epidemiological, sanitary-hygienic, medical and behavioral occupational health risk factors for stock-breeders, veterinaries and workers employed at meat-processing enterprises, contacting brucellar animals and infected meat
Full Text Available We have studied sanitary-hygienic characteristics of working conditions, charts with results of sanitary-epidemiologic examination performed in a zoogenous nidus, outpatient clinic cards and questionnaires filled in by 202 patients living in Omsk region and suffering from occupational brucellosis. The disease usually prevails among stock-breeders, veterinaries and workers employed at meat-processing enterprises. Our goal was to detect risks of occupational, production-induced and general pathology evolvement. Working conditions which all the examined people had to work in corresponded to hazardous (3.3 or even dangerous (4 category as per occurrence of contacts with infectious agents and parasites (biological risk. Apart from biological factor, a number of workers were under complex exposure to ammonia concentrations (higher than MPC, noise higher than MPL, vibration, cooling microclimate, uncomfortable lighting environment, labor process hardness and intensity. There were several factors causing epidemiologic risks as well. Disinfectants were absent or their quantity was not sufficient; industrial and amenity rooms were not well-organized; there was no central hot water supply or shower rooms, separate rooms for meals, specialized implements for removing abortus and stillborn fetuses and afterbirths, correctly organized burial grounds, or first aid kits. Hygienic health risks were caused by insufficient cleaning agents supply, absence of centralized protecting clothing laundering, and insufficient provision with personal protection means. Occupational health risks resulted from absence of preliminary medical examinations in standard recruitment procedures, irregularity and low quality of periodical medical examinations. Our qualitative assessment of behavioral health risks revealed that a lot of workers tended to have irresponsible medical and hygienic behavior, there were disorders in their work and rest regime (shift work with shifts rotation
Incidence, Progression, and Associated Risk Factors of Posterior Vitreous Detachment in Type 2 Diabetes Mellitus: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS II, Report No. 7).
Gella, Laxmi; Raman, Rajiv; Pal, Swakshyar Saumya; Ganesan, Suganeswari; Sharma, Tarun
To report the incidence and progression of posterior vitreous detachment (PVD) and factors influencing the same in a cohort of patients with type 2 diabetes in a South Indian population. A subset of 615 subjects from Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study II were included in this study. All of the subjects underwent detailed ophthalmic evaluation including stereo fundus photography. The status of PVD was assessed using B-scan ultrasonography. A p value of <0.05 was considered statistically significant. The incidence of either incomplete PVD (IPVD) or complete PVD (CPVD) from no PVD at baseline visit was 80.8%. Of them, 32.63% converted to CPVD from IPVD at baseline. High prevalence of emmetropia was observed in subjects with stable No PVD. Risk factors associated with the conversion of CPVD from no PVD and IPVD at baseline were age (OR: 1.04, p = 0.002), myopia (OR: 2.14, p = 0.009), and increase in axial length (OR: 1.35, p = 0.004). Subjects undergoing cataract surgery were at 2.32 times higher risk of converting to CPVD (p = 0.038). Independent risk factors for the progression of PVD were increase in age, myopia, increased axial length, and cataract surgery.
Richard, Edo; Moll van Charante, Eric P.; van Gool, Willem A.
Epidemiological studies have consistently shown that vascular risk factors including hypertension, diabetes, obesity, hypercholesterolemia, smoking, and lack of physical exercise are associated with an increased risk of cognitive decline and dementia. Neuroradiological and neuropathological studies
Verbeek, Diederik O; Ponsen, Kornelis J; Fiocco, Marta; Amodio, Sonia; Leenen, Luke P H; Goslings, J Carel
To examine nationwide epidemiology of pelvic fractures in the Netherlands and to compare characteristics and outcome of older versus younger patients as well as predictors for in-hospital mortality. Retrospective review of pelvic fracture patients admitted to all Dutch hospitals (2008-2012) utilizing National Trauma Registry. Average annual incidence of (minor and major) pelvic fractures was calculated for the population. Older (≥ 65 years) and younger (< 65 years) patients were compared. Multivariate regression analysis was performed to identify independent predictors for in-hospital mortality. Of 11,879 pelvic fracture patients (61.8%, ≥ 65 years), annual incidence of pelvic fractures in older versus younger population was 57.9 versus 6.4 per 100,000 persons. Older patients had lower ISS (7.1 (SD 6.9) vs 15.4 (SD 13.4)) and less frequently had severe associated injuries (15.6 vs 43.5%), an admission systolic blood pressure (SBP) ≤ 90 mmHg (1.6 vs 4.1%) or Glasgow Coma Score (GCS) ≤ 12 (2.0 vs 13.3%) (all, p < 0.01). In-hospital mortality was equal in older and younger patients (5.3 vs 4.8%: p = 0.28). In both subgroups, greatest independent predictors for in-hospital mortality were GCS ≤ 12, ISS ≥ 16, and SBP ≤ 90 mmHg and in all patients age ≥ 65 (OR 6.59 (5.12-8.48): p < 0.01). The annual incidence of (both minor and major) pelvic fractures in the older population was substantially higher than in the younger population. Elderly patients had a disproportionately high in-hospital mortality rate considering they were less severely injured. Among other factors, age was the greatest independent predictor for in-hospital mortality in all pelvic fracture patients.
Full Text Available Few studies have monitored late presentation (LP of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality.LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE as HIV diagnosis with a CD4 count <350/mm(3 or an AIDS diagnosis within 6 months of HIV diagnosis among persons presenting for care between 1 January 2000 and 30 June 2011. Logistic regression was used to identify factors associated with LP and Poisson regression to explore the impact on AIDS/death. 84,524 individuals from 23 cohorts in 35 countries contributed data; 45,488 were LP (53.8%. LP was highest in heterosexual males (66.1%, Southern European countries (57.0%, and persons originating from Africa (65.1%. LP decreased from 57.3% in 2000 to 51.7% in 2010/2011 (adjusted odds ratio [aOR] 0.96; 95% CI 0.95-0.97. LP decreased over time in both Central and Northern Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19-20.70 and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55-12.43.LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and
Schendel, Diana E.; Bresnahan, Michaeline; Carter, Kim W.; Francis, Richard W.; Gissler, Mika; Grønborg, Therese K.; Gross, Raz; Gunnes, Nina; Hornig, Mady; Hultman, Christina M.; Langridge, Amanda; Lauritsen, Marlene B.; Leonard, Helen; Parner, Erik T.; Reichenberg, Abraham; Sandin, Sven; Sourander, Andre; Stoltenberg, Camilla; Suominen, Auli; Surén, Pål; Susser, Ezra
The International Collaboration for Autism Registry Epidemiology (iCARE) is the first multinational research consortium (Australia, Denmark, Finland, Israel, Norway, Sweden, USA) to promote research in autism geographical and temporal heterogeneity, phenotype, family and life course patterns, and etiology. iCARE devised solutions to challenges in…
Retrospective epidemiological study of canine epilepsy in Japan using the International Veterinary Epilepsy Task Force classification 2015 (2003-2013): etiological distribution, risk factors, survival time, and lifespan.
Hamamoto, Yuji; Hasegawa, Daisuke; Mizoguchi, Shunta; Yu, Yoshihiko; Wada, Masae; Kuwabara, Takayuki; Fujiwara-Igarashi, Aki; Fujita, Michio
Epilepsy is the most common neurological disease in veterinary practice. However, contrary to human medicine, epilepsy classification in veterinary medicine had not been clearly defined until recently. A number of reports on canine epilepsy have been published, reflecting in part updated proposals from the human epilepsy organization, the International League Against Epilepsy. In 2015, the International Veterinary Epilepsy Task Force (IVETF) published a consensus report on the classification and definition of canine epilepsy. The purpose of this retrospective study was to investigate the etiological distribution, survival time of dogs with idiopathic epilepsy (IdE) and structural epilepsy (StE), and risk factors for survival time, according to the recently published IVETF classification. We investigated canine cases with epilepsy that were referred to our teaching hospital in Japan during the past 10 years, and which encompassed a different breed population from Western countries. A total of 358 dogs with epilepsy satisfied our etiological study criteria. Of these, 172 dogs (48 %) were classified as IdE and 76 dogs (21 %) as StE. Of these dogs, 100 dogs (consisting of 65 with IdE and 35 with StE) were included in our survival study. Median survival time from the initial epileptic seizure in dogs with IdE and StE was 10.4 and 4.5 years, respectively. Median lifespan of dogs with IdE and StE was 13.5 and 10.9 years, respectively. Multivariable analysis demonstrated that risk factors for survival time in IdE were high seizure frequency (≥0.3 seizures/month) and focal epileptic seizures. Focal epileptic seizures were identified as a risk factor for survival time in IdE. Clinicians should carefully differentiate seizure type as it is difficult to identify focal epileptic seizures. With good seizure control, dogs with IdE can survive for nearly the same lifespan as the general dog population. Our results using the IVETF classification are similar to previous
Muniesa, A; Mardones, F O; Chávez, M C; Montoya, L; Cabanillas, J A; de Blas, I; Martínez-López, B
White spot disease (WSD), caused by the white spot syndrome virus, is currently one of the primary causes of mortality and economic losses in the shrimp farming industry worldwide. In Mexico, shrimp production is one of the most important primary activities generating an annual income of USD 711 million. However, WSD introduction in 1999 had a devastating impact for the Mexican shrimp industry. The aim of this study was to characterize the WSD spatio-temporal patterns and to identify the primary risk factors contributing to WSD occurrence from 2005 to 2011 in Sinaloa, Mexico. We used data collected by the 'Comité Estatal de Sanidad Acuícola de Sinaloa' from 2005 to 2011 regarding WSD outbreaks as well as environmental, production and husbandry factors at farm level. The spatio-temporal patterns of WSD were described using space-time scan statistics. The effect of 52 variables on the time to WSD outbreak occurrence was assessed using a multivariable Cox proportional hazards model. Results reveal that WSD risk and survival time were not homogeneously distributed as suggested by the significant clusters obtained using the space-time permutation model and the space-time exponential model, respectively. The Cox model revealed that the first production cycle [hazard ratio (HR) = 11.31], changes from 1 to 1.4°C of temperature oscillation caused by 'El Niño'/'La Niña' events (HR = 1.44) and high average daily growths (HR = 1.26) were significantly associated with lower survival (i.e. shorter time to WSD outbreak) on farm. Conversely, shrimp weight at the moment of the outbreak (HR = 0.159), changes from -0.9 to -0.5°C of temperature oscillation caused by 'El Niño'/'La Niña' events (HR = 0.540), high superficial water temperature during the pound stocking (HR = 0.823) and high (>100) number of days of culture (HR = 0.830) were factors associated with higher survival. Results are expected to inform the design of risk-based, intervention strategies to
A total of 194 adolescent girls were participated in this study. Early menarche was found in 22.68% of all subjects. There was no association between menarche status and daily macronutrients intake pattern and physical activity level score. Early menarche subjects had significantly higher BMI (p<0.001, CDC-percentile (p<0.001, WHO Z-score (p<0.001, and waist circumference values (p=0.02. Furthermore, early menarche subjects also had higher systolic blood pressure (p=0.035, total cholesterol level (p=0.028, LDL-cholesterol level (p=0.013, and triglyceride level (p=0.026. There was no association between menarche status and diastolic blood pressure, fasting blood glucose, HDL-C level, lipid profile ratio. In conclusion, early menarche is an important determinant factor of metabolic risks, and balance between dietary intake and physical activity level should be prioritized among them.
Madeira, S; Manteigas, A; Ribeiro, R; Otte, J; Fonseca, A Pina; Caetano, P; Abernethy, D; Boinas, F
Bovine tuberculosis (bTB) is a worldwide zoonotic disease of domestic and wild animals. Eradication has proved elusive in those countries with intensive national programmes but with ongoing transmission between wildlife and cattle. In Portugal, a high-risk area for bTB was defined and specific measures implemented to assess and minimize the risk from wildlife. Data from the 2011 to 2014 hunting seasons for red deer (Cervus elaphus) and wild boar (Sus scrofa) were analysed with bovine demographic and bTB information to assess factors that determined the occurrence and distribution of bTB in both species. The likelihood of bTB-like lesions in wild boar was positively associated with density of red deer, wild boar and cattle, while for red deer, only their density and age were significant factors. The likelihood of Mycobacterium bovis isolation in wild boar was associated with density of cattle and red deer and also with the anatomical location of lesions, while for red deer, none of the variables tested were statistically significant. Our results suggest that, in the study area, the role of red deer and wild boar may be different from the one previously suggested by other authors for the Iberian Peninsula, as red deer may be the driving force behind M. bovis transmission to wild boar. These findings may assist the official services and game managing bodies for the management of hunting zones, what could also impact the success of the bTB eradication programme. © 2015 Blackwell Verlag GmbH.
Bellodi, G; Bernini, G; Manicardi, V; Veneri, L; Muratori, L; Magnanini, G; Rossi, G; Bossini, P; Descovich, G
The objectives of this research were to determine the prevalence of essential and borderline hypertension in a population of blood donors and their families and to determine if there is a correlation between blood pressure and lifestyle and/or other cardiovascular risk factors. The study was comprised of 1976 individuals, of whom 1290 were men and 686 were women, aged 18-65 years. The prevalence of essential hypertension was 15.1% for males and 12.5% for females: the prevalence of borderline hypertension was 22.3% for males and 15.7% for females. The population was divided into two groups: the first group included only subjects (1170 men, 543 women) who did not regularly use drugs that could modify the blood pressure and the heart rate, the second group included the entire population. In the first group, the multiple regression analysis indicated, in order of importance: age, BMI (body mass index), and heart rate. These variables were important in determining the systolic blood pressure in both sexes, uricemia for males and glycemia for females. The diastolic blood pressure was dependent on BMI, heart rate, and alcohol in both sexes, and glycemia, LDL cholesterol, and uricemia in the men. In the second group, primary and borderline hypertension are significantly correlated with age, BMI, and uricemia in both sexes and glycemia in females. A program of health and nutritional education could modify some factors related to blood pressure, such as obesity and alcohol consumption. The result would be a reduction of the prevalence not only of essential and borderline hypertension, but also of metabolic diseases such as dyslipidaemias, diabetes and hyperuricemia, with a global reduction of the cardiovascular risk.
Bassit Leda C
Full Text Available Abstract Background Patients under haemodialysis are considered at high risk to acquire hepatitis B virus (HBV infection. Since few data are reported from Brazil, our aim was to assess the frequency and risk factors for HBV infection in haemodialysis patients from 22 Dialysis Centres from Santa Catarina State, south of Brazil. Methods This study includes 813 patients, 149 haemodialysis workers and 772 healthy controls matched by sex and age. Serum samples were assayed for HBV markers and viraemia was detected by nested PCR. HBV was genotyped by partial S gene sequencing. Univariate and multivariate statistical analyses with stepwise logistic regression analysis were carried out to analyse the relationship between HBV infection and the characteristics of patients and their Dialysis Units. Results Frequency of HBV infection was 10.0%, 2.7% and 2.7% among patients, haemodialysis workers and controls, respectively. Amidst patients, the most frequent HBV genotypes were A (30.6%, D (57.1% and F (12.2%. Univariate analysis showed association between HBV infection and total time in haemodialysis, type of dialysis equipment, hygiene and sterilization of equipment, number of times reusing the dialysis lines and filters, number of patients per care-worker and current HCV infection. The logistic regression model showed that total time in haemodialysis, number of times of reusing the dialysis lines and filters, and number of patients per worker were significantly related to HBV infection. Conclusions Frequency of HBV infection among haemodialysis patients at Santa Catarina state is very high. The most frequent HBV genotypes were A, D and F. The risk for a patient to become HBV positive increase 1.47 times each month of haemodialysis; 1.96 times if the dialysis unit reuses the lines and filters ≥ 10 times compared with haemodialysis units which reuse
Carrilho, Flair J; Moraes, Cleusa R; Pinho, João R R; Mello, Isabel M V G C; Bertolini, Dennis A; Lemos, Marcílio F; Moreira, Regina C; Bassit, Leda C; Cardoso, Rita A; Ribeiro-dos-Santos, Gabriela; Da Silva, Luiz C
Patients under haemodialysis are considered at high risk to acquire hepatitis B virus (HBV) infection. Since few data are reported from Brazil, our aim was to assess the frequency and risk factors for HBV infection in haemodialysis patients from 22 Dialysis Centres from Santa Catarina State, south of Brazil. This study includes 813 patients, 149 haemodialysis workers and 772 healthy controls matched by sex and age. Serum samples were assayed for HBV markers and viraemia was detected by nested PCR. HBV was genotyped by partial S gene sequencing. Univariate and multivariate statistical analyses with stepwise logistic regression analysis were carried out to analyse the relationship between HBV infection and the characteristics of patients and their Dialysis Units. Frequency of HBV infection was 10.0%, 2.7% and 2.7% among patients, haemodialysis workers and controls, respectively. Amidst patients, the most frequent HBV genotypes were A (30.6%), D (57.1%) and F (12.2%). Univariate analysis showed association between HBV infection and total time in haemodialysis, type of dialysis equipment, hygiene and sterilization of equipment, number of times reusing the dialysis lines and filters, number of patients per care-worker and current HCV infection. The logistic regression model showed that total time in haemodialysis, number of times of reusing the dialysis lines and filters, and number of patients per worker were significantly related to HBV infection. Frequency of HBV infection among haemodialysis patients at Santa Catarina state is very high. The most frequent HBV genotypes were A, D and F. The risk for a patient to become HBV positive increase 1.47 times each month of haemodialysis; 1.96 times if the dialysis unit reuses the lines and filters > or = 10 times compared with haemodialysis units which reuse < 10 times; 3.42 times if the number of patients per worker is more than five. Sequence similarity among the HBV S gene from isolates of different patients pointed out
Schizophrenia is a multifactorial, neurodevelopmental disorder caused by a combination of genetic and environmental risk factors. Disturbances of brain development begin prenatally, while different environmental insults further affect postnatal brain maturation during childhood and adolescence. Genome-wide association studies (GWAS) have succeeded in identifying hundreds of new risk variants for common, multifactorial diseases. In schizophrenia research, GWAS have found several rare copy number variants that considerably increase the risk of schizophrenia, and have shown an association between schizophrenia and the major histocompatibility complex. Research on environmental risk factors in recent years has provided new information particularly on risk factors related to pregnancy and childhood rearing environment. Gene-environment interactions have become a central research topic. There is evidence that genetically susceptible children are more vulnerable to the effects of unstable childhood rearing environment and other environmental risk factors.
Anuar, Tengku Shahrul; Al-Mekhlafi, Hesham M; Abdul Ghani, Mohamed Kamel; Abu Bakar, Edariah; Azreen, Siti Nor; Salleh, Fatmah Md; Ghazali, Nuraffini; Bernadus, Mekadina; Moktar, Norhayati
Currently, species-specific information on Entamoeba infections is unavailable in Malaysia and is restricted worldwide due to the re-description of pathogenic Entamoeba histolytica and non-pathogenic Entamoeba dispar and Entamoeba moshkovskii. Therefore, this cross-sectional study was conducted to provide the first known documented data on the true prevalence of these three species in western Malaysia using a molecular method. Another aim of this study was to determine the association of potential risk factors associated with each Entamoeba sp. A total of 500 stool samples from three Orang Asli tribes were randomly collected. The overall prevalence of E. histolytica, E. dispar and E. moshkovskii determined by microscopy was 18.6% (93/500). Molecular analysis revealed that while most Entamoeba-positive individuals were infected with E. dispar (13.4%), followed by E. histolytica (3.2%) and E. moshkovskii (1.0%), the present findings show low prevalence rates of mixed infections with E. histolytica and E. dispar (2%), E. dispar and E. moshkovskii (1.2%) and association infections of E. histolytica, E. dispar and E. moshkovskii (0.4%). Logistical regression analysis indicates that the dynamics of the transmission of the three Entamoeba spp. was different. Of six statistically significant variables observed in the univariate analysis, three were retained as significant risk factors for E. histolytica infection in the logistical regression model. These factors were (i) not washing hands after playing with soil or gardening (Odds ratio (OR)=4.7; 95% confidence level (CI)=1.38, 16.14; P=0.013), (ii) indiscriminate defecation in the river or bush (OR=5.7; 95% CI=1.46, 21.95; P=0.012) and (iii) close contact with domestic animals (OR=5.4; 95% CI=1.36, 2.51; P=0.017). However, subjects with family members who were infected with E. histolytica/E. dispar/E. moshkovskii (OR=3.8; 95 CI=2.11, 6.86; PEntamoeba spp. Copyright © 2012 Australian Society for Parasitology Inc
Kyung Suk Lee
Full Text Available Background. Atopic dermatitis (AD is a common chronic inflammatory skin disease, but only few studies involved samples of children and adolescents that are representative of the entire Korean population. This study aimed to estimate the prevalence and risk factors of AD among children and adolescents in Korea by using nationally representative data. Methods. We used data from the fifth Korean National Health and Nutrition Examination Survey in 2010 and retrospectively evaluated 2,116 children and adolescents. Logistic regression analysis was performed to determine the relationship between AD and other variables, including IgE levels. Results. The prevalence rate of AD in children and adolescents was 15.0%. In the multivariate analysis of ages from 1 to 18 years, age (adjusted odds ratio [aOR], 0.96; p<0.01 was related to AD. From age of 12 to 18 years, smoking (aOR, 8.99; p<0.01 and elevated total IgE serum level (aOR, 5.31; p<0.01 were related to AD. Conclusion. Age, smoking, and elevated total IgE level were related to AD in the children and adolescents. Thus, an antismoking policy and public education are necessary for reducing the prevalence of allergic diseases. In addition, measurement of total IgE level and age may be helpful in the diagnosis of AD.
Full Text Available The recent series of reviews conducted within the Global Action Plan for Pneumonia and Diarrhoea (GAPPD addressed epidemiology of the two deadly diseases at the global and regional level; it also estimated the effectiveness of interventions, barriers to achieving high coverage and the main implications for health policy. The aim of this paper is to provide the estimates of childhood pneumonia at the country level. This should allow national policy–makers and stakeholders to implement proposed policies in the World Health Organization (WHO and UNICEF member countries.
Brachner, A.; Grosche, B.
A broad survey is given of risk factors for neoplasms. The main carcinogenic substances (including also ionizing radiation and air pollution) are listed, and are correlated with the risk factors for various cancers most frequently explained and discussed in the literature. The study is intended to serve as a basis for a general assessment of the incidence of neoplasms in children, and of cancer mortality in the entire population of Bavaria in the years 1983-1989, or 1979-1988, respectively, with the principal idea of drawing up an environment-related health survey. The study therefore takes into account not only ionizing radiation as a main risk factor, but also other risk factors detectable within the ecologic context, as e.g. industrial installations and their effects, refuse incineration plants or waste dumps, or the social status. (orig./MG) [de
The Volpe Center has used three sources of datathe Federal Railroad Administrations required accident reports, locomotive video, and U.S. Census datato investigate common risk factors for railroad trespassing incidents, the leading cause of ...
Böhm, Stephan K; Kruis, Wolfgang
Diverticulosis is a very common condition. Around 20% of the carriers of diverticula are believed to suffer from diverticular disease during their lifetime. This makes diverticular disease one of the clinically and economically most significant diseases in gastroenterology. The etiopathogenesis of diverticulosis and diverticular disease is not well understood. Epidemiological studies allow defining risk factors for the development of diverticulitis and its complications. A comprehensive literature search was performed and the current knowledge about risk factors for diverticulitis and associated conditions reviewed. Besides non-controllable risk factors like age and sex, lifestyle factors like food, drinks and physical activity, drugs are described to increase or decrease the risk to develop diverticulitis or to suffer from complications. The recognition of risk factors for the development of diverticular disease or even complicated disease like lifestyle habits or medication is crucial for patient management.
Horan, Richard D.; Fenichel, Eli P.; Finnoff, David; Wolf, Christopher A.
