WorldWideScience

Sample records for incidence prevalence management

  1. 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.

  2. 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...

  3. 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.

  4. 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.

  5. 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…

  6. 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...

  7. Incidence and prevalence of psoriasis in Denmark

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Skov, Lone; Gislason, Gunnar H.

    2017-01-01

    The incidence and temporal trends of psoriasis in Denmark between 2003 and 2012 were examined. There was a female predominance ranging between 50.0% (2007) and 55.4% (2009), and the mean age at time of diagnosis was 47.7-58.7 years. A total of 126,055 patients with psoriasis (prevalence 2.2%) were...... identified. Incidence rates of psoriasis (per 100,000 person years) ranged from 107.5 in 2005 to a peak incidence of 199.5 in 2010. Incidence rates were higher for women, and patients aged 60-69 years, respectively. Use of systemic non-biologic agents, i.e. methotrexate, cyclosporine, retinoids, or psoralen...... plus ultraviolet A (PUVA) increased over the study course, and were used in 15.0% of all patients. Biologic agents (efalizumab, etanercept, infliximab, adalimumab, or ustekinumab) were utilized in 2.7% of patients. On a national level, incidence of psoriasis fluctuated during the 10- year study course...

  8. 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

  9. Incidence and prevalence of NMOSD in Australia and New Zealand.

    Science.gov (United States)

    Bukhari, Wajih; Prain, Kerri M; Waters, Patrick; Woodhall, Mark; O'Gorman, Cullen M; Clarke, Laura; Silvestrini, Roger A; Bundell, Christine S; Abernethy, David; Bhuta, Sandeep; Blum, Stefan; Boggild, Mike; Boundy, Karyn; Brew, Bruce J; Brown, Matthew; Brownlee, Wallace J; Butzkueven, Helmut; Carroll, William M; Chen, Celia; Coulthard, Alan; Dale, Russell C; Das, Chandi; Dear, Keith; Fabis-Pedrini, Marzena J; Fulcher, David; Gillis, David; Hawke, Simon; Heard, Robert; Henderson, Andrew P D; Heshmat, Saman; Hodgkinson, Suzanne; Jimenez-Sanchez, Sofia; Killpatrick, Trevor; King, John; Kneebone, Christopher; Kornberg, Andrew J; Lechner-Scott, Jeannette; Lin, Ming-Wei; Lynch, Christpher; Macdonell, Richard; Mason, Deborah F; McCombe, Pamela A; Pender, Michael P; Pereira, Jennifer A; Pollard, John D; Reddel, Stephen W; Shaw, Cameron; Spies, Judith; Stankovich, James; Sutton, Ian; Vucic, Steve; Walsh, Michael; Wong, Richard C; Yiu, Eppie M; Barnett, Michael H; Kermode, Allan G; Marriott, Mark P; Parratt, John D E; Slee, Mark; Taylor, Bruce V; Willoughby, Ernest; Wilson, Robert J; Vincent, Angela; Broadley, Simon A

    2017-08-01

    We have undertaken a clinic-based survey of neuromyelitis optica spectrum disorders (NMOSDs) in Australia and New Zealand to establish incidence and prevalence across the region and in populations of differing ancestry. NMOSD is a recently defined demyelinating disease of the central nervous system (CNS). The incidence and prevalence of NMOSD in Australia and New Zealand has not been established. Centres managing patients with demyelinating disease of the CNS across Australia and New Zealand reported patients with clinical and laboratory features that were suspicious for NMOSD. Testing for aquaporin 4 antibodies was undertaken in all suspected cases. From this group, cases were identified who fulfilled the 2015 Wingerchuk diagnostic criteria for NMOSD. A capture-recapture methodology was used to estimate incidence and prevalence, based on additional laboratory identified cases. NMOSD was confirmed in 81/170 (48%) cases referred. Capture-recapture analysis gave an adjusted incidence estimate of 0.37 (95% CI 0.35 to 0.39) per million per year and a prevalence estimate for NMOSD of 0.70 (95% CI 0.61 to 0.78) per 100 000. NMOSD was three times more common in the Asian population (1.57 (95% CI 1.15 to 1.98) per 100 000) compared with the remainder of the population (0.57 (95% CI 0.50 to 0.65) per 100 000). The latitudinal gradient evident in multiple sclerosis was not seen in NMOSD. NMOSD incidence and prevalence in Australia and New Zealand are comparable with figures from other populations of largely European ancestry. We found NMOSD to be more common in the population with Asian ancestry. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. 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...

  11. Global prevalence and incidence of traumatic spinal cord injury

    Directory of Open Access Journals (Sweden)

    Singh A

    2014-09-01

    region (58 per million, and Olmsted County in Minnesota (54.8 per million and were lower than 20 per million in Taipei, Taiwan (14.6 per million, the Rhone-Alpes region in France (12.7 per million, Aragon, Spain (12.1 per million, Southeast Turkey (16.9 per million, and Stockholm, Sweden (19.5 per million. The highest national incidence was 49.1 per million in New Zealand, and the lowest incidences were in Fiji (10.0 per million and Spain (8.0 per million. The majority of studies showed a high male-to-female ratio and an age of peak incidence of younger than 30 years old. Traffic accidents were typically the most common cause of SCI, followed by falls in the elderly population. Conclusion: This review demonstrates that the incidence, prevalence, and causation of SCI differs between developing and developed countries and suggests that management and preventative strategies need to be tailored to regional trends. The rising aging population in westernized countries also indicates that traumatic SCI secondary to falls may become an increasing public health challenge and that incidence among the elderly may rise with increasing life expectancy. Keywords: SCI, causation, epidemiology

  12. Prevalence and incidence of precocious pubertal development in Denmark

    DEFF Research Database (Denmark)

    Teilmann, Grete; Pedersen, Carsten; Jensen, Tina Kold

    2005-01-01

    To our knowledge, no population-based epidemiologic studies on the incidence and prevalence of precocious pubertal development have been published. Danish national registries provide sufficient data for estimating the prevalence and incidence of this condition. The aim of this study was to estima...

  13. Hepatitis B prevalence and incidence in Greenland

    DEFF Research Database (Denmark)

    Børresen, Malene Landbo; Andersson, Mikael; Wohlfahrt, Jan

    2015-01-01

    Greenland remains a highly endemic area for hepatitis B virus (HBV) infection. This is in sharp contrast to other modern societies, such as Denmark. To address this discrepancy, we investigated the natural history of HBV infection in Greenland by estimating the age-specific incidence of HBV...... infection, the proportion of chronic carriers, and the rates of hepatitis B surface antigen seroclearance. In total, 8,879 Greenlanders (16% of the population) from population-based surveys conducted in 1987 and 1998 were followed through March 2010. Data on HBV status were supplemented by HBV test results...... from all available HBV registries in Greenland to determine changes in HBV status over time. Incidence rates of HBV infection and hepatitis B surface antigen seroclearance were estimated after taking into account interval censoring. The incidence of HBV infection in 5-14-year-old subjects was less than...

  14. Incidence and prevalence of epilepsy in Denmark

    DEFF Research Database (Denmark)

    Christensen, Jakob; Vestergaard, Mogens; Pedersen, Marianne G

    2007-01-01

    PURPOSE: To estimate the occurrence of epilepsy in Denmark between 1977 and 2002, taking gender, age, and secular trends into consideration. METHODS: We used the Danish Civil Registration System to identify all persons born in Denmark and the Danish National Hospital Register to identify persons...... registered with epilepsy between 1977 and 2002. RESULTS: Between 1977 and 2002 the average incidence of epilepsy was 68.8 new epilepsy patients per 100,000 person-years at risk. However, the incidence changed with calendar time and increased steeply from 1990 to 1995, probably due to changes in diagnostic...... declined from a high level in children to a low level between 20 and 40 years of age, and thereafter a gradual increase was seen. The incidence rate was slightly higher in men than in women except for the age range 10-20 years. About 2% of the population was diagnosed with epilepsy at some point during...

  15. Information Security Incident Management Practical Aspects

    Directory of Open Access Journals (Sweden)

    A. B. Kostina

    2010-03-01

    Full Text Available The information security incident management process model (ISIMP is developed; the role of this process in the information security management system is established. Input and output data of the process are determined. Key practical aspects of incident management are determined.

  16. Diabetes incidence and projections from prevalence surveys in Fiji.

    Science.gov (United States)

    Morrell, Stephen; Lin, Sophia; Tukana, Isimeli; Linhart, Christine; Taylor, Richard; Vatucawaqa, Penina; Magliano, Dianna J; Zimmet, Paul

    2016-11-25

    Type 2 diabetes mellitus (T2DM) incidence is traditionally derived from cohort studies that are not always feasible, representative, or available. The present study estimates T2DM incidence in Fijian adults from T2DM prevalence estimates assembled from surveys of 25-64 year old adults conducted over 30 years (n = 14,288). T2DM prevalence by five-year age group from five population-based risk factor surveys conducted over 1980-2011 were variously adjusted for urban-rural residency, ethnicity, and sex to previous censuses (1976, 1986, 1996, 2009) to improve representativeness. Prevalence estimates were then used to calculate T2DM incidence based on birth cohorts from the age-period (Lexis) matrix following the Styblo technique, first used to estimate annual risk of tuberculosis infection (incidence) from sequential Mantoux population surveys. Poisson regression of year, age, sex, and ethnicity strata (n = 160) was used to develop projections of T2DM prevalence and incidence to 2020 based on various scenarios of population weight measured by body mass index (BMI) change. T2DM prevalence and annual incidence increased in Fiji over 1980-2011. Prevalence was higher in Indians and men than i-Taukei and women. Incidence was higher in Indians and women. From regression analyses, absolute reductions of 2.6 to 5.1% in T2DM prevalence (13-26% lower), and 0.5-0.9 per 1000 person-years in incidence (8-14% lower), could be expected in 2020 in adults if mean population weight could be reduced by 1-4 kg, compared to the current period trend in weight gain. This is the first application of the Styblo technique to calculate T2DM incidence from population-based prevalence surveys over time. Reductions in population BMI are predicted to reduce T2DM incidence and prevalence in Fiji among adults aged 25-64 years.

  17. 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.

  18. 49 CFR 1542.307 - Incident management.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats, threats...

  19. Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates

    OpenAIRE

    Smink, Frédérique R. E.; van Hoeken, Daphne; Hoek, Hans W.

    2012-01-01

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increas...

  20. Increased incidence and prevalence of psoriasis in multiple sclerosis.

    Science.gov (United States)

    Marrie, Ruth Ann; Patten, Scott B; Tremlett, Helen; Wolfson, Christina; Leung, Stella; Fisk, John D

    2017-04-01

    Psoriasis and multiple sclerosis (MS) share some risk factors, and fumarates are effective disease-modifying therapies for both psoriasis and MS, suggesting a common pathogenesis. However, findings regarding the occurrence of psoriasis in the MS population are inconsistent. We aimed to estimate the incidence and prevalence of psoriasis in the MS population versus a matched cohort from the general population. We used population-based administrative data from the Canadian province of Manitoba to identify 4911 persons with MS and 23,274 age-, sex- and geographically-matched controls aged 20 years and older. We developed case definitions for psoriasis using ICD-9/10 codes and prescription claims. These case definitions were compared to self-reported psoriasis diagnoses. The preferred definition was applied to estimate the incidence and prevalence of psoriasis over the period 1998-2008. We used multivariable Cox regression to estimate the risk of psoriasis in the MS population at the individual level, adjusting for sex, age at the index date, socioeconomic status and physician visits. In 2008, the crude incidence of psoriasis per 100,000 person-years was 466.7 (95%CI: 266.8-758.0) in the MS population, and 221.3 in the matched population (95%CI: 158.1-301.4). The crude prevalence of psoriasis per 100,000 persons was 4666.1 (95%CI: 3985.2-5429.9) in the MS population, and 3313.5 (95%CI: 3057.4-3585.3) in the matched population. The incidence and prevalence of psoriasis rose slightly over time. After adjusting for sex, age at the index date, socioeconomic status and physician visits, the risk of incident psoriasis was 54% higher in the MS population (HR 1.54; 95%CI: 1.07-2.24). Psoriasis incidence and prevalence are higher in the MS population than in the matched population. Copyright © 2017. Published by Elsevier B.V.

  1. Cardiovascular risks associated with incident and prevalent periodontal disease.

    Science.gov (United States)

    Yu, Yau-Hua; Chasman, Daniel I; Buring, Julie E; Rose, Lynda; Ridker, Paul M

    2015-01-01

    While prevalent periodontal disease associates with cardiovascular risk, little is known about how incident periodontal disease influences future vascular risk. We compared effects of incident versus prevalent periodontal disease in developing major cardiovascular diseases (CVD), myocardial infarction (MI), ischaemic stroke and total CVD. In a prospective cohort of 39,863 predominantly white women, age ≥45 years and free of cardiovascular disease at baseline were followed for an average of 15.7 years. Cox proportional hazard models with time-varying periodontal status [prevalent (18%), incident (7.3%) versus never (74.7%)] were used to assess future cardiovascular risks. Incidence rates of all CVD outcomes were higher in women with prevalent or incident periodontal disease. For women with incident periodontal disease, risk factor adjusted hazard ratios (HRs) were 1.42 (95% CI, 1.14-1.77) for major CVD, 1.72 (1.25-2.38) for MI, 1.41 (1.02-1.95) for ischaemic stroke and 1.27 (1.06-1.52) for total CVD. For women with prevalent periodontal disease, adjusted HRs were 1.14 (1.00-1.31) for major CVD, 1.27 (1.04-1.56) for MI, 1.12 (0.91-1.37) for ischaemic stroke and 1.15 (1.03-1.28) for total CVD. New cases of periodontal disease, not just those that are pre-existing, place women at significantly elevated risks for future cardiovascular events. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Prevalence and incidence of bloodborne viral infections among Danish prisoners

    NARCIS (Netherlands)

    Christensen, P B; Krarup, H B; Niesters, H G; Norder, H; Georgsen, J

    2000-01-01

    In order to determine the prevalence and incidence of bloodborne viral infections among prisoners, we conducted a prospective study in a Danish medium security prison for males. The prisoners were offered an interview and blood test for hepatitis and human immunodeficiency virus HIV at inclusion as

  3. Prevalence, incidence, and autoimmune comorbidities of celiac disease

    DEFF Research Database (Denmark)

    Grode, Louise; Bech, Bodil H; Jensen, Thomas Møller

    2018-01-01

    AIM: The aim of this study was to describe and identify potential trends with respect to prevalence, incidence, age, sex, and autoimmune comorbidity of celiac disease (CD). PATIENTS AND METHODS: A Danish nationwide cohort study of CD using data from The National Patient Register. Patients...

  4. Incidence and prevalence of episcleritis and scleritis in Northern California.

    Science.gov (United States)

    Honik, Grace; Wong, Ira G; Gritz, David C

    2013-12-01

    To evaluate the incidence and prevalence of episcleritis and scleritis in a large well-defined population in Northern California. Secondary analysis was performed on data from the Northern California Epidemiology of Uveitis Study. The patient database of a large regional health maintenance organization was searched for all patients who potentially experienced ocular inflammatory disease during the 12-month study period. Medical records were reviewed for all potential patients to confirm ocular inflammatory disease and specific diagnosis, establish the time of onset, and collect additional data. Age- and sex-stratified quarterly study population data were used to calculate incidence rates and prevalence ratios. After reviewing 2011 possible cases, 297 new-onset cases of episcleritis, 39 prior-onset cases of episcleritis, 25 new-onset cases of scleritis, and 8 prior-onset cases of scleritis were confirmed. For episcleritis, the overall incidence was 41.0 per 100,000 person-years and an annual prevalence ratio of 52.6 per 100,000. The overall incidence of scleritis was 3.4 per 100,000 person-years and an annual prevalence ratio of 5.2 per 100,000 persons. For both episcleritis and scleritis, there was a statistically significant increase in eye disease in older patients (P = 0.05 and episcleritis (P = 0.017). This study found that patients with scleritis were older than those with episcleritis and that women had higher rates of both episcleritis and scleritis compared with what men had.

  5. Epidemiology of Eating Disorders : Incidence, Prevalence and Mortality Rates

    NARCIS (Netherlands)

    Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms

  6. Review of the prevalence and incidence of eating disorders

    NARCIS (Netherlands)

    Hoek, HW; van Hoeken, D

    2003-01-01

    Objective: To review the literature on the incidence and prevalence of eating disorders. Methods: We searched Medline using several key terms relating to epidemiology and eating disorders and we checked the reference lists of the articles that we found. Special attention has been paid to

  7. Incidence and prevalence of thyroid dysfunction in type 1 diabetes

    NARCIS (Netherlands)

    Nederstigt, Christa; Corssmit, Eleonora P M; de Koning, Eelco J P; Dekkers, Olaf M

    AIMS: To estimate prevalence and incidence of auto-immune thyroid disease and thyroid auto-antibodies in an unselected cohort of patients with DM1, including stratification by age, gender and duration of diabetes. METHODS: Patients with T1D visiting our outpatient clinic between 1995 and 2011 were

  8. Prevalence, incidence and molecular identification of root-knot ...

    African Journals Online (AJOL)

    Tomato is a widely grown vegetable in Pakistan. However, its production is severely constrained by root knot nematodes (RKNs). Accurate identification of RKNs is essential for an appropriate control program. The current study evaluated the prevalence, incidence and diversity of RKNs of tomato crops grown in the Khyber ...

  9. Incidence and prevalence of hepatitis C virus infection in Chile.

    Science.gov (United States)

    González, Robinson; Soza, Alejandro; Hernández, Verónica; Pérez, Rosa M; Alvarez, Manuel; Morales, Arturo; Arellano, Marco; Riquelme, Arnoldo; Viviani, Paola; Covarrubias, Carmen; Arrese, Marco; Miquel, Juan Francisco; Nervi, Flavio

    2005-01-01

    Chronic hepatitis C is a major cause of liver-related morbidity and mortality. Epidemiological data regarding this infection in developing countries is scanty. Prevalence of hepatitis C (HCV) infection was investigated in a random sample of Chilean general adult population older than 20 years of age. Additionally, frequency of HCV infection was assessed in group of native Chilean Amerindians (Mapuche Indians) living in an isolated locality of the Southern Chile. Incidence of HCV infection was estimated using serum samples separated by 7 years (1993-2000). Among 959 subjects, prevalence of anti-HCV antibodies was 1.15% (95% CI 0.48-1.82%) and 0.83% when only RIBA-confirmed cases were considered. Among these subjects, 62.5% had detectable HCV RNA in serum and 40% of them had a history of blood transfusion. Age distribution of cases showed a steadily increasing prevalence with age. Estimated incidence of new HCV infections was 15 per 100,000 subjects per year in the period 1993-2000. No cases were detected among the 145 Mapuche subjects studied. HCV infection is a prevalent disease in the Hispanic population of Chile with a low incidence in the last decade, whereas it was not detected in an isolated Mapuche Indian community. Age distribution of prevalence suggests that the peak of infection in Chile occurred 30 to 50 years ago.

  10. Prevalence, incidence, and age at diagnosis in Marfan Syndrome

    DEFF Research Database (Denmark)

    Groth, Kristian A; Hove, Hanne; Kyhl, Kasper

    2015-01-01

    Background: Marfan syndrome is a genetic disorder with considerable morbidity and mortality. Presently, clinicians use the 2010 revised Ghent nosology, which includes optional genetic sequencing of the FBN1 gene, to diagnose patients. So far, only a few studies based on older diagnostic criteria...... have reported a wide range of prevalence and incidence. Our aim was to study prevalence, incidence, and age at diagnosis in patients with Marfan syndrome. Method: Using unique Danish patient-registries, we identified all possible Marfan syndrome patients recorded by the Danish healthcare system (1977......-2014). Following, we confirmed or rejected the diagnosis according to the 2010 revised Ghent nosology. Results: We identified a total of 1628 persons with possible Marfan syndrome. We confirmed the diagnosis in 412, whereof 46 were deceased, yielding a maximum prevalence of 6.5/100,000 at the end of 2014...

  11. Incidence and Prevalence of Musculoskeletal Injury in Ballet

    Science.gov (United States)

    Smith, Preston J.; Gerrie, Brayden J.; Varner, Kevin E.; McCulloch, Patrick C.; Lintner, David M.; Harris, Joshua D.

    2015-01-01

    Background Most published studies on injuries in the ballet dancer focus on the lower extremity. The rigors of this activity require special training and care. By understanding prevalence and injury pattern to the musculoskeletal system, targeted prevention and treatment for this population can be developed. Purpose To determine the incidence and prevalence of musculoskeletal injuries in ballet. Study Design Systematic review; Level of evidence, 4. Methods A systematic review registered with PROSPERO was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Level 1 through 4 evidence studies reporting incidence of musculoskeletal injuries in male and female ballet dancers were included, with the numbers and types of injuries extracted from each. Injury rates were recorded and calculated based on professional status, sex, and nature of injury. Incidence was defined as number of injuries sustained over a specific time. Prevalence was defined as proportion of subjects with an injury at a given point in time. Results The studies analyzed reported injury incidence or prevalence in more than 1365 amateur and 900 professional dancers. The mean age was 16.2 years among amateur and 27.0 years among professional dancers. The incidence of injury among amateur dancers was 0.99 and 1.09 injuries per 1000 dance hours in males and females, respectively; 75% of injuries were overuse, with similar rates among males and females. In professional dancers, the incidence of injury was 1.06 and 1.46 injuries per 1000 dance hours in males and females, respectively, and 64% of female injuries were overuse, compared with 50% in males (P ballet dancers is 0.97 and 1.24 injuries per 1000 dance hours, respectively. The majority are overuse in both amateur and professional dancers, with amateur ballet dancers showing a higher proportion of overuse injuries than professionals (P < .001). Male professional dancers show a higher proportion of

  12. Napier grass stunt disease prevalence, incidence, severity and genetic variability of the associated phytoplasma in Uganda

    DEFF Research Database (Denmark)

    Kawube, Geofrey; Talwana, Herbert; Nicolaisen, Mogens

    2015-01-01

    The prevalence, incidence and severity of Napier grass stunt disease (NGSD) caused by phytoplasma on Pennisetum purpureum, the main fodder for livestock under intensive and semi-intensive management systems in Uganda were determined following a field survey carried out in 17 districts. A total of...

  13. Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-06-01

    Kentucky s Highway Incident Management Strategic Plan consists of a mission statement, 4 goals, 16 objectives, and 49 action strategies. The action strategies are arranged by priority and recommended time frame for implementation. When implemented...

  14. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.

    1992-01-01

    In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

  15. Prevalence, incidence, and age at diagnosis in Marfan Syndrome.

    Science.gov (United States)

    Groth, Kristian A; Hove, Hanne; Kyhl, Kasper; Folkestad, Lars; Gaustadnes, Mette; Vejlstrup, Niels; Stochholm, Kirstine; Østergaard, John R; Andersen, Niels H; Gravholt, Claus H

    2015-12-02

    Marfan syndrome is a genetic disorder with considerable morbidity and mortality. Presently, clinicians use the 2010 revised Ghent nosology, which includes optional genetic sequencing of the FBN1 gene, to diagnose patients. So far, only a few studies based on older diagnostic criteria have reported a wide range of prevalence and incidence. Our aim was to study prevalence, incidence, and age at diagnosis in patients with Marfan syndrome. Using unique Danish patient-registries, we identified all possible Marfan syndrome patients recorded by the Danish healthcare system (1977-2014). Following, we confirmed or rejected the diagnosis according to the 2010 revised Ghent nosology. We identified a total of 1628 persons with possible Marfan syndrome. We confirmed the diagnosis in 412, whereof 46 were deceased, yielding a maximum prevalence of 6.5/100,000 at the end of 2014. The annual median incidence was 0.19/100,000 (range: 0.0-0.7) which increased significantly with an incidence rate ratio of 1.03 (95% CI: 1.02-1.04, p Marfan syndrome during the study period is possibly due to build-up of a registry. Since early diagnosis is essential in preventing aortic events, diagnosing Marfan syndrome remains a task for both pediatricians and physicians caring for adults.

  16. Incident Management Organization succession planning stakeholder feedback

    Science.gov (United States)

    Anne E. Black

    2013-01-01

    This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...

  17. Segmented polynomials for incidence rate estimation from prevalence data.

    Science.gov (United States)

    Mahiané, Severin Guy; Laeyendecker, Oliver

    2017-01-30

    The study considers the problem of estimating incidence of a non remissible infection (or disease) with possibly differential mortality using data from a(several) cross-sectional prevalence survey(s). Fitting segmented polynomial models is proposed to estimate the incidence as a function of age, using the maximum likelihood method. The approach allows automatic search for optimal position of knots, and model selection is performed using the Akaike information criterion. The method is applied to simulated data and to estimate HIV incidence among men in Zimbabwe using data from both the NIMH Project Accept (HPTN 043) and Zimbabwe Demographic Health Surveys (2005-2006). Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Increasing prevalence and incidence of multiple sclerosis in Poland.

    Science.gov (United States)

    Brola, Waldemar; Sobolewski, Piotr; Flaga, Stanisław; Fudala, Małgorzata; Jantarski, Konrad

    Epidemiologic data on multiple sclerosis (MS) in Poland are limited. Our objectives were to assess a mean annual incidence rate, and MS prevalence on December 31, 2015 in the Swietokrzyskie province (central Poland). We analyzed data of 1525 patients, collected in the Polish Multiple Sclerosis Registry. On December 31, 2015, overall crude prevalence of MS was not less than 121.3/100,000 (95% CI, 114.6-128.4). Significantly higher prevalence was recorded in females (167.1; 95% CI, 155.6-179.1) than in males (73.2; 95% CI, 64.2-82.6; PPoland confirmed that central Poland is a high risk area for MS. Copyright © 2016. Published by Elsevier Urban & Partner Sp. z o.o.

  19. Constipation - prevalence and incidence among medical patients acutely admitted to hospital with a medical condition

    DEFF Research Database (Denmark)

    Noiesen, Eline; Trosborg, Ingelise; Bager, Louise

    2014-01-01

    To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients.......To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients....

  20. Epidemiology of eating disorders: incidence, prevalence and mortality rates.

    Science.gov (United States)

    Smink, Frédérique R E; van Hoeken, Daphne; Hoek, Hans W

    2012-08-01

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15-19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals.

  1. IT Security Vulnerability and Incident Response Management

    NARCIS (Netherlands)

    Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.

    2006-01-01

    This paper summarises the results of a Dutch PhD research project on IT security vulnerability and incident response management, which is supervised by the University of Twente in the Netherlands and which is currently in its final stage. Vulnerabilities are ‘failures or weaknesses in computer

  2. Incidence and prevalence of salivary gland tumours in Valparaiso, Chile

    Science.gov (United States)

    Araya, Juan; Martinez, René; Niklander, Sven; Marshall, Maureen

    2015-01-01

    Background To determine the incidence and prevalence of salivary gland tumours in the province of Valparaíso, Chile. Material and Methods Retrospective review of salivary gland tumours diagnosed between the years 2000 and 2011 from four local pathology services. Information on demographics and histopathology were retrieved from the medical records. Results The study sample consisted of 279 salivary gland tumours. Prevalence and incidence rates per 100.000 persons were 15.4 and 2.51, respectively. Most of the neoplasms corresponded to benign tumours (70.3%). The most affected gland was the parotid gland. Pleomorphic adenoma was the most common benign tumour (53.8%) and mucoepidermoid carcinoma was the most common malignant tumour (7.2%). Conclusions Salivary gland tumours are uncommon neoplasms that usually arise in the parotid gland. Pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malignant tumours reported in this series. Key words:Salivary gland tumours, benign tumours, malignant tumours, salivary glands neoplasms, cancer, neoplasia. PMID:26034925

  3. Evaluating and improving incident management using historical incident data : case studies at Texas transportation management centers.

    Science.gov (United States)

    2009-08-01

    The companion guidebook (0-5485-P2) developed as part of this study provides the procedures and : methodologies for effective use of historical incident data at Texas Transportation Management Centers : (TMCs). This research report documents the resu...

  4. Prevalence, Incidence and stability of premenstrual dysphoric disorder in the community

    NARCIS (Netherlands)

    Wittchen, H.U.; Becker, E.S.; Lieb, R.; Krause, P.

    2002-01-01

    Background. Despite an abundance of clinical research on premenstrual and menstrual symptoms. few epidemiological data provide estimates of the prevalence, incidence, co-morbidity, stability and correlates of premenstrual dysphoric disorder (PMDD) in the community. Aims. To describe the prevalence,

  5. Computer incident response and forensics team management conducting a successful incident response

    CERN Document Server

    Johnson, Leighton

    2013-01-01

    Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

  6. New York integrated incident management system evaluation project final report

    Science.gov (United States)

    2007-03-23

    The Integrated Incident Management System (IIMS) enables incident response personnel to transmit data about an incident to other responders and dispatchers on a real-time basis. When an incident is entered into IIMS, the system uses GPS to identify t...

  7. A systematic review of the incidence and prevalence of cancer in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey

    2015-01-01

    BACKGROUND: Studies of cancer incidence and prevalence in multiple sclerosis (MS) have produced conflicting results. OBJECTIVE: To estimate the incidence and prevalence of cancer in persons with MS and review the quality of included studies. METHODS: We searched the PUBMED, SCOPUS, Web of Knowledge...

  8. Incident Management in Academic Information System using ITIL Framework

    Science.gov (United States)

    Palilingan, V. R.; Batmetan, J. R.

    2018-02-01

    Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.

  9. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies.

    Science.gov (United States)

    Fiest, Kirsten M; Sauro, Khara M; Wiebe, Samuel; Patten, Scott B; Kwon, Churl-Su; Dykeman, Jonathan; Pringsheim, Tamara; Lorenzetti, Diane L; Jetté, Nathalie

    2017-01-17

    To review population-based studies of the prevalence and incidence of epilepsy worldwide and use meta-analytic techniques to explore factors that may explain heterogeneity between estimates. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed. We searched MEDLINE and EMBASE for articles published on the prevalence or incidence of epilepsy since 1985. Abstract, full-text review, and data abstraction were conducted in duplicate. Meta-analyses and meta-regressions were used to explore the association between prevalence or incidence, age group, sex, country level income, and study quality. A total of 222 studies were included (197 on prevalence, 48 on incidence). The point prevalence of active epilepsy was 6.38 per 1,000 persons (95% confidence interval [95% CI] 5.57-7.30), while the lifetime prevalence was 7.60 per 1,000 persons (95% CI 6.17-9.38). The annual cumulative incidence of epilepsy was 67.77 per 100,000 persons (95% CI 56.69-81.03) while the incidence rate was 61.44 per 100,000 person-years (95% CI 50.75-74.38). The prevalence of epilepsy did not differ by age group, sex, or study quality. The active annual period prevalence, lifetime prevalence, and incidence rate of epilepsy were higher in low to middle income countries. Epilepsies of unknown etiology and those with generalized seizures had the highest prevalence. This study provides a comprehensive synthesis of the prevalence and incidence of epilepsy from published international studies and offers insight into factors that contribute to heterogeneity between estimates. Significant gaps (e.g., lack of incidence studies, stratification by age groups) were identified. Standardized reporting of future epidemiologic studies of epilepsy is needed. © 2016 American Academy of Neurology.

  10. Xerostomia: prevalence, diagnosis, and management.

    Science.gov (United States)

    Navazesh, Mahvash; Kumar, Satish K S

    2009-01-01

    This article summarizes the common causes, clinical presentation, and complications of xerostomia and salivary gland hypofunction in the geriatric population and discusses the various management options.

  11. Prevalence of Weight Problems among Youth with High-Incidence Disabilities in Residential Care

    Science.gov (United States)

    Trout, Alexandra L.; Lambert, Matthew C.; Nelson, Timothy D.; Thompson, Ronald W.

    2014-01-01

    The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of…

  12. A review of PU prevalence and incidence across Scandinavia, Iceland and Ireland (Part I).

    Science.gov (United States)

    Moore, Z; Johanssen, E; van Etten, M

    2013-07-01

    To provide a critical appraisal and synthesis of the published literature pertaining to pressure ulcer (PU) prevalence, incidence and prevention practices from the context of Scandinavia, Iceland and Ireland. An integrative research review following Cooper's five stages. Studies published in peer-reviewed journals, involving any study design, but specifically exploring PU prevalence or incidence in adults or children, in any care setting, were included. Fifty-five papers were data extracted, quality appraised and included in the qualitative synthesis of the review. Mean prevalence in Norway was 17% (4.8-29%) in Ireland was 16% (4-37%), in Denmark was 15% (2.2-35.5%) and in Sweden was 25%, (0.04-42.7%). Prevalence in Iceland was 8.9%. In acute care, mean prevalence was 21% (0-42.7%) and in long stay was 12% (2.4-23.7%). Prevalence among hospice patients was 35.7%, and in community care was 0.04% and 4%. No incidence study from Iceland was identified; the single incidence study from Norway noted a figure of 16.4%. The mean incidence from Ireland was 11% (8-14.4%) from Sweden was 20% (3.1-49%) and Denmark was 1.8% (1.4-2.7%). Mean incidence in acute care setting was 17.6%, (1.4-49%); in long stay was 6.63% (3.1-8.4%). Incidence in the hospice setting was 20.4%. No study reported PU incidence figures from the community setting. Figures for both prevalence and incidence were similar in Ireland and Norway and highest in Sweden, whereas Denmark demonstrated the lowest incidence rates and Iceland demonstrated the lowest prevalence rates. Figures were consistently highest in acute care and hospice settings, and lowest in the care of the older person setting.

  13. Development of Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-05-01

    ven though Kentucky has undertaken many initiatives to improve specific aspects of incident management, there has never been a plan that establishes an overall framework for a systematic, statewide, multi-agency effort to improve the management of hi...

  14. Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An overview.

    Science.gov (United States)

    Alotaibi, Abdulellah; Perry, Lin; Gholizadeh, Leila; Al-Ganmi, Ali

    2017-12-01

    This study aimed to report on the trends in incidence and prevalence rates of diabetes mellitus in Saudi Arabia over the last 25 years (1990-2015). A descriptive review. A systematic search was conducted for English-language, peer reviewed publications of any research design via Medline, EBSCO, PubMed and Scopus from 1990 to 2015. Of 106 articles retrieved, after removal of duplicates and quality appraisal, 8 studies were included in the review and synthesised based on study characteristics, design and findings. Studies originated from Saudi Arabia and applied a variety of research designs and tools to diagnosis diabetes. Of the 8 included studies; three reported type 1 diabetes and five on type 2 diabetes. Overall, findings indicated that the incidence and prevalence rate of diabetes is rising particularly among females, older children/adolescent and in urban areas. Further development are required to assess the health intervention, polices, guidelines, self-management programs in Saudi Arabia. Copyright © 2017. Published by Elsevier Ltd.

  15. Review article: the prevalence of Helicobacter pylori and the incidence of gastric cancer across Europe.

    Science.gov (United States)

    Roberts, S E; Morrison-Rees, S; Samuel, D G; Thorne, K; Akbari, A; Williams, J G

    2016-02-01

    There is little up-to-date review evidence on the prevalence of Helicobacter pylori across Europe. To establish regional and national patterns in H. pylori prevalence across Europe. Secondly, to establish trends over time in H. pylori prevalence and gastric cancer incidence and, thirdly, to report on the relationship between H. pylori prevalence and age group across Europe. A review of H. pylori prevalence from unselected surveys of adult or general populations across 35 European countries and four European regions since 1990. Secondly, an analysis of trends over time in H. pylori prevalence and in gastric cancer incidence from cancer registry data. Helicobacter pylori prevalence was lower in northern and western Europe than in eastern and southern Europe (P Europe from 1993 to 2007 was 2.1% with little variation regionally across Europe (north 2.2%, west 2.3%, east 1.9% and south 2.0%). Sharp increases in age-related prevalence of H. pylori often levelled off for middle age groups of about 50 years onwards, especially in areas with high prevalence. This review shows that H. pylori prevalence is much higher in less affluent regions of Europe and that age-related increases in prevalence are confined to younger age groups in some areas. There were sharp reductions in both H. pylori prevalence and gastric cancer incidence throughout Europe. © 2015 John Wiley & Sons Ltd.

  16. Prevalence and incidence of Parkinson's disease in The Faroe Islands

    DEFF Research Database (Denmark)

    Wermuth, Lene; Bech, Sara Brynhild Winther; Petersen, Maria Skaalum

    2008-01-01

    A study in The Faroe Islands in 1995 suggested a high prevalence of idiopathic Parkinson's disease (IPD) and total parkinsonism of 187.6 and 233.4 per 100,000 inhabitants respectively.......A study in The Faroe Islands in 1995 suggested a high prevalence of idiopathic Parkinson's disease (IPD) and total parkinsonism of 187.6 and 233.4 per 100,000 inhabitants respectively....

  17. Contributions of incidence and persistence to the prevalence of childhood obesity during the emerging epidemic in Denmark

    DEFF Research Database (Denmark)

    Andersen, Lise Geisler; Baker, Jennifer L; Sørensen, Thorkild I A

    2012-01-01

    Prevalence of obesity is the result of preceding incidence of newly developed obesity and persistence of obesity. We investigated whether increasing incidence and/or persistence during childhood drove the prevalence of childhood obesity during the emerging epidemic....

  18. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    Directory of Open Access Journals (Sweden)

    Faisal R. Ali

    2012-01-01

    Full Text Available The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group.

  19. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    International Nuclear Information System (INIS)

    Ali, F. R.; Lear, J. T.

    2012-01-01

    The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group

  20. Pro-active Management of Traffic Incidents Using Novel Technologies

    NARCIS (Netherlands)

    Nitsche, P.; Olstam, J.; Taylor, N.; Reinthaler, M.; Ponweiser, W.; Bernhardsson, V.; Mocanu, I.; Uittenbogaard, J.; Dam, E. van

    2016-01-01

    This paper presents the results of the assessment phase of the project PRIMA (Pro-Active Incident Management), where the benefits, costs and risks of novel traffic incident management techniques are investigated. The project targets the enhancement of current state-of-the-art measures for handling

  1. Current approaches to managing aggressive incidents among in ...

    African Journals Online (AJOL)

    Background: Aggressive behavior and incidents in psychiatric wards are commonplace and management approaches should be evidencebased. This audit aims to review the management of violent incidents and aggressive behaviour in the acute wards of the Federal Neuropsychiatric Hospital Calabar against the NICE ...

  2. The incidence and prevalence of Huntington's disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Pringsheim, Tamara; Wiltshire, Katie; Day, Lundy; Dykeman, Jonathan; Steeves, Thomas; Jette, Nathalie

    2012-08-01

    Huntington's disease (HD) is a rare, neurodegenerative disorder characterized by chorea, behavioral manifestations, and dementia. The aim of this study was to estimate the incidence and prevalence of HD through a systematic review of the literature. Medline and Embase databases were searched using terms specific to HD as well as studies of incidence, prevalence, and epidemiology. All studies reporting the incidence and/or prevalence of HD were included. Twenty original research articles were included. Eight studies examined incidence, and 17 studies examined prevalence. Meta-analysis of data from four incidence studies revealed an incidence of 0.38 per 100,000 per year (95% confidence interval [CI]: 0.16, 0.94). Lower incidence was reported in the Asian studies (n = 2), compared to the studies performed in Europe, North America, and Australia (n = 6). The worldwide service-based prevalence of HD, based on a meta-analysis (n = 13 studies), was 2.71 per 100,000 (95% CI: 1.55-4.72). Eleven studies were conducted in Europe, North American, and Australia, with an overall prevalence of 5.70 per 100,000 (95% CI: 4.42-7.35). Three studies were conducted in Asia, with an overall prevalence of 0.40 per 100,000 (95% CI: 0.26-0.61). Metaregression revealed a significantly lower prevalence of HD in Asia, compared to European, North American, and Australian populations. HD is a devastating neurodegenerative disorder with a higher prevalence in Europe, North America, and Australia than in Asia. The difference in prevalence of this genetic disorder can be largely explained by huntingtin gene haplotypes. Copyright © 2012 Movement Disorder Society.

  3. 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...

  4. Incidence of HIV-1 infection and changes in prevalence of ...

    African Journals Online (AJOL)

    Sexual risk behaviours and RTIs may have contributed to HIV-1 transmission in this community. The data collected may help to inform the future design and evaluation of various intervention measures. Keywords: Africa, bacterial vaginosis, candidiasis, chlamydia, epidemiological synergy, gonorrhoea, incidence, sequelae

  5. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review.

    Science.gov (United States)

    Pereira, D; Peleteiro, B; Araújo, J; Branco, J; Santos, R A; Ramos, E

    2011-11-01

    To understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints. A systematic review was carried out in PUBMED and SCOPUS databases comprising the date of publication period from January 1995 to February 2011. We attempted to summarise data on the incidence and prevalence of OA according to different methods of assessment: self-reported, radiographic and symptomatic OA (clinical plus radiographic). Prevalence estimates were combined through meta-analysis and between-study heterogeneity was quantified. Seventy-two papers were reviewed (nine on incidence and 63 on prevalence). Higher OA prevalences are seen when radiographic OA definition was used for all age groups. Prevalence meta-analysis showed high heterogeneity between studies even in each specific joint and using the same OA definition. Although the knee is the most studied joint, the highest OA prevalence estimates were found in hand joints. OA of the knee tends to be more prevalent in women than in men independently of the OA definition used, but no gender differences were found in hip and hand OA. Insufficient data for incidence studies didn't allow us to make any comparison according to joint site or OA definition. Radiographic case definition of OA presented the highest prevalences. Within each joint site, self-reported and symptomatic OA definitions appear to present similar estimates. The high heterogeneity found in the studies limited further conclusions. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  6. Distribution, incidence, prevalence and default of patients with ...

    African Journals Online (AJOL)

    Results. The study showed that the majority (38.7%) of patients with diabetes on the public sector register were from the district of eThekwini. Positive correlations were found between the prevalence of diabetes, the mortality rate and the number of defaulters (patients with diabetes who did not return for regular treatment).

  7. A New Model For Understanding Incident Management

    Science.gov (United States)

    2016-12-01

    emergency management agencies and practitioners. Additionally, NEMA seeks to improve and create “ strategic partnerships, innovative programs, and...formulated, and revised administrative responsibilities for emergency management .”33 Several scholarly journals , academic papers, and practitioner articles... management as a profession, David T. Crews states, “In their primary and ‘ strategic ’ roles, emergency managers must analyze the threat to economic

  8. Incidence, prevalence and mortality of anorexia nervosa and other eating disorders

    NARCIS (Netherlands)

    Hoek, Hans Wijbrand

    Purpose of review The purpose of this review is to evaluate the recent literature on the incidence and prevalence of and mortality associated with eating disorders. Recent findings General-practice studies shove that the overall incidence rates of anorexia nervosa remained stable during the 1990s,

  9. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics

    NARCIS (Netherlands)

    Maarsingh, Otto R.; Dros, Jacquelien; Schellevis, François G.; van Weert, Henk C.; Bindels, Patrick J.; Horst, Henriette E. van der

    2010-01-01

    Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and incidence of dizziness reported

  10. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics

    NARCIS (Netherlands)

    Maarsingh, O.R.; Dros, J.; Schellevis, F.G.; van Weert, H.C.; Bindels, P.J.; van der Horst, H.E.

    2010-01-01

    Background: Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and incidence of

  11. Female Overweight and Obesity in Adolescence: Developmental Trends and Ethnic Differences in Prevalence, Incidence, and Remission

    Science.gov (United States)

    Huh, David; Stice, Eric; Shaw, Heather; Boutelle, Kerri

    2012-01-01

    Despite substantial increases in the prevalence of adolescent overweight and obesity documented in recent decades, few studies have prospectively tracked their development during the entire adolescent period. The aims of this study were to characterize developmental trends in prevalence, incidence, and remission of overweight and obesity using…

  12. Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada

    DEFF Research Database (Denmark)

    Choi, Stephanie K Y; Boyle, E.; Cairney, John

    2016-01-01

    Introduction: Current studies of depression among people living with HIV focus on describing its point prevalence. Given the fluctuating nature of depression and its profound impacts on clinical and quality-of-life outcomes, this study aimed to examine the prevalence, recurrence and incidence...

  13. Incidence and prevalence of idiopathic pulmonary fibrosis: review of the literature

    Directory of Open Access Journals (Sweden)

    Luba Nalysnyk

    2012-12-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF is a chronic, progressive, fibrosing interstitial pneumonia of unknown aetiology. It is a rare disease, and its incidence and prevalence are not clear. Therefore, we sought to review the published evidence on the global epidemiology of IPF. A comprehensive review of English language literature was performed by searching Medline and EMBASE for studies on IPF epidemiology published between January 1990 and August 2011. Studies providing quantitative data on IPF incidence and/or prevalence were identified and key data collected. 15 studies reporting on the incidence and/or prevalence of IPF were identified and summarised. IPF prevalence estimates in the USA varied between 14 and 27.9 cases per 100,000 population using narrow case definitions, and 42.7 and 63 per 100,000 population using broad case definitions. In Europe, IPF prevalence ranged from 1.25 to 23.4 cases per 100,000 population. The annual incidence of IPF in the USA was estimated at 6.8–8.8 per 100,000 population using narrow case definitions and 16.3–17.4 per 100,000 population using broad case definitions. In Europe, the annual incidence ranged between 0.22 and 7.4 per 100,000 population. IPF prevalence and incidence increase with age, are higher among males and appear to be on the increase in recent years. IPF is an orphan disease that affects a potentially increasing number of people in Europe and the USA. The observed variability in IPF incidence and prevalence may be explained by the differences in diagnostic criteria used, case definition, study population and study design.

  14. Socioeconomic inequalities in the incidence and prevalence of type 2 diabetes mellitus in Europe.

    Science.gov (United States)

    Espelt, Albert; Borrell, Carme; Palència, Laia; Goday, Alberto; Spadea, Teresa; Gnavi, Roberto; Font-Ribera, Laia; Kunst, Anton E

    2013-01-01

    The aim of this study was to analyze socioeconomic position (SEP) inequalities in the prevalence and incidence of type 2 diabetes mellitus (T2DM) in people aged 50 years and over in Europe and to describe the contribution of body mass index (BMI) and other possible mediators. This was a cross-sectional and longitudinal study including men and women ≥ 50 years old in 11 European countries in 2004 and 2006 (n = 21,323). The prevalence and cumulative incidence of T2DM were calculated with self-reported T2DM or when the individual took drugs for diabetes. Prevalence ratio (PR) and relative risk (RR) of prevalent and incident T2DM were calculated according to educational level and adjusted by BMI and other possible mediators. The age-adjusted and country-adjusted prevalence of T2DM in 2004 was 10.2% in men and 8.5% in women. Compared to those with higher education, men and women with lower education had a PR [95% CI] of T2DM of 1.29 [1.12-1.50] and 1.61 [1.39-1.86], respectively. SEP-related inequalities in incidence (RR [95%CI]) were 1.88 [1.35-2.62] in women and 1.04 [0.78-1.40] in men. Adjusting for potential mediators reduced inequalities in the prevalence and incidence of T2DM among women by 26.2% and 21.6%, respectively, and inequalities in prevalence among men by 44.8%. We observed significant inequalities in the prevalence and incidence (women only) of T2DM as a function of socioeconomic position. These inequalities were mediated by BMI. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. Sports Related Injuries: Incidence, Management and Prevention

    OpenAIRE

    Stanger, Michael A.

    1982-01-01

    The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...

  16. Safer travel, improved economic productivity : incident management systems

    Science.gov (United States)

    1999-01-01

    This brochure gives an overview of how incident management technologies can be used to reduce incident-related congestion and increase road safety. It focuses on the need for interagency cooperation and the benefits that can be derived from the coope...

  17. Wildfire incidence and management in the forest transition zone of ...

    African Journals Online (AJOL)

    A survey was conducted in eight communities in the forest transition zone to assess the perceptions of farmers on farming-related wildfire incidences, specific activities in farming associated with incidence of wildfires and coping measures being used by farmers to manage wildfires. Farmers in the studied settlements hold ...

  18. Prevalence and incidence density of unavoidable pressure ulcers in elderly patients admitted to medical units.

    Science.gov (United States)

    Palese, Alvisa; Trevisani, Barbara; Guarnier, Annamaria; Barelli, Paolo; Zambiasi, Paola; Allegrini, Elisabetta; Bazoli, Letizia; Casson, Paola; Marin, Meri; Padovan, Marisa; Picogna, Michele; Taddia, Patrizia; Salmaso, Daniele; Chiari, Paolo; Marognolli, Oliva; Federica, Canzan; Saiani, Luisa; Ambrosi, Elisa

    2017-05-01

    To describe the prevalence and incidence density of hospital-acquired unavoidable pressure sores among patients aged ≥65 years admitted to acute medical units. A secondary analysis of longitudinal study data collected in 2012 and 2013 from 12 acute medical units located in 12 Italian hospitals was performed. Unavoidable pressure ulcers were defined as those that occurred in haemodynamically unstable patients, suffering from cachexia and/or terminally ill and were acquired after hospital admission. Data at patient and at pressure ulcer levels were collected on a daily basis at the bedside by trained researchers. A total of 1464 patients out of 2080 eligible (70.4%) were included. Among these, 96 patients (6.5%) hospital-acquired a pressure ulcer and, among 19 (19.7%) were judged as unavoidable. The incidence of unavoidable pressure ulcer was 8.5/ 100 in hospital-patient days. No statistically significant differences at patient and pressure ulcers levels have emerged between those patients that acquired unavoidable and avoidable pressure sores. Although limited, evidence on unavoidable pressure ulcer is increasing. More research in the field is recommended to support clinicians, managers and policymakers in the several implications of unavoidable pressure ulcers both at the patient and at the system levels. Copyright © 2017 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  19. Defining Incident Management Processes for CSIRTs: A Work in Progress

    National Research Council Canada - National Science Library

    Alberts, Chris; Dorofee, Audrey; Killcrece, Georgia; Ruefle, Robin; Zajicek, Mark

    2004-01-01

    .... Workflow diagrams and descriptions are provided for each of these processes. One advantage of the model is that it enables examination of incident management processes that cross organizational boundaries, both internally and externally...

  20. Air quality evaluation of Rhode Island's incident management program

    Science.gov (United States)

    1997-09-01

    The objective of this preliminary air quality analysis was to assess the potential air quality benefits associated with the implementation of Providence's Metropolitan portion of Rhode Island's Incident Management Program. Specifically, the air quali...

  1. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  2. Prevalence and incidence rate of injuries in runners at a local athletic club in Cape Town

    Directory of Open Access Journals (Sweden)

    C. Hendricks

    2013-12-01

    Full Text Available People across the world are running on a daily basis to improvetheir health status. However, running can predispose an individual to injuryto the back and lower limb. Baseline data on prevalence, incidence rate ofinjury and aetiological factors associated with running injuries are neededby physiotherapists to develop and implement effective prevention programmesto allow optimal performance in runners. Thus, the purpose of this study wasto determine the prevalence and incidence of injuries in runners at a localathletic club.Methods: A prospective, non-experimental cohort study was conductedover a 16 week period. A sample of 50 runners completed a self-administeredquestionnaire and an injury report form recording injuries sustained during the 16 week study period. Injury prevalence andcumulative incidence was calculated as a proportion rate along with 95% confidence interval.Results: The prevalence rate of injuries was 32%. The incidence rate of injuries was 0.67 per 1000km run (95% CI: 0.41- 1.08.The most common anatomical sites for new injuries were the calf (20% and the knee (18%.Conclusions: The study found a moderate prevalence and incidence rate of injury in runners, thus the need for physiotherapyledinjury surveillance and prevention programmes have been highlighted.

  3. Burden of type 2 diabetes in Mexico: past, current and future prevalence and incidence rates.

    Science.gov (United States)

    Meza, Rafael; Barrientos-Gutierrez, Tonatiuh; Rojas-Martinez, Rosalba; Reynoso-Noverón, Nancy; Palacio-Mejia, Lina Sofia; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

    2015-12-01

    Mexico diabetes prevalence has increased dramatically in recent years. However, no national incidence estimates exist, hampering the assessment of diabetes trends and precluding the development of burden of disease analyses to inform public health policy decision-making. Here we provide evidence regarding current magnitude of diabetes in Mexico and its future trends. We used data from the Mexico National Health and Nutrition Survey, and age-period-cohort models to estimate prevalence and incidence of self-reported diagnosed diabetes by age, sex, calendar-year (1960-2012), and birth-cohort (1920-1980). We project future rates under three alternative incidence scenarios using demographic projections of the Mexican population from 2010-2050 and a Multi-cohort Diabetes Markov Model. Adult (ages 20+) diagnosed diabetes prevalence in Mexico increased from 7% to 8.9% from 2006 to 2012. Diabetes prevalence increases with age, peaking around ages 65-68 to then decrease. Age-specific incidence follows similar patterns, but peaks around ages 57-59. We estimate that diagnosed diabetes incidence increased exponentially during 1960-2012, roughly doubling every 10 years. Projected rates under three age-specific incidence scenarios suggest diabetes prevalence among adults (ages 20+) may reach 13.7-22.5% by 2050, affecting 15-25 million individuals, with a lifetime risk of 1 in 3 to 1 in 2. Diabetes prevalence in Mexico will continue to increase even if current incidence rates remain unchanged. Continued implementation of policies to reduce obesity rates, increase physical activity, and improve population diet, in tandem with diabetes surveillance and other risk control measures is paramount to substantially reduce the burden of diabetes in Mexico. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Burden of Type 2 Diabetes in Mexico: Past, Current and Future Prevalence and Incidence Rates

    Science.gov (United States)

    Meza, Rafael; Barrientos-Gutierrez, Tonatiuh; Rojas-Martinez, Rosalba; Reynoso-Noverón, Nancy; Palacio-Mejia, Lina Sofia; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

    2015-01-01

    Introduction Mexico diabetes prevalence has increased dramatically in recent years. However, no national incidence estimates exist, hampering the assessment of diabetes trends and precluding the development of burden of disease analyses to inform public health policy decision-making. Here we provide evidence regarding current magnitude of diabetes in Mexico and its future trends. Methods We used data from the Mexico National Health and Nutrition Survey, and age-period-cohort models to estimate prevalence and incidence of self-reported diagnosed diabetes by age, sex, calendar-year (1960–2012), and birth-cohort (1920–1980). We project future rates under three alternative incidence scenarios using demographic projections of the Mexican population from 2010–2050 and a Multi-cohort Diabetes Markov Model. Results Adult (ages 20+) diagnosed diabetes prevalence in Mexico increased from 7% to 8.9% from 2006 to 2012. Diabetes prevalence increases with age, peaking around ages 65–68 to then decrease. Age-specific incidence follows similar patterns, but peaks around ages 57–59. We estimate that diagnosed diabetes incidence increased exponentially during 1960–2012, roughly doubling every 10 years. Projected rates under three age-specific incidence scenarios suggest diabetes prevalence among adults (ages 20+) may reach 13.7–22.5% by 2050, affecting 15–25 million individuals, with a lifetime risk of 1 in 3 to 1 in 2. Conclusions Diabetes prevalence in Mexico will continue to increase even if current incidence rates remain unchanged. Continued implementation of policies to reduce obesity rates, increase physical activity, and improve population diet, in tandem with diabetes surveillance and other risk control measures is paramount to substantially reduce the burden of diabetes in Mexico. PMID:26546108

  5. Prevalence, incidence and progression of lumbar spondylosis by gender and age strata.

    Science.gov (United States)

    Muraki, Shigeyuki; Yoshimura, Noriko; Akune, Toru; Tanaka, Sakae; Takahashi, Ikuno; Fujiwara, Saeko

    2014-07-01

    To identify the prevalence, incidence and progression of radiographic lumbar spondylosis (LS). From the Adult Health Study conducted by the Radiation Effects Research Foundation, 1,204 participants aged 44-85 years who had lumbar spine radiographs in 1990-1992 were reexamined in 1998-2000 (mean 7.9-year interval). The radiographic severity of LS was determined by Kellgren/Lawrence (KL) grading. In the overall population, the prevalence of radiographic KL ≥ 2 and ≥ 3 LS was 52.9% and 23.6%, respectively. KL ≥ 2 LS was more prevalent in men, whereas KL ≥ 3 LS was more prevalent in women. During the 8-year follow-up, the incidence of KL ≥ 2 LS in men and women was 65.5% and 46.6%, that of KL ≥ 3 LS was 27.3% and 29.5%, that of progressive LS was 31.3% and 34.0%, and multilevel LS was 44.9% and 33.4%, respectively. Body-mass index was a risk factor for both KL ≥ 2 and KL ≥ 3 LS, after adjusting for age and sex. The present longitudinal study revealed the prevalence, incidence and progression of radiographic LS. Prevalence and incidence of KL ≥ 2 LS was higher in men than women, while, those of KL ≥ 3 were similar between men and women.

  6. Incidence and prevalence of non-melanoma skin cancer in Australia: A systematic review.

    Science.gov (United States)

    Perera, Eshini; Gnaneswaran, Neiraja; Staines, Carolyn; Win, Aung Ko; Sinclair, Rod

    2015-11-01

    Non-melanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common cancer occurring in people with fair skin. Australia has been reported to have the highest incidence of NMSC in the world. Using a systematic search of the literature in EMBASE and Medline, we identified 21 studies that investigated the incidence or prevalence of NMSC in Australia. Studies published between 1948 and 2011 were identified and included in the analysis. There were six studies that were conducted on national level, two at state level and 13 at the regional level. Overall, the incidence of NMSC had steadily increased over calendar-years in Australia. The incidence of NMSC per 100,000 person-years was estimated to be 555 in 1985; 977 in 1990; 1109 in 1995; 1170 in 2002 and 2448 in 2011. The incidence was higher for men than women and higher for BCC than SCC. Incidence varied across the states of Australia, with the highest in Queensland. The prevalence of NMSC was estimated to be 2% in Australia in 2002. The incidence and prevalence of NMSC still need to be accurately established at both national and state levels to determine the costs and burden of the disease on the public health system in Australia. © 2015 The Australasian College of Dermatologists.

  7. 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.

  8. MS incidence and prevalence in Africa, Asia, Australia and New Zealand: A systematic review.

    Science.gov (United States)

    Makhani, N; Morrow, S A; Fisk, J; Evans, C; Beland, S G; Kulaga, S; Kingwell, E; Marriott, J J; Dykeman, J; Jetté, N; Pringsheim, T; Wolfson, C; Marrie, R A; Koch, M W

    2014-01-01

    Studies of multiple sclerosis (MS) incidence and prevalence from Africa, Asia, Australia and New Zealand are relatively scarce. We systematically reviewed MS incidence and prevalence in these regions including a standardized evaluation of study quality. We searched MEDLINE and EMBASE databases for studies of MS prevalence or incidence in Africa, Asia, Australia and New Zealand published in English or French between January 1, 1985 and January 31, 2011. Study quality was assessed using a standardized tool. All steps of the review were performed in duplicate. Of 3925 citations identified, 28 studies met inclusion criteria and 21 of these were from Asia. Quality scores ranged from 1/8 to 8/8; the lowest scores were observed in studies from Asia (median 4/8, IQR 3,6). Prevalence was lowest in South African Blacks (0.22/100,000) and highest amongst Australian-born individuals in Australia (125/100,000). Prevalence increased over time in many countries. MS prevalence increased with increasing latitude only in some regions, and prevalence varied significantly with ethnicity. Eight studies reported incidence, which ranged from 0.67/100,000/year in Taiwan to 3.67/100,00/year in Australia. This comprehensive study provides an update of MS epidemiology in Africa, Asia, Australia, and New Zealand. Incidence and prevalence were lowest in Africa and Asia and highest in Australia, but many Asian studies were of poor quality. Use of consistent case ascertainment methods, standardized data collection tools, and similar outcomes would all improve study quality and comparability. The underlying basis of observed ethnic differences is an important area for future study. © 2013 Elsevier B.V. All rights reserved.

  9. The Prevalence and Incidence of Glaucoma in Denmark in a Fifteen Year Period

    DEFF Research Database (Denmark)

    Kolko, Miriam; Horwitz, Anna; Thygesen, John

    2015-01-01

    PURPOSE: The purpose of the present study was to describe the prevalence, incidence and geographic variation of glaucoma in Denmark in the period from 1996 to 2011. Moreover, the aim was to identify the treatment patterns of glaucoma within the studied period. METHODS: All Danish citizens were...... included throughout the study period. The National Prescription Registry was used to identify all claimed prescriptions for glaucoma medication. RESULTS: A total of 116,592 incident glaucoma patients were identified. Average age at onset was 66 years (range: 0-105 years), 55% were women. The prevalence...... of glaucoma increased from 0.79% to 1.72% during the investigated period. In 2011 glaucoma affected 3.76% of the population above 50 years and 10% in patients above 80 years. The age-specific incidence rate of glaucoma seemed to be constant and the increasing prevalence was primarily attributed to an aging...

