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Sample records for incidence decreased significantly

  1. Decreasing incidence rates of bacteremia

    DEFF Research Database (Denmark)

    Nielsen, Stig Lønberg; Pedersen, C; Jensen, T G

    2014-01-01

    BACKGROUND: Numerous studies have shown that the incidence rate of bacteremia has been increasing over time. However, few studies have distinguished between community-acquired, healthcare-associated and nosocomial bacteremia. METHODS: We conducted a population-based study among adults with first......-acquired, 50.0 for healthcare-associated and 66.7 for nosocomial bacteremia. During 2000-2008, the overall incidence rate decreased by 23.3% from 254.1 to 198.8 (3.3% annually, p ...) and the incidence rate of nosocomial bacteremia decreased by 28.9% from 82.2 to 56.0 (4.2% annually, p

  2. Cranberry juice concentrate does not significantly decrease the incidence of acquired bacteriuria in female hip fracture patients receiving urine catheter: a double-blind randomized trial

    Directory of Open Access Journals (Sweden)

    Gunnarsson AK

    2017-01-01

    Full Text Available Anna-Karin Gunnarsson,1 Lena Gunningberg,2 Sune Larsson,1 Kenneth B Jonsson1 1Institution of Surgical Sciences, Uppsala University, Uppsala, Sweden; 2Institution of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Background: Urinary tract infection (UTI is a common complication among patients with hip fractures. Receiving an indwelling urinary catheter is a risk factor for developing UTIs. Treatment of symptomatic UTIs with antibiotics is expensive and can result in the development of antimicrobial resistance. Cranberries are thought to prevent UTI. There is no previous research on this potential effect in patients with hip fracture who receive urinary catheters. Aim: The aim of this study is to investigate whether intake of cranberry juice concentrate preoperatively decreases the incidence of postoperative UTIs in hip fracture patients that received a urinary catheter. Design: This study employed a randomized, placebo-controlled double-blind trial. Method: Female patients, aged 60 years and older, with hip fracture (n=227 were randomized to receive cranberry or placebo capsules daily, from admission, until 5 days postoperatively. Urine cultures were obtained at admission, 5 and 14 days postoperatively. In addition, Euro Qual five Dimensions assessments were performed and patients were screened for UTI symptoms. Result: In the intention-to-treat analysis, there was no difference between the groups in the proportion of patients with hospital-acquired postoperative positive urine cultures at any time point. When limiting the analysis to patients that ingested at least 80% of the prescribed capsules, 13 of 33 (39% in the placebo group and 13 of 47 (28% in the cranberry group (P=0.270 had a positive urine culture at 5 days postoperatively. However, this difference was not statistically significant (P=0.270. Conclusion: Cranberry concentrate does not seem to effectively prevent UTIs in female patients with hip fracture and

  3. Significant incidents in nuclear fuel cycle facilities

    International Nuclear Information System (INIS)

    1996-03-01

    In contrast to nuclear power plants, events in nuclear fuel cycle facilities are not well documented. The INES database covers all the nuclear fuel cycle facilities; however, it was developed in the early 1990s and does not contain information on events prior to that. The purpose of the present report is to collect significant events and analyze them in order to give a safety related overview of nuclear fuel cycle facilities. Significant incidents were selected using the following criteria: release of radioactive material or exposure to radiation; degradation of items important to safety; and deficiencies in design, quality assurance, etc. which include criticality incidents, fire, explosion, radioactive release and contamination. This report includes an explanation, where possible, of root causes, lessons learned and action taken. 4 refs, 4 tabs

  4. Hip fracture incidence is decreasing in the high incidence area of Oslo, Norway.

    Science.gov (United States)

    Støen, R O; Nordsletten, L; Meyer, H E; Frihagen, J F; Falch, J A; Lofthus, C M

    2012-10-01

    This study reports a significant decrease in age-adjusted incidence rates of hip fracture for women in Oslo, Norway, even compared with data from 1978/1979. Use of bisphosphonate may explain up to one third of the decline in the incidence. The aims of the present study were to report the current incidence of hip fractures in Oslo and to estimate the influence of bisphosphonates on the current incidence. Using the electronic diagnosis registers and lists from the operating theaters of the hospitals of Oslo, all patients with ICD-10 codes S72.0 and S72.1 (hip fracture) in 2007 were identified. Medical records of all identified patients were reviewed to verify the diagnosis. Age- and gender-specific annual incidence rates were calculated using the population of Oslo on January 1, 2007 as the population at risk. Data on the use of bisphosphonates were obtained from official registers. A total number of 1,005 hip fractures, 712 (71%) in women, were included. The age-adjusted fracture rates per 10,000 for the age group >50 years were 82.0 for women and 39.1 for men in 2007, compared with 110.8 and 41.4 in 1996/1997, 116.5 and 42.9 in 1988/1989, and 97.5 and 34.5 in 1978/1979, respectively. It was estimated that the use of bisphosphonates may explain up to 13% of the decline in incidence in women aged 60-69 years and up to 34% in women aged 70-79 years. The incidence of hip fractures in women in Oslo has decreased significantly during the last decade and is now at a lower level than in 1978/1979. This reduction was not evident in men. The incidence of hip fractures in Oslo is, however, still the highest in the world.

  5. Incidence and Significance of Haematemesis in Cirrhosis

    African Journals Online (AJOL)

    1974-06-08

    Jun 8, 1974 ... tract (oesophageal varices) is an uncommon cause of death in patients with cirrhosis and portal hypertension. The view was that death occurs from liver failure per se more often than from haemorrhage, although opinion was not available as to whether this was because of a low incidence of haemorrhage ...

  6. Increased detection of clinically significant antibodies and decreased incidence of delayed haemolytic transfusion reaction with the indirect antiglobulin test potentiated by polyethylene glycol compared to albumin: a Japanese study

    Science.gov (United States)

    Okutsu, Miho; Ohto, Hitoshi; Yasuda, Hiroyasu; Kawabata, Kinuyo; Ono, Satoshi; Saito, Shunnichi; Sugawara, Akiko; Kikuchi, Masami; Miura, Saori; Ishii, Youko; Watanabe, Kazuya; Tohyama, Yuriko; Nollet, Kenneth E.

    2011-01-01

    Background The indirect antiglobulin test (IAT) can be potentiated by agents such as polyethylene glycol (PEG-IAT) and albumin (Alb-IAT). PEG-IAT is generally regarded as superior to Alb-IAT for the detection of clinically significant red blood cell (RBC) antibodies. However, supporting data come from Caucasian-dominant populations. Non-Caucasian populations should be investigated as well. Material and methods In this single-centre, retrospective, sequential study, Alb-IAT was used from 1989 to 1996 (8 years) and PEG-IAT from 1997 to 2008 (12 years). Pre-transfusion RBC alloantibody detection rates and specificity, post-transfusion alloantibody production, and the incidence of delayed haemolytic transfusion reaction were assessed and compared for the two periods. Results Although overall RBC alloantibody detection rates were comparable, PEG-IAT more frequently detected clinically significant antibodies such as anti-E, anti-Fyb, and anti-Jka, and less frequently detected insignificant antibodies such as anti-Leb and anti-P1. New alloantibodies emerged comparably during the two periods. Delayed haemolytic transfusion reaction was less frequent during the PEG-IAT period (0.30% versus 0.12%, ptransfusion reaction better than Alb-IAT among Japanese transfusion recipients in this retrospective survey of limited power. PMID:21251459

  7. Colchicine Significantly Reduces Incident Cancer in Gout Male Patients

    Science.gov (United States)

    Kuo, Ming-Chun; Chang, Shun-Jen; Hsieh, Ming-Chia

    2015-01-01

    Abstract Patients with gout are more likely to develop most cancers than subjects without gout. Colchicine has been used for the treatment and prevention of gouty arthritis and has been reported to have an anticancer effect in vitro. However, to date no study has evaluated the relationship between colchicine use and incident cancers in patients with gout. This study enrolled male patients with gout identified in Taiwan's National Health Insurance Database for the years 1998 to 2011. Each gout patient was matched with 4 male controls by age and by month and year of first diagnosis, and was followed up until 2011. The study excluded those who were diagnosed with diabetes or any type of cancer within the year following enrollment. We calculated hazard ratio (HR), aged-adjusted standardized incidence ratio, and incidence of 1000 person-years analyses to evaluate cancer risk. A total of 24,050 male patients with gout and 76,129 male nongout controls were included. Patients with gout had a higher rate of incident all-cause cancers than controls (6.68% vs 6.43%, P = 0.006). A total of 13,679 patients with gout were defined as having been ever-users of colchicine and 10,371 patients with gout were defined as being never-users of colchicine. Ever-users of colchicine had a significantly lower HR of incident all-cause cancers than never-users of colchicine after adjustment for age (HR = 0.85, 95% CI = 0.77–0.94; P = 0.001). In conclusion, colchicine use was associated with a decreased risk of incident all-cause cancers in male Taiwanese patients with gout. PMID:26683907

  8. Prognostic Significance of Preterm Isolated Decreased Fetal Movement

    Directory of Open Access Journals (Sweden)

    Ertuğrul Karahanoğlu

    2017-12-01

    Full Text Available Objective: Our aim is to evaluate the prognostic significance of isolated, preterm decreased fetal movement following normal initial full diagnostic workup. Study design: A retrospective observational study was conducted at a tertiary centre. The applied protocol was approved by the Medical Research Ethics Department of the hospital where the research was conducted. Obstetrics outcomes of preterm- and term-decreased fetal movement were compared following an initial, normal diagnostic work up. Evaluated outcomes were birth weight, mode of delivery, stillbirth rate, induction of labour, development of gestational hypertension, small for gestational age and oligohydramnios, polyhydramnios during the follow up period. Result: Obstetric complications related to placental insufficiency develops more frequently for decreased fetal movement in preterm cases with respect to that of in term cases. Following the diagnosis of decreased fetal movement, pregnancy hypertension occurred in 17% of preterm decreased fetal movement cases and in 4.7% of term decreased fetal movement cases. Fetal growth restriction developed in 6.6% of preterm decreased fetal movement and in 2.3% of term decreased fetal movement. Amniotic fluid abnormalities more frequently developed in preterm decreased fetal movement. Conclusion: Following an initial normal diagnostic workup, preterm decreased fetal movement convey a higher risk for the development of pregnancy complications associated with placental insufficiency. The patient should be monitored closely and management protocols must be developed for initial normal diagnostic workups in cases of preterm decreased fetal movement.

  9. Analysis of significant factors for dengue fever incidence prediction.

    Science.gov (United States)

    Siriyasatien, Padet; Phumee, Atchara; Ongruk, Phatsavee; Jampachaisri, Katechan; Kesorn, Kraisak

    2016-04-16

    Many popular dengue forecasting techniques have been used by several researchers to extrapolate dengue incidence rates, including the K-H model, support vector machines (SVM), and artificial neural networks (ANN). The time series analysis methodology, particularly ARIMA and SARIMA, has been increasingly applied to the field of epidemiological research for dengue fever, dengue hemorrhagic fever, and other infectious diseases. The main drawback of these methods is that they do not consider other variables that are associated with the dependent variable. Additionally, new factors correlated to the disease are needed to enhance the prediction accuracy of the model when it is applied to areas of similar climates, where weather factors such as temperature, total rainfall, and humidity are not substantially different. Such drawbacks may consequently lower the predictive power for the outbreak. The predictive power of the forecasting model-assessed by Akaike's information criterion (AIC), Bayesian information criterion (BIC), and the mean absolute percentage error (MAPE)-is improved by including the new parameters for dengue outbreak prediction. This study's selected model outperforms all three other competing models with the lowest AIC, the lowest BIC, and a small MAPE value. The exclusive use of climate factors from similar locations decreases a model's prediction power. The multivariate Poisson regression, however, effectively forecasts even when climate variables are slightly different. Female mosquitoes and seasons were strongly correlated with dengue cases. Therefore, the dengue incidence trends provided by this model will assist the optimization of dengue prevention. The present work demonstrates the important roles of female mosquito infection rates from the previous season and climate factors (represented as seasons) in dengue outbreaks. Incorporating these two factors in the model significantly improves the predictive power of dengue hemorrhagic fever forecasting

  10. Projections of increased and decreased dengue incidence under climate change.

    Science.gov (United States)

    Williams, C R; Mincham, G; Faddy, H; Viennet, E; Ritchie, S A; Harley, D

    2016-10-01

    Dengue is the world's most prevalent mosquito-borne disease, with more than 200 million people each year becoming infected. We used a mechanistic virus transmission model to determine whether climate warming would change dengue transmission in Australia. Using two climate models each with two carbon emission scenarios, we calculated future dengue epidemic potential for the period 2046-2064. Using the ECHAM5 model, decreased dengue transmission was predicted under the A2 carbon emission scenario, whereas some increases are likely under the B1 scenario. Dengue epidemic potential may decrease under climate warming due to mosquito breeding sites becoming drier and mosquito survivorship declining. These results contradict most previous studies that use correlative models to show increased dengue transmission under climate warming. Dengue epidemiology is determined by a complex interplay between climatic, human host, and pathogen factors. It is therefore naive to assume a simple relationship between climate and incidence, and incorrect to state that climate warming will uniformly increase dengue transmission, although in general the health impacts of climate change will be negative.

  11. Increased incidence of ectopic pregnancy after in vitro fertilization in women with decreased ovarian reserve.

    Science.gov (United States)

    Lin, Shengli; Yang, Rui; Chi, Hongbin; Lian, Ying; Wang, Jiejing; Huang, Shuo; Lu, Cuiling; Liu, Ping; Qiao, Jie

    2017-02-28

    The incidence of ectopic pregnancy after assisted reproductive technology is increased approximately 2.5-5-fold compared with natural conceptions.Strategies were used to decrease the incidence of ectopic pregnancy, but ectopic pregnancy still occurs. In the present study, women were selected with decreased ovarian reserve (defined as FSH > 10 IU/L) aged 20 to 38 years who underwent IVF-ET between 2009 and 2014. These 2,061 women were age-matched with an equal number of women with normal ovarian reserve (defined as FSH ≤ 10 IU/L). During cycles following fresh embryo transfer, 93 patients were diagnosed with ectopic pregnancy. The incidence of ectopic pregnancy in clinical pregnancies was significantly higher in the decreased ovarian reserve than in the normal ovarian reserve group (5.51% vs. 2.99%). After adjusting for confounding factors, the incidence of ectopic pregnancy was significantly associated with decreased ovarian reserve. Our results showed that decreased ovarian reserve is an independent risk factor for ectopic pregnancy after in vitro fertilization-embryo transfer.

  12. Normalization of Testosterone Levels After Testosterone Replacement Therapy Is Associated With Decreased Incidence of Atrial Fibrillation.

    Science.gov (United States)

    Sharma, Rishi; Oni, Olurinde A; Gupta, Kamal; Sharma, Mukut; Sharma, Ram; Singh, Vikas; Parashara, Deepak; Kamalakar, Surineni; Dawn, Buddhadeb; Chen, Guoqing; Ambrose, John A; Barua, Rajat S

    2017-05-09

    Atrial fibrillation (AF) is the most common cardiac dysrhythmia associated with significant morbidity and mortality. Several small studies have reported that low serum total testosterone (TT) levels were associated with a higher incidence of AF. In contrast, it is also reported that anabolic steroid use is associated with an increase in the risk of AF. To date, no study has explored the effect of testosterone normalization on new incidence of AF after testosterone replacement therapy (TRT) in patients with low testosterone. Using data from the Veterans Administrations Corporate Data Warehouse, we identified a national cohort of 76 639 veterans with low TT levels and divided them into 3 groups. Group 1 had TRT resulting in normalization of TT levels (normalized TRT), group 2 had TRT without normalization of TT levels (nonnormalized TRT), and group 3 did not receive TRT (no TRT). Propensity score-weighted stabilized inverse probability of treatment weighting Cox proportional hazard methods were used for analysis of the data from these groups to determine the association between post-TRT levels of TT and the incidence of AF. Group 1 (40 856 patients, median age 66 years) had significantly lower risk of AF than group 2 (23 939 patients, median age 65 years; hazard ratio 0.90, 95% CI 0.81-0.99, P =0.0255) and group 3 (11 853 patients, median age 67 years; hazard ratio 0.79, 95% CI 0.70-0.89, P =0.0001). There was no statistical difference between groups 2 and 3 (hazard ratio 0.89, 95% CI 0.78- 1.0009, P =0.0675) in incidence of AF. These novel results suggest that normalization of TT levels after TRT is associated with a significant decrease in the incidence of AF. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  13. Neurointermediate pituitary lobectomy decreases the incidence and severity of experimental autoimmune encephalomyelitis in Lewis rats.

    Science.gov (United States)

    Quintanar-Stephano, Andrés; Chavira-Ramírez, Roberto; Kovacs, Kalman; Berczi, Istvan

    2005-01-01

    Acute experimental autoimmune encephalomyelitis (EAE) is an inflammatory disease of the central nervous system, mediated by T lymphocytes. Immunization of Lewis rats with myelin antigens suspended in complete Freund's adjuvant induces EAE. In a previous study on rats we have found that neurointermediate pituitary lobectomy (NIL) decreased both the humoral and cell-mediated immune responses. Here we investigated the effect of NIL on the incidence and severity of EAE and on the function of the hypothalamic-pituitary-adrenal axis in Lewis rats. NIL, hypophysectomized (Hypox) and sham-operated (Sham) rats were immunized s.c. with guinea-pig brain extract suspended in complete Freund's adjuvant. Untreated rats were used as controls. Water intake, body weight gain, clinical and histopathologic incidence and severity of EAE were evaluated in the operated groups. On killing, plasma adrenocorticotropin and corticosterone levels were measured and adrenals, thymuses and spleens were weighed. Histopathologic lesions were counted in the brain and spinal cord. Water intake and body weight gain were significantly decreased in Sham and Hypox animals with EAE whereas higher intakes persisted in the NIL group. Plasma levels of adrenocorticotropin were within the normal range whereas corticosterone levels increased in Sham and occasionally in NIL animals. Thymus weights were decreased in NIL and Hypox groups. The clinical and histopathologic incidence and severity of EAE were significantly decreased in NIL animals as compared with Sham and Hypox rats. We concluded that NIL affects the cell-mediated immune response and plays a role in the development and progression of EAE in the Lewis rat.

  14. The incidence and economic significance of ovine toxoplasmosis in Uruguay.

    Science.gov (United States)

    Freyre, A; Bonino, J; Falcón, J; Castells, D; Correa, O; Casaretto, A

    1999-02-01

    Antibodies to Toxoplasma gondii were measured before and after pregnancy in a 1:64 dilution of sera with the direct agglutination test in 1613 ewes from 18 farms in eight different counties of Uruguay from 1992 to 1994. The overall seroprevalence increased from 28.7% before mating to 38.5% after lambing in 2.5 years and thus the incidence was 9.8%. Losses due to toxoplasmosis during pregnancy were estimated to be 1.4-3.9% of the total number of ewes investigated, amounting to approximately US$1.4-4.7 million for the whole country.

  15. Significant gastrointestinal morbidity after sacrocolpopexy: The incidence and risk factors.

    Science.gov (United States)

    Jo, Yu Ri; Kim, Ji Young; Jeon, Myung Jae

    2014-07-01

    This study aimed to quantify the risk of significant gastrointestinal (GI) morbidity after sacrocolpopexy (SCP), and to identify related risk factors. A retrospective study was performed of 258 patients who underwent laparotomic SCP for symptomatic pelvic organ prolapse (POP) from November 2008 to August 2013. By the review of medical records, the frequency of significant GI morbidity that resulted in a prolonged initial hospitalization, readmission, or reoperation was assessed. Thereafter, risk factors for significant GI morbidity were assessed using univariate and multivariate analyses. Ten patients (3.9%) were identified as having significant GI morbidity; nine (3.5%) had a prolonged initial hospital stay or were readmitted for the medical treatment of postoperative ileus and 1 (0.4%) underwent reoperation for small bowel obstruction. The occurrence of significant GI morbidity was significantly associated with patient's age and prior laparotomy. By multivariable logistic regression analysis, age (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.01-1.27; P=0.03) and prior laparotomy (OR, 6.82; 95% CI, 1.37-34.07; P=0.02) were found as independent risk factors for significant GI morbidity. One in 25 (3.9%) women after SCP experiences significant GI morbidity. Particularly, women with older age and prior laparotomy have a higher risk for significant GI morbidity. This data will aid preoperative counseling for Korean POP patients undergoing SCP.

  16. Increasing prevalence despite decreasing incidence of ischeamic heart disease and myocardial infarction

    DEFF Research Database (Denmark)

    Koch, Mette Bjerrum; Davidsen, Michael; Andersen, Lisbeth V.

    2015-01-01

    ,000 in 2009. The number of subjects having survived an AMI increased from 67,000 to 72,000. About 3% of the Danish population is afflicted by IHD. CONCLUSION: Decreasing incidence, reduced case fatality and demographic development result in an increased prevalence of IHD, since the decline in incidence......AIMS: Mortality from ischaemic heart disease (IHD) including acute myocardial infarction (AMI) in Denmark peaked around 1977, after which a marked decline has occurred as a result of decreasing incidence and increasing effect of treatment. IHD is a chronic, relapsing condition, and the effect...... of these changes on the prevalence of IHD is not known. METHODS AND RESULTS: Changes in incidence and prevalence in 2000-2009 are presented, using nationwide data from public registers. An incident case is defined as a subject registered with a diagnosis of IHD/AMI and without a prior diagnosis for the past 20...

  17. Significant reduction in the incidence of C5 palsy after cervical laminoplasty using chilled irrigation water.

    Science.gov (United States)

    Takenaka, S; Hosono, N; Mukai, Y; Tateishi, K; Fuji, T

    2016-01-01

    The aim of this study was to determine whether chilled irrigation saline decreases the incidence of clinical upper limb palsy (ULP; a reduction of one grade or more on manual muscle testing; MMT), based on the idea that ULP results from thermal damage to the nerve roots by heat generated by friction during bone drilling. Irrigation saline for drilling was used at room temperature (RT, 25.6°C) in open-door laminoplasty in 400 patients (RT group) and chilled to a mean temperature of 12.1°C during operations for 400 patients (low-temperature (LT) group). We assessed deltoid, biceps, and triceps brachii muscle strength by MMT. ULP occurring within two days post-operatively was categorised as early-onset palsy. The incidence of ULP (4.0% vs 9.5%, p = 0.003), especially early-onset palsy (1.0% vs 5.5%, p irrigation saline use, concomitant foraminotomy, and opened side were significant predictors for ULP. Using chilled irrigation saline during bone drilling significantly decreased the ULP incidence, particularly the early-onset type, and shortened the recovery period for ULP. Chilled irrigation saline can thus be recommended as a simple method for preventing ULP. Chilled irrigation during laminoplasty reduces C5 palsy. ©2016 The British Editorial Society of Bone & Joint Surgery.

  18. Colchicine Significantly Reduces Incident Cancer in Gout Male Patients: A 12-Year Cohort Study.

    Science.gov (United States)

    Kuo, Ming-Chun; Chang, Shun-Jen; Hsieh, Ming-Chia

    2015-12-01

    Patients with gout are more likely to develop most cancers than subjects without gout. Colchicine has been used for the treatment and prevention of gouty arthritis and has been reported to have an anticancer effect in vitro. However, to date no study has evaluated the relationship between colchicine use and incident cancers in patients with gout. This study enrolled male patients with gout identified in Taiwan's National Health Insurance Database for the years 1998 to 2011. Each gout patient was matched with 4 male controls by age and by month and year of first diagnosis, and was followed up until 2011. The study excluded those who were diagnosed with diabetes or any type of cancer within the year following enrollment. We calculated hazard ratio (HR), aged-adjusted standardized incidence ratio, and incidence of 1000 person-years analyses to evaluate cancer risk. A total of 24,050 male patients with gout and 76,129 male nongout controls were included. Patients with gout had a higher rate of incident all-cause cancers than controls (6.68% vs 6.43%, P = 0.006). A total of 13,679 patients with gout were defined as having been ever-users of colchicine and 10,371 patients with gout were defined as being never-users of colchicine. Ever-users of colchicine had a significantly lower HR of incident all-cause cancers than never-users of colchicine after adjustment for age (HR = 0.85, 95% CI = 0.77-0.94; P = 0.001). In conclusion, colchicine use was associated with a decreased risk of incident all-cause cancers in male Taiwanese patients with gout.

  19. Potential prognostic significance of decreased serum levels of TRAIL after acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Paola Secchiero

    Full Text Available BACKGROUND: Since soluble TRAIL exhibits anti-inflammatory and anti-atherosclerotic activities both in vitro and in animal models, this study was designed to assess the relationship between the serum levels of TRAIL and clinical outcomes in patients with acute myocardial infarction (AMI. METHODOLOGY/PRINCIPAL FINDINGS: Levels of TRAIL were measured by ELISA in serial serum samples obtained from 60 patients admitted for AMI, both during hospitalization and in a follow-up of 12 months, as well as in 60 healthy control subjects. Serum levels of TRAIL were significantly decreased in patients with AMI at baseline (within 24 hours from admission, compared with healthy controls, and showed a significant inverse correlation with a series of negative prognostic markers, such as CK, CK-MB and BNP. TRAIL serum levels progressively increased at discharge, but normalized only at 6-12 months after AMI. Of note, low TRAIL levels at the patient discharge were associated with increased incidence of cardiac death and heart failure in the 12-month follow-up, even after adjustment for demographic and clinical risk parameters (hazard ratio [HR] of 0.93 [95% CI, 0.89 to 0.97]; p = 0.001. CONCLUSIONS/SIGNIFICANCE: Although the number of patients studied was limited, our findings indicate for the first time that circulating TRAIL might represent an important predictor of cardiovascular events, independent of conventional risk markers.

  20. [Decrease in the incidence of chickenpox in the Community of Madrid after universal childhood immunization. Years 2001-2015].

    Science.gov (United States)

    García Comas, Luis; Latasa Zamalloa, Pello; Alemán Vega, Guadalupe; Ordobás Gavín, María; Arce Arnáez, Araceli; Rodero Garduño, Inmaculada; Estirado Gómez, Alicia; Marisquerena, Ester Insúa

    2018-01-01

    Varicella vaccine was recommended in the Community of Madrid (CM) at 15months of age between November 2006 and December 2013. The objective was to describe the impact of vaccination on the incidence of varicella in the CM during the period 2001-2015. A descriptive study of cases of varicella reported to the Sentinel Physician Network of the CM and the cases recorded in the Minimum Basic Data Set at hospital discharge was carried out. Total incidence of cases and of hospital admissions were calculated, as well as specific incidence by age and sex. The incidence was 94.0% lower between 2012 and 2013 than between 2001 and 2003. Between 2014 and 2015 the incidence was 61.8% higher than between 2012 and 2013. The highest incidence was observed in children aged 0 to 4years except for 2010-2014, which was exceeded by the incidence in children aged 5 to 9. The trend in hospital admissions was also decreasing, with the highest incidence in children aged 0 to 1year, followed by 1-4years. There has been a significant decrease in the incidence of cases and of hospital admissions by varicella in all age groups after the recommendation to vaccinate at 15months of age, which is compatible with the effectiveness of a dose and its ability to produce immunity group. The withdrawal of this recommendation between 2014 and 2015 has led to an increase in the incidence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  1. Decreasing Incidence of Skin and Soft Tissue Infections With a Seasonal Pattern at an Academic Medical Center, 2006-2014.

    Science.gov (United States)

    Morgan, Ethan; Daum, Robert S; David, Michael Z

    2016-10-01

    Background.  The incidence of skin and soft tissue infections (SSTIs) in the United States increased sharply after 2000 with the emergence of USA300 methicillin-resistant Staphylococcus aureus . We examined trends in SSTI incidence in 2006-2014 at the University of Chicago Medicine (UCM). Methods.  Data were obtained for patient encounters at UCM with an International Classification of Diseases, Ninth Revision -coded SSTI diagnosis between January 1, 2006 and March 31, 2014. Incidence density was calculated per 1000 encounters by quarter and year. Encounters were stratified by inpatient, outpatient clinic and emergency department (ED) encounters and by age group, gender, and race. Poisson regression was used to assess change over time. Results.  In 2006-2014, data were collected for 38 201 SSTI-associated encounters among 31 869 subjects. Among all patients treated at UCM, there was a decrease of 1% per year in the incidence of SSTIs during 2006-2013, with an overall decrease of 16%. There was a significant decrease in SSTI-related encounters among inpatients (rate ratio [RR] = 0.97; 95% confidence interval [CI], .96-.98), ED patients (RR = 0.98; 95% CI, .97-.98), adults (RR = 0.98; 95% CI, .97-.98), children (RR = 0.96; 95% CI, .95-.97), and African Americans (RR = 0.99; 95% CI, .98-.99). There was an annual seasonal trend, with the peak incidence occurring during the late summer. Conclusions.  The incidence of SSTIs at UCM decreased in children and adults with seasonal variation, peaking during the summer months. This suggests a reversal of the massive increase in SSTI incidence in the United States after 2000.

  2. Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa.

    Science.gov (United States)

    Smink, F R E; van Hoeken, D; Donker, G A; Susser, E S; Oldehinkel, A J; Hoek, H W

    2016-04-01

    Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s. A nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985-1989, 1995-1999, and 2005-2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios. The overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100,000 person-years in 1985-1989 to 6.1 in 1995-1999, and 3.2 in 2005-2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 100,000 person-years in 1985-1989, 7.8 in 1995-1999, and 6.0 in 2005-2009. The incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.

  3. Perioperative use of tamsulosin significantly decreases rates of urinary retention in men undergoing pelvic surgery.

    Science.gov (United States)

    Poylin, Vitaliy; Curran, Thomas; Cataldo, Thomas; Nagle, Deborah

    2015-09-01

    Urinary retention is a common complication of pelvic surgery, leading to urinary tract infection and prolonged hospital stays. Tamsulosin is an alpha blocker that works by relaxing bladder neck muscles. It is used to treat benign prostatic hypertrophy and retention. We aim to investigate the potential benefits of preemptive tamsulosin use on rates of urinary retention in men undergoing pelvic surgery. This is a retrospective review of an institutional colorectal database. All men undergoing pelvic surgery between 2004 and 2013 were included. Patients given 0.4 mg of tamsulosin 3 days prior and after surgery at discretion of surgeon starting in 2007 were compared with patients receiving expectant postoperative management. One hundred eighty-five patients were included in the study (study group: N = 30; control group: N = 155). Study group patients were older (56.8 vs. 50.1 years). Overall urinary retention rate was 22% with significantly lower rates in the study group compared with control (6.7 vs. 25%; p = 0.029). Study group had higher rates of minimally invasive surgery (61 vs. 29.7%); however, this did not impact urinary retention rate (20.6 vs. 22.7% for minimally invasive surgery vs. open surgery; p = 0.85). Independent predictors of urinary retention included lack of preemptive tamsulosin (odds ratio (OR), 7.67; 95% confidence interval (CI), 1.4-41.7) and cancer location in the distal third of the rectum (OR, 18.8; 95% CI, 2.1-172.8). Preemptive perioperative use of tamsulosin may significantly decrease the incidence of urinary retention in men undergoing pelvic surgery. This may play a role in avoidance of urinary retention, particularly in patients with distal rectal cancer.

  4. Early antiretroviral therapy and potent second-line drugs could decrease HIV incidence of drug resistance.

    Science.gov (United States)

    Shen, Mingwang; Xiao, Yanni; Rong, Libin; Meyers, Lauren Ancel; Bellan, Steven E

    2017-06-28

    Early initiation of antiretroviral therapy (ART) reduces the risk of drug-sensitive HIV transmission but may increase the transmission of drug-resistant HIV. We used a mathematical model to estimate the long-term population-level benefits of ART and determine the scenarios under which earlier ART (treatment at 1 year post-infection, on average) could decrease simultaneously both total and drug-resistant HIV incidence (new infections). We constructed an infection-age-structured mathematical model that tracked the transmission rates over the course of infection and modelled the patients' life expectancy as a function of ART initiation timing. We fitted this model to the annual AIDS incidence and death data directly, and to resistance data and demographic data indirectly among men who have sex with men (MSM) in San Francisco. Using counterfactual scenarios, we assessed the impact on total and drug-resistant HIV incidence of ART initiation timing, frequency of acquired drug resistance, and second-line drug effectiveness (defined as the combination of resistance monitoring, biomedical drug efficacy and adherence). Earlier ART initiation could decrease the number of both total and drug-resistant HIV incidence when second-line drug effectiveness is sufficiently high (greater than 80%), but increase the proportion of new infections that are drug resistant. Thus, resistance may paradoxically appear to be increasing while actually decreasing. © 2017 The Author(s).

  5. Incidence and complications of peptic ulcer disease requiring hospitalisation have markedly decreased in Finland.

    Science.gov (United States)

    Malmi, H; Kautiainen, H; Virta, L J; Färkkilä, N; Koskenpato, J; Färkkilä, M A

    2014-03-01

    The characteristics of peptic ulcer disease (PUD) are changing. To evaluate time trends in the incidence of PUD and its complications in hospitalised patients at the beginning of the 21st century, drug therapies in out-patient care as a risk factor for recurrent PUD, and medication used by PUD patients compared with the background population. In this retrospective epidemiologic cohort study, data from the years 2000-2008 came from The Hospital District of Helsinki and Uusimaa, and the Finnish Care Register. All hospitalised adult patients with PUD in the capital region of Finland were included. The data were linked with nationwide Prescription Register of the Finnish Social Insurance Institution allowing detailed individual medicine purchase data. A total of 9951 peptic ulcers were detected among 8146 individual patients during the study period. The mean annual incidence of all peptic ulcers decreased from 121/100,000 (95% CI: 117-125) in 2000-2002, to 79 (95% CI: 76-82) in 2006-2008 [Incidence rate ratio = 0.62 (95% CI: 0.58-0.64), P ulcers was 13%. Use of several drugs was associated with increased risk for recurrence. The purchases of various drugs were more common among PUD patients compared with background population. Both the incidence and complication rates have markedly decreased during the study period. Recurrent peptic ulcer disease was associated with polypharmacy. © 2014 John Wiley & Sons Ltd.

  6. Silencing of the rotavirus NSP4 protein decreases the incidence of biliary atresia in murine model.

    Directory of Open Access Journals (Sweden)

    Jiexiong Feng

    Full Text Available Biliary atresia is a common disease in neonates which causes obstructive jaundice and progressive hepatic fibrosis. Our previous studies indicate that rotavirus infection is an initiator in the pathogenesis of experimental biliary atresia (BA through the induction of increased nuclear factor-kappaB and abnormal activation of the osteopontin inflammation pathway. In the setting of rotavirus infection, rotavirus nonstructural protein 4 (NSP4 serves as an important immunogen, viral protein 7 (VP7 is necessary in rotavirus maturity and viral protein 4 (VP4 is a virulence determiner. The purpose of the current study is to clarify the roles of NSP4, VP7 and VP4 in the pathogenesis of experimental BA. Primary cultured extrahepatic biliary epithelia were infected with Rotavirus (mmu18006. Small interfering RNA targeting NSP4, VP7 or VP4 was transfected before rotavirus infection both in vitro and in vivo. We analyzed the incidence of BA, morphological change, morphogenesis of viral particles and viral mRNA and protein expression. The in vitro experiments showed NSP4 silencing decreased the levels of VP7 and VP4, reduced viral particles and decreased cytopathic effect. NSP4-positive cells had strongly positive expression of integrin subunit α2. Silencing of VP7 or VP4 partially decreased epithelial injury. Animal experiments indicated after NSP4 silencing, mouse pups had lower incidence of BA than after VP7 or VP4 silencing. However, 33.3% of VP4-silenced pups (N = 6 suffered BA and 50% of pups (N = 6 suffered biliary injury after VP7 silencing. Hepatic injury was decreased after NSP4 or VP4 silencing. Neither VP4 nor VP7 were detected in the biliary ducts after NSP4. All together, NSP4 silencing down-regulates VP7 and VP4, resulting in decreased incidence of BA.

  7. National Emergency Preparedness and Response: Improving for Incidents of National Significance

    National Research Council Canada - National Science Library

    Clayton, Christopher M

    2006-01-01

    .... More appropriately, the Department of Defense (DoD), the Department of Homeland Security (DHS), and the states need to become better partners in planning for, exercising for, and responding to Incidents of National Significance...

  8. Reduced oxygen protocol decreases the incidence of threshold retinopathy of prematurity in infants of <33 weeks gestation.

    Science.gov (United States)

    Tokuhiro, Yumiko; Yoshida, Tomoko; Nakabayashi, Yoshinobu; Nakauchi, Shohei; Nakagawa, Yumi; Kihara, Minako; Mitsufuji, Nobuto; Kizaki, Zenro

    2009-12-01

    The relationship between oxygen and retinopathy of prematurity (ROP) has been studied frequently, and a pulse oximeter has the potential to facilitate the control of oxygen fluctuation in neonates. The objective of the present study was to compare the incidence of threshold ROP (stage 3 requiring laser treatment and stage 4) in infants of Kyoto First Red Cross Hospital neonatal intensive care unit (NICU) from 1 July 2004 to 31 October 2007 (closed 1 December 2006-30 March 2007 for reconstruction). A reduced oxygen protocol was implemented to maintain oxygen saturation (SpO(2)) values using a pulse oximeter between 88% and 92%. The incidence of threshold ROP in the earlier period (1 July 2004-31 December 2005) and the later period (1 January 2006-31 October 2007) were compared. The incidence of threshold ROP significantly decreased from 32.2% to 16.7%, after changing to the reduced oxygen protocol (P < 0.05). A significant decrease in the rate of threshold ROP in infants of <33 weeks gestation was observed after implementation of the new clinical O(2) management practice.

  9. Cavum septi pellucidi and cavum vergae. Incidence on CT scan and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, S.; Hojo, H.; Kataoka, K.; Yamasaki, S. (Shizuoka Children' s Hospital, Shizuoka (Japan))

    1980-10-01

    1050 CT scans of patients under 15 years were reviewed. We also investigated the clinical features of these cases and made an attempt to disclose the incidence of cavum septi pellucidi (CSP) and cavum Vergae (CV) on the CT scan and to clarify their clinical significance. As a whole, CSP was demonstrated in 23 patients (2.2%), CV in 4 (0.4%), and both CSP and CV at the same time in 31 (3.0%). The incidence of CSP and CV in each age bracket decreased with an advance in age. No sexual differences were found. The incidences of CSP and CV in the patients with convulsive disorders, developmental delay, and other disorders were 6.4%, 5.1%, and 5.2% respectively. Of 64 patients with febrile convulsion, 4 had both CSP and CV at the same time, while one had only CSP. The four patients with both CSP and CV had convulsions three or more times, while the patient with only CSP had only one. These results suggested that those patients with febrile convulsions who had both CSP and CV at the same time were liable to have recurrent convulsions. Of 32 patients with benign infantile convulsions, only one had both CSP and CV. On the other hand, of 29 patients with infantile spasms, 2 had only CSP, and another 2 had both CSP and CV. Some patients with infantile spasms had CT scans demonstrating cerebral atrophy, porencephaly, cerebral angioma, and calcification in the brain, suggesting various types of etiology. Of 187 patients with other convulsive disorders, 4 had only CSP and 6 had both CSP and CV. Of 468 patients with developmental delay, 13 had only CSP (2.8%), one had only CV (0.2%), and 10 had both (2.1%). Of these 24 patients with developmental delay who had CSP and/or CV, 14 had cerebral atrophy besides, suggesting other etiological factors. Of 270 patients with other disorders, 3 had only CSP (1.1%), other 3 had only CV (1.1%), and 8 had both (3.0%).

  10. Prognostic Significance of Decreased Expression of Six Large Common Fragile Site Genes in Oropharyngeal Squamous Cell Carcinomas

    Directory of Open Access Journals (Sweden)

    Ge Gao

    2014-12-01

    Full Text Available Common fragile sites (CFSs are large regions with profound genomic instability that often span extremely large genes a number of which have been found to be important tumor suppressors. RNA sequencing previously revealed that there was a group of six large CFS genes which frequently had decreased expression in oropharyngeal squamous cell carcinomas (OPSCCs and real-time reverse transcriptase polymerase chain reaction experiments validated that these six large CFS genes (PARK2, DLG2, NBEA, CTNNA3, DMD, and FHIT had decreased expression in most of the tumor samples. In this study, we investigated whether the decreased expression of these genes has any clinical significance in OPSCCs. We analyzed the six CFS large genes in 45 OPSCC patients and found that 27 (60% of the OPSCC tumors had decreased expression of these six genes. When we correlated the expression of these six genes to each patient’s clinical records, for 11 patients who had tumor recurrence, 10 of them had decreased expression of almost all 6 genes. When we divided the patients into two groups, one group with decreased expression of the six genes and the other group with either slight changes or increased expression of the six genes, we found that there is significant difference in the incidence of tumor recurrence between these two groups by Kaplan-Meier plot analysis (P < .05. Our results demonstrated that those OPSCC tumors with decreased expression of this select group of six large CFS genes were much more likely to be associated with tumor recurrence and these genes are potential prognostic markers for predicting tumor recurrence in OPSCC.

  11. [Incidence of long (short) PR interval in electrocardiogram among healthy people in Changsha and its clinical significance].

    Science.gov (United States)

    Liu, Liping; Lin, Ping; Xu, Yi; Wu, Lijia; Zou, Runmei; Xie, Zhenwu; Wang, Cheng

    2016-04-01

    To analyze the incidence of long (short) PR interval in electrocardiogram among healthy people in Changsha and the clinical significance.
 Twelve-lead body surface electrocardiogram was taken to measure the heart rates and PR intervals from 4 025 healthy individuals (age range from 6 min after birth to 83 years old) who performed physical examination from Jan, 1993 to Dec, 2012 in the Second Xiangya Hospital, Central South University. Statistics were analyzed by SPSS 16.0.
 The total incidence of short PR interval was 19.65% (791/4 025). The age group from birth to 13 years old had a higher incidence than the other age groups (χ2=432, PPR intervals was 3.58% (144/4 025). The 1 year-old group had the highest incidence (6.74%), which decreased with the increase of age. The lowest incidence of long PR intervals occurred in the age group from 14-17 years old, which gradually increased after 50 years old. There were no significant differences in long (short) PR intervals between the gender (P>0.05).
 The incidence of long (short) PR intervals varies in different age groups of healthy people. The incidences of long (short) PR intervals in children before 10 years old are higher than those in adults, especially the short PR intervals, as a result of the heart rate affected by childhood autonomic nervous function and the change in atrial volume with age. Adults have long (short) PR interval should be regularly followed-up to prevent cardiovascular events.

  12. Trends in testicular cancer incidence in the Nordic countries with a special focus on the recent decrease in Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Rune; Møller, Henrik; Pukkala, Eero

    Testicular cancer is the most frequent malignancy among young men, and there have been steady increases in its incidence in most western countries for many decades. Recently, a decrease was seen in some countries, including Denmark. Here, we report recent trends in testicular cancer incidence...... and non-seminoma tumours. This descriptive study confirms the hypothesis that birth cohort has a major influence on the incidence pattern of testicular tumours and suggests that seminoma and non-seminoma have common aetiological factors....

  13. Incidence of hospitalised schizophrenia in Finland since 1980: decreasing and increasing again.

    Science.gov (United States)

    Salokangas, Raimo K R; Helminen, Mika; Koivisto, Anna-Maija; Rantanen, Helena; Oja, Hannu; Pirkola, Sami; Wahlbeck, Kristian; Joukamaa, Matti

    2011-04-01

    It is suggested that the incidence of schizophrenia is decreasing. However, changes in the number of psychiatric beds available and diagnostic practice have not always been taken into account. We studied the annual first-admission rate (per 100,000) for schizophrenia (FARsch) during a rapid deinstitutionalisation period in Finland. From the National Finnish Hospital discharge register, we identified all 30,041, 15- to 64-year-old patients admitted for the first time with schizophrenia to hospitals in Finland between 1980 and 2003. FARsch decreased from 56.39 in 1980 to 29.51 in 1991 and slightly increased thereafter. Changes in FARsch corresponded with changes in all admissions. FARsch was higher when using ICD-8, but lower when DSM-IIIR and ICD-10 were used. Changes in the number of psychiatric beds available, admission policy and diagnostic practice may explain the majority of variations in FARsch. Possibly, increased use of illegal drugs and improved treatment of depression are reflected in the increase in FARsch.

  14. Nebulized ketamine decreases incidence and severity of post-operative sore throat

    Directory of Open Access Journals (Sweden)

    Vanita Ahuja

    2015-01-01

    Full Text Available Background and Aims: Post-operative sore throat (POST occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST. Methods: We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA were enrolled. Patients were randomised into two groups; group saline (S received saline nebulisation 5.0 ml and group ketamine (K received ketamine 50 mg (1.0 ml with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3. Results: The overall incidence of POST was 33%; 23 patients (46% in saline and 10 patients (20% in ketamine group experienced POST (Fisher′s exact P = 0.01. The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05. The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03 experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02. Conclusion: Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects.

  15. Nebulized ketamine decreases incidence and severity of post-operative sore throat.

    Science.gov (United States)

    Ahuja, Vanita; Mitra, Sukanya; Sarna, Rashi

    2015-01-01

    Post-operative sore throat (POST) occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST. We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA) were enrolled. Patients were randomised into two groups; group saline (S) received saline nebulisation 5.0 ml and group ketamine (K) received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3). The overall incidence of POST was 33%; 23 patients (46%) in saline and 10 patients (20%) in ketamine group experienced POST (Fisher's exact P = 0.01). The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05). The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03) experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02). Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects.

  16. Significant decrease in congenital malformations in newborn infants of an unselected population of diabetic women

    DEFF Research Database (Denmark)

    Damm, P; Mølsted-Pedersen, L

    1989-01-01

    In an unselected and consecutive series of 1858 newborn infants of diabetic mothers, born in the Rigshospital, Copenhagen, in the period 1967 to 1986, congenital malformations were studied. The malformation rate in White Classes B to F was remarkably constant from 1967 to 1981, but a significant...... decrease in major congenital malformations was found in the period 1982 to 1986 versus 1977 to 1981 (2.7% vs. 7.4%, p less than 0.05). This decrease was mainly due to a fourfold decline in major congenital malformations in White Classes D and F (p less than 0.01), and consequently a correlation between...... the severity of maternal diabetes and the frequency of congenital malformations was no longer present. In the offspring of a control group of 1715 nondiabetic women, major congenital malformations were found in 1.7% (p greater than 0.05). Seventy-five percent of the diabetic pregnancies were planned...

  17. An Acute Lateral Ankle Sprain Significantly Decreases Physical Activity across the Lifespan

    Directory of Open Access Journals (Sweden)

    Tricia Hubbard-Turner, Erik A. Wikstrom, Sophie Guderian, Michael J. Turner

    2015-09-01

    Full Text Available We do not know the impact an ankle sprain has on physical activity levels across the lifespan. With the negative consequences of physical inactivity well established, understanding the effect of an ankle sprain on this outcome is critical. The objective of this study was to measure physical activity across the lifespan after a single ankle sprain in an animal model. Thirty male mice (CBA/J were randomly placed into one of three groups: the transected calcaneofibular ligament (CFL group, the transected anterior talofibular ligament (ATFL/CFL group, and a SHAM group. Three days after surgery, all of the mice were individually housed in a cage containing a solid surface running wheel. Physical activity levels were recorded and averaged every week across the mouse’s lifespan. The SHAM mice ran significantly more distance each day compared to the remaining two running groups (post hoc p = 0.011. Daily duration was different between the three running groups (p = 0.048. The SHAM mice ran significantly more minutes each day compared to the remaining two running groups (post hoc p=0.046 while the ATFL/CFL mice ran significantly less minutes each day (post hoc p = 0.028 compared to both the SHAM and CFL only group. The SHAM mice ran at a faster daily speed versus the remaining two groups of mice (post hoc p = 0.019 and the ATFL/CFL mice ran significantly slower each day compared to the SHAM and CFL group (post hoc p = 0.005. The results of this study indicate that a single ankle sprain significantly decreases physical activity across the lifespan in mice. This decrease in physical activity can potentially lead to the development of numerous chronic diseases. An ankle sprain thus has the potential to lead to significant long term health risks if not treated appropriately.

  18. Significant decrease of mortality due to anastomotic leaks following esophageal resection: management makes the difference.

    Science.gov (United States)

    Schaible, Anja; Brenner, Thorsten; Hinz, Ulf; Schmidt, Thomas; Weigand, Markus; Sauer, Peter; Büchler, Markus W; Ulrich, Alexis

    2017-12-01

    Anastomotic leakage is the most frequent cause of postoperative mortality following esophageal surgery. However, no gold standard for diagnosing and managing leakage has been established. Continuous clinical judgment is extremely important; therefore, to optimize the management of leakage, we established a special group for decision-making in cases of suspected leakage in the early postoperative period. Between January 2010 and December 2016, 234 consecutive patients underwent elective esophageal resection with a thoracoabdominal incision. In 2014, we established a group consisting of a surgeon, surgical endoscopist, and anesthesiologist for decision-making in cases of suspected leakage. They discussed emerging problems and decided on further diagnostics or therapy. The data were documented prospectively and compared to the years prior to 2014. Two hundred and thirty-four consecutive patients were enrolled in the study, 110 in the years 2010-2013 (group A), and 124 in the years 2014-2016 (group B). Neither patients' characteristics nor the rate of anastomotic leakage differed significantly between the two study groups. The hospital mortality rate was 10% (11 patients) in group A and 4.8% (six patients) in group B. Most interestingly, mortality due to anastomotic leakage was 35% in group A (9/26), whereas it decreased significantly to 6.5% (2/31 patients) (P < 0.001) in group B. Our data clearly demonstrated that optimizing the management of anastomotic leakage by making team decisions can lead to a significant decrease in mortality.

  19. Use of an intraoperative checklist to decrease the incidence of re-exploration for postoperative bleeding after cardiac surgery.

    Science.gov (United States)

    van Boxtel, Astrid G M; van Veghel, Dennis; Soliman Hamad, Mohamed A; Schulz, Daniela N; Stepaniak, Pieter S; van Straten, Albert H M

    2017-10-01

    We have implemented an intraoperative checklist aiming to reduce the incidence of re-exploration for bleeding after cardiac surgery. The present report addresses the results of adopting such a checklist regarding the incidence of postoperative bleeding. The checklist was implemented by presenting it in several staff meetings of the Catharina Heart Center. Copies of the checklist were presented in every operating room. Data were collected by the Catharina Heart Center, aligned with the 'Meetbaar Beter' data manual and validated by 'Meetbaar Beter' through their data quality system. The incidence of re-exploration for bleeding was analysed in a variable life-adjusted display curve. The patient population operated after the implementation of the checklist was compared with a recent historical population before its implementation. From January 2013 through April 2016, 4817 cardiac surgical procedures were performed in our institution. Before May 2015, 3210 procedures were performed (Group 1), complicated by 112 re-exploration for bleeding (3.5%). The 'reoperation for bleeding checklist' was implemented on 1 May 2015. After this date, the number of re-explorations for bleeding decreased to 29 (1.8%) of the 1607 cardiac surgical procedures (Group 2) (P checklist is feasible to implement, low cost, quick and simple to measure with a significant reduction in the incidence of re-exploration for bleeding. This report shows an example of the positive effects of transparency in publishing outcomes' data in cardiac surgery. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. Circulating Microparticles Decrease After Cardiac Stress in Patients With Significant Coronary Artery Stenosis.

    Science.gov (United States)

    Sinning, Jan-Malte; Jansen, Felix; Hammerstingl, Christoph; Meier, Arne; Losch, Jan; Rohwer, Katharina; Schmitz, Theresa; Paul, Kathrin; Sedaghat, Alexander; Schueler, Robert; Vasa-Nicotera, Mariuca; Müller, Cornelius; Nickenig, Georg; Werner, Nikos

    2016-10-01

    Cardiac stress leads to a dynamic increase of circulating microparticles (MPs) in healthy individuals that is diminished in individuals with vascular disease. The impact of coronary ischemia on circulating MP level is unknown. This study investigates the kinetics of circulating MPs during cardiac stress in patients with coronary artery stenosis. Patients with significant coronary stenosis show altered circulating MP levels after cardiac stress. Eighty patients with stable coronary artery disease underwent dobutamine stress echocardiography (DSE) on the day before coronary angiography. Before, immediately after, at 4 hours, and at 24 hours after DSE, blood was drawn to determine CD144 + endothelial microparticles (EMPs), CD14 + CD16 + monocyte-derived microparticles (MMPs), and CD31 + CD42b + platelet microparticles. A significant stenosis was defined as stenosis diameter ≥70% in a major native epicardial coronary artery with a diameter of ≥2.5 mm. Significant coronary artery stenoses were found in 41 patients. In these patients, CD144 + -EMP and CD14 + CD16 + -MMP concentrations decreased immediately after DSE. Stimulation of target endothelial cells with sera from patients with significant coronary artery stenoses significantly augmented endothelial capacity to take up EMPs, but not MMPs, in vitro. Serum-induced enhancement of endothelial phosphatidylserine receptor expression was found as a potential mechanism of increased endothelial EMP uptake and subsequently reduced circulating EMP levels after cardiac stress. Cardiac ischemia leads to reduced circulating MP levels under cardiac stress. Changes of endothelial MP uptake capacities could be one possible mechanism. © 2016 Wiley Periodicals, Inc.

  1. Decreasing incidence of peptic ulcer complications after the introduction of the proton pump inhibitors, a study of the Swedish population from 1974–2002

    Directory of Open Access Journals (Sweden)

    Ranstam Jonas

    2009-04-01

    Full Text Available Abstract Background Despite a decreasing incidence of peptic ulcer disease, most previous studies report a stabile incidence of ulcer complications. We wanted to investigate the incidence of peptic ulcer complications in Sweden before and after the introduction of the proton pump inhibitors (PPI in 1988 and compare these data to the sales of non-steroid anti-inflammatory drugs (NSAID and acetylsalicylic acid (ASA. Methods All cases of gastric and duodenal ulcer complications diagnosed in Sweden from 1974 to 2002 were identified using the National hospital discharge register. Information on sales of ASA/NSAID was obtained from the National prescription survey. Results When comparing the time-periods before and after 1988 we found a significantly lower incidence of peptic ulcer complications during the later period for both sexes (p Conclusion When comparing the periods before and after the introduction of the proton pump inhibitors we found a significant decrease in the incidence of peptic ulcer complications in the Swedish population after 1988 when PPI were introduced on the market. The cause of this decrease is most likely multifactorial, including smoking habits, NSAID consumption, prevalence of Helicobacter pylori and the introduction of PPI. Sales of prescribed NSAID/ASA increased, especially in middle-aged and elderly women. This fact seems to have had little effect on the incidence of peptic ulcer complications.

  2. L-carnitine significantly decreased aging of rat adipose tissue-derived mesenchymal stem cells.

    Science.gov (United States)

    Mobarak, Halimeh; Fathi, Ezzatollah; Farahzadi, Raheleh; Zarghami, Nosratollah; Javanmardi, Sara

    2017-03-01

    Mesenchymal stem cells are undifferentiated cells that have the ability to divide continuously and tissue regeneration potential during the transplantation. Aging and loss of cell survival, is one of the main problems in cell therapy. Since the production of free radicals in the aging process is effective, the use of antioxidant compounds can help in scavenging free radicals and prevent the aging of cells. The aim of this study is evaluate the effects of L-carnitine (LC) on proliferation and aging of rat adipose tissue-derived mesenchymal stem cells (rADSC). rADSCs were isolated from inguinal region of 5 male Rattus rats. Oil red-O, alizarin red-S and toluidine blue staining were performed to evaluate the adipogenic, osteogenic and chondrogenic differentiation of rADSCs, respectively. Flow cytometric analysis was done for investigating the cell surface markers. The methyl thiazol tetrazolium (MTT) method was used to determine the cell proliferation of rADSCs following exposure to different concentrations of LC. rADSCs aging was evaluated by beta-galactosidase staining. The results showed significant proliferation of rADSCs 48 h after treatment with concentrations of 0.2 mM LC. In addition, in the presence of 0.2 mM LC, rADSCs appeared to be growing faster than control group and 0.2 mM LC supplementation could significantly decrease the population doubling time and aging of rADSCs. It seems that LC would be a good antioxidant to improve lifespan of rADSCs due to the decrease in aging.

  3. Intravenous Iron Repletion Does Not Significantly Decrease Platelet Counts in CKD Patients with Iron Deficiency Anemia

    Directory of Open Access Journals (Sweden)

    Neville R. Dossabhoy

    2013-01-01

    Full Text Available Purpose. We sought to investigate the effect of IV iron repletion on platelet (PLT counts in CKD patients with iron deficiency anemia (IDA. Methods. We conducted a retrospective chart review, including all patients with CKD and IDA who were treated with iron dextran total dose infusion (TDI between 2002 and 2007. Patient demographics were noted, and laboratory values for creatinine, hemoglobin (Hgb, iron stores and PLT were recorded pre- and post-dose. Results. 153 patients received a total of 251 doses of TDI (mean ± SD = 971 ± 175 mg; age years and Creatinine  mg/dL. All CKD stages were represented (stage 4 commonest. Hgb and Fe stores improved post-TDI (. There was a very mild decrease in PLT (pre-TDI 255 versus post-TDI 244, . The mild reduction in PLT after TDI remained non-significant ( when data was stratified by molecular weight (MW of iron dextran used (low versus high, as well as by dose administered (<1000 versus ≥1000 mg. Linear regression analysis between pre-dose PLT and Tsat and Fe showed R2 of 0.01 and 0.04, respectively. Conclusion. Correction of iron deficiency did not significantly lower PLT in CKD patients, regardless of MW or dose used. Correlation of PLT to severity of iron deficiency was very weak.

  4. A national retrospective survey of anisakidosis in France (2010-2014: decreasing incidence, female predominance, and emerging allergic potential

    Directory of Open Access Journals (Sweden)

    Yera Hélène

    2018-01-01

    Full Text Available A retrospective survey was carried out over the years 2010–2014 among all Parasitology laboratories of University hospitals in France (ANOFEL network. The objective was to estimate the incidence of anisakidosis in France as new culinary habits such as the consumption of raw fish (sushi or undercooked fish are increasing. A total of 37 cases of anisakidosis were notified by all French laboratories: 7 proven cases with evidence of a worm, 12 possible cases with abdominal pain after consumption of raw fish with detection of anti-Anisakis precipitins, and 18 allergic cases defined as acute manifestations after consumption of fish, associated with specific IgE for Anisakis. The median age of affected individuals was 42 years (11-69 and there was a significant predominance of women (67%. Compared with previous surveys in France, this study indicates a decrease in clinical cases of anisakidosis and illustrates the emerging allergic potential of anisakids.

  5. A phase II trial of a surgical protocol to decrease the incidence of wound complications in obese gynecologic oncology patients.

    Science.gov (United States)

    Novetsky, Akiva P; Zighelboim, Israel; Guntupalli, Saketh R; Ioffe, Yevgeniya J M; Kizer, Nora T; Hagemann, Andrea R; Powell, Matthew A; Thaker, Premal H; Mutch, David G; Massad, L Stewart

    2014-08-01

    Obese women have a high incidence of wound separation after gynecologic surgery. We explored the effect of a prospective care pathway on the incidence of wound complications. Women with a body mass index (BMI) ≥30 kg/m(2) undergoing a gynecologic procedure by a gynecologic oncologist via a vertical abdominal incision were eligible. The surgical protocol required: skin and subcutaneous tissues to be incised using a scalpel or cutting electrocautery, fascial closure using #1 polydioxanone suture, placement of a 7 mm Jackson-Pratt drain below Camper's fascia, closure of Camper's fascia with 3-0 plain catgut suture and skin closure with staples. Wound complication was defined as the presence of either a wound infection or any separation. Demographic and perioperative data were analyzed using contingency tables. Univariable and multivariable regression models were used to identify predictors of wound complications. Patients were compared using a multivariable model to a historical group of obese patients to assess the efficacy of the care pathway. 105 women were enrolled with a median BMI of 38.1. Overall, 39 (37%) had a wound complication. Women with a BMI of 30-39.9 kg/m(2) had a significantly lower risk of wound complication as compared to those with a BMI >40 kg/m(2) (23% vs 59%, pcontrolling for factors associated with wound complications the prospective care pathway was associated with a significantly decreased wound complication rate in women with BMI <40 kg/m(2) (OR 0.40, 95% C.I.: 0.18-0.89). This surgical protocol leads to a decreased rate of wound complications among women with a BMI of 30-39.9 kg/m(2). Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) decreases the incidence of MRSA bacteremia.

    Science.gov (United States)

    Shitrit, Pnina; Gottesman, Bat-Sheva; Katzir, Michal; Kilman, Avi; Ben-Nissan, Yona; Chowers, Michal

    2006-10-01

    To evaluate the influence of performance of active surveillance cultures for methicillin-resistant Staphylococcus aureus (MRSA) on the incidence of nosocomial MRSA bacteremia in an endemic hospital. Before-after trial. A 700-bed hospital. All patients admitted to the hospital who were at high risk for MRSA bacteremia. Performance of surveillance cultures for detection of MRSA were recommended for all patients at high risk, and contact isolation was implemented for patients with positive results of culture. Each MRSA-positive patient received one course of eradication treatment. We compared the total number of surveillance cultures, the percentage of surveillance cultures with positive results, and the number of MRSA bacteremia cases before the intervention (from January 2002 through February 2003) after the start of the intervention (from July 2003 through October 2004). The number of surveillance cultures performed increased from a mean of 272.57 cultures/month before the intervention to 865.83 cultures/month after the intervention. The percentage of surveillance cultures with positive results increased from 3.13% before to 5.22% after the intervention (P hidden reservoirs of MRSA. Contact isolation can prevent new colonization and infection and lead to a significant reduction of morbidity and healthcare costs.

  7. MRI detection of unsuspected vertebral injury in acute spinal trauma: incidence and significance

    International Nuclear Information System (INIS)

    Qaiyum, M.; Tyrrell, P.N.M.; McCall, I.W.; Cassar-Pullicino, V.N.

    2001-01-01

    Objective. Multilevel spinal injury is well recognised. Previous studies reviewing the radiographs of spinal injury patients have shown an incidence of 15.2% of unsuspected spinal injury. It is recognised that magnetic resonance imaging (MRI) can identify injuries that are not demonstrated on radiographs. The objective of this study was to determine the incidence and significance of spinal injuries using MRI in comparison with radiographs.Design and patients. The radiographs and MR images of 110 acute spinal injury patients were reviewed independently of each other and the findings were then correlated to determine any unsuspected injury.Results. MRI detected vertebral body bone bruises (microtrabecular bone injury) in 41.8% of spinal injury patients which were not seen on radiographs. These bone bruises were best appreciated on sagittal short tau inversion recovery MR sequences and seen at contiguous and non-contiguous levels in relation to the primary injury.Conclusion. This level of incidence of bone bruises has not previously been appreciated. We recommend that patients undergoing MRI for an injured segment of the spine are better assessed by MRI of the entire spine at the same time to exclude further injury. (orig.)

  8. Decrease of the incidence of human and canine visceral leishmaniasis after dog vaccination with Leishmune in Brazilian endemic areas.

    Science.gov (United States)

    Palatnik-de-Sousa, Clarisa B; Silva-Antunes, Ilce; Morgado, Adilson de Aguiar; Menz, Ingrid; Palatnik, Marcos; Lavor, Carlile

    2009-06-02

    Leishmune, the first prophylactic vaccine licensed against canine visceral leishmaniasis (CVL), has been used in Brazil since 2004, where seropositive dogs are sacrificed in order to control human visceral leishmaniasis (VL). We demonstrate here that vaccination with Leishmune does not interfere with the serological control campaign (110,000 dogs). Only 1.3% of positivity (76 among 5860) was detected among Leishmune uninfected vaccinees. We also analyzed the possible additive effect of Leishmune vaccination over dog culling, on the decrease of the incidence of CVL and VL in two Brazilian endemic areas, from 2004 to 2006. In Araçatuba, a 25% of decline was seen in CVL with a 61% decline in human cases, indicating the additive effect of Leishmune vaccination of 5.7% of the healthy dogs (1419 dogs), on regular dog culling. In Belo Horizonte (BH), rising curves of canine and human incidence were observed in the districts of Barreiro, Venda Nova and Noroeste, while the canine and human incidence of Centro Sul, Leste, Nordeste, Norte, Pampulha and Oeste, started to decrease or maintained a stabilized plateau after Leishmune vaccination. Among the districts showing a percent decrease of human incidence (-36.5%), Centro Sul and Pampulha showed the highest dog vaccination percents (63.27% and 27.27%, respectively) and the lowest dog incidence (-3.36% and 1.89%, respectively). They were followed by Oeste, that vaccinated 25.30% of the animals and experienced an increase of only 12.86% of dog incidence and by Leste and Nordeste, with lower proportions of vaccinees (11.72% and 10.76%, respectively) and probably because of that, slightly higher canine incidences (42.77% and 35.73%). The only exception was found in Norte district where the reduced human and canine incidence were not correlated to Leishmune vaccination. Much lower proportions of dogs were vaccinated in Venda Nova (4.35%), Noroeste (10.27%) and Barreiro (0.09%) districts, which according to that exhibited very

  9. Norfloxacin and cisapride combination decreases the incidence of spontaneous bacterial peritonitis in cirrhotic ascites.

    Science.gov (United States)

    Sandhu, Bimaljit S; Gupta, Rajesh; Sharma, Jayant; Singh, Jagdeep; Murthy, Nandagudi S; Sarin, Shiv K

    2005-04-01

    Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis with ascites, having high recurrence despite antibiotic prophylaxis. Small bowel dysmotility and bacterial overgrowth have been documented to be related to SBP. The purpose of the present paper was (i) to study whether addition of a prokinetic agent to norfloxacin ameliorates the development of SBP in high-risk patients; and (ii) to identify risk factors for SBP development. A prospective, single blinded, randomized controlled trial was conducted in high-risk cirrhotic patients with ascites who had either recovered from an episode of SBP or who had low ascitic fluid protein. Norfloxacin 400 mg once daily (group I) or norfloxacin 400 mg once daily with cisapride 20 mg twice a day (group II) was given and occurrence of side-effects of therapy and mortality were recorded. Of the 94 patients, 48 (51%) were in group I, and 46 (49%) in group II. The actuarial probability of developing SBP at 12 month in group I was 56.8% and in group II, 21.7% (P = 0.026). Treatment failure was observed in five patients (10%) in group I and none in group II (P = 0.003). The actuarial probability of death at 18 months was 20.6% in group I and 6.2% in group II (P = 0.1). Low serum albumin, low ascitic fluid protein and alcoholic cirrhosis were related to development of SBP (P norfloxacin and cisapride significantly reduces the incidence of SBP in high-risk cirrhosis patients; low serum albumin, low ascitic fluid protein and alcoholic cirrhosis predispose to the development of SBP in high-risk cirrhosis patients; and low ascitic fluid protein should also be considered as a risk factor for the development of SBP requiring prophylaxis.

  10. Guideline implementation results in a decrease of pressure ulcer incidence in critically ill patients.

    NARCIS (Netherlands)

    Laat, E.H. de; Pickkers, P.; Schoonhoven, L.; Verbeek, A.L.M.; Feuth, T.; Achterberg, T. van

    2007-01-01

    OBJECTIVE: To describe the short-term and long-term effects of a hospital-wide pressure ulcer prevention and treatment guideline on both the incidence and the time to the onset of pressure ulcers in critically ill patients. DESIGN: Prospective cohort study. SETTING: Adult intensive care department

  11. Perioperative intravenous lidocaine decreases the incidence of persistent pain after breast surgery.

    LENUS (Irish Health Repository)

    Grigoras, Anca

    2012-09-01

    Breast cancer surgery is associated with a high incidence of persistent postsurgical pain (PPSP). The aim of this study was to evaluate the impact of intravenous (IV) lidocaine on acute and PPSP, analgesic requirements, and sensation abnormalities in patients undergoing surgery for breast cancer.

  12. Automated reminders decrease postoperative nausea and vomiting incidence in a general surgical population

    NARCIS (Netherlands)

    Kooij, F. O.; Vos, N.; Siebenga, P.; Klok, T.; Hollmann, M. W.; Kal, J. E.

    2012-01-01

    Guidelines to minimize the incidence of postoperative nausea and vomiting (PONV) have been implemented in many hospitals. In previous studies, we have demonstrated that guideline adherence is suboptimal and can be improved using decision support (DS). In this study, we investigate whether DS

  13. The incidence of mesothelioma has not decreased for the last twenty ...

    African Journals Online (AJOL)

    Background: Malignant pleural Mesothelioma (MPM) is a very rarely encountered tumor in the normal population. Objectives: To investigate the variations in incidence of MPM in Southeast region of Turkey. Methods: We retrospectively investigated the data of 161 MPM patients who were diagnosed from January 2000 to ...

  14. An Inexpensive Modified Primary Closure Technique for Class IV (Dirty) Wounds Significantly Decreases Superficial and Deep Surgical Site Infection.

    Science.gov (United States)

    Kim, Bradford J; Aloia, Thomas A

    2016-11-01

    Despite the creation of several programs to decrease the incidence of surgical site infection, it remains a common complication that has a significant impact on patient recovery and medical costs. The following is a description and brief outcome report of a modified primary closure technique used for dirty (Class IV) wounds. There were 14 consecutive patients who had a laparotomy with Class IV wounds treated by a single surgeon (TAA) from 2011 to 2015. All patients had a history of cancer and either showed signs suggestive for an acute abdomen and required an emergent exploratory laparotomy or were found to have purulent intraabdominal infection at the time of elective surgery. The operation and "modified primary closure" technique (subcutaneous wound wicks with stapled skin closure) were performed in every case. The modified primary closure technique was utilized in 14 patients with a Class IV wound. There were no 30-day mortalities or readmissions. Wound wicks were slowly advanced out over a 7-day period, and only one patient required subsequent wound packing of a single-wicked area. There were no superficial or deep surgical site infections, or wound dehiscence during the hospital course, or 30-day postoperative period. The modified primary closure technique is efficient and inexpensive and was effective in a series of 14 patients with wounds classified as dirty.

  15. Sleep duration is significantly associated with carotid artery atherosclerosis incidence in a Japanese population.

    Science.gov (United States)

    Abe, Tsueko; Aoki, Toshinari; Yata, Syogo; Okada, Masahiko

    2011-08-01

    Previous studies have indicated that sleep duration is associated with total mortality in a U-shaped fashion. The purpose of the current study was to examine the relationship between self-reported sleep duration and carotid artery atherosclerosis in a Japanese population. In 2009-2010, a total of 2498 participants (1195 men, 1303 women; age range, 23-92 years) were recruited from members of a Japanese community receiving annual health check-up at a local health center who agreed to participate in the study. Exclusion criteria were as follows: age <40 or ≥85 years; and more than one missing value from either laboratory data or questionnaire responses. A total of 2214 participants were entered into the study. Carotid artery arteriosclerosis was evaluated ultrasonographically and quantified as intima-medial thickness (IMT). The presence of carotid artery atherosclerosis was defined as IMT≥1.2 mm. Sleep durations were compared with IMT measurements after controlling for confounding factors such as age, sex, lipid profile, fasting plasma glucose, hemoglobin A1c, blood pressure, alcohol intake, and smoking habit. Sleep duration ≥7 h correlated significantly with the incidence of IMT≥1.2 m when compared with a sleep duration of 6 h (multivariate-adjusted odds ratio, 1.263; 95% confidence interval, 1.031-1.546, P=0.024). Shorter sleep duration ≤5 h did not correlate significantly with the risk compared with a sleep duration of 6 h. Long sleep duration (≥7 h) correlated significantly with the incidence of carotid artery atherosclerosis compared with a sleep duration of 6 h, but shorter sleep duration did not. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. A review of clinical trials in dietary interventions to decrease the incidence of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Miettinen Tatu A

    2001-04-01

    Full Text Available Abstract Of the associations between dietary elements and coronary artery disease (CAD, the greatest body of evidence deals with the beneficial effect of reducing the dietary intake of saturated fatty acids and cholesterol. Furthermore, it is well established, on the basis of convincing evidence, that reduction in serum total cholesterol results in reduction in coronary morbidity and mortality, as well as in regression of other atherosclerotic manifestations.In fact, dietary intervention studies revealed that it is possible to reduce the incidence of coronary death and nonfatal myocardial infarction, as well as manifestations of atherosclerosis in cerebral and peripheral arteries, by reducing dietary intake of saturated fat and cholesterol. In two recently reported dietary interventions the incidence of coronary events, especially coronary mortality, and total mortality were reduced by increased intake of n-3 long-chain polyunsaturated fatty acids and by a modification of the diet toward a Mediterranean-type diet (rich in α-linolenic acid. In addition to those findings, the potential efficacy of the dietary newcomers phytostanol and phytosterol esters on reducing coronary incidence is discussed in the present review.