There is growing concern that trade, by connecting geographically isolated regions, unintentionally facilitates the spread of invasive pathogens and pests – forms of biological pollution that pose significant risks to ecosystem and human health. We use a bioeconomic framework to examine whether trade always increases private risks, focusing specifically on pathogen risks from live animal trade. When the pathogens have already established and traders bear some private risk, we find two results that run counter to the conventional wisdom on trade. First, uncertainty about the disease status of individual animals held in inventory may increase the incentives to trade relative to the disease-free case. Second, trade may facilitate reduced long-run disease prevalence among buyers. These results arise because disease risks are endogenous due to dynamic feedback processes involving valuable inventories, and markets facilitate the management of private risks that producers face with or without trade. PMID:25914431
Trask, Catherine; Bath, Brenna; Johnson, Peter W; Teschke, Kay
Studies of many geographical settings and agricultural commodities show that low back disorders are an important public health issue among farmers, who represent a special rural population. However, few studies have examined the impact of low back disorders on farmers' work or the strategies that they adopt to avoid associated pain and disability. This study protocol will investigate 3 issues related to low back disorders in Saskatchewan farmers: (1) the vibration, heavy lifting, and awkward postures farmers encounter during their work that might contribute to low back disorders; (2) the impact low back disorders have on farmers in terms of their ability to work; and (3) the types of preventative measures and solutions that farmers implement to reduce the occurrence of low back pain. To answer these questions, researchers will travel to 30 farms to make measurements of vibration, lifting, and posture during the farmers' regular work tasks. Farmers will be interviewed about any pain and/or disability using standardized interview questions. Farmers will also be asked about safety measures they have implemented at their farm, such as modified tools or equipment, to reduce the occurrence of low back disorders or pain. Data collection is currently underway for this study, with the intention to complete all data collection and analysis by the end of 2018. Occupational determinants of health such as vibration, heavy lifting, and awkward postures are important in the development and progression of low back disorders, and the results of this study will allow for cost-effective epidemiological studies of these determinants in the future. In identifying prevention strategies, this study will also facilitate future research evaluating the effectiveness of safety measures.
Mansour, Wael; Malick, F-Zahra Fall; Sidiya, Ahmad; Ishagh, Elkhalil; Chekaraou, Mariama Abdou; Veillon, Pascal; Ducancelle, Alexandra; Brichler, Ségolène; Le Gal, Frédéric; Lo, Baidy; Gordien, Emmanuel; Lunel-Fabiani, Françoise
No recent data are available on hepatitis B virus (HBV) and hepatitis Delta virus (HDV) prevalence in Mauritania. One thousand twenty pregnant women and 946 patients visiting for routine checkups were screened for HBV and HDV infection. Demographic, epidemiological, ethnic, clinical, and biological data were recorded. HBV and HDV genotypes were determined by sequencing and phylogenetic analyses. In the pregnant women and patients cohorts, respectively, the prevalence of HBsAg (10.7% and 18.3%) and anti-HBcAb (66.3% and 76.5%) indicated high HBV endemicity. In pregnant women, exposure to HBV was significantly associated in multivariate analysis with education level, ethnicity, blood transfusion, and occupation. HDV antibodies (HDVAb) were found in 14.7% of pregnant women. In patients, HBsAg was found less frequently in females than in males. Again in multivariate analysis, exposure to HBV was significantly correlated with gender (males), and HDVAb positivity with age and gender. The HBV DNA viral load was >3 log IU/ml in only 10.1% of pregnant women and in 17.3% of patients. HDV-RNA was detectable in 21 (67.7%) of the 31 patients positive for HDVAb, and in 11 of the 16 pregnant women positive for HDVAb (68.8%). The most frequent HBV genotypes were: HBV/D, 53%; HBV/E, 35%; and HBV/A, 12%. Sub-genotyping revealed HBV/D1,/D7, and the recently described/D8. HDV genotypes were: HDV-1, 90.3% and HDV-5, 9.7%. This study confirms the high prevalence of HBV and HDV infections in Mauritania and demonstrates the high genetic diversity of HBV in this country. Copyright © 2012 Wiley Periodicals, Inc.
Mocroft, Amanda; Lundgren, Jens D.; Sabin, Miriam Lewis; Monforte, Antonella d'Arminio; Brockmeyer, Norbert; Casabona, Jordi; Castagna, Antonella; Costagliola, Dominique; Dabis, Francois; De Wit, Stéphane; Fätkenheuer, Gerd; Furrer, Hansjakob; Johnson, Anne M.; Lazanas, Marios K.; Leport, Catherine; Moreno, Santiago; Obel, Niels; Post, Frank A.; Reekie, Joanne; Reiss, Peter; Sabin, Caroline; Skaletz-Rorowski, Adriane; Suarez-Lozano, Ignacio; Torti, Carlo; Warszawski, Josiane; Zangerle, Robert; Fabre-Colin, Céline; Kjaer, Jesper; Chene, Genevieve; Grarup, Jesper; Kirk, Ole
Background Few studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality. Methods and Findings LP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count Europe among homosexual men, and male and female heterosexuals, but increased over time for female heterosexuals and male intravenous drug users (IDUs) from Southern Europe and in male and female IDUs from Eastern Europe. 8,187 AIDS/deaths occurred during 327,003 person-years of follow-up. In the first year after HIV diagnosis, LP was associated with over a 13-fold increased incidence of AIDS/death in Southern Europe (adjusted incidence rate ratio [aIRR] 13.02; 95% CI 8.19–20.70) and over a 6-fold increased rate in Eastern Europe (aIRR 6.64; 95% CI 3.55–12.43). Conclusions LP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP. Please see later in the article for the Editors' Summary PMID:24137103
Linet, Martha S.; Rajaraman, Preetha [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kim, Kwang pyo [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kyung Hee University, Department of Nuclear Engineering, Yongin-si, Gyeonggi (Korea)
While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)
Linet, Martha S.; Rajaraman, Preetha; Kim, Kwang pyo
While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)
Arnold, Robert W
In 2003, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) published a set of risk factors for amblyopia. The intent was to promote uniformity of reporting and development in screening. Because this prevalence is not yet known, this meta-analysis is an attempt to estimate it. Major community preschool eye examination studies were reviewed and AAPOS cut-offs estimated. The approximate prevalence of anisometropia is 1.2%, hyperopia is 6%, astigmatism is 15%, myopia is 0.6%, strabismus is 2.5%, and visual acuity less than 20/40 is 6%. The mean combined prevalence is 21% ± 2% compared to a prevalence of amblyopia 20/40 and worse of 2.5%. Knowing risk factor prevalence simplifies validation efforts. Amblyopia screening with a risk factor sensitivity less than 100% is expected and desirable. Copyright 2013, SLACK Incorporated.
Public Health Risks of Enterobacterial Isolates Producing Extended-Spectrum β-Lactamases or AmpC β-Lactamases in Food and Food-Producing Animals: An EU Perspective of Epidemiology, Analytical Methods, Risk Factors, and Control Options
Liebana, Ernesto; Carattoli, Alessandra; Coque, Teresa M.
The blaESBL and blaAmpC genes are spread by plasmid-mediated integrons, insertion sequences, and transposons, some of which are homologous in food animals and humans. Cephalosporin usage in animal production is an important risk factor; restricting such use would be an effective control option....
Nov 5, 2013 ... Maternal hormonal interventions as a risk factor for Autism. Spectrum Disorder: An epidemiological assessment from India. MADHU POORNIMA MAMIDALA. 1. , ANUPAMA POLINEDI. 1. , PTV PRAVEEN KUMAR. 2. , N RAJESH. 3. ,. OMSAI RAMESH VALLAMKONDA. 4. , VRAJESH UDANI. 5.
Monte-Secades, R; Blanco-Soto, M; Díaz-Peromingo, J A; Sanvisens-Bergé, A; Martín-González, M C; Barbosa, A; Rosón-Hernández, B; Tejero-Delgado, M A; Puerta-Louro, R; Rabuñal-Rey, R
To analyse the influence of epidemiological and sociodemographic factors in complicated alcohol withdrawal syndrome (AWS). A multicentre, observational prospective study was conducted on consecutively added patients with AWS hospitalised in internal medicine departments. We recorded sociodemographic, epidemiological, clinical and progression data. Complicated AWS was defined as that which progressed with seizures or delirium tremens. We studied 228 episodes of AWS in 219 patients. The mean age was 54.5 years (SD, 11.5), and 90.8% were men. AWS was the cause for hospitalisation in 39.9% of the patients. Some 27.1% of the cases presented seizures, and 32.4% presented delirium tremens. The daily quantity of alcohol ingested was 17.8 standard drink units (SD, 21.4), with 16.6 years of dependence (SD, 11.3). The pattern of alcohol abuse was regular in 82.8% of the patients. Some 38.4% of the patients were married or had a partner, and 45.6% had children. Some 72.7% of the patients were unemployed or retired. Some 68.5% had only completed primary studies. Some 4.8% consumed cannabis, 5.2% consumed cocaine and 3% consumed opioids. The independent variables related to complicated AWS were consumption of a drug other than alcohol (OR, 5.3; 95% CI 1.5-18.7), low education level (OR, 3.4; 95% CI 1.6-7.3) and hospitalisation for AWS (OR, 2.9; 95% CI 1.5-5.6). The model's receiver operating characteristic area was 0.718 (95% CI 0.643-0.793). Concomitant drug abuse and a low educational level could help identify patients at risk of complicated AWS. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.
Brouwers, M.M.; Feitz, W.F.J.; Roelofs, L.A.J.; Kiemeney, L.A.L.M.; Gier, R.P.E. de; Roeleveld, N.
Despite being one of the most common congenital defects in boys, the etiology of hypospadias remains largely unknown. In this case-referent study, we evaluated a wide spectrum of potential risk factors for hypospadias. Cases were identified from the hospital information system, and referents were
Zhao, S-Y; Zhang, J; Zhang, Y-L; Wang, Y-C; Xiao, S-Z; Gu, F-F; Guo, X-K; Ni, Y-X; Han, L-Z
Nursing homes (NHs) have been implicated as significant reservoirs of antibiotic-resistant organisms causing severe infectious disease. We investigated the prevalence and molecular epidemiology of, and risk factors for, faecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). A multicentre cross-sectional study was conducted in seven NHs in Shanghai between March 2014 and May 2014. Antimicrobial susceptibility testing and polymerase chain reaction were used to detect genes coding for ESBLs and carbapenemases. NH records at individual-resident level and facility level were examined for potential risk factors. Four hundred and fifty-seven Enterobacteriaceae isolates were collected of which 183 (46·92%) were colonized by ESBL-E. CTX-M enzymes (198/200, 99%) predominated, with CTX-M-14 (84/200, 42%) the most common types. Two carbapenemase producers harboured blaKPC-2. Resistance rates to carbapenems, TZP, AK, FOS, CL and TGC were low. History of invasive procedures [odds ratio (OR) 2·384, 95% confidence interval (CI) 1·318-4·310, P = 0·004], narrow-spectrum cephalosporins (OR 1·635, 95% CI 1·045-2·558, P = 0·031) and broad-spectrum cephalosporins (OR 3·276, 95% CI 1·278-8·398, P = 0·014) were independently associated with ESBL-E carriage. In conclusion, NH residents have a very high prevalence of faecal carriage of ESBL-E. Continuous and active surveillance is important, as are prudent infection control measures and antibiotic use to prevent and control the spread of these antibiotic-resistant strains.
Full Text Available The occurrence of developmental stages of endoparasite germs (cysts, oocysts, protozoa, and helminth eggs as an indirect detection factor of endoparasitoses circulation in the environment, was examined in raw municipal wastewater, sludge and biologically cleaned waste water. Examination of municipal wastewater and sludge from five monitored wastewater treatment plants (WWTPs in east Slovakia, from various fractions of municipal wastewater, confirmed 35.87 % positivity of samples for the endoparasitic germs. Among of all analysed samples 11.09 % were protozoan oo(cysts and 20.87 % were helminth eggs. 3.91 % of samples showed positivity to both the helminth eggs and protozoan oo(cysts. In the raw wastewater the protozoa comprised of Giardia spp. (1.08 % and Entamoeba spp. (1.08 %. The helminth eggs primarily consisted of Ascaris spp. (4.35 % and strongyle-type eggs (3.26 %. No germs of protozoa or helminths were found in the treated wastewater. However, the highest presence of the germs was found in drained stabilised sludge. The average number of oo(cysts/kg was 2.86±0.24 and the average number of helminth eggs/kg was 5.77±0.09. In all kinds of sludge, obtained during the process of wastewater treatment, there were protozoan (Giardia spp., Cryptosporidium spp., Entamoeba spp. and helminths eggs (Ascaris spp., Trichuris spp., Taenia spp., Hymenolepis spp., or strongyle-type eggs presented. In drained (condensed stabilised sludge the eggs of Capillaria spp. and Toxocara spp. were also detected. From the epidemiological aspect the sewage sludge, due to high concentration of protozoal oo(cysts or helminth eggs, represents a significant epidemiological risk for the endoparasitoses dissemination.
Caffarelli, C; Stringari, G; Pajno, G B; Peroni, D G; Franceschini, F; Dello Iacono, I; Bernardini, R
Perioperative anaphylactic as well as anaphylactoid reactions can be elicited by drugs, diagnostic agents, antiseptics, disinfectants and latex. In some individuals, allergic reactions occur in the absence of any evident risk factor. Previous history of specific safe exposure to a product does not permit to exclude the risk of having a reaction. We have systematically reviewed characteristics in the patient's history or clinical parameters that affect the risk of developing reactions during anesthesia. Evidence shows that patients with previous unexplained reaction during anesthesia are at risk for perioperative allergic reactions. An allergic reaction to an agent is associated with previous reaction to a product that is related with the culprit agent. Multiple surgery procedures, professional exposure to latex and allergy to fruit are associated with an increased frequency of latex allergy. It has been shown that in some instances, allergic perioperative reactions may be more common in atopic patients and in females.
Ambrož, P.; Janoutová, J.; Machaczka, O.; Kovalová, M.; Pohlídalová, A.; Vařechová, K.; Kosta, O.; Tomášková, H.; Šerý, Omar; Hosák, L.; Janout, V.
Roč. 82, č. 1 (2017), s. 24-27 ISSN 1210-7832 Institutional support: RVO:67985904 Keywords : schizophrenia * risk factors * pregnancy Subject RIV: FN - Epidemiology, Contagious Diseases ; Clinical Immunology OBOR OECD: Epidemiology
Bouju, G; Grall-Bronnec, M; Landreat-Guillou, M; Venisse, J-L
In France, consumption of gambling games increased by 148% between 1960 and 2005. In 2004, gamblers lost approximately 0.9% of household income, compared to 0.4% in 1960. This represents approximately 134 Euros per year and per head. In spite of this important increase, the level remains lower than the European average (1%). However, gambling practices may continue to escalate in France in the next few years, particularly with the recent announce of the legalisation of online games and sports betting. With the spread of legalised gambling, pathological gambling rates may increase in France in the next years, in response to more widely available and more attractive gambling opportunities. In this context, there is a need for better understanding of the risk factors that are implicated in the development and maintenance of pathological gambling. This paper briefly describes the major risk factors for pathological gambling by examining the recent published literature available during the first quarter of 2008. This documentary basis was collected by Inserm for the collective expert report procedure on Gambling (contexts and addictions). Seventy-two articles focusing on risk factors for pathological gambling were considered in this review. Only 47 of them were taken into account for analysis. The selection of these 47 publications was based on the guide on literature analysis established by the French National Agency for Accreditation and Assessment in Health (ANAES, 2000). Some publications from more recent literature have also been added, mostly about Internet gambling. We identify three major types of risk factors implicated in gambling problems: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors), and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling seems to be
Full Text Available Dementia is a complex human disease. The incidence of dementia among the elderly population is rising rapidly worldwide. In the United States, Alzheimer's disease (AD is the leading type of dementia and was the fifth and eighth leading cause of death in women and men aged ≥ 65 years, respectively, in 2003. In Taiwan and many other counties, dementia is a hidden health issue because of its underestimation in the elderly population. In Western countries, the prevalence of AD increases from 1–3% among people aged 60–64 years to 35% among those aged > 85 years. In Taiwan, the prevalence of dementia for people aged ≥ 65 years was 2–4% by 2000. Therefore, it is important to identify protective and risk factors for dementia to prevent this disease at an early stage. Several factors are related to dementia, e.g. age, ethnicity, sex, genetic factors, physical activity, smoking, drug use, education level, alcohol consumption, body mass index, comorbidity, and environmental factors. In this review, we focus on studies that have evaluated the association between these factors and the risk of dementia, especially AD and vascular dementia. We also suggest future research directions for researchers in dementia-related fields.
Full Text Available Objectives: In\tour\tstudy,\tthe\tassessment\tof\tage,\tgender,\tincidence\tand\tseasonal\tdifferences\tin\tthe\tregions\trelated\tto\tappendicitis were\tinvestigated. Methods: 676\tpatients\tthat\treceived\tan\toperation\tfollowing\ta\tdiagnosis\tof\tappendicitis\tin\t3\thospitals\tfrom\t3\tdifferent\tregions\tof Turkey occurring at different dates were examined retrospectively after being categorized by region. The differences among groups\twere\tcompared\tto\teach. Results: The\tmean\tage\tof\tmale\t(63%\t(n\t=\t426\tand\tfemale\t(37%\t(n\t=\t250\tpatients\t(total\t=\t676\twas\t10.8\tyears\t(range,\t1–18 years.\tThe\tpercentage\tof\tfemale\tpatients\tin\tthe\tThe\tBlack\tSea\tRegion\t(BR\tgroup\twas\tsignificantly\thigher\t(48%\tthan\tthat\tin\tthe other two groups (%33 for SR, 30% for\tMR (P = 0.001. The frequency of appendicitis was higher (36%\tin the spring and winter\t(25% than that\tduring\tsummer\tor fall.\tThe\tnumber\tof\tcases\tincreased the\tmost\tin the\tBR\tgroup\tin\tspring\t(47%\t(P\t< 0.001.\tWhen\tthe\ttypes\tof\tappendicitis\tin\tthe\tdifferent\tage\tgroups\twere\tcompared\twith\tseason,\tacute\tappendicitis\t(P\t<\t0.02\twas more\tfrequently\t(93%\tseen\tin\tthe\tchild-adolesan\t(CA\tgroup\tin\tthe\tspring;\thowever,\tperfore\tapandicitis\t(45%\twas\tgreater\tin the\tInfant-Preschool\t(IPS\tgroup\t(P\t<\t0.02.\tAcute\tappendicitis\tcomprised\t55%\tand\tperforated\tappendicitis\tcomprised\t45%\tof cases\tin\tthe\tIPS\tgroup,\twhereas\tacute\tappendicitis\tcomprised\t78%\tand\tperforated\tappendicitis\tcomprised\t22%\tin\tthe\tCA\tgroup. Conclusion: According\tto\tthe\tresults\tof\tour\tstudy,\tappendicitis\twas\tmost\tfrequently\tseen\tin\tthe\tspring\tand\twinter\tseasons\tand more frequent\tin\tboys\tbetween the\tages\tof\t10-13 years.\tAs\tage\tdecreases, the frequency\tof\tperforated\tappendicitis\tincreases. Appendicitis is affected by environmental factors. Reducing the incidence of appendicitis may be possible by
Background. Burns continue to be responsible for significant morbidity and mortality in developing countries. In this study we aimed to determine the factors affecting mortality and epidemiological data by examining the records of burned patients. Method. The hospital records of 980 patients who were hospitalised in the ...
Jun 2, 2007 ... Background:Effective control and management of severe malaria cases depends on a clear understanding of the local epidemiological factors and specific clinical ... PCV tests done. Results: Clinical diagnosis was confirmed microscopically in 78% (290/372) for Plasmodium infection using thick film slides.
Jae Hoon Moon
Full Text Available Cognitive impairment, including Alzheimer's disease and other kinds of dementia, is a major health problem in older adults worldwide. Although numerous investigators have attempted to develop effective treatment modalities or drugs, there is no reasonably efficacious strategy for preventing or recovering from cognitive impairment. Therefore, modifiable risk factors for cognitive impairment have received attention, and the growing literature of metabolic risk factors for cognitive impairment has expanded from epidemiology to molecular pathogenesis and therapeutic management. This review focuses on the epidemiological evidence for the association between cognitive impairment and several endocrine risk factors, including insulin resistance, dyslipidemia, thyroid dysfunction, vitamin D deficiency, and subclinical atherosclerosis. Researches suggesting possible mechanisms for this association are reviewed. The research investigating modifiable endocrine risk factors for cognitive impairment provides clues for understanding the pathogenesis of cognitive impairment and developing novel treatment modalities. However, so far, interventional studies investigating the beneficial effect of the "modification" of these "modifiable risk factors" on cognitive impairment have reported variable results. Therefore, well-designed, randomized prospective interventional studies are needed.
Epidemiologic studies on workers who have been exposed to ionizing radiation have allowed to demonstrate certain cancer risks associated with elevated, often retrospectively reconstituted exposures. Present studies on still active workers or workers having worked for the last 15 years are indispensable to define the risk associated with low irradiation doses; they must, however, take into account confounding factors that may play a role in the etiology of the cancer studied
Full Text Available Background Autosomal recessive polycystic kidney disease (ARPKD is a heterogeneous inherited disorder most commonly seen in childhood. The presentation is usually a palpable large mass in the flank or abdomen appearing at infancy or birth, leading to electrolyte abnormalities, pulmonary hypoplasia, oligohydramnious and the Potter’s syndrome. The survival rate of this disease is 70%. Multiple mutations of the polycystic kidney and hepatic disease 1 (PKHD1 are known that can cause ARPKD. On the other hand, mutations in PKHD1 have also been identified in about 30% of children with congenital hepatic fibrosis (the Caroli’s syndrome without any evidence of kidney involvement. Based on this evidence, not everyone with PKHD1 mutations will present with ARPKD. Recent studies have shown that nongenetic factors, including environmental exposures had a significant effect on manifestations of ARPKD. The present study aimed at investigating the possible link between ARPKD and its epidemiologic factors, hypothesizing that these epidemiologic conditions would influence the incidence of ARPKD. Objectives The present study aimed at evaluating a possible link between the ARPKD and its epidemiologic factors. Methods In this case-control study, children with ARPKD referred to Amirkabir hospital in Arak city, Iran, were compared with noninfected children. Examinations, interviews, and questionnaires were performed to collect data and the disease was diagnosed by a physician. Results The results of this study showed no significant relationship between epidemiological factors such as age, place of residence for families, sex, family education/occupation/ income, body mass index, stunted growth, slow growth, good growth, milk intake, water intake, failure to thrive and ARPKD. Conclusions Based on our findings, epidemiological factors did not have a significant effect on the occurrence of ARPKD.
The main aim of this lecture is focus on different aspects of occurerence of depression in Adolescence, especially with focus on risk factors. I introduced epidemiology of depression : causes, treatment, and prevention (Abela & Hankin,2008). The special part of the lecture was focus on etiology of depression. Adolescence is characterized by positive gains in cognitive maturity, better interpersonal skills, new experiences, increased autonomy, and hormonal changes (Feldman & Elliot, 1990). Alt...
Goldsmith, R.; Peterson, H.T. Jr.
The health risk from ionizing radiation commonly is expressed in two forms: (1) the relative risk, which is the percentage increase in natural disease rate and (2) the absolute or attributable risk which represents the difference between the natural rate and the rate associated with the agent in question. Relative risk estimates for ionizing radiation generally are higher than those expressed as the absolute risk. This raises the question of which risk estimator is the most appropriate under different conditions. The absolute risk has generally been used for radiation risk assessment, although mathematical combinations such as the arithmetic or geometric mean of both the absolute and relative risks, have also been used. Combinations of the two risk estimators are not valid because the absolute and relative risk are not independent variables. Both human epidemiologic studies and animal experimental data can be found to illustrate the functional relationship between the natural cancer risk and the risk associated with radiation. This implies that the radiation risk estimate derived from one population may not be appropriate for predictions in another population, unless it is adjusted for the difference in the natural disease incidence between the two populations
Hou, I-Chun; Amarnani, Saral; Chong, Mok T; Bishayee, Anupam
Gastric cancer (GC) is one of the leading causes of cancer death in the world. Numerous efforts are being made to find chemoprotective agents able to reduce its risk. Amongst these, green tea has been reported to have a protective effect against stomach cancer. This article aims to critically evaluate all epidemiological studies reporting an association between green tea consumption and GC risk. MEDLINE, EBSCOHOST and Google Scholar were used to search for clinical trials of green tea and its correlation to stomach cancer. Studies include cohort and case-control studies. Outcome of interests are inverse association, no association, and positive association. Seventeen epidemiologic studies were reviewed. Eleven studies were conducted in Japan, five in China, and one with Japanese descendent in Hawaii. Ten case-control studies and seven cohort studies were included. The relative risks or odds ratio of GC for the highest level of green tea consumption was compared. Seven studies suggested no association, eight an inverse association, and one a positive association. One study had shown a significantly lowered GC risk when tea was served warm to cold. Another study also showed a significantly risk with lukewarm tea. All studies that analyzed men and women separately have suggested a reduced risk in women than in men, albeit no significant difference. This review demonstrates that there is insufficient information to support green tea consumption reduces the risk of GC. More studies on the subject matter are warranted. PMID:23840110
Keel, Pamela K; Forney, K Jean
One goal in identifying psychosocial risk factors is to discover opportunities for intervention. The purpose of this review is to examine psychosocial risk factors for disordered eating, placing research findings in the larger context of how etiological models for eating disorders can be transformed into models for intervention. A qualitative literature review was conducted focusing on psychological and social factors that increase the risk for developing eating disorders, with an emphasis on well-replicated findings from prospective longitudinal studies. Epidemiological, cross-cultural, and longitudinal studies underscore the importance of the idealization of thinness and resulting weight concerns as psychosocial risk factors for eating disorders. Personality factors such as negative emotionality and perfectionism contribute to the development of eating disorders but may do so indirectly by increasing susceptibility to internalize the thin ideal or by influencing selection of peer environment. During adolescence, peers represent self-selected environments that influence risk. Peer context may represent a key opportunity for intervention, as peer groups represent the nexus in which individual differences in psychological risk factors shape the social environment and social environment shapes psychological risk factors. Thus, peer-based interventions that challenge internalization of the thin ideal can protect against the development of eating pathology. Copyright © 2013 Wiley Periodicals, Inc.