  10. Changing Incidence, Outcome and Management of Myelomeningocele

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-07-01

    Full Text Available Pediatric neurosurgeons at Children’s Memorial Hospital, Chicago, review their long-term experience and the evolution of the etiology, diagnosis and management of patients born with myelomeningocele (MM in 1975-1979 and followed for 25 years in a multi-disciplinary spina bifida clinic.

  11. Congenital clinical malaria: Incidence, management and outcome ...

    African Journals Online (AJOL)

    Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in ...

  12. Incidence and prevalence of head lice in a district health authority area.

    Science.gov (United States)

    Harris, J; Crawshaw, J G; Millership, S

    2003-09-01

    There are very few recent studies of the incidence and prevalence of head lice in the UK. A population-based questionnaire survey was carried out in a district health authority area. Two hundred and four of 235 primary schools (87%) agreed to participate. A total of 21,556 of 43,889 (49%) questionnaires were returned by parents. Overall 438 children had head lice at the time of the survey, giving a prevalence of 2.03%; 8,059 had had lice at some time in the last year giving an annual incidence of 37.4%.

  13. HIV in the workplace in Botswana: incidence, prevalence, and disease severity.

    Science.gov (United States)

    Riviello, Elisabeth D; Sterling, Timothy R; Shepherd, Bryan; Fantan, Tsetsele; Makhema, Joseph

    2007-12-01

    Few detailed epidemiologic data exist regarding the impact of HIV infection on the workplace in the developing world. In addition, most HIV surveys examine only prevalence, without data on incidence or disease severity. In June 2003, we conducted a voluntary anonymous HIV serosurvey among employees of the Debswana Mining Company, the largest nongovernmental employer in Botswana. Among the 3558 participants, annual HIV incidence was estimated to be 3.4%, and HIV prevalence was 23.8%. HIV-infected participants had a median CD4(+) lymphocyte count of 427 cells/mm(3) (interquartile range 269-642), with 13.3% of samples Botswana.

  14. Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012.

    Directory of Open Access Journals (Sweden)

    Katharine J Looker

    Full Text Available Herpes simplex virus type 1 (HSV-1 commonly causes orolabial ulcers, while HSV-2 commonly causes genital ulcers. However, HSV-1 is an increasing cause of genital infection. Previously, the World Health Organization estimated the global burden of HSV-2 for 2003 and for 2012. The global burden of HSV-1 has not been estimated.We fitted a constant-incidence model to pooled HSV-1 prevalence data from literature searches for 6 World Health Organization regions and used 2012 population data to derive global numbers of 0-49-year-olds with prevalent and incident HSV-1 infection. To estimate genital HSV-1, we applied values for the proportion of incident infections that are genital.We estimated that 3709 million people (range: 3440-3878 million aged 0-49 years had prevalent HSV-1 infection in 2012 (67%, with highest prevalence in Africa, South-East Asia and Western Pacific. Assuming 50% of incident infections among 15-49-year-olds are genital, an estimated 140 million (range: 67-212 million people had prevalent genital HSV-1 infection, most of which occurred in the Americas, Europe and Western Pacific.The global burden of HSV-1 infection is huge. Genital HSV-1 burden can be substantial but varies widely by region. Future control efforts, including development of HSV vaccines, should consider the epidemiology of HSV-1 in addition to HSV-2, and especially the relative contribution of HSV-1 to genital infection.

  15. Incidence, prevalence and genetic determinants of neonatal diabetes mellitus: a systematic review and meta-analysis protocol.

    Science.gov (United States)

    Nansseu, Jobert Richie N; Ngo-Um, Suzanne S; Balti, Eric V

    2016-11-10

    In the absence of existing data, the present review intends to determine the incidence, prevalence and/or genetic determinants of neonatal diabetes mellitus (NDM), with expected contribution to disease characterization. We will include cross-sectional, cohort or case-control studies which have reported the incidence, prevalence and/or genetic determinants of NDM between January 01, 2000 and May 31, 2016, published in English or French languages and without any geographical limitation. PubMed and EMBASE will be extensively screened to identify potentially eligible studies, completed by manual search. Two authors will independently screen, select studies, extract data, and assess the risk of bias; disagreements will be resolved by consensus. Clinical heterogeneity will be investigated by examining the design and setting (including geographic region), procedure used for genetic testing, calculation of incidence or prevalence, and outcomes in each study. Studies found to be clinically homogeneous will be pooled together through a random effects meta-analysis. Statistical heterogeneity will be assessed using the chi-square test of homogeneity and quantified using the I 2 statistic. In case of substantial heterogeneity, subgroup analyses will be undertaken. Publication bias will be assessed with funnel plots, complemented with the use of Egger's test of bias. This systematic review and meta-analysis is expected to draw a clear picture of phenotypic and genotypic presentations of NDM in order to better understand the condition and adequately address challenges in respect with its management. PROSPERO CRD42016039765.

  16. Incidence and prevalence of systemic lupus erythematosus among the native Arab population in UAE.

    Science.gov (United States)

    Al Dhanhani, A M; Agarwal, M; Othman, Y S; Bakoush, O

    2017-05-01

    Background and objectives There is a paucity of information about the epidemiology of systemic lupus erythematosus (SLE) amongst Arabs. The objective of this study was to determine the incidence and prevalence of SLE among the native Arab population of United Arab Emirates (UAE). Methods Patients with SLE were identified from three sources: medical records of two local tertiary hospitals (four years; 2009 to 2012), laboratory requests for serum double stranded deoxyribonucleic acid and serum anti-nuclear antibody and confirmed histopathologic diagnosis of SLE (skin and kidney biopsy specimens). All the patients identified with SLE met the criteria of the American College of Rheumatology. Incidence and prevalence were calculated using the state records of the UAE native population as the denominator. The age-adjusted incidence was calculated by direct standardization using the World Health Organization world standard population 2000-2025. Results Sixteen new cases (13 females and three males) fulfilled the American College of Rheumatology SLE criteria. The mean (±SD) age at time of diagnosis was 28.6 ± 12.4 years. The crude incidence ratio (per 100,000 population) was 3.5, 1.1, 2.1 and 2.1 in years 2009, 2010, 2011, 2012, respectively. The age-standardized incidence per 100,000 population for the four years was 8.6 (95% confidence interval 4.2-15.9). The age-standardized prevalence of SLE among the native population according to the 2012 population consensus was 103/100,000 population (95% confidence interval 84.5-124.4). Conclusion The age-adjusted incidence and prevalence among UAE Arabs is higher than has been reported among most other Caucasian populations. Furthermore, the prevalence of SLE in UAE seems much higher than other similar Arab countries in the Gulf region.

  17. Playing-related musculoskeletal disorders in musicians: a systematic review of incidence and prevalence.

    Science.gov (United States)

    Zaza, C

    1998-04-21

    Work-related musculoskeletal disorders cause pain, disability and loss of employment for many workers, including musicians. Although performing arts medicine is a growing field, the health problems of musicians remain under-recognized and under-researched. Therefore, the author undertook a systematic review of published information on the incidence and prevalence of playing-related musculoskeletal disorders (PRMDs) in classical musicians. Seven databases were searched for the period 1980 to 1996. The main textbook and performing arts medicine journals were searched manually, as were reference lists of all relevant papers. The author also contacted individuals familiar with the literature of performing arts medicine. Studies were included for review if they reported PRMD incidence or prevalence in classical musicians. Of the 24 studies identified, 18 cross-sectional surveys and cohort studies were reviewed. The author subjectively assessed the studies using criteria modified from an existing evaluation scale and used 4 criteria for data combination. On the basis of prevalence values from the eligible studies, chi 2 tests for heterogeneity were performed. Only one study estimated PRMD incidence. Ten of the 17 prevalence studies were ineligible for data combination, because of low response rates and other methodological problems. In the 7 eligible studies, PRMD point prevalence ranged from 39% to 87% in adult musicians and from 34% to 62% in secondary school music students. The best estimates of PRMD prevalence were derived from the 3 studies that excluded mild complaints; these studies indicated that PRMD prevalence was 39% and 47% in adults and 17% in secondary school music students respectively. Statistical combination of data across studies within each demographic category was not possible. Available data indicate that the prevalence of PRMD in adult classical musicians is comparable to the prevalence of work-related musculoskeletal disorders reported for other

  18. Reasons for discrepancy between incidence and prevalence of epilepsy in lower income countries: Epilepsia's survey results.

    Science.gov (United States)

    Mathern, Gary W; Beninsig, Laurie; Nehlig, Astrid

    2015-02-01

    From July to August 2014, Epilepsia conducted an online survey seeking opinions that explained the discrepancy between the incidence and prevalence of epilepsy in lower income countries. Data on cumulative incidence suggest a higher rate of active epilepsy than reported in lifetime prevalence surveys. This study reports the findings of that poll addressing the proposal in our Controversy in Epilepsy series that it could be from increased death rates. The survey consisted of a question addressing possible reasons to explain the discrepancy between the incidence and prevalence of epilepsy. Another four questions addressed demographic information. There were 34 responders who completed the survey. Half (50%) of the responders felt that the discrepancy between cumulative incidence and lifetime prevalence was due to lack of uniform definitions and misclassification of patients in study design, 23.5% said the discrepancy was due to a higher mortality from diseases and conditions such as trauma and infections associated with epilepsy, 23.5% indicated that the stigma of epilepsy prevented people from acknowledging their disease in prevalence surveys, and 2.9% felt it was from poor access to qualified medical personal and utilization of medical treatments that increased death rates directly related to epilepsy. Within the limitations of sample size, the results of this survey support that the discrepancy between the incidence and prevalence of epilepsy in lower income regions of the world is due to problems in acquiring the data and stigma rather than higher mortality from diseases associated with epilepsy and repeated seizures. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  19. A Meta-Analysis of Alzheimer's Disease Incidence and Prevalence Comparing African-Americans and Caucasians.

    Science.gov (United States)

    Steenland, Kyle; Goldstein, Felicia C; Levey, Allan; Wharton, Whitney

    2016-01-01

    Several studies have shown higher Alzheimer's disease (AD) incidence rates are in African-Americans (AAs) than Caucasians (CCs). If this finding is consistent across studies, it raises important etiologic questions regarding factors responsible for this discrepancy. It also affects the likely public health burden of AD in the US in the future, as the non-Caucasian population becomes the majority. Estimate the AA/CC rate ratio for AD incidence across all available studies. We conducted a meta-analysis of population-based studies for the rate ratio (RR) of AD incidence for AAs versus CCs, after identifying six relevant studies from the literature. We calculated an AA/CC rate ratio across all studies using inverse-variance weighting, and assessed inter-study heterogeneity. Using these incidence data, as well as data on survival after diagnosis, and on all-cause mortality, we also estimated the US prevalence of AD among AAs and CCs. There were six population-based studies with data comparing AD incidence between AAs and CCs, with an estimated 370 AA and 640 CC incident cases. The meta-analysis RR showed that the AD rate for AAs was 64% higher than for CCs (RR = 1.64 (95% CI 1.35-2.00)) 1.35-2.00)), with no evidence of heterogeneity. We estimated the current US AD prevalence for ages 65-90 to be 5.5% for CCs, and 8.6% for AAs (prevalence ratio 1.56). AAs have an increased risk of incident and prevalent AD compared to CCs for reasons which are unknown, but are hypothesized to reflect biological, psychological, and socioeconomic factors.

  20. Estimating incidence from prevalence in generalised HIV epidemics: methods and validation.

    Directory of Open Access Journals (Sweden)

    Timothy B Hallett

    2008-04-01

    Full Text Available HIV surveillance of generalised epidemics in Africa primarily relies on prevalence at antenatal clinics, but estimates of incidence in the general population would be more useful. Repeated cross-sectional measures of HIV prevalence are now becoming available for general populations in many countries, and we aim to develop and validate methods that use these data to estimate HIV incidence.Two methods were developed that decompose observed changes in prevalence between two serosurveys into the contributions of new infections and mortality. Method 1 uses cohort mortality rates, and method 2 uses information on survival after infection. The performance of these two methods was assessed using simulated data from a mathematical model and actual data from three community-based cohort studies in Africa. Comparison with simulated data indicated that these methods can accurately estimates incidence rates and changes in incidence in a variety of epidemic conditions. Method 1 is simple to implement but relies on locally appropriate mortality data, whilst method 2 can make use of the same survival distribution in a wide range of scenarios. The estimates from both methods are within the 95% confidence intervals of almost all actual measurements of HIV incidence in adults and young people, and the patterns of incidence over age are correctly captured.It is possible to estimate incidence from cross-sectional prevalence data with sufficient accuracy to monitor the HIV epidemic. Although these methods will theoretically work in any context, we have able to test them only in southern and eastern Africa, where HIV epidemics are mature and generalised. The choice of method will depend on the local availability of HIV mortality data.

  1. Multiple drug intolerance syndrome: prevalence, clinical characteristics, and management.

    Science.gov (United States)

    Macy, Eric; Ho, Ngoc J

    2012-02-01

    Population-based data on the demographics and clinical characteristics of patients with multiple unrelated drug class intolerances noted in their medical records are lacking. To provide population-based drug "allergy" incidence rates and prevalence, and to identify individuals with multiple drug intolerance syndrome (MDIS) defined by 3 or more unrelated drug class "allergies," and to provide demographic and clinical information on MDIS cases. Electronic medical record data from 2,375,424 Kaiser Permanente Southern California health plan members who had a health care visit and at least 11 months of health care coverage during 2009 were reviewed. Population-based drug "allergy" incidence rates and prevalence were determined for 23 unrelated medication classes. On January 1, 2009, 478,283 (20.1%) health plan members had at least one reported "allergy." Individuals with a history of at least 1 "allergy" and females, in general, reported higher population-based new "allergy" incidence rates. Multiple drug intolerance syndrome was present in 49,582 (2.1%). The MDIS cases were significantly older, 62.4 ± 16.1 years; heavier, body mass index 29.3 ± 7.1; and likely to be female, 84.9%, compared with average health plan members. They had high rates of health care utilization, medication usage, and new drug "allergy" incidence. They sought medical attention for common nonmorbid conditions. Multiple drug intolerance syndrome is in part iatrogenic. It is associated with overweight elderly women who have high rates of health care and medication usage. Urticarial syndromes only explain a small fraction of MDIS cases. Multiple drug intolerance syndrome is associated with anxiety, but not predominately with immunoglobulin E (IgE)-mediated allergy or life-threatening illness. Multiple drug intolerance syndrome can be managed by medication avoidance and judicious rechallenge. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights

  2. Prevalence and incidence of drug use among college students: an 8-year longitudinal analysis.

    Science.gov (United States)

    Arria, Amelia M; Caldeira, Kimberly M; Allen, Hannah K; Bugbee, Brittany A; Vincent, Kathryn B; O'Grady, Kevin E

    2017-11-01

    Drug use among college students is associated with adverse academic and health outcomes and risks to personal safety. This study utilized data from a longitudinal study to estimate annual prevalence, cumulative lifetime prevalence, and incidence of ten types of drug use during the eight years after college entry and the average age of onset of each drug used. Participants (N = 1,253; 52% female) were young adults who were originally enrolled as first-time, first-year students at a university in the mid-Atlantic US. Annual personal interviews gathered data about the use of seven illicit drugs and three prescription drugs used nonmedically. Annual follow-up rates ranged from 76 to 91%. Marijuana was the most commonly used drug in every year of the study, with the highest annual prevalence estimates in Year 3 (47% wt ). In Year 8, when the modal age of participants was 25, 29% wt used marijuana during the past year. Nonmedical use of prescription drugs was more prevalent during college than in the later years of the study. Although the prevalence of cocaine and ecstasy use was low (cumulative prevalence estimates of 17% wt and 13% wt, respectively), incidence for these drugs was particularly high in the later years of the study. Drug use is prevalent among college students, and drug use persists among young adults, even after many have graduated college. More attention should be directed at identifying and intervening with students at risk for drug use to mitigate possible academic, health, and safety consequences.

  3. Obesity in older adults is associated with an increased prevalence and incidence of pain

    NARCIS (Netherlands)

    Heim, Noor; Snijder, Marieke B; Deeg, Dorly J H; Seidell, Jaap C; Visser, Marjolein

    2008-01-01

    Cross-sectional studies suggest an association between BMI and pain. This prospective study investigated the associations of measured BMI and waist circumference with prevalent and incident pain in older adults. The study included participants of the Longitudinal Aging Study Amsterdam, aged 55-85

  4. Obesity in older adults is associated with an increased prevalence and incidence of pain.

    NARCIS (Netherlands)

    Heim, N.; Snijder, M.B.; Deeg, D.J.H.; Seidell, J.C.; Visser, M.

    2008-01-01

    Cross-sectional studies suggest an association between BMI and pain. This prospective study investigated the associations of measured BMI and waist circumference with prevalent and incident pain in older adults. The study included participants of the Longitudinal Aging Study Amsterdam, aged 55-85

  5. Age-specific incidence and prevalence of keratoconus : a nationwide registration study

    NARCIS (Netherlands)

    Godefrooij, Daniel A|info:eu-repo/dai/nl/413648990; de Wit, G Ardine|info:eu-repo/dai/nl/167546589; Uiterwaal, Cuno S|info:eu-repo/dai/nl/136603947; Imhof, Saskia M|info:eu-repo/dai/nl/151386439; Wisse, Robert P L|info:eu-repo/dai/nl/344481336

    PURPOSE: To determine the age-specific incidence and prevalence of keratoconus in the modern era of diagnostics. DESIGN: Epidemiologic study. PARTICIPANTS: 4.4 million patients from a mandatory health insurance database. METHODS: Data were extracted from the largest health insurance provider in the

  6. Incidence and prevalence of cryptogenic fibrosing alveolitis in a Norwegian community

    DEFF Research Database (Denmark)

    von Plessen, C; Grinde, O; Gulsvik, A

    2003-01-01

    This study assesses the incidence and prevalence of cryptogenic fibrosing alveolitis (CFA) in a well-defined and stable Norwegian population of 250,000 inhabitants during a period of 15 years. We conducted a file survey of all patients (n = 376) aged 16 years or older with a clinician's diagnosis...

  7. Socioeconomic inequalities in the incidence and prevalence of type 2 diabetes mellitus in Europe

    NARCIS (Netherlands)

    Espelt, Albert; Borrell, Carme; Palència, Laia; Goday, Alberto; Spadea, Teresa; Gnavi, Roberto; Font-Ribera, Laia; Kunst, Anton E.

    2013-01-01

    The aim of this study was to analyze socioeconomic position (SEP) inequalities in the prevalence and incidence of type 2 diabetes mellitus (T2DM) in people aged 50 years and over in Europe and to describe the contribution of body mass index (BMI) and other possible mediators. This was a

  8. Prevalence and Incidence of Myocardial Infarction and Cerebrovascular Accident in Ageing Persons with Intellectual Disability

    Science.gov (United States)

    Jansen, J.; Rozeboom, W.; Penning, C.; Evenhuis, H. M.

    2013-01-01

    Background: Epidemiological information on age-related cardiovascular disease in people with intellectual disability (ID) is scarce and inconclusive. We compared prevalence and incidence of cerebrovascular accident and myocardial infarction over age 50 in a residential population with ID to that in a general practice population. Method: Lifetime…

  9. Prevalence, incidence, and risk factors of hepatitis C virus infection among drug users in Amsterdam

    NARCIS (Netherlands)

    van den Hoek, J. A.; van Haastrecht, H. J.; Goudsmit, J.; de Wolf, F.; Coutinho, R. A.

    1990-01-01

    The prevalence, risk factors, and incidence of hepatitis C virus (HCV) infection were studied in a cohort of drug users in Amsterdam. In intravenous drug users, the seroprevalence was 74% (224/304) versus 10% (4/42) in nonintravenous drug users. Risk factors independently associated with HCV

  10. Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study

    NARCIS (Netherlands)

    N. Terzikhan (Natalie); K.M.C. Verhamme (Katia); A. Hofman (Albert); B.H.Ch. Stricker (Bruno); G.G. Brusselle (Guy); L. Lahousse (Lies)

    2016-01-01

    textabstractCOPD is the third leading cause of death in the world and its global burden is predicted to increase further. Even though the prevalence of COPD is well studied, only few studies examined the incidence of COPD in a prospective and standardized manner. In a prospective population-based

  11. Prevalence of tuberculous infection and incidence of tuberculosis: a re-assessment of the Styblo rule

    NARCIS (Netherlands)

    van Leth, F.; van der Werf, M. J.; Borgdorff, M. W.

    2008-01-01

    OBJECTIVE: To evaluate the validity of the fixed mathematical relationship between the annual risk of tuberculous infection (ARTI), the prevalence of smear-positive tuberculosis (TB) and the incidence of smear-positive TB specified as the Styblo rule, which TB control programmes use to estimate the

  12. Female Overweight and Obesity in Adolescence: Developmental Trends and Ethnic Differences in Prevalence, Incidence, and Remission

    Science.gov (United States)

    Huh, David; Stice, Eric; Shaw, Heather; Boutelle, Kerri

    2012-01-01

    Despite substantial increases in the prevalence of adolescent overweight and obesity documented in recent decades, few studies have prospectively tracked their development during the entire adolescent period. The aims of this study were to characterize developmental trends in prevalence, incidence, and remission of overweight and obesity using annual data collected from ages 12 to 19 for 496 adolescent females. Ethnic differences between African American (n = 37), Latina (n = 96), and European American (n = 348) adolescents were also compared. The prevalence of overweight decreased slightly across adolescence and remission rates exceeded incidence (onset). Obesity was more chronic, with increasing incidence accompanied by decreasing remission rates. Middle through late adolescence was the period of greatest risk for the transition from overweight to obesity. African American and Latina females had higher overweight and obesity prevalence than European American females throughout adolescence. Differences in prevalence were driven by higher onset rates for African American and Latina females, whereas remission rates were comparable across ethnic groups. Results suggest that adolescence is not a high-risk period for onset of obesity for European American adolescent females, but is for African American and Latina adolescent females. PMID:21499888

  13. The global relationship between the prevalence of diabetes mellitus and incidence of tuberculosis: 2000-2012.

    Science.gov (United States)

    Badawi, Alaa; Sayegh, Suzy; Sallam, Mohamed; Sadoun, Eman; Al-Thani, Mohamed; Alam, Muhammad Wasif; Arora, Paul

    2014-10-28

    The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has increased over the past decade with DM prevalence increasing in countries already afflicted with a high burden of TB. The coexistence of the two conditions presents a serious threat to global public health. The present study examines the global relationship between the prevalence of DM and the incidence of TB to evaluate their coexistence worldwide and their contribution to one another. This is an ecological longitudinal study covering the period between years 2000 to 2012. We utilized data from the WHO and World Bank sources and International Diabetes Federation to estimate prevalence of DM (%) and the incidence of TB (per 100,000). Measures of central tendency and dispersion as well as the harmonic mean and linear regression were used for different WHO regions. The association between DM prevalence and TB incidence was examined by quartile of DM prevalence. The worldwide average (±S.D.) prevalence of DM within the study period was 6.6±3.8% whereas TB incidence was 135.0±190.5 per 100,000. DM prevalence was highest in the Eastern Mediterranean (8.3±4.1) and West Pacific (8.2±5.6) regions and lowest in the Africa (3.5±2.6). TB incidence was highest in Africa (313.1±275.9 per 100,000) and South-East Asia (216.7±124.9) and lowest in the European (46.5±68.6) and American (47.2±52.9) regions. Only countries with high DM prevalence (>7.6%) showed a significant positive association with TB incidence (r=0.17, p=0.013). A positive association between DM and TB may exist in some - but not all - world regions, a dual burden that necessitates identifying the nature of this coexistence to assist in developing public health approaches that curb their rising burden.

  14. Algorithms for the Capture and Adjudication of Prevalent and Incident Diabetes in UK Biobank.

    Science.gov (United States)

    Eastwood, Sophie V; Mathur, Rohini; Atkinson, Mark; Brophy, Sinead; Sudlow, Cathie; Flaig, Robin; de Lusignan, Simon; Allen, Naomi; Chaturvedi, Nishi

    2016-01-01

    UK Biobank is a UK-wide cohort of 502,655 people aged 40-69, recruited from National Health Service registrants between 2006-10, with healthcare data linkage. Type 2 diabetes is a key exposure and outcome. We developed algorithms to define prevalent and incident diabetes for UK Biobank. The algorithms will be implemented by UK Biobank and their results made available to researchers on request. We used UK Biobank self-reported medical history and medication to assign prevalent diabetes and type, and tested this against linked primary and secondary care data in Welsh UK Biobank participants. Additionally, we derived and tested algorithms for incident diabetes using linked primary and secondary care data in the English Clinical Practice Research Datalink, and ran these on secondary care data in UK Biobank. For prevalent diabetes, 0.001% and 0.002% of people classified as "diabetes unlikely" in UK Biobank had evidence of diabetes in their primary or secondary care record respectively. Of those classified as "probable" type 2 diabetes, 75% and 96% had specific type 2 diabetes codes in their primary and secondary care records. For incidence, 95% of people with the type 2 diabetes-specific C10F Read code in primary care had corroborative evidence of diabetes from medications, blood testing or diabetes specific process of care codes. Only 41% of people identified with type 2 diabetes in primary care had secondary care evidence of type 2 diabetes. In contrast, of incident cases using ICD-10 type 2 diabetes specific codes in secondary care, 77% had corroborative evidence of diabetes in primary care. We suggest our definition of prevalent diabetes from UK Biobank baseline data has external validity, and recommend that specific primary care Read codes should be used for incident diabetes to ensure precision. Secondary care data should be used for incident diabetes with caution, as around half of all cases are missed, and a quarter have no corroborative evidence of diabetes in

  15. Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study.

    Science.gov (United States)

    Terzikhan, Natalie; Verhamme, Katia M C; Hofman, Albert; Stricker, Bruno H; Brusselle, Guy G; Lahousse, Lies

    2016-08-01

    COPD is the third leading cause of death in the world and its global burden is predicted to increase further. Even though the prevalence of COPD is well studied, only few studies examined the incidence of COPD in a prospective and standardized manner. In a prospective population-based cohort study (Rotterdam Study) enrolling subjects aged ≥45, COPD was diagnosed based on a pre-bronchodilator obstructive spirometry (FEV1/FVC spirometry within the Rotterdam Study, cases were defined as having COPD diagnosed by a physician on the basis of clinical presentation and obstructive lung function measured by the general practitioner or respiratory physician. Incidence rates were calculated by dividing the number of incident cases by the total number of person years of subjects at risk. In this cohort of 14,619 participants, 1993 subjects with COPD were identified of whom 689 as prevalent ones and 1304 cases as incident ones. The overall incidence rate (IR) of COPD was 8.9/1000 person-years (PY); 95 % Confidence Interval (CI) 8.4-9.4. The IR was higher in males and in smokers. The proportion of female COPD participants without a history of smoking was 27.2 %, while this proportion was 7.3 % in males. The prevalence of COPD in the Rotterdam Study is 4.7 % and the overall incidence is approximately 9/1000 PY, with a higher incidence in males and in smokers. The proportion of never-smokers among female COPD cases is substantial.

  16. Management of adult spontaneous spondylodiscitis and its rising incidence.

    Science.gov (United States)

    Sur, A; Tsang, K; Brown, M; Tzerakis, N

    2015-09-01

    Spondylodiscitis refers to the infection of the intervertebral disc and osteomyelitis of the adjacent endplates, and it is uncommon in the developed world. Broad consensus indicates its incidence is on the rise. The aim of this retrospective study was twofold. First, we sought to give an up-to-date incidence estimate by comparing case presentation over two time periods (1995-1999 and 2008-2011). Data from the England and Wales census in 2001 and 2011 were used for incidence estimation. The second part of this study aimed to generate management guidance from data from medical and radiographic records of the 2008-2011 patient cohort. The incidence of adult spontaneous spondylodiscitis in the local region between 2008 and 2011 was 3.67/100,000 per year, representing a 150% increase from the incidence in 1995-1999. Our data demonstrate that methicillin sensitive Staphylococcus aureus remains the most common offending pathogen of spontaneous spondylodiscitis. The mean C-reactive protein (CRP) level remained at >30mg/l after a month of starting antibiotic treatment in both medically and surgically managed groups. Evidence suggests that the incidence of spondylodiscitis is on the rise. A review of our case series has demonstrated the effectiveness of intravenous antibiotic therapy. While no official guidance exists for when to switch from intravenous to oral antibiotics, our study shows that CRP at 1 month is >30mg/l and we recommend 6 weeks of intravenous therapy, followed by 6 further weeks of oral therapy.

  17. Incidence and prevalence of nutritional and hereditary rickets in southern Denmark

    DEFF Research Database (Denmark)

    Beck-Nielsen, Signe; Jacobsen, Bendt; Gram, Jeppe

    2009-01-01

    Objective To estimate the incidence of nutritional rickets and the incidence and prevalence of hereditary rickets. Design Population-based retrospective cohort study based on a review of medical records. Methods Patients aged 0-14.9 years referred to or discharged from hospitals in Southern Denmark...... from 1985 to 2005 with a diagnosis of rickets were identified by register search and their medical records were retrieved. Patients fulfilling the diagnostic criteria of primary rickets were included. Results We identified 112 patients with nutritional rickets of whom 74% were immigrants. From 1995......-2005 the average incidence of nutritional rickets in children aged 0-14.9 years and 0-2.9 years was 2.9 and 5.8 per 100,000 per year, respectively. Among immigrant children born in Denmark the average incidence was 60 (0-14.9 years) per 100,000 per year. Ethnic Danish children were only diagnosed in early...

  18. Early identification and management of critical incident stress.

    Science.gov (United States)

    Caine, Randy M; Ter-Bagdasarian, Levon

    2003-02-01

    Everyone experiences stress. That stress may be related to work (internal), community (external), or family; it may be cumulative or related to a particular critical incident. The cost related to treating acute stress is staggering, both to individuals and to organizations. Critical care nurses are well educated in the physiological responses to the stress of acute illness. Recognizing the emotional impact of stress and the techniques to manage it in themselves and in those with whom they work is equally as important. CISD is widely advocated as an intervention after critical incidents. Although debriefing in and of itself is effective, a single-session semistructured crisis intervention will not prevent posttraumatic stress; thus, the use of CISD as part of a comprehensive multifaceted approach to the management of acute stress related to a critical incident is recommended.

  19. Pneumococci in the African meningitis belt: meningitis incidence and carriage prevalence in children and adults.

    Directory of Open Access Journals (Sweden)

    Judith E Mueller

    Full Text Available The development of optimal vaccination strategies for pneumococcal conjugate vaccines requires serotype-specific data on disease incidence and carriage prevalence. This information is lacking for the African meningitis belt.We conducted hospital-based surveillance of acute bacterial meningitis in an urban and rural population of Burkina Faso during 2007-09. Cerebrospinal fluid was evaluated by polymerase chain reaction for species and serotype. In 2008, nasopharyngeal swabs were obtained from a representative population sample (1 month to 39 years; N = 519 and additional oropharyngeal swabs from 145 participants. Swabs were evaluated by culture.Annual pneumococcal meningitis incidence rates were highest among <6-month-old (58/100,000 and 15- to 19-year-old persons (15/100,000. Annual serotype 1 incidence was around 5/100,000 in all age groups. Pneumococcal carriage prevalence in nasopharyngeal swabs was 63% among <5-year-old children and 22% among ≥5-year-old persons, but adding oropharyngeal to nasopharyngeal swabs increased the estimated carriage prevalence by 60%. Serotype 1 showed high propensity for invasive disease, particularly among persons aged ≥5 years.Serotype 1 causes the majority of cases with a relatively constant age-specific incidence. Pneumococcal carriage is common in all age groups including adults. Vaccination programs in this region may need to include older target age groups for optimal impact on disease burden.

  20. Increasing prevalence and high incidence of celiac disease in elderly people: a population-based study.

    Science.gov (United States)

    Vilppula, Anitta; Kaukinen, Katri; Luostarinen, Liisa; Krekelä, Ilkka; Patrikainen, Heikki; Valve, Raisa; Mäki, Markku; Collin, Pekka

    2009-06-29

    Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb) and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s). The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002-2005 was 0.23%, giving an annual incidence of 0.08% in this population. The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

  1. Increasing prevalence and high incidence of celiac disease in elderly people: A population-based study

    Directory of Open Access Journals (Sweden)

    Vilppula Anitta

    2009-06-01

    Full Text Available Abstract Background Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s. Methods The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy. Results Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002–2005 was 0.23%, giving an annual incidence of 0.08% in this population. Conclusion The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

  2. Sex differences in the prevalence and incidence of mild cognitive impairment: A meta-analysis.

    Science.gov (United States)

    Au, Bonnie; Dale-McGrath, Sydney; Tierney, Mary C

    2017-05-01

    More women have Alzheimer's disease (AD) than men. Understanding sex differences in mild cognitive impairment (MCI) may further knowledge of AD etiology and prevention. We conducted a meta-analysis to examine sex differences in the prevalence and incidence of MCI, which included amnestic and non-amnestic subtypes. Systematic searches were performed in July 2015 using MEDLINE/PubMed, Scopus, and PsycINFO for population-or community-based studies with MCI data for men and women. Random-effects model were used. Fifty-six studies were included. There were no statistically significant sex differences in prevalence or incidence of amnestic MCI. There was a significantly higher prevalence (p=0.038), but not incidence, of non-amnestic MCI among women. There were no sex differences in studies that combined both subtypes of MCI. The only statistically significant finding emerging from this study was that women have a higher prevalence of non-amnestic MCI. To better understand sex differences in the preclinical stages of dementia, studies must better characterize the etiology of the cognitive impairment. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Incidence and management of postoperative bile leaks: A ...

    African Journals Online (AJOL)

    Incidence and management of postoperative bile leaks: A prospective cohort analysis of 467 liver resections. A.J. Dell, J.E.J. Krige, E. Jonas, S.R. Thomson, S.J. Beningfield, U.K. Kotze, S.A. Tromp, S. Burmeister, M.M. Bernon, P.C. Bornman ...

  4. Prevalence and incidence of hypoparathyroidism in the United States using a large claims database.

    Science.gov (United States)

    Powers, Julia; Joy, Karen; Ruscio, Aimee; Lagast, Hjalmar

    2013-12-01

    Hypoparathyroidism is a rare endocrine disorder whose incidence and prevalence have not been well defined. This study aimed to 1) estimate the number of insured adult patients with hypoparathyroidism in the United States and 2) obtain physician assessment of disease severity and chronicity. Prevalence was estimated through calculation of diagnoses of hypoparathyroidism in a large proprietary health plan claims database over a 12-month period from October 2007 through September 2008 and projected to the US insured population. Incidence was also calculated from the same database by determining the proportion of total neck surgeries resulting in either transient (≤6 months) or chronic (>6 months) hypoparathyroidism. A physician primary market research study was conducted to assess disease severity and determine the percentage of new nonsurgical patients with hypoparathyroidism. Incidence data were entered into an epidemiologic model to derive an estimate of prevalence. The diagnosis-based prevalence approach estimated 58,793 insured patients with chronic hypoparathyroidism in the United States. The surgical-based incidence approach yielded 117,342 relevant surgeries resulting in 8901 cases over 12 months. Overall, 7.6% of surgeries resulted in hypoparathyroidism (75% transient, 25% chronic). The prevalence of chronic hypoparathyroidism among insured patients included in the surgical database was estimated to be 58,625. The physician survey found that 75% of cases treated over the past 12 months were reported due to surgery and, among all thyroidectomies and parathyroidectomies and neck dissections performed in a year, 26% resulted in transient hypoparathyroidism and 5% progressed to a chronic state. In conclusion, the two claims-based methods yielded similar estimates of the number of insured patients with chronic hypoparathyroidism in the United States (~58,700). The physician survey was consistent with those calculations and confirmed the burden imposed by

  5. Analysis of Incident and Accident Reports and Risk Management in Spine Surgery.

    Science.gov (United States)

    Kobayashi, Kazuyoshi; Imagama, Shiro; Ando, Kei; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Morozumi, Masayoshi; Nishida, Yoshihiro; Nagao, Yoshimasa; Ishiguro, Naoki

    2017-08-01

    A review of accident and incident reports. To analyze prevalence, characteristics, and details of perioperative incidents and accidents in patients receiving spine surgery. In our institution, a clinical error that potentially results in an adverse event is usually submitted as an incident or accident report through a web database, to ensure anonymous and blame-free reporting. All reports are analyzed by a medical safety management group. These reports contain valuable data for management of medical safety, but there have been no studies evaluating such data for spine surgery. A total of 320 incidents and accidents that occurred perioperatively in 172 of 415 spine surgeries were included in the study. Incidents were defined as events that were "problematic, but with no damage to the patient," and accidents as events "with damage to the patient." The details of these events were analyzed. There were 278 incidents in 137 surgeries and 42 accidents in 35 surgeries, giving prevalence of 33% (137/415) and 8% (35/415), respectively. The proportion of accidents among all events was significantly higher for doctors than non-doctors [68.0% (17/25) vs. 8.5% (25/295), P < 0.01] and in the operating room compared with outside the operating room [40.5% (15/37) vs. 9.5% (27/283), P < 0.01]. There was no significant difference in years of experience among personnel involved in all events. The major types of events were medication-related, line and tube problems, and falls and slips. Accidents also occurred because of a long-term prone position, with complications such as laryngeal edema, ulnar nerve palsy, and tooth damage. Surgery and procedures in the operating room always have a risk of complications. Therefore, a particular effort is needed to establish safe management of this environment and to provide advice on risk to the doctor and medical care team. 4.

  6. Prevalence, incidence and risk factors for overuse injuries of the wrist in young athletes: a systematic review

    NARCIS (Netherlands)

    Kox, Laura S.; Kuijer, P. Paul F. M.; Kerkhoffs, Gino M. M. J.; Maas, Mario; Frings-Dresen, Monique H. W.

    2015-01-01

    Overuse wrist injuries can cause long-term symptoms in young athletes performing wrist-loading sports. Information on the prevalence, incidence and associated risk factors is required. We aimed to review the prevalence and incidence of overuse wrist injuries in young athletes and to identify

  7. Variations in Incidence and Prevalence of Parkinson’s Disease in Taiwan: A Population-Based Nationwide Study

    Directory of Open Access Journals (Sweden)

    Chih-Ching Liu

    2016-01-01

    Full Text Available Demographic, socioeconomic, and urbanization level variations in Parkinson’s disease (PD are rarely investigated, especially in Asia. This study describes an eight-year trend in PD incidence and prevalence in Taiwan as well as assessing the effects of sociodemographics and urbanization on the incidence and prevalence of PD. The data analyzed were acquired from the Taiwan National Health Insurance Research Database (NHIRD entries between 2002 and 2009. The calendar year, sex, and age-specific rates were standardized, and the effects of the sociodemographics and urbanization on PD were assessed using Poisson regression analysis. PD incidence and prevalence showed a significantly increasing trend, with a greater magnitude noted for prevalence than for incidence (87.3% versus 9.2%. The PD incidence and prevalence increased with age and were slightly higher in men than in women. The people who were not under the labor force (i.e., dependents or with lower monthly incomes were at significantly increased adjusted incidence rate ratio (1.50–1.56 and adjusted prevalence rate ratio (1.66–1.71 of PD. Moreover, significantly higher PD incidence and prevalence were noted in areas with lesser urbanization. This information emphasizes the need for preventive and clinical care strategies targeting the segment of Taiwanese population that exhibited a greater incidence and prevalence of PD.

  8. Incidence, prevalence, and mortality of insulin-dependent (type 1) diabetes mellitus in Lithuanian children during 1983-98

    DEFF Research Database (Denmark)

    Urbonaite, Brone; Zalinkevicius, Rimas; Green, Anders

    2002-01-01

    AIMS/HYPOTHESIS: Our purpose is to analyze interrelations of the incidence, prevalence and mortality of childhood-onset insulin-dependent diabetes mellitus (type 1) in Lithuania. METHODS: Incidence and prevalence rates were based on the national type 1 diabetes register during 1983-98. The cohort...

  9. Epidemiology of stroke in the elderly in the Nordic countries. Incidence, survival, prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Torgeir Engstad

    2012-11-01

    Full Text Available Objective: To review what is known at present with respect to incidence, survival, risk factors and prevalence among the elderly stroke patients in the Nordic countries.Method: This article is based mainly on literature identified through search engines (Mc Master Plus, Cochrane Library, Medline and PubMed, restricted to first-ever stroke in Nordic population-based studies and having applied to the standard WHO definition, a prospective study design and no upper age limit.Results: Data from the Nordic countries show an incidence rate of 1250 to 1796/100 000 in the age group 75-84, and 1628 to 2234 in those above 85 years. The incidence rates are higher among men, but women are expected to contribute more to incident cases due to their higher life expectancy. If the age-specific incidence of stroke remains stable, the proportion of stroke patients aged 80 years and older may reach 50% in a few decades. The elderly stroke patients have a higher 30-days case fatality, and a higher risk of dependency. Better treatment of stroke patients has improved the survival over the last two decades. The prevalence is expected to increase due to the decrease in lethality, a slower fall in incidence and a higher proportion of elderly. Cardiovascular risk factors increase with age. Hypertension is a major risk factor for stroke mortality in the elderly. Cardioembolic stroke due to atrial fibrillation is the most common stroke subtype in the elderly. Lifestyle risk factors are less prevalent in the older stroke patients.Conclusion: The growing proportion of elderly stroke patients is a major challenge for future stroke care. The elderly stroke patients have a different risk factor profile compared to younger stroke patients. Treatment should focus on regaining independency. The age-specific epidemiology of stroke needs to be studied further in large studies in order to plan for future health care.

  10. Sex Differences in Stroke Incidence, Prevalence, Mortality and Disability-Adjusted Life Years

    DEFF Research Database (Denmark)

    Barker-Collo, Suzanne; Bennett, Derrick A; Krishnamurthi, Rita V

    2015-01-01

    BACKGROUND: Accurate information on stroke burden in men and women are important for evidence-based healthcare planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality...... incidence, prevalence, mortality, disability-adjusted life years (DALYs) and healthy years lost due to disability were estimated as part of the Global Burden of Disease (GBD) 2013 Study. Data inputs included all available information on stroke incidence, prevalence and death and case fatality rates...... ischemic stroke (IS) and hemorrhagic stroke (HS) incidence (per 100,000) in men (IS 132.77 (95% UI 125.34-142.77); HS 64.89 (95% UI 59.82-68.85)) exceeded those of women (IS 98.85 (95% UI 92.11-106.62); HS 45.48 (95% UI 42.43-48.53)). IS incidence rates were lower in 2013 compared with 1990 rates for both...

  11. Incidence and prevalence of elite male cricket injuries using updated consensus definitions

    Directory of Open Access Journals (Sweden)

    Orchard JW

    2016-12-01

    Full Text Available John W Orchard, Alex Kountouris, Kevin Sims National Cricket Centre, Cricket Australia, Brisbane, Australia Background: T20 (Twenty20 or 20 over cricket has emerged in the last decade as the most popular form of cricket (in terms of spectator attendances. International consensus cricket definitions, first published in 2005, were updated in 2016 to better reflect the rise to prominence of T20 cricket.  Methods: Injury incidence and prevalence rates were calculated using the new international methods and units for elite senior male Australian cricketers over the past decade (season 2006–2007 to season 2015–2016 inclusive.  Results: Over the past 10 seasons, average match injury incidence, for match time-loss injuries, was 155 injuries/1,000 days of play, with the highest daily rates in 50-over cricket, followed by 20-over cricket and First-Class matches. Annual injury incidence was 64 injuries/100 players per season, and average annual injury prevalence was 12.5% (although fast bowlers averaged 20.6%, much higher than other positions. The most common injury was the hamstring strain (seasonal incidence 8.7 injuries/100 players per season. The most prevalent injury was lumbar stress fractures (1.9% of players unavailable at all times owing to these injuries, which represents 15% of all missed playing time.  Discussion: The hamstring strain has emerged from being one of the many common injuries in elite cricket a decade ago to being clearly the most common injury in the sport at the elite level. This is presumably in association with increased T20 cricket. Lumbar stress fractures in fast bowlers are still the most prevalent injury in the sport of cricket at the elite level, although these injuries are more associated with high workloads arising from the longer forms of the game. Domestic and international matches have very similar match injury incidence rates across the formats, but injury prevalence is higher in international players as

  12. Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study.

    Science.gov (United States)

    Dodds, Richard Matthew; Granic, Antoneta; Davies, Karen; Kirkwood, Thomas B L; Jagger, Carol; Sayer, Avan Aihie

    2017-04-01

    Recognition that an older person has sarcopenia is important because this condition is linked to a range of adverse outcomes. Sarcopenia becomes increasingly common with age, and yet there are few data concerning its descriptive epidemiology in the very old (aged 85 years and above). Our aims were to describe risk factors for sarcopenia and estimate its prevalence and incidence in a British sample of the very old. We used data from two waves (2006/07 and 2009/10) of the Newcastle 85+ Study, a cohort born in 1921 and registered with a Newcastle/North Tyneside general practice. We assessed sarcopenia status using the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Grip strength was measured using a Takei digital dynamometer (Takei Scientific Instruments Ltd., Niigata, Japan), gait speed was calculated from the Timed Up and Go test, and lean mass was estimated using a Tanita-305 body fat analyzer. We used logistic regression to examine associations between risk factors for prevalent sarcopenia at baseline and incident sarcopenia at follow-up. European Working Group on Sarcopenia in Older People sarcopenia was present in 21% of participants at baseline [149/719 participants, mean age 85.5 (0.4) years]. Many participants had either slow gait speed or weak grip strength (74.3%), and hence measurement of muscle mass was frequently indicated by the EWGSOP definition. Incidence data were available for 302 participants, and the incident rate was 3.7 cases per 100 person years at risk. Low Standardized Mini-Mental State Examination, lower occupational social class, and shorter duration of education were associated with sarcopenia at baseline, while low muscle mass was associated with incident sarcopenia. Low body mass index (BMI) was a risk factor for both in a graded fashion, with each unit decrease associated with increased odds of prevalent [odds ratio (OR) 1.29, 95% confidence interval (CI): 1.21, 1.37] and incident (OR 1.20, 95% CI: 1.08, 1

  13. The incidence and prevalence of comorbid gastrointestinal, musculoskeletal, ocular, pulmonary, and renal disorders in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Stuve, Olaf

    2015-01-01

    was assessed. For population-based studies we quantitatively assessed studies using the I² statistic, and conducted random effects meta-analyses. RESULTS: Study designs were heterogeneous with respect to populations, case definitions, and methods of ascertainment. Incidence of the studied comorbidities......BACKGROUND: As new disease-modifying therapies emerge a better knowledge of the risk of comorbid disease in multiple sclerosis (MS) is needed. OBJECTIVE: To estimate the incidence and prevalence of comorbid gastrointestinal, musculoskeletal, ocular, pulmonary, and renal disorders in MS. METHODS: We...

  14. Estimates of Incidence and Prevalence of Visual Impairment, Low Vision, and Blindness in the United States.

    Science.gov (United States)

    Chan, Tiffany; Friedman, David S; Bradley, Chris; Massof, Robert

    2018-01-01

    Updated estimates of the prevalence and incidence rates of low vision and blindness are needed to inform policy makers and develop plans to meet the future demands for low vision rehabilitation services. To provide updated estimates of the incidence and prevalence of low vision and blindness in the United States. Visual acuity measurements as a function of age from the 2007-2008 National Health and Nutrition Examination Survey, with representation of racial and ethnic groups, were used to estimate the prevalence and incidence of visual impairments. Data from 6016 survey participants, ranging in age from younger than 18 years to older than 45 years, were obtained to estimate prevalence rates for different age groups. Incidence and prevalence rates of low vision (best-corrected visual acuity [BCVA] in the better-seeing eye of United States were estimated, using the 2010 US census data by age, from the rate models applied to the census projections for 2017, 2030, and 2050. Data were collected from November 1, 2007, to October 31, 2008. Data analysis took place from March 31, 2016, to March 19, 2017. Prevalence and incidence rates of low vision and blindness in the United States. Of the 6016 people in the study, 1714 (28.4%) were younger than 18 years of age, 2358 (39.1%) were 18 to 44 years of age, and 1944 (32.3%) were 45 years of age or older. There were 2888 male (48%) and 3128 female (52%) participants. The prevalence of low vision and blindness for older adults (≥45 years) in the United States in 2017 is estimated to be 3 894 406 persons (95% CI, 3 034 442-4 862 549 persons) with a BCVA less than 20/40, 1 483 703 persons (95% CI, 968 656-2 370 513 persons) with a BCVA less than 20/60, and 1 082 790 persons (95% CI, 637 771-1 741 864 persons) with a BCVA of 20/200 or less. The estimated 2017 annual incidence (projected from 2010 census data) of low vision and blindness among older adults (≥45 years) in the United States is 481

  15. [A SYSTEMATIC REVIEW ON THE PREVALENCE AND INCIDENCE OF LATENT TUBERCULOSIS INFECTION AMONG PRISON POPULATION].

    Science.gov (United States)

    Kawatsu, Lisa; Uchimura, Kazuhiro; Izumi, Kiyohiko; Ohkado, Akihiro

    2016-04-01

    We conducted a systematic review of literatures on the prevalence and incidence of latent tuberculosis infection in correctional settings, with the aim of offering one of the resources to guide establishment of policies on screening for and treating LTBI among prisoners in Japan. Using the keywords "latent tuberculosis AND (prison OR jail OR correctional)" and "tuberculosis infection AND (prison OR jail OR correctional)", we conducted a systematic review of relevant literatures on PubMed and secondary searches from the reference list of primary sources. We limited our search to those original articles published since 1980, and in English. 55 articles were identified, and 15 were subject to the systematic review. Of the 12 articles on prevalence of LTBI, 5 were from middle and high-burden and 7 from low-burden countries. The average prevalence of LTBI among middle and high-burden countries was 73.0%, and among low-burden countries, 40.3%. "Duration of incarceration" and "history of previous incarceration" were identified as risk factors for high LTBI prevalence which were specific to the prison population. Incidence of LTBI among the high-burden country was 61.8 per 100 person years, while 5.9 and 6.3 in the two reports from low-burden countries. Prevalence and incidence of LTBI were higher than the general population, both in middle/high- and low-burden countries. The fact that "duration of incarceration" and "history of previous incarceration" were identified as risk factors indicate that high prevalence of LTBI among prison population is not just attributable to the characteristics of prisoners themselves, but also to the possibility of TB infection occurring in prison settings.

  16. Prevalence of tuberculous infection and incidence of tuberculosis: a re-assessment of the Styblo rule.

    Science.gov (United States)

    van Leth, F; van der Werf, M J; Borgdorff, M W

    2008-01-01

    To evaluate the validity of the fixed mathematical relationship between the annual risk of tuberculous infection (ARTI), the prevalence of smear-positive tuberculosis (TB) and the incidence of smear-positive TB specified as the Styblo rule, which TB control programmes use to estimate the incidence of TB disease at a population level and the case detection rate. Population-based tuberculin surveys and surveys on prevalence of smear-positive TB since 1975 were identified through a literature search. For these surveys, the ratio between the number of tuberculous infections (based on ARTI estimates) and the number of smear-positive TB cases was calculated and compared to the ratio of 8 to 12 tuberculous infections per prevalent smear- positive TB case as part of the Styblo rule. Three countries had national population-based data on both ARTI and prevalence of smear-positive TB for more than one point in time. In China the ratio ranged from 3.4 to 5.8, in the Philippines from 2.6 to 4.4, and in the Republic of Korea, from 3.2 to 4.7. All ratios were markedly lower than the ratio that is part of the Styblo rule. According to recent country data, there are typically fewer than 8 to 12 tuberculous infections per prevalent smear-positive TB case, and it remains unclear whether this ratio varies significantly among countries. The decrease in the ratio compared to the Styblo rule probably relates to improvements in the prompt treatment of TB disease (by national TB programmes). A change in the number of tuberculous infections per prevalent smear-positive TB case in population-based surveys makes the assumed fixed mathematical relationship between ARTI and incidence of smear-positive TB no longer valid.

  17. Impact of incident and prevalent herpes simplex virus-2 infection on the incidence of HIV-1 infection among commercial sex workers in South Africa

    CSIR Research Space (South Africa)

    Ramjee, G

    2005-07-01

    Full Text Available This study investigated the impact of prevalent and incident HSV-2 infection on the incidence of HIV-1 infection in a cohort of female commercial sex workers in KwaZulu-Natal, South Africa. Prior to a vaginal microbicide trial, 416 women were...

  18. Safety Incident Management Team Report for NIMLT Case 50796

    LENUS (Irish Health Repository)

    2017-01-17

    This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\

  19. Prevalence and 25 year incidence of proliferative retinopathy among Danish type 1 diabetic patients

    DEFF Research Database (Denmark)

    Grauslund, J; Green, A; Sjølie, A K

    2009-01-01

    AIMS/HYPOTHESIS: This study aimed to evaluate the prevalence of retinopathy in long-surviving type 1 diabetic patients. It also investigated the 25 year incidence of proliferative retinopathy and associated risk factors in a Danish population-based cohort. METHODS: A population-based cohort of 727......-2008. RESULTS: The median age and duration of diabetes at follow-up were 58.8 and 43 years, respectively. At follow-up, the prevalence of diabetic retinopathy was 97.0%. Non-proliferative retinopathy was found in 45.8%, and 51.2% had proliferative retinopathy. The 25 year incidence of proliferative retinopathy...... type 1 diabetic patients from Fyn County, Denmark, was identified in 1973. In 1981-1982, baseline retinopathy was graded and other risk factors were assessed in 573 patients. Twenty-five years later, 308 patients were still alive. Of these, 201 (65.3%) were re-examined at follow-up in 2007...

  20. Incidence and prevalence of systemic sclerosis in Campo Grande, State of Mato Grosso do Sul, Brazil.

    Science.gov (United States)

    Horimoto, Alex Magno Coelho; Matos, Erica Naomi Naka; Costa, Márcio Reis da; Takahashi, Fernanda; Rezende, Marcelo Cruz; Kanomata, Letícia Barrios; Locatelli, Elisangela Possebon Pradebon; Finotti, Leandro Tavares; Maegawa, Flávia Kamy Maciel; Rondon, Rosa Maria Ribeiro; Machado, Natália Pereira; Couto, Flávia Midori Arakaki Ayres Tavares do; Figueiredo, Túlia Peixoto Alves de; Ovidio, Raphael Antonio; Costa, Izaias Pereira da

    Systemic sclerosis is an autoimmune disease which shows extreme heterogeneity in its clinical presentation and that follows a variable and unpredictable course. Although some discrepancies in the incidence and prevalence rates between geographical regions may reflect methodological differences in the definition and verification of cases, they may also reflect true local differences. To determine the prevalence and incidence of systemic sclerosis in the city of Campo Grande, state capital of Mato Grosso do Sul (MS), Brazil, during the period from January to December 2014. All health care services of the city of Campo Grande - MS with attending in the specialty of Rheumatology were invited to participate in the study through a standardized form of clinical and socio-demographic assessment. Physicians of any specialty could report a suspected case of systemic sclerosis, but necessarily the definitive diagnosis should be established by a rheumatologist, in order to warrant the standardization of diagnostic criteria and exclusion of other diseases resembling systemic sclerosis. At the end of the study, 15 rheumatologists reported that they attended patients with systemic sclerosis and sent the completed forms containing epidemiological data of patients. The incidence rate of systemic sclerosis in Campo Grande for the year 2014 was 11.9 per million inhabitants and the prevalence rate was 105.6 per million inhabitants. Systemic sclerosis patients were mostly women, white, with a mean age of 50.58 years, showing the limited form of the disease with a mean duration of the disease of 8.19 years. Regarding laboratory tests, 94.4% were positive for antinuclear antibody, 41.6% for anti-centromere antibody and 19.1% for anti-Scl70; anti-RNA Polymerase III was performed in 37 patients, with 16.2% positive. The city of Campo Grande, the state capital of MS, presented a lower incidence/prevalence of systemic sclerosis in comparison with those numbers found in US studies and close

  1. A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Cohen, Jeffrey; Stuve, Olaf

    2015-01-01

    approach. We quantitatively assessed population-based studies using the I² statistic, and conducted random-effects meta-analyses. RESULTS: We included 249 articles. Study designs were variable with respect to source populations, case definitions, methods of ascertainment and approaches to reporting...... about comorbidity in Central or South America, Asia or Africa. Findings in North America and Europe are inconsistent. Future studies should report age-, sex- and ethnicity-specific estimates of incidence and prevalence, and standardize findings to a common population....

  2. The Incidence and Prevalence of Child Sexual Abuse in the Contemporary World

    OpenAIRE

    SORIN M. RĂDULESCU

    2010-01-01

    The article analyzes the evolution of incidence and prevalence rates of child sexual abuse recorded in the statistics of different states and regions of the world, including the United States of America, Canada, Australia, Central America and South America, Africa, Asia, the Middle East and Europe. The paper also discusses the conclusions of the main international reports and assessments on the extent of the child sexual abuse phenomenon and it emphasizes certain distinct characteristics of ...

  3. Incidence and prevalence of uveitis in South Korea: a nationwide cohort study.

    Science.gov (United States)

    Rim, Tyler Hyungtaek; Kim, Sung Soo; Ham, Don-Il; Yu, Seung-Young; Chung, Eun Jee; Lee, Sung Chul

    2018-01-01

    To evaluate the incidence and prevalence of uveitis and associated risk factors in South Korea. For this retrospective national cohort study, approximately 1 000 000 Korean residents were randomly selected from the Korean National Health Insurance Service database. Uveitis was defined according to the Korean Classification of Diseases. The uveitis incidence and prevalence were calculated. Sociodemographic factors and comorbidities associated with uveitis were evaluated via Cox proportional regression models. A total of 1 094 440 subjects were evaluated over 7 051 346 person-years (mean follow-up: 6.44 years). Overall, 7447 newly developed uveitis cases were identified during the period of 2007-2013; the average incidence of uveitis was 10.6 per 10 000 person-years (95% CI 10.3 to 10.8). The average incidences of anterior and non-anterior uveitis were 9.0 and 1.5 per 10 000 person-years, respectively. The prevalence rates of uveitis, anterior uveitis and non-anterior uveitis were 17.3, 15.0 and 2.3 per 10 000 persons, respectively, during the period of 2007-2013. Increasing age, male sex, residing in a relatively rural area and high income were associated with uveitis, along with Behçet's disease, juvenile idiopathic arthritis, ankylosing spondylitis, systemic lupus erythematous, ulcerative colitis and tuberculosis. The overall incidence of uveitis in Korea was similar to those reported in Taiwan and the USA. Despite a potentially inaccurate disease definition, claims data may be useful for monitoring the substantial uveitis burden in South Korea. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. The changing prevalence and incidence of dementia over time - current evidence.

    Science.gov (United States)

    Wu, Yu-Tzu; Beiser, Alexa S; Breteler, Monique M B; Fratiglioni, Laura; Helmer, Catherine; Hendrie, Hugh C; Honda, Hiroyuki; Ikram, M Arfan; Langa, Kenneth M; Lobo, Antonio; Matthews, Fiona E; Ohara, Tomoyuki; Pérès, Karine; Qiu, Chengxuan; Seshadri, Sudha; Sjölund, Britt-Marie; Skoog, Ingmar; Brayne, Carol

    2017-06-01

    Dementia is an increasing focus for policymakers, civil organizations and multidisciplinary researchers. The most recent descriptive epidemiological research into dementia is enabling investigation into how the prevalence and incidence are changing over time. To establish clear trends, such comparisons need to be founded on population-based studies that use similar diagnostic and research methods consistently over time. This narrative Review synthesizes the findings from 14 studies that investigated trends in dementia prevalence (nine studies) and incidence (five studies) from Sweden, Spain, the UK, the Netherlands, France, the USA, Japan and Nigeria. Besides the Japanese study, these studies indicate stable or declining prevalence and incidence of dementia, and some provide evidence of sex-specific changes. No single risk or protective factor has been identified that fully explains the observed trends, but major societal changes and improvements in living conditions, education and healthcare might have favourably influenced physical, mental and cognitive health throughout an individual's life course, and could be responsible for a reduced risk of dementia in later life. Analytical epidemiological approaches combined with translational neuroscientific research could provide a unique opportunity to explore the neuropathology that underlies changing occurrence of dementia in the general population.

  5. The Prevalence and Incidence of Latent Tuberculosis Infection and Its Associated Factors among Village Doctors in China.