  17. Incidence and prognostic significance of new onset atrial fibrillation/flutter in acute pericarditis.

    Science.gov (United States)

    Imazio, Massimo; Lazaros, George; Picardi, Elisa; Vasileiou, Panagiotis; Orlando, Fabrizio; Carraro, Mara; Tsiachris, Dimitris; Vlachopoulos, Charalambos; Georgiopoulos, George; Tousoulis, Dimitrios; Belli, Riccardo; Gaita, Fiorenzo

    2015-09-01

    Data on the incidence of new onset atrial fibrillation and flutter (AF/f) in patients with acute pericarditis are limited. We sought to determine the incidence and prognostic significance of AF/f in this setting. Between January 2006 and June 2014, consecutive new cases of acute pericarditis were included in two urban referral centres for pericardial diseases. All new cases of AF/f defined as episodes lasting ≥30 s were recorded. Events considered during follow-up consisted of AF/f and pericarditis recurrence, cardiac tamponade, pericardial constriction and death. 822 consecutive new cases of acute pericarditis (mean age 53±15 years, 444 men) were analysed. AF/f was detected in 35 patients (4.3%, mean age 66.5±11.3 years, 18 men). Patients with AF/f were significantly older (p=0.017) and presented more frequently with pericardial effusion (ppericarditis onset in 91.4% of cases, lasted >24 h in 25.7% and spontaneously converted in 74.3% of patients. Underlying structural heart disease was present in 17% of AF/f cases. In a 30-month follow-up, patients with history of AF/f at the initial episode had a higher rate of arrhythmia occurrence (34.3% vs 0.9%, ppericarditis identifies a predisposed population to AF/f with a high recurrence risk (about 35%): in these patients, pericarditis may act as an arrhythmic trigger and oral anticoagulation should be seriously considered according to guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: a hospital-based clinical analysis

    Directory of Open Access Journals (Sweden)

    Wang C

    2016-01-01

    Full Text Available Chuanling Wang,1,* Fuming Tian,1,* Yingjun Zhou,2 Wenbo He,1 Zhiyou Cai1 1Department of Neurology, 2Physical Examination Center, Renmin Hospital, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, People’s Republic of China *These authors contributed equally to this work Background and purpose: Cervical spondylosis is well accepted as a common degenerative change in the cervical spine. Compelling evidence has shown that the incidence of cervical spondylosis increases with age. However, the relationship between age and the incidence of cervical spondylosis remains obscure. It is essential to note the relationship between age and the incidence of cervical spondylosis through more and more clinical data.Methods: In the case-controlled study reported here, retrospective clinical analysis of 1,276 cases of cervical spondylosis has been conducted. We analyzed the general clinical data, the relationship between age and the incidence of cervical spondylosis, and the relationship between age-related risk factors and the incidence of cervical spondylosis. A chi-square test was used to analyze the associations between different variables. Statistical significance was defined as a P-value of less than 0.05.Results: The imaging examination demonstrated the most prominent characteristic features of cervical spondylosis: bulge or herniation at C3-C4, C4-C5, and C5-C6. The incidence of cervical spondylosis increased with aging before age 50 years and decreased with aging after age 50 years, especially in the elderly after 60 years old. The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 increased with aging before age 50 years and decreased with aging after age 50 years, especially after 60 years. Moreover, the incidence of hyperosteogeny and spinal stenosis increased with aging before age 60 years and decreased with aging after age 60 years, although there was no obvious change in calcification. The age

  19. Significance of the factor analysis due to decreasing anthropogenic pollution--exemplified by river sediments.

    Science.gov (United States)

    Möller, Stefan; Einax, Jürgen W

    2015-05-01

    Environmental datasets often consist of numerous features analyzed in many investigated samples. Therefore, the evaluation of those datasets is difficult. Chemometric methods like the factor analysis are useful tools to handle big datasets. In this paper, we discussed the relation between the geogenic background (noise) and anthropogenic pollution (source) for the suitability of environmental datasets for factor analytical methods. Thus, computed test datasets with different sources, diverse maximum of the sources, and various geogenic backgrounds were generated. Afterward, the maximum of the source was decreased stepwise, a factor analysis was computed, and the corresponding results were investigated in respect of the credibility. The major impacts on the evaluation of a feature are the mean value of the noise and the standard deviation of the noise. With the help of these two parameters, a pollution index can be calculated. The maximum of the source has to exceed that index in order to be usefully evaluable with the factor analyses. The evaluation of the results of the factor analysis would become increasingly complicated if the variability of a dataset decreases due to reduced maximum values or geogenic/anthropogenic sources which correspond to increasing environmental quality.

  20. Defining the incidence and clinical significance of lymph node metastasis in soft tissue sarcoma.

    Science.gov (United States)

    Keung, Emily Z; Chiang, Yi-Ju; Voss, Rachel K; Cormier, Janice N; Torres, Keila E; Hunt, Kelly K; Feig, Barry W; Roland, Christina L

    2018-01-01

    The incidence and clinical significance of lymph node metastasis (LNM, N1) in soft tissue sarcoma (STS) is unclear. Recent studies have focused on extremity/trunk STS (ETSTS). We sought to define the subgroup of patients with LNM at sarcoma diagnosis across all disease sites and histologies. We identified and categorized 89,870 STS patients from the National Cancer Data Base (1998-2012) by nodal stage. Pathologically confirmed LNM (pN1) were identified in 1404 patients; 1750 had clinically suspicious but not pathologically confirmed LNM (cN1). Survival analyses were performed by Kaplan-Meier method. Of 3154 patients (3.5%) with pN1 or cN1 LNM at presentation, 1310 had synchronous distant metastasis (M1). LNM affected a small proportion of patients (5.8% head/neck, 5.3% intrathoracic, 5.1% intra-abdominal, 2.0% ETSTS). Angiosarcoma (6%), epithelioid (13%), clear cell (16%), and small cell sarcoma (19%) had the highest incidence of LNM, although liposarcoma, fibrous histiocytoma, and leiomyosarcoma accounted for the greatest number of LNM patients. For pN1M0 disease, median overall survival (OS) was 28.2 months, varying by histology. Among patients with pN1M0 STS, angiosarcoma, clear cell sarcoma, leiomyosarcoma, and fibrous histiocytoma were associated with worse median OS (19.4, 23.8, 27.1, and 29.3 months) compared to epithelioid sarcoma and liposarcoma (49.6 and 56.0 months, p < 0.001). Despite clinical suspicion, pathologic LN evaluation in STS is inconsistently performed. LNM occurs across anatomic disease sites and is unevenly distributed across histologies. Although M1 disease portends poor prognosis regardless of LN status, LNM predicts worse OS in a histology-dependent manner in M0 disease. Published by Elsevier Ltd.

  1. The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: a hospital-based clinical analysis.

    Science.gov (United States)

    Wang, Chuanling; Tian, Fuming; Zhou, Yingjun; He, Wenbo; Cai, Zhiyou

    2016-01-01

    Cervical spondylosis is well accepted as a common degenerative change in the cervical spine. Compelling evidence has shown that the incidence of cervical spondylosis increases with age. However, the relationship between age and the incidence of cervical spondylosis remains obscure. It is essential to note the relationship between age and the incidence of cervical spondylosis through more and more clinical data. In the case-controlled study reported here, retrospective clinical analysis of 1,276 cases of cervical spondylosis has been conducted. We analyzed the general clinical data, the relationship between age and the incidence of cervical spondylosis, and the relationship between age-related risk factors and the incidence of cervical spondylosis. A chi-square test was used to analyze the associations between different variables. Statistical significance was defined as a P-value of less than 0.05. The imaging examination demonstrated the most prominent characteristic features of cervical spondylosis: bulge or herniation at C3-C4, C4-C5, and C5-C6. The incidence of cervical spondylosis increased with aging before age 50 years and decreased with aging after age 50 years, especially in the elderly after 60 years old. The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 increased with aging before age 50 years and decreased with aging after age 50 years, especially after 60 years. Moreover, the incidence of hyperosteogeny and spinal stenosis increased with aging before age 60 years and decreased with aging after age 60 years, although there was no obvious change in calcification. The age-related risk factors, such as hypertension, hyperlipidemia, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking, have no relationship with the incidence of cervical spondylosis. A decreasing proportion of cervical spondylosis with aging occurs in the elderly, while the proportion of cervical spondylosis increases with aging in the young

  2. Angiogenic activity in patients with psoriasis is significantly decreased by Goeckerman's therapy

    Energy Technology Data Exchange (ETDEWEB)

    Andrys, C.; Borska, L.; Pohl, D.; Fiala, Z.; Hamakova, K.; Krejsek, J. [Faculty Hospital, Hradec Kralove (Czech Republic). Dept. of Clinical Immunology & Allergy

    2007-03-15

    Goeckerman's therapy (GT) of psoriasis is based on daily application of pharmacy grade coal tar on affected skin with subsequent exposure to UV light. Goeckerman's therapy is still the first line therapy of psoriasis in the Czech Republic because of its low cost and long-term efficacy. Disturbances in angiogenic activity are characteristic for the immunopathogenesis of psoriasis. An abnormal spectrum of cytokines, growth factors and proangiogenic mediators is produced by keratinocytes and inflammatory cells in patients suffering from the disease. The aim of this study was to evaluate the influence of GT of psoriasis on angiogenic activities by comparing serum levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in 44 patients with psoriasis in peripheral blood samples collected before and after therapy. It was found that the angiogenic potential which is abnormally increased in patients with psoriasis is significantly alleviated by GT.

  3. Aprotinin decreases the incidence of cognitive deficit following CABG and cardiopulmonary bypass: a pilot randomized controlled study.

    LENUS (Irish Health Repository)

    Harmon, Dominic C

    2012-02-03

    PURPOSE: Cognitive deficit after coronary artery bypass surgery (CABG) has a high prevalence and is persistent. Meta-analysis of clinical trials demonstrates a decreased incidence of stroke after CABG when aprotinin is administrated perioperatively. We hypothesized that aprotinin administration would decrease the incidence of cognitive deficit after CABG. METHODS: Thirty-six ASA III-IV patients undergoing elective CABG were included in a prospective, randomized, single-blinded pilot study. Eighteen patients received aprotinin 2 x 10(6) KIU (loading dose), 2 x 10(6) KIU (added to circuit prime) and a continuous infusion of 5 x 10(5) KIU.hr(-1). A battery of cognitive tests was administered to patients and spouses (n = 18) the day before surgery, four days and six weeks postoperatively. RESULTS: Four days postoperatively new cognitive deficit (defined by a change in one or more cognitive domains using the Reliable Change Index method) was present in ten (58%) patients in the aprotinin group compared to 17 (94%) in the placebo group [95% confidence interval (CI) 0.10-0.62, P = 0.005); (P = 0.01)]. Six weeks postoperatively, four (23%) patients in the aprotinin group had cognitive deficit compared to ten (55%) in the placebo group (95% CI 0.80-0.16, P = 0.005); (P = 0.05). CONCLUSION: In this prospective pilot study, the incidence of cognitive deficit after CABG and cardiopulmonary bypass is decreased by the administration of high-dose aprotinin.

  4. Incidence and prognostic significance of postoperative complications demonstrated on CT after brain tumor removal

    International Nuclear Information System (INIS)

    Fukamachi, Akira; Koizumi, Hidehito; Kimura, Ryoichi; Nukui, Hideaki; Kunimine, Hideo.

    1987-01-01

    We surveyed the computed tomographic (CT) findings in 273 patients who had undergone 301 craniotomies for brain tumors to determine the incidence and clinical outcome of the postoperative complications demonstrated on CT. The frequencies of medium-sized or large postoperative lesions were as follows: intracerebral hemorrhage, 11 % of 301 operations; subdural fluid collection, 8 %; brain edema, 6 %; extradural hemorrhage, 4 %; cerebral infarction, 3 %; ventricular enlargement, 3 %; intraventricular hemorrhage, 2 %; chronic subdural hematoma, 1 %; porencephalic cyst, 0.7 %; tension pneumocephalus, 0.7 %. In association with these complications, poor outcomes (deaths) developed with the following frequencies: intracerebral hemorrhage including an association with other types of hemorrhage, 4 % (deaths, 2 %) of 301 operations; cerebral infarction, 1 % (deaths, 0.7 %); brain edema, 0.7 % (deaths, 0.7 %); simple intraventricular hemorrhage, 0.3 % (no deaths); tension pneumocephalus, 0.3 % (no deaths). From these results, we conclude that medium-sized or large intracerebral hemorrhage, massive cerebral infarction and edema have a grave clinical significance in the postoperative course of patients with brain tumors. (author)

  5. Prophylactic digital cryotherapy is associated with decreased incidence of laminitis in horses diagnosed with colitis.

    Science.gov (United States)

    Kullmann, A; Holcombe, S J; Hurcombe, S D; Roessner, H A; Hauptman, J G; Geor, R J; Belknap, J

    2014-09-01

    Recent research suggested that prophylactic digital cryotherapy (ICE) improved lameness scores, diminished histological changes and early laminar inflammatory signalling in horses following oligofructose administration. In clinical practice, horses at risk for sepsis-associated laminitis receive ICE. Evidence to support this practice is lacking. To determine factors associated with development of laminitis in horses diagnosed with colitis, including ICE. Multicentre retrospective case series. Medical records for horses admitted to 2 university hospitals diagnosed with colitis with evidence of systemic inflammatory response from 2002 to 2012 were reviewed. Horses were excluded if they exhibited signs of laminitis at admission, were ponies, miniature or draught breeds, or laminitis. Seven of 69 (10%) horses treated with ICE developed laminitis compared with 20/61 (33%) horses that developed laminitis but did not receive ICE. Factors associated with laminitis included site of hospitalisation, admission respiratory rate (↑) and blood L-lactate (↑), and ICE (↓), Plaminitis compared with horses treated without ICE (odds ratio 0.11, 95% confidence limit 0.03-0.44). Sixteen horses (16/130, 12%) were subjected to euthanasia in hospital. Fourteen of these horses had laminitis and 2 did not develop laminitis. Survival for horses with colitis that developed laminitis was 13/27 (48%) compared with survival for horses with colitis that did not develop laminitis, 101/103 (98%). Laminitis occurred in more clinically compromised horses. Use of ICE reduced the incidence of clinical laminitis in the study population suggesting that digital cryotherapy is an effective prophylactic strategy for the prevention of laminitis in horses with colitis. © 2013 EVJ Ltd.

  6. Incidence and clinical significance of zygomaticomaxillary complex fracture involving the temporomandibular joint with emphasis on trismus.

    Science.gov (United States)

    Chang, Chia-Ming; Ko, Edward C; Kao, Chu-Chiang; Chang, Pei-Ying; Chen, Michael Y C

    2012-06-01

    Trismus is frequently a sequel of temporomandibular joint (TMJ) involvement in a zygomaticomaxillary complex (ZMC) fracture. Although trismus is commonly observed in patients with ZMC fracture, continuous follow-up examinations of their degree of mouth opening have rarely been documented. The aim of this retrospective study was to determine the incidence and clinical significance of ZMC fracture involving the glenoid fossa or articular eminence of the TMJ with an emphasis on trismus. The medical and computed tomography (CT) imaging data of 28 patients with ZMC fracture treated by oral and maxillofacial surgeons (OMFSs) (OMFS group) and 174 patients with ZMC fracture treated by surgeons other than OMFSs (non-OMFS group) between May 2002 and May 2006 were reviewed. Maximal interincisal opening (MIO) less than 35 mm or three-finger width was considered limited mouth opening and indicative of trismus. Preoperative CT imaging data indicated that about 64% (18/28) and 50% (87/174) of the patients in the OMFS and non-OMFS groups, respectively, had a ZMC fracture involving the TMJ. Among these OMFS patients, 17 (94.40%) patients had limited mouth opening (MIO range, 7-33 mm) preoperatively, which improved markedly postoperatively. Among the non-OMFS patients with such fractures, 42 (48.3%) patients had trismus preoperatively and two retained trismus postoperatively. Lack of proper preoperative CT images, inadequate postoperative follow-up protocol, and/or neglect by patients and medical staff could influence the outcomes of ZMC fracture involving the TMJ. We make recommendations for reducing the risk of complications subsequent to ZMC fracture involving the TMJ. Copyright © 2012. Published by Elsevier B.V.

  7. Incidence and clinical significance of zygomaticomaxillary complex fracture involving the temporomandibular joint with emphasis on trismus

    Directory of Open Access Journals (Sweden)

    Chia-Ming Chang

    2012-06-01

    Full Text Available Trismus is frequently a sequel of temporomandibular joint (TMJ involvement in a zygomaticomaxillary complex (ZMC fracture. Although trismus is commonly observed in patients with ZMC fracture, continuous follow-up examinations of their degree of mouth opening have rarely been documented. The aim of this retrospective study was to determine the incidence and clinical significance of ZMC fracture involving the glenoid fossa or articular eminence of the TMJ with an emphasis on trismus. The medical and computed tomography (CT imaging data of 28 patients with ZMC fracture treated by oral and maxillofacial surgeons (OMFSs (OMFS group and 174 patients with ZMC fracture treated by surgeons other than OMFSs (non-OMFS group between May 2002 and May 2006 were reviewed. Maximal interincisal opening (MIO less than 35 mm or three-finger width was considered limited mouth opening and indicative of trismus. Preoperative CT imaging data indicated that about 64% (18/28 and 50% (87/174 of the patients in the OMFS and non-OMFS groups, respectively, had a ZMC fracture involving the TMJ. Among these OMFS patients, 17 (94.40% patients had limited mouth opening (MIO range, 7–33 mm preoperatively, which improved markedly postoperatively. Among the non-OMFS patients with such fractures, 42 (48.3% patients had trismus preoperatively and two retained trismus postoperatively. Lack of proper preoperative CT images, inadequate postoperative follow-up protocol, and/or neglect by patients and medical staff could influence the outcomes of ZMC fracture involving the TMJ. We make recommendations for reducing the risk of complications subsequent to ZMC fracture involving the TMJ.

  8. Disposable diapers decrease the incidence of neonatal infections compared to cloth diapers in a level II neonatal intensive care unit.

    Science.gov (United States)

    Babu, M Chowdary; Tandur, Baswaraj; Sharma, Deepak; Murki, Srinivas

    2015-08-01

    To study whether disposable diapers decrease the incidence of neonatal infections compared with cloth diapers in a level II neonatal intensive care unit (NICU). All neonates admitted to the NICU and having duration of stay >48 h were enrolled. Those babies with signs and symptoms of infection were screened with septic screen and/or blood culture. The primary outcome of the study was incidence of probable sepsis. Of 253 babies enrolled in the study period, probable sepsis was present in 101 (39.9%) infants in the total study group and was higher in cloth diaper group as compared with disposable diaper group (p = 0.01). For an average NICU stay of 6 days, cloth diapers would cost Rs. 241 vs. Rs. 162 for disposable diaper for any infant. Usage of disposable diapers decrease the incidence of probable sepsis in babies admitted to NICU. It is also cost effective to use disposable diapers in the NICU. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Decreased incidence of myelomeningocele at birth: effect of folic acid recommendations or prenatal diagnostics?

    DEFF Research Database (Denmark)

    Clemmensen, Dorte; Thygesen, Mathias; Rasmussen, Mikkel Mylius

    2011-01-01

    a unique chance to study a true MMC population. The total group of MMC children since 1983 is 121. One hundred and eight (89%) parents answered a questionnaire. Results: Following the changes in prenatal ultrasonography screening programme in 2004, a significant decline of 60% live birth MMC pr. year...

  10. Communicating risk: news media reportage of a significant nuclear contamination incident in the UK

    International Nuclear Information System (INIS)

    Walker, G.P.; Macgill, S.M.

    1988-02-01

    The way the mass media reported a controversial discharge incident at British Nuclear Fuel's reprocessing plant at Sellafield in Cumbria in November 1983 is discussed. Apart from the Windscale fire in 1957 this was the most serious radiation incident at any nuclear installation in the United Kingdom. The aim of the study was to use that incident to develop a more complete understanding of the way information about risk is communicated through the news media. Two issues, in particular, are assessed. First, the accuracy of the reports of events and how factual, technical or scientific aspects of risk are portrayed through the news media. Secondly, risk evaluation is studied: what value judgements are made, what sentiments of alarm, danger and hazard are presented. (author)

  11. Western Dietary Pattern Increases, and Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study.

    Science.gov (United States)

    Strate, Lisa L; Keeley, Brieze R; Cao, Yin; Wu, Kana; Giovannucci, Edward L; Chan, Andrew T

    2017-04-01

    Dietary fiber is implicated as a risk factor for diverticulitis. Analyses of dietary patterns may provide information on risk beyond those of individual foods or nutrients. We examined whether major dietary patterns are associated with risk of incident diverticulitis. We performed a prospective cohort study of 46,295 men who were free of diverticulitis and known diverticulosis in 1986 (baseline) using data from the Health Professionals Follow-Up Study. Each study participant completed a detailed medical and dietary questionnaire at baseline. We sent supplemental questionnaires to men reporting incident diverticulitis on biennial follow-up questionnaires. We assessed diet every 4 years using a validated food frequency questionnaire. Western (high in red meat, refined grains, and high-fat dairy) and prudent (high in fruits, vegetables, and whole grains) dietary patterns were identified using principal component analysis. Follow-up time accrued from the date of return of the baseline questionnaire in 1986 until a diagnosis of diverticulitis, diverticulosis or diverticular bleeding; death; or December 31, 2012. The primary end point was incident diverticulitis. During 894,468 person years of follow-up, we identified 1063 incident cases of diverticulitis. After adjustment for other risk factors, men in the highest quintile of Western dietary pattern score had a multivariate hazard ratio of 1.55 (95% CI, 1.20-1.99) for diverticulitis compared to men in the lowest quintile. High vs low prudent scores were associated with decreased risk of diverticulitis (multivariate hazard ratio, 0.74; 95% CI, 0.60-0.91). The association between dietary patterns and diverticulitis was predominantly attributable to intake of fiber and red meat. In a prospective cohort study of 46,295 men, a Western dietary pattern was associated with increased risk of diverticulitis, and a prudent pattern was associated with decreased risk. These data can guide dietary interventions for the prevention of

  12. Western Dietary Pattern Increases, Whereas Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study

    Science.gov (United States)

    Strate, Lisa L; Keeley, Brieze R; Cao, Yin; Wu, Kana; Giovannucci, Edward L; Chan, Andrew T

    2017-01-01

    Background & Aims Dietary fiber is implicated as a risk factor for diverticulitis. Analyses of dietary patterns may provide information on risk beyond those of individual foods or nutrients. We examined whether major dietary patterns are associated with risk of incident diverticulitis. Methods We performed a prospective cohort study of 46,295 men who were free of diverticulitis and known diverticulosis in 1986 (baseline) using data from the Health Professionals Follow-up Study. Each study participant completed a detailed medical and dietary questionnaire at baseline. We sent supplemental questionnaires to men reporting incident diverticulitis on biennial follow-up questionnaires. We assessed diet every 4 years using a validated food frequency questionnaire. Western (high in red meat, refined grains, and high-fat dairy) and prudent (high in fruits, vegetables, and whole grains) dietary patterns were identified using principal component analysis. Follow-up time accrued from the date of return of the baseline questionnaire in 1986 until a diagnosis of diverticulitis, diverticulosis or diverticular bleeding; death; or December 31, 2012. The primary endpoint was incident diverticulitis. Results During 894,468 person years of follow-up, we identified 1063 incident cases of diverticulitis. After adjustment for other risk factors, men in the highest quintile of western dietary pattern score had a multivariate hazard ratio (HR) of 1.55 (95% CI, 1.20–1.99) for diverticulitis compared to men in the lowest quintile. High vs low prudent scores were associated with decreased risk of diverticulitis (multivariate HR 0.74; 95% CI, 0.60–0.91). The association between dietary patterns and diverticulitis was predominantly attributable to intake of fiber and red meat. Conclusions In a prospective cohort study of 46,295 men, a western dietary pattern was associated with increased risk of diverticulitis, whereas a prudent pattern was associated with decreased risk. These data may

  13. Eosinophilia detected by automated blood cell counting in ambulatory North American outpatients. Incidence and clinical significance.

    Science.gov (United States)

    Brigden, M; Graydon, C

    1997-09-01

    To audit a cohort of ambulatory outpatients with eosinophilia detected on automated blood cell counting. Specific objectives included the determination of whether the eosinophilia had been anticipated, the etiology of the eosinophilia, the clinical follow-up and investigations performed on patients with eosinophilia, and the effect of the detection of eosinophilia on patient management and ultimate clinical outcome. A year-long retrospective review of all patients with an absolute eosinophil count of greater than 0.7 x 10(9)/L. A large outpatient laboratory system. The patient population was managed by family physicians and specialists. Data collection included the results of the hematology profile, the absolute eosinophil count, the clinical situation responsible for the hematologic profile determination, and the probable cause of eosinophilia. Individual physicians were surveyed to determine if discovery of the eosinophilia had changed patient management plan or clinical outcome. Out of 195,300 patients who had a hematology profile performed, 225 were found to have an absolute eosinophilia count higher than 0.7 x 10(9)/L. The overall incidence of eosinophilia in the study population was 0.1%. The eosinophilia was not anticipated in 85% of patients. No obvious cause was detected for the eosinophilia in 36% of patients. Various allergic diseases were responsible for the eosinophilia in the majority of the remaining patients. Fewer than 9% of individuals manifested a serious systemic illness or parasitemia. Further clinical follow-up had been performed in 69% of patients. Additional laboratory tests had been ordered in 59% of patients. The laboratory tests most frequently ordered were a repeat hematology profile or stool examinations for ova and parasites. In only two instances did the discovery of the eosinophilia appear to result in a significant change in patient management or ultimate clinical income. The vast majority of eosinophilias detected in ambulatory

  14. Feeding a higher forage diet prepartum decreases incidences of subclinical ketosis in transition dairy cows.

    Science.gov (United States)

    Vickers, L A; Weary, D M; Veira, D M; von Keyserlingk, M A G

    2013-02-01

    A common feeding practice during the dry period is to switch dairy cows to an energy-dense diet 3 wk prepartum, but this practice may lead to the overconsumption of energy and increase the risk of metabolic disease postpartum. The aim of this trial was to compare the metabolic status of transition Holstein dairy cows fed a 77% forage diet (77F; NEl = 1.46 Mcal/kg; NDF = 41%) vs. those fed an 87% forage diet (87F; NEl = 1.41 Mcal/kg; 48% NDF). Approximately 60 d before calving, cows were dried off, housed in a free stall barn, and fed the 87F diet. Three weeks before expected calving, cows were randomly assigned to either the 77F treatment and switched to this diet (n = 45) or assigned to the 87F treatment and stayed on the dry cow ration until parturition (n = 42). After parturition, all cows were fed a common lactation diet (NEl = 1.59 Mcal/kg; 36% NDF). Dry matter intake was measured daily from 2 wk before to 2 wk after calving. Blood was sampled daily for 10 d postpartum. Subclinical ketosis was diagnosed using a threshold of β-hydroxybutyrate (BHBA) ≥ 1.0 mmol/L after calving. The percentage of cows pregnant and odds of being pregnant for each treatment group were determined at 60, 90, and 120 d in milk through ultrasound by the herd veterinarian. Cows on the 87F diet consumed less DM prepartum than those on the 77F diet (12.7 ± 0.3 kg/d vs. 15.4 ± 0.3 kg/d, P ketosis (SCK; 49% vs. 17%; P = 0.001). Milk production tended to be less for cows fed the 87F diet prepartum (47.3 ± 0.4 kg/d vs. 48.8 ± 0.4 kg/d; P = 0.10) for the first 22 wk of lactation, which was significant for d 7 to 28 of lactation (44.6 ± 1.1 kg/d vs. 47.6 ± 1.0 kg/d; P = 0.05). Although sample size was small to draw strong conclusions on reproductive performance, at 120 d in milk, cows on the 87F diet were 0.3 times more likely to be pregnant (P = 0.03). These results indicate that feeding an 87F diet before calving can reduce rates of SCK in transition dairy cows.

  15. Incidence of Accessory Phrenic Nerve and its Clinical Significance: A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    Soubhagya R. Nayak

    2008-01-01

    Full Text Available The description of accessory phrenic nerve (APN in the standard textbooks and available literature is vague and sometimes limited to few lines. The incidence of APN varies a great deal from 17.6 % to 80.9 % in the available literature. The aim of the present study was to calculate the incidence and variation of APN in Indian population. Material and methods: Forty five adult formalin-fixed cadavers (35 male, 10 female; 90 sides used for gross anatomy dissection for undergraduates; during the 2 year period 2006–2007 were considered. Findings were recorded at different stages of the dissection. Results: Out of 90 body sides studied, the APN was present in 48 sides (53.3 %. In 17 of the above sides the APN was confined to the cervical region (Cervical type and in 31 sides the APN entered the thorax (Thoracic type, all anterior to the subclavian vein (SV. In eleven specimens the APN was found bilaterally. Conclusion: The incidence of APN, with its course and relation to the various structures in cervical and thoracic region will help the surgeons while performing internal thoracic artery (ITA grafting and other radical neck surgery.

  16. The introduction of sialendoscopy has significantly contributed to a decreased number of excised salivary glands in Denmark

    DEFF Research Database (Denmark)

    Rye Rasmussen, Eva; Lykke, Eva; Wagner, Niels

    2015-01-01

    surgical interventions on the major salivary glands due to benign non-tumorous disease. Nationally and regionally the total number of resected major salivary glands due to benign obstructive disease also decreased significantly during the study period. A positive outcome, like the ones described here...

  17. The Significance of Witness Sensors for Mass Casualty Incidents and Epidemic Outbreaks.

    Science.gov (United States)

    Pan, Chih-Long; Lin, Chih-Hao; Lin, Yan-Ren; Wen, Hsin-Yu; Wen, Jet-Chau

    2018-02-02

    Due to the increasing number of natural and man-made disasters, mass casualty incidents occur more often than ever before. As a result, health care providers need to adapt in order to cope with the overwhelming patient surge. To ensure quality and safety in health care, accurate information in pandemic disease control, death reduction, and health quality promotion should be highlighted. However, obtaining precise information in real time is an enormous challenge to all researchers of the field. In this paper, innovative strategies are presented to develop a sound information network using the concept of "witness sensors." To overcome the reliability and quality limitations of information obtained through social media, researchers must focus on developing solutions that secure the authenticity of social media messages, especially for matters related to health. To address this challenge, we introduce a novel concept based on the two elements of "witness" and "sensor." Witness sensors can be key players designated to minimize limitations to quality of information and to distinguish fact from fiction during critical events. In order to enhance health communication practices and deliver valid information to end users, the education and management of witness sensors should be further investigated, especially for implementation during mass casualty incidents and epidemic outbreaks. ©Chih-Long Pan, Chih-Hao Lin, Yan-Ren Lin, Hsin-Yu Wen, Jet-Chau Wen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.02.2018.

  18. Acute ischemic stroke associated with nephrotic syndrome: Incidence and significance — Retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Hirotaka Iwaki

    2015-09-01

    Full Text Available We report 10 cases with arterial ischemic stroke (AIS with nephrotic syndrome (NS, and clarified its incidence and clinical characteristics. The patients having albumin less than 3.0 g/dl and serum cholesterol greater than 250 mg/dl at the same time were retrospectively screened from 11,161 cases of stroke. Furthermore, the patients of AIS showing heavy proteinuria were selected. The 10 cases were diagnosed as AIS with NS. Its incidence was 0.09% of all kinds of stroke and 0.12% of AIS. Their subtypes were 6 large-artery atherosclerosis, 3 small-vessel occlusion, and 1 cardioembolism. We carried out a retrospective cohort study to assess the association between NS and atherosclerosis progression in AIS patients. Seven AIS patients with NS due to diabetic nephropathy (cases; NS group were compared with patients with AIS and diabetes mellitus (DM without NS (control group. Control group subjects were matched in a 2:1 ratio to cases by age, sex, use of medications for DM, and hemoglobin A1c (HbA1c level. The NS group had high cerebral artery atherosclerosis scores, especially in the anterior circulation. The NS group demonstrated atherosclerosis of the internal carotid and lower extremity arteries, although there were no statistical differences between the two groups. Study subjects had high serum fibrinogen and D-dimer levels, suggesting that AIS patients with NS have a greater degree of hypercoagulability than AIS patients without NS.

  19. [The euthyroid sick syndrome. Its incidence and clinical significance in an internal medicine department].

    Science.gov (United States)

    Di Napoli, M; Reda, G; Zannoni, G; Russo, S; Morace, G; Vasselli, C

    1994-04-01

    In this paper the authors have evaluated the incidence and the clinical implications of sick euthyroid syndrome (SES) in a group of 144 patients in a department of internal medicine. SES is an alteration of thyroid hormone values in the absence of a thyroid disease, which is seen in patients suffering from serious diseases. Having classified SES into 3 subgroups according to the different alterations seen in the values of T3, T4, FT3, FT4, TSH, rT3 and TBG, they show the hypotheses that explain the biochemical mechanisms which are at the basis of these hormonal alterations. Fourteen of the 144 patients under observation were excluded as they were suffering from ascertained or subclinical thyroid disease. Thirty (23% of cases) of the remaining 130 patients had alterations of the thyroid hormones in accordance with SES diagnosis. Of these 30 patients, 19 had hormone values found in SES type I (63%), 2 in SES type II (6.5%) and 9 in SES type III (30.5%). In SES type I the diseases seen, in order of frequency, were: obstructive chronic bronchopneumopathy with acute respiratory failure, diabetic ketoacidosis, neoplasms, ischemic heart disease, cardiac failure, chronic renal failure, liver diseases, acute cerebral vasculopathies, sepsis and collagenopathies. The disease seen in the 2 cases of SES type II was obstructive chronic bronchopneumopathy with acute respiratory failure. In SES type III the diseases seen were, in order of frequency: diabetic ketoacidosis, lung diseases, ischemic heart disease, cardiac failure, peripheral arteriopathies, acute cerebral vasculopathies, neoplasms, liver diseases, acute renal failure. The incidence of SES in 23% of the admitted to hospital patients was found to be slightly higher than in other studies; this could be explained by a stricter selection of inpatients: in fact self-sufficient patients or those not needing urgent admission, were sent to an efficient out patient clinic where necessary examinations were quickly carried out

  20. Five-year decreased incidence of surgical site infections following gastrectomy and prosthetic joint replacement surgery through active surveillance by the Korean Nosocomial Infection Surveillance System.

    Science.gov (United States)

    Choi, H J; Adiyani, L; Sung, J; Choi, J Y; Kim, H B; Kim, Y K; Kwak, Y G; Yoo, H; Lee, Sang-Oh; Han, S H; Kim, S R; Kim, T H; Lee, H M; Chun, H K; Kim, J-S; Yoo, J D; Koo, H-S; Cho, E H; Lee, K W

    2016-08-01

    Surveillance of healthcare-associated infection has been associated with a reduction in surgical site infection (SSI). To evaluate the Korean Nosocomial Infection Surveillance System (KONIS) in order to assess its effects on SSI since it was introduced. SSI data after gastrectomy, total hip arthroplasty (THA), and total knee arthroplasty (TKA) between 2008 and 2012 were analysed. The pooled incidence of SSI was calculated for each year; the same analyses were also conducted from hospitals that had participated in KONIS for at least three consecutive years. Standardized SSI rates for each year were calculated by adjusting for SSI risk factors. SSI trends were analysed using the Cochran-Armitage test. The SSI rate following gastrectomy was 3.12% (522/16,918). There was a significant trend of decreased crude SSI rates over five years. This trend was also evident in analysis of hospitals that had participated for more than three years. The SSI rate for THA was 2.05% (157/7656), which decreased significantly from 2008 to 2012. The risk factors for SSI after THA included the National Nosocomial Infections Surveillance risk index, trauma, reoperation, and age (60-69 years). The SSI rate for TKA was 1.90% (152/7648), which also decreased significantly during a period of five years. However, the risk-adjusted analysis of SSI did not show a significant decrease for all surgical procedures. The SSI incidence of gastrectomy and prosthetic joint replacement declined over five years as a result of active surveillance by KONIS. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. Does a herniated nucleus pulposus contribute significantly to a decrease in height of the intervertebral disc? Quantitative volumetrich MRI

    Energy Technology Data Exchange (ETDEWEB)

    Holodny, A.I.; Kisza, P.S.; Contractor, S.; Liu, W.C. [Department of Radiology, UMDNJ-New Jersey Medical School, University Hospital C-320, 150 Bergen Street, Newark, NJ 07103-2714 (United States)

    2000-06-01

    A lumbar intervertebral disc with a herniated nucleus pulposus (HNP) often exhibits a decrease in the height of the intervertebral space. Our purpose was to ascertain whether the loss of volume of an HNP is sufficient to cause a perceptible decrease in the height of the intervertebral space. MRI of 44 patients with 51 HNPs were reviewed. The volumes of the herniated material and of the intervertebral discs were calculated for every level from L 1-2 to L 5-S 1. The average volume of the HNP was 503{+-}301 mm{sup 3}. The average volumes of all 220 intervertebral discs and of the 127 normal-appearing discs were 14442{+-}4200 mm{sup 3} and 17476{+-}2885 mm{sup 3} respectively. The average volume of the HNP represented 3.5% of the parent disc. An average HNP caused a decrease in intervertebral space height of 0.35 mm (0.56 pixels). Therefore, the loss of the volume of the HNP does not cause a significant decrease in the intervertebral space height. The average calculated decrease in the disc height is less than that reported in normal diurnal variation. (orig.)

  2. Dietary intake of fiber, fruit and vegetables decreases the risk of incident kidney stones in women: a Women's Health Initiative report.

    Science.gov (United States)

    Sorensen, Mathew D; Hsi, Ryan S; Chi, Thomas; Shara, Nawar; Wactawski-Wende, Jean; Kahn, Arnold J; Wang, Hong; Hou, Lifang; Stoller, Marshall L

    2014-12-01

    We evaluated the relationship between dietary fiber, fruit and vegetable intake, and the risk of kidney stone formation. Overall 83,922 postmenopausal women from the Women's Health Initiative observational study were included in the analysis and followed prospectively. Cox proportional hazards regression analyses were used to evaluate the associations between total dietary fiber, fruit and vegetable intake, and the risk of incident kidney stone formation, adjusting for nephrolithiasis risk factors (age, race/ethnicity, geographic region, diabetes mellitus, calcium supplementation, hormone therapy use, body mass index and calibrated caloric intake; and dietary water, sodium, animal protein and calcium intake). Women with a history of kidney stones (3,471) were analyzed separately. Mean age of the women was 64±7 years, 85% were white and 2,937 (3.5%) experienced a kidney stone in a median followup of 8 years. In women with no history of kidney stones higher total dietary fiber (6% to 26% decreased risk, p vegetable intake (9% to 22% decreased risk, p=0.002) were associated with a decreased risk of incident kidney stone formation in separate adjusted models. In women with a history of stones there were no significant protective effects of fiber, fruit or vegetable intake on the risk of kidney stone recurrence. Greater dietary intake of fiber, fruits and vegetables was associated with a reduced risk of incident kidney stones in postmenopausal women. The protective effects were independent of other known risk factors for kidney stones. In contrast, there was no reduction in risk in women with a history of stones. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Dietary Intake of Fiber, Fruit, and Vegetables Decrease the Risk of Incident Kidney Stones in Women: A Women's Health Initiative (WHI) Report

    Science.gov (United States)

    Sorensen, Mathew D.; Hsi, Ryan S.; Chi, Thomas; Shara, Nawar; Wactawski-Wende, Jean; Kahn, Arnold J.; Wang, Hong; Hou, Lifang; Stoller, Marshall L.

    2014-01-01

    Purpose We evaluated the relationship between dietary fiber, fruit, and vegetable intake, and the risk of kidney stone formation. Methods Overall, 83,922 postmenopausal women from the WHI Observational Study were included and followed prospectively. Cox proportional hazards regression analyses evaluated the associations between total dietary fiber, fruits, and vegetable intake, and the risk of incident kidney stone formation adjusting for nephrolithiasis risk factors (age, race/ethnicity, geographic region, diabetes mellitus, calcium supplementation, hormone therapy use, body mass index, calibrated caloric intake, and dietary water, sodium, animal protein, and calcium intake). Women with a prior history of kidney stones (3,471 women) were analyzed separately. Results Mean age was 64±7 years, 85% of women were Caucasian and 2,937 women (3.5%) experienced a kidney stone occurrence in 8 years median follow-up. In women with no history of kidney stones, higher total dietary fiber (6-26% decreased risk, pvegetable intake (9-22% decreased risk, p=0.002) were associated with a decreased risk of incident kidney stone formation in separate adjusted models. In women with a history of stones, there were no significant protective effects of fiber, fruits, or vegetable intake on the risk of kidney stone recurrence. Conclusions Greater dietary intake of fiber, fruits and vegetables were each associated with a reduced risk of incident kidney stones in postmenopausal women. The protective effects were independent of other known risk factors for kidney stones. In contrast, there was no reduction in risk in women with a history of stones. PMID:24859445

  4. Significant decrease in thermal conductivity of multi-walled carbon nanotube induced by inter-wall van der Waals interactions

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xue; Zhou, Wu-Xing, E-mail: wuxingzhou@hnu.edu.cn; Chen, Xue-Kun; Liu, Yue-Yang; Chen, Ke-Qiu, E-mail: keqiuchen@hnu.edu.cn

    2016-05-06

    The thermal transport properties of multi-walled carbon nanotubes (MWCNTs) were investigated by using non-equilibrium molecular dynamics simulation. The results show that the thermal conductivity of MWCNTs decreases significantly comparing to that of single-walled carbon nanotubes (SWCNTs) due to the inter-wall van der Waals interactions. The more interesting is a fact that the thermal conductance of MWCNTs is significantly greater than the thermal conductance summation of each SWCNTs. This is because the thermal conductance of a carbon nanotube protected by an outer tube is much larger than that of one that is not protected. Moreover, we also studied the thermal flux distribution of MWCNTs, and found that the outer tube plays a dominant role in heat energy transfer. - Highlights: • Significant decrease in thermal conductivity of multi-walled carbon nanotube induced by inter-wall interactions. • The thermal conductivity of the inner tube is increased significantly due to protected by outer tube. • The outer tube plays a dominant role in heat energy transfer in multi-walled carbon nanotube.

  5. Incidence and significance of cystic structures in the ovaries of gadoid fish

    Directory of Open Access Journals (Sweden)

    Rosario Domínguez-Petit

    2011-06-01

    Full Text Available Fish regulate egg production by atresia. Sometimes, oocytes are encapsulated in cystic structures that might remain in the ovary for months, altering female reproductive potential in future spawning seasons. Ovaries of Atlantic cod (Gadus morhua, L. from the Flemish Cap and European hake (Merluccius merluccius, L. from the Galician Shelf (NW Spain were analysed from 1999 to 2006. The prevalence and abundance of ovarian cysts were estimated. Cyst prevalence increased with female size and/or age for both species, and decreased with high condition factor in hake. Cyst intensity does not correlate with any analysed factor. The size/age structure of spawning stock biomass and female condition could affect the prevalence of cysts in the ovaries, though it does not seem to affect cyst intensity in the ovary. Further research is needed to determine cyst resorption time and the impact that it has on egg production and consequently on stock reproductive potential.

  6. Use of Plan-Do-Study-Act cycles to decrease incidence of neonatal hypothermia in the labor room.

    Science.gov (United States)

    Shaw, Subhash Chandra; Devgan, Amit; Anila, Sushila; Anushree, Neha; Debnath, Himadri

    2018-04-01

    Body temperature of a neonate continues to be under-documented, under-recognized, and under-managed, even though studies have shown that neonatal hypothermia increases mortality and morbidity. We aimed to reduce neonatal hypothermia (body temperature improvement (QI) initiative using the rapid-cycle Plan-Do-Study-Act approach (PDSA) improvement model and the project was conducted from 15 Jan 2017 to 25 Feb 2017. All singleton neonates with gestational ages above 34 completed weeks born by vaginal delivery were targeted. Exclusion criteria included neonates needing any form of resuscitation, those developing respiratory distress after birth needing any form of respiratory support or observation in NICU. We ran PDSA cycles (including pre-warmed cloths, skin to skin care with mother, early breast feeding, delaying weight check by 1 h and checklist of planned steps), every week, after taking the baseline data in the first week. A total of 46 neonates were studied. After 4 PDSA cycles, incidence of neonatal hypothermia at 1 h of birth dropped to zero from 50% at baseline and we were able to sustain 100% normal temperature (36.5-37.5 °C) since then. This QI project has significantly reduced the incidence of hypothermia in term and late preterm neonates born by vaginal delivery in our institute.

  7. Pre-induction low dose pethidine does not decrease incidence of postoperative shivering in laparoscopic gynecological surgeries

    Directory of Open Access Journals (Sweden)

    Ishwar Bhukal

    2011-01-01

    Results: Core body temperatures were statistically insignificant between groups at pre-induction, post-induction, and in the PACU (P > 0.05. At the end of surgery, shivering was present in 18 patients (30%. In groups I, II, and III, six (30%, three (15%, and nine (45% patients shivered, respectively. The differences in incidence and grading of shivering among groups was found to be statistically insignificant (P > 0.05. The core body temperature of shiverers and non-shiverers were compared. In the PACU at 0, 15, and 30 minutes, the temperature among shiverers was significantly lower than that in the non-shiverers. Rescue drug i.v. pethidine 20 mg was given to patients with shivering grade ≥2. None of the patients had shivering after 10 minutes. Conclusions: Prophylactic pre-induction, low-dose pethidine does not have major role in preventing postoperative shivering.

  8. Decreases in left atrial compliance during early-stage exercise are related to exercise intolerance in asymptomatic significant mitral stenosis.

    Science.gov (United States)

    Jung, Mi-Hyang; Jung, Hae Ok; Lee, Jung-Won; Youn, Ho-Joong

    2017-11-01

    Doppler-driven net atrioventricular compliance (C n ), which represents left atrial (LA) compliance, is an important determinant of pulmonary hypertension in mitral stenosis (MS). We hypothesized that decreases in C n during early-stage exercise underlie exercise intolerance in patients with MS. Thirty-three asymptomatic patients with significant MS (valve area 1.24 ± 0.16 cm 2 ) underwent resting and bicycle exercise echocardiography. LA compliance and conventional parameters were assessed at each workload. The patients were classified into two groups based on whether they developed dyspnea during exercise: an exercise-intolerance group (n = 22) and an exercise-tolerance group (n = 11). Moreover, "50 W" was defined as an early exercise stage. Although the groups had similar resting characteristics, there were striking differences in their echocardiographic parameters from the early stages of exercise. The relative C n decrease at 50 W (expressed as a percentage of the resting C n ) was significantly greater in the exercise-intolerance group (70.3 ± 15.4% vs 49.7 ± 9.7%, P intolerance group (P = .0005). Furthermore, differences in the trends in this parameter were observed between the two groups (P intolerance (adjusted OR 1.105, 95% CI 1.030-1.184) after adjustment for other conventional parameters. Decreases in C n during early-stage exercise are an important mechanism underlying exercise intolerance in MS. © 2017, Wiley Periodicals, Inc.

  9. Flavonol-rich dark cocoa significantly decreases plasma endothelin-1 and improves cognitive responses in urban children.

    Directory of Open Access Journals (Sweden)

    Lilian eCalderon-Garciduenas

    2013-08-01

    Full Text Available Air pollution exposures are linked to systemic inflammation, cardiovascular and respiratory morbidity and mortality, neuroinflammation and neuropathology in young urbanites. In particular, most Mexico City Metropolitan Area (MCMA children exhibit subtle cognitive deficits, and neuropathology studies show 40% of them exhibiting frontal tau hyperphosphorylation and 51% amyloid-β diffuse plaques (compared to 0% in low pollution control children. We assessed whether a short cocoa intervention can be effective in decreasing plasma endothelin 1 (ET-1 and/or inflammatory mediators in MCMA children. Thirty g of dark cocoa with 680 mg of total flavonols were given daily for 10.11± 3.4 days (range 9 to 24 days to 18 children (10.55yrs, SD =1.45; 11F/7M. Key metabolite ratios in frontal white matter and in hippocampus pre and during cocoa intervention were quantified by magnetic resonance spectroscopy. ET-1 significantly decreased after cocoa treatment (p=0.0002. Fifteen children (83% showed a marginally significant individual improvement in one or both of the applied simple short memory tasks. Endothelial dysfunction is a key feature of exposure to particulate matter and decreased endothelin-1 bioavailability is likely useful for brain function in the context of air pollution. Our findings suggest that cocoa interventions may be critical for early implementation of neuroprotection of highly exposed urban children. Multi-domain nutraceutical interventions could limit the risk for endothelial dysfunction, cerebral hypoperfusion, neuroinflammation, cognitive deficits, structural volumetric detrimental brain effects, and the early development of the neuropathological hallmarks of Alzheimer’s and Parkinson’s diseases.

  10. Significant Incidence of Extra-Articular Tibia Vara Affects Radiological Outcome of Total Knee Arthroplasty

    Science.gov (United States)

    Saibaba, Balaji; Chouhan, Devendra K.; Kanojia, Rajendra K.; Prakash, Mahesh; Bachhal, Vikas

    2015-01-01

    Purpose To identify and quantify the presence of extra-articular tibia vara that might influence the mechanical axis alignment after total knee arthroplasty (TKA). Materials and Methods A total of 48 TKAs in 30 osteoarthritic Indian patients were prospectively evaluated. The hip-knee-ankle angle (HKA), joint line convergence angle, and varus angulation at the femur and tibia were measured from the preoperative and postoperative standing hip-to-ankle radiographs. Four different methods were used to measure the varus angulation at the tibia: metaphyseo-diaphyseal angle (MDA), the angle between the anatomical axis and mechanical axis of the tibia, the angle between the proximal third and distal third of tibia and the angle between the proximal half and distal half of tibia. Results Extra-articular tibia vara quantified using MDA had the most positive correlation with HKA. Receiver operating characteristic plotting showed that MDA of >4° predicts abnormal postoperative HKA. Twenty-eight out of 48 knees had MDA of >4°, and 78.6% of these had postoperative HKA under-correction and 21.4% had less than ideal tibial component position. Conclusions A significant inherent extra-articular varus angulation best measured using MDA exists in the proximal tibia in osteoarthritic Indian patients undergoing TKA. MDA of >4° is associated with abnormal postoperative HKA. Computer navigation may be useful for achieving ideal correction in such cases. PMID:26389071

  11. Decrease of CD4+ T lymphocytes in patients with H1N1 in early stage and its clinical significances

    International Nuclear Information System (INIS)

    Zuo Lingyun; Zhao Wei; Zhao Hong; Yu Haiying; Sun Weiwei

    2010-01-01

    Objective: To observe the change of CD4 + T Lymphocytes in patients with H1N1 at early stage and figure out its clinical significances on the progress and therapeutic selection of H1N1. Methods: The absolute counts of T lymphocyte subset from the peripheral blood samples of 48 H1N1 patients in first ten days' duration were detected by flow cytometry, and the serial chest CT examinations were performed. Results: In all 48 clinical cases, 28 cases were in normal range of CD4 + lymphocyte absolute count, whose pulmonary lesions were limited and illness condition stayed in the stability, they didn't need steroid. In the other 20 cases with low level of CD4 + , 4 cases' illness presented the progressive development and needed to be treated with steroid and 16 cases with lightly decreased CD4 + level which had a stable condition without treatment with steroid. The result of Pearson correlation analysis showed that there were negative correlations between absolute count of CD4 + cells and pulmonary lesions (r=-0.299, P + cell absolute count of H1N1 patients at early stage indicates the worse condition of pulmonary lesions. The patients with remarkable decrease of CD4 + lymphocytes are in need of treatment with steroid. (authors)

  12. The decreased expression of TIPE2 protein in the decidua of patients with missed abortion and possible significance.

    Science.gov (United States)

    Sun, Yingshuo; Wang, Xiaoyan; Li, Yue; Sun, Han; Wan, Lu; Wang, Xishuang; Zhang, Lining; Fang, Zhenghui; Wei, Zengtao

    2017-08-29

    Missed abortion is a common occurrence for otherwise healthy women. Immunological factor is one of the most important reasons. Tumor necrosis factor-α-induced protein-8 like-2 (TIPE2) is a novel negative immune regulator related to several human diseases. However, the expression level and clinical significance of TIPE2 in missed abortion remain unclear. The expression of TIPE2 mRNA and protein in decidua and chorion from 36 missed abortion patients and 36 healthy controls was detected using quantitative real-time PCR, western blot and immunohistochemistry. In addition, serum TNF-ɑ and IL-10 levels were measured using flow cytometry. Serum estradiol and progesterone levels were measured by radioimmunoassay test. The correlations of TIPE2 protein levels with TNF-ɑ, IL-10, estradiol and progesterone were further analyzed. TIPE2 protein levels were significantly lower in decidual tissues of missed abortion patients than those in healthy controls. The patients with missed abortion had significantly higher levels of serum TNF-ɑ, and lower levels of serum IL-10, estradiol and progesterone compared with healthy controls. The TIPE2 protein levels were positively related to serum IL-10 levels. Our data indicate TIPE2 could play important roles in maintaining the maternal-fetal tolerance and decreased TIPE2 expression in the decidua may be related to the development of missed abortion.

  13. Online training on the safe use of fluoroscopy can result in a significant decrease in patient dose.

    Science.gov (United States)

    Frederick-Dyer, Katherine C; Faulkner, Austin R; Chang, Ted T; Heidel, R Eric; Pasciak, Alexander S

    2013-10-01

    Concerns over medical radiation exposure have received national press in recent years, and training in the appropriate use of radiation has become an essential component of every radiology residency program. Appropriate training is particularly important in fluoroscopy because it is commonly used by inexperienced radiology residents and has the potential to impart relatively high patient radiation doses. In an effort to minimize the radiation doses received by patients, our institution has recently initiated an online training program in the safe use of fluoroscopy. This course is required and must be completed by new radiology residents before their first fluoroscopy rotation. The goal of this study was to determine if the use of an online course in the safe use of fluoroscopy could result in decreased patient dose without affecting diagnostic quality. Four years of retrospective procedural data for residents performing gastrointestinal and genitourinary fluoroscopic procedures without specialized training were reviewed. Incoming residents took an American Medical Association-accredited online training program in the safe use of fluoroscopy the week before their first fluoroscopy rotation. Patient dose and diagnostic quality data, inferred from the frequency of attending physician intervention necessary to complete the procedure, were collected for all exams performed by the new group of residents after completion of the training course. This was then compared to data from prior classes and stratified by procedure type. Statistically significant reductions in both average fluoroscopy time (FT) or dose-area-product (DAP) were found for many of the fluoroscopic procedures performed by residents who participated in the online fluoroscopy training program. Specifically, statistically significant reductions in FT for barium enema, cystogram, defecogram, and esophagram procedures (P fluoroscopy rotation, decreasing patient dose without affecting diagnostic quality

  14. Three decades of eating disorders in Dutch primary care : decreasing incidence of bulimia nervosa but not of anorexia nervosa

    NARCIS (Netherlands)

    Smink, F. R. E.; van Hoeken, D.; Donker, G. A.; Susser, E. S.; Oldehinkel, A. J.; Hoek, H. W.

    Background Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and

  15. Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa.

    NARCIS (Netherlands)

    Smink, F.R.E.; Hoeken, D. van; Donker, G.A.; Susser, E.S.; Oldehinkel, A.L.; Hoek, H.W.

    2016-01-01

    Background: Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and

  16. Deletion of the NMDA receptor GluN2A subunit significantly decreases dendritic growth in maturing dentate granule neurons.

    Directory of Open Access Journals (Sweden)

    Timal S Kannangara

    Full Text Available It is known that NMDA receptors can modulate adult hippocampal neurogenesis, but the contribution of specific regulatory GluN2 subunits has been difficult to determine. Here we demonstrate that mice lacking GluN2A (formerly NR2A do not show altered cell proliferation or neuronal differentiation, but present significant changes in neuronal morphology in dentate granule cells. Specifically, GluN2A deletion significantly decreased total dendritic length and dendritic complexity in DG neurons located in the inner granular zone. Furthermore, the absence of GluN2A also resulted in a localized increase in spine density in the middle molecular layer, a region innervated by the medial perforant path. Interestingly, alterations in dendritic morphology and spine density were never seen in dentate granule cells located in the outer granular zone, a region that has been hypothesized to contain older, more mature, neurons. These results indicate that although the GluN2A subunit is not critical for the cell proliferation and differentiation stages of the neurogenic process, it does appear to play a role in establishing synaptic and dendritic morphology in maturing dentate granule cells localized in the inner granular zone.

  17. Intensity-Modulated Radiotherapy Results in Significant Decrease in Clinical Toxicities Compared With Conventional Wedge-Based Breast Radiotherapy

    International Nuclear Information System (INIS)

    Harsolia, Asif; Kestin, Larry; Grills, Inga; Wallace, Michelle; Jolly, Shruti; Jones, Cortney; Lala, Moinaktar; Martinez, Alvaro; Schell, Scott; Vicini, Frank A.

    2007-01-01

    Purpose: We have previously demonstrated that intensity-modulated radiotherapy (IMRT) with a static multileaf collimator process results in a more homogenous dose distribution compared with conventional wedge-based whole breast irradiation (WBI). In the present analysis, we reviewed the acute and chronic toxicity of this IMRT approach compared with conventional wedge-based treatment. Methods and Materials: A total of 172 patients with Stage 0-IIB breast cancer were treated with lumpectomy followed by WBI. All patients underwent treatment planning computed tomography and received WBI (median dose, 45 Gy) followed by a boost to 61 Gy. Of the 172 patients, 93 (54%) were treated with IMRT, and the 79 patients (46%) treated with wedge-based RT in a consecutive fashion immediately before this cohort served as the control group. The median follow-up was 4.7 years. Results: A significant reduction in acute Grade 2 or worse dermatitis, edema, and hyperpigmentation was seen with IMRT compared with wedges. A trend was found toward reduced acute Grade 3 or greater dermatitis (6% vs. 1%, p = 0.09) in favor of IMRT. Chronic Grade 2 or worse breast edema was significantly reduced with IMRT compared with conventional wedges. No difference was found in cosmesis scores between the two groups. In patients with larger breasts (≥1,600 cm 3 , n = 64), IMRT resulted in reduced acute (Grade 2 or greater) breast edema (0% vs. 36%, p <0.001) and hyperpigmentation (3% vs. 41%, p 0.001) and chronic (Grade 2 or greater) long-term edema (3% vs. 30%, p 0.007). Conclusion: The use of IMRT in the treatment of the whole breast results in a significant decrease in acute dermatitis, edema, and hyperpigmentation and a reduction in the development of chronic breast edema compared with conventional wedge-based RT

  18. Significant Aerosol Influence on the Recent Decadal Decrease in Tropical Cyclone Activity Over the Western North Pacific

    Science.gov (United States)

    Takahashi, Chiharu; Watanabe, Masahiro; Mori, Masato

    2017-09-01

    Over the past two decades, the number of tropical cyclones (TCs) has decreased markedly in the southeastern part of the western North Pacific (WNP) as a component of the interdecadal variation. This decrease has partially been explained by an internal low-frequency variability of sea surface temperature (SST) in the Pacific, but influences of external forcing remain unclear. Here we show that past changes in sulfate aerosol emissions contributed approximately 60% of the observed decreasing trends in TC genesis frequency in the southeastern WNP for 1992-2011, using multiple simulations by a global climate model. This decrease was mainly attributed to the increased vertical wind shear and decreased low-level vorticity, associated with a trans-basin multidecadal SST change driven by aerosol forcing. The near-future projection shows that the aerosol forcing still has some potential influence on decadal TC change, but the projected decreasing frequency is mainly due to increasing greenhouse gases forcing.

  19. N-acetylcysteine plus deferoxamine for patients with prolonged hypotension does not decrease acute kidney injury incidence: a double blind, randomized, placebo-controlled trial.

    Science.gov (United States)

    Fraga, Cassiana Mazon; Tomasi, Cristiane Damiani; Damasio, Danusa de Castro; Vuolo, Francieli; Ritter, Cristiane; Dal-Pizzol, Felipe

    2016-10-17

    The aim was to test the primary hypothesis that in patients suffering from shock, treatment with N-acetylcysteine (NAC) plus deferoxamine (DFX) decreases the incidence of acute kidney injury (AKI). A double-blind, randomized, placebo-controlled trial was conducted in a general intensive care unit in an academic hospital. Patients were included if they had new-onset hypotension, defined as mean arterial blood pressure hypotension did not decrease the incidence of AKI. Clinicaltrials.gov NCT00870883 (Registered 25 March 2009.).

  20. Dietary intake of fiber, fruit and vegetables decreases the risk of incident kidney stones in women: A women's health initiative report

    OpenAIRE

    Sorensen, MD; Hsi, RS; Chi, T; Shara, N; Wactawski-Wende, J; Kahn, AJ; Wang, H; Hou, L; Stoller, ML

    2014-01-01

    © 2014 American Urological Association Education and Research, Inc. Results Mean age of the women was 64±7 years, 85% were white and 2,937 (3.5%) experienced a kidney stone in a median followup of 8 years. In women with no history of kidney stones higher total dietary fiber (6% to 26% decreased risk, p < 0.001), greater fruit intake (12% to 25% decreased risk, p < 0.001) and greater vegetable intake (9% to 22% decreased risk, p=0.002) were associated with a decreased risk of incident kidney...

  1. Decreasing incidence of foot ulcer among patients with type 1 and type 2 diabetes in the period 2001-2014

    DEFF Research Database (Denmark)

    Rasmussen, A.; Almdal, T.; Nielsen, A. Anker

    2017-01-01

    Aim: Diabetic foot ulcer (DFU) is a serious complication to diabetes. The aim was to study the incidence of first DFU among patients with type 1 (T1DM) and type 2 diabetes (T2DM), stratified according to etiology: neuropathic, neuro-ischemic or ischemic, over a period of 14 years (2001–2014). Met...

  2. Incidence of childhood diabetes in The Netherlands: A decrease from north to south over North-Western Europe?

    NARCIS (Netherlands)

    Vaandrager, G.J.; Bruining, G.J.; Veenhof, F.J.; Drayer, N.M.

    1984-01-01

    The incidence of childhood diabetes (0-19 years of age) in The Netherlands, where there is no nationalized health-care system, was investigated retrospectively in the years 1978 to 1980 inclusive. The method chosen was a questionnaire among all Dutch paediatricians and internal physicians acting as

  3. Incidence and significance of FLT3-ITD and NPM1 mutations in patients with normal karyotype acute myeloid leukaemia.

    LENUS (Irish Health Repository)

    Haslam, K

    2012-02-01

    BACKGROUND: Acute myeloid leukaemia (AML) is a heterogeneous clonal disorder of haematopoietic progenitor cells. Approximately half of all adult AML patients have a normal karyotype (NK-AML) and an intermediate risk prognosis. AIMS: To determine the incidence and prognostic significance of NPM1 and FLT3-ITD mutations in a population of patients with NK-AML. METHODS: FLT3-ITD and NPM1 mutation status was retrospectively sought in presentation samples from 44 NK-AML patients. RESULTS: FLT3-ITD and NPM1 mutations were detected in 45.5 and 54.5% of patients, respectively, allowing stratification according to genotype. CONCLUSIONS: FLT3-ITD and NPM1 mutation status can be defined in NK-AML. Prospective screening for these mutations is advocated in all NK-AML patients, as the genotype is of clinical importance when considering treatment options including stem cell transplantation.

  4. Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial.

    Science.gov (United States)

    Hasanin, Ahmed; Aiyad, Ahmed; Elsakka, Ahmed; Kamel, Atef; Fouad, Reham; Osman, Mohamed; Mokhtar, Ali; Refaat, Sherin; Hassabelnaby, Yasmin

    2017-04-24

    Maternal hypotension is a common complication after spinal anesthesia for cesarean section (CS). In this study we investigated the role of leg elevation (LE) as a method for prevention of post-spinal hypotension (PSH) for cesarean section. One hundred and fifty full term parturients scheduled for CS were included in the study. Patients were randomized into two groups: Group LE (leg elevation group, n = 75) and group C (Control group, n = 75). Spinal block was performed in sitting position after administration of 10 mL/Kg Ringer's lactate as fluid preload. After successful intrathecal injection of local anesthetic, Patients were positioned in the supine position. Leg elevation was performed for LE group directly after spinal anesthesia and maintained till skin incision. Intraoperative hemodynamic parameters (Arterial blood pressure and heart rate), intra-operative ephedrine consumption, incidence of PSH, and incidence of nausea and vomiting were reported. LE group showed lower incidence of PSH (34.7% Vs 58.7%, P = 0.005) compared to the control group. Arterial blood pressure was higher in the LE group compared to the control group in the first two readings after spinal block. Other readings showed comparable arterial blood pressure and heart rate values between both study groups; however, LE showed less ephedrine consumption (4.9 ± 7.8 mg Vs 10 ± 11 mg, P = 0.001). LE performed immediately after spinal block reduced the incidence of PSH in parturients undergoing CS. The study was registered at Pan African Clinical Trials Registry system on 5/10/2015 with trial number PACTR201510001295348 .

  5. Significant relationship between soil bacterial community structure and incidence of bacterial wilt disease under continuous cropping system.

    Science.gov (United States)

    She, Siyuan; Niu, Jiaojiao; Zhang, Chao; Xiao, Yunhua; Chen, Wu; Dai, Linjian; Liu, Xueduan; Yin, Huaqun

    2017-03-01

    Soil bacteria are very important in biogeochemical cycles and play significant role in soil-borne disease suppression. Although continuous cropping is responsible for soil-borne disease enrichment, its effect on tobacco plant health and how soil bacterial communities change are yet to be elucidated. In this study, soil bacterial communities across tobacco continuous cropping time-series fields were investigated through high-throughput sequencing of 16S ribosomal RNA genes. The results showed that long-term continuous cropping could significantly alter soil microbial communities. Bacterial diversity indices and evenness indices decreased over the monoculture span and obvious variations for community structures across the three time-scale tobacco fields were detected. Compared with the first year, the abundances of Arthrobacter and Lysobacter showed a significant decrease. Besides, the abundance of the pathogen Ralstonia spp. accumulated over the monoculture span and was significantly correlated with tobacco bacterial wilt disease rate. Moreover, Pearson's correlation demonstrated that the abundance of Arthrobacter and Lysobacter, which are considered to be beneficial bacteria had significant negative correlation with tobacco bacterial wilt disease. Therefore, after long-term continuous cropping, tobacco bacterial wilt disease could be ascribed to the alteration of the composition as well as the structure of the soil microbial community.

  6. Fasting Ghrelin Levels Are Decreased in Obese Subjects and Are Significantly Related With Insulin Resistance and Body Mass Index

    Directory of Open Access Journals (Sweden)

    Dimitrios Papandreou

    2017-10-01

    CONCLUSION: Obese subjects have low fasting ghrelin levels that they are significantly related to insulin resistance and body mass index. More prospective studies are needed to establish the role of ghrelin in the pathogenesis of human obesity.

  7. Apoptosis inhibitor of macrophage depletion decreased M1 macrophage accumulation and the incidence of cardiac rupture after myocardial infarction in mice.

    Directory of Open Access Journals (Sweden)

    Shohei Ishikawa

    Full Text Available Cardiac rupture is an important cause of death in the acute phase after myocardial infarction (MI. Macrophages play a pivotal role in cardiac remodeling after MI. Apoptosis inhibitor of macrophage (AIM is secreted specifically by macrophages and contributes to macrophage accumulation in inflamed tissue by maintaining survival and recruiting macrophages. In this study, we evaluated the role of AIM in macrophage accumulation in the infarcted myocardium and cardiac rupture after MI.Wild-type (WT and AIM‒/‒ mice underwent permanent left coronary artery ligation and were followed-up for 7 days. Macrophage accumulation and phenotypes (M1 pro-inflammatory macrophage or M2 anti-inflammatory macrophage were evaluated by immunohistological analysis and RT-PCR. Matrix metalloproteinase (MMP activity levels were measured by gelatin zymography. The survival rate was significantly higher (81.1% vs. 48.2%, P<0.05, and the cardiac rupture rate was significantly lower in AIM‒/‒ mice than in WT mice (10.8% vs. 31.5%, P<0.05. The number of M1 macrophages and the expression levels of M1 markers (iNOS and IL-6 in the infarcted myocardium were significantly lower in AIM‒/‒ mice than in WT mice. In contrast, there was no difference in the number of M2 macrophages and the expression of M2 markers (Arg-1, CD206 and TGF-β1 between the two groups. The ratio of apoptotic macrophages in the total macrophages was significantly higher in AIM‒/‒ mice than in WT mice, although MCP-1 expression did not differ between the two groups. MMP-2 and 9 activity levels in the infarcted myocardium were significantly lower in AIM‒/‒ mice than in WT mice.These findings suggest that AIM depletion decreases the levels of M1 macrophages, which are a potent source of MMP-2 and 9, in the infarcted myocardium in the acute phase after MI by promoting macrophage apoptosis, and leads to a decrease in the incidence of cardiac rupture and improvements in survival rates.

  8. Hyoscine butylbromide significantly decreases motion artefacts and allows better delineation of anatomic structures in mp-MRI of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Ullrich, T.; Quentin, M.; Schmaltz, A.K.; Rubbert, C.; Blondin, D.; Antoch, G.; Schimmoeller, L. [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Arsov, C.; Rabenalt, R.; Albers, P. [University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf (Germany)

    2018-01-15

    To prospectively evaluate the effect of hyoscine butylbromide (HBB) on visualisation of anatomical details and motion-related artefacts in mp-MRI of the prostate at 3.0 Tesla. One hundred and three consecutive patients (65 ± 10 years) were included in this trial, powered to demonstrate an improvement of image quality after HBB administration, assessed on a 5-point scale by two blinded readers. All patients received high-spatial resolution axial T2-weighted TSE sequences at 3.0 T without spasmolytic agent, repeated after application of 40 mg HBB and followed by routine mp-MRI. Secondary endpoints were (1) susceptibility to side effects, (2) dependence of spasmolytic effect on patients and acute; weight, and (3) prostate volume. In 68% of patients, HBB significantly improved the anatomic score (mean 3.4 ± 0.9 before and 4.4 ± 0.7 after HBB for both readers, p = <0.001). In 67%, HBB significantly enhanced the artefact score (mean 3.2 ± 1 before and 4.2 ± 0.8 after HBB for reader 1, p = <0.001; 3.2 ± 1 and 4.1 ± 0.8 for reader 2, p = <0.001). Subgroup analysis revealed no statistically significant difference between patients with different bodyweight or prostate volume. Inter-reader agreement was excellent (k = 0.95-0.98). Hyoscine butylbromide significantly improves image quality and reduces motion-related artefacts in mp-MRI of the prostate independent of bodyweight or prostate volume. No side effects were reported. (orig.)

  9. Decreasing incidence of cancer after liver transplantation-A Nordic population-based study over 3 decades

    DEFF Research Database (Denmark)

    Nordin, A; Åberg, F; Pukkala, E

    2018-01-01

    for colorectal cancer in recipients with primary sclerosing cholangitis (4.04) and for lung cancer in recipients with alcoholic liver disease (4.96). A decrease in the SIR for cancers occurring within 10 years post-LT was observed from the 1980s: 4.53 (95%CI, 2.47-7.60), the 1990s: 3.17 (95%CI, 2...

  10. Sericin accelerates the production of hyaluronan and decreases the incidence of polyspermy fertilization in bovine oocytes during in vitro maturation.

    Science.gov (United States)

    Hosoe, Misa; Yoshida, Nao; Hashiyada, Yutaka; Teramoto, Hidetoshi; Takahashi, Toru; Niimura, Sueo

    2014-01-01

    Fetal bovine serum (FBS) has been widely used as a supplement in the maturation medium of bovine oocytes in vitro. However, serum contains many undefined factors and is potentially infectious to humans and animals. As a serum replacement, we evaluated the feasibility of using the silk protein, sericin, derived from the cocoons of silkworm. To examine the rates of oocyte maturation and fertilization, cumulus-oocyte complexes were cultured in TCM-199 supplemented with 0.01%, 0.05%, 0.1% or 0.15% sericin or 5% FBS. The sizes of the perivitelline space that might relate to polyspermy, the expressions of Has2 and CD44 mRNA, the amount of hyaluronan (hyaluronic acid: HA) contained in the oocytes and the rates of blastocyst formation following insemination were then compared between the oocytes cultured with 0.05% sericin and 5% FBS, because the polyspermy rates in oocytes cultured with 0.05% sericin were significantly lower than in those cultured with 5% FBS. After in vitro maturation (IVM), the mean size of the perivitelline space was significantly greater in oocytes cultured with sericin than in those cultured with FBS, although the rates of nuclear maturation, fertilization and blastocyst formation of oocytes under both IVM conditions were not significantly different. The expression of HAS2 and CD44 mRNA and the amount of HA in the denuded oocytes cultured with 0.05% sericin were significantly greater than in those cultured with FBS. These results indicate the feasibility of sericin as an alternative protein supplement for IVM in bovine oocytes.