Tang, Hung-Jen; Liu, Wei-Lun; Lin, Hsin-Lan; Lai, Chih-Cheng
The present retrospective study was carried out to investigate the epidemiological characteristics and the prognostic factors of candidemia among elderly patients. From 2009 to 2012, elderly patients with candidemia were identified at the Chi Mei medical center, a 900-bed regional hospital in southern Taiwan, and their medical records retrospectively reviewed. During the 4-year period, a total of 175 episodes of candidemia among elderly patients were identified. The patients ranged in age from 65 to 98 years (mean 76.4 years) and the mean (±standard deviation) Charlson Comorbidity Index score was 7.6 (±2.7). Cancer was the most common underlying disease (n = 127, 72.6%), followed by diabetes mellitus (n = 69, 39.4%). Candida albicans (n = 96, 54.9%) was the most common pathogen, followed by C. tropicalis (n = 39, 22.3%), C. parapsilosis (n = 24, 13.7%), C. glabrata (n = 22, 12.6%), C. guilliermondii (n = 2, 1.1%) and Candida species (n = 3, 1.7%). The ratio of C. albicans causing candidemia was significantly higher in young-old than old-old patients (64.1% vs 47.4%, P = 0.027). The overall in-hospital mortality was 50.3%. Multivariate analysis showed that the in-hospital mortality was only significantly associated with jaundice (P = 0.004), no use of antifungal agent (P = 0.021) and intensive care unit admission (P Candidemia can develop in elderly patients, especially patients with cancer or other risk factors. C. albicans is the most common Candida species causing candidemia among elderly patients, followed by C. tropicalis. The mortality of candidemia among elderly patients remains high. © 2014 Japan Geriatrics Society.
Striegel-Moore, Ruth H.; Bulik, Cynthia M.
The authors review research on risk factors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized risk factor over onset of the disorder is established. They illustrate how studies of sociocultural risk factors and biological factors have progressed on parallel tracks and propose that major advances…
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.
Phua, Chun Seng; Jayaram, Lata; Wijeratne, Tissa
Stroke is a leading cause of death and disability worldwide. While various risk factors have been identified, sleep has only been considered a risk factor more recently. Various epidemiologic studies have associated stroke with sleep such as sleep duration, and laboratory and clinical studies have proposed various underlying mechanisms. The pathophysiology is multifactorial, especially considering sleep affects many common risk factors for stroke. This review aims to provide an outline of the...
Janse Van Rensburg, Dina Christina; Schwellnus, Martin; Derman, Wayne; Webborn, Nick
Paralympic athletes have unique preexisting medical conditions that predispose them to increased risk of illness, but data are limited to studies conducted during the last 3 Paralympic Games. This article reviews the epidemiology of illness (risk, patterns, and predictors) in Paralympic athletes and provides practical guidelines for illness prevention. The incidence rate of illness (per 1000 athlete-days) in Paralympic athletes is high in Summer (10.0-13.2) and Winter (18.7) Paralympic Games. The authors propose general and specific guidelines on preventative strategies regarding illness in these athletes. Copyright © 2018 Elsevier Inc. All rights reserved.
... Stay Informed Cancer Home What Are the Risk Factors for Lung Cancer? Language: English (US) Español (Spanish) ... your cell phone Research has found several risk factors that may increase your chances of getting lung ...
O Fator Acidentário Previdenciário como instrumento epidemiológico de controle de riscos do trabalho The work accident and social security factor as an epidemiologic tool for controlling risks in work settings
Heleno Rodrigues Corrêa Filho
estimates the frequency, severity and costs to be accounted for in tax calculation. It multiplies tax rates due to work risks and may reduce by up to 50% the taxes due by companies that apply efficient collective methods for disease prevention. The method is analyzed for its consistency in selecting groups of morbidity used as a mean to build frequency, severity and cost burden vectors. The validity of the application of epidemiologic concepts to the economic activity that generates the specific morbidity is also assessed. The discussion addresses the antagonism between the concepts of traditional morbidity lists and the mobile epidemiologic criteria usually adopted to solve conflicts on the existence of a causal link amongst diseases, lesions, accidents and means of production. The floating groups of morbidity that reach significant 99% confidence intervals for epidemiologic risks above the null value _ 1.0 _ are supported. The conclusion is that the method is in accordance with epidemiologic requirements, as long as a systematic review panel assesses aspects of sensitivity and specificity. A warning is presented not to rely solely on methods as unilateral means of social action for evaluating, controlling and preventing the diseases associated with the means of production that are inherent to our social development. Methods are instruments that ought to be considered in decision-making and in the desired political action.
Hamlyn, Jess; Duhig, Michael; McGrath, John; Scott, James
Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain risk factors. The aims of this review are to describe modifiable risk factors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared risk factors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable risk factors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable risk factors associated with both autism and schizophrenia. We identified three modifiable risk factors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a risk factor for schizophrenia in a single meta-analysis and as a risk factor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risks factors for autism whilst a meta-analysis of eight studies identified obstetric complications as a risk factor for schizophrenia. Migrant status was identified as a risk factor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic risk factors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors. Copyright © 2012 Elsevier Inc
Pieskä, J. (Jukka)
Abstract The aim of this thesis is to study risk factor based investing and test how well MSCI constructs their risk factor based indices. Risk factor based investing has gained a lot of media exposure in the recent years and “Smart Beta” products are becoming more popular. Blackrock estimated that there are more than 700 exchange traded products available and they have over $ 529 billion in assets under management. Risk fa...
Connell, Paul P
Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715\\/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.
Gülşen Tükenmez Demirc
Full Text Available Background and Design: There have been reports suggesting the involvement of environmental factors in the disease process of pemphigus. In this study, we aimed to find out the risk factors which could play role in the etiopathogenesis in our pemphigus patients.Material and method: A total of 42 patients (15 male and 27 female who were diagnosed as pemphigus with histopathological and direct immunoflurosence examinations in our clinic between the years 1998-2004, were interviewed for assessment of regarding with the subjects of the demographic properties, occupational groups, educational level, the number of pregnancies, stressfull life events, diet habits, smoking and alcohol consumption before the onset of the disease and the results were compared to 42 age and gender-matched controls with similar socioeconomic circumstances. Results: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were found to be statistically significant in pemphigus patients than in controls. Conclusion: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were assumed to play role in the etiopathogenesis and course of pemphigus.
Torp-Pedersen, Tobias; Boyd, Heather A; Poulsen, Gry
Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype.......Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype....
Tirmarche, M.; Baysson, H.; Telle-Lamberton, M.
Objective: At the end of 2000, certain diseases including leukemia were reported among soldiers who participated in the Balkan and in the Gulf wars. Depleted uranium used during these conflicts was considered as a possible cause. Its radiotoxicity is close to that of natural uranium. This paper reviews the epidemiological knowledge of uranium, the means of exposure and the associated risk of cancer. Methods: The only available epidemiological data concerns nuclear workers exposed to uranium. A review of the international literature is proposed by distinguishing between uranium miners and other workers of the nuclear industry. French studies are described in details. Results: In ionizing radiation epidemiology, contamination by uranium is often cited as a risk factor, but the dose-effect relationship is rarely studied. Retrospective assessment of individual exposure is generally insufficient. Moreover, it is difficult to distinguish between uranium radiotoxicity, its chemical toxicity and the radiotoxicity of its progeny. A causal relation between lung cancer and radon exposure, a gas derived from the decay of uranium, has been demonstrated in epidemiological studies of miners. Among other nuclear workers exposed to uranium, there is a mortality deficit from all causes (healthy worker effect). No cancer site appears systematically in excess compared to the national population; very few studies describe a dose-response relationship. Conclusion: Only studies with a precise reconstruction of doses and sufficient numbers of workers will allow a better assessment of risks associated with uranium exposure at levels encountered in industry or during conflicts using depleted uranium weapons. (author)
Knight, J.A.; Bernstein, L.; Largent, J.
Women with primary breast cancer are at increased risk of developing second primary breast cancer. Few studies have evaluated risk factors for the development of asynchronous contralateral breast cancer in women with breast cancer. In the Women's Environmental Cancer and Radiation Epidemiology St...
Verlinden, S; Hersen, M; Thomas, J
Nine incidents of multiple-victim homicide in American secondary schools are examined and common risk factors are identified. The literature dealing with individual, family, social, societal, and situational risk factors for youth violence and aggression is reviewed along with existing risk assessment methods. Checklists of risk factors for serious youth violence and school violence are used in reviewing each school shooting case. Commonalties among the cases and implications for psychologists practicing in clinical and school settings are discussed.
Talykova, L V
Congenital abnormalities could result from exposure to occupational hazards. Epidemiologic study of nickel compounds influence on reproductive health in females engaged into nickel purification in Murmansk region enterprises did not reveal increased risk of the anomalies. The study was aimed to define influence of various risk factors connected not to work conditions, but to mother's health, bad habits, age, on congenital abnormalities in newborns.
Background: The incidence of antiretroviral therapy (ART)-induced lactic acidosis and its associated mortality may be reduced by appropriate dosing, risk stratification and early detection. Objectives: To describe the epidemiology of lactic acidosis, define the risk factors and identify predictive laboratory markers in the context ...
Gilligan, Christopher A.; Belloc, Catherine; Filipe, João A. N.; Vergu, Elisabeta
Conventional epidemiological studies of infections spreading through trade networks, e.g. via livestock movements, generally show that central large-size holdings (hubs) should be preferentially surveyed and controlled in order to reduce epidemic spread. However, epidemiological strategies alone may not be economically optimal when costs of control are factored in together with risks of market disruption from targeting core holdings in a supply chain. Using extensive data on animal movements in supply chains for cattle and swine in France, we introduce a method to identify effective strategies for preventing outbreaks with limited budgets while minimizing the risk of market disruptions. Our method involves the categorization of holdings based on position along the supply chain and degree of market share. Our analyses suggest that trade has a higher risk of propagating epidemics through cattle networks, which are dominated by exchanges involving wholesalers, than for swine. We assess the effectiveness of contrasting interventions from the perspectives of regulators and the market, using percolation analysis. We show that preferentially targeting minor, non-central agents can outperform targeting of hubs when the costs to stakeholders and the risks of market disturbance are considered. Our study highlights the importance of assessing joint economic–epidemiological risks in networks underlying pathogen propagation and trade. PMID:26984191
Moslonka-Lefebvre, Mathieu; Gilligan, Christopher A; Monod, Hervé; Belloc, Catherine; Ezanno, Pauline; Filipe, João A N; Vergu, Elisabeta
Conventional epidemiological studies of infections spreading through trade networks, e.g., via livestock movements, generally show that central large-size holdings (hubs) should be preferentially surveyed and controlled in order to reduce epidemic spread. However, epidemiological strategies alone may not be economically optimal when costs of control are factored in together with risks of market disruption from targeting core holdings in a supply chain. Using extensive data on animal movements in supply chains for cattle and swine in France, we introduce a method to identify effective strategies for preventing outbreaks with limited budgets while minimizing the risk of market disruptions. Our method involves the categorization of holdings based on position along the supply chain and degree of market share. Our analyses suggest that trade has a higher risk of propagating epidemics through cattle networks, which are dominated by exchanges involving wholesalers, than for swine. We assess the effectiveness of contrasting interventions from the perspectives of regulators and the market, using percolation analysis. We show that preferentially targeting minor, non-central agents can outperform targeting of hubs when the costs to stakeholders and the risks of market disturbance are considered. Our study highlights the importance of assessing joint economic-epidemiological risks in networks underlying pathogen propagation and trade. © 2016 The Authors.
Demosthenes B Panagiotakos
Full Text Available Demosthenes B Panagiotakos, Vassilis StavrinosOffice of Biostatistics, Epidemiology, Department of Dietetics, Nutrition, Harokopio University, Athens, GreeceAbstract: During the past years there has been increasing interest in the development of cardiovascular disease functions that predict future events at individual level. However, this effort has not been so far very successful, since several investigators have reported large differences in the estimation of the absolute risk among different populations. For example, it seems that predictive models that have been derived from US or north European populations overestimate the incidence of cardiovascular events in south European and Japanese populations. A potential explanation could be attributed to several factors such as geographical, cultural, social, behavioral, as well as genetic variations between the investigated populations in addition to various methodological, statistical, issues relating to the estimation of these predictive models. Based on current literature it can be concluded that, while risk prediction of future cardiovascular events is a useful tool and might be valuable in controlling the burden of the disease in a population, further work is required to improve the accuracy of the present predictive models.Keywords: cardiovascular disease, risk, models
Adamová, Z; Slováček, R; Sankot, J
Colonic diverticular disease is a common illness, especially in the elderly population. It may be asymptomatic and cause chronic intestinal problems, colonic diverticular bleeding or inflammatory complications with considerable morbidity and mortality. We have attempted at finding factors that would help us identify patients with a higher risk of diverticulitis recurrence as well as patients with a higher likelihood of perforated diverticulitis. This retrospective study included all patients admitted to our surgical ward for inflammatory complications of diverticular disease between 2000 and 2012: 278 patients, 88 men and 190 women. We looked up the first attack of diverticulitis in our documentation as well as the relapses, if any, their number and course, and the time from the first attack to the relapse. We analyzed the influence of age, gender, comorbidities (diabetes mellitus, overweight, ischemic heart disease, chronic renal failure, gastroduodenal disease), nicotine abuse and medication (glucocorticoids and other immunosuppressive drugs, acetylsalicylic acid) on diverticulitis recurrence and its complicated course. We compared the results of conservative and surgical therapy. Statistical analysis was performed using Fishers exact test and Man-Whitney U tests. We did not demonstrate any statistically significant dependence of diverticulitis recurrence on age or gender. Colectomy (both acute and elective surgery) clearly decreases the likelihood of recurrence (p=0.00007). Comorbidities, nicotine abuse and medication were not associated with an increased risk of recurrence. Steroid and immunosuppressive drugs use was significantly associated with higher perforation rates, without impacting on the likelihood of recurrence. Regular smoking of cigarettes had no impact on recurrence or on its severity. We did not find any reliable indicator of recurrent diverticulitis. Age, gender, comorbidities, smoking and medication are not significant. Immunocompromised
Zambrano Aguayo, Marina Dalila; Departamento de Medicina Veterinaria, Facultad de Ciencias Veterinarias, Universidad Técnica de Manabí (UTM), Portoviejo; Pérez Ruano, Miguel; Departamento de Medicina Preventiva, Facultad de Medicina Veterinaria, Universidad Agraria de la Habana (UNAH), Mayabeque; Rodríguez Villafuerte, Ximena; Departamento del Área del Conocimiento de la Tierra, Carrera de Ingeniería Agropecuaria, Universidad Estatal Amazónica (UEA), Puyo
A cross-sectional epidemiological study was carried out to determine animal and herd risk factors associated to bovine brucellosis. It was randomly selected 2369 cattle in the Manabí province, Ecuador. In addition, an epidemiological study of ecological type was carried out using 20 positive herds (cases) and 20 negative herds (controls) to the disease. In both studies, an epidemiological survey was conducted to determine the main risk factors associated to the disease. The individual study s...
Blettner, M.; Zeeb, H.; Grosche, B.
Occupational studies of aircrew in civil or military aviation did not receive much attention until the beginning of this decade. Since 1990, a number of epidemiological studies has been published on the cancer risk among flight personnel. Their results are equivocal: elevated cancer risks have been observed in some studies, but not in others. The exposure situation for pilots and flight attendants is unique with respect to several factors and particularly in that cosmic rays contribute substantially to their cumulative radiation dose. The average annual doses received are relatively low, however, and commonly range between 3 and 6 mSv. Results of epidemiological studies are presented as well as information on planned studies. (orig.)
Breast cancer and induced abortion: a comprehensive review of breast development and pathophysiology, the epidemiologic literature, and proposal for creation of databanks to elucidate all breast cancer risk factors.
Lanfranchi, Angela E; Fagan, Patrick
This article synthesizes breast developmental biology and pathophysiology which cause induced abortion to be a risk for breast cancer with the extant epidemiologic studies that differentiate induced and spontaneous abortions. These studies are rigorously statistically analyzed. It also outlines a proposal for the establishment of much-needed data banks that will be able to supply gold-standard prospective data for all breast cancer risks. We recommend collecting longitudinal data though the use of National Accreditation Program for Breast Centers (NAPBC)-approved mammography centers, which can also be linked to a corresponding tissue bank. The data is greatly needed to control the cost of mass mammography screening by identifying those women who are at higher risk of breast cancer and in need of regular or early screening. It is the authors' hope that through this rigorously referenced review, analysis, and proposal that medical science will be advanced and both medical professionals and the lay public will understand the risks contributing to the continued epidemic of breast cancer both here and abroad.
McCarthy, Bridget J; Rankin, Kristin M; Aldape, Ken
Oligodendroglial tumors are rare subtypes of brain tumors and are often combined with other glial tumors in epidemiological analyses. However, different demographic associations and clinical characteristics suggest potentially different risk factors. The purpose of this study was to investigate p...... that additional factors specific to oligodendroglial tumors have yet to be identified. Large, multi-institution international studies will be necessary to better characterize these etiological risk factors.......Oligodendroglial tumors are rare subtypes of brain tumors and are often combined with other glial tumors in epidemiological analyses. However, different demographic associations and clinical characteristics suggest potentially different risk factors. The purpose of this study was to investigate...... possible risk factors for oligodendroglial tumors (including oligodendroglioma, anaplastic oligodendroglioma, and mixed glioma). Data from 7 case-control studies (5 US and 2 Scandinavian) were pooled. Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals...
Persad, Amanda S; Cooper, Glinda S
In human health risk assessment, information from epidemiologic studies is typically utilized in the hazard identification step of the risk assessment paradigm. However, in the assessment of many chemicals by the Integrated Risk Information System (IRIS), epidemiologic data, both observational and experimental, have also been used in the derivation of toxicological risk estimates (i.e., reference doses [RfD], reference concentrations [RfC], oral cancer slope factors [CSF] and inhalation unit risks [IUR]). Of the 545 health assessments posted on the IRIS database as of June 2007, 44 assessments derived non-cancer or cancer risk estimates based on human data. RfD and RfC calculations were based on a spectrum of endpoints from changes in enzyme activity to specific neurological or dermal effects. There are 12 assessments with IURs based on human data, two assessments that extrapolated human inhalation data to derive CSFs and one that used human data to directly derive a CSF. Lung or respiratory cancer is the most common endpoint for cancer assessments based on human data. To date, only one chemical, benzene, has utilized human data for derivation of all three quantitative risk estimates (i.e., RfC, RfD, and dose-response modeling for cancer assessment). Through examples from the IRIS database, this paper will demonstrate how epidemiologic data have been used in IRIS assessments for both adding to the body of evidence in the hazard identification process and in the quantification of risk estimates in the dose-response component of the risk assessment paradigm.
Persad, Amanda S.; Cooper, Glinda S.
In human health risk assessment, information from epidemiologic studies is typically utilized in the hazard identification step of the risk assessment paradigm. However, in the assessment of many chemicals by the Integrated Risk Information System (IRIS), epidemiologic data, both observational and experimental, have also been used in the derivation of toxicological risk estimates (i.e., reference doses [RfD], reference concentrations [RfC], oral cancer slope factors [CSF] and inhalation unit risks [IUR]). Of the 545 health assessments posted on the IRIS database as of June 2007, 44 assessments derived non-cancer or cancer risk estimates based on human data. RfD and RfC calculations were based on a spectrum of endpoints from changes in enzyme activity to specific neurological or dermal effects. There are 12 assessments with IURs based on human data, two assessments that extrapolated human inhalation data to derive CSFs and one that used human data to directly derive a CSF. Lung or respiratory cancer is the most common endpoint for cancer assessments based on human data. To date, only one chemical, benzene, has utilized human data for derivation of all three quantitative risk estimates (i.e., RfC, RfD, and dose-response modeling for cancer assessment). Through examples from the IRIS database, this paper will demonstrate how epidemiologic data have been used in IRIS assessments for both adding to the body of evidence in the hazard identification process and in the quantification of risk estimates in the dose-response component of the risk assessment paradigm
Bouafia, N; Mahjoub, M; Nouira, A; Ben Aissa, R; Saïdi, H; Guedana, N; Njah, M
This descriptive study assessed the frequency of selected risk factors for high risk pregnancy (HRP) among women in Sousse region. All pregnant women (beyond 28 weeks gestation) giving birth in 4 public maternity hospitals between 15 February 2005 and 15 August 2005 and who had at least 1 risk factorwere enrolled. Data were collected within 24 hours of birth from obstetric and antenatal records and by interview. Of 4660 pregnant women, 1194 (25.6%) had at least 1 risk factor and were considered at-risk pregnancies. Mean age of the at-risk women was 31.3 (SD 5.4) years, 73% were urban residents, 38% had secondary education or higher and 75% were housewives. The mean number of risk factors was 1.5 per woman. The majority of women (59.3%) had 1 risk factor and 30.4% had 2. The mean number of prenatal visits was 4, 68.6% were seen by an obstetrician and 43% used the private sector. Certain factors were inadequately screened: age >35 years, parity >4, previous low birth weight and neonatal death, excessive fundal height and anaemia.
Brian C. Peach MSN
Full Text Available Objective: To identify factors that predispose older adults to urosepsis and urosepsis-related mortality. Method: A systematic search using PubMed and CINAHL databases. Articles that met inclusion criteria were assessed using the Strengthening the Reporting of OBservational studies in Epidemiology (STROBE criteria and were scored on a 4-point Likert-type scale. Results: A total of 180 articles were identified, and six met inclusion criteria. The presence of an internal urinary catheter was associated with the development of urosepsis and septic shock. Although a number of factors were examined, functional dependency, number of comorbidities, and low serum albumin were associated with mortality across multiple studies included in this review. Discussion: Little scientific evidence is available on urosepsis, its associated risk factors, and those factors associated with urosepsis-related mortality in older adults. More research is warranted to better understand urosepsis in this vulnerable population in an effort to improve the quality of patient care.
Full Text Available Caroline Ingre,1 Per M Roos,2 Fredrik Piehl,1 Freya Kamel,3 Fang Fang4 1Department of Clinical Neuroscience, 2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 3Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA; 4Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Abstract: Amyotrophic lateral sclerosis (ALS is the most common motor neuron disease. It is typically fatal within 2–5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS. Keywords: amyotrophic lateral sclerosis, risk factors, genetics, lifestyle, environment
Jensen, Peter; Thyssen, Jacob P; Zachariae, Claus
Background Epidemiological data have established an association between cardiovascular disease and psoriasis. Only one general population study has so far compared prevalences of cardiovascular risk factors among subjects with psoriasis and control subjects. We aimed to determine the prevalence...... of cardiovascular risk factors in subjects with and without psoriasis in the general population. Methods During 2006-2008, a cross-sectional study was performed in the general population in Copenhagen, Denmark. A total of 3471 subjects participated in a general health examination that included assessment of current...... smoking status, weight, height, waist and hip circumferences, systolic and diastolic blood pressures, resting heart rate, and plasma lipids, hemoglobin A1c, fasting glucose, and insulin levels. Results Physician-diagnosed psoriasis was reported by 238 (7.1%) of 3374 participants. There were no differences...
...) contribute to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary lifestyle are more prevalent among black than white women...
suggest that obstetric factors increase the risk of damage to the anal sphincter and subsequent development of AI.[4-6] These ... variations may impact on obstetric risk factors and AI prevalence. We therefore performed a study in our population, which .... Regulatory approvals. Institutional and hospital ethical approval were ...