    Directory of Open Access Journals (Sweden)

    Guangxue He

    Full Text Available China is a high tuberculosis (TB burden country. More than half of acute TB cases first seek medical care in village doctors' clinics or community health centers. Despite being responsible for patient referral and management, village doctors are not systematically evaluated for TB infection or disease. We assessed prevalence and incidence of latent TB infection (LTBI among village doctors in China.A longitudinal study was conducted in Inner Mongolia Autonomous Region. We administered a questionnaire on demographics and risk factors for TB exposure and disease; Tuberculin skin testing (TST and QuantiFERON-TB Gold in-tube assay (QFT-GIT was conducted at baseline and repeated 12 months later. We used a logistic regression model to calculate adjusted odds ratios (ORs for risk factors for TST and QFT-GIT prevalence and incidence. At the time of follow up, 19.5% of the 880 participating village doctors had a positive TST and 46.0% had a positive QFT-GIT result. Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03-2.04 and smoking (OR = 1.69, 95%CI 1.17-2.44. Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63-2.89, below college education (OR=1.42, 95%CI 1.01-1.97, and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12-2.39. The annual incidence of LTBI was 11.4% by TST and 19.1% by QFT-GIT. QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95%CI 1.39-4.97 and having BCG scar (OR = 0.53, 95%CI 0.28-1.00.Prevalence and incidence of LTBI among Chinese village doctors is high. TB infection control measures should be strengthened among village doctors and at village healthcare settings.

  6. Prevalence and incidence of overweight and obesity among Vietnamese preschool children: a longitudinal cohort study.

    Science.gov (United States)

    Do, Loan Minh; Tran, Toan Khanh; Eriksson, Bo; Petzold, Max; Ascher, Henry

    2017-06-19

    A plateau in childhood overweight and obesity has been reported in some developed countries while in almost all developing countries this problem is on the rise. The aim of this paper is to describe the changes in prevalence of overweight and obesity within a cohort of preschool children followed for 3 years, and to estimate and compare the incidences in urban and rural children of Hanoi, Vietnam. A longitudinal study of a cohort of 2677 children aged 3 to 6 years old at the beginning of the study was conducted in urban DodaLab and rural FilaBavi, Hanoi, Vietnam. Overall, 2602 children, 1311 urban and 1291 rural, were followed for 3 years with identical measurements of weight and height in 2013, 2014 and 2016. Standard methods were used to estimate prevalence and incidence as well as confidence intervals. During the three-year follow-up, the overall estimated prevalence of overweight increased from 9.1% to 16.7%. For the urban children, the increase was considerably higher. The overall prevalence of obesity decreased from 6.4% to 4.5% with less decrease in the urban children. In the group of children who were overweight and obese at the start of the study, 41.4% and 30.7%, respectively, remained in the same state three years later. The incidence of overweight and obesity during the three years were 12.4% and 2.7%, respectively. Boys were more likely to develop obesity than girls. Already in preschool age, the prevalence of overweight is high and it continues to increase with age, especially in the urban area. Prevention and intervention programs need to start at early preschool age and actions in urban areas deserve priority.

  7. Incidence, morbidity, mortality, and prevalence of diabetes in Denmark, 2000-2011

    DEFF Research Database (Denmark)

    Green, Anders; Sortsø, Camilla; Jensen, Peter Bjødstrup

    2015-01-01

    PURPOSE: As part of the Danish Diabetes Impact Study 2013, we present trends in the incidence, morbidity, mortality, and prevalence of diabetes in Denmark for the period 2000 through 2011. PATIENTS AND METHODS: The Danish National Diabetes Register was established in 2006 and is assumed to cover...... of diabetes increased approximately 5% annually. During the same period, decreasing trends were observed for both the rates of progression in complications and of the complication-specific mortality. During the same period, the prevalence of diabetes doubled. CONCLUSION: The increasing prevalence of diabetes...... all patients with diabetes, alive as of the end of 1996, and all subsequent new cases. The present study is based on the content of the register as of July 3, 2013 (n=497,232 patients). Using the personal identification code assigned to all Danish inhabitants, all available supplementary information...

  8. Incidence, Prevalence, Diagnostic Delay, and Clinical Presentation of Female 46,XY Disorders of Sex Development

    DEFF Research Database (Denmark)

    Berglund, Agnethe; Johannsen, Trine H; Stochholm, Kirstine

    2016-01-01

    , prevalence, age at diagnosis, and clinical presentation at diagnosis in 46,XY females. DESIGN AND SETTING: A nationwide study covering all known females with a 46,XY karyotype in Denmark since 1960. The diagnosis of 46,XY disorder of sex development (DSD) was determined by medical record evaluation, data......CONTEXT: The prevalence of phenotypic females with a 46,XY karyotype is low, thus current knowledge about age and clinical presentation at diagnosis is sparse even for the most frequent conditions, androgen insensitivity syndrome (AIS), and gonadal dysgenesis. OBJECTIVE: To estimate incidence.......0-13.5; range, 0-34 y) in AIS and 17.0 years (95% confidence interval, 15.5-19.0; range, 0-28 y) in gonadal dysgenesis (P = .001). Clinical presentation was dependent on cause of DSD. CONCLUSIONS: The first estimate on prevalence of 46,XY females is 6.4 per 100 000 live born females. The presentation of AIS...

  9. Incidence and prevalence of mental disorders among immigrants and native Finns: a register-based study.

    Science.gov (United States)

    Markkula, Niina; Lehti, Venla; Gissler, Mika; Suvisaari, Jaana

    2017-12-01

    Migrants appear to have a higher risk of mental disorders, but findings vary across country settings and migrant groups. We aimed to assess incidence and prevalence of mental disorders among immigrants and Finnish-born controls in a register-based cohort study. A register-based cohort study of 184.806 immigrants and 185.184 Finnish-born controls (1.412.117 person-years) was conducted. Information on mental disorders according to ICD-10 was retrieved from the Hospital Discharge Register, which covers all public health care use. The incidence of any mental disorder was lower among male (adjusted HR 0.82, 95% CI 0.77-0.87) and female (aHR 0.76, 95% CI 0.72-0.81) immigrants, being lowest among Asian and highest among North African and Middle Eastern immigrants. The incidence of bipolar, depressive and alcohol use disorders was lower among immigrants. Incidence of psychotic disorders was lower among female and not higher among male immigrants, compared with native Finns. Incidence of PTSD was higher among male immigrants (aHR 4.88, 95% CI 3.38-7.05). The risk of mental disorders varies significantly across migrant groups and disorders and is generally lower among immigrants than native Finns.

  10. Point prevalence and incidence of Mycobacterium tuberculosis complex in captive elephants in the United States of America.

    Science.gov (United States)

    Feldman, Melissa; Isaza, Ramiro; Prins, Cindy; Hernandez, Jorge

    2013-01-01

    Captive elephants infected with tuberculosis are implicated as an occupational source of zoonotic tuberculosis. However, accurate estimates of prevalence and incidence of elephant tuberculosis from well-defined captive populations are lacking in the literature. Studies published in recent years contain a wide range of prevalence estimates calculated from summary data. Incidence estimates of elephant tuberculosis in captive elephants are not available. This study estimated the annual point prevalence, annual incidence, cumulative incidence, and incidence density of tuberculosis in captive elephants within the USA during the past 52 years. We combined existing elephant census records from captive elephants in the USA with tuberculosis culture results obtained from trunk washes or at necropsy. This data set included 15 years where each elephant was screened annually. Between 1960 and 1996, the annual point prevalence of tuberculosis complex mycobacteria for both species was 0. From 1997 through 2011, the median point prevalence within the Asian elephant population was 5.1%, with a range from 0.3% to 6.7%. The incidence density was 9.7 cases/1000 elephant years (95% CI: 7.0-13.4). In contrast, the annual point prevalence during the same time period within the African elephant population remained 0 and the incidence density was 1.5 cases/1000 elephant years (95% CI: 0.7-4.0). The apparent increase in new cases noted after 1996 resulted from a combination of both index cases and the initiation of mandatory annual tuberculosis screening in 1997 for all the elephants. This study found lower annual point prevalence estimates than previously reported in the literature. These discrepancies in prevalence estimates are primarily due to differences in terminology and calculation methods. Using the same intensive testing regime, the incidence of tuberculosis differed significantly between Asian and African elephants. Accurate and species specific knowledge of prevalence and

  11. Prevalence and incidence of Alzheimer's disease in Europe: A meta-analysis.

    Science.gov (United States)

    Niu, H; Álvarez-Álvarez, I; Guillén-Grima, F; Aguinaga-Ontoso, I

    2017-10-01

    A disease of unknown aetiology, Alzheimer's disease (AD) is the most common type of dementia. As the elderly population grows worldwide, the number of patients with AD also increases rapidly. The aim of this meta-analysis is to evaluate the prevalence and incidence of AD in Europe. We conducted a literature search on Medline, Scopus, and CINAHL Complete using the keywords «Alzheimer», «Alzheimer's disease», and «AD» combined with «prevalence», «incidence», and «epidemiology». A Bayesian random effects model with 95% credible intervals was used. The I 2 statistic was applied to assess heterogeneity. The prevalence of Alzheimer's disease in Europe was estimated at 5.05% (95% CI, 4.73-5.39). The prevalence in men was 3.31% (95% CI, 2.85-3.80) and in women, 7.13% (95% CI, 6.56-7.72), and increased with age. The incidence of Alzheimer's disease in Europe was 11.08 per 1000 person-years (95% CI, 10.30-11.89). Broken down by sex, it was 7.02 per 1000 person-years (95% CI, 6.06-8.05) in men and 13.25 per 1000 person-years (95% CI, 12.05-14.51) in women; again these rates increased with age. The results of our meta-analysis allow a better grasp of the impact of this disease in Europe. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Obesity increases the prevalence and the incidence of asthma and worsens asthma severity.

    Science.gov (United States)

    Barros, R; Moreira, P; Padrão, P; Teixeira, V H; Carvalho, P; Delgado, L; Moreira, A

    2017-08-01

    We aimed to explore the association between obesity and asthma prevalence, incidence and severity. The study included 32,644 adults, 52.6% female, from a representative sample of the 4th Portuguese National Health Survey. The following asthma definitions were used: ever asthma (ever medical doctor asthma diagnosis), current asthma (asthma within the last 12 months), current persistent asthma (required asthma medication within the last 12 months), current severe asthma (attending an emergency department because of asthma within the last 12 months), and incident asthma (asthma diagnosis within the last 12 months). Body mass index was calculated based on self-reported weight and height and categorised according to WHO classification. Logistic regression models adjusted for confounders were performed. Prevalence of ever asthma was 5.3%, current asthma 3.5%, current persistent asthma 3.0%, current severe asthma 1.4%, and incident asthma 0.2%. Prevalence of obesity was 16%, overweight 37.6%, normal weight 44.6% and underweight 0.2%. Being overweight, obesity class I and II, and obesity class III were associated with an OR (95% CI) with ever asthma 1.22 (1.21-1.24), 1.39 (1.36-1.41), 3.24 (3.08-3.40) respectively; current asthma 1.16 (1.14-1.18), 1.86 (1.82-1.90), 4.73 (4.49-4.98) respectively; current persistent asthma 1.08 (1.06-1.10), 2.06 (2.01-2.10), 5.24 (4.96-5.53), and current severe asthma 1.36 (1.32-1.40), 1.50 (1.45-1.55) and 3.70 (3.46-3.95), respectively. Considering the incidence of asthma, obesity more than quadrupled the odds (OR = 4.46, 95% CI 4.30, 4.62). Obesity is associated in a dose dependent way with an increase of prevalent and incident asthma, and it seems to increase the odds of a more persistent and severe asthma phenotype independently of socio-demographic determinants, physical activity, and dietary patterns. Our results provide rational for future lifestyle intervention studies for weight reduction in the obesity-asthma phenotype. Copyright

  13. Lifetime prevalence and incidence of parasomnias in a population of young adult Nigerians.

    Science.gov (United States)

    Oluwole, O S A

    2010-07-01

    Lifetime prevalence, incidence, and risk factors for parasomnias were determined. Past experiences of non-REM, REM, and sleep-transition parasomnias were recorded. Diaries of night sleep duration, parasomnias, perception of aliens, levels of physical activity, headaches and intake of all substances, drugs, and tobacco were kept for 14 consecutive days. A total of 276 subjects were studied. Lifetime prevalences (95% CI) were 725 (668-776) for occurrence of any parasomnia, 43 (25-74) for sleepwalking, 112 (80-155) for sleep terror, 475 (416-533) for nightmares, 225 (179-277) for sleep paralysis, 43 (25-74) for sleep starts, 322 (270-380) for sleep talking, and 344 (291-402) for enuresis. Incidences (95% CI) were 210 (166-262) for occurrence of any parasomnia, 14 (6-37) for sleepwalking, 11 (4-31) for sleep terror, 170 (131-219) for confusional arousal, 18 (8-42) for nightmares, 14 (6-37) for sleep paralysis, 33 (17-61) for sleep starts, and 4 (1-20) for sleep enuresis. Multivariate analysis showed associations of increase occurrence of parasomnias and duration of sleep >7 h (p night terrors are the commonest parasomnias experienced in the past, while confusional arousal, sleep starts, and nightmares are the commonest parasomnias currently experienced. Incidence estimates show that all parasomnias persist into adulthood at reduced rates, but reduction of occurrence was greatest for enuresis. Long duration of night sleep and intake of alcohol predisposed subjects to higher occurrence of parasomnias.

  14. Incidence and prevalence of unrecognized myocardial infarction in people with diabetes: a substudy of the Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes (RECORD) study

    DEFF Research Database (Denmark)

    Arnskov, Michael Macdonald; Petrie, Mark C; Home, Philip D

    2011-01-01

    To examine the prevalence and incidence of unrecognized myocardial infarction in a contemporary population with type 2 diabetes.......To examine the prevalence and incidence of unrecognized myocardial infarction in a contemporary population with type 2 diabetes....

  15. Incidence and prevalence of copper deficiency following roux-en-y gastric bypass surgery.

    Science.gov (United States)

    Gletsu-Miller, N; Broderius, M; Frediani, J K; Zhao, V M; Griffith, D P; Davis, S S; Sweeney, J F; Lin, E; Prohaska, J R; Ziegler, T R

    2012-03-01

    The frequency of copper deficiency and clinical manifestations following roux-en-y gastric bypass (RYGB) surgery is not yet clear. Objectives were to determine the prevalence and incidence of copper deficiency in patients who have undergone RYGB. We sought to determine the number of RYGB patients undergoing medical and nutritional follow-up visits at the Emory Bariatric Center who experienced copper deficiency and associated hematological and neurological complaints (n=136). Separately, in patients followed longitudinally before and during 6 and 24 months following RYGB surgery, we obtained measures of copper status (n=16). Systemic blood cell counts and measures of copper, zinc and ceruloplasmin were determined using standardized assays in reference laboratories including atomic absorption spectrometry and immunoassays. Thirteen patients were identified to have copper deficiency suggesting a prevalence of copper deficiency of 9.6%, and the majority of these had concomitant complications including anemia, leukopenia and various neuro-muscular abnormalities. In the longitudinal study, plasma copper concentrations and ceruloplasmin activity decreased over 6 and 24 months following surgery, respectively (Pdeficiency in these subjects was determined to be 18.8%. The prevalence and incidence of copper deficiency following RYGB surgery was determined to be 9.6% and 18.8%, respectively, with many patients experiencing mild-to-moderate symptoms. Given that copper deficiency can lead to serious and irreversible complications if untreated, frequent monitoring of the copper status of RYGB patients is warranted.

  16. Medical management of three workers following a radiation exposure incident

    International Nuclear Information System (INIS)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

  17. Medical management of three workers following a radiation exposure incident

    Energy Technology Data Exchange (ETDEWEB)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

  18. Obstetric anal sphincter injury: incidence, risk factors, and management.

    Science.gov (United States)

    Dudding, Thomas C; Vaizey, Carolynne J; Kamm, Michael A

    2008-02-01

    Obstetric sphincter damage is the most common cause of fecal incontinence in women. This review aimed to survey the literature, and reach a consensus, on its incidence, risk factors, and management. This systematic review identified relevant studies from the following sources: Medline, Cochrane database, cross referencing from identified articles, conference abstracts and proceedings, and guidelines published by the National Institute of Clinical Excellence (United Kingdom), Royal College of Obstetricians and Gynaecologists (United Kingdom), and American College of Obstetricians and Gynecologists. A total of 451 articles and abstracts were reviewed. There was a wide variation in the reported incidence of anal sphincter muscle injury from childbirth, with the true incidence likely to be approximately 11% of postpartum women. Risk factors for injury included instrumental delivery, prolonged second stage of labor, birth weight greater than 4 kg, fetal occipitoposterior presentation, and episiotomy. First vaginal delivery, induction of labor, epidural anesthesia, early pushing, and active restraint of the fetal head during delivery may be associated with an increased risk of sphincter trauma. The majority of sphincter tears can be identified clinically by a suitably trained clinician. In those with recognized tears at the time of delivery repair should be performed using long-term absorbable sutures. Patients presenting later with fecal incontinence may be managed successfully using antidiarrheal drugs and biofeedback. In those who fail conservative treatment, and who have a substantial sphincter disruption, elective repair may be attempted. The results of primary and elective repair may deteriorate with time. Sacral nerve stimulation may be an appropriate alternative treatment modality. Obstetric anal sphincter damage, and related fecal incontinence, are common. Risk factors for such trauma are well recognized, and should allow for reduction of injury by proactive

  19. Submicroscopic Plasmodium prevalence in relation to malaria incidence in 20 villages in western Cambodia.

    Science.gov (United States)

    Tripura, Rupam; Peto, Thomas J; Veugen, Christianne C; Nguon, Chea; Davoeung, Chan; James, Nicola; Dhorda, Mehul; Maude, Richard J; Duanguppama, Jureeporn; Patumrat, Krittaya; Imwong, Mallika; von Seidlein, Lorenz; Grobusch, Martin P; White, Nicholas J; Dondorp, Arjen M

    2017-01-31

    Cambodia has seen a marked reduction in the incidence of Plasmodium falciparum over the past decade without a corresponding decline in Plasmodium vivax incidence. It is unknown to what extent local transmission is sustained by a chain of clinical and sub-clinical infections or by continued re-introduction via migration. Using an ultrasensitive molecular technique, 20 villages in western Cambodia were surveyed to detect the low season prevalence of P. falciparum and P. vivax and local treatment records were reviewed. During March to May 2015 cross-sectional surveys were conducted in 20 villages in Battambang, western Cambodia. Demographic and epidemiological data and venous blood samples were collected from 50 randomly selected adult volunteers in each village. Blood was tested for Plasmodium infections by rapid diagnostic test (RDT), microscopy and high volume (0.5 ml packed red blood cell) quantitative polymerase chain reaction (uPCR). Positive samples were analysed by nested PCR to determine the Plasmodium species. Malaria case records were collected from the Provincial Health Department and village malaria workers to determine incidence and migration status. Among the 1000 participants, 91 (9.1%) were positive for any Plasmodium infection by uPCR, seven (0.7%) by microscopy, and two (0.2%) by RDT. uPCR P. vivax prevalence was 6.6%, P. falciparum 0.7%, and undetermined Plasmodium species 1.8%. Being male (adjusted OR 2.0; 95% CI 1.2-3.4); being a young adult <30 years (aOR 2.1; 95% CI 1.3-3.4); recent forest travel (aOR 2.8; 95% CI 1.6-4.8); and, a history of malaria (aOR 5.2; 95% CI 2.5-10.7) were independent risk factors for parasitaemia. Of the clinical malaria cases diagnosed by village malaria workers, 43.9% (297/634) and 38.4% (201/523) were among migrants in 2013 and in 2014, respectively. Plasmodium vivax prevalence determined by uPCR significantly correlated with vivax malaria incidences in both 2014 and 2015 (p = 0.001 and 0.002, respectively

  20. Incidence and prevalence of hypercholesterolemia in Portugal: a systemic review. Part II.

    Science.gov (United States)

    Costa, João; Borges, Margarida; Oliveira, Eduardo; Gouveia, Miguel; Carneiro, António Vaz

    2003-05-01

    Over 50% of the mortality and disability caused by ischemic heart disease and stroke could be avoided by controlling individual risk factors (hypertension, hypercholesterolemia, smoking and obesity). The ignorance of the extent and impact of hypercholesterolemia (HC) in Portugal prompted us to undertake this systematic review of the prevalence and incidence of hyperlipidemia in Portugal, based exclusively on work published nationally. We included every study published in the country that could provide data on the prevalence or incidence of hypercholesterolemia. The search strategy included an electronic search of national and international biomedical databases (Medline, Index Revistas Médicas Portuguesas, the Portuguese Directorate-General for Health and the Portuguese National School of Public Health), screening of reference lists from the individual studies, and personal contacts with institutions, groups and authors (such as the Portuguese Foundation of Cardiology). The data--recorded in electronic format--was collected independently by two of the authors (JC and MB), with consensus achieved with a third (AVC) when there were differences in the study coding. We could only identify one paper on the incidence of HC in Portugal, which gave an incidence of 559 new cases per 100,000 inhabitants, increasing with age up to 54 years for men and 64 years for women. There was a higher incidence in men than in women up to the age of 54, but at more advanced ages this relationship was reversed. Prevalence studies on HC included 53,445 individuals overall, with sample size lower than 1000 in most of the individual studies. The most frequently used criterion for HC was > 200 mg/dL, with the mean level being higher in most studies. We calculated the mean prevalence for several cut-off points (190 mg/dL: 63.8%; 200 mg/dL: 56.7%; 240 mg/dL: 31.7%; 250 mg/dL: 21%). Due to the heterogeneity of the data, these results are to be interpreted with caution, even though they are

  1. Incidence and prevalence of hypercholesterolemia in Portugal: a systematic review. Part I.

    Science.gov (United States)

    Costa, João; Borges, Margarida; Oliveira, Eduardo; Gouveia, Miguel; Carneiro, António Vaz

    2003-04-01

    Over 50% of the mortality and disability caused by ischemic heart disease and stroke could be avoided by controlling individual risk factors (hypertension, hypercholesterolemia, smoking and obesity). The ignorance of the extent and impact of hypercholesterolemia (HC) in Portugal prompted us to undertake this systematic review of the prevalence and incidence of hyperlipidemia in Portugal, based exclusively on work published nationally. We included every study published in the country that could provide data on the prevalence or incidence of hypercholesterolemia. The search strategy included an electronic search of national and international biomedical databases (Medline, Index Revistas Médicas Portuguesas, the Portuguese Directorate-General for Health and the Portuguese National School of Public Health), screening of reference lists from the individual studies, and personal contacts with institutions, groups and authors (such as the Portuguese Foundation of Cardiology). The data--recorded in electronic format--was collected independently by two of the authors (JC and MB), with consensus achieved with a third (AVC) when there were differences in the study coding. We could only identify one paper on the incidence of HC in Portugal, which gave an incidence of 559 new cases per 100,000 inhabitants, increasing with age up to 54 years for men and 64 years for women. There was a higher incidence in men than in women up to the age of 54, but at more advanced ages this relationship was reversed. Prevalence studies on HC included 53,445 individuals overall, with sample size lower than 1000 in most of the individual studies. The most frequently used criterion for HC was > 200 mg/dL, with the mean level being higher in most studies. We calculated the mean prevalence for several cut-off points (190 mg/dL: 63.8%; 200 mg/dL: 56.7%; 240 mg/dL: 31.7%; 250 mg/dL: 21%). Due to the heterogeneity of the data, these results are to be interpreted with caution, even though they are

  2. Incidence and prevalence of hypercholesterolemia in Portugal: a systematic review. Part III.

    Science.gov (United States)

    Costa, João; Borges, Margarida; Oliveira, Eduardo; Gouveia, Miguel; Carneiro, António Vaz

    2003-06-01

    Over 50% of the mortality and disability caused by ischemic heart disease and stroke could be avoided by controlling individual risk factors (hypertension, hypercholesterolemia, smoking and obesity). The ignorance of the extent and impact of hypercholesterolemia (HC) in Portugal prompted us to undertake this systematic review of the prevalence and incidence of hyperlipidemia in Portugal, based exclusively on work published nationally. We included every study published in the country that could provide data on the prevalence or incidence of hypercholesterolemia. The search strategy included an electronic search of national and international biomedical databases (Medline, Index Revistas Médicas Portuguesas, the Portuguese Directorate-General for Health and the Portuguese National School of Public Health), screening of reference lists from the individual studies, and personal contacts with institutions, groups and authors (such as the Portuguese Foundation of Cardiology). The data--recorded in electronic format--was collected independently by two of the authors (JC and MB), with consensus achieved with a third (AVC) when there were differences in the study coding. We could only identify one paper on the incidence of HC in Portugal, which gave an incidence of 559 new cases per 100,000 inhabitants, increasing with age up to 54 years for men and 64 years for women. There was a higher incidence in men than in women up to the age of 54, but at more advanced ages this relationship was reversed. Prevalence studies on HC included 53,445 individuals overall, with sample size lower than 1000 in most of the individual studies. The most frequently used criterion for HC was > 200 mg/dL, with the mean level being higher in most studies. We calculated the mean prevalence for several cut-off points (> or = 190 mg/dL: 63.8%; > or = 200 mg/dL: 56.7%; > or = 240 mg/dL; 31.7%; > or 250 mg/d; 21%). Due to the heterogeneity of the data, these results are to be interpreted with caution

  3. Incidence and prevalence of Crohn's disease in the county of Copenhagen, 1962-87

    DEFF Research Database (Denmark)

    Munkholm, P; Langholz, E; Nielsen, O H

    1992-01-01

    The incidence of Crohn's disease increased sixfold from 1962 to 1987 in the county of Copenhagen. The mean annual incidence for 1979-87 was 4.1 per 10(5) inhabitants. The increase was found equally in both sexes, with an approximately 40% higher incidence in women. The maximal incidence was found...... in the 15- to 24-year age group, being 12.8 per 10(5) per year for women and 6.0 per 10(5) per year for men, as mean of the period 1979-87. The prevalence at the end of the study was 54 per 10(5) inhabitants, 46 per 10(5) in men and 63 per 10(5) in women. The clinical appearance of the disease at the time...... of diagnosis was remarkably similar during the study period with regard to both the localization of disease and the clinical symptoms and signs. A slightly higher percentage of the patients, however, were in high disease activity at diagnosis in the later years of the study....

  4. Incidence and prevalence of cryptogenic fibrosing alveolitis in a Norwegian community

    DEFF Research Database (Denmark)

    von Plessen, C; Grinde, O; Gulsvik, A

    2003-01-01

    This study assesses the incidence and prevalence of cryptogenic fibrosing alveolitis (CFA) in a well-defined and stable Norwegian population of 250,000 inhabitants during a period of 15 years. We conducted a file survey of all patients (n = 376) aged 16 years or older with a clinician's diagnosis...... of pulmonary fibrosis (ICD 8: 517 and ICD 9: 515 and 516). Cases with a history of exposure to fibrogenic agents or with collagen vascular disease were excluded and the remaining 158 cases were defined as CFA. The average annual incidence of hospitalised CFA was 4.3 per 100,000. No change was observed...... with age were also found when the diagnosis of CFA was exclusively based on cases with hospital file records of breathlessness, bilateral crackles and bilateral shadows on chest radiograph....

  5. Canadian Digestive Health Foundation Public Impact Series 5: Pancreatitis in Canada. Incidence, prevalence, and direct and indirect economic impact.

    Science.gov (United States)

    Teshima, Christopher W; Bridges, Ronald J; Fedorak, Richard N

    2012-08-01

    The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning pancreatitis.

  6. Canadian Digestive Health Foundation Public Impact Series 5: Pancreatitis in Canada. Incidence, Prevalence, and Direct and Indirect Economic Impact

    Directory of Open Access Journals (Sweden)

    Christopher W Teshima

    2012-01-01

    Full Text Available The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning pancreatitis.

  7. Canadian Digestive Health Foundation Public Impact Series 4: celiac disease in Canada. Incidence, prevalence, and direct and indirect economic impact.

    Science.gov (United States)

    Fedorak, Richard N; Switzer, Connie M; Bridges, Ron J

    2012-06-01

    The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning celiac disease.

  8. Prostate cancer trends in Latvia during 1990-2012: incidence, prevalence, mortality, and survival rates.

    Science.gov (United States)

    Plonis, Juris; Bokums, Kristaps; Cauce, Vinita; Miklasevics, Edvins; Vaganovs, Peteris; Irmejs, Arvids; Gardovskis, Janis; Vjaters, Egils

    2014-01-01

    Prostate cancer (PCa) is one of the most common form of cancer in males worldwide. One of the highest PCa-related mortality rates in the world is observed in Latvia. Our study included male patients diagnosed with PCa between 1990 and 2012. We analyzed incidence, prevalence and mortality trends using joinpoint analysis. Kaplan-Meier analysis was performed for 5-, 10-, 15- and 20-year overall survival and cancer-specific survival rates. A total of 14,083PCa patients with a mean age of initial PCa diagnosis being 70.1 (SD 8.6) was registered. The standardized incidence rates (per 100,000) increased from 18.9 in 1990 to 74.7 in 2012, while the standardized prevalence rates (per 100,000) increased from 69.9 in 1990 to 437.6 in 2012. Standardized PCa mortality rates (per 100,000) also rose from 13.2 in 1990 to 27.2 in 2006 followed by statistically insignificant decrease continuing up to 2012. The mean 5-year cancer-specific survival rates increased from 43.6% in 1990 to 70.7% in 2007, and the mean 10-year cancer-specific survival rates from 32.9% in 1990 to 40.5% in 2001. This study revealed that the incidence, prevalence and mortality rates increased between 1990 and 2012, and although the 5- and 10-year overall and cancer-specific survival rates improved over the reviewed period they still needed to get better. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  9. Persistent perineal sinus. Incidence, pathogenesis, risk factors, and management

    International Nuclear Information System (INIS)

    Lohsiriwat, V.

    2009-01-01

    This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for Low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed. (author)

  10. Incidence and prevalence of diabetes in children aged Fiji, 2001-2012.

    Science.gov (United States)

    Ogle, Graham D; Morrison, Melinda K; Silink, Martin; Taito, Rigamoto S

    2016-05-01

    Determine the incidence and prevalence of diabetes in children Fiji. Data on all new cases from 2001 to 2012 was collected from the three paediatric diabetes services through the International Diabetes Federation Life for a Child Program. There was no formal secondary ascertainment source, however the medical community is small and all known cases are believed to be included. Forty-two children aged Fiji is very low. Furthermore, its occurrence is markedly more frequent in Indo-Fijians than in native Fijians. Type 2 and neonatal diabetes also occur. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes.

    Science.gov (United States)

    Murphy, C; Livingstone, I; Foot, B; Murgatroyd, H; MacEwen, C J

    2014-11-01

    Orbital cellulitis is a potentially blinding and life-threatening condition. There are little published data on the incidence of orbital cellulitis and little is known about the differences between children and adults affected. The purpose of this study was to identify the incidence, aetiology, management and outcome of orbital cellulitis in children and adults in Scotland. This study was a 1-year prospective observational study using the Scottish Ophthalmic Surveillance Unit reporting system among Scottish ophthalmologists. The response rate from ophthalmologists was 66.4%. There were 15 children and 5 adults reported giving an incidence of 1.6 per 100 000 and 0.1 per 100 000 in children and adults, respectively. 47% of children had a preceding upper respiratory tract infection with 87% having radiological evidence of sinus disease. Within the adult group, there was preceding immunosuppression and trauma. Streptococcus (66%) and Haemophilus (46%) species were the most commonly isolated pathogens in children. Respiratory pathogens were less predictable in adults. All patients were treated with intravenous antibiotics. All children with orbital and subperiosteal abscesses had surgery; one adult with orbital abscess did not have surgery. There were two cases of series morbidity: one intracranial spread of infection and one evisceration. The incidence of orbital cellulitis is higher in children than in adults. In children, it commonly follows upper respiratory infection and sinus disease; however, in adults, preceding illness and trauma are more common. Respiratory pathogens are common in affected children. Intravenous antibiotics and surgical treatment of abscesses remain the preferred management. 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.

  12. Diagnosis of Helicobacter Pylori Infection is Associated with Lower Prevalence and Subsequent Incidence of Crohn's Disease

    DEFF Research Database (Denmark)

    Bartels, Lars E; Jepsen, Peter; Christensen, Lisbet A

    2016-01-01

    BACKGROUND AND AIMS: Helicobacter pylori infection may protect against some chronic inflammatory diseases. This study examined H. pylori infection and its association with the prevalence of the gastrointestinal diseases Crohn's disease [CD], ulcerative colitis [UC], and coeliac disease [Ce......D]. Incident cases in a follow-up period after H. pylori testing were recorded to investigate if protective effects of H. pylori persisted after probable eradication. METHODS: This was a historical cohort study performed in the Central Denmark Region. Patients were enrolled consecutively from primary health...... care centres after a urea breath test [UBT] for H. pylori and were then followed for a median of 6 years. The patient's diseases, country of birth, and gender were acquired from nationwide administrative registries. We used logistic regression to compare the prevalences of CD, UC, and CeD and Cox...

  13. Variations in Incidence and Prevalence of Parkinson’s Disease in Taiwan: A Population-Based Nationwide Study

    OpenAIRE

    Liu, Chih-Ching; Li, Chung-Yi; Lee, Pei-Chen; Sun, Yu

    2016-01-01

    Demographic, socioeconomic, and urbanization level variations in Parkinson's disease (PD) are rarely investigated, especially in Asia. This study describes an eight-year trend in PD incidence and prevalence in Taiwan as well as assessing the effects of sociodemographics and urbanization on the incidence and prevalence of PD. The data analyzed were acquired from the Taiwan National Health Insurance Research Database (NHIRD) entries between 2002 and 2009. The calendar year, sex, and age-specifi...

  14. Monitoring Clostridium difficile infection in an acute hospital: prevalence or incidence studies?

    LENUS (Irish Health Repository)

    Lavan, A H

    2012-02-15

    BACKGROUND: Surveillance of Clostridium difficile infection (CDI) is an essential component of a CDI preventative programme. AIMS: The aim of this study was to evaluate two methods of CDI surveillance. METHODS: Prevalence of CDI, antibiotic use and associated co-morbidity was assessed weekly on two wards over 6 weeks. In addition, CDI incidence surveillance was performed on all new CDI cases over a 13-week period. Cases were assessed for CDI risk factors, disease severity, response to treatment and outcome at 6 months. RESULTS: Clostridium difficile infection prevalence was 3.5% (range 2.9-6.1%) on the medical ward and 1.1% (range 0-3.5%) on the surgical ward. Patients on the medical ward were older and more likely to be colonised with MRSA; however, recent antibiotic use was more prevalent among surgical patients. Sixty-one new CDI cases were audited. Patients were elderly (mean age 71 years) with significant co-morbidity (median age adjusted Charlson co-morbidity score 5). CDI ribotypes included 027 (29 cases) 078 (5) and 106 (4). Eight patients developed severe CDI, seven due to 027. Antibiotic use was common with 56% receiving three or more antibiotics in the preceding 8 weeks. Twenty-four patients had died at 6 months, five due to CDI. CONCLUSION: Clostridium difficile infection prevalence gives a broad overview of CDI and points to areas that require more detailed surveillance and requires little time. However, patient-based CDI incidence surveillance provides a more useful analysis of CDI risk factors, disease and outcome for planning preventative programmes and focusing antibiotic stewardship efforts.

  15. Epidemiology of glaucoma in sub-saharan Africa: prevalence, incidence and risk factors.

    Science.gov (United States)

    Kyari, Fatima; Abdull, Mohammed M; Bastawrous, Andrew; Gilbert, Clare E; Faal, Hannah

    2013-01-01

    The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa. Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition. Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma.

  16. Epidemiology of Glaucoma in Sub-Saharan Africa: Prevalence, Incidence and Risk Factors

    Science.gov (United States)

    Kyari, Fatima; Abdull, Mohammed M.; Bastawrous, Andrew; Gilbert, Clare E.; Faal, Hannah

    2013-01-01

    Purpose: The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. Methods: Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa. Results: Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition. Conclusion: Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma. PMID:23741130

  17. Prevalence, incidence and associated comorbidities of treated hypothyroidism: an update from a European population.

    Science.gov (United States)

    Giorda, Carlo B; Carnà, Paolo; Romeo, Francesco; Costa, Giuseppe; Tartaglino, Barbara; Gnavi, Roberto

    2017-05-01

    Estimates of the prevalence of hypothyroidism in unselected populations date from the late 1990s. We present an update on the prevalence and incidence of overt hypothyroidism in Piedmont, northwest Italy and examine the association between hypothyroidism and multiple chronic comorbidities. Data were obtained from drug prescription and hospital discharge databases. Individuals who had received at least two levothyroxine prescriptions in 2012 were defined as having hypothyroidism; those who had undergone thyroidectomy or I 131 irradiation in the previous 5 years were defined as having iatrogenic hypothyroidism and those who had either obtained exemption from treatment co-payment or had been discharged from hospital with a chronic comorbidity (diabetes and connective tissue diseases) were identified as having one of these conditions. The overall crude prevalence was 31.1/1000 (2.3/1000 for iatrogenic hypothyroidism) and the overall crude incidence was 7/1000. The average daily dose of thyroxine (122 µg) roughly corresponded to 1.7 µg/kg. There was a strong association between hypothyroidism and diabetes (type 1, type 2 or gestational) and with autoimmune diseases, with the odds ratio ranging from 1.43 (1.02-1.99) for psoriatic arthritis to 4.99 (3.06-8.15) for lupus erythematosus. As compared with previous estimates, the prevalence of hypothyroidism rose by about 35%, driven mainly by non-iatrogenic forms. The increase may be due to either population aging or improved diagnostic capability or both. The frequent co-occurrence of hypothyroidism with other multiple chronic conditions characterizes it more as a comorbidity rather than an isolated chronic disease. © 2017 European Society of Endocrinology.

  18. Management of response to the polonium-210 incident in London

    International Nuclear Information System (INIS)

    Croft, John; Bailey, Michael; Tattersall, Phil; Morrey, Mary; McColl, Neil; Prosser, Lesley; Maguire, Helen; Fraser, Graham; Gross, Roger

    2008-01-01

    On the 23 November 2006, Alexander Litvinenko died in London allegedly from poisoning by 210 Po, an alpha particle emitter. The spread of radioactive contamination, arising from the poisoning and the events leading up to it, involved many locations in London. The potential for intakes of 210 Po arising from the contamination posed a public health risk and generated significant public concern. The scale of the event required a multi-agency response, including top level UK Government emergency response management arrangements. The Health Protection Agency (HPA) had a leading role in co-ordinating and managing the public health response. This paper reviews the management of the incident response and the issues involved. The fatal poisoning of Mr Litvinenko with 210 Po, and the associated public health hazard from the spread of contamination to many locations across London, was an unprecedented event. Fortunately, no one else is known to have suffered any acute effects. Results from the programme of individual monitoring showed that whilst more than 100 people had measurable intakes of 210 Po, only 17 had assessed doses in excess of 6 mSv. The highest dose of about 100 mSv gives rise to an increased risk of fatal cancer of about 0.5%, compared with the natural incidence of about 25%. The incident required a co-ordinated and sustained multi-agency emergency response. The Health Protection Agency, as the lead on public health matters played a significant role in this. Whilst inevitably some lessons have been identified, the response is considered to have been very effective and to have benefited from the wide spectrum of experience and expertise developed through normal work, together with the effort put into emergency preparedness and the various emergency response. (author)

  19. [Second victim : Critical incident stress management in clinical medicine].

    Science.gov (United States)

    Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

    2013-09-01

    Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

  20. Program for accident and incident management support, AIMS

    International Nuclear Information System (INIS)

    Putra, M.A.

    1993-12-01

    A prototype of an advisory computer program is presented which could be used in monitoring and analyzing an ongoing incident in a nuclear power plant. The advisory computer program, called the Accident and Incident Management Support (AIMS), focuses on processing a set of data that is to be transmitted from a nuclear power plant to a national or regional emergency center during an incident. The AIMS program will assess the reactor conditions by processing the measured plant parameters. The applied model of the power plant contains a level of complexity that is comparable with the simplified plant model that the power plant operator uses. A standardized decay heat function and a steam water property library is used in the integral balance equations for mass and energy. A simulation of the station blackout accident of the Borssele plant is used to test the program. The program predicts successively: (1) the time of dryout of the steam generators, (2) the time of saturation of the primary system, and (3) the onset of core uncovery. The coolant system with the actual water levels will be displayed on the screen. (orig./HP)

  1. Criminal victimisation in people with severe mental illness: A multi-site prevalence and incidence survey in the Netherlands

    NARCIS (Netherlands)

    Kamperman, A.; Henrichs, J.; Bogaerts, S.; Lesaffre, E.M.; Wierdsma, A.I.; Ghauharali, R.R.R.; Swildens, W.; Nijssen, Y.; van der Gaag, M.; Theunissen, J.R.; Delespaul, P.A.; van Weeghel, J.; Busschbach, J.T. van; Kroon, H.; Teplin, L.A.; van de Mheen, D.; Mulder, C.L.

    2014-01-01

    Background: Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so), few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the

  2. Criminal victimisation in people with severe mental illness: A multi-site prevalence and incidence survey in the netherlands

    NARCIS (Netherlands)

    A.M. Kamperman (Astrid); J. Henrichs (Jens); S. Bogaerts (Stefan); E.M.E.H. Lesaffre (Emmanuel); A.I. Wierdsma (André); R.R.R. Ghauharali (Razia R.); W. Swildens (Wilma); Y. Nijssen (Yolanda); M. van der Gaag (Mark); J.R. Theunissen (Jan); P.A.E.G. Delespaul (Philippe); J. van Weeghel (Jaap); J.T. van Busschbach (Jooske); H. Kroon (Hans); L.A. Teplin (Linda); H. van de Mheen (Dike); C.L. Mulder (Niels)

    2014-01-01

    textabstractBackground: Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so), few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and

  3. Criminal Victimisation in People with Severe Mental Illness : A Multi-Site Prevalence and Incidence Survey in the Netherlands

    NARCIS (Netherlands)

    Kamperman, Astrid M.; Henrichs, Jens; Bogaerts, Stefan; Lesaffre, Emmanuel M. E. H.; Wierdsma, Andre I.; Ghauharali, Razia R. R.; Swildens, Wilma; Nijssen, Yolanda; van der Gaag, Mark; Theunissen, Jan R.; Delespaul, Philippe A.; van Weeghel, Jaap; van Busschbach, Jooske T.; Kroon, Hans; Teplin, Linda A.; van de Mheen, Dike; Mulder, Cornelis L.

    2014-01-01

    Background: Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so), few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the

  4. Criminal victimisation in people with severe mental illness : A multisite prevalence and incidence survey in the Netherlands

    NARCIS (Netherlands)

    Kamperman, A.; Henrichs, J.; Bogaerts, S.; Lesaffre, E.M.E.H.; Wiersma, A.I.; Ghauharali, R.R.R.; Swildens, W.; Nijssen, Y.A.M.; van der Gaag, M.; Theunissen, J.R.; Delespaul, P.; van Weeghel, J.; van Busschbach, J.; Kroon, H.; Teplin, L.; van de Mheen, D.; Mulder, C.L.

    2014-01-01

    Background Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so), few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the

  5. Prevalence of human endogenous retroviral element associates with Hodgkin's lymphoma incidence rates

    Directory of Open Access Journals (Sweden)

    Wee Hong Woo

    2014-01-01

    Full Text Available Human endogenous retrovirus-H (HERV-H is implicated in leukaemias and lymphomas, but the precise molecular mechanism underlying HERV-mediated carcinogenesis remains unknown. We determined the prevalence of HERV-H in a cross-section of the Singapore population and explored the relationship between HERV-H positivity and incidence rates for Hodgkin's lymphoma in three major ethnic groups of Singapore. We observed that Malays were 1.11 times likely (95% CI=1.05–1.17; P<0.01, and Indians 1.12 times likely (95% CI=1.07–1.18; P<0.01 to be HERV-H positive when compared to Chinese. Interestingly, the incidence rates of Hodgkin's lymphoma for the three races positively correlated to the respective prevalence rate for HERV-H positivity (r=0.9921 for male; r=0.9801 for female, suggesting that viral inheritance in human may predispose certain racial origin unfavourably to malignancy.

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

    Science.gov (United States)

    Gabriel, Sherine E; Michaud, Kaleb

    2009-01-01

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

  7. Towards Incidence Management in 5G Based on Situational Awareness

    Directory of Open Access Journals (Sweden)

    Lorena Isabel Barona López

    2017-01-01

    Full Text Available The fifth generation mobile network, or 5G, moves towards bringing solutions to deploying faster networks, with hundreds of thousands of simultaneous connections and massive data transfer. For this purpose, several emerging technologies are implemented, resulting in virtualization and self-organization of most of their components, which raises important challenges related to safety. In order to contribute to their resolution, this paper proposes a novel architecture for incident management on 5G. The approach combines the conventional risk management schemes with the Endsley Situational Awareness model, thus improving effectiveness in different aspects, among them the ability to adapt to complex and dynamical monitoring environments, and countermeasure tracking or the role of context when decision-making. The proposal takes into account all layers for information processing in 5G mobile networks, ranging from infrastructure to the actuators responsible for deploying corrective measures.

  8. Small area mapping of domestic radon, smoking prevalence and lung cancer incidence – A case study in Northamptonshire, UK

    International Nuclear Information System (INIS)

    Denman, Antony R.; Rogers, Stephen; Ali, Akeem; Sinclair, John; Phillips, Paul S.; Crockett, Robin G.M.; Groves-Kirkby, Christopher J.

    2015-01-01

    Smoking and radon both cause lung cancer, and together the risk is significantly higher. UK public health campaigns continue to reduce smoking prevalence, and other initiatives identify houses with raised radon (radon-222) levels and encourage remedial action. Smoking prevalence and radon levels in the UK have been mapped at Primary Care Trust level. This paper extends that work, using a commercial socio-demographic database to estimate smoking prevalence at the postcode sector level, and to predict the population characteristics at postcode sector level for 87 postcode sectors in Northamptonshire. Likely smoking prevalence in each postcode sector is then modelled from estimates of the smoking prevalence in the different socio-economic groups used by the database. Mapping estimated smoking prevalence, radon potential and average lung cancer incidence for each postcode sector suggested that there was little correlation between smoking prevalence and radon levels, as radon potential was generally lower in urban areas in Northamptonshire, where the estimates of smoking prevalence were highest. However, the analysis demonstrated some sectors where both radon potential and smoking prevalence were moderately raised. This study showed the potential of this methodology to map estimated smoking prevalence and radon levels to inform locally targeted public health campaigns to reduce lung cancer incidence. - Highlights: • We use a commercial socio-demographic database to estimate smoking prevalence in small areas in Northamptonshire, UK. • We map the estimated smoking prevalence and average domestic radon levels in these small areas. • We estimate annual average lung cancer incidence in these small areas. • The methodology is useful to evaluate and plan localised public health campaigns to reduce lung cancer incidence.

  9. Cuban Ocular Toxoplasmosis Epidemiology Study (COTES): incidence and prevalence of ocular toxoplasmosis in Central Cuba.

    Science.gov (United States)

    Bustillo, Jorge L; Diaz, Jose D; Pacheco, Idarmes C; Gritz, David C

    2015-03-01

    Serological studies indicate that rates of ocular toxoplasmosis (OT) vary geographically, with higher rates in tropical regions. Little is known about population-based rates of active OT. We aimed to describe the epidemiology of OT in Central Cuba. This large-population, cross-sectional cohort study used a prospective database at a large regional referral centre in Central Cuba. The patient database was searched for all patients who presented with OT during the 12-month study period from 1 April 2011 to 31 March 2012. Inclusion criteria were the clinical diagnosis of OT, characterised by focal retinochoroidal inflammation and a response to therapy as expected. Gender-stratified and age-stratified study population data from the 2012 Cuban Census were used to calculate incidence rates and prevalence ratios. Among 279 identified patients with OT, 158 presented with active OT. Of these, 122 new-onset and 36 prior-onset cases were confirmed. Based on the total population in the Sancti Spiritus province (466,106 persons), the overall incidence of active OT was 26.2 per 100,000 person-years (95% CI 21.7 to 31.3) with an annual prevalence ratio of 33.9 per 100,000 persons (95% CI 28.8 to 39.6). The incidence of active OT was lowest in the oldest age group and highest in patients aged 25-44 years (4.5 and 42.1 per 100,000 person-years, respectively). This first report describing population-based rates of OT in the Cuban population highlights the importance of patient age as a likely risk factor for OT. Disease rates were found to be highest in females and young to middle-aged adults. 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.

  10. The prevalence, incidence and natural history of primary sclerosing cholangitis in an ethnically diverse population

    Directory of Open Access Journals (Sweden)

    Li Chin-Shang

    2011-07-01

    Full Text Available Abstract Background Primary sclerosing cholangitis (PSC is a rare chronic cholestatic liver disease often associated with inflammatory bowel diseases (IBD. Current epidemiological data are limited to studies of predominantly Caucasian populations. Our aim was to define the epidemiology of PSC in a large, ethnically diverse US population. Methods The Northern California Kaiser Permanente (KP database includes records from over 3 million people and was searched for cases of PSC between January 2000 and October 2006. All identified charts were reviewed for diagnosis confirmation, IBD co-morbidity, and major natural history endpoints. Results We identified 169 (101 males cases fulfilling PSC diagnostic criteria with a mean age at diagnosis of 44 years (range 11-81. The age-adjusted point prevalence was 4.15 per 100,000 on December 31, 2005. The age-adjusted incidence per 100,000 person-years was not significantly greater in men 0.45 (95% CI 0.33 - 0.61 than women 0.37 (95% CI 0.26 - 0.51. IBD was present in 109/169 (64.5% cases and was significantly more frequent in men than women with PSC (73.3% and 51.5%, respectively, p = 0.005. The cumulative average yearly mortality rate was 1.9%. Age and serum sodium, creatinine and bilirubin at diagnosis and albumin at last entry were identified as significant factors associated with death, liver transplant or cholangiocarcinoma. Conclusions The incidence and prevalence of PSC observed in a representative Northern California population are lower compared to previous studies in Caucasian populations and this might reflect differences in the incidence of PSC among various ethnic groups.

  11. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  12. Prevalence and etiology of mastitis in traditionally managed camels ...

    African Journals Online (AJOL)

    Prevalence and causes of mastitis in traditionally managed camels in selected pastoral areas in eastern Ethiopia were assessed. The prevalence of camel mastitis was determined by the California mastitis test (CMT) and by clinical examinations of the udder and milk samples. A total of 642 udder quarters from 161 camels ...

  13. Prevalence and management of diarrhoea among children in ...

    African Journals Online (AJOL)

    Prevalence and management of diarrhoea among children in Nsukka, Nigeria. Kelvin Ebere Omelonye, Chidinma Adanna Okolo, Daniel Don Nwibo, Christian Onyeka Chukwuka, Mirabel Ifeyinwa Nwibo, Patience Obiageli Ubachukwu ...

  14. Suicidality in sleep disorders: prevalence, impact, and management strategies

    Directory of Open Access Journals (Sweden)

    Drapeau CW

    2017-09-01

    Full Text Available Christopher W Drapeau, Michael R Nadorff Department of Psychology, Mississippi State University, Mississippi State, MS, USA Abstract: Sleep disturbances are associated with suicide-related thoughts and behaviors, and the incidence of sleep concerns and suicide has increased recently in the US. Most published research exploring the sleep–suicidality relation is focused on select sleep disorders, with few reviews offering a comprehensive overview of the sleep–suicidality literature. This narrative review broadly investigates the growing research literature on sleep disorders and suicidality, noting the prevalence of suicide ideation and nonfatal and fatal suicide attempts, the impact of several sleep disorders on suicide risk, and potential sleep-disorder management strategies for mitigating suicide risk. Aside from insomnia symptoms and nightmares, there exist opportunities to learn more about suicide risk across many sleep conditions, including whether sleep disorders are associated with suicide risk independently of other psychiatric conditions or symptoms. Generally, there is a lack of randomized controlled trials examining the modification of suicide risk via evidence-based sleep interventions for individuals with sleep disorders. Keywords: sleep, suicide, suicidality, insomnia, nightmares, treatment

  15. Lessons Learnt from the Improvement of Customer Support Processes: A Case Study on Incident Management

    Science.gov (United States)

    Jäntti, Marko

    IT Infrastructure Library (ITIL) is the most widely used IT service management framework that provides guidelines how to create, manage and support IT services. Service support processes, such as incident management and problem management, are among the first ITIL processes that organizations start to implement. However, several challenges may exist in the process implementation. The research question of this study is: which issues are important in establishing an ITIL-based incident management process? The main contribution of this paper is to present lessons learnt from an ITIL-based process improvement project that focused on establishing an incident management process in an IS department of a university hospital. Our results show that key issues in implementing incident management are to 1) define the basic concepts of incident management with concrete examples and 2) define process interfaces between incident management and other support processes.

  16. Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults.

    Science.gov (United States)

    Nagl, Michaela; Jacobi, Corinna; Paul, Martin; Beesdo-Baum, Katja; Höfler, Michael; Lieb, Roselind; Wittchen, Hans-Ulrich

    2016-08-01

    We aimed to assess the prevalence, incidence, age-of-onset and diagnostic stability of threshold and subthreshold anorexia nervosa (AN) and bulimia nervosa (BN) in the community. Data come from a prospective-longitudinal community study of 3021 subjects aged 14-24 at baseline, who were followed up at three assessment waves over 10 years. Eating disorder (ED) symptomatology was assessed with the DSM-IV/M-CIDI at each wave. Diagnostic stability was defined as the proportion of individuals still affected with at least symptomatic eating disorders (EDs) at follow-ups. Baseline lifetime prevalence for any threshold ED were 2.9 % among females and 0.1 % among males. For any subthreshold ED lifetime prevalence were 2.2 % for females and 0.7 % for males. Symptomatic expressions of EDs (including core symptoms of the respective disorder) were most common with a lifetime prevalence of 11.5 % among females and 1.8 % among males. Symptomatic AN showed the earliest onset with a considerable proportion of cases emerging in childhood. 47 % of initial threshold AN cases and 42 % of initial threshold BN cases showed at least symptomatic expressions of any ED at any follow-up assessment. Stability for subthreshold EDs and symptomatic expressions was 14-36 %. While threshold EDs are rare, ED symptomatology is common particularly in female adolescents and young women. Especially threshold EDs are associated with a substantial risk for stability. A considerable degree of symptom fluctuation is characteristic especially for subthreshold EDs.

  17. Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

    Science.gov (United States)

    Naradko, Anthony M.

    2017-01-01

    The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

  18. Prevalence, birth incidence, and penetrance of von Hippel-Lindau disease (vHL) in Denmark

    DEFF Research Database (Denmark)

    Binderup, Marie Louise Mølgaard; Galanakis, Michael Carter Bisgaard; Budtz-Jørgensen, Esben

    2017-01-01

    Von Hippel-Lindau disease (vHL) is a rare hereditary tumour predisposition with multiorgan involvement that is not always easily recognized. The disease is reported to be almost fully penetrant at age 60 years. Previous estimates of vHL prevalence and incidence are all regional and vary widely....... Most are >20 years old and prone to selection bias because of inclusion of only clinically affected vHL patients who were diagnosed before genetic testing was available. In an unselected cohort of all known Danish carriers of a disease-causing VHL variant, we assessed vHL penetrance on a national basis....... We further used national health registers to identify individuals who fulfilled the clinical diagnostic vHL criteria based on their registered diagnostic codes, but had not been diagnosed with vHL. We also assessed the medical histories of first-degree relatives to identify familial cases. This study...

  19. Prevalence and Associated Factors of Eating Disorders in Weight Management Centers in Tanta, Egypt

    Directory of Open Access Journals (Sweden)

    Noha Eladawi

    2018-01-01

    Conclusions: EDs are prevalent among individuals attending the weight management centers in a northern city in Egypt. Specific management strategies are warranted to address this commonly prevalent disease.

  20. Development of the decision make supporting system on incident management

    International Nuclear Information System (INIS)

    Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke

    2017-01-01

    Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this

  1. Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors.

    Science.gov (United States)

    Keski-Rahkonen, Anna; Mustelin, Linda

    2016-11-01

    Eating disorders - anorexia nervosa, bulimia nervosa, and binge eating disorder - affect numerous Europeans. This narrative review summarizes European studies on their prevalence, incidence, comorbidity, course, consequences, and risk factors published in 2015 and the first half of 2016. Anorexia nervosa is reported by eating disorder eating disorders by 2-3% of women in Europe. Of men, 0.3-0.7% report eating disorders. Incidences of anorexia appear stable, whereas bulimia may be declining. Although the numbers of individuals receiving treatment have increased, only about one-third is detected by healthcare. Over 70% of individuals with eating disorders report comorbid disorders: anxiety disorders (>50%), mood disorders (>40%), self-harm (>20%), and substance use (>10%) are common. The long-term course of anorexia nervosa is favorable for most, but a substantial minority of eating disorder patients experience longstanding symptoms and somatic problems. The risk of suicide is elevated. Parental psychiatric disorders, prenatal maternal stress, various family factors, childhood overweight, and body dissatisfaction in adolescence increase the risk of eating disorders. Eating disorders are relatively common disorders that are often overlooked, although they are associated with high comorbidity and serious health consequences.

  2. Prevalence, incidence, and mortality of stroke in the chinese island populations: a systematic review.

    Directory of Open Access Journals (Sweden)

    Xiaomei Wu

    Full Text Available BACKGROUND: In China, there are 2.5 million new stroke cases each year and 7.5 million stroke survivors. However, stroke incidence in some island populations is obviously lower compared with inland regions, perhaps due to differences in diet and lifestyle. As the lifestyle in China has changed significantly, along with dramatic transformations in social, economic and environmental conditions, such changes have also been seen in island regions. Thus, we analyzed stroke in the Chinese island regions over the past 30 years. METHODS: We conducted a systematic review to identify reliable and comparable epidemiologic evidence about stroke in the Chinese island regions between 1980 and 2013. Two authors independently assessed the eligibility and the quality of the articles and disagreement was resolved by discussion. Owing to the great heterogeneity among individual study estimates, a random-effects or fixed-effects model was used to incorporate the heterogeneity among records into a pooled estimate for age-standardized rates. Age-standardized rates were calculated by the direct method with the 2000 world population if included records provided the necessary information. RESULTS: During the past three decades, the overall pooled age-standardized prevalence of stroke is 6.17 per 1000 (95% CI 4.56-7.78, an increase from 5.54 per 1000 (95% CI 3.88-7.20 prior to 2000 to 8.34 per 1000 (95% CI 5.98-10.69 after 2000. However, this difference was not found to be statistically significant. The overall pooled age-standardized incidence of stroke is 120.42 per 100,000 person years (95% CI 26.17-214.67. Between 1982 and 2008, the incidence of stroke increased and mortality declined over time. CONCLUSIONS: Effective intervention and specific policy recommendations on stroke prevention should be required, and formulated in a timely fashion to effectively curb the increased trend of stroke in Chinese island regions.

  3. Prevalence, incidence, and mortality of stroke in the chinese island populations: a systematic review.

    Science.gov (United States)

    Wu, Xiaomei; Zhu, Bo; Fu, Lingyu; Wang, Hailong; Zhou, Bo; Zou, Safeng; Shi, Jingpu

    2013-01-01

    In China, there are 2.5 million new stroke cases each year and 7.5 million stroke survivors. However, stroke incidence in some island populations is obviously lower compared with inland regions, perhaps due to differences in diet and lifestyle. As the lifestyle in China has changed significantly, along with dramatic transformations in social, economic and environmental conditions, such changes have also been seen in island regions. Thus, we analyzed stroke in the Chinese island regions over the past 30 years. We conducted a systematic review to identify reliable and comparable epidemiologic evidence about stroke in the Chinese island regions between 1980 and 2013. Two authors independently assessed the eligibility and the quality of the articles and disagreement was resolved by discussion. Owing to the great heterogeneity among individual study estimates, a random-effects or fixed-effects model was used to incorporate the heterogeneity among records into a pooled estimate for age-standardized rates. Age-standardized rates were calculated by the direct method with the 2000 world population if included records provided the necessary information. During the past three decades, the overall pooled age-standardized prevalence of stroke is 6.17 per 1000 (95% CI 4.56-7.78), an increase from 5.54 per 1000 (95% CI 3.88-7.20) prior to 2000 to 8.34 per 1000 (95% CI 5.98-10.69) after 2000. However, this difference was not found to be statistically significant. The overall pooled age-standardized incidence of stroke is 120.42 per 100,000 person years (95% CI 26.17-214.67). Between 1982 and 2008, the incidence of stroke increased and mortality declined over time. Effective intervention and specific policy recommendations on stroke prevention should be required, and formulated in a timely fashion to effectively curb the increased trend of stroke in Chinese island regions.