  11. A presedation fluid bolus does not decrease the incidence of propofol-induced hypotension in pediatric patients.

    Science.gov (United States)

    Jager, Matthew D; Aldag, Jean C; Deshpande, Girish G

    2015-02-01

    Propofol is commonly used in pediatric sedation, which may cause hypotension during induction. Our goal was to determine the effect of a preinduction 20-mL/kg isotonic fluid bolus on propofol-induced hypotension, assess clinical signs of hypoperfusion during hypotension, and evaluate for age-related propofol dosing differences. This prospective, randomized, controlled, nonblinded study was conducted at Children's Hospital of Illinois. Patients were children 6 to 60 months of age who needed sedation for MRI or auditory brainstem-evoked response testing. The treatment group received a preinduction 20-mL/kg isotonic saline bolus before procedure initiation. Patients were continuously monitored via cardiorespiratory monitor with pulse oximetry and end-tidal carbon dioxide measurements. Cardiovascular indices and clinical signs of hypoperfusion were compared between groups, and propofol dosing differences were compared between age groups. One hundred twenty-six patients were randomly assigned to treatment (n=52) or control (n=74) conditions. Twelve patients in the treatment group and 14 patients in the control group experienced postinduction hypotension, as defined by the Pediatric Advanced Life Support guidelines. One patient in each group was given volume resuscitation when blood pressure did not improve after a reduction in the propofol infusion rate. No hypotensive patients had physical signs of hypoperfusion, and patients≤1 year of age needed significantly more propofol. A 20-mL/kg preinduction isotonic saline bolus does not prevent propofol-induced hypotension. No clinical signs of hypoperfusion were noted with induced hypotension, and infants≤12 months old need significantly more propofol per kilogram for procedures. Copyright © 2015 by the American Academy of Pediatrics.

  12. High incidence of functional ion-channel abnormalities in a consecutive Long QT cohort with novel missense genetic variants of unknown significance

    DEFF Research Database (Denmark)

    Steffensen, Annette Buur; Refaat, Marwan M; David, Jens-Peter

    2015-01-01

    The Long QT syndrome (LQTS) is a disorder characterized by a prolongation of the QT interval and a propensity to ventricular tachyarrhythmias, which may lead to syncope, cardiac arrest, or sudden death. Our objective was to (1) determine the incidence of variants with unknown significance (VUS) i...

  13. A Significant Breakthrough in the Incidence of Childhood Cancers and Evaluation of its Risk Factors in Southern Iran.

    Science.gov (United States)

    Erjaee, Asma; Niknam, Maryam; Sadeghi, Ahmadreza; Dehghani, Maryam; Safaei, Zeinab; Teshnizi, Saeed Hosseini; Karimi, Mehran

    2017-01-01

    This study investigates epidemiologic and practical information about the incidence and risk factors of childhood cancer in a population of Southern Iranian children. A total number of 300 cancer patients along with 600 age- and gender-matched healthy control were interviewed by a trained physician regarding their demographic characteristics, and major family-associated risk factors, childhood malignancies. The average annual percentage change for cancers in the studied population is calculated as 45%. Our study indicated that possible risk factors which could contribute to the development of childhood cancer are maternal oral contraceptive pill use during pregnancy, exposure to radiation during pregnancy, parental smoking, residence near high voltage electricity lines, exposure to pesticides and fertilizers, patient allergy, contact with domestic animals and father's educational degree. Furthermore, new ecological risk factors such as air pollution due to nonstandard petroleum or toxic inhalant particles, nonhealthy food consumption, and satellite jamming are other predisposing factors. Our study reported a higher average annual percentage change of childhood cancers in our area, compared to the existing literature. In conclusion, detection and prevention of the consistent and possible new environmental risk factors such as nonstandard petroleum or satellite jamming from all around the country should be taking into consideration.

  14. Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings

    Energy Technology Data Exchange (ETDEWEB)

    Rutherford, Elaine; Weir-McCall, Jonathan R.; Houston, J.G.; Struthers, Allan D. [Ninewells Hospital, Division of Cardiovascular and Diabetes Medicine, Dundee (United Kingdom); Patel, Rajan K.; Jardine, Alan G.; Mark, Patrick B. [Institute of Cardiovascular and Medical Sciences, Glasgow (United Kingdom); Roditi, Giles [NHS Greater Glasgow and Clyde, Department of Radiology, Glasgow Royal Infirmary, Glasgow (United Kingdom)

    2017-01-15

    Left ventricular mass (LVM) at cardiac magnetic resonance imaging (CMR) is a frequent end point in clinical trials in nephrology. Trial participants with end stage renal disease (ESRD) may have a greater frequency of incidental findings (IF). We retrospectively investigated prevalence of IF in previous research CMR and reviewed their subsequent impact on participants. Between 2002 and 2006, 161 ESRD patients underwent CMR in a transplant assessment study. Images were used to assess LV mass and function. In the current study a radiologist reviewed the scans for IF. Review of patient records determined the subsequent clinical significance of IF. There were 150 IF in 95 study participants. Eighty-four (56 %) were new diagnoses. One hundred and two were non-cardiac. Fifteen were suspicious of malignancy. There was a clinically significant IF for 14.9 % of the participants. In six cases earlier identification of an IF may have improved quality of life or survival. Without radiology support clinically important IF may be missed on CMR. Patients undergoing CMR in trials should be counselled about the frequency and implications of IF. Patients with ESRD have a higher prevalence of IF than reported in other populations. Nephrology studies require mechanisms for radiologist reporting and strategies for dealing with IF. (orig.)

  15. Deletion of C7L and K1L genes leads to significantly decreased virulence of recombinant vaccinia virus TianTan.

    Directory of Open Access Journals (Sweden)

    Zheng Liu

    Full Text Available The vaccinia virus TianTan (VTT has been modified as an HIV vaccine vector in China and has shown excellent performance in immunogenicity and safety. However, its adverse effects in immunosuppressed individuals warrant the search for a safer vector in the following clinic trails. In this study, we deleted the C7L and K1L genes of VTT and constructed six recombinant vaccinia strains VTT△C7L, VTT△K1L, VTT△C7LK1L, VTKgpe△C7L, VTKgpe△K1L and VTT△C7LK1L-gag. The pathogenicity and immunogenicity of these recombinants were evaluated in mouse and rabbit models. Comparing to parental VTT, VTT△C7L and VTT△K1L showed significantly decreased replication capability in CEF, Vero, BHK-21 and HeLa cell lines. In particular, replication of VTT△C7LK1L decreased more than 10-fold in all four cell lines. The virulence of all these mutants were decreased in BALB/c mouse and rabbit models; VTT△C7LK1L once again showed the greatest attenuation, having resulted in no evident damage in mice and erythema of only 0.4 cm diameter in rabbits, compared to 1.48 cm for VTT. VTKgpe△C7L, VTKgpe△K1L and VTT△C7LK1L-gag elicited as strong cellular and humoral responses against HIV genes as did VTKgpe, while humoral immune response against the vaccinia itself was reduced by 4-8-fold. These data show that deletion of C7L and K1L genes leads to significantly decreased virulence without compromising animal host immunogenicity, and may thus be key to creating a more safe and effective HIV vaccine vector.

  16. Long-Term Coffee Consumption Is Associated with Decreased Incidence of New-Onset Hypertension: A Dose–Response Meta-Analysis

    Science.gov (United States)

    Grosso, Giuseppe; Micek, Agnieszka; Pajak, Andrzej; Sciacca, Salvatore; Bes-Rastrollo, Maira; Martinez-Gonzalez, Miguel A.

    2017-01-01

    Objective: To perform a dose–response meta-analysis of prospective cohort studies investigating the association between long-term coffee intake and risk of hypertension. Methods: An online systematic search of studies published up to November 2016 was performed. Linear and non-linear dose–response meta-analyses were conducted; potential evidence of heterogeneity, publication bias, and confounding effect of selected variables were investigated through sensitivity and meta-regression analyses. Results: Seven cohorts including 205,349 individuals and 44,120 cases of hypertension were included. In the non-linear analysis, there was a 9% significant decreased risk of hypertension per seven cups of coffee a day, while, in the linear dose–response association, there was a 1% decreased risk of hypertension for each additional cup of coffee per day. Among subgroups, there were significant inverse associations for females, caffeinated coffee, and studies conducted in the US with longer follow-up. Analysis of potential confounders revealed that smoking-related variables weakened the strength of association between coffee consumption and risk of hypertension. Conclusions: Increased coffee consumption is associated with a modest decrease in risk of hypertension in prospective cohort studies. Smoking status is a potential effect modifier on the association between coffee consumption and risk of hypertension. PMID:28817085

  17. Long-Term Coffee Consumption Is Associated with Decreased Incidence of New-Onset Hypertension: A Dose–Response Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Giuseppe Grosso

    2017-08-01

    Full Text Available Objective: To perform a dose–response meta-analysis of prospective cohort studies investigating the association between long-term coffee intake and risk of hypertension. Methods: An online systematic search of studies published up to November 2016 was performed. Linear and non-linear dose–response meta-analyses were conducted; potential evidence of heterogeneity, publication bias, and confounding effect of selected variables were investigated through sensitivity and meta-regression analyses. Results: Seven cohorts including 205,349 individuals and 44,120 cases of hypertension were included. In the non-linear analysis, there was a 9% significant decreased risk of hypertension per seven cups of coffee a day, while, in the linear dose–response association, there was a 1% decreased risk of hypertension for each additional cup of coffee per day. Among subgroups, there were significant inverse associations for females, caffeinated coffee, and studies conducted in the US with longer follow-up. Analysis of potential confounders revealed that smoking-related variables weakened the strength of association between coffee consumption and risk of hypertension. Conclusions: Increased coffee consumption is associated with a modest decrease in risk of hypertension in prospective cohort studies. Smoking status is a potential effect modifier on the association between coffee consumption and risk of hypertension.

  18. Expression of chicken interleukin-2 by a highly virulent strain of Newcastle disease virus leads to decreased systemic viral load but does not significantly affect mortality in chickens.

    Science.gov (United States)

    Susta, Leonardo; Diel, Diego G; Courtney, Sean; Cardenas-Garcia, Stivalis; Sundick, Roy S; Miller, Patti J; Brown, Corrie C; Afonso, Claudio L

    2015-08-08

    In mammals, interleukin 2 (IL-2) has been shown to decrease replication or attenuate pathogenicity of numerous viral pathogens (herpes simplex virus, vaccinia virus, human respiratory syncytial virus, human immunodeficiency virus) by activating natural killer cells (NK), cytotoxic T lymphocytes and expanding subsets of memory cells. In chickens, IL-2 has been shown to activate T cells, and as such it might have the potential to affect replication and pathogenesis of Newcastle disease virus (NDV). To assess the effect of IL-2 during NDV infection in chickens, we produced a recombinant virulent NDV strain expressing chicken IL-2 (rZJ1-IL2). The effects of IL-2 expression were investigated in vivo using the intracerebral pathogenicity index (ICPI) in day-old chicks and pathogenesis experiments in 4-week-old chickens. In these studies, rZJ1-IL2 was compared to a control virus expressing the green fluorescent protein (rZJ1-GFP). Assessed parameters included survival curves, detailed histological and immunohistochemical grading of lesions in multiple organs, and virus isolation in blood, spleen and mucosal secretions of infected birds. At the site of infection (eyelid), expression of IL-2 was demonstrated in areas of rZJ-IL2 replication, confirming IL-2 production in vivo. Compared to rZJ1-GFP strain, rZJ1-IL2 caused milder lesions and displayed decreased viral load in blood, spleen and mucosal secretions of infected birds. In the rZJ1-IL2-infected group, virus level in the blood peaked at day 4 post-infection (pi) (10(3.46) EID50 /0.1 ml) and drastically decreased at day 5 pi (10(0.9) EID50/0.1 ml), while in the rZJ1-GFP-infected group virus levels in the blood reached 10(5.35) EID50/0.1 ml at day 5. However, rZJ1-IL2-infected groups presented survival curves similar to control birds infected with rZJ1-GFP, with comparable clinical signs and 100 % mortality. Further, expression of IL-2 did not significantly affect the ICPI scores, compared to rZJ1-GFP strain. Increased

  19. Treated domestic sewage irrigation significantly decreased the CH4, N2O and NH3 emissions from paddy fields with straw incorporation

    Science.gov (United States)

    Xu, Shanshan; Hou, Pengfu; Xue, Lihong; Wang, Shaohua; Yang, Linzhang

    2017-11-01

    Straw incorporation and domestic sewage irrigation have been recommended as an environmentally friendly agricultural practice and are widely used not only in China but also in other countries. The individual effects on yield and environmental impacts have been studied extensively, but the comprehensive effect when straw returning and domestic sewage irrigation are combined together has seldom been reported. This study was conducted to examine the effects of straw returning and domestic sewage irrigation on rice yields, greenhouse gas emissions (GHGs) and ammonia (NH3) volatilization from paddy fields from 2015 to 2016. The results showed that the rice yield was not affected by the irrigation water sources and straw returning under the same total N input, which was similar in both years. Due to the rich N in the domestic sewage, domestic sewage irrigation could reduce approximately 45.2% of chemical nitrogen fertilizer input without yield loss. Compared to straw removal treatments, straw returning significantly increased the CH4 emissions by approximately 7-9-fold under domestic sewage irrigation and 13-14-fold under tap water irrigation. Straw returning also increased the N2O emissions under the two irrigation water types. In addition, the seasonal NH3 volatilization loss was significantly increased by 88.8% and 61.2% under straw returning compared to straw removal in 2015 and 2016, respectively. However, domestic sewage irrigation could decrease CH4 emissions by 24.5-26.6%, N2O emissions by 37.0-39.0% and seasonal NH3 volatilization loss by 27.2-28.3% under straw returning compared to tap water irrigation treatments. Global warming potentials (GWP) and greenhouse gas intensities (GHGI) were significantly increased with straw returning compared with those of straw removal, while they were decreased by domestic sewage irrigation under straw returning compared to tap water irrigation. Significant interactions between straw returning and domestic sewage irrigation on

  20. Combining Cue-Lure and Methyl Eugenol in Traps Significantly Decreases Catches of Most Bactrocera, Zeugodacus and Dacus Species (Diptera: Tephritidae: Dacinae) in Australia and Papua New Guinea.

    Science.gov (United States)

    Royer, Jane E; Mayer, David G

    2018-02-09

    Male fruit fly attractants, cue-lure (CL) and methyl eugenol (ME), are important in the monitoring and control of pest fruit fly species. Species respond to CL or ME but not both, and there are conflicting reports on whether combining CL (or its hydroxy analogue raspberry ketone) and ME decreases their attractiveness to different species. Fruit fly monitoring programs expend significant effort using separate CL and ME traps and avoiding lure cross-contamination, and combining the two lures in one trap would create substantial savings. To determine if combining lures has an inhibitory effect on trap catch, CL and ME wicks placed in the same Steiner trap were field tested in comparison to CL alone and ME alone in Australia and Papua New Guinea (PNG). In Australia, 24 out of 27 species trapped were significantly more attracted to CL or ME alone than the combination ME/CL lure, including the pests Bactrocera bryoniae (Tryon), B. frauenfeldi (Schiner), B. kraussi (Hardy), B. neohumeralis (Hardy), B. tryoni (Froggatt) (CL-responsive), and B. musae (Tryon) (ME-responsive). In PNG, 13 out of 16 species trapped were significantly more attracted to CL or ME alone than the ME/CL combination, including the pests B. bryoniae, B. frauenfeldi, B. neohumeralis, B. trivialis (Drew), Zeugodacus cucurbitae (Coquillett) (CL-responsive) and B. dorsalis (Hendel), B. musae, and B. umbrosa (Fabricius) (ME-responsive). This study shows that combining CL and ME in the one trap in equal parts significantly reduces catches of most species of Dacini fruit flies in Australia and PNG. © The Author(s) 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. [Multiparameter analysis of the ergometric test. Significance of the failure of systolic blood pressure to decrease during recovery phase as an index of coronary disease].

    Science.gov (United States)

    Doria, G; Scaccianoce, G; Artale, S; Francaviglia, B; Platania, F; Circo, A

    1990-10-01

    Ergometric tests were performed in 27 patients who had previously undergone coronarography following instrumental findings and/or symptoms which seemed highly indicative of ischemic cardiopathy. The aim of the study was to assess the diagnostic importance of the failure of systolic blood pressure to decrease during the third minute of the recovery phase of the test as an index of coronary disease. In particular, as reported by other studies, the ratio between systolic blood pressure at the third minute of recovery and maximum systolic blood pressure during the test was also assessed values above 0.7 were considered pathological. Sixteen out the 27 patients examined showed lesions which were hemodynamically significant, whereas 11 patients were free of lesions and 9 had previous myocardial necrosis. The level of the above ratio in subjects without significant coronary lesions was 0.66 +/- 0.05, whereas it was 0.85 +/- 0.04 (p less than 0.01) in patients with coronary disease. Sensitivity, specificity, and positive and negative prognostic values were respectively 91.6%, 62%, 64.7% and 90.9%. In patients with lesions to the three main arteries both the sensitivity and the specificity were 100%. In the same patients, the ST criteria were 85.7%, 50%, 81.8% and 74.3%.

  2. Assessment of the role of fibular fixation in distal-third tibia-fibula fractures and its significance in decreasing malrotation and malalignment.

    Science.gov (United States)

    Prasad, Manish; Yadav, Sanjay; Sud, Ajaydeep; Arora, Naresh C; Kumar, Narender; Singh, Shambhu

    2013-12-01

    In the treatment of distal-third tibia/fibula fractures treated by interlocking nailing, the role of fibular fixation is not clearly defined. This study aimed to assess the benefits of fibular fixation in such fractures. Sixty patients with fractures of the lower third of the leg were enrolled into the study and divided into two groups based on whether the fibula was fixed (group A) or not (group B). Fracture tibia was treated with interlocked intramedullary nailing and fibular fixation was done using a 3.5-mm Limited Contact Dynamic Compression Plate (LC-DCP). The two groups were compared for differences in rotation at ankle, angulation at the fracture site, time of union and complications. Clinical and functional outcomes were assessed regularly. Merchant-Dietz criteria were used to assess ankle function. The demographics of the two groups were similar. Average valgus angulation was significantly less in group A (average 5°) versus group B (average 9°). The degree of rotational malalignment at the ankle in group A was average 7° versus average 15° in group B. The outcome of two groups for clinical ankle score, time of union and complications showed no significant differences. Fixation of the fibula along with interlocking nailing of the tibia decreases the malalignment of the tibia and malrotation of the ankle in distal-third fractures of the tibia and fibula as compared with only interlocking nailing. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Effectiveness of breed-specific legislation in decreasing the incidence of dog-bite injury hospitalisations in people in the Canadian province of Manitoba

    OpenAIRE

    Raghavan, Malathi; Martens, Patricia J; Chateau, Dan; Burchill, Charles

    2012-01-01

    Background The city of Winnipeg was the first among several jurisdictions in Manitoba, Canada, to introduce breed specific legislation (BSL) by banning pit-bull type dogs in 1990. The objective of the present work was to study the effectiveness of BSL in Manitoba. Methods Temporal differences in incidence of dog-bite injury hospitalisations (DBIH) within and across Manitoba jurisdictions with and without BSL were compared. Incidence was calculated as the number of unique cases of DBIH divided...

  4. A Novel Hands-Free Abdominal Compression Device for Colonoscopy Significantly Decreases Cecal Intubation Time: A Prospective Single-Blinded Pilot Study.

    Science.gov (United States)

    Schulman, Allison R; Ryou, Marvin; Chan, Walter W

    2017-06-01

    Colonoscopy outcome is limited by endoscope looping, which leads to patient discomfort, prolonged procedure, and increased sedation requirement. Traditional manual abdominal pressure is imprecise and manually intensive. A hands-free abdominal compression device (ACD) may improve colonoscopy outcome. We aimed to assess the effect of a novel ACD on colonoscopy outcomes compared to manual pressure. This was a prospective single-blinded study of patients undergoing outpatient colonoscopy. The ACD (N-Doe Pillow™) was applied on 50 consecutive patients. Endoscopists were blinded to device usage. Control cases using manual pressure were randomly selected in a 2:1 manner. Primary outcome was cecal intubation time. Secondary outcomes included sedation requirement and complications. Subgroup analyses evaluated ACD effect on endoscopists with different experiences and patients at higher risk of difficult colonoscopy. Fisher's exact and Student's t-tests were performed for univariate analyses. Multivariate analysis was performed using generalized linear regression. Fifty patients undergoing colonoscopy with ACD assistance were compared to 100 matched controls. Mean cecal intubation time was significantly reduced in the ACD group compared to controls (6.38 minutes versus 11.8 minutes, P ACD use was independently associated with reduction in cecal intubation time (β-coeff: -4.11, P = .007). Subgroup analyses revealed a trend toward increased improvement in cecal intubation time among junior endoscopists and obese patients. A novel, hands-free ACD significantly decreased cecal intubation time in this prospective, single-blinded, match-controlled study. A trend toward more improvement was seen among junior faculty, suggesting an application for trainees and/or endoscopists with smaller case volumes.

  5. Clinical significance of incident hypokalemia and hyperkalemia in treated hypertensive patients in the antihypertensive and lipid-lowering treatment to prevent heart attack trial.

    Science.gov (United States)

    Alderman, Michael H; Piller, Linda B; Ford, Charles E; Probstfield, Jeffrey L; Oparil, Suzanne; Cushman, William C; Einhorn, Paula T; Franklin, Stanley S; Papademetriou, Vasilios; Ong, Stephen T; Eckfeldt, John H; Furberg, Curt D; Calhoun, David A; Davis, Barry R

    2012-05-01

    Concerns exist that diuretic-induced changes in serum potassium may have adverse effects in hypertensive patients. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, a large practice-based clinical trial, made it possible to examine consequences of observed changes in potassium during care in conventional practice settings. Normokalemic participants randomized to chlorthalidone (C) versus amlodipine or lisinopril as a first-step drug were stratified by year-1 potassium. Postyear-1 outcomes among hypokalemics (potassium, 5.4 mmol/L) were compared with normokalemics (potassium, 3.5-5.4 mmol/L). Year-1 hypokalemia incidence was 6.8%; incidence in C (12.9%) differed from amlodipine (2.1%; Pheart disease occurred in 8.1% with hypokalemia, 8.0% with normokalemia, and 11.1% with hyperkalemia. Overall, mortality was higher in hypokalemics than in normokalemics (Cox hazard ratio, 1.21 [95% CI, 1.02-1.44]) with statistically significant (interaction, P<0.01) disparity in hazard ratios for the 3 treatment arms (hazard ratios, C=1.21, amlodipine=1.60, lisinopril=3.82). Hyperkalemia was associated with increased risk of combined cardiovascular disease (hazard ratio, 1.58 [95% CI, 1.15-2.18]) without significant treatment interactions. In conventional practice settings, the uncommon appearance of hyperkalemia was associated with increased cardiovascular disease risk. Hypokalemia was associated with increased mortality; however, the statistically significant heterogeneity in hazard ratios across treatment groups strongly suggests that the observed increase in mortality is unrelated to the specific effects of C. Thus, for most patients, concerns about potassium levels should not influence the clinician's decision about initiating hypertension treatment with low-moderate doses of thiazide diuretics (12.5-25.0 mg of C).

  6. Convergence of decreasing male and increasing female incidence rates in major tobacco-related cancers in Europe in 1988-2010

    NARCIS (Netherlands)

    J.G.A. Lortet-Tieulent (Joannie); E. Renteria (Elisenda); L. Sharp (Linda); E. Weiderpass (Elisabete); H. Comber; P. Baas (Paul); F. Bray (Freddie); J.W.W. Coebergh (Jan Willem); I. Soerjomataram (Isabelle)

    2013-01-01

    textabstractIntroduction: Smoking prevalence has been declining in men all over Europe, while the trend varies in European regions among women. To study the impact of past smoking prevalence, we present a comprehensive overview of the most recent trends in incidence, during 1988-2010, in 26

  7. Convergence of decreasing male and increasing female incidence rates in major tobacco-related cancers in Europe in 1988-2010.

    Science.gov (United States)

    Lortet-Tieulent, Joannie; Renteria, Elisenda; Sharp, Linda; Weiderpass, Elisabete; Comber, Harry; Baas, Paul; Bray, Freddie; Coebergh, Jan Willem; Soerjomataram, Isabelle

    2015-06-01

    Smoking prevalence has been declining in men all over Europe, while the trend varies in European regions among women. To study the impact of past smoking prevalence, we present a comprehensive overview of the most recent trends in incidence, during 1988-2010, in 26 countries, of four of the major cancers in the respiratory and upper gastro-intestinal tract associated with tobacco smoking. Data from 47 population-based cancer registries for lung, laryngeal, oral cavity and pharyngeal, and oesophageal cancer cases were obtained from the newly developed data repository within the European Cancer Observatory (http://eco.iarc.fr/). Truncated age-standardised incidence rates (35-74 years) by calendar year, average annual percentage change in incidence over 1998-2007 were calculated. Smoking prevalence in selected countries was extracted from the Organisation for Economic Co-operation and Development and the World Health Organization databases. There remained great but changing variation in the incidence rates of tobacco-related cancers by European region. Generally, the high rates among men have been declining, while the lower rates among women are increasing, resulting in convergence of the rates. Female lung cancer rates were above male rates in Denmark, Iceland and Sweden (35-64 years). In lung and laryngeal cancers, where smoking is the main risk factor, rates were highest in central and eastern Europe, southern Europe and the Baltic countries. Despite a lowering of female smoking prevalence, female incidence rates of lung, laryngeal and oral cavity cancers increased in most parts of Europe, but were stable in the Baltic countries. Mixed trends emerged in oesophageal cancer, probably explained by differing risk factors for the two main histological subtypes. This data repository offers the opportunity to show the variety of incidence trends by sex among European countries. The diverse patterns of trends reflect varied exposure to risk factors. Given the heavy cancer

  8. Expression of chicken interleukin-2 by a highly virulent strain of Newcastle disease virus leads to decreased systemic viral load but does not significantly affect mortality in chickens

    Science.gov (United States)

    In mammals, interleukin 2 (IL-2) has been shown to decrease replication or attenuate pathogenicity of numerous viral pathogens by activating natural killer cells (NK), cytotoxic T lymphocytes, and expanding subsets of memory cells. In chickens, IL-2 has been shown to activate T cells, and as such i...

  9. The incidence and prognostic significance of new-onset atrial fibrillation in patients with acute myocardial infarction and left ventricular systolic dysfunction: a CARISMA substudy

    DEFF Research Database (Denmark)

    Jons, Christian; Jacobsen, Uffe G; Joergensen, Rikke Moerch

    2011-01-01

    The incidence and risk associated with new-onset atrial fibrillation (AF) occurring after discharge in patients with acute myocardial infarction (MI) remains unknown.......The incidence and risk associated with new-onset atrial fibrillation (AF) occurring after discharge in patients with acute myocardial infarction (MI) remains unknown....

  10. High incidence of clinically significant concomitant prostate cancer in patients undergoing radical cystectomy for bladder cancer: A 10-year single-center experience.

    Science.gov (United States)

    Heidegger, Isabel; Oberaigner, Willi; Horninger, Wolfgang; Pichler, Renate

    2017-04-01

    To analyze prostate cancer (PCa) incidence, clinical significance, and recurrence in 213 patients who underwent radical cystectomy (RC) for advanced bladder cancer (BC). We conducted a 10-year retrospective analysis of a single-center database comprising the effect of PCa in RC specimens. In total, 113/213 male patients (53.1%) had PCa in the RC specimen. Patients׳ age, prostate-specific antigen (PSA), and also free PSA% were significant predictors for PCa. In addition, adverse bladder histology (≥pT3) was found in 63.7% of patients with PCa. A total of 52.2% (59/113) of patients had at least a Gleason score (GS) 7 in final pathology and 10.6% of RC specimens showed an organ border growth (≥pT3a). It was noted that 28.3% of patients experienced a biochemical recurrence (PSA≥0.2ng/ml), among them 86.7% had GS≥7 in the RC specimen; however, 2 patients were diagnosed with a GS 5. Moreover, we found that 80% of patients with biochemical recurrence had an organ-extended (≥pT3) histology of the bladder and 40% of patients with biochemical recurrence died of PCa rather than from BC. Concomitant PCa is occurring in>50% of RC specimens with a significant proportion having characteristics (GS, pathological stage) of clinically relevant disease. Adverse bladder histology is a risk factor for both PCa and biochemical PSA recurrence. Follow-up analyses after RC should include PSA measurements also in low-risk PCa as a considerable number of patients develop biochemical recurrence and metastases from PCa partly ending up with death related to PCa in patients suffering from BC. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Reduced LAK cytotoxicity of peripheral blood mononuclear cells in patients with bladder cancer: Decreased LAK cytotoxicity caused by a low incidence of CD56+ and CD57+ mononuclear blood cells

    International Nuclear Information System (INIS)

    Hermann, G.G.; Petersen, K.R.; Steven, K.; Zeuthen, J.

    1990-01-01

    The cytotoxicity of unstimulated peripheral blood mononuclear cells (US-PBMC), phytohemagglutinin (PHA)-stimulated PBMC (PS-PBMC) and interleukin-2 (IL-2)-activated PBMC (LAK cells) was assessed in patients with noninvasive and invasive transitional-cell bladder cancer and compared with those determined in healthy controls. The differences in the cytotoxicities were correlated with specific changes in the subsets of peripheral blood mononuclear cells (PBMC). PBMC from 37 patients and 13 healthy controls were tested against the bladder cancer cell line T24 in 51 Cr-release assays. The PBMC subsets were analyzed using monoclonal antibodies against T cells, natural killer (NK) -cells, monocytes, and activation markers. The cytotoxicities of US-PBMC, PS-PBMC, and LAK cells were all significantly lower in the cancer patients than in the controls (P less than 0.05). The percentages of PBMC positive for the NK-cell markers CD56 and CD57 were lowest in the patients and were correlated to the decrease in cytotoxicity. Depletion of CD56+ or CD57+ cells from PBMC prior to or after 2 days stimulation with IL-2 demonstrated that these cells are the major source of LAK-cell cytotoxicity and showed that the reduced ability of bladder cancer patient PBMC to develop LAK-cell cytotoxicity is a result of a low incidence of CD56+ and CD57+ cells in the blood. These findings indicate that IL-2 therapy alone might not be a sufficient therapy of bladder cancer patients

  12. Significant Reduction in the Incidence of Genital Warts in Young Men 5 Years into the Danish Human Papillomavirus Vaccination Program for Girls and Women

    DEFF Research Database (Denmark)

    Bollerup, Signe; Baldur-Felskov, Birgitte; Blomberg, Maria

    2016-01-01

    BACKGROUND: Denmark introduced the quadrivalent human papillomavirus vaccine into the vaccination program for 12- to 15-year-old girls in 2008 to 2009. In 2012, the program was supplemented with a catch-up program for women aged up to 27 years. We evaluated the effectiveness of the Danish...... vaccination program on the nationwide incidence of genital warts (GWs), after the second catch-up by including information on both hospital treatments and on self-administered treatment with podophyllotoxin. Genital wart incidence was investigated in both sexes; however, the main focus was on potential herd...... protection of men. METHODS: Incident cases of GWs were identified from the Danish National Patient Register and through redemptions of prescription for podophyllotoxin in the Danish National Prescription Registry in 2006 to 2013. Age-specific incidence rates (IRs) were assessed, and estimated annual...

  13. Human circulating plasma DNA significantly decreases while lymphocyte DNA damage increases under chronic occupational exposure to low-dose gamma-neutron and tritium β-radiation

    Energy Technology Data Exchange (ETDEWEB)

    Korzeneva, Inna B., E-mail: inna.korzeneva@molgen.vniief.ru [Russian Federal Nuclear Center – All-Russian Research Institute of Experimental Physics (RFNC-VNIIEF) 607190, Sarov, 37 Mira ave., Nizhniy Novgorod Region (Russian Federation); Kostuyk, Svetlana V.; Ershova, Liza S. [Research Centre for Medical Genetics, Russian Academy of Medical Sciences, 115478 Moscow, 1 Moskvorechye str. (Russian Federation); Osipov, Andrian N. [Federal Medial and Biological Center named after Burnazyan of the Federal Medical and Biological Agency (FMBTz named after Burnazyan of FMBA), Moscow (Russian Federation); State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Zhivopisnaya, 46, Moscow, 123098 (Russian Federation); Zhuravleva, Veronika F.; Pankratova, Galina V. [Russian Federal Nuclear Center – All-Russian Research Institute of Experimental Physics (RFNC-VNIIEF) 607190, Sarov, 37 Mira ave., Nizhniy Novgorod Region (Russian Federation); Porokhovnik, Lev N.; Veiko, Natalia N. [Research Centre for Medical Genetics, Russian Academy of Medical Sciences, 115478 Moscow, 1 Moskvorechye str. (Russian Federation)

    2015-09-15

    Highlights: • The chronic exposure to low-dose IR induces DSBs in human lymphocytes (TM index). • Exposure to IR decreases the level of human circulating DNA (cfDNA index). • IR induces an increase of DNase1 activity (DNase1 index) in plasma. • IR induces an increase of the level of antibodies to DNA (Ab DNA index) in plasma. • The ratio cfDNA/(DNase 1 × Ab DNA × TM) is a potential marker of human exposure to IR. - Abstract: The blood plasma of healthy people contains cell-fee (circulating) DNA (cfDNA). Apoptotic cells are the main source of the cfDNA. The cfDNA concentration increases in case of the organism’s cell death rate increase, for example in case of exposure to high-dose ionizing radiation (IR). The objects of the present research are the blood plasma and blood lymphocytes of people, who contacted occupationally with the sources of external gamma/neutron radiation or internal β-radiation of tritium N = 176). As the controls (references), blood samples of people, who had never been occupationally subjected to the IR sources, were used (N = 109). With respect to the plasma samples of each donor there were defined: the cfDNA concentration (the cfDNA index), DNase1 activity (the DNase1 index) and titre of antibodies to DNA (the Ab DNA index). The general DNA damage in the cells was defined (using the Comet assay, the tail moment (TM) index). A chronic effect of the low-dose ionizing radiation on a human being is accompanied by the enhancement of the DNA damage in lymphocytes along with a considerable cfDNA content reduction, while the DNase1 content and concentration of antibodies to DNA (Ab DNA) increase. All the aforementioned changes were also observed in people, who had not worked with the IR sources for more than a year. The ratio cfDNA/(DNase1 × Ab DNA × TM) is proposed to be used as a marker of the chronic exposure of a person to the external low-dose IR. It was formulated the assumption that the joint analysis of the cfDNA, DNase1, Ab

  14. In the Absence of a Mechanical Bowel Prep, Does the Addition of Pre-Operative Oral Antibiotics to Parental Antibiotics Decrease the Incidence of Surgical Site Infection after Elective Segmental Colectomy?

    Science.gov (United States)

    Atkinson, Sarah J; Swenson, Brian R; Hanseman, Dennis J; Midura, Emily F; Davis, Bradley R; Rafferty, Janice F; Abbott, Daniel E; Shah, Shimul A; Paquette, Ian M

    2015-12-01

    Pre-operative oral antibiotics administered the day prior to elective colectomy have been shown to decrease the incidence of surgical site infections (SSI) if a mechanical bowel prep (MBP) is used. Recently, the role for mechanical bowel prep has been challenged as being unnecessary and potentially harmful. We hypothesize that if MBP is omitted, oral antibiotics do not alter the incidence of SSI following colectomy. We selected patients who underwent an elective segmental colectomy from the 2012 and 2013 National Surgical Quality Improvement Program colectomy procedure targeted database. Indications for surgery included colon cancer, diverticulitis, inflammatory bowel disease, or benign polyp. Patients who received mechanical bowel prep were excluded. The primary outcome measured was surgical site infection, defined as the presence of superficial, deep or, organ space infection within 30 d from surgery. A total of 6,399 patients underwent elective segmental colectomy without MBP. The incidence of SSI differed substantially between patients who received oral antibiotics, versus those who did not (9.7% vs. 13.7%, p=0.01). Multivariate analysis indicated that age, smoking status, operative time, perioperative transfusions, oral antibiotics, and surgical approach were associated with post-operative SSI. When controlling for confounding factors, the use of pre-operative oral antibiotics decreased the incidence of surgical site infection (odds ratio=0.66, 95% confidence interval=0.48-0.90, p=0.01). Even in the absence of mechanical bowel prep, pre-operative oral antibiotics appear to reduce the incidence of surgical site infection following elective colectomy.

  15. Incidence of clinically significant antibodies in patients and healthy blood donors: a prospective cross-sectional study from a tertiary healthcare center in India.

    Science.gov (United States)

    Tiwari, Aseem K; Pandey, Prashant; Sharma, Jyoti; Shailja, Kumari; Dixit, Surbhi; Raina, Vimarsh

    2014-04-01

    Since there is scarce data available on incidence and type of irregular antibodies in patients and donors in India, a study was undertaken to find the incidence of irregular antibodies in patients and irregular antibodies and a positive Direct Antiglobulin Test (DAT) in blood donors. Antibody screening was performed using commercial pooled "O" cells and three-cell panel for donors and patients respectively and an 11-cell panel for identification using Column Agglutination Technology (CAT) with Low-Ionic-Strength Saline-Indirect Antiglobulin Test (LISS-IAT) technique (Ortho Clinical Diagnostics, Johnson & Johnson, USA). The cassettes used were Anti-human Globulin (AHG) type. DAT on donors was also performed using the AHG cassettes. Cumulative incidence of irregular antibodies amongst patients (n=32,560) and donors (n=31,367) were 0.12-0.009%, respectively. In patients, the commonest antibodies were from Rh system with anti-D being the most common antibody type (14/40; 35%) while in donors it was the MNS system with anti M (2/3) being the most common. Incidence of a positive DAT amongst the healthy blood donors was 0.04% (n=13/32,560). Incidence of irregular antibodies in patients at 0.12% was slightly lower than published reports and could be because of the fact that the patient population studied comprised largely of surgical patients many of whom have never received blood transfusion. This data could also be more representative since the number of patients studied was much higher as compared to the previous Indian studies (32,560 vs. 531-2026). The report on incidence of irregular antibodies and DAT (0.009-0.04%) in blood donors was first such attempt in India. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Changes in T-cell subpopulations and cytokine network during early period of ibrutinib therapy in chronic lymphocytic leukemia patients: the significant decrease in T regulatory cells number.

    Science.gov (United States)

    Podhorecka, Monika; Goracy, Aneta; Szymczyk, Agnieszka; Kowal, Malgorzata; Ibanez, Blanca; Jankowska-Lecka, Olga; Macheta, Arkadiusz; Nowaczynska, Aleksandra; Drab-Urbanek, Elzbieta; Chocholska, Sylwia; Jawniak, Dariusz; Hus, Marek

    2017-05-23

    B cell receptor (BCR) stimulation signal plays an important role in the pathogenesis of chronic lymphocytic leukemia (CLL), and kinase inhibitors directed toward the BCR pathway are now the promising anti-leukemic drugs. Ibrutinib, a Bruton tyrosine kinase inhibitor, demonstrates promising clinical activity in CLL. It is reported that ibrutinib, additionally to directly targeting leukemic cells, also inhibits the interactions of these cells with T cells, macrophages and accessory cells. Assessment of these mechanisms is important because of their non -direct anti-leukemic effects and to identify possible side effects connected with long-term drug administration.The aim of this study was to assess the in vivo effects of ibrutinib on T-cell subpopulations and cytokine network in CLL. The analysis was performed on a group of 19 patients during first month of ibrutinib therapy. The standard multicolor flow cytometry and cytometric bead array methods were used for assessment of T-cell subsets and cytokines/chemokines, respectively.The data obtained indicates that Ibrutinib treatment results in changes in T-cell subpopulations and cytokine network in CLL patients. Particularly, a significant reduction of T regulatory cells in peripheral blood was observed. By targeting these populations of T cells Ibrutinib can stimulate rejection of tumor cells by the immune system.

  17. N- and C-terminal truncations of a GH10 xylanase significantly increase its activity and thermostability but decrease its SDS resistance.

    Science.gov (United States)

    Zheng, Fei; Huang, Jingxuan; Liu, Xingchen; Hu, Hang; Long, Liangkun; Chen, Kaixiang; Ding, Shaojun

    2016-04-01

    XynII from Volvariella volvacea has high sodium dodecyl sulfate (SDS) resistance, with the potential for industrial applications under harsh conditions. It consists of a single glycoside hydrolase family 10 (GH10) catalytic domain but contains an additional unique 10 and 4 amino acid residues at the N- and C-terminus, respectively. In this study, five XynII derivatives with N- and/or C-terminus deletions were constructed to determine the effects of these regions on enzyme activity, substrate specificity, thermostability, and SDS resistance. Our results revealed that N- and/or C-terminal truncations significantly increased enzyme activity and thermostability, but reduced SDS resistance. Specifically, the XynIIΔNC4 mutant had 2.53-fold more catalytic efficiency (k cat/K m) towards beechwood xylan than wild-type and 3.0-fold more thermostability (t 1/2 [55°C]). XynIIΔNC4 displayed 3.33-, 4.38-, 1.37-, and 1.98-fold more activity against xylotriose, xylotetraose, xylopentaose, and xylohexaose, respectively, than XynII did. However, its half-life (t 1/2) in 4 % SDS was only 1.72 h, while that of XynII was 4.65 h. Circular dichroism analysis revealed that deletion of N- and C-terminal segments caused minor changes in secondary structure. Our observations suggest that the extra N- and C-terminal segments in wild-type XynII evolved to strengthen the interaction between these regions of the protein, making the local structure more rigid and reducing structural flexibility. In this way, N- and C-terminal truncations increased the thermostability and activity of XynII on different xylans and linear xylooligosaccharides, but reduced its resistance to SDS.

  18. Treadmill exercise decreases incidence of Alzheimer’s disease by suppressing glycogen synthase kinase-3β expression in streptozotocin-induced diabetic rats

    Science.gov (United States)

    Kim, Dae-Young; Jung, Sun-Young; Kim, Tae-Woon; Lee, Kwang-Sik; Kim, Kijeong

    2015-01-01

    Diabetes is a metabolic disorder, and it is considered as a major risk factor for Alzheimer’s disease (AD). In the present study, we evaluated whether treadmill exercise ameliorates progression of AD in relation with glycogen synthase kinase-3β (GSK-3β) activity using streptozotocin (STZ)-induced diabetic rats. For this study, step-down avoidance task, immunohistochemistry for glycogen synthase kinase-3β (GSK-3β) and tau, and western blot for phosphor-phosphoinositide 3 kinase (p-PI3K)/PI3K and phosphor-Akt (p-Akt)/Akt were performed. Diabetes mellitus was induced by intraperitoneal injection of STZ. The rats in the exercise groups were made to run on the treadmill for 30 min per one day, five times a week, during 12 weeks. The present results showed that short-term and long-term latencies in the step-down avoidance task were decreased by induction of diabetes, and treadmill exercise inhibited these latencies in the diabetic rats. Induction of diabetes suppressed the ratio of p-PI3K to PI3K and the ratio of p-Akt to Akt, and treadmill exercise increased these ratios in the diabetic rats. The numbers of GSK-3β-positive and tau-positive cells in the hippocampal dentate gyrus was higher in the diabetes-induction group than that in the control group, and treadmill exercise inhibited these numbers in the diabetic rats. In the present study, treadmill exercise suppressed hyperphosphorylation of tau in the hippocampus by decreased GSK-3β activity through PI3K/Akt pathway activation in the diabetic rats. Based on the present results, treadmill exercise may helpful to prevent diabetes-associated AD occurrence. PMID:25960981

  19. CO{sub 2} emissions by installations submitted to quotas have significantly decreased in 2009; Les emissions de CO{sub 2} des installations soumises a quotas ont fortement baisse en 2009

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This document comments the significant decrease of CO{sub 2} emissions by installations submitted to quotas in the European Union. It outlines that French installations are among the most over-the-target ones. They notice that this decrease occurred in all the main emitting sectors, notably in iron and steel industry. However, this decrease is reduced by an increase of production's carbon intensity almost in all sectors, and more particularly in small and medium enterprises. As the economic recession is the main reason for the emission decrease, the price per ton of CO{sub 2} should be the incentive for further emission reductions

  20. Zinc and Vitamin Supplementation in an Under-5 Indigenous Population of Guatemala: Influence of Lay Health Promoters in Decreasing Incidence of Diarrhea.

    Science.gov (United States)

    Grossmann, Vicki M; Turner, Barbara S; Snyder, Denise; Stewart, Robert D; Bowen, Toni; Cifuentes, Ariadna A; Cliff, Cheryl

    2015-09-01

    Malnutrition is an urgent problem in the developing world, especially for children under 5 years of age. The article describes the utilization of a standard of practice designed to prevent illness in a malnourished, under-5 indigenous population and reinforced by weekly basic health messages taught by lay community health promoters. The two villages were chosen for observation after administration of the standard of care among the Maya-Kíché, the most numerous Mayan group in Guatemala. The standard of practice, 20 mg of daily oral zinc, was administered for 10 days in the home and followed by daily vitamin supplementation that continued throughout the 3 months of the project. All patients received four monthly clinic visits, with one of the village groups receiving weekly health promoter visits. Data evaluated after the quality improvement project showed significant differences in adherence to the zinc regimen (χ(2) = 3.677, p ≤ .05) as well as lower rates of diarrheal illnesses (χ(2) = 5.850, p ≤ .05), with both of these improved in the health promoter group. This study suggests that the training and implementation of para-health professionals from the lay community in response to specific health care needs could be considered a best practice in developing countries. Public health professionals are key to health promoter training and direction, and their importance in the global setting cannot be understated. © The Author(s) 2014.

  1. Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003-2005: a population-based study from the Danish Crohn colitis database

    DEFF Research Database (Denmark)

    Vind, Ida; Riis, L; Jess, T

    2006-01-01

    incidence rates and patient characteristics in Copenhagen County and City. METHODS: All patients diagnosed with IBD during 2003-2005 were followed prospectively. Demographic and clinical characteristics, such as disease extent, extraintestinal manifestations, smoking habits, medical treatment, surgical...... interventions, cancer, and death, were registered. RESULTS: Five-hundred sixty-two patients were diagnosed with IBD, resulting in mean annual incidences of 8.6/10(5) for CD, 13.4/10(5) for UC, and 1.1/10(5) for IC. Time from onset to diagnosis was 8.3 months in CD and 4.5 months in UC patients. A family history...... of IBD, smoking, and extraintestinal manifestations was significantly more common in CD than in UC patients. Only 0.6% of UC patients had primary sclerosing cholangitis. In CD, old age at diagnosis was related to pure colonic disease, whereas children significantly more often had proximal and extensive...

  2. Eficiência de Trichoderma harzianum e Gliocladium viride na redução da incidência de Botrytis cinerea em tomateiro cultivado sob ambiente protegido Efficiency of Trichoderma harzianum and Gliocladium viride in decreasing the incidence of Botrytis cinerea in tomato cultivated in protected environment

    Directory of Open Access Journals (Sweden)

    Bruno Brito Lisboa

    2007-10-01

    conditions with tomatoes cultivated under protected environment. In this experiment, the weekly foliar pulverization of a suspension with 2x10(7 conidia mL-1 significantly decreased the incidence of gray mold, while the application of the antagonists on the seeds, substrate and seed hole during seeding did not reduced the incidence of the pathogen.

  3. Parkinson's disease incidence: magnitude, comparability, time trends.

    Science.gov (United States)

    de Pedro-Cuesta, J; Stawiarz, L

    1991-11-01

    In this study, we reviewed incidence surveys of Parkinson's Disease (PD) from all over the world, published during the period 1945-1989, using reported quality criteria. In addition, we compared age-specific PD incidences from selected observations by stratified analysis. Crude incidences were described for 11 populations, and age-specific incidences for three of them: Iceland, Rochester (Minn, USA), and Turku (Finland). Effect modification by age was detected: a) by comparing incidences by age at diagnosis with incidence by age at clinical disease onset; and b) when only data on onset of disease was computed. For disease onsets, the incidences in Rochester for the period 1955-1966, and in Turku (Finland) during the interval 1968-1970, were lower than that in Iceland for the period 1958-1960: RR = 0.58 95% CI (0.41, 0.83), and RR = 0.67 95% CI (0.51, 0.87), respectively. For the Rochester population aged 40-69 years, a statistically significant 56% decrease in the incidences of Parkinsonism onsets during the period 1945-1966 was found. Validity problems in comparing PD incidences and the role of PD underdiagnosis were emphasized. We concluded that: a) stratified analysis is more suitable than standardization when comparing incidences for etiological purposes; b) the incidence of PD was highest in Iceland; and c) in Rochester, PD incidence under the age of 70 decreased with time.

  4. Decreased Libido

    Science.gov (United States)

    ... causes decreased libido? Decreased libido often accompanies other sexual disorders. Although most men with erectile dysfunction do not complain of decreased libido, after time, persistent failure with erections and sexual performance can lead to reduced sex drive in ...

  5. Suicide in Recent Onset Psychosis Revisited: Significant Reduction of Suicide Rate over the Last Two Decades - A Replication Study of a Dutch Incidence Cohort.

    Directory of Open Access Journals (Sweden)

    Stynke Castelein

    Full Text Available This study aims to compare the suicide risk over the past decade following recent onset psychosis to findings from the eighties and nineties in the same catchment area and to identify predictors of suicide in the context of the Psychosis Recent Onset Groningen-Survey (PROGR-S. A medical file search was carried out to determine the current status of all patients admitted between 2000 and 2009. The suicide rate was compared with a study executed in 1973-1988 in the same catchment area. Predictors of suicide were investigated using Cox regression. The status of 424 of the 614 patients was known in July 2014. Suicide occurred in 2.4% of patients with psychosis disorders (n = 10; mean follow-up 5.6 years; 6 out of 10 suicides took place within two years. Within two decades, the suicide rate dropped from 11% (follow-up 15 years, 8.5% after 5 years to 2.4%. The Standardized Mortality Rate (SMR of suicides compared with the general population was 41.6. A higher age was the only significant predictor for suicide. Neuroticism, living situation, disorganized and negative symptoms, and passive coping style all showed a trend for significance. A significant reduction in the suicide rate was found for people with psychosis over the past decades. Given the high SMR, suicide research should be given the highest priority. Identifying predictors may contribute to further reduction of suicide among patients with psychosis.

  6. Incidents analysis

    International Nuclear Information System (INIS)

    Francois, P.

    1996-01-01

    We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

  7. A circle dance in a psychiatric setting : can a circle dance intervention decrease levels of depressed affect among patients with mental health illnesses and, if so, what aspect of this dance is most significant?

    OpenAIRE

    Beard, Ella King

    2016-01-01

    This study investigates the role of the circle dance in decreasing depressed affect amongst a group of 45 patients with severe mental health illnesses and highlights the most significant aspect of that dance. Patients participated in one of four conditions: a group performing a regular traditional upbeat Irish circle dance holding hands and with a jump step [jump+hands]; a group performing the same dance holding hands with no jump step [hands]; a group performing the same dance without holdin...

  8. FLT3 Mutation as a Significant Prognostic Marker in de novo Acute Myeloid Leukemia Patients: Incidence, Distribution and Association with Cytogenetic Findings in a Study from South India

    Directory of Open Access Journals (Sweden)

    Santhi Sarojam

    2014-10-01

    Full Text Available Background: Fms-like tyrosine kinase 3 is a tyrosine kinase receptor that plays an important role in proliferation and differentiation of hematopoietic stem cells. Internal tandem duplication and tyrosine kinase domain mutation are the two most common types of fms-like tyrosine kinase 3 mutations frequently reported in acute myeloid leukemia associated with pathogenesis of this disease. The present study investigates the prevalence and distribution pattern in different acute myeloid leukemia sub- and cytogenetic groups, the association with clinical parameters and the prognostic importance of these mutations in acute myeloid leukemia patients from South India. Methods:Mutation analysis was performed in 276 de novo acute myeloid leukemia patients by polymerase chain reaction restriction fragment length polymorphism using specific restriction enzymes followed by sequencing to confirm the mutations. Kaplan-Meier survival analysis was performed to detect the prognosis. Results: Fms-like tyrosine kinase 3 internal tandem duplication mutations were observed in 20%, tyrosine kinase domain mutation in 4% and dual mutations in 0.3% of the analyzed cases. The internal tandem duplication mutations ranged from 15-107 nucleotides with the majority at the juxta membrane domain of the receptor. Three types of tyrosine kinase domain point mutations were identified: D835Y, D835H and D835V. We observed a significant association between fms-like tyrosine kinase 3 mutations and increased WBC and LDH counts (P<0.001 and blast percentage but not with age, gender and FAB subtypes. A significant association with normal karyotype was observed for the mutants (P=0.002. Survival analysis revealed that the fms-like tyrosine kinase 3 gene mutation was a negative prognostic marker for acute myeloid leukemia patients. The risk stratified analysis showed the mutation to be a risk factor for the intermediate karyotype group, especially for those with normal cytogenetics

  9. A significant reduction in the frequency of HIV-1 drug resistance in Québec from 2001 to 2011 is associated with a decrease in the monitored viral load.

    Directory of Open Access Journals (Sweden)

    Hugues Charest

    Full Text Available BACKGROUND: HIV drug resistance represents a major threat for effective treatment. We assessed the trends in the frequency of drug resistance mutations and the monitored viral load (VL in treatment-naïve (TN and treatment-experienced (TE individuals infected with HIV-1 in Québec, Canada, between 2001 and 2011. METHODS AND FINDINGS: Resistance data were obtained from 4,105 and 5,086 genotypic tests performed on TN and TE patients, respectively. Concomitantly, 274,161 VL tests were carried out in the Province. Changes over time in drug resistance frequency and in different categories of VL were assessed using univariate logistic regression. Multiple logistic regression was used to evaluate associations between the rates of certain mutations and antiretroviral prescriptions. From 2001 to 2011, the proportion of undetectable VL test results continually increased, from 42.1% to 75.9%, while a significant decrease in the frequency of resistance mutations associated with protease inhibitors [PI (from 54% to 16%], nucleoside [NRTI (from 78% to 37% and non-nucleoside reverse transcriptase inhibitors [NNRTI (from 44% to 31%] was observed in TE patients. In TN individuals, the overall frequency of transmitted drug resistance was 13.1%. A multiple logistic regression analysis indicated that the introduction of co-formulated emtricitabine/tenofovir or emtricitabine/tenofovir/efavirenz was positively associated with the decrease of the frequency of the M184I/V mutations observed overtime (p = 0.0004. CONCLUSIONS: We observed a significant decrease in the frequency of drug resistance mutations in TE patients, concomitant with a decrease in the proportion of patients with detectable viremia. These findings may be related to both the increased potencies and adherence to therapy associated with newer antiretroviral regimens. Nevertheless, our data demonstrate that broad use of antiretrovirals does not increase the level of circulating drug resistant

  10. Incidence and Significance of Haematemesis in Cirrhosis

    African Journals Online (AJOL)

    1974-06-08

    Jun 8, 1974 ... The indication for doing a barium swallow, how- ever, was not clear, and in 50 of the 75 patients there wa no history or clinical evidence of gastro-intestinal tract bleeding. Of [he 50 patients 20 had oesophageal varice . Contrast studies were done in only 16 of the 45 patients with a history of haematemesis, ...

  11. Trends in the incidence of cervical cancer and severe precancerous lesions in Denmark, 1997-2012

    DEFF Research Database (Denmark)

    Baldur-Felskov, Birgitte; Munk, Christian; Nielsen, Thor Schütt Svane

    2015-01-01

    PURPOSE: The incidence of cervical cancer, including squamous cell carcinoma (SCC), has been decreasing in several developed countries since the onset of organized screening programs; in some countries, however, the incidence of adenocarcinoma has increased among young women. We investigated......, importantly, they decreased significantly during 2009-2012 in women aged ≤20 years. CONCLUSIONS: The Danish screening program has successfully reduced the incidence of cervical cancer, especially of SCC in older women; however, the program has not significantly reduced the incidence in young women...... or the incidence of adenocarcinoma, which is increasing. Decreases in the incidences of CIN3 and AIS in age groups with high HPV vaccine coverage may herald a future decrease in cervical cancer incidence in young Danish women....

  12. Wheelchair incidents

    NARCIS (Netherlands)

    Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

    2002-01-01

    This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

  13. Human circulating ribosomal DNA content significantly increases while circulating satellite III (1q12) content decreases under chronic occupational exposure to low-dose gamma- neutron and tritium beta-radiation.

    Science.gov (United States)

    Korzeneva, Inna B; Kostuyk, Svetlana V; Ershova, Elizaveta S; Skorodumova, Elena N; Zhuravleva, Veronika F; Pankratova, Galina V; Volkova, Irina V; Stepanova, Elena V; Porokhovnik, Lev N; Veiko, Natalia N

    A single exposure to ionizing radiation (IR) results in an elevated cell-free DNA (cfDNA) content in the blood plasma. In this case, the cfDNA concentration can be a marker of the cell death in the organism. However, a chronic exposure to a low-dose IR enhances both the endonuclease activity and titer of antibodies to DNA in blood plasma, resulting in a decrease of the total concentration of circulating cfDNA in exposed people. In this case, the total cfDNA concentration should not be considered as a marker of the cell death in an exposed body. We assumed that a pool of the cfDNA circulating in the exposed people contains DNA fragments, which are resistant to a double-strand break formation in the environment of the elevated plasma endonuclease activity, and can be accumulated in the blood plasma. In order to test this hypothesis, we studied the content of GC-rich sequences (69%GC) of the transcribed region of human ribosomal repeat (rDNA), as well as the content of AT-rich repeat (63%AT) of satellite III (1q12) in the cfDNA samples obtained from 285 individuals. We have found that a chronic exposure to gamma-neutron radiation (N=88) and tritium β-radiation (N=88) evokes an increase of the rDNA content (RrDNA index) and a decrease of the satellite III content (RsatIII index) in the circulating cfDNA as compared with the cfDNA of non-exposed people (N=109). Such index that simultaneously displays both the increase of rDNA content and decrease of satellite III content in the cfDNA (RrDNA/RsatIII) can be recommended as a marker of chronic processes in the body that involve the elevated cell death rate and/or increased blood plasma endonuclease activity. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Inhibition of Intestinal OATP2B1 by the Calcium Receptor Antagonist Ronacaleret Results in a Significant Drug-Drug Interaction by Causing a 2-Fold Decrease in Exposure of Rosuvastatin.

    Science.gov (United States)

    Johnson, Marta; Patel, Dipal; Matheny, Christopher; Ho, May; Chen, Liangfu; Ellens, Harma

    2017-01-01

    Rosuvastatin is a widely prescribed antihyperlipidemic which undergoes limited metabolism, but is an in vitro substrate of multiple transporters [organic anion transporting polypeptide 1B1 (OATP1B1), OATP1B3, OATP1A2, OATP2B1, sodium-taurocholate cotransporting polypeptide, breast cancer resistance protein (BCRP), multidrug resistance protein 2 (MRP2), MRP4, organic anion transporter 3]. It is therefore frequently used as a probe substrate in clinical drug-drug interaction (DDI) studies to investigate transporter inhibition. Although each of these transporters is believed to play a role in rosuvastatin disposition, multiple pharmacogenetic studies confirm that OATP1B1 and BCRP play an important role in vivo. Ronacaleret, a drug-development candidate for treatment of osteoporosis (now terminated), was shown to inhibit OATP1B1 in vitro (IC 50 = 11 µM), whereas it did not inhibit BCRP. Since a DDI risk through inhibition of OATP1B1 could not be discharged, a clinical DDI study was performed with rosuvastatin before initiation of phase II trials. Unexpectedly, coadministration with ronacaleret decreased rosuvastatin exposure by approximately 50%, whereas time of maximal plasma concentration and terminal half-life remained unchanged, suggesting decreased absorption and/or enhanced first-pass elimination of rosuvastatin. Of the potential in vivo rosuvastatin transporter pathways, two might explain the observed results: intestinal OATP2B1 and hepatic MRP4. Further investigations revealed that ronacaleret inhibited OATP2B1 (in vitro IC 50 = 12 µM), indicating a DDI risk through inhibition of absorption. Ronacaleret did not inhibit MRP4, discharging the possibility of enhanced first-pass elimination of rosuvastatin (reduced basolateral secretion from hepatocytes into blood). Therefore, a likely mechanism of the observed DDI is inhibition of intestinal OATP2B1, demonstrating the in vivo importance of this transporter in rosuvastatin absorption in humans. Copyright © 2016

  15. Is the incidence of heart attack still decreasing in Australia? Developing reliable methods for monitoring trends in myocardial infarction and coronary heart disease (AUS-MOCHA): a study protocol.

    Science.gov (United States)

    Nedkoff, Lee; Knuiman, Matthew; Hobbs, Michael S T; Hung, Joseph; Mathur, Sushma; Beilby, John; Reynolds, Anna; Briffa, Tom G; Lopez, Derrick; Sanfilippo, Frank M

    2016-08-24

    Accurate monitoring of acute coronary heart disease (CHD) is essential for understanding the effects of primary and secondary prevention and for planning of healthcare services. The ability to reliably monitor acute CHD has been affected by new diagnostic tests for myocardial infarction (MI) and changing clinical classifications and management of CHD. Our study will develop new and reliable methods for monitoring population trends in incidence, outcomes and health service usage for acute CHD and chest pain. The study cohort of all CHD will be identified from the Western Australian Data Linkage System using state-wide data sets for emergency department presentation, hospitalisations and mortality data for 2002-2014. This core linked data set will be supplemented with data from hospital medical record reviews, pathology data and hospital pharmacy dispensing databases. The consistency over time of the coding of the different subgroups of CHD/chest pain (ST-elevation MI, non-ST elevation MI, unstable angina, stable angina, other CHD, non-CHD chest pain) in linked data will be assessed using these data sources, and an algorithm developed detailing groups in which temporal trends can be reliably measured. This algorithm will be used for measurement of trends in incidence and outcomes of acute CHD, and to develop further methods for monitoring acute CHD using unlinked and linked data with varying availability of hospitalisation history. Ethics approval has been obtained from the Human Research Ethics Committees of the WA Department of Health (#2016/23) and The University of Western Australia (RA/4/1/7230). Findings will be disseminated via publication in peer-reviewed journals, and presentation at national and international conferences. There will also be a strong platform for dissemination of new monitoring methods via collaboration with the Australian Institute of Health and Welfare which will assist with promotion of these methods at state and national levels

  16. Critical incident stress management.

    Science.gov (United States)

    Lim, J J; Childs, J; Gonsalves, K

    2000-10-01

    Recent studies have indicated implementation of the CISM Program has impacted and reduced the cost of workers' compensation claims for stress related conditions and the number of lost work days (Ott, 1997; Western Management Consultants, 1996). Occupational health professionals need to be ready to develop and implement a comprehensive critical incident stress management process in anticipation of a major event. The ability to organize, lead, or administer critical incident stress debriefings for affected employees is a key role for the occupational health professional. Familiarity with these concepts and the ability to identify a critical incident enhances value to the business by mitigating the stress and impact to the workplace. Critical Incident Stress Management Systems have the potential for decreasing stress and restoring employees to normal life function--a win/win situation for both the employees and the organization.

  17. Ultrasound guidance for brachial plexus block decreases the incidence of complete hemi-diaphragmatic paresis or vascular punctures and improves success rate of brachial plexus nerve block compared with peripheral nerve stimulator in adults.

    Science.gov (United States)

    Yuan, Jia-Min; Yang, Xiao-Hu; Fu, Shu-Kun; Yuan, Chao-Qun; Chen, Kai; Li, Jia-Yi; Li, Quan

    2012-05-01

    The use of traditional techniques (such as landmark techniques, paresthesia and peripheral nerve stimulator) for upper-limb anesthesia has often been restricted to the expert or enthusiast, which was blind. Recently, ultrasound (US) has been applied to differ blood vessel, pleura and nerve, thus may reduce the risk of complications while have a high rate of success. The aim of this study was to determine if the use of ultrasound guidance (vs. peripheral nerve stimulator, (PNS)) decreases risk of vascular puncture, risk of hemi-diaphragmatic paresis and risk of Horner syndrome and improves the success rate of nerve block. A search strategy was developed to identify randomized control trials (RCTs) reporting on complications of US and PNS guidance for upper-extremity peripheral nerve blocks (brachial plexus) in adults available through PubMed databases, the Cochrane Central Register of Controlled Trials, Embase databases, SinoMed databases and Wanfang data (date up to 2011-12-20). Two independent reviewers appraised eligible studies and extracted data. Risk ratios (OR) were calculated for each outcome and presented with 95% confidence intervals (CI) with the software of Review Manager 5.1.0 System (Cochrane Library). Sixteen trials involving 1321 adults met our criteria were included for analysis. Blocks performed using US guidance were more likely to be successful (risk ratio (RR) for block success 0.36, 95%CI 0.23 - 0.56, P block performance (RR 0.13, 95%CI 0.06 - 0.27, P complete hemi-diaphragmatic paresis (RR 0.09, 95%CI 0.03 - 0.52, P = 0.0001). US decreases risks of complete hemi-diaphragmatic paresis or vascular puncture and improves success rate of brachial plexus nerve block compared with techniques that utilize PNS for nerve localization. Larger studies are needed to determine whether or not the use of US can decrease risk of neurologic complications.

  18. Near infra-red photoimmunotherapy with anti-CEA-IR700 results in extensive tumor lysis and a significant decrease in tumor burden in orthotopic mouse models of pancreatic cancer.

    Directory of Open Access Journals (Sweden)

    Ali A Maawy

    Full Text Available Photoimmunotherapy (PIT of cancer utilizes tumor-specific monoclonal antibodies conjugated to a photosensitizer phthalocyanine dye IR700 which becomes cytotoxic upon irradiation with near infrared light. In this study, we aimed to evaluate the efficacy of PIT on human pancreatic cancer cells in vitro and in vivo in an orthotopic nude mouse model. The binding capacity of anti-CEA antibody to BxPC-3 human pancreatic cancer cells was determined by FACS analysis. An in vitro cytotoxicity assay was used to determine cell death following treatment with PIT. For in vivo determination of PIT efficacy, nude mice were orthotopically implanted with BxPC-3 pancreatic tumors expressing green fluorescent protein (GFP. After tumor engraftment, the mice were divided into two groups: (1 treatment with anti-CEA-IR700 + 690 nm laser and (2 treatment with 690 nm laser only. Anti-CEA-IR700 (100 μg was administered to group (1 via tail vein injection 24 hours prior to therapy. Tumors were then surgically exposed and treated with phototherapy at an intensity of 150 mW/cm2 for 30 minutes. Whole body imaging was done subsequently for 5 weeks using an OV-100 small animal imaging system. Anti-CEA-IR700 antibody bound to the BxPC3 cells to a high degree as shown by FACS analysis. Anti-CEA-IR700 caused extensive cancer cell killing after light activation compared to control cells in cytotoxicity assays. In the orthotopic models of pancreatic cancer, the anti-CEA-IR700 group had significantly smaller tumors than the control after 5 weeks (p<0.001. There was no significant difference in the body weights of mice in the anti-CEA-IR700 and control groups indicating that PIT was well tolerated by the mice.

  19. Effects of high fat diet on incidence of spontaneous tumors in Wistar rats

    DEFF Research Database (Denmark)

    KRISTIANSEN, E.; Madsen, Charlotte Bernhard; Meyer, Otto A.

    1993-01-01

    . There was no difference in food consumption, body weight, weight gain, and longevity between the two groups. A statistically significant increase in the incidence of tumors in the high-fat group was seen in fibroadenoma of the mammae (female, p = 0.05). No statistically significant difference was seen when the incidence...... of benign mammary tumors (adenomas and fibroadenomas) was combined, just as the overall incidence of mammary tumors (adenomas, fibroadenomas, and adenocarcinomas) was not significantly different between the groups. A statistically significant decrease in the incidence of tumors in the high-fat group...

  20. A nationwide registry-based cohort study of incidence of tonsillectomy in Denmark, 1991-2012

    DEFF Research Database (Denmark)

    Juul, Marie Louise; Rasmussen, Eva Rye; Rasmussen, Stig Hebbelstrup Rye

    2018-01-01

    , and by the age of 20, 7.7% of the Danish people has had a tonsillectomy. There were significant regional differences in the number of tonsillectomies. CONCLUSION: The incidence rate of tonsillectomies in Denmark decreased significantly in the study period, but with great regional variance.......OBJECTIVE: To update tonsillectomy incidence rates in Denmark and identify whether the incidence rates vary between geographical areas in the country during the period 1991-2012. DESIGN: This was a retrospective nationwide cohort study using data from the comprehensive Danish patient registries...... tonsillectomies were conducted, and the overall incidence of tonsillectomy decreased significantly over time. The overall annual incidence of tonsillectomies decreased from 155.7 per 100 000 inhabitants in 1991 to 129.4 per 100 000 inhabitants in 2012. In 1991, 5.5% of tonsillectomies were performed in office...

  1. Consecutive Acupuncture Stimulations Lead to Significantly Decreased Neural Responses

    NARCIS (Netherlands)

    Yeo, S.; Choe, I.H.; Noort, M.W.M.L. van den; Bosch, M.P.C.; Lim, S.

    2010-01-01

    Objective: Functional magnetic resonance imaging (fMRI), in combination with block design paradigms with consecutive acupuncture stimulations, has often been used to investigate the neural responses to acupuncture. In this study, we investigated whether previous acupuncture stimulations can affect

  2. Lateral Squats Significantly Decrease Sprint Time in Collegiate Baseball Athletes

    Directory of Open Access Journals (Sweden)

    Jason B. White

    2016-03-01

    Full Text Available The purpose was to examine the effect of prior performance of dumbbell lateral squats (DBLS on an agility movement-into-a-sprint (AMS test. Twelve collegiate, resistance-trained, baseball athletes participated in three sessions separated by three days. Session One consisted of AMS baseline test, DBLS 5-RM test, and experimental protocol familiarization. Subjects were randomly assigned the protocol order for Sessions Two and Three, which consisted of warm up followed by 1-min sitting (no-DBLS or performing the DBLS for 1 × 5 repetitions @ 5RM for each leg. Four minutes of slow recovery walking preceded the AMS test, which consisted of leading off a base and waiting for a visual stimulus. In reaction to stimulus, subjects exerted maximal effort while moving to the right by either pivoting or drop stepping and sprinting for 10 yards (yd. In Session Three, subjects switched protocols (DBLS, no-DBLS. Foot contact time (FCT, stride frequency (SF, stride length (SL, and 10-yd sprint time were measured. There were no differences between conditions for FCT, SF, or SL. Differences existed between DBLS (1.85 ± 0.09 s and no-DBLS (1.89 ± 0.10 s for AMS (p = 0.03. Results from the current study support the use of DBLS for performance enhancement prior to performing the AMS test.

  3. Radiation incidents in dentistry

    International Nuclear Information System (INIS)

    Lovelock, D.J.

    1996-01-01

    Most dental practitioners act as their own radiographer and radiologist, unlike their medical colleagues. Virtually all dental surgeons have a dental X-ray machine for intraoral radiography available to them and 40% of dental practices have equipment for dental panoramic tomography. Because of the low energy of X-ray equipment used in dentistry, radiation incidents tend to be less serious than those associated with other aspects of patient care. Details of 47 known incidents are given. The advent of the 1985 and 1988 Ionising Radiation Regulations has made dental surgeons more aware of the hazards of radiation. These regulations, and general health and safety legislation, have led to a few dental surgeons facing legal action. Because of the publicity associated with these court cases, it is expected that there will be a decrease in radiation incidents arising from the practice of dentistry. (author)

  4. Prevention measures and socio-economic development result in a decrease in malaria in Hainan, China.

    Science.gov (United States)

    Wang, Shan-Qing; Li, Yu-Chun; Zhang, Zhi-Ming; Wang, Guang-Ze; Hu, Xi-Min; Qualls, Whitney A; Xue, Rui-De

    2014-09-15

    Historically, the incidence of malaria in the Hainan Province, China has been high. However, since 2001 the malaria incidence in Hainan has decreased due to large-scale, public educational, promotional campaigns and the adoption of preventative measures against malaria following the fast growth of socio-economic development. The present study analysed the correlation between prevention measures and social economic development on the incidence of malaria in Hainan from 2001 to 2013. The data of malaria preventative measures and socio-economic development were collected from various cities and counties in Hainan Province from 2001 to 2013 and analysed by the grey correlation analysis system. Seasonal preventive medication and local fiscal revenue increases are significantly related to the reduction of malaria incidence from 2001 to 2013 (R1 = 0.751677; R5 = 0.764795). Malaria prevention and control measures and local economic development in Hainan decreased malaria incidence from 2001 to 2013.