Joseph P. Dudley
Full Text Available Avian influenza viruses are now widely recognized as important threats to agricultural biosecurity and public health, and as the potential source for pandemic human influenza viruses. Human infections with avian influenza viruses have been reported from Asia (H5N1, H5N2, H9N2, Africa (H5N1, H10N7, Europe (H7N7, H7N3, H7N2, and North America (H7N3, H7N2, H11N9. Direct and indirect public health risks from avian influenzas are not restricted to the highly pathogenic H5N1 "bird flu" virus, and include low pathogenic as well as high pathogenic strains of other avian influenza virus subtypes, e.g., H1N1, H7N2, H7N3, H7N7, and H9N2. Research has shown that the 1918 Spanish Flu pandemic was caused by an H1N1 influenza virus of avian origins, and during the past decade, fatal human disease and human-to-human transmission has been confirmed among persons infected with H5N1 and H7N7 avian influenza viruses. Our ability to accurately assess and map the potential economic and public health risks associated with avian influenza outbreaks is currently constrained by uncertainties regarding key aspects of the ecology and epidemiology of avian influenza viruses in birds and humans, and the mechanisms by which highly pathogenic avian influenza viruses are transmitted between and among wild birds, domestic poultry, mammals, and humans. Key factors needing further investigation from a risk management perspective include identification of the driving forces behind the emergence and persistence of highly pathogenic avian influenza viruses within poultry populations, and a comprehensive understanding of the mechanisms regulating transmission of highly pathogenic avian influenza viruses between industrial poultry farms and backyard poultry flocks. More information is needed regarding the extent to which migratory bird populations to contribute to the transnational and transcontinental spread of highly pathogenic avian influenza viruses, and the potential for wild bird
Leenhouts, H P; Chadwick, K H
This paper expands on our recent comments in a letter to this journal about the analysis of epidemiological studies and the determination of low dose RBE of low LET radiation (Chadwick and Leenhouts 2009 J. Radiol. Prot. 29 445-7). Using the assumption that radiation induced cancer arises from a somatic mutation (Chadwick and Leenhouts 2011 J. Radiol. Prot. 31 41-8) a model equation is derived to describe cancer induction as a function of dose. The model is described briefly, evidence is provided in support of it, and it is applied to a set of experimental animal data. The results are compared with a linear fit to the data as has often been done in epidemiological studies. The article presents arguments to support several related messages which are relevant to epidemiological analysis, the derivation of low dose risk and the weighting factor of sparsely ionising radiations. The messages are: (a) cancer incidence following acute exposure should, in principle, be fitted to a linear-quadratic curve with cell killing using all the data available; (b) the acute data are dominated by the quadratic component of dose; (c) the linear fit of any acute data will essentially be dependent on the quadratic component and will be unrelated to the effectiveness of the radiation at low doses; consequently, (d) the method used by ICRP to derive low dose risk from the atomic bomb survivor data means that it is unrelated to the effectiveness of the hard gamma radiation at low radiation doses; (e) the low dose risk value should, therefore, not be used as if it were representative for hard gamma rays to argue for an increased weighting factor for tritium and soft x-rays even though there are mechanistic reasons to expect this; (f) epidemiological studies of chronically exposed populations supported by appropriate cellular radiobiological studies have the best chance of revealing different RBE values for different sparsely ionising radiations.
Alexander J. Ambinder
Full Text Available Follicular lymphoma (FL is an indolent malignancy of germinal center B cells with varied incidence across racial groups and geographic regions. Improvements in the classification of non-Hodgkin lymphoma subtypes provide an opportunity to explore associations between environmental exposures and FL incidence. Our paper found that aspects of Western lifestyle including sedentary lifestyle, obesity, and diets high in meat and milk are associated with an increased risk of FL. Diets rich in fruits and vegetables, polyunsaturated fatty acids, vitamin D, and certain antioxidants are inversely associated with FL risk. A medical history of Sjogren's syndrome, influenza vaccination, and heart disease may be associated with FL incidence. Associations between FL and exposure to pesticides, industrial solvents, hair dyes, and alcohol/tobacco were inconsistent. Genetic risk factors include variants at the 6p21.32 region of the MHC II locus, polymorphisms of the DNA repair gene XRCC3, and UV exposure in individuals with certain polymorphisms of the vitamin D receptor. Increasing our understanding of risk factors for FL must involve integrating epidemiological studies of genetics and exposures to allow for the examination of risk factors and interactions between genes and environment.
Klinda, J.; Lieskovska, Z.
In this chapter the physical risk factors (as radiation [air contamination, contamination of the environment components and food contamination], radon and its radioactive decay products, radioactive wastes, noise), chemical risk factors [chemical substances, xenobiotics in the food chain the ozone depletion], wastes (waste generation, waste management, municipal waste management, import, export and transit of waste) and natural an technological hazards (water quality deterioration as a result of various accidents and fire risk) in the Slovak Republic in 1997 are reviewed
Cardis, E. [Centre International de Recherche sur le Cancer, Unite Rayonnement et Cancer, 69 - Lyon (France)
The results of several major epidemiology studies on populations with particular exposure to ionizing radiation should become available during the first years of the 21. century. These studies are expected to provide answers to a number of questions concerning public health and radiation protection. Most of the populations concerned were accidentally exposed to radiation in ex-USSR or elsewhere or in a nuclear industrial context. The results will complete and test information on risk coming from studies among survivors of the Hiroshima and Nagasaki atomic bombs, particularly studies on the effects of low dose exposure and prolonged low-dose exposure, of different types of radiation, and environmental and host-related factors which could modify the risk of radiation-induced effects. These studies are thus important to assess the currently accepted scientific evidence on radiation protection for workers and the general population. In addition, supplementary information on radiation protection could be provided by formal comparisons and analyses combining data from populations with different types of exposure. Finally, in order to provide pertinent information for public health and radiation protection, future epidemiology studies should be targeted and designed to answer specific questions, concerning, for example, the risk for specific populations (children, patients, people with genetic predisposition). An integrated approach, combining epidemiology and studies on the mechanisms of radiation induction should provide particularly pertinent information. (author)
Sánchez, R; Mirada, E; Arias, J; Paño, J-R; Burgueño, M
A retrospective study is made of the odontogenic infections treated in La Paz University Hospital (Madrid, Spain) during 2007 and 2008, with an epidemiological and microbiological analysis of a large group of patients. A retrospective descriptive study was made, involving the consecutive inclusion of all patients with odontogenic infection requiring admission to our hospital in the period between January 2007 and December 2008. A total of 151 patients were included, with a mean age of 40.3 years and a balanced gender distribution. The most frequently affected teeth were those located in the posterior mandibular segments, caries being the main underlying cause. Most isolates comprised mixed flora, particularly viridans streptococci, different species of Prevotella, Micromonas micros, and different species of Actinomyces. Susceptibility analysis of the microbial isolates showed a high percentage resistance to clindamycin (42.8% of all isolates), particularly among Viridans Streptococci. The use of antibiotics in head and neck infections requires updated protocols based not only on the existing scientific evidence but also on the epidemiological reality of each center. On the other hand, identification is required of the surgical factors determining infection and how they influence morbidity associated with this type of pathology.
Elizabeth Mary John; Clarence James Samuel
Context: India is experiencing an epidemiological health transition characterized by rapid decline in nutritional and parasitic diseases (pre-transitional diseases) with an alarming rise in cardiovascular diseases, mainly coronary heart disease and stroke (post-transitional diseases). Many of these risk factors manifesting themselves as diseases in adults can be found during adolescence. Aims: To determine the prevalence of risk factors of heart disease among urban high-school students aged 1...
Mehrez Mehrez M. Jadaon
Full Text Available Venous thromboembolic disorders (VTE are serious disorders with high morbidity and mortality rates. Many genetic and acquired risk factors were identified to cause VTE The most common genetic risk factor is Factor V Leiden mutation (FVL. FVL was found in high percentage of populations of Caucasian origin but was almost absent in non-Caucasians. It was also reported in populations living in North Africa and the Middle East. This review article briefly explains FVL and how it causes VTE, the distribution of FVL worldwide, and then it elaborates on the epidemiology of FVL in the Mediterranean Region and how this brought speculations that FVL might have originated in the Eastern Mediterranean area.
Jadaon, Mehrez M.
Venous thromboembolic disorders (VTE) are serious disorders with high morbidity and mortality rates. Many genetic and acquired risk factors were identified to cause VTE. The most common genetic risk factor is Factor V Leiden mutation (FVL). FVL was found in high percentage of populations of Caucasian origin but was almost absent in non-Caucasians. It was also reported in populations living in North Africa and the Middle East. This review article briefly explains FVL and how it causes VTE, the distribution of FVL worldwide, and then it elaborates on the epidemiology of FVL in the Mediterranean Region and how this brought speculations that FVL might have originated in the Eastern Mediterranean area. PMID:22224194
Katsouyanni, K. [Athens Univ. (Greece). Dept. of Hygiene and Epidemiology
Air pollution epidemiology is the study of the occurrence and distribution of health outcomes in association with community air pollution exposure. It is therefore specific in the exposure variable. Air pollution health effects became evident during high air pollution episodes which occurred in the first decades of our century. Since then, legal and other control measures have led to lower air pollution levels. However, recent results from several studies indicate that lower levels of air pollution than the previously considered safe have serious adverse health effects. Although, there is increasingly agreement that air pollution, at levels measured today, affects health, there is still a lot to be understood concerning specific causal pollutants, biologic mechanisms involved and sensitive groups of individuals. The extent of potential confounding, time-considerations in air pollution effects, individual variation in air pollution exposure and exposure misclassification are some factors which complicate the study of these issues. (author)
Davies, Eryl A; Jones, Alyson C
To quantify the incidence of child sexual abuse allegations referred to a forensic examination centre; to identify possible risk factors predisposing children to sexual abuse by measuring their prevalence among the complainant population. The records of children involved in sexual abuse allegations presenting over a 12 month period were reviewed retrospectively. Demographic data such as nature of case, sex, ethnicity, number of previous allegations, assailant relationship, month of presentation, and age were compiled. Potential risk factors such as alcohol or drug use, being 'looked after', physical disability, learning disability, previous consensual sexual intercourse, past psychiatric history, and history of psychiatric support were compiled. Descriptive statistics were calculated. 138 cases were recorded, of which the majority were acute. Epidemiological data demonstrated a higher incidence in females and most complainants were of White British origin. Most of the cases were of first allegations and the assailant relationship was most frequently an acquaintance. The incidence was highest in January. The modal age was 15 years and age distribution was positively skewed. Of the potential risk factors studied, alcohol and drug use was the most prevalent. Prevalence increased with age for the majority of factors studied. Alcohol and drug use may be an area in which preventative strategies would be beneficial. Ethnic minorities may hold a large amount of unreported cases. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Background: Placenta praevia, a major cause of obstetric haemorrhage, is potentially lifethreatening to the mother and frequently results in high perinatal morbidity and mortality. Several epidemiological and clinical studies report disparate data on the risk factors associated with this condition. Although several studies on ...
Zhou, Zongkui; Tang, Hanying; Tian, Yuan; Wei, Hua; Zhang, Fengjuan; Morrison, Chelsey M.
Cyberbullying has become a common occurrence among adolescents worldwide; however, it has yet to receive adequate scholarly attention in China, especially in the mainland. The present study investigated the epidemiological characteristics and risk factors of cyberbullying, utilizing a sample of 1,438 high school students from central China.…
Bovine brucellosis is a contagious disease of cattle causing reproductive failure, loss of milk production and zoonosis worldwide. A cross-sectional epidemiological study was conducted on 816 dairy cattle (449 were cows) from 60 dairy farms to determine the seroprevalence and associated risk factors of bovine brucellosis ...
Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut
Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...
Chambers, Douglas B.; Harley, Naomi H.
Everyone is exposed to radon, an inert radioactive gas that occurs naturally and is present everywhere in the atmosphere. The annual dose from radon and its (short-lived) decay products is typically about one-half of the dose received by members of the public from all natural sources of ionizing radiation. Data on exposures and consequent effects have recently been reviewed by the National Council on Radiation Protection and Measurements (NCRP) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Studies of underground miners provides a well-established basis for estimating risks from occupational exposures to radon and for studying factors that may affect the dose response relationship such as the reduction of risk (coefficients) with increasing time since exposure. Miners' studies previously formed the basis for estimating risks to people exposed to radon at home, with downward extrapolation from exposures in mines to residential levels of radon. Presently, the risk estimates from residential studies are adequate to estimate radon risks in homes. Although there are major uncertainties in extrapolating the risks of exposure to radon from the miner studies to assessing risks in the home, there is remarkably good agreement between the average of risk factors derived from miner studies and those from pooled residential case-control studies. There are now over 20 analytical studies of residential radon and lung cancer. These studies typically assess the relative risk from exposure to radon based on estimates of residential exposure over a period of 25 to 30 years prior to diagnosis of lung cancer. Recent pooled analyses of residential case-control studies support a small but detectable lung cancer risk from residential exposure, and this risk increases with increasing concentrations. The excess relative risk of lung cancer from long-term residential exposure is about the same for both smokers and non-smokers; however, because the
Tamègnon Victorien DOUGNON
Full Text Available Salmonella infections are major public health problems worldwide. The hereby review aimed to establish an overview on the pathogenicity, epidemiology and virulence factors of Salmonella spp. in the world. A systematic search was conducted online using the keywords ‘Salmonella’, ‘Salmonella spp.’, ‘Salmonella spp. Epidemiology’, ‘virulence factors of Salmonella spp. in the world’, ‘bacteria responsible for the contamination of meat products’, ‘non-typhoid salmonella’. These keywords were entered into databases such as PubMed and Google Scholar using mainly French language. The obtained articles were included based on the reliability of their source, the study area (usually Benin and Africa and the subject. The review revealed that Salmonella spp. is motile Gram-negative rod-shaped bacteria, of the family Enterobacteriaceae, currently counting more than 2,600 serovars. Human contamination occurs through the ingestion of contaminated water and food and can cause gastroenteritis or typhoid fever, which are two serious public health problems. A gene set constituting the pathogenicity islands determines the pathogenesis of Salmonella spp. The diagnosis is based on bacteriological, serological and molecular techniques. Salmonella infections are usually treated using antibiotics; however, emergence of antibiotic resistance in these microorganisms suggests that the anti-salmonella control should explore new sources such as medicinal plants
Overbeek, F.; Pauwels, E.K.J.; Broerse, J.J.
During the last decade new data have become available on the mechanism of carcinogenesis and on cancer induction by ionizing radiation. This review concentrates on these two items in relation to the use of radiopharmaceuticals in diagnostic nuclear medicine. On the basis of reports of expert committees, the concept of radiation risk is elucidated for high and low doses. Mortality risk factors due to ionizing radiation are put in perspective to other risks. The extra risk for patients who undergo a scintigraphic examination for fatal cancer is very small and is of the order of 1.4 x 10 -4 . It is most unlikely that this figure can even be verified by actual measurement since the majority of nuclear medicine patients will die of other causes before the radiogenic cancer manifests itself. (orig.)
Bautista-Amorocho, Henry; Castellanos-Domínguez, Yeny Zulay; Rodríguez-Villamizar, Laura Andrea; Velandia-Cruz, Sindi Alejandra; Becerra-Peña, Jeysson Andrey; Farfán-García, Ana Elvira
Introduction Chronic hepatitis B virus (HBV) infection is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. HIV-positive patients are commonly co-infected with HBV due to shared routes of transmission. Objectives Our aim was to determine the risk factors, prevalence, genotypes, and mutations of the Surface S gene of HBV, and occult hepatitis B infection (OBI) among patients infected with HIV in a northeastern Colombian city. Methods A c...
Thomsen, Line H.; Schnack, Tine H.; Buchardi, Kristina
INTRODUCTION: To evaluate the published literature on epidemiologic risk factors for epithelial ovarian cancer among women with a diagnosis of endometriosis. MATERIAL AND METHODS: A systematic literature search was conducted in PubMed and Scopus. Studies comparing epidemiologic risk factors...... of epithelial ovarian cancer among women with endometriosis were included. A quality assessment was conducted using the Newcastle-Ottawa Scale. RESULTS: Eight of 794 articles met the inclusion criteria. A lower risk of epithelial ovarian cancer was observed in women with documented complete surgical excision...... of endometriotic tissue and suggested among women with unilateral oophorectomy. The use of oral contraceptives (≥10 years) may be associated with a lower risk of epithelial ovarian cancer among women with endometriosis, whereas older age at endometriosis diagnosis (≥45 years, pre- or postmenopausal), nulliparity...
Sevalho, Gil; Stotz, Eduardo
Adopting an interdisciplinary approach, the concept of epidemiological risk is critically discussed. The work of Elizabeth Teixeira, who uses the ideas of Boaventura de Sousa Santos, is presented. The proposal for symbolic cartography of epidemiological risk is sketched out, defining analytical scales ranging from exteriority and distancing from the field of science to the proximity of territory and place, conceptualized on the basis of the geography of Milton Santos, in which conceptions of risk are drawn up from the perspective of the everyday routine of social existence. Questions relating to space, territoriality, subjectivity and time give meaning to a cartography of risk which is proposed as a model for epidemiological investigations.
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,
PUSTIV?EK, Suzana; HAD?I?, Vedran; DERVI?EVI?, Edvin
Objective Eating disorders (ED) are an important and increasing problem in adolescents. The objective of this study was to examine the risk factors and the prevalence of risk for ED among male adolescent elite athletes and nonathletic controls. Differences between male athletes competing in aerobic, anaerobic and aerobic-anaerobic sports were examined as well. Methods This was a cross-sectional epidemiological study. A cross-sectional questionnaire survey and anthropometric measurements were ...
Rao, Xiaoquan; Patel, Priti; Puett, Robin; Rajagopalan, Sanjay
Recent studies in both humans and animals suggest that air pollution is an important risk factor for type 2 diabetes mellitus (T2DM). However, the mechanism by which air pollution mediates propensity to diabetes is not fully understood. While a number of epidemiologic studies have shown a positive association between ambient air pollution exposure and risk for T2DM, some studies have not found such a relationship. Experimental studies in susceptible disease models do support this association ...
Full Text Available Although the association between blood pressure, serum lipids and cancer risk has been investigated, the results are controversial. The aim of this literature review was to examine the epidemiological evidence and provide overview of the association between blood pressure, serum lipids and cancer risk. The arterial hypertension is closely linked with renal cell cancer development. Risk of renal cell cancer was 2–4 times higher for persons with arterial hypertension, independently of sex. In some studies arterial hypertension as one of the components of the metabolic syndrome, was associated with a higher risk of colorectal, prostate cancer and malignant melanoma. Studies suggest that a higher total serum cholesterol level is linked with higher risk of colorectum, colon, prostate and testicular cancer and lower risk of stomach, liver and hematopoietic and lymphoid tissues cancer. There was positive association between serum triglycerides and esophageal, colorectal, lung, renal, thyroid cancer. Given that hypertension is a common risk factor worldwide and its control remains inadequate, our analysis supports the relevance of public health programs aimed at reducing hypertension to reduce the incidence of a number of cancers including renal cell cancer. Effective cholesterol control may lower the risk of cancer, but further studies with longer follow-up and repeated measurements of cholesterol and other lipids are needed.
Grübler, Martin Robert; März, Winfried; Pilz, Stefan; Grammer, Tanja B; Trummer, Christian; Müllner, Christian; Schwetz, Verena; Pandis, Marlene; Verheyen, Nicolas; Tomaschitz, Andreas; Fiordelisi, Antonella; Laudisio, Daniela; Cipolletta, Ersilia; Iaccarino, Guido
Vitamin D has long been established as an elemental factor of bone physiology. Beyond mineral metabolism, the expression of the vitamin D receptor has been identified throughout the cardiovascular (CV) system. Experimental studies showed beneficial effects of vitamin D on heart and vessels, but vitamin D intoxication in animals also led to hypercalcemia and vascular calcification. Our knowledge has been extended by epidemiological studies that showed that 25-hydroxyvitamin D (25(OH)D) levels are inversely associated with an increased CV risk itself, but also with established CV risk factors, such as arterial hypertension, endothelial dysfunction and atherosclerosis. Conversely, randomized controlled trials could not document significant and consistent effects of vitamin D supplementation on CV risk or events. Potential explanations may lie in differences in reference ranges or the possibility that low vitamin D in CV disease is only an epiphenomenon. In the latter case, the key question is why low 25(OH)D levels are such a strong predictor of health. While we wait for new data, the current conclusion is that vitamin D is a strong risk marker for CV risk factors and for CV diseases itself.
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.
Chandra Prakash Pal
Conclusions: There is scarcity of studies done in India which has varied socio geographical background and communities. We conducted this study for analyzing the current prevalence of OA in different locations. This study has evidenced a large percentage of population as borderline OA; therefore, it depends mainly on the prevention of modifiable risk factors to preserve at ease movement in elderly population through awareness programs.
Zeighami, E.A.; Walsh, P.J.; Morris, M.D.; Jones, T.D.
The scientific basis for compensation of persons developing cancer who have a documented history of exposure to radiation or other carcinogens is an important legal issue. The measure Relative Attributable Risk (RAR) has been proposed as a basis for determining eligibility for compensation. The purpose of this report is to present results of an analysis of the magnitude and sources of uncertainty in the RAR measure. The range of 1/10 6 /rad-year to 6/10 6 /rad-year was chosen as a reasonable range of excess-risk estimates for thyroid cancer based on published estimates. The use of such a range in risk estimates produces very wide variability in RAR estimates. Uncertainty in underlying incidence levels and in dosimetry are other major factors contributing to large variability in estimated RAR levels
For the purposes of radiation protection, the noteworthy risk of thyroid is carcinogenesis. The risk factor which ICRP presented in the publication-26 is 5 x 10 - 6 rem - 1 . This numerical value is based upon the estimated likelihood of inducing fatal thyroid cancer. On the other hand, the risk factor presented by the BEIR report is 4 x 10 - 6 yr - 1 . This value was decided after consideration of the risks of both fatal and non-fatal cancer of thyroid. The following features distinguished thyroid cancer from malignancy of other tissue from medical point of view. 1) A large difference between incidence and mortality in case of thyroid cancer is recognized, because the thyroid cancer could be successfully treated by surgical or radiological treatment. 2) The high prevalence of clinically silent tumor in thyroid gland has been reported. The incidence of thyroid cancer, therefore, is very dependent on methods of medical inspection. The prevalence of radiation induced thyroid cancer is modified by various factors such as age, sex, latency, dose and dose rate. The latent period is very important factors such as ave, sex, latency, dose and dose rate. The latent period is a very important factor in the estimation of accumulated total risk of thyroid malignancy. What is included in the risk caused by thyroid irradiation must be investigated. The risk of non-fatal cancer should be considered in the same way as that of fatal cancer. The dose-equivalent limit of thyroid in non-uniform irradiation caused by radioactive iodine is decided by the limit for non-stochastic effects. Therefore the further consideration of non-stochastic effects of thyroid is necessary. (author)
Leukaemia is the most common malignancy in childhood, with an incidence rate in Germany of 5.5 per 100,000 children aged 0 to 14 years per year. Overall, epidemiological studies suggest a rather minor role of environmental factors in the development of childhood leukaemia. Ionising radiation is the only established risk factor; however, it is currently unclear at which doses effects occur. Low doses from terrestrial exposures or related to living close to a nuclear power plant show weak associations in recent epidemiological studies, but the findings can at present not be explained with mechanistic models from radiation biology. The consistent association observed in epidemiological studies between extremely low-frequency magnetic fields and childhood leukaemia risk also lacks a good explanation and it is still not known whether this observation displays an artefact or a causal link. Some pesticides appear to be carcinogenic in experiments, but the results from epidemiological studies are inconsistent. No substantial risk appears to be related to air pollution from road traffic. Recent research focused on working hypotheses related to patterns of infections, in particular that an isolation from infectious stimulation in infancy leads to an immature immune system reacting inappropriately to later common infections. While children being at day care at an early age appear to have a reduced risk of childhood leukaemia, more work needs to be done to clearly identify the agents involved in a putative mechanism. (orig.)