  4. Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study

    DEFF Research Database (Denmark)

    Dal, Jakob; Feldt-Rasmussen, Ulla; Andersen, Marianne

    2016-01-01

    remained stable. The prevalence in 2010 was 85 cases/10(6) persons. The patients were at increased risk of diabetes mellitus (HR: 4.0 (95% CI: 2.7-5.8)), heart failure (HR: 2.5 (95% CI: 1.4-4.5)), venous thromboembolism (HR: 2.3 (95% CI: 1.1-5.0)), sleep apnoea (HR: 11.7 (95% CI: 7.0-19.4)) and arthropathy...... (HR: 2.1 (95% CI: 1.6-2.6)). The complication risk was also increased before the diagnosis of acromegaly. Overall mortality risk was elevated (HR: 1.3 (95% CI: 1.0-1.7)) but uninfluenced by treatment modality. CONCLUSION: (i) The incidence rate and age at diagnosis of acromegaly have been stable over...... decades, and the prevalence is higher than previously reported. (ii) The risk of complications is very high even before the diagnosis. (iii) Mortality risk remains elevated but uninfluenced by mode of treatment....

  5. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection...

  6. Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country.

    Science.gov (United States)

    Bernabé-Ortiz, Antonio; White, Peter J; Carcamo, Cesar P; Hughes, James P; Gonzales, Marco A; Garcia, Patricia J; Garnett, Geoff P; Holmes, King K

    2009-02-03

    Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure. Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; > or = 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > or = 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception. The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially

  7. Effects of weed management on the prevalence of pink pineapple ...

    African Journals Online (AJOL)

    Effects of weed management on the prevalence of pink pineapple mealybugs in Ghana. JW Tachie-Menson, J Sarkodie-Addo, AG Carlson. Abstract. An on-farm experiment was conducted in August 2010 to evaluate the efficacy of various weed management methods used in pineapple cultivation in Ghana in limiting the ...

  8. Prevalence of Candida spp. in Healthy Oral Mucosa Surfaces with Higher Incidence of Chronic Hyperplastic Candidosis.

    Science.gov (United States)

    Arruda, Claúdia; Artico, Gabriela; Freitas, Roseli; Filho, Antônio; Migliari, Dante

    2016-08-01

    Predisposing factors in chronic hyperplastic candidosis (CHC) have been poorly recognized. This study aimed at assessing the prevalence of Candida spp. in areas of the oral mucosa showing greater prevalent rate of CHC, such as the retrocomissural area, the lateral borders of the tongue, and the hard-palate mucosa in four groups of individuals presenting predisposing factors as follows: Smoking habits (group I); patients with low salivary flow rate (SFR) (hyposalivation - group II); patients with loss of vertical dimension of occlusion (LVDO -group III); and control subjects (group IV). A total of 44 individuals (age 4090 years, mean: 55.8 years) were divided into four groups: Group I (11 smokers); group II (10 hyposalivation patients); group III (10 LVDO patients); and group IV (control, 13 healthy subjects). All individuals were tested for Candida-pseudohyphae form by direct examination and for Candida spp. culture growth in samples obtained from the retrocomissural, tongue's lateral border, and hard-soft palatal mucosa. Direct examination showed a statistically significant prevalence rate for pseudohyphae (p < 0.05) on the retrocomissural and on tongue's lateral borders of individuals with LVDO. A statistically significant (p < 0.05) culture growth for Candida spp. was found on the retrocomissural areas of those with hyposalivation and with LVDO, and on the palate mucosa and on the tongue's lateral borders in the smokers and in the individuals with LVDO when compared with those of the control group. While direct examination is effective for detecting pseudohyphae, LVDO and tobacco smoking seem to be factors of relevance to the development of CHC. Since CHC has been linked to a high rate of malignant transformation, this study analyzes some clinical (and exogenous) factors that may contribute to the development of CHC and addresses some preventive measures to reduce its incidence.

  9. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015

    DEFF Research Database (Denmark)

    Truelsen, Thomas Clement

    2016-01-01

    incidence and prevalence by age, sex, cause, year, and geography with a wide range of updated and standardised analytical procedures. Improvements from GBD 2013 included the addition of new data sources, updates to literature reviews for 85 causes, and the identification and inclusion of additional studies...... published up to November, 2015, to expand the database used for estimation of non-fatal outcomes to 60 900 unique data sources. Prevalence and incidence by cause and sequelae were determined with DisMod-MR 2.1, an improved version of the DisMod-MR Bayesian meta-regression tool first developed for GBD 2010......, educational attainment, and fertility (the Socio-demographic Index [SDI]) and used it to compare observed patterns of health loss to the expected pattern for countries or locations with similar SDI scores. FINDINGS: We generated 9·3 billion estimates from the various combinations of prevalence, incidence...

  10. HTLV-1 in rural Guinea-Bissau: prevalence, incidence and a continued association with HIV between 1990 and 2007

    Directory of Open Access Journals (Sweden)

    Sarge-Njie Ramu

    2010-06-01

    Full Text Available Abstract Background HTLV-1 is endemic in Guinea-Bissau, and the highest prevalence in the adult population (5.2% was observed in a rural area, Caió, in 1990. HIV-1 and HIV-2 are both prevalent in this area as well. Cross-sectional associations have been reported for HTLV-1 with HIV infection, but the trends in prevalence of HTLV-1 and HIV associations are largely unknown, especially in Sub Saharan Africa. In the current study, data from three cross-sectional community surveys performed in 1990, 1997 and 2007, were used to assess changes in HTLV-1 prevalence, incidence and its associations with HIV-1 and HIV-2 and potential risk factors. Results HTLV-1 prevalence was 5.2% in 1990, 5.9% in 1997 and 4.6% in 2007. Prevalence was higher among women than men in all 3 surveys and increased with age. The Odds Ratio (OR of being infected with HTLV-1 was significantly higher for HIV positive subjects in all surveys after adjustment for potential confounding factors. The risk of HTLV-1 infection was higher in subjects with an HTLV-1 positive mother versus an uninfected mother (OR 4.6, CI 2.6-8.0. The HTLV-1 incidence was stable between 1990-1997 (Incidence Rate (IR 1.8/1,000 pyo and 1997-2007 (IR 1.6/1,000 pyo (Incidence Rate Ratio (IRR 0.9, CI 0.4-1.7. The incidence of HTLV-1 among HIV-positive individuals was higher compared to HIV negative individuals (IRR 2.5, CI 1.0-6.2, while the HIV incidence did not differ by HTLV-1 status (IRR 1.2, CI 0.5-2.7. Conclusions To our knowledge, this is the largest community based study that has reported on HTLV-1 prevalence and associations with HIV. HTLV-1 is endemic in this rural community in West Africa with a stable incidence and a high prevalence. The prevalence increases with age and is higher in women than men. HTLV-1 infection is associated with HIV infection, and longitudinal data indicate HIV infection may be a risk factor for acquiring HTLV-1, but not vice versa. Mother to child transmission is likely to

  11. Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management.

    Science.gov (United States)

    Fang, Fang; Sun, Hongwei; Wang, Zuowei; Ren, Ming; Calabrese, Joseph R; Gao, Keming

    2016-09-01

    Somnolence is a common side effect of antipsychotics. To assess the incidence of this side effect, we performed a MEDLINE search for randomized, double-blinded, placebo- or active-controlled studies of adult patients treated with antipsychotics for schizophrenia, mania, bipolar depression, or bipolar disorder. We extracted rates of somnolence from original publications and pooled them based on the dose of each antipsychotic in the same psychiatric condition, then estimated the absolute risk increase (ARI) and the number needed to harm (NNH) of an antipsychotic relative to placebo or an active comparator in the same psychiatric condition. According to the ARI in acute schizophrenia, bipolar mania, and bipolar depression, antipsychotics can be classified as high somnolence (clozapine), moderate somnolence (olanzapine, perphenazine, quetiapine, risperidone, ziprasidone), and low somnolence (aripiprazole, asenapine, haloperidol, lurasidone, paliperidone, cariprazine). The risk of somnolence with blonanserin, brexpiprazole, chlorpromazine, iloperidone, sertindole, and zotepine needs further investigation. The rates of somnolence were positively correlated to dose and duration for some antipsychotics, but not for others. Many factors, including antipsychotic per se, the method used to measure somnolence, patient population, study design, and dosing schedule, might affect the incidence of antipsychotic-induced somnolence. The mechanisms of antipsychotic-induced somnolence are likely multifactorial, although the blockade of histamine 1 receptors and α1 receptors may play a major role. The management of antipsychotic-induced somnolence should include sleep hygiene education, choosing an antipsychotic with a lower risk for somnolence, starting at a lower dose with a slower titration based on psychiatric diagnoses, adjusting doses when necessary, and minimizing concurrent somnolence-prone agents. Since most cases of somnolence were mild to moderate, allowing tolerance to

  12. STUDY OF INCIDENCE & MANAGEMENT OF PARA PHARYNGEAL TUMORS

    Directory of Open Access Journals (Sweden)

    Aruna Kumari

    2015-11-01

    Full Text Available INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52% and highest incidence is seen in 3rd and 5th decade (24% each. Most common presenting symptoms are difficulty in swallowing (36% and swelling either intraoral or in the neck (28%. Least common symptoms being cranial nerve palsy (4%, difficulty in breathing/noisy breathing (4%, nasal regurgitation (4% and hard of hearing (8%. FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma.i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%, paragangliomas (12%. Other less

  13. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management.

    Science.gov (United States)

    Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John

    2017-01-01

    This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

  14. Sexual assault incidents among college undergraduates: Prevalence and factors associated with risk.

    Directory of Open Access Journals (Sweden)

    Claude A Mellins

    Full Text Available Sexual assault on college campuses is a public health issue. However varying research methodologies (e.g., different sexual assault definitions, measures, assessment timeframes and low response rates hamper efforts to define the scope of the problem. To illuminate the complexity of campus sexual assault, we collected survey data from a large population-based random sample of undergraduate students from Columbia University and Barnard College in New York City, using evidence based methods to maximize response rates and sample representativeness, and behaviorally specific measures of sexual assault to accurately capture victimization rates. This paper focuses on student experiences of different types of sexual assault victimization, as well as sociodemographic, social, and risk environment correlates. Descriptive statistics, chi-square tests, and logistic regression were used to estimate prevalences and test associations. Since college entry, 22% of students reported experiencing at least one incident of sexual assault (defined as sexualized touching, attempted penetration [oral, anal, vaginal, other], or completed penetration. Women and gender nonconforming students reported the highest rates (28% and 38%, respectively, although men also reported sexual assault (12.5%. Across types of assault and gender groups, incapacitation due to alcohol and drug use and/or other factors was the perpetration method reported most frequently (> 50%; physical force (particularly for completed penetration in women and verbal coercion were also commonly reported. Factors associated with increased risk for sexual assault included non-heterosexual identity, difficulty paying for basic necessities, fraternity/sorority membership, participation in more casual sexual encounters ("hook ups" vs. exclusive/monogamous or no sexual relationships, binge drinking, and experiencing sexual assault before college. High rates of re-victimization during college were reported across

  15. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges.

    Science.gov (United States)

    Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J

    2017-12-01

    To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.

  16. Policies for managing emergency medical services in mass casualty incidents.

    Science.gov (United States)

    Adini, B; Bodas, M; Nilsson, H; Peleg, K

    2017-09-01

    Diverse decision-making is needed in managing mass casualty incidents (MCIs), by emergency medical services (EMS). The aim of the study was to review consensus among international experts concerning policies of EMS management during MCIs. Applicability of 21 EMS policies was tested through a 2-cycle modified e-Delphi process, in which 38 multi-disciplinary experts from 10 countries participated. Threshold for approving proposed solutions was defined as consensus of >80%. Policies that did not achieve the targeted consensus were reviewed to detect variability according to respondents' origin country. 16 policies were endorsed in the first cycle including collaboration between ambulance service providers; implementing a unified mode of operation; preparing criteria for ground versus aerial evacuation; and, developing support systems for caregivers exposed to violence. An additional policy which proposed that senior EMS officers should not necessarily act as on-site MCI commanders was endorsed in the second cycle. Demographic breakdown of views concerning non-consensual policies revealed differences according to countries of origin. Assigning ambulances to off-duty team members was highly endorsed by experts from Israel and South Africa and strongly rejected by European respondents. Avoiding entry to risk areas until declared safe was endorsed by European, Asian and Oceanic experts, but rejected by Israeli, South African and North American experts. Despite uniqueness of countries and EMS agencies, solutions to most dilemmas were applicable to all organizations, regardless of location or affiliation. Cultural diversity was found concerning readiness to implement military-civilian collaboration in MCIs and a rigid separation between work-leisure responsibilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Incidence, prevalence, and trends of general practitioner-recorded diagnosis of peanut allergy in England, 2001 to 2005.

    Science.gov (United States)

    Kotz, Daniel; Simpson, Colin R; Sheikh, Aziz

    2011-03-01

    Previous descriptions of the epidemiology of peanut allergy have mainly been derived from small cross-sectional studies. To interrogate a large national research database to provide estimates for the incidence, prevalence, and trends of general practitioner (GP)-recorded diagnosis of peanut allergy in the English population. Version 10 of the QRESEARCH database was used with data from 2,958,366 patients who were registered with 422 United Kingdom general practices in the years 2001 to 2005. The primary outcome was a recording of clinician-diagnosed peanut allergy. The age-sex standardized incidence rate of peanut allergy in 2005 was 0.08 per 1000 person-years (95% CI, 0.07-0.08), and the prevalence rate was 0.51 per 1000 patients (95% CI, 0.49-0.54). This translated into an estimated 4000 incident cases (95% CI, 3500-4600) and 25,700 prevalent cases (95% CI, 24,400-27,100) of GP-recorded diagnosis of peanut allergy in England in 2005. During the study period, the incidence rate of peanut allergy remained fairly stable, whereas the prevalence rate doubled. In those under 18 years of age, the crude lifetime prevalence rate was higher in males than females. A significant inverse relationship between prevalence and socioeconomic status was found. These data on GP-recorded diagnosis of peanut allergy from a large general practice database suggest a much lower prevalence in peanut allergy than has hitherto been found. This difference may in part be explained by underrecording of peanut allergy in general practice. Further research is needed to assess the true frequency of peanut allergy in the population and whether there has been a true increase in recent years. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  18. The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study.

    Directory of Open Access Journals (Sweden)

    Bo Kyung Koo

    Full Text Available The incidence and prevalence of type 2 diabetes mellitus (T2DM and related macrovascular complications in Korea were estimated using the Health Insurance Review and Assessment (HIRA database from 2007-2011, which covers the claim data of 97.0% of the Korean population.T2DM, coronary artery disease (CAD, cerebrovascular disease (CVD, and peripheral artery disease (PAD were defined according to ICD-10 codes. We used the Healthcare Common Procedure Coding System codes provided by HIRA to identify associated procedures or surgeries. When calculating incidence, we excluded cases with preexisting T2DM within two years before the index year. A Poisson distribution was assumed when calculating 95% confidence intervals for prevalence and incidence rates.The prevalence of T2DM in Korean adults aged 20-89 years was 6.1-6.9% and the annual incidence rates of T2DM ranged from 9.5-9.8/1,000 person-year (PY during the study period. The incidence rates of T2DM in men and women aged 20-49 years showed decreasing patterns from 2009 to 2011 (P<0.001; by contrast, the incidence in subjects aged 70-79 years showed increased patterns from 2009 to 2011 (P<0.001. The incidence rates of CAD and CVD in patients newly diagnosed with T2DM were 18.84/1,000 PY and 11.32/1,000 PY, respectively, in the year of diagnosis. Among newly diagnosed individuals with T2DM who were undergoing treatment for PAD, 14.6% underwent angioplasty for CAD during the same period.Our study measured the national incidences of T2DM, CAD, CVD, and PAD, which are of great concern for public health. We also confirmed the relatively higher risk of CAD and CVD newly detected T2DM patients compared to the general population in Korea.

  19. Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: A retrospective chart review.

    Science.gov (United States)

    Artico, Marco; Dante, Angelo; D'Angelo, Daniela; Lamarca, Luciano; Mastroianni, Chiara; Petitti, Tommasangelo; Piredda, Michela; De Marinis, Maria Grazia

    2018-01-01

    Terminally ill patients are at high risk of pressure ulcers, which have a negative impact on quality of life. Data about pressure ulcers' prevalence, incidence and associated factors are largely insufficient. To document the point prevalence at admission and the cumulative incidence of pressure ulcers in terminally ill patients admitted to an Italian home palliative care unit, and to analyse the patients' and caregivers' characteristics associated with their occurrence. Retrospective chart review. Patients ( n = 574) with a life expectancy ⩽6 months admitted to a palliative home care service were included in this study. The prevalence and incidence rates were 13.1% and 13.0%, respectively. The logistic regression models showed body mass index ( p 70 and >1 caregiver at home as the dichotomous variables predictors of presenting with a pressure ulcer at time of admission and during home palliative care. The notable pressure ulcers' incidence and prevalence rates suggest the need to include this issue among the main outcomes to pursue during home palliative care. The accuracy of body mass index, Braden Scale and Karnofsky Performance Scale in predicting the pressure ulcers risk is confirmed. Therefore, they appear as essential tools, in combination with nurses' clinical judgment, for a structured approach to pressure ulcers prevention. Further research is needed to explore the home caregivers' characteristics and attitudes associated with the occurrence of pressure ulcers and the relations between their strategies for pressure ulcer prevention and gender-related patient's needs.

  20. Canadian Digestive Health Foundation Public Impact Series 4: Celiac Disease in Canada. Incidence, Prevalence, and Direct and Indirect Economic Impact

    Directory of Open Access Journals (Sweden)

    Richard N Fedorak

    2012-01-01

    Full Text Available The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning celiac disease.

  1. Canadian Digestive Health Foundation Public Impact Series: Gastroesophageal Reflux Disease in Canada: Incidence, Prevalence, and Direct and Indirect Economic Impact

    Directory of Open Access Journals (Sweden)

    Richard N Fedorak

    2010-01-01

    Full Text Available The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada. The current article presents the updated findings from the study concerning gastroesophageal reflux disease – a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications (Montreal definition.

  2. Canadian Digestive Health Foundation Public Impact Series: gastroesophageal reflux disease in Canada: incidence, prevalence, and direct and indirect economic impact.

    Science.gov (United States)

    Fedorak, Richard N; Veldhuyzen van Zanten, Sander; Bridges, Ron

    2010-07-01

    The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada. The current article presents the updated findings from the study concerning gastroesophageal reflux disease - a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications (Montreal definition).

  3. Canadian Digestive Health Foundation Public Impact Series. Inflammatory Bowel Disease in Canada: Incidence, Prevalence, and Direct and Indirect Economic Impact

    Directory of Open Access Journals (Sweden)

    Richard N Fedorak

    2010-01-01

    Full Text Available The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning inflammatory bowel diseases – specifically, Crohn’s disease and ulcerative colitis.

  4. Canadian Digestive Health Foundation Public Impact Series. Inflammatory bowel disease in Canada: Incidence, prevalence, and direct and indirect economic impact.

    Science.gov (United States)

    Fedorak, Richard N; Wong, Karen; Bridges, Ron

    2010-11-01

    The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning inflammatory bowel diseases - specifically, Crohn's disease and ulcerative colitis.

  5. Measuring the Prevalence and Incidence of Low Back Pain Disorders Among American Workers in the Aerospace and Defense Industry.

    Science.gov (United States)

    Goetzel, Ron Z; D'Arco, Malinda; Thomas, Jordana; Wang, Degang; Tabrizi, Maryam J; Roemer, Enid Chung; Prasad, Aishwarya; Yarborough, Charles M

    2015-09-01

    To determine the prevalence and incidence of low back pain (LBP) among workers in the aerospace and defense industry and in a specific company. Claims and demographic data from the Truven Health MarketScan normative database representing more than 1 million workers were drawn from a group of 18 US benchmark companies and compared with one particular company, Lockheed Martin Corporation. The prevalence of LBP in the MarketScan normative group was 15.6% in the final study year (2012), whereas the incidence of new cases was 7.2% and 7.3% in years 2011 and 2012, respectively. Compared with the normative group, the company's prevalence and incidence rates were lower. Women and older workers were more likely to experience LBP compared with men and younger workers. The analysis was used to inform the company's leadership about the health burden of the condition and evaluate alternative treatment options to prevent the incidences and reduce the prevalence of clinical back pain among workers.

  6. Incidence, prevalence and survival of patients with rare epithelial digestive cancers diagnosed in Europe in 1995–2002

    NARCIS (Netherlands)

    Faivre, J.; Trama, A.; De Angelis, R.; Elferink, M.A.G.; Siesling, Sabine; Audisio, R.; Bosset, J.F.; Cervantes, A.; Lepage, C.

    2012-01-01

    Background and aims Little is known about the epidemiology of rare epithelial digestive cancers. The aim of this study was to report on their incidence, prevalence and survival across Europe. Methods The analysis was carried out on 50,646 cases diagnosed from 1995 to 2002 within a population of

  7. Radiating low back pain in general practice : Incidence, prevalence, diagnosis, and long-term clinical course of illness

    NARCIS (Netherlands)

    Spijker-Huiges, Antje; Groenhof, Feikje; Winters, Jan C.; van Wijhe, Marten; Groenier, Klaas H.; van der Meer, Klaas

    Objective. The aim of this study was to calculate the incidence and prevalence of radiating low back pain, to explore the long-term clinical course of radiating low back pain including the influence of radiculopathy (in a subsample of the study population) and non-radiating low back pain thereon,

  8. Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors.

    Science.gov (United States)

    Brown, Stephanie J; Donath, Susan; MacArthur, Christine; McDonald, Ellie A; Krastev, Ann H

    2010-02-01

    Few studies have examined associations of prepregnancy urinary incontinence (UI). Multicentre prospective pregnancy cohort study (n = 1,507) using standardised measures to assess frequency and severity of UI. Prevalence of UI increased from 10.8% in the 12 months before the index pregnancy to 55.9% in the third trimester. Stress incontinence (36.9%) and mixed incontinence (13.1%) were more common during pregnancy than urge incontinence alone (5.9%). UI before pregnancy was associated with childhood enuresis (adjusted odds ratio (AdjOR) = 2.4, 95% confidence interval (CI) 1.6-3.4), higher maternal body mass index (AdjOR = 2.3, 95% CI 1.4-3.8), and previous miscarriages or terminations (AdjOR = 1.6, 95% CI 1.1-2.3). The strongest predictor of incident UI in pregnancy was occasional leakage (less than once a month) before pregnancy (AdjOR = 3.6, 95% CI 2.8-4.7). Further research is needed to elucidate the complex interplay of prepregnancy and pregnancy-related factors in the aetiology of UI in nulliparous women.

  9. Management practices associated with the incidence rate of clinical mastitis.

    Science.gov (United States)

    Barkema, H W; Schukken, Y H; Lam, T J; Beiboer, M L; Benedictus, G; Brand, A

    1999-08-01

    Risk factors for the incidence rate of clinical mastitis were studied in 274 Dutch dairy herds. Variables that were associated with resistance to disease were the feeding, housing, and milking machine factors. Variables that were associated with exposure were grazing, combined housing of dry cows and heifers, and calving area hygiene. Postmilking teat disinfection in herds with a low bulk milk somatic cell count and years of practicing dry cow therapy were positively associated with the incidence rate of clinical mastitis. Herds with a low bulk milk somatic cell count and in which postmilking teat disinfection was not used had lower incidence rates of clinical mastitis than did other herds. The incidence rate of clinical mastitis caused by Escherichia coli was mostly related to housing conditions, hygiene, and machine milking. The incidence rate of clinical mastitis caused by Staphylococcus aureus was mostly related to factors associated with bulk milk somatic cell count and factors that might be due to cause and effect reversal. A strong positive correlation existed between the incidence rate of clinical mastitis caused by Streptococcus dysgalactiae and the incidence rate of clinical mastitis caused by Staph. aureus. The incidence rate of clinical mastitis caused by Streptococcus dysgalactiae was related to nutrition, milking technique, and machine milking. The incidence rate of clinical mastitis caused by Streptococcus uberis was associated with factors related to housing, nutrition, and machine milking.

  10. Prevalence and Incidence of Epilepsy Associated with Convulsive Seizures in Rural Bolivia. A Global Campaign against Epilepsy Project

    Science.gov (United States)

    Crespo Gómes, Elizabeth Blanca; Sofia, Vito; Padilla, Sandra; Camargo, Mario; Zappia, Mario; Bartoloni, Alessandro; Nicoletti, Alessandra

    2015-01-01

    Objective we performed a three-stages door-to-door survey to estimate incidence and prevalence of epilepsy associated with convulsive seizures (EACS) in a rural area of Bolivia. Methods the study was carried out in the Cordillera Province, southern-eastern Bolivia. One hundred fourteen rural communities with a total population of 18,907 inhabitants were included in the survey. In order to identify subjects with EACS, trained fieldworkers administered a validated single screening question to the householders (stage I). A second face-to-face questionnaire was administered to each positive subject (stage II) that, in case of positive answer, underwent a complete neurological examination to confirm the diagnosis (stage III). We estimated age and sex specific life-time and active EACS prevalence at the prevalence day (30th June 2010). Incidence risk was evaluated for the 10-year period between January 2000 and December 2010. Results on prevalence day we identified 136 subjects with EACS, 124 of whom had active epilepsy. The life-time prevalence of EACS was 7.2/1,000 (7.6/1,000 age-adjusted to the world standard population) while the prevalence of active EACS was 6.6/1,000 (6.7/1,000 age-adjusted to the world standard population). Both life-time and active prevalence showed a peak (10.3/1,000) in the 15–24 years age group and, overall, were higher among women. During the incidence study period, 105 patients living in the study area had the onset of EACS. The crude incidence risk was 55.4/100,000 (49.5/100,000 age-adjusted to the world standard population). Incidence was slightly but not significantly higher among women (58.9/100,000 versus 51.9/100,000). Conclusions the present study demonstrated a considerable burden of EACS in the Bolivian Chaco, showing prevalence and incidence estimates close to those reported for low and middle- income countries and underlying the need of treatment programs. PMID:26427017

  11. Prevalence and Incidence of Epilepsy Associated with Convulsive Seizures in Rural Bolivia. A Global Campaign against Epilepsy Project.

    Science.gov (United States)

    Bruno, Elisa; Quattrocchi, Graziella; Crespo Gómes, Elizabeth Blanca; Sofia, Vito; Padilla, Sandra; Camargo, Mario; Zappia, Mario; Bartoloni, Alessandro; Nicoletti, Alessandra

    2015-01-01

    we performed a three-stages door-to-door survey to estimate incidence and prevalence of epilepsy associated with convulsive seizures (EACS) in a rural area of Bolivia. the study was carried out in the Cordillera Province, southern-eastern Bolivia. One hundred fourteen rural communities with a total population of 18,907 inhabitants were included in the survey. In order to identify subjects with EACS, trained fieldworkers administered a validated single screening question to the householders (stage I). A second face-to-face questionnaire was administered to each positive subject (stage II) that, in case of positive answer, underwent a complete neurological examination to confirm the diagnosis (stage III). We estimated age and sex specific life-time and active EACS prevalence at the prevalence day (30th June 2010). Incidence risk was evaluated for the 10-year period between January 2000 and December 2010. on prevalence day we identified 136 subjects with EACS, 124 of whom had active epilepsy. The life-time prevalence of EACS was 7.2/1,000 (7.6/1,000 age-adjusted to the world standard population) while the prevalence of active EACS was 6.6/1,000 (6.7/1,000 age-adjusted to the world standard population). Both life-time and active prevalence showed a peak (10.3/1,000) in the 15-24 years age group and, overall, were higher among women. During the incidence study period, 105 patients living in the study area had the onset of EACS. The crude incidence risk was 55.4/100,000 (49.5/100,000 age-adjusted to the world standard population). Incidence was slightly but not significantly higher among women (58.9/100,000 versus 51.9/100,000). the present study demonstrated a considerable burden of EACS in the Bolivian Chaco, showing prevalence and incidence estimates close to those reported for low and middle- income countries and underlying the need of treatment programs.

  12. The Prevalence and Management of Systemic Amyloidosis in Western Countries.

    Science.gov (United States)

    Nienhuis, Hans L A; Bijzet, Johan; Hazenberg, Bouke P C

    2016-04-01

    Amyloidosis has been a mystery for centuries, but research of the last decennia has clarified many of the secrets of this group of diseases. A protein-based classification of amyloidosis helps to understand problems that were part of the obsolete clinical classification in primary, secondary, and familial amyloidosis. All types of amyloid are secondary to some underlying precursor-producing process: each type is caused by a misfolded soluble precursor protein that becomes deposited as insoluble amyloid fibrils. The incidence of amyloidosis is not well documented, but probably falls between 5 and 13 per million per year. Prevalence data are scarce, but one UK study indicates about 20 per million inhabitants. Amyloidosis can be localized (amyloid deposited in the organ or tissue of precursor production) or systemic (amyloid at one or more sites distant from the site of precursor production). The major systemic types of amyloidosis are AL (associated with a light chain-producing plasma cell dyscrasia), AA (associated with longstanding inflammation), wild-type ATTR (associated with normal transthyretin and old age), and hereditary ATTR (associated with a transthyretin mutation) amyloidosis. Imaging techniques, such as cardiac ultrasound, magnetic resonance imaging, bone scintigraphy, and serum amyloid P component scintigraphy, are useful both for diagnosing amyloidosis and for assessing disease severity. Serologic markers are useful for detecting organ disease and disease monitoring during follow-up. Current treatment modalities are directed against the ongoing supply of precursor proteins and thereby aim to stop further accumulation of amyloid. Novel treatment modalities, such as interference with amyloid formation and even removal of amyloid, are being studied. A well-thought and planned monitoring during follow-up helps to assess the effect of treatment and to early detect possible progression of amyloidosis. Clinical management comprises histologic proof of amyloid

  13. Medically unexplained and explained physical symptoms in the general population: association with prevalent and incident mental disorders.

    Directory of Open Access Journals (Sweden)

    Jonna van Eck van der Sluijs

    Full Text Available Clinical studies have shown that Medically Unexplained Symptoms (MUS are related to common mental disorders. It is unknown how often common mental disorders occur in subjects who have explained physical symptoms (PHY, MUS or both, in the general population, what the incidence rates are, and whether there is a difference between PHY and MUS in this respect.To study the prevalence and incidence rates of mood, anxiety and substance use disorders in groups with PHY, MUS and combined MUS and PHY compared to a no-symptoms reference group in the general population.Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2, a nationally representative face-to-face survey of the general population aged 18-64 years. We selected subjects with explained physical symptoms only (n=1952, with MUS only (n=177, with both MUS and PHY (n=209, and a reference group with no physical symptoms (n=4168. The assessment of common mental disorders was through the Composite International Diagnostic Interview 3.0. Multivariate logistic regression analyses were used to examine the association between group membership and the prevalence and first-incidence rates of comorbid mental disorders, adjusted for socio-demographic characteristics.MUS were associated with the highest prevalence rates of mood and anxiety disorders, and combined MUS and PHY with the highest prevalence rates of substance disorder. Combined MUS and PHY were associated with a higher incidence rate of mood disorder only (OR 2.9 (95%CI:1.27,6.74.In the general population, PHY, MUS and the combination of both are related to mood and anxiety disorder, but odds are highest for combined MUS and PHY in relation to substance use disorder. Combined MUS and PHY are related to a greater incidence of mood disorder. These findings warrant further research into possibilities to improve recognition and early intervention in subjects with combined MUS and PHY.

  14. Incidence, diagnosis and management of eye affections in dogs ...

    African Journals Online (AJOL)

    A retrospective study of ocular affections in dogs was conducted at some selected clinics and hospitals in Southwest Nigeria between 2003 and, 2013 to determine the incidence, pattern of distribution, methods of diagnosis and treatment modalities using descriptive statistical tool. Overall incidence of eye affection in dogs ...

  15. The World Trade Center attack. Helping the helpers: the role of critical incident stress management.

    Science.gov (United States)

    Hammond, J; Brooks, J

    2001-12-01

    Healthcare and prehospital workers involved in disaster response are susceptible to a variety of stress-related psychological and physical sequelae. Critical incident stress management, of which critical incident stress debriefing is a component, can mitigate the response to these stressors. Critical incident stress debriefing is a peer-driven, therapist-guided, structured, group intervention designed to accelerate the recovery of personnel. The attack on the World Trade Center, and the impact it may have on rescue, prehospital, and healthcare workers, should urge us to incorporate critical incident stress management into disaster management plans.

  16. Prevalence, farmers' knowledge and management of mange in ...

    African Journals Online (AJOL)

    The current study investigated, on the basis of farm and clinical records, the prevalence, knowledge of farmers and methods of management of mange in sixty small-scale sheep and goat farms in the rural areas of Ejisu-Juaben Municipality in the Ashanti Region of Ghana. Data was compiled with employment of descriptive ...

  17. Major incident medical management and support the practical approach at the scene

    CERN Document Server

    Advanced Life Support Group

    2012-01-01

    Major Incident Medical Management and Support (MIMMS) is the coursebook for the Advanced Life Support Group's internationally taught training for health care professionals responding to major incidents. The practical approach employed in MIMMS has proved an invaluable aid to both civilian and military doctors, nurses and paramedics working in disaster management worldwide.

  18. Forecasting the Incidence and Prevalence of Patients with End-Stage Renal Disease in Malaysia up to the Year 2040

    Directory of Open Access Journals (Sweden)

    Mohamad Adam Bujang

    2017-01-01

    Full Text Available Background. The incidence of patients with end-stage renal disease (ESRD requiring dialysis has been growing rapidly in Malaysia from 18 per million population (pmp in 1993 to 231 pmp in 2013. Objective. To forecast the incidence and prevalence of ESRD patients who will require dialysis treatment in Malaysia until 2040. Methodology. Univariate forecasting models using the number of new and current dialysis patients, by the Malaysian Dialysis and Transplant Registry from 1993 to 2013 were used. Four forecasting models were evaluated, and the model with the smallest error was selected for the prediction. Result. ARIMA (0, 2, 1 modeling with the lowest error was selected to predict both the incidence (RMSE = 135.50, MAPE = 2.85, and MAE = 87.71 and the prevalence (RMSE = 158.79, MAPE = 1.29, and MAE = 117.21 of dialysis patients. The estimated incidences of new dialysis patients in 2020 and 2040 are 10,208 and 19,418 cases, respectively, while the estimated prevalence is 51,269 and 106,249 cases. Conclusion. The growth of ESRD patients on dialysis in Malaysia can be expected to continue at an alarming rate. Effective steps to address and curb further increase in new patients requiring dialysis are urgently needed, in order to mitigate the expected financial and health catastrophes associated with the projected increase of such patients.

  19. Geographic variation in the age- and gender-specific prevalence and incidence of epilepsy: analysis of Taiwanese National Health Insurance-based data.

    Science.gov (United States)

    Chen, Chih-Chuan; Chen, Li-Sheng; Yen, Ming-Fang; Chen, Hsiu-Hsi; Liou, Horng-Huei

    2012-02-01

    We studied geographic variation in age- and gender-specific prevalence and incidence of epilepsy in four different areas of Taiwan. By using large-scale, National Health Insurance (NHI)-based data from 2000-2003 in Taiwan, we identified 131,287 patients diagnosed with epilepsy (ICD code 345) receiving at least of one of 11 antiepileptic drugs (AEDs). Information on age, gender, and location were also collected. The multivariable Poisson regression analysis was used to assess the heterogeneity of the morbidity of epilepsy in different regions. External data validation was also performed to assess the accuracy of capturing epilepsy cases through our NHI data set. The age-adjusted prevalence and incidence of epilepsy were 5.85 (per 1,000) between 2000 and 2003 and 97 (per 100,000 person-years) during the follow-up time from 2001 to 2003 in Taiwan. The sensitivity and specificity of ICD-9 coding for epilepsy in the NHI data set were 83.91% and 99.83%, respectively, resulting in a slight overestimation. Male patients had a higher probability of having epilepsy than did females. East Taiwan had significantly higher prevalence and incidence than did other areas. The age-specific incidence pattern in east Taiwan was atypical in that it revealed clustering in young and middle-aged groups. Our study demonstrated geographic variation in epidemiologic patterns of epilepsy within Taiwan. The findings are informative and provide insight into the clinical management of epilepsy based on consideration of different target groups in different areas. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  20. Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada: Results from the Ontario HIV Treatment Network Cohort Study.

    Directory of Open Access Journals (Sweden)

    Stephanie K Y Choi

    Full Text Available Current studies of depression among people living with HIV focus on describing its point prevalence. Given the fluctuating nature of depression and its profound impacts on clinical and quality-of-life outcomes, this study aimed to examine the prevalence, recurrence and incidence of current depressive symptoms and its underlying catalysts longitudinally and systematically among these individuals.We conducted a prospective cohort study between October 1, 2007 and December 31, 2012 using longitudinal linked data sources. Current depressive symptoms was identified using the Centre for Epidemiologic Studies Depression Scale or the Kessler Psychological Distress Scale, first at baseline and again during follow-up interviews. Multivariable regressions were used to characterize the three outcomes.Of the 3,816 HIV-positive participants, the point prevalence of depressive symptoms was estimated at 28%. Of the 957 participants who were identified with depressive symptoms at baseline and who had at least two years of follow-up, 43% had a recurrent episode. The cumulative incidence among 1,745 previously depressive symptoms free participants (at or prior to baseline was 14%. During the five-year follow-up, our multivariable models showed that participants with greater risk of recurrent cases were more likely to feel worried about their housing situation. Participants at risk of developing incident cases were also likely to be younger, gay or bisexual, and unable to afford housing-related expenses.Depressive symptoms are prevalent and likely to recur among people living with HIV. Our results support the direction of Ontario's HIV/AIDS Strategy to 2026, which addresses medical concerns associated with HIV (such as depression and the social drivers of health in order to enhance the overall well-being of people living with or at risk of HIV. Our findings reinforce the importance of providing effective mental health care and demonstrate the need for long

  1. Increasing incidence and prevalence of diabetes among the Status Aboriginal population in urban and rural Alberta, 1995-2006.

    Science.gov (United States)

    Johnson, Jeffrey A; Vermeulen, Stephanie U; Toth, Ellen L; Hemmelgarn, Brenda R; Ralph-Campbell, Kelli; Hugel, Greg; King, Malcolm; Crowshoe, Lynden

    2009-01-01

    To compare changes in diagnosed diabetes prevalence and incidence among Status Aboriginal men and women living in urban and rural areas of Alberta. We compared trends in diabetes prevalence and incidence from 1995 to 2006 based on diagnostic codes from Alberta Health and Wellness (AHW) administrative records for adults aged 20 years and older. The AHW Registry file was used to determine registered Aboriginal status, as well as rural and urban residence (based on postal code). Multivariable logistic regression was used to compare diabetes rates over time, by sex and location of residence. Age- and sex-adjusted diabetes prevalence increased 35% in rural Status Aboriginals, from 10.9 (10.4-11.5) per 100 in 1995 to 14.7 (14.2-15.2) per 100 in 2006. Rates in urban Status Aboriginals increased 22% in the same time period from 9.4 (8.5-10.3) per 100 in 1995 to 11.5 (10.9-12.1) per 100 in 2006. The increases in prevalence were greater (p increased 45% in Status Aboriginal men, from 7.4 (4.9-10.6) per 1000 in 1995 to 10.7 (8.3-13.5) per 1000 in 2006 in urban locations, compared to a 35% increase among Status Aboriginal men living in rural locations (p = 0.628). Among Status Aboriginal women, incidence increased by 25% for those living in urban locations, but did not change for those in rural locations (p = 0.109). Prevalence and incidence of diagnosed diabetes were highest in Status Aboriginal women, but these rates have increased faster in men over the past decade, regardless of their location of residence.

  2. HbA1c as the diagnostic criterion for diabetes reduces incidence and prevalence of DM2 by 25% but strongly depending on analytical quality

    DEFF Research Database (Denmark)

    Brandslund, Ivan; Nielsen, Aneta Aleksandra; Hyldtoft Petersen, Per

    HbA1c as the diagnostic criterion for diabetes reduces incidence and prevalence of DM2 by 25% but strongly depending on analytical quality......HbA1c as the diagnostic criterion for diabetes reduces incidence and prevalence of DM2 by 25% but strongly depending on analytical quality...

  3. HIV prevalence, incidence and residual risk of transmission by transfusions at REDS-II blood centers in Brazil

    Science.gov (United States)

    Sabino, Ester C; Gonçalez, Thelma T; Carneiro-Proietti, Anna Bárbara; Sarr, Moussa; Ferreira, João Eduardo; Sampaio, Divaldo A; Salles, Nanci A; Wright, David J.; Custer, Brian; Busch, Michael

    2011-01-01

    Background In Brazil nationally representative donor data are limited on HIV prevalence, incidence and residual transfusion risk. The objective of this study was to analyze HIV data obtained over 24 months by the REDS-II program in Brazil. Methods Donations reactive to 3rd and 4th generation immunoassays (IAs) were further confirmed by a less-sensitive (LS) IA algorithm and Western blot (WB). Incidence was calculated for first-time (FT) donors using the LS-EIA results and for repeat donors with a model developed to include all donors with a previous negative donation. Residual risk was projected by multiplying composite FT/repeat donor incidence rates by HIV marker-negative infectious window periods. Results HIV prevalence among FT donors was 92.2/105 donations. FT, repeat donor and composite incidence were 38.5 (95%CI: 25.6–51.4), 22.5 (95%CI: 17.6–28.0) and 27.5 (95%CI: 22.0–33.0) per 100,000 person-years, respectively. Male and community donors had higher prevalence and incidence rates than female and replacement donors. Estimated residual risk of HIV transfusion-transmission was 11.3 per 106 donations (95%CI: 8.4–14.2), which could be reduced to 4.2 per 106 donations (95%CI: 3.2–5.2) by use of individual donation nucleic acid testing (NAT). Conclusion Incidence and residual transfusion risk of HIV infection are relatively high in Brazil. Implementation of NAT testing will not be sufficient to decrease transmission rates to levels seen in the US or Europe, therefore other measures focused on decreasing donations by at-risk individuals are also necessary. PMID:21981109

  4. ORGANIZATIONAL AND LEGAL RESEARCH OF INDICATORS OF INCIDENCE AND PREVALENCE OF DIABETES MELLITUS IN COUNTRYSIDE AREAS

    Directory of Open Access Journals (Sweden)

    Zbrozhek SI

    2017-03-01

    legal framework for the organization of pharmacy of the healthcare system in countryside areas; forensic and pharmaceutical practice concerning the complaints on countryside accessibility for their antidiabetic drugs; regional statistics of incidence and prevalence of diabetes mellitus. In conducting the research used the following methods: legal, documentary, bibliography, comparative, forensic and pharmaceutical, graphical analysis. Results and discussion. In the limited funding of the healthcare system and low pharmaceutical ensuring of patients with diabetes mellitus in countryside areas, the question of the optimal use of funds to avoid negative consequences, as evidenced presented in the article on an example of forensic and pharmaceutical practice. Among the possible reasons for such organizations to ensure pharmaceutical provision for privileged categories of citizens can point to the constant rise in prices for antidiabetic drugs and delay in timely registration of wholesale prices for these drugs. Also during the study was a comparative analysis of incidence and prevalence of diabetes at the regional level by the example of Kharkov region. The increase in the prevalence of diabetes is due to various factors, including stress, obesity, aging population, quality of food and life. The increase in the prevalence of the disease may indicate a lack of financing health systems, insufficient qualifications and training of medical personnel, the remoteness of rural health facilities and inadequate organization providing pharmaceutical rural antidiabetic drugs passivity farmers regarding preventive examinations, treatment their health, compliance with recommendations and a low level in the chain of relations "doctor - patient with diabetes mellitus - pharmacist." Conclusions. Diabetes mellitus treatment should be based on the principles of pharmaceutical law provided in Art. 4 of the Law of Ukraine "On the basis of legislation of Ukraine on healthcare" from the state

  5. Incidence and prevalence of type 2 diabetes mellitus with HIV infection in Africa: a systematic review and meta-analysis.

    Science.gov (United States)

    Prioreschi, A; Munthali, R J; Soepnel, L; Goldstein, J A; Micklesfield, L K; Aronoff, D M; Norris, S A

    2017-03-29

    This systematic review aims to investigate the incidence and prevalence of type 2 diabetes mellitus (T2DM) in patients with HIV infection in African populations. Only studies reporting data from Africa were included. A systematic search was conducted using four databases for articles referring to HIV infection and antiretroviral therapy, and T2DM in Africa. Articles were excluded if they reported data on children, animals or type 1 diabetes exclusively. Incidence of T2DM and prevalence of T2DM. Risk ratios were generated for pooled data using random effects models. Bias was assessed using an adapted Cochrane Collaboration bias assessment tool. Of 1056 references that were screened, only 20 were selected for inclusion. Seven reported the incidence of T2DM in patients with HIV infection, eight reported the prevalence of T2DM in HIV-infected versus uninfected individuals and five reported prevalence of T2DM in HIV-treated versus untreated patients. Incidence rates ranged from 4 to 59 per 1000 person years. Meta-analysis showed no significant differences between T2DM prevalence in HIV-infected individuals versus uninfected individuals (risk ratio (RR) =1.61, 95% CI 0.62 to 4.21, p=0.33), or between HIV-treated patients versus untreated patients (RR=1.38, 95% CI 0.66 to 2.87, p=0.39), and heterogeneity was high in both meta-analyses (I 2 =87% and 52%, respectively). Meta-analysis showed no association between T2DM prevalence and HIV infection or antiretroviral therapy; however, these results are limited by the high heterogeneity of the included studies and moderate-to-high risk of bias, as well as, the small number of studies included. There is a need for well-designed prospective longitudinal studies with larger population sizes to better assess incidence and prevalence of T2DM in African patients with HIV. Furthermore, screening for T2DM using gold standard methods in this population is necessary. PROSPERO42016038689. Published by the BMJ Publishing Group Limited. For

  6. Trends in adult chlamydia and gonorrhoea prevalence, incidence and urethral discharge case reporting in Mongolia from 1995 to 2016 – estimates using the Spectrum-STI model

    Science.gov (United States)

    Badrakh, Jugderjav; Zayasaikhan, Setsen; Jagdagsuren, Davaalkham; Enkhbat, Erdenetungalag; Jadambaa, Narantuya; Munkhbaatar, Sergelen; Taylor, Melanie; Rowley, Jane; Mahiané, Guy

    2017-01-01

    Objective To estimate Mongolia’s prevalence and incidence trends of gonorrhoea and chlamydia in women and men 15–49 years old to inform control of STIs and HIV, a national health sector priority. Methods We applied the Spectrum-STI estimation model, fitting data from two national population surveys (2001 and 2008) and from routine gonorrhoea screening of pregnant women in antenatal care (1997 to 2016) adjusted for diagnostic test performance, male/female differences and missing high-risk populations. Prevalence and incidence estimates were then used to assess completeness of national case reporting. Results Gonorrhoea prevalence was estimated at 3.3% (95% confidence interval, 1.6–3.9%) in women and 2.9% (1.6–4.1%) in men in 2016; chlamydia prevalence levels were 19.5% (17.3–21.9%) and 15.6% (10.0–21.2%), respectively. Corresponding new incident cases in women and men in 2016 totalled 60 334 (36 147 to 121 933) and 76 893 (35 639 to 254 913) for gonorrhoea and 131 306 (84 232 to 254 316) and 148 162 (71 885 to 462 588) for chlamydia. Gonorrhoea and chlamydia prevalence declined by an estimated 33% and 11%, respectively from 2001 to 2016. Comparing numbers of symptomatic and treated cases estimated by Spectrum with gonorrhoea case reports suggests that 15% of symptomatic treated gonorrhoea cases were reported in 2016; only a minority of chlamydia episodes were reported as male urethral discharge cases. Discussion Gonorrhoea and chlamydia prevalence are estimated to have declined in Mongolia during the early 2000s, possibly associated with syndromic management in primary care facilities and improving treatment coverage since 2001 and scale up of HIV/STI prevention interventions since 2003. However, prevalence remains high with most gonorrhoea and chlamydia cases not treated or recorded in the public health system. PMID:29487760

  7. Walk the talk: leaders' enacted priority of safety, incident reporting, and error management.

    Science.gov (United States)

    Van Dyck, Cathy; Dimitrova, Nicoletta G; de Korne, Dirk F; Hiddema, Frans

    2013-01-01

    The main goal of the current research was to investigate whether and how leaders in health care organizations can stimulate incident reporting and error management by "walking the safety talk" (enacted priority of safety). Open interviews (N = 26) and a cross-sectional questionnaire (N = 183) were conducted at the Rotterdam Eye Hospital (REH) in The Netherlands. As hypothesized, leaders' enacted priority of safety was positively related to incident reporting and error management, and the relation between leaders' enacted priority of safety and error management was mediated by incident reporting. The interviews yielded rich data on (near) incidents, the leaders' role in (non)reporting, and error management, grounding quantitative findings in concrete case descriptions. We support previous theorizing by providing empirical evidence showing that (1) enacted priority of safety has a stronger relationship with incident reporting than espoused priority of safety and (2) the previously implied positive link between incident reporting and error management indeed exists. Moreover, our findings extend our understanding of behavioral integrity for safety and the mechanisms through which it operates in medical settings. Our findings indicate that for the promotion of incident reporting and error management, active reinforcement of priority of safety by leaders is crucial. Social sciences researchers, health care researchers and health care practitioners can utilize the findings of the current paper in order to help leaders create health care systems characterized by higher incident reporting and more constructive error handling.

  8. Prevalent and incident tuberculosis are independent risk factors for mortality among patients accessing antiretroviral therapy in South Africa.

    Directory of Open Access Journals (Sweden)

    Ankur Gupta

    Full Text Available Patients with prevalent or incident tuberculosis (TB in antiretroviral treatment (ART programmes in sub-Saharan Africa have high mortality risk. However, published data are contradictory as to whether TB is a risk factor for mortality that is independent of CD4 cell counts and other patient characteristics.This observational ART cohort study was based in Cape Town, South Africa. Deaths from all causes were ascertained among patients receiving ART for up to 8 years. TB diagnoses and 4-monthly CD4 cell counts were recorded. Mortality rates were calculated and Poisson regression models were used to calculate incidence rate ratios (IRR and identify risk factors for mortality. Of 1544 patients starting ART, 464 patients had prevalent TB at baseline and 424 developed incident TB during a median of 5.0 years follow-up. Most TB diagnoses (73.6% were culture-confirmed. A total of 208 (13.5% patients died during ART and mortality rates were 8.84 deaths/100 person-years during the first year of ART and decreased to 1.14 deaths/100 person-years after 5 years. In multivariate analyses adjusted for baseline and time-updated risk factors, both prevalent and incident TB were independent risk factors for mortality (IRR 1.7 [95% CI, 1.2-2.3] and 2.7 [95% CI, 1.9-3.8], respectively. Adjusted mortality risks were higher in the first 6 months of ART for those with prevalent TB at baseline (IRR 2.33; 95% CI, 1.5-3.5 and within the 6 months following diagnoses of incident TB (IRR 3.8; 95% CI, 2.6-5.7.Prevalent TB at baseline and incident TB during ART were strongly associated with increased mortality risk. This effect was time-dependent, suggesting that TB and mortality are likely to be causally related and that TB is not simply an epiphenomenon among highly immunocompromised patients. Strategies to rapidly diagnose, treat and prevent TB prior to and during ART urgently need to be implemented.

  9. Prevalence and incidence of HIV in a rural community-based HIV vaccine preparedness cohort in Masaka, Uganda.

    Directory of Open Access Journals (Sweden)

    Eugene Ruzagira

    Full Text Available Local HIV epidemiology data are critical in determining the suitability of a population for HIV vaccine efficacy trials. The objective of this study was to estimate the prevalence and incidence of, and determine risk factors for HIV transmission in a rural community-based HIV vaccine preparedness cohort in Masaka, Uganda.Between February and July 2004, we conducted a house-to-house HIV sero-prevalence survey among consenting individuals aged 18-60 years. Participants were interviewed, counseled and asked to provide blood for HIV testing. We then enrolled the HIV uninfected participants in a 2-year HIV sero-incidence study. Medical evaluations, HIV counseling and testing, and sample collection for laboratory analysis were done quarterly. Sexual risk behaviour data was collected every 6 months.The HIV point prevalence was 11.2%, and was higher among women than men (12.9% vs. 8.6%, P = 0.007. Risk factors associated with prevalent HIV infection for men were age <25 years (aOR = 0.05, 95% CI 0.01-0.35 and reported genital ulcer disease in the past year (aOR = 2.17, 95% CI 1.23-3.83. Among women, being unmarried (aOR = 2.59, 95% CI 1.75-3.83 and reported genital ulcer disease in the past year (aOR = 2.40, 95% CI 1.64-3.51 were associated with prevalent HIV infection. Twenty-one seroconversions were recorded over 2025.8 person-years, an annual HIV incidence of 1.04% (95% CI: 0.68-1.59. The only significant risk factor for incident HIV infection was being unmarried (aRR = 3.44, 95% CI 1.43-8.28. Cohort retention after 2 years was 87%.We found a high prevalence but low incidence of HIV in this cohort. HIV vaccine efficacy trials in this population may not be feasible due to the large sample sizes that would be required. HIV vaccine preparatory efforts in this setting should include identification of higher risk populations.

  10. A 60-year follow-up of the incidence and prevalence of multiple sclerosis in Hordaland County, Western Norway.

    Science.gov (United States)

    Grytten, N; Aarseth, J H; Lunde, H M B; Myhr, K M

    2016-01-01

    Investigate the incidence of multiple sclerosis during 1953-2013 and estimate the prevalence rate of MS on 1 January 2003 and 2013 in Hordaland County, Western Norway. All patients with onset of disease in Hordaland 1953-2013 were identified in files from previous studies until 2003 and from patient records at the departments of Neurology, Haukeland University Hospital and Haugesund Hospital during 2003-2013. 1558 patients were assessed and 1402 of these were included, of whom 1035 were alive and living in Hordaland at prevalence day 1 January 2013. Annual incidence rates were calculated for 1953-2013. On 1 January 2003, the crude prevalence rate was 191/100 000 population and on 1 January 2013, the crude prevalence rate was 211.4 (95% CI 198.3 to 224.2) per 100 000; 270.9 (95% CI 250.6 to 292.3) for women and 151.8 (95% CI 136.8 to 167.9) for men. Prevalence peaked at ages 55-59 years for women and 60-64 years for men. The annual incidence rate increased from 1.9 (95% CI 1.2 to 2.6) per 100 000 during 1953-1957 to 7.2 (95% CI 6.0 to 8.5) during 1978-1982 and to 8.5 (95% CI 7.3 to 9.7) during 2003-2007, thus indicating a stabilising incidence over the past 35 years. The female/male ratio ranged from 1.2:1 to 1.8:1 (p=0.381) during the period. Stabilising rather than increasing incidence combined with the stable female/male ratio are indicative of non-fluctuating environmental factors in a geographical area otherwise characterised by lack of vitamin D effective sun exposure. The rising prevalence of MS could result from improved survival and follow-up methodology. 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/

  11. Prevalent and incident use of androgen deprivation therapy among men with prostate cancer in the United States.

    Science.gov (United States)

    Gilbert, Scott M; Kuo, Yong-Fang; Shahinian, Vahakn B

    2011-01-01

    Androgen deprivation therapy (ADT) for prostate cancer increased substantially through the 1990s, but more recent national trends regarding incident and prevalent use have been incompletely characterized. Linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data were used to study patterns of ADT utilization. Prevalence of ADT in the male Medicare population was estimated by examining a cohort of prostate cancer patients and a 5% noncancer control population, from 1991 to 2005. ADT use across different indications was examined for men with incident cancers from 2000 to 2002. Nested logit models were used to examine determinants of ADT use in men with lower risk prostate cancer not treated definitively by surgery or radiation. Prevalent ADT use increased through the 1990s, peaked in 2000 at 3.17% of all male Medicare beneficiaries, subsequently stabilized, then dropped in 2005 to 2.92%. Between 2000 and 2002, use in incident prostate cancer was stable, with 44.8% use in all cases, 15% of cases as an adjuvant with radiation, and 14% as a primary therapy. In the nested logit model, predictors of ADT use in a lower risk setting were older age, higher stage and grade, and elevated prostate-specific antigen levels. Following a period of rapid expansion during the 1990s, incident and prevalent use of ADT has leveled, and may be starting to decline. Further research is needed to monitor how reductions in reimbursement for GnRH agonists will affect appropriate use of ADT as well as use in settings where its benefits may be marginal. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015

    OpenAIRE

    Vos, Theo; Allen, Christine; Arora, Megha; Barber, R.M.; Bhutta, Zulfiqar; Brown, Alexandria; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Chen, Alan Z.; Geleijnse, J.M.

    2016-01-01

    BackgroundNon-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at t...

  13. The prevalence, incidence, and gender and age-specific incidence of problem gambling: results of the Swedish longitudinal gambling study (Swelogs).

    Science.gov (United States)

    Abbott, Max; Romild, Ulla; Volberg, Rachel

    2018-04-01

    To estimate the prevalence, incidence and gender and age-specific incidence of problem gambling in the Swedish adult population. Longitudinal cohort study with linkage to register data. Sweden. Stratified random sample aged 16-84 years at baseline (n = 8165) re-assessed a year later (n = 6021). Problem gambling (life-time and past 12 months) was measured by the South Oaks Gambling Screen-Revised (SOGS-R). Past 12-month (current) problem gambling was also measured by the Problem Gambling Severity Index (PGSI). The SOGS-R combined current pathological and problem gambling prevalence rate (PR) was 2.1 [95% confidence interval (CI) = 1.8-2.4] at baseline and 1.7 (1.4-2.0) at follow-up, approximately half the corresponding life-time estimates.[Correction added on 22 Dec 2017, after first online publication: In the preceding sentence, the SOGS-R combined current pathological and problem gambling prevalence rate (PR) was incorrectly reported as being double the corresponding life-time rate. It has been corrected in this version.] PGSI combined current problem and moderate-risk gambling PRs were 2.2 (1.9-2.5) at baseline and 1.9 (1.6-2.2) at follow-up. Combined incidence rates (IRs) were 1.0 (0.8-1.3) (SOGS-R) and 1.4 (1.1-1.7) (PGSI), with more than three-quarters being new cases. While first-time IRs did not vary by gender, males had a higher relapse IR and proportionately more females were new cases. The young adult IR was more than double the older adult IR; similar proportions were new cases. The actual incidence of problem gambling relapse in Sweden is likely to be higher than estimated. The profile of problem gambling in Sweden is likely to change over time, with increased proportions of women and older adults. © 2017 Society for the Study of Addiction.

  14. Comparison of the prevalence and characteristics of inpatient adverse events using medical records review and incident reporting.

    Science.gov (United States)

    Macharia, W M; Muteshi, C M; Wanyonyi, S Z; Mukaindo, A M; Ismail, A; Ekea, H; Abdallah, A; Tole, J M; Ngugi, A K

    2016-09-08

    Information on adverse events (AEs) in hospitalised patients in developing countries is scanty. To compare the magnitude and characteristics of inpatient AEs in a tertiary, not-for-profit healthcare facility in Kenya, using medical records review and incident reporting. Estimation of prevalence was done using incidents reported in 2010 from a random sample of medical records for hospital admissions. Nurse reviewers used 18 screening criteria, followed by physician reviewers to confirm occurrence. An AE was defined as an unexpected clinical event (UE) associated with death, disability or prolonged hospitalisation not explained by the disease condition. The kappa statistic was used to estimate inter-rater agreement, and analysis was done using logistic regression. The study identified 53 UEs from 2 000 randomly selected medical records and 33 reported UEs from 23 026 admissions in the index year. The prevalences of AEs from medical records review and incident reports were 1.4% (95% confidence interval (CI) 0.9 - 2.0) and 0.03% (95% CI 0.012 - 0.063), respectively. Compared with incident reporting, review of medical records identified more disability (13.2% v. 0%; p=0.03) and prolonged hospital stays (43.4% v. 18.2%; p=0.02). Review of medical records is preferable to incident reporting in determining the prevalence of AEs in health facilities with limited inpatient quality improvement experience. Further research is needed to determine whether staff education and a positive culture change through promotion of non-punitive UE reporting or a combination of approaches would improve the comprehensiveness of AE reporting.

  15. Effect of montanide adjuvanted staphylococcus aureus bacterin-toxiod on prevalence and incidence of mastitis in cows

    International Nuclear Information System (INIS)

    Yousif, A.; Muhmmad, G.; Masood, M.Z.; Rahman, S.U.; Siddique, M.