  5. Trends in thyroid cancer incidence and mortality in Portugal.

    Science.gov (United States)

    Raposo, Luís; Morais, Samantha; Oliveira, Maria J; Marques, Ana P; José Bento, Maria; Lunet, Nuno

    2017-03-01

    The objective was to quantify thyroid cancer incidence and mortality trends in Portugal. The number of thyroid cancer cases and incidence rates were retrieved from the Regional Cancer Registries for the period 1989-2011. The number of deaths and mortality rates were obtained from the WHO cancer mortality database (1988-2003 and 2007-2012) and Statistics Portugal (2004-2006; 1988-2012 by region). Joinpoint regression of the standardized incidence and mortality rates was performed. A significant, rapid and continued increase in incidence was observed for both sexes in each of the Regional Cancer Registries, with annual per cent changes (APCs) ranging between 2 and 9. Incidence in Portuguese women is higher than estimates for the world and Europe. Mortality decreased for women (APC: -1.5), with the greatest decrease in the North, and increased marginally for men (APC: +0.2), with a greater increase in the South. The significant increases in incidence in Portugal are predominantly because of the increase in incidence among women from the North. These trends, combined with an overall low mortality and high 5-year relative survival, raise concerns on the extent to which overdiagnosis may be taking place. Further research is needed, quantifying the importance of the most likely determinants of these trends as well as the extent and potentially deleterious effects of overdiagnosis and overtreatment in the Portuguese setting.

  6. Cancer incidence among firefighters

    DEFF Research Database (Denmark)

    Pukkala, Eero; Martinsen, Jan Ivar; Weiderpass, Elisabete

    2014-01-01

    .51), adenocarcinoma of the lung (SIR=1.90, 95% CI 1.34 to 2.62), and mesothelioma (SIR=2.59, 95% CI 1.24 to 4.77). By contrast with earlier studies, the incidence of testicular cancer was decreased (SIR=0.51, 95% CI 0.23 to 0.98). CONCLUSIONS: Some of these associations have been observed previously, and potential...

  7. Twenty six-week exposure to 2 amino-3 methylimidazo [4,5-f]quinoline (IQ) does not significantly increase the incidence of tumours in HMGCR/mts1 tg579 transgenic mice

    DEFF Research Database (Denmark)

    Mortensen, Alicja; Lukanidin, E.; Ambartsumian, N.S.

    2004-01-01

    HMGCR/mtsl t9579 transgenic mice were designed to direct the expression of metastasis-promoting mts 1 (S100A4) gene to all the tissues. In order to test the usefulness of this mouse model for carcinogenicity tests shorter than that recommended by OECD guideline mr. 451, HMGCR/mtsl tg579 transgenic...... and C57BL/6ByA (wild type) mice (15 males and 15 females of each genotype per group) received either a control diet for 53 weeks or a control diet plus 0.03% 2-amino-3 methylimidazo[4,5-f]quinoline (IQ) for 26 weeks and a control diet for the remaining 27 weeks. IQ is a food mutagen with a carcinogenic...... effect in non-human primates and rodents. IQ is a liver carcinogen and also causes lung tumours and tumours of the forestomach in mice. Body weight gain and feed intake were decreased (p...

  8. Obesity Decreases Perioperative Tissue Oxygenation

    Science.gov (United States)

    Kabon, Barbara; Nagele, Angelika; Reddy, Dayakar; Eagon, Chris; Fleshman, James W.; Sessler, Daniel I.; Kurz, Andrea

    2005-01-01

    Background: Obesity is an important risk factor for surgical site infections. The incidence of surgical wound infections is directly related to tissue perfusion and oxygenation. Fat tissue mass expands without a concomitant increase in blood flow per cell, which might result in a relative hypoperfusion with decreased tissue oxygenation. Consequently, we tested the hypotheses that perioperative tissue oxygen tension is reduced in obese surgical patients. Furthermore, we compared the effect of supplemental oxygen administration on tissue oxygenation in obese and non-obese patients. Methods: Forty-six patients undergoing major abdominal surgery were assigned to one of two groups according to their body mass index (BMI): BMI < 30 kg/m2 (non-obese) and BMI ≥ 30 kg/m2 (obese). Intraoperative oxygen administration was adjusted to arterial oxygen tensions of ≈150 mmHg and ≈300 mmHg in random order. Anesthesia technique and perioperative fluid management were standardized. Subcutaneous tissue oxygen tension was measured with a polarographic electrode positioned within a subcutaneous tonometer in the lateral upper arm during surgery, in the recovery room, and on the first postoperative day. Postoperative tissue oxygen was also measured adjacent to the wound. Data were compared with unpaired two tailed t-tests and Wilcoxon rank-sum tests; P < 0.05 was considered statistically significant. Results: Intraoperative subcutaneous tissue oxygen tension was significantly less in the obese patients at baseline (36 vs. 57 mmHg, P = 0.002) and with supplemental oxygen administration (47 vs. 76 mmHg, P = 0.014). Immediate postoperative tissue oxygen tension was also significantly less in subcutaneous tissue of the upper arm (43 vs. 54 mmHg, P = 0.011) as well as near the incision (42 vs. 62 mmHg, P = 0.012) in obese patients. In contrast, tissue oxygen tension was comparable in each group on the first postoperative morning. Conclusion: Wound and tissue hypoxia were common in obese

  9. Trends in stroke incidence. The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Truelsen, T; Prescott, E; Grønbaek, M

    1997-01-01

    in men, whose annual rate ratio was 0.97 (95% CI, 0.95 to 0.99), but not in women, whose annual rate ratio was 0.98 (95% CI, 0.95 to 1.00). Throughout four observed periods the stroke incidence among men remained significantly higher than that for women. CONCLUSIONS: During the period from 1976 to 1993......BACKGROUND AND PURPOSE: Stroke incidence has increased in some countries and decreased in others. After 20 years of intensive antihypertensive treatment the latter could be expected, and we have evaluated the sex-specific temporal trends in stroke incidence using 17 years of follow...... at least one of the two first examinations as well as the total cohort including nonresponders. Subjects between 45 and 84 years of age were followed from March 1, 1976 until March 1, 1993. Changes in age-specific stroke incidence were calculated by means of Poisson regression analysis. RESULTS...

  10. [Incidence of haematological neoplasms in Castilla y León, Spain].

    Science.gov (United States)

    Rodríguez-García, José Antonio; Vázquez, Lourdes; Ramos, Fernando; Cuevas, Beatriz; Martín, Alejandro; Smucler, Alicia; Guerola, Dulce Nombre; Cantalapiedra, Alberto; Alonso, José María; Fernández, Silvia; Díez, Eva; Rodríguez, María Jesús; Calmuntia, María José; Aguilar, Carlos; Sierra, Magdalena; Gracia, José Antonio; Cebeira, María José; Cantalejo, Rosa

    2015-06-08

    We aimed to assess the incidence of haematological neoplasms (HNs) in Castilla y León (2,5 million inhabitants) and its distribution by age, gender and histological type. The epidemiological profile based on the described variables of the 10,943 HNs diagnosed during a 10-years period was analyzed, compared with other studies. The overall age-adjusted incidence was 29.4 cases/10(5) inhabitants-year, with some geographical differences. The mean age was 67.3 years, with a turning point between the 6th-7th decades of life from which there was a very significant increase of incidence. Two relevant facts where simultaneous with advancing age: decreased lymphoid neoplasms incidence and increased low degree neoplasms incidence. Lymphoid low degree neoplasms accounted for half of the registered processes, showed the greatest preference for male and reached the mode before the rest of neoplasms. Myeloid neoplasms incidence (9.5) was higher than that reported in other European registries, specially compared to southern European countries, opposite to lymphoid neoplasms incidence (20.0). A higher myeloid neoplasms incidence and lower lymphoid one than expected was observed. The turning point of incidence is between the 6th-7th decades of life, with a preference for male that decreases with age. There is an increased incidence of HNs in the area where a higher density of potentially polluting facilities is concentrated. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  11. Trends in Dementia Incidence in a Birth Cohort Analysis of the Einstein Aging Study.

    Science.gov (United States)

    Derby, Carol A; Katz, Mindy J; Lipton, Richard B; Hall, Charles B

    2017-11-01

    Trends in dementia incidence rates have important implications for planning and prevention. To better understand incidence trends over time requires separation of age and cohort effects, and few prior studies have used this approach. To examine trends in dementia incidence and concomitant trends in cardiovascular comorbidities among individuals aged 70 years or older who were enrolled in the Einstein Aging Study between 1993 and 2015. In this birth cohort analysis of all-cause dementia incidence in persons enrolled in the Einstein Aging Study from October 20, 1993, through November 17, 2015, a systematically recruited, population-based sample of 1348 participants from Bronx County, New York, who were 70 years or older without dementia at enrollment and at least one annual follow-up was studied. Poisson regression was used to model dementia incidence as a function of age, sex, educational level, race, and birth cohort, with profile likelihood used to identify the timing of significant increases or decreases in incidence. Birth year and age. Incident dementia defined by consensus case conference based on annual, standardized neuropsychological and neurologic examination findings, using criteria from the DSM-IV. Among 1348 individuals (mean [SD] baseline age, 78.5 [5.4] years; 830 [61.6%] female; 915 [67.9%] non-Hispanic white), 150 incident dementia cases developed during 5932 person-years (mean [SD] follow-up, 4.4 [3.4] years). Dementia incidence decreased in successive birth cohorts. Incidence per 100 person-years was 5.09 in birth cohorts before 1920, 3.11 in the 1920 through 1924 birth cohorts, 1.73 in the 1925 through 1929 birth cohorts, and 0.23 in cohorts born after 1929. Change point analyses identified a significant decrease in dementia incidence among those born after July 1929 (95% CI, June 1929 to January 1930). The relative rate for birth cohorts before July 1929 vs after was 0.13 (95% CI, 0.04-0.41). Prevalence of stroke and myocardial infarction

  12. Risk factors for radiotherapy incidents and impact of an online electronic reporting system

    International Nuclear Information System (INIS)

    Chang, David W.; Cheetham, Lynn; Marvelde, Luc te; Bressel, Mathias; Kron, Tomas; Gill, Suki; Tai, Keen Hun; Ball, David; Rose, William; Silva, Linas; Foroudi, Farshad

    2014-01-01

    Background and purpose: To ascertain the rate, type, significance, trends and the potential risk factors associated with radiotherapy incidents in a large academic department. Materials and methods: Data for all radiotherapy activities from July 2001 to January 2011 were reviewed from radiotherapy incident reporting forms. Patient and treatment data were obtained from the radiotherapy record and verification database (MOSAIQ) and the patient database (HOSPRO). Logistic regression analyses were performed to determine variables associated with radiotherapy incidents. Results: In that time, 65,376 courses of radiotherapy were delivered with a reported incident rate of 2.64 per 100 courses. The rate of incidents per course increased (1.96 per 100 courses to 3.52 per 100 courses, p < 0.001) whereas the proportion of reported incidents resulting in >5% deviation in dose (10.50 to 2.75%, p < 0.001) had decreased after the introduction of an online electronic reporting system. The following variables were associated with an increased rate of incidents: afternoon treatment time, paediatric patients, males, inpatients, palliative plans, head-and-neck, skin, sarcoma and haematological malignancies. In general, complex plans were associated with higher incidence rates. Conclusion: Radiotherapy incidents were infrequent and most did not result in significant dose deviation. A number of risk factors were identified and these could be used to highlight high-risk cases in the future. Introduction of an online electronic reporting system resulted in a significant increase in the number of incidents being reported

  13. Report of the ASSET (Assessment of Safety Significant Events Team) mission to the Zaporozhe nuclear power plant in Ukraine 13-24 June 1994 Division of Nuclear Safety. Root cause analysis of operational events with a view to enhancing the prevention of incidents

    International Nuclear Information System (INIS)

    1994-01-01

    The IAEA Assessment of Safety Significant Events Team (ASSET) report presents the results of an ASSET team's assessment of their investigation of the effectiveness of the plant for prevention of incidents since 1990 at Zaporozhe nuclear power plant. The results, conclusions and suggestions presented herein reflect the views of the ASSET experts. They are provided for consideration by the responsible authorities in Ukraine. The ASSET team's views presented in this report are based on visits to the plant, on review of documentation made available by the operating organization and on discussions with utility personnel. The report is intended to enhance operational safety at Zaporozhe by proposing improvements to the policy for the prevention of incidents at the plant. The report includes, as a usual practice, the official response of the operating organization as well as of the regulatory body to the ASSET recommendations. Figs

  14. Lightning incidents in Mongolia

    Directory of Open Access Journals (Sweden)

    Myagmar Doljinsuren

    2015-11-01

    Full Text Available This is one of the first studies that has been conducted in Mongolia on the distribution of lightning incidents. The study covers a 10-year period from 2004 to 2013. The country records a human death rate of 15.4 deaths per 10 million people per year, which is much higher than that of many countries with similar isokeraunic level. The reason may be the low-grown vegetation observed in most rural areas of Mongolia, a surface topography, typical to steppe climate. We suggest modifications to Gomes–Kadir equation for such countries, as it predicts a much lower annual death rate for Mongolia. The lightning incidents spread over the period from May to August with the peak of the number of incidents occurring in July. The worst lightning affected region in the country is the central part. Compared with impacts of other convective disasters such as squalls, thunderstorms and hail, lightning stands as the second highest in the number of incidents, human deaths and animal deaths. Economic losses due to lightning is only about 1% of the total losses due to the four extreme weather phenomena. However, unless precautionary measures are not promoted among the public, this figure of losses may significantly increase with time as the country is undergoing rapid industrialization at present.

  15. Cancer incidence among waiters

    DEFF Research Database (Denmark)

    Reijula, Jere; Kjaerheim, Kristina; Lynge, Elsebeth

    2015-01-01

    AIMS: To study cancer risk patterns among waiters in the Nordic countries. METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were...... diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS: The SIR of all cancers in waiters, in the five countries combined......, was 1.46 (95% CI 1.41-1.51) in men and 1.09 (1.07-1.11) in women. In male waiters, the SIR decreased from 1.79 (1.63-1.96) in 1961-1975, to 1.33 (1.26-1.40) in 1991-2005, but remained stable among women. The SIR among male waiters was highest for cancers in the pharynx (6.11; 95% CI 5.02-7.37), oral...

  16. Trends in head and neck cancer incidence in Denmark, 1978-2007: Focus on human papillomavirus associated sites

    DEFF Research Database (Denmark)

    Blomberg, Maria; Nielsen, Ann; Plum, Christian Edinger Munk

    2011-01-01

    The aim of our study was to assess the overall trends in the incidence of head-and-neck cancer (HNC) among Danish men and women in 1978-2007, to describe the distribution and incidences of HNCs at different anatomical sites, and to determine whether the incidence of human papillomavirus (HPV......)-associated cancers is increasing. Data were extracted from the nationwide Cancer Registry database. To assess the possible impact of HPV infection, the sites of squamous cell carcinomas were categorized as HPV-associated, potentially HPV-associated or HPV-unrelated. In total, 26,474 incident cases were identified...... and the overall incidence increased throughout the period. Significantly increasing incidence rates were notably seen for tumors in the oral cavity (2.2% per year), tonsils (4.8% per year), oropharynx (3.5% per year) and hypopharynx (4.4% per year). A significantly decreasing incidence of lip cancer was observed...

  17. A big oil company's approach to significantly reduce fatal incidents

    NARCIS (Netherlands)

    Peuscher, W.; Groeneweg, J.

    2012-01-01

    Within the Shell Group of companies (Shell), keeping people safe at work is a deeply held value and the company actively pursues the goal of no harm to people. Shell actively works to build a culture where every employee and contractor takes responsibility for making this goal possible - it is

  18. Anthropological significance of phenylketonuria.

    Science.gov (United States)

    Saugstad, L F

    1975-01-01

    The highest incidence rates of phenylketonuria (PKU) have been observed in Ireland and Scotlant. Parents heterozygous for PKU in Norway differ significantly from the general population in the Rhesus, Kell and PGM systems. The parents investigated showed an excess of Rh negative, Kell plus and PGM type 1 individuals, which makes them similar to the present populations in Ireland and Scotlant. It is postulated that the heterozygotes for PKU in Norway are descended from a completely assimilated sub-population of Celtic origin, who came or were brought here, 1ooo years ago. Bronze objects of Western European (Scottish, Irish) origin, found in Viking graves widely distributed in Norway, have been taken as evidence of Vikings returning with loot (including a number of Celts) from Western Viking settlements. The continuity of residence since the Viking age in most habitable parts of Norway, and what seems to be a nearly complete regional relationship between the sites where Viking graves contain western imported objects and the birthplaces of grandparents of PKUs identified in Norway, lend further support to the hypothesis that the heterozygotes for PKU in Norway are descended from a completely assimilated subpopulation. The remarkable resemblance between Iceland and Ireland, in respect of several genetic markers (including the Rhesus, PGM and Kell systems), is considered to be an expression of a similar proportion of people of Celtic origin in each of the two countries. Their identical, high incidence rates of PKU are regarded as further evidence of this. The significant decline in the incidence of PKU when one passes from Ireland, Scotland and Iceland, to Denmark and on to Norway and Sweden, is therefore explained as being related to a reduction in the proportion of inhabitants of Celtic extraction in the respective populations.

  19. Statin Use, Incident Dementia and Alzheimer Disease in Elderly African Americans.

    Science.gov (United States)

    Hendrie, Hugh C; Hake, Ann; Lane, Kathleen; Purnell, Christianna; Unverzagt, Frederick; Smith-Gamble, Valerie; Murrell, Jill; Ogunniyi, Adesola; Baiyewu, Olusegun; Callahan, Chris; Saykin, Andrew; Taylor, Stanley; Hall, Kathleen; Gao, Su

    2015-08-07

    To investigate the association between statin use, incident dementia, and Alzheimer disease (AD) in a prospective elderly African American cohort. Two stage design with a screening interview followed by a comprehensive in-home assessment conducted over an eight-year period. Diagnoses of incident AD and dementia were made by consensus. Statin use was collected at each evaluation. Measurements of low-density lipoprotein cholesterol (LDL), C-reactive protein (CRP) and APOE genotype were obtained from baseline blood samples. Logistic regression models were used to test the association of statin use on incident dementia and AD and its possible association with lipid and CRP levels. Indianapolis, Indiana. From an original cohort of 2629 participants, a subsample of 974 African Americans aged >70 years with normal cognition, at least one follow up evaluation, complete statin information, and biomarker availability were included. Incident dementia and incident AD. After controlling for age at diagnosis, sex, education level, presence of the APOE ε4 allele and history of stroke for the incident dementia model, baseline use of statins was associated with a significantly decreased risk of incident dementia (OR=.44, P=.029) and incident AD (OR=.40, P=.029). The significant effect of statin use on reduced AD risk and trend for dementia risk was found only for those participants who reported consistent use over the observational period (incident AD: P=.034; incident dementia: P=.061). Additional models found no significant interaction between baseline statin use, baseline LDL, or CRP level and incident dementia/AD. Consistent use of statin medications during eight years of follow-up resulted in significantly reduced risk for incident AD and a trend toward reduced risk for incident dementia.

  20. Contaminated Mexican steel incident

    International Nuclear Information System (INIS)

    1985-01-01

    This report documents the circumstances contributing to the inadvertent melting of cobalt 60 (Co-60) contaminated scrap metal in two Mexican steel foundries and the subsequent distribution of contaminated steel products into the United States. The report addresses mainly those actions taken by US Federal and state agencies to protect the US population from radiation risks associated with the incident. Mexico had much more serious radiation exposure and contamination problems to manage. The United States Government maintained a standing offer to provide technical and medical assistance to the Mexican Government. The report covers the tracing of the source to its origin, response actions to recover radioactive steel in the United States, and return of the contaminated materials to Mexico. The incident resulted in significant radiation exposures within Mexico, but no known significant exposure within the United States. Response to the incident required the combined efforts of the Nuclear Regulatory Commission (NRC), Department of Energy, Department of Transportation, Department of State, and US Customs Service (Department of Treasury) personnel at the Federal level and representatives of all 50 State Radiation Control Programs and, in some instances, local and county government personnel. The response also required a diplomatic interface with the Mexican Government and cooperation of numerous commercial establishments and members of the general public. The report describes the factual information associated with the event and may serve as information for subsequent recommendations and actions by the NRC. 8 figures

  1. Decreasing relative risk premium

    DEFF Research Database (Denmark)

    Hansen, Frank

    2007-01-01

    such that the corresponding relative risk premium is a decreasing function of present wealth, and we determine the set of associated utility functions. We find a new characterization of risk vulnerability and determine a large set of utility functions, closed under summation and composition, which are both risk vulnerable...... and have decreasing relative risk premium. We finally introduce the notion of partial risk neutral preferences on binary lotteries and show that partial risk neutrality is equivalent to preferences with decreasing relative risk premium...

  2. Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.

    Directory of Open Access Journals (Sweden)

    J Jaime Miranda

    Full Text Available The epidemiological profile and trends of road traffic injuries (RTIs in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth.Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31 on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43, while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43. Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP per capita.The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.

  3. Epidemiology of Road Traffic Incidents in Peru 1973–2008: Incidence, Mortality, and Fatality

    Science.gov (United States)

    Miranda, J. Jaime; López-Rivera, Luis A.; Quistberg, D. Alex; Rosales-Mayor, Edmundo; Gianella, Camila; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Paca, Ada; Luis, López; Luna, Diego; Rosales, Edmundo; Best, Pablo; Best, Pablo; Egúsquiza, Miriam; Gianella, Camila; Lema, Claudia; Ludeña, Esperanza; Miranda, J. Jaime; Huicho, Luis

    2014-01-01

    Background The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973–2008, as well as their relationship to population trends such as economic growth. Methods and Findings Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43–5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15–0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09–1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita Conclusions The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs. PMID:24927195

  4. Cancer incidence in Spain, 2015.

    Science.gov (United States)

    Galceran, J; Ameijide, A; Carulla, M; Mateos, A; Quirós, J R; Rojas, D; Alemán, A; Torrella, A; Chico, M; Vicente, M; Díaz, J M; Larrañaga, N; Marcos-Gragera, R; Sánchez, M J; Perucha, J; Franch, P; Navarro, C; Ardanaz, E; Bigorra, J; Rodrigo, P; Bonet, R Peris

    2017-07-01

    Periodic cancer incidence estimates of Spain from all existing population-based cancer registries at any given time are required. The objective of this study was to present the current situation of cancer incidence in Spain. The Spanish Network of Cancer Registries (REDECAN) estimated the numbers of new cancer cases occurred in Spain in 2015 by applying the incidence-mortality ratios method. In the calculus, incidence data from population-based cancer registries and mortality data of all Spain were used. In 2015, nearly a quarter of a million new invasive cancer cases were diagnosed in Spain, almost 149,000 in men (60.0%) and 99,000 in women. Globally, the five most common cancers were those of colon-rectum, prostate, lung, breast and urinary bladder. By gender, the four most common cancers in men were those of prostate (22.4%), colon-rectum (16.6%), lung (15.1%) and urinary bladder (11.7%). In women, the most common ones were those of breast (28.0%), colon-rectum (16.9%), corpus uteri (6.2%) and lung (6.0%). In recent years, cancer incidence in men seems to have stabilized due to the fact that the decrease in tobacco-related cancers compensates for the increase in other types of cancer like those of colon and prostate. In women, despite the stabilization of breast cancer incidence, increased incidence is due, above all, to the rise of colorectal and tobacco-related cancers. To reduce these incident cancer cases, improvement of smoking control policies and extension of colorectal cancer screening should be the two priorities in cancer prevention for the next years.

  5. Decreasing Relative Risk Premium

    DEFF Research Database (Denmark)

    Hansen, Frank

    We consider the risk premium demanded by a decision maker with wealth x in order to be indifferent between obtaining a new level of wealth y1 with certainty, or to participate in a lottery which either results in unchanged present wealth or a level of wealth y2 > y1. We define the relative risk...... premium as the quotient between the risk premium and the increase in wealth y1–x which the decision maker puts on the line by choosing the lottery in place of receiving y1 with certainty. We study preferences such that the relative risk premium is a decreasing function of present wealth, and we determine...... relative risk premium in the small implies decreasing relative risk premium in the large, and decreasing relative risk premium everywhere implies risk aversion. We finally show that preferences with decreasing relative risk premium may be equivalently expressed in terms of certain preferences on risky...

  6. Decreasing serial cost sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter Raahave

    2009-01-01

    The increasing serial cost sharing rule of Moulin and Shenker (Econometrica 60:1009-1037, 1992) and the decreasing serial rule of de Frutos (J Econ Theory 79:245-275, 1998) are known by their intuitive appeal and striking incentive properties. An axiomatic characterization of the increasing serial...... rule was provided by Moulin and Shenker (J Econ Theory 64:178-201, 1994). This paper gives an axiomatic characterization of the decreasing serial rule....

  7. Decreasing Serial Cost Sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter

    The increasing serial cost sharing rule of Moulin and Shenker [Econometrica 60 (1992) 1009] and the decreasing serial rule of de Frutos [Journal of Economic Theory 79 (1998) 245] have attracted attention due to their intuitive appeal and striking incentive properties. An axiomatic characterization...... of the increasing serial rule was provided by Moulin and Shenker [Journal of Economic Theory 64 (1994) 178]. This paper gives an axiomatic characterization of the decreasing serial rule...

  8. Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2015.

    Science.gov (United States)

    Jung, Kyu-Won; Won, Young-Joo; Kong, Hyun-Joo; Lee, Eun Sook

    2018-04-01

    This study presents the 2015 nationwide cancer statistics in Korea, including the incidence, survival, prevalence, and mortality. Cancer incidence data from 1999 to 2015 was obtained from the Korea National Cancer Incidence Database and followed until December 31, 2016. Mortality data from 1983 to 2015 were obtained from Statistics Korea. The prevalence was defined as the number of cancer patients alive on January 1, 2016, among all cancer patients diagnosed since 1999. Crude and age-standardized rates (ASRs) for incidence, mortality and prevalence and 5-year relative survivals were also calculated. Herein, 214,701 and 76,855 Koreans were newly diagnosed and died from cancer in 2015, respectively. The ASRs for cancer incidence and mortality in 2015 were 258.9 and 82.0 per 100,000, respectively. The overall cancer incidence rate has increased significantly by 3.4% annually from 1999 to 2012, and started to decrease after 2012 (2012-2015, annual percent change, -6.1%). However, the overall cancer mortality has decreased 2.7% annually since 2002. The 5-year relative survival rate for patients diagnosed with cancer between 2011 and 2015 was 70.7%, an improvement from the 41.2% for patients diagnosed between 1993 and 1995. Age-standardized cancer incidence rates have decreased since 2012 and mortality rates have declined since 2002; however, the 5-year survival rates have improved remarkably from 1993-1995 to 2011-2015 in Korea.

  9. Time Trends in the Incidence and Mortality of Ovarian Cancer in Ireland, Northern Ireland, and Israel, 1994-2013.

    Science.gov (United States)

    Keinan-Boker, Lital; Silverman, Barbara G; Walsh, Paul M; Gavin, Anna T; Hayes, Catherine

    2017-10-01

    The aims of this study were to compare time trends in ovarian cancer incidence and mortality in populations with (1) similar genetics but different health care systems (Ireland and Northern Ireland [NI]) and (2)different genetics but similar health care system (Israeli Jews and Arabs) and to interpret the results. Age-standardized rates of ovarian cancer incidence and mortality for 1994-2013 in the 3 countries were obtained from national cancer registries and national statistics. Time trends in incidence, mortality, and incidence-to-mortality ratio were assessed by linear regression models applied to each country and between populations (Ireland-NI, Ireland-Israeli Jews, Israeli Jews-Arabs). Joinpoint analysis was used to calculate the annual percentage change (APC). Ovarian cancer incidence and mortality rates in 1994 were similar in the countries studied. Thereafter a reduction in incidence and mortality was observed in Ireland (incidence APC1994-2013 = -0.75%, P Trends in Israeli Arabs remained stable. Significant incidence trend differences between Ireland and Israeli Jews (P = 0.009) and between Israeli Jews and Arabs (P = 0.004) were observed. The only significant trend difference for mortality was between Israeli Jews and Arabs (P = 0.038). Incidence-to-mortality ratios showed stable trends in all groups except for Israeli Jews (APC1994-2013 = -1.0%, P trends in ovarian cancer incidence (decreasing) and mortality (decreasing) were similar in Ireland, NI, and Israeli Jews, following global trends, with a more prominent incidence decline in Israeli Jews. Decreasing mortality trends are driven by falling incidence in the countries studied rather than improved survival.

  10. MCFRS Incidents by Station

    Data.gov (United States)

    Montgomery County of Maryland — This dataset contains the monthly summary data indicating incident occurred in each fire station response area. The summary data is the incident count broken down by...

  11. Police Incident Reports Written

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — This table contains incident reports filed with the Chapel Hill Police Department. Multiple incidents may have been reported at the same time. The most serious...

  12. Cancer incidence in Canada: trends and projections (1983-2032

    Directory of Open Access Journals (Sweden)

    Lin Xie

    2015-01-01

    liver cancer and leukemia in both sexes. In contrast, this region is projected to experience elevated incidence rates in males for about half the cancers studied. The incidence rates for all cancers combined are projected to continue to be highest for males in the Atlantic region and for females in Quebec in 15 years but in Ontario thereafter, and lowest in British Columbia. The inter-regional differences are larger in males than in females, possibly due to variations in prostate-specific antigen (PSA testing (for prostate cancer and risk factors. In both males and females, colorectal cancer incidence rates will remain highest in the Atlantic region and lowest in British Columbia. Lung cancer incidence rates are projected to be highest in Quebec and lowest in Ontario and British Columbia for both sexes. The similar regional rates of breast cancer in females are expected to persist. The significantly lowest rates of prostate cancer in Quebec are projected to continue, as are the elevated rates in the Atlantic region. Incidence by sex and age: Cancer is more common in males than in females except in those aged under 55. The overall cancer incidence rate in men aged 65 or older has been falling and will continue to do so. The decrease in lung cancer rates in men aged 65 or older from decreased tobacco use and the decrease in prostate cancer rates in men aged 75 or older have contributed to the overall decrease in this age range. In women aged 65 or older, the relatively stable rate is primarily the result of an increase in lung cancer incidence offset by decreases in incidence for the other cancer sites. This stable trend is projected to continue. Targeted cancer prevention efforts and specific needs for health care services can be expected to vary at different points in the age continuum for males and females. Smoking-related cancers: Between 2003-2007 and 2028-2032, substantial risk reductions are projected for major common tobacco-related cancers in Canada, even with

  13. Disparities in the incidence of acute myocardial infarction: long-term trends from the Hunter region.

    Science.gov (United States)

    Davies, Allan J; Naudin, Crystal; Al-Omary, Mohammed; Khan, Arshad; Oldmeadow, Chris; Jones, Mark; Bastian, Bruce; Bhagwandeen, Rohan; Fletcher, Peter; Leitch, James; Boyle, Andrew

    2017-05-01

    Trends in the incidence of acute myocardial infarction (AMI) provide important information for healthcare providers and can allow for accurate planning of future health needs and targeted interventions in areas with an excess burden of cardiovascular disease. To investigate the regional variations in AMI incidence in the Hunter region. Incident cases of AMI identified between 1996 and 2013 from the Hunter New England Health Cardiac and Stroke Outcomes Unit were prospectively collected for this study. We calculated crude and age-adjusted incidence of AMI over an 18-year period and explored differences in remoteness, age, sex and indigenous status. During 1996-2013, a total of 15 480 cases of AMI were identified. There was a significantly higher incidence of AMI in patients from regional areas compared to patients from metropolitan areas. More importantly, while rates of AMI declined by 28% in metropolitan patients, they increased by 8% in regional patients. Males had higher rates of AMI throughout the study period than females, however there was trend over time towards a reduction in AMI incidence in males that was not seen in females. The age-adjusted incidence of AMI for indigenous patients increased by 48% from 2007 to 2013, compared to a 23% decrease in non-indigenous patients. Between 1996 and 2013 in the Hunter region, the adjusted incidence of AMI increased for regional patients compared to metropolitan patients with a trend towards a higher adjusted incidence of AMI in the indigenous population. © 2017 Royal Australasian College of Physicians.

  14. Decreasing asthma morbidity

    African Journals Online (AJOL)

    1994-12-12

    Dec 12, 1994 ... Apart from the optimal use of drugs, various supplementary methods have been tested to decrease asthma morbidity, usually in patients from reiatively affluent socio-economic backgrounds. A study of additional measures taken in a group of moderate to severe adult asthmatics from very poor socio- ...

  15. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir

    2015-01-01

    Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

  16. Effectiveness and Sustainability of Education about Incident Reporting at a University Hospital in Japan.

    Science.gov (United States)

    Nakamura, Noriko; Yamashita, Yuichi; Tanihara, Shinichi; Maeda, Chiemi

    2014-07-01

    The aim of this study was to evaluate the effectiveness and sustainability of educational interventions to encourage incident reporting. This was a quasi-experimental design. The study involved nurses working in two gastroenterology surgical wards at Fukuoka University Hospital, Japan. The number of participants on each ward was 26 nurses at baseline. For the intervention group, we provided 15 minutes of education about patient safety and the importance of incident reporting once per month for six months. After the completion of the intervention, we compared incident reporting in the subsequent 12 months for both groups. Questionnaires about reasons/motives for reporting were administered three times, before the intervention, after the intervention, and six months after the intervention for both the intervention group and the control group. For the intervention group, incident reporting during the 6 months after the intervention period increased significantly compared with the baseline. During the same period, the reasons and motives for reporting changed significantly in the intervention group. The increase in reported incidents during the 6- to 12-month period following the intervention was not significant. In the control group, there was no significant difference during follow-up compared with the baseline. A brief intervention about patient safety changed the motives for reporting incidents and the frequency of incidents reported by nurses working in surgical wards in a university hospital in Japan. However, the effect of the education decreased after six months following the education. Regular and long-term effort is required to maintain the effect of education.

  17. Pleural tent for decreasing air leak following upper lobectomy: a prospective randomised trial.

    Science.gov (United States)

    Allama, Amr Mohammad

    2010-12-01

    Prolonged air leak is still one of the most frequent complications after pulmonary resections, particularly upper lobectomy. This study aimed at evaluating the efficacy of pleural tenting in decreasing air leak after upper lobectomy. This was a prospective randomised study of 48 patients who had upper lobectomy. They were divided into two groups: the first group included 23 patients in whom the pleural tent was done, and the other group included 25 patients in whom no tenting was performed. These two groups were compared regarding the preoperative, operative and postoperative characteristics. The incidence of air leak was significantly lower in the tent group at postoperative day 3 and thereafter. The intensity of air leak at postoperative day 2 was significantly lower in the tent group (p=0.028), and the duration of air leak was significantly shorter in the tent group (2.96±1.43 days vs 4.68±2.95 days, p=0.015). The total amount of pleural drainage was significantly larger in the tent group (1278±407 ml vs 1054±266 ml, p=0.027). The chest tube duration and the total hospital stay showed no significant difference between both groups. The incidence of development of postoperative apical dead space was lower in the tent group but it did not reach a significant level. The incidence of prolonged air leak was significantly lower in the tent group and regression analysis for its risk factors showed that pleural tenting was significantly associated with decreasing the incidence of prolonged air leak while chronic obstructive pulmonary disease (COPD) was significantly associated with increasing it. Pleural tenting is a simple, short, safe and effective procedure for decreasing air leak following upper lobectomy and may be used especially in those patients, who have increased risk of prolonged air leak. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  18. Calorie restriction reduces the incidence of radiation-induced myeloid leukemia and spontaneous tumor

    International Nuclear Information System (INIS)

    Yoshida, Kazuko

    1999-01-01

    The host-defense mechanisms against cancers are known to be modulated by changing the environmental factor(s). The spontaneous incidence of myeloid leukemia is about 1% in C3H/He mice, and the incidence increases up to 23.3% when a single dose of radiation, 3 Gy X-ray, is exposed to a whole-body. Since calorie restriction was known to reduce the incidence of spontaneous tumors, a question as to whether such radiation induced-increase of myeloid leukemia would be also decreased by calorie restriction, was aimed to answer to elucidate possible mechanism of radiation-induced myeloid leukemia. By the calorie restriction, the incidence of myeloid leukemia was significantly decreased; it was reduced to 7.9% and 10.7% when restriction was started before (6 weeks old) and after (10 weeks old) irradiation, respectively. In addition, the latent period of the myeloid leukemia in the groups for calorie restriction was significantly extended at a greater extent as compared with the control diet groups. Number of hematopoietic stem cells, the possible target cells for radiation-induced leukemias, in the groups for the calorie restriction demonstrated a significant decrease, especially in the spleen, as compared with that in the control, when the evaluation was made at the time of radiation exposure. Then, we examined whether the decreased number of target cells at the time of exposure is caused by the reduction of radiation-induced myeloid leukemia with caloric restriction. The third restricted groups were fed 65 kcal diet (restricted diet) for the first 4 weeks i.e. from 6 weeks to 10 weeks old, then, the mice were fed with control diet after radiation. The incidence of myeloid leukemia in this group was slightly decreased but did not show statistically significance. Therefore, the caloric restriction seems to be more effective in the promotion stage than the initiation stage on radiation-induced leukemogenesis. It is well known that C3H/He mice develop hepatoma spontaneously

  19. Calorie restriction reduces the incidence of radiation-induced myeloid leukemia and spontaneous tumor

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Kazuko [National Inst. of Radiological Sciences, Chiba (Japan)

    1999-06-01

    The host-defense mechanisms against cancers are known to be modulated by changing the environmental factor(s). The spontaneous incidence of myeloid leukemia is about 1% in C3H/He mice, and the incidence increases up to 23.3% when a single dose of radiation, 3 Gy X-ray, is exposed to a whole-body. Since calorie restriction was known to reduce the incidence of spontaneous tumors, a question as to whether such radiation induced-increase of myeloid leukemia would be also decreased by calorie restriction, was aimed to answer to elucidate possible mechanism of radiation-induced myeloid leukemia. By the calorie restriction, the incidence of myeloid leukemia was significantly decreased; it was reduced to 7.9% and 10.7% when restriction was started before (6 weeks old) and after (10 weeks old) irradiation, respectively. In addition, the latent period of the myeloid leukemia in the groups for calorie restriction was significantly extended at a greater extent as compared with the control diet groups. Number of hematopoietic stem cells, the possible target cells for radiation-induced leukemias, in the groups for the calorie restriction demonstrated a significant decrease, especially in the spleen, as compared with that in the control, when the evaluation was made at the time of radiation exposure. Then, we examined whether the decreased number of target cells at the time of exposure is caused by the reduction of radiation-induced myeloid leukemia with caloric restriction. The third restricted groups were fed 65 kcal diet (restricted diet) for the first 4 weeks i.e. from 6 weeks to 10 weeks old, then, the mice were fed with control diet after radiation. The incidence of myeloid leukemia in this group was slightly decreased but did not show statistically significance. Therefore, the caloric restriction seems to be more effective in the promotion stage than the initiation stage on radiation-induced leukemogenesis. It is well known that C3H/He mice develop hepatoma spontaneously

  20. Osteopathy may decrease obstructive apnea in infants: a pilot study.

    Science.gov (United States)

    Vandenplas, Yvan; Denayer, Etienne; Vandenbossche, Thierry; Vermet, Luc; Hauser, Bruno; Deschepper, Jean; Engelen, Agnes

    2008-07-19

    Obstructive apnea is a sleep disorder characterized by pauses in breathing during sleep: breathing is interrupted by a physical block to airflow despite effort. The purpose of this study was to test if osteopathy could influence the incidence of obstructive apnea during sleep in infants. Thirty-four healthy infants (age: 1.5-4.0 months) were recruited and randomized in two groups; six infants dropped out. The osteopathy treatment group (n = 15 infants) received 2 osteopathic treatments in a period of 2 weeks and a control group (n = 13 infants) received 2 non-specific treatments in the same period of time. The main outcome measure was the change in the number of obstructive apneas measured during an 8-hour polysomnographic recording before and after the two treatment sessions. The results of the second polysomnographic recordings showed a significant decrease in the number of obstructive apneas in the osteopathy group (p = 0.01, Wilcoxon test), in comparison to the control group showing only a trend suggesting a gradual physiologic decrease of obstructive apneas. However, the difference in the decline of obstructive apneas between the groups after treatment was not significant (p = 0.43). Osteopathy may have a positive influence on the incidence of obstructive apneas during sleep in infants with a previous history of obstructive apneas as measured by polysomnography. Additional research in this area appears warranted.

  1. Cancer incidence in ethnic German migrants from the Former Soviet Union in comparison to the host population.

    Science.gov (United States)

    Winkler, Volker; Holleczek, Bernd; Stegmaier, Christa; Becher, Heiko

    2014-02-01

    To investigate cancer incidence patterns among ethnic German migrants (Aussiedler) from the Former Soviet Union, a large migrant group in Germany, in comparison to autochthonous Saarland population over a 20 year observation period. Data were obtained from a cohort of Aussiedler residing in the federal state of Saarland (n=18,619). Cancer incidence and vital status were ascertained through record linkage with the Saarland Cancer Registry and local population registries. During the follow up period from 1990 to 2009 we observed 638 incident diagnoses of malignant neoplasms (except non-melanoma skin cancer). The overall standardized incidence ratio (SIR) was 0.98 (95% confidence interval 0.92, 1.04). However, site-specific SIRs revealed great variation. Stomach cancer incidence was significantly higher among Aussiedler. Lung cancer was elevated for males, but lower among females. Additionally, diagnoses for colorectal cancer among males were significantly lower. Age-standardized rates (ASRs) over time show not all cancer rates of Aussiedler attenuate as expected to Saarland rates. For example, lung and prostate cancer incidence rates show increasing disparity from Saarland rates and female breast cancer incidence develops in parallel. Furthermore, ASR for overall cancer incidence of Aussiedler shows a yearly decrease (p=0.06) whereas Saarland rates remain stable. Aussiedler incidence rates reflect incidence pattern observed in their countries of origin. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Demographic variation in incidence of adult glioma by subtype, United States, 1992-2007

    Directory of Open Access Journals (Sweden)

    Darefsky Amy S

    2011-07-01

    Full Text Available Abstract Background We hypothesized that race/ethnic group, sex, age, and/or calendar period variation in adult glioma incidence differs between the two broad subtypes of glioblastoma (GBM and non-GBM. Primary GBM, which constitute 90-95% of GBM, differ from non-GBM with respect to a number of molecular characteristics, providing a molecular rationale for these two broad glioma subtypes. Methods We utilized data from the Surveillance, Epidemiology, and End Results Program for 1992-2007, ages 30-69 years. We compared 15,088 GBM cases with 9,252 non-GBM cases. We used Poisson regression to calculate adjusted rate ratios and 95% confidence intervals. Results The GBM incidence rate increased proportionally with the 4th power of age, whereas the non-GBM rate increased proportionally with the square root of age. For each subtype, compared to non-Hispanic Whites, the incidence rate among Blacks, Asians/Pacific Islanders, and American Indians/Alaskan Natives was substantially lower (one-fourth to one-half for GBM; about two-fifths for non-GBM. Secondary to this primary effect, race/ethnic group variation in incidence was significantly less for non-GBM than for GBM. For each subtype, the incidence rate was higher for males than for females, with the male/female rate ratio being significantly higher for GBM (1.6 than for non-GBM (1.4. We observed significant calendar period trends of increasing incidence for GBM and decreasing incidence for non-GBM. For the two subtypes combined, we observed a 3% decrease in incidence between 1992-1995 and 2004-2007. Conclusions The substantial difference in age effect between GBM and non-GBM suggests a fundamental difference in the genesis of primary GBM (the driver of GBM incidence versus non-GBM. However, the commonalities between GBM and non-GBM with respect to race/ethnic group and sex variation, more notable than the somewhat subtle, albeit statistically significant, differences, suggest that within the context of a

  3. Incidence and survival trends in oligodendrogliomas and anaplastic oligodendrogliomas in the United States from 2000 to 2013: a CBTRUS Report.

    Science.gov (United States)

    Achey, Rebecca L; Khanna, Vishesh; Ostrom, Quinn T; Kruchko, Carol; Barnholtz-Sloan, Jill S

    2017-05-01

    Measuring tumor-specific trends in incidence is necessary to elucidate tumor-type contribution to overall cancer burden in the US population. Recently, there have been conflicting reports concerning the incidence of oligodendrogliomas (OD) and anaplastic oligodendrogliomas (AOD). Therefore, our goal was to examine trends in OD and AOD incidence and survival by age, gender and race. Data was analyzed from the Central Brain Tumor Registry of the United States (CBTRUS) from 2000 to 2013. Age-adjusted incidence rates per 100,000 person-years with 95% confidence intervals (CI) and annual percent changes (APCs) with 95% CI were calculated for OD and AOD by age, sex and race. Survival rates were calculated for age, sex and race using a subset of the CBTRUS data. OD and AOD incidence peaked at 36-40 and 56-60 years, respectively. AOD:OD ratio increased up to age 75. Overall, OD and AOD incidence decreased [OD: APC -3.2 (2000-2013), AOD: -6.5 (2000-2007)]. OD incidence was highest in Whites but decreased significantly (2000-2013: APC -3.1) while incidence in Black populations did not significantly decrease (2000-2013: APC -1.6). Survival rates decreased with advancing age for OD, while persons aged 0-24 had the lowest survival for AOD. The current study reports a decrease in overall OD and AOD incidence from 2000 to 2013. Furthermore, AOD makes up an increasing proportion of oligodendroglial tumors up to age 75. Lower AOD survival in 0-24 years old may indicate molecular differences in pediatric cases. Thus, surveillance of tumor-specific trends by age, race and sex can reveal clinically relevant variations.

  4. COMPARATIVE ANATOMICAL STUDY AND INCIDENCE OF OS PERONEUM IN PERONEUS LONGUS TENDON AND ITS CLINICAL SIGNIFICANCE. Estudio anatómico comparativo e incidencia del os peroneum en el tendón de peroneo largo y su significación clínica

    Directory of Open Access Journals (Sweden)

    Poonam Verma

    2016-03-01

    Full Text Available Introducción: El objetivo de nuestro estudio fue evaluar la tasa de incidencia del os peroneo (OP en el tendón del peroneo lateral largo (PLT y su importancia clínica. Métodos: La disección de 60 cadáveres embalsamados (56 hombres y 4 mujeres del grupo de mediana edad se hizo para tener acceso a la  tasa de incidencia del os peroneo en PLT. Resultados: En nuestro estudio se observó que la  tasa de incidencia del os peroneo fue de  86,6% (52  extremidades. La ubicación del os peroneo es también un tema de controversia. La mayoría de los autores afirman que se relaciona con el hueso cuboides y de vez en cuando se ve inferior al calcáneo distal a la articulación calcáneo-cuboidea. Pero en el presente estudio el os- peroneo estuvo en relación al hueso cuboides en 40 extremidades (76.9%  y distal a articulación calcaneocuboidea en el resto de las 12 extremidades (23.1%. Conclusión: Este estudio sugiere que existe una alta tasa de incidencia de un OP en cadaveres. Esto puede ser como consecuencia de la técnica utilizada para localizar el mismo. La importancia clínica ha sido mencionada en relación con la ubicación del os peroneo, que puede ser confundido con fracturas estiloides y de Jones. Introduction: The aim of our study was to assess the incidence rate of the os peroneum (OP in the peroneus longus tendon (PLT and its clinical significance. Methods: Dissection of 60 embalmed cadavers (56 male and 4 female of middle age group was done to access the incidence rate of os peroneum in peroneus longus tendon. Results: In our study the incidence rate of os peroneum was 86.6% (52 limbs. The location of os peroneum is also a subject of dispute. Most authors stated that it is related to the cuboid bone and occasionally it is seen inferior to the calcaneum distal to the calcaneocuboid joint. But in the present study os peroneum was in relation to cuboid bone in 40 limbs (76.9% and distal to calcaneocuboid joint in 12 limbs (23

  5. Characteristics and comparison of colorectal cancer incidence in Beijing with other regions in the world

    Science.gov (United States)

    Li, Zhongmin; Yang, Lei; Du, Changzheng; Fang, Xuedong; Wang, Ning; Gu, Jin

    2017-01-01

    Background Population-based epidemiologic studies about colorectal cancer are lacking in China. This study aims to provide a basis for colorectal cancer screening and prevention, through analysis and comparisons the characteristics of the trends in colorectal cancer incidence in Beijing and selected representative regions. RESULTS The annual incidence rate in Beijing region increased significantly, from 9.40/100,000 in 1998 to 18.61/100,000 in 2012. The stratified rate showed that the incidence of distal colon adenocarcinoma increased substantially in men, especially in those aged > 75 years and residing in urban areas. Although the incidence rate in Beijing is still lower than in Shanghai, Jiashan, and Hong Kong in China, it is increasing rapidly. Further, the incidence rate in Beijing is lower than in New York, Oxford and Osaka, but higher than in Mumbai and Kyadondo. The incidence trend in Beijing is increasing especially in older groups, while in other regions such as New York, it is decreasing in these age groups. Materials and Methods Colorectal cancer incidence data were obtained from Beijing Cancer Registry and Cancer Incidence in Five Continents Plus database. All incidence rates were age-standardized according to Segi's world population. Incidence trends were characterized by calculating the annual percent changes using the Joinpoint Regression Program. Conclusions Compared with other regions, Beijing has a medium level of colorectal cancer incidence, however, it is increasing significantly. There are obvious differences in the cancer subsite, sex and age distributions between Beijing and other regions. Prevention and screening of colorectal cancer in Beijing should be strengthened. PMID:28445947

  6. Cyber Incidents Involving Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Robert J. Turk

    2005-10-01

    information available to Department of Homeland Security (DHS) and others who require it. This report summarizes the rise in frequency of cyber attacks, describes the perpetrators, and identifies the means of attack. This type of analysis, when used in conjunction with vulnerability analyses, can be used to support a proactive approach to prevent cyber attacks. CSSC will use this document to evolve a standardized approach to incident reporting and analysis. This document will be updated as needed to record additional event analyses and insights regarding incident reporting. This report represents 120 cyber security incidents documented in a number of sources, including: the British Columbia Institute of Technology (BCIT) Industrial Security Incident Database, the 2003 CSI/FBI Computer Crime and Security Survey, the KEMA, Inc., Database, Lawrence Livermore National Laboratory, the Energy Incident Database, the INL Cyber Incident Database, and other open-source data. The National Memorial Institute for the Prevention of Terrorism (MIPT) database was also interrogated but, interestingly, failed to yield any cyber attack incidents. The results of this evaluation indicate that historical evidence provides insight into control system related incidents or failures; however, that the limited available information provides little support to future risk estimates. The documented case history shows that activity has increased significantly since 1988. The majority of incidents come from the Internet by way of opportunistic viruses, Trojans, and worms, but a surprisingly large number are directed acts of sabotage. A substantial number of confirmed, unconfirmed, and potential events that directly or potentially impact control systems worldwide are also identified. Twelve selected cyber incidents are presented at the end of this report as examples of the documented case studies (see Appendix B).

  7. Measurable improvement in patient safety culture: A departmental experience with incident learning.

    Science.gov (United States)

    Kusano, Aaron S; Nyflot, Matthew J; Zeng, Jing; Sponseller, Patricia A; Ermoian, Ralph; Jordan, Loucille; Carlson, Joshua; Novak, Avrey; Kane, Gabrielle; Ford, Eric C

    2015-01-01

    Rigorous use of departmental incident learning is integral to improving patient safety and quality of care. The goal of this study was to quantify the impact of a high-volume, departmental incident learning system on patient safety culture. A prospective, voluntary, electronic incident learning system was implemented in February 2012 with the intent of tracking near-miss/no-harm incidents. All incident reports were reviewed weekly by a multiprofessional team with regular department-wide feedback. Patient safety culture was measured at baseline with validated patient safety culture survey questions. A repeat survey was conducted after 1 and 2 years of departmental incident learning. Proportional changes were compared by χ(2) or Fisher exact test, where appropriate. Between 2012 and 2014, a total of 1897 error/near-miss incidents were reported, representing an average of 1 near-miss report per patient treated. Reports were filed by a cross section of staff, with the majority of incidents reported by therapists, dosimetrists, and physicists. Survey response rates at baseline and 1 and 2 years were 78%, 80%, and 80%, respectively. Statistically significant and sustained improvements were noted in several safety metrics, including belief that the department was openly discussing ways to improve safety, the sense that reports were being used for safety improvement, and the sense that changes were being evaluated for effectiveness. None of the surveyed dimensions of patient safety culture worsened. Fewer punitive concerns were noted, with statistically significant decreases in the worry of embarrassment in front of colleagues and fear of getting colleagues in trouble. A comprehensive incident learning system can identify many areas for improvement and is associated with significant and sustained improvements in patient safety culture. These data provide valuable guidance as incident learning systems become more widely used in radiation oncology. Copyright © 2015

  8. Two /sup 238/Pu inhalation incidents

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, R.R.; Hall, R.M.

    1978-06-01

    Two employees inhaled significant amounts of /sup 238/Pu in separate unrelated contamination incidents in 1977. Both acute exposure incidents are described and the urine, feces, and in-vivo chest count data for each employee. Case B (/sup 238/PuNO/sub 3/) received 24 DTPA treatments beginning the day of the incident while, for medical reasons, Case A (/sup 238/PuO/sub 2/) received no therapy.

  9. Incidence of thoracic vertebral fractures among adult health study participants, Hiroshima and Nagasaki, 1958-86

    International Nuclear Information System (INIS)

    Fujiwara, Saeko; Mizuno, Shoichi; Ochi, Yoshimichi; Sasaki, Hideo; Kodama, Kazunori; Russell, W.J.; Hosoda, Yutaka.

    1990-01-01

    The incidence of thoracic vertebral fractures (TVF) in a fixed Hiroshima and Nagasaki population of 16,027 was determined by sex, age, and atomic bomb ionizing radiation exposure. Diagnosis was based on lateral chest radiographs made from 1 July 1958 to 28 February 1986. Born between 1880 and 1940, the subjects were categorized by sex into 10-year birth cohorts. When examined by birth cohort and age at onset, the age dependency of TVF incidence showed a good fit to a log-linear regression model. In females, TVF incidence tended to be lower in the younger birth cohorts and tended to increase with age in all birth cohorts. With each 10-year increase in age, the incidence among females increased by a factor of 1.7. In males, the incidence was significantly lower in the younger birth cohorts, but did not increase with age. The incidence decreased by a factor of 0.5 in males and 0.6 in females as the birth cohort age became younger. TVF incidence was greater in males until the age of 50, was equal by sex in the sixth decade, and was greater among females, who were 60 years of age or older. TVF incidence did not differ by city, and no correlation with A-bomb radiation exposure was demonstrated. (author)

  10. Work-related ill health in doctors working in Great Britain: incidence rates and trends.

    Science.gov (United States)

    Zhou, Anli Yue; Carder, Melanie; Gittins, Matthew; Agius, Raymond

    2017-11-01

    Background Doctors have a higher prevalence of mental ill health compared with other professional occupations but incidence rates are poorly studied. Aims To determine incidence rates and trends of work-related ill health (WRIH) and work-related mental ill health (WRMIH) in doctors compared with other professions in Great Britain. Method Incidence rates were calculated using an occupational physician reporting scheme from 2005-2010. Multilevel regression was use to study incidence rates from 2001 to 2014. Results Annual incidence rates for WRIH and WRIMH in doctors were 515 and 431 per 100 000 people employed, respectively. Higher incidence rates for WRIH and WRMIH were observed for ambulance staff and nurses, respectively. Doctors demonstrated an annual average incidence rates increase for WRIH and WRMIH, especially in women, whereas the other occupations demonstrated a decreasing or static trend. The difference in trends between the occupations was statistically significant. Conclusions WRIH and WRMIH incidence rate are increasing in doctors, especially in women, warranting further research. © The Royal College of Psychiatrists 2017.

  11. Calbindins decreased after space flight.

    Science.gov (United States)

    Sergeev, I N; Rhoten, W B; Carney, M D

    1996-12-01

    Exposure of the body to microgravity during space flight causes a series of well-documented changes in Ca2+ metabolism, yet the cellular and molecular mechanisms leading to these changes are poorly understood. Calbindins, vitamin D-dependent Ca2+ binding proteins, are believed to have a significant role in maintaining cellular Ca2+ homeostasis. In this study, we used biochemical and immunocytochemical approaches to analyze the expression of calbindin-D28k and calbindin-D9k in kidneys, small intestine, and pancreas of rats flown for 9 d aboard the space shuttle. The effects of microgravity on calbindins in rats from space were compared with synchronous Animal Enclosure Module controls, modeled weightlessness animals (tail suspension), and their controls. Exposure to microgravity resulted in a significant and sustained decrease in calbindin-D28k content in the kidney and calbindin-D9k in the small intestine of flight animals, as measured by enzyme-linked immunosorbent assay (ELISA). Modeled weightlessness animals exhibited a similar decrease in calbindins by ELISA. Immunocytochemistry (ICC) in combination with quantitative computer image analysis was used to measure in situ the expression of calbindins in the kidney and the small intestine, and the expression of insulin in pancreas. There was a large decrease of immunoreactivity in renal distal tubular cell-associated calbindin-D28k and in intestinal absorptive cell-associated calbindin-D9k of space flight and modeled weightlessness animals compared with matched controls. No consistent difference in pancreatic insulin immunoreactivity between space flight, modeled weightlessness, and controls was observed. Regression analysis of results obtained by quantitative ICC and ELISA for space flight, modeled weightlessness animals, and their controls demonstrated a significant correlation. These findings after a short-term exposure to microgravity or modeled weightlessness suggest that a decreased expression of calbindins

  12. Delta9-tetrahydrocannabinol decreases somatic and motivational manifestations of nicotine withdrawal in mice

    OpenAIRE

    Aso Pérez, Ester; Maldonado, Rafael, 1961-; Murtra, Patricia; Balerio, Graciela N.; Berrendero Díaz, Fernando, 1971-

    2004-01-01

    The possible interactions between Delta9-tetrahydrocannabinol (THC) and nicotine remain unclear in spite of the current association of cannabis and tobacco in humans. The aim of the present study was to explore the interactions between these two drugs of abuse by evaluating the consequences of THC administration on the somatic manifestations and the aversive motivational state associated to nicotine withdrawal in mice. Acute THC administration significantly decreased the incidence of several ...

  13. Oxidative Stress Increases the Blood Brain Barrier Permeability Resulting in Increased Incidence of Brain Metastasis in BRCA Mutation Carriers

    Science.gov (United States)

    2014-08-01

    Increased Incidence of Brain Metastasis in BRCA Mutation Carriers PRINCIPAL INVESTIGATOR: Hava Avraham, Ph.D. CONTRACTING ORGANIZATION: Beth Israel...Permeability Resulting in Increased Incidence of Brain Metastasis in BRCA Mutation Carriers 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0172 5c...significantly up-regulated with a decrease in cellular sensitivity to paclitaxel. Cells that harbor endogenous mutant or defective BRCA l (such as MDA-MB-436

  14. Acute incidents during anaesthesia

    African Journals Online (AJOL)

    Incidents can occur during induction, maintenance and emergence from anaesthesia. The following acute critical incidents are discussed in this article: • Anaphylaxis. • Aspiration ..... Already used in South Africa and Malawi, a scale-up of the technique is under way in Tanzania, Rwanda and Ghana. The report found that.

  15. Radiological incidents in radiotherapy

    International Nuclear Information System (INIS)

    Hobzova, L.; Novotny, J.

    2008-01-01

    In many countries a reporting system of radiological incidents to national regulatory body exists and providers of radiotherapy treatment are obliged to report all major and/or in some countries all incidents occurring in institution. State Office for Nuclear Safety (SONS) is providing a systematic guidance for radiotherapy departments from 1997 by requiring inclusion of radiation safety problems into Quality assurance manual, which is the basic document for obtaining a license of SONS for handling with sources of ionizing radiation. For that purpose SONS also issued the recommendation 'Introduction of QA system for important sources in radiotherapy-radiological incidents' in which the radiological incidents are defined and the basic guidance for their classification (category A, B, C, D), investigation and reporting are given. At regular periods the SONS in co-operation with radiotherapy centers is making a survey of all radiological incidents occurring in institutions and it is presenting obtained information in synoptic communication (2003 Motolske dny, 2005 Novy Jicin). This presentation is another summary report of radiological incidents that occurred in our radiotherapy institutions during last 3 years. Emphasis is given not only to survey and statistics, but also to analysis of reasons of the radiological incidents and to their detection and prevention. Analyses of incidents in radiotherapy have led to a much broader understanding of incident causation. Information about the error should be shared as early as possible during or after investigation by all radiotherapy centers. Learning from incidents, errors and near misses should be a part of improvement of the QA system in institutions. Generally, it is recommended that all radiotherapy facilities should participate in the reporting, analyzing and learning system to facilitate the dissemination of knowledge throughout the whole country to prevent errors in radiotherapy.(authors)

  16. Longitudinal trends in organophosphate incidents reported to the National Pesticide Information Center, 1995–2007

    Directory of Open Access Journals (Sweden)

    Jenkins Jeffrey J

    2009-04-01

    Full Text Available Abstract Background Regulatory decisions to phase-out the availability and use of common organophosphate pesticides among the general public were announced in 2000 and continued through 2004. Based on revised risk assessments, chlorpyrifos and diazinon were determined to pose unacceptable risks. To determine the impact of these decisions, organophosphate (OP exposure incidents reported to the National Pesticide Information Center (NPIC were analyzed for longitudinal trends. Methods Non-occupational human exposure incidents reported to NPIC were grouped into pre- (1995–2000 and post-announcement periods (2001–2007. The number of total OP exposure incidents, as well as reports for chlorpyrifos, diazinon and malathion, were analyzed for significant differences between these two periods. The number of informational inquiries from the general public was analyzed over time as well. Results The number of average annual OP-related exposure incidents reported to NPIC decreased significantly between the pre- and post-announcement periods (p Conclusion Consistent with other findings, the number of chlorpyrifos and diazinon exposure incidents reported to NPIC significantly decreased following public announcement and targeted regulatory action.

  17. Lung cancer incidence trends by gender, race and histology in the United States, 1973-2010.

    Directory of Open Access Journals (Sweden)

    Rafael Meza

    Full Text Available Lung cancer (LC incidence in the United States (US continues to decrease but with significant differences by histology, gender and race. Whereas squamous, large and small cell carcinoma rates have been decreasing since the mid-80s, adenocarcinoma rates remain stable in males and continue to increase in females, with large racial disparities. We analyzed LC incidence trends by histology in the US with an emphasis on gender and racial differences.LC incidence rates from 1973-2010 were obtained from the SEER cancer registry. Age-adjusted incidence trends of five major histological types by gender and race were evaluated using joinpoint regression. Trends of LC histology and stage distributions from 2005-2010 were analyzed.US LC incidence varies by histology. Squamous, large and small cell carcinoma rates continue to decrease for all gender/race combinations, whereas adenocarcinoma rates remain relatively constant in males and increasing in females. An apparent recent increase in the incidence of squamous cell carcinoma and adenocarcinoma since 2005 can be explained by a concomitant decrease in the number of cases classified as other non-small cell carcinoma. Black males continue to be disproportionally affected by squamous LCs, and blacks continue to be diagnosed with more advanced cancers than whites.LC incidence by histology continues to change over time. Additional variations are expected as screening becomes disseminated. It is important to continue to monitor LC rates to evaluate the impact of screening on current trends, assess the continuing benefits of tobacco control, and focus efforts on reducing racial disparities.

  18. Cancer incidence of A-bomb survivors in Nagasaki City, 1973 - 1982

    International Nuclear Information System (INIS)

    Ikeda, Takayoshi; Shimokawa, Isao; Iwasaki, Keisuke; Matsuo, Takeshi; Mori, Hiroyuki; Mine, Mariko

    1988-01-01

    Subjects were residents older than 30 years ascertained through the population-based cancer registry in Nagasaki City during a ten-year period from 1973 to 1982. The total number of cancer patients was 6,243 (3,456 men and 2,787 women), 2,626 of whom were A-bomb survivors. Stomach cancer was the most common, irrespective of sex, in both exposed and non-exposed groups. Crude incidence of cancer of any organ was higher in the exposed group, especially the group of people entering the city early after the bombing, than the non-exposed group. In the groups exposed at <2,000 m and at 2,000 - 10,000 m from the hypocenter, the incidence of stomach, lung, and thyroid cancers and malignant lymphoma; and the incidence of stomach, breast, and thyroid cancers were radiation-dose dependent in men and women, respectively. Age-adjusted relative risks of breast and thyroid cancers were significantly higher in the exposed group of women than the non-exposed group. Comparing cancer incidence during the first and latter five years, the incidence of thyroid cancer and malignant lymphoma tended to decrease or remain unchanged in both men and women. The incidence of colorectal cancer showed a tendency to increase. An increased incidence of stomach and lung cancers was restricted to the exposed group of women. As for breast cancer, the exposed group of women had a tendency for decrease, as opposed to the non-exposed group with the increased incidence. There was no significant difference in histologic types between the exposed and non-exposed groups. (Namekawa, K.)

  19. Climatic variables and malaria incidence in Dehradun, Uttaranchal, India.

    Science.gov (United States)

    Devi, N Pemola; Jauhari, R K

    2006-03-01

    Mosquito-borne diseases particularly malaria and Japanese encephalitis (JE) are becoming most dreaded health problems in Dehradun district. Keeping in view that the climatic factors particularly temperature and rainfall may alter the distribution of vector species--increasing or decreasing the ranges, depending on weather conditions that are favourable or unfavourable for mosquito breeding, it is aimed to find out the effect of climatic factors on malaria incidence with particular emphasis to capture the essential events as a result of climatic variability. Mosquito sampling and identification was done using WHO entomological methods and follow-up of recognised keys and catalogues. Data on malaria incidence and meteorological information were gathered in a collaborative study with the District Malaria Office, and the Forest Research Institute, Dehradun respectively. Pearson's correlation analysis was applied for establishing relationship between climate variables and malaria transmission. Higher positive correlation of association was found between monthly parasite incidence and climatic variables (temperature, rainfall and humidity). However, highest significant correlation was found between rainfall and malaria incidence (r = 0.718, p Climatic variables that predict the presence or absence of malaria are likely to be the best suited for forecasting the distribution of this disease at the edges of its range.

  20. [Incidence and clinical characteristics of maculopapular exanthemas of viral aetiology].

    Science.gov (United States)

    Vega Alonso, T; Gil Costa, M; Rodríguez Recio, M J; de la Serna Higuera, P

    2003-11-30

    To estimate the incidence of maculo-papular viral exanthemas and to describe the epidemiological and clinical patterns. Observational descriptive study with a sample design. 154 practitioners from the Castilla y León Sentinel Network with a surveilled population of 23 237 people-year under 15 years old, notified in 2002 the cases of diseases by means of a standard form with the variables and inclusion and exclusion criteria. It was included the maculo-papular exanthemas associated to a presumable systemic virus disease in patients under 15 years old. It was excluded the infectious mononucleose, the chickenpox, and other non viral infections or exanthemas. 368 cases were notified which represent a incidence rate of 158.37 cases per 10 000 (95% CI, 142.31-174.42). The incidence was maximum under four years old, more than 350 per 10 000, decreasing significantly in children over this age. Erythema infectiousum presented the highest rate, followed by exanthema subitum. The exanthemas caused by measles or rubella were insignificants. Childhood exanthematous diseases of presumable viral etiology have an important incidence in primary care, although the majorities are banal and self-limited diseases. Clinical characteristics supported the suspicion diagnosis, which was consistent with the observed epidemiological description and expected presentations of each disease. Although serological analysis could diminish the uncertainly on notification and control of diseases submited to especial programs of vaccination and eradication, they would not improve substantially the diagnosis and treatment of these patients.

  1. Goiania incident case study

    International Nuclear Information System (INIS)

    Petterson, J.S.

    1988-06-01

    The reasons for wanting to document this case study and present the findings are simple. According to USDOE technical risk assessments (and our own initial work on the Hanford socioeconomic study), the likelihood of a major accident involving exposure to radioactive materials in the process of site characterization, construction, operation, and closure of a high-level waste repository is extremely remote. Most would agree, however, that there is a relatively high probability that a minor accident involving radiological contamination will occur sometime during the lifetime of the repository -- for example, during transport, at an MRS site or at the permanent site itself during repacking and deposition. Thus, one of the major concerns of the Yucca Mountain Socioeconomic Study is the potential impact of a relatively minor radiation-related accident. A large number of potential impact of a relatively minor radiation-related accident. A large number of potential accident scenarios have been under consideration (such as a transportation or other surface accident which results in a significant decline in tourism, the number of conventions, or the selection of Nevada as a retirement residence). The results of the work in Goiania make it clear, however, that such a significant shift in established social patterns and trends is not likely to occur as a direct outcome of a single nuclear-related accident (even, perhaps, a relatively major one), but rather, are likely to occur as a result of the enduring social interpretations of such an accident -- that is, as a result of the process of understanding, communicating, and socially sustaining a particular set of associations with respect to the initial incident

  2. Marine Animal Incident Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Large whale stranding, death, ship strike and entanglement incidents are all recorded to monitor the health of each population and track anthropogenic factors that...

  3. Police Incident Blotter (Archive)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Police Blotter Archive contains crime incident data after it has been validated and processed to meet Uniform Crime Reporting (UCR) standards, published on a...

  4. Prediction of Safety Incidents

    Data.gov (United States)

    National Aeronautics and Space Administration — Safety incidents, including injuries, property damage and mission failures, cost NASA and contractors thousands of dollars in direct and indirect costs. This project...

  5. 2011 Japanese Nuclear Incident

    Science.gov (United States)

    EPA’s RadNet system monitored the environmental radiation levels in the United States and parts of the Pacific following the Japanese Nuclear Incident. Learn about EPA’s response and view historical laboratory data and news releases.

  6. The evaluation of a web-based incident reporting system.

    Science.gov (United States)

    Kuo, Ya-Hui; Lee, Ting-Ting; Mills, Mary Etta; Lin, Kuan-Chia

    2012-07-01

    A Web-based reporting system is essential to report incident events anonymously and confidentially. The purpose of this study was to evaluate a Web-based reporting system in Taiwan. User satisfaction and impact of system use were evaluated through a survey answered by 249 nurses. Incident events reported in paper and electronic systems were collected for comparison purposes. Study variables included system user satisfaction, willingness to report, number of reports, severity of the events, and efficiency of the reporting process. Results revealed that senior nurses were less willing to report events, nurses on internal medicine units had higher satisfaction than others, and lowest satisfaction was related to the time it took to file a report. In addition, the Web-based reporting system was used more often than the paper system. The percentages of events reported were significantly higher in the Web-based system in laboratory, environment/device, and incidents occurring in other units, whereas the proportions of reports involving bedsores and dislocation of endotracheal tubes were decreased. Finally, moderate injury event reporting decreased, whereas minor or minimal injury event reporting increased. The study recommends that the data entry process be simplified and the network system be improved to increase user satisfaction and reporting rates.

  7. Information Security Incident Management

    Directory of Open Access Journals (Sweden)

    D. I. Persanov

    2010-03-01

    Full Text Available The present report highlights the points of information security incident management in an enterprise. Some aspects of the incident and event classification are given. The author presents his view of the process scheme over the monitoring and processing information security events. Also, the report determines a few critical points of the listed process and gives the practical recommendations over its development and optimization.

  8. Study on laser welding of austenitic stainless steel by varying incident angle of pulsed laser beam

    Science.gov (United States)

    Kumar, Nikhil; Mukherjee, Manidipto; Bandyopadhyay, Asish

    2017-09-01

    In the present work, AISI 304 stainless steel sheets are laser welded in butt joint configuration using a robotic control 600 W pulsed Nd:YAG laser system. The objective of the work is of twofold. Firstly, the study aims to find out the effect of incident angle on the weld pool geometry, microstructure and tensile property of the welded joints. Secondly, a set of experiments are conducted, according to response surface design, to investigate the effects of process parameters, namely, incident angle of laser beam, laser power and welding speed, on ultimate tensile strength by developing a second order polynomial equation. Study with three different incident angle of laser beam 89.7 deg, 85.5 deg and 83 deg has been presented in this work. It is observed that the weld pool geometry has been significantly altered with the deviation in incident angle. The weld pool shape at the top surface has been altered from semispherical or nearly spherical shape to tear drop shape with decrease in incident angle. Simultaneously, planer, fine columnar dendritic and coarse columnar dendritic structures have been observed at 89.7 deg, 85.5 deg and 83 deg incident angle respectively. Weld metals with 85.5 deg incident angle has higher fraction of carbide and δ-ferrite precipitation in the austenitic matrix compared to other weld conditions. Hence, weld metal of 85.5 deg incident angle achieved higher micro-hardness of ∼280 HV and tensile strength of 579.26 MPa followed by 89.7 deg and 83 deg incident angle welds. Furthermore, the predicted maximum value of ultimate tensile strength of 580.50 MPa has been achieved for 85.95 deg incident angle using the developed equation where other two optimum parameter settings have been obtained as laser power of 455.52 W and welding speed of 4.95 mm/s. This observation has been satisfactorily validated by three confirmatory tests.