M C Patel
Full Text Available Background and objective: dental trauma is an irreversible pathology that after occurrence is characterized by life-long debilitating effects. The objectives of this study were to measure the prevalence of anterior teeth fracture and their association with predisposing factors such as lip coverage, molar relationship, overjet, and variables such as age, sex, cause, and place of trauma. Materials and Methods: an epidemiological cross-sectional study was carried out among 3708 school children aged 8-13 years in the Vadodara city. All children completed a questionnaire related to history of trauma to their anterior teeth after which they were examined for lip competence, Angle′s molar relationship amount of overjet and nature of trauma sustained. The results were statistically analyzed using the prevalence test, Chi-square test, and Mantel-Haenszel Common Odds Ratio. Results: the prevalence of traumatic injuries was 8.79% and the ratio of boys: girl′s was 1.28:1. Inadequate lip coverage group sustained about five times more injuries than the adequate lip coverage group (P = 0.000, OR= 5.407. The maximum traumatic injuries were seen in children having Angle Class II Div 1 molar relationship and/or overjet greater than 5.5 mm and was statistically significant (P<0.05. Maximum number of injuries occurred at 9 years of age. The most predominant injuries were enamel fractures, the most common place for occurrence was home and fall against object, the most frequent cause. Conclusion: the prevalence of dental injuries in the Vadodara city is high and it has a great potential to be considered as an emerging public health problem.
Full Text Available The aim of the study was to determine the correlation between risk factors and diabetic retinopathy, which is the leading cause of blindness in developed countries for patients aged 20 to 65.We compared risk factors between patients without retinopathy, with non-proliferate and with proliferate retinopathy (p< 0.05. Duration of diabetes is most important for the development of retinopathy. Hyperglycaemia and high blood pressure are important for progression. Better control of blood sugar and elevated blood pressure can reduce progression of retinopathy and riskof vision loss.
Søreide, Kjetil; Boermeester, Marja A.; Humes, David J.; Velmahos, George C.
Conservative, non-antibiotic and non-surgical management of acute diverticulitis is currently being investigated. To better inform clinical decisions, better understanding of disease mechanisms, disease burden and severity is needed. Literature search of risk factors, pathophysiology, epidemiology
Andriushchenko, I V; Liubenzon, R T; Liakhov, N T
A relationship was examined between the blood pressures and the social and living conditions in 2026 female workers at a ship-repairing plant. The persons having a primary or incomplete secondary education and those periodically working at night were demonstrated to constitute an elevated blood pressure risk groups. The regression analysis indicated that the blood pressure values were significantly affected by the following variables: education, extra or overtime work, average income per household, and living conditions. The influence of social and living factors on the systolic blood pressure was 9.4% of the total number of impacts. This parameter accounted for 7.9% for diastolic blood pressure. The examination of the relationship of blood pressure to the labour pattern in the female workers demonstrated a significant increase in the mean systolic and diastolic pressures and in the incidence of systolic and diastolic arterial hypertensions in manual workers. The social and living conditions and the labour pattern can exert a substantial action on the blood pressure values in females, so they may be regarded as risk factors for arterial hypertension and borne in mind in implementing therapeutical and prophylactic measures to control arterial hypertension at the industrial enterprises.
Roč. 15, 1/2 (1995), s. 203-212 ISSN 0208-5216. [Seminar on Statistics and Clinical Practice. Warsaw, 20.06.1994-23.06.1994] Keywords : risk factors * genetics * association * epidemilogy * measures of association * screening * genetics
Marti-Soler, Helena; Gubelmann, Cédric; Aeschbacher, Stefanie
OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist...
Brouwers, M.M.; Bruijne, L.M. de; Gier, R.P.E. de; Zielhuis, G.A.; Feitz, W.F.J.; Roeleveld, N.
OBJECTIVE: To contribute to the understanding of the etiology of undescended testis (UDT), by exploring a wide range of potential risk factors in a case-referent study. PATIENTS AND METHODS: Cases and referents were recruited at five hospitals and included 200 boys with surgically corrected UDT and
Wu, Yen-Mu; Hsu, Po-Chang; Yang, Chien-Chang; Chang, Hong-Jyun; Ye, Jung-Jr; Huang, Ching-Tai; Lee, Ming-Hsun
Serratia marcescens is a rare pathogen of central nervous system infections. This study was to investigate the epidemiology, prognostic factors, and treatment outcomes of S. marcescens meningitis. This retrospective analysis included 33 patients with culture-proven S. marcescens meningitis hospitalized between January 2000 and June 2011. Of the 33 patients enrolled, only one did not receive neurosurgery before the onset of S. marcescens meningitis. Patients with S. marcescens meningitis had higher ratios of brain solid tumors (54.5%) and neurosurgery (97.0%) with a mortality rate of 15.2%. The mean interval between the first neurosurgical procedure and the diagnosis of meningitis was 17.1 days (range, 4-51 days). Only one third-generation cephalosporin-resistant S. marcescens isolate was recovered from the patients' cerebrospinal fluid (CSF) specimens. Compared with the favorable outcome group (n = 20), the unfavorable outcome group (n = 13) had a higher percentage of brain solid tumors, more intensive care unit stays, and higher Sequential Organ Failure Assessment score, CSF lactate and serum C-reactive protein concentrations at diagnosis of meningitis. Under the multiple regression analysis, CSF lactate concentration ≥2-fold the upper limit of normal (ULN) was independently associated with unfavorable outcomes (odds ratio, 7.20; 95% confidence interval, 1.08-47.96; p = 0.041). S. marcescens meningitis is highly associated with neurosurgical procedures for brain solid tumors. CSF lactate concentration ≥2x ULN may predict an unfavorable outcome. Its mortality is not high and empiric treatment with parenteral third-generation cephalosporins may have a satisfactory clinical response. Copyright © 2012. Published by Elsevier B.V.
Full Text Available It is shown, on the examples of concrete publications, that "person-years" category application in multi-factor health risks analysis can lead to false conclusions in the process of observation data grouping due to Simpson paradox influence when examinations are performed via demographic or epidemiological techniques. The paradox occurs when heterogeneous strata are being compared. "Person-years" category first appeared in the middle of the 17th century, long before first applications of mathematical tools in statistics and probability theory; it does not fully correspond to up-to-date requirements of epidemiological research. Risk theory should change 17–18 century paradigm as it focuses on conditional probability of unwanted events occurrence and not on a principle of comparing their intensities. It is particularly vital in case when we deal with determining possible damage to health caused by effects exerted by such factors and under such conditions when individual damage cannot be measured objectively but when it is possible to quantitatively determine regularities of changes in stochastic ability to survive for a large group of people or remote consequences occurrence for it. We prove it is necessary to create specialized mathematical tools and hybrid software able to solve a risks assessment task as an inverse one. Mathematical tools of large contingency tables could serve as prototypes of such tools; we can also use multi-factor logistical and Poisson regressions which are usually applied in countable events analysis. We should note that it is also necessary to eliminate a number of methodological drawbacks which are attributable to the said tools.
Davies, J.M.; Lee, T.R.
This paper is divided into two parts. The first deals with theoretical aspects of risk assessment by scientists and by the public and the second with specific applications in relation to epidemiological reports
Lonardo, A.; Bellentani, S.; Argo, C.K.; Ballestri, S.; Byrne, Christopher D.; Caldwell, S.H.; Cortez-Pinto, H.; Grieco, A.; Machado, M.V.; Miele, L.; Targher, G.
An improved understanding of non-alcoholic fatty liver disease epidemiology would lead to identification of individuals at high risk of developing chronic liver disease and extra-hepatic complications, thus contributing to more effective case finding of non-alcoholic fatty liver disease among selected groups.We aimed to illustrate the epidemiology of non-alcoholic fatty liver disease in high-risk groups, which were identified based on existing literature. To this end, PubMed was searched to r...
A. O. Karelin; G. B. Yeremin; I. V. May; A. Yu. Lomtev; A. V. Kiselev; N. A. Mozzhukhina
The article reviewsthe possibility to work out and introduce risk-oriented model for control and surveillance in the field of the sanitary-epidemiological well-being of the population in the Russian Federation. In implementation of risk-oriented approaches, choice of a model is of importance. If the static model is the starting one, then in the future, the dynamic model will be the most promising allowing for assessment of stability of the sanitary-epidemiologic situation in time. Introductio...
Christoffersen, Mette; Tybjærg-Hansen, Anne
Association of common aging signs (i.e., male pattern baldness, hair graying, and facial wrinkles) as well as other age-related appearance factors (i.e., arcus corneae, xanthelasmata, and earlobe crease) with increased risk of ischemic heart disease was initially described in anecdotal reports from clinicians observing trends in the physical appearance of patients with ischemic heart disease. Following these early observations numerous epidemiological studies have reported these associations. Since the prevalences of both visible aging signs and ischemic heart disease have a strong correlation with increasing age, it has been extensively debated whether the observed associations could be entirely explained by a common association with age. Furthermore, the etiologies of the visible aging signs are rarely fully understood, and pathophysiological explanations for these associations remain controversial, and are mostly speculative. As a consequence of inconsistent findings and lack of mechanistic explanations for the observed associations with ischemic heart disease, consensus on the clinical importance of these visible aging signs has been lacking. The aim of this review is for each of the visible aging signs to (i) review the etiology, (ii) to discuss the current epidemiological evidence for an association with risk of ischemic heart disease, and (iii) to present possible pathophysiological explanations for these associations. Finally this review discusses the potential clinical implications of these findings. Copyright © 2015 Elsevier B.V. All rights reserved.
Florian Joachim Raabe
Full Text Available Epidemiological and clinical studies have shown that children exposed to adverse experiences are at increased risk for the development of depression, anxiety disorders and PTSD. A history of child abuse and maltreatment increases the likelihood of being subsequently exposed to traumatic events or of developing PTSD as an adult. The brain is highly plastic during early life and encodes acquired information into lasting memories that normally subserve adaptation. Translational studies in rodents showed that enduring sensitization of neuronal and neuroendocrine circuits in response to early life adversity are likely risk factors of life time vulnerability to stress. Hereby, the hypothalamic-pituitary-adrenal (HPA axis integrates cognitive, behavioural and emotional responses to early-life stress and can be epigenetically programmed during sensitive windows of development. Epigenetic mechanisms, comprising reciprocal regulation of chromatin structure and DNA methylation, are important to establish and maintain sustained, yet potentially reversible, changes in gene transcription. The relevance of these findings for the development of PTSD requires further studies in humans where experience-dependent epigenetic programming can additionally depend on genetic variation in the underlying substrates which may protect from or advance disease development. Overall, identification of early-life stress associated epigenetic risk markers informing on previous stress history can help to advance early diagnosis, personalized prevention and timely therapeutic interventions, thus reducing long-term social and health costs.
Pelosi, Emanuele; Simonsick, Eleanor; Forabosco, Antonino; Garcia-Ortiz, Jose Elias; Schlessinger, David
The narrow standard age range of menopause, ∼50 yr, belies the complex balance of forces that govern the underlying formation and progressive loss of ovarian follicles (the "ovarian reserve" whose size determines the age of menopause). We show here the first quantitative graph of follicle numbers, distinguished from oocyte counts, across the reproductive lifespan, and review the current state of information about genetic and epidemiological risk factors in relation to possible preservation of reproductive capacity. In addition to structural X-chromosome changes, several genes involved in the process of follicle formation and/or maintenance are implicated in Mendelian inherited primary ovarian insufficiency (POI), with menopause before age 40. Furthermore, variants in a largely distinct cohort of reported genes-notably involved in pathways relevant to atresia, including DNA repair and cell death-have shown smaller but additive effects on the variation in timing of menopause in the normal range, early menopause (age menopause, equivalent to the summed effect of the top 17 genetic variants. The identified genetic and epidemiological factors underline the importance of early detection of reproductive problems to enhance possible interventions. © 2015 by the Society for the Study of Reproduction, Inc.
Bortolato, Beatrice; Köhler, Cristiano A.; Evangelou, Evangelos
Objectives: The pathophysiology of bipolar disorder is likely to involve both genetic and environmental risk factors. In our study, we aimed to perform a systematic search of environmental risk factors for BD. In addition, we assessed possible hints of bias in this literature, and identified risk...... factors supported by high epidemiological credibility. Methods: We searched the Pubmed/MEDLINE, EMBASE and PsycInfo databases up to 7 October 2016 to identify systematic reviews and meta-analyses of observational studies that assessed associations between putative environmental risk factors and BD....... For each meta-analysis, we estimated its summary effect size by means of both random- and fixed-effects models, 95% confidence intervals (CIs), the 95% prediction interval, and heterogeneity. Evidence of small-study effects and excess of significance bias was also assessed. Results: Sixteen publications...
Bøttcher, Louise; Dammeyer, Jesper
and psychopathology. Both a congenital hearing impairment and cerebral palsy were found to be dominating risk factors for all types of psychopathology, but no relationship was identified between degree of disability and risk of psychopathology. The higher risk cannot be explained by biological impairments alone......Empirical research has established that children with disabilities are more likely to develop psychopathology than children without disabilities. But too little is known about the association between disability and psychopathology. The aim of this article is to discuss developmental...... psychopathological models that conceptualize the connection between childhood disability and psychopathology. Empirical studies of psychopathology among children with a congenital hearing impairment and children with cerebral palsy will be reviewed, representing in-depth examples of association between disability...
Full Text Available The authors review environmental and neurodevelopmental risk factors for schizophrenic disorders, with emphasis on minor physical anomalies, particularly craniofacial anomalies and dermatoglyphic variations. The high prevalence of these anomalies among schizophrenic subjects supports the neurodevelopmental theory of the etiology of schizophrenia, since they suggest either genetically or epigenetically controlled faulty embryonic development of structures of ectodermal origin like brain and skin. This may disturb neurodevelopment that in turn may cause these subjects to be at increased risk for the development of schizophrenia and related disorders. The precise confirmation of this theory, at least in some cases, will provide further understanding of these illnesses, allowing easy and inexpensive identification of subjects at risk and providing guidelines for the development of new pharmacological interventions for early treatment and even for primary prevention of the illness.
Garba, Bashiru; Bahaman, Abdul Rani; Bejo, Siti Khairani; Zakaria, Zunita; Mutalib, Abdul Rahim; Bande, Faruku
Leptospirosis is a zoonotic disease caused by a diverse pathogenic leptospira species and serovars. The disease is transmitted directly following contact with infected urine and other body fluids or indirectly after contact with water or soil contaminated with infected urine. While a wide range of domestic and wild animals are known to be reservoirs of the disease, occupation, international travel and recreation are beginning to assume a center stage in the transmission of the disease. The objective of this study is to review available literatures to determine the extent to which these aforementioned risk factors aid the transmission, increase incidence and outbreak of leptospirosis in Malaysia. The review was conducted based on prevalence, incidence, and outbreak cases of leptospirosis among human and susceptible animals predisposed to several of the risk factors identified in Malaysia. Literature searchers and reviews were conducted based on articles published in citation index journals, Malaysian ministry of health reports, periodicals as well as reliable newspapers articles and online media platforms. In each case, the newspapers and online media reports were supported by press briefings by officials of the ministry of health and other agencies responsible. The disease is endemic in Malaysia, and this was attributed to the large number of reservoir animals, suitable humid and moist environment for proliferation as well as abundant forest resources. Over 30 different serovars have been detected in Malaysia in different domestic and wild animal species. This, in addition to the frequency of flooding which has increased in recent years, and has helped increase the risk of human exposure. Occupation, recreation, flooding and rodent population were all identified as an important source and cause of the disease within the study population. There is an urgent need for the government and other stakeholders to intensify efforts to control the spread of the disease
Agger, William A; Siddiqui, Danish; Lovrich, Steven D; Callister, Steven M; Borgert, Andrew J; Merkitch, Kenneth W; Mason, Tina C; Baumgardner, Dennis J; Burmester, James K; Shukla, Sanjay K; Welter, Joseph D; Stewart, Katharina S; Washburn, M J; Bailey, Howard H
To correlate epidemiologic factors with urogenital infections associated with preterm birth. Pregnant women were sequentially included from four Wisconsin cohorts: large urban, midsize urban, small city, and rural city. Demographic, clinical, and current pregnancy data were collected. Cervical and urine specimens were analyzed by microscopy, culture, and polymerase chain reaction for potential pathogens. Six hundred seventy-six women were evaluated. Fifty-four (8.0%) had preterm birth: 12.1% (19/157) large urban, 8.8% (15/170) midsize urban, 9.4% (16/171) small city, and 2.3% (4/178) rural city. Associated host factors and infections varied significantly among sites. Urogenital infection rates, especially Mycoplasma hominis and Ureaplasma parvum, were highest at the large urban site. Large urban site, minority ethnicity, multiple infections, and certain historical factors were associated with preterm birth by univariable analysis. By multivariable analysis, preterm birth was associated with prior preterm birth (adjusted odds ratio [aOR] 2.76, 95% confidence interval [CI] 1.27-6.02) and urinary tract infection (aOR 2.62, 95% CI 1.32-519), and negatively associated with provider-assessed good health (aOR 0.42, 95% CI 0.23-0.76) and group B streptococcal infection treatment (surrogate for health care use) (aOR 0.38, 95% CI 0.15-.99). Risk and protective factors were similar for women with birth at less than 35 weeks, and additionally associated with M hominis (aOR 3.6, 95% CI 1.4-9.7). These measured differences among sites are consistent with observations that link epidemiologic factors, both environmental and genetic, with minimally pathogenic vaginal bacteria, inducing preterm birth, especially at less than 35 weeks of gestation.
Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut
Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross-sectional de......Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross......-sectional designed study of 508 healthy males, aged 41 to 72 years. We determined total testosterone (T), sex hormone-binding globulin (SHBG), free androgen index (FAI), and estradiol (E2) and studied their relationship to body fat mass (BF), blood pressure (BP), aortic compliance, left ventricular mass (LVM...... lipids. We suggest that conflicting results of cross-sectional and intervention studies of sex hormones and lipids, in part, may be explained by interindividual differences or changes in SHBG. Thus, further studies on the potential role of SHBG in the development of ischemic heart disease (IHD) should...
Verhoeven, D.T.H.; Goldbohm, R.A.; Poppel, G. van; Verhagen, H.; Brandt, P.A. van den
This paper gives an overview of the epidemiological data concerning the cancer-preventive effect of brassica vegetables, including cabbage, kale, broccoli, Brussels sprouts, and cauliflower. The protective effect of brassicas against cancer may be due to their relatively high content of
Fuster-Parra, P; Tauler, P; Bennasar-Veny, M; Ligęza, A; López-González, A A; Aguiló, A
An extensive, in-depth study of cardiovascular risk factors (CVRF) seems to be of crucial importance in the research of cardiovascular disease (CVD) in order to prevent (or reduce) the chance of developing or dying from CVD. The main focus of data analysis is on the use of models able to discover and understand the relationships between different CVRF. In this paper a report on applying Bayesian network (BN) modeling to discover the relationships among thirteen relevant epidemiological features of heart age domain in order to analyze cardiovascular lost years (CVLY), cardiovascular risk score (CVRS), and metabolic syndrome (MetS) is presented. Furthermore, the induced BN was used to make inference taking into account three reasoning patterns: causal reasoning, evidential reasoning, and intercausal reasoning. Application of BN tools has led to discovery of several direct and indirect relationships between different CVRF. The BN analysis showed several interesting results, among them: CVLY was highly influenced by smoking being the group of men the one with highest risk in CVLY; MetS was highly influence by physical activity (PA) being again the group of men the one with highest risk in MetS, and smoking did not show any influence. BNs produce an intuitive, transparent, graphical representation of the relationships between different CVRF. The ability of BNs to predict new scenarios when hypothetical information is introduced makes BN modeling an Artificial Intelligence (AI) tool of special interest in epidemiological studies. As CVD is multifactorial the use of BNs seems to be an adequate modeling tool. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Rao, Xiaoquan; Montresor-Lopez, Jessica; Puett, Robin; Rajagopalan, Sanjay; Brook, Robert D
Growing evidence supports that air pollution has become an important risk factor for developing diabetes mellitus. Understanding the contributing effect of air pollution in population studies, elucidating the potential mechanisms involved, and identifying the most responsible pollutants are all required in order to promulgate successful changes in policy and to help formulate preventive measures in an effort to reduce the risk for diabetes. This review summarizes recent findings from epidemiologic studies and mechanistic insights that provide links between exposure to air pollution and a heightened risk for diabetes.
Full Text Available The incidence rate of melanoma and non-melanoma skin cancer entities is dramatically increasing worldwide. Exposure to UVB radiation is known to induce basal and squamous cell skin cancer in a dose-dependent way and the depletion of stratospheric ozone has implications for increases in biologically damaging solar UVB radiation reaching the earth’s surface. In humans, arsenic is known to cause cancer of the skin, as well as cancer of the lung, bladder, liver, and kidney. Exposure to high levels of arsenic in drinking water has been recognized in some regions of the world. SCC and BCC (squamous and basal cell carcinoma have been reported to be associated with ingestion of arsenic alone or in combination with other risk factors. The impact of changes in ambient temperature will influence people’s behavior and the time they spend outdoors. Higher temperatures accompanying climate change may lead, among many other effects, to increasing incidence of skin cancer.
Fabbrocini, Gabriella, E-mail: email@example.com [Department of Systematic Pathology, Division of Dermatology, University of Naples Federico II, Naples (Italy); Triassi, Maria [Department of Preventive Medical Sciences, Division of Hygiene, University of Naples Federico II Naples (Italy); Mauriello, Maria Chiara [Department of Systematic Pathology, Division of Dermatology, University of Naples Federico II, Naples (Italy); Torre, Guglielma [Department of Preventive Medical Sciences, Division of Hygiene, University of Naples Federico II Naples (Italy); Annunziata, Maria Carmela; Vita, Valerio De; Pastore, Francesco; D’Arco, Vincenza; Monfrecola, Giuseppe [Department of Systematic Pathology, Division of Dermatology, University of Naples Federico II, Naples (Italy)
The incidence rate of melanoma and non-melanoma skin cancer entities is dramatically increasing worldwide. Exposure to UVB radiation is known to induce basal and squamous cell skin cancer in a dose-dependent way and the depletion of stratospheric ozone has implications for increases in biologically damaging solar UVB radiation reaching the earth’s surface. In humans, arsenic is known to cause cancer of the skin, as well as cancer of the lung, bladder, liver, and kidney. Exposure to high levels of arsenic in drinking water has been recognized in some regions of the world. SCC and BCC (squamous and basal cell carcinoma) have been reported to be associated with ingestion of arsenic alone or in combination with other risk factors. The impact of changes in ambient temperature will influence people’s behavior and the time they spend outdoors. Higher temperatures accompanying climate change may lead, among many other effects, to increasing incidence of skin cancer.
Aslam, Hafiz Muhammad; Saleem, Shafaq; Afzal, Rafia; Iqbal, Umair; Saleem, Sehrish Muhammad; Shaikh, Muhammad Waqas Abid; Shahid, Nazish
Birth asphyxia is an insult to the fetus or newborn due to failure to breath or breathing poorly, leads to decrease oxygen perfusion to various organs. According to WHO, 4 million neonatal deaths occurred each year due to birth asphyxia. Our goal was to evaluate antepartum, intrapartum, and fetal risk factors of birth asphyxia. It was a Retrospective Case control study, conducted at Neonatal Intensive Care Unit of pediatric ward (I, II, III) and in Gynecology wards (I, II, III) of Civil Hospital Karachi, Dow University of Health Sciences. Study was conducted from January 2011-November 2012. Neonates diagnosed with birth asphyxia were considered as "cases" while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as "control". Demographics of both the mother and neonate were noted and Questions regarding possible risk factors were asked from mother. Ethical issues were confirmed from Institutional review board of Civil Hospital Karachi, Dow University of Health Sciences. All data was entered and analyzed through SPSS 19. Out of total 240 neonates, 123 were "cases" and 117 were "control". Mean maternal age in "case" group was 24.22 ± 3.38 while maternal age of control group was 24.30 ± 4.04. Significant antepartum risk factors were maternal age of 20-25 (OR 0.30 CI 95% 0.07-1.21), booking status (OR 0.20 CI 95% 0.11-0.37), pre-eclampsia (OR 0.94 CI 95% 0.90-0.98) and primigravidity (OR 2.64 CI 95% 1.56-4.46). Significant Intrapartum risk factors were breech presentation (OR 2.96 CI 95% 1.25-7.02), home delivery (OR 16.16 CI 95% 3.74-69.75) and maternal fever (OR 10.01 CI95% 3.78-26.52). Significant Fetal risk factors were resuscitation of child (OR 23 CI 95% 31.27-1720.74), pre-term babies(OR 0.34 CI 95% 0.19-0.58), fetal distress (OR 0.01 CI 95% 0.00-0.11) and baby weight (OR 0.13 CI 95% 0.05-0.32). Measures should be taken to prevent neonatal mortality with great emphasis on skilled attendance at birth
Brachner, A.; Grosche, B.