    2009-01-01

    The current study was conducted to investigate the prevalence and incidence of mastitis associated with Montanide adjuvanted Staphylococcus aureus bacterin toxiod in dairy cows in Faisalabad (Punjab, Pakistan). A total of 60 mastitis free dairy cows, in first and second month of lactation, were selected on the basis of results determined by California mastitis test and Surf field mastitis test. The animals were randomly divided into three groups (C1, C2, and C3) each containing twenty cows. The vaccine was administered twice with four weeks interval at the rate of 5 ml intramuscularly in the neck region in all the animals of group C1 and C2. Levamisole HCl (Nilverm at the rate, ICI, Pakistan) at the rate 2.5 mg per kg weight was given orally to animals of group C2 after first and second injections of vaccine, while the animals in group C3 were kept as control (non-vaccinated and non-medicated with levamisole HCl). Prevalence and incidence rates were determined at 1st, 30th , 60th , 120th and 180th days post-vaccination. The results showed that maximum numbers of quarters were found positive in group C3 with maximum cumulative prevalence (27.5%) while minimum (11.25%) was recorded in group C2 followed by vaccinated group (13.75 %). There was no significant variation in cumulative incidence between the vaccinated and vaccinated plus levamisole HCl group. (author)

  16. Critical evaluation of incidence and prevalence of white spot lesions during fixed orthodontic appliance treatment: A meta-analysis.

    Science.gov (United States)

    Sundararaj, Dhinahar; Venkatachalapathy, Sudhakar; Tandon, Akshay; Pereira, Aaron

    2015-01-01

    Development of dental caries, specifically, white spot lesions (WSLs), continues to be a well-recognized and troubling side effect of orthodontic fixed appliance therapy, despite vast improvement in preventive dental techniques and procedures. The aim of this meta-analysis is to evaluate, determine, and summarize the incidence and prevalence rates of WSLs during orthodontic treatment that have been published in the literature. According to predetermined criteria, databases were searched for appropriate studies. References of the selected articles and relevant reviews were searched for any missed publications. In the 14 studies evaluated for WSLs, the incidence of new carious lesions formed during orthodontic treatment in patients was 45.8% and the prevalence of lesions in patients undergoing orthodontic treatment was 68.4%. The incidence and prevalence rates of WSLs in patients undergoing orthodontic treatment are quite high and significant. This widespread problem of WSL development is an alarming challenge and warrants significant attention from both patients and providers, which should result in greatly increased emphasis on effective caries prevention.

  17. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil.

    Science.gov (United States)

    Saffier, Igor Pedrosa; Kawa, Hélia; Harling, Guy

    2017-10-11

    Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any time in the HIV epidemic which provided estimates specific to ages 10-25 (or some subset of this age range) for Brazilians on either: (a) HIV prevalence or incidence; or (b) the association between HIV and socio-demographic or behavioral risk factors. Forty eight publications met the inclusion criteria: 44 cross-sectional, two case-control, two cohort. Four studies analysed national data. Forty seven studies provided HIV prevalence estimates, largely for six population subgroups: Counselling and Testing Center attendees; blood donors; pregnant women; institutional individuals; men-who-have-sex-with-men (MSM) and female sex workers (FSW); four provided HIV incidence estimates. Twelve studies showed HIV status to be associated with a wide range of risk factors, including age, sexual and reproductive history, infection history, substance use, geography, marital status, mental health and socioeconomic status. Few published studies have examined HIV amongst young people in Brazil, and those published have been largely cross-sectional and focused on traditional risk groups and the south of the country. Despite these limitations, the literature shows raised HIV prevalence amongst MSM and FSW, as well as amongst those using drugs. Time trends are harder to identify, although rates appear to be falling for pregnant women, possibly reversing an earlier de-masculinization of the epidemic. Improved surveillance of HIV incidence, prevalence and risk factors is a key component of efforts to eliminate HIV in

  18. Acute Appendicitis: Incidence and Management in Nigeria | Alatise ...

    African Journals Online (AJOL)

    Appendicitis is the leading cause of surgical emergency admission in most hospital in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life.

  19. The Critical Incident Technique in Library and Information Management Research.

    Science.gov (United States)

    Fisher, Shelagh; Oulton, Tony

    1999-01-01

    Focuses on the application of the Critical Incident Technique (CIT) in three studies at the Department of Information and Communications, Manchester Metropolitan University, United Kingdom. Examines staff-development needs as a key element in change in higher education; decision-making practices in small- to medium-size libraries; and development…

  20. Incidence, Pattern and Management of Ovarian Cancer at a Tertiary ...

    African Journals Online (AJOL)

    Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku‑Ozalla 1Department of. Histopathology, University of ... ovarian cancer giving an incidence rate of 1/405 gynecological admissions per year or 0.3% (95% .... not found in the records. Follow up of patients was by clinical examination and.

  1. Submicroscopic Plasmodium prevalence in relation to malaria incidence in 20 villages in western Cambodia

    NARCIS (Netherlands)

    Tripura, Rupam; Peto, Thomas J.; Veugen, Christianne C.; Nguon, Chea; Davoeung, Chan; James, Nicola; Dhorda, Mehul; Maude, Richard J.; Duanguppama, Jureeporn; Patumrat, Krittaya; Imwong, Mallika; von Seidlein, Lorenz; Grobusch, Martin P.; White, Nicholas J.; Dondorp, Arjen M.

    2017-01-01

    Cambodia has seen a marked reduction in the incidence of Plasmodium falciparum over the past decade without a corresponding decline in Plasmodium vivax incidence. It is unknown to what extent local transmission is sustained by a chain of clinical and sub-clinical infections or by continued

  2. Prevalence, Incidence, and Sex Ratio of Transsexualism in the Autonomous Region of Madrid (Spain) According to Healthcare Demand.

    Science.gov (United States)

    Becerra-Fernández, Antonio; Rodríguez-Molina, José Miguel; Asenjo-Araque, Nuria; Lucio-Pérez, María Jesús; Cuchí-Alfaro, Miguel; García-Camba, Eduardo; Pérez-López, Gilberto; Menacho-Román, Miriam; Berrocal-Sertucha, María Carmen; Ly-Pen, Domingo; Aguilar-Vilas, María Victorina

    2017-07-01

    In recent years, different studies have provided estimates of the prevalence of transsexualism with very diverse results. The purpose of this study was to ascertain the prevalence, incidence, and sex ratio of transsexualism in the autonomous region of Madrid (Spain). A total of 1234 patients who attended from 2007 to the end of 2015 in the only Gender Identity Unit (GIU) in Madrid were analyzed. Sixty-three patients were excluded for various reasons; thus, 1171 could be included: 803 male-to-female (MtF) and 368 female-to-male (FtM) transsexual patients. Transsexualism was diagnosed based on the ICD-10, World Health Organization, 1992, and/or gender identity disorder based on the DSM-IV-TR, American Psychiatric Association, 2000. The demographic statistics were calculated on the basis of the population over 15 years old of Madrid. Based on healthcare demand, the prevalence of transsexualism was 22.1 in 100,000 inhabitants: 31.2 for MtF and 12.9 for FtM, making the MtF/FtM ratio approximately 2.2:1. The incidence rate was 2.5 in 100,000 inhabitants, representing an annual average of 130 demands. Although transsexualism occurs in all countries with different rates of prevalence, in our area, this prevalence was higher than reported from other European countries. We believe that two main circumstances might influence this high prevalence: the easy accessibility and the absence of a waiting list to the GIU, and the permissive social and legal climate and openness of Spain, especially in Madrid.

  3. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection and han...

  4. Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies

    Science.gov (United States)

    Brunton, Margaret Ann; Jeffrey, Lynn Maud

    2010-01-01

    This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

  5. Dysmenorrhoea among Hong Kong university students: prevalence, impact, and management.

    Science.gov (United States)

    Chia, C F; Lai, Joyce H Y; Cheung, P K; Kwong, L T; Lau, Fiona P M; Leung, K H; Leung, M T; Wong, Francis C H; Ngu, S F

    2013-06-01

    OBJECTIVE. To evaluate the prevalence of dysmenorrhoea, its impact, and management approaches in Hong Kong university students, and to compare between medical and non-medical students for any potential differences in coping strategies. DESIGN. Cross-sectional questionnaire survey. SETTING. The University of Hong Kong, Hong Kong. PARTICIPANTS. A total of 240 undergraduate (128 medical and 112 non-medical) students. MAIN OUTCOME MEASURES. Data on the presence and severity of dysmenorrhoea, its impact on daily life, management approaches, specific strategies, and their self-perceived effectiveness were obtained and analysed. RESULTS. In these subjects, the prevalence of dysmenorrhoea was 80% (95% confidence interval, 75-85%) with a mean (standard deviation) pain score of 5.0 (1.7). The most common impacts on daily life included reduced ability to concentrate and/or disturbance with study (75%) and changes in normal physical activity (60%). Only 6% sought medical advice, while 70% practised self-management. Pain scores and pain affecting normal physical activities were important predictive factors for self-management and for management based on pharmacological or non-pharmacological means. The commonest specific strategies used were a warm beverage (62%), paracetamol (57%), and sleeping (45%), while the most effective strategies were non-steroidal anti-inflammatory drugs (100%), traditional Chinese medicine (93%), and dietary/nutritional supplements (92%). Regarding the comparison of medical and non-medical students, the former used fewer pharmacological strategies among the various management approaches investigated. CONCLUSION. With data showing dysmenorrhoea as a very common condition having a significant impact in the Hong Kong community, primary care doctors should reassure young women with dysmenorrhoea that it is a common experience in the same age-group. Health education on the existence of effective treatment from medical practitioners could help women whose

  6. Incidence of type 1 diabetes mellitus during 26 years of observation and prevalence of diabetic ketoacidosis in the later years.

    Science.gov (United States)

    Wojcik, Malgorzata; Sudacka, Malgorzata; Wasyl, Barbara; Ciechanowska, Marta; Nazim, Joanna; Stelmach, Malgorzata; Starzyk, Jerzy B

    2015-10-01

    The prevalence of type 1 diabetes (T1D) varies greatly between countries. However, over the past several decades, a global rise in the incidence of T1D in the pediatric population has been noted. The aim of our study was to investigate the incidence of T1D in children living in the Lesser Poland during the period of time from January 1, 1987, to December 31, 2012, and to analyze the demographic characteristics and occurrence of diabetic ketoacidosis (DKA) in patients with newly diagnosed T1D in the second part of the study (2006-2012). During 26 years, 636 children (331 boys, 305 girls) aged 0-14 years were newly diagnosed with T1D (0-4 years old, n = 131; 5-9 years old, n = 253, 10-14 years old, n = 252). The standardized incidence ratio (SIR) ranged significantly (p diabetes mellitus in Europe is increasing. The initial manifestation of the type 1 diabetes mellitus is diabetic ketoacidosis. What is New: • This is the longest (26 years) continuous analysis of the incidence of type 1 diabetes in Poland and the first analysis focused on the incidence rate and also on presence of diabetic ketoacidosis.

  7. Simulation analysis of route diversion strategies for freeway incident management : final report.

    Science.gov (United States)

    1995-02-01

    The purpose of this project was to investigate whether simulation models could : be used as decision aids for defining traffic diversion strategies for effective : incident management. A methodology was developed for using such a model to : determine...

  8. Criminal victimisation in people with severe mental illness: a multi-site prevalence and incidence survey in the Netherlands.

    Directory of Open Access Journals (Sweden)

    Astrid M Kamperman

    Full Text Available BACKGROUND: Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so, few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the results with victimisation rates in the general population. METHOD: This multisite epidemiological survey included a random sample of 956 adult severely mentally ill outpatients. Data on victimisation were obtained using the victimisation scale of the Dutch Crime and Victimisation Survey, which assesses crime victimisation over the preceding 12 months. Comparison data were derived from the nationwide survey on safety and victimisation in the Netherlands. Prevalence and incident rates were weighted for sex, age, ethnicity and socioeconomic status, and compared with a general population sample matched by region (N = 38,227. RESULTS: In the past year, almost half of the severely mentally ill outpatients (47% had been victim of a crime. After control for demographic differences, prevalence rates of overall and specific victimisation measures were significantly higher in severely mentally ill outpatients than in the general population. The relative rates were especially high for personal crimes such as violent threats (RR = 2.12, 95% CI: 1.72-2.61, physical assaults (RR = 4.85, 95% CI: 3.69-6.39 and sexual harassment and assaults (RR = 3.94, 95% CI: 3.05-5.09. In concordance, severely mentally ill outpatients reported almost 14 times more personal crime incidents than persons from the general population (IRR = 13.68, 95% CI: 12.85-14.56. CONCLUSION: Crime victimisation is a serious problem in Dutch severely mentally ill outpatients. Mental-healthcare institutions and clinicians should become aware of their patients' victimisation risk, and should implement structural measures to detect and prevent (re-victimisation.

  9. Incidence and prevalence of lower extremity tendinopathy in a Dutch general practice population: a cross sectional study.

    Science.gov (United States)

    Albers, Iris Sophie; Zwerver, Johannes; Diercks, Ronald Leo; Dekker, Janny Hendrika; Van den Akker-Scheek, Inge

    2016-01-13

    Lower extremity tendinopathy is a common sports injury, but it can also affect non-athletes. Because tendinopathy is difficult to treat and has negative effects on the ability to work and quality of life, development of preventive interventions is important. The first step in the Van Mechelen prevention model is to determine the extent of the problem. The primary aim of this study was to determine the incidence and prevalence of lower extremity tendinopathy in a Dutch general practice population. The secondary aim was to investigate possible associated factors. A cross-sectional study was performed in a Dutch general practice. Using International Classification of Primary Care codes, the electronic patient files were searched to identify cases of adductor tendinopathy, greater trochanteric pain syndrome, jumper's knee, Achilles tendinopathy, and plantar fasciopathy in 2012. The tendinopathy patients were compared to the general practice population regarding age, gender, use of medication, and comorbidity using 95% confidence intervals. The prevalence and incidence rates of lower extremity tendinopathy found in this study were 11.83 and 10.52 per 1000 person-years. Lower extremity tendinopathy was more prevalent among older patients. No differences between tendinopathy patients and the general practice population were found regarding gender, use of medication, or comorbidity. In this cross-sectional study in a Dutch general practice, the prevalence and incidence rates of lower extremity tendinopathy were 11.83 and 10.52 per 1000 person-years. Lower extremity tendinopathy deserves a higher place in locomotor system research to develop preventive interventions.

  10. Charcot-Marie-Tooth disease in Denmark: a nationwide register-based study of mortality, prevalence and incidence

    Science.gov (United States)

    Vaeth, Signe; Vaeth, Michael; Andersen, Henning; Christensen, Rikke; Jensen, Uffe Birk

    2017-01-01

    Objectives Charcot-Marie-Tooth disease (CMT) is the most common inherited disorder of the peripheral nervous system, yet no studies have compared the mortality in patients with CMT with that of the general population, and prevalence estimates vary considerably. We performed a nationwide register-based study to investigate the prevalence, incidence and mortality of CMT in Denmark. Design We used the Danish National Patient Registry to select all records with primary diagnostic codes for CMT between 1977 and 2012 given at a neurological, neurophysiological, paediatric or clinical genetic clinic. The prevalence was estimated by 31 December 2012, and the incidence rate was calculated based on data from 1988 to 2012. We calculated a standardised mortality ratio (SMR) and an absolute excess mortality rate (AER) stratified according to age categories and disease duration. Results A total of 1534 patients (652 women) were identified. The prevalence proportion was 22.5 per 100 000 (95% CI 21.2 to 23.7) and the incidence rate was 0.98 (95% CI 0.93 to 1.04) per 100 000 person-years. The SMR was 1.36 (95% CI 1.21 to 1.53), and the AER was 4.87 per 1000 person-years (95% CI 2.77 to 6.96). We found a significantly higher SMR in cases below 50 years of age, and in cases with disease duration of more than 10 years. Conclusions We found a reduced life expectancy among patients diagnosed with CMT. To our knowledge, this is the first study of CMT to use nationwide register-based data, and the first to report an SMR and an AER. PMID:29101144

  11. [Upper Austria model study to assess the prevalence and incidence of congenital abnormalities].

    Science.gov (United States)

    Schaller, A; Vutuc, C; Bartsch, F; Bodingbauer, G; Bodingbauer, J; Fiedler, T; Fröhlich, H; Golob, E; Gotschall, J; Gruber, L

    1987-04-30

    Among the 15.998 live births recorded in Upper Austria in the year 1985, a representative malformation rate of 1.79, respectively a representative incidence of 17.94 in 1000 live births is reported. The incidences of characteristic malformations and of single malformations combined in malformation groups are determined. An instrument of investigation, especially developed for and successfully used in this examination in form of an illustrated questionnaire is introduced.

  12. Subnormal Peripheral Blood Leukocyte Counts Are Related to the Lowest Prevalence and Incidence of Metabolic Syndrome: Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study

    Science.gov (United States)

    Sun, Shaomei; Wu, Hongmei; Zhang, Qing; Wang, Chongjin; Guo, Yinting; Du, Huanmin; Liu, Li; Jia, Qiyu; Wang, Xing; Song, Kun

    2014-01-01

    Few studies have assessed the relationship between a subnormal inflammatory status and metabolic syndrome (MS). We therefore designed a cross-sectional and 5-year cohort study to evaluate how a subnormal peripheral blood leukocyte count is related to MS. Participants were recruited from Tianjin Medical University General Hospital-Health Management Centre. Both a baseline cross-sectional (n = 46,179) and a prospective assessment (n = 13,061) were performed. Participants without a history of MS were followed up for 5 years. Leukocyte counts and MS components were assessed at baseline and yearly during the follow-up. Adjusted logistic and Cox proportional hazards regression models were used to assess relationships between the categories of leukocyte counts and MS. The subnormal leukocyte counts group (1,100–3,900 cells/mm3) had the lowest prevalence and incidence of MS. The odds ratio and hazard ratio (95% confidence interval) of the highest leukocyte counts were 1.98 (1.57–2.49) and 1.50 (1.22–1.84) (both P for trend leukocyte counts group after adjusting for potential confounders. This study has shown that subnormal leukocyte counts are independently related to the lowest prevalence and incidence of MS. The findings suggest that it is necessary to restudy and discuss the clinical or preventive value of subnormal leukocyte counts. PMID:24876672

  13. The Prevalence of Helicobacter pylori Virulence Factors in Bhutan, Vietnam, and Myanmar Is Related to Gastric Cancer Incidence

    Directory of Open Access Journals (Sweden)

    Tran Thi Huyen Trang

    2015-01-01

    Full Text Available Gastric cancer is a significant health problem in Asia. Although the prevalence of Helicobacter pylori infection is similar in Bhutan, Vietnam, and Myanmar, the incidence of gastric cancer is highest in Bhutan, followed by Vietnam and Myanmar. We hypothesized that H. pylori virulence factors contribute to the differences. The status of cagA, vacA, jhp0562, and β-(1,3galT(jhp0563 was examined in 371 H. pylori-infected patients from Bhutan, Vietnam, and Myanmar. Each virulence factor could not explain the difference of the incidence of gastric cancer. However, the prevalence of quadruple-positive for cagA, vacA s1, vacA m1, and jhp0562-positive/β-(1,3galT-negative was significantly higher in Bhutan than in Vietnam and Myanmar and correlated with gastric cancer incidence. Moreover, gastritis-staging scores measured by histology of gastric mucosa were significantly higher in quadruple-positive strains. We suggest that the cagA, vacA s1, vacA m1, and jhp0562-positive/β-(1,3galT-negative genotype may play a role in the development of gastric cancer.

  14. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies.

    Science.gov (United States)

    Doherty, Cailbhe; Delahunt, Eamonn; Caulfield, Brian; Hertel, Jay; Ryan, John; Bleakley, Chris

    2014-01-01

    Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with

  15. Prevalent and Incident Vertebral Deformities in Midlife Women: Results from the Study of Women's Health Across the Nation (SWAN.

    Directory of Open Access Journals (Sweden)

    Gail A Greendale

    Full Text Available Vertebral fractures are the most common type of osteoporotic fracture among women, but estimates of their prevalence and incidence during middle-age are limited. The development of vertebral morphometry (VM using dual energy X-ray absorptiometry (DXA makes it more feasible to measure VM in large, longitudinal, observational studies. We conducted this study to: 1 contribute to the scant knowledge of the prevalence, incidence and risk factors for vertebral deformities in middle-aged women; and 2 to evaluate the performance of DXA-based VM measurement in a large, community based sample.The sample is derived from the Study of Women's Health Across the Nation (SWAN, a multi-site, community-based, longitudinal cohort study of the MT. Using Hologic QDR 4500A instruments, we acquired initial VM measurements in 1446 women during calendar years 2004-2007; in 2012-2013, a follow-up VM was obtained in 1108. Annually, lumbar spine (LS and femoral neck (FN bone mineral density (BMD were measured and participant characteristics were assessed with standardized instruments. Multivariable logistic regression models examined the relations between prevalent deformity and relevant characteristics. Analyses of characteristics associated with prevalent deformity were restricted to 824 women who had not taken bone active medications since SWAN baseline. We calculated incident deformity per person year (PY of observation, standardized to 1000 person-years.The cranial portion of the VM image yielded the lowest proportions of readable vertebrae: from T4 through T6, between 43% and 63% of vertebral bodies were evaluable. Greater BMI was associated with fewer readable levels (B = -0.088, p<0.0001. In the baseline sample of 1446 women, the prevalence of vertebral deformity was 3.2% (95% CI: 2.3, 4.1. The relative odds of deformity increased by 61% per SD decrement in baseline LS BMD (p = 0.02 and were 67% greater per SD decrement in baseline FN BMD (p = 0.04. Odds of

  16. Incidence, Prevalence, and Survival of Biopsy-Proven Giant Cell Arteritis in Northern Italy During a 26-Year Period.

    Science.gov (United States)

    Catanoso, Mariagrazia; Macchioni, Pierluigi; Boiardi, Luigi; Muratore, Francesco; Restuccia, Giovanna; Cavazza, Alberto; Pipitone, Nicolò; Mancuso, Pamela; Luberto, Ferdinando; Salvarani, Carlo

    2017-03-01

    To investigate the epidemiology and mortality in patients with biopsy-proven giant cell arteritis (GCA) in northern Italy. All patients with incident temporal-artery biopsy-positive GCA, diagnosed between 1986 and 2012 and living in the Reggio Emilia area, were identified by using a pathology register and by reviewing all histopathologic specimens. For each patient, we identified 1 comparison subject from the same geographic area, matched for age and sex. Mortality rates and specific causes of death were reported. There were 285 incident cases of biopsy-proven GCA (210 women) during the 26-year study period. The overall age- and sex-adjusted incidence per 100,000 persons ages ≥50 years was 5.8 (95% confidence interval [95% CI] 5.1, 6.5). Incidence was significantly higher in women (7.8 [95% CI 6.7, 8.9]) than in men (3.3 [95% CI 2.6, 4.1]) (P < 0.0001). Annual age- and sex-adjusted incidence rates significantly increased by 15.9% per 3 years from 1986 to 2000, then significantly fell by -4.8% per 3 years from 2001-2012. The prevalence of GCA on December 31, 2012 was 87.9 (95% CI 75.8, 101.4). No significant differences in the mortality rates were observed between GCA patients (4.9 per 100 person-years [95% CI 4.1, 5.8]) and non-GCA subjects (5.6 [95% CI 4.7, 6.6]). No significant differences in causes of death were observed comparing GCA patients to non-GCA subjects. This large population-based study of biopsy-proven GCA confirmed the lower incidence of GCA in Mediterranean countries and did not observe any increased mortality risk. © 2016, American College of Rheumatology.

  17. Prevalence, incidence burden, and clinical impact of healthcare-associated infections and antimicrobial resistance: a national prevalent cohort study in acute care hospitals in Greece

    Directory of Open Access Journals (Sweden)

    Kritsotakis EI

    2017-10-01

    Full Text Available Evangelos I Kritsotakis,1 Flora Kontopidou,2 Eirini Astrinaki,3 Maria Roumbelaki,4 Eleni Ioannidou,5 Achilles Gikas6 1School of Health and Related Research, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK; 2Healthcare Associated Infections and Antimicrobial Resistance Office, Hellenic Center for Disease Control and Prevention, Athens, 3Infection Control Committee, University Hospital of Heraklion, 4Department of Nursing, Technological Educational Institute of Crete, Heraklion, 5Department of Internal Medicine, Rethymnon General Hospital, Rethymnon, 6Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, Heraklion, Greece Background: Assessing the overall burden of healthcare-associated infections (HAIs is challenging, but imperative in evaluating the cost-effectiveness of infection control programs. This study aimed to estimate the point prevalence and annual incidence of HAIs in Greece and assess the excess length of stay (LOS and mortality attributable to HAIs, overall and for main infection sites and tracer antimicrobial resistance (AMR phenotypes and pathogens.Patients and methods: This prevalent cohort study used a nationally representative cross-section of 8,247 inpatients in 37 acute care hospitals to record active HAIs of all types at baseline and overall LOS and in-hospital mortality up to 90 days following hospital admission. HAI incidence was estimated using prevalence-to-incidence conversion methods. Excess mortality and LOS were assessed by Cox regression and multistate models correcting for confounding and time-dependent biases.Results: HAIs were encountered with daily prevalence of 9.1% (95% confidence interval [CI] 7.8%–10.6%. The estimated annual HAI incidence was 5.2% (95% CI 4.4%–5.3%, corresponding to approximately 121,000 (95% CI 103,500–123,700 affected patients each year in the country. Ninety-day mortality risk was increased by 80% in patients

  18. Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study.

    Science.gov (United States)

    Ahmadi-Abhari, Sara; Guzman-Castillo, Maria; Bandosz, Piotr; Shipley, Martin J; Muniz-Terrera, Graciela; Singh-Manoux, Archana; Kivimäki, Mika; Steptoe, Andrew; Capewell, Simon; O'Flaherty, Martin; Brunner, Eric J

    2017-07-05

    Objective  To forecast dementia prevalence with a dynamic modelling approach that integrates calendar trends in dementia incidence with those for mortality and cardiovascular disease. Design  Modelling study. Setting  General adult population of England and Wales. Participants  The English Longitudinal Study of Ageing (ELSA) is a representative panel study with six waves of data across 2002-13. Men and women aged 50 or more years, selected randomly, and their cohabiting partners were recruited to the first wave of ELSA (2002-03). 11392 adults participated (response rate 67%). To maintain representativeness, refreshment participants were recruited to the study at subsequent waves. The total analytical sample constituted 17 906 people. Constant objective criteria based on cognitive and functional impairment were used to ascertain dementia cases at each wave. Main outcome measures  To estimate calendar trends in dementia incidence, correcting for bias due to loss to follow-up of study participants, a joint model of longitudinal and time-to-event data was fitted to ELSA data. To forecast future dementia prevalence, the probabilistic Markov model IMPACT-BAM (IMPACT-Better Ageing Model) was developed. IMPACT-BAM models transitions of the population aged 35 or more years through states of cardiovascular disease, cognitive and functional impairment, and dementia, to death. It enables prediction of dementia prevalence while accounting for the growing pool of susceptible people as a result of increased life expectancy and the competing effects due to changes in mortality, and incidence of cardiovascular disease. Results  In ELSA, dementia incidence was estimated at 14.3 per 1000 person years in men and 17.0/1000 person years in women aged 50 or more in 2010. Dementia incidence declined at a relative rate of 2.7% (95% confidence interval 2.4% to 2.9%) for each year during 2002-13. Using IMPACT-BAM, we estimated there were approximately 767 000 (95% uncertainty

  19. Canadian Digestive Health Foundation Public Impact Series 3: irritable bowel syndrome in Canada. Incidence, prevalence, and direct and indirect economic impact.

    Science.gov (United States)

    Fedorak, Richard N; Vanner, Stephen J; Paterson, William G; Bridges, Ron J

    2012-05-01

    The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning irritable bowel syndrome.

  20. Prevalence, incidence and types of mild anemia in the elderly: the "Health and Anemia" population-based study.

    Science.gov (United States)

    Tettamanti, Mauro; Lucca, Ugo; Gandini, Francesca; Recchia, Angela; Mosconi, Paola; Apolone, Giovanni; Nobili, Alessandro; Tallone, Maria Vittoria; Detoma, Paolo; Giacomin, Adriano; Clerico, Mario; Tempia, Patrizia; Savoia, Luigi; Fasolo, Gilberto; Ponchio, Luisa; Della Porta, Matteo G; Riva, Emma

    2010-11-01

    Hemoglobin concentrations slightly below the lower limit of normal are a common laboratory finding in the elderly, but scant evidence is available on the actual occurrence of mild anemia despite its potential effect on health. The objectives of this study were to estimate the prevalence and incidence of mild grade anemia and to assess the frequency of anemia types in the elderly. This was a prospective, population-based study in all residents 65 years or older in Biella, Italy. Blood test results were available for analysis from 8,744 elderly. Hemoglobin concentration decreased and mild anemia increased steadily with increasing age. Mild anemia (defined as a hemoglobin concentration of 10.0-11.9 g/dL in women and 10.0-12.9 g/dL in men) affected 11.8% of the elderly included in the analysis, while the estimated prevalence in the entire population was 11.1%. Before hemoglobin determination, most mildly anemic individuals perceived themselves as non-anemic. Chronic disease anemia, thalassemia trait, and renal insufficiency were the most frequent types of mild anemia. The underlying cause of mild anemia remained unexplained in 26.4% of the cases, almost one third of which might be accounted for by myelodysplastic syndromes. In a random sample of non-anemic elderly at baseline (n=529), after about 2 years, the annual incidence rate of mild anemia was 22.5 per 1000 person-years and increased with increasing age. The prevalence and incidence of mild anemia increase with age and mild anemia affects more than one out of ten elderly individuals. Unexplained anemia is common and may be due to myelodysplastic syndromes in some cases.

  1. Incidence and management of biliary leakage after hepaticojejunostomy

    NARCIS (Netherlands)

    de Castro, Steve M. M.; Kuhlmann, Koert F. D.; Busch, Olivier R. C.; van Delden, Otto M.; Laméris, Johan S.; van Gulik, Thomas M.; Obertop, Hugo; Gouma, Dirk J.

    2005-01-01

    This study analyzes the change in the management of biliary leakage after hepaticojejunostomy. Between 1993 and 2003 all patients (n = 1033) were studied with a hepaticojejunostomv as part of a pancreatoduodenectomy (n = 486), proximal bile duct resection (without liver resection) (n = 35), and

  2. Low incidence of lymphoproliferative disease post kidney transplantation with prevalent use of alemtuzumab

    Directory of Open Access Journals (Sweden)

    John Fredy Nieto-Ríos

    2014-01-01

    Full Text Available Introduction: It is well known that the incidence of malignancy is significantly higher in transplanted patients than in general population. The incidence of lymphoproliferative disease post-transplantation (PTLD is approximately of 1% to 2% in kidney transplantation recipients. Objective: The main objective of this study was to evaluate the PTLD incidence when monitoring kidney transplanted patients between the years 2005 and 2010. Methods: Kidney transplanted patients’ data was retrospectively taken between the years 2005 to 2010 in order to determine the number of PTLD cases according to the inductor scheme used. Results: 425 patients were transplanted between 2005 and 2010. They received alemtuzumab 76.2%, daclizumab 10.7%, basiliximab 3.6% and thymoglobulin 2.4%. The 7% did not receive antibody induction. During this period 2 cases of PTLD ocurred: One with multiple myeloma and the other with lymphoma. One of them had been treated with alemtuzumab and the other with thymoglobulin. Conclusions: The PTLD incidence in our group, where alemtuzumab was used predominantly as inductor, was very low; this might suggest that alemtuzumab is a medication that does not increase the risk of this kind of neoplasia.

  3. A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey

    2015-01-01

    BACKGROUND: Several studies have suggested that comorbid neurologic disorders are more common than expected in multiple sclerosis (MS). OBJECTIVE: To estimate the incidence and prevalence of comorbid seizure disorders and sleep disorders in persons with MS and to evaluate the quality of studies...... was 3.09% (95% CI: 2.01-4.16%). For sleep disorders we evaluated 18 studies; none were population-based. The prevalence ranged from 0-1.6% for narcolepsy, 14.4-57.5% for restless legs syndrome, 2.22-3.2% for REM behavior disorder, and 7.14-58.1% for obstructive sleep apnea. CONCLUSION: This review...... suggests that seizure disorders and sleep disorders are common in MS, but highlights gaps in the epidemiological knowledge of these conditions in MS worldwide. Other than central-western Europe and North America, most regions are understudied....

  4. MANAGEMENT OF DIABETIC RETINOPATHY, PREVALENCE AND CLINICAL CLASSIFICATION.

    Science.gov (United States)

    Ajvazi, Alil; Lutaj, Pajtim; Goranci, Ilhami

    2014-01-01

    To ascertain the prevalence of diabetic retinopathy--DR, based on the duration of the diabetes mellitus--DM and to compare it with data from relevant literature and other referent clinics. In this study are included the patients with diabetes mellitus type 1 insulin-dependent--DMID and diabetes mellitus type 2 non-insulin-dependent--DMNID. The duration of diabetes in the examined patients varied from 5 till 30 years. We have applied examination by ophthalmoscope, slit lamp bio-microscopy with Volk and Goldman lens, optical coherence tomography--OCT as well as fluorescein angiography--FAG. Have been included the treated patients with DR, from September 2004-2014. In diabetic patients suffering for a period of 5 years, the prevalence of DR is 10%. In diabetic patients suffering over 30 years, the prevalence of DR is varied from 82% until 97%. Diabetic retinopathy, undertakes a multidisciplinary approach in all patients with diabetes to achieve optimal blood glucose control HbA1c levels 7.0% or lower and to adequately manage systolic blood pressure less than 140 mmHg and serum LDL cholesterol of less than 2.5 mmol/L and triglycerides of less than 2.0 mmol/L. Always should be assessed visual acuity at the time of DR examination.

  5. 76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams

    Science.gov (United States)

    2011-10-04

    ...). 11. Division/Group Supervisor. 12. Unit Leader. 13. Strike Team/Task Force Leader. 14. Technical... Teams AGENCY: Federal Emergency Management Agency; DHS. ACTION: Notice of availability; request for comments. SUMMARY: The All-Hazard Position Task Books for Type 3 Incident Management Teams were developed...

  6. High HIV prevalence and incidence among women in Southern Mozambique: Evidence from the MDP microbicide feasibility study.

    Science.gov (United States)

    Mocumbi, Sibone; Gafos, Mitzy; Munguambe, Khatia; Goodall, Ruth; McCormack, Sheena

    2017-01-01

    The study aimed to assess the feasibility of conducting large scale HIV prevention clinical trials in Mozambique by measuring HIV prevalence and incidence among women of reproductive age. This paper describes the baseline socio-demographic characteristics of the Mozambique Microbicides Development Programme (MDP) feasibility cohort, baseline prevalence of HIV and other STIs, and HIV incidence. The Mozambique MDP feasibility study was conducted from September 2007 to August 2009 in urban Mavalane and rural Manhiça, in Southern Mozambique. Sexually active, HIV negative women aged 18 years and above were recruited to attend the study clinic every 4 weeks for a total of 40 weeks. At baseline, we collected demographic and sexual behaviour data, samples to test for sexually transmitted infections (STI) and conducted HIV rapid testing. STI and HIV testing were repeated at clinical follow-up visits. We describe HIV prevalence of women at screening, the demographic, behavioural and clinical characteristics of women at enrolment, and HIV incidence during follow-up. We screened 793 women (369 at Mavalane and 424 at Manhiça) and enrolled 505 eligible women (254 at Mavalane and 251 at Manhiça). Overall HIV prevalence at screening was 17%; 10% at Mavalane and 22% at Manhiça. Women screened at Manhiça were twice as likely as women screened at Mavalane to be HIV positive and HIV positive status was associated with younger age (18-34), lower educational level, not using a reliable method of contraception and being Zionist compared to other Christian religions. At enrolment contraceptive use was low in both clinics at 19% in Mavalane and 21% in Manhiça, as was reported condom use at last sex act at 48% in Mavalane and 25% in Manhiça. At enrolment, 8% of women tested positive for Trichomonas vaginalis, 2% for Neisseria gonorrhoeae, 4% for Chlamydia trachomatis and 46% for bacterial vaginosis. In Manhiça, 8% of women had active syphilis at screening. HIV incidence was 4.3 per

  7. The incidence and prevalence of juvenile-onset recurrent respiratory papillomatosis in the Free State province of South Africa and Lesotho.

    Science.gov (United States)

    Seedat, R Y

    2014-12-01

    Although the estimated incidence and prevalence of juvenile-onset recurrent respiratory papillomatosis (JORRP) has been determined in countries in North America and Europe and in Australia, no studies have attempted to determine the incidence or prevalence of JORRP in African countries. The aim of this study is to determine the incidence and prevalence of JORRP in the Free State province of South Africa and Lesotho. This was a retrospective study in which the records of all patients with JORRP from the Free State province of South Africa or Lesotho treated at Universitas Academic Hospital or by otorhinolaryngologists in private practice between 1 January 2011 and 31 December 2013 were reviewed. The estimated incidence and prevalence of JORRP in the Free State were 1.34 and 3.88 per 100,000 population respectively while the estimated incidence and prevalence in Lesotho were 0.49 and 1.04 per 100,000 population respectively. However, these figures are probably an underestimation. The incidence and prevalence calculated for the Free State were generally higher than those found in other studies, while those calculated for Lesotho was similar to those obtained in other studies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Incident and prevalence of HIV/AIDS among patients attending a ...

    African Journals Online (AJOL)

    Young people, ages 15–24, account for approximately 40% of new HIV infections (among those 15 and over). Globally, young women are twice as likely to become infected with HIV than their male counterparts. As at 2012, UNAIDS revealed that the HIV/AIDS prevalence rate among adults of ages 15-49 in Nigeria was ...

  9. Malaria prevalence and incidence in an isolated, meso-endemic area of Mozambique

    DEFF Research Database (Denmark)

    Charlwood, Jaques Derek; Tomás, Erzelia V E; Bragança, Mauro

    2015-01-01

    ) for diagnosis and artemisinin based combination therapy (ACT) for treatment and these were applied on the peninsula. In 2007, following a census of the population and mapping of 500 households, five annual all-age prevalence surveys were conducted. Information on LLIN use, house construction, and animal...

  10. Low free testosterone levels are associated with prevalence and incidence of depressive symptoms in older men

    NARCIS (Netherlands)

    Joshi, D.; van Schoor, N.M.; de Ronde, W.; Schaap, L.A.; Comijs, H.; Beekman, A.T.F.; Lips, P.T.A.M.

    2010-01-01

    Objective The prevalence of both low testosterone levels and depression increases with age. Currently, there is no consensus regarding the existence of an association. Our study analyses the cross-sectional association of testosterone levels with depressive symptoms and its prospective association

  11. Prevalence and Incidence of Toxoplasmosis in HIV-Positive Patients in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Kodym, P.; Hrdá, Š.; Machala, L.; Rozsypal, H.; Staňková, M.; Malý, Marek

    2006-01-01

    Roč. 53, Suppl. 1 (2006), s. 160-161 ISSN 1066-5234 Source of funding: V - iné verejné zdroje Keywords : toxoplasmosis * HIV infection * prevalence Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 2.288, year: 2006

  12. [Preclinical and intrahospital management of mass casualties and terrorist incidents].

    Science.gov (United States)

    Franke, A; Bieler, D; Friemert, B; Kollig, E; Flohe, S

    2017-10-01

    Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care. There is a need to adapt the known established medical structure for a conventional mass casualty situation to the special requirements that are raised by this new kind of terrorist threat to our social life. It is the aim of this article, from a surgical point of view, to depict the tactics and challenges of preclinical care of the special kind of terrorist attack-related injuries from the site of the incident, via the advanced medical post or casualty collecting point, to the triage point at the hospital. The special needs of medical care and organizational aspects of the primary treatment in the hospital are highlighted and possible decisional options and different approaches are discussed.

  13. Is Sleep Apnea an Independent Risk Factor for Prevalent and Incident Diabetes in the Busselton Health Study?

    Science.gov (United States)

    Marshall, Nathaniel S.; Wong, Keith K. H.; Phillips, Craig L.; Liu, Peter Y.; Knuiman, Matthew W.; Grunstein, Ronald R.

    2009-01-01

    Background: Cross-sectional analyses of North American population-based cohorts and one nonsignificant longitudinal analysis have suggested that obstructive sleep apnea (OSA) is a risk factor for diabetes mellitus. However, this observation has yet to be replicated outside the USA or be observed lonigitudinally. Methods: Residents of the Western Australian town of Busselton had their OSA quantified by the respiratory disturbance index (RDI) overnight in their own homes (MESAM IV device). Diabetes was defined as either a fasting blood glucose ≥ 7 mmol/L or physician diagnosed diabetes. Results: Of 399 participants at baseline, 295 had complete data and did not have diabetes at baseline; 9 incident cases were observed within 4 years. At baseline moderate-severe OSA was associated with a univariate, but not multivariate, increased risk of diabetes (odds ratio = 4.37, 95% CL = 1.12, 17.12). Longitudinally, moderate-severe OSA was a significant univariate and independent risk factor for incident diabetes (fully adjusted OR = 13.45, 95% CL = 1.59, 114.11). Conclusions: Moderate-severe sleep apnea was a significant risk factor for incident diabetes in this Australian population-based cohort. However, the confidence intervals were wide and meta-analyses or studies with greater power will be required to verify the relationship between sleep apnea and the incidence of diabetes in community-based populations. Citation: Marshall NS; Wong KKH; Phillips CL; Liu PY; Knuiman MW; Grunstein RR. Is sleep apnea an independent risk factor for prevalent and incident diabetes in the busselton health study? J Clin Sleep Med 2009;5(1):15–20. PMID:19317376

  14. Risk of tuberculosis during pregnancy in Mongolia, a high incidence setting with low HIV prevalence.

    Science.gov (United States)

    Rendell, N L; Batjargal, N; Jadambaa, N; Dobler, C C

    2016-12-01

    To investigate the epidemiology and the relative risk of tuberculosis (TB) in pregnant women in Mongolia, a high TB incidence setting with a low rate of human immunodeficiency virus co-infection, where active case finding for TB in pregnancy is implemented. We retrospectively collected data on pregnant women diagnosed with TB during 2013. Data were collected through doctors at central TB dispensaries who extracted the relevant information from patients' clinical records. The overall incidence of TB among pregnant women was 228 (95%CI 187276) per 100000 person-years, resulting in an incidence rate ratio of 1.31 (95%CI 1.081.59) in pregnant women compared to the general population. Twelve per cent of the pregnant women with TB chose to have an abortion. In this study, pregnant women had a 1.3-fold higher risk of developing TB than the general population. Based on a moderately increased risk of TB during pregnancy in our study and the potential for adverse health outcomes, TB screening among pregnant women can currently be justified, but the cost-effectiveness of this intervention remains unclear. Patients and doctors need to be educated about the safety of standard TB treatment in pregnancy to reduce the rate of abortions.

  15. Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study

    NARCIS (Netherlands)

    Borst, Jorien M.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2016-01-01

    A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems

  16. Prevalence and Incidence of Black Band Disease of Scleractinian Corals in the Kepulauan Seribu Region of Indonesia

    Directory of Open Access Journals (Sweden)

    Ofri Johan

    2016-04-01

    Full Text Available Black band disease (BBD is the oldest recognised disease associated with scleractinian corals. However, despite this, few BBD surveys have been conducted in the Indonesian archipelago, one of the world’s hot spots for coral diversity. In this study, we show that BBD was recorded in the reefs of Kepulauan Seribu, Indonesia, at the time of surveying. The disease was found to mainly infect corals of the genus Montipora. In some instances, upwards of 177 colonies (31.64% were found to be infected at specific sites. Prevalence of the disease ranged from 0.31% to 31.64% of Montipora sp. colonies throughout the archipelago. Although BBD was found at all sites, lower frequencies were associated with sites closest to the mainland (17.99 km, as well as those that were furthest away (63.65 km. Despite there being no linear relationship between distance from major population centers and BBD incidence, high incidences of this disease were associated with sites characterized by higher levels of light intensity. Furthermore, surveys revealed that outbreaks peaked during the transitional period between the dry and rainy seasons. Therefore, we suggest that future surveys for disease prevalence in this region of Indonesia should focus on these transitory periods.

  17. Prevalence and estimated incidence of blood-borne viral pathogen infection in organ and tissue donors from northern Alberta.

    Science.gov (United States)

    Zahariadis, G; Plitt, S S; O'Brien, S; Yi, Q-L; Fan, W; Preiksaitis, J K

    2007-01-01

    To determine the potential safety benefit of introducing nucleic acid testing (NAT) in tissue and organ donors, the risk of virus transmission was examined in a Canadian population. Anonymous data on Northern Alberta tissue and organ donors from 1998 to 2004 were used to determine the seroprevalence and estimate the seroincidence and residual risk of HIV, HBV, HCV and HTLV infection. Of the 3372 donors identified, 71.1% were surgical bone, 13.2% were living organ and 15.6% were deceased organ/tissue donors. Seroprevalence was: HIV 0.00%, HBV 0.09%, HCV 0.48% and HTLV 0.03%. Incidence (/100,000 p-yrs) and residual risks (/100,000 donors) could only be estimated for HBV (24.2 and 3.9) and HCV (11.2 and 2.2). Risk estimates were higher for deceased donors than surgical bone donors. HCV had the highest prevalence and HBV had the highest estimated incidence. HIV and HTLV risks were extremely low precluding accurate quantification. In this region of low overall viral prevalence, HCV NAT would be most effective in deceased organ donors. In surgical bone donors the cost of implementing NAT is high without significant added safety benefit.

  18. Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment

    Science.gov (United States)

    2017-12-01

    Traffic incidents have long been recognized as the main contributor to congestion in highway networks. Thus, contending with non-recurrent congestion has been a priority task for most highway agencies over the past decades. Under most incident scenar...

  19. Control systems, personnel policies and management initiatives to limit pollution incidents

    International Nuclear Information System (INIS)

    Martin, B.F.

    1991-01-01

    After the regulatory requirements are met, an important collateral step in the continuing Hazardous Waste/Environmental Management cycle of activities is to minimize the possibility of a pollution incident, spill, contamination, mislabeling, mishandling or exposure, since this minimizes a major contingent liability of the company. Human failure accounts for 88% of accidents, 10% occur from mechanical failure and only 2% are unpreventable force majeure. This implies that fully 98% of all accidents can be prevented or minimized. Good engineering, production, management and educational practices can be formulated to minimize the occurrence and effects of accidental pollution incidents. Hazardous Material/Environmental Management tends to focus on technical and regulatory objectives, a reactionary mode caused in part by the rapidly changing regulatory environment and the need to continually adapt to these changes. Management functions such as personnel management and situational management get shortchanged in research and in practice. What is needed is a system that incorporates change readily, adapts personnel to change easily and mobilizes all the human resources of a company in meeting environmental and regulatory goals in the same way other goals of the company are met. Feedback Loop/Control System concepts have been applied to management practice in the popular Management By Objectives School as well as other schools of management practice. An Environmental Management program is proposed which incorporates feedback loop/ control systems to facilitate operations and training objectives and requirements. By incorporating Environmental and Hazardous Waste goals with other management goals in a system involving all levels of management and workers on the same team, the proposed system will reduce the probability of accidental pollution incidents and thus the contingent liability of a spill or other incident

  20. Air Force Critical Incident Stress Management outreach with Pentagon staff after the terrorist attack.

    Science.gov (United States)

    Rowan, Anderson B

    2002-09-01

    This article describes the Critical Incident Stress Management outreach to Pentagon staff conducted after the terrorist attack by a team of Air Force mental health and chaplain personnel. Also discussed are lessons learned from the author's experience while leading the mental health component and working in a larger tri-service outreach. Finally, the observed impacts of the outreach effort are examined along with recommendations for future postcritical incident outreach efforts.

  1. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  2. The Duchenne muscular dystrophy population in Denmark, 1977-2001: prevalence, incidence and survival in relation to the introduction of ventilator use

    DEFF Research Database (Denmark)

    Jeppesen, J; Green, A; Steffensen, B.F.

    2003-01-01

    Mechanical ventilation of patients with Duchenne muscular dystrophy continues to be a subject of study. The purpose was to estimate prevalence, incidence, mortality and use of mechanical ventilation in the total Duchenne muscular dystrophy population in Denmark between 1977 and 2001 and further....... While overall incidence remained stable at 2.0 per 105, prevalence rose from 3.1 to 5.5 per 105, mortality fell from 4.7 to 2.6 per 100 years at risk and prevalence of Duchenne muscular dystrophy ventilator users rose from 0.9 to 43.4 per 100. We conclude that survival of Duchenne muscular dystrophy...

  3. Managing shoreline assessment data during the Lake Wabamun incident

    Energy Technology Data Exchange (ETDEWEB)

    Lamarche, A. [Environmental Performance and Decision Support, Montreal, PQ (Canada); Martin, V. [Eastern Canada Response Corp. Ltd., Vercheres, PQ (Canada)

    2009-07-01

    A freight train derailed near the shore of Lake Wabamun near Edmonton in August 2003, spilling about 750 m{sup 3} of heavy Bunker C oil on the lakeshore. The nature and extent of oiling was assessed over a period of 3 consecutive summers using a variety of techniques. Surface oiling along the shore was evaluated using the Shoreline Cleanup Assessment Team (SCAT) approach, with some modifications to consider local conditions. Oiling conditions of the submerged tar ball oil in the shallow near shore waters was evaluated in the summer of 2006. Several computerized functions were developed in order to provide reports and maps of the submerged oil conditions, so that the treatment team could remove most of the oil before the next reed growing season. The location of all observations were recorded using GPS. Lake Wabamun includes the following along its shores: industry which uses the lake water for cooling purposes; a provincial park; a First-nations reservation; and private residences. Since all survey data was made available to the general public, it had to be detailed and easy to understand. This paper described how some of the data management issues were addressed within the framework of the shoreline assessment organization. 6 refs., 3 tabs., 13 figs.

  4. Different management methods on prevalence of lameness in 25 Holstein-Friesian herds in Hungary

    Directory of Open Access Journals (Sweden)

    Gudaj R.

    2013-01-01

    Full Text Available Lameness in dairy cattle is the third most expensive outbreak after mastitis and reproductive disorders. 25 Holstein-Friesian herds in Hungary were observed for two years to estimate the impact of different trimming methods and managements for the controll of the incidence of lameness. Professional trimming was found to be more effective on farms with no nutritional disorders and where refurnishment works were carried out. The greatest decrease in the prevalence of lameness was observed on farms which provided professional trimming, effective footbathing, improved walking and resting surfaces and which treated severely lame cows between regular trimmings. The greatest increase in occurrence of lameness was reported on farms with on-farm trimmers and where building projects were carried out and nutritional disorders found.

  5. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  6. Prevalence of Helicobacter pylori infection in two Spanish regions with different incidence of gastric cancer.

    Science.gov (United States)

    Senra-Varela, A; Lopez-Saez, J B; Gomez-Biondi, V

    1998-07-01

    It is a cross-sectional study, comparing the prevalence of Helicobacter pylori infection (prevalence of IgG antibodies to H. pylori) in the healthy population of Ubrique and Grazalema (mountain location, mortality from stomach cancer 20/100,000) and in Barbate, (coastal location, mortality from stomach cancer 10/100,000) in the province of Cadiz, southern Spain. The subjects were randomly selected, 163 men and 169 women, 18 years or older; 179 persons were studied in the inland, and 154 in the littoral in January 1997. Of the 332 subjects investigated, 43% were positive, a mean antibody titer of 337 IU/1 (95 % CI: 254-420), and 56% were negative, with a mean titer of 18 IU/1 (95% CI: 15-19). In the coastal population, 30% has positive titers and 54% in the mountain location. By age: 18-40 years, 30% of littoral and 41% of inland population had positive titers; 41-60 years, 35% of those living in the littoral and 58% of inland population had positive titers; > 60 years, 24% of coastal inhabitants and 62% of those living in the inland had positive titers. Living in mountain locations in the province of Cadiz involves a greater ecological risk for H. pylori infection (p < 0.05).

  7. Multi-Tiered Observation and Response Charts: Prevalence and Incidence of Triggers, Modifications and Calls, to Acutely Deteriorating Adult Patients.

    Directory of Open Access Journals (Sweden)

    Arthas Flabouris

    Full Text Available Observation charts are the primary tool for recording patient vital signs. They have a critical role in documenting triggers for a multi-tiered escalation response to the deteriorating patient. The objectives of this study were to ascertain the prevalence and incidence of triggers, trigger modifications and escalation response (Call amongst general medical and surgical inpatients following the introduction of an observation and response chart (ORC.Prospective (prevalence, over two 24-hour periods, and retrospective (incidence, over entire hospital stay, observational study of documented patient observations intended to trigger one of three escalation responses, being a MER-Medical Emergency Response [highest tier], MDT-Multidisciplinary Team [admitting team], or Nurse-senior ward nurse [lowest tier] response amongst adult general medical and surgical patients.416 patients, 321 (77.2% being medical admissions, median age 76 years (IQR 62, 85 and 95 (22.8% Not for Resuscitation (NFR. Overall, 193 (46.4% patients had a Trigger, being 17 (4.1% MER, 45 (10.8% MDT and 178 (42.8% Nurse triggers. 60 (14.4% patients had a Call, and 72 (17.3% a modified Trigger.206 patients, of similar age, of whom 166 (80.5% had a Trigger, 122 (59.2% a Call, and 91 (44.2% a modified Trigger. PREVALENCE and incidence of failure to Call was 33.2% and 68% of patients, respectively, particular for Nurse Triggers (26.7% and 62.1%, respectively. The number of Modifications, Calls, and failure to Call, correlated with the number of Triggers (0.912 [p<0.01], 0.631 [p<0.01], 0.988 [p<0.01].Within a multi-tiered response system for the detection and response to the deteriorating patient Triggers, their Modifications and failure to Call are common, particularly within the lower tiers of escalation. The number of Triggers and their Modifications may erode the structure, compliance, and potential efficacy of structured observation and response charts within a multi-tiered response

  8. The incidence and prevalence of systemic lupus erythematosus in Thrace, 2003-2014: A 12-year epidemiological study.

    Science.gov (United States)

    Pamuk, O N; Balci, M A; Donmez, S; Tsokos, G C

    2016-01-01

    We estimated the prevalence and incidence, clinical features, treatment, and prognosis of systemic lupus erythematosus (SLE) patients in the Thrace region of Turkey. We retrospectively evaluated 331 patients (307 female, 24 male, mean age 38.5 years) diagnosed with SLE between 2003 and 2014. Clinical features, treatments, and response to various treatment modalities were recorded. Our hospital has been the only tertiary referral center for rheumatological diseases for a mixed rural and urban population of 620,477 people (306,036 females, 314,411 males) for more than 16 years. The mean annual incidence of SLE was 4.44/100,000 (females, 8.4/100,000; males, 0.6/100,000). The overall prevalence of SLE was 51.7/100,000 (females, 97.7/100,000; males, 7/100,000). Major organ involvement was present in the following percentages: neurologic involvement: 20.1%; renal involvement: 28.2%; autoimmune hemolytic anemia: 9.6%; thrombocytopenia: 14.7%. Seventeen SLE patients (13 females, four males) died at a median follow-up of 48 months. The five-year survival was 94.5%, and the ten-year survival was 89.9%. According to Kaplan-Meier survival analysis, poor prognostic factors were: male gender (p = 0.015); smoking (p = 0.02); pleural involvement (p = 0.011); thrombocytopenia (p = 0.021); myocarditis (p = 0.028); renal involvement (p = 0.037); treatment with cyclophosphamide (p = 0.011); and an initial high SLEDAI score (>4) (p = 0.02). Lymphopenia at the time of diagnosis appeared as a favorable prognostic factor (p = 0.008). Cox regression analysis revealed myocarditis (OR: 20.4, p = 0.018) and age at diagnosis (OR: 1.11, p = 0.035) to be poor, and lymphopenia at the time of diagnosis to be good prognostic factors (OR:0.13, p = 0.031). The annual incidence and prevalence of SLE in the Thrace region of Turkey is lower than those reported in North America, however they are similar to those reported for European countries. Clinical manifestations appear to be milder, whereas

  9. Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.

    Directory of Open Access Journals (Sweden)

    Jennifer A Whitaker

    Full Text Available Tuberculosis is a major occupational hazard in low and middle-income countries. Limited data exist on serial testing of healthcare workers (HCWs with interferon-γ release assays (IGRAs for latent tuberculosis infection (LTBI, especially in low and middle-income countries. We sought to evaluate the rates of and risk factors for LTBI prevalence and LTBI test conversion among HCWs using the tuberculin skin test (TST and QuantiFERON-TB Gold In-tube assay (QFT-GIT.A prospective longitudinal study was conducted among HCWs in the country of Georgia. Subjects completed a questionnaire, and TST and QFT-GIT tests were performed. LTBI testing was repeated 6-26 months after baseline testing.Among 319 HCWs enrolled, 89% reported prior BCG vaccination, and 60% worked in TB healthcare facilities (HCFs. HCWs from TB HCFs had higher prevalence of positive QFT-GIT and TST than those from non-TB HCFs: 107/194 (55% vs. 30/125 (31% QFT-GIT positive (p<0.0001 and 128/189 (69% vs. 64/119 (54% TST positive (p = 0.01. There was fair agreement between TST and QFT-GIT (kappa = 0.42, 95% CI 0.31-0.52. In multivariate analysis, frequent contact with TB patients was associated with increased risk of positive QFT-GIT (aOR 3.04, 95% CI 1.79-5.14 but not positive TST. Increasing age was associated with increased risk of positive QFT-GIT (aOR 1.05, 95% CI 1.01-1.09 and TST (aOR 1.05, 95% CI 1.01-1.10. High rates of HCW conversion were seen: the QFT-GIT conversion rate was 22.8/100 person-years, and TST conversion rate was 17.1/100 person-years. In multivariate analysis, female HCWs had decreased risk of TST conversion (aOR 0.05, 95% CI 0.01-0.43, and older HCWs had increased risk of QFT-GIT conversion (aOR 1.07 per year, 95% CI 1.01-1.13.LTBI prevalence and LTBI test conversion rates were high among Georgian HCWs, especially among those working at TB HCFs. These data highlight the need for increased implementation of TB infection control measures.

  10. Low prevalence and incidence of Helicobacter pylori infection in children: a population-based study in Japan.

    Science.gov (United States)

    Okuda, Masumi; Osaki, Takako; Lin, Yingsong; Yonezawa, Hideo; Maekawa, Kohei; Kamiya, Shigeru; Fukuda, Yoshihiro; Kikuchi, Shogo

    2015-04-01

    Infection of Helicobacter pylori mainly occurs in childhood. In Japan, incidence of gastric cancer is still high in the senior citizen population, but little is known about the current H. pylori infection status among children or their family members. As a population-based study, the prevalence of H. pylori infection and change in infection status over a 1-year interval in children were determined. Family members of some participants were also invited to participate in the study to determine their infection status. All children of specific ages attending 16 schools in Sasayama, Hyogo Prefecture, were invited to participate. H. pylori infection was determined by the stool antigen test and diagnosis confirmed by polymerase chain reaction and the urea breath test. Helicobacter pylori prevalence was 1.9% among 689 children aged 0-8 years in 2010 and 1.8% among 835 children aged 0-11 in 2011. No feco-conversion was observed in 430 children aged 0-8 years (170 were aged 0-4 years) who provided follow-up stool samples after 1 year. The prevalence of infection was 6% (2 of 33) and 38% (6 of 16) in mothers of negative and positive probands (p = .04), respectively, and 12% (3 of 25) and 50% (8 of 16) (p = .01), respectively, in fathers. Helicobacter pylori prevalence in Japanese children is approximately 1.8%, which is much lower than that reported in Japanese adults. New infection may be rare. Parent-to-child infection is thought to be the main infection route of the infrequent infection for children in Japan. © 2014 John Wiley & Sons Ltd.

  11. Two incidents that changed quality management in the Australian livestock export industry

    Directory of Open Access Journals (Sweden)

    Peter R. Stinson

    2008-03-01

    Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

  12. Musculoskeletal disorders of the neck and shoulders in female sewing machine operators: prevalence, incidence, and prognosis

    DEFF Research Database (Denmark)

    Kaergaard, A.; Andersen, JH

    2000-01-01

    for two main neck-shoulder disorders were defined: rotator cuff tendinitis and myofascial pain syndrome. A baseline control group consisted of 357 women with varied non-repetitive work. RESULTS: At baseline the overall prevalence of myofascial pain syndrome and rotator cuff tendinitis was 15.2% and 5...... ratio (PR)=2.54; 95% confidence interval (95% CI) 1.28 to 5.05) when adjusted for age, body mass index, smoking, living alone with children, job strain, and social support from colleagues and supervisors. Only one of 13 participants with rotator cuff tendinitis at baseline recovered during follow up...... with children. CONCLUSION: Rotator cuff tendinitis showed a higher degree of persistence than myofascial pain syndrome. Both disorders highly influenced the perception of general health. Women who lived alone with children, were smokers, or experienced low support from colleagues and supervisors had a higher...

  13. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

    Science.gov (United States)

    Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

    2014-07-01

    In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, type, and risk factors.