  9. Summarization of Injury and Fatality Factors Involving Children and Youth in Grain Storage and Handling Incidents.

    Science.gov (United States)

    Issa, S F; Field, W E; Hamm, K E; Cheng, Y H; Roberts, M J; Riedel, S M

    2016-01-01

    This article summarizes data gathered on 246 documented cases of children and youth under the age of 21 involved in grain storage and handling incidents in agricultural workplaces from 1964 to 2013 in the U.S. that have been entered into the Purdue Agricultural Confined Space Incident Database. The database is the result of ongoing efforts to collect and file information on documented injuries, fatalities, and entrapments in all forms of agricultural confined spaces. While the frequency of injuries and fatalities involving children and youth in agriculture has decreased in recent years, incidents related to agricultural confined spaces, especially grain storage and handling facilities, have remained largely unchanged during the same period. Approximately 21% of all documented incidents involved children and youth (age 20 and younger), and more than 77% of all documented incidents were fatal, suggesting an under-reporting of non-fatal incidents. Findings indicate that the majority of youth incidents occurred at OSHA exempt agricultural worksites. The states reporting the most incidents were Indiana, Iowa, Nebraska, Illinois, and Minnesota. Grain transport vehicles represented a significant portion of incidents involving children under the age of 16. The overwhelming majority of victims were male, and most incidents (50%) occurred in June, October, and November. Recommendations include developing intervention strategies that target OSHA exempt farms, feedlots, and seed processing facilities; preparing engineering design and best practice standards that reduce the exposure of children and youth to agricultural confined spaces; and developing gender-specific safety resources that incorporate gender-sensitive strategies to communicate safety information to the population of young males with the greatest risk of exposure to the hazards of agricultural confined spaces.

  10. Frequência de sintomas de asma e de redução da função pulmonar entre crianças e adolescentes nadadores amadores Incidence of asthma symptoms and decreased pulmonary function in young amateur swimmers

    Directory of Open Access Journals (Sweden)

    Iara Nely Fiks

    2009-03-01

    Full Text Available OBJETIVO: Investigar a frequência de sintomas de asma entre crianças e adolescentes nadadores amadores e descrever o tratamento clínico entre as crianças asmáticas em um clube esportivo privado na cidade de São Paulo. MÉTODOS: Foram incluídos no estudo 171 nadadores amadores de 6 a 14 anos de idade. Todos os participantes ou seus responsáveis foram solicitados a responder o questionário International Study of Asthma and Allergies in Childhood (ISAAC, e 119 realizaram prova de função pulmonar em repouso. RESULTADOS: A frequência geral de sintomas de asma (ISAAC > 6 pontos entre os nadadores foi de 16,8%. Entre os 119 nadadores que realizaram a espirometria, 39 (32,7% apresentaram alterações espirométricas (VEF1/CVF 6, 10 (31,2% alegaram não realizar nenhum tipo de tratamento para a doença. Daqueles que afirmaram realizar tratamento medicamentoso, 24% faziam uso de broncodilatadores mas não de corticosteroides. CONCLUSÕES: A frequência de sintomas de asma e de alterações da função pulmonar em nadadores amadores de 6 a 14 anos foi elevada. Além disso, uma proporção considerável destes atletas não recebia tratamento.OBJECTIVE: To investigate the incidence of asthma symptoms in young amateur swimmers, and to describe the clinical treatment of the children with asthma in a private sports club in the city of São Paulo, Brazil. METHODS: The study included 171 amateur swimmers, ranging from 6 to14 years of age. All of the participants or their legal guardians were asked to complete the International Study of Asthma and Allergies in Childhood (ISAAC questionnaire, and 119 were submitted to pulmonary function testing at rest. RESULTS: The overall incidence of asthma symptoms (ISAAC score > 6 among the swimmers was 16.8%. Of the 119 swimmers submitted to spirometry, 39 (32.7% presented spirometric alterations (FEV1/FVC 6, there were 10 (31.2% who stated that they were receiving no asthma treatment. Of those who reported

  11. The potential of non-invasive ventilation to decrease BPD.

    Science.gov (United States)

    Bhandari, Vineet

    2013-04-01

    Bronchopulmonary dysplasia (BPD), the most common chronic lung disease in infancy, has serious long-term pulmonary and neurodevelopmental consequences right up to adulthood, and is associated with significant healthcare costs. BPD is a multifactorial disease, with genetic and environmental factors interacting to culminate in the characteristic clinical and pathological phenotype. Among the environmental factors, invasive endotracheal tube ventilation is considered a critical contributing factor to the pathogenesis of BPD. Since BPD currently has no specific preventive or effective therapy, considerable interest has focused on the use of non-invasive ventilation as a means to potentially decrease the incidence of BPD. This article reviews the progress made in the last 5 years in the use of nasal continuous positive airways pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) as it pertains to impacting on BPD rates. Research efforts are summarized, and some guidelines are suggested for clinical use of these techniques in neonates. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Ac-SDKP decreases mortality and cardiac rupture after acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Pablo Nakagawa

    Full Text Available The natural peptide N-Acetyl-Seryl-Aspartyl-Lysyl-Proline (Ac-SDKP decreases inflammation in chronic diseases such as hypertension and heart failure. However, Ac-SDKP effects on acute inflammatory responses during myocardial infarction (MI are unknown. During the first 72 hours post-MI, neutrophils, M1 macrophages (pro-inflammatory, and M2 macrophages (pro-resolution and release of myeloperoxidase (MPO and matrix metalloproteinases (MMP are involved in cardiac rupture. We hypothesized that in the acute stage of MI, Ac-SDKP decreases the incidence of cardiac rupture and mortality by preventing immune cell infiltration as well as by decreasing MPO and MMP expression. MI was induced by ligating the left descending coronary artery in C57BL/6 mice. Vehicle or Ac-SDKP (1.6 mg/kg/d was infused via osmotic minipump. Cardiac immune cell infiltration was assessed by flow cytometry, cardiac MPO and MMP levels were measured at 24-48 hrs post-MI. Cardiac rupture and mortality incidence were determined at 7 days post-MI. In infarcted mice, Ac-SDKP significantly decreased cardiac rupture incidence from 51.0% (26 of 51 animals to 27.3% (12 of 44 and mortality from 56.9% (29 of 51 to 31.8% (14 of 44. Ac-SDKP reduced M1 macrophages in cardiac tissue after MI, without affecting M2 macrophages and neutrophils. Ac-SDKP decreased MMP-9 activation in infarcted hearts with no changes on MPO expression. Ac-SDKP prevents cardiac rupture and decreases mortality post-acute MI. These protective effects of Ac-SDKP are associated with decreased pro-inflammatory M1 macrophage infiltration and MMP-9 activation.

  13. Hyperhomocysteinemia decreases bone blood flow

    Directory of Open Access Journals (Sweden)

    Neetu T

    2011-01-01

    Full Text Available Neetu Tyagi*, Thomas P Vacek*, John T Fleming, Jonathan C Vacek, Suresh C TyagiDepartment of Physiology and Biophysics, School of Medicine, University of Louisville, Louisville, KY, USA *These authors have equal authorshipAbstract: Elevated plasma levels of homocysteine (Hcy, known as hyperhomocysteinemia (HHcy, are associated with osteoporosis. A decrease in bone blood flow is a potential cause of compromised bone mechanical properties. Therefore, we hypothesized that HHcy decreases bone blood flow and biomechanical properties. To test this hypothesis, male Sprague–Dawley rats were treated with Hcy (0.67 g/L in drinking water for 8 weeks. Age-matched rats served as controls. At the end of the treatment period, the rats were anesthetized. Blood samples were collected from experimental or control rats. Biochemical turnover markers (body weight, Hcy, vitamin B12, and folate were measured. Systolic blood pressure was measured from the right carotid artery. Tibia blood flow was measured by laser Doppler flow probe. The results indicated that Hcy levels were significantly higher in the Hcy-treated group than in control rats, whereas vitamin B12 levels were lower in the Hcy-treated group compared with control rats. There was no significant difference in folate concentration and blood pressure in Hcy-treated versus control rats. The tibial blood flow index of the control group was significantly higher (0.78 ± 0.09 flow unit compared with the Hcy-treated group (0.51 ± 0.09. The tibial mass was 1.1 ± 0.1 g in the control group and 0.9 ± 0.1 in the Hcy-treated group. The tibia bone density was unchanged in Hcy-treated rats. These results suggest that Hcy causes a reduction in bone blood flow, which contributes to compromised bone biomechanical properties.Keywords: homocysteine, tibia, bone density

  14. Trends in Incidence of Hospitalized Acute Myocardial Infarction in the Cardiovascular Research Network (CVRN).

    Science.gov (United States)

    Reynolds, Kristi; Go, Alan S; Leong, Thomas K; Boudreau, Denise M; Cassidy-Bushrow, Andrea E; Fortmann, Stephen P; Goldberg, Robert J; Gurwitz, Jerry H; Magid, David J; Margolis, Karen L; McNeal, Catherine J; Newton, Katherine M; Novotny, Rachel; Quesenberry, Charles P; Rosamond, Wayne D; Smith, David H; VanWormer, Jeffrey J; Vupputuri, Suma; Waring, Stephen C; Williams, Marc S; Sidney, Stephen

    2017-03-01

    Monitoring trends in cardiovascular events can provide key insights into the effectiveness of prevention efforts. Leveraging data from electronic health records provides a unique opportunity to examine contemporary, community-based trends in acute myocardial infarction hospitalizations. We examined trends in hospitalized acute myocardial infarction incidence among adults aged ≥25 years in 13 US health plans in the Cardiovascular Research Network. The first hospitalization per member for acute myocardial infarction overall and for ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction was identified by International Classification of Diseases, Ninth Revision, Clinical Modification primary discharge codes in each calendar year from 2000 through 2008. Age- and sex-adjusted incidence was calculated per 100,000 person-years using direct adjustment with 2000 US census data. Between 2000 and 2008, we identified 125,435 acute myocardial infarction hospitalizations. Age- and sex-adjusted incidence rates (per 100,000 person-years) of acute myocardial infarction decreased an average 3.8%/y from 230.5 in 2000 to 168.6 in 2008. Incidence of ST-segment elevation myocardial infarction decreased 8.7%/y from 104.3 in 2000 to 51.7 in 2008, whereas incidence of non-ST-segment elevation myocardial infarction increased from 126.1 to 129.4 between 2000 and 2004 and then decreased thereafter to 116.8 in 2008. Age- and sex-specific incidence rates generally reflected similar patterns, with relatively larger decreases in ST-segment elevation myocardial infarction rates in women compared with men. As compared with 2000, the age-adjusted incidence of ST-segment elevation myocardial infarction in 2008 was 48% lower among men and 61% lower among women. Among a large, diverse, multicenter community-based insured population, there were significant decreases in incidence of hospitalized acute myocardial infarction and the more serious ST-segment elevation

  15. Prophylactic ondansetron does not prevent shivering or decrease shivering severity during cesarean delivery under combined spinal epidural anesthesia: a randomized trial.

    Science.gov (United States)

    Browning, Roger M; Fellingham, William H; O'Loughlin, Edmond J; Brown, Nicholas A; Paech, Michael J

    2013-01-01

    Cesarean delivery is commonly performed under regional anesthesia, which is often associated with maternal shivering. This can cause distress and interfere with monitoring. The study objective was to evaluate the antishivering efficacy of ondansetron, which reduces the incidence and severity of shivering in nonobstetric patients. We hypothesized that there would be a significant decrease in the incidence and/or severity of shivering in women who are given intravenous ondansetron 8 mg before combined spinal epidural (CSE) anesthesia, when compared with placebo. This was a randomized, double-blinded, parallel-group, placebo-controlled trial of 118 women scheduled for elective cesarean surgery. Women received either intravenous ondansetron 8 mg (n = 58) or saline (n = 60) before CSE anesthesia (intrathecal hyperbaric bupivacaine 0.5% 2.2-2.5 mL plus fentanyl 15 μg). The incidence and severity of shivering, measured on a validated 5-point scale, and other outcomes, such as nausea, pruritus, headache, or satisfaction, were assessed at 3 time points during the surgery and postoperative period. The incidence of shivering at any time point did not differ significantly between groups: ondansetron 41% versus placebo 47% (P = 0.54). The incidence of severe shivering at any time was not significantly different: ondansetron 32% versus placebo 33% (P = 0.79). There were no significant differences between the groups for any secondary outcomes. Intravenous ondansetron 8 mg before performing CSE anesthesia in women undergoing elective cesarean delivery does not decrease the incidence or severity of shivering.

  16. Impact of cephalosporin restriction on incidence of infections with extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in an endemic setting.

    Science.gov (United States)

    Nadrah, Kristina; Pirs, Mateja; Kreft, Samo; Mueller Premru, Manica; Beovic, Bojana

    2018-02-12

    Decreasing cephalosporin use was described as an effective intervention in decreasing the incidence of infections caused by Klebsiella pneumoniae harbouring extended-spectrum beta-lactamase (ESBLKP). Due to sustained increased levels of infections caused by ESBLKP, a multifaceted antibiotic stewardship intervention aimed to decrease cephalosporin use was carried out at a large medical unit of a teaching hospital. All cephalosporins except the first-generation were restricted and could only be prescribed after authorization by an infectious disease physician. The use of cephalosporins decreased significantly after intervention. The effect was most prominent for the third-generation cephalosporins (7.9-1.5 DDD/100 OBD). There was an increase in the consumption of piperacillin/tazobactam, carbapenems and fluoroquinolones. In contrast to our expectations the ESBLKP incidence increased, but the changes were not statistically significant. The intervention was successful in controlling the prescribing of cephalosporins, but had no impact on incidence of ESBLKP infections.

  17. Pharmaceutical sales of pseudoephedrine: the impact of electronic tracking systems on methamphetamine crime incidents.

    Science.gov (United States)

    Mazerolle, Lorraine; McGuffog, Ingrid; Ferris, Jason; Chamlin, Mitchell B

    2017-03-01

    Electronic tracking systems (ETS) are used extensively in pharmacies across the United States and Australia to control suspicious sales of pseudoephedrine. This study measures the impact of one ETS-Project STOP-on the capacity of police to reduce production, supply and possession of methamphetamine. Using official police data of incidents of production, supply and possession from January 1996 to December 2011 (n = 192 data points/months over 16 years), we used a quasi-experimental, time-series approach. The State of Queensland, Australia. No individual participants are included in the study. The unit of analysis is reported police incidents. The study examines the impact of the ETS on production (n = 5938 incidents), drug supply and trafficking (n = 20 094 incidents) and drug possession or use (n = 118 926) of methamphetamine. Introduction of the ETS in November 2005 was associated with an insignificant decrease (P = 0.15) in the production of methamphetamine. The intervention was associated with a statistically significant increase in supply incidents (P = 0.0001). There was no statistically significant effect on the incidence of possession (P = 0.59). Electronic tracking systems can reduce the capacity of people to produce methamphetamine domestically, but seem unlikely to affect other aspects of the methamphetamine problem such as possession, distribution and importation. © 2016 Society for the Study of Addiction.

  18. Changing incidence and residual lifetime risk of common osteoporosis-related fractures

    DEFF Research Database (Denmark)

    Lauritzen, J B; Schwarz, Peter; Lund, B

    1993-01-01

    1735 fractures of the distal radius, 747 fractures of the proximal humerus, 878 cervical and 635 trochanteric hip fractures were included. In men 273 cervical and 232 trochanteric hip fractures were included. The fractures were registered during the period 1976 to 1984 and changes in age.......05) during the observation period, while no significant decrease was found in the incidence of trochanteric fractures. No significant changes in incidence were observed in women with radial or humeral fractures, or in men with hip fractures. A women 60 years old with a life expectancy of 81 years had......Changes in incidence and lifetime risk of fractures are of major importance in the epidemiology of osteoporosis. We focused on hip fractures in women and men and on radial and humeral fractures in women. The study subjects comprised 4500 women and men 20 years old or more with fractures. In women...

  19. Comparison of the incidence of oesophageal cancer in two 6-year ...

    African Journals Online (AJOL)

    current data in South Africa regarding trends in incidence. Objectives. The objective of ... Global trends suggest that the incidence of squamous cell carcinoma (SCC) has decreased but that the incidence of adenocarcinoma (AC) has ..... incidence, which is not in keeping with international trends where an increase in AC is ...

  20. Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008-2015.

    Directory of Open Access Journals (Sweden)

    Takeshi Nishijima

    Full Text Available The epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM largely remains unknown.The incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8 among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods.Of 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21% or became infected with syphilis during follow-up (13%. After excluding 214 patients (MSM with syphilis at baseline (n = 190 and no follow-up syphilis test (n = 24, of 671 men, 112 (17% developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5-52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008-2009: 48.2/1,000 person-years, 2010-2011: 51.1/1,000 person-years, 2012-2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315. Multivariable analysis identified young age (40, HR 4.0, 95%CI 2.22-7.18, p<0.001, history of syphilis at baseline (HR 3.0, 95%CI 2.03-4.47, p<0.001, positive anti-amoeba antibody (HR 1.8, 95%CI 1.17-2.68, p = 0.006, and high baseline CD4 count (CD4 ≥350 /μL versus CD4 <200, HR 1.6, 95%CI 1.00-2.53, p = 0.050 as risk factors for incident syphilis. Incidence of syphilis was particularly high among young patients (age <33 years: 60.1/1,000 person-years. Interestingly, 37% of patients with incident syphilis were asymptomatic.Although incidence of syphilis did not increase during the observation period, it was high among HIV-1-infected MSM, especially among young HIV-1-infected MSM and those with history of syphilis, in Tokyo. Regular screening for syphilis needs to be

  1. Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012.

    Directory of Open Access Journals (Sweden)

    Jennifer O Lam

    Full Text Available In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV. Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968-2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC, 183 anal squamous cell carcinoma (ASCC and 8,019 invasive cervical cancer (ICC cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC cases were included as comparators. Age-standardized incidence rates (ASR were determined by gender and ethnicity (Chinese, Malay and Indian. Joinpoint regression was used to evaluate annual percentage change (APC in incidence. OPSCC incidence increased in both genders (men 1993-2012, APC = 1.9%, p<0.001; women 1968-2012, APC = 2.0%, p = 0.01 and was 5 times higher in men than women. In contrast, non-OP HNC incidence declined between 1968-2012 among men (APC = -1.6%, p<0.001 and women (APC = -0.4%, p = 0.06. ASCC and ANSCC were rare (ASR = 0.2 and 0.7 per 100,000 person-years, respectively and did not change significantly over time except for increasing ANSCCs in men (APC = 2.8%, p<0.001. ICC was the most common HPV-associated cancer (ASR = 19.9 per 100,000 person-years but declined significantly between 1968-2012 (APC = -2.4%. Incidence of each cancer varied across ethnicities. Similar to trends in Western countries, OPSCC incidence increased in recent years, while non-OP HNC decreased. ICC remains the most common HPV-related cancer in Singapore, but Pap screening programs have led to consistently decreasing incidence.

  2. Diagnosed hypertension in Canada: incidence, prevalence and associated mortality

    Science.gov (United States)

    Robitaille, Cynthia; Dai, Sulan; Waters, Chris; Loukine, Lidia; Bancej, Christina; Quach, Susan; Ellison, Joellyn; Campbell, Norman; Tu, Karen; Reimer, Kim; Walker, Robin; Smith, Mark; Blais, Claudia; Quan, Hude

    2012-01-01

    Background: Hypertension is a leading risk factor for cardiovascular diseases. Our objectives were to examine the prevalence and incidence of diagnosed hypertension in Canada and compare mortality among people with and without diagnosed hypertension. Methods: We obtained data from linked health administrative databases from each province and territory for adults aged 20 years and older. We used a validated case definition to identify people with hypertension diagnosed between 1998/99 and 2007/08. We excluded pregnant women from the analysis. Results: This retrospective population-based study included more than 26 million people. In 2007/08, about 6 million adults (23.0%) were living with diagnosed hypertension and about 418 000 had a new diagnosis. The age-standardized prevalence increased significantly from 12.5% in 1998/99 to 19.6% in 2007/08, and the incidence decreased from 2.7 to 2.4 per 100. Among people aged 60 years and older, the prevalence was higher among women than among men, as was the incidence among people aged 75 years and older. The prevalence and incidence were highest in the Atlantic region. For all age groups, all-cause mortality was higher among adults with diagnosed hypertension than among those without diagnosed hypertension. Interpretation: The overall prevalence of diagnosed hypertension in Canada from 1998 to 2008 was high and increasing, whereas the incidence declined during the same period. These findings highlight the need to continue monitoring the effectiveness of efforts for managing hypertension and to enhance public health programs aimed at preventing hypertension. PMID:22105752

  3. Incidence of blindness in southern Germany between 1990 and 1998.

    Science.gov (United States)

    Trautner, C; Haastert, B; Giani, G; Berger, M

    2001-02-01

    A reduction of diabetes-related blindness by at least one third was declared a primary objective for Europe in 1989 (St. Vincent Declaration). To ascertain a potential change of incidence rates, we collected data on blindness in a German district (population: about 5 million) over 9 years. We obtained complete lists of newly registered blindness-allowance recipients between 1990 and 1998 and population data on Württemberg-Hohenzollern, Germany. We estimated incidence rates of blindness in the general population and the diabetic population. To ascertain any time trend, we applied Poisson regression models. There were 6371 newly registered blindness allowance recipients (1990-1998). Of these 67% were women and 27 % had diabetes. Mean age was 71.7 years. Standardised results in the diabetic population (incidence rates per 100,000 person-years; standard: diabetic population; 95 % CI): 1990: 72 (61;82); 1991: 88 (76;100); 1992: 77 (67;88); 1993: 82 (71;93); 1994: 62 (53;72); 1995: 82 (71;93); 1996: 70 (60;80); 1997: 69 (59;79); 1998: 59 (49;68). The Poisson model estimated a 3 % decrease of incident blindness in the diabetic population for each year (Relative risk per year 0.97; CI: 0.95; 0.99). No significant change could be observed in the non-diabetic population (Relative risk: 0.99; CI: 0.98; 1.00). Relative risks for each year varied between sub-groups according to sex, diabetic status and cause of blindness between 0.94 and 1.01. A slight reduction of incident blindness could be shown but a reduction by one third has not been reached. Several possible sources of bias in the data have to be considered.

  4. Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008-2015.

    Science.gov (United States)

    Nishijima, Takeshi; Teruya, Katsuji; Shibata, Satoshi; Yanagawa, Yasuaki; Kobayashi, Taiichiro; Mizushima, Daisuke; Aoki, Takahiro; Kinai, Ei; Yazaki, Hirohisa; Tsukada, Kunihisa; Genka, Ikumi; Kikuchi, Yoshimi; Oka, Shinichi; Gatanaga, Hiroyuki

    2016-01-01

    The epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM) largely remains unknown. The incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8) among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods. Of 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21%) or became infected with syphilis during follow-up (13%). After excluding 214 patients (MSM with syphilis at baseline (n = 190) and no follow-up syphilis test (n = 24)), of 671 men, 112 (17%) developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5-52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008-2009: 48.2/1,000 person-years, 2010-2011: 51.1/1,000 person-years, 2012-2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315). Multivariable analysis identified young age (40, HR 4.0, 95%CI 2.22-7.18, pTokyo. Regular screening for syphilis needs to be strictly applied to this population.

  5. Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

    Science.gov (United States)

    Nishijima, Takeshi; Teruya, Katsuji; Shibata, Satoshi; Yanagawa, Yasuaki; Kobayashi, Taiichiro; Mizushima, Daisuke; Aoki, Takahiro; Kinai, Ei; Yazaki, Hirohisa; Tsukada, Kunihisa; Genka, Ikumi; Kikuchi, Yoshimi; Oka, Shinichi; Gatanaga, Hiroyuki

    2016-01-01

    Background The epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM) largely remains unknown. Methods The incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8) among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods. Results Of 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21%) or became infected with syphilis during follow-up (13%). After excluding 214 patients (MSM with syphilis at baseline (n = 190) and no follow-up syphilis test (n = 24)), of 671 men, 112 (17%) developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5–52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008–2009: 48.2/1,000 person-years, 2010–2011: 51.1/1,000 person-years, 2012–2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315). Multivariable analysis identified young age (40, HR 4.0, 95%CI 2.22–7.18, pTokyo. Regular screening for syphilis needs to be strictly applied to this population. PMID:27992604

  6. Serious incidents after death: content analysis of incidents reported to a national database.

    Science.gov (United States)

    Yardley, Iain E; Carson-Stevens, Andrew; Donaldson, Liam J

    2018-02-01

    Objectives To describe serious incidents occurring in the management of patient remains after their death. Design Incidents occurring after patient deaths were analysed using content analysis to determine what happened, why it happened and the outcome. Setting The Strategic Executive Information System database of serious incidents requiring investigation occurring in the National Health Service in England. Participants All cases describing an incident that occurred following death, regardless of the age of the patient. Main outcome measures The nature of the incident, the underlying cause or causes of the incident and the outcome of the incident. Results One hundred and thirty-two incidents were analysed; these related to the storage, management or disposal of deceased patient remains. Fifty-four incidents concerned problems with the storage of bodies or body parts. Forty-three incidents concerned problems with the management of bodies, including 25 errors in postmortem examination, or postmortems on the wrong body. Thirty-one incidents related to the disposal of bodies, 25 bodies were released from the mortuary to undertakers in error; of these, nine were buried or cremated by the wrong family. The reported underlying causes were similar to those known to be associated with safety incidents occurring before death and included weaknesses in or failures to follow protocol and procedure, poor communication and informal working practices. Conclusions Serious incidents in the management of deceased patient remains have significant implications for families, hospitals and the health service more broadly. Safe mortuary care may be improved by applying lessons learned from existing patient safety work.

  7. [Skin cancer incidence in Zacatecas].

    Science.gov (United States)

    Pinedo-Vega, José Luis; Castañeda-López, Rosalba; Dávila-Rangel, J Ignacio; Mireles-García, Fernando; Ríos-Martínez, Carlos; López-Saucedo, Adrián

    2014-01-01

    Skin cancer is the most frequent cancer related to ultraviolet radiation. The aim was to estimate the incidence of skin cancer type, melanoma and non-melanoma in Zacatecas, Mexico. An epidemiological study was carried out during the period from 2008 to 2012. The data were obtained from the Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Secretaría de Salud de Zacatecas (SSZ) and a private source, the Centro Médico Alameda. The incidence and the global prevalence were estimated. We studied 958 skin cancer cases, histopathologically confirmed. The cases were distributed as: 63.6 % basal cell carcinomas, 25.8 % squamous cell carcinomas, and 10.6 % melanoma. Significantly higher proportions were observed in women in the basal cell carcinomas (60.4 %) and squamous cell carcinomas (53.4 %). However, in the case of melanoma, the major proportion was observed in men (55.9 %). The more frequent skin cancer location was the face and for basal cell carcinoma was the nose (53 %); for squamous cell carcinomas were the lips (36 %), and for melanoma it was also the nose (40 %). The skin cancer incidence was estimated in 20 cases for each 100 000 inhabitants. Linear regression analysis showed that the skin cancer is increasing at an annual rate of 10.5 %. The anatomical location indicates that solar UV radiation is a risk factor, since the face is the zone with major exposure to solar radiation.

  8. Trends in incidence of disability in activities of daily living among Chinese older adults, 1993-2006

    Science.gov (United States)

    Liang, Yajun; Welmer, Anna-Karin; Wang, Rui; Song, Aiqin; Fratiglioni, Laura; Qiu, Chengxuan

    2016-01-01

    BACKGROUND A decline in prevalence of disability in activities of daily living (ADL) among Chinese elderly people has been reported, but data on secular trends of incidence of ADL disability are sparse. OBJECTIVES We seek to investigate the time trends in incidence of ADL disability among Chinese older adults, and further, to explore factors potentially contributing to the trends. DESIGN A population-based prospective study. SETTING Participants were selected from nine provinces of China through a multistage, randomized, cluster sampling process. PARTICIPANTS We identified three consecutive cohorts of people aged ≥60 years within China Health and Nutrition Survey: cohort 1993-2000 (n=831), cohort 1997-2004 (n=1,091), and cohort 2000-2006 (n=1,152). MEASUREMENTS Disability in ADL was defined as inability to perform at least one of the five self-care activities, i.e., transferring, dressing, toileting, bathing, and feeding. Data were analyzed with Cox and generalized estimating equation models. RESULS The incidence (per 1,000 person-years) of ADL disability significantly decreased from 35.3 in 1993-2000 and 28.9 in 1997-2004 to 24.3 in 2000-2006 in Chinese older adults (Ptrend<.001). The incidence of ADL disability significantly decreased in both men and women, in young-old adults (aged 60-74 years), and in those living in rural area (Ptrend<.02) after controlling for multiple potential influential factors. Of the five ADL items, the decline in incidence of disability was significant in transferring (Ptrend<.001) and bathing (Ptrend=.002) and marginally significant in toileting (Ptrend=.061), but the incidence was stable in dressing (Ptrend=.384) and feeding (Ptrend=.258). CONCLUSION The incidence of ADL disability decreased from 1993 to 2006 among older adults in China, especially in transferring and bathing, independent of socio-demographics, lifestyles, and chronic health conditions. PMID:27682324

  9. Cyber crisis management: a decision-support framework for disclosing security incident information

    NARCIS (Netherlands)

    Kulikova, Olga; Heil, Ronald; van den Berg, Jan; Pieters, Wolter

    2012-01-01

    The growing sophistication and frequency of cyber attacks force modern companies to be prepared beforehand for potential cyber security incidents and data leaks. A proper incident disclosure strategy can significantly improve timeliness and effectiveness of incident response activities, reduce legal

  10. Incidence trends of cannabis and cocaine use from periodic Spanish general population surveys: effect of standardizing results by age structure.

    Science.gov (United States)

    Sánchez-Niubò, Albert; Sordo, Luis; Fortiana, Josep; Brugal, M Teresa; Domingo-Salvany, Antònia

    2013-08-01

    This study estimates life-time incidence trends of cannabis and cocaine use over 38 years from general population surveys of drug use (GPSDU) in Spain, taking into account changes of population age structure. Periodic cross-sectional studies. Eight biennial GPSDU from 1995 to 2009 in Spain. Interviewees aged 15-64 years who reported age of first ever cannabis and/or cocaine use between 10 and 64 years between 1971 and 2008. Estimates of raw and standardized incidences were calculated as a weighted mean of the incidences from all surveys. Standardization was conducted to take into account changes of population age structure. Incidence trends were extracted applying weighted cubic smoothing splines to incidence estimates. For both substances, estimated raw incidence trends increased up until 2000 (rates of 11.5 ± 0.7 and 3.6 ± 0.5 per 1000, respectively, for cannabis and cocaine), and then decreased significantly (in 2008, 9.6 ± 1.2 and 2.7 ± 0.6, respectively). In contrast, standardized rates exhibit a steadily increasing trend up to 2000 (9.0 ± 0.6 and 2.8 ± 0.4), followed by a statistically non-significant increasing trend afterwards (in 2008, 9.5 ± 1.2 and 2.8 ± 0.6). The largest increases of incidence were observed in both male and female subjects aged 15-19 years. Using data from Spanish general population surveys of drug use, an apparently decreasing trend of raw incidence rates in both cannabis and cocaine use from 2000 became non-decreasing trends when these rates were standardized. First experiences of cannabis and cocaine use in Spain occur mainly in younger ages (15-19 years). © 2013 Society for the Study of Addiction.

  11. The combination of ultrasound with antibiotics released from bone cement decreases the viability of planktonic and biofilm bacteria : an in vitro study with clinical strains

    NARCIS (Netherlands)

    Ensing, Geert T.; Neut, Danielle; Horn, Jim R. van; van der Mei, Henny C.; Busscher, Henk J.

    2006-01-01

    Objectives: Antibiotic-loaded bone cements are used for the permanent fixation of joint prostheses. Antibiotic-loaded cements significantly decrease the incidence of infection. The objective of this study was to investigate whether the viability of bacteria derived from patients with a

  12. Incidents in nuclear installations

    International Nuclear Information System (INIS)

    Franzen, L.F.; Wienhold, W.

    1976-09-01

    With reference to the incident list of the Ministry for the period 1971-74, Prof. Bechert has expressed a lot of questions and statements in a letter to the Government. The letter is quoted in full. Inadequate conclusions drawn by Prof. Bechert in connection with quotations from daily newspapers and other documents are put right. (HP) [de

  13. Fire Incident Reporting Manual

    Science.gov (United States)

    1984-02-01

    the result of an incident that requires (or should require) treatment by a practitioner of medicine , a registered emergency medical technician, or a...UNANNOUNCED AIRCRAFT EMERGENCYS ~~PRIOR TO TAKE OFF OR AFTERLADN 5 FUEL OPERATIONS REQUIRING 1AREING G A FIRE10 ARRESTING GEAR’BARRIER FR . ENGAGEMENTS AND

  14. NEA incident reporting system: Three years' experience

    International Nuclear Information System (INIS)

    Otsuka, Y.; Haeussermann, W.

    1984-01-01

    The paper presents an overview of the NEA Incident Reporting System (IRS) which was set up to collect, assess and disseminate on safety-related incidents in nuclear power plants. The IRS information exchange is significant in two senses. First, it enables regulatory authorities and utilities in participating countries to take appropriate action to prevent the reported mishaps occurring again elsewhere. Secondly, the continuous collection and systematic analysis of such information allows identification of areas of concern where safety research should be strengthened. There are two stages in the IRS information exchange. First, the national IRS Co-ordinator selects information on significant incidents, in accordance with a common reporting threshold, from the abnormal occurrences reported to the regulatory body, to be distributed through the NEA Secretariat. This screening is intended to exclude minor events, so that only significant information is sent to participating countries. Secondly, a group of experts periodically reviews the incidents reported during the preceding twelve months to identify major areas of concern. To assist this process, a computer-based data retrieval system is being developed for IRS incident reports. The paper gives some details of the IRS mechanism and discusses reporting criteria and the information included in a report. Areas of concern derived from reported incidents, an outline of the data retrieval system, and examples of feedback of lessons learned and possibilities for international co-operation are also discussed. (author)

  15. Trends in Lung Cancer Incidence Rates by Histological Type in 1975-2008: A Population-Based Study in Osaka, Japan.

    Science.gov (United States)

    Kinoshita, Fukuaki Lee; Ito, Yuri; Nakayama, Tomio

    2016-11-05

    Monitoring trends in lung cancer incidence and mortality is important for the evaluation of cancer control activities. We investigated recent trends in age-standardized incidence rates by histological type of lung cancer in Osaka, Japan. Cancer incidence data for 1975-2008 were obtained from the Osaka Cancer Registry. Lung cancer mortality data with population data in Osaka during 1975-2012 were obtained from vital statistics. We examined trends in age-standardized incidence and mortality rates for all histological types and age-standardized incidence rates by histological type and age group using a joinpoint regression model. The age-standardized incidence rate of lung cancer levelled off or slightly increased from 1975-2008, with an annual percentage change of 0.3% (95% confidence interval [CI], 0.1%-0.4%) for males and 1.1% (95% CI, 0.9%-1.3%) for females, and the mortality rate decreased by 0.9% (95% CI, 1.2%-0.7%) for males and 0.5% (95% CI, 0.8%-0.3%) for females. The incidence rates of squamous cell carcinoma (SQC) and small cell carcinoma (SMC) significantly decreased for both genders, whereas that of adenocarcinoma (ADC) significantly increased among almost all age groups in both genders. The incidence rates of SQC and SMC decreased with the decline in smoking prevalence, which probably explains the change in trends in the incidence rates of lung cancer from the mid-1980s. However, the reason for the increase in ADC remains unclear. Therefore, trends in incidence rates of lung cancer should be carefully monitored, especially for ADC, and the associations between ADC and its possible risk factors should be studied.

  16. Cumulative incidence of postoperative severe pain at Hospital Universitario San Jose, Popayan. Preliminar report

    Directory of Open Access Journals (Sweden)

    Ingrid Muñoz

    2013-12-01

    Full Text Available Introduction: Postoperative pain remains as a problem. National studies report incidences of 31% for moderate and 22% for severe pain. Inadequate analgesia is related to dissatisfaction and adverse outcomes. The aim of this study was to describe the incidence and characteristics of the postoperative pain in the post-anesthesia care unit (PACU at Hospital Universitario San José of Popayán (HUSJ in patients undergoing general anesthesia during the first postoperative hour. Methods: Cohort study. We recruited patients attending PACU and undergoing procedures using general anesthesia, between 18 and 70 years. Using a standardized collection form medical history, demographic data, medical history, anesthetic management, intraoperative analgesia and postoperative pain assessment by verbal and numerical pain scale (1-10 were recorded. Postoperative outcome data were also collected in the PACU. Results: The incidence of severe postoperative pain at 10 minutes was 12.3% 95%CI [7.1-18.2] (19 patients. Within 30 minutes of assessment 4.5% 95%CI [1.3-8.4] (7 patients and 1.9% 60 minutes 95%CI [0-4.5] (3 patients. 48.7% required rescue analgesic at PACU. Incidence of postoperative nausea and vomiting (PONV was significantly different in patients requiring rescue analgesic. Conclusion: The incidence of severe postoperative pain in the first postoperative hour at HUSJ is close to 12% and it decreases as time goes by. Patients requiring rescue analgesic have a higher incidence of postoperative complications such as PONV.

  17. Clinical incidents involving students on placement: an analysis of incident reports to identify potential risk factors.

    Science.gov (United States)

    Gaida, J E; Maloney, S; Lo, K; Morgan, P

    2015-06-01

    Students are sometimes involved in incidents during clinical training. To the authors' knowledge, no quantitative studies of incidents specifically involving physiotherapy students on clinical placement are available in the literature. A retrospective audit (2008 to 2011) of incident reports involving physiotherapy students was conducted to identify the nature and features of incidents. The study aimed to determine if injuries to a student or patient were more or less likely when the supervisor was in close proximity, and whether students with lower academic performance in their preclinical semester were more likely to be involved in an incident. There were 19 care-delivery-related and three equipment-related incidents. There were no incidents of violent, aggressive or demeaning behaviour towards students. The incident rate was 9.0/100,000 student-hours for third-year students and 6.8/100,000 student-hours for fourth-year students. The majority of incidents (55%) occurred from 11 am to 12-noon and from 3 pm to 3.30 pm. Incidents more often resulted in patient or student injury when the supervisor was not in close proximity (approximately 50% vs approximately 20%), although the difference was not significant (P=0.336). The academic results of students involved in incidents were equivalent to the whole cohort in their preclinical semester {mean 75 [standard deviation (SD) 6] vs 76 (SD 7); P=0.488}. The unexpected temporal clustering of incidents warrants further investigation. Student fatigue may warrant attention as a potential contributor; however, contextual factors, such as staff workload, along with organisational systems, structures and procedures may be more relevant. The potential relationship between supervisor proximity and injury also warrants further exploration. The findings of the present study should be integrated into clinical education curricula and communicated to clinical educators. Copyright © 2014 Chartered Society of Physiotherapy. Published by

  18. INCIDENCE OF AMPUTATION IN EMERGENCY

    Directory of Open Access Journals (Sweden)

    K. Rojaramani Kumbha

    2016-08-01

    Full Text Available Advanced Technology and early detection of disease by recent improvements in investigation modalities lead to decreased incidents of amputations while Road Traffic Accidents (RTA increase. Furthermore, it leads to variation and decreased morbidity, mortality and accidents (crush injuries, and better equipped and trained staff, specialist services, diabetic food, rehabilitation centres, and giving good support physically and psychologically for Amputated patients. OBJECTIVE To know incidence rates of Emergency Amputation who attended causality with advanced disease and severe Trauma. METHODOLOGY The study is done over a period of one year i.e. between June 2015 to June 2016 who attended causality with advanced and severe disease affecting the limbs either due to diabetes, trauma or vascular diseases. RESULTS During one-year period, total 6,371 patients attended for general surgery OP. In those, 187 patients needed emergency surgery which included both major and minor operations. Among those, 81 patients were amputated. CONCLUSION As per our available records and observation, even though there is increased literacy and access to advanced technology, there is still increased incidence of patients undergoing amputations due to diseases. Therefore, there is a need to improve awareness and importance of early detection of diabetes, hazards of smoking, and regular general health checkups for patients at root level. With that we can treat diabetes and/or any disease in time. So there must be awareness in peripheral health staff i.e. PHC, subcentres, and community health centres about early detection of disease which in turn improves the quality of life of the patient. Due to diabetes slight injury to the glucose laden tissue may cause chronic infection and ulcer formation.(1 The tumours are seen commonly in the age group of 20-40 years after bone fusion, bones affected commonly are those around the knee (lower end of knee, upper end of tibia. A lytic

  19. Constipation and Incident CKD.

    Science.gov (United States)

    Sumida, Keiichi; Molnar, Miklos Z; Potukuchi, Praveen K; Thomas, Fridtjof; Lu, Jun Ling; Matsushita, Kunihiro; Yamagata, Kunihiro; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P

    2017-04-01

    Constipation is one of the most prevalent conditions in primary care settings and increases the risk of cardiovascular disease, potentially through processes mediated by altered gut microbiota. However, little is known about the association of constipation with CKD. In a nationwide cohort of 3,504,732 United States veterans with an eGFR ≥60 ml/min per 1.73 m 2 , we examined the association of constipation status and severity (absent, mild, or moderate/severe), defined using diagnostic codes and laxative use, with incident CKD, incident ESRD, and change in eGFR in Cox models (for time-to-event analyses) and multinomial logistic regression models (for change in eGFR). Among patients, the mean (SD) age was 60.0 (14.1) years old; 93.2% of patients were men, and 24.7% were diabetic. After multivariable adjustments, compared with patients without constipation, patients with constipation had higher incidence rates of CKD (hazard ratio, 1.13; 95% confidence interval [95% CI], 1.11 to 1.14) and ESRD (hazard ratio, 1.09; 95% CI, 1.01 to 1.18) and faster eGFR decline (multinomial odds ratios for eGFR slope constipation associated with an incrementally higher risk for each renal outcome. In conclusion, constipation status and severity associate with higher risk of incident CKD and ESRD and with progressive eGFR decline, independent of known risk factors. Further studies should elucidate the underlying mechanisms. Copyright © 2017 by the American Society of Nephrology.

  20. Trichomonas vaginalis Incidence Associated with Hormonal Contraceptive Use and HIV Infection among Women in Rakai, Uganda

    Directory of Open Access Journals (Sweden)

    Heena Brahmbhatt

    2014-01-01

    Full Text Available Background. Data on the incidence of Trichomonas vaginalis and use of hormonal contraception (HC are limited. Methods. 2,374 sexually active women aged 15–49 years from cohort surveys in Rakai, Uganda, were included. Incidence of T. vaginalis was estimated per 100 person years (py and association between HC (DMPA, Norplant, and oral contraceptives and T. vaginalis infection was assessed by incidence rate ratios (IRR, using Poisson regression models. Results. At baseline, 34.9% had used HC in the last 12 months, 12.8% HIV+, 39.7% with high BV-scores (7–10, and 3.1% syphilis positive. The 12-month incidence of T. vaginalis was 2.4/100 py; CI (1.90, 3.25. When stratified by type of HC used, compared to women who did not use HC or condoms, incidence of T. vaginalis was significantly higher among users of Norplant (adj.IRR = 3.01, CI: 1.07–8.49 and significantly lower among DMPA users (adj.IRR = 0.55, CI: 0.30, 0.98 and women who discontinued HC use at follow-up (adj.IRR = 0.30, CI: 0.09, 0.99. HIV infection was associated with an increase in incidence of T. vaginalis (adj.IRR = 2.34, CI: 1.44, 3.78. Conclusions. Use of Norplant and being HIV+ significantly increased the risk of T. vaginalis, while use of DMPA and discontinuation of overall HC use were associated with a decreased incidence of T. vaginalis.

  1. Significance of iatrogenic pneumothoraces.

    Science.gov (United States)

    Despars, J A; Sassoon, C S; Light, R W

    1994-04-01

    The purpose of this study was to review the cases of iatrogenic pneumothorax that occurred between October 1983 and December 1988 at the Veterans Administration Medical Center, Long Beach, Calif, to determine the treatment and complications. During this time period, 106 patients were identified with iatrogenic pneumothorax, and the charts of 98 were available for review. There were 90 cases of spontaneous pneumothorax at this institution during the same time period. The most common cause of iatrogenic pneumothorax was transthoracic needle aspiration (35), followed by thoracentesis (30), subclavian venipuncture (23), and positive pressure ventilation (7). In 11 cases, the cause was due to miscellaneous triggers. The majority of the patients (65 of 98) were treated with chest tubes. The chest tubes were in place 4.7 +/- 3.9 days. Nine of the patients required a second chest tube. Aspiration of the pneumothorax only was attempted in five patients, and all patients subsequently received a chest tube. Two patients died from iatrogenic pneumothorax. One patient receiving positive pressure ventilation developed an unrecognized tension pneumothorax. The other patient developed a pneumothorax after thoracentesis and was treated with a chest tube, which led to a staphylococcal empyema and death. From this study, we conclude that the incidence of iatrogenic pneumothorax exceeds that of spontaneous pneumothorax and that there is substantial morbidity and some mortality from iatrogenic pneumothorax.

  2. Detecting Novelty and Significance

    Science.gov (United States)

    Ferrari, Vera; Bradley, Margaret M.; Codispoti, Maurizio; Lang, Peter J.

    2013-01-01

    Studies of cognition often use an “oddball” paradigm to study effects of stimulus novelty and significance on information processing. However, an oddball tends to be perceptually more novel than the standard, repeated stimulus as well as more relevant to the ongoing task, making it difficult to disentangle effects due to perceptual novelty and stimulus significance. In the current study, effects of perceptual novelty and significance on ERPs were assessed in a passive viewing context by presenting repeated and novel pictures (natural scenes) that either signaled significant information regarding the current context or not. A fronto-central N2 component was primarily affected by perceptual novelty, whereas a centro-parietal P3 component was modulated by both stimulus significance and novelty. The data support an interpretation that the N2 reflects perceptual fluency and is attenuated when a current stimulus matches an active memory representation and that the amplitude of the P3 reflects stimulus meaning and significance. PMID:19400680

  3. Global Inequalities in Cervical Cancer Incidence and Mortality are Linked to Deprivation, Low Socioeconomic Status, and Human Development

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh, PhD

    2012-11-01

    Full Text Available Objective: This study examined global inequalities in cervical cancer incidence and mortality rates as a function of cross-national variations in the Human Development Index (HDI, socioeconomic factors, Gender Inequality Index (GII, and healthcare expenditure.Methods: Age-adjusted incidence and mortality rates were calculated for women in 184 countries using the 2008 GLOBOCAN database, and incidence and mortality trends were analyzed using the WHO cancer mortality database. Log-linear regression was used to model annual trends, while OLS and Poisson regression models were used to estimate the impact of socioeconomic and human development factors on incidence and mortality rates.Results: Cervical cancer incidence and mortality rates varied widely, with many African countries such as Guinea, Zambia, Comoros, Tanzania, and Malawi having at least 10-to-20-fold higher rates than several West Asian, Middle East, and European countries, including Iran, Saudi Arabia, Syria, Egypt, and Switzerland. HDI, GII, poverty rate, health expenditure per capita, urbanization, and literacy rate were all significantly related to cervical cancer incidence and mortality, with HDI and poverty rate each explaining >52% of the global variance in mortality. Both incidence and mortality rates increased in relation to lower human development and higher gender inequality levels. A 0.2 unit increase in HDI was associated with a 20% decrease in cervical cancer risk and a 33% decrease in cervical cancer mortality risk. The risk of a cervical cancer diagnosis increased by 24% and of cervical cancer death by 42% for a 0.2 unit increase in GII. Higher health expenditure levels were independently associated with decreased incidence and mortality risks.Conclusions and Public Health Implications: Global inequalities in cervical cancer are clearly linked to disparities in human development, social inequality, and living standards. Reductions in cervical cancer rates are achievable by

  4. Global Inequalities in Cervical Cancer Incidence and Mortality are Linked to Deprivation, Low Socioeconomic Status, and Human Development.

    Science.gov (United States)

    Singh, Gopal K; Azuine, Romuladus E; Siahpush, Mohammad

    2012-01-01

    This study examined global inequalities in cervical cancer incidence and mortality rates as a function of cross-national variations in the Human Development Index (HDI), socioeconomic factors, Gender Inequality Index (GII), and healthcare expenditure. Age-adjusted incidence and mortality rates were calculated for women in 184 countries using the 2008 GLOBOCAN database, and incidence and mortality trends were analyzed using the WHO cancer mortality database. Log-linear regression was used to model annual trends, while OLS and Poisson regression models were used to estimate the impact of socioeconomic and human development factors on incidence and mortality rates. Cervical cancer incidence and mortality rates varied widely, with many African countries such as Guinea, Zambia, Comoros, Tanzania, and Malawi having at least 10-to-20-fold higher rates than several West Asian, Middle East, and European countries, including Iran, Saudi Arabia, Syria, Egypt, and Switzerland. HDI, GII, poverty rate, health expenditure per capita, urbanization, and literacy rate were all significantly related to cervical cancer incidence and mortality, with HDI and poverty rate each explaining >52% of the global variance in mortality. Both incidence and mortality rates increased in relation to lower human development and higher gender inequality levels. A 0.2 unit increase in HDI was associated with a 20% decrease in cervical cancer risk and a 33% decrease in cervical cancer mortality risk. The risk of a cervical cancer diagnosis increased by 24% and of cervical cancer death by 42% for a 0.2 unit increase in GII. Higher health expenditure levels were independently associated with decreased incidence and mortality risks. Global inequalities in cervical cancer are clearly linked to disparities in human development, social inequality, and living standards. Reductions in cervical cancer rates are achievable by reducing inequalities in socioeconomic conditions, availability of preventive health

  5. Causes of visual loss and their risk factors: an incidence summary from the Barbados Eye Studies.

    Science.gov (United States)

    Leske, M Cristina; Wu, Suh-Yuh; Nemesure, Barbara; Hennis, Anselm

    2010-04-01

    To summarize incidence and risk factors for each main cause of visual loss in an African-Caribbean population and discuss the implications of these data from a public health perspective. A nationally representative cohort (n = 4 709; ages 40-84 years at baseline) had ophthalmic and other examinations over 9 years. Incidence rates were estimated by the product-limit approach. Risk factors were evaluated from Cox regression models. Average incidence was ~ 0.1% per year for blindness (visual impairment was high and significantly affected quality of life. Age-related cataract and OAG caused ~ 75% of blindness, indicating the need for public health action to increase appropriate cataract surgery and early OAG detection and treatment. Controlling DM and hypertension would help prevent DR-related complications and could lower cataract risk, further decreasing visual loss.

  6. ALThe incidence of sexually transmitted infections and contagious skin diseases in the Saratov region

    Directory of Open Access Journals (Sweden)

    Schnaider D.A.

    2014-09-01

    Full Text Available Objective: Clinical and epidemiological analysis of the incidence of sexually transmitted infections (STI and the most frequently reported infectious skin diseases in the Saratov region. To estimate the contribution of immigrants to the formation and number of episodes of infections with sexually transmission in the region. Materials and methods. Retrospective evaluation of the incidence and manifestations of the epidemiological process conducted by evaluating data obtained from the forms of state statistical reporting (№ 9 and № 34, annual report of Saratov regional dermatovenerologic dispensary (2009-2013. Results. We carried out a comparative analysis of the incidence of STI and the most common infectious skin diseases of the population of Saratov region and noted resistant dynamics to decrease. Conclusion. Population displacement within the country and the influx of immigrants from the former CIS countries, have a significant impact on the epidemiological situation in the Saratov region

  7. Significant NRC Enforcement Actions

    Data.gov (United States)

    Nuclear Regulatory Commission — This dataset provides a list of Nuclear Regulartory Commission (NRC) issued significant enforcement actions. These actions, referred to as "escalated", are issued by...

  8. Incident Duration Modeling Using Flexible Parametric Hazard-Based Models

    Directory of Open Access Journals (Sweden)

    Ruimin Li

    2014-01-01

    Full Text Available Assessing and prioritizing the duration time and effects of traffic incidents on major roads present significant challenges for road network managers. This study examines the effect of numerous factors associated with various types of incidents on their duration and proposes an incident duration prediction model. Several parametric accelerated failure time hazard-based models were examined, including Weibull, log-logistic, log-normal, and generalized gamma, as well as all models with gamma heterogeneity and flexible parametric hazard-based models with freedom ranging from one to ten, by analyzing a traffic incident dataset obtained from the Incident Reporting and Dispatching System in Beijing in 2008. Results show that different factors significantly affect different incident time phases, whose best distributions were diverse. Given the best hazard-based models of each incident time phase, the prediction result can be reasonable for most incidents. The results of this study can aid traffic incident management agencies not only in implementing strategies that would reduce incident duration, and thus reduce congestion, secondary incidents, and the associated human and economic losses, but also in effectively predicting incident duration time.

  9. Decreasing post-succinylcholine myalgia in outpatients.

    Science.gov (United States)

    Melnick, B; Chalasani, J; Uy, N T; Phitayakorn, P; Mallett, S V; Rudy, T E

    1987-05-01

    The effectiveness of four pretreatment regimens in decreasing succinylcholine-induced myalgias was studied in healthy outpatients undergoing general anaesthesia for ambulatory surgery. Four hundred and forty adult females were randomly assigned to one of four pretreatment groups. Three hundred and ninety-five patients completed the study. One of the following pretreatments was given prior to injection of 1.5 mg X kg-1 of succinylcholine: normal saline IV three minutes and again immediately prior to succinylcholine; 0.06 mg X kg-1 d-tubo-curarine (dTc) IV three minutes prior and normal saline IV immediately prior; normal saline IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior; 0.06 mg X kg-1 dTc IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior. Fasciculations after injection of succinylcholine were observed and recorded. Patients were contacted by telephone 40-48 hours postoperatively and questioned about the presence of muscle pains. These pains, if present, were graded either mild or moderate to severe. The patients in the two dTc-containing groups exhibited less fasciculations than patients in the other two experimental groups. The dTc-lidocaine group had a lower incidence of moderate to severe fasciculations than in any of the other three groups. Patients in the dTc, lidocaine, and dTc-lidocaine experimental groups reported a higher incidence of absence of muscle pain and a lower incidence of moderate-severe pain than did patients in the saline group. The dTc-lidocaine group had more patients without myalgia and less patients with moderate to severe myalgias than any of the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Incidence of childhood leukemia around French nuclear sites between 1990 and 1998

    International Nuclear Information System (INIS)

    White-Koning, M.; Hemon, D.; Goubin, A.; Clavel, J.; Laurier, D.; Tirmarche, M.; Jougla, E.

    2006-01-01

    The works presented here constitute the first systematic study of the incidence of childhood leukemia around the whole of French nuclear facilities. Globally, the incidence of childhood leukemia does not diverge significantly of the expected incidence during the period 1990-1998. It does not show a decrease of S.I.R. (standardized incidence ratio) in function of the distance from child's home to the nuclear site whatever be the age. This study represents the first analysis of the incidence of leukemia focusing on 29 French nuclear sites, including the whole of the 19 C.N.P.E. ( nuclear power plants that produce electric power), and is based on incidence data rather than mortality. The period, the age groups and the studied area have been all chosen a priori, that gives a statistical validity to the results. The estimation of population at risk have been made with several different methods of interpolation in order to check the stability of estimations. The different methods of statistical analysis used have lead to extremely close results, reinforcing our confidence in the reliability of our estimations. The excess of leukemia incidence observed at Chinon and Civaux and the deficit observed at Bruyere/Saclay/Fontenay loose their statistical significance when the correction of Bonferroni is applied. So, the global analysis of the 29 sites and the analysis by site have not shown statistically significant difference between the numbers of observed and expected cases. The study of the 19 C.N.P.E. gave same results, even in taken into account their electric power or their year of service. The possibility of confounding factors has been excluded. The power of the study to detect excess incidence and a decrease of S.I.R. with distance from the site was examined under different alternative hypotheses through simulation methods. For values of S.I.R. near the site (0-5 km) between 1.5 and 2 and a risk of error of 5%, the power of the study is between 96% and 100% depending

  11. Trends in the incidences of acute myocardial infarction in coastal and inland areas in Japan: The Yamagata AMI Registry.

    Science.gov (United States)

    Wanezaki, Masahiro; Watanabe, Tetsu; Nishiyama, Satoshi; Hirayama, Atsushi; Arimoto, Takanori; Takahashi, Hiroki; Shishido, Tetsuro; Miyamoto, Takuya; Kawasaki, Ryo; Fukao, Akira; Kubota, Isao

    2016-08-01

    It has been reported that there are regional differences in the incidence of acute myocardial infarction (AMI) in Japan. The purpose of this study was to investigate trends in regional differences in AMI incidence and dyslipidemia between coastal and inland areas. We investigated trends in AMI incidence and risk factors in 5325 first-ever AMI patients residing in a coastal area (n=1817), a rural inland area (n=1959), or an urban inland area (n=1549) for the periods 1994-2002, and 2003-2010, using data from the Yamagata AMI Registry. Patients in the coastal area were significantly older than those in rural and urban inland areas and had a lower prevalence of dyslipidemia. The age-adjusted incidence rate of AMI was significantly lower in coastal and rural inland areas patients than those from urban inland area (males: 43.3, 42.2, and 51.3/10(5) person-years; females: 17.4, 20.0, and 23.7/10(5) person-years, respectively) during 2 observation periods. Due to a large increase in AMI incidence in younger males of the coastal area and a decrease in AMI incidence in late elderly females of the urban inland area, no significant regional differences in the age-adjusted incidence rates of AMI were observed during the 2003-2010 period in both genders. The increase in AMI incidence in males in the coastal area was associated with an increasing prevalence of dyslipidemia. There were no longer any regional differences observed in AMI incidence, which was considered to be associated with increased dyslipidemia especially in the coastal area. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  12. Correlation between antimicrobial consumption and incidence of health-care-associated infections due to methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci at a university hospital in Taiwan from 2000 to 2010.

    Science.gov (United States)

    Lai, Chih-Cheng; Chu, Chen-Chen; Cheng, Aristine; Huang, Yu-Tsung; Hsueh, Po-Ren

    2015-08-01

    This study was conducted to investigate the correlation between antibiotic consumption and the incidence of health-care-associated infections (HCAIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) (HCAI-MRSA) and vancomycin-resistant enterococci (VREs) (HCAI-VREs) at a university hospital in Taiwan during the period from 2000 to 2010. Data on annual patient-days and annual consumption (defined daily dose/1000 patient-days) of glycopeptides (vancomycin and teicoplanin), linezolid, fusidic acid, tigecycline, and daptomycin were analyzed. Yearly aggregated data on the number of nonduplicate clinical MRSA and VRE isolates causing HCAI were collected. Overall, the consumption of teicoplanin and linezolid significantly increased during the study period. A significant decrease in the incidence of HCAI-MRSA and a significant increase in the incidence of HCAI-VRE were found during the study period. A significant correlation was found between the increased use of teicoplanin and linezolid and the decreased incidence of HCAI-MRSA. By contrast, positive correlations were found between the consumption of teicoplanin and tigecycline and the incidence of HCAI-VRE. This study identified various correlations between the consumption of antibiotics and the incidence of HCAI-MRSA and HCAI-VRE. Strict implementation of infection-control guidelines and reinforcement of administering appropriate antibiotic agents would be helpful in decreasing the incidence of MRSA and VRE in hospitals. Copyright © 2013. Published by Elsevier B.V.

  13. Medication incidents reported to an online incident reporting system.

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

    AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

  14. Age at menopause and incident heart failure: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Ebong, Imo A; Watson, Karol E; Goff, David C; Bluemke, David A; Srikanthan, Preethi; Horwich, Tamara; Bertoni, Alain G

    2014-06-01

    This study aims to evaluate the associations of early menopause (menopause occurring before age 45 years) and age at menopause with incident heart failure (HF) in postmenopausal women. We also explored the associations of early menopause and age at menopause with left ventricular (LV) measures of structure and function in postmenopausal women. We included 2,947 postmenopausal women, aged 45 to 84 years without known cardiovascular disease (2000-2002), from the Multi-Ethnic Study of Atherosclerosis. Cox proportional hazards models were used to examine the associations of early menopause and age at menopause with incident HF. In 2,123 postmenopausal women in whom cardiac magnetic resonance imaging was obtained at baseline, we explored the associations of early menopause and age at menopause with LV measures using multivariable linear regression. Across a median follow-up of 8.5 years, we observed 71 HF events. There were no significant interactions with ethnicity for incident HF (Pinteraction > 0.05). In adjusted analysis, early menopause was associated with an increased risk of incident HF (hazard ratio, 1.66; 95% CI, 1.01-2.73), whereas every 1-year increase in age at menopause was associated with a decreased risk of incident HF (hazard ratio, 0.96; 95% CI, 0.94-0.99). We observed significant interactions between early menopause and ethnicity for LV mass-to-volume ratio (LVMVR; Pinteraction = 0.02). In Chinese-American women, early menopause was associated with a higher LVMVR (+0.11; P = 0.0002), whereas every 1-year increase in age at menopause was associated with a lower LVMVR (-0.004; P = 0.04) at baseline. Older age at menopause is independently associated with a decreased risk of incident HF. Concentric LV remodeling, indicated by a higher LVMVR, is present in Chinese-American women who experienced early menopause at baseline.

  15. Misdiagnosing of malaria as RTI decreased after introduction of RDTs in rural areas of Kenya.

    Science.gov (United States)

    Mamova, Alexandra; Mikolasova, Gertruda; Krčméry, Vladimír; Mulera, Michaela

    2017-11-01

    Clinical presentation of malaria is highly variable and can be mistaken for number of other diseases, including respiratory tract diseases, which are associated with significant morbidity and mortality. However, presumptive management of fever as malaria can result in significant overdiagnosis, even in high-risk areas. Quality microscopy services for the diagnosis of malaria are not widely available in rural areas of Sub-Saharan Africa as well as in substandard conditions of low-income settings and the accuracy of microscopy is usually poor. The aim of the study was to determine how introduction of RDTs influenced diagnostics of malaria in high risk area of Eldoret, Kenya. Documentation of every patient was screened for data of current disease and diagnostic tools used. In patients with suspected malaria, either microscopy, or RDT or both were done to confirm the diagnosis. Initially, incidence of malaria was very high, about 50-70% of all visits in OPD due to any infectious condition. In 2010, when rapid diagnostic tests became available in Eldoret, decrease in incidence of malaria from 49% (2010) to 29% (2011) and further to 5.3% (2016) was noted. At the same time, increased incidence of upper and especially lower respiratory tract infections was noted. Results suggest that upper and lower respiratory tract infections were formerly diagnosed and treated as malaria. Other contributing factors, such as improvement of infrastructure and malaria preventive and treatment programs also play a role in decreasing malaria incidence in rural areas of Kenya, however, RDTs play a key role in proper diagnostics of malaria.

  16. Correlation between levofloxacin consumption and the incidence of nosocomial infections due to fluoroquinolone-resistant Escherichia coli.

    Science.gov (United States)

    Wu, Hui-Hsiu; Liu, Hsin-Yi; Lin, Yi-Chun; Hsueh, Po-Ren; Lee, Yuarn-Jang

    2016-06-01

    The relationship between fluoroquinolone resistance in Escherichia coli isolates causing nosocomial infection and hospital antibiotic consumption were investigated. Restriction of levofloxacin use was implemented to control the incidence of fluoroquinolone-resistant E coli in the hospital. The study was conducted from January 2004 to December 2010. Antimicrobial agent consumption was obtained from the pharmacy computer system and presented as the defined daily doses per 1000 patient-days every 6 months. The incidence of fluoroquinolone-resistant E coli isolates causing nosocomial infections was obtained from the Department of Infection Control every 6 months. An antimicrobial stewardship program, restricting levofloxacain use, was implemented in July 2007. The incidence of fluoroquinolone-resistant E coli causing nosocomial infections was significantly correlated with fluoroquinolone usage (p = 0.005), but not with the use of third- or fourth-generation cephalosporins, piperacillin-tazobactam, or carbapenems. Parenteral (p = 0.002), oral (p = 0.018), and total levofloxacin (p = 0.001) use were significantly correlated with the extent of fluoroquinolone resistance. With a reduction of levofloxacin use, a decrease of the incidence of fluoroquinolone resistance in E coli isolates was observed. There is a significant correlation between levofloxacin use and the incidence of nosocomial fluoroquinolone-resistant E coli isolates. The incidence of fluoroquinolone-resistant E coli could be reduced by limiting levofloxacin consumption. Copyright © 2011. Published by Elsevier B.V.

  17. Colorectal cancer incidence among atomic bomb survivors, 1950-80

    International Nuclear Information System (INIS)

    Nakatsuka, Hirofumi; Shimizu, Yukiko; Yamamoto, Tsutomu

    1992-01-01

    Colorectal cancer incidence in the Life Span Study (LSS) sample during 1950-80 was investigated. A total of 730 incidence cases of colorectal cancer were confirmed from a variety of sources. Sixty-two percent of the cancers were microscopically verified and 12% were ascertained through death certificate only. The risk of colon cancer increased significantly with intestinal dose, but no definite increase of risk was observed for rectal cancer. Relative risk at 1 Sv and excess risk per 10 4 PY-Sv for colon cancer are 1.80 (90% confidence interval 1.37-2.36) and 0.36 (90% confidence interval 0.06-0.77) respectively. City and sex did not significantly modify the dose-response of colon cancer, but the risk decreased with age at the time of bombings (ATB). The relative risk of colon cancer does not vary substantially over time following exposure. A non-linear dose response did not significantly improve the fit. Further, the anatomic location of the tumors indicate that the cecum and ascending, transverse and descending, and sigmoid colon seem equally sensitive to radiation. No difference in the distribution of tumor histological types could be observed by radiation dose. (author)

  18. Colorectal cancer incidence among atomic bomb survivors, 1950-80

    International Nuclear Information System (INIS)

    Hirofumi Nakatsuka; Yukiko Shimizu; Tsutomu Yamamoto; Ichiro Sekine; Haruo Ezaki; Eiichi Tahara; Makoto Takahashi; Takatoshi Shimoyama; Nobuo Mochinaga; Masao Tomita; Ryoichi Tsuchiya; Land, Charles E.

    1992-10-01

    Colerectal cancer incidence in the LSS sample during 1950-80 was investigated. A total of 730 incidence cases of colorectal cancer were confirmed from a variety of sources. Sixty-two percent of the cancers were microscopically verified and 12% were ascertained through death certificate only. The risk of colon cancer increased significantly with intestinal dose, but no definite increase of risk was observed for rectal cancer. Relative risk at 1 Sv and excess risk per 10 4 PY-Sv for colon cancer are 1.80 (90% confidence internal 1.37-2.36) and 0.36 (90% confidence interval 0.06-0.77) respectively. City and sex did not significantly modify the dos-response of colon cancer, but the risk decreased with age at the time of bombings (ATB). The relative risk of colon cancer does not vary substantially over time following exposure. A non-linear dose response did not significantly improve the fit. Further, the anatomic location of the tumors indicate that the cecum and ascending, transverse and descending, and sigmoid colon seem equally sensitive to radiation. No difference in the distribution of tumor histological types could be observed by radiation dose. (author)

  19. Significant decrease in yield under future climate conditions: Stability and production of 138 spring barley accessions

    DEFF Research Database (Denmark)

    Ingvordsen, Cathrine Heinz; Backes, Gunter; Lyngkjær, Michael Foged

    2015-01-01

    The response in production parameters to projected future levels of temperature, atmospheric carbondioxide ([CO2]), and ozone ([O3]) was investigated in 138 spring barley accessions. The comprehensive setof landraces, cultivars, and breeder-lines, were during their entire life cycle exposed...

  20. Russian wheat aphid, Diuraphis noxia in the Czech Republic – cause of the significant population decrease

    Czech Academy of Sciences Publication Activity Database

    Havelka, Jan; Žurovcová, Martina; Rychlý, S.; Starý, Petr

    2014-01-01

    Roč. 138, č. 4 (2014), s. 273-280 ISSN 0931-2048 R&D Projects: GA ČR GA522/09/ 1940 Institutional support: RVO:60077344 Keywords : alien aphid species * anholocyclic populations * aphids overwintering mortality Subject RIV: EH - Ecology, Behaviour Impact factor: 1.650, year: 2014 http://onlinelibrary.wiley.com/doi/10.1111/jen.12068/pdf

  1. Incident users of antipsychotics

    DEFF Research Database (Denmark)

    Baandrup, Lone; Kruse, Marie

    2016-01-01

    PURPOSE: In Denmark, as well as in many other countries, consumption of antipsychotics is on the rise, partly due to increasing off-label use. The aim of this study was to analyze and quantify the extent of off-label use and polypharmacy in incident users of antipsychotic medication, and to examine...... initial antipsychotic prescribing patterns and associated use of mental health care services. METHOD: Population-based cohort study linking the following Danish national registers: the Central Psychiatric Research Register, the Register of Medicinal Product Statistics, and Statistics Denmark. RESULTS...

  2. The Prevalence of Helicobacter pylori Infection Decreases with Older Age in Atrophic Gastritis

    Directory of Open Access Journals (Sweden)

    Shaohua Chen

    2013-01-01

    Full Text Available The clinical pathological characteristics of 3969 adult patients with chronic atrophic gastritis were retrospectively studied. The positivity of intestinal metaplasia and dysplasia in atrophic gastric specimens increased with age; however, H. pylori positivity and inflammatory activity decreased significantly with increased age. H. pylori infection was present in 21.01% of chronic atrophic gastritis patients, and 92.33% of the subjects with H. pylori infection were found to have simultaneous inflammatory activity. The intestinal metaplasia and dysplasia positivity markedly increased as the degree of gastric atrophy increased. In conclusion, the incidence of H. pylori infection decreased with age and correlated significantly with inflammatory activity in atrophic gastritis patients. The intestinal metaplasia and dysplasia positivity notably increased as the degree of gastric atrophy increased. Large population-based prospective studies are needed to better understand the progression of CAG.

  3. Improving freight crash incident management.

    Science.gov (United States)

    2015-06-01

    The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...

  4. Common Causes of Pesticide Incidents

    Science.gov (United States)

    There are many types of pesticide incidents. EPA staff analyze pesticide incident reports involving people (including children and farm workers), pets, domestic animals, wildlife including bees and other pollinators, and the environment.

  5. Incidence and risk of heart failure in systemic lupus erythematosus.

    Science.gov (United States)

    Kim, Chang H; Al-Kindi, Sadeer G; Jandali, Bochra; Askari, Ali D; Zacharias, Michael; Oliveira, Guilherme H

    2017-02-01

    Although case series suggest a higher burden of cardiovascular risk factors in patients with systemic lupus erythematosus (SLE) compared with the general population, the association between SLE and heart failure (HF) remains undefined. We sought to investigate the incidence and risk of HF in patients with SLE. In April 2016, we performed a retrospective cohort analysis using the Explorys platform, which provides aggregated electronic medical record data from 26 major integrated healthcare systems across the USA from 1999 to present. Demographic and regression analyses were performed to assess the impact of SLE on HF incidence. Among 45 284 540 individuals in the database, we identified 95 400 (0.21%) with SLE and 98 900 (0.22%) with a new diagnosis of HF between May 2015 and April 2016. HF incidence was markedly higher in the SLE group compared with controls (0.97% vs 0.22%, relative risk (RR): 4.6 (95% CI 4.3 to 4.9)), as were other cardiovascular risk factors. In regression analysis, SLE was an independent predictor of HF (adjusted OR: 3.17 (2.63 to 3.83), prisk but decreasing RR with advancing age in both sexes. Renal involvement in SLE correlated with earlier and higher incidence of HF. The findings of this study suggest that patients with SLE have significantly higher risk of developing HF and a worse cardiovascular risk profile compared with the general population. These results need to be confirmed by prospective studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Increasing incidence of pyogenic spondylodiscitis

    DEFF Research Database (Denmark)

    Kehrer, Michala; Pedersen, Court; Jensen, Thøger G

    2014-01-01

    Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008.......Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008....

  7. Incident Management: Process into Practice

    Science.gov (United States)

    Isaac, Gayle; Moore, Brian

    2011-01-01

    Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

  8. Evaluating Coincident Relationships Between Obesity Incidence and Normal Weight Incidence From Birth Through Kindergarten for US Children.

    Science.gov (United States)

    Yeaton, William H; Shah, Megha K; Moss, Brian G

    2018-01-01

    We examine the concurrent relationship between obesity incidence and normal weight status incidence and prevalence in children between 9 months and kindergarten. Multistage, probability sample from the Early Childhood Longitudinal Study-Birth cohort. United States. Representative sample of US preschool children (n = 9950) followed from birth through kindergarten. From direct, anthropometric measures, we reported prevalence and incidence rates across 4 follow-up periods. In addition to prevalence and incidence rates, we reported risk ratios based on multiple definitions and estimated predicted probabilities of obesity and normal weight status using clinically meaningful body mass index (BMI)-for-age percentiles. Obesity prevalence (13%-20%) was much smaller than normal weight status prevalence (66%-70%). Lower socioeconomic status, Hispanic, and non-Hispanic black children had greater risk of obesity. During 9 months to kindergarten, obesity incidence decreased two-thirds (15.6%), while normal weight status incidence decreased almost one-half (44.6%). Coincidently, normal weight status incidence (ranged from 23% to 45%) was consistently and substantially higher than obesity incidence (ranged from 5% to 15%). During 4 years to kindergarten, the obesity risk for overweight children was 13 times higher than that for normal weight status children. Overall rates of obese and normal weight incidence were substantial at 9 months, trended lower, but remained high through kindergarten. At 4 years to kindergarten, children with relatively high initial BMI were very likely to become obese but far less likely to achieve normal weight status.