The study gives a survey of the factors most frequently mentioned in the literature as factors likely to adversely affect a pregnancy. One essential aspect is the discussion of those factors that can be counted among the causes of malformations, as among others, prenatal radiation exposure. The study prepared within the framework of the research project 'Radiobiological environmental monitoring in Bavaria' is intended to serve as a basis for a retrospective and prospective evaluation of infant mortality, perinatal conditions and occurrence of malformations in Bavaria, with the principal idea of drawing up an environment - related health survey. The study therefore, in addition to ionizing radiation also takes into account other detectable risks within the ecologic context, as e.g. industrial installations, refuse incineration plants or waste dumps, or urbanity. (orig./MG) [de
Edwards, Lauren E; Mezuk, Briana
Depression is increasingly recognized as a risk factor for type 2 diabetes, and is also commonly comorbid with anxiety. However, few studies have examined whether anxiety is predictive of diabetes risk. The objectives of this study are to examine the prospective relationship between anxiety disorders (generalized anxiety disorder, panic disorder, social phobia, and agoraphobia) and risk of type 2 diabetes over an 11-year period, and to investigate the association between anxiety and risk of diabetes-related complications among those with prevalent type 2 diabetes. Data come from the 1993/6 and 2004/5 waves of the Baltimore Epidemiologic Catchment Area Study (N=1920), a population-based prospective cohort. Anxiety disorders were assessed using the Diagnostic Interview Schedule. The prospective association between anxiety and incident type 2 diabetes was evaluated using a series of nested multivariable logistic regression models. At baseline, 315 participants (21.8%) had an anxiety disorder. The relationship between anxiety and risk of developing type 2 diabetes was not statistically significant after controlling for demographic characteristics (Odds Ratio (OR): 1.28, 95% Confidence Interval (CI): 0.75, 2.18). There was no relationship between anxiety and diabetes risk after controlling for health behaviors and depression status (OR: 1.00, 95% CI: 0.53, 1.89). There was no significant relationship between anxiety and development of diabetes-related complications among those with prevalent type 2 diabetes (OR: 2.02, 95% CI: 0.61, 6.74). Anxiety disorders are not associated with increased risk of type 2 diabetes or risk of diabetes complications among those who have diabetes. Copyright © 2012 Elsevier Inc. All rights reserved.
Bishehsari, Faraz; Mahdavinia, Mahboobeh; Vacca, Michele; Malekzadeh, Reza; Mariani-Costantini, Renato
Colorectal cancer (CRC) is one of the leading causes of cancer and cancer-related mortality worldwide. The disease has been traditionally a major health problem in industrial countries, however the CRC rates are increasing in the developing countries that are undergoing economic growth. Several environmental risk factors, mainly changes in diet and life style, have been suggested to underlie the rise of CRC in these populations. Diet and lifestyle impinge on nuclear receptors, on the intestinal microbiota and on crucial molecular pathways that are implicated in intestinal carcinogenesis. In this respect, the epidemiological transition in several regions of the world offers a unique opportunity to better understand CRC carcinogenesis by studying the disease phenotypes and their environmental and molecular associations in different populations. The data from these studies may have important implications for the global prevention and treatment of CRC.
Picciotto, I.-H.; Neutra, R.; Alexeeff, G.; Lipsett, M.; Holtzman, D. (California Department of Health Services, Berkeley, CA (USA))
Quantitative assessment of cancer is an important health policy application of environmental epidemiology. This paper addresses how epidemiology can reduce uncertainty in estimates of cancer risk from environmental exposures. To extrapolate to low levels, epidemiologic studies need well-qualified exposure data, adequate control of confounding, and a positive dose-response trend. In cases such as cadmium and arsenic, a critical issue is the shape of the dose-response curve. The data on arsenic suggest that assumption of linearity may under-estimate risk. Other uncertainties arise in extrapolating from adult males in occupational settings to a heterogeneous population exposed environmentally. Epidemiologic studies with less exposure data or negative findings may be used for a risk assessment based on animal data (e.g., ethylene dibromide, ethylene oxide, and methylene chloride). Then the hypothesized effect level for humans depends on the animal-based potency and estimated human exposures. Therefore, statistical power hinges on study size and on exposure levels (ethylene oxide, methylene chloride, and saccharin). Comparisons of human epidemiologic data and animal bioassays may permit the rejection of models and a narrowing of the range of plausible risks (e.g., ethylene dibromide, cadmium), or suggest that the animal-based assessment is not contradicted by the epidemiologic data (e.g., ethylene oxide, acrylonitrile, methylene chloride).
Background: The prevalence and incidence of HCV infection varies geographically due to exposure to different risk factors. Identification of HCV genotype is important to defining the epidemiology of the disease. The objective of this study was to describe genotype distribution and its relation to risk factors among HCV ...
Full Text Available It is unclear whether the different histologic subtypes of epithelial ovarian carcinoma have different risk factors. We investigated the relationships between selected epidemiologic variables (i.e., parity, family history of ovarian cancer, oral contraceptive use, a history of tubal ligation and noncontraceptive estrogen use and the major histologic subtypes of epithelial ovarian cancer in a hospital-based case-control study of adult women at Roswell Park Cancer Institute in Buffalo, NY, USA. Multivariate unconditional logistic regression models were used for statistical analysis. We observed a pattern of increased risk associated with family history and a pattern of risk reduction associated with parity, noncontraceptive estrogen use and tubal ligation across all histologic subtype groups. However, we did not observe a consistent pattern of risk associated with oral contraceptive use. These results provide some additional support for the hypothesis that the effects of various ovarian cancer risk factors may differ according to the histologic subtype.
Mtibaa, L; Fakhfakh, N; Kallel, A; Belhadj, S; Belhaj Salah, N; Bada, N; Kallel, K
To determine epidemiological, clinical and mycological characteristics of vulvovaginal candidiasis (VVC) in Tunisian population and to evaluate predisposing factors. In this retrospective study, 2160 vaginal swabs were performed over 2 years (January 2014-December 2015). It was carried out at the laboratory of Parasitology and Mycology, Rabta Hospital in Tunisia. After swab collecting, direct examination and culture on Sabouraud Chloramphenicol and Sabouraud Chloramphenicol Actidione media were implemented to research yeasts. Then identifying of yeast species was through chlamydosporulation test and auxanogram. For each patient, a questionnaire was filled noting age, medical and surgical history, symptoms and risk factors. Statistical analysis of data was performed on SPSS 16 using Khi 2 test, P<0.05 was considered significant. Direct examination was positive showed spore and/or pseudohypha in 24.72%. Candida albicans was isolated most frequently (76.61%) followed by Candida glabrata (17.18%). The maximum frequency of Candida-positive cultures was in 25-34 years old age group. Leucorrhea was the most common symptom (72.25%) followed by vulvar prurits (63.23%), dyspareunia (32.25%) and urinary burning (24.92%). Only pregnancy was correlated positively with VVC. It appears from our study that VVC is relatively common in Tunisia. His diagnosis results from confrontation of anamnestic, clinical and mycological data. The knowledge of risk factors and their correction would be necessary to prevent the occurrence of VVC, especially in its recurrent form. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Because of the concern of people, a study of mortality has previously been conducted in two Pennsylvania counties located near manufacturing and reprocessing plants of nuclear materials over the period 1950-1995. No excessive mortality has been identified in the population exposed counties in comparison to control counties. The current study is the continuation of the previous study of mortality over a period of eight additional years (up to 2004) and the addition of a study of cancer incidence over the period 1990-2004 and mortality for causes out of cancer from 1996 to 2004. Method: The population of each county of the study was compared to the population of three control counties selected according to socioeconomic and demographic characteristics, the same way as in the previous study. The demographic, mortality and incidence data for the different counties have been earned at the state of Pennsylvania. Results: over the period 1996-2004, mortality from cancer (10 457 deaths) in the two counties studied was comparable to that of six control counties (relative risk .97 [95% CI .94 -. 99]) and previous results. Similarly, the incidence of cancer was similar in the counties studied (39350 cases of cancer) and the control counties (relative risk .99 [95% CI .97-1.00]). The number of deaths unrelated to cancer was 36 565, very close to the expected number (relative risk .99 [95% CI 1.01-1.01]). Conclusion: Overall, no increase in cancer or non-cancer disease could be attributed to living in counties that had manufacturing and reprocessing plants of nuclear materials. (N.C.)
Deilami, Kaveh; Hayes, John F; McGree, James; Goonetilleke, Ashantha
Clear identification of areas vulnerable to waterborne diseases is essential for protecting community health. This is particularly important in developing countries where unsafe disposal of domestic wastewater and limited potable water supply pose potential public health risks. However, data paucity can be a compounding issue. Under these circumstances, landscape epidemiology can be applied as a resource efficient approach for mapping potential disease risk areas associated with poor sanitation. However, in order to realise the full potential offered by this approach, an in-depth understanding of the impact of different classes of an explanatory variable on a target disease and the validity of hotspot analysis using limited datasets is needed. Accordingly, this research study focused on typhoid and diarrhoea incidence with respect to different classes of elevation, flood inundation, land use, soil permeability, population density and rainfall as explanatory variables. An integrated methodology consisting of hot spot analysis and Poisson regression was employed to map potential disease risk areas. The study findings confirmed the significant differences in the influence exerted by the various classes of an explanatory variable in relation to a target disease. The results also confirmed the feasibility of the hotspot analysis for identifying areas vulnerable to the target diseases using a limited dataset. The study outcomes are expected to contribute to creating an in-depth understanding of the relationship between disease prevalence and associated landscape factors for the delineation of disease risk zones in the context of data paucity. Copyright © 2017 Elsevier Ltd. All rights reserved.
Zákutná, Ľubica; Dorko, Erik; Mattová, Eva; Rimárová, Kvetoslava
IIntroduction and objective. The aim of the presented cross-sectional sero-epidemiological study was to determine the current presence of antibodies against B. burgdorferi s.l. in the high-risk groups of the Slovak population, and to identify potential risk factors to LB infections. A group of 277 agricultural and forestry workers - persons with frequent stay in the countryside and employees of State Border and Customs Police - from years 2011-2012 in the Eastern Slovakia were examined in order to assess the seroprevalence of anti-Borrelia antibodies. Sera were screened by commercial enzyme-linked immunosorbent assay (ELISA). The study subjects completed a questionnaires with general demographic, epidemiological and clinical data. The results were evaluated statistically. A 25.3% presence of positive and 8.7% presence of borderline IgG antibodies was detected in all investigated groups. The seroprevalence of B. burgdorferi s.l. was significantly higher (P<0.05) among the agricultural and forestry workers when compared to employees of State Border and Customs Police. Higher seropositivity was observed in older subjects over 30 years of age (P=0.004) than those who were younger, and also in males (P=0.045). A significant number of persons with rheumatologic conditions was statistically higher (P=0.020) in the group with seropositivity than in the group with seronegativity. The presented study confirms the higher risk of Borrelia infection in individuals with frequent exposure to ticks in eastern Slovakia. The seropositivity tests confirmed the highest seropositivity in agriculture and forestry workers, middle positivity was confirmed among other sector workers, and lowest positivity in policemen and employees of the Customs and Border Inspection. The outputs also simultaneously filling the gap of missing seroprevalence data among these exposed groups.
Osteoporosis is a major public health problem all over the world. Caucasian women have the highest risk. Osteoporosis affects about 10% of the total population but the prevalence among postmenopausal women is more than 30%. It had long been stated that general osteoporosis played no role in the etiology of destructive periodontitis with inflammatory nature. Nevertheless a substantial number of publications in recent years indicated just an opposite relationship. It has been shown that total body calcium and bone density was closely associated with mandibular bone density and several studies have demonstrated close relationship between edentulism and systemic osteopenia. Certain data showed clear relationship between osteoporosis and periodontal disease, and osteoporosis is considered as one of the risk factors for periodontal bone loss. Both osteoporosis and periodontal disease are chronic multifactorial diseases with many genetic and behavioral risk factors and determinants. Both diseases can be successfully controlled by eliminating several risk factors. Estrogen replacement therapy can be protective against both postmenopausal osteoporosis and severe periodontitis in postmenopausal women. Tobacco smoking and diet are also important risk factors for both diseases and genetic factors have also been identified as important risk factors in the etiology of both diseases. Recent epidemiological and clinical data provides limited but convincing evidence suggesting an association between osteoporosis and periodontal disease, and many common risk factors could have been detected in the etiology of both diseases.
Radiation risk estimates may be made for an increase in mortality from, or for an increase in incidence of, particular types of disease. For both endpoints, two numerical systems of risk expression are used: the absolute risk system (usually the excess deaths or cases per million persons per year per rad), and the relative risk system (usually excess deaths or cases per year per rad expressed as a percentage of those normally expected). Risks may be calculated for specific age groups or for a general population. An alternative in both risk systems is the estimation of cumulative of lifetime risk rather than annual risk (e.g. in excess deaths per million per rad over a specified long period including the remainder of lifespan). The derivation of both absolute and relative risks is illustrated by examples. The effects on risk estimates of latent period, follow-up time, age at exposure and age standardization within dose groups are illustrated. The dependence of the projected cumulative (lifetime) risk on the adoption of a constant absolute risk or constant relative risk is noted. The use of life-table data in the adjustment of cumulative risk for normal mortality following single or annual doses is briefly discussed
Li, K.; Huesing, A.; Fortner, R. T.; Tjonneland, A.; Hansen, L.; Dossus, L.; Chang-Claude, J.; Bergmann, M.; Steffen, A.; Bamia, C.; Trichopoulos, D.; Trichopoulou, A.; Palli, D.; Mattiello, A.; Agnoli, C.; Tumino, R.; Onland-Moret, N. C.; Peeters, P. H.; Bueno-de-Mesquita, H. B(as); Gram, I. T.; Weiderpass, E.; Sanchez-Cantalejo, E.; Chirlaque, M-D; Duell, E. J.; Ardanaz, E.; Idahl, A.; Lundin, E.; Khaw, K-T; Travis, R. C.; Merritt, M. A.; Gunter, M. J.; Riboli, E.; Ferrari, P.; Terry, K.; Cramer, D.; Kaaks, R.
Background: Ovarian cancer has a high case-fatality ratio, largely due to late diagnosis. Epidemiologic risk prediction models could help identify women at increased risk who may benefit from targeted prevention measures, such as screening or chemopreventive agents. Methods: We built an ovarian
Full Text Available The objective of the article is to analyse and present the classification of risks actual to derivative securities. The analysis is based on classical and modern literature findings and analysis of newest statistical data. The analysis led to the conclusion, that the main risks typical for derivatives contracts and their traders are market risk, liquidity risk, credit and counterparty risk, legal risk and transactions risk. Pricing risk and systemic risk is also quite important. The analysis showed that market risk is the most important kind of risk that in many situations influences the level of remaining risks.
Curhan, Gary C.
Epidemiology has improved our understanding and management of stone. These types of studies have quantified changes in patterns and burden of disease, while identification of risk factors has changed clinical practice and provided insight into pathophysiologic processes related to stone formation. Because nephrolithiasis is a complex disease, an understanding of the epidemiology, particularly the interactions among different factors, may help lead to approaches that reduce the risk of stone f...
Barnard, Neal; Levin, Susan; Trapp, Caroline
Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption), as a scalar variable (i.e., gradations of meat consumption), or as part of a broader dietary pattern. PMID:24566443
Full Text Available Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption, as a scalar variable (i.e., gradations of meat consumption, or as part of a broader dietary pattern.
Wang, Zhong-Xu; Qin, Ru-Li; Li, Yu-Zhen; Zhang, Xue-Yan; Jia, Ning; Zhang, Qiu-Ling; Li, Gang; Zhao, Jie; Li, Huan-Huan; Jiang, Hai-Qiang
To investigate the work-related musculoskeletal disorders among automobile assembly workers, to discusses the related risk factors and their relationship. The selected 1508 automobile assembly workers from a north car manufacturing company were regarded as the study object. The hazard zone jobs checklist, Nordic musculoskeletal symptom questionnaire (NMQ) and pain questionnaire were used to perform the epidemiological cross-sectional and retrospective survey and study for the General status, awkward ergonomics factors and related influencing factors, and musculoskeletal disorders of workers. The predominant body sites of occurring WMSDs among automobile assembly workers were mainly low back, wrist, neck and shoulders, the predominant workshop section of occurring WMSDs were mostly concentrated in engine compartment, interior ornament, door cover, chassis and debugging section. The predominant body site of WMSDs among engine compartment and chassis section workers was low back, interior ornament workers were low back and wrist, door cover workers was wrist, chassis workers was low back, debugging workers were neck and low back. Neck musculoskeletal disorders had the trend with the increase of a body height; Smoking may increase the occurrence of musculoskeletal disorders. The WMSDs appears to be a serious ergonomic proble assem among automobile assembly workers, predominant occurring site of WMSDs is with different workshop section, its characteristics is quite obvious, probably related to its existing awkward work position or activities. The worker height and smoking habits may be important factors which affect musculoskeletal disorders happen.
Rao, Xiaoquan; Patel, Priti; Puett, Robin; Rajagopalan, Sanjay
Recent studies in both humans and animals suggest that air pollution is an important risk factor for type 2 diabetes mellitus (T2DM). However, the mechanism by which air pollution mediates propensity to diabetes is not fully understood. While a number of epidemiologic studies have shown a positive association between ambient air pollution exposure and risk for T2DM, some studies have not found such a relationship. Experimental studies in susceptible disease models do support this association and suggest the involvement of tissues involved in the pathogenesis of T2DM such as the immune system, adipose, liver, and central nervous system. This review summarizes the epidemiologic and experimental evidence between ambient outdoor air pollution and T2DM. © The Author 2015. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: firstname.lastname@example.org.
Rao, Xiaoquan; Patel, Priti; Puett, Robin; Rajagopalan, Sanjay
Recent studies in both humans and animals suggest that air pollution is an important risk factor for type 2 diabetes mellitus (T2DM). However, the mechanism by which air pollution mediates propensity to diabetes is not fully understood. While a number of epidemiologic studies have shown a positive association between ambient air pollution exposure and risk for T2DM, some studies have not found such a relationship. Experimental studies in susceptible disease models do support this association and suggest the involvement of tissues involved in the pathogenesis of T2DM such as the immune system, adipose, liver, and central nervous system. This review summarizes the epidemiologic and experimental evidence between ambient outdoor air pollution and T2DM. PMID:25628401
Mishra, Apurva; Pandey, Ramesh K
To determine the prevalence of molar incisor hypomineralization (MIH) in Indian children and to analyze the possible etiological factors. First permanent molars and all permanent incisors were examined in 1,369 children aged 8 to 12 years. Examinations were performed by two calibrated observers. The subjects were evaluated using judgment criteria proposed by Weerheijm et al in 2003. The parents accompanying children were given a questionnaire regarding pre- and postnatal history of the children. A total of 191 children were diagnosed with MIH with a prevalence of 13.9%. Chi-square/Fisher exact test was used to compare the dichotomous variables. The relative risk with its 95% confidence interval was calculated to find the risk of clinical infections, such as chicken pox, jaundice, renal disorders, cardiac disorders, and affected molars with sex and type of delivery. Pre- and postnatal history of infection in a child was significantly correlated with the prevalence of MIH. The prevalence of MIH was 13.9% in the age group of 8 to 12 years. Prenatal and postnatal infections play an important role in hypomineralization of molars and incisors. How to cite this article: Mishra A, Pandey RK. Molar Incisor Hypomineralization: An Epidemiological Study with Prevalence and Etiological Factors in Indian Pediatric Population. Int J Clin Pediatr Dent 2016;9(2):167-171.
Porten, Sima P; Cooperberg, Matthew R
Nonmuscle invasive bladder cancer represents a large majority of patients diagnosed with this disease. Precise definition and risk stratification are paramount in this group as high-risk patients have higher rates of progression and mortality and may benefit from early identification and aggressive treatment. The mainstay definitions of high-risk nonmuscle invasive bladder cancer are based on grade and stage. Recently, efforts have been made to incorporate other clinical variables into multivariate risk assessment tools and nomograms to predict disease behavior and guide management. Variant histology and molecular biomarkers are being explored as tools to refine risk stratification; however, results are still preliminary and need validation. Future research should concentrate on ways to better risk-stratify patients and identify early those that are most likely to recur and progress quickly. Topics of focus should be on better multivariate risk assessment tools and nomograms providing continuous scales and incorporating molecular markers with validation in large multi-institutional cohorts.
Conclusions: Hypocitraturia and hypomagnesuria were the most frequent risk factors associated with urolithiasis, followed by hypercalciuria. High PTH values were excluded. Children presented two or more risk factors for urolithiasis.
Field, Tiffany; Diego, Miguel; Sanders, Christopher
Seventy-nine high school seniors were administered the Center for Epidemiological Studies Depression Scale (CES-D), as well as a questionnaire on parent relationships; peer relationships; positive and negative feelings including suicidal thoughts; and lifestyle variables including academic performance, exercise, and drug use. Results are discussed…
Littlejohns, Thomas J; Travis, Ruth C; Key, Tim J; Allen, Naomi E
The central role of prostate-specific antigen (PSA) testing in the diagnosis of prostate cancer leads to the possibility that observational studies that report associations between risk factors and prostate cancer could be affected by detection bias. This study aims to investigate whether reported risk factors for prostate cancer are associated with PSA testing in a large middle-aged population-based cohort in the UK. The cross-sectional association between a wide range of sociodemographic, lifestyle, dietary and health characteristics with PSA testing was examined in 212,039 men aged 40-69 years in UK Biobank. A total of 62,022 (29%) men reported they had ever had a PSA test. A wide range of factors was associated with a higher likelihood of PSA testing including age, height, education level, family history of prostate cancer, black ethnic origin, not being in paid/self-employment, living with a wife or partner, having had a vasectomy, being diagnosed with cancer or hypertension and having a high dietary intake of cereal, cooked and salad/raw vegetables, fresh fruit and tea. Conversely, socioeconomic deprivation, Asian ethnic origin, current smoking, low alcohol intake, high body-mass index, high coffee consumption and being diagnosed with diabetes, heart disease or stroke were associated with a lower likelihood of PSA testing. A variety of sociodemographic, lifestyle and health-related characteristics are associated with PSA testing, suggesting that observed associations of some of these traits with risk for prostate cancer in epidemiological studies may be, at least partially, due to detection bias. Copyright Â© 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Deng, R Z; Jiao, W; Mu, L G; Chen, K; Li, G; Huang, W; Wang, R X; Tan, S R
Objective: The aim of this study was to investigate the response in health-related epidemiological investigation among Chinese population aged 15 and over. We analyzed the specific causes of non-response, and explored the effective ways to improve the response rate, so as to provide reference for future epidemiological studies of this kind. Methods: Two modes of studies regarding the prevalence of important cardiovascular diseases were used in Chongqing, during the 12(th) Five-Year Plan period in oder to find out the cause related to non-response. Intervention programs were carried out to evaluate the effects. Results: When using the concentrated mode (CM), the completion rate to the questionnaires was only 20.00 % in the pre-investigation, with the response rate as 13.48 % . In the deconcentrated mode (DM), the completion rate was 31.16 % , with the response rate as 25.19 % . After a series of incentives provided to both the respondents and the project-related core staff in the two modes, response rates of the two modes increased to the expected 60 % . Conclusions: CM appeared having advantages on quality control, but was more time consuming, with higher cost, and without effective follow-up measures to improve the response rate. However, DM had the advantages on controlling the cost and could increase the response rate through making advanced appointment with the households but quality control remained difficult. Two key points should be strengthened to improve the response rates, which including: Precisely finding out the research objects and providing incentives to the respondents to attract their interests of participating in the investigation.
Copeland, William; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian
Background: Co-occurrence of psychosocial risk factors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial risk factors. Methods: Latent class analysis (LCA) was applied to 17 putative psychosocial risk factors in a representative population sample of 920 children ages 9 to 17. The resultant class…
Modai, Shira; Shomron, Noam
Schizophrenia (SZ) is a complex and strongly heritable mental disorder, which is also associated with developmental-environmental triggers. As opposed to most diagnosable diseases (yet similar to other mental disorders), SZ diagnosis is commonly based on psychiatric evaluations. Recently, large-scale genetic and epigenetic approaches have been applied to SZ research with the goal of potentially improving diagnosis. Increased computational analyses and applied statistical algorithms may shed some light on the complex genetic and epigenetic pathways contributing to SZ pathogenesis. This review discusses the latest advances in molecular risk factors and diagnostics for SZ. Approaches such as these may lead to a more accurate definition of SZ and assist in creating extended and reliable clinical diagnoses with the potential for personalized treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.