    Science.gov (United States)

    Daly, Deirdre; Clarke, Mike; Begley, Cecily

    2018-03-01

    While many women report urinary incontinence (UI) during pregnancy, associations with pre-pregnancy urinary leakage remain under-explained. We performed a multi-strand prospective cohort study with 860 nulliparous women recruited during pregnancy. Prevalence of any urinary leakage was 34.8% before and 38.7% during pregnancy. Prevalence of UI, leaking urine at least once per month, was 7.2% and 17.7% respectively. Mixed urinary incontinence (MUI) was reported by 59.7% of women before and 58.8% during pregnancy, stress urinary incontinence (SUI) by 22.6% and 37.2%, and urge urinary incontinence (UUI) by 17.7% and 4.0%, respectively. SUI accounted for half (50.0%), MUI for less than half (44.2%), and UUI for 5.8% of new-onset UI in pregnancy. Pre-pregnancy UI was significantly associated with childhood enuresis [adjusted odds ratio (AOR) 2.9, 95% confidence interval (CI) 1.5-5.6, p = 0.001) and a body mass index (BMI) ≥30 kg/m 2 (AOR 4.2, 95% CI 1.9-9.4, p pregnancy BMI was 25-29.99 kg/m 2 (AOR 2.0, 95% CI 1.2-3.5, p = 0.01), and women who leaked urine less than once per month (AOR 2.6, 95% CI 1.6-4.1, p  pregnancy. Considerable proportions of nulliparous women leak urine before and during pregnancy, and most ignore symptoms. Healthcare professionals have several opportunities for promoting continence in all pregnant women, particularly in women with identifiable risk factors. If enquiry about UI, and offering advice on effective preventative and curative treatments, became routine in clinical practice, it is likely that some of these women could become or stay continent.

  15. Incidence and prevalence of diabetes mellitus in the Americas Incidencia y prevalencia de la diabetes en América

    Directory of Open Access Journals (Sweden)

    Alberto Barceló

    2001-11-01

    Full Text Available Objective. To present the incidence and prevalence of diabetes mellitus in the Americas as found through a thorough review of published information on the subject. Methods. Data were obtained through a comprehensive review using the MEDLINE and BIREME bibliographical databases. In addition, government publications, conference reports, and meeting documents were identified by contacting government and nongovernmental organizations and other institutions. Incidence and prevalence rates were adjusted by age and sex, when possible, by the direct method using the world Segi population as the standard. The 95% confidence intervals were calculated using the Poisson distribution or the normal distribution. Results. Diabetes mellitus represents a major public health problem in the Americas, and there is evidence that its prevalence is increasing in some countries. Conclusions. Given that most Latin American and Caribbean nations are experiencing a demographic transition, it is expected that the prevalence of diabetes will continue to increase rapidly in the near future. Despite the economic constraints faced by the countries of the Americas, there is a clear need for more efforts in the area of diabetes prevention and control.Objetivo. Describir la incidencia y prevalencia de la diabetes sacarina en el continente americano, de acuerdo con los resultados de una revisión exhaustiva de la literatura publicada acerca de este tema. Métodos. Los datos se obtuvieron mediante una completa revisión de las bases de datos MEDLINE y BIREME. Además se contactaron las organizaciones gubernamentales y no gubernamentales y otras instituciones para identificar las publicaciones gubernamentales y los informes de conferencias y reuniones. Las tasas de incidencia y prevalencia se ajustaron por edad y sexo, utilizando, siempre que fuera posible, el método directo, con la población de Segi como estándar. Los intervalos de confianza del 95% se calcularon utilizando la

  16. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  17. Incidence, prevalence, diagnostic delay, morbidity, mortality and socioeconomic status in males with 46,XX disorders of sex development

    DEFF Research Database (Denmark)

    Berglund, A; Johannsen, T H; Stochholm, K

    2017-01-01

    STUDY QUESTION: What is the epidemiology and trajectory of health and socioeconomic status in males with 46,XX disorders of sex development (DSD)? SUMMARY ANSWER: 46,XX DSD males had an increased overall morbidity compared to male background population controls, and the socioeconomic status...... was inferior on outcome parameters such as education and long-term income. WHAT IS KNOWN ALREADY: 46,XX DSD males are rare and estimates of prevalence and incidence are limited. An increased morbidity and mortality as well as a negatively affected socioeconomic status are described in males with Klinefelter...... diagnosed 46,XX DSD males only, conclusions cannot be extended to non-diagnosed 46,XX DSD males. WIDER IMPLICATIONS OF THE FINDINGS: This study provides a new insight into trajectory of health and socioeconomic status of 46,XX DSD males. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by research...

  18. Higher prevalence of risk factors for type 2 diabetes mellitus and subsequent higher incidence in men

    DEFF Research Database (Denmark)

    Almdal, T.; Scharling, H.; Jensen, J.S.

    2008-01-01

    Background: This study investigates risk factors and the incidence of type 2 diabetes mellitus (type 2 DM) in both sexes of a northern European population. Methods: A total of 14,223 randomly selected men and women were studied from 1976 to 1978. Patients with diabetes (self-reported type 2 DM......, non-fasting blood glucose and triglycerides. Significantly more men (242, 5.4%) than women (152, 2.5%) developed type 2 DM. The odds ratio (OR) for developing diabetes with a BMI above 30 kg/m(2) compared to a BMI of 20-25 kg/m(2) was 8.1 in women and 6.3 in men; for a non-fasting plasma glucose of 8.......4-11.0 mmol/l compared to a plasma glucose of 5.5-6.4, the ORs were 7.8 in women and 4.7 in men. The OR for developing diabetes in persons with a non-fasting triglyceride level above 2.0 mmol/l compared to 1.0-2.0 mmol/l was 1.8 in both sexes; women with non -fasting triglycerides below 1.0 mmol/l had...

  19. Higher prevalence of risk factors for type 2 diabetes mellitus and subsequent higher incidence in men

    DEFF Research Database (Denmark)

    Almdal, Thomas; Scharling, Henrik; Jensen, Jan Skov

    2008-01-01

    BACKGROUND: This study investigates risk factors and the incidence of type 2 diabetes mellitus (type 2 DM) in both sexes of a northern European population. METHODS: A total of 14,223 randomly selected men and women were studied from 1976 to 1978. Patients with diabetes (self-reported type 2 DM......, non-fasting blood glucose and triglycerides. Significantly more men (242, 5.4%) than women (152, 2.5%) developed type 2 DM. The odds ratio (OR) for developing diabetes with a BMI above 30 kg/m(2) compared to a BMI of 20-25 kg/m(2) was 8.1 in women and 6.3 in men; for a non-fasting plasma glucose of 8.......4-11.0 mmol/l compared to a plasma glucose of 5.5-6.4, the ORs were 7.8 in women and 4.7 in men. The OR for developing diabetes in persons with a non-fasting triglyceride level above 2.0 mmol/l compared to 1.0-2.0 mmol/l was 1.8 in both sexes; women with non -fasting triglycerides below 1.0 mmol/l had...

  20. HIV and tuberculosis co-infection among migrants in Europe: A systematic review on the prevalence, incidence and mortality.

    Science.gov (United States)

    Tavares, Ana Maria; Fronteira, Inês; Couto, Isabel; Machado, Diana; Viveiros, Miguel; Abecasis, Ana B; Dias, Sónia

    2017-01-01

    International human migration has been rapidly growing. Migrants coming from low and middle income countries continue to be considerably vulnerable and at higher risk for infectious diseases, namely HIV (Human Immunodeficiency Virus) and tuberculosis (TB). In Europe, the number of patients with HIV-TB co-infection has been increasing and migration could be one of the potential driving forces. This systematic review aims to improve the understanding on the burden of HIV-TB co-infection among migrants in Europe and to assess whether these populations are particularly vulnerable to this co-infection compared to nationals. MEDLINE®, Web of Science® and Scopus® databases were searched from March to April 2016 using combinations of keywords. Titles and abstracts were screened and studies meeting the inclusion criteria proceeded for full-text revision. These articles were then selected for data extraction on the prevalence, incidence and mortality. The majority of HIV-TB prevalence data reported in the analysed studies, including extrapulmonary/disseminated TB forms, was higher among migrant vs. nationals, some of the studies even showing increasing trends over time. Additionally, while HIV-TB incidence rates have decreased among migrants and nationals, migrants are still at a higher risk for this co-infection. Migrants with HIV-TB co-infection were also more prone to unsuccessful treatment outcomes, death and drug resistant TB. However, contradicting results also showed lower mortality compared to nationals. Overall, a disproportionate vulnerability of migrants to acquire the HIV-TB co-infection was observed across studies. Such vulnerability has been associated to low socioeconomic status, poor living conditions and limited access to healthcare. Adequate social support, early detection, appropriate treatment, and adequate access to healthcare are key improvements to tackle HIV-TB co-infection among these populations.

  1. Diabetes in older people: Prevalence, incidence and its association with medium- and long-term mortality from all causes.

    Science.gov (United States)

    Sánchez Martínez, Mercedes; Blanco, Augusto; Castell, María Victoria; Gutiérrez Misis, Alicia; González Montalvo, Juan Ignacio; Zunzunegui, María Victoria; Otero, Ángel

    2014-01-01

    To estimate the prevalence and incidence of self-reported diabetes and to study its association with medium- and long-term mortality from all causes in persons ≥ 65 years. A population-based cohort study begun in 1993. "Envejecer en Leganés" cohort (Madrid). A random sample of persons ≥ 65 years (n=1277 in the 1993 baseline sample). Participants were classified as having diabetes if they so reported and had consulted a physician for this reason within the last year. Diabetes history was categorized in diabetic individuals (1965 persons/2 years). Vital status was recorded on 31 December 2011. The association between diabetes history ≥ 10 years and mortality at 6 and 18 years follow-up was studied by the Kaplan-Meier and Cox regression analyses after adjusting for age, sex, heart disease and comorbidity. The prevalence of self-reported diabetes rose from 10.3% in 1993 to 16.1% in 1999 (p ≤ 0.001) and was higher in women than men (p ≤ 0.05). Total incidence density was 2.6 cases/100 persons/2 years (95% CI: 2.0-3.3). Medium- and long-term mortality was higher in persons with diabetes history ≥ 10 years than in non-diabetic individuals (HR: 2.0; 95% CI: 1.2-3.3 and HR: 1.7; 95% CI: 1.1-2.5, respectively). In diabetics with history diabetes is clearly associated with increased risk of mortality, it is significant only for patients with ≥ 10 years' history of diabetes. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  2. Prevalence, incidence, indication, and choice of antidepressants in patients with and without chronic kidney disease: a matched cohort study in UK Clinical Practice Research Datalink.

    Science.gov (United States)

    Iwagami, Masao; Tomlinson, Laurie A; Mansfield, Kathryn E; McDonald, Helen I; Smeeth, Liam; Nitsch, Dorothea

    2017-07-01

    People with chronic kidney disease (CKD) have an increased prevalence of depression, anxiety, and neuropathic pain. We examined prevalence, incidence, indication for, and choice of antidepressants among patients with and without CKD. Using the UK Clinical Practice Research Datalink, we identified patients with CKD (two measurements of estimated glomerular filtration rate antidepressant prescribing in the six months prior to index date (prevalence), the first prescription after index date among non-prevalent users (incidence), and recorded diagnoses (indication). We compared antidepressant choice between patients with and without CKD among patients with a diagnosis of depression. There were 242 349 matched patients (median age 76 [interquartile range 70-82], male 39.3%) with and without CKD. Prevalence of antidepressant prescribing was 16.3 and 11.9%, and incidence was 57.2 and 42.4/1000 person-years, in patients with and without CKD, respectively. After adjusting for confounders, CKD remained associated with higher prevalence and incidence of antidepressant prescription. Regardless of CKD status, selective serotonin reuptake inhibitors were predominantly prescribed for depression or anxiety, while tricyclic antidepressants were prescribed for neuropathic pain or other reasons. Antidepressant choice was similar in depressed patients with and without CKD. The rate of antidepressant prescribing was nearly one and a half times higher among people with CKD than in the general population. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd.

  3. Applying the concept of network enabled capabilities to incident management in the Netherlands

    NARCIS (Netherlands)

    Immers, L.H.; Huisken, G.

    2008-01-01

    The application of Incident Management to the Dutch road network suffers from serious problems in terms of availability of accurate and up-to-date information. In this paper we present an approach aimed at diminishing the occurrence of misunderstandings. This approach is based on the concept of

  4. Smothering in UK free-range flocks. Part 1: incidence, location, timing and management.

    Science.gov (United States)

    Barrett, J; Rayner, A C; Gill, R; Willings, T H; Bright, A

    2014-07-05

    Smothering in poultry is an economic and welfare-related concern. This study presents the first results from a questionnaire addressing the incidence, location, timing and management of smothering of free-range farm managers from two commercial egg companies (representing 35 per cent of the UK free-range egg supply). Overall, nearly 60 per cent of farm mangers experienced smothering in their last flock, with an average of 25.5 birds lost per incidence, although per cent mortality due to smothering was low (x̄=1.6 per cent). The majority of farm managers also reported that over 50 per cent of all their flocks placed had been affected by smothering. The location and timing of smothering (excluding smothering in nest boxes) tended to be unpredictable and varied between farms. Blocking off corners/nest boxes and walking birds more frequently were identified as popular smothering reduction measures, although there was a wide variety of reduction measures reported overall. The motivation to implement reduction measures was related to a farm manager's previous experience of smothering. To our knowledge, this is the first study to provide a representative industry estimate on the incidence, location, timing and management of smothering. The results suggest that smothering is a common problem, unpredictable between flocks with no clear, effective reduction strategies. A follow-up study will investigate the correlations among smothering, disease and other welfare problems and may shed further light on management solutions. British Veterinary Association.

  5. Errors in the management of cardiac arrests: an observational study of patient safety incidents in England.

    Science.gov (United States)

    Panesar, Sukhmeet S; Ignatowicz, Agnieszka M; Donaldson, Liam J

    2014-12-01

    The aim of this qualitative study is to better understand the types of error occurring during the management of cardiac arrests that led to a death. All patient safety incidents involving management of cardiac arrests and resulting in death which were reported to a national patient safety database over a 17-month period were analysed. Structured data from each report were extracted and these together with the free text, were subjected to content analysis which was inductive, with the coding scheme emerged from continuous reading and re-reading of incidents. There were 30 patient safety incidents involving management of cardiac arrests and resulting in death. The reviewers identified a main shortfall in the management of each cardiac arrest and this resulted in 12 different factors being documented. These were grouped into four themes that highlighted systemic weaknesses: miscommunication involving crash number (4/30, 13%), shortfalls in staff attending the arrest (4/30, 13%), equipment deficits (11/30, 36%), and poor application of knowledge and skills (11/30, 37%). The factors identified represent serious shortfalls in the quality of response to cardiac arrests resulting in death in hospital. No firm conclusion can be drawn about how many deaths in the study population would have been averted if the emergency had been managed to a high standard. The effective management of cardiac arrests should be considered as one of the markers of safe care within a healthcare organisation.

  6. Effect of pronase on high-incidence blood group antigens and the prevalence of antibodies to pronase-treated erythrocytes.

    Science.gov (United States)

    Reid, M E; Greeen, C A; Hoffer, J; Øyen, R

    1996-01-01

    Pronase is a useful and relatively nonspecific protease that cleaves many red blood cell (RBC) membrane proteins that carry blood group antigens. Unexpected findings in tests using pronase-treated RBCs during the investigation of a patient's blood sample led us to test which high-incidence blood group antigens were sensitive and which were resistant to pronase treatment, and to determine the prevalence of antipronase in the serum of blood donors. Our results show that antigens in the Cromer and Lutheran blood group systems and the JMH antigen were sensitive to pronase treatment of RBCs. Antigens in the Dombrock blood group system and Sc1 were either sensitive to or markedly weakened by pronase treatment of RBCs. The following high-incidence antigens were resistant to treatment of RBCs with pronase: AnWj, Ata, Coa, Co3, Dib, EnaFR, Era, Fy3, Jk3, Jra, k, Kpb, Jsb, K14, Lan, Oka, Rh17, U, Vel, and Wrb. Over half of the serum samples from normal blood donors contained antibodies to pronase-treated RBCs. When testing human serum against pronase-treated RBCs, it is essential either to use an autocontrol or to perform the testing with an eluate.

  7. The prevalence and incidence of active syphilis in women in Morocco, 1995-2016: Model-based estimation and implications for STI surveillance.

    Science.gov (United States)

    Bennani, Aziza; El-Kettani, Amina; Hançali, Amina; El-Rhilani, Houssine; Alami, Kamal; Youbi, Mohamed; Rowley, Jane; Abu-Raddad, Laith; Smolak, Alex; Taylor, Melanie; Mahiané, Guy; Stover, John; Korenromp, Eline L

    2017-01-01

    Evolving health priorities and resource constraints mean that countries require data on trends in sexually transmitted infections (STI) burden, to inform program planning and resource allocation. We applied the Spectrum STI estimation tool to estimate the prevalence and incidence of active syphilis in adult women in Morocco over 1995 to 2016. The results from the analysis are being used to inform Morocco's national HIV/STI strategy, target setting and program evaluation. Syphilis prevalence levels and trends were fitted through logistic regression to data from surveys in antenatal clinics, women attending family planning clinics and other general adult populations, as available post-1995. Prevalence data were adjusted for diagnostic test performance, and for the contribution of higher-risk populations not sampled in surveys. Incidence was inferred from prevalence by adjusting for the average duration of infection with active syphilis. In 2016, active syphilis prevalence was estimated to be 0.56% in women 15 to 49 years of age (95% confidence interval, CI: 0.3%-1.0%), and around 21,675 (10,612-37,198) new syphilis infections have occurred. The analysis shows a steady decline in prevalence from 1995, when the prevalence was estimated to be 1.8% (1.0-3.5%). The decline was consistent with decreasing prevalences observed in TB patients, fishermen and prisoners followed over 2000-2012 through sentinel surveillance, and with a decline since 2003 in national HIV incidence estimated earlier through independent modelling. Periodic population-based surveys allowed Morocco to estimate syphilis prevalence and incidence trends. This first-ever undertaking engaged and focused national stakeholders, and confirmed the still considerable syphilis burden. The latest survey was done in 2012 and so the trends are relatively uncertain after 2012. From 2017 Morocco plans to implement a system to record data from routine antenatal programmatic screening, which should help update and re

  8. A retrospective study of chronic post-surgical pain following thoracic surgery: prevalence, risk factors, incidence of neuropathic component, and impact on qualify of life.

    Directory of Open Access Journals (Sweden)

    Zhiyou Peng

    Full Text Available BACKGROUND: Thoracic surgeries including thoracotomy and VATS are some of the highest risk procedures that often lead to CPSP, with or without a neuropathic component. This retrospective study aims to determine retrospectively the prevalence of CPSP following thoracic surgery, its predicting risk factors, the incidence of neuropathic component, and its impact on quality of life. METHODS: Patients who underwent thoracic surgeries including thoracotomy and VATS between 01/2010 and 12/2011 at the First Affiliated Hospital, School of Medicine, Zhejiang University were first contacted and screened for CPSP following thoracic surgery via phone interview. Patients who developed CPSP were then mailed with a battery of questionnaires, including a questionnaire referenced to Maguire's research, a validated Chinese version of the ID pain questionnaire, and a SF-36 Health Survey. Logistic regression analyses were subsequently performed to identify risk factors for CPSP following thoracic surgery and its neuropathic component. RESULTS: The point prevalence of CPSP following thoracic surgery was 24.9% (320/1284 patients, and the point prevalence of neuropathic component of CPSP was 32.5% (86/265 patients. CPSP following thoracic surgery did not improve significantly with time. Multiple predictive factors were identified for CPSP following thoracic surgery, including age<60 years old, female gender, prolonged duration of post-operative chest tube drainage (≥ 4 days, options of post-operative pain management, and pre-existing hypertension. Furthermore, patients who experienced CPSP following thoracic surgery were found to have significantly decreased physical function and worse quality of life, especially those with neuropathic component. CONCLUSIONS: Our study demonstrated that nearly 1 out of 4 patients underwent thoracic surgery might develop CPSP, and one third of them accompanied with a neuropathic component. Early prevention as well as aggressive

  9. Prevalence and seasonal incidence of nematode parasites and fluke infections of sheep and goats in eastern Ethiopia.

    Science.gov (United States)

    Sissay, Menkir M; Uggla, Arvid; Waller, Peter J

    2007-10-01

    A 2-year abattoir survey was carried out to determine the prevalence, abundance and seasonal incidence of gastro-intestinal (GI) nematodes and trematodes (flukes) of sheep and goats in the semi-arid zone of eastern Ethiopia. During May 2003 to April 2005, viscera including liver, lungs and GI tracts were collected from 655 sheep and 632 goats slaughtered at 4 abattoirs located in the towns of Haramaya, Harar, Dire Dawa and Jijiga in eastern Ethiopia. All animals were raised in the farming areas located within the community boundaries for each town. Collected materials were transported within 24 h to the parasitology laboratory of Haramaya University for immediate processing. Thirteen species belonging to 9 genera of GI nematodes (Haemonchus contortus, Trichostrongylus axei, T. colubriformis, T. vitrinus, Nematodirus filicollis, N. spathiger Oesopha-gostomum columbianum, O. venulosum, Strongyloides papillosus, Bunostomum trigonocephalum, Trichuris ovis, Cooperia curticei and Chabertia ovina), and 4 species belonging to 3 genera of trematodes (Fasciola hepatica, F. gigantica, Paramphistomum {Calicohoron} microbothrium and Dicrocoelium dendriticum) were recorded in both sheep and goats. All animals in this investigation were infected with multiple species to varying degrees. The mean burdens of adult nematodes were generally moderate in both sheep and goats and showed patterns of seasonal abundance that corresponded with the bi-modal annual rainfall pattern, with highest burdens around the middle of the rainy season. In both sheep and goats there were significant differences in the mean worm burdens and abundance of the different nematode species between the four geographic locations, with worm burdens in the Haramaya and Harar areas greater than those observed in the Dire Dawa and Jijiga locations. Similar seasonal variations were also observed in the prevalence of flukes. But there were no significant differences in the prevalence of each fluke species between the

  10. Prevalence, clinical investigation, and management of gallbladder disease in Rett syndrome.

    Science.gov (United States)

    Freilinger, Michael; Böhm, Michael; Lanator, Ines; Vergesslich-Rothschild, Klara; Huber, Wolf-Dietrich; Anderson, Alison; Wong, Kingsley; Baikie, Gordon; Ravikumara, Madhur; Downs, Jenny; Leonard, Helen

    2014-08-01

    This study determined the prevalence of cholelithiasis and/or cholecystectomy in Rett syndrome, described gallbladder function in a clinical cohort, and identified recommendations for assessment and management of gallbladder disease. The incidence of cholelithiasis/cholecystectomy was estimated from data describing 270 and 681 individuals with a pathogenic MECP2 mutation in the Australian Rett Syndrome Database and the International Rett Syndrome Phenotype Database respectively. Gallbladder function in 25 females (mean age 16y 5mo, SD 20y 7mo, range 3y 5mo-47y 10mo) with Rett syndrome (RTT) was evaluated with clinical assessment and ultrasound of the gallbladder. The Delphi technique was used to develop assessment and treatment recommendations. The incidence rate for cholelithiasis and/or cholecystectomy was 2.3 (95% confidence interval [CI] 1.1-4.2) and 1.8 (95% CI 1.0-3.0) per 1000 person-years in the Australian and International Databases respectively. The mean contractility index of the gallbladder for the clinical sample was 46.5% (SD 38.3%), smaller than for healthy individuals but similar to children with Down syndrome, despite no clinical symptoms. After excluding gastroesophageal reflux, gallbladder disease should be considered as a cause of abdominal pain in RTT and cholecystectomy recommended if symptomatic. Gallbladder disease is relatively common in RTT and should be considered in the differential diagnosis of abdominal pain in RTT. © 2014 Mac Keith Press.

  11. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013

    DEFF Research Database (Denmark)

    Vos, Theo; Barber, Ryan M.; Bell, Brad

    2015-01-01

    for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders......, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1...... the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated...

  12. Prevalence, pattern, etiology, and management of maxillofacial trauma in a developing country: a retrospective study.

    Science.gov (United States)

    Singaram, Mohanavalli; G, Sree Vijayabala; Udhayakumar, Rajesh Kumar

    2016-08-01

    This retrospective study aims to evaluate the prevalence of maxillofacial trauma in a developing country, along with its pattern, etiology and management. Data for the present study were collected from the Department of Dentistry, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Chennai in India. The medical records of patients treated for maxillofacial injuries between May 2014 and November 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. SPSS software version 16.0 was used for the data analysis. Maxillofacial fractures accounts for 93.3% of total injuries. The mean and standard deviation for the age of the patients were 35.0±11.8 years and with a minimum age of 5 years and maximum age of 75 years. Adults from 20 to 40 years age groups were more commonly involved, with a male to female ratio of 3:1. There was a statistically significantly higher proportion of males more commonly involved in accident and injuries (P maxillofacial injury was road traffic accidents (RTA) followed by falls and assaults, the sports injuries seem to be very less. In RTA, motorized two-wheelers (MTW) were the most common cause of incidents. The majority of victims of RTA were young adult males between the ages of 20 to 40 years. The malar bone and maxilla were the most common sites of fracture, followed by the mandible. The right side of the zygomatic complex was the predominant side of MTW injury. The majority of the zygomatic complex fractures were treated by conservative management. Open reduction and internal fixation were performed for indicated fracture patients.

  13. Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015.

    Science.gov (United States)

    McCabe, Marita P; Sharlip, Ira D; Lewis, Ron; Atalla, Elham; Balon, Richard; Fisher, Alessandra D; Laumann, Edward; Lee, Sun Won; Segraves, Robert T

    2016-02-01

    The incidence and prevalence of various sexual dysfunctions in women and men are important to understand to designate priorities for epidemiologic and clinical research. This manuscript was designed to conduct a review of the literature to determine the incidence and prevalence of sexual dysfunction in women and men. Members of Committee 1 of the Fourth International Consultation on Sexual Medicine (2015) searched and reviewed epidemiologic literature on the incidence and prevalence of sexual dysfunctions. Key older studies and most studies published after 2009 were included in the text of this article. The outcome measures were the reports in the various studies of the incidence and prevalence of sexual dysfunction among women and men. There are more studies on incidence and prevalence for men than for women and many more studies on prevalence than incidence for women and men. The data indicate that the most frequent sexual dysfunctions for women are desire and arousal dysfunctions. In addition, there is a large proportion of women who experience multiple sexual dysfunctions. For men, premature ejaculation and erectile dysfunction are the most common sexual dysfunctions, with less comorbidity across sexual dysfunctions for men compared with women. These data need to be treated with caution, because there is a high level of variability across studies caused by methodologic differences in the instruments used to assess presence of sexual dysfunction, ages of samples, nature of samples, methodology used to gather the data, and cultural differences. Future research needs to use well-validated tools to gather data and ensure that the data collection strategy is clearly described. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  14. Prevalence of ectopic intrathyroidal thymus in Japan: the Fukushima health management survey.

    Science.gov (United States)

    Fukushima, Toshihiko; Suzuki, Satoru; Ohira, Tetsuya; Shimura, Hiroki; Midorikawa, Sanae; Ohtsuru, Akira; Sakai, Akira; Abe, Masafumi; Yamashita, Shunichi; Suzuki, Shinichi

    2015-05-01

    Ectopic intrathyroidal thymus is thought to be a rare entity, often discovered incidentally, and is due to aberrant thymic migration during embryogenesis. The aim of this study was to determine the prevalence of ectopic intrathyroidal thymus in children using ultrasound screening. This study was cross-sectional and was conducted with the initial preliminary survey of the Fukushima Health Management Survey between October 9, 2011, and March 31, 2012, after the Fukushima Daiichi Nuclear Power Plant accident. A total of 37,816 children were examined in the survey. Diagnostic criteria are based on the ultrasonographic appearance of ectopic intrathyroidal thymus, which were round, oval, or polygonal hypoechoic or hyperechoic areas, with multiple granular and punctate echogenic foci. A total of 375 (0.99%) cases (164 girls) with ectopic intrathyroidal thymus were observed. The mean age was 7.0 years (range 0-18 years). Ectopic intrathyroidal thymus was located in the right (n=180), left (n=178), or bilateral (n=17) thyroid lobes. The incidence of ectopic intrathyroidal thymus was inversely correlated with age and body mass index. The results reflect the prevalence of ectopic intrathyroidal thymus using ultrasonography in the general population. Further examination will be needed by way of longitudinal follow-up.

  15. A management plan for hospitals and medical centers facing radiation incidents.

    Science.gov (United States)

    Davari, Fereshteh; Zahed, Arash

    2015-09-01

    Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  16. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  17. [Incidence and management of ectopic pregnancy in Iceland 2000-2009].

    Science.gov (United States)

    Baldvinsdottir, Áslaug; Gudmundsson, Jens A; Geirsson, Reynir Tómas

    2013-12-01

    Ectopic pregnancy can be life-threatening. Its treatment has changed radically during the last two decades. The study objective was to evaluate incidence and treatment of ectopic pregnancy in the Icelandic population during the decade 2000-2009. Information was collected about all diagnosed cases, place and method of treatment and admissions. The annual incidence was calculated with reference to number of pregnancies (n/1000), number of women aged 15-44 years (n/10 000) and by 5-year age groups, comparing the periods 2000-2004 and 2005-2009. The number of ectopic pregnancies during these 10 years was 836, or 444 during the years 2000-2004 and 392 during 2005-2009. The average annual incidence was 15.6/1000 pregnancies and 12.9/10 000 women. There was an annual incidence reduction from 17.3 to 14.1/1000 pregnancies (ptreatment for 94.9% of women, methotrexate in 3.2% and expectant management in 1.9%. Surgical management decreased from 98.0% to 91.3% between 5-year periods as medical treatment increased (0.4% to 6.4%; pectopic pregnancy is comparable to the development in neighbouring countries. Management has changed with increased use of laparoscopic surgery, medical and expectant treatment.

  18. Incidence and prevalence of idiopathic inflammatory myopathies among commercially insured, Medicare supplemental insured, and Medicaid enrolled populations: an administrative claims analysis

    Directory of Open Access Journals (Sweden)

    Smoyer-Tomic Karen E

    2012-06-01

    Full Text Available Abstract Background Idiopathic inflammatory myopathies (IIMs are a rare group of autoimmune syndromes characterized by chronic muscle inflammation and muscle weakness with no known cause. Little is known about their incidence and prevalence. This study reports the incidence and prevalence of IIMs among commercially insured and Medicare and Medicaid enrolled populations in the US. Methods We retrospectively examined medical claims with an IIM diagnosis (ICD-9-CM 710.3 [dermatomyositis (DM], 710.4 [polymyositis (PM], 728.81[interstitial myositis] in the MarketScan® databases to identify age- and gender-adjusted annual IIM incidence and prevalence for 2004–2008. Sensitivity analysis was performed for evidence of a specialist visit (rheumatologist/ neurologist/dermatologist, systemic corticosteroid or immunosuppressant use, or muscle biopsy. Results We identified 2,990 incident patients between 2004 and 2008 (67% female, 17% Medicaid enrollees, 27% aged ≥65 years. Overall adjusted IIM incidence for 2004–2008 for commercial and Medicare supplemental groups combined were 4.27 cases (95% CI, 4.09-4.44 and for Medicaid, 5.23 (95% CI 4.74-5.72 per 100,000 person-years (py. Disease sub-type incidence rates per 100,000-py were 1.52 (95% CI 1.42-1.63 and 1.70 (1.42-1.97 for DM, 2.46 (2.33-2.59 and 3.53 (3.13-3.94 for PM, and 0.73 (0.66-0.81 and 0.78 (0.58-0.97 for interstitial myositis for the commercial/Medicare and Medicaid cohorts respectively. Annual incidence fluctuated over time with the base MarketScan populations. There were 7,155 prevalent patients, with annual prevalence ranging from 20.62 to 25.32 per 100,000 for commercial/Medicare (83% of prevalent cases and from 15.35 to 32.74 for Medicaid. Conclusions We found higher IIM incidence than historically reported. Employer turnover, miscoding and misdiagnosing, care seeking behavior, and fluctuations in database membership over time can influence the results. Further studies are needed to

  19. Hyperthyroxinemia is positively associated with prevalent and incident type 2 diabetes mellitus in two population-based samples from Northeast Germany and Denmark

    DEFF Research Database (Denmark)

    Ittermann, T; Schipf, S; Dörr, M

    2017-01-01

    BACKGROUND AND AIMS: A potential causal relationship between thyroid function and type 2 diabetes mellitus is currently under debate, but the current state of research is limited. Our aim was to investigate the association of thyroid hormone levels with prevalent and incident type 2 diabetes mell......DM (RR per pmol/L = 1.21; 95%-CI = 1.16-1.27). CONCLUSION: We demonstrated positive associations of thyroid hormones with prevalent and incident type 2 diabetes mellitus suggesting that hyperthyroxinemia may contribute to the pathogenesis of this condition....

  20. A systematic review describing incidence rate and prevalence of dysvascular partial foot amputation; how both have changed over time and compare to transtibial amputation

    Directory of Open Access Journals (Sweden)

    Michael P Dillon

    2017-11-01

    Full Text Available Abstract Background Partial foot amputation (PFA is a common consequence of advanced peripheral vascular disease. Given the different ways incidence rate and prevalence data have been measured and reported, it is difficult to synthesize data and reconcile variation between studies. As such, there is uncertainty in whether the incidence rates and prevalence of PFA have increased over time compared to the decline in transtibial amputation (TTA. The aims of this systematic review were to describe the incidence rate and prevalence of dysvascular PFA over time, and how these compare to TTA. Method Databases (i.e., MEDLINE, EMBASE, psychINFO, AMED, CINAHL, ProQuest Nursing and Allied Health were searched using MeSH terms and keywords related to amputation level and incidence rate or prevalence. Original research published in English from 1 January 2000 to 31 December 2015 were independently appraised, and data extracted, by two reviewers. The McMaster Critical Review Forms were used to assess methodological quality and bias. Results were reported as narrative summaries given heterogeneity of the literature and included the weighted mean annual incidence rate and 95% confidence interval. Results Twenty two cohort studies met the inclusion criteria. Twenty one reported incidence rate data for some level of PFA; four also included a TTA cohort. One study reported prevalence data for a cohort with toe(s amputation. Samples were typically older, male and included people with diabetes among other comorbidities. Incidence rates were reported using a myriad of denominators and strata such as diabetes type or initial/recurrent amputation. Conclusion When appropriately grouped by denominator and strata, incidence rates were more homogenous than might be expected. Variation between studies did not necessarily reduce confidence in the conclusion; for example, incidence rate of PFA were many times larger in cohorts with diabetes (94.24 per 100,000 people with

  1. Self-reported heart attack in Mexican-American elders: examination of incidence, prevalence, and 7-year mortality.

    Science.gov (United States)

    Otiniano, Max E; Ottenbacher, Kenneth J; Markides, Kyriakos S; Ray, Laura A; Du, Xianglin L

    2003-07-01

    To examine the prevalence, incidence, and mortality of self-reported heart attack in older Mexican Americans and to identify significant factors associated with heart attack. Cross-sectional and longitudinal study. Baseline and three follow-up interviews in five southwestern states (Arizona, California, Colorado, New Mexico, and Texas) of the Hispanic Established Population for the Epidemiological Study of the Elderly. Three thousand fifty Mexican Americans aged 65 to 107 (mean age = 73). Sociodemographic factors (age, sex, marital status, language of interview, health insurance coverage, living arrangements, and financial strain) and health factors (smoking, alcohol consumption, obesity, diabetes mellitus, hypertension, stroke, cancer, hip fracture, arthritis, depression, limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and mortality) were determined at baseline (1993-94). New heart attacks were assessed at follow-ups in 1995-96, 1998-99, and 2000-01. Vital status was determined over the 7-year follow-up. Prevalence of self-reported heart attack was 9.1% at baseline. Incidence of self-reported heart attack was 6.1%, 9.1%, and 7.9%, respectively, for the three subsequent follow-ups. Older age, male sex, diabetes mellitus, hypertension, and stroke were significantly associated with heart attack at baseline. Age was a significant predictor for new heart attack at each follow-up. Having ADL (odds ratio (OR) = 2.91, 95% confidence interval (CI) = 2.19-3.86) and IADL (OR = 2.25, CI = 1.72-2.94) disabilities was significantly associated with self-reported heart attack. Subjects with heart attack were significantly more likely to die at 7 years (hazard ratio = 1.57, 95% CI = 1.29-1.91). Of those with self-reported heart attack, 42.4% had died of heart attack as the underlying cause of death by 7-year follow-up. In Mexican Americans, self-reported heart attack was associated with being older and male and having diabetes

  2. Uma metodologia para estimar a incidência a partir de prevalências obtidas em Pesquisas Nacionais por Amostra de Domicílios: o exemplo da alfabetização A methodology to estimate incidence from prevalence rates in household surveys: the example of literacy

    Directory of Open Access Journals (Sweden)

    Greice Maria Silva da Conceição

    2008-06-01

    Full Text Available Conhecer a incidência de algum evento por idade e tempo é sem dúvida um dos maiores interesses da epidemiologia. Devido à relação matemática que existe entre as medidas de incidência e prevalência, alguns métodos foram desenvolvidos com o objetivo de obter a incidência a partir da prevalência. Este estudo descreve, de forma tutorial, um método que fornece estimativas de incidências por idade e tempo desde que existam prevalências repetidas de um evento, que a ocorrência do mesmo esteja relacionada à idade do indivíduo e que este possua características de uma doença crônica. O estudo foi realizado para a alfabetização da população brasileira, utilizando as prevalências por idade obtidas na Pesquisa Nacional por Amostra de Domicílios (PNAD 1981, 1985, 1989, 1992, 1995 e 2001, e permitiu recuperar as estimativas da incidência de alfabetização nas idades entre 5 e 20 anos entre os anos de 1960 a 2000. O método ajusta os parâmetros de incidência para idade e tempo com o auxílio de um modelo linear generalizado para dados categóricos e utiliza o algoritmo EM para obter os dados não observados.Age and time-specific incidence rates are highly relevant to epidemiologists. Due to the mathematical relationship between incidence and prevalence, several methods have been developed to obtain incidence based on prevalence. The present study didactically describes a method to estimate age and time incidence, based on: repeated measurements of prevalence for an event; events related to the individual's age; and events with the characteristics of a chronic disease. The method was used to analyze literacy in the Brazilian population, using prevalence by age obtained from the National Household Sample Survey (PNAD for 1981, 1985, 1989, 1992, 1995, and 2001, and allowed obtaining literacy incidence estimates for ages 5 to 20 years, for the years 1960 through 2001. The method adjusts incidence parameters for age and time with the

  3. Prevalence, Incidence, Impairment, and Course of the Proposed DSM-5 Eating Disorder Diagnoses in an 8-Year Prospective Community Study of Young Women

    OpenAIRE

    Stice, Eric; Marti, C. Nathan; Rohde, Paul

    2012-01-01

    We examined the prevalence, incidence, impairment, duration, and course for the proposed DSM-5 eating disorders in a community sample of 496 adolescent females who completed annual diagnostic interviews over 8-years. Lifetime prevalence by age 20 was 0.8% for anorexia nervosa (AN), 2.6% for bulimia nervosa (BN), 3.0% for binge eating disorder (BED), 2.8% for atypical AN, 4.4% for subthreshold BN, 3.6% for subthreshold BED, 3.4% for purging disorder (PD); with a combined prevalence of 13.1% (5...

  4. Studies on prevalence of malaria and management practices of the ...

    African Journals Online (AJOL)

    A prevalence survey of malaria was carried out in Azia, a rural community in Ihiala Local Government Area of Anambra State, southeast Nigeria. Thick blood films of 1000 individuals attending local hospitals in the community were used to determine the prevalence. Also, structured questionnaire was administered to 1000 ...

  5. Impact of insecticide resistance inAnopheles arabiensison malaria incidence and prevalence in Sudan and the costs of mitigation.

    Science.gov (United States)

    Kafy, Hmooda Toto; Ismail, Bashir Adam; Mnzava, Abraham Peter; Lines, Jonathan; Abdin, Mogahid Shiekh Eldin; Eltaher, Jihad Sulieman; Banaga, Anuar Osman; West, Philippa; Bradley, John; Cook, Jackie; Thomas, Brent; Subramaniam, Krishanthi; Hemingway, Janet; Knox, Tessa Bellamy; Malik, Elfatih M; Yukich, Joshua O; Donnelly, Martin James; Kleinschmidt, Immo

    2017-12-26

    Insecticide-based interventions have contributed to ∼78% of the reduction in the malaria burden in sub-Saharan Africa since 2000. Insecticide resistance in malaria vectors could presage a catastrophic rebound in disease incidence and mortality. A major impediment to the implementation of insecticide resistance management strategies is that evidence of the impact of resistance on malaria disease burden is limited. A cluster randomized trial was conducted in Sudan with pyrethroid-resistant and carbamate-susceptible malaria vectors. Clusters were randomly allocated to receive either long-lasting insecticidal nets (LLINs) alone or LLINs in combination with indoor residual spraying (IRS) with a pyrethroid (deltamethrin) insecticide in the first year and a carbamate (bendiocarb) insecticide in the two subsequent years. Malaria incidence was monitored for 3 y through active case detection in cohorts of children aged 1 to resistance may have had an impact on pyrethroid-based IRS. The study was not designed to assess whether resistance had an impact on LLINs. These data alone should not be used as the basis for any policy change in vector control interventions. Copyright © 2017 the Author(s). Published by PNAS.

  6. PROACTIVE APPROACH TO THE INCIDENT AND PROBLEM MANAGEMENT IN COMMUNICATION NETWORKS

    Directory of Open Access Journals (Sweden)

    Vjeran Strahonja

    2007-06-01

    Full Text Available Proactive approach to communication network maintenance has the capability of enhancing the integrity and reliability of communication networks, as well as of reducing maintenance costs and overall number of incidents. This paper presents approaches to problem and incident prevention with the help of root-cause analysis, aligning that with the goal to foresee software performance. Implementation of proactive approach requires recognition of enterprise's current level of maintenance better insights into available approaches and tools, as well as their comparison, interoperability, integration and further development. The approach we are proposing and elaborating in this paper lies on the construction of a metamodel of the problem management of information technology, particularly the proactive problem management. The metamodel is derived from the original ITIL specification and presented in an object-oriented fashion by using structure (class diagrams conform to UML notation. Based on current research, appropriate metrics based on the concept of Key Performance Indicators is suggested.

  7. Prevalence and incidence of multiple sclerosis in Oppland County: a cross-sectional population-based study in a landlocked county of Eastern Norway.

    Science.gov (United States)

    Risberg, Geir; Aarseth, Jan Harald; Nyland, Harald; Lauer, Klaus; Myhr, Kjell-Morten; Midgard, Rune

    2011-10-01

    OBJECTIVES - We report the prevalence and incidence rates of multiple sclerosis (MS) in Oppland County, Norway. METHODS - Records from all patients diagnosed with MS at the two Oppland County hospitals, Gjøvik and Lillehammer during 1989-2001 were evaluated. In addition, all general practitioners in Oppland County reported their patients into the study. RESULTS - The age-adjusted prevalence rate of definite MS was 174.4/ 100 000 on the prevalence day 1 January 2002. When the probable cases were included, the prevalence rate rose to 185.6/100 000. The highest prevalence rates were detected in the northern mountain areas, thus corroborating the results from previous local surveys 30-50 years ago. The prevalence of MS was statistically significantly associated with climatic, socioeconomic and geographic variables in the county. The age-adjusted incidence of definite and probable MS in Oppland County was 6.6/100 000 during 1989-1993 increasing to 7.6/100 000 during 1994-1998. DISCUSSION - We found the highest prevalence rates of MS ever reported in Norway. Our findings indicate a possible influence of environmental factors. © 2010 John Wiley & Sons A/S.

  8. Comparison of the prevalence and incidence of infection with bovine virus diarrhoea virus (BVDV) in Denmark and Michigan and association with possible risk factors

    DEFF Research Database (Denmark)

    Houe, H.; Baker, J.C.; Maes, R.K.

    1995-01-01

    Based on 2 previous surveys on the occurrence of infection with bovine virus diarrhoea virus (BVDV) in Danish and Michigan dairy herds, the prevalence and incidence of the infection were compared. The presence of certain possible risk factors for the occurrence of infection in the 2 areas were...

  9. Mediterranean dietary pattern and prevalence and incidence of depressive symptoms in mid-aged women: results from a large community-based prospective study

    NARCIS (Netherlands)

    Rienks, J.; Dobson, A.; Mishra, G.D.

    2013-01-01

    BACKGROUND/OBJECTIVES: To investigate the association between dietary patterns and prevalence and incidence 3 years later of depressive symptoms using data from the mid-aged cohort in the Australian Longitudinal Study on Women’s Health. SUBJECTS/METHODS: Participants (aged 50–55 years) completed a

  10. Calendar time trends in the incidence and prevalence of triple-class virologic failure in antiretroviral drug-experienced people with HIV in Europe

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Lodwick, Rebecca; Costagliola, Dominique

    2012-01-01

    Despite the increasing success of antiretroviral therapy (ART), virologic failure of the 3 original classes [triple-class virologic failure, (TCVF)] still develops in a small minority of patients who started therapy in the triple combination ART era. Trends in the incidence and prevalence of TCVF...

  11. Canadian Digestive Health Foundation Public Impact Series 3: Irritable Bowel Syndrome in Canada. Incidence, Prevalence, and Direct and Indirect Economic Impact

    Directory of Open Access Journals (Sweden)

    Richard N Fedorak

    2012-01-01

    Full Text Available The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning irritable bowel syndrome.

  12. Prevalence, Cumulative Incidence, Monotherapy and Combination Therapy, and Treatment Duration of Frequently Prescribed Psychoactive Medications in the Netherlands : Retrospective Database Analysis for the Years 2000 to 2005

    NARCIS (Netherlands)

    Ravera, Silvia; Visser, Sipke T.; de Gier, Johan J.; den Berg, Lolkje T. W. de Jong-van

    2010-01-01

    Background: Psychoactive drugs have been reported to impair daily activities (eg, driving), but data regarding the use of such drugs in the Netherlands are lacking. Objective: The aim of this work was to examine the prevalence, cumulative incidence, use of monotherapy and combination therapy, and

  13. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : the Global Burden of Disease Study 2015

    NARCIS (Netherlands)

    Wang, Haidong; Wolock, Tim M.; Carter, Austin; Nguyen, Grant; Kyu, Hmwe Hmwe; Gakidou, Emmanuela; Hay, Simon I.; Mills, Edward J.; Trickey, Adam; Msemburi, William; Coates, Matthew M.; Mooney, Meghan D.; Fraser, Maya S.; Sligar, Amber; Salomon, Joshua; Larson, Heidi J.; Friedman, Joseph; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbas, Kaja M.; Abd El Razek, Mohamed Magdy; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw Ferede; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Abyu, Gebre Yitayih; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adelekan, Ademola Lukman; Adofo, Koranteng; Adou, Arsene Kouablan; Ajala, Oluremi N.; Akinyemiju, Tomi F.; Akseer, Nadia; Al Lami, Faris Hasan; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore K. M.; Alasfoor, Deena; Aldhahri, Saleh Fahed S.; Aldridge, Robert William; Alegretti, Miguel Angel; Aleman, Alicia V.; Alemu, Zewdie Aderaw; Alfonso-Cristancho, Rafael; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Al-Raddadi, Rajaa Mohammad Salem; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Ammar, Walid; Amrock, Stephen Marc; Antonio, Carl Abelardo T.; Anwari, Palwasha; Arnlov, Johan; Al Artaman, Ali; Asayesh, Hamid; Asghar, Rana Jawad; Assadi, Reza; Atique, Suleman; Atkins, Lydia S.; Avokpaho, Euripide Frinel G. Arthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Barnighausen, Till; Basu, Arindam; Bayou, Tigist Assefa; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Bennett, Derrick A.; Bensenor, Isabela M.; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhatia, Eesh; Bhutta, Zulfiqar A.; Biadgilign, Sibhatu; Bikbov, Boris; Birlik, Sait Mentes; Bisanzio, Donal; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J. K.; Brown, Alexandria; Burch, Michael; Butt, Zahid A.; Campuzano, Julio Cesar; Cardenas, Rosario; Carrero, Juan Jesus; Castaneda-Orjuela, Carlos A.; Rivas, Jacqueline Castillo; Catala-Lopez, Ferran; Chang, Hsing-Yi; Chang, Jung-chen; Chavan, Laxmikant; Chen, Wanqing; Chiang, Peggy Pei-Chia; Chibalabala, Mirriam; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G.; Cooper, Cyrus; Dahiru, Tukur; Damtew, Solomon Abreha; Dandona, Lalit; Dandona, Rakhi; das Neves, Jose; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Dellavalle, Robert P.; Deribe, Kebede; Deribew, Amare; Jarlais, Don C. Des; Dharmaratne, Samath D.; Ding, Eric L.; Doshi, Pratik Pinal; Driscoll, Tim R.; Dubey, Manisha; Elshrek, Yousef Mohamed; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Faghmous, Imad D. A.; Sofia e Sa Farinha, Carla; Faro, Andre; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fernandes, Joao C.; Fischer, Florian; Fitchett, Joseph Robert Ander; Foigt, Nataliya; Fullman, Nancy; Furst, Thomas; Gankpe, Fortune Gbetoho; Gebre, Teshome; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Geleijnse, Johanna M.; Gessner, Bradford D.; Gething, Peter W.; Ghiwot, Tsegaye Tewelde; Giroud, Maurice; Gishu, Melkamu Dedefo; Glaser, Elizabeth; Goenka, Shifalika; Goodridge, Amador; Gopalani, Sameer Vali; Goto, Atsushi; Gugnani, Harish Chander; Guimaraes, Mark D. C.; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Haagsma, Juanita; Hafezi-Nejad, Nima; Hagan, Holly; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Hammami, Mouhanad; Hankey, Graeme J.; Hao, Yuantao; Harb, Hilda L.; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Harun, Kimani M.; Havmoeller, Rasmus; Hedayati, Mohammad T.; Heredia-Pi, Ileana Beatriz; Hoek, Hans W.; Horino, Masako; Horita, Nobuyuki; Hosgood, H. Dean; Hoy, Damian G.; Hsairi, Mohamed; Hu, Guoqing; Huang, Hsiang; Huang, John J.; Iburg, Kim Moesgaard; Idrisov, Bulat T.; Innos, Kaire; Iyer, Veena J.; Jacobsen, Kathryn H.; Jahanmehr, Nader; Jakovljevic, Mihajlo B.; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jonas, Jost B.; Kabir, Zubair; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karema, Corine Kakizi; Karletsos, Dimitris; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young-Ho; Khubchandani, Jagdish; Kim, Yun Jin; Kinfu, Yohannes; Kivipelto, Miia; Kokubo, Yoshihiro; Kosen, Soewarta; Koul, Parvaiz A.; Koyanagi, Ai; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kulkarni, Veena S.; Kumar, G. Anil; Lal, Dharmesh Kumar; Lam, Hilton; Lam, Jennifer O.; Langan, Sinead M.; Lansingh, Van C.; Larsson, Anders; Leigh, James; Leung, Ricky; Li, Yongmei; Lim, Stephen S.; Lipshultz, Steven E.; Liu, Shiwei; Lloyd, Belinda K.; Logroscino, Giancarlo; Lotufo, Paulo A.; Lunevicius, Raimundas; Abd El Razek, Hassan Magdy; Mahdavi, Mahdi; Majdan, Marek; Majeed, Azeem; Makhlouf, Carla; Malekzadeh, Reza; Mapoma, Chabila C.; Marcenes, Wagner; Martinez-Raga, Jose; Marzan, Melvin Barrientos; Masiye, Felix; Mason-Jones, Amanda J.; Mayosi, Bongani M.; Mckee, Martin; Meaney, Peter A.; Mehndiratta, Man Mohan; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A.; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J.; Mhimbira, Francis Apolinary; Miller, Ted R.; Mikesell, Joseph; Mirarefin, Mojde; Mohammad, Karzan Abdulmuhsin; Mohammed, Shafiu; Mokdad, Ali H.; Monasta, Lorenzo; Moradi-Lakeh, Maziar; Mori, Rintaro; Mueller, Ulrich O.; Murimira, Brighton; Murthy, Gudlavalleti Venkata Satyanarayana; Naheed, Aliya; Naldi, Luigi; Nangia, Vinay; Nash, Denis; Nawaz, Haseeb; Nejjari, Chakib; Ngalesoni, Frida Namnyak; Ngirabega, Jean De Dieu; Quyen Le Nguyen, [Unknown; Nisar, Muhammad Imran; Norheim, Ole F.; Norman, Rosana E.; Nyakarahuka, Luke; Ogbo, Felix Akpojene; Oh, In-Hwan; Ojelabi, Foluke Adetola; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Ota, Erika; Padukudru, Mahesh Anand; Park, Hye-Youn; Park, Jae-Hyun; Patil, Snehal T.; Patten, Scott B.; Paul, Vinod K.; Pearson, Katherine; Peprah, Emmanuel Kwame; Pereira, Claudia C.; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Pillay, Julian David; Plass, Dietrich; Polinder, Suzanne; Pourmalek, Farshad; Prokop, David M.; Qorbani, Mostafa; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Ram, Usha; Rana, Saleem M.; Rao, Paturi Vishnupriya; Remuzzi, Giuseppe; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roy, Ambuj; Ruhago, George Mugambage; Saeedi, Mohammad Yahya; Sagar, Rajesh; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Santos, Itamar S.; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Sawhney, Monika; Schutte, Aletta E.; Schwebel, David C.; Seedat, Soraya; Sepanlou, Sadaf G.; Servan-Mori, Edson E.; Shaikh, Masood Ali; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Shibuya, Kenji; Shin, Hwashin Hyun; Sigfusdottir, Inga Dora; Silpakit, Naris; Santos Silva, Diego Augusto; Alves Silveira, Dayane Gabriele; Simard, Edgar P.; Sindi, Shireen; Singh, Jasvinder A.; Singh, Om Prakash; Singh, Prashant Kumar; Skirbekk, Vegard; Sliwa, Karen; Soneji, Samir; Sorensen, Reed J. D.; Soriano, Joan B.; Soti, David O.; Sreeramareddy, Chandrashekhar T.; Stathopoulou, Vasiliki; Steel, Nicholas; Sunguya, Bruno F.; Swaminathan, Soumya; Sykes, Bryan L.; Tabares-Seisdedos, Rafael; Talongwa, Roberto Tchio; Tavakkoli, Mohammad; Taye, Bineyam; Tedla, Bemnet Amare; Tekle, Tesfaye; Shifa, Girma Temam; Temesgen, Awoke Misganaw; Terkawi, Abdullah Sulieman; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thapa, Kiran; Thomson, Alan J.; Thorne-Lyman, Andrew L.; Tobe-Gai, Ruoyan; Topor-Madry, Roman; Towbin, Jeffrey Allen; Bach Xuan Tran,; Dimbuene, Zacharie Tsala; Tsilimparis, Nikolaos; Tura, Abera Kenay; Ukwaja, Kingsley Nnanna; Uneke, Chigozie Jesse; Uthman, Olalekan A.; Venketasubramanian, N.; Vladimirov, Sergey K.; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wang, Linhong; Weiderpass, Elisabete; Weintraub, Robert G.; Werdecker, Andrea; Westerman, Ronny; Wijeratne, Tissa; Wilkinson, James D.; Wiysonge, Charles Shey; Wolfe, Charles D. A.; Won, Sungho; Wong, John Q.; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yano, Yuichiro; Yaseri, Mehdi; Yebyo, Henock Gebremedhin; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z.; Yu, Chuanhua; Yu, Shicheng; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zhang, Hao; Zhao, Yong; Zodpey, Sanjay; Zoeckler, Leo; Zuhlke, Liesl Joanna; Lopez, Alan D.; Murray, Christopher J. L.

    Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral

  14. Prevalence, incidence and mortality of type 2 diabetes mellitus revisited : A prospective population-based study in The Netherlands (ZODIAC-1)

    NARCIS (Netherlands)

    Ubink-Veltmaat, LJ; Bilo, HJG; Groenier, KH; Houweling, ST; Rischen, RO; Meyboom-de Jong, B

    2003-01-01

    Background: To present actual data to estimate prevalence, incidence and mortality of known type 2 diabetes mellitus in all age categories in The Netherlands. Methods: Prospective population-based study between 1998 and 2000 in The Netherlands. Baseline population of 155,774 patients, registered

  15. Vitamin B12 status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor.

    Science.gov (United States)

    Pfisterer, Kaylen J; Sharratt, Mike T; Heckman, George G; Keller, Heather H

    2016-02-01

    Vitamin B12 (B12) deficiency, although treatable, impacts up to 43% of community-living older adults; long-term care (LTC) residents may be at greater risk. Recommendations for screening require further evidence on prevalence and incidence in LTC. Small, ungeneralizable samples provide a limited perspective on these issues. The purposes of this study were to report prevalence of B12 deficiency at admission to LTC, incidence 1 year post-admission, and identify subgroups with differential risk. This multi-site (8), retrospective prevalence study used random proportionate sampling of resident charts (n = 412). Data at admission extracted included demographics, B12 status, B12 supplementation, medications, diagnoses, functional independence, cognitive performance, and nutrition. Prevalence at admission of B12 deficiency (B12 (>300 pmol/L). One year post-admission incidence was 4%. Better B12 status was significantly associated with supplementation use prior to LTC admission. Other characteristics were not associated with status. This work provides a better estimate of B12 deficiency prevalence than previously available for LTC, upon which to base protocols and policy. Prospective studies are needed to establish treatment efficacy and effect on health related outcomes.

  16. Post-operative pain prevalence, predictors, management practices ...

    African Journals Online (AJOL)

    MWASHAMBWA

    range= 14–80 years). The prevalence ... delayed wound healing, transition to chronic pain, reduced vital capacity and alveolar ventilation, pneumonia ... The most common predictors of severe pain reported include female sex, young age, high.

  17. Modelling the Impact of Condom Distribution on the Incidence and Prevalence of Sexually Transmitted Infections in an Adult Male Prison System.

    Directory of Open Access Journals (Sweden)

    Nick Scott

    Full Text Available To determine the effects of 1 a condom distribution program and 2 a condom distribution program combined with opt-out sexually transmitted infection (STI screening on the transmission and prevalence of STIs in a prison system.Using data from an implementation evaluation of a state-wide prison condom program and parameter estimates from available literature, a deterministic model was developed to quantify the incidence and prevalence of sexually transmitted HIV, hepatitis B, chlamydia, syphilis and gonorrhoea across 14 Victorian prisons. The model included individual prison populations (by longer (>2 years or shorter sentence lengths and monthly prisoner transfers. For each STI, simulations were compared: without any intervention; with a condom distribution program; and with a combined condom and opt-out STI screening at prison reception intervention program.Condoms reduced the annual incidence of syphilis by 99% (N = 66 averted cases; gonorrhoea by 98% (N = 113 cases; hepatitis B by 71% (N = 5 cases; chlamydia by 27% (N = 196 cases; and HIV by 50% (N = 2 cases every 10 years. Condom availability changed the in-prison epidemiology of gonorrhoea and syphilis from self-sustaining to levels unlikely to result in infection outbreaks; however, condoms did not reduce chlamydia prevalence below a self-sustaining level due to its high infectiousness, high prevalence and low detection rate. When combined with a screening intervention program, condoms reduced chlamydia prevalence further, but not below a self-sustaining level. The low prevalence of HIV and hepatitis B in Australian prisons meant the effects of condoms were predicted to be small.Condoms are predicted to effectively reduce the incidence of STIs in prison and are predicted to control syphilis and gonorrhoea transmission, however even combined with a screening on arrival program may be insufficient to reduce chlamydia prevalence below self-sustaining levels. To control chlamydia transmission

  18. Modelling the Impact of Condom Distribution on the Incidence and Prevalence of Sexually Transmitted Infections in an Adult Male Prison System.