  9. Trends in hepatitis B incidence in Romania, 1989-2005.

    Science.gov (United States)

    Pitigoi, Dana; Rafila, A; Pistol, A; Arama, V; Molagic, V; Streinu-Cercel, Adrian

    2008-01-10

    In the early 1990s, Romania had a high incidence of hepatitis B, with over 30 cases per 100,000 population annually. The disease represented a serious public health problem, especially for children. As a result, public health measures were introduced during the 1990s such as the enforcement of the use of single-use needles and a routine vaccination programme for children and health workers. This paper describes the change in incidence of HBV infection in Romania from the late 1980s until 2005, and demonstrates the impact of those measures. They have lead to a dramatic decrease in hepatitis B incidence across the country: overall, the incidence has decreased from 43 per 100,000 in 1989 to 8.5 per 100,000 in 2004. The decrease has been most prominent in children under 15, dropping from 81 to 11 per 100,000 population and year during that period.

  10. Airplane radiation dose decrease during a strong Forbush decrease

    Czech Academy of Sciences Publication Activity Database

    Spurný, František; Kudela, K.; Dachev, T.

    2004-01-01

    Roč. 2, S05001 (2004), s. 1-4 ISSN 1542-7390 Grant - others:EC project(XE) FIGM-CT2000-00068 Institutional research plan: CEZ:AV0Z1048901 Keywords : airplane dose * Forbush decrease * cosmic rays Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders

  11. The association of the human development index with global kidney cancer incidence and mortality.

    Science.gov (United States)

    Patel, Amit R; Prasad, Sandip M; Shih, Ya-Chen Tina; Eggener, Scott E

    2012-06-01

    We describe contemporary worldwide age standardized incidence and mortality rates for kidney cancer, and their association with social and economic development metrics. We obtained gender specific, age standardized incidence and mortality rates for 184 countries and 16 major world regions from the GLOBOCAN 2008 database. We compared the mortality-to-incidence ratio on the national and regional levels in males and females, and assessed the association with the development level of each country using the United Nations Human Development Index. The age standardized incidence rate varied twentyfold worldwide with the highest rate in North America, and the lowest in Africa and South Central Asia (11.8 vs 1.2 and 1.0/100,000 individuals, respectively). The geographic distribution of the age standardized mortality rate was similar to that of the age standardized incidence rate with the highest rates in Europe and North America (3.1 and 2.6/100,000 individuals, respectively) and the lowest rates in Asian and African regions (0.6 to 1.5). Age standardized incidence and mortality rates were 4.5 and 2.8 times higher, respectively, in more developed countries than in developing countries. However, the mortality-to-incidence ratio was highest in Africa and Asia, and lowest in North America (0.6 to 0.8 vs 0.2/100,000 individuals). There was a strong inverse relationship between the Human Development Index and the mortality-to-incidence ratio (regression coefficient -0.79, p<0.0001). Kidney cancer incidence and mortality rates vary widely throughout the world while the mortality-to-incidence ratio is highest in less developed nations. These observations suggest significant health care disparities and may reflect differences in risk factors, health care access, quality of care, diagnostic modalities and treatment options available. Future research should assess whether the mortality-to-incidence ratio decreases with increasing development. Copyright © 2012 American Urological

  12. Significant Tsunami Events

    Science.gov (United States)

    Dunbar, P. K.; Furtney, M.; McLean, S. J.; Sweeney, A. D.

    2014-12-01

    Tsunamis have inflicted death and destruction on the coastlines of the world throughout history. The occurrence of tsunamis and the resulting effects have been collected and studied as far back as the second millennium B.C. The knowledge gained from cataloging and examining these events has led to significant changes in our understanding of tsunamis, tsunami sources, and methods to mitigate the effects of tsunamis. The most significant, not surprisingly, are often the most devastating, such as the 2011 Tohoku, Japan earthquake and tsunami. The goal of this poster is to give a brief overview of the occurrence of tsunamis and then focus specifically on several significant tsunamis. There are various criteria to determine the most significant tsunamis: the number of deaths, amount of damage, maximum runup height, had a major impact on tsunami science or policy, etc. As a result, descriptions will include some of the most costly (2011 Tohoku, Japan), the most deadly (2004 Sumatra, 1883 Krakatau), and the highest runup ever observed (1958 Lituya Bay, Alaska). The discovery of the Cascadia subduction zone as the source of the 1700 Japanese "Orphan" tsunami and a future tsunami threat to the U.S. northwest coast, contributed to the decision to form the U.S. National Tsunami Hazard Mitigation Program. The great Lisbon earthquake of 1755 marked the beginning of the modern era of seismology. Knowledge gained from the 1964 Alaska earthquake and tsunami helped confirm the theory of plate tectonics. The 1946 Alaska, 1952 Kuril Islands, 1960 Chile, 1964 Alaska, and the 2004 Banda Aceh, tsunamis all resulted in warning centers or systems being established.The data descriptions on this poster were extracted from NOAA's National Geophysical Data Center (NGDC) global historical tsunami database. Additional information about these tsunamis, as well as water level data can be found by accessing the NGDC website www.ngdc.noaa.gov/hazard/

  13. Cancer incidence in atomic bomb survivors. Part IV: Comparison of cancer incidence and mortality

    International Nuclear Information System (INIS)

    Ron, E.; Preston, D.L.; Mabuchi, Kiyohiko; Thompson, D.E.; Soda, Midori

    1994-01-01

    This report compares cancer incidence and mortality among atomic bomb survivors in the Radiation Effects Research Foundation Life Span Study (LSS) cohort. Because the incidence data are derived from the Hiroshima and Nagasaki tumor registries, case ascertainment is limited to the time (1958-1987) and geographic restrictions (Hiroshima and Nagasaki) of the registries, whereas mortality data are available from 1950-1987 anywhere in Japan. With these conditions, there were 9,014 first primary incident cancer cases identified among LSS cohort members compared with 7,308 deaths for which cancer was listed as the underlying cause of death on death certificates. When deaths were limited to those occurring between 1958-1987 in Hiroshima or Nagasaki, there were 3,155 more incident cancer cases overall, and 1,262 more cancers of the digestive system. For cancers of the oral cavity and pharynx, skin, breast, female and male genital organs, urinary system and thyroid, the incidence series was at least twice as large as the comparable mortality series. Although the incidence and mortality data are dissimilar in many ways, the overall conclusions regarding which solid cancers provide evidence of a significant dose response generally confirm the mortality findings. When either incidence or mortality data are evaluated, significant excess risks are observed for all solid cancers, stomach, colon, liver (when it is defined as primary liver cancer or liver cancer not otherwise specified on the death certificate), lung, breast, ovary and urinary bladder. No significant radiation effect is seen for cancers of the pharynx, rectum, gallbladder, pancreas, nose, larynx, uterus, prostate or kidney in either series. There is evidence of a significant excess of nonmelanoma skin cancer in the incidence data, but not in the mortality series. 19 refs., 2 figs., 10 tabs

  14. Grazing incidence beam expander

    Energy Technology Data Exchange (ETDEWEB)

    Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

    1985-01-01

    A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

  15. Elevated plasma homocysteine in association with decreased ...

    African Journals Online (AJOL)

    Conclusion: This study showed a significant increase in plasma tHcy coexisting with a decrease in plasma vitamin B12 TC, LDLC and HDLC, in depressed patients. Increased plasma homocysteine could be a sensitive indicator of plasma B vitamin deficiency. Keywords: Cholesterol; Depression; Homocysteine; Tryptophan; ...

  16. The incidence of schizophrenia and schizophrenia spectrum disorders in Denmark in the period 2000-2012. A register-based study.

    Science.gov (United States)

    Kühl, Johanne Olivia Grønne; Laursen, Thomas Munk; Thorup, Anne; Nordentoft, Merete

    2016-10-01

    We aimed to examine changes over time in the incidence of broad and narrow schizophrenia spectrum disorders in Denmark from 2000 to 2012. Patients were classified as incident schizophrenia if registered with a first time in- or outpatient contact with relevant diagnostic codes in the Danish Psychiatric Central Register between 2000 and 2012. Their history of contacts was traced back to 1969. Broad schizophrenia included schizophrenia, schizotypal disorder, persistent delusional disorder, acute and transient psychotic disorders, schizoaffective disorders, and other nonorganic and unspecified psychotic disorders, (ICD 10 codes F20-F29). Narrow schizophrenia was defined with the ICD 10 codes F20.0-F20.9. Incidence rates (IR) and incidence rate ratios (IRR) were calculated using Poisson regression. The IRR for broad schizophrenia increased by 1.43 (CI 95% 1.34-1.52) for females and 1.26 (CI 95% 1.20-1.33) for males. IRR for narrow schizophrenia increased by 1.36 (CI 95% 1.24-1.48) for females and 1.20 (CI 95% 1.11-1.29) for males. There was a significantly increased incidence in patients up to 32years of age. This was mainly explained by a significant 2-3 fold increase in outpatient incidence. We found a significant decrease in IRR for patients with broad and narrow schizophrenia aged 33 or older for both in- and outpatients. The increased incidence of schizophrenia could partly be explained by better implementation of the diagnostic criteria for schizophrenia in child and adolescent psychiatry and improved access to early intervention services, but a true increase in incidence of schizophrenia cannot be excluded. The decrease of incidence in the older age group could indicate that the national Danish early intervention strategy was successful. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Lung cancer incidence after exposure of rats to low doses of radon: influence of dose rate

    International Nuclear Information System (INIS)

    Morlier, J.P.; Morin, M.; Monchaux, G.; Fritsch, P.; Lafuma, J.; Masse, R.; Chameaud, J.

    1994-01-01

    To study the effect on lung cancer incidence of a long exposure to low levels of radon, 500 male 3-months-old Sprague-Dawley rats, were exposed to a cumulative dose of 25 WLM of radon and its daughters, 6 hours a day, 5 days a week, during 18 months. Exposure conditions were controlled in order to maintain a defined PAEC: 42 x 10 6 J.m -3 (2 WL), in the range of domestic and environmental exposures. Animals were kept until they died or given euthanasia when moribund. Mean survival times were similar in both irradiated and control groups: 828 days (SD = 169) and 830 days (SD = 137), as well as lung cancer incidence, 0.60% at 25 WLM and 0.63% for controls. The incidence of lung lesions was compared statistically with controls and those previously obtained at cumulative exposures of 25 and 50 WLM delivered over a 4-6 month period, inducing a significant increase of lung cancer, 2.2% and 3.8% respectively. Such a comparison showed a decreased lung cancer incidence related to a decrease in the dose rate for low levels of radon exposure. (author)

  18. Lung cancer incidence after exposure of rats to low doses of radon: influence of dose rate

    Energy Technology Data Exchange (ETDEWEB)

    Morlier, J.P.; Morin, M.; Monchaux, G.; Fritsch, P.; Lafuma, J.; Masse, R. [CEA Centre d`Etudes Nucleaires de Fontenay-aux-Roses, 92 (France). Dept. de Protection Technique; Pineau, J.F. [ALGADE, Bessines (France); Chameaud, J. [Compagnie Generale des Matieres Nucleaires (COGEMA), 87 - Razes (France)

    1994-12-31

    To study the effect on lung cancer incidence of a long exposure to low levels of radon, 500 male 3-months-old Sprague-Dawley rats, were exposed to a cumulative dose of 25 WLM of radon and its daughters, 6 hours a day, 5 days a week, during 18 months. Exposure conditions were controlled in order to maintain a defined PAEC: 42 x 10{sup 6} J.m{sup -3} (2 WL), in the range of domestic and environmental exposures. Animals were kept until they died or given euthanasia when moribund. Mean survival times were similar in both irradiated and control groups: 828 days (SD = 169) and 830 days (SD = 137), as well as lung cancer incidence, 0.60% at 25 WLM and 0.63% for controls. The incidence of lung lesions was compared statistically with controls and those previously obtained at cumulative exposures of 25 and 50 WLM delivered over a 4-6 month period, inducing a significant increase of lung cancer, 2.2% and 3.8% respectively. Such a comparison showed a decreased lung cancer incidence related to a decrease in the dose rate for low levels of radon exposure. (author).

  19. Age and ethnic disparities in incidence of stroke over time: the South London Stroke Register.

    Science.gov (United States)

    Wang, Yanzhong; Rudd, Anthony G; Wolfe, Charles D A

    2013-12-01

    Data on continuous monitoring of stroke risk among different age and ethnic groups are lacking. We aimed to investigate age and ethnic disparities in stroke incidence over time from an inner-city population-based stroke register. Trends in stroke incidence and before-stroke risk factors were investigated with the South London Stroke Register, a population-based register covering a multiethnic population of 357 308 inhabitants. Age-, ethnicity-, and sex-specific incidence rates with 95% confidence intervals were calculated, assuming a Poisson distribution and their trends over time tested by the Cochran-Armitage test. Four thousand two hundred forty-five patients with first-ever stroke were registered between 1995 and 2010. Total stroke incidence reduced by 39.5% during the 16-year period from 247 to 149.5 per 100 000 population (Pstroke incidence were observed in men, women, white groups, and those aged>45 years, but not in those aged 15 to 44 years (12.6-10.1; P=0.2034) and black groups (310.1-267.5; P=0.3633). The mean age at stroke decreased significantly from 71.7 to 69.6 years (P=0.0001). The reduction in prevalence of before-stroke risk factors was mostly seen in white patients aged>55 years, whereas an increase in diabetes mellitus was observed in younger black patients aged 15 to 54 years. Total stroke incidence decreased during the 16-year time period. However, this was not seen in younger age groups and black groups. The advances in risk factor reduction observed in white groups aged>55 years failed to be transferred to younger age groups and black groups.

  20. Trends in the incidence of lower limb amputation after implementation of a Multidisciplinary Diabetic Foot Unit.

    Science.gov (United States)

    Jiménez, Sara; Rubio, José Antonio; Álvarez, Julia; Ruiz-Grande, Fernando; Medina, Carlos

    2017-04-01

    Incidence of lower extremity amputations (LEA) in the population with and without diabetes mellitus (DM) was assessed after implementation of a Multidisciplinary Diabetic Foot Unit (MDFU) during 2008. Non-traumatic LEA were analyzed, and those performed before (2001-2007) and after (2008-2014) introduction of the MDFU were compared. LEA were grouped by age and sex. Their incidence was expressed as a rate per 100,000 population per year, adjusted to the standard European population. A total of 664 LEA were performed during the 2001-2014 period, 486 (73%) of them in patients with DM. Total LEA incidence was 11.2/10 5 population in DM versus 3.9/10 5 in the population without DM. Incidence of major LEA in patients with DM significantly decreased from 6.1/10 5 population in the 2001-2007 period to 4.5/10 5 in the 2008-2014 period (p=.03). Joinpoint regression analysis also showed a reduction in the trend of incidence of major LEA in patients with DM, with an annual percentage change of -3.3% [95% CI, -6.2-0.3] (p=.025). No significant differences were found for all other incidences and trends in the diabetic and non-diabetic populations. Implementation of a MDFU has been shown to be associated with a significant reduction in major amputation rate in the diabetic population, although the results are not optimal yet. Both results and work at the MDFU should be improved. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Clinical study on the incidence of vancomycin intraocular injection in treatment with suppurative endophthalmitis

    Directory of Open Access Journals (Sweden)

    Yi-Qin Duan

    2015-05-01

    Full Text Available AIM:To estimate the clinical significance of the microculture of humor and vitreous and vancomycin intraocular injection in treatment of suppurative endophthalmitis associated with intraocular foreign bodies.METHODS: Totally 65 patients with penetrating eye trauma and retained intraocular foreign bodies in emergency operation and intraocular injection from January 2012 to September 2014 were regarded as the study group, another 62 patients with penetrating eye trauma and retained intraocular foreign bodies in emergency operation without intraocular injection before August 2011 were regarded as the control group. Aqueous humor and vitreous humor were taken from each patient of the study group and the control group for bacteria and fungus cultivation. The study group was treated with 1mg vancomycin intraocular injection after operation, while the control group was not. RESULTS: The incidence of endophthalmitis in the control group was 16%(10 cases, while in the study group was 3%(2 cases, with significant difference between two groups(x2=6.32, PP>0.05. The positive rate of vitreous humor germiculture in study group was 14%(9 cases, and the incidence of endophthalmitis was 3%. The positive rate of vitreous humor germiculture in control group was 11%(7 casesand the incidence of endophthalmitis was 16%, with significant differences between two groups(PCONCLUSION: Intraocular foreign bodies treated with emergency operation and vancomycin intraocular injections can decrease the incidence of suppurative endophthalmitis and have a good vision prognosis for the second stage of operation.

  2. Annual incidences of visual impairment during 10-year period in Mie prefecture, Japan.

    Science.gov (United States)

    Ikesugi, Kengo; Ichio, Takako; Tsukitome, Hideyuki; Kondo, Mineo

    2017-07-01

    To determine the annual incidence of visual impairment in a Japanese population during a 10-year period. We examined the physical disability certificates issued yearly between 2004 and 2013 in Mie prefecture, Japan. During this period 2468 visually impaired people were registered under the newly defined Act on Welfare of the Physically Disabled Persons' criteria. The age, sex distribution, and causes of visual impairment were determined from the certificates. The major causes of visual impairment during the ten-year period were glaucoma (23.3%), diabetic retinopathy (17.3%), retinitis pigmentosa (12.2%), macular degeneration (9.0%), chorioretinal degeneration or high myopia (7.4%), optic atrophy (5.8%), stroke or brain tumor (5.4%) and cataracts (3.7%). The incidence of glaucoma was significantly higher throughout the period (2004-2013), and that of diabetic retinopathy was lower between 2007 and 2013. The incidence of retinitis pigmentosa did not change significantly during the 10-year period. The incidence of macular degeneration tended to increase between 2004 and 2007, but it decreased significantly between 2007 and 2013. The results indicate that in Japan, the rates of the major causes of visual impairment altered in the most recent 10-year period reflecting the recent changes in the social background and advances in ocular and systemic treatment.

  3. Oral Health Education Program on Dental Caries Incidence for School Children.

    Science.gov (United States)

    Jaime, R A; Carvalho, T S; Bonini, G C; Imparato, Jcp; Mendes, F M

    2015-01-01

    This 3-year retrospective controlled clinical trial assessed the effect of a school-based oral health education program on caries incidence in children. A total of 240 students, aged 5 to 7 years, from two public schools in Monte Sião, Brazil, were included in this study. A school-based oral health education program was developed in one of the schools (experimental group), including 120 students, while the 120 students from the other school did not participate in the program (control group). All children were initially examined for dental caries (dmf-t), and after 3 years, 98 children from the experimental group and 96 from the control group were again examined and answered a questionnaire on oral health issues. The between-groups difference in caries incidence on permanent teeth was calculated using Poisson regression analyses. Logistic regression was used to observe the association between caries incidence and other variables. More students from the experimental group stated knowing what was dental caries and declared that they use dental floss daily, but no significant differences in caries incidence was observed between the experimental and control groups. The school-based oral health education program is not adequately efficient to decrease caries incidence after three years, but some issues about oral health knowledge could be slightly improved.

  4. Childhood cancer incidence and survival in Japan and England: A population-based study (1993-2010).

    Science.gov (United States)

    Nakata, Kayo; Ito, Yuri; Magadi, Winnie; Bonaventure, Audrey; Stiller, Charles A; Katanoda, Kota; Matsuda, Tomohiro; Miyashiro, Isao; Pritchard-Jones, Kathy; Rachet, Bernard

    2018-02-01

    The present study aimed to compare cancer incidence and trends in survival for children diagnosed in Japan and England, using population-based cancer registry data. The analysis was based on 5192 children with cancer (age 0-14 years) from 6 prefectural cancer registries in Japan and 21 295 children diagnosed in England during 1993-2010. Differences in incidence rates between the 2 countries were measured with Poisson regression models. Overall survival was estimated using the Kaplan-Meier method. Incidence rates for Hodgkin lymphoma, renal tumors and Ewing sarcomas in England were more than twice as high as those in Japan. Incidence of germ cell tumors, hepatic tumors, neuroblastoma and acute myeloid leukemia (AML) was higher in Japan than in England. Incidence of all cancers combined decreased in Japan throughout the period 1993 to 2010, which was mainly explained by a decrease in registration of neuroblastoma in infants. For many cancers, 5-year survival improved in both countries. The improvement in survival in chronic myeloid leukemia (CML) was particularly dramatic in both countries. However, 5-year survival remained less than 80% in 2005-2008 in both countries for AML, brain tumors, soft tissue sarcomas, malignant bone tumors and neuroblastoma (age 1-14 years). There were significant differences in incidence of several cancers between countries, suggesting variation in genetic susceptibility and possibly environmental factors. The decrease in incidence for all cancers combined in Japan was related to the cessation of the national screening program for neuroblastoma. The large improvement in survival in CML coincided with the introduction of effective therapy (imatinib). © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  5. Significant engineering developments

    International Nuclear Information System (INIS)

    Pon, G.A.

    1987-01-01

    The CANDU nuclear power system is a successful product of creative intelligence combined with the tenacious pursuit of practical solutions to complex engineering challenges. Outstanding engineering developments have transformed a demanding technology into a safe, economic and reliable one. Among the noteworthy developments that have been made CANDU the world's best performing reactor system are those relating to fuel, pressure tubes, heavy water production and management, steam generators, live-load valve packing, pump seals, on-power refuelling and computer control. In addition to pragmatic engineering accomplishments, there has been significant engineering input to guide the direction and shaping of the unique form of safety design and regulation of the CANDU system

  6. Incidence, symptomatology and aetiological factors for Asherman's ...

    African Journals Online (AJOL)

    Background: Asherman's syndrome is a significant cause of secondary amenorrhoea and infertility in Nigeria. It is largely preventable and safe practices will make it rare. Aim: To determine the incidence, symptomatology and aetiological factors for Asherman's syndrome in Orlu, South East Nigeria. Methods: A prospective ...

  7. Aluminum-induced testosterone decrease results in physiological ...

    African Journals Online (AJOL)

    A significant decrease in both serotonin and dopamine levels was simultaneously obtained with the decrease of testosterone level especially at the high dose of aluminum. In contrast, at the high dose, acetylcholine recorded significantly high value. In conclusion, aluminum-induced testosterone decrease resulted in a ...

  8. Aspirin as a Promising Agent for Decreasing Incidence of Cerebral Aneurysm Rupture

    NARCIS (Netherlands)

    Hasan, David M.; Mahaney, Kelly B.; Brown, Robert D.; Meissner, Irene; Piepgras, David G.; Huston, John; Capuano, Ana W.; Torner, James C.; Groen, R.J.M.

    2011-01-01

    Background and Purpose-Chronic inflammation is postulated as an important phenomenon in intracranial aneurysm wall pathophysiology. This study was conducted to determine if aspirin use impacts the occurrence of intracranial aneurysm rupture. Methods-Subjects enrolled in the International Study of

  9. Forbush decreases registered onboard aircraft

    Czech Academy of Sciences Publication Activity Database

    Spurný, František; Kudela, K.; Dachev, T.

    2005-01-01

    Roč. 36, č. 9 (2005), s. 1634-1637 ISSN 0273-1177 Institutional research plan: CEZ:AV0Z10480505 Keywords : Forbush decrease * aircraft exposure * Si-detector Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 0.706, year: 2005

  10. Data analysis of grade crossing incidents : research results.

    Science.gov (United States)

    2011-12-01

    Incidents and fatalities at highway-rail grade crossing in the United States have declined significantly over the past two decades despite a significant increase in both train and vehicle traffic. Therefore, to provide a more realistic comparison of ...

  11. Safety significance evaluation system

    International Nuclear Information System (INIS)

    Lew, B.S.; Yee, D.; Brewer, W.K.; Quattro, P.J.; Kirby, K.D.

    1991-01-01

    This paper reports that the Pacific Gas and Electric Company (PG and E), in cooperation with ABZ, Incorporated and Science Applications International Corporation (SAIC), investigated the use of artificial intelligence-based programming techniques to assist utility personnel in regulatory compliance problems. The result of this investigation is that artificial intelligence-based programming techniques can successfully be applied to this problem. To demonstrate this, a general methodology was developed and several prototype systems based on this methodology were developed. The prototypes address U.S. Nuclear Regulatory Commission (NRC) event reportability requirements, technical specification compliance based on plant equipment status, and quality assurance assistance. This collection of prototype modules is named the safety significance evaluation system

  12. Mindfulness-based stress reduction teachers, practice characteristics, cancer incidence, and health: a nationwide ecological description.

    Science.gov (United States)

    Robb, Sara Wagner; Benson, Kelsey; Middleton, Lauren; Meyers, Christine; Hébert, James R

    2015-02-14

    Studies have demonstrated the potential of the Mindfulness-Based Stress Reduction (MBSR) program to improve the condition of individuals with health outcomes such as hypertension, diabetes, and chronic pain; improve psychological well-being; reduce stress levels; and increase survival among cancer patients. To date, only one study has focused on the effect of long-term meditation on stress, showing a positive protective relationship. However, the relationship between meditation and cancer incidence remains unexplored. The objective of this study was to describe the state-level relationship between MBSR instructors and their practices and county-level health outcomes, including cancer incidence, in the United States. This ecologic study was performed using geospatial mapping and descriptive epidemiology of statewide MBSR characteristics and overall health, mental health state rankings, and age-adjusted cancer incidence rates. Weak to moderate state-level correlations between meditation characteristics and colorectal and cervical cancer incidence were detected, with states with more meditation (e.g., more MBSR teachers per population) correlated with a decreased cancer incidence. A negative correlation was detected between lung & bronchus cancer and years teaching MBSR only. Moderate positive correlations were detected between Hodgkin's Lymphoma and female breast cancer in relation to all meditation characteristics. Statistically significant correlations with moderate coefficients were detected for overall health ranks and all meditation characteristics, most strongly for total number of years teaching MBSR and total number of years of general meditation practice. Our analyses might suggest that a relationship exists between the total number of MBSR teachers per state and the total number of years of general meditation practice per state, and colorectal and cervical cancer incidence. Positive correlations were observed with overall health rankings. Despite this study

  13. Mortality and Incidence of Hospital Admissions for Stroke among Brazilians Aged 15 to 49 Years between 2008 and 2012.

    Directory of Open Access Journals (Sweden)

    Fernando Adami

    Full Text Available The objective was to analyze rates of stroke-related mortality and incidence of hospital admissions in Brazilians aged 15 to 49 years according to region and age group between 2008 and 2012.Secondary analysis was performed in 2014 using data from the Hospital and Mortality Information Systems and the Brazilian Institute of Geography and Statistics. Stroke was defined by ICD, 10th revision (I60-I64. Crude and standardized mortality (WHO reference and incidence of hospital admissions per 100,000 inhabitants, stratified by region and age group, were estimated. Absolute and relative frequencies; and linear regression were also used. The software used was Stata 11.0.There were 35,005 deaths and 131,344 hospital admissions for stroke in Brazilians aged 15-49 years old between 2008 and 2012. Mortality decreased from 7.54 (95% CI 7.53; 7.54 in 2008 to 6.32 (95% CI 6.31; 6.32 in 2012 (β = -0.27, p = 0.013, r2 = 0.90. During the same time, incidence of hospital admissions stabilized: 24.67 (95% CI 24.66; 24.67 in 2008 and 25.11 (95% CI 25.10; 25.11 in 2012 (β = 0.09, p = 0.692, r2 = 0.05. There was a reduction in mortality in all Brazilian regions and in the age group between 30 and 49 years. Incidence of hospitalizations decreased in the South, but no significant decrease was observed in any age group.We observed a decrease in stroke-related mortality, particularly in individuals over 30 years old, and stability of the incidence of hospitalizations; and also regional variation in stroke-related hospital admission incidence and mortality among Brazilian young adults.

  14. Mortality and Incidence of Hospital Admissions for Stroke among Brazilians Aged 15 to 49 Years between 2008 and 2012

    Science.gov (United States)

    Adami, Fernando; Figueiredo, Francisco Winter dos Santos; Paiva, Laércio da Silva; de Sá, Thiago Hérick; Santos, Edige Felipe de Sousa; Martins, Bruno Luis; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos

    2016-01-01

    Introduction The objective was to analyze rates of stroke-related mortality and incidence of hospital admissions in Brazilians aged 15 to 49 years according to region and age group between 2008 and 2012. Methods Secondary analysis was performed in 2014 using data from the Hospital and Mortality Information Systems and the Brazilian Institute of Geography and Statistics. Stroke was defined by ICD, 10th revision (I60–I64). Crude and standardized mortality (WHO reference) and incidence of hospital admissions per 100,000 inhabitants, stratified by region and age group, were estimated. Absolute and relative frequencies; and linear regression were also used. The software used was Stata 11.0. Results There were 35,005 deaths and 131,344 hospital admissions for stroke in Brazilians aged 15–49 years old between 2008 and 2012. Mortality decreased from 7.54 (95% CI 7.53; 7.54) in 2008 to 6.32 (95% CI 6.31; 6.32) in 2012 (β = -0.27, p = 0.013, r2 = 0.90). During the same time, incidence of hospital admissions stabilized: 24.67 (95% CI 24.66; 24.67) in 2008 and 25.11 (95% CI 25.10; 25.11) in 2012 (β = 0.09, p = 0.692, r2 = 0.05). There was a reduction in mortality in all Brazilian regions and in the age group between 30 and 49 years. Incidence of hospitalizations decreased in the South, but no significant decrease was observed in any age group. Conclusion We observed a decrease in stroke-related mortality, particularly in individuals over 30 years old, and stability of the incidence of hospitalizations; and also regional variation in stroke-related hospital admission incidence and mortality among Brazilian young adults. PMID:27332892

  15. Tuberculosis incidence in prisons: a systematic review.

    Science.gov (United States)

    Baussano, Iacopo; Williams, Brian G; Nunn, Paul; Beggiato, Marta; Fedeli, Ugo; Scano, Fabio

    2010-12-21

    Transmission of tuberculosis (TB) in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI) and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF%) to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR) for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8) and 23.0 (IQR: 11.7-36.1), respectively. The median estimated fraction (PAF%) of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9%) and 6.3% (IQR: 2.7%-17.2%) in high- and middle/low-income countries, respectively. The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.

  16. SU-E-P-07: Retrospective Analysis of Incident Reports at a Radiology Department: Feedback From Incident Reporting System

    Energy Technology Data Exchange (ETDEWEB)

    Kakinohana, Y; Toita, T; Heianna, J; Murayama, S [School of medicine, University of the Ryukyus, Nishihara-cho, Okinawa (Japan)

    2015-06-15

    Purpose: To provide an overview of reported incidents that occurred in a radiology department and to describe the most common causal source of incidents. Methods: Incident reports from the radiology department at the University of the Ryukyus Hospital between 2008 and 2013 were collected and analyzed retrospectively. The incident report form contains the following items, causal factors of the incident and desirable corrective actions to prevent recurrence of similar incidents. These items allow the institution to investigate/analyze root causes of the incidents and suggest measures to be taken to prevent further, similar incidents. The ‘causal factors of the incident’ item comprises multiple selections from among 24 selections and includes some synonymous selections. In this study, this item was re-categorized into four causal source types: (i) carelessness, (ii) lack of skill or knowledge, (iii) deficiencies in communication, and (iv) external factors. Results: There were a total of 7490 incident reports over the study period and 276 (3.7%) were identified as originating from the radiology department. The most frequent causal source type was carelessness (62%). The other three types showed similar frequencies (10–14%). The staff members involved in incidents indicate three predominant desirable corrective actions to prevent or decrease the recurrence of similar incidents. These are ‘improvement in communication’ (24%), ‘staff training/education’ (19%), and ‘daily medical procedures’ (22%), and the most frequent was ‘improvement in communication’. Even though the most frequent causal factor was related to carelessness, the most desirable corrective action indicated by the staff members was related to communication. Conclusion: Our finding suggests that the most immediate causes are strongly related to carelessness. However, the most likely underlying causes of incidents would be related to deficiencies in effective communication. At our

  17. Worldwide Increasing Incidences of Cutaneous Malignant Melanoma

    Directory of Open Access Journals (Sweden)

    Dianne E. Godar

    2011-01-01

    Full Text Available The incidence of cutaneous malignant melanoma (CMM has been increasing at a steady rate in fair-skinned populations around the world for decades. Scientists are not certain why CMM has been steadily increasing, but strong, intermittent UVB (290–320 nm exposures, especially sunburn episodes, probably initiate, CMM, while UVA (321–400 nm passing through glass windows in offices and cars probably promotes it. The CMM incidence may be increasing at an exponential rate around the world, but it definitely decreases with increasing latitude up to ~50°N where it reverses and increases with the increasing latitude. The inversion in the incidence of CMM may occur because there is more UVA relative to UVB for most of the year at higher latitudes. If windows, allowing UVA to enter our indoor-working environment and cars, are at least partly responsible for the increasing incidence of CMM, then UV filters can be applied to reduce the rate of increase worldwide.

  18. Tumor significant dose

    International Nuclear Information System (INIS)

    Supe, S.J.; Nagalaxmi, K.V.; Meenakshi, L.

    1983-01-01

    In the practice of radiotherapy, various concepts like NSD, CRE, TDF, and BIR are being used to evaluate the biological effectiveness of the treatment schedules on the normal tissues. This has been accepted as the tolerance of the normal tissue is the limiting factor in the treatment of cancers. At present when various schedules are tried, attention is therefore paid to the biological damage of the normal tissues only and it is expected that the damage to the cancerous tissues would be extensive enough to control the cancer. Attempt is made in the present work to evaluate the concent of tumor significant dose (TSD) which will represent the damage to the cancerous tissue. Strandquist in the analysis of a large number of cases of squamous cell carcinoma found that for the 5 fraction/week treatment, the total dose required to bring about the same damage for the cancerous tissue is proportional to T/sup -0.22/, where T is the overall time over which the dose is delivered. Using this finding the TSD was defined as DxN/sup -p/xT/sup -q/, where D is the total dose, N the number of fractions, T the overall time p and q are the exponents to be suitably chosen. The values of p and q are adjusted such that p+q< or =0.24, and p varies from 0.0 to 0.24 and q varies from 0.0 to 0.22. Cases of cancer of cervix uteri treated between 1978 and 1980 in the V. N. Cancer Centre, Kuppuswamy Naidu Memorial Hospital, Coimbatore, India were analyzed on the basis of these formulations. These data, coupled with the clinical experience, were used for choice of a formula for the TSD. Further, the dose schedules used in the British Institute of Radiology fraction- ation studies were also used to propose that the tumor significant dose is represented by DxN/sup -0.18/xT/sup -0.06/

  19. Increasing incidence of invasive and in situ cervical adenocarcinoma in the Netherlands during 2004-2013

    NARCIS (Netherlands)

    van der Horst, J. (Judith); A.G. Siebers (Albertus); J. Bulten (Johannes); L.F. Massuger (Leon); de Kok, I.M. (Inge Mcm)

    2017-01-01

    textabstractIn the developed world, the incidence of cervical squamous cell carcinoma has decreased, however, the incidence of adenocarcinoma in situ (AIS) and invasive adenocarcinoma increased, predominantly in young females. The goal of this study was to evaluate the most recent incidence rates of

  20. Decreased Levels of Circulating Cancer-Associated Protein Biomarkers Following Bariatric Surgery.

    Science.gov (United States)

    Farey, John Edward; Fisher, Oliver M; Levert-Mignon, Angelique J; Forner, Patrice M; Lord, Reginald V

    2017-03-01

    Epidemiological studies have identified obesity as a major risk factor for cancer in humans, and trials have demonstrated a significant reduction in the incidence of cancer after bariatric surgery. The rapidity of weight loss after bariatric surgery provides an opportunity to identify the molecular changes associated with effective obesity treatment. Indirectly, this may provide some insights into the mechanisms that drive the association between obesity and cancer. We sought to measure circulating cancer-associated proteins before and after laparoscopic sleeve gastrectomy (LSG). We prospectively enrolled 15 patients undergoing LSG. Thirty-four plasma protein biomarkers thought to be associated with cancer processes were analyzed at baseline and following successful weight loss at 12 weeks using a multiplex bead-based assay. Mean excess body weight loss was 44 % at 12-week follow-up. After LSG, a significant reduction in circulating plasma levels was observed for half (17/34) of the proteins assessed: VEGF-A, VEGF-C, VEGF-D, endoglin, PLGF, sFASL, IGFBP-1, IL-18, prolactin, EGF, TGFα, sCD40L, IL-18, TNFα, IL-6, HB-EGF, and PAI-1. Nonsignificant decreases were found for the remaining proteins. Circulating cancer-related biomarker levels were reduced by surgical weight loss, and this benefit was achieved as early as 3 months after operation. The observed reduction in cancer biomarkers may be related to the reported decrease in cancer incidence following bariatric surgery.

  1. Intensity-Modulated Radiation Therapy Significantly Improves Acute Gastrointestinal Toxicity in Pancreatic and Ampullary Cancers

    International Nuclear Information System (INIS)

    Yovino, Susannah; Poppe, Matthew; Jabbour, Salma; David, Vera; Garofalo, Michael; Pandya, Naimesh; Alexander, Richard; Hanna, Nader; Regine, William F.

    2011-01-01

    Purpose: Among patients with upper abdominal malignancies, intensity-modulated radiation therapy (IMRT) can improve dose distributions to critical dose-limiting structures near the target. Whether these improved dose distributions are associated with decreased toxicity when compared with conventional three-dimensional treatment remains a subject of investigation. Methods and Materials: 46 patients with pancreatic/ampullary cancer were treated with concurrent chemoradiation (CRT) using inverse-planned IMRT. All patients received CRT based on 5-fluorouracil in a schema similar to Radiation Therapy Oncology Group (RTOG) 97-04. Rates of acute gastrointestinal (GI) toxicity for this series of IMRT-treated patients were compared with those from RTOG 97-04, where all patients were treated with three-dimensional conformal techniques. Chi-square analysis was used to determine if there was a statistically different incidence in acute GI toxicity between these two groups of patients. Results: The overall incidence of Grade 3-4 acute GI toxicity was low in patients receiving IMRT-based CRT. When compared with patients who had three-dimensional treatment planning (RTOG 97-04), IMRT significantly reduced the incidence of Grade 3-4 nausea and vomiting (0% vs. 11%, p = 0.024) and diarrhea (3% vs. 18%, p = 0.017). There was no significant difference in the incidence of Grade 3-4 weight loss between the two groups of patients. Conclusions: IMRT is associated with a statistically significant decrease in acute upper and lower GI toxicity among patients treated with CRT for pancreatic/ampullary cancers. Future clinical trials plan to incorporate the use of IMRT, given that it remains a subject of active investigation.

  2. Unusually High Incidence of Paediatric Coeliac Disease in Sweden during the Period 1973 - 2013.

    Science.gov (United States)

    Tapsas, Dimitrios; Hollén, Elisabet; Stenhammar, Lars; Fälth-Magnusson, Karin

    2015-01-01

    The prevalence of coeliac disease in Sweden during the "epidemic period" (1984-1996) was one of the highest in the world. The aim of this study was to assess the coeliac disease incidence in our region over the 41-year period, and how diagnostic activity and diagnostic accuracy were affected by the introduction of antibody testing. We also looked into how patients with mild enteropathy were evaluated. In the county of Östergötland in Sweden, 2790 paediatric patients were investigated for suspected coeliac disease between 1973 and 2013. Notes were scrutinised for data on sex, age, histopathological reports and final diagnosis. For comparative purposes this period was divided into three sub-periods (1973-1983, 1984-1996 and 1997-2013) named pre-epidemic, epidemic and post-epidemic. Coeliac disease diagnosis was received by 1,030 patients. The peak incidence rate, 301 cases/100,000 in 1994 for the age group 0-1.9 years is the highest figure ever reported. The other age groups, 2-4.9, 5-14.9, and 15-17.9 years, also had high incidence rates. After the 1984-1996 "epidemic period" the incidence decreased for the youngest group but continued to increase for the other groups. The cumulative incidence at 18 years-of-age for children born during the epidemic reached 14 cases/1000 births, the highest figure hitherto reported. Diagnostic activity differed significantly between the three sub-periods (pcoeliac disease cases, decreasing significantly in the "post-epidemic" period (pcoeliac disease were possibly the highest ever reported. Changes in diagnostic activity and accuracy could not be attributed to the introduction of new antibody tests, possibly because of other changes e.g. variations in the symptoms at presentation and improved knowledge of the disease among parents and health professionals.

  3. Incidence and overall survival of malignant ameloblastoma.

    Science.gov (United States)

    Rizzitelli, Alexandra; Smoll, Nicolas R; Chae, Michael P; Rozen, Warren M; Hunter-Smith, David J

    2015-01-01

    Malignant ameloblastoma, comprising metastasizing ameloblastoma and ameloblastic carcinoma, represents 1.6-2.2% of all odontogenic tumors. Due to its rare nature, malignant ameloblastoma has only been reported in the literature in small case series or case reports. Using the Surveillance, Epidemiology and End-Results (SEER) database, we have performed a population-based study to determine the incidence rate and the absolute survival of malignant ameloblastoma. Using the International Classification of Diseases for Oncology (ICD-O) codes 9310/3 and 9270/3, data from the SEER database were used to calculate the incidence rate and absolute survival rate of population with malignant ameloblastoma. The overall incidence rate of malignant ameloblastoma was 1.79 per 10 million person/year. The incidence rate was higher in males than females and also higher in black versus white population. The median overall survival was 17.6 years from the time of diagnosis and increasing age was associated with a statistically significant poorer survival. To our best knowledge, we report the largest population-based series of malignant ameloblastoma. The incidence rate was 1.79 per 10 million person/year and the overall survival was 17.6 years.

  4. Incidence and overall survival of malignant ameloblastoma.

    Directory of Open Access Journals (Sweden)

    Alexandra Rizzitelli

    Full Text Available Malignant ameloblastoma, comprising metastasizing ameloblastoma and ameloblastic carcinoma, represents 1.6-2.2% of all odontogenic tumors. Due to its rare nature, malignant ameloblastoma has only been reported in the literature in small case series or case reports. Using the Surveillance, Epidemiology and End-Results (SEER database, we have performed a population-based study to determine the incidence rate and the absolute survival of malignant ameloblastoma.Using the International Classification of Diseases for Oncology (ICD-O codes 9310/3 and 9270/3, data from the SEER database were used to calculate the incidence rate and absolute survival rate of population with malignant ameloblastoma.The overall incidence rate of malignant ameloblastoma was 1.79 per 10 million person/year. The incidence rate was higher in males than females and also higher in black versus white population. The median overall survival was 17.6 years from the time of diagnosis and increasing age was associated with a statistically significant poorer survival.To our best knowledge, we report the largest population-based series of malignant ameloblastoma. The incidence rate was 1.79 per 10 million person/year and the overall survival was 17.6 years.

  5. Piroxicam decreases postirradiation colonic neoplasia in the rat

    International Nuclear Information System (INIS)

    Northway, M.G.; Scobey, M.W.; Cassidy, K.T.; Geisinger, K.R.

    1990-01-01

    This study evaluated the effects of the nonsteroidal antiinflammatory agent piroxicam on chronic radiation proctitis in the rat. Forty female Wistar rats received a 2250-cGy dose of irradiation to the distal 2 cm of the colon. Twenty received piroxicam 8.0 mg/kg orally 30 minutes before exposure and 24 hours after exposure; 20 rats served as irradiated controls. All animals were evaluated by colonoscopy 1 and 3 weeks postexposure and every third week until death or killing at 1 year. At killing, colons were removed for light microscopic examination. One year postirradiation results showed no differences in mortality, vascular changes, acute inflammation, colitis cystica profunda, or rectal stricture between the control and piroxicam-treated groups. However, at 1 year postirradiation the control group demonstrated neoplasia in 15 of 19 animals compared with eight of 20 animals in the piroxicam-treated group. The first endoscopic appearance of colonic neoplasm occurred at 15 weeks postirradiation in one control irradiated rat whereas the first evidence of endoscopic neoplasm in the piroxicam-treated group did not occur until 36 weeks postirradiation. Histologic examination documented a tendency toward a greater presence of adenocarcinomas in the control group compared with the piroxicam-treated group. The authors conclude that piroxicam treatment significantly decreased the incidence of colonic neoplasia in general as well as delayed the endoscopic appearance of colonic neoplasia in rats after pelvic irradiation. 41 references

  6. Piroxicam decreases postirradiation colonic neoplasia in the rat

    Energy Technology Data Exchange (ETDEWEB)

    Northway, M.G.; Scobey, M.W.; Cassidy, K.T.; Geisinger, K.R. (Wake Forest Univ., Winston Salem, NC (USA))

    1990-12-01

    This study evaluated the effects of the nonsteroidal antiinflammatory agent piroxicam on chronic radiation proctitis in the rat. Forty female Wistar rats received a 2250-cGy dose of irradiation to the distal 2 cm of the colon. Twenty received piroxicam 8.0 mg/kg orally 30 minutes before exposure and 24 hours after exposure; 20 rats served as irradiated controls. All animals were evaluated by colonoscopy 1 and 3 weeks postexposure and every third week until death or killing at 1 year. At killing, colons were removed for light microscopic examination. One year postirradiation results showed no differences in mortality, vascular changes, acute inflammation, colitis cystica profunda, or rectal stricture between the control and piroxicam-treated groups. However, at 1 year postirradiation the control group demonstrated neoplasia in 15 of 19 animals compared with eight of 20 animals in the piroxicam-treated group. The first endoscopic appearance of colonic neoplasm occurred at 15 weeks postirradiation in one control irradiated rat whereas the first evidence of endoscopic neoplasm in the piroxicam-treated group did not occur until 36 weeks postirradiation. Histologic examination documented a tendency toward a greater presence of adenocarcinomas in the control group compared with the piroxicam-treated group. The authors conclude that piroxicam treatment significantly decreased the incidence of colonic neoplasia in general as well as delayed the endoscopic appearance of colonic neoplasia in rats after pelvic irradiation. 41 references.

  7. Fungi producing significant mycotoxins.

    Science.gov (United States)

    2012-01-01

    Mycotoxins are secondary metabolites of microfungi that are known to cause sickness or death in humans or animals. Although many such toxic metabolites are known, it is generally agreed that only a few are significant in causing disease: aflatoxins, fumonisins, ochratoxin A, deoxynivalenol, zearalenone, and ergot alkaloids. These toxins are produced by just a few species from the common genera Aspergillus, Penicillium, Fusarium, and Claviceps. All Aspergillus and Penicillium species either are commensals, growing in crops without obvious signs of pathogenicity, or invade crops after harvest and produce toxins during drying and storage. In contrast, the important Fusarium and Claviceps species infect crops before harvest. The most important Aspergillus species, occurring in warmer climates, are A. flavus and A. parasiticus, which produce aflatoxins in maize, groundnuts, tree nuts, and, less frequently, other commodities. The main ochratoxin A producers, A. ochraceus and A. carbonarius, commonly occur in grapes, dried vine fruits, wine, and coffee. Penicillium verrucosum also produces ochratoxin A but occurs only in cool temperate climates, where it infects small grains. F. verticillioides is ubiquitous in maize, with an endophytic nature, and produces fumonisins, which are generally more prevalent when crops are under drought stress or suffer excessive insect damage. It has recently been shown that Aspergillus niger also produces fumonisins, and several commodities may be affected. F. graminearum, which is the major producer of deoxynivalenol and zearalenone, is pathogenic on maize, wheat, and barley and produces these toxins whenever it infects these grains before harvest. Also included is a short section on Claviceps purpurea, which produces sclerotia among the seeds in grasses, including wheat, barley, and triticale. The main thrust of the chapter contains information on the identification of these fungi and their morphological characteristics, as well as factors

  8. Prospective studies of the effect of breast feeding on incidence of infection and allergy.

    Science.gov (United States)

    Chandra, R K

    1979-09-01

    The effect of exclusive breast feeding in the first few weeks after birth on infant morbidity due to infectious and allergic disorders was investigated in three separate prospective studies. In a rural community in India, breast-fed infants had a significantly lower incidence of respiratory infection, otitis, diarrhoea, dehydration and pneumonia. In an urban population in Canada, breast feeding was associated with a marked decrease in the occurrence of otitis and respiratory disease and to a lesser extent of diarrhoea and dehydration. In newborn siblings of children with atopic disease exclusively breast-fed for a minimum of six weeks, the incidence of eczema, recurrent wheezing, elevated serum IgE-antibodies to cow's milk, complement activation in vivo after milk challenge and hemagglutinating antibodies to beta-lactoglobulin was significantly lower compared with formula-fed matched group. These observations provide clinical data attesting the immunologic advantages of human milk.

  9. Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993-2006.

    Science.gov (United States)

    Liang, Yajun; Welmer, Anna-Karin; Wang, Rui; Song, Aiqin; Fratiglioni, Laura; Qiu, Chengxuan

    2017-02-01

    To investigate time trends in incidence of activity of daily living (ADL) disability of Chinese older adults and to explore factors potentially contributing to trends. Population-based prospective study using a multistage, randomized, cluster sampling process. Nine provinces of China. Three consecutive cohorts of people aged 60 and older from the China Health and Nutrition Survey: cohort 1993-2000 (n = 831), cohort 1997-2004 (n = 1,091), cohort 2000-2006 (n = 1,152). Disability in ADLs was defined as inability to perform at least one of five self-care activities (transferring, dressing, toileting, bathing, feeding). Data were analyzed using Cox and generalized estimating equation models. The incidence (per 1,000 person-years) of ADL disability decreased significantly from 35.3 in 1993-2000 and 28.9 in 1997-2004 to 24.3 in 2000-2006 in Chinese older adults (P trend < .001). The incidence of ADL disability decreased significantly in men and women, in young-old adults (aged 60-74), and in those living in rural areas (all P trend ≤ .02) after controlling for multiple potential influential factors. Of the five ADL items, decline in incidence of disability was significant in transferring (P trend < .001) and bathing (P trend = .002) and marginally significant in toileting (P trend = .06) but stable in dressing (P trend = .38) and feeding (P trend = .26). The incidence of ADL disability decreased from 1993 to 2006 in older adults in China, especially in transferring and bathing, independent of sociodemographic, lifestyle, and chronic health conditions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  10. Cancer incidence among Nordic airline cabin crew.

    Science.gov (United States)

    Pukkala, Eero; Helminen, Mika; Haldorsen, Tor; Hammar, Niklas; Kojo, Katja; Linnersjö, Anette; Rafnsson, Vilhjálmur; Tulinius, Hrafn; Tveten, Ulf; Auvinen, Anssi

    2012-12-15

    Airline cabin crew are occupationally exposed to cosmic radiation and jet lag with potential disruption of circadian rhythms. This study assesses the influence of work-related factors in cancer incidence of cabin crew members. A cohort of 8,507 female and 1,559 male airline cabin attendants from Finland, Iceland, Norway and Sweden was followed for cancer incidence for a mean follow-up time of 23.6 years through the national cancer registries. Standardized incidence ratios (SIRs) were defined as ratios of observed and expected numbers of cases. A case-control study nested in the cohort (excluding Norway) was conducted to assess the relation between the estimated cumulative cosmic radiation dose and cumulative number of flights crossing six time zones (indicator of circadian disruption) and cancer risk. Analysis of breast cancer was adjusted for parity and age at first live birth. Among female cabin crew, a significantly increased incidence was observed for breast cancer [SIR 1.50, 95% confidence interval (95% CI) 1.32-1.69], leukemia (1.89, 95% CI 1.03-3.17) and skin melanoma (1.85, 95% CI 1.41-2.38). Among men, significant excesses in skin melanoma (3.00, 95% CI 1.78-4.74), nonmelanoma skin cancer (2.47, 95% CI 1.18-4.53), Kaposi sarcoma (86.0, 95% CI 41.2-158) and alcohol-related cancers (combined SIR 3.12, 95% CI 1.95-4.72) were found. This large study with complete follow-up and comprehensive cancer incidence data shows an increased incidence of several cancers, but according to the case-control analysis, excesses appear not to be related to the cosmic radiation or circadian disruptions from crossing multiple time zones. Copyright © 2012 UICC.

  11. Incidence and mortality rates in breast, corpus uteri, and ovarian cancers in Poland (1980–2013: an analysis of population-based data in relation to socio-economic changes

    Directory of Open Access Journals (Sweden)

    Banas T

    2016-09-01

    Full Text Available Tomasz Banas,1 Grzegorz Juszczyk,2 Kazimierz Pitynski,1 Dorota Nieweglowska,1 Artur Ludwin,1 Aleksandra Czerw2 1Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, 2Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland Objectives: This study aimed to analyze incidence and mortality trends in breast cancer (BC, corpus uteri cancer (CUC, and ovarian cancer (OC in Poland in the context of sociodemographic changes.Materials and methods: Incidence and mortality data (1980–2013 were retrieved from the Polish National Cancer Registry, while socioeconomic data (1960–2013 were obtained from the World Bank. Age-standardized incidence and mortality rates were calculated by direct standardization, and join-point regression was performed to describe trends using the average annual percentage change (AAPC.Results: A significant decrease in birth and fertility rates and a large increase in gross domestic product were observed together with a decrease in the total mortality rate among women, as well as an increase in life expectancy for women. A large, significant increase in BC incidence was observed (AAPC1980–1990 2.14, AAPC1990–1996 4.71, AAPC1996–2013 2.21, with a small but significant decrease in mortality after a slight increase (AAPC1980–1994 0.52, AAPC1994–2013 −0.66. During the period 1980–2013, a significant increase in CUC incidence (AAPC1980–1994 3.7, AAPC1994–2013 1.93 was observed, with an initial mortality-rate reduction followed by a significant increase (AAPC1980–2006 −1.12, AAPC2006–2013 3.74. After the initial increase of both OC incidence and mortality from 1994, the incidence rate decreased significantly (AAPC1980–1994 2.98, AAPC1994–2013 −0.49, as did the mortality rate (AAPC1980–1994 0.52, AAPC1994–2013 −0.66.Conclusion: After 1994, a decrease in OC incidence was found, while the incidence of BC and CUC continued to increase. A reduction in

  12. A Tool for the Concise Analysis of Patient Safety Incidents.

    Science.gov (United States)

    Pham, Julius Cuong; Hoffman, Carolyn; Popescu, Ioana; Ijagbemi, O Mayowa; Carson, Kathryn A

    2016-01-01

    Patient safety incidents, sometimes referred to as adverse events, incidents, or patient safety events, are too common an occurrence in health care. Most methods for incident analysis are time and labor intensive. Given the significant resource requirements of a root cause analysis, for example, there is a need for a more targeted and efficient method of analyzing a larger number of incidents. Although several concise incident analysis tools are in existence, there are no published studies regarding their usability or effectiveness. Building on previous efforts, a Concise Incident Analysis (CIA) methodology and tool were developed to facilitate analysis of no- or low-harm incidents. Staff from 11 hospitals in five countries-Australia, Canada, Hong Kong, India, and the United States-pilot tested the tool in two phases. The tool was evaluated and refined after each phase on the basis of user perceptions of usability and effectiveness. From September 2013 through January 2014, 52 patient safety incidents were analyzed. A broad variety of incident types were investigated, the most frequent being patient falls (25%). Incidents came from a variety of hospital work areas, the most frequent being from the medical ward (37%). Most incidents investigated resulted in temporary harm or no harm (94%). All or most sites found the tool "understandable" (100%), "easy to use" (89%), and "effective" (89%). Some 95% of participants planned to continue to use all or some parts of the tool after the pilot. Qualitative feedback suggested that the tool allowed analysis of incidents that were not currently being analyzed because of insufficient resources. The tool was described as simple to use, easy to document, and aligned with the flow of the incident analysis. A concise tool for the investigation of patient safety incidents with low or no harm was well accepted across a select group of hospitals from five countries.

  13. A whey protein supplement decreases post-prandial glycemia

    Directory of Open Access Journals (Sweden)

    Jenkins Alexandra L

    2009-10-01

    Full Text Available Abstract Background Incidence of diabetes, obesity and insulin resistance are associated with high glycemic load diets. Identifying food components that decrease post-prandial glycemia may be beneficial for developing low glycemic foods and supplements. This study explores the glycemic impact of adding escalating doses of a glycemic index lowering peptide fraction (GILP from whey to a glucose drink. Methods Ten healthy subjects (3M, 7F, 44.4 ± 9.3 years, BMI 33.6 ± 4.8 kg/m2 participated in an acute randomised controlled study. Zero, 5, 10 and 20 g of protein from GILP were added to a 50 g glucose drink. The control (0 g of GILP meal was repeated 2 times. Capillary blood samples were taken fasting (0 min and at 15, 30, 45, 60, 90 and 120 minutes after the start of the meal and analyzed for blood glucose concentration. Results Increasing doses of GILP decreased the incremental areas under the curve in a dose dependant manner (Pearson's r = 0.48, p = 0.002. The incremental areas (iAUC under the glucose curve for the 0, 5, 10, and 20 g of protein from GILP were 231 ± 23, 212 ± 23, 196 ± 23, and 138 ± 13 mmol.min/L respectively. The iAUC of the 20 g GILP was significantly different from control, 5 g GILP and 10 g GILP (p Conclusion Addition of GILP to a oral glucose bolus reduces blood glucose iAUC in a dose dependent manner and averages 4.6 ± 1.4 mmol.min/L per gram of GILP. These data are consistent with previous research on the effect of protein on the glycemic response of a meal.

  14. Lactate and risk of incident diabetes in a case-cohort of the atherosclerosis risk in communities (ARIC study.

    Directory of Open Access Journals (Sweden)

    Stephen P Juraschek

    Full Text Available Oxidative capacity is decreased in type 2 diabetes. Whether decreased oxidative capacity is a cause or consequence of diabetes is unknown. Our purpose is to evaluate whether lactate, a marker of oxidative capacity, is associated with incident diabetes.We conducted a case-cohort study in the Atherosclerosis Risk in Communities (ARIC study at year 9 of follow-up. We evaluated lactate's association with diabetes risk factors at baseline and estimated the hazard ratio for incident diabetes by quartiles of plasma lactate in 544 incident diabetic cases and 533 non-cases. Plasma lactate showed a graded positive relationship with fasting glucose and insulin (P<0.001. The relative hazard for incident diabetes increased across lactate quartiles (P-trend ≤0.001. Following adjustment for demographic factors, medical history, physical activity, adiposity, and serum lipids, the hazard ratio in the highest quartile was 2.05 times the hazard in the lowest quartile (95% CI: 1.28, 3.28. After including fasting glucose and insulin the association became non-significant.Lactate, an indicator of oxidative capacity, predicts incident diabetes independent of many other risk factors and is strongly related to markers of insulin resistance. Future studies should evaluate the temporal relationship between elevated lactate and impaired fasting glucose and insulin resistance.

  15. Understanding differences in cervical cancer incidence in Western Europe: comparing Portugal and England.

    Science.gov (United States)

    Mendes, Diana; Mesher, David; Pista, Angela; Baguelin, Marc; Jit, Mark

    2018-04-01

    Cervical cancer incidence has decreased over time in England particularly after the introduction of organized screening. In Portugal, where opportunistic screening has been widely available with only slightly lower coverage than that of the organized programme in England, rates of cervical cancer have been higher than in England. We compared the burden of cervical cancer, risk factors and preventive interventions over time in both countries, to identify elements hindering the further decline in incidence and mortality in Portugal. We used joinpoint regression to identify significant changes in rate time-trends. We also analyzed individual-level Portuguese data on sexual behaviour and human papillomavirus prevalence, and recent aggregate data on organized and opportunistic screening coverage. We compared published estimates of survival, risk factors and historical screening coverage for both countries. Despite stable incidence, cervical cancer mortality has declined in both countries in the last decade. The burden has been 4 cases and 1 death per 100 000 women annually higher in Portugal than in England. Differences in human papillomavirus prevalence and risk factors for infection and disease progression do not explain the difference found in cervical cancer incidence. Significant mortality declines in both countries followed the introduction of different screening policies, although England showed a greater decline than Portugal over nearly 2 decades after centralizing organized screening. The higher rates of cervical cancer in Portugal compared to England can be explained by differences in screening quality and coverage.

  16. Assessment the effect of dexmedetomidine on incidence of paradoxical hypertension after surgical repair of aortic coarctation in pediatric patients

    Directory of Open Access Journals (Sweden)

    Rabie Soliman

    2018-01-01

    Full Text Available Objective: The aim of the study was to assess the effect of dexmedetomidine on the incidence of paradoxical hypertension in patients undergoing aortic coarctation repair. Design: Randomized observational study. Setting: University hospital and cardiac center. Patients: The study included 108 pediatric patients with isolated aortic coarctation. Methods: The patients were classified into two groups (each = 54: Group D: the patients received dexmedetomidine as a loading dose of 0.5 μg/kg over 10 min followed by infusion 0.3 μg/kg/h during surgery and continued for the first 48 postoperative hours. Group C: The patients received an equal amount of normal saline. The medication was prepared by the nursing staff and given to anesthetist blindly. The collected data included the heart rate, systolic and diastolic arterial blood pressure, incidence, onset, severity and treatment of paradoxical hypertension, fentanyl dose and end-tidal sevoflurane concentration, amount of blood loss and urine output. Main Results: The heart rate, systolic and diastolic blood pressure decreased significantly with dexmedetomidine than Group C (P < 0.05. The incidence and severity of the paradoxical hypertension was lower with dexmedetomidine than Group C (P = 0.011, P = 0.017, respectively. The onset the paradoxical hypertension was earlier in Group C than dexmedetomidine (P = 0.026. The dose of fentanyl and sevoflurane concentration decreased significantly with dexmedetomidine (P = 0.034, P = 0.026, respectively. The blood loss decreased with dexmedetomidine (P = 0.020 and the urine output increased with dexmedetomidine (P = 0.024. The incidence of hypotension and bradycardia was more with dexmedetomidine (P < 0.05. Conclusion: Dexmedetomidine is safe in pediatric patients undergoing aortic coarctation repair. It minimized the incidence and severity of paradoxical hypertension. It decreased the required antihypertensive medications.

  17. Increasing Incidence of Melanoma among Middle-Aged Adults: An Epidemiologic Study in Olmsted County, Minnesota

    Science.gov (United States)

    Lowe, Garrett C.; Saavedra, Alexandra; Reed, Kurtis B.; Velazquez, Ana I.; Dronca, Roxana S.; Markovic, Svetomir N.; Lohse, Christine M.; Brewer, Jerry D.

    2015-01-01

    Objective To identify changes in incidence of cutaneous melanoma over time in the fastest-growing segment of the US population, middle-aged adults. Patients and Methods Using the Rochester Epidemiology Project resource, we identified patients aged 40 to 60 years who had a first lifetime diagnosis of melanoma between January 1, 1970, and December 31, 2009, in Olmsted County, Minnesota. Incidence of melanoma and overall and disease-specific survival rates were compared by age, sex, year of diagnosis, and stage of disease. Results From 1970 through 2009, age- and sex-adjusted incidence increased significantly over time (P<.001) from 7.9 to 60.0 per 100,000 person-years, with a 24-fold increase in women and a 4.5-fold increase in men. Although not significant (P=.06), incidence of melanoma increased with age. Overall and disease-specific survival improved over time, with hazard ratios of 0.94 (P<.001) and 0.93 (P<.001) for each 1-year increase in year of diagnosis, respectively. Each 1-year increase in age at diagnosis was associated with increased risk of death from any cause (hazard ratio, 1.07; P=.01) but was not significantly associated with disease-specific death. Sex was not significantly associated with death from any cause or death from disease. No patient with malignant melanoma in situ died from disease. Patients with stage II, III, and IV disease were over 14 times more likely to die from disease compared with patients with stage 0 or I disease (P<.001). Conclusion The incidence of cutaneous melanoma among middle-aged adults increased over the past 4 decades, especially in middle-aged women, while mortality decreased. PMID:24388022

  18. Grazing Incidence Optics Technology

    Science.gov (United States)

    Ramsey, Brian; Smith, W. Scott; Gubarev, Mikhail; McCracken, Jeff

    2015-01-01

    This project is to demonstrate the capability to directly fabricate lightweight, high-resolution, grazing-incidence x-ray optics using a commercially available robotic polishing machine. Typical x-ray optics production at NASA Marshall Space Flight Center (MSFC) uses a replication process in which metal mirrors are electroformed on to figured and polished mandrels from which they are later removed. The attraction of this process is that multiple copies can be made from a single master. The drawback is that the replication process limits the angular resolution that can be attained. By directly fabricating each shell, errors inherent in the replication process are removed. The principal challenge now becomes how to support the mirror shell during all aspects of fabrication, including the necessary metrology to converge on the required mirror performance specifications. This program makes use of a Zeeko seven-axis computer-controlled polishing machine (see fig. 1) and supporting fabrication, metrology, and test equipment at MSFC. The overall development plan calls for proof-of-concept demonstration with relatively thick mirror shells (5-6 mm, fig. 2) which are straightforward to support and then a transition to much thinner shells (2-3 mm), which are an order of magnitude thinner than those used for Chandra. Both glass and metal substrates are being investigated. Currently, a thick glass shell is being figured. This has enabled experience to be gained with programming and operating the polishing machine without worrying about shell distortions or breakage. It has also allowed time for more complex support mechanisms for figuring/ polishing and metrology to be designed for the more challenging thinner shells. These are now in fabrication. Figure 1: Zeeko polishing machine.

  19. Bronchoaspiration: incidence, consequences and management.

    Science.gov (United States)

    Beck-Schimmer, Beatrice; Bonvini, John M

    2011-02-01

    Aspiration is defined as the inhalation of oropharyngeal or gastric contents into the lower respiratory tract. Upon injury, epithelial cells and alveolar macrophages secrete chemical mediators, attracting and activating neutrophils, which in turn release proteases and reactive oxygen species, degrading the alveolocapillary unit. Aspiration can lead to a range of diseases such as infectious pneumonia, chemical pneumonitis or respiratory distress syndrome with significant morbidity and mortality. It occurs in approximately 3-10 per 10 000 operations with an increased incidence in obstetric and paediatric anaesthesia. Patients are most at risk during induction of anaesthesia and extubation, in particular in emergency situations. The likelihood of significant aspiration can be reduced by fasting, pharmacological intervention and correct anaesthetic management using a rapid sequence induction. Treatment of acid aspiration is by suctioning after witnessed aspiration; antibiotics are indicated in patients with aspiration pneumonia only. Steroids are not proven to improve outcome or reduce mortality. Patients with acute lung injury requiring mechanical ventilation should be ventilated using lung protective strategies with low tidal volumes and low plateau pressure values, attempting to limit peak lung distension and end-expiratory collapse.

  20. Decreasing Fires in Mediterranean Europe.

    Directory of Open Access Journals (Sweden)

    Marco Turco

    Full Text Available Forest fires are a serious environmental hazard in southern Europe. Quantitative assessment of recent trends in fire statistics is important for assessing the possible shifts induced by climate and other environmental/socioeconomic changes in this area. Here we analyse recent fire trends in Portugal, Spain, southern France, Italy and Greece, building on a homogenized fire database integrating official fire statistics provided by several national/EU agencies. During the period 1985-2011, the total annual burned area (BA displayed a general decreasing trend, with the exception of Portugal, where a heterogeneous signal was found. Considering all countries globally, we found that BA decreased by about 3020 km2 over the 27-year-long study period (i.e. about -66% of the mean historical value. These results are consistent with those obtained on longer time scales when data were available, also yielding predominantly negative trends in Spain and France (1974-2011 and a mixed trend in Portugal (1980-2011. Similar overall results were found for the annual number of fires (NF, which globally decreased by about 12600 in the study period (about -59%, except for Spain where, excluding the provinces along the Mediterranean coast, an upward trend was found for the longer period. We argue that the negative trends can be explained, at least in part, by an increased effort in fire management and prevention after the big fires of the 1980's, while positive trends may be related to recent socioeconomic transformations leading to more hazardous landscape configurations, as well as to the observed warming of recent decades. We stress the importance of fire data homogenization prior to analysis, in order to alleviate spurious effects associated with non-stationarities in the data due to temporal variations in fire detection efforts.

  1. Availability of Clean Tap Water and Medical Services Prevents the Incidence of Typhoid Fever

    OpenAIRE

    Lee, Deog-Yong; Lee, Esther; Park, HyeMin; Kim, SeongHan

    2013-01-01

    Objective: In this study, the factors that induced a decrease in the incidence of typhoid fever were analyzed. Based on the study results, we propose a quantitative and concrete solution to reduce the incidence of typhoid fever. Methods: We analyzed the incidence and fatality rate of typhoid fever in Korea. Tap water service rate and the number of pharmacies, which affect the incidence rate of typhoid fever, were used as environmental factors. Results: To prevent typhoid fever in the communit...

  2. [Incidence of intestinal parasites in municipal sanitary workers in Malatya].

    Science.gov (United States)

    Karaman, Ulkü; Atambay, Metin; Aycan, Ozlem; Yoloğlu, Saim; Daldal, Nilgün

    2006-01-01

    The incidence of intestinal parasites is closely related to such factors as the socio-economic level of the society, nutritional and hygienic habits, climate, environmental conditions, infrastructure and degree of literacy. In this study, the municipal sanitary workers who are regarded as a high risk group in Malatya were examined for intestinal parasites. Cellophane slides and fecal samples from 241 workers were examined and intestinal parasites were found in 93 (39.0%). The most common parasite was Entamoeba coli (34). Other parasites detected include Enterobius vermicularis (32), Giardia intestinalis (22), Blastocystis hominis (8), Iodamoeba butschlii (5), Entamoeba histolytica (2), Taenia sp. (2), Chilomastix mesnili (2), Dientamoeba fragilis (2), Entamoeba hartmanni (1), Trichomonas intestinalis (1) Hymenolepis nana (1), and Ascaris lumbricoides (1). A training seminary was conducted in order to inform all the workers about means of protection. The workers were given suitable treatment and were called for control after a month. The examinations revealed a significant decrease in the incidence rate of parasites (qui-square test in dependent samples P<0.05). It was concluded that offering training seminaries for certain occupational groups under risk is efficient in terms of protection.

  3. Patterns and Trends in Age-Specific Black-White Differences in Breast Cancer Incidence and Mortality - United States, 1999-2014.

    Science.gov (United States)

    Richardson, Lisa C; Henley, S Jane; Miller, Jacqueline W; Massetti, Greta; Thomas, Cheryll C

    2016-10-14

    Breast cancer continues to be the most commonly diagnosed cancer and the second leading cause of cancer deaths among U.S. women (1). Compared with white women, black women historically have had lower rates of breast cancer incidence and, beginning in the 1980s, higher death rates (1). This report examines age-specific black-white disparities in breast cancer incidence during 1999-2013 and mortality during 2000-2014 in the United States using data from United States Cancer Statistics (USCS) (2). Overall rates of breast cancer incidence were similar, but death rates remained higher for black women compared with white women. During 1999-2013, breast cancer incidence decreased among white women but increased slightly among black women resulting in a similar average incidence at the end of the period. Breast cancer incidence trends differed by race and age, particularly from 1999 to 2004-2005, when rates decreased only among white women aged ≥50 years. Breast cancer death rates decreased significantly during 2000-2014, regardless of age with patterns varying by race. For women aged ≥50 years, death rates declined significantly faster among white women compared with black women; among women aged death rates decreased at the same rate among black and white women. Although some of molecular factors that lead to more aggressive breast cancer are known, a fuller understanding of the exact mechanisms might lead to more tailored interventions that could decrease mortality disparities. When combined with population-based approaches to increase knowledge of family history of cancer, increase physical activity, promote a healthy diet to maintain a healthy bodyweight, and increase screening for breast cancer, targeted treatment interventions could reduce racial disparities in breast cancer.

  4. Incidence of abacavir hypersensitivity reactions in euroSIDA

    DEFF Research Database (Denmark)

    Bannister, Wendy P; Friis-Møller, Nina; Mocroft, Amanda

    2008-01-01

    BACKGROUND: The aim of the study was to investigate the incidence of abacavir-related hypersensitivity reaction (HSR) and associated deaths in EuroSIDA HIV-1-infected patients. METHODS: Poisson regression models were developed to compare incidence of abacavir discontinuation according to the line...... in first-line therapy, which could indicate increased over-diagnosis. HSR incidence has decreased in recent years, which might reflect the wider availability of genetic screening and improved awareness of symptoms. There were no reported deaths due to abacavir HSR....

  5. The Epidemiology of Pheochromocytoma: Increasing incidence and changing clinical presentation

    DEFF Research Database (Denmark)

    Ebbehoj, A; Søndergaard, Esben; Trolle, Christian

    2017-01-01

    (population 1.75 million).Incidence rates were calculated using Poisson regression and time trends were analysed with year as a continuous explanatory variable. As incidence increased significantly in 2007–2015, we compared the clinical characteristics of patients diagnosed in this time interval with patients...