Full Text Available Falls are a common and serious problem for older adults. Approximately one-third of older communitydwelling people fall at least once a year. The main purpose of this paper is to present risk factors for fall in older people living at home. The databases used for identifying documentation of risk factors are Cinahl, Eric, ISI Web of Science, Cochrane Medline, Psycinfo and dissertation. Many psychosocial and medical conditions and impairment of sensorimotor function, balance and gait have been shown in large epidemiological studies to be strongly associated with falls. Several of the risk factors are interrelated. The intrinsic-extrinsic distinction seem to be an oversimplification. A better understanding of falls is usually obtained when examining the person in association with the environmental factors. Advanced age, history of falls, ADL limitations, impaired gait and mobility, visual impairment, reduced sensation, muscular weakness, poor reaction time, impaired cognition, diseases as stroke, use of psychoactive medication and use of many medications are risk factors shown to be strongly associated with falls. This means recommendation of multifactorial fall risk assessment must incorporate a range of physiological and mental tests in addition to assessing balance and gait as well as taking multiple chronic diseases and medications into account. These finding underscore the importance of multidimensional fall intervention with special focus on modifiable risk factors
Ibrahim, Y W; Boase, D L; Cree, I A
The aim of the study was to identify the epidemiological characteristics, predisposing factors, and the clinical and microbiological diagnosis of infectious corneal ulcers in a population based in southern England. A retrospective review was undertaken of the medical records of patients presenting with infectious corneal ulcers at the eye casualty department of Queen Alexandra Hospital, Portsmouth, UK, between January 1997 and December 2003. A total of 1786 patients presented with infectious corneal ulcers, with a mean age of 45 years and female predominance (54.5%). Contact lens wear was the main predisposing factor in 554 patients (31%). Corneal scrapes from 1254 patients grew positive cultures in 800 patients. Gram-positive bacteria accounted for 696 (71.1%) of the total 979 bacterial isolates, while Gram-negative bacteria accounted for 283 (28.9%) with the predominance of Pseudomonas aeruginosa. Nine out of 11 patients with Acanthamoeba keratitis were contact lens wearers. The majority of patients 1728 (96.8%) sought medical help more than once and 34 patients (1.9%) had poor visual outcome. Follow-up was completed in 1633 patients (91.4%) with an average of 11.5 days. Wearing contact lenses remains the most important risk factor for infectious corneal ulcers. Reduction of the rate and severity of infectious keratitis requires continuous education of patients, and of professionals.
Seidell, J C; Hautvast, J.G.A.J.; Deurenberg, P.
Several expert panels have recommended the use of a body mass index (BMI = weight/height2) to assess obesity. Excessive risks of chronic diseases and mortality are clear when BMI exceeds 30 kg/m2. Probably more important in assessing the health risks of excessive fat stores is the distribution of
Boehme, Amelia K; Esenwa, Charles; Elkind, Mitchell S V
Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends on the specific pathogenesis of stroke. Risk factors for stroke can be categorized as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet, and physical inactivity are among some of the more commonly reported modifiable risk factors. More recently described risk factors and triggers of stroke include inflammatory disorders, infection, pollution, and cardiac atrial disorders independent of atrial fibrillation. Single-gene disorders may cause rare, hereditary disorders for which stroke is a primary manifestation. Recent research also suggests that common and rare genetic polymorphisms can influence risk of more common causes of stroke, due to both other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic factors, particularly those with environmental interactions, may be more modifiable than previously recognized. Stroke prevention has generally focused on modifiable risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular diseases. Other prevention strategies include identifying and treating medical conditions, such as hypertension and diabetes, that increase stroke risk. Recent research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention. © 2017 American Heart Association, Inc.
Mirza, N M; Caulfield, L E; Black, R E; Macharia, W M
To identify child feeding behavior and household hygiene practices that are risk factors for prolonged diarrheal illness, a longitudinal community study was conducted over a 14-month period among 920 children aged 3-37 months who lived in an urban slum settlement in Nairobi, Kenya. Morbidity surveillance was done by home visits every third day in the absence of diarrhea and daily during diarrheal illness until termination of the episode. In-home observations were made to characterize maternal hygiene, cooking, and child feeding practices. Overall, 1,496 episodes of diarrhea were detected. The average diarrheal incidence was 3.5 episodes/child-year, and the incidence of diarrhea > 14 days was 3 episodes/100 child-years. Cox regression was used to examine the independent effects of covariates on time to recovery from a diarrheal episode. Adjusted behavioral factors that were observed to influence recovery from diarrhea included: uncovered water containers (rate ratio (RR) = 0.77, 95% confidence interval (CI) 0.64-0.94); giving no fluids (as opposed to oral rehydration solutions (ORS)/sugar salt solutions (SSS)) (RR = 1.42, 95% CI 1.14-1.77); and administration of diluted cow's milk during the first 3 days of an episode (RR = 1.23, 95% CI 1.00-1.52). These associations remained significant after adjusting for diarrheal severity. The authors recommend, among other measures, improvement of water storage and promotion of continued feeding with cereal-milk mix during diarrhea.
Cabezas Cruz, Alejandro; de la Fuente, J.
Roč. 72, č. 12 (2017), s. 2044-2045 ISSN 0105-4538 Institutional support: RVO:60077344 Keywords : a-Gal * prevalence * blood type Subject RIV: EC - Immunology OBOR OECD: Immunology Impact factor: 7.361, year: 2016
Chen, Zi-Li; He, Rui-Zhi; Peng, Qian; Guo, Ke-Yu; Zhang, Yu-Qiong; Yuan, Hui-Hua; Liu, Jian-Xin
Neonatal asphyxia is the third leading cause of neonatal death and main cause of long-term neurodevelopmental handicap throughout the world. Prevention is more important than treatment. Most previous reports are limited to retrospective investigations of the relationships between some prenatal risk factors and low Apgar scores. This study was designed to prospectively investigate the relationship between prenatal risk factors and neonatal asphyxia and the influence of single or multiple risk factors on the incidence of neonatal asphyxia, and examine significant risk factors for neonatal asphyxia. From April 2002 through October 2004, a total of 10 376 live-born newborns were enrolled. Forty-six prenatal risk factors were investigated. Neonatal asphyxia was diagnosed based on the following four items: 1. 1-min Apgar score asphyxia was analyzed. The significant risk factors were screened by single logistic regression analysis and forward stepwise conditional multiple logistic regression analysis, with enrolled threshold alphaor=0.10 and pasphyxia occurred in 117 cases (1.13%) out of the 8 530 cases. In the 1 846 cases without risk factors, none had asphyxia (x2=25.6, pasphyxia increased with increasing numbers of risk factors, from 0.23% in newborns with one risk factor to 14.29% in newborns who had nine risk factors (r=0.96, pasphyxia by systematically examining prenatal risk factors and giving interventions for the newborns with risk factors, especially those with the above significant risk factors or with multiple risk factors. Proper cesareon section according to indications might be helpful to decrease the incidence of birth asphyxia.
Vizsolyi, P; Taunton, J; Robertson, G; Filsinger, L; Shannon, H S; Whittingham, D; Gleave, M
Competitive swimmers have a high incidence of breaststroke-related knee injuries. Although previous investigators have implicated the terminal phase of the kick in the injury mechanism, athletes often complain of pain during the initial phase of rearward thrust. Disagreement in the current literature surrounds the precise anatomical derangement(s) constituting "breaststroker's knee." The purpose of this investigation was to delineate the epidemiology, anatomy, and pathobiomechanics of breaststroke knee injuries. Descriptive data were obtained by surveying 391 athletes. An extremely high incidence of knee pain was documented both among breaststroke specialists (73%) and nonbreaststrokers (48%). Age, years of competitive swimming, and specific training characteristics were positively correlated with knee pain. Both the medial collateral ligament and the inferomedial patellar border were involved. A further 21 swimmers were assessed in detail using four methods: interview, physical examination, Cybex II isokinetic quadriceps and hamstring testing, and cinematographic analyses. The interview and physical examination data supported the conclusions derived from the descriptive data, while Cybex testing and kinematic film analyses failed to demonstrate statistical differences between the injured and noninjured groups. Although kinematic film analyses did not demonstrate statistical differences between cases and controls, dramatic differences in the injury rate were noted when hip abduction angles at kick initiation were less than 37 degrees or greater than 42 degrees. This bimodal increase in injury rates suggests that modification of hip abduction at kick initiation, in conjunction with altered training regimens, will lead to a reduction in medial knee joint stress and hence fewer breastroke injuries.
The International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) held its 12th Annual Meeting in January 2010. The international awareness among the issue of TBE is on the rise, as the European Center for Disease Control considers TBE of high relevance and has launched a series of activities aimed at improving awareness of this tick-transmissible infection and also the World Health Organization has taken up the cause of TBE. The epidemiology of TBE in Europe is characterized by two distinct trends, i.e., a consistent expansion of risk areas on the one hand and major fluctuations in case numbers on the other. TBE risk areas have spread both northward and to higher altitudes - a development thought to be attributable to climate changes having created more favorable living conditions for ticks. Social, political, ecological, economic, and demographic factors also have a role in this development. Preliminary data from 12 European countries show that TBE case numbers in 2009 amounted to 95.8% of those reported in 2006 when Russia is included and to 88% of 2006 data when Russia is excluded. Overall, the level of knowledge of TBE in endemic countries is quite high, but actual vaccination coverage has not kept pace.
Full Text Available Sompol PermpongkosolDivision of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandAbstract: The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units.Keywords: iatrogenic disease, elderly, risk factors, prevention
Shur, P Z; Zaĭtseva, N V; Kostarev, V G; Lebedeva-Nesevria, N A; Shliapnikov, D M
Results of health risk evaluation in workers engaged into powder metallurgy, using complex of hygienic, medical, epidemiologic and sociologic studies, enable to define priority occupational and social risk factors, to assess degree of their influence on the workers' health and to identify occupationally induced diseases.
May 16, 2017 ... 2nd ed. Berlin: Springer-Verlag; 2000. p. 585-607. 3. Albandar JM. Epidemiology and risk factors of periodontal diseases. Dent Clin North Am 2005;49:517-32. 4. Heitz-Mayfield LJA. Disease progression: Identification of high- risk groups and individuals for periodontitis. J Clin Periodontol. 2005;32:196-09.
Lonardo, Amedeo; Bellentani, Stefano; Argo, Curtis K; Ballestri, Stefano; Byrne, Christopher D; Caldwell, Stephen H; Cortez-Pinto, Helena; Grieco, Antonio; Machado, Mariana V; Miele, Luca; Targher, Giovanni
An improved understanding of non-alcoholic fatty liver disease epidemiology would lead to identification of individuals at high risk of developing chronic liver disease and extra-hepatic complications, thus contributing to more effective case finding of non-alcoholic fatty liver disease among selected groups. We aimed to illustrate the epidemiology of non-alcoholic fatty liver disease in high-risk groups, which were identified based on existing literature. To this end, PubMed was searched to retrieve original articles published until May 2015 using relevant and pertinent keywords "nonalcoholic fatty liver disease" and "diabetes", "obesity", "hyperlipidaemia", "familial heterozygous hypobetalipoproteinaemia", "hypertension", "metabolic syndrome", "ethnicity", "family history" or "genetic polymorphisms". We found that age, sex and ethnicity are major physiological modifiers of the risk of non-alcoholic fatty liver disease, along with belonging to "non-alcoholic fatty liver disease families" and carrying risk alleles for selected genetic polymorphisms. Metabolic syndrome, diabetes, obesity, mixed hyperlipidaemia and hypocholesterolaemia due to familial hypobetalipoproteinaemia are the major metabolic modifiers of non-alcoholic fatty liver disease risk. Compared with these metabolic conditions, however, arterial hypertension appears to carry a relatively more modest risk of non-alcoholic fatty liver disease. A better understanding of the epidemiology of non-alcoholic fatty liver disease may result in a more liberal policy of case finding among high-risk groups. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Kannathasan, Selvam; Murugananthan, Arumugam; Kumanan, Thirunavukarasu; de Silva, Nilanthi Renuka; Rajeshkannan, Nadarajah; Haque, Rashidul; Iddawela, Devika
Clinically diagnosed amoebic liver abscess (ALA) caused by Entamoeba histolytica has been an important public health problem in Jaffna district, northern Sri Lanka for last three decades. In order to draw up a control strategy for elimination of this condition, knowledge of its epidemiology and factors associated with this condition in the local context is vital. All clinically diagnosed ALA patients admitted to the Teaching Hospital, Jaffna during the study period were included in the study and the data were collected using an interviewer administered questionnaire. One hundred blood samples from randomly selected toddy (a local alcoholic drink consisting of the fermented sap of the Palmyrah palm) consumers and 200 toddy samples were collected. Toddy samples were cultured in Robinson's medium to establish the presence of Entamoeba histolytica in the sample. Climatic data and the total toddy sales in the district were obtained from the Meteorological and Excise Departments respectively. A sub group of randomly selected 100 patients were compared with 100 toddy consumers who were negative for E. histolytica antibody to explore the potential risk factors. Between July 2012 and July 2015, 346 of 367 ALA patients were enrolled in this study. Almost all patients (98.6%) were males with a history of heavy consumption of alcohol (100%). Almost all (94.2%) were within the age group 31-50 years. None of the cultured toddy samples grew E. histolytica. The monthly incidence of disease peaked in the dry season, matching the total toddy sales in the district. Age, type of alcohol and frequency of drinking were identified as potential risk factors whereas frequency of alcohol consumption and type of alcohol (consuming toddy and arrack) were identified as the independent risk factors. Moreover, the knowledge, attitude and practices towards ALA were poor among participants and the control group. Though the number of cases has declined in recent years, ALA still remains as an
Dagrada, H; Verbanck, P; Kornreich, C
This paper aims to review current knowledge on risk factors leading to burn-out of general practitioners, who are particularly concerned by burn-out, as 50% of them are being more or less affected. This article is based on bibliographic research covering literature between 1975 and 2010, using PUB MED software, medical books and articles. 44 articles were selected as dealing well with the aspects of the burn-out reviewed here. It seems established that stress precedes burnout symptoms. Theories investigating relationships between stress and work are presented. Exogenic stress (load and organization of work, emotional interaction with the patient, constraints, lack of recognition, conflicts between private and professional life) interacts with endogenous stress (idealism, (too much) acute feeling of responsibility, mood disorder, difficulty in collaborating, character, personality). Burn-out symptoms would appear preferentially when these two stresses coexist. Despite the wealth of publications, there is still a lack of knowledge of the causes of burn-out, requiring therefore increased research efforts, in order to improve the implementation of preventive measures, beneficial to the doctors as well as to their patients.
Mathew, Mariam; Saquib, Shabnam; Rizvi, Syed G
To determine the risk factors associated with polyhydramnios, and assess the maternal and perinatal outcome in these patients. A prospective study of all deliveries complicated with polyhydramnios in Sultan Qaboos University Hospital, Sultanate of Oman between January 2005 and April 2006. Polyhydramnios was divided into mild and moderate to severe based on the amniotic fluid index values. The demographic data, antenatal complications, gestational age at delivery, mode of delivery, postpartum complications, and perinatal outcome were studied. A total of 2648 singleton deliveries occurred during the study period. Two hundred and eight (7.8%) women with polyhydramnios formed the study group, and 2440 women with normal amniotic fluid formed the control. Polyhydramnios was mild in 179 (86.1%) and moderate to severe in 29 (13.9%) cases. Sixty-eight (32.7%) of these pregnancies were complicated with diabetes as compared with 12.4% of the controls. Preterm delivery occurred in 16 (7.7%) cases. Cesarean delivery rate was 27.9% in the study group compared with 17.3% in the control. Major congenital anomalies were found in 2.8% of newborns compared with 1% among the controls. Eighteen babies were admitted to the special care baby unit. These data demonstrates a significant positive relation with maternal age, diabetes in pregnancy, and fetal macrosomia with polyhydramnios. Anemia during pregnancy, cesarean delivery rate, and congenital anomalies were significantly higher in the study group.
Frost, P.; Kolstad, H.A.; Bonde, Jens Peter
Objective The objective of this review was to evaluate the epidemiologic evidence for a causal relation between shift work and ischemic heart disease. Methods We conducted a systematic search until the end of March 2008 for studies providing information on the relative risk of ischemic heart...
Bronsveld, Heleen K.; Ter Braak, Bas; Karlstad, Øystein; Vestergaard, Peter; Starup-Linde, Jakob; Bazelier, Marloes T.; de Bruin, Marieke; De Boer, Anthonius; Siezen, Christine L.E.; Van De Water, Bob; Van Der Laan, Jan Willem; Schmidt, Marjanka K.
Background: In 2009, the concern has been raised that insulin analogues, especially insulin glargine, might increase risk of (breast) cancer. Many in vitro and epidemiological and some animal studies have been performed, but there is still no clarity on this issue. Objectives: The aim of this study
Drinking water contaminated with microbial pathogens can cause outbreaks of infectious disease, and these outbreaks are traditionally studied using epidemiologic methods. Quantitative microbial risk assessment (QMRA) can predict – and therefore help prevent – such outbreaks, but it has never been r...
A Roadmap for Reducing Cardiac Device Infections: a Review of Epidemiology, Pathogenesis, and Actionable Risk Factors to Guide the Development of an Infection Prevention Program for the Electrophysiology Laboratory.
Cardiovascular implantable electronic device (CIED) infections are highly morbid, common, and costly, and rates are increasing (Sohail et al. Arch Intern Med 171(20):1821-8 2011; Voigt et al. J Am Coll Cardiol 48(3):590-1 2006). Factors that contribute to the development of CIED infections include patient factors (comorbid conditions, self-care, microbiome), procedural details (repeat procedure, contamination during procedure, appropriate pre-procedural prep, and antimicrobial use), environmental and organizational factors (patient safety culture, facility barriers, such as lack of space to store essential supplies, quality of environmental cleaning), and microbial factors (type of organism, virulence of organism). Each of these can be specifically targeted with infection prevention interventions. Basic prevention practices, such as administration of systemic antimicrobials prior to incision and delaying the procedure in the setting of fever or elevated INR, are helpful for day-to-day prevention of cardiac device infections. Small single-center studies provide proof-of-concept that bundled prevention interventions can reduce infections, particularly in outbreak settings. However, data regarding which prevention strategies are the most important is limited as are data regarding the optimal prevention program for day-to-day prevention (Borer et al. Infect Control Hosp Epidemiol 25(6):492-7 2004; Ahsan et al. Europace 16(10):1482-9 2014). Evolution of infection prevention programs to include ambulatory and procedural areas is crucial as healthcare delivery is increasingly provided outside of hospitals and operating rooms. The focus on traditional operating rooms and inpatient care leaves the vast majority of healthcare delivery-including cardiac device implantations in the electrophysiology laboratory-uncovered.
van Dam, R.M.
Results from ecological and migration studies indicate that a western lifestyle is associated with a higher prevalence of type 2 diabetes. In recent years, there has been a rapid accumulation of data on lifestyle and risk for type 2 diabetes from studies on an individual level. This article gives an
Virtanen, Helena E; Tapanainen, Anna E; Kaleva, Marko M
CONTEXT: Cryptorchidism is the most common malformation in newborn boys. Maternal diabetes has previously been suggested to be a risk factor for this disorder in one epidemiological study. OBJECTIVE: Evaluation of the prevalence of maternal glucose metabolism disorders during pregnancy in newborn...... boys having normal testicular descent or congenital cryptorchidism. DESIGN: Postnatal analysis of maternal history concerning glucose metabolism abnormalities during pregnancy among cryptorchid and healthy Finnish boys. SETTING AND PARTICIPANTS: The material of this case-control study comprises 1163...... diabetes diagnosis and abnormality of the result of a 2-h 75-g oral glucose tolerance test during pregnancy were obtained from the hospital records after delivery. RESULTS: After adjustment for possible confounding factors, i.e. maternal smoking during pregnancy, maternal age at delivery, and risk factors...
Prevalence, risk factors and risk perception of tuberculosis infection among medical students and healthcare workers in Johannesburg, South Africa. A van Rie, K McCarthy, L Scott, A Dow, WDF Venter, WS Stevens ...
Shimoe, Masayuki; Yamamoto, Tadashi; Iwamoto, Yoshihiro; Shiomi, Nobuyuki; Maeda, Hiroshi; Nishimura, Fusanori; Takashiba, Shogo
Multiple risk factor syndrome is a clustering of cardiovascular risk factors, such as diabetes, dyslipidemia, hypertension, and obesity associated epidemiologically with insulin resistance. This report describes the clinical course of a patient suffering from severe periodontitis with multiple risk factor syndrome, and discusses the association between periodontal infection and systemic health. The patient had a history of type 2 diabetes, dyslipidemia, and hypertension for over 10 years. At baseline, her hemoglobin A1 c was 8.1%. However, she had no diabetic complications except periodontitis. The IgG antibody titers against Porphyromonas gingivalis FDC 381 and SU63 were elevated above the mean of healthy subjects +2 standard deviations. Intensive periodontal treatment, including periodontal surgery, was performed to reduce periodontal infection and bacteremia. Her systemic and periodontal conditions were evaluated longitudinally for 10 years. Following periodontal treatment, antibody titers against Porphyromonas gingivalis and hemoglobin A1c values were significantly improved. The other clinical data and medication for her systemic condition also remained stable during supportive periodontal therapy. However, she developed myocardial infarction, and showed continuous deterioration of hemoglobin A1 c level and periodontitis. The long-term clustering of risk factors, such as diabetes, dyslipidemia, hypertension, and periodontitis, are associated with the development of myocardial infarction. Treatment of systemic conditions in combination with comprehensive periodontal treatment is important in management of patients with multiple risk factor syndrome.
Full Text Available Exposure to smoking during pregnancy is known to be one of the main modifiable risk factors, which threatens maternal and child health. Along with this factor, are not to be neglected also other risk factors belonging to lifestyle sphere, such as alcohol, sedentary, irregular daily meal serving plan, lack of knowledge.
Mendoza, Walter; Miranda, J Jaime
One of the major drivers of change in the practice of cardiology is population change. This article discusses the current debate about epidemiologic transition paired with other ongoing transitions with direct relevance to cardiovascular conditions. Challenges specific to patterns of risk factors over time; readiness for disease surveillance and meeting global targets; health system, prevention, and treatment efforts; and physiologic traits and human-environment interactions are identified. This article concludes that a focus on the most populated regions of the world will contribute substantially to protecting the large gains in global survival and life expectancy accrued over the last decades. Copyright Â© 2016 Elsevier Inc. All rights reserved.
Objectives. To describe the diarrhoea admissions and the influencing factors in 6 - 60-month-old children at Morogoro Regional Hospital. Design. A retrospective descriptive study of the type of diarrhoea, patient age, home address, nutritional status, diagnosed infection, month of admission, admission duration and outcome ...
Fu, Wenning; Wang, Chao; Zou, Li; Liu, Qiaoyan; Gan, Yong; Yan, Shijiao; Song, Fujian; Wang, Zhihong; Lu, Zuxun; Cao, Shiyi
An increasing amount of original studies suggested that exposure to noise could be associated with the risk of hypertension, but the results remain inconsistent and inconclusive. We aimed to synthesize available epidemiological evidence about the relationship between various types of noise and hypertension, and to explore the potential dose-response relationship between them in an up-to-date meta-analysis. We conducted a literature search of PubMed and Embase from these databases' inception through December 2016 to identify observational epidemiological studies examining the association between noise and risk of hypertension. A random effects model was used to combine the results of included studies. Dose-response meta-analysis was conducted to examine the potential dose-response relationship. In total, 32 studies (five cohort studies, one case-control study, and 26 cross-section studies) involving 264 678 participants were eligible for inclusion. Pooled result showed that living or working in environment with noise exposure was significantly associated with increased risk of hypertension (odds ratio 1.62; 95% confidence interval: 1.40-1.88). We found no evidence of a curve linear association between noise and risk of hypertension. A dose-response analysis suggested that, for an increment of per 10 dB(A) of noise, the combined odds ratio of hypertension was 1.06 (95% confidence interval: 1.04-1.08). Integrated epidemiological evidence supports the hypothesis that exposure to noise may be a risk factor of hypertension, and there is a positive dose-response association between them.
U.S. Department of Health & Human Services — The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive...