    Science.gov (United States)

    Scott, Nick; McBryde, Emma; Kirwan, Amy; Stoové, Mark

    2015-01-01

    To determine the effects of 1) a condom distribution program and 2) a condom distribution program combined with opt-out sexually transmitted infection (STI) screening on the transmission and prevalence of STIs in a prison system. Using data from an implementation evaluation of a state-wide prison condom program and parameter estimates from available literature, a deterministic model was developed to quantify the incidence and prevalence of sexually transmitted HIV, hepatitis B, chlamydia, syphilis and gonorrhoea across 14 Victorian prisons. The model included individual prison populations (by longer (>2 years) or shorter sentence lengths) and monthly prisoner transfers. For each STI, simulations were compared: without any intervention; with a condom distribution program; and with a combined condom and opt-out STI screening at prison reception intervention program. Condoms reduced the annual incidence of syphilis by 99% (N = 66 averted cases); gonorrhoea by 98% (N = 113 cases); hepatitis B by 71% (N = 5 cases); chlamydia by 27% (N = 196 cases); and HIV by 50% (N = 2 cases every 10 years). Condom availability changed the in-prison epidemiology of gonorrhoea and syphilis from self-sustaining to levels unlikely to result in infection outbreaks; however, condoms did not reduce chlamydia prevalence below a self-sustaining level due to its high infectiousness, high prevalence and low detection rate. When combined with a screening intervention program, condoms reduced chlamydia prevalence further, but not below a self-sustaining level. The low prevalence of HIV and hepatitis B in Australian prisons meant the effects of condoms were predicted to be small. Condoms are predicted to effectively reduce the incidence of STIs in prison and are predicted to control syphilis and gonorrhoea transmission, however even combined with a screening on arrival program may be insufficient to reduce chlamydia prevalence below self-sustaining levels. To control chlamydia transmission

  19. Prevalence

    Directory of Open Access Journals (Sweden)

    Ahmed E. Mansour

    2013-07-01

    Conclusion: The prevalence of spontaneous bacterial pleuritis in the studied group of patients with hepatic hydrothorax was 14.3%. Patients with advanced liver disease, low pleural fluid protein, or SBP are at risk for spontaneous bacterial pleuritis.

  20. Mass Casualty Decontamination Guidance and Psychosocial Aspects of CBRN Incident Management: A Review and Synthesis

    Science.gov (United States)

    Carter, Holly; Amlôt, Richard

    2016-01-01

    Introduction: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents. The review focuses on five psychosocial aspects of incident management: likely public behaviour; responder management style; communication strategy; privacy/ modesty concerns; and vulnerable groups. Methods: Two structured literature reviews were carried out; one to identify decontamination guidance documents for first responders, and another to identify evidence which is relevant to the understanding of the psychosocial aspects of mass decontamination.  The guidance documents and relevant research were reviewed to identify whether the guidance documents contain information relating to psychosocial issues and where it exists, that the guidance is consistent with the existing evidence-base. Results: Psychosocial aspects of incident management receive limited attention in current decontamination guidance.  In addition, our review has identified a number of gaps and inconsistencies between guidance and research evidence.  For each of the five areas we identify: what is currently presented in guidance documents, to what extent this is consistent with the existing research evidence and where it diverges.  We present a series of evidence-based recommendations for updating decontamination guidance to address the psychosocial aspects of mass decontamination. Conclusions: Effective communication and respect for casualties’ needs are critical in ensuring

  1. Incidence and prevalence rates of diabetes mellitus in Taiwan: Analysis of the 2000–2009 Nationwide Health Insurance database

    Directory of Open Access Journals (Sweden)

    Yi-Der Jiang

    2012-11-01

    Conclusion: The incidence of diabetes, including type 1, remained stable over this 10-year period in Taiwan. However, the incidence rate in men aged 20–59 years was higher than that in age-matched women. With our nationwide database, subgroup analysis of DM incidence can be performed to refine our health policies for the prevention, screening, and treatment of diabetes mellitus.

  2. Incidence and Prevalence of Systemic Lupus Erythematosus Among Arab and Chaldean Americans in Southeastern Michigan: The Michigan Lupus Epidemiology and Surveillance Program

    Science.gov (United States)

    DeGuire, Peter; Lyon-Callo, Sarah; Wang, Lu; Marder, Wendy; McCune, W. Joseph; Helmick, Charles G.; Gordon, Caroline; Dhar, J. Patricia; Leisen, James; Somers, Emily C.

    2015-01-01

    Objectives. We assessed the burden of systemic lupus erythematosus (SLE) among Arab and Chaldean Americans residing in southeast Michigan. Methods. For those meeting SLE criteria from the Michigan Lupus Epidemiology and Surveillance Registry, we determined Arab or Chaldean ethnicity by links with demographic data from birth certificates and with a database of Arab and Chaldean names. We compared prevalence and incidence of SLE for Arab and Chaldean Americans with estimates for non-Arab and non-Chaldean American Whites and Blacks. Results. We classified 54 individuals with SLE as Arab and Chaldean Americans. The age-adjusted incidence and prevalence estimates for Arab and Chaldean Americans were 7.6 and 62.6 per 100 000, respectively. Arab and Chaldean Americans had a 2.1-fold excess SLE incidence compared with non-Arab and non-Chaldean American Whites. Arab and Chaldean American women had both significantly higher incidence rates (5.0-fold increase) and prevalence estimates (7.4-fold increase) than did Arab and Chaldean American men. Conclusions. Recognizing that Arab and Chaldean Americans experience different disease burdens from Whites is a first step toward earlier diagnosis and designing targeted interventions. Better methods of assigning ethnicity would improve research in this population. PMID:25790387

  3. Incidence and prevalence of systemic lupus erythematosus among Arab and Chaldean Americans in southeastern Michigan: the Michigan Lupus Epidemiology and Surveillance Program.

    Science.gov (United States)

    Housey, Michelle; DeGuire, Peter; Lyon-Callo, Sarah; Wang, Lu; Marder, Wendy; McCune, W Joseph; Helmick, Charles G; Gordon, Caroline; Dhar, J Patricia; Leisen, James; Somers, Emily C

    2015-05-01

    We assessed the burden of systemic lupus erythematosus (SLE) among Arab and Chaldean Americans residing in southeast Michigan. For those meeting SLE criteria from the Michigan Lupus Epidemiology and Surveillance Registry, we determined Arab or Chaldean ethnicity by links with demographic data from birth certificates and with a database of Arab and Chaldean names. We compared prevalence and incidence of SLE for Arab and Chaldean Americans with estimates for non-Arab and non-Chaldean American Whites and Blacks. We classified 54 individuals with SLE as Arab and Chaldean Americans. The age-adjusted incidence and prevalence estimates for Arab and Chaldean Americans were 7.6 and 62.6 per 100 000, respectively. Arab and Chaldean Americans had a 2.1-fold excess SLE incidence compared with non-Arab and non-Chaldean American Whites. Arab and Chaldean American women had both significantly higher incidence rates (5.0-fold increase) and prevalence estimates (7.4-fold increase) than did Arab and Chaldean American men. Recognizing that Arab and Chaldean Americans experience different disease burdens from Whites is a first step toward earlier diagnosis and designing targeted interventions. Better methods of assigning ethnicity would improve research in this population.

  4. Prevalence and overlap of Disease Management Program diseases in older hospitalized patients.

    Science.gov (United States)

    Juul-Larsen, Helle Gybel; Petersen, Janne; Sivertsen, Ditte Maria; Andersen, Ove

    2017-09-01

    Many countries, like Denmark, have tailored Disease Management Programs (DMPs) based on patients having single chronic diseases [defined institutionally as "program diseases" (PDs)], which can complicate treatment for those with multiple chronic diseases. The aims of this study were (a) to assess the prevalence and overlap among acutely hospitalized older medical patients of PDs defined by the DMPs, and (b) to examine transitions between different departments during hospitalization and mortality and readmission within two time intervals among patients with the different PDs. We conducted a registry study of 4649 acutely hospitalized medical patients ≥65 years admitted to Copenhagen University Hospital, Hvidovre, Denmark, in 2012, and divided patients into six PD groups (type 2 diabetes, chronic obstructive pulmonary disease, cardiovascular disease, musculoskeletal disease, dementia and cancer), each defined by several ICD-10 codes predefined in the DMPs. Of these patients, 904 (19.4%) had 2 + PDs, and there were 47 different combinations of the six different PDs. The most prevalent pair of PDs was type 2 diabetes with cardiovascular disease in 203 (22.5%) patients, of whom 40.4% had an additional PD. The range of the cumulative incidence of being readmitted within 90 days was between 28.8% for patients without a PD and 46.6% for patients with more than one PD. PDs overlapped in many combinations, and all patients had a high probability of being readmitted. Hence, developing strategies to create a new generation of DMPs applicable to older patients with comorbidities could help clinicians organize treatment across DMPs.

  5. Comparing geographic area-based and classical population-based incidence and prevalence rates, and their confidence intervals

    Directory of Open Access Journals (Sweden)

    Ding-Geng Chen

    2017-09-01

    Full Text Available To quantify the HIV epidemic, the classical population-based prevalence and incidence rates (P rates are the two most commonly used measures used for policy interventions. However, these P rates ignore the heterogeneity of the size of geographic region where the population resides. It is intuitive that with the same P rates, the likelihood for HIV can be much greater to spread in a population residing in a crowed small urban area than the same number of population residing in a large rural area. With this limitation, Chen and Wang (2017 proposed the geographic area-based rates (G rates to complement the classical P rates. They analyzed the 2000–2012 US data on new HIV infections and persons living with HIV and found, as compared with other methods, using G rates enables researchers to more quickly detect increases in HIV rates. This capacity to reveal increasing rates in a more efficient and timely manner is a crucial methodological contribution to HIV research. To enhance this newly proposed concept of G rates, this article presents a discussion of 3 areas for further development of this important concept: (1 analysis of global HIV epidemic data using the newly proposed G rates to capture the changes globally; (2 development of the associated population density-based rates (D rates to incorporate the heterogeneities from both geographical area and total population-at-risk; and (3 development of methods to calculate variances and confidence intervals for the P rates, G rates, and D rates to capture the variability of these indices.

  6. Longitudinal change in health-related quality of life in people with prevalent and incident type 2 diabetes compared to diabetes-free controls.

    Science.gov (United States)

    Schunk, Michaela; Reitmeir, Peter; Rückert-Eheberg, Ina-Maria; Tamayo, Teresa; Schipf, Sabine; Meisinger, Christa; Peters, Annette; Scheidt-Nave, Christa; Ellert, Ute; Hartwig, Saskia; Kluttig, Alexander; Völzke, Henry; Holle, Rolf

    2017-01-01

    The objective of this analysis is to compare people with prevalent type 2 diabetes, incident type 2 diabetes and without diabetes with respect to longitudinal change in health-related quality of life (HRQOL) when adjusting for baseline determinants of HRQOL. Primary baseline and follow-up data from three regional and one national population-based cohort studies in Germany were pooled for analysis. HRQOL was measured using physical and mental health summary scores (PCS and MCS) from the German version of the Short Form Health Survey with 36 or 12 items. Mean score change per observation year was compared between the three groups (prevalent diabetes, incident diabetes, no diabetes) based on linear regression models. The analysis included pooled data from 5367 people aged 45-74 years at baseline. Of these, 85.5% reported no diabetes at baseline and follow-up, 6.3% reported diabetes at both baseline and follow-up (prevalent diabetes), and 8.2% reported diabetes only at follow-up (incident diabetes). Over a mean observation period of 8.7 years, annual decline in HRQOL scores is pronounced at 0.27-0.32 (PCS) and 0.34-0.38 (MCS) in the group with prevalent diabetes compared with people without diabetes. Those with incident diabetes showed intermediate values but did not differ significantly from people without diabetes after adjustment for covariates in the full model. Compared with data from cross-sectional analysis, the HRQOL loss associated with prevalent diabetes appears to be much larger than previously assumed.

  7. Twenty-Year Evolution of Hepatitis B Virus and Human Immunodeficiency Virus Prevalence and Incidence in Voluntary Blood Donors in Côte d'Ivoire.

    Science.gov (United States)

    Seri, Benjamin; Minga, Albert; Gabillard, Delphine; Dembele, Bamori; Konate, Seidou; Le Carrou, Jérôme; Dohoun, Lambert; Abo, Yao; Karcher, Sophie; Coffie, Patrick; N'Dri-Yoman, Thérèse; Attia, Alain; Eholié, Serge P; Danel, Christine; Lacombe, Karine; Anglaret, Xavier; Boyd, Anders

    2018-04-01

    Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share common risk factors. The parallel description of their frequency over time may help capture their similarities and differences. Using data from the National Transfusion Center of Abidjan, we estimated the following over a 20-year period: (1) the prevalence of HIV and hepatitis B surface antigen (HBsAg) positivity at first contact; and (2) the incidence of HIV and HBsAg seroconversion in negative first-time blood donors. Between 1992 and 2012, 422319 donors (men [M] = 74%) provided 1063825 blood donations. For first-time donors, HIV prevalence decreased from 7.1% (M = 5.9%, women [W] =11.0%) in 1992-1994 to 1.1% (M = 0.8%, W = 2.0%) in 2010-2012. Prevalence of HBsAg positivity remained stable at 10.8% (M = 11.7%, W = 7.3%) in 1992-1994 to 11.1% (M = 12.5%, W = 7.1%) in 2010-2012. Among regular donors (N = 129256), the incidence of becoming HIV or HBsAg positive, respectively, decreased from 4.9 per 100 (M = 4.5, W = 8.6) and 7.3 per 100 person-years (M = 7.8, W = 2.3) in 1992-1994 to 0.07 (M = 0.06, W = 0.11) and 0.2 per 100 person-years (M = 0.2, W = 0.2) in 2010-2012. Human immunodeficiency virus prevalence and incidence decreased dramatically over time, whereas HBV prevalence remained stable. Incidence of HBsAg seroconversion, although decreasing, still reached unexpected levels, suggesting that the risk of HBV infection in adults may be higher than expected. Hepatitis B surface antigen-negative blood-donors should be offered HBV vaccination.

  8. Twenty-Year Evolution of Hepatitis B Virus and Human Immunodeficiency Virus Prevalence and Incidence in Voluntary Blood Donors in Côte d’Ivoire

    Science.gov (United States)

    Seri, Benjamin; Minga, Albert; Gabillard, Delphine; Dembele, Bamori; Konate, Seidou; Le Carrou, Jérôme; Dohoun, Lambert; Abo, Yao; Karcher, Sophie; Coffie, Patrick; N’Dri-Yoman, Thérèse; Attia, Alain; Eholié, Serge P; Danel, Christine; Lacombe, Karine; Anglaret, Xavier; Boyd, Anders

    2018-01-01

    Abstract Background Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share common risk factors. The parallel description of their frequency over time may help capture their similarities and differences. Methods Using data from the National Transfusion Center of Abidjan, we estimated the following over a 20-year period: (1) the prevalence of HIV and hepatitis B surface antigen (HBsAg) positivity at first contact; and (2) the incidence of HIV and HBsAg seroconversion in negative first-time blood donors. Results Between 1992 and 2012, 422319 donors (men [M] = 74%) provided 1063825 blood donations. For first-time donors, HIV prevalence decreased from 7.1% (M = 5.9%, women [W] =11.0%) in 1992–1994 to 1.1% (M = 0.8%, W = 2.0%) in 2010–2012. Prevalence of HBsAg positivity remained stable at 10.8% (M = 11.7%, W = 7.3%) in 1992–1994 to 11.1% (M = 12.5%, W = 7.1%) in 2010–2012. Among regular donors (N = 129256), the incidence of becoming HIV or HBsAg positive, respectively, decreased from 4.9 per 100 (M = 4.5, W = 8.6) and 7.3 per 100 person-years (M = 7.8, W = 2.3) in 1992–1994 to 0.07 (M = 0.06, W = 0.11) and 0.2 per 100 person-years (M = 0.2, W = 0.2) in 2010–2012. Conclusions Human immunodeficiency virus prevalence and incidence decreased dramatically over time, whereas HBV prevalence remained stable. Incidence of HBsAg seroconversion, although decreasing, still reached unexpected levels, suggesting that the risk of HBV infection in adults may be higher than expected. Hepatitis B surface antigen-negative blood-donors should be offered HBV vaccination. PMID:29644251

  9. 12 CFR 250.181 - Reports of change in control of bank management incident to a merger.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Reports of change in control of bank management... change in control of bank management incident to a merger. (a) A State member bank has inquired whether Pub. L. 88-593 (78 Stat. 940) requires reports of change in control of bank management in situations...

  10. Herd-level prevalence and incidence of porcine epidemic diarrhoea virus (PEDV) and porcine deltacoronavirus (PDCoV) in swine herds in Ontario, Canada.

    Science.gov (United States)

    Ajayi, T; Dara, R; Misener, M; Pasma, T; Moser, L; Poljak, Z

    2018-04-01

    Porcine epidemic diarrhoea virus (PEDV) and porcine deltacoronavirus (PDCoV) were first identified in Canada in 2014. Surveillance efforts have been instrumental in controlling both diseases. In this study, we provide an overview of surveillance components for the two diseases in Ontario (Canada), as well as PEDV and PDCoV incidence and prevalence measures. Swine herds located in the Province of Ontario, of any type, whose owners agreed to participate in a voluntary industry-led disease control programme (DCP) and with associated diagnostic or epidemiological information about the two swine coronaviruses, were eligible to be included for calculation of disease frequency at the provincial level. PEDV and PDCoV data stored in the industry DCP database were imported into the R statistical software and analysed to produce weekly frequency of incidence counts and prevalence counts, in addition to yearly herd-level incidence risk and prevalence between 2014 and 2016. The yearly herd-level incidence risk of PEDV, based on industry data, was 13.5%, 3.0% and 1.4% (95% CI: 11.1-16.2, 2.0-4.2, 0.8-2.3), while the yearly herd-level incidence risk of PDCoV was 1.1%, 0.3%, and 0.1% (95% CI: 0.5-2.2, 0.1-0.9, 0.0-0.5), for 2014, 2015 and 2016, respectively. Herd-level prevalence estimates for PEDV in the last week of 2014, 2015 and 2016 were 4.4%, 2.3% and 1.4%, respectively (95% CI: 3.1-6.0, 1.5-3.3, 0.8-2.2), while herd-level prevalence estimates for PDCoV in the last week of 2014, 2015 and 2016 were 0.5%, 0.2% and 0.2%, respectively (95% CI: 0.1-1.2, 0.0-0.6, 0.0-0.6). Collectively, our results point to low and decreasing incidence risk and prevalence for PEDV and PDCoV in Ontario, making both diseases possible candidates for disease elimination at the provincial level. © 2018 Blackwell Verlag GmbH.

  11. Mathematical model as means of optimization of the automation system of the process of incidents of information security management

    Directory of Open Access Journals (Sweden)

    Yulia G. Krasnozhon

    2018-03-01

    Full Text Available Modern information technologies have an increasing importance for development dynamics and management structure of an enterprise. The management efficiency of implementation of modern information technologies directly related to the quality of information security incident management. However, issues of assessment of the impact of information security incidents management on quality and efficiency of the enterprise management system are not sufficiently highlighted neither in Russian nor in foreign literature. The main direction to approach these problems is the optimization of the process automation system of the information security incident management. Today a special attention is paid to IT-technologies while dealing with information security incidents at mission-critical facilities in Russian Federation such as the Federal Tax Service of Russia (FTS. It is proposed to use the mathematical apparatus of queueing theory in order to build a mathematical model of the system optimization. The developed model allows to estimate quality of the management taking into account the rules and restrictions imposed on the system by the effects of information security incidents. Here an example is given in order to demonstrate the system in work. The obtained statistical data are shown. An implementation of the system discussed here will improve the quality of the Russian FTS services and make responses to information security incidents faster.

  12. On the Appropriateness of Incident Management Systems in Developing Countries: A Case from the UAE

    Directory of Open Access Journals (Sweden)

    Faouzi Kamoun

    2010-12-01

    Full Text Available Road traffic incidents are eliciting growing public concerns due to their devastating social, economical, and environmental impacts. The severity of these random events is particularly alarming in developing countries, where the situation is just worsening. Recently, Incident Management Systems (IMSs have been proposed as powerful tools to enhance the coordination and management of rescue operations during traffic accidents. However, most of the available commercial IMS solutions are designed for large metropolitan cities and within the contexts of developed nations. This paper explores the issues of appropriateness and customization of IMS solutions in developing countries through an exploratory inquiry consisting of a case study from the United Arab Emirates (UAE. The paper also explores the important issues related to managing the organizational changes that an IMS introduces to the operations of the command and control room. This contribution calls for the development of more comprehensive theoretical frameworks that can guide towards the implementation of appropriate IMS solutions in developing countries. Our research highlights the need for developing countries to acquire appropriate IMS solutions that are tailored to the local organizational work context in which these systems will be used. The experience reported herein can also inspire other public safety agencies in developing countries to consider the option of developing customized IMS solutions that best suit their needs.

  13. Non-medical aspects of civilian-military collaboration in management of major incidents.

    Science.gov (United States)

    Khorram-Manesh, A; Lönroth, H; Rotter, P; Wilhelmsson, M; Aremyr, J; Berner, A; Andersson, A Nero; Carlström, E

    2017-10-01

    Disasters and major incidents demand a multidisciplinary management. Recent experiences from terrorist attacks worldwide have resulted in a search for better assessment of the needs, resources, and knowledge in the medical and non-medical management of these incidents and also actualized the need for collaboration between civilian and military healthcare. The aim of this study was to evaluate the impact of the civilian-military collaboration in a Swedish context with the main focus on its non-medical management. An exercise, simulating a foreign military attack centrally on Swedish soil, was designed, initiated, and conducted by a team consisting of civilian and military staff. Data were collected prospectively and evaluated by an expert team. Specific practical and technical issues were presented in collaboration between civilian and military staffs. In addition, shortcomings in decision-making, follow-up, communication, and collaboration due to prominent lack of training and exercising the tasks and positions in all managerial levels of the hospital were identified. Current social and political unrests and terror attacks worldwide necessitate civilian-military collaboration. Such collaboration, however, needs to be synchronized and adjusted to avoid preventable medical and non-medical consequences. Simulation exercises might be one important source to improve such collaboration.

  14. European Clearinghouse. Incidents related to reactivity management. Contributing factors, failure modes and corrective actions

    International Nuclear Information System (INIS)

    Bruynooghe, Christiane; Noel, Marc

    2009-01-01

    This work is part of the European Clearinghouse on Nuclear Power Plant Operational Experience Feedback (NPP-OEF) activity carried out at the Joint Research Centre/Institute for Energy (JRC/IE) with the participation of nine EU Regulatory Authorities. It investigates the 1999 Shika-1 criticality event together with other shortcomings in reactivity management reported to the IAE4 Incident Reporting System in the period 1981-2008. The aim of the work was to identify reactivity control failure modes, reactor status and corrective actions. Initiating factors and associated root causes were also analysed. Five of the 7 factors identified for all events were present in the 1999 Shika-1 event where criticality has been unexpectedly reached and maintained during 15 minutes. Most of the events resulted in changes in procedures, material or staff and management training. The analysis carried out put in evidence that in several instances appropriate communication based on operational experience feedback would have prevented incident to occur. This paper also summarises the action taken at power plants and by the regulatory bodies in different countries to avoid repetition of similar events. It identifies insights that might be useful to reduce the likelihood of operational events caused by shortcomings in reactivity management. (orig.)

  15. Implementation of the National Incident Management System (NIMS)/Incident Command System (ICS) in the Federal Radiological Monitoring and Assessment Center(FRMAC) - Emergency Phase

    International Nuclear Information System (INIS)

    NSTec Environmental Restoration

    2007-01-01

    Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, including acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the NIMS

  16. Implementation of the National Incident Management System (NIMS)/Incident Command System (ICS) in the Federal Radiological Monitoring and Assessment Center(FRMAC) - Emergency Phase

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-04-01

    Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, including acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the

  17. Prevalence and management of Falciparium malaria among infants ...

    African Journals Online (AJOL)

    Studies were carried out to determine the prevalence of malaria parasite infection among infants and children (0-12yrs) in Ota, Southwestern Nigeria between April and December 2008. The two hospitals used were Ota General Hospital and Covenant University Health Centre, Canaanland, Ota. Thick and thin films were ...

  18. Prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in an indigenous community from the Venezuelan Amazon with a high incidence of malaria.

    Science.gov (United States)

    García-Casal, Maria Nieves; Leets, Irene; Bracho, Carmen; Hidalgo, Mariana; Bastidas, Gilberto; Gomez, Ana; Peña, Ana; Pérez, Hilda

    2008-03-01

    The objective of this work was to determine the prevalence of anemia and deficiencies of iron, folic acid and vitamin B12 in Betania del Topocho, a Piaroa community from Estado Amazonas, Venezuela, a zone with a high incidence of malaria. The group studied included 184 subjects of all ages that assisted to the local health center for malaria diagnosis. Analysis performed included hematology by coulter counter, ferritin quantification by ELISA with monoclonal antibodies and folic acid and vitamin B12 determinations by an immunoradiometric assay. It was found that the prevalence of anemia was 89.6% and deficiencies of iron, folic acid and vitamin B12 affected 37.1,70.3 and 12.4% of the population studied, respectively. Plasmodium infection was detected by molecular diagnosis in 53.2% of the cases, and 86% of them were anemic. The highest incidence of anemia was found in children, with a prevalence of 100% in infants of both sexes. The high prevalence of anemia, iron and folic acid deficiencies found, indicates an important health and nutrition problem that should be immediately and properly addressed. The number of cases of anemia due to iron deficiency could be underestimated, since ferritin concentration increased as a acute phase protein, although prevalence data was also analyzed with a cutoff point of 30 microg/L for ferritin concentration.

  19. Coordinating a multiple casualty Critical Incident Stress Management (CISM) response within a medical/surgical hospital setting.

    Science.gov (United States)

    Morrow, H E

    2001-01-01

    The medical/surgical hospital environment presents numerous challenges to a Critical Incident Stress Management (CISM) Team Coordinator responsible for implementing a psychological crisis intervention. Often this person is responsible for managing a response to a large in-house multiple-casualty incident, sometimes involving fatalities. Many mental health professionals have not had the opportunity to work in a medical/surgical healthcare facility and consequently are not familiar with the environment (and agency culture) that exists within these employment settings. This article will review important factors to be considered during the initial assessment of a critical incident in a hospital setting, logistical concerns that are unique to this setting, and the subsequent planning of the Critical Incident Stress Management Team crisis management response.

  20. Critical incident stress management in a school setting following police shooting of an adolescent.

    Science.gov (United States)

    Miller, Ronald L; Grueninger, Carl E

    2010-01-01

    Cincinnati Public Schools Critical Incident Stress Management Team responded when a teenager who was in possession of a pellet gun was killed by police. The themes that emerged had more to do with rage than typical bereavement or trauma responses. The primary objective was the prevention of school and community violence. Strategic planning was critical in preventing violence and responding to the changing needs of students, staff and families during the weeks following this tragedy. Team members had to consider cultural differences related to interpretation of events, grieving rituals, and expectations for appropriate behavior when planning and providing interventions.

  1. Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.

    LENUS (Irish Health Repository)

    Hargrove, M

    2012-02-03

    The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

  2. Prevalence

    Directory of Open Access Journals (Sweden)

    Mohammed Al-Darwish

    2014-07-01

    Conclusion: Results indicated that dental caries prevalence among school children in Qatar has reached critical levels, and is influenced by socio-demographic factors. The mean decayed, missing, and filled teeth values obtained in this study were the second highest detected in the Eastern Mediterranean region.

  3. [Effects of ecological characteristics of place of residence on the incidence, prevalence and risk of multiple sclerosis in the Republic North Ossetia - Alania].

    Science.gov (United States)

    Khodova, M A; Sivertseva, S A; Smirnova, N F; Gusev, E I; Boĭko, A N

    2014-01-01

    Objective. To study the relationship between characteristics of place of residence and epidemiological indicators of multiple sclerosis (MS) in the Republic North Ossetia - Alania. Material and methods. We present the data on the effects of environmental characteristics of place of residence on the incidence, prevalence and risk of MS. Data of 110 MS patients and matched controls have been analyzed. Results. Ecological characteristics of place of residence of MS patients differ significantly from those of controls. The prevalence and incidence of MS increase in patients who have moved from presumably pollution free areas to the places with high population density and plant facilities. Conclusion. MS is thought to be a disease caused by the interaction of genetic susceptibility and environmental factors. Risk factors are intoxication with heavy metal and chemical compounds and living in environmentally disadvantaged areas.

  4. Obesity: Prevalence, Theories, Medical Consequences, Management, and Research Directions

    Directory of Open Access Journals (Sweden)

    Nassar Erika

    2005-12-01

    Full Text Available Abstract Obesity and its associated disorders are a growing epidemic across the world. Many genetic, physiological, and behavioral factors play a role in the etiology of obesity. Diet and exercise are known to play a valuable role in the treatment and prevention of obesity and associated disorders such as hypertension, heart disease, and diabetes. Therefore, the purpose of this review is to examine the prevalence, etiology, consequences, and treatment of obesity.

  5. Prevalence

    Directory of Open Access Journals (Sweden)

    Jeanesse Scerri

    2013-09-01

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is a major nosocomial pathogen worldwide. Malta is one of the countries with the highest MRSA prevalence in Europe, as identified from hospital blood cultures [1]. However, community prevalence of MRSA has never previously been investigated. This study aimed at establishing the prevalence of community MRSA nasal colonization in Maltese individuals and identifying the clonal characteristics of the detected isolates. Nasal swabs were collected from 329 healthy individuals who were also asked to complete a brief questionnaire about risk factors commonly associated with MRSA carriage and infection. The swabs were transported and enriched in a nutrient broth supplemented with NaCl. The presence of MRSA was then determined by culturing on MRSA Select chromogenic agar and then confirming by several assays, including catalase, coagulase and PBP2a agglutination tests. The isolates were assayed for antibiotic susceptibilities and typed by microarray analysis to determine the clonal characteristics of each strain. The prevalence of MRSA nasal colonization in the healthy Maltese population was found to be 8.81% (95% confidence interval [CI], 5.75–11.87%, much higher than that found in other studies carried out in several countries. No statistical association was found between MRSA carriage and demographics or risk factors; however, this was hindered by the small sample size. Almost all the isolates were fusidic-acid resistant. The majority were found to belong to a local endemic clone (CC5 which seems to be replacing the previously prevalent European clone UK-EMRSA-15 in the country. A new clone (CC50-MRSA-V was also characterized. The presence of such a significant community reservoir of MRSA increases the burdens already faced by the local healthcare system to control the MRSA epidemic. Colonization of MRSA in otherwise healthy individuals may represent a risk for endogenous infection and transmission to

  6. Oral complications of head and neck radiotherapy: prevalence and management.

    Science.gov (United States)

    Germano, F; Melone, P; Testi, D; Arcuri, L; Marmiroli, L; Petrone, A; Arcuri, C

    2015-08-01

    The aim of the study was to evaluate the short-term and long-term toxicity caused by radiation treatment in the head and neck with the technique of intensity-modulated radiotherapy (IMRT). We selected 20 patients, 18 men and 2 women aged between 21 and 71 years, undergoing radiation therapy (IMRT) in head and neck. Patients were visited during radiotherapy and followed for six months after the end of the therapy. We assessed the presence of: mucositis, xerostomia, dysgeusia, dysphagia, pain, trismus and, in the case of late-onset complications, radiation cavities. Acute toxicity: in 20 patients, 18 reported mucositis, 19 xerostomia, 17, dysgeusia, 15 dysphagia, 18 had pain and 3 patients had trismus. Tardive toxicity: in 14 patients, 5 reported mucositis, 11 xerostomia, 6 dysgeusia, 2 dysphagia, 3 had pain, 4 trismus and in 4 patients were found radiation cavities. Acute complications with higher prevalence were xerostomia (19 of 20 patients), dysgeusia of 2nd grade (11 patients of 20), mucositis of 1st grade and pain of 1st grade (10 patients of 20). Among the late complications it was noted a maintenance of the high prevalence of xerostomia (11 patients of 14) and an increase in prevalence of trismus (4 patients of 14) against a reduction of all other complications. The presence of radiation cavities in 4 patients of 14 was also recorded.

  7. Estimating cancer incidence, prevalence, and the number of cancer patients treated with antitumor therapy in 2015 and 2020 -  analysis of the Czech National Cancer Registry.

    Science.gov (United States)

    Dusek, L; Pavlík, T; Májek, O; Büchler, T; Muzik, J; Maluskova, D; Koptíková, J; Bortlicek, Z; Abrahámová, J

    2015-01-01

    Cancer burden in the Czech population ranks among the highest worldwide, which introduces a strong need for a prospective modelling of cancer incidence and prevalence rates. Moreover, a prediction of number of cancer patients requiring active antitumor therapy is also an important issue. This paper presents the stage-specific predictions of cancer incidence and prevalence, and the stage- and region-specific patients requiring active antitumor therapy for the most common cancer diagnoses in the Czech Republic for years 2015 and 2020. The stage-specific estimates are also presented with regard to the treatment phase as newly diagnosed patients, patients treated for non-terminal recurrence, and patients treated for terminal recurrence. Data of the Czech National Cancer Registry from 1977 to 2011 has been used for the analysis, omitting the records of patients diagnosed as death certificate only or at autopsy. In total, 1,777,775 incidences have been considered for the estimation using a statistical model utilizing solely the population-based cancer registry data. All estimates have been calculated with respect to the changing demographic structure of the Czech population and the clinical stage at diagnosis. Considering year 2011 as the baseline, we predict 89%, 15%, 31% and 32% increase in prostate, colorectal, female breast and lung cancer incidence, respectively, in 2020 resulting in 13,153, 9,368, 8,695, and 8,604 newly dia-g--nosed cancer patients in that year, respectively. Regarding cancer prevalence in 2020, the estimated increase is 140%, 40%, 51%, and 17% for prostate, colorectal, female breast and lung cancer, respectively, meaning that more than 100,000 prevalent female breast cancer patients as well as more than 100,000 prevalent prostate cancer patients are expected in the Czech Republic. The estimated numbers of patients requiring active antitumor therapy for prostate, colorectal, female breast and lung cancer in the Czech Republic in 2020 are 23,652, 14

  8. Prevalence, incidence, and residual risk of human immunodeficiency virus among community and replacement first-time blood donors in São Paulo, Brazil.

    Science.gov (United States)

    Barreto, Claudia C; Sabino, Ester C; Gonçalez, Thelma T; Laycock, Megan E; Pappalardo, Brandee L; Salles, Nanci A; Wright, David J; Chamone, Dalton F; Busch, Michael P

    2005-11-01

    Concerted efforts have been directed toward recruitment of community rather than replacement donors in Brazil. Time trends and demographic correlates of human immunodeficiency (HIV) prevalence and incidence among first-time (FT) donors in Brazil were examined by donation type. HIV residual risk from FT-donor transfusions, and projected yield of p24 antigen and nucleic acid test (NAT) screening were estimated. HIV prevalence data and seroreactive specimens were obtained at Fundação Pró-Sangue/Hemocentro-de-São Paulo from 1995 to 2001. To estimate incidence, confirmed-positive samples from July 1998 through December 2001 were tested with a less-sensitive (detuned) enzyme immunoassay to detect recent seroconversions. Incidence data were used to estimate residual risk and p24 and NAT yield based on published window periods (WPs). HIV prevalence was 22 percent higher among the FT community donors than replacement donors (19.6 vs. 16.1 per 10,000; p < 0.01) and 48 percent higher among men than women (19.1 vs. 12.9; p < 0.01). In the multivariable logistic regression, both variables remained significant predictors of HIV prevalence. HIV prevalence decreased from 20.4 (1995) to 13.1 per 10,000 FT donations (2001). HIV incidence was 2.7 per 10,000 person-years. The estimated rate of infected antibody-negative donations was 14.9 per 1,000,000 units (95% confidence interval, 9.8-20.0). It was estimated that addition of p24 antigen, minipool NAT, and individual-donation NAT assays would detect 3.9 (2.0-5.8), 8.3 (5.3-11.3), and 10.8 (7.1-14.5) WP units per 1,000,000 FT donations, respectively. HIV incidence and residual transfusion risk estimates are approximately 10 times higher in Brazil FT donors compared to US and European FT donors. Community FT donors had higher HIV prevalence than replacement FT donors. The yield of p24 antigen or RNA screening will be low in Brazilian donors, but substantially higher than in US donors.

  9. Prevalence of Serological Markers for Hepatitis B and C Viruses in Brazilian Blood Donors, and Incidence and Residual Risk of Transfusion-Transmission of Hepatitis C Virus

    Science.gov (United States)

    de Almeida-Neto, Cesar; Sabino, Ester Cerdeira; Liu, Jing; Blatyta, Paula Fraiman; Mendrone-Junior, Alfredo; Salles, Nanci Alves; Leão, Silvana Carneiro; Wright, David J.; Basques, Fernando Valadares; Ferreira, João Eduardo; Busch, Michael P.; Murphy, Edward L.

    2012-01-01

    Background We evaluate the current prevalence of serological markers for HBV and HCV in blood donors and estimated HCV incidence and residual transfusion-transmitted risk at three large Brazilian blood centers. Material and Methods Data on whole blood and platelet donations were collected from January through December 2007 and analyzed by center, donor type (replacement vs. community), age, sex, donation status (first-time vs. repeat), and serological results for HBsAg, anti-HBc and anti-HCV. HBV (HBsAg+/anti-HBc+) and HCV (anti-HCV) prevalence rates were calculated for all first time donations. HCV incidence was derived including inter-donation intervals that preceded first repeat donations given during the study and HCV residual risk was estimated for transfusions derived from repeat donors. Results There were 307,354 donations from January through December 2007. Overall prevalence of concordant HBsAg and anti-HBc reactivity was 289 per 100,000 donations and of anti-HCV confirmed reactivity 191 per 100,000 donations. There were significant associations between older age and hepatitis markers, especially for HCV. HCV incidence was 3.11 (95% CI 0.77-7.03) per 100,000 person-years, and residual risk of HCV window-phase infections was estimated at 5.0 per million units transfused. Conclusion Improvement in blood donor selection, socioeconomic conditions and preventive measures, implemented over time, may have helped to decrease prevalence of hepatitis B and C viruses, relative to previous reports. Incidence and residual risk of HCV are also diminishing. Ongoing monitoring of hepatitis B and C viral markers among Brazilian blood donors should help guide improved recruitment procedures, donor selection, laboratory screening methods and counseling strategies. PMID:22882510

  10. [Incidence of acute agitation and variation in acute agitation management by emergency services].

    Science.gov (United States)

    Casado Flórez, Isabel; Sánchez Santos, Luis; Rodríguez Calzada, Rafael; Rico-Villademoros, Fernando; Roset Arissó, Pere; Corral Torres, Ervigio

    2017-07-01

    To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. Observational descriptive study based on aggregate data from unpublished internal EMS reports. Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.

  11. Association of Baseline Depressive Symptoms with Prevalent and Incident Pre-Hypertension and Hypertension in Postmenopausal Hispanic Women: Results from the Women's Health Initiative.

    Directory of Open Access Journals (Sweden)

    Ruth E Zambrana

    Full Text Available Depression and depressive symptoms are risk factors for hypertension (HTN and cardiovascular disease (CVD. Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women.Prospective cohort study, Women's Health Initiative (WHI, included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression-social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms.Prevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04-1.51, although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10-2.74 after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported.In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor

  12. Extensive Genetic Diversity of HIV-1 in Incident and Prevalent Infections among Malaysian Blood Donors: Multiple Introductions of HIV-1 Genotypes from Highly Prevalent Countries.

    Directory of Open Access Journals (Sweden)

    Wei Zhen Chow

    Full Text Available Transfusion-transmissible infections including HIV-1 continue to pose major risks for unsafe blood transfusions due to both window phase infections and divergent viruses that may not be detected by donor screening assays. Given the recent emergence of several HIV-1 circulating recombinant forms (CRFs in high-risk populations in the Southeast Asia region, we investigated the genetic diversity of HIV-1 among the blood donors in Kuala Lumpur, Malaysia. A total of 211 HIV-positive plasma samples detected among 730,188 donations to the National Blood Centre between 2013 and 2014 were provided (90.5% male, median age: 27.0 years old. Recent or long-term infection status at the time of donation was determined using a limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA. HIV-1 gag-pol genes were amplified and sequenced from residual plasma for 149 cases followed by genotype determination using phylogenetic and recombination analyses. Transmitted antiretroviral resistance mutations were not observed among the blood donors, among which 22.7% were classified as recent or incident infections. Major circulating HIV-1 genotypes determined by neighbour-joining phylogenetic inference included CRF01_AE at 40.9% (61/149, CRF33_01B at 21.5% (32/149, and subtype B at 10.1% (15/149. Newly-described CRFs including CRF54_01B circulated at 4.0%, CRF74_01B at 2.0%, and CRF53_01B and CRF48_01B at 0.7% each. Interestingly, unique HIV-1 genotypes including African subtype G (8.7%, CRF45_cpx (1.3%, CRF02_AG (0.7% and CRF07_BC (0.7% from China were detected for the first time in the country. A cluster of subtype G sequences formed a distinct founder sub-lineage within the African strains. In addition, 8.7% (13/149 of HIV-infected donors had unique recombinant forms (URFs including CRF01_AE/B' (4.7%, B'/C (2.7% and B'/G (1.3% recombinants. Detailed analysis identified similar recombinant structures with shared parental strains among the B'/C and B'/G URFs, some of

  13. Extensive Genetic Diversity of HIV-1 in Incident and Prevalent Infections among Malaysian Blood Donors: Multiple Introductions of HIV-1 Genotypes from Highly Prevalent Countries

    Science.gov (United States)

    Chow, Wei Zhen; Bon, Abdul Hamid; Keating, Sheila; Anderios, Fread; Halim, Hazwan Abdul; Takebe, Yutaka; Kamarulzaman, Adeeba; Busch, Michael P.; Tee, Kok Keng

    2016-01-01

    Transfusion-transmissible infections including HIV-1 continue to pose major risks for unsafe blood transfusions due to both window phase infections and divergent viruses that may not be detected by donor screening assays. Given the recent emergence of several HIV-1 circulating recombinant forms (CRFs) in high-risk populations in the Southeast Asia region, we investigated the genetic diversity of HIV-1 among the blood donors in Kuala Lumpur, Malaysia. A total of 211 HIV-positive plasma samples detected among 730,188 donations to the National Blood Centre between 2013 and 2014 were provided (90.5% male, median age: 27.0 years old). Recent or long-term infection status at the time of donation was determined using a limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA). HIV-1 gag-pol genes were amplified and sequenced from residual plasma for 149 cases followed by genotype determination using phylogenetic and recombination analyses. Transmitted antiretroviral resistance mutations were not observed among the blood donors, among which 22.7% were classified as recent or incident infections. Major circulating HIV-1 genotypes determined by neighbour-joining phylogenetic inference included CRF01_AE at 40.9% (61/149), CRF33_01B at 21.5% (32/149), and subtype B at 10.1% (15/149). Newly-described CRFs including CRF54_01B circulated at 4.0%, CRF74_01B at 2.0%, and CRF53_01B and CRF48_01B at 0.7% each. Interestingly, unique HIV-1 genotypes including African subtype G (8.7%), CRF45_cpx (1.3%), CRF02_AG (0.7%) and CRF07_BC (0.7%) from China were detected for the first time in the country. A cluster of subtype G sequences formed a distinct founder sub-lineage within the African strains. In addition, 8.7% (13/149) of HIV-infected donors had unique recombinant forms (URFs) including CRF01_AE/B' (4.7%), B'/C (2.7%) and B'/G (1.3%) recombinants. Detailed analysis identified similar recombinant structures with shared parental strains among the B'/C and B'/G URFs, some of which

  14. Tick bite anaphylaxis: incidence and management in an Australian emergency department.

    Science.gov (United States)

    Rappo, Tristan B; Cottee, Alice M; Ratchford, Andrew M; Burns, Brian J

    2013-08-01

    Ticks are endemic to the eastern coastline of Australia. The aim of the present study is to describe the incidence of tick bites in such an area, the seasonal and geographical distribution, the incidence of anaphylaxis due to tick bite and its management. We retrospectively analysed emergency presentations of patients with tick bites to Mona Vale Hospital on Sydney's Northern Beaches over a 2 year period from 1 January 2007 to 1 January 2009. We recorded the geographical and seasonal distribution of tick bites as well as the symptoms from tick bite and its emergency management. We report over 500 cases of tick bites presenting to a single New South Wales hospital over a 2 year period, of which 34 resulted in anaphylaxis. Cutaneous symptoms were the most common feature associated with anaphylaxis (32/34, 94%). Forty per cent (13/34) of patients with tick bite anaphylaxis had a history of allergy or previous anaphylaxis. Seventy-six per cent (26/34) of patients were administered adrenaline either prior to presenting or in the ED, while 97% (33/34) were treated with steroids. Fifty-three per cent were referred to an immunologist and only one-quarter were discharged with an adrenaline auto-injector. We report 34 cases of tick bite anaphylaxis over a 2 year period at a single hospital in a tick endemic area. The variation in the presenting symptoms and signs, as well as in management highlights the need for increased awareness for tick bite management in tick endemic areas. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  15. Prevalence and incidence of attention-deficit/hyperactivity disorder in Slovenian children and adolescents: a database study from a national perspective.

    Science.gov (United States)

    Štuhec, Matej; Švab, Vesna; Locatelli, Igor

    2015-04-01

    To estimate prevalence and incidence of attention deficit hyperactivity disorder (ADHD) in children and adolescents in Slovenia using different epidemiological models. Data from the National Institute of Public Health of the Republic of Slovenia for the period 1997-2012 were analyzed. The database includes the annual number of newly diagnosed outpatients with ADHD in Slovenia. The evaluation for ADHD diagnoses was done in accordance with the Tenth Revision of the International Classification of Diseases (ICD-10) outpatient data codes. In model 1, a linear increase was proposed to fit the data in the period from 1997 to 2003 in order to extrapolate the data before 1997. In model 2 and 3, an exponential increase in the annual incidence rate was proposed. The incidence rate of ADHD diagnosis in 1997 was 0.032% and in 2012 it increased to 0.082%. Mean prevalence rate was 750 (95% confidence interval: 660-840) per 100 000 children and adolescents. It was estimated that the prevalence rate in 2020 would be 1% (95% confidence interval: 0.875-1.125), which is 6.3-fold higher than in 1997. ADHD is a common mental health disorder among Slovenian children and adolescents, but it remained underdiagnosed compared with Western countries. Our results indicated a need for improved timely interventions in Slovenia, not only in child and adolescent psychiatry but also in primary settings and adult psychiatry, where ADHD should be more efficiently recognized.

  16. [Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

    Science.gov (United States)

    Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

    2009-06-01

    Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

  17. [Risk management in the operation room. Results of a pilot project of interdisciplinary "incident reporting"].

    Science.gov (United States)

    Horstmann, R; Hofinger, G; Mäder, M; Gaidzik, P W; Waleczek, H

    2006-08-01

    Methods for error analysis are suitable to increase patients' safety as well as staff satisfaction and may avoid, in a sense of process control, financial damage to the hospital. The aim of the presented pilot study was to establish and evaluate an incident reporting system as a first step towards a new safety culture. In June 2003 an incident reporting system was introduced in the central surgical suite, in which the surgical and anaesthesiologic departments took part as well medical and nursing staff. Besides conceiving a report form, a "board of confidence" was elected, kick-off meetings were held and a baseline study on the basis of industrial psychological knowledge was initialised. The process of creating confidence is arduous and depends elementarily on sincere cooperation of management staff, especially of the heads of the departments. The exclusive participation of only two medical departments led to conflicts. Therefore, after finishing the pilot study, the system was expanded to the whole surgical suite including all operating departments. In order to increase the motivation for the strictly voluntarily participation, the frequency of regular echoes to the staff was optimised. To achieve high acceptance in the whole staff, the board of confidence needs a clearly defined position within the system of quality management. For the first time in Germany an incident reporting system under participation of several medical departments has been installed. After finishing the pilot project, in future we will be able to evaluate changes caused by this system. Simultaneously an electronic database for reported adverse events and strategies to avoid them are being developed based on similar systems in aviation industry. In near future, the system will be of increasing importance likewise for inpatient units and non-operative departments.

  18. The incidence and prevalence of hepatitis C in prisons and other closed settings: Results of a systematic review and meta-analysis

    Science.gov (United States)

    Larney, Sarah; Kopinski, Hannah; Beckwith, Curt G.; Zaller, Nickolas D.; Jarlais, Don Des; Hagan, Holly; Rich, Josiah D.; van den Bergh, Brenda J.; Degenhardt, Louisa

    2013-01-01

    People detained in prisons and other closed settings are at elevated risk of infection with hepatitis C virus (HCV). We undertook a systematic review and meta-analysis with the aim of determining the rate of incident HCV infection and the prevalence of anti-HCV among detainees of closed settings. We systematically searched databases of peer-reviewed literature and widely distributed a call for unpublished data. We calculated summary estimates of incidence and prevalence among general population detainees and detainees with a history of injecting drug use (IDU), and explored heterogeneity through stratification and meta-regression. The summary prevalence estimates were used to estimate the number of anti-HCV positive prisoners globally. HCV incidence among general detainees was 1·4 per 100 person-years (py; 95% CI: 0·1, 2·7; k=4), and 16·4 per 100py (95% CI: 0·8, 32·1; k=3) among detainees with a history of IDU. The summary prevalence estimate of anti-HCV in general detainees was 26% (95% CI: 23%, 29%; k=93), and in detainees with a history of IDU, 64% (95% CI: 58%, 70%; k=51). The regions of highest prevalence were Central Asia (38%; 95% CI 32%, 43%; k=1) and Australasia (35%; 95% CI: 28%, 43%; k=9). We estimate that 2·2 million (range: 1·4 million – 2·9 million) detainees globally are anti-HCV positive, with the largest populations in North America (668,500; range: 553,500–784,000) and East and Southeast Asia (638,000; range: 332,000–970,000). Conclusion HCV is a significant concern in detained populations, with one in four detainees anti-HCV positive. Epidemiological data on the extent of HCV infection in detained populations is lacking in many countries. Greater attention towards prevention, diagnosis and treatment of HCV infection among detained populations is urgently required. PMID:23504650

  19. Frequency, prevalence, incidence and risk factors associated with visual hallucinations in a sample of patients with Parkinson's disease: a longitudinal 4-year study.

    Science.gov (United States)

    Gibson, G; Mottram, P G; Burn, D J; Hindle, J V; Landau, S; Samuel, M; Hurt, C S; Brown, R G; M Wilson, K C

    2013-06-01

    To examine the prevalence, incidence and risk factors associated with visual hallucinations (VHs) amongst people suffering from Parkinson's disease (PD). We recruited 513 patients with PD from movement disorder and PD clinics within three sites in the UK. Patients were interviewed using a series of standardised clinical rating scales at baseline, 12, 24 and 36 months. Data relating to VHs were collected using the North-East Visual Hallucinations Interview. Prevalence rates for VHs at each assessment were recorded. Associations were determined using multiple regression analysis. Cross-sectional prevalence rates for VHs at baseline, 12, 24 and 36 months indicated VHs in approximately 50% of patients. A cumulative frequency of 82.7% of cases at the end of the study period exhibited VHs. The incidence rate for VHs was 457 cases per 1000 population. Longer disease duration, greater impairment in activities of daily living and higher rates of anxiety were most commonly associated with VHs. No factors predictive of VHs could be ascertained. When examined longitudinally, VHs affect more patients than is commonly assumed in cross-sectional prevalence studies. Clinicians should routinely screen for VHs throughout the disease course. Disease duration, impairment in activities of daily living and anxiety presented as co-morbidities associated with VHs in PD, and therefore those presenting with VHs should be screened for anxiety disorder and vice versa. Copyright © 2012 John Wiley & Sons, Ltd.

  20. [Prevalence and incidence studies of voice disorders among teaching staff of La Rioja, Spain. Clinical study: questionnaire, function vocal examination, acoustic analysis and videolaryngostroboscopy].

    Science.gov (United States)

    Preciado, J; Pérez, C; Calzada, M; Preciado, P

    2005-05-01

    The aim of this study was calculate the prevalence and incidence of voice disorders among teaching staff of La Rioja, Spain. We carried out a transversal study of voice disorders in teaching staff of La Rioja (a random sample of 931 of 3113 teachers) and a longitudinal study (we collect the new cases during the 3 years which lasts the study). 527 teachers of random sample took part of study: 332 female (63%) and 195 male (37%). All of teachers fill in a standard questionnaire, ENT and function vocal examination, videolaryngostroboscopy and acoustic analysis with MDVP. The prevalence of voice disorders among La Rioja Teachers was 57%: 20.3% for organic lesions [nodular lesions (14%), polyps (2%), submucous suffusions (1.4%), edema Reinke (1.2%) Sulcus (0.4%), scalp (0.6%), leucoplasia (0.2%) vocal cord paralysis (0.2%)] 8.1% for chronic laryngitis [not specific (2.8%), smoke (3.9%) gastroe-sofageal reflux (2.5%)] and 29% for functional lesions [hyperfunctional dysphonia (7.5%) hypofunctional dysphonia (0.4%) vocal overefforts (18%) hyperplasia false cords (2.8)]. The incidence rate was 4 new cases each 1000 teachers and year. Organic lesions were more prevalent in women (25.4%) than in men (9.5%), but functional lesions and chronic laryngitis were more prevalent in men (36.5% and 13.2%) than in women (24% and 5%).

  1. Latin American Dialysis and Transplant Registry: 2008 prevalence and incidence of end-stage renal disease and correlation with socioeconomic indexes

    Science.gov (United States)

    Cusumano, Ana M; Garcia-Garcia, Guillermo; Gonzalez-Bedat, Maria C; Marinovich, Sergio; Lugon, Jocemir; Poblete-Badal, Hugo; Elgueta, Susana; Gomez, Rafael; Hernandez-Fonseca, Fabio; Almaguer, Miguel; Rodriguez-Manzano, Sandra; Freire, Nelly; Luna-Guerra, Jorge; Rodriguez, Gaspar; Bochicchio, Tommaso; Cuero, Cesar; Cuevas, Dario; Pereda, Carlos; Carlini, Raul

    2013-01-01

    In 2008, 563,294,000 people were living in Latin America (LA), of which 6.6% were older than 65. The region is going through a fast demographic and epidemiologic transition process, in the context of an improvement in socio-economic indices. The Latin American Dialysis and Renal Transplant Registry has collected data since 1991, through an annual survey completed by 20 affiliated National Societies. Renal replacement treatment (RRT) prevalence and incidence showed an increase year by year. The prevalence rate (in all modalities) correlated with the World Bank country classification by income and the epidemiologic transition stage the countries were experiencing. RRT prevalence and kidney transplantation rates correlated significantly with gross national income (GNI), health expenditure in constant dollars (HeExp), % older than 65, life expectancy at birth, and % of the population living in urban settings. Kidney transplantation increased also, year by year, with more than 50% of transplants performed using kidneys from deceased donors. Double transplants were performed in six countries. RRT prevalence and incidence increased in LA, and are associated with indexes reflecting higher and more evenly distributed national wealth (GNI and HeExp), and the stage of demographic and epidemiological transition. PMID:25018980

  2. 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

  3. Developing an incident management system to support Ebola response -- Liberia, July-August 2014.

    Science.gov (United States)

    Pillai, Satish K; Nyenswah, Tolbert; Rouse, Edward; Arwady, M Allison; Forrester, Joseph D; Hunter, Jennifer C; Matanock, Almea; Ayscue, Patrick; Monroe, Benjamin; Schafer, Ilana J; Poblano, Luis; Neatherlin, John; Montgomery, Joel M; De Cock, Kevin M

    2014-10-17

    The ongoing Ebola virus disease (Ebola) outbreak in West Africa is the largest and most sustained Ebola epidemic recorded, with 6,574 cases. Among the five affected countries of West Africa (Liberia, Sierra Leone, Guinea, Nigeria, and Senegal), Liberia has had the highest number cases (3,458). This epidemic has severely strained the public health and health care infrastructure of Liberia, has resulted in restrictions in civil liberties, and has disrupted international travel. As part of the initial response, the Liberian Ministry of Health and Social Welfare (MOHSW) developed a national task force and technical expert committee to oversee the management of the Ebola-related activities. During the third week of July 2014, CDC deployed a team of epidemiologists, data management specialists, emergency management specialists, and health communicators to assist MOHSW in its response to the growing Ebola epidemic. One aspect of CDC's response was to work with MOHSW in instituting incident management system (IMS) principles to enhance the organization of the response. This report describes MOHSW's Ebola response structure as of mid-July, the plans made during the initial assessment of the response structure, the implementation of interventions aimed at improving the system, and plans for further development of the response structure for the Ebola epidemic in Liberia.

  4. Prevalence and risk factors for central diabetes insipidus in cardiac arrest survivor treated with targeted temperature management.

    Science.gov (United States)

    Lee, Dong Hun; Lee, Byung Kook; Song, Kyoung Hwan; Jung, Yong Hun; Park, Jung Soo; Lee, Sung Min; Cho, Yong Soo; Kim, Jin Woong; Jeung, Kyung Woon

    2016-08-01

    Central diabetes insipidus (CDI) is a marker of severe brain injury. Here we aimed to investigate the prevalence and risk factors of CDI in cardiac arrest survivors treated with targeted temperature management (TTM). This retrospective observational study included consecutive adult cardiac arrest survivors treated with TTM between 2008 and 2014. Central diabetes insipidus was confirmed if all of the following criteria were met: urine volume >50 cc kg(-1) d(-1), serum osmolarity >300 mmol/L, urine osmolarity 145 mEq/L. The primary outcome was the incidence of CDI. Of the 385 included patients, 45 (11.7%) had confirmed central CDI. Univariate analysis showed that younger age, nonwitness of collapse, nonshockable rhythm, a high incidence of asphyxia arrest, longer downtime, and lower initial core temperature were associated with CDI development. Patients with CDI had a higher incidence of poor neurologic outcomes at discharge and higher in-hospital mortality rate (20/45 vs 76/340, P= .001) as well as 180-day mortality (44/45 vs 174/340, Pdiabetes insipidus developed in 12% of cardiac arrest survivors treated with TTM, and those with CDI showed poor neurologic outcomes and high mortality rates. Younger age, nonshockable rhythm, long downtime, and asphyxia arrest were significant risk factors for development of CDI. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The prevalence and incidence of frailty in Pre-diabetic and diabetic community-dwelling older population: results from Beijing longitudinal study of aging II (BLSA-II).

    Science.gov (United States)

    Chhetri, Jagadish Kumar; Zheng, Zheng; Xu, Xitong; Ma, Cuihong; Chan, Piu

    2017-02-08

    Various factors including cardio-metabolic disorders are found to be correlated with frailty. With the increase in age, older adults are likely to have elevated blood glucose level. In this study we intend to investigate the prevalence and incidence of frailty in the pre-diabetic and diabetic community dwelling elderly population and the associated risk factors. At baseline total of 10,039 subjects with a mean age of 70.51 (±7.82) were included. A total of 6,293 older adults were followed up at 12 months. A Frailty index (FI) with 32 items was developed using Rockwood's cumulative deficits method. Frailty index ≥0.25 was used as cut-off criteria for the diagnosis of frailty. Diagnosis of pre-diabetes and diabetes was set according to the World Health Organization (WHO) criteria for fasting plasma glucose (FPG) level. Chi-square tests were performed to compare percentages by 3 major groups (non-diabetes, pre-diabetes, diabetes), ANOVA and student's t-tests was used to compare means of group for continuous variables. Multiple logistic regression models were performed to estimate the risk factors for frailty in non-diabetic, pre-diabetic and diabetic elderly populations using baseline and longitudinal data. Diabetic population had a much higher prevalence (19.32%) and incidence (12.32%) of frailty, compared to that of non-diabetic older adults (prevalence of 11.92% and incidence of 7.04%). And pre-diabetics had somewhat similar prevalence of 11.43% and slightly higher incidence of 8.73% for frailty than non-diabetic older adults. Diabetics were at 1.36 (95% CI = 1.18,1.56) and 1.56 (95%CI = 1.32,1.85) fold increase in risk of frailty compared to non-diabetic population for prevalence and incidence, respectively. Being female, urban living, high waist circumference, less house work and need regular anti-diabetic medications were independent risk factors only in pre-diabetic and diabetic older adults. This study confirms that diabetes is an independent

  6. Prevalence, incidence, and associated risk factors of tuberculosis in children with HIV living in the UK and Ireland (CHIPS): a cohort study.

    Science.gov (United States)

    Turkova, Anna; Chappell, Elizabeth; Judd, Ali; Goodall, Ruth L; Welch, Steven B; Foster, Caroline; Riordan, Andrew; Shingadia, Delane; Shackley, Fiona; Doerholt, Katja; Gibb, Diana M; Collins, Intira J

    2015-12-01

    Tuberculosis is the most common serious co-infection in people living with HIV worldwide, but little is known about its incidence in HIV-infected children living in high-resource settings with low tuberculosis prevalence. We aimed to assess the incidence and prevalence of tuberculosis in children with HIV living in the UK and Ireland to understand rates, risk factors, and outcomes of the disease in this group. We did an analysis of children enrolled in CHIPS, an observational multicentre cohort of children receiving HIV care in the UK and Ireland. We assessed characteristics and prevalence of tuberculosis at baseline, measured incidence of disease through the follow-up period using the CHIPS database, and calculated associated risk factors in these children with multivariable logistic and Cox regression models. Between Jan 1, 1996, to Sept 18, 2014, data for 1848 children with 14 761 years of follow-up were reported to CHIPS. 57 (3%) children were diagnosed with tuberculosis: 29 children had tuberculosis at presentation (prevalent tuberculosis) and 29 had the disease diagnosed during follow-up (incident tuberculosis), including one child with recurrent tuberculosis events. Median age at diagnosis was 9 years (IQR 5-12). 25 (43%) children had pulmonary tuberculosis, 24 (41%) had extrapulmonary tuberculosis with or without pulmonary involvement, and the remainder (n=9; 16%) had unspecified-site tuberculosis. The overall incidence rate for the follow-up period was 196 cases per 100 000 person-years (95% CI 137-283). In our multivariable model, tuberculosis at presentation was associated with more severe WHO immunological stage at baseline (odds ratio 0·25, 95% CI 0·08-0·74; p=0·0331; for none vs severe) and being born abroad (odds ratio 0·28, 0·10-0·73; p=0·0036; for UK and Ireland vs abroad). Incident tuberculosis was associated with time-updated more severe WHO immunological stage (hazard ratio 0·15, 95% CI 0·06-0·41; p=0·0056; for none vs severe

  7. Technical Review of Law Enforcement Standards and Guides Relative to Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.