  6. Social, institutional, and psychological factors affecting wildfire incident decision making

    Science.gov (United States)

    Matthew P. Thompson

    2014-01-01

    Managing wildland fire incidents can be fraught with complexity and uncertainty. Myriad human factors can exert significant influence on incident decision making, and can contribute additional uncertainty regarding programmatic evaluations of wildfire management and attainment of policy goals. This article develops a framework within which human sources of uncertainty...

  7. Incidence of shoulder injuries and related risk factors among master ...

    African Journals Online (AJOL)

    Swimmers engaging in strength training (OR = 0.78) showed a reduced incidence of shoulder pain. The calculated incidence of shoulder pain over the three-year period among the master swimmers was 62.4%. Significant statistical associations between shoulder pain and the risk factors of osteoporosis, volume of training ...

  8. Real time freeway incident detection.

    Science.gov (United States)

    2014-04-01

    The US Department of Transportation (US-DOT) estimates that over half of all congestion : events are caused by highway incidents rather than by rush-hour traffic in big cities. Real-time : incident detection on freeways is an important part of any mo...

  9. PROTEIN MALNUTRITION INCIDENCE COMPARISON AFTER GASTRIC BYPASS VERSUS BILIOPANCREATIC DIVERSION.

    Science.gov (United States)

    Suárez Llanos, José Pablo; Fuentes Ferrer, Manuel; Alvarez-Sala-Walther, Luis; García Bray, Bruno; Medina González, Laura; Bretón Lesmes, Irene; Moreno Esteban, Basilio

    2015-07-01

    bariatric surgery is widely employed nowadays. Nutritional complications following malabsorptive bariatric surgery are common. to compare protein malnutrition incidence, the amount of protein intake and the influence of various risk factors in patients undergoing Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). retrospective study comparing the development of hypoalbuminemia in 92 patients undergoing BPD and 121 RYGB, before surgery and 3, 6, 12, 18 and 24 months after it. Protein intake was estimated by serum prealbumin. The influence of prior body mass index (BMI), age and sex was analyzed. hypoprealbuminemia was found in around 40% of patients 3 months after both procedures, decreasing to about 10% after 2 years of surgery. Hypoalbuminemia incidence was close to 20% in the first post-surgery year in BPD, persisting in 10-15% of cases thereafter. After RYGB, hypoalbuminemia incidence was lower (5-9% in all postoperative follow-up measurements). During the first year after surgery, hypoalbuminemia was more frequent after BPD than after RYGB (at the 3rd month (OR:3.9; p=0.006; 95%CI:1.5-10.4), 6th (OR:5.0; p=0.002; 95% CI:1.8-13.8), and at the 12th month (OR:4.4;p=0.007;95%;CI:1.5-12.8)), but not after the first year. A higher preoperative BMI favored it (OR: 1.03; p=0.046; 95% CI:1-1.06), as well as greater age during the first 6 months. Patients with BPD had a higher risk for hypoproteinemia than those undergoing RYGB, especially during the first year post-surgery. Higher preoperative BMI, and age (in the short-term period) could have a significant inverse relation to hypoproteinemia. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  10. Breast cancer incidence and use of hormone therapy in Denmark 1978-2007

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My

    2011-01-01

    Internationally, there have recently been reports of declining incidence rates for breast cancer. Decreased use of hormone therapy and decreased use of mammography has been put forward as possible reasons for this decline. The aim of this study was to analyse breast cancer incidence trends in Den...

  11. Resveratrol Reduces the Incidence of Portal Vein System Thrombosis after Splenectomy in a Rat Fibrosis Model

    Directory of Open Access Journals (Sweden)

    Meng Xu

    2016-01-01

    Full Text Available Purpose. To investigate the preventive effect of resveratrol (RES on the formation of portal vein system thrombosis (PVST in a rat fibrosis model. Methods. A total of 64 male SD rats, weighing 200–300 g, were divided into five groups: Sham operation, Splenectomy I, Splenectomy II, RES, and low molecular weight heparin (LMWH, with the former two groups as nonfibrosis controls. Blood samples were subjected to biochemical assays. Platelet apoptosis was measured by flow cytometry. All rats were euthanized for PVST detection one week after operation. Results. No PVST occurred in nonfibrosis controls. Compared to Splenectomy II, the incidences of PVST in RES and LMWH groups were significantly decreased (both p<0.05. Two rats in LMWH group died before euthanasia due to intra-abdominal hemorrhage. In RES group, significant decreases in platelet aggregation, platelet radical oxygen species (ROS production, and increase in platelet nitric oxide (NO synthesis and platelet apoptosis were observed when compared with Splenectomy II (all p<0.001, while in LMWH group only significant decrease in platelet aggregation was observed. Conclusion. Prophylactic application of RES could safely reduce the incidence of PVST after splenectomy in cirrhotic rat. Regulation of platelet function and induction of platelet apoptosis might be the underlying mechanisms.

  12. Incidence and characteristics of chemical burns.

    Science.gov (United States)

    Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol

    2017-05-01

    Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  13. Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity - United States, 2005-2014.

    Science.gov (United States)

    Steele, C Brooke; Thomas, Cheryll C; Henley, S Jane; Massetti, Greta M; Galuska, Deborah A; Agurs-Collins, Tanya; Puckett, Mary; Richardson, Lisa C

    2017-10-03

    Overweight and obesity are associated with increased risk of at least 13 different types of cancer. Data from the United States Cancer Statistics for 2014 were used to assess incidence rates, and data from 2005 to 2014 were used to assess trends for cancers associated with overweight and obesity (adenocarcinoma of the esophagus; cancers of the breast [in postmenopausal women], colon and rectum, endometrium, gallbladder, gastric cardia, kidney, liver, ovary, pancreas, and thyroid; meningioma; and multiple myeloma) by sex, age, race/ethnicity, state, geographic region, and cancer site. Because screening for colorectal cancer can reduce colorectal cancer incidence through detection of precancerous polyps before they become cancerous, trends with and without colorectal cancer were analyzed. In 2014, approximately 631,000 persons in the United States received a diagnosis of a cancer associated with overweight and obesity, representing 40% of all cancers diagnosed. Overweight- and obesity-related cancer incidence rates were higher among older persons (ages ≥50 years) than younger persons; higher among females than males; and higher among non-Hispanic black and non-Hispanic white adults compared with other groups. Incidence rates for overweight- and obesity-related cancers during 2005-2014 varied by age, cancer site, and state. Excluding colorectal cancer, incidence rates increased significantly among persons aged 20-74 years; decreased among those aged ≥75 years; increased in 32 states; and were stable in 16 states and the District of Columbia. The burden of overweight- and obesity-related cancer is high in the United States. Incidence rates of overweight- and obesity-related cancers except colorectal cancer have increased in some age groups and states. The burden of overweight- and obesity-related cancers might be reduced through efforts to prevent and control overweight and obesity. Comprehensive cancer control strategies, including use of evidence

  14. Interatrial septum pacing decreases atrial dyssynchrony on strain rate imaging compared with right atrial appendage pacing.

    Science.gov (United States)

    Yasuoka, Yoshinori; Abe, Haruhiko; Umekawa, Seiko; Katsuki, Keiko; Tanaka, Norio; Araki, Ryo; Imanaka, Takahiro; Matsutera, Ryo; Morisawa, Daisuke; Kitada, Hirokazu; Hattori, Susumu; Noda, Yoshiki; Adachi, Hidenori; Sasaki, Tatsuya; Miyatake, Kunio

    2011-03-01

    Interatrial septum pacing (IAS-P) decreases atrial conduction delay compared with right atrial appendage pacing (RAA-P). We evaluate the atrial contraction with strain rate of tissue Doppler imaging (TDI) during sinus activation or with IAS-P or RAA-P. Fifty-two patients with permanent pacemaker for sinus node disease were enrolled in the study. Twenty-three subjects were with IAS-P and 29 with RAA-P. The time from end-diastole to peak end-diastolic strain rate was measured and corrected with RR interval on electrocardiogram. It was defined as the time from end-diastole to peak end-diastolic strain rate (TSRc), and the balance between maximum and minimum TSRc at three sites (ΔTSRc) was compared during sinus activation and with pacing rhythm in each group. There were no significant differences observed in general characteristics and standard echocardiographic parameters except the duration of pacing P wave between the two groups. The duration was significantly shorter in the IAS-P group compared with the RAA-P group (95 ± 34 vs 138 ± 41; P = 0.001). TSRc was significantly different between sinus activation and pacing rhythm (36.3 ± 35.7 vs 61.6 ± 36.3; P = 0.003) in the RAA-P group, whereas no significant differences were observed in the IAS-P group (25.4 ± 12.1 vs 27.7 ± 14.7; NS). During the follow-up (mean 2.4 ± 0.7 years), the incidence of paroxysmal atrial fibrillation (AF) conversion to permanent AF was not significantly different between the two groups. IAS-P decreased the contraction delay on atrial TDI compared to RAA-P; however, it did not contribute to the reduction of AF incidence in the present study. ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.

  15. Vancomycin Paste Does Not Reduce the Incidence of Deep Sternal Wound Infection After Cardiac Operations.

    Science.gov (United States)

    Lander, Heather L; Ejiofor, Julius I; McGurk, Siobhan; Tsuyoshi, Kaneko; Shekar, Prem; Body, Simon C

    2017-02-01

    Deep sternal wound infection (DSWI) is a devastating complication that increases morbidity and death in cardiac surgical patients. Vancomycin is often administered intravenously for antibiotic prophylaxis in cardiac operations. Many cardiac surgeons also apply vancomycin paste topically to the sternal edges. We examined the effect of vancomycin paste on the incidence of DSWI in patients undergoing elective cardiac operations. We retrospectively reviewed the medical records of all patients from 2003 to 2015 who underwent coronary artery bypass grafting, valve, or combined coronary artery bypass grafting and valve operations at a single institution. We derived The Society for Thoracic Surgeons (STS) DSWI risk index for each patient and systematically reviewed operative, pharmacy, microbiology, and discharge records to document DSWI in these patients. Multivariate analyses were used to identify predictors of DSWI in this cohort and to quantify the effect of vancomycin paste. Of the 14,492 patients whose records we examined, DSWI developed in 136 patients, resulting in an overall incidence of 0.9%. After multivariate analysis, body mass index, New York Heart Association Functional Classification, and the STS DSWI risk index remained statistically significant and associated with DSWI. Although the incidence of DSWI decreased over time, the use of vancomycin paste was not associated with a reduced incidence of DSWI. There was a marked decrease in the incidence of DSWI during the study period, concurrent with institutional implementation of revised STS antibiotic dosing guidelines in 2007 and other strategies. However, the application of vancomycin paste to the sternal edges of patients undergoing cardiac operations was not associated with a reduced risk of DSWI. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women.

    Science.gov (United States)

    DeSantis, Carol E; Fedewa, Stacey A; Goding Sauer, Ann; Kramer, Joan L; Smith, Robert A; Jemal, Ahmedin

    2016-01-01

    In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Approximately 231,840 new cases of invasive breast cancer and 40,290 breast cancer deaths are expected to occur among US women in 2015. Breast cancer incidence rates increased among non-Hispanic black (black) and Asian/Pacific Islander women and were stable among non-Hispanic white (white), Hispanic, and American Indian/Alaska Native women from 2008 to 2012. Although white women have historically had higher incidence rates than black women, in 2012, the rates converged. Notably, during 2008 through 2012, incidence rates were significantly higher in black women compared with white women in 7 states, primarily located in the South. From 1989 to 2012, breast cancer death rates decreased by 36%, which translates to 249,000 breast cancer deaths averted in the United States over this period. This decrease in death rates was evident in all racial/ethnic groups except American Indians/Alaska Natives. However, the mortality disparity between black and white women nationwide has continued to widen; and, by 2012, death rates were 42% higher in black women than in white women. During 2003 through 2012, breast cancer death rates declined for white women in all 50 states; but, for black women, declines occurred in 27 of 30 states that had sufficient data to analyze trends. In 3 states (Mississippi, Oklahoma, and Wisconsin), breast cancer death rates in black women were stable during 2003 through 2012. Widening racial disparities in breast cancer mortality are likely to continue, at least in the short term, in view of the increasing trends in breast cancer incidence rates in black women. © 2015 American Cancer Society.

  17. Errors in 'BED'-derived estimates of HIV incidence will vary by place, time and age.

    Directory of Open Access Journals (Sweden)

    Timothy B Hallett

    2009-05-01

    Full Text Available The BED Capture Enzyme Immunoassay, believed to distinguish recent HIV infections, is being used to estimate HIV incidence, although an important property of the test--how specificity changes with time since infection--has not been not measured.We construct hypothetical scenarios for the performance of BED test, consistent with current knowledge, and explore how this could influence errors in BED estimates of incidence using a mathematical model of six African countries. The model is also used to determine the conditions and the sample sizes required for the BED test to reliably detect trends in HIV incidence.If the chance of misclassification by BED increases with time since infection, the overall proportion of individuals misclassified could vary widely between countries, over time, and across age-groups, in a manner determined by the historic course of the epidemic and the age-pattern of incidence. Under some circumstances, changes in BED estimates over time can approximately track actual changes in incidence, but large sample sizes (50,000+ will be required for recorded changes to be statistically significant.The relationship between BED test specificity and time since infection has not been fully measured, but, if it decreases, errors in estimates of incidence could vary by place, time and age-group. This means that post-assay adjustment procedures using parameters from different populations or at different times may not be valid. Further research is urgently needed into the properties of the BED test, and the rate of misclassification in a wide range of populations.

  18. Mercury Exposure in Young Adulthood and Incidence of Diabetes Later in Life

    Science.gov (United States)

    He, Ka; Xun, Pengcheng; Liu, Kiang; Morris, Steve; Reis, Jared; Guallar, Eliseo

    2013-01-01

    OBJECTIVE Laboratory studies suggest that exposure to methylmercury at a level similar to those found in fish may induce pancreatic islet β-cell dysfunction. Few, if any, human studies have examined the association between mercury exposure and diabetes incidence. We examined whether toenail mercury levels are associated with incidence of diabetes in a large prospective cohort. RESEACH DESIGN AND METHODS A prospective cohort of 3,875 American young adults, aged 20–32 years, free of diabetes in 1987 (baseline), were enrolled and followed six times until 2005. Baseline toenail mercury levels were measured with instrumental neutron-activation analysis. Incident diabetes was identified by plasma glucose levels, oral glucose tolerance tests, hemoglobin A1C levels, and/or antidiabetes medications. RESULTS A total of 288 incident cases of diabetes occurred over 18 years of follow-up. In multivariate analyses adjusted for age, sex, ethnicity, study center, education, smoking status, alcohol consumption, physical activity, family history of diabetes, intakes of long-chain n-3 fatty acids and magnesium, and toenail selenium, toenail mercury levels were positively associated with the incidence of diabetes. The hazard ratio (95% CI) of incident diabetes compared the highest to the lowest quintiles of mercury exposure was 1.65 (1.07–2.56; P for trend = 0.02). Higher mercury exposure at baseline was also significantly associated with decreased homeostasis model assessment of β-cell function index (P for trend mercury exposure in young adulthood may have elevated risk of diabetes later in life. PMID:23423697

  19. Cancer incidence among Danish seafarers

    DEFF Research Database (Denmark)

    Kærlev, Linda; Hansen, Johnny; Lyngbeck Hansen, Hans

    2005-01-01

    .19 to 1.32) for men and 1.07 (95% CI 0.95 to 1.20) for women. This was mainly due to an excess of cancer of the larynx, lung, tongue, mouth, pharynx, oesophagus, pancreas, kidney, urinary bladder, colon, and bone as well as skin melanomas among men (the three latter borderline significantly increased...... extensively in ships. The aim of this study was to study cancer morbidity among Danish seafarers in relation to type of ship and job title. METHODS: A cohort of all Danish seafarers during 1986-1999 (33,340 men; 11,291 women) registered by the Danish Maritime Authority with an employment history was linked...... with the nationwide Danish Cancer Registry and followed up for cancer until the end of 2002. The number of person years at risk was 517,518. Standardised incidence ratios (SIR) were estimated by use of the corresponding national rates. RESULTS: The SIR of all cancers combined was higher than expected: 1.26 (95% CI 1...

  20. High Tidal Volume Decreases ARDS, Atelectasis, and Ventilator Days Compared to Low Tidal Volume in Pediatric Burned Patients with Inhalation Injury

    Science.gov (United States)

    Sousse, Linda E; Herndon, David N; Andersen, Clark R; Ali, Arham; Benjamin, Nicole C; Granchi, Thomas; Suman, Oscar E; Mlcak, Ronald P

    2015-01-01

    Background Inhalation injury, which is among the causes of acute lung injury and acute respiratory distress syndrome (ARDS), continues to represent a significant source of mortality in burned patients. Inhalation injury often requires mechanical ventilation, but the ideal tidal volume strategy is not clearly defined in burned pediatric patients. The aim of the present study is to determine the effects of low and high tidal volume on the number of ventilator days, ventilation pressures, and incidence of atelectasis, pneumonia and ARDS in pediatric burned patients with inhalation injury within one year post burn injury. Methods From 1986–2014, inhalation injury was diagnosed by bronchoscopy in pediatric burned patients (n=932). Patients were divided into three groups: (1) unventilated (n=241), (2) high tidal volume (HTV, 15 ± 3 ml/kg, n=190), and (3) low tidal volume (LTV, 9 ± 3 ml/kg, n = 501). Results HTV was associated with significantly decreased ventilator days (p<0.005) and maximum positive end expiratory pressure (p<0.0001) and significantly increased maximum peak inspiratory pressure (p<0.02) and plateau pressure (p<0.02) compared to patients with LTV. The incidence of atelectasis (p<0.0001) and ARDS (p<0.02) was significantly decreased with HTV compared to LTV. However, the incidence of pneumothorax was significantly increased in the HTV group compared with LTV (p<0.03). Conclusions HTV significantly decreases ventilator days and the incidence of both atelectasis and ARDS compared to low tidal volume in pediatric burned patients with inhalation injury. Thus, the use of HTV may interrupt sequences leading to lung injury in our patient population. PMID:25724604

  1. Cigarette Smoking and Risk of Incident Rosacea in Women.

    Science.gov (United States)

    Li, Suyun; Cho, Eunyoung; Drucker, Aaron M; Qureshi, Abrar A; Li, Wen-Qing

    2017-07-01

    The relationship between smoking and rosacea is poorly understood. We aimed to conduct the first cohort study to determine the association between smoking and risk of incident rosacea. We included 95,809 women from Nurses' Health Study II (1991-2005). Information on smoking was collected biennially during follow-up. Information on history of clinician-diagnosed rosacea and year of diagnosis was collected in 2005. We used Cox proportional hazards models to estimate age- and multivariable-adjusted hazard ratios and 95% confidence intervals for the association between different measures of smoking and risk of rosacea. During follow-up, we identified 5,462 incident cases of rosacea. Compared with never smoking, we observed an increased risk of rosacea associated with past smoking (multivariable-adjusted hazard ratio = 1.09, 95% confidence interval: 1.03, 1.16) but a decreased risk associated with current smoking (hazard ratio = 0.65, 95% confidence interval: 0.58, 0.72). We further found that increasing pack-years of smoking was associated with an elevated risk of rosacea among past smokers (P for trend = 0.003) and with a decreased risk of rosacea among current smokers (P for trend smoking cessation, and the significant association persisted among past smokers who had quit over 30 years before. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. [Five steps to decreasing nosocomial infections in large immature premature infants: A quasi-experimental study].

    Science.gov (United States)

    García González, Ana; Leante Castellanos, José Luis; Fuentes Gutiérrez, Carmen; Lloreda García, José María; Fernández Fructuoso, José Ramón; Gómez Santos, Elisabet; García González, Verónica

    2017-07-01

    An evaluation is made of the impact of a series of five interventions on the incidence of hospital-related infections in a level iii neonatal unit. Quasi-experimental, pre-post intervention study, which included preterm infants weighing 1,500g at birth or delivered at <32 weeks gestation, admitted in the 12 months before and after the measures were implemented (January 2014). The measures consisted of: optimising hand washing, following a protocol for insertion and handling of central intravenous catheters, encouraging breastfeeding; applying a protocol for rational antibiotic use, and establishing a surveillance system for multi-resistant bacteria. The primary endpoint was to assess the incidence of hospital-acquired infections before and after implementing the interventions. Thirty-three matched patients were included in each period. There was an incidence of 8.7 and 2.7 hospital-related infections/1,000 hospital stay days in the pre- and post-intervention periods, respectively (P<.05). Additionally, patients in the treatment group showed a statistically-significant decrease in days on mechanical ventilation, use of blood products, and vasoactive drugs. The strategy, based on implementing five specific measures in a unit with a high rate of hospital-related infections, proved effective in reducing their incidence. This reduction could contribute to lowering the use of mechanical ventilation, blood products, and vasoactive drugs. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. A decrease in total bilirubin predicted hyper-LDL cholesterolemia in a health screening population.

    Science.gov (United States)

    Oda, Eiji

    2014-08-01

    To investigate cross-sectional and longitudinal associations between serum total bilirubin (TB) and LDL cholesterol. It is a retrospective observational study. Cross-sectional and longitudinal associations between TB and hyper-LDL cholesterolemia were investigated in a health screening population. Odds ratios (ORs) of coexisting hyper-LDL cholesterolemia for TB were calculated in 3,866 subjects, Spearman's correlation coefficients between baseline TB and LDL cholesterol at baseline and after 4 years were calculated in 1,735 subjects who did not use antihyperlipidemic drugs and hazard ratios (HRs) of incident hyper-LDL cholesterolemia for TB were calculated in 1,992 followed subjects. The ORs (p values) of coexisting hyper-LDL cholesterolemia for each 1 SD increase in TB was 1.04 (0.998) adjusted for sex, age, smoking, LDL cholesterol and other confounders. Spearman's correlation coefficients (p values) between baseline TB and LDL cholesterol at baseline and after 4 years and changes in LDL cholesterol were -0.026 (0.271), -0.078 (0.001) and -0.062 (0.010), respectively. Among 1,992 followed subjects, 481 developed hyper-LDL cholesterolemia during 4 years (60.4 per 1,000 person-years). The HRs (95% confidence intervals; p values) of incident hyper-LDL cholesterolemia for each 1 SD increase in TB was 0.86 (0.77-0.96; 0.006) adjusted for sex, age, smoking, LDL cholesterol, body mass index, triglycerides, HDL cholesterol, fasting glucose and other confounders. The quintiles of TB were significantly associated with the incident hyper-LDL cholesterolemia adjusted for the above covariates (p for trend = 0.008). A decrease in TB predicted incident hyper-LDL cholesterolemia in a health screening population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. [Incidence of melanoma and changes in stage-specific incidence after implementation of skin cancer screening in Schleswig-Holstein].

    Science.gov (United States)

    Eisemann, N; Waldmann, A; Katalinic, A

    2014-01-01

    A pilot project in skin cancer screening (SCREEN) was conducted in Schleswig-Holstein from July 2003 to June 2004. Although the impact of this screening on the stage-specific incidence of melanoma is of great importance for screening evaluation, it remains unknown. In theory, an effective skin cancer screening program should result in a medium-term incidence decrease of melanomas with a prognostically unfavorable stage. This is studied on a population-based level by using cancer registry data. Based on data from the Cancer Registry of Schleswig-Holstein for 1999-2009, stage-specific (T-category of the TNM-classification system) age-standardized incidence rates were calculated. After implementation of the SCREEN project, the incidence of prognostically favorable melanomas (in situ and T1) was higher than before, while the incidence of advanced melanomas (T2, T3, and for women also T4) decreased considerably. The classification of tumor stages changed during the project period, which may have contributed to an artificial decrease of the stages with a poor prognosis. Nevertheless, the results are in agreement with the observed decrease of melanoma mortality in the screening region.

  5. Corticosteroids decrease glomerular angiotensin receptors

    Energy Technology Data Exchange (ETDEWEB)

    Douglas, J.G.

    1987-03-01

    Angiotensin II (ANG II) receptors of glomerular mesangial cells are regulated in vivo by changes in Na balance, effects that are presumed to be secondary to changes in circulating ANG II. However, since changes in ANG II were accompanied by parallel changes in plasma aldosterone in all models tested, it is possible that aldosterone may have also participated in the modulation of glomerular ANG II receptors. To test this hypothesis, short-term aldosterone infusions within the physiological range were employed to favor actions that would be mediated through a high-affinity mineralocorticoid receptor. The glucocorticoid, dexamethasone, was also tested to determine the mineralocorticoid specificity of the response. Two infusion rates were associated with a decrease in glomerular /sup 125/I ANG II receptor density of 33 and 45%, respectively. Serum potassium and urinary Na/K ratio were lower in the aldosterone group. Spironolactone abolished the effect of aldosterone consistent with an action mediated through a specific mineralocorticoid receptor. These studies support the hypothesis that corticosteroids modulate glomerular ANG II receptors and validate the complexity of glomerular receptor modulation. The downregulation observed would be expected to diminish the ability of ANG II to influence glomerular hemodynamics in models such as mineralocorticoid and glucocorticoid-induced hypertension.

  6. Unmodifiable variables related to thyroid cancer incidence

    Directory of Open Access Journals (Sweden)

    Cornelia Nitipir

    2018-04-01

    Full Text Available The incidence of thyroid cancer is significantly different between male and female patients. Thyroid cancer is also the only form of cancer where age can be considered a staging variable. Identifying biological prognostic factors such as age or sex is important as it helps select an optimal personalized therapy. The present analysis is an observational, prospective study that enrolled all patients with thyroid disease who were operated upon at a single center. The study aimed to determine the most frequent age at presentation, the predominance of one sex over the other, the incidence of malignant thyroid disease, and the relative risk for each sex to develop thyroid carcinoma. The incidence of thyroid carcinoma was higher for women than for men, with a higher relative risk in the female subgroup. Incidence was also highest in the 50-60-year-old group. Given that studies show better survival for women and for younger patients, even when presenting with advanced disease, compared with older, male patients, such prognostic indicators should be a factor in the treatment decision.

  7. Norepinephrine inhibits macrophage migration by decreasing CCR2 expression.

    Directory of Open Access Journals (Sweden)

    Fangming Xiu

    Full Text Available Increased incidences of infectious and septic complications during post-burn courses represent the main contributor to burn injury mortality. Sustained increases in catecholamine levels, especially norepinephrine (NE, contribute to immune disturbances in severely burned patients. The precise mechanisms underlying NE-mediated immunoregulation are not fully understood. Here we hypothesize that persistently elevated NE levels are associated with immunodysfunctions. We examined the effects of NE on the phenotype and functions of bone marrow-derived macrophages (BMMs. Whole mouse bone marrow cells were treated in vitro with 40 ng/mL of M-CSF and with 1 x 10(-6 M or 1 x 10(-8 M of NE or without NE for 7 days; cells were collected and stained with antibodies for CD11b, F4/80, MHC II and the inflammatory CC chemokine receptor 2 (CCR2. We found 1 x 10(-6 M of NE inhibited MHC II and CCR2 expression on CD11b(+/F4/80(+ BMM cells. It also inhibited BMM proliferation by inhibiting CSF-1R expression. On the contrary, 1 x 10(-8 M of NE slightly increased both MHC II and CCR2 expression on CD11b(+/F4/80(+ BMM cells but inhibited CD11b(+/F4/80(+ BMM proliferation. MCP-1 based migration assay showed that the migration of 1 x 10(-6 M of NE-treated BMM toward MCP-1 was significantly decreased compared to BMM without NE treatment. Both 1 x 10(-8 M and 1 x 10(-6 M of NE enhanced TNF-α production and phagocytosis of FITC-Dextran. Intracellular staining of transcriptional factor MafB showed that 1 x 10(-6 M of NE treatment enhanced its expression, whereas 1 x 10(-8 M of NE decreased expression. Stimulation with LPS in the last 24-hours of BMM culture further decreased CCR2 and MHC II expression of these BMM, suggesting the synergistic effect of LPS and NE on macrophage. Our results demonstrate that NE regulates macrophage differentiation, proliferation and function, and may play a critical role in the dysfunctional immune response post-burn.

  8. Incidence of colorectal cancer in young patients

    Directory of Open Access Journals (Sweden)

    FÁBIO GUILHERME C. M. DE CAMPOS

    Full Text Available ABSTRACT Sporadic colorectal cancer (CRC is traditionally diagnosed after de sixth decade of life, although a small percentage of cases are diagnosed in patients under 40 years of age, and incidence is increasing. There exists a great volume of controversy regarding clinical outcome of young patients diagnosed with colorectal cancer (CRC when compared to elder counterparts. Our aims were to evaluate the rate of CRC in young patients, to review the pertaining literature and to discuss outcomes and clinical prognosis. A retrospective review involving patients with CRC was undertaken, focusing on age at diagnosis. The information extracted from this literature review showed a trend towards a decreased incidence in older people with an opposite effect among adolescents and young adults. Moreover, biological aggressiveness in young adults diagnosed with CRC has not been fully recognized, although it is usually diagnosed later and in association with adverse histological features. Besides that, these features don't affect outcome. These apparent increase in CRC incidence among young patients during the last decades raises the need for a greater suspicious when evaluating common symptoms in this group. Thus, educational programs should widespread information for both population and physicians to improve prevention and early diagnosis results.

  9. Unmodifiable variables related to thyroid cancer incidence

    OpenAIRE

    Cornelia Nitipir; Lucian Alecu; Iulian Slavu; Raluca Tulin; Radu C. Jecan

    2018-01-01

    The incidence of thyroid cancer is significantly different between male and female patients. Thyroid cancer is also the only form of cancer where age can be considered a staging variable. Identifying biological prognostic factors such as age or sex is important as it helps select an optimal personalized therapy. The present analysis is an observational, prospective study that enrolled all patients with thyroid disease who were operated upon at a single center. The study aimed to determine the...

  10. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature.

    Science.gov (United States)

    Kilic, O; Maas, M; Verhagen, E; Zwerver, J; Gouttebarge, V

    2017-07-01

    Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies.

  11. Multimicronutrient supplementation in older persons decreased zinc deficiency but not serum TNF-á

    Directory of Open Access Journals (Sweden)

    Elly Herwana

    2011-08-01

    Full Text Available The increase in the population of older persons needs to be accompanied by increased quality of healthcare in older persons, particularly a decrease in the incidence of infections. Impaired immune responses are common in older adults, and immune senescence likely contributes to the increased incidence of infectious diseases in the older persons. The aging process decreases the immune response and many studies have been conducted to explain the role of supplementation with various micronutrients, such as vitamin C, vitamin E, â-carotene and zinc, on the immune response. The aim of the present study was to assess the influence of 6 months of multi-micronutrient (MMN supplementation on zinc and tumor necrosis factor (TNF-á levels in older persons. A randomized controlled trial was conducted on 78 older persons, who were divided into two groups. The treatment group received MMN supplementation containing 40 mg elemental zinc, 120 mg ascorbic acid, 6 mg â-carotene, 15 mg á-tocopherol and 400 ìg folic acid and the control group 400 mg calcium carbonate. The study did not demonstrate that 6 months of MMN supplementation resulted in significant differences between both groups, with respect to total protein, albumin, globulin, and TNF-á levels. In contrast, MMN supplementation significantly decreased the proportion of older persons with zinc deficiency in the treatment group, in comparison with the control group. The present data suggest that in older persons with relatively good immune and protein status, improvement of the immune status by MMN supplementation may be difficult and at best limited.

  12. Are urban noise pollution levels decreasing?

    Science.gov (United States)

    Arana, M

    2010-04-01

    The majority of acoustic impact studies developed over the last 50 years have used a similar acoustic parameter (L(eq), L(dn)) but the noise mapping methodology has been very uneven. The selection of the measurement points, the measurement periods, or the evaluation indices have not followed a unique criterion. Therefore, it is not possible to compare the sound pollution levels between different cities from those studies, at least in a rigorous sense. Even more, different studies carried out in the same city by different researchers during different years and using different methodologies are not conclusive whether the acoustic pollution increases or decreases. The present paper shows results, with statistical significance, about the evolution of the acoustic pollution obtained for two Spanish cities, Pamplona and Madrid. In both cases, it can be concluded that noise pollution decreases over time (P<0.01).

  13. Trends in the incidence of stroke and cardiovascular risk factors on the isolated island of Okinawa: the Miyakojima study.

    Science.gov (United States)

    Sugama, Chikako; Isa, Katsunori; Okumura, Koichiro; Iseki, Kunitoshi; Kinjo, Kozen; Ohya, Yusuke

    2013-10-01

    Rapid deterioration of cardiovascular risk control, especially obesity, has occurred in Okinawa; this may affect cardiovascular disease incidence, including stroke. Cross-sectional field studies were conducted in 2 periods, 1988-1991 as the first period, and 2002-2005 as the second period, in the isolated island of Okinawa, Miyakojima. To evaluate population backgrounds related to cardiovascular risk factors, data from the health checkup programs conducted in 1987 and 2001 were surveyed. Total of 257 patients in the first period and 370 in the second were diagnosed with first-time stroke. The age-adjusted annual incidence rate of first-time stroke of the first and second periods was 124 and 144 per 100,000 standard population of Japan. The age-adjusted annual incidence rate showed an upward trend for brain infarction (50 to 73) and downward trend for brain hemorrhage (61 to 54); however, those trends were not significant. The health checkup surveys illustrated that blood pressure decreased in all age groups during the second survey period. However, the body mass index increased in patients aged 50 years or more. Fasting blood glucose levels of patients aged 30-79 years and non-HDL cholesterol levels of patients aged 50-79 years significantly increased. In Miyakojima, the incidence of first-time stroke and all of its subtypes did not change significantly between two periods, even though blood pressure decreased significantly in the second period. Metabolic deterioration may be associated with the upward trend in incidence of brain infarction. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Incidence of myocardial infarction in the Danish MONICA population 1982-1991

    DEFF Research Database (Denmark)

    Kirchhoff, M; Davidsen, M; Brønnum-Hansen, H

    1999-01-01

    BACKGROUND: Cardiovascular mortality has been declining in Denmark over the past 20 years. Trends in incidence of myocardial infarction (MI) over the period 1982-1991 are described within the framework of the World Health Organization MONICA Project. METHODS: The DAN-MONICA heart register included......-MONICA criteria for definite or possible MI, recurrent as well as first-ever MI, were registered. Subsequent tracing of cases through national registers on deaths and hospitalizations by means of the patient's civil registration number ensured the completeness of the registration. RESULTS: A total of 6025 cases...... register meets the requirements for completeness and uniformity throughout the registration period. Causes and magnitude of bias are well described. Even when possible sources of bias are taken into account, the incidence of MI decreased significantly over the 10-year-period 1982-1991 by an average of 5...

  15. Incidence of amlodipine-induced gingival overgrowth in the rural population of Loni

    Directory of Open Access Journals (Sweden)

    Avneesh Tejnani

    2014-01-01

    Full Text Available Aims: Since the incidence of gingival overgrowth induced by amlodipine remains poorly defined, this study was carried out with an aim to determine the incidence. Materials and Methods: Dental patients who received amlodipine (N = 115, for more than 3 months were studied to determine the drug-induced gingival overgrowth. Clinical diagnosis of drug-induced overgrowth was verified by disappearance or decreased severity of gingival overgrowth after withdrawal of the causative drug. Results: The prevalence rate of amlodipine-induced gingival hyperplasia among experimental patients was 3.4%, while it was not observed among the control subjects. Oral examination revealed gingival overgrowth as a lobular or nodular enlargement on interdental papilla located in the anterior interproximal regions. Conclusions: In this study, there was a significant relationship between gingival inflammation resulting from dental plaque and drug dosage, and hyperplasia.

  16. Heated wire humidification circuit attenuates the decrease of core temperature during general anesthesia in patients undergoing arthroscopic hip surgery.

    Science.gov (United States)

    Park, Sooyong; Yoon, Seok-Hwa; Youn, Ann Misun; Song, Seung Hyun; Hwang, Ja Gyung

    2017-12-01

    Intraoperative hypothermia is common in patients undergoing general anesthesia during arthroscopic hip surgery. In the present study, we assessed the effect of heating and humidifying the airway with a heated wire humidification circuit (HHC) to attenuate the decrease of core temperature and prevent hypothermia in patients undergoing arthroscopic hip surgery under general anesthesia. Fifty-six patients scheduled for arthroscopic hip surgery were randomly assigned to either a control group using a breathing circuit connected with a heat and moisture exchanger (HME) (n = 28) or an HHC group using a heated wire humidification circuit (n = 28). The decrease in core temperature was measured from anesthetic induction and every 15 minutes thereafter using an esophageal stethoscope. Decrease in core temperature from anesthetic induction to 120 minutes after induction was lower in the HHC group (-0.60 ± 0.27℃) compared to the control group (-0.86 ± 0.29℃) (P = 0.001). However, there was no statistically significant difference in the incidence of intraoperative hypothermia or the incidence of shivering in the postanesthetic care unit. The use of HHC may be considered as a method to attenuate intraoperative decrease in core temperature during arthroscopic hip surgery performed under general anesthesia and exceeding 2 hours in duration.

  17. Changes in the incidence of occupational disability as a result of back and neck pain in the Netherlands

    Directory of Open Access Journals (Sweden)

    Verbeek Jos H

    2006-07-01

    Full Text Available Abstract Background Back pain (including neck pain is one of the most prevalent health problems for which physicians are consulted. Back pain can decrease the quality of life considerably during a great part of the lives of those who suffer from it. At the same time it has an enormous economic impact, mainly through sickness absence and long-term disability. The objective of this paper is to compare the incidence of occupational disability as a result of back and neck pain in 1980–1985 to 1999–2000 and to explain the findings. Methods A descriptive study was performed at population level of changes in incidence of occupational disability as a result of back and neck pain. Statistics from the National Institute of Social Insurance in the Netherlands are used to calculate age and gender specific incidence rates for back pain diagnoses based on the ICD-classification. Incidence rate ratios stratified according to gender and adjusted for age were calculated to indicate changes over time. Results The incidence of occupational disability as a result of back pain decreased significantly by 37% (95% CI 37%–38% in men and with 21% (95% CI 20%–24% in women, after adjustment for age. For overall occupational disability as a result of all diagnoses this was 18% (95% CI 18%–19% and 34% (95% CI 33%–35% respectively. Changes were not homogeneous over diagnostic subcategories and age groups. Spondylosis decreased most in men by 59% (95% CI 57%–61%. The incidence of non-specific back pain and neck pain increased most by 196% (95% CI 164%–215%. Post-laminectomy syndrome increased over all age categories both for men (85%, 95% CI 61%–113% and women (113%, 95% CI 65%–179%. Conclusion The decrease in occupational disability as a result of back pain was larger than the decrease in occupational disability over all diagnoses. However, time trends were not homogeneous over age-, nor over sex- nor back pain categories. Most of this decrease was due to

  18. Physical activity decreases diverticular complications

    Science.gov (United States)

    Strate, Lisa L.; Liu, Yan L.; Aldoori, Walid H.; Giovannucci, Edward L.

    2011-01-01

    Objectives Little is known about the effect of physical activity on diverticular complications. This study examined prospectively the association between physical activity and diverticular bleeding and diverticulitis. Methods We studied 47,230 US males in the Health Professionals Follow-up Study cohort who were aged 40–75 years and free of diverticular disease, gastrointestinal cancer and inflammatory bowel disease at baseline in 1986. Men reporting newly diagnosed diverticular disease on biennial follow-up questionnaires were sent supplemental questionnaires outlining details of diagnosis and treatment. Physical activity was assessed every 2 years. Men recorded the average time per week spent in 8 recreational activities, and flights of stairs climbed per day. Cox proportional hazards regression was used to calculate relative risks. Results During 18 years of follow-up, 800 cases of diverticulitis, and 383 cases of diverticular bleeding were identified. Total cumulative physical activity was associated with a decreased risk of diverticulitis and diverticular bleeding. After adjustment for potential confounders, the relative risk (RR) for men in the highest quintile of total activity (≥57.4 Metabolic Equivalent (MET h/wk) was 0.75 (95% CI 0.58–0.95) for diverticulitis, and 0.54 (95% CI, 0.38–0.77) for bleeding when compared to men in the lowest quintile (≤8.2 MET h/wk). Vigorous activity was inversely related to diverticulitis (multivariable RR 0.66, 95% CI, 0.51–0.86), and bleeding (multivariable RR 0.61, 95% CI, 0.41 – 0.90) in a high vs. low comparison, whereas non-vigorous activity was not. These results were similar for recent (simple updated) and baseline activity. Conclusions Data from this large prospective cohort suggest that physical activity lowers the risk of diverticulitis and diverticular bleeding. Vigorous activity appears to account for this association. PMID:19367267

  19. Bulimia: Estimate of Incidence and Relationship of Shyness.

    Science.gov (United States)

    Segal, Shirley Ann; Figley, Charles R.

    1985-01-01

    Surveyed 160 college women to examine the incidence of bulimia and its relationship to shyness. Results indicated 23 percent of the participants were bulimic. A significant relationship was found between bulimia and fear of rejection (private shyness). (JAC)

  20. Traffic incident management resource management.

    Science.gov (United States)

    2009-01-01

    The necessity of a multi-disciplinary approach involving law enforcement, fire and rescue, transportation, towing and recovery, and others has been well-recognized and integrated into incident management operations. This same multidisciplinar...

  1. Police Incident Blotter (30 Day)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The 30 Day Police Blotter contains the most recent initial crime incident data, updated on a nightly basis. All data is reported at the block/intersection level,...

  2. Regional comparison of cancer incidence

    International Nuclear Information System (INIS)

    Obralic, N.; Gavrankapetanovic, F.; Dizdarevic, Z.; Duric, O.; Sisic, F.; Selak, I.; Balta, S.; Nakas, B.

    2004-01-01

    Background. Due to specific war and post-war situation in Balkan region, differences in the number, type, development, biological course, treatment of malignant tumours and its outcome are possible. In order to perceive the situation realistically, it is necessary to gather continuously exact data about malignant tumours and compare them with the data from other European and world countries.The aim of the study was to collect and analyse the data on cancer incidence in the region of Sarajevo city, which represents a symbol of difficult times in the recent past, and to compare it to the incidence in the neighbouring countries. Patients and methods. Data on all newly diagnosed cancer cases, permanent residents of Sarajevo Canton, in the years 1999 and 2000 were collected. Crude incidence rate has been calculated according to the years observed, gender and localizations of the disease The data were compared to the cancer registries of Slovenia and Croatia and were observed in the light of specific local situation. Results. The crude cancer incidence of all sites but skin was the highest in both years and by both genders in Croatia. The incidence of the most common tumours (lung and breast cancer) was similar in all three countries. The differences in the incidence between both genders in the Sarajevo canton were registered in laryngeal and urinary bladder cancer, as well as in bone and cartilage sarcoma. Cervical cancer had extremely high incidence and was high up on the incidence list in the Sarajevo canton, which correlates with the data in developing countries. The incidence of other tumours in the post-war period is reaching expected numbers. Conclusions. It is difficult to identify whether the war and post-war stress, irregular and insufficient nutrition during and after the siege of the city of Sarajevo or some other factor influenced the cancer incidence among exposed population. The prevalence of smoking in the whole region is extremely high, in Bosnia and

  3. Asymptotics for incidence matrix classes

    OpenAIRE

    Cameron, Peter; Prellberg, Thomas; Stark, Dudley

    2005-01-01

    We define {\\em incidence matrices} to be zero-one matrices with no zero rows or columns. A classification of incidence matrices is considered for which conditions of symmetry by transposition, having no repeated rows/columns, or identification by permutation of rows/columns are imposed. We find asymptotics and relationships for the number of matrices with $n$ ones in these classes as $n\\to\\infty$.

  4. Incidence Handling and Response System

    OpenAIRE

    Kalbande, Prof. Dhananjay R.; Thampi, Dr. G. T.; Singh, Mr. Manish

    2009-01-01

    A computer network can be attacked in a number of ways. The security-related threats have become not only numerous but also diverse and they may also come in the form of blended attacks. It becomes difficult for any security system to block all types of attacks. This gives rise to the need of an incidence handling capability which is necessary for rapidly detecting incidents, minimizing loss and destruction, mitigating the weaknesses that were exploited and restoring the computing services. I...

  5. Significance of myocardial scintigraphy in hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Emoto, Tsugumichi; Shimizu, Yoshimi; Yuo, Hiroyuki (Kanazawa Univ. (Japan). School of Medicine) (and others)

    1994-02-01

    The study investigated the relationship between the occurrence incidence of abnormal findings on exercice Tl-201 myocardial scintigraphy and pathophysiology in hypertrophic cardiomyopathy (HCM). Fifty HCM patients underwent exercise Tl-201 scintigraphy. Simultaneously, 12-lead ECG was recorded during exercise. In addition, 17 patients, who were randomly selected from the 50 patients, underwent I-123 BMIPP myocardial scintigraphy. Abnormal findings were observed in 23 of the 50 patients (46%) on Tl images. Among these patients, 19 patients (38%) had redistribution on 3 hr images (the group of reversible defects (R)), and 4 (8%) had no redistribution (the group of fixed defects (F)). Regarding the occurrence incidence of ischemic ST changes and exercise tolerance ability, there was no difference between the group of normal findings and the group of R. In the group of F, however, ST changes were seen in all patients, although there was no difference in exercise tolerance ability. Of 17 patients who underwent I-123 BMIPP scintigraphy, 7 had normal findings on Tl images. Of these 7, 4 had abnormal findings on BMIPP images and decreased exercise tolerance ability as well. These findings suggest the necessity for careful follow-up even in HCM patients who had no abnormal findings on Tl images. (N.K.).

  6. Decreased Emotional Perception in Obesity.

    Science.gov (United States)

    Giel, Katrin Elisabeth; Hartmann, Armin; Zeeck, Almut; Jux, Anna; Vuck, Alexander; Gierthmuehlen, Petra C Guess; Wetzler-Burmeister, Edda; Sandholz, Angelika; Marjanovic, Goran; Joos, Andreas

    2016-07-01

    There is hardly any empirical evidence on emotion processing by controlled studies in obesity. Participants rated their emotions in response to visual emotional stimuli from the International Affective Picture System. Study 1 compared obese women with normal-weight controls and women with eating disorders. Study 2 compared obese men with normal-weight controls. Obese women had reduced emotional intensity scores for all basic emotions and the mixed emotion sadness-fear. Obese men had reduced scores for all emotions except happiness and disgust; anger showed a trend towards significance. The results were mainly based on ratings from non-depressed obese individuals. Obese men and women scored significantly lower on most basic and mixed emotions. Non-depressed obese subjects seem particularly affected. These new findings must be validated by further study, and longitudinal evaluation after weight loss, e.g. by bariatric surgery, will be of interest. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  7. [Leukemia mortality and incidence of infantile leukemia near the Vatican Radio Station of Rome].

    Science.gov (United States)

    Michelozzi, P; Kirchmayer, U; Capon, A; Forastiere, F; Biggeri, A; Barca, A; Ancona, C; Fusco, D; Sperati, A; Papini, P; Pierangelini, A; Rondelli, R; Perucci, C A

    2001-01-01

    Some recent epidemiological studies suggest an association between lymphatic and haematopoietic cancers and residential exposure to high frequency electromagnetic fields (100 kHz-300 GHz) generated by radio and television transmitters. Vatican Radio, a very powerful radio station transmitting all over the world (up to 600 kW) is located in Santa Maria di Galeria, in the northern suburbs of the city of Rome. Electric field measurements in the proximity of the radio station ranged between 1.5 and 25 V/m. In the 10 km area around the station, with 60.182 residents (1999), leukaemia mortality among adults (> 14 years, 40 cases) in the period 1987-98 and childhood leukaemia incidence in the period 1987-99 (8 cases) were evaluated. The analysis (Stone's conditional test) was performed computing observed and expected cases (reference: population of Rome) in 5 bands of increasing radius (2 km width). The risk of childhood leukaemia was higher than expected within 6 km from the station (Standardized Incidence Ratio = 217; 95% Confidence Interval 99-405). Stone's test showed a significant decrease in risk with increasing distance both for male adult mortality (p-value = 0.03) and for childhood incidence (p-value = 0.04). A Score test, showed a significant decrease in risk of childhood incidence as function of the distance. The main limitations of this study are the small number of observed cases and the use of distance as a proxy for RF exposure. Further research will require a systematic campaign of electromagnetic field measurements to allow better assessment of the population exposure.

  8. Effects of Modification of Pain Protocol on Incidence of Post Operative Nausea and Vomiting.

    Science.gov (United States)

    Schwarzkopf, Ran; Snir, Nimrod; Sharfman, Zachary T; Rinehart, Joseph B; Calderon, Michael-David; Bahn, Esther; Harrington, Brian; Ahn, Kyle

    2016-01-01

    A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol. All total joint replacement PSH (TJR-PSH) patients who underwent primary THA (n=149) or TKA (n=212) in the study period were included. The modified protocol added a single dose of intravenous (IV) ketorolac given in the operating room and oxycodone immediate release orally instead of IV Hydromorphone in the Post Anesthesia Care Unit (PACU). The outcomes were (1) incidence of PONV and (2) average pain score in the PACU. We also examined the effect of primary anesthetic (spinal vs . GA) on these outcomes. The groups were compared using chi-square tests of proportions. The incidence of post-operative nausea in the PACU decreased significantly with the modified protocol (27.4% vs . 38.1%, p=0.0442). There was no difference in PONV based on choice of anesthetic or procedure. Average PACU pain scores did not differ significantly between the two protocols. Simple modifications to TJR-PSH multimodal pain management protocol, with decrease in IV narcotic use, resulted in a lower incidence of postoperative nausea, without compromising average PACU pain scores. This report demonstrates the need for continuous monitoring of PSH pathways and implementation of revisions as needed.

  9. Safety-related incidents at the Finnish nuclear power plants

    International Nuclear Information System (INIS)

    Lehtinen, P.

    1985-01-01

    This report contains detailed descriptions of operating incidents and other safety-related matters at the Finnish nuclear power plants regarded as significant by the regulatory authority, the Finnish Centre for Radiation and Nuclear Safety. In this connection, an account is given of the practical actions caused by the incidents, and their significance to reactor safety is evaluated. The main features of the incidents are also described in the general Quartely Reports, Operation of Finnish Nuclear Power Plants, which are supplemented by this report intended for experts. (author)

  10. Effects of the German skin cancer screening programme on melanoma incidence and indicators of disease severity.

    Science.gov (United States)

    Trautmann, F; Meier, F; Seidler, A; Schmitt, J

    2016-11-01

    In Germany a nationwide melanoma screening programme for adults aged ≥ 35 years was introduced in July 2008. Evidence on utilization and effects is limited. To examine the uptake and effects of the German nationwide screening programme. This analysis is based on pseudonymized outpatient routine data of a German health insurance company covering data of > 2 million individuals from Saxony for the years 2005-2012. Cases of melanoma and nonmelanoma skin cancer (NMSC) were identified using an algorithm based on the International Classification of Diseases, 10th Revision. Cross-sectional and longitudinal analyses were applied to determine the utilization of the screening programme and effects on skin cancer incidence and disease severity as a proxy for prognosis. Overall, 38·0% of eligible persons (≥ 35 years) were screened at least once between July 2008 and December 2012. The annual participation rate was 12·4%. Out of 533 393 persons screened, melanoma and NMSC were diagnosed in 0·3% and 2·5%, respectively. The 6-month melanoma incidence per 100 000 insured persons decreased from 12·8 before screening introduction (January to June 2008) to 10·2 after introduction (July to December 2008). NMSC incidence increased from 173·8 to 175·5 per 100 000. The numbers of screening participants receiving interferon alpha and/or being diagnosed with lymph node and/or distant metastasis (8·6%, 5·9%, 1·5%, respectively) were lower than in nonparticipants (11·2%, 8·5%, 3·5%). These differences were not significant. The results suggest that the introduction of a generic skin cancer screening programme in Germany was not associated with significant changes in incidence. No firm conclusions regarding the effects of skin cancer screening on prognosis can be drawn. Longer follow-up and linkage with clinical registry data are necessary to clarify the effect of screening participation on incidence and prognosis. © 2016 British Association of Dermatologists.

  11. Incidence rate of thyroid cancer in Neuquén (2001-2012).

    Science.gov (United States)

    Cohen Sabban, Marcos Alejandro; Palmero, Cintia; Bertrand, Beatriz; Aiello, Ana; Ghiglioni, Amalia; Mac Donell, Maria Celina; Croci, Cecilia; Cabaeiro, Patricia; Juvenal, Guillermo Juan

    2014-11-01

    During the past decades, an increasing incidence of thyroid cancer (TC) has been reported worldwide. In Argentina there is no national cancer registry, and its incidence has therefore not been established. The aim of our study was to determine the incidence of TC in the province of Neuquén and to compare it to that reported in the literature. The medical records of 229 patients admitted over a period of 12 years (2001 to 2012) were used for data analysis. Tumor size, age, sex, and histological type were evaluated. The study period was divided into four three-year periods, and differences in each of these features were analyzed. We found an incidence of 4.72/100,000 inhabitants/year, and almost all patients had papillary TC. TC was five times more common in females as compared to males (7.78 and 1.55 respectively). Mean tumor size was 22.2 ± 1.1 mm. Tumor size was significantly greater in men (31.8 ± 3.7 mm) than in women (20.4 ± 1.0 mm). When grouped by three-year periods, a higher number of cases was found in the last one (47, 49, 49 and 84 respectively). As regards tumor distribution by size, there was a significant decrease in mean tumor size in the fourth period and an increase in the proportion of tumors <10mm. We report an increase in TC incidence in the Argentinean province of Neuquén which is similar to the overall increase reported in the international literature. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

  12. Women, Loneliness, and Incident Coronary Heart Disease

    Science.gov (United States)

    Thurston, Rebecca C.; Kubzansky, Laura D.

    2010-01-01

    Objective To examine associations between loneliness and risk of incident coronary heart disease (CHD) over a 19-year follow-up period in a community sample of men and women. Loneliness, the perceived discrepancy between actual and desired social relationships, has been linked to several adverse health outcomes. However, no previous research has prospectively examined the association between loneliness and incident CHD in a community sample of men and women. Methods Hypotheses were examined using data from the First National Health and Nutrition Survey and its follow-up studies (n = 3003). Loneliness, assessed by one item from the Center for Epidemiologic Studies of Depression scale, and covariates were derived from baseline interviews. Incident CHD was derived from hospital records/death certificates over 19 years of follow-up. Hypotheses were evaluated, using Cox proportional hazards models. Results Among women, high loneliness was associated with increased risk of incident CHD (high: hazard ratio = 1.76, 95% Confidence Interval = 1.17â2.63; medium: hazard ratio = 0.98, 95% Confidence Interval = 0.64â1.49; reference: low), controlling for age, race, education, income, marital status, hypertension, diabetes, cholesterol, physical activity, smoking, alcohol use, systolic and diastolic blood pressures, and body mass index. Findings persisted additionally controlling for depressive symptoms. No significant associations were observed among men. Conclusions Loneliness was prospectively associated with increased risk of incident CHD, controlling for multiple confounding factors. Loneliness among women may merit clinical attention, not only due to its impact on quality of life but also its potential implications for cardiovascular health. PMID:19661189

  13. Significance of postoperative irradiation for breast cancer

    International Nuclear Information System (INIS)

    Murai, Nobuko; Ogami, Koji; Nishikawa, Kiyoshi; Koga, Kenji; Waki, Norio; Higashi, Hidefumi; Hayashi, Asami; Shibata, Koichiro; Watanabe, Katsuji

    1986-01-01

    From 1978 through 1983, 27 patients were treated with surgery followed by irradiation (irradiated group) and 29 with surery alone (non-irradiated group). In the irradiated group, 10 had stage II and 17 stage III; in the non-irradiated group, 25 had stage II and 4 stage III. The most common histology was medullary tubular carcinoma (MTC). There was no significant difference in survivals at 3 years and 5 years between the groups. Similarly, no significant difference was seen among stage II patients. Patients with MTC tended to have worse survivals in the irradiated group than in the non-irradiated group, with no statistically significant difference. Among stage II patients, no major differences in local recurrence were seen between the groups; the incidence of distant metastases tended to be high in the irradiated group. The incidence of both local recurrence and distant metastases for stage III patients showed a tendency to be higher in the irradiated group than in the non-irradiated group. The results indicated no apparent benifit of postoperative irradiation for breast cancer. A randomized clinical trial is needed for the evaluation of postoperative irradiation for breast cancer. (Namekawa, K.)

  14. Persistent perforation in non-faeculant diverticular peritonitis--incidence and clinical significance.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2013-02-01

    Non-resectional strategies (NRS) have improved outcomes for a sub-group of patients with perforated diverticulitis. NRS are applicable to patients with non-faeculant peritonitis (Hinchey II and III). Success is dependent on the initial perforation sealing, which Hinchey estimated occurred \\'most of the time\\'. An exact percentage remains ill-defined.

  15. Focal cerebral hyperemia in acute stroke. Incidence, pathophysiology and clinical significance

    DEFF Research Database (Denmark)

    Olsen, T S; Larsen, B; Skriver, E B

    1981-01-01

    tissue pressure on brain tissue. Cortical infarcts (10 patients) all had extensive hyperemic areas. Because the 254 detector camera has an excellent resolution in the cortical surface, our findings strongly suggest that all acute cerebral infarcts are, in fact, associated with hyperemic areas......In a consecutive study comprising 41 patients with completed stroke of less than 72 hours duration, cerebral angiography and measurements of the regional cerebral blood flow (rCBF) were performed within 24 hours after admission. The rCBF study was done using the 133-Xenon intracarotid injection...... method and a 254 multi-detector camera. CT scan was done 24 hours after the rCBF study. Focal cerebral hyperemia was found in 16 patients. The study revealed 3 different types of hyperemia: Border-zone hyperemia, surrounding ischemic areas, was seen in patients with occluded arteries on angiography...

  16. Tuberculosis incidence in prisons: a systematic review.

    Directory of Open Access Journals (Sweden)

    Iacopo Baussano

    Full Text Available BACKGROUND: Transmission of tuberculosis (TB in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. METHODS AND FINDINGS: A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF% to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8 and 23.0 (IQR: 11.7-36.1, respectively. The median estimated fraction (PAF% of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9% and 6.3% (IQR: 2.7%-17.2% in high- and middle/low-income countries, respectively. CONCLUSIONS: The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.

  17. Low Dose Aminophylline Effectively Decreases the Risk of Post-Operative Apnea in Premature Infants

    Science.gov (United States)

    Roodneshin, Fatemeh

    2014-01-01

    Background Retinopathy of prematurity (ROP) is the most common reason behind surgical procedures in premature newborns. Anesthesia in these patients is life-threatening due to post-operative apnea of prematurity (POA). This study aimed to determine the predisposing factors to POA in premature infants and to explore the role of prophylactic aminophylline in decreasing the incidence of POA. Materials and Methods Fifty patients with prematurity who were candidates for elective eye surgery (less than one hour) were selected and received aminophylline (3 mg/kg) 5 minutes after the induction of anesthesia with sevoflurane. Patients were kept in the recovery room for 2 hours post-operation in an incubator and were monitored for SPO2, apnea, bradycardia and other signs of desaturation and apnea. Results There were no statistically significant differences in the gestational age and weight, sex, postconceptual age and weight and other demographic characteristics between the experimental and control groups. Gestational ageapnea. Treatment with aminophylline as compared with the placebo was associated with a significantly decreased risk of post-operative apnea (OR=0.53; 95% CI 0.28–0.98; P=0.034). Conclusion Aminophylline can be used prophylactically to decrease the risk of postoperative apnea with no major adverse effects. PMID:25713589

  18. Low dose aminophylline effectively decreases the risk of post-operative apnea in premature infants.

    Science.gov (United States)

    Mohajerani, Seyed Amir; Roodneshin, Fatemeh

    2014-01-01

    Retinopathy of prematurity (ROP) is the most common reason behind surgical procedures in premature newborns. Anesthesia in these patients is life-threatening due to post-operative apnea of prematurity (POA). This study aimed to determine the predisposing factors to POA in premature infants and to explore the role of prophylactic aminophylline in decreasing the incidence of POA. Fifty patients with prematurity who were candidates for elective eye surgery (less than one hour) were selected and received aminophylline (3 mg/kg) 5 minutes after the induction of anesthesia with sevoflurane. Patients were kept in the recovery room for 2 hours post-operation in an incubator and were monitored for SPO2, apnea, bradycardia and other signs of desaturation and apnea. There were no statistically significant differences in the gestational age and weight, sex, postconceptual age and weight and other demographic characteristics between the experimental and control groups. Gestational ageapnea. Treatment with aminophylline as compared with the placebo was associated with a significantly decreased risk of post-operative apnea (OR=0.53; 95% CI 0.28-0.98; P=0.034). Aminophylline can be used prophylactically to decrease the risk of postoperative apnea with no major adverse effects.

  19. Incidence study of head blows and concussions in competition taekwondo.

    Science.gov (United States)

    Koh, Jae O; Cassidy, J David

    2004-03-01

    To examine the incidence of head blows and concussions in competition taekwondo. Incidence cohort design. Taekwondo tournament in 2001, in South Korea. A total of 2328 competitors (female, 676; male, 1652; age, 11-19 years) from 424 schools participated in the tournament. All recipients of head blows were interviewed immediately after the match. All matches were recorded on videotape. Head blow and concussion rates were calculated. Also, factors associated with head blows and concussions were analyzed. The incidence of head blows and concussions was 226 and 50 per 1000 athlete exposures, respectively. Only 17% of competitors reported that they had had a concussion in the last 12 months. A multinomial logistic model showed that head blows and concussions were associated with young age and a lack of blocking skills. The incidence of head blows and concussions is high in competition taekwondo. Promoting blocking skills to prevent head blows could decrease concussions in taekwondo.

  20. Unchanged incidence of necrotising enterocolitis in a tertiary neonatal department

    DEFF Research Database (Denmark)

    Hein-Nielsen, Anne Lysbeck; Meinich Petersen, Sandra; Greisen, Gorm

    2015-01-01

    to 0.5% in the 1,200-1,299 g birth-weight group. There was no trend over time in the incidence of NEC (b = -0.02/year (95% confidence interval: -0.59; 0.55, p = 0.98) and no evidence of a higher frequency of NEC in certain months or certain seasons (p = 0.52 and p = 0.32). CONCLUSION: Our incidence...... of NEC was close to average compared with incidences reported in international literature. There was no suggestion of an epidemic cause or that the incidence was decreasing. Considering the impact of NEC on the individual infant, it is important to keep searching for new ways to reduce the problem...

  1. Decreased prefrontal cortical dopamine transmission in alcoholism.

    Science.gov (United States)

    Narendran, Rajesh; Mason, Neale Scott; Paris, Jennifer; Himes, Michael L; Douaihy, Antoine B; Frankle, W Gordon

    2014-08-01

    Basic studies have demonstrated that optimal levels of prefrontal cortical dopamine are critical to various executive functions such as working memory, attention, inhibitory control, and risk/reward decisions, all of which are impaired in addictive disorders such as alcoholism. Based on this and imaging studies of alcoholism that have demonstrated less dopamine in the striatum, the authors hypothesized decreased dopamine transmission in the prefrontal cortex in persons with alcohol dependence. To test this hypothesis, amphetamine and [11C]FLB 457 positron emission tomography were used to measure cortical dopamine transmission in 21 recently abstinent persons with alcohol dependence and 21 matched healthy comparison subjects. [11C]FLB 457 binding potential, specific compared to nondisplaceable uptake (BPND), was measured in subjects with kinetic analysis using the arterial input function both before and after 0.5 mg kg-1 of d-amphetamine. Amphetamine-induced displacement of [11C]FLB 457 binding potential (ΔBPND) was significantly smaller in the cortical regions in the alcohol-dependent group compared with the healthy comparison group. Cortical regions that demonstrated lower dopamine transmission in the alcohol-dependent group included the dorsolateral prefrontal cortex, medial prefrontal cortex, orbital frontal cortex, temporal cortex, and medial temporal lobe. The results of this study, for the first time, unambiguously demonstrate decreased dopamine transmission in the cortex in alcoholism. Further research is necessary to understand the clinical relevance of decreased cortical dopamine as to whether it is related to impaired executive function, relapse, and outcome in alcoholism.

  2. Increased physical activity decreases periodontitis risk in men

    International Nuclear Information System (INIS)

    Merchant, Anwar T.; Pitiphat, Waranuch; Rimm, Eric B.; Joshipura, Kaumudi

    2003-01-01

    Background: Increased physical activity improves insulin sensitivity and glucose metabolism, and may therefore affect incidence of periodontitis. Methods: We studied the association of physical activity, walking and periodontitis in 39,461 male, US based, health professionals, 40-75 years old at baseline, more than half of whom were dentists, being followed up continuously since 1986. Participants were free of periodontitis, coronary heart disease and stroke at the start of follow-up. Physical activity and periodontitis were measured by validated questionnaires (expressed in metabolic equivalents - METs); the first report of professionally diagnosed periodontitis was considered a case. Results: Periodontitis risk decreased by 3% for every 10-MET increase in average physical activity after adjustment for age, smoking, diabetes, BMI, alcohol consumption and total calories (RR = 0.97; 95% CI: 0.95-0.99). The inverse trend remained significant in the categorical analysis. Compared to men in the lowest quintile of physical activity, those in the highest quintile had a 13% lower risk of periodontitis (RR = 0.87; 95% CI: 0.76-1.01, p-value, test for trend = 0.02). In a sub-sample of men with radiographs (n = 137) the physically active had less average bone loss (β = -0.29, p-value = 0.03) after multivariate adjustment compared to those inactive. Conclusions: In this large-scale prospective study, we found an inverse, linear association between sustained physical activity and periodontitis independent of known risk factors. The benefits of a physically active lifestyle may extend to periodontal health

  3. Breast cancer incidence in Mongolia

    Science.gov (United States)

    Altantsetseg, Dalkhjav; Davaasambuu, Ganmaa; Rich-Edwards, Janet; Davaalkham, Dambadarjaa; Tretli, Steinar; Hoover, Robert N.; Frazier, A. Lindsay

    2013-01-01

    Purpose Data on international variation in breast cancer incidence may help to identify additional risk factors. Substantially lower breast cancer rates in Asia than in North America and Western Europe are established, but differences within Asia have been largely ignored despite heterogeneity in lifestyles and environments. Mongolia’s breast cancer experience is of interest because of its shared genetics but vastly different diet compared with other parts of Asia. Methods Age-standardized breast cancer incidence and mortality rates obtained from the International Association of Cancer Registries are presented for several Asian countries. Mongolian incidence rates obtained from its cancer registry describe incidence within the country. Results Breast cancer incidence in Mongolia (age standardized 8.0/100,000) is almost a third of rates in China (21.6/100,000), and over five times that of Japan (42.7/100,000) and Russia (43.2/100,000). Rates within Mongolia appear to have increased slightly over the last decade and are higher in urban than rural areas (annual percentage increase of age-standardized rates from 1998 to 2005 was 3.60 and 2.57%, respectively). The increase in breast cancer incidence with age plateaus at menopause, as in other Asian populations. Conclusions Mongolia’s low breast cancer incidence is of particular interest because of their unusual diet (primarily red meat and dairy) compared with other Asian countries. More intensive study of potential dietary, reproductive and lifestyle factors in Mongolia with comparison to other Asian populations may provide more clarity in what drives the international breast cancer rate differences. PMID:22543542

  4. Incidence and survival of gynecologic sarcomas in England.

    Science.gov (United States)

    Francis, Matthew; Dennis, Nicola L; Hirschowitz, Lynn; Grimer, Robert; Poole, Jason; Lawrence, Gill; Nordin, Andy

    2015-06-01

    Gynecologic sarcomas account for approximately 3% to 4% of all gynecologic malignancies and are associated with poor outcomes compared with gynecologic carcinomas. The aim of this study is to report the incidence and survival rates of the main gynecologic sarcomas using national English cancer registration data. Records of gynecologic sarcomas diagnosed between 1985 and 2008 were extracted from the English National Cancer Data Repository. ICD-O3 morphology codes were used to assign tumor records to specific histologic subgroups. Incidence and 5-year relative survival rates were calculated. There were 5316 new cases of gynecologic sarcoma diagnosed in England between 1985 and 2008. Incidence rates increased significantly in the early 1990s, probably due to coding changes. Age-specific incidence rates were highest in women aged between 45 and 64 years. In the most recent period studied (2001-2008), incidence rates fluctuated between 8 and 9.6 per million. The most common anatomical site was the uterus (83% of all diagnoses), and the most common histologic diagnosis was leiomyosarcoma (52% of all diagnoses). Overall 5-year relative survival increased significantly between 1985-1989 and 2000-2004, from 34% to 48%. Gynecologic sarcoma incidence rates have varied little since 1993, whereas survival has improved significantly. These results are consistent with previously published small series and case studies, and provide a more complete picture of gynecologic sarcoma incidence and survival patterns in England.

  5. Factors influencing incident reporting in surgical care.

    Science.gov (United States)

    Kreckler, S; Catchpole, K; McCulloch, P; Handa, A

    2009-04-01

    To evaluate the process of incident reporting in a surgical setting. In particular: the influence of event outcome on reporting behaviour; staff perception of surgical complications as reportable events. Anonymous web-based questionnaire survey. General Surgical Department in a UK teaching hospital. Of 203 eligible staff, 55 (76.4%) doctors and 82 (62.6%) nurses participated. Knowledge and use of local reporting system; propensity to report incidents which vary by outcome (harm, no harm, harm prevented); propensity to report surgical complications; practical and psychological barriers to reporting. Nurses were significantly more likely to know of the local reporting system and to have recently completed a report than doctors. The level of harm (F(1.8,246) = 254.2, pvs 53%, z = 4.633, psystems.

  6. Increased venous thrombosis incidence in pregnancies after in vitro fertilization

    DEFF Research Database (Denmark)

    Hansen, Anette Tarp; Kesmodel, U S; Juul, S

    2014-01-01

    STUDY QUESTION Is venous thrombosis risk increased in pregnancies after in vitro fertilization? SUMMARY ANSWER The venous thrombosis incidence was significantly increased in pregnancies after in vitro fertilization; especially in the first trimester and in the first 6 weeks post-partum. WHAT...... IS KNOWN ALREADY In vitro fertilization without pregnancy is not associated with increased venous thrombosis incidence. STUDY DESIGN, SIZE, DURATION This national register-based cohort study covered the period from 1995 to 2005. PARTICIPANTS/MATERIALS, SETTING, METHODS All Danish pregnancies conceived...... by in vitro fertilization (n = 18 787) were included. Venous thrombosis incidence rates in pregnancies after in vitro fertilization were compared with venous thrombosis incidence rates in reference pregnancies, by calculating incidence rate ratios. MAIN RESULTS AND THE ROLE OF CHANCE In total, 48 cases were...

  7. Information sharing for traffic incident management.

    Science.gov (United States)

    2009-01-01

    Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...

  8. Reduction in diarrhea incidence by soluble fiber in patients receiving total or supplemental enteral nutrition.

    Science.gov (United States)

    Homann, H H; Kemen, M; Fuessenich, C; Senkal, M; Zumtobel, V

    1994-01-01

    Gastrointestinal side effects, particularly diarrhea, are still the main reasons for discontinuation of enteral nutrition. Although the causes of diarrhea are diverse, the enteral nutrition solution is frequently suspected of playing a leading role in causing diarrhea. Our randomized, prospective, double-blind trial with 100 patients assessed the effects of feeding a standard diet (Nutrodrip Standard) vs the same diet supplemented with 20 g of soluble fiber, containing partially hydrolyzed guar gum (Sunfiber), per 1000 mL. Thirty patients received total enteral nutrition postoperatively, and 70 patients received enteral supplementation. The patients receiving total enteral nutrition with soluble fiber had decreased diarrhea but increased flatulence. In none of these patients did enteral feeding have to be discontinued because of gastrointestinal side effects, whereas in four patients who were on a standard diet, enteral feeding had to be interrupted because of diarrhea (p < .05). Similar observations were made in patients receiving enteral supplementation. In both groups, the incidence of diarrhea decreased significantly with the soluble fiber diet compared with the standard diet (6 vs 15, p < .05). Enteral feeding with a formula supplemented with partially hydrolyzed guar gum reduces the incidence of diarrhea in patients receiving total enteral nutrition as well as in those receiving enteral supplementation, regardless of the cause of diarrhea. The increased hydrogen production and the significantly higher rate of flatulence are likely to result from fermentation of the soluble fiber in the colon, with concomitant production of short-chain fatty acids, which leads to increased absorption of short-chain fatty acids, sodium, and water by the colonocytes. This effect, together with the observed cholecystokinin-mediated decrease in colonic transit time with partially hydrolyzed guar gum, may explain the reduction in the incidence of diarrhea in this study.