Mendoza, Walter; Miranda, J. Jaime
One of the major drivers of change in the practice of cardiology, in both developed and developing countries, is population change, whose dynamics can be expressed by secular epidemiological and demographic trends, with increasing survival and life expectancy across all age strata. The sole concept of transition, whether epidemiological or demographic, is quite dynamic. From a global health point of view, one element merits attention: developed countries have had longer time to double or triple their population, usually more than one century, whereas the same increases in population size in the developing world occurred just over decades. The epidemiological transition theory, far from being perfect, introduced a booster to the understanding of the changing dynamics of epidemiological profiles and provided a complement to the discourse of the demographic change. In this article, with an special emphasis on the challenges faced by low- and middle-income settings, we describe current debates of the epidemiological transition paired with other ongoing transitions with direct relevance to cardiovascular conditions. Challenges specific to patterns of risk factors over time; readiness for disease surveillance and meeting global targets; health systems, prevention and treatment efforts; and physiological traits and human-environment interactions are identified. These challenges provide also an opportunity to redefine the agenda of global health cardiology and global cardiovascular research. This article concludes that a focus on the most populated regions of the world, who bear the highest disease burden related to cardiovascular conditions, will contribute substantially to protect the large gains in global survival and life expectancy accrued over the last decades. It then follows that a renewed workforce in global health cardiology must swiftly adapt to these changing environments. As the world changes, the practice of cardiology, clinical cardiology, global health
David G. Hoel, PhD
The basic purpose of this one year research grant was to extend the two stage clonal expansion model (TSCE) of carcinogenesis to exposures other than the usual single acute exposure. The two-stage clonal expansion model of carcinogenesis incorporates the biological process of carcinogenesis, which involves two mutations and the clonal proliferation of the intermediate cells, in a stochastic, mathematical way. The current TSCE model serves a general purpose of acute exposure models but requires numerical computation of both the survival and hazard functions. The primary objective of this research project was to develop the analytical expressions for the survival function and the hazard function of the occurrence of the first cancer cell for acute, continuous and multiple exposure cases within the framework of the piece-wise constant parameter two-stage clonal expansion model of carcinogenesis. For acute exposure and multiple exposures of acute series, it is either only allowed to have the first mutation rate vary with the dose, or to have all the parameters be dose dependent; for multiple exposures of continuous exposures, all the parameters are allowed to vary with the dose. With these analytical functions, it becomes easy to evaluate the risks of cancer and allows one to deal with the various exposure patterns in cancer risk assessment. A second objective was to apply the TSCE model with varing continuous exposures from the cancer studies of inhaled plutonium in beagle dogs. Using step functions to estimate the retention functions of the pulmonary exposure of plutonium the multiple exposure versions of the TSCE model was to be used to estimate the beagle dog lung cancer risks. The mathematical equations of the multiple exposure versions of the TSCE model were developed. A draft manuscript which is attached provides the results of this mathematical work. The application work using the beagle dog data from plutonium exposure has not been completed due to the fact
Failure to initiate early insulin therapy - A risk factor for diabetic retinopathy in insulin users with Type 2 diabetes mellitus: Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS, Report number 35).
Gupta, Aditi; Delhiwala, Kushal S; Raman, Rajiv P G; Sharma, Tarun; Srinivasan, Sangeetha; Kulothungan, Vaitheeswaran
Insulin users have been reported to have a higher incidence of diabetic retinopathy (DR). The aim was to elucidate the factors associated with DR among insulin users, especially association between duration, prior to initiating insulin for Type 2 diabetes mellitus (DM) and developing DR. Retrospective cross-sectional observational study included 1414 subjects having Type 2 DM. Insulin users were defined as subjects using insulin for glycemic control, and insulin nonusers as those either not using any antidiabetic treatment or using diet control or oral medications. The duration before initiating insulin after diagnosis was calculated by subtracting the duration of insulin usage from the duration of DM. DR was clinically graded using Klein's classification. SPSS (version 9.0) was used for statistical analysis. Insulin users had more incidence of DR (52.9% vs. 16.3%, P diabetes (>5 years) and sub-optimal glycemic control (glycosylated hemoglobin <7.0%). Among insulin users, abdominal obesity was found to be a significant predictor of DR; DR is associated with longer duration prior to initiating insulin therapy in Type 2 DM subjects with suboptimal glycemic control.
Abend, Michael; Port, Matthias
The authors herein summarize six presentations dedicated to the key session "molecular radiation epidemiology" of the ConRad meeting 2015. These presentations were chosen in order to highlight the promise when combining conventional radiation epidemiology with molecular biology. Conventional radiation epidemiology uses dose estimates for risk predictions on health. However, combined with molecular biology, dose-dependent bioindicators of effect hold the promise to improve clinical diagnostics and to provide target molecules for potential therapeutic intervention. One out of the six presentations exemplified the use of radiation-induced molecular changes as biomarkers of exposure by measuring stabile chromosomal translocations. The remaining five presentations focused on molecular changes used as bioindicators of the effect. These bioindicators of the effect could be used for diagnostic purposes on colon cancers (genomic instability), thyroid cancer (CLIP2), or head and neck squamous cell cancers. Therapeutic implications of gene expression changes were examined in Chernobyl thyroid cancer victims and Mayak workers.
Verger, P.; Cherie-Challine, L.
This report jointly written by IPSN and InVS, reviews the sanitary consequences in France of the Chernobyl accident, which occurred in 1986. The first point is dedicated to a short presentation of the knowledge relative to the sanitary consequences of the Chernobyl accident in the high contaminated countries and to the risk factors of the thyroid cancer. Secondly, this report describes the main systems of epidemiological surveillance of health implemented in France in 1986 and in 1999, as well as the data of the incidence and mortality of thyroid cancer observed in France since 1975. In addition, this report presents an analysis of the risk of thyroid cancer related to radioactive contamination in France, for young people of less than 15 years of age who where living in 1986 in the highest contaminated areas of France (Eastern territories). For this purpose, the theoretical number of thyroid cancers in excess is evaluated for this population, on the basis of different available risk model. Finally starting from the results of risk assessment, there is a discussion about the relevance and the feasibility of different epidemiological methods in view of answering the questions related to the sanitary consequences of the Chernobyl accident. In conclusion, this report recommends to reinforce the surveillance of thyroid cancer in France. (author)
Virtanen, Iita M; Karppinen, Jaro; Taimela, Simo; Ott, Jürg; Barral, Sandra; Kaikkonen, Kaisu; Heikkilä, Olli; Mutanen, Pertti; Noponen, Noora; Männikkö, Minna; Tervonen, Osmo; Natri, Antero; Ala-Kokko, Leena
Cross-sectional epidemiologic study. To evaluate the interaction between known genetic risk factors and whole-body vibration for symptomatic intervertebral disc disease (IDD) in an occupational sample. Risk factors of IDD include, among others, whole-body vibration and heredity. In this study, the importance of a set of known genetic risk factors and whole-body vibration was evaluated in an occupational sample of train engineers and sedentary controls. Eleven variations in 8 genes (COL9A2, COL9A3, COL11A2, IL1A, IL1B, IL6, MMP-3, and VDR) were genotyped in 150 male train engineers with an average of 21-year exposure to whole-body vibration and 61 male paper mill workers with no exposure to vibration. Subjects were classified into IDD-phenotype and asymptomatic groups, based on the latent class analysis. The number of individuals belonging to the IDD-phenotype was significantly higher among train engineers (42% of train engineers vs. 17.5% of sedentary workers; P = 0.005). IL1A -889T allele represented a significant risk factor for the IDD-phenotype both in the single marker allelic association test (P = 0.043) and in the logistic regression analysis (P = 0.01). None of the other allele markers was significantly associated with symptoms when analyzed independently. However, for all the SNP markers considered, whole-body vibration represents a nominally significant risk factor. The results suggest that whole-body vibration is a risk factor for symptomatic IDD. Moreover, whole-body vibration had an additive effect with genetic risk factors increasing the likelihood of belonging to the IDD-phenotype group. Of the independent genetic markers, IL1A -889T allele had strongest association with IDD-phenotype.
Ghaedrahmati, Maryam; Kazemi, Ashraf; Kheirabadi, Gholamreza; Ebrahimi, Amrollah; Bahrami, Masood
Postpartum depression is a debilitating mental disorder with a high prevalence. The aim of this study was review of the related studies. In this narrative review, we report studies that investigated risk factors of postpartum depression by searching the database, Scopus, PubMed, ScienceDirect, Uptodate, Proquest in the period 2000-2015 published articles about the factors associated with postpartum depression were assessed in Farsi and English. The search strategy included a combination of keywords include postpartum depression and risk factors or obstetrical history, social factors, or biological factors. Literature review showed that risk factors for postpartum depression in the area of economic and social factors, obstetrical history, and biological factors, lifestyle and history of mental illness detected. Data from this study can use for designing a screening tools for high-risk pregnant women and for designing a prevention programs.
Dorner, T E; Rieder, A
Overweight and obesity are independent risk factors for the development of disease and death in the general population. However, in people with various conditions (old age, wasting diseases, heart diseases or renal dialysis) overweight and obesity are associated with a higher survival rate. The terms "reverse epidemiology" or "obesity paradox" have been suggested to describe this finding. However, it still remains uncertain, whether this phenomenon is attributable to a real protective effect of high body fat mass. Methodological problems in studies suggesting an obesity paradox such as survivor bias, selection bias, lead time bias or, in meta analyses, publication bias and confounders have been discussed. These cannot, however, entirely explain the observed phenomenon. Biological models, examining possible explanations for the protective effect of high body mass, for instance, in wasting diseases and elderly patients, have also been produced. In particular high inflammation markers combined with malnutrition predict a high mortality rate among patients with various medical conditions: overweight and obesity could counter these effects. Possible implications for clinical and public health recommendations regarding weight management and nutrition are issues for future research. In elderly subjects and patients with a poor prognosis the impact of weight management on quality of life should also be taken into account.
Shirlina, N G; Vilms, E A; Stasenko, V L
Nutrition is an important biological factor, which affects largely on the development of the all functions of the human body. There is known association of the appearance of breast cancer with alimentary factors: inadequate consumption of fruits, vegetables, dairy products, excessive consumption of coffee, tea, sugar, salt, bread, fatty foods, overweight, early age of onset and frequent alcohol consumption. To study the prevalence of risk factors for breast cancer related to nutrition in the female population of the Omsk region. An epidemiological (observational analytical) study of "case-control", which was participated by 1002 women (797 women without breast cancer; 205--with breast cancer). In the study there were used epidemiological, hygienic, sociological, statistical methods. Out of 13 risk factors for the development of breast cancer related to nutrition, for female residents of the Omsk region there were confirmed their importance: a significant consumption of black tea (OR: 5,182, CI: 95% 3,721 ÷ 7,218), an early age of onset of alcohol consumption (OR: 4,832, CI: 95% 3,477 ÷ 6,715), overweight (OR: 1,440, CI 95% 1,005 ÷ 2,062). Such factors as low consumption of fruit and dairy products, increased consumption of fats with high content of cholesterin, salt and coffee failed to confirm their relevance. In the female population of the Omsk region the leading risk factors for development of breast cancer related to diet, are: excessive consumption of black tea, early age of onset of alcohol use, high body mass index.
Ferrís, J; Berbel, O; Alonso-López, J; Garcia, J; Ortega, J A
Bladder carcinoma (BC), due its high morbidity and relapsing course, generates significant economic and health care costs. Accordingly, review the environmental nonoccupational risk factors (RF), more or less evidence-based, in the etiology and pathogenesis of BC, because the involvement of urologists is essential for prevention. Review of the peer-reviewed literature (1987-2012) on nonoccupational environmental RF associated with BC retrieved from Medline, Embase and Science Citation Index. The search profiles have been "Risk factors/Epidemiology/Tobacco-smoking/Diet-nutrition-water-liquids/Radiation/Infectious/Farmacological drugs" and "Bladder cancer". Smoking was associated with 50% of BC in both sexes. Smokers have a 2-5 times higher risk than nonsmokers, directly proportional to the amount and duration of addiction. Drinking water contaminated with arsenic and chromium chlorination byproducts increases the risk of BC. High consumption of red meat and saturated fat may increase the risk, while high intake of fruits and vegetables decreases it. Patients treated with cyclophosphamide, ifosfamide and ionizing radiation have an increased risk of BC. Frequent and prolonged use of hair dyes and Schistosoma haematobium infestation increases the risk of BC. The reduction or the cessation of smoking decrease BC. The contaminant-free water consumption with the increase of vegetal foods favour BC prevention. Cancer survivors treated with cyclophosphamide, ifosfamide and radiation therapy should be monitored for early diagnosis of BC. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.
Barthold, Julia Spencer; Reinhardt, Susanne; Thorup, Jorgen
Unilateral or bilateral cryptorchidism is an isolated anomaly in the majority of cases, with evidence to date suggesting that it is a complex disorder resulting from interactions between genetic and environmental factors. Population, family, and limited genome-wide association data suggest moderate...... or gubernacular response to hormonal stimulation. However, we have yet to determine the degree to which EDCs contribute to cryptorchidism risk in humans, in part due to the varying methodology used in epidemiological and exposure studies. Large populations will be required to define the gene......-environment interactions that predispose to cryptorchidism, in view of multiple small effect genetic susceptibility loci, ubiquitous exposure to mixtures of EDCs, and possible epigenetic effects. The present review provides an update of potential genetic and environmental risk factors for cryptorchidism, and future work...
Badr Eldin Mostafa
Full Text Available Objective. The aim of our study was to try to determine the possible environmental risk factors for noninvasive fungal sinusitis in Egyptian patients. Methods. This is a prospective epidemiological case control study on the environmental risk factors of noninvasive fungal sinusitis. It included 60 patients and 100 age and sex matched controls. Results. There was a statistically significant relation between apartment floor, surface area, exposure to dust, exposure to cockroaches, poor air conditioning, and fungal sinusitis. Yet, no statistical significance was found between allergy related occupations, exposure to animals or plants, although their percentages were higher among cases, smoking, and urban or rural residence. Conclusion. We suggest that for patients with noninvasive fungal sinusitis a change in their living environment must be implied with better exposure to sunlight, larger well ventilated homes, proper cleaning of dust and cockroach extermination, and if possible the judicious use of air conditioners.
Gama, Zenewton André da Silva; Gómez-Conesa, Antonia
To systematize results of prospective cohort studies on multiple risk factors for falls in the elderly and to assess their methodological quality. Systematic review of epidemiological studies from Medline, SciELO and Lilacs database. We included prospective cohort studies with samples of more than 100 subjects of both sexes, older than 64 years, and living either in the community or a nursing home. Of 726 studied identified, 15 met the inclusion criteria of being published between 1988 and 2005. The methodology of the studies varied. The main factors associated with increased risk of falls include: previous falls, altered gait, functional impairment, cognitive impairment, psychotropic medication use and excessive physical activity. Despite contradictory findings, being a woman at an advanced age may also be a predictor of falls. Methodological limitations were identified in prospective cohort studies on falls. There is a need for further studies on extrinsic determinants, including evaluator blinding and closer monitoring during follow-up with reduced time of recall.
Full Text Available Background and objective It has been proven that the lung cancer mortality rate in Xuanwei County, China was among the highest in the country and has been associated with exposure to indoor smoky coal emissions that contain high levels of polycyclic aromatic hydrocarbons. This risk may be modified by variation in genetic polymorphisms and coal subtypes. Our objective was to use molecular epidemiological techniques to investigate the relationship among genetic polymorphisms, coal subtype and lung cancer risk in Xuanwei County. Methods On the basis of two population-based case-control studies in residents of Xuanwei County, China, questionnaires covering demographic information, smoking history, family and personal medical history, and information on other variables were administered and buccal cells and sputum samples were collected separately from each subject enrolled to extract DNA. GST superfamily, AKR1C3 superfamily, OGG1 superfamily and other genotype were scanned by useing PCR method. ORs and 95%CIs were used to estimate the association between genotypes, coal subtypes and lung cancer risk factors by conditional Logistic regression using Statistical Analysis Software. Results Compared with subjects who using smokeless coal or wood, smoky coal use was statistically significantly associated with lung cancer risk (OR=7.7, 95%CI: 4.5-13.3. There was marked heterogeneity in risk estimates for specific subtypes of smoky coal. Estimates were highest for coal from the Laibin (OR=24.8, Longtan (OR=11.6 and Baoshan (OR=6.0 coal types, and lower for coal from other types; the risk within the same subtype of coal in male and female were similar. The GSTM1-null genotype, the AKR1C3 (Ex1-70C>G, OGG1 (Ex6-315C>G genotypes were closely associated with increased risk of lung cancer in Xuanwei County, and their odds ratios (95%CI were 2.3 (1.3-4.2, 1.8 (1.0-3.5 and 1.9 (1.1-3.3, respectively. Compared to subjects who with GSTM1-positive and used less than
Golovaty, A.S.; Lapko, A.G.
The novel field of molecular epidemiology of human cancer risk has added a new branch to classical epidemiology by providing a direct link between human cancer and carcinogen exposure. It was estimated that about 80% of cancers are due to environmental factors. The blood proteins are almost certainly targets for modification in human cancer, and their identification and characterization will be of primary importance in the development of the new and rapidly evolving field of molecular epidemiology. Among blood proteins that are altered in human cancer, TBG occupies a special place because the level of human blood TBG is the most sensitive to intensification of biosynthesis and proliferation processes in organisms in different types of cancer. The increase of TBG concentration in cancer can be result from both activation of TBG biosynthesis in liver or altering of post translation glycosylation that prolongs protein survival time. The molecular basis for the change in the properties of TBG in cancer is unknown. These distinctive changes could have important consequences for the function of TBG in cancer and may help to develop more precise markers for monitoring pathological progression in this disease. Considerable variability and subtlety can occur in the carbohydrate composition and structure of serum glycoproteins in disease. This can be either as a major change, such as an increase in the number of oligosaccharide branches at a particular glycosylation site or as a minor change such as the addition of an extra fucose or sialic acid residue. Increased fucosylation has also been reported for transferrin and alpha-fetoprotein in liver cancer; thyroglobulin in thyroid cancer, IgG in myeloma, haptoglobin in ovarian cancer. The last own studies have shown that in clinically healthy teenagers born in Khojniki (137 Cs 185-555 kBq/m), we have found an unusual thyroid profile exhibiting increased levels of total triiodothyronine (T3), total thyroxine (T4), and thyroxine
... present. History of Preeclampsia/Eclampsia: Women with a history of preeclampsia/eclampsia have an increased risk of future hypertension and stroke one to 30 years after delivery. Hypertension: Women with chronic primary or secondary hypertension, ...
Tourassi, Georgia; Yoon, Hong-Jun; Xu, Songhua; Han, Xuesong
The World Wide Web has emerged as a powerful data source for epidemiological studies related to infectious disease surveillance. However, its potential for cancer-related epidemiological discoveries is largely unexplored. Using advanced web crawling and tailored information extraction procedures, the authors automatically collected and analyzed the text content of 79 394 online obituary articles published between 1998 and 2014. The collected data included 51 911 cancer (27 330 breast; 9470 lung; 6496 pancreatic; 6342 ovarian; 2273 colon) and 27 483 non-cancer cases. With the derived information, the authors replicated a case-control study design to investigate the association between parity (i.e., childbearing) and cancer risk. Age-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each cancer type and compared to those reported in large-scale epidemiological studies. Parity was found to be associated with a significantly reduced risk of breast cancer (OR = 0.78, 95% CI, 0.75-0.82), pancreatic cancer (OR = 0.78, 95% CI, 0.72-0.83), colon cancer (OR = 0.67, 95% CI, 0.60-0.74), and ovarian cancer (OR = 0.58, 95% CI, 0.54-0.62). Marginal association was found for lung cancer risk (OR = 0.87, 95% CI, 0.81-0.92). The linear trend between increased parity and reduced cancer risk was dramatically more pronounced for breast and ovarian cancer than the other cancers included in the analysis. This large web-mining study on parity and cancer risk produced findings very similar to those reported with traditional observational studies. It may be used as a promising strategy to generate study hypotheses for guiding and prioritizing future epidemiological studies. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Soomann, Maarja; Vibo, Riina; Kõrv, Janika
Risk factor management is the key to stroke prevention. Although several studies have assessed the awareness of different risk factors in the general public, there are limited data available on how well acute stroke patients know their own risk factors. The aim of this study was to assess stroke patients' informedness of their own stroke risk factors. All consecutive eligible acute stroke and transient ischemic attack patients hospitalized at the Tartu University Hospital, Department of Neurology, during 9 months in 2010 were interviewed about different stroke risk factors within 72 hours from hospitalization. The respective information was also retrieved from medical records. Of the 341 patients admitted during the study period, 195 were eligible for the interview. Diabetes was the best known risk factor (89%) followed by hypertension (80%), atrial fibrillation (78%), previous stroke (77%), and heart failure and/or ischemic heart disease (66%). We found that acute stroke patients are best informed of their diabetes and worst informed of their ischemic heart disease and/or heart failure. There is, however, room for amelioration in the awareness of all of the studied risk factors. More attention should be addressed to explaining the risks and treatment options to patients at risk of stroke and the general population. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Piltoft, Johanne Spanggaard; Larsen, Signe Benzon; Dalton, Susanne Oksbjerg
PURPOSE: One established risk factors for testicular cancer is cryptorchidism. However, it remains unclear whether cryptorchidism is a risk factor in itself or whether the two conditions share common causes in early life (estrogen hypothesis), such as birth weight and birth order. The objective o...
Ariëns, G.A.M.; Mechelen, W. van; Bongers, P.M.; Wal, G. van der; Bouter, L.M.
To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22
Apr 4, 2003 ... Objective: To review risk factors for stroke and the use of echocardiography in its diagnosis. ... therapy. Several risk factors are shared between ischaemic heart disease and ischaemic stroke and these have been well documented. Stroke has .... history, physical examination, electrocardiography or chest.
Lee, Joseph K. P.; Jackson, Henry J.; Pattison, Pip; Ward, Tony
A study involving 64 Australian sex offenders and 33 non-sex offenders found childhood emotional abuse and family dysfunction, childhood behavior problems, and childhood sexual abuse were developmental risk factors for paraphilia. Emotional abuse and family dysfunction was found to be a risk factor for pedophilia, exhibitionism, rape, or multiple…
Endemic pemphigus in the peruvian Amazon: epidemiology and risk factors for the development of complications during treatment Pênfigo endêmico na Amazônia peruana: epidemiologia e fatores de risco para o desenvolvimento de complicações durante o tratamento
Full Text Available BACKGROUND: Pemphigus is an autoimmune blistering disease. According to a report, in areas of endemic pemphigus foliaceus (EPF in Peru there are cases of pemphigus vulgaris with epidemiologic, clinical and histopathologic characteristics similar to those of "endemic pemphigus vulgaris" (EPV in Brazil. OBJECTIVES: To determine the clinical and epidemiologic characteristics of endemic pemphigus and the risk factors of patients for developing complications during treatment. METHODS: A study was carried out from July 2003 to March 2008. The study population was 60 patients with EPF and 7 patients with EPV evaluated in hospitals and clinics in the Peruvian Amazon and Lima. A multivariate analysis was carried out using binary logistic regression. RESULTS: The average age of EPF patients was 31.4 years; 55% were men; 60% presented the generalized clinical variant. Non-compliance with the treatment was seen in 57.1% of the patients. Thirty-five percent presented complications (e.g. pyodermitis and pyelonephritis during treatment. The risk factors for developing complications during treatment were non-compliance with the treatment and having the generalized clinical form. In the EPV group, the average age was 21.7 years; 71.4% were men. All patients presented with the mucocutaneous clinical variant and the initial presentation consisted of oral mucosa lesions; 71.4% presented complications during treatment, pyodermitis being the most frequent. CONCLUSIONS: Non-compliance with the treatment and the generalized clinical form are risk factors for the development of complications during treatment of patients with EPF. Peru indeed has EPV cases with epidemiologic characteristics similar to EPF. Living in a rural area may represent a risk factor for the development of complications during treatment of patients with EPV.FUNDAMENTOS: O pênfigo é uma doença auto-imune bolhosa. Segundo um relatório, em áreas de pênfigo foliáceo endêmico no Peru há casos
Methods: A cross-sectional study was conducted to screen dogs in south-western Nigeria for antibodies to Brucella sp using the rapid slide agglutination test (RSA) and Rose Bengal test (RBT), with positive samples confirmed respectively by serum agglutination test (SAT) and competitive enzyme linked immunosorbent ...
de Jong, S.W.
Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease of motor neurons leading to progressive weakness of the limbs, the bulbar muscles and the respiratory muscles. Fifty percent of patients die within 3 years after onset of symptoms, mainly due to respiratory failure. In a
Ferrís, J; Garcia, J; Berbel, O; Ortega, J A
Bladder carcinoma (BC) is the fourth most common type of cancer in males from Western countries, with primary prevention an important healthcare challenge. We review the associated constitutional and occupational risk factors (RF), with greater or lesser scientific evidence, in the aetiology of BC. Literature review of the last 25 years of the constitutional and occupational RF associated with BC, conducted on MedLine, CancerLit, Science Citation Index and Embase. The search profiles were Risk factors/Genetic factors/Genetic polymorphisms/Epidemiology