  9. Serum Soluble Corin is Decreased in Stroke.

    Science.gov (United States)

    Peng, Hao; Zhu, Fangfang; Shi, Jijun; Han, Xiujie; Zhou, Dan; Liu, Yan; Zhi, Zhongwen; Zhang, Fuding; Shen, Yun; Ma, Juanjuan; Song, Yulin; Hu, Weidong

    2015-07-01

    Soluble corin was decreased in coronary heart disease. Given the connections between cardiac dysfunction and stroke, circulating corin might be a candidate marker of stroke risk. However, the association between circulating corin and stroke has not yet been studied in humans. Here, we aimed to examine the association in patients wtith stroke and community-based healthy controls. Four hundred eighty-one patients with ischemic stroke, 116 patients with hemorrhagic stroke, and 2498 healthy controls were studied. Serum soluble corin and some conventional risk factors of stroke were examined. Because circulating corin was reported to be varied between men and women, the association between serum soluble corin and stroke was evaluated in men and women, respectively. Patients with ischemic and hemorrhagic stroke had a significantly lower level of serum soluble corin than healthy controls in men and women (all P values, stroke than men in the highest quartile. Women in the lowest quartile of serum soluble corin were also more likely to have ischemic (OR, 3.10; 95% confidence interval, 1.76-5.44) and hemorrhagic (OR, 8.54; 95% confidence interval, 2.35-31.02) stroke than women in the highest quartile. ORs of ischemic and hemorrhagic stroke were significantly increased with the decreasing levels of serum soluble corin in men and women (all P values for trend, stroke compared with healthy controls. Our findings raise the possibility that serum soluble corin may have a pathogenic role in stroke. © 2015 American Heart Association, Inc.

  10. Lymphedema treatment decreases pain intensity in lipedema.

    Science.gov (United States)

    Szolnoky, G; Varga, E; Varga, M; Tuczai, M; Dósa-Rácz, E; Kemény, L

    2011-12-01

    Lipedema is a disproportional obesity featuring light pressure-induced or spontaneous pain. On the basis of our clinical observations, lymphedema therapy, as practiced in our clinic, reduces the perception of pain beyond leg volume reduction. We therefore aimed to measure pain intensity prior and subsequent to treatment. 38 women with lipedema were enrolled in the study with 19 patients undergoing treatment and 19 serving as the control group using exclusively moisturizers. Treatment consisted of once daily manual lymph drainage (MLD), intermittent pneumatic compression (IPC), and multilayered short-stretch bandaging performed throughout a 5-day-course. Pain was evaluated with a 10-item questionnaire, a pain rating scale (PRS), and the Wong-Baker Faces scale. Treatment resulted in a significant reduction of pain with a decrease in mean scores of all three measures. In the control group, only PRS showed significant decrease. Our study results indicate that this treatment regimen not only reduces leg volume and capillary fragility, but also improves pain intensity in patients with lipedema.

  11. Dietary total antioxidant capacity and incidence of chronic kidney disease in subjects with dysglycemia: Tehran Lipid and Glucose Study.

    Science.gov (United States)

    Asghari, Golaleh; Yuzbashian, Emad; Shahemi, Sahar; Gaeini, Zahra; Mirmiran, Parvin; Azizi, Fereidoun

    2017-07-24

    We aimed to investigate the association of dietary total antioxidant capacity (TAC) with incidence of CKD in subjects with dysglycemia. We followed-up 1179 subjects aged ≥30 years with dysglycemia from the Tehran Lipid and Glucose Study (TLGS) for 3 years, who were initially free of CKD. Dietary intakes of TAC, vitamin C, vitamin E, and β-carotene were assessed by a food-frequency questionnaire at the baseline. Dietary TAC was estimated using the oxygen radical absorbance capacity method. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease Study equation and CKD was defined as eGFR intake, the top tertile of dietary TAC compared to the bottom was associated with 39% [95% confidence interval (CI) = 0.40-0.93] lower risk of incident CKD (P for trend = 0.025). Furthermore, the highest tertile of vitamin C intake compared to the lowest risk of incident CKD was decreased (OR 0.60; 95% CI 0.38-0.93, P trend 0.023). Intakes of vitamin E and β-carotene were not significantly associated with incident CKD risk. Our findings suggest that diets high in TAC are associated with a lower risk of incident CKD among subjects with hyperglycemia after 3 years of follow-up.

  12. Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study.

    Science.gov (United States)

    Makino, Keitaro; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Suzuki, Takao; Shimada, Hiroyuki

    2018-04-01

    Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study. A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care. During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98). Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Morphological development of coasts at very oblique wave incidence

    DEFF Research Database (Denmark)

    Petersen, Dorthe Pia; Deigaard, Rolf; Fredsøe, Jørgen

    2003-01-01

    This study focuses on one distinct feature to be found on coasts exposed to a very oblique wave incidence, namely an accumulating spit. That is a spit where no retreat of the shoreline is going on along the spit. This requires a monotonically decreasing sediment transport capacity from the updrift...

  14. resistant containers on the incidence of paraffin (kerosene)

    African Journals Online (AJOL)

    The commonest cause of accidental poisoning in the. South African black paediatric population is paraffin ingestion. In this intervention study a specificall¥ designed child-resistant container (CRG) was introduced·to evaluate whether its use would decrease the incidence ofparaffin ingestion. CRCs were distributed to 20 ...

  15. Decreasing transobturator sling groin pain without decreasing efficacy using TVT-Abbrevo.

    Science.gov (United States)

    Shaw, Jonathan S; Jeppson, Peter C; Rardin, Charles R

    2015-09-01

    Groin pain following a transobturator (TO) midurethral sling is not uncommon and can be difficult to manage. We sought to determine if decreasing the mesh burden in the groin would decrease pain. The primary objective was to compare the incidence of post-operative groin pain following placement of full-length TVT-Obturator versus the shorter TVT-Abbrevo. Secondarily, we aimed to compare the efficacy between both devices 6 months after surgery. This is a retrospective cohort study of all women who underwent a TO midurethral sling by the division of urogynecology at one institution between 1 January 2007 and 31 October 2013. Charts were reviewed and the incidence of post-operative groin pain in the two groups dichotomized as present or absent and compared using a Chi-squared test. Validated questionnaire scores of the groups were compared using t tests. There were 125 patients who received a TVT-Obturator and 100 patients who received a TVT-Abbrevo. No differences in demographic data were present between the groups. Twelve patients (9.6 %) in the TVT-Obturator group and 1 patient (1 %) in the TVT-Abbrevo group experienced bothersome groin pain (P value = 0.007). The complete pre- and 6-month post-operative ISI, UDI-6 and PFIQ-7 scores were available for 76 (61 %), 47 (38 %), and 45 (36 %) patients following TVT-Obturator and 57 (57 %), 30 (30 %), and 28 (28 %) following TVT-Abbrevo treatment. At 6 months the mean improvement in questionnaire scores for the TVT-Obturator and TVT-Abbrevo groups were as follows: 5.0 and 5.1 for ISI (P value = 0.9), 8.3 and 7.9 for UDI-6 (P value = 0.8), and 4.8 and 6.1 for PFIQ-7 (P value = 0.4). Use of TVT-Abbrevo reduces post-operative groin pain compared with the full-length TVT-Obturator, without any reduction in efficacy.

  16. The incidence of type 1 diabetes in the age group 0-39 years has not increased in Antwerp (Belgium) between 1989 and 2000: evidence for earlier disease manifestation.

    Science.gov (United States)

    Weets, Ilse; De Leeuw, Ivo H; Du Caju, Marc V L; Rooman, Raoul; Keymeulen, Bart; Mathieu, Chantal; Rottiers, Raoul; Daubresse, Jean-Claude; Rocour-Brumioul, Danielle; Pipeleers, Daniel G; Gorus, Frans K

    2002-05-01

    A worldwide increase in the incidence of childhood type 1 diabetes has been observed. Because in various countries the majority of new type 1 diabetic patients are diagnosed in adulthood, we investigated whether the rising incidence of this disorder in children reflects a global increase in the incidence of diabetes or a shift toward earlier clinical presentation. The incidence of type 1 diabetes presenting before age 40 years was prospectively measured in the Antwerp district over a 12-year period (1989-2000). The completeness of ascertainment was evaluated by the capture-recapture method. Trends in incidence during the study period were analyzed by Poisson regression. The incidence of type 1 diabetes diagnosed before age 40 years remained constant over the 12-year period, averaging 9.9 cases per 100,000 individuals per year. The incidence was similar in both sexes under age 15 years, but a marked male excess was noted for adult-onset disease, in particular after age 20 years, resulting in a male-to-female ratio of 0.9 under age 15 years vs. 1.6 thereafter (P = 0.001). During the 12-year observation period, there was a significant tendency toward increasing incidence under age 15 years at the expense of a decreasing incidence between ages 15 and 40 years (P = 0.025). The annual increase in incidence averaged 1.8% under age 15 years and 5.0% under age 5 years (P = 0.06). Our results indicate that in Belgium, the increasing incidence of childhood type 1 diabetes-especially for children under age 5 years-is not attributable to a global increase in disease incidence, but rather to earlier clinical manifestation. The results suggest that an environmental factor may preferentially accelerate the subclinical disease process in young diabetes-prone subjects.

  17. Incidence of scabies in Belgium

    Science.gov (United States)

    LAPEERE, H.; NAEYAERT, J.-M.; De WEERT, J.; De MAESENEER, J.; BROCHEZ, L.

    2008-01-01

    SUMMARY A prospective survey on scabies in Ghent, Belgium was performed in 2004. Sixty-four individual cases were reported, corresponding to a crude incidence rate of 28/100 000 inhabitants. The incidence was higher in the elderly (51/100 000 in persons aged >75 years) and a higher incidence was also found in immigrants (88/100 000). More than 40% of the registered scabies patients had symptoms for more than 4 weeks at the time of presentation. In 54% of the consultations, the patient had already consulted a physician for his/her skin problem. Of this group, 44% had not yet received any scabicidal treatment, indicating that scabies was not yet diagnosed or that an inappropriate treatment was prescribed. The observations suggest that the diagnosis and/or treatment of scabies in this region can still be improved. PMID:17506916

  18. Invasive cancer incidence - Puerto Rico, 2007-2011.

    Science.gov (United States)

    O'Neil, Mary Elizabeth; Henley, S Jane; Singh, Simple D; Wilson, Reda J; Ortiz-Ortiz, Karen J; Ríos, Naydi Pérez; Torres Cintrón, Carlos R; Luna, Guillermo Tortolero; Zavala Zegarra, Diego E; Ryerson, A Blythe

    2015-04-17

    Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifying new trends and patterns of cancer incidence, Puerto Rico Central Cancer Registry staff and CDC analyzed data from Puerto Rico included in U.S. Cancer Statistics (USCS) for 2007-2011, the most recent data available. This is the first report of invasive cancer incidence rates for 2007-2011 among Puerto Rican residents by sex, age, cancer site, and municipality. Cancer incidence rates in Puerto Rico were compared with those in the U.S. population for 2011. A total of 68,312 invasive cancers were diagnosed and reported in Puerto Rico during 2007-2011. The average annual incidence rate was 330 cases per 100,000 persons. The cancer sites with the highest cancer incidence rates included prostate (152), female breast (84), and colon and rectum (43). Cancer incidence rates varied by municipality, particularly for prostate, lung and bronchus, and colon and rectum cancers. In 2011, cancer incidence rates in Puerto Rico were lower for all cancer sites and lung and bronchus, but higher for prostate and thyroid cancers, compared with rates within the U.S. Identifying these variations can aid evaluation of factors associated with high incidence, such as cancer screening practices, and development of targeted cancer prevention and control efforts. Public health professionals can monitor cancer incidence trends and use these findings to evaluate the impact of prevention efforts, such as legislation prohibiting tobacco use in the workplace and public places and the Puerto Rico Cessation Quitline in decreasing lung and other tobacco-related cancers.

  19. Preemptive antibiotic treatment based on gram staining reduced the incidence of ARDS in mechanically ventilated patients.

    Science.gov (United States)

    Matsushima, Asako; Tasaki, Osamu; Shimizu, Kentaro; Tomono, Kazunori; Ogura, Hiroshi; Shimazu, Takeshi; Sugimoto, Hisashi

    2008-08-01

    Ventilator-associated pneumonia (VAP) is one of the major complications in the intensive care unit. VAP sometimes results in acute respiratory distress syndrome (ARDS), and the associated mortality is high. We hypothesized that preemptive antibiotic therapy based on results of bedside gram staining would reduce the incidence of VAP. Patients who were endotracheally intubated in our intensive care unit for more than 72 hours were included. Patients younger than 16 years of age or patients died because of brain death were excluded. The study was divided into two periods. During the first period, we used antibiotics according to the American Thoracic Society guidelines. During the second period, antibiotics were given according to the results of bedside gram staining even before radiographic infiltrate appeared. One hundred twenty-eight patients and 133 patients were included in the first and second periods, respectively. The incidence of VAP was significantly decreased in the second period (first period, 22%; second period, 9%, p gram staining significantly reduced the incidences of VAP and ARDS without an increase in the use of antibiotics.

  20. High Incidence of Breast Cancer in Light-Polluted Areas with Spatial Effects in Korea.

    Science.gov (United States)

    Kim, Yun Jeong; Park, Man Sik; Lee, Eunil; Choi, Jae Wook

    2016-01-01

    We have reported a high prevalence of breast cancer in light-polluted areas in Korea. However, it is necessary to analyze the spatial effects of light polluted areas on breast cancer because light pollution levels are correlated with region proximity to central urbanized areas in studied cities. In this study, we applied a spatial regression method (an intrinsic conditional autoregressive [iCAR] model) to analyze the relationship between the incidence of breast cancer and artificial light at night (ALAN) levels in 25 regions including central city, urbanized, and rural areas. By Poisson regression analysis, there was a significant correlation between ALAN, alcohol consumption rates, and the incidence of breast cancer. We also found significant spatial effects between ALAN and the incidence of breast cancer, with an increase in the deviance information criterion (DIC) from 374.3 to 348.6 and an increase in R2 from 0.574 to 0.667. Therefore, spatial analysis (an iCAR model) is more appropriate for assessing ALAN effects on breast cancer. To our knowledge, this study is the first to show spatial effects of light pollution on breast cancer, despite the limitations of an ecological study. We suggest that a decrease in ALAN could reduce breast cancer more than expected because of spatial effects.

  1. Stable malaria incidence despite scaling up control strategies in a malaria vaccine-testing site in Mali.

    Science.gov (United States)

    Coulibaly, Drissa; Travassos, Mark A; Kone, Abdoulaye K; Tolo, Youssouf; Laurens, Matthew B; Traore, Karim; Diarra, Issa; Niangaly, Amadou; Daou, Modibo; Dembele, Ahmadou; Sissoko, Mody; Guindo, Bouréima; Douyon, Raymond; Guindo, Aldiouma; Kouriba, Bourema; Sissoko, Mahamadou S; Sagara, Issaka; Plowe, Christopher V; Doumbo, Ogobara K; Thera, Mahamadou A

    2014-09-19

    The recent decline in malaria incidence in many African countries has been attributed to the provision of prompt and effective anti-malarial treatment using artemisinin-based combination therapy (ACT) and to the widespread distribution of long-lasting, insecticide-treated bed nets (LLINs). At a malaria vaccine-testing site in Bandiagara, Mali, ACT was introduced in 2004, and LLINs have been distributed free of charge since 2007 to infants after they complete the Expanded Programme of Immunization (EPI) schedule and to pregnant women receiving antenatal care. These strategies may have an impact on malaria incidence. To document malaria incidence, a cohort of 400 children aged 0 to 14 years was followed for three to four years up to July 2013. Monthly cross-sectional surveys were done to measure the prevalence of malaria infection and anaemia. Clinical disease was measured both actively and passively through continuous availability of primary medical care. Measured outcomes included asymptomatic Plasmodium infection, anaemia and clinical malaria episodes. The incidence rate of clinical malaria varied significantly from June 2009 to July 2013 without a clear downward trend. A sharp seasonality in malaria illness incidence was observed with higher clinical malaria incidence rates during the rainy season. Parasite and anaemia point prevalence also showed seasonal variation with much higher prevalence rates during rainy seasons compared to dry seasons. Despite the scaling up of malaria prevention and treatment, including the widespread use of bed nets, better diagnosis and wider availability of ACT, malaria incidence did not decrease in Bandiagara during the study period.

  2. Effect of pimobendan on the incidence of arrhythmias in small breed dogs with myxomatous mitral valve degeneration.

    Science.gov (United States)

    Lake-Bakaar, Geri A; Singh, Manreet K; Kass, Philip H; Griffiths, Leigh G

    2015-06-01

    To determine if pimobendan, a phosphodiesterase III inhibitor and calcium sensitizer with positive survival benefits, has an effect on incidence of arrhythmias compared to placebo in small breed dogs with congestive heart failure (CHF) due to myxomatous mitral valve degeneration (MMVD). Eight client-owned small breed dogs (quality of life (QOL) questionnaire at each time point and recorded sleeping respiratory rates (SRR). Mixed effects analysis of variance, with dog as the random variable was used to compare values obtained between baseline, placebo, and pimobendan. Compared to baseline, QOL scores were significantly improved following administration of either placebo or pimobendan (p = 0.021 and p < 0.001, respectively). No significant differences in type or incidence of supraventricular or ventricular arrhythmia were identified. Average heart rate with pimobendan was significantly lower than baseline (p < 0.001). Compared to baseline, SRR was significantly lower with pimobendan (p = 0.004), and significantly different from placebo (p = 0.045). No significant difference between pimobendan and placebo was found on incidence of supraventricular or ventricular arrhythmia. The decrease in average heart rate and SRR may be reflective of superior heart failure control achieved with pimobendan therapy. Published by Elsevier B.V.

  3. Metabolic Syndrome and Incident Diabetes

    OpenAIRE

    Ford, Earl S.; Li, Chaoyang; Sattar, Naveed

    2008-01-01

    OBJECTIVE?Our objective was to perform a quantitative review of prospective studies examining the association between the metabolic syndrome and incident diabetes. RESEARCH DESIGN AND METHODS?Using the title terms ?diabetes? and ?metabolic syndrome? in PubMed, we searched for articles published since 1998. RESULTS?Based on the results from 16 cohorts, we performed a meta-analysis of estimates of relative risk (RR) and incident diabetes. The random-effects summary RRs were 5.17 (95% CI 3.99?6....

  4. Cardiovascular disease incidence and survival

    DEFF Research Database (Denmark)

    Byberg, Stine; Agyemang, Charles; Zwisler, Ann-Dorthe

    2016-01-01

    Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute...... of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health....

  5. Impact of dexmedetomidine on the incidence of delirium in elderly patients after cardiac surgery: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Xue Li

    Full Text Available Delirium is a frequent complication after cardiac surgery and its occurrence is associated with poor outcomes. The purpose of this study was to investigate the impact of perioperative dexmedetomidine administration on the incidence of delirium in elderly patients after cardiac surgery.This randomized, double-blinded, and placebo-controlled trial was conducted in two tertiary hospitals in Beijing between December 1, 2014 and July 19, 2015. Eligible patients were randomized into two groups. Dexmedetomidine (DEX was administered during anesthesia and early postoperative period for patients in the DEX group, whereas normal saline was administered in the same rate for the same duration for patients in the control (CTRL group. The primary endpoint was the incidence of delirium during the first five days after surgery. Secondary endpoints included the cognitive function assessed on postoperative days 6 and 30, the overall incidence of non-delirium complications within 30 days after surgery, and the all-cause 30-day mortality.Two hundred eighty-five patients were enrolled and randomized. Dexmedetomidine did not decrease the incidence of delirium (4.9% [7/142] in the DEX group vs 7.7% [11/143] in the CTRL group; OR 0.62, 95% CI 0.23 to 1.65, p = 0.341. Secondary endpoints were similar between the two groups; however, the incidence of pulmonary complications was slightly decreased (OR 0.51, 95% CI 0.26 to 1.00, p = 0.050 and the percentage of early extubation was significantly increased (OR 3.32, 95% CI 1.36 to 8.08, p = 0.008 in the DEX group. Dexmedetomidine decreased the required treatment for intraoperative tachycardia (21.1% [30/142] in the DEX group vs 33.6% [48/143] in the CTRL group, p = 0.019, but increased the required treatment for postoperative hypotension (84.5% [120/142] in the DEX group vs 69.9% [100/143] in the CTRL group, p = 0.003.Dexmedetomidine administered during anesthesia and early postoperative period did not decrease the incidence

  6. Changes in the Incidence of Candidiasis in Neonatal Intensive Care Units

    Science.gov (United States)

    Aliaga, Sofia; Clark, Reese H.; Laughon, Matthew; Walsh, Thomas J.; Hope, William W.; Benjamin, Daniel K.; Kaufman, David; Arrieta, Antonio; Benjamin, Daniel K.

    2014-01-01

    OBJECTIVE: Neonatal invasive candidiasis is associated with significant morbidity and mortality. We describe the association between invasive candidiasis and changes in use of antifungal prophylaxis, empirical antifungal therapy, and broad-spectrum antibacterial antibiotics over time. METHODS: We examined data from 709 325 infants at 322 NICUs managed by the Pediatrix Medical Group from 1997 to 2010. We determined the cumulative incidence of invasive candidiasis and use of antifungal prophylaxis, broad-spectrum antibacterial antibiotics, and empirical antifungal therapy by year. RESULTS: We identified 2063 (0.3%) infants with 2101 episodes of invasive candidiasis. Over the study period, the annual incidence of invasive candidiasis decreased from 3.6 episodes per 1000 patients to 1.4 episodes per 1000 patients among all infants, from 24.2 to 11.6 episodes per 1000 patients among infants with a birth weight of 750–999 g, and from 82.7 to 23.8 episodes per 1000 patients among infants with a birth weight candidiasis in the NICU decreased over the 14-year study period. Increased use of fluconazole prophylaxis and empirical antifungal therapy, along with decreased use of broad-spectrum antibacterial antibiotics, may have contributed to this observation. PMID:24446441

  7. [Incidence of unplanned extubations in a neonatal intensive care unit. A before and after study].

    Science.gov (United States)

    Utrera Torres, M I; Moral Pumarega, M T; García Lara, N R; Melgar Bonís, A; Frías García, M E; Pallás Alonso, C R

    2014-05-01

    Unplanned extubations (UE) of mechanically ventilated newborns involves an undesirable increase in morbidity and mortality. A 2-stage study compared the frequency of UE in a Neonatal Intensive Care Unit before and after the implementation of a program of preventive measures to decrease UE. A before and after prospective study included all mechanically ventilated newborns participating in the 2 stage study from May-December 2011 and June-December 2012. In stage 1, the rate of UE per 100 intubated patient days was calculated and the characteristics of unplanned extubated newborns, circumstances of UE occurrence and need for re-intubation were studied. Consequently, a program of preventive measures for UE was designed and implemented, with the same variables being analysed in stage 2. No differences were found in patient characteristics during the two stages. Stage 1, incidence of UE was 5/100 intubated patient days; Stage 2, 4.5 UE/100 intubated patient days (P=.657). In both stages, most UE occurred during patient handling with re-intubation incidence at 77.4% and 67.7%, respectively. The combined rate of both stages during summer months of July, August and September was 6.2 UE/100 intubation days, in contrast with the remaining months of both stages: UE incidence rate, 3.4 UE/100 intubation days (p=.043). The implementation of a preventive measures program did not significantly reduce the incidence of UE. The summer period showed the highest incidence of UE. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  8. Changes in Cycling and Incidence of Overweight and Obesity among Danish Men and Women.

    Science.gov (United States)

    Rasmussen, Martin G; Overvad, Kim; Tjønneland, Anne; Jensen, Majken K; Østergaard, Lars; Grøntved, Anders

    2018-02-13

    Overweight and obesity is associated with increased risk of several non-communicable diseases and is a growing public health issue. The primary purpose of the current study was to investigate incidence of overweight and obesity according to five-year cycling habits. The secondary purpose was to investigate incidence of remission from overweight and obesity according to five-year cycling habits. We analyzed 9014 men and 8661 women without chronic disease who between 1993 and 2003 completed two assessments approximately five years apart. At both assessments participants reported habitual cycling habits. Also, bodyweight and waist circumference was measured by a lab technician at baseline and self-assessed at second examination. We computed multivariable adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for development of and remission from abdominal and general overweight and obesity, according to five-year cycling habits. Continued cycling was associated with lower odds for incidence of abdominal (men:>102 cm, women:>88 cm) and incidence of general (BMI≥30 kg/m) obesity; compared to no cycling, ORs (95% CIs) were 0.82 (0.74,0.91) and 0.74 (0.60,0.92) for abdominal and general obesity, respectively. Also, those who initiated cycling had lower odds for incidence of abdominal obesity; OR (95% CI) was 0.85 (0.73,1.00) relative to no cycling. Although we found no evidence of remission from abdominal and general overweight and obesity according to five-year cycling habits, those who continued cycling had significantly larger decreases in waist circumference relative to non-cyclists (β-coefficient (95% CI): -0,95 cm (-1,56 cm,-0,33 cm). Continued cycling compared to no cycling was associated with lower odds for abdominal and general obesity. Also, late-in-life initiation of cycling was associated with lower odds for abdominal obesity, relative to no cycling.

  9. Decline in overall, smear-negative and HIV-positive TB incidence while smear-positive incidence stays stable in Guinea-Bissau 2004-2011

    DEFF Research Database (Denmark)

    Lemvik, G; Rudolf, F; Vieira, F

    2014-01-01

    OBJECTIVE: To calculate Tuberculosis (TB) incidence rates in Guinea-Bissau over an 8-year period. METHODS: Since 2003, a surveillance system has registered all TB cases in six suburban districts of Bissau. In this population-based prospective follow-up study, 1205 cases of pulmonary TB were...... identified between January 2004 and December 2011. Incidence rates were calculated using census data from the Bandim Health and Demographic Surveillance System (HDSS). RESULTS: The overall incidence of pulmonary TB was 279 per 100 000 person-years of observation; the male incidence being 385, and the female...... 191. TB incidence rates increased significantly with age in both sexes, regardless of smear or HIV status. Despite a peak with unknown cause of 352 per 100 000 in 2007, the overall incidence of pulmonary TB declined over the period. The incidence of HIV infected TB cases declined significantly from...

  10. Clinical significance of right ventricular function in the cases with congestive heart failure

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Hayashida, Kohei; Uehara, Toshiisa; Kozuka, Takahiro.

    1988-01-01

    Recently, right and left ventricular ejection fraction (RVEF and LVEF) were accurately assessed by gated blood pool scan and these clinical parameters were applied to evaluate the pre and postoperative evaluation of ischemic, valvular and congenital heart disease. This study was under taken to investigate the clinical significance of right ventricular function in the case with congestive heart failure which had lower LVEF (≤35%). There were divided into three groups: (A) 37 cases of myocardial infarction with normal RVEF (RVEF>46%), (B) 16 cases of myocardial infarction with decreased RVEF (RVEF≤46%) and (C) 20 cases of dilated cardiomyopathy with decreased RVEF (RVEF≤46%). Group (B) had increased pulmonary artery pressure, and left ventricular end-diastolic pressure. The incidence of recurrent attack and multivessel disease were not different between group (A) and (B), however, the exercise tolerance was decreased in group (B), Group (C) had also decreased exercise tolerance. These data demonstrated that decreased RVEF in congestive heart failure had high risk sub-group, and RVEF correlated with exercise tolerance compared to LVEF. (author)

  11. Impact of a partial smoke-free legislation on myocardial infarction incidence, mortality and case-fatality in a population-based registry: the REGICOR Study.

    Directory of Open Access Journals (Sweden)

    Fernando Agüero

    Full Text Available Coronary heart disease (CHD is the leading cause of death, and smoking its strongest modifiable risk factor. Our aim was to determine the impact of the Spanish 2006 partial smoke-free legislation on acute myocardial infarction (AMI incidence, hospitalization and mortality rates, and 28-day case-fatality in Girona, Spain.Using a population-based registry (the REGICOR Study, we compared population incidence, hospitalization, and mortality rates, and 28-day case-fatality in the pre- and post-ban periods (2002-2005 and 2006-2008, respectively by binomial regression analysis adjusted for confounding factors. We also analyzed the ban's impact on the outcomes of interest using the AMI definitions of the American Heart Association (AHA/European Society of Cardiology (ESC and the World Health Organization (WHO-Monitoring trends and determinants in cardiovascular diseases (MONICA.In the post-ban period, AMI incidence and mortality rates significantly decreased (relative risk [RR] = 0.89; 95% confidence interval [CI] = 0.81-0.97 and RR = 0.82; 95% CI = 0.71-0.94, respectively. Incidence and mortality rates decreased in both sexes, especially in women, and in people aged 65-74 years. Former and non-smokers (passive smokers showed diminished incidence rates. Implementation of the ban was not associated with AMI case-fatality. Models tended to be more significant with the WHO-MONICA than with the AHA/ESC definition.The 2006 Spanish partial smoke-free legislation was associated with a decrease in population AMI incidence and mortality, particularly in women, in people aged 65-74 years, and in passive smokers. These results clarify the association between AMI mortality and the enactment of a partial smoke-free legislation and reinforce the effectiveness of smoking regulations in preventing CHD.

  12. Obesity is a significant susceptibility factor for idiopathic AA amyloidosis.

    Science.gov (United States)

    Blank, Norbert; Hegenbart, Ute; Dietrich, Sascha; Brune, Maik; Beimler, Jörg; Röcken, Christoph; Müller-Tidow, Carsten; Lorenz, Hanns-Martin; Schönland, Stefan O

    2018-01-24

    To investigate obesity as susceptibility factor in patients with idiopathic AA amyloidosis. Clinical, biochemical and genetic data were obtained from 146 patients with AA amyloidosis. Control groups comprised 40 patients with long-standing inflammatory diseases without AA amyloidosis and 56 controls without any inflammatory disease. Patients with AA amyloidosis had either familial Mediterranean fever (FMF) or long-standing rheumatic diseases as underlying inflammatory disease (n = 111, median age 46 years). However, in a significant proportion of patients with AA amyloidosis no primary disease was identified (idiopathic AA; n = 37, median age 60 years). Patients with idiopathic AA amyloidosis were more obese and older than patients with AA amyloidosis secondary to FMF or rheumatic diseases. Serum leptin levels correlated with the body mass index (BMI) in all types of AA amyloidosis. Elevated leptin levels of more than 30 µg/l were detected in 18% of FMF/rheumatic + AA amyloidosis and in 40% of patients with idiopathic AA amyloidosis (p = .018). Finally, the SAA1 polymorphism was confirmed as a susceptibility factor for AA amyloidosis irrespective of the type of the disease. Obesity, age and the SAA1 polymorphism are susceptibility factors for idiopathic AA amyloidosis. Recent advances in treatment of FMF and rheumatic disorders will decrease the incidence of AA amyloidosis due to these diseases. Idiopathic AA, however, might be an emerging problem in the ageing and increasingly obese population.

  13. Risk Insights Gained from Fire Incidents

    International Nuclear Information System (INIS)

    Kazarians, Mardy; Nowlen, Steven P.

    1999-01-01

    There now exist close to 20 years of history in the application of Probabilistic Risk Assessment (PRA) for the analysis of fire risk at nuclear power plants. The current methods are based on various assumptions regarding fire phenomena, the impact of fire on equipment and operator response, and the overall progression of a fire event from initiation through final resolution. Over this same time period, a number of significant fire incidents have occurred at nuclear power plants around the world. Insights gained from US experience have been used in US studies as the statistical basis for establishing fire initiation frequencies both as a function of the plant area and the initiating fire source.To a lesser extent, the fire experience has also been used to assess the general severity and duration of fires. However, aside from these statistical analyses, the incidents have rarely been scrutinized in detail to verify the underlying assumptions of fire PRAs. This paper discusses an effort, under which a set of fire incidents are being reviewed in order to gain insights directly relevant to the methods, data, and assumptions that form the basis for current fire PRAs. The paper focuses on the objectives of the effort, the specific fire events being reviews methodology, and anticipated follow-on activities

  14. Presentation of a method for the sequential analysis of incidents

    International Nuclear Information System (INIS)

    Delage, M.; Giroux, C.; Quentin, P.

    1990-01-01

    This paper presents a method which is designed to assist in the analysis of safety and is based on the graphic representation of the occurrence of incidents significant for safety in 900 MWe PWR units. The graphs obtained are linked together to produce a general tree of events. With this tool, and on the basis of operating experience, we are then able to imagine complex incident scenarios, to evaluate the potential consequences of a particular incident or to seek out the causes which could lead to a given event. Interactions between systems or common mode faults can also appear with this method

  15. Post-operative adhesions after digestive surgery: their incidence and prevention: review of the literature.

    Science.gov (United States)

    Ouaïssi, M; Gaujoux, S; Veyrie, N; Denève, E; Brigand, C; Castel, B; Duron, J J; Rault, A; Slim, K; Nocca, D

    2012-04-01

    Post-operative adhesions after gastrointestinal surgery are responsible for significant morbidity and constitute an important public health problem. The aim of this study was to review the surgical literature to determine the incidence, consequences and the variety of possible countermeasures to prevent adhesion formation. A systematic review of English and French language surgical literature published between 1995 and 2009 was performed using the keywords "adhesion" and "surgery". Peritoneal adhesions are reported as the cause of 32% of acute intestinal obstruction and 65-75% of all small bowel obstructions. It is estimated that peritoneal adhesions develop after 93-100% of upper abdominal laparotomies and after 67-93% of lower abdominal laparotomies. Nevertheless, only 15-18% of these adhesions require surgical re-intervention. The need for re-intervention for adhesion-related complications varies depending on the initial type of surgery, the postoperative course and the type of incision. The laparoscopic approach appears to decrease the risk of adhesion formation by 45% and the need for adhesion-related re-intervention to 0.8% after appendectomy and to 2.5% after colorectal surgery. At the present time, only one product consisting of hyaluronic acid applied to a layer of carboxymethylcellulose (Seprafilm(®)) has been shown to significantly reduce the incidence of postoperative adhesion formation; but this product is also associated with a significant increase in the incidence of anastomotic leakage when the membrane is applied in direct contact with the anastomosis. The use of this product has not been shown to decrease the risk of re-intervention for bowel obstruction. The prevention of postoperative adhesions is an important public health goal, particularly in light of the frequency of this complication. The routine use of anti-adhesion products is not recommended given the lack of studies with a high level of evidence concerning their efficacy and safety of

  16. Incidence of dog bites in Milwaukee, wis.

    Science.gov (United States)

    Ndon, J A; Jach, G J; Wehrenberg, W B

    1996-04-01

    Dogs are everywhere. The incidence of and injuries caused by dog bites have grown to such epidemic proportions in certain parts of the United States that they are now considered a major public health concern. Playful Rover is no longer a harmless pet. Uncontrolled, he now can be considered a public nuisance. In this study, we evaluated the epidemiology of dog bites recorded in Milwaukee, for calendar years 1989-1991. This assessment included anatomical location of bites, victims' ages, behavioral antecedents, leading up to the bite incidents, season of the year, and animal ownership. The evaluation also measured the correlation coefficient between the frequency of dog bite incidents and median household income distribution within the city. During the 3-year period, a total of 3,926 animal bites, including 3,244 (83%) dog bites, were reported to the City of Milwaukee Department of Health. Of all the dog bites reported, 60% were on the upper extremities. Children less than 15 years old sustained 44% of the injuries, mostly to the head and face. Provocation by the victim accounted for 19% of the cases. The majority of the incidents (67%) occurred during the spring and summer months. In 49% of all cases, the victims families or neighbors owned the animals involved in the biting. Researchers also observed a significant negative correlation between bites and median household income distribution. Study results suggest a need to educate the public about the magnitude of dog-bite problems, enforce leash laws and impound stray dogs as an integral part of prevention programs.

  17. Cancer incidence study in Mesa County, Colorado

    International Nuclear Information System (INIS)

    Ouimette, D.R.; Ferguson, S.W.; Zoglo, D.; Murphy, S.; Alley, S.; Bahler, S.

    1983-01-01

    In November of 1982 the Colorado Department of Health completed an epidemiologic investigation of leukemia, multiple myeloma, and cancers of the lung, stomach, pancreas and colon in Mesa County, Colorado for the years 1970 to 1979. This investigation was performed in response to a concern that the presence of uranium mill tailings in some Mesa County homes presents a potential cancer hazard. The results of the investigation show that the incidence of multiple myeloma, colon, stomach and pancreatic cancer are not above expected rates. The incidence of leukemia is not above expected rates for the entire study period, 1970 to 1979. The incidence of lung cancer appears elevated when compared to the The Third National Cancer Survey data for Colorado but lower than expected when compared to Surveillance, Epidemiology and End Results data. To further examine the leukemia and lung cancer incidence findings, a case/control study was conducted. The controls consisted of colon, stomach and pancreatic cancer cases. The results of the leukemia case/control analysis show no association with the radiation exposure variables: occupational radiation exposure; uranium mining exposure; having ever lived in a type A home (uranium tailings home); and radiation therapy. The lung cancer case/control analysis shows a significant association with only the radiation exposure variable, uranium mining history, indicating cases were more likely to have been uranium miners than were controls. As with leukemia, the study found no association between lung cancer and living in a uranium mill tailings home. The relatively low radiation exposures typical of type A homes and the small number of persons exposed make it very difficult to establish, by epidemiologic methods, that a risk exists

  18. Impetigo in epidemic and nonepidemic phases: an incidence study over 4(1/2) years in a general population.

    Science.gov (United States)

    Rørtveit, S; Rortveit, G

    2007-07-01

    Little is known about incidence and natural variation of impetigo in general populations. To investigate the natural course of impetigo in a well-defined population, and to study the resistance pattern of the causal bacteria over time. This is a population-based incidence study in Austevoll, an island community of 4457 inhabitants in Norway, in the years 2001-2005. Incidence rates are given as events per person-year. Epidemic periods were identified by statistical process-control analyses. The incidence rate of impetigo for the whole study period was 0.017 events per person-year, corresponding to a total of 334 cases. The incidence rates were 0.009, 0.026, 0.019, 0.016 and 0.009 in the years 2001, 2002, 2003, 2004 and 2005, respectively. Three epidemics were identified, starting in August of 2002, 2003 and 2004, lasting for 11, 11 and 5 weeks, respectively. Incidence rates in these epidemic periods were 0.099, 0.045 and 0.074, respectively. In epidemic periods, Staphylococcus aureus was the causal bacterium in 89% (117/132) of cases, while this proportion was 68% (84/123) in nonepidemic periods (P impetigo cases in epidemic and nonepidemic periods, respectively (P impetigo cases (152/201, 76%) differed significantly from fusidic acid resistance in other infections (18/116, 16%) (P < 0.01). Distinctive epidemic outbreaks occurred during the summer of three of the five follow-up years. In outbreaks, S. aureus was more frequently the causal agent and the sensitivity to fusidic acid decreased significantly.

  19. Aphid incidence and its correlation with different environmental factors

    OpenAIRE

    Hasan, M.R; Ahmad, M.; Rahman, M.H; Haque, M.A

    2009-01-01

    The aphid incidence and its correlation with environmental factors were studied. Mustard variety “Sampad” was used as test crop. Aphid incidence varied significantly at various parts of mustard plant and time of the day. The highest number of aphid was observed in the vegetative parts of the mustard plant in the morning. High cloudiness, relative humidity and dew point favoured the aphid population and slight rain fall quickly declined the aphid population. Among the different environmental f...

  20. The Nature and Incidence of Software Piracy: Evidence from Windows

    OpenAIRE

    Athey, Susan; Stern, Scott

    2013-01-01

    This paper evaluates the nature, relative incidence and drivers of software piracy. In contrast to prior studies, we analyze data that allows us to measure piracy for a specific product - Windows 7 - which was associated with a significant level of private sector investment. Using anonymized telemetry data, we are able to characterize the ways in which piracy occurs, the relative incidence of piracy across different economic and institutional environments, and the impact of enforcement effort...

  1. Nonalcoholic Fatty Liver Disease Incidence and Impact on Metabolic Burden and Death: a 20 Year-Community Study.

    Science.gov (United States)

    Allen, Alina M; Terry, Therneau M; Larson, Joseph J; Coward, Alexandra; Somers, Virend K; Kamath, Patrick S

    2017-09-23

    Recent population-based data on nonalcoholic fatty liver disease (NAFLD) epidemiology in general and incidence in particular, are lacking. We examined trends in NAFLD incidence in a US community, and the impact of NAFLD on incident metabolic comorbidities (MC), cardiovascular (CV) events and mortality. A community cohort of all adults diagnosed with NAFLD in Olmsted County, MN between 1997-2014 was constructed using the Rochester Epidemiology Project database. The yearly incidence rate was calculated. The impact of NAFLD on incident MC, CV events and mortality was studied using a multi-state model, with a 4:1 age and sex-matched general population as reference. We identified 3,869 NAFLD subjects (median age 53, 52% women) and 15,209 controls; median follow-up was 7 (1 to 20) years. NAFLD incidence increased 5-fold, from 62 to 329/100,000 person-years. The increase was highest (7-fold) in young adults, age 18-39 years. The 10-year mortality was higher in NAFLD subjects (10.2%) than controls (7.6%) (p<0.0001). NAFLD was an independent risk factor for incident MC and death. Mortality risk decreased as the number of incident MC increased: RR= 2.16 (95% CI 1.41-3.31), 1.99 (95% CI 1.48-2.66), 1.75 (95% CI 1.42-2.14) and 1.08 (95% CI 0.89-1.30) when 0, 1, 2, or 3 MC were present, respectively. The NAFLD impact on CV events was significant only in subjects without MC (RR=1.96, 95% CI=1.35-2.86). NAFLD reduced life expectancy by 4 years, with more time spent in high metabolic burden. The incidence of NAFLD diagnosis in the community has increased 5-fold, particularly in young adults. NAFLD is a consequence but also a precursor of MC. Incident MC attenuates the impact of NAFLD on death and annuls its impact on CV disease. This article is protected by copyright. All rights reserved. © 2017 by the American Association for the Study of Liver Diseases.

  2. Acquisition and analysis of road incidents based on vehicle dynamics.

    Science.gov (United States)

    Naude, Claire; Serre, Thierry; Dubois-Lounis, Maxime; Fournier, Jean-Yves; Lechner, Daniel; Guilbot, Michèle; Ledoux, Vincent

    2017-03-09

    Because motor vehicle crashes have decreased during the last decade in many countries in the world and are more diffuse, local authorities have difficulties to define road safety policies. An experiment with 51 cars of public fleets equipped with a specific Event Data Recorder was carried out in France during one year. The purposes of this research were to evaluate if incident data (critical driving situations) help to understand crashes, and to explore a new way for road infrastructure safety diagnosis. The analysis of 339 genuine incidents and 1237 simple events recorded illustrates the potentiality of such an experiment and provides: some insights about conditions in which incidents occur, a general overview of their distribution according to different road layouts, as well as information on the different levels of accelerations reached. It can be noticed that there is an overrepresentation of incidents in right curves compared to left curves. The simple events involving mostly the infrastructure could be used to detect road defects. Genuine incidents where the vehicle is subjected to important dynamic demands, related to potentially unsafe driving situations, can be used to improve knowledge of the motor vehicle crashes thanks to incident mechanisms analysis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Incidence of falls and preventive actions in a University Hospital.

    Science.gov (United States)

    Luzia, Melissa de Freitas; Cassola, Talita Portela; Suzuki, Lyliam Midori; Dias, Vera Lucia Mendes; Pinho, Leandro Barbosa de; Lucena, Amália de Fátima

    2018-01-01

    Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

  4. Pediatric melanoma: incidence, treatment, and prognosis

    Directory of Open Access Journals (Sweden)

    Saiyed FK

    2017-04-01

    Full Text Available Faiez K Saiyed,1 Emma C Hamilton,1 Mary T Austin,1,2 1Department of Pediatric Surgery, McGovern Medical School, 2Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole. Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level. Keywords: melanoma, pediatric, adolescent, childhood

  5. The incidence of induced abortion in Malawi.

    Science.gov (United States)

    Levandowski, Brooke A; Mhango, Chisale; Kuchingale, Edgar; Lunguzi, Juliana; Katengeza, Hans; Gebreselassie, Hailemichael; Singh, Susheela

    2013-06-01

    Abortion is legally restricted in Malawi, and no data are available on the incidence of the procedure. The Abortion Incidence Complications Methodology was used to estimate levels of induced abortion in Malawi in 2009. Data on provision of postabortion care were collected from 166 public, nongovernmental and private health facilities, and estimates of the likelihood that women who have abortions experience complications and seek care were obtained from 56 key informants. Data from these surveys and from the 2010 Malawi Demographic and Health Survey were used to calculate abortion rates and ratios, and rates of pregnancy and unintended pregnancy. Approximately 18,700 women in Malawi were treated in health facilities for complications of induced abortion in 2009. An estimated 67,300 induced abortions were performed, equivalent to a rate of 23 abortions per 1,000 women aged 15-44 and an abortion ratio of 12 per 100 live births. The abortion rate was higher in the North (35 per 1,000) than in the Central region or the South (20-23 per 1,000). The unintended pregnancy rate in 2010 was 139 per 1,000 women aged 15-44, and an estimated 52% of all pregnancies were unintended. Unsafe abortion is common in Malawi. Interventions are needed to help women and couples avoid unwanted pregnancy, reduce the need for unsafe abortion and decrease maternal mortality.

  6. Detecting Terrorism Incidence Type from News Summary

    DEFF Research Database (Denmark)

    Nizamani, Sarwat; Memon, Nasrullah

    2012-01-01

    The paper presents the experiments to detect terrorism incidence type from news summary data. We have applied classification techniques on news summary data to analyze the incidence and detect the type of incidence. A number of experiments are conducted using various classification algorithms...... and results show that a simple decision tree classifier can learn incidence type with satisfactory results from news data....

  7. Incidence Angle Effect of Energetic Carbon Ions on Deposition Rate, Topography, and Structure of Ultrathin Amorphous Carbon Films Deposited by Filtered Cathodic Vacuum Arc

    KAUST Repository

    Wang, N.

    2012-07-01

    The effect of the incidence angle of energetic carbon ions on the thickness, topography, and structure of ultrathin amorphous carbon (a-C) films synthesized by filtered cathodic vacuum arc (FCVA) was examined in the context of numerical and experimental results. The thickness of a-C films deposited at different incidence angles was investigated in the light of Monte Carlo simulations, and the calculated depth profiles were compared with those obtained from high-resolution transmission electron microscopy (TEM). The topography and structure of the a-C films were studied by atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS), respectively. The film thickness decreased with the increase of the incidence angle, while the surface roughness increased and the content of tetrahedral carbon hybridization (sp 3) decreased significantly with the increase of the incidence angle above 45° , measured from the surface normal. TEM, AFM, and XPS results indicate that the smoothest and thinnest a-C films with the highest content of sp 3 carbon bonding were produced for an incidence angle of 45°. The findings of this study have direct implications in ultrahigh-density magnetic recording, where ultrathin and smooth a-C films with high sp 3 contents are of critical importance. © 2012 IEEE.

  8. A mathematical model to evaluate the routine use of fecal microbiota transplantation to prevent incident and recurrent Clostridium difficile infection.

    Science.gov (United States)

    Lofgren, Eric T; Moehring, Rebekah W; Anderson, Deverick J; Weber, David J; Fefferman, Nina H

    2014-01-01

    Fecal microbiota transplantation (FMT) has been suggested as a new treatment to manage Clostridium difficile infection (CDI). With use of a mathematical model of C. difficile within an intensive care unit (ICU), we examined the potential impact of routine FMT. A mathematical model of C. difficile transmission, supplemented with prospective cohort, surveillance, and billing data from hospitals in the southeastern United States. Cohort, surveillance, and billing data as well as data from the literature were used to construct a compartmental model of CDI within an ICU. Patients were defined as being in 1 of 6 potential health states: uncolonized and at low risk; uncolonized and at high risk; colonized and at low risk; colonized and at high risk; having CDI; or treated with FMT. The use of FMT to treat patients after CDI was associated with a statistically significant reduction in recurrence but not with a reduction in incident cases. Treatment after administration of high-risk medications, such as antibiotics, did not result in a decrease in recurrence but did result in a statistically significant difference in incident cases across treatment groups, although whether this difference was clinically relevant was questionable. Our study is a novel mathematical model that examines the effect of FMT on the prevention of recurrent and incident CDI. The routine use of FMT represents a promising approach to reduce complex recurrent cases, but a reduction in CDI incidence will require the use of other methods to prevent transmission.

  9. Phalangeal bone mineral density predicts incident fractures

    DEFF Research Database (Denmark)

    Friis-Holmberg, Teresa; Brixen, Kim; Rubin, Katrine Hass

    2012-01-01

    This prospective study investigates the use of phalangeal bone mineral density (BMD) in predicting fractures in a cohort (15,542) who underwent a BMD scan. In both women and men, a decrease in BMD was associated with an increased risk of fracture when adjusted for age and prevalent fractures....... PURPOSE: The aim of this study was to evaluate the ability of a compact and portable scanner using radiographic absorptiometry (RA) to predict major osteoporotic fractures. METHODS: This prospective study included a cohort of 15,542 men and women aged 18-95 years, who underwent a BMD scan in Danish Health...... Examination Survey 2007-2008. BMD at the middle phalanges of the second, third and fourth digits of the non-dominant hand was measured using RA (Alara MetriScan®). These data were merged with information on incident fractures retrieved from the Danish National Patient Registry comprising the International...

  10. Patient safety incidents involving neuromuscular blockade: analysis of the UK National Reporting and Learning System data from 2006 to 2008.

    Science.gov (United States)

    Arnot-Smith, J; Smith, A F

    2010-11-01

    Neuromuscular blockade is a powerful anaesthetic tool that has the potential for significant adverse outcomes. We sought to explore the national picture by analysing incidents relating to neuromuscular blockade in anaesthesia from the National Reporting and Learning System from England and Wales between 2006 and 2008. We searched the database of incidents using SNOMED CT search terms and reading the free text of relevant incidents. There were 231 incidents arising from the use or reversal of neuromuscular blocking agents. The main themes identified were: non-availability of drugs (45 incidents, 19%), possible unintentional awareness under general anaesthesia (42 incidents, 18%), potential allergic reaction (31 incidents, 13%), problems with reversal of blockade (13 incidents, 6%), storage (13 incidents, 6%) and prolonged apnoea (11 incidents, 5%). We make recommendations to reduce human error in the use of neuromuscular blocking agents and on future incident reporting in anaesthesia. © 2010 The Authors. Anaesthesia © 2010 The Association of Anaesthetists of Great Britain and Ireland.

  11. Incidence of cancer in the area around Amsterdam Airport Schiphol in 1988–2003: a population-based ecological study

    Directory of Open Access Journals (Sweden)

    van Leeuwen Flora E

    2005-12-01

    Full Text Available Abstract Background Amsterdam Airport Schiphol is a major source of complaints about aircraft noise, safety risks and concerns about long term adverse health effects, including cancer. We investigated whether residents of the area around Schiphol are at higher risk of developing cancer than the general Dutch population. Methods In a population-based study using the regional cancer registry, we estimated the cancer incidence during 1988–2003 in residents of the area surrounding Schiphol. We defined a study area based on aircraft noise contours and 4-digit postal code areas, since historical data on ambient air pollution were not available and recent emission data did not differ from the background urban air quality. Results In residents of the study area 13 207 cancer cases were diagnosed, which was close to the expected number, using national incidence rates as a reference (standardized incidence ratio [SIR] 1.02. We found a statistically significantly increased incidence of hematological malignancies (SIR 1.12, 95% confidence interval [CI]: 1.05, 1.19, mainly due to high rates for non-Hodgkin lymphoma (SIR 1.22, 95% CI: 1.12, 1.33 and acute lymphoblastic leukemia (SIR 1.34, 95% CI: 0.95, 1.83. The incidence of cancer of the respiratory system was statistically significantly decreased (SIR 0.94, 95% CI: 0.90, 0.99, due to the low rate in males (SIR 0.89. In the core zone of the study area, cancer incidence was slightly higher than in the remaining ring zone (rate ratio of the core zone compared to the ring zone 1.05, 95% CI 1.01, 1.10. This was caused by the higher incidence of cancer of the respiratory system, prostate and the female genital organs in the core zone in comparison to the ring zone. Conclusion The overall cancer incidence in the Schiphol area was similar to the national incidence. The moderately increased risk of hematological malignancies could not be explained by higher levels of ambient air pollution in the Schiphol area

  12. Periodontal Disease and Decreased Kidney Function in Japanese Elderly

    NARCIS (Netherlands)

    Iwasaki, Masanori; Taylor, George W.; Nesse, Willem; Vissink, Arjan; Yoshihara, Akihiro; Miyazaki, Hideo

    Background: Early detection of decreased kidney function can help prevent the progression of kidney disease to kidney failure and cardiovascular events. Potentially significant associations between kidney function and periodontal disease have been reported in cross-sectional studies. However, no

  13. Clinical significance of percutaneous endoscopic gastrostomy for patients with severe craniocerebral injury

    Directory of Open Access Journals (Sweden)

    Du Hanggen

    2014-12-01

    Full Text Available Objective: To investigate the application of percutaneous endoscopic gastrostomy (PEG to patients with severe craniocerebral injury for the purpose of nutritional support therapy and pulmonary infection prevention. Methods: A total of 43 patients with severe craniocerebral injury admitted to our department from January 2008 to December 2012 received PEG followed by nutritional therapy. There were other 82 patients who were prescribed nasal-feeding nutrition. Nutrition status was evaluated by comparing serum albumin levels, and the incidence of pulmonary infection 1 week before and 2 weeks after operation was identifi ed and compared. Results: Both PEG and nasal-feeding nutrition therapies have significantly levated serum albumin levels (P<0.05. Serum albumin levels before and after nutritional therapies showed no significant difference between the two groups (P>0.05. The incidence of pulmonary infection in PEG group was significantly decreased compared with that in nasal-feeding nutrition group (P<0.05. Conclusion: PEG is an effective method for severe craniocerebral injury patients. It can not only provide enteral nutrition but also prevent pulmonary infection induced by esophageal refl ux. Key words: Gastrostomy; Craniocerebral trauma; Enteral nutrition

  14. Incidence of hyperthyroidism in Slovenia since improved iodine supply

    International Nuclear Information System (INIS)

    Zaletel, K.; Gaberscek, S.; Pirnat, E.; Hojker, S.

    2002-01-01

    Full text: Since the year 1953, when iodine prophylaxis was introduced in Slovenia, several epidemiological studies confirmed the existence of mild iodine deficiency on the whole territory of Slovenia. In January 1999 the implementation of higher iodine content (25 mg of KI or 32 mg of KIO 3 ) was recommended and since then the increased incidence of thyrotoxicosis was observed. Here we present 5-year follow-up data of the incidence of hyperthyroidism due to thyroid autonomy and Graves' disease. We estimated incidence rates from 1997 to 2001 for hyperthyroidism due to thyroid autonomy and Graves' disease among 1000000 people, living in the area of Ljubljana. We assumed that most cases were seen and treated in the Outpatient Department for thyroid diseases of Department for Nuclear Medicine of University Medical Centre Ljubljana. Immediately after correction of iodine deficiency, the incidence of hyperthyroidism due to thyroid autonomy rose almost twice in 1999 (320 cases in 1999 compared to 173 cases in 1997), but afterwards the incidence slightly decreased (240 cases in 2000). Similarly, the incidence of Graves' disease rose in 1999 (267 cases in 1999 compared to 237 in 1997) and in contrast to thyroid autonomy the incidence further increased in the following years (337 in 2000 and 246 in the first half of 2001). The increased incidence of hyperthyroidism due to thyroid autonomy and Graves' disease after elevation of iodine prophylaxis in Slovenia is comparable with data in some other endemic areas. Those data indicate that stepwise supplementation is preferable to immediate corrections. However, we believe that iodine prophylaxis is reasonable and justified and to reassess the iodine nutrition status we plan a follow up evaluation in year 2002. (author)

  15. Assays for estimating HIV incidence: updated global market assessment and estimated economic value.

    Science.gov (United States)

    Morrison, Charles S; Homan, Rick; Mack, Natasha; Seepolmuang, Pairin; Averill, Megan; Taylor, Jamilah; Osborn, Jennifer; Dailey, Peter; Parkin, Neil; Ongarello, Stefano; Mastro, Timothy D

    2017-11-01

    Accurate incidence estimates are needed to characterize the HIV epidemic and guide prevention efforts. HIV Incidence assays are cost-effective laboratory assays that provide incidence estimates from cross-sectional surveys. We conducted a global market assessment of HIV incidence assays under three market scenarios and estimated the economic value of improved incidence assays. We interviewed 27 stakeholders, and reviewed journal articles, working group proceedings, and manufacturers' sales figures. We determined HIV incidence assay use in 2014, and estimated use in 2015 to 2017 and in 5 to 10-years under three market scenarios, as well as the cost of conducting national and key population surveys using an HIV incidence assay with improved performance. Global 2014 HIV incidence assay use was 308,900 tests, highest in Asia and mostly for case- and population-based surveillance. Estimated 2015 to 2017 use was 94,475 annually, with declines due to China and the United States discontinuing incidence assay use for domestic surveillance. Annual projected 5 to 10 year use under scenario 1 - no change in technology - was 94,475. For scenario 2 - a moderately improved incidence assay - projected annual use was 286,031. Projected annual use for scenario 3 - game-changing technologies with an HIV incidence assay part of (a) standard confirmatory testing, and (b) standard rapid testing, were 500,000 and 180 million, respectively. As HIV incidence assay precision increases, decreased sample sizes required for incidence estimation resulted in $5 to 23 million annual reductions in survey costs and easily offset the approximately $3 million required to develop a new assay. Improved HIV incidence assays could substantially reduce HIV incidence estimation costs. Continued development of HIV incidence assays with improved performance is required to realize these cost benefits. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on

  16. Colorectal-Cancer Incidence and Mortality with Screening Flexible Sigmoidoscopy

    Science.gov (United States)

    Schoen, Robert E.; Pinsky, Paul F.; Weissfeld, Joel L.; Yokochi, Lance A.; Church, Timothy; Laiyemo, Adeyinka O.; Bresalier, Robert; Andriole, Gerald L.; Buys, Saundra S.; Crawford, E. David; Fouad, Mona N.; Isaacs, Claudine; Johnson, Christine C.; Reding, Douglas J.; O'Brien, Barbara; Carrick, Danielle M.; Wright, Patrick; Riley, Thomas L.; Purdue, Mark P.; Izmirlian, Grant; Kramer, Barnett S.; Miller, Anthony B.; Gohagan, John K.; Prorok, Philip C.; Berg, Christine D.

    2013-01-01

    Background The benefits of endoscopic testing for colorectal-cancer screening are uncertain. We evaluated the effect of screening with flexible sigmoidoscopy on colorectal-cancer incidence and mortality. Methods From 1993 through 2001, we randomly assigned 154,900 men and women 55 to 74 years of age either to screening with flexible sigmoidoscopy, with a repeat screening at 3 or 5 years, or to usual care. Cases of colorectal cancer and deaths from the disease were ascertained. Results Of the 77,445 participants randomly assigned to screening (intervention group), 83.5% underwent baseline flexible sigmoidoscopy and 54.0% were screened at 3 or 5 years. The incidence of colorectal cancer after a median follow-up of 11.9 years was 11.9 cases per 10,000 person-years in the intervention group (1012 cases), as compared with 15.2 cases per 10,000 person-years in the usual-care group (1287 cases), which represents a 21% reduction (relative risk, 0.79; 95% confidence interval [CI], 0.72 to 0.85; Pcolorectal cancer (479 cases in the intervention group vs. 669 cases in the usual-care group; relative risk, 0.71; 95% CI, 0.64 to 0.80; Pcolorectal cancer (512 cases vs. 595 cases; relative risk, 0.86; 95% CI, 0.76 to 0.97; P = 0.01). There were 2.9 deaths from colorectal cancer per 10,000 person-years in the intervention group (252 deaths), as compared with 3.9 per 10,000 person-years in the usual-care group (341 deaths), which represents a 26% reduction (relative risk, 0.74; 95% CI, 0.63 to 0.87; Pcolorectal cancer was reduced by 50% (87 deaths in the intervention group vs. 175 in the usual-care group; relative risk, 0.50; 95% CI, 0.38 to 0.64; Pcolorectal cancer was unaffected (143 and 147 deaths, respectively; relative risk, 0.97; 95% CI, 0.77 to 1.22; P = 0.81). Conclusions Screening with flexible sigmoidoscopy was associated with a significant decrease in colorectal-cancer incidence (in both the distal and proximal colon) and mortality (distal colon only). (Funded by the

  17. Characteristics, rates, and trends of melanoma incidence among Hispanics in the USA.

    Science.gov (United States)

    Garnett, Erin; Townsend, Julie; Steele, Brooke; Watson, Meg

    2016-05-01

    The purpose of this study is to describe the epidemiology of melanoma among Hispanics using data that cover nearly 100 % of the US population. The study used population-based cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology and End Results Program to examine melanoma incidence rates and trends among Hispanics by sex, age, race, histology, anatomic location, stage, and tumor thickness. From 2008 to 2012, 6,623 cases of melanoma were diagnosed among Hispanics. Rates were higher among males (4.6) than among females (4.0), but females younger than age 55 had higher rates than males. The most common histologic subtype was superficial spreading melanoma (23 %). Melanomas with poorer outcomes, such as nodular (NM) and acral lentiginous melanoma (ALM), were more common among males. Hispanic females had the highest proportion of melanoma on the lower limb and hip (33.7 %), while Hispanic males had the highest proportion on the trunk (29.9 %). Incidence rates for later-stage diagnosis and thicker tumors were significantly higher among Hispanic men than among women. Incidence rates decreased significantly during 2003-2012 (AAPC = -1.4). Clinicians and public health practitioners will need to reach the growing Hispanic population in the USA with strategies for primary prevention and early diagnosis of melanoma. Results suggest Hispanics and providers need education to increase awareness about the characteristics of melanoma among Hispanics, including types that occur on non-sun-exposed areas (ALM and NM). Skin cancer prevention and awareness interventions targeting Hispanics should be culturally relevant.

  18. Potential association between the recent increase in campylobacteriosis incidence in the Netherlands and proton-pump inhibitor use : an ecological study

    NARCIS (Netherlands)

    Bouwknegt, M.; van Pelt, W.; Kubbinga, M. E.; Weda, M.; Havelaar, A. H.

    2014-01-01

    The Netherlands saw an unexplained increase in campylobacteriosis incidence between 2003 and 2011, following a period of continuous decrease. We conducted an ecological study and found a statistical association between campylobacteriosis incidence and the annual number of prescriptions for proton

  19. Incidence, seasonality and comorbidity in vestibular neuritis.

    Science.gov (United States)

    Adamec, Ivan; Krbot Skorić, Magdalena; Handžić, Jadranka; Habek, Mario

    2015-01-01

    Aims of the present study were: (1) to assess the incidence of vestibular neuritis (VN) in the adult population in two cities in Croatia, (2) to identify distribution of new VN cases in the different months and seasons by years, and (3) to identify comorbidities associated with VN. This is a prospective, population-based study conducted in the cities of Zagreb and Velika Gorica, Croatia in the 2011-2012 period. All diagnoses were confirmed either with caloric test or vestibular evoked myogenic potentials within 7 days of symptom onset. Following clinical parameters were collected from all patients: age, gender, side of the lesion, month and season of symptoms onset and comorbidities. We identified 79 new cases of VN (34 in 2011, 45 in 2012). The male to female ratio was 1.1:1. The mean age at the onset of the disease was 52.3 (range 20-86) years. The average annual incidence was 11.7 per 100,000 (95 % CI 7.8-15.6) in the 2011 period and 15.5 per 100,000 (95 % CI 11.0-20.0) in the 2012 period. For both years there was no statistically significant uneven distribution in the different months or seasons by years. The most frequent comorbidities present in VN patients were hypertension (30.4 %), diabetes mellitus (8.9 %), hyperlipidemia (7.5 %) and hypothyreosis (6.3 %). Our study has shown higher incidence of VN than previously reported. We have found no evidence of seasonality of VN and significant proportion of VN patients older than 50 years who had vascular risk factors present.

  20. Partial scram incident in FBTR

    International Nuclear Information System (INIS)

    Usha, S.; Pillai, C.P.; Muralikrishna, G.

    1989-01-01

    Evaluation of a partial scram incident occurred at the Fast Breeder Test Reactor at Kalpakkam was carried out. Based on the observations of the experiments it was ascertained that the nonpersistant order was due to superimposed noise component on the channel that was close to the threshold and had resulted in intermittent supply to electro-magnetic (EM) coils. Owing to a larger discharge time and a smaller charge time, the EM coils got progressively discharged. It was confirmed that during the incident, partial scram took place since the charging and discharging patterns of the EM coils are dissimilar and EM coils of rods A, E and F had discharged faster than others for noise component of a particular duty cycle. However, nonlatching of scram order was because of the fact that noise pulse duration was less than latching time. (author)

  1. Dissociative Tendencies and Traffic Incidents

    Directory of Open Access Journals (Sweden)

    Valle, Virginia

    2012-01-01

    Full Text Available This paper analyses the relationship between dissociative experiences and road traffic incidents (crashes and traffic tickets in drivers (n=295 from Mar del Plata (Argentina city. A self-report questionnaire was applied to assess traffic crash involvement and sociodemographic variables. Dissociative tendencies were assessed by a modified version of the DES scale. To examine differences in DES scores tests of the difference of means were applied. Drivers who reported to be previously involved in traffic incidents obtained higher puntuations in the dissociative experiences scale than drivers who did not report such events. This result is observed for the total scale and for the three sub-scales (absorption, amnesia and depersonalization. However, differences appeared mainly for minor damage collisions. Further studies are needed to evaluate the role of dissociative tendencies as a risk factor in road traffic safety.

  2. [Incidence and mortality of children and teenagers with AIDS: challenges in the southern region of Brazil].

    Science.gov (United States)

    Melo, Márcio Cristiano de; Ferraz, Rosemeire de Olanda; Nascimento, Juliana Luporini do; Donalisio, Maria Rita

    2016-12-01

    The objective of this study is to describe the time trend of coefficients of incidence and mortality associated with AIDS in children and adolescents. An ecological time trend study was conducted among individuals under 14 living in the regional context of high incidence of AIDS - Porto Alegre and the State of Rio Grande do Sul - from 1996 to 2012. For this purpose, a segmented regression model was adjusted for age categories and place of residence. AIDS morbidity and mortality indicators in Porto Alegre are still higher than those registered in the State, the southern region and other areas of the country. In Porto Alegre, 59.1% of cases (371/628) occurred in children under four years of age, the incidence showed peaks in the period and the mortality dropped from 9 to 2 per 100,000. A significant decreasing in annual percentage change in mortality was observed especially in children under 1 year of age in Porto Alegre. This drop may be related to prevention and treatment of pregnant women. The challenge is to identify possible fragilities of the STD/AIDS Program and its vulnerable points in order to make specific interventions and investments with a greater impact potential.

  3. Factors influencing upon the incidence of seed migration in I-125 seed transperineal prostate implantation

    International Nuclear Information System (INIS)

    Itami, Jun; Onishi, Kayoko; Kanemura, Mikio

    2005-01-01

    Transperineal I-125 seed brachytherapy for prostate cancer is rapidly expanding in Japan. Seed migrations to lung and abdomen are well known complication in the seed brachytherapy. The rate of incidence and the predisposing factors were studied. From April 2004 through January 2005, 36 patients underwent transperineal I-125 seed brachytherapy for prostate cancer. In all patients loose I-125 seeds were inserted with Mick applicator according to modified peripheral loading pattern. One day, 1 week, and 1 month after the procedure, posteroanterior and lateral chest X-rays and abdominal X-ray were performed. Abdominal and chest seed migrations were seen in 11 (30.6%) and 14 (38.9%) patients, respectively. In total, 20 patients (55.6%) showed seed migrations. Forty-two I-125 seeds migrated out of 2,508 implanted seeds. Most of the migrations were seen until 1 month after the procedure. The preplanned number of the extraprostatic seeds had a statistically significant influence upon the incidence of seed migration. Seed migration is not a rare phenomenon in transperineal I-125 seed brachytherapy for prostate cancer. To confirm seed migration, X-ray examinations 1 month after the procedure are suited. At the preplanning, the number of extraprostatic seeds should be limited to minimal to decrease the incidence of seed migration. In future, the introduction of linked I-125 seeds is preferred. (author)

  4. Polarimetric Scattering Properties of Landslides in Forested Areas and the Dependence on the Local Incidence Angle

    Directory of Open Access Journals (Sweden)

    Takashi Shibayama

    2015-11-01

    Full Text Available This paper addresses the local incidence angle dependence of several polarimetric indices corresponding to landslides in forested areas. Landslide is deeply related to the loss of human lives and their property. Various kinds of remote sensing techniques, including aerial photography, high-resolution optical satellite imagery, LiDAR and SAR interferometry (InSAR, have been available for landslide investigations. SAR polarimetry is potentially an effective measure to investigate landslides because fully-polarimetric SAR (PolSAR data contain more information compared to conventional single- or dual-polarization SAR data. However, research on landslide recognition utilizing polarimetric SAR (PolSAR is quite limited. Polarimetric properties of landslides have not been examined quantitatively so far. Accordingly, we examined the polarimetric scattering properties of landslides by an assessment of how the decomposed scattering power components and the polarimetric correlation coefficient change with the local incidence angle. In the assessment, PolSAR data acquired from different directions with both spaceborne and airborne SARs were utilized. It was found that the surface scattering power and the polarimetric correlation coefficient of landslides significantly decrease with the local incidence angle, while these indices of surrounding forest do not. This fact leads to establishing a method of effective detection of landslide area by polarimetric information.

  5. Decreased chewing activity during mouth breathing.

    Science.gov (United States)

    Hsu, H-Y; Yamaguchi, K

    2012-08-01

    This study examined the effect of mouth breathing on the strength and duration of vertical effect on the posterior teeth using related functional parameters during 3 min of gum chewing in 39 nasal breathers. A CO(2) sensor was placed over the mouth to detect expiratory airflow. When no airflow was detected from the mouth throughout the recording period, the subject was considered a nasal breather and enrolled in the study. Electromyographic (EMG) activity was recorded during 3 min of gum chewing. The protocol was repeated with the nostrils occluded. The strength of the vertical effect was obtained as integrated masseter muscle EMG activity, and the duration of vertical effect was also obtained as chewing stroke count, chewing cycle variation and EMG activity duration above baseline. Baseline activity was obtained from the isotonic EMG activity during jaw movement at 1.6 Hz without making tooth contact. The duration represented the percentage of the active period above baseline relative to the 3-min chewing period. Paired t-test and repeated analysis of variance were used to compare variables between nasal and mouth breathing. The integrated EMG activity and the duration of EMG activity above baseline, chewing stroke count and chewing cycle significantly decreased during mouth breathing compared with nasal breathing (Pbreathing was significantly greater than nasal breathing (Pbreathing reduces the vertical effect on the posterior teeth, which can affect the vertical position of posterior teeth negatively, leading to malocclusion. © 2012 Blackwell Publishing Ltd.

  6. COGNITIVE THERAPY DECREASE THE LEVEL OF DEPRESSION

    Directory of Open Access Journals (Sweden)

    Ah. Yusuf

    2017-07-01

    Full Text Available Introduction: Aging is a natural process in individuals. Most of the elderly have problems in dealing with this natural process. Lost of occupation, friends and loneliness may result in depression in this age group. Cognitive therapy changes pessimistic idea, unrealistic hopes and excessive self evaluation may result and justify depression. Cognitive therapy may help elderly to recognize the problem in life, to develop positive objective of life and to create more positive personality. The aimed of this study was to analyze the effect of cognitive therapy to reduce the level of depression. Method: This study was used a pre experimental pre post test design. Sample were 10 elderly people who met to the inclusion criteria. The independent variable was cognitive therapy and dependent variable was the level of depression in elderly. Data were collected by using Geriatric Depression Scale (GDS 15, then analyzed by using Wilcoxon Signed Rank Test with significance levelα≤0.05. Result: The result showed that cognitive therapy has an effect on reducing depression with significance level p=0.005. Discussion: It can be concluded that cognitive therapy was effective in reducing depression level in elderly. Further studies are recommended to analyze the effect of cognitive therapy on decreasing anxiety in elderly by measuring cathecolamin.

  7. Lower skin temperature decreases maximal cycling performance.

    Science.gov (United States)

    Imai, Daiki; Okazaki, Kazunobu; Matsumura, Shinya; Suzuki, Takashi; Miyazawa, Taiki; Suzuki, Akina; Takeda, Ryosuke; Hamamoto, Takeshi; Zako, Tetsuo; Kawabata, Takashi; Miyagawa, Toshiaki

    2011-12-01

    It is known that external cooling of body regions involved in exercise, prior to exercise, decreases anaerobic performance. However, there have been no studies reporting the effects of whole body skin surface cooling before exercise on maximal anaerobic capacity. In order to clarify the effects, we compared power output during the Wingate anaerobic test between preconditioning by exposure to temperature 10 degrees C and 25 degrees C. Eight healthy males carried out the Wingate test for 30 seconds, after pre-conditioning for 60 minutes using a perfusion suit with water at a temperature of 10 de