    2009-03-24

    In an effort to locate potential law enforcement-related standards that support incident management, a team from the Pacific Northwest National Laboratory (PNNL) contacted representatives from the National Institute of Standards-Office of Law Enforcement Standards (NIST-OLES), National Institute of Justice (NIJ), Federal Bureau of Investigation (FBI), Secret Service, ASTM International committees that have a law enforcement focus, and a variety of individuals from local and regional law enforcement organizations. Discussions were held with various state and local law enforcement organizations. The NIJ has published several specific equipment-related law enforcement standards that were included in the review, but it appears that law enforcement program and process-type standards are developed principally by organizations that operate at the state and local level. Input is provided from state regulations and codes and from external non-government organizations (NGOs) that provide national standards. The standards that are adopted from external organizations or developed independently by state authorities are available for use by local law enforcement agencies on a voluntary basis. The extent to which they are used depends on the respective jurisdictions involved. In some instances, use of state and local disseminated standards is mandatory, but in most cases, use is voluntary. Usually, the extent to which these standards are used appears to depend on whether or not jurisdictions receive certification from a “governing” entity due to their use and compliance with the standards. In some cases, these certification-based standards are used in principal but without certification or other compliance monitoring. In general, these standards appear to be routinely used for qualification, selection for employment, and training. In these standards, the term “Peace Officer” is frequently used to refer to law enforcement personnel. This technical review of national law

  8. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  9. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  10. A remotely piloted aircraft system in major incident management: concept and pilot, feasibility study.

    Science.gov (United States)

    Abrahamsen, Håkon B

    2015-06-10

    Major incidents are complex, dynamic and bewildering task environments characterised by simultaneous, rapidly changing events, uncertainty and ill-structured problems. Efficient management, communication, decision-making and allocation of scarce medical resources at the chaotic scene of a major incident is challenging and often relies on sparse information and data. Communication and information sharing is primarily voice-to-voice through phone or radio on specified radio frequencies. Visual cues are abundant and difficult to communicate between teams and team members that are not co-located. The aim was to assess the concept and feasibility of using a remotely piloted aircraft (RPA) system to support remote sensing in simulated major incident exercises. We carried out an experimental, pilot feasibility study. A custom-made, remotely controlled, multirotor unmanned aerial vehicle with vertical take-off and landing was equipped with digital colour- and thermal imaging cameras, a laser beam, a mechanical gripper arm and an avalanche transceiver. We collected data in five simulated exercises: 1) mass casualty traffic accident, 2) mountain rescue, 3) avalanche with buried victims, 4) fisherman through thin ice and 5) search for casualties in the dark. The unmanned aerial vehicle was remotely controlled, with high precision, in close proximity to air space obstacles at very low levels without compromising work on the ground. Payload capacity and tolerance to wind and turbulence were limited. Aerial video, shot from different altitudes, and remote aerial avalanche beacon search were streamed wirelessly in real time to a monitor at a ground base. Electromagnetic interference disturbed signal reception in the ground monitor. A small remotely piloted aircraft can be used as an effective tool carrier, although limited by its payload capacity, wind speed and flight endurance. Remote sensing using already existing remotely piloted aircraft technology in pre

  11. Incidence and management of N-acetylcysteine-related anaphylactoid reactions during the management of acute paracetamol overdose.

    Science.gov (United States)

    Yamamoto, Takahiro; Spencer, Tanya; Dargan, Paul I; Wood, David M

    2014-02-01

    Adverse drug reactions (ADRs) to N-acetylcysteine (NAC) treatment for paracetamol overdose are typically anaphylactoid in origin and occur in 2-48% of treated patients. We explored the incidence and management of NAC ADR in our unit. Case notes of patients who presented with paracetamol overdose and had ADR to NAC between February 2005 and June 2011 were reviewed. A total of 1648 patients presented with suspected paracetamol overdose and 660 received NAC treatment. Within this group, 82 patients had documented NAC-related ADR. ADR developed in 12.4% (82/660) of patients receiving intravenous NAC and 59 had full documentation available and were included in this study (34 women, 25 men). ADR occurred in the 15-min (150 mg/kg) bag in 36 cases (61%), 22 in the 4-h (50 mg/kg) bag (37%) and one in the 16-h (100 mg/kg) bag (2%). Symptoms were classified as minimal (n=16, 27%), moderate (n=26, 44%) and severe (n=17, 29%). Asthma and female sex, which are reported risk factors for ADR, did not lead to the development of more severe ADR (P=0.771 and 0.330, respectively). Treatments administered included stopping the NAC infusion (n=32, 54%), administration of antiemetics (n=36, 61%), H1 antihistamines (n=26, 44%), steroids (n=16, 27%), inhaled B2 agonists (n=6, 10%) and adrenaline (n=3, 5%). The incidence of ADR to NAC was comparable with published studies, although there was no association of severity with asthma or female sex. The management of ADRs is variable, with frequent, inappropriate use of steroids. Education about the pathophysiology of these ADRs may improve management.

  12. Does marital status matter in an HIV hyperendemic country? Findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey.

    Science.gov (United States)

    Shisana, Olive; Risher, Kathryn; Celentano, David D; Zungu, Nompumelelo; Rehle, Thomas; Ngcaweni, Busani; Evans, Meredith G B

    2016-01-01

    South Africa has experienced declining marriage rates and the increasing practice of cohabitation without marriage. This study aims to improve the understanding of the relationship between marital status and HIV in South Africa, an HIV hyperendemic country, through an analysis of findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The nationally representative population-based cross-sectional survey collected data on HIV and socio-demographic and behavioural determinants in South Africa. This analysis considered respondents aged 16 years and older who consented to participate in the survey and provided dried blood spot specimens for HIV testing (N = 17,356). After controlling for age, race, having multiple sexual partners, condom use at last sex, urban/rural dwelling and level of household income, those who were married living with their spouse had significantly reduced odds of being HIV-positive compared to all other marital spouses groups. HIV incidence was 0.27% among respondents who were married living with their spouses; the highest HIV incidence was found in the cohabiting group (2.91%). Later marriage (after age 24) was associated with increased odds of HIV prevalence. Our analysis suggests an association between marital status and HIV prevalence and incidence in contemporary South Africa, where odds of being HIV-positive were found to be lower among married individuals who lived with their spouses compared to all other marital status groups. HIV prevention messages therefore need to be targeted to unmarried populations, especially cohabitating populations. As low socio-economic status, low social cohesion and the resulting destabilization of sexual relationships may explain the increased risk of HIV among unmarried populations, it is necessary to address structural issues including poverty that create an environment unfavourable to stable sexual relationships.

  13. Prediction of Incident Major Osteoporotic and Hip Fractures by Trabecular Bone Score (TBS) and Prevalent Radiographic Vertebral Fracture in Older Men.

    Science.gov (United States)

    Schousboe, John T; Vo, Tien; Taylor, Brent C; Cawthon, Peggy M; Schwartz, Ann V; Bauer, Douglas C; Orwoll, Eric S; Lane, Nancy E; Barrett-Connor, Elizabeth; Ensrud, Kristine E

    2016-03-01

    Trabecular bone score (TBS) has been shown to predict major osteoporotic (clinical vertebral, hip, humerus, and wrist) and hip fractures in postmenopausal women and older men, but the association of TBS with these incident fractures in men independent of prevalent radiographic vertebral fracture is unknown. TBS was estimated on anteroposterior (AP) spine dual-energy X-ray absorptiometry (DXA) scans obtained at the baseline visit for 5979 men aged ≥65 years enrolled in the Osteoporotic Fractures in Men (MrOS) Study and its association with incident major osteoporotic and hip fractures estimated with proportional hazards models. Model discrimination was tested with Harrell's C-statistic and with a categorical net reclassification improvement index, using 10-year risk cutpoints of 20% for major osteoporotic and 3% for hip fractures. For each standard deviation decrease in TBS, there were hazard ratios of 1.27 (95% confidence interval [CI] 1.17 to 1.39) for major osteoporotic fracture, and 1.20 (95% CI 1.05 to 1.39) for hip fracture, adjusted for FRAX with bone mineral density (BMD) 10-year fracture risks and prevalent radiographic vertebral fracture. In the same model, those with prevalent radiographic vertebral fracture compared with those without prevalent radiographic vertebral fracture had hazard ratios of 1.92 (95% CI 1.49 to 2.48) for major osteoporotic fracture and 1.86 (95% CI 1.26 to 2.74) for hip fracture. There were improvements of 3.3%, 5.2%, and 6.2%, respectively, of classification of major osteoporotic fracture cases when TBS, prevalent radiographic vertebral fracture status, or both were added to FRAX with BMD and age, with minimal loss of correct classification of non-cases. Neither TBS nor prevalent radiographic vertebral fracture improved discrimination of hip fracture cases or non-cases. In conclusion, TBS and prevalent radiographic vertebral fracture are associated with incident major osteoporotic fractures in older men independent of each other

  14. Predicting Antimicrobial Resistance Prevalence and Incidence from Indicators of Antimicrobial Use: What Is the Most Accurate Indicator for Surveillance in Intensive Care Units?

    Directory of Open Access Journals (Sweden)

    Élise Fortin

    Full Text Available The optimal way to measure antimicrobial use in hospital populations, as a complement to surveillance of resistance is still unclear. Using respiratory isolates and antimicrobial prescriptions of nine intensive care units (ICUs, this study aimed to identify the indicator of antimicrobial use that predicted prevalence and incidence rates of resistance with the best accuracy.Retrospective cohort study including all patients admitted to three neonatal (NICU, two pediatric (PICU and four adult ICUs between April 2006 and March 2010. Ten different resistance/antimicrobial use combinations were studied. After adjustment for ICU type, indicators of antimicrobial use were successively tested in regression models, to predict resistance prevalence and incidence rates, per 4-week time period, per ICU. Binomial regression and Poisson regression were used to model prevalence and incidence rates, respectively. Multiplicative and additive models were tested, as well as no time lag and a one 4-week-period time lag. For each model, the mean absolute error (MAE in prediction of resistance was computed. The most accurate indicator was compared to other indicators using t-tests.Results for all indicators were equivalent, except for 1/20 scenarios studied. In this scenario, where prevalence of carbapenem-resistant Pseudomonas sp. was predicted with carbapenem use, recommended daily doses per 100 admissions were less accurate than courses per 100 patient-days (p = 0.0006.A single best indicator to predict antimicrobial resistance might not exist. Feasibility considerations such as ease of computation or potential external comparisons could be decisive in the choice of an indicator for surveillance of healthcare antimicrobial use.

  15. From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the perinatal depression-research & screening unit study.

    Science.gov (United States)

    Banti, Susanna; Mauri, Mauro; Oppo, Annalisa; Borri, Chiara; Rambelli, Cristina; Ramacciotti, Daniele; Montagnani, Maria S; Camilleri, Valeria; Cortopassi, Sonia; Rucci, Paola; Cassano, Giovanni B

    2011-01-01

    Perinatal depression is a particular challenge to clinicians, and its prevalence estimates are difficult to compare across studies. Furthermore, to our knowledge, there are no studies that systematically assessed the incidence of perinatal depression. The aim of this study is to estimate the prevalence, incidence, recurrence, and new onset of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, minor and major depression (mMD) in an unselected population of women recruited at the third month of pregnancy and followed up until the 12th month postpartum. One thousand sixty-six pregnant women were recruited. Minor and major depression was assessed in a naturalistic, longitudinal study. The Edinburgh Postnatal Depression Scale and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders were administered at different time points during pregnancy and in the postpartum period. The period prevalence of mMD was 12.4% in pregnancy and 9.6% in the postpartum period. The cumulative incidence of mMD in pregnancy and in the postpartum period was 2.2% and 6.8%, respectively. Thirty-two (7.3%) women had their first episode in the perinatal period: 1.6% had a new onset of depression during pregnancy, 5.7% in the postpartum period. Our postpartum prevalence figures, which are lower than those reported in the literature, may reflect treatment during the study, suggesting that casting a multiprofessional network around women in need of support may be potentially useful for reducing the effects of this disorder on the mother and the newborn child. Furthermore, our results indicate that women with a history of depression have a 2-fold risk of developing mMD in the perinatal period. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Severe obesity increases the prevalence but not the incidence of depressive symptoms in the elderly-population-based cohort in Southern Brazil.

    Science.gov (United States)

    Goes, Vanessa Fernanda; Wazlawik, Elisabeth; D'Orsi, Eleonora; González-Chica, David Alejandro

    2017-08-01

    The relation between body weight status and depressive symptoms in the elderly differs according to age and country of origin. The goal of this study was to analyze the cross-sectional and longitudinal relationship between body mass index (BMI), waist circumference (WC) and depressive symptoms in the elderly. A population-based cohort study of 1,702 elderly individuals (70.6+8.0 years) in Southern Brazil evaluated in 2009/10 and 2013/14 was accessed. The body weight status was assessed using measured data of BMI and WC. The Geriatric Depression Scale (GDS-15) was used to determine depressive symptoms. Logistic regression analysis adjusted for sociodemographic and behavioral variables was performed. The prevalence of depressive symptoms in 2009/10 was 23.3% (95% CI 20.3-26.6) and the cumulative incidence in the 4-years period was 10.9% (95% CI 8.7-13.6). Elderly people with obesity class II-III and WC in the highest quartile had higher prevalence odds ratio of being depressed than individuals with normal weight or WC in the lower quartile (OR 2.34; 95% CI 1.42-3.87 and OR 1.73; 95% CI 1.13-2.65, respectively). Meanwhile, intermediary values of BMI and WC were associated with a lower prevalence. When evaluating the incidence of depressive symptoms, overweight individuals and those in the second quartile of WC had a lower risk (58% and 57%, respectively), but severely obese individuals had the same risk compared to those with normal BMI/WC. Severely obese individuals presented a similar incidence of depressive symptoms compared to those with normal BMI/WC, but higher prevalence. Intermediary values of body weight status decrease the risk of depressive symptoms.

  17. Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study

    Directory of Open Access Journals (Sweden)

    van Weel Chris

    2011-04-01

    Full Text Available Abstract Background Patient safety can be at stake in both hospital and general practice settings. While severe patient safety incidents have been described, quantitative studies in large samples of patients in general practice are rare. This study aimed to assess patient safety in general practice, and to show areas where potential improvements could be implemented. Methods We conducted a retrospective review of patient records in Dutch general practice. A random sample of 1,000 patients from 20 general practices was obtained. The number of patient safety incidents that occurred in a one-year period, their perceived underlying causes, and impact on patients' health were recorded. Results We identified 211 patient safety incidents across a period of one year (95% CI: 185 until 241. A variety of types of incidents, perceived causes and consequences were found. A total of 58 patient safety incidents affected patients; seven were associated with hospital admission; none resulted in permanent disability or death. Conclusions Although this large audit of medical records in general practices identified many patient safety incidents, only a few had a major impact on patients' health. Improving patient safety in this low-risk environment poses specific challenges, given the high numbers of patients and contacts in general practice.

  18. Risk Factors and Prevalence of Helicobacter pylori Infection in Persistent High Incidence Area of Gastric Carcinoma in Yangzhong City

    Directory of Open Access Journals (Sweden)

    Yangchun Zhu

    2014-01-01

    Full Text Available Aim. The aim of this study was to investigate the prevalence and risk factors of H. pylori infection in areas with high prevalence of gastric cancer in Jiangsu Province, China. Methods. A prospective epidemiologic survey of H. pylori infection was accomplished in a natural population of 5417 individuals in Yangzhong city. Questionnaires and 13C-urea breath test for H. pylori infection were performed. Results. Among 5417 subjects who completed questionnaires and 13C-urea breath test, 3435 (63.41% were H. pylori positive. The prevalence reached a peak at the age of 30–39 years (90.82%. There was significant difference between sexes and women had a higher infection rate than men. The prevalence of H. pylori infection was also associated with eating kipper food and fried food. No association between H. pylori prevalence and smoking or drinking was found. Compared to healthy individuals, people with dyspeptic diseases (peptic ulcer, gastroenteritis presented a high prevalence of H. pylori infection. Using multivariate logistic regression analysis, age and history of peptic ulcer and gastroenteritis were the independent predictors for H. pylori infection. Conclusions. Yangzhong city had a high prevalence of H. pylori infection and was related to several risk factors. The underlying mechanisms are needed to be further investigated.

  19. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael B.; Dappa, Evelyn; Jungmann, Florian; Kloeckner, Roman; Schotten, Sebastian; Wirth, Gesine M.; Mildenberger, Peter; Kreitner, Karl-Friedrich; Oberholzer, Katja; Dueber, Christoph [University Hospital of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mittler, Jens; Lang, Hauke [University Hospital of Mainz, Department of Abdominal, Visceral and Transplantation Surgery, Mainz (Germany)

    2015-07-15

    To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. 233 patients with 253 VAA were analyzed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3 % vs.3.1 %). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. Pseudoaneurysms of visceral arteries have a high risk for rupture. Aneurysm size seems to be no reliable predictor for rupture. Interventional treatment is safe and effective for management of VAA. (orig.)

  20. Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

    Directory of Open Access Journals (Sweden)

    Ng HY

    2016-12-01

    Full Text Available Hak Yung Ng Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong, China Abstract: Obesity in adolescence is a public health priority because it usually tracks into adulthood, resulting in enormous medical and social costs. This underscores the importance of early identification and intervention. Acanthosis nigricans (AN was once considered a rare paraneoplastic dermatosis, but is now frequently observed in obese adolescents. Current understanding suggests that it is associated with insulin resistance and has a unique role in secondary prevention. The purpose of this narrative review is to provide a comprehensive overview of AN in obese adolescents, covering its history, current knowledge on the condition, its clinical significance, management challenges, and the direction of future research. Keywords: Differential diagnosis, screening, insulin resistance, type 2 diabetes mellitus, metabolically healthy obesity, behavioral weight management, pharmacotherapy, bariatric surgery

  1. Lithiasis in 1,313 kidney transplants: incidence, diagnosis, and management.

    Science.gov (United States)

    Ferreira Cassini, M; Cologna, A J; Ferreira Andrade, M; Lima, G J; Medeiros Albuquerque, U; Pereira Martins, A C; Tucci Junior, S

    2012-10-01

    Renal transplantation remains the optimal treatment of patients with end-stage renal disease. Urinary lithiasis represents an unusual urologic complication in renal transplantation, with an incidence of lithiasis, which does not occur in patients from living donors, owing to screening with computerized tomography. The aim of this study was to evaluate the incidence, diagnosis, and therapeutic management of renal lithiasis in transplanted kidneys at a single institution. We reviewed the medical records for 1,313 patients who underwent kidney transplantation from February 1968 to February 2011. Among the grafts, 17 patients (1.29%) had nephrolithiasis: 9 women and 8 men. Ages ranged from 32 to 63 years (mean = 45.6 years). Fifteen patients received kidneys from cadaveric and only 2 from living related donors. Two stones, both located inside the ureter, were identified during transplant surgery (11.7%). Three instances of lithiasis were incidentally diagnosed by ultrasound during graft evaluation, within 7 days after surgery (17.6%); all 3 were in the calyces. The 12 remaining patients had the stones diagnosed later (70.58%): 6 in the calyces, 3 in the renal pelvis, and 3 inside the ureter. Urinary lithiasis is a rare complication in renal transplantation. In most patients the condition occurs without pain. The diagnosis and treatment options for graft urolithiasis are similar to those patients with nephrolithiasis in the general population. Extracorporeal shock wave lithotripsy (ESWL) was the most common treatment method. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease.

    Science.gov (United States)

    Lin, C Huie; Hegde, Sanjeet; Marshall, Audrey C; Porras, Diego; Gauvreau, Kimberlee; Balzer, David T; Beekman, Robert H; Torres, Alejandro; Vincent, Julie A; Moore, John W; Holzer, Ralf; Armsby, Laurie; Bergersen, Lisa

    2014-01-01

    Continued advancements in congenital cardiac catheterization and interventions have resulted in increased patient and procedural complexity. Anticipation of life-threatening events and required rescue measures is a critical component to preprocedural preparation. We sought to determine the incidence and nature of life-threatening adverse events in congenital and pediatric cardiac catheterization, risk factors, and resources necessary to anticipate and manage events. Data from 8905 cases performed at the 8 participating institutions of the Congenital Cardiac Catheterization Project on Outcomes were captured between 2007 and 2010 [median 1,095/site (range 133-3,802)]. The incidence of all life-threatening events was 2.1 % [95 % confidence interval (CI) 1.8-2.4 %], whereas mortality was 0.28 % (95 % CI 0.18-0.41 %). Fifty-seven life-threatening events required cardiopulmonary resuscitation, whereas 9 % required extracorporeal membrane oxygenation. Use of a risk adjustment model showed that age events. Using this model, standardized life-threatening event ratios were calculated, thus showing that one institution had a life-threatening event rate greater than expected. Congenital cardiac catheterization and intervention can be performed safely with a low rate of life-threatening events and mortality; preprocedural evaluation of risk may optimize preparation of emergency rescue and bailout procedures. Risk predictors (age < 1, hemodynamic vulnerability, and procedure risk category) can enhance preprocedural patient risk stratification and planning.

  3. Incidence and management of chemotherapy-induced nausea and vomiting in women with breast cancer

    Directory of Open Access Journals (Sweden)

    Thais de Oliveira Gozzo

    Full Text Available The objective of this study was to analyze the incidence of chemotherapy-induced nausea and vomiting in women with breast cancer and identify strategies used by them to control these signs and symptoms. Data for this cross-sectional study were collected through interviews during the last cycle of chemotherapy, between August 2011 and March 2012, in a university hospital in the State of São Paulo. The sample consisted of 22 women between the ages of 31 and 70, of whom 77.3% reported nausea and 50% vomiting during treatment. Regarding symptom management, 82% of the women reported having received some information centered on the use of prescribed medication. However, 27.3% did not know what medication they had taken. We concluded that there is a lack of systematic care and institutional protocol to guide professionals in providing standardized information to women so they can better control nausea and vomiting.

  4. Atherogenic dyslipidemia: prevalence and management in lipid clinics.

    Science.gov (United States)

    Pedro-Botet, J; Flores-Le Roux, J A; Mostaza, J M; Pintó, X; de la Cruz, J J; Banegas, J R

    2014-12-01

    Atherogenic dyslipidemia, which is characterized by increased triglyceride levels and reduced HDL cholesterol levels, is underestimated and undertreated in clinical practice. We assessed its prevalence and the achievement of therapeutic objectives for HDL cholesterol and triglyceride levels in patients treated at lipid and vascular risk units in Spain. This was an observational, longitudinal, retrospective, multicenter study performed in 14 autonomous Spanish communities that consecutively included 1828 patients aged ≥18 years who were referred for dyslipidemia and vascular risk to 43 lipid clinics accredited by the Spanish Society of Arteriosclerosis. We collected information from the medical records corresponding to 2 visits conducted during 2010 and 2011-12, respectively. Of the 1649 patients who had a lipid profile in the first visit (90.2%), 295 (17.9%) had atherogenic dyslipidemia. The factors associated with atherogenic dyslipidemia were excess weight/obesity, not taking hypolipidemic drugs (statins and/or fibrates), diabetes, myocardial infarction and previous heart failure. Of the 273 (92.5%) patients with atherogenic dyslipidemia that had a lipid profile in the last visit, 44 (16.1%) achieved the therapeutic objectives for HDL cholesterol and triglyceride levels. The predictors of therapeutic success were normal weight and normoglycemia. One of every 6 patients treated in lipid and vascular risk units had atherogenic dyslipidemia. The degree to which the therapeutic goals for HDL cholesterol and triglyceride levels were achieved in these patients was very low. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  5. The Prevalence and Incidence of Sexually Transmitted Infections in a Prospective Cohort of Injection Drug Users in Vancouver, British Columbia

    Directory of Open Access Journals (Sweden)

    Laura M Kuyper

    2005-01-01

    Full Text Available BACKGROUND: While several studies have reported on sexual risk behaviours and the prevalence of sexually transmitted infections (STIs among injection drug users (IDUs, there are fewer prospective studies that have been able to examine populations of IDUs with no history of STIs. Therefore, the authors examined prevalence, correlates and factors associated with time to first STI infection in a prospective cohort of IDUs in Vancouver, British Columbia.

  6. Hepatic adenoma: incidence and management between the year 2002-2006 Hospital R. Calderon Guardia

    International Nuclear Information System (INIS)

    Pages Zamora, Alberto

    2008-01-01

    The incidence and management of hepatic adenoma at the Hospital Calderon Guardia are analyzed between the years 2002-2006. The main hepatic pathologies diagnosed by biopsy are shown. The relationship of hepatic adenoma with the above risk factors and presentation of each case of hepatic adenoma found are analyzed. The media diagnosed in this type of pathology were investigated. The evolution and control of each case of hepatic adenoma have been studied. The results of the management of each case are compared with the recommended in literature. The ideal management of this type of pathology is analyzed. Among the conclusions is given benign liver pathology as the most frequent cause of liver biopsy in the Hospital Calderon Guardia. Metastatic disease of the digestive tract has been the primary neoplastic disease at the hepatic level. Focal nodular hyperplasia has been the biopsy of benign tumor that is performed more frequently. Hepatic adenoma has been a rare entity, but with significant mortality rates. All cases were presented as solitary lesions. It is more common in women of childbearing age but can occur also in older people and in men. A close relationship has existed between the use of oral gestagens and the incidence of hepatic adenoma. Hepatic adenomas and its complications have been related to its size. Most cases of hepatic adenoma were presented with symptoms. The preoperative studies have shown high sensitivity in the detection of lesions, but little specificity. A protocol for the study of hepatic masses is required. A relationship between the size of the adenoma and possible complications was demonstrated. The reason for surgery in most cases has been the possibility of malignancy in the liver injury. The correlation between preoperative diagnosis and the end was unsuccessful in 75 percent of cases. The mortality related to the procedures did not exist, but if a case of morbidity. The study of liver masses should be more exhaustive to improve

  7. Prevalence, incidence and correlates of low risk HPV infection and anogenital warts in a cohort of women living with HIV in Burkina Faso and South Africa.

    Science.gov (United States)

    Chikandiwa, Admire; Kelly, Helen; Sawadogo, Bernard; Ngou, Jean; Pisa, Pedro T; Gibson, Lorna; Didelot, Marie-Noelle; Meda, Nicolas; Weiss, Helen A; Segondy, Michel; Mayaud, Philippe; Delany-Moretlwe, Sinead

    2018-01-01

    To report the prevalence and incidence of low-risk human papillomavirus infection (LR-HPV) and anogenital warts (AGW) among women living with HIV (WLHIV) in Burkina Faso (BF) and South Africa (SA), and to explore HIV-related factors associated with these outcomes. We enrolled 1238 WLHIV (BF = 615; SA = 623) aged 25-50 years and followed them at three time points (6, 12 and 16 months) after enrolment. Presence of AGW was assessed during gynaecological examination. Cervico-vaginal swabs for enrolment and month 16 follow-up visits were tested for HPV infection by Inno-LiPA® genotyping. Logistic regression was used to assess risk factors for prevalent infection or AGW. Cox regression was used to assess risk factors for incident AGW. Women in SA were more likely than those in BF to have prevalent LR-HPV infection (BF: 27.1% vs. SA: 40.9%; p500 cells/μL). Duration of ART and HIV plasma viral load were not associated with any LR-HPV infection or AGW outcomes. LR-HPV infection and AGW are common in WLHIV in sub-Saharan Africa. Type-specific HPV vaccines and effective ART with immunological reconstitution could reduce the burden of AGW in this population.

  8. Prevalence and incidence of hyperkalaemia in the Spanish population with heart failure with reduced ejection fraction: a systematic review and populational relevance.

    Science.gov (United States)

    Hernáez, Á; Delgado, J F; Cinca, J; Fernández-Avilés, F; Marrugat, J

    2018-02-26

    Hyperkalaemia (K + levels≥5.5mmol/L) is a severe ion imbalance that occurs in patients who have heart failure (HF) with reduced ejection fraction (HFrEF) and increases the risk of ventricular fibrillation. Given that there are no estimates on the number of patients with this complication, the aim of this study was to estimate the prevalence and incidence of hyperkalaemia in patients with HFrEF in Spain. Based on a systematic literature search and through a meta-analysis, we calculated an HFrEF prevalence of ≤40% in the European and U.S. Based on another systematic literature search, we calculated the prevalence of hyperkalaemia in patients with HF and its annual incidence rate. Considering the previous values and the Spanish population pyramid in 2016, we estimated the number of individuals with HFrEF who currently have hyperkalaemia and those who develop it each year in Spain. Approximately 17,100 (10,000 men and 7100 women) of the 508,000 patients with HFrEF in Spain have hyperkalaemia. Furthermore, approximately 14,900 patients with HFrEF (9500 men and 5400 women) develop hyperkalaemia each year. Approximately 1 of every 30 patients with HFrEF has plasma potassium values >5.5 mmol/L. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  9. [Incidence and management of monozygotic twin conceived by assisted reproductive techniques].

    Science.gov (United States)

    Mo, Lijing; Jin, Congcong; Wu, Yonggen; Wang, Peiyu; Lin, Jia; Zhao, Junzhao

    2015-08-01

    To analysis the incidence and management of monozygotic twin (MZT) conceived by assisted reproductive techniques (ART). A retrospective analysis of clinical pregnancies and MZT that resulted from ART was performed in Reproductive Medical Center, the First Affiliated Hospital, Wenzhou Medical University between January 2011 and January 2014. A total of 5 908 pregnancies were diagnosed: 2 012 twins, 157 high-order multiple pregnancy (HOMP), including 4 quadruplets. Overall, 51 MZT pregnancies were identified of them including 32 cases HOMP and 19 cases MZT. The incidence of MZT resulting from cleavage-stage embryo transfer was similar to blastocyst transfer (P = 0.960). The percent of MZT resulting from in vitro fertilization [0.93% (28/3 022)], frozen-thawed embryo transfer [0.87% (13/1 502)] and intracytoplamic sperm injection [0.72% (10/1 384)] did not show statistical significance (P = 0.794). The expectantly managed MZT was associated with a significantly greater likelihood of miscarriage [6/19 vs 5.11% (101/1 976)], and low birth weight infant [73.91% (17/23) vs 42.89% (1 453/3 388), P < 0.01], when compared with dizygotic twin (DZT) did not undergo selective embryo reduction (SER). In monozygotic (MZ)-triplets with SER to 2 fetuses or to 1 fetus, there was no cases of preterm birth or low birth weight infant observed in MZ-triplets with SER to 1 fetus; when compared with MZ-triplets with SER to 2 fetuses, the low birth weight infant [56.00% (14/25), P = 0.021] has statistical significance. The likelihood of the survival of two babies was lower in MZ-triplets with SER to 2 fetuses when compared with non-MZ triplets with SER to 2 fetuses [42.86% (9/21) vs 75.21% (91/121), P = 0.003]. The incidence of MZT pregnancies following ART is high. It plays a significant role in the occurrence of HOMP. MZT pregnancies are at an increased risk of adverse outcomes, it should transform to a single embryo thansfer (SET) program to reduce them incideuce. Reduction of MZT

  10. Effects of Climate on Incidence of Campylobacter spp. in Humans and Prevalence in Broiler Flocks in Denmark

    DEFF Research Database (Denmark)

    Patrick, Mary Evans; Christiansen, Lasse Engbo; Wainø, Michael

    2004-01-01

    Campylobacter infections are increasing and pose a serious public health problem in Denmark. Infections in humans and broiler flocks show similar seasonality, suggesting that climate may play a role in infection. We examined the effects of temperature, precipitation, relative humidity, and hours...... of sunlight on Campylobacter incidence in humans and broiler flocks by using lag dependence functions, locally fitted linear models, and cross validation methods. For humans, the best model included average temperature and sunlight 4 weeks prior to infection; the maximum temperature lagged at 4 weeks...... humidity predicted the incidence in humans equally well. For broiler flock incidence these factors explained considerably less. Future research should focus on elements within the broiler environment that may be affected by climate, as well as the interaction of microclimatic factors on and around broiler...

  11. Incidence and risk factor prevalence of community-acquired pneumonia in adults in primary care in Spain (NEUMO-ES-RISK project).

    Science.gov (United States)

    Rivero-Calle, I; Pardo-Seco, J; Aldaz, P; Vargas, D A; Mascarós, E; Redondo, E; Díaz-Maroto, J L; Linares-Rufo, M; Fierro-Alacio, M J; Gil, A; Molina, J; Ocaña, D; Martinón-Torres, Federico

    2016-11-07

    Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in adults even in developed countries. Several lifestyle factors and comorbidities have been linked to an increased risk, although their prevalence has not been well documented in the primary care setting. The aim of this study is to assess the incidence, risk factor and comorbid conditions distribution of CAP in adults in primary care in Spain. Retrospective observational study in adults (>18 years-old) with CAP diagnosed and attended at primary care in Spain between 2009 and 2013, using the Computerized Database for Pharmacoepidemiological Studies in Primary Care (BIFAP). Twenty-eight thousand four hundred thirteen patient records were retrieved and analyzed. Mean age (standard deviation): 60.5 (20.3) years, 51.7 % males. Global incidence of CAP in adults was estimated at 4.63 per 1000 persons/year. CAP incidence increased progressively with age, ranging from a 1.98 at 18-20 years of age to 23.74 in patients over 90 years of age. According to sex, global CAP incidence was slightly higher in males (5.04) than females (4.26); CAP incidence from 18 to 65 year-olds up was comparable between males (range: 2.18-5.75) and females (range: 1.47-5.21), whereas from 65 years of age, CAP incidence was noticeable higher in males (range: 7.06-36.93) than in females (range: 5.43-19.62). Average prevalence of risk factors was 71.3 %, which increased with age, doubling the risk in males by the age of 75 (females 20 % vs males 40 %). From 55 years of age, at least one risk factor was identified in 85.7 % of cases: one risk factor (23.8 %), two risk factors (23.4 %), three or more risk factors (38.5 %). Major risk factors were: metabolic disease (27.4 %), cardiovascular disease (17.8 %) and diabetes (15.5 %). The annual incidence of CAP in primary care adults in Spain is high, comparable between males and females up to 65 years of age, but clearly increasing in males from that age. CAP

  12. Correlates of prevalent HIV infection among adults and adolescents in the Kisumu incidence cohort study, Kisumu, Kenya.

    Science.gov (United States)

    Gumbe, Anne; McLellan-Lemal, Eleanor; Gust, Deborah A; Pals, Sherri L; Gray, Kristen Mahle; Ndivo, Richard; Chen, Robert T; Mills, Lisa A; Thomas, Timothy K

    2015-11-01

    We estimated HIV prevalence and identified correlates of HIV infection among 1106 men and women aged 16-34 years residing in Kisumu, Kenya. Demographic, sexual, and other behavioural data were collected using audio computer-assisted self-interview in conjunction with a medical examination, real-time parallel rapid HIV testing, and laboratory testing for pregnancy, gonorrhoea, chlamydia, syphilis, and herpes simplex virus type 2. Multivariate logistic regression was used to identify variables associated with prevalent HIV infection by gender. Overall HIV prevalence was 12.1%. HIV prevalence among women (17.1%) was approximately two-and-one-half times the prevalence among men (6.6%). Odds of HIV infection in men increased with age (aOR associated with one-year increase in age = 1.21, CI = 1.07-1.35) and were greater among those who were uncircumcised (aOR = 4.42, CI = 1.41-13.89) and those who had an herpes simplex virus type 2-positive (aOR = 3.13, CI = 1.12-8.73) test result. Odds of prevalent HIV infection among women also increased with age (aOR associated with one-year increase in age = 1.16, CI = 1.04-1.29). Women who tested herpes simplex virus type 2 positive had more than three times the odds (aOR = 3.85, CI = 1.38-10.46) of prevalent HIV infection compared with those who tested herpes simplex virus type 2 negative. Tailored sexual health interventions and programs may help mitigate HIV age and gender disparities. © The Author(s) 2015.

  13. High hepatitis C virus prevalence and incidence in a community cohort of young heroin injectors in a context of extensive harm reduction programmes.

    Science.gov (United States)

    Vallejo, Fernando; Barrio, Gregorio; Brugal, M Teresa; Pulido, Jose; Toro, Carlos; Sordo, Luis; Espelt, Albert; Bravo, María J

    2015-06-01

    Cohort studies on hepatitis C virus (HCV) among drug injectors are scarcer than studies on HIV. Combined harm reduction interventions (HRIs) can prevent HCV infection. Spain has a medium-high coverage of HRIs. 513 young heroin users who injected drugs in the past 12 months (recent injectors) were street-recruited in 2001-2003 and followed until 2006 in three Spanish cities; 137 were anti-HCV seronegative, 77 of whom had ≥1 follow-up visit. Dried blood spots were tested for anti-HCV. HCV incidence and predictors of infection were estimated using Poisson models. At baseline, 73% were anti-HCV positive. Overall incidence (n=77) of HCV seroconversion was 39.8/100 person-years (py) (95% CI 28.7 to 53.8). Excluding non-injectors during follow-up from the analysis (n=57), HCV incidence was 52.9/100 py (95% CI 37.4 to 72.5). Injecting at least weekly (incidence rate ratio (IRR)=5.2 (95% CI 2.5 to 11.1)) and having ≥2 sexual partners (IRR=2.2 (95% CI 1.1 to 4.7)) were independent predictors of HCV seroconversion; drug-injection history <2 years was marginally associated (IRR=2.4 (95% CI 0.9 to 4.7)). HCV incidence may have been underestimated due to differential attrition. Despite fairly high HRI coverage among Spanish drug injectors, a distressingly high incidence of HCV in a context of high HCV prevalence was found among young heroin injectors. 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.

  14. Oncohematological diseases in the Vale do Paraíba, State of São Paulo: demographic aspects, prevalences and incidences

    Directory of Open Access Journals (Sweden)

    Fernando Callera

    2011-01-01

    Full Text Available BACKGROUND: Based on the necessity of detailed information that supports effective strategies to improve cancer outcomes in the different regions of Brazil, the aims of this study were to report demographic aspects and to calculate the prevalence and incidence rates of oncohematological diseases in the region of Vale do Paraíba. METHODS: This is a multicentric prospective study carried out from October 2009 to March 2010. A total of 500 over 19-year-old patients were enrolled. Data such as type of healthcare insurance, gender, age, ethnic classification, place of residence, schooling, income, body mass index, new cases and the period between the first symptoms and a definite diagnosis were collected. The prevalence and incidence rates were calculated according to an estimated number of 1,319,800 inhabitants. RESULTS: The prevalence and incidence rates per 100,000 inhabitants in the period of six months were, respectively: acute myeloid leukemia 1.5 and 0.7; acute lymphoblastic leukemia 0.5 and 0.1; chronic lymphocytic leukemia 2.4 and 0.4; chronic myeloid leukemia 6.2 and 0.8; Hodgkin's lymphoma 2.9 and 0.9; non-Hodgkin lymphoma 9.8 and 4.3; multiple myeloma 5.7 and 0.7; myelodysplastic syndromes 2.1 and 0.2 and myeloproliferative syndromes 5.1 and 0.3. CONCLUSION: Giving the paucity of data in this field of investigation, our data may be useful for comparisons with those of other regions of Brazil and will assist in the implementation of treatment programs of oncohematological diseases in this region.

  15. Prevalence and cumulative incidence of abnormal cervical cytology among HIV-infected Thai women: a 5.5-year retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Thamkhantho Manopchai

    2011-01-01

    Full Text Available Abstract Background Cervical cancer is one of the most common AIDS-related malignancies in Thailand. To prevent cervical cancer, The US Public Health Service and The Infectious Disease Society of America have recommended that all HIV-infected women should obtain 2 Pap smears 6 months apart after the initial HIV diagnosis and, if results of both are normal, should undergo annual cytological screening. However, there has been no evidence in supporting whether this guideline is appropriate in all settings - especially in areas where HIV-infected women are living in resource-constrained condition. Methods To determine the appropriate interval of Pap smear screenings for HIV-infected Thai women and risk factors for subsequent abnormal cervical cytology, we assessed the prevalence, cumulative incidence and associated factors of cervical cell abnormalities (atypical squamous cell of undetermined significance or higher grades, ASCUS+ among this group of patients. Results The prevalence of ASCUS+ was 15.4% at the first visit, and the cumulative incidence of ASCUS+ gradually increased to 37% in the first 3.5 years of follow-up appointments (first 7 times, and tended to plateau in the last 2 years. For multivariate correlation analysis, women with a CD4 count P = 0.043. There were no associations of subsequent ASCUS+ with age, pregnancy, contraceptive method, highly active anti-retroviral treatment, assumed duration of infection, or the CD4 count nadir level. Conclusion There are high prevalence and cumulative incidence of ASCUS+ in HIV-infected Thai women. With a high lost-to-follow-up rate, an appropriate interval of Pap smear screening cannot be concluded from the present study. Nevertheless, the HIV-infected Thai women may require more than two normal semi-annual Pap smears before shifting to routinely annual cytologic screening.

  16. Bleeding complications after oral surgery in outpatients with compromised haemostasis: incidence and management.

    Science.gov (United States)

    Reich, Waldemar; Kriwalsky, Marcus S; Wolf, Hans H; Schubert, Johannes

    2009-06-01

    PURPOSE AND RESULTS: The aim of this prospective study was to determine the incidence of postoperative bleeding after oral surgery under local anaesthesia performed in outpatients with haemostatic disorders within a 5-year period (2003-2007). One hundred twenty one (70 males, 51 females) out of 2,056 outpatients with different haemostatic disorders (acquired or hereditary) were included in this study. The following data were recorded: medical history and general condition; medications; indication for the surgical procedure; specification of local anaesthesia; applied surgical techniques, considering the kind of haemostatic disorder; and peri- or postoperative bleeding complications. Postoperative bleeding was observed in 12 patients (9.9%). In three cases, inpatient treatment became necessary. The management of two patients with a haemostatic disorder (von Willebrand s disease and haemophilia A) is presented in short case reports. In a heterogeneous group of 121 outpatients with known haemostatic disorders, a combination of a few haemostatic agents with appropriate operative technique enables an effective wound management. In cases of failed local interventions after postoperative bleeding, further diagnostic investigations are required.

  17. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  18. Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study

    NARCIS (Netherlands)

    Gaal, S.; Verstappen, W.H.J.M.; Wolters, R.J.; Lankveld, H.; Weel, C. van; Wensing, M.J.P.

    2011-01-01

    BACKGROUND: Patient safety can be at stake in both hospital and general practice settings. While severe patient safety incidents have been described, quantitative studies in large samples of patients in general practice are rare. This study aimed to assess patient safety in general practice, and to

  19. Medically unexplained and explained physical symptoms in the general population : Association with prevalent and incident mental disorders

    NARCIS (Netherlands)

    van Eck van der Sluis, J.F.; Ten Have, M.; Rijnders, C.A.Th.; van Marwijk, H.W.J.; de Graaf, R.; Cornelis, Christina

    2015-01-01

    Background Clinical studies have shown that Medically Unexplained Symptoms (MUS) are related to common mental disorders. It is unknown how often common mental disorders occur in subjects who have explained physical symptoms (PHY), MUS or both, in the general population, what the incidence rates are,

  20. Medically Unexplained and Explained Physical Symptoms in the General Population: Association with Prevalent and Incident Mental Disorders

    NARCIS (Netherlands)

    van der Sluijs, J.V.; ten Have, M.; Rijnders, C.; van Marwijk, H.W.J.; de Graaf, R.; van der Feltz-Cornelis, C.

    2015-01-01

    Background Clinical studies have shown that Medically Unexplained Symptoms (MUS) are related to common mental disorders. It is unknown how often common mental disorders occur in subjects who have explained physical symptoms (PHY), MUS or both, in the general population, what the incidence rates are,

  1. Impact of incident vertebral fractures on health related quality of life (HRQOL) in postmenopausal women with prevalent vertebral fractures

    NARCIS (Netherlands)

    Oleksik, A.M.; Ewing, S.; Shen, W.; van Schoor, N.M.; Lips, P.T.A.M.

    2005-01-01

    Vertebral fractures are a common complication of osteoporosis and may cause a decrease of health-related quality of life (HRQOL). This study was designed to determine the impact of incident vertebral fractures on HRQOL. The Multiple Outcomes of Raloxifene Evaluation (MORE), a multicenter,

  2. Comparison of the prevalence and incidence of infection with bovine virus diarrhoea virus (BVDV) in Denmark and Michigan and association with possible risk factors

    DEFF Research Database (Denmark)

    Houe, H.; Baker, J.C.; Maes, R.K.

    1995-01-01

    Based on 2 previous surveys on the occurrence of infection with bovine virus diarrhoea virus (BVDV) in Danish and Michigan dairy herds, the prevalence and incidence of the infection were compared. The presence of certain possible risk factors for the occurrence of infection in the 2 areas were...... purchased more than 40 animals within recent 3 1/2-4 years were significantly associated with presence of PI animals in the dairy herds (p = 0.01) when tested by the Mantel-Haenszel chi 2. Using multivariable logistic regression, the occurrence of PI animals was found to be significantly related...

  3. Trends in HIV testing, prevalence among first-time testers, and incidence in most-at-risk populations in Spain: the EPI-VIH Study, 2000 to 2009.

    Science.gov (United States)

    Diez, M; Bleda, M J; Varela, J R; Ordonana, J; Azpiri, M A; Vall, M; Santos, C; Viloria, L; de Armas, C; Urena, J M; Trullen, J; Pueyo, I; Martinez, B; Puerta, T; Vera, M; Sanz, I; Junquera, M L; Landa, M C; Martinez, E; Camara, M M; Belda, J; Bru, F J; Diaz, A

    2014-11-27

    During 2000 to 2009, data on people undergoing HIV testing and on those newly diagnosed with HIV were collected in a network of 20 Spanish clinics specialising in sexually transmitted infections and/or HIV testing and counselling. The number of tests performed, overall and disaggregated by different variables, was obtained. HIV prevalence among first-time testers and HIV incidence among repeat testers were calculated. To evaluate trends, joinpoint regression models were fitted. In total, 236,939 HIV tests were performed for 165,745 individuals. Overall HIV prevalence among persons seeking HIV testing was 2.5% (95% CI: 2.4 to 2.6). Prevalence was highest in male sex workers who had sex with other men (19.0% (95% CI: 16.7 to 21.4)) and was lowest in female sex workers (0.8% (95% CI: 0.7 to 0.9)). Significant trends in prevalence were observed in men who have sex with men (MSM) (increasing) and heterosexual individuals (decreasing). The incidence analysis included 30,679 persons, 64,104 person-years (py) of follow-up and 642 seroconversions. The overall incidence rate (IR) was 1.0/100 py (95% CI: 0.9/100 to 1.1/100). Incidence was significantly higher in men and transgender females than in women (1.8/100 py (95% CI: 1.6 to 1.9), 1.2/100 py (95% CI: 0.5 to 2.8) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively) and increased with age until 35–39 years. IRs in MSM and people who inject drugs were significantly greater than in heterosexual individuals (2.5/100 py (95% CI: 2.3 to 2.7), 1.6/100 py (95% CI: 1.1 to 2.2) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively), and an upward trend was observed in MSM. Our results call for HIV prevention to be reinforced in MSM and transgender women in Spain.

  4. Urinary incontinence 4 and 12 years after first delivery: Risk factors associated with prevalence, incidence, remission, and persistence in a cohort of 236 women

    OpenAIRE

    Pizzoferrato, Anne-Cécile; Fauconnier, Arnaud; Quiboeuf, Emeline; Morel, Karine; Schaal, Jean-Patrick; Fritel, Xavier

    2013-01-01

    International audience; AIMS: Our aim was to study risk factors associated with prevalence, incidence, and remission of UI 4 and 12 years after first delivery. METHODS: Seven hundred seventy-four nulliparous women who gave birth in 1996 in two French maternity units at term received a questionnaire about their urinary symptoms in 2000 and again in 2008. Two hundred thirty-six women returned a questionnaire about UI 4 and 12 years after first delivery. Four groups of women were built: (A) wome...

  5. The MentDis_ICF65+study protocol: prevalence, 1-year incidence and symptom severity of mental disorders in the elderly and their relationship to impairment, functioning (ICF) and service utilisation

    OpenAIRE

    Andreas, Sylke; Haerter, Martin; Volkert, Jana; Hausberg, Maria; Sehner, Susanne; Wegscheider, Karl; Rabung, Sven; Ausin, Berta; Canuto, Alessandra; Da Ronch, Chiara; Grassi, Luigi; Hershkovitz, Yael; Lelliott, Paul; Munoz, Manuel; Quirk, Alan

    2013-01-01

    Background The EU currently lacks reliable data on the prevalence and incidence of mental disorders in older people. Despite the availability of several national and international epidemiological studies, the size and burden of mental disorders in the elderly remain unclear due to various reasons. Therefore, the aims of the MentDis_ICF65+ study are (1) to adapt existing assessment instruments, and (2) to collect data on the prevalence, the incidence, and the natural course and prognosis of me...

  6. Final Documentation: Incident Management And Probabilities Courses of action Tool (IMPACT).

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Donna M.; Ray, Jaideep; Tucker, Mark D.; Whetzel, Jonathan; Cauthen, Katherine Regina

    2018-03-01

    This report pulls together the documentation produced for the IMPACT tool, a software-based decision support tool that provides situational awareness, incident characterization, and guidance on public health and environmental response strategies for an unfolding bio-terrorism incident.

  7. Evidence for the benefits of food chain interventions on E. coli 0157:H7/NM prevalence in retail ground beef and human disease incidence: A success story.

    Science.gov (United States)

    Pollari, Frank; Christidis, Tanya; Pintar, Katarina D M; Nesbitt, Andrea; Farber, Jeff; Lavoie, Marie-Claude; Gill, Alex; Kirsch, Penelope; Johnson, Roger P

    2017-04-20

    Human infection with Escherichia coli O157:H7/NM has historically been associated with consumption of undercooked ground beef. The purpose of this paper is to investigate the correlation of the decline in E. coli O157:H7/NM infections in Canada with the introduction of control efforts in ground beef by industry. The human incidence of E. coli O157:H7/NM, prevalence in ground beef and interventions from 1996 to 2014 were analyzed. Pathogen prevalence data were obtained from federal government and industry surveillance and inspection/compliance programs. A survey of the largest ground beef producers in Canada was conducted to identify when interventions were implemented. The incidence of E. coli O157:H7/NM infections in Canada declined from ∼4 cases/100 000 to ∼1 case/100 000 from 2000 to 2010. Verotoxigenic Escherichia coli (VTEC) prevalence in ground beef sold at retail declined from about 30% around the year 2000 to <2% since 2012. Other measures of the prevalence of E. coli, VTEC, and E. coli O157:H7/NM in beef and ground beef also declined. The number and types of interventions implemented in the major beef processing establishments in Canada increased from 1996 to 2016. The observed decline in human illnesses and pathogen levels in relation to retail meats was associated with the introduction of control efforts by industry, federal and provincial/territorial governments, and the general population. Industry-led changes in beef processing along with the introduction of food safety policies, regulations, and public education have led to improved food safety in Canada.

  8. Incidental intracardiac thromboemboli during liver transplantation: incidence, risk factors, and management.

    Science.gov (United States)

    Xia, Victor W; Ho, Jonathan K; Nourmand, Hamid; Wray, Christopher; Busuttil, Ronald W; Steadman, Randolph H

    2010-12-01

    Even though numerous cases of massive thromboemboli have been reported in the literature, intracardiac thromboemboli (ICTs) incidentally found during orthotopic liver transplantation (OLT) have not been examined. In this study, we retrospectively examined the incidence, risk factors, and management of incidental ICTs during OLT. After institutional review board approval, adult patients who underwent OLT between January 2004 and December 2008 at our center were reviewed. ICTs were identified and confirmed by the examination of OLT datasheets, anesthesia records, and recorded transesophageal echocardiography (TEE) clips. The clinical presentation, management, and outcomes of the patients with ICTs were reviewed. Risk factors were analyzed by multivariate logistic regression. During the study period, 426 of the 936 adult OLT patients (45.5%) underwent intraoperative TEE monitoring. Incidental ICTs were identified in 8 of these 426 patients (1.9%). Two ICTs occurred before reperfusion, and 6 ICTs occurred after reperfusion. The treatment was at the discretion of the treating physicians; however, none of the patients received an anticoagulant or thrombolytics. Multivariate analysis identified 2 independent risk factors for intraoperative incidental ICTs: the presence of symptomatic or surgically treated portal hypertension (a history of gastrointestinal bleeding, a transjugular intrahepatic portosystemic shunt procedure, or portocaval shunt surgery) before OLT and intraoperative hemodialysis (odds ratios of 4.05 and 7.29, respectively; P ICTs during OLT occurred at a rate of 1.9% and were associated with several preoperative and intraoperative risk factors. The use of TEE allows early identification, which may be important. Our management for incidental ICTs is described; however, no conclusions can be made about the optimal therapy. Copyright © 2010 American Association for the Study of Liver Diseases.

  9. Vertebral artery injury during foraminal decompression in "low-risk" cervical spine surgery: incidence and management.

    Science.gov (United States)

    Obermüller, Thomas; Wostrack, Maria; Shiban, Ehab; Pape, Haiko; Harmening, Kathrin; Friedrich, Benjamin; Prothmann, Sascha; Meyer, Bernhard; Ringel, Florian

    2015-11-01

    Vertebral artery injury (VAI) during foraminal decompression in cervical spine surgery in the absence of repositioning or screw stabilization is rare. Without immediate recognition and treatment, it may have disastrous consequences. We aimed to describe the incidence and management of iatrogenic VAI in low-risk cervical spine surgery. The records of all patients who underwent surgical procedures of the cervical spine between January 2007 and May 2012 were retrospectively consecutively evaluated. Anterior cervical discectomy and fusion or arthroplasty as well as dorsal foraminal decompression through the Frykholm approach in degenerative diseases were defined as low-risk surgeries (n = 992). VAI occurred in 0.3 % (n = 3) of 992 procedures: in one case during a dorsal foraminal decompression, and in two cases during the anterior cervical discectomy and fusion (ACDF) of two or four levels, respectively. In the first case, the VAI was intraoperatively misdiagnosed. Despite an initially uneventful course, the patient suffered hemorrhage from a pseudoaneurysm of the injured VA 1 month after surgery. The aneurysm was successfully occluded by endovascular coiling. In both ACDF cases, angiography and endovascular stenting of the lacerated segment proceeded immediately after the surgery. All three patients suffered no permanent deterioration. In a high-volume surgical center, the incidence of VAI during low-risk cervical spine surgery is extremely low, comprising 0.3 % of all cases. The major risks are delayed sequels of the vessel wall laceration. In cases of VAI, immediate angiographic diagnostics and generous indications for endovascular treatment are obligatory.

  10. Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

    Directory of Open Access Journals (Sweden)

    Huber-Wagner S

    2009-12-01

    Full Text Available Abstract Background Hospitals have a critically important role in the management of mass causality incidents (MCI, yet there is little information to assist emergency planners. A significantly limiting factor of a hospital's capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations. Methods The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission. Results From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%, pelvic injuries (11.5%, thoracic injuries (5.0% and major amputations (3.1%. The mean cut to suture time was 130 min (IQR 65-165 min. Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00, ISS ≥ 35 (OR 2,94, hemoglobin level ≤ 8 mg/dL (OR 1,40, pulse rate on hospital admission 120/min (OR 1,39, blood pressure on hospital admission Conclusions The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI.

  11. The incidence and management of infusion reactions to infliximab: a large center experience.

    Science.gov (United States)

    Cheifetz, Adam; Smedley, Michelle; Martin, Sara; Reiter, Monica; Leone, Grace; Mayer, Lloyd; Plevy, Scott

    2003-06-01

    To assess the incidence and management of infusion reactions to infliximab, a chimeric monoclonal antibody that targets human tumor necrosis factor-alpha, in patients with Crohn's disease treated at a large infusion center. A total of 165 consecutive patients who received 479 infliximab infusions in the Division of Clinical Immunology Infusion Center at Mount Sinai Medical Center from July, 1998 to January, 2001 were evaluated. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. The overall incidence of infusion reactions to infliximab was 6.1% (29 of 479) of infusions, affecting 9.7% (16 of 165) of patients. Mild, moderate, or severe acute reactions occurred in 3.1% (15 of 479), 1.2% (six of 479), and 1.0% (five of 479) of infliximab infusions, respectively. Use of treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With the prophylaxis protocol, all patients who experienced an initial mild or moderate acute reaction were able to receive additional infusions. Four patients experienced a total of five severe acute reactions. Three patients were retreated: two patients had no further problems, whereas one patient had a second severe acute reaction that rapidly resolved with treatment. Suggesting that acute infusion reactions are not type I hypersensitivity reactions, in 11 patients who experienced 14 acute infusion reactions, serum tryptase levels were normal. Delayed infusion reactions occurred in 0.6% (three of 479) of infusions. Infliximab infusions were accompanied by acute reactions in approximately 5% of infusions. These reactions did not seem to be true IgE-mediated type I hypersensitivity events. Using appropriate treatment protocols, these reactions were effectively treated and prevented upon retreatment in nearly all patients. Delayed reactions were rare, occurring in <1% of infusions.

  12. Results of an online questionnaire to survey calf management practices on dairy cattle breeding farms in Austria and to estimate differences in disease incidences depending on farm structure and management practices.

    Science.gov (United States)

    Klein-Jöbstl, Daniela; Arnholdt, Tim; Sturmlechner, Franz; Iwersen, Michael; Drillich, Marc

    2015-08-19

    Calf disease may result in great economic losses. To implement prevention strategies it is important to gain information on management and to point out risk factors. The objective of this internet based survey was to describe calf management practices on registered dairy breeding farms in Austria and to estimate differences in calf disease incidences depending on farm structure and management practices. A total of 1287 questionnaires were finally analysed (response rate 12.2 %). Herd characteristics and regional distribution of farms indicated that this survey gives a good overview on calf management practices on registered dairy farms in Austria. The median number of cows per farm was 20 (interquartile range 13-30). Significant differences regarding farm characteristics and calf management between small and large farms (≤20 vs >20 cows) were present. Only 2.8 % of farmers tested first colostrum quality by use of a hydrometer. Storing frozen colostrum was more prevalent on large farms (80.8 vs 64.2 %). On 85.1 % of the farms, whole milk, including waste milk, was fed to the calves. Milk replacer and waste milk were more often used on large farms. In accordance with similar studies from other countries, calf diarrhoea was indicated as the most prevalent disease. Multivariable logistic regression analysis revealed that herd size was associated with calf diarrhoea and calf respiratory tract disease, with higher risk of disease on large farms. Furthermore, feeding waste milk to the calves was associated with increasing calf diarrhoea incidence on farm. In the final model with calf respiratory tract disease as outcome, respondents from organic farms reported less often a respiratory tract disease incidence of over 10 % compared with conventional farms [odds ratio (OR) 0.40, 95 % confidence interval (CI) 0.21-0.75] and farmers that housed calves individually or in groups after birth significantly reported more often to have an incidence of respiratory tract

  13. Prevalence, Incidence, Prognosis, Early Stroke Risk, and Stroke-Related Prognostic Factors of Definite or Probable Transient Ischemic Attacks in China, 2013

    Directory of Open Access Journals (Sweden)

    Bin Jiang

    2017-06-01

    Full Text Available The epidemiological characteristics of transient ischemic attacks (TIAs in China are unclear. In 2013, we conducted a nationally representative, door-to-door epidemiological survey on TIA in China using a complex, multistage, probability sampling design. Results showed that the weighted prevalence of TIA in China was 103.3 [95% confidence interval (CI: 83.9–127.2] per 100,000 in the population, 92.4 (75.0–113.8 per 100,000 among men, and 114.7 (87.2–151.0 per 100,000 among women. The weighted incidence of TIA was 23.9 (17.8–32.0 per 100,000 in the population, 21.3 (14.3–31.5 per 100,000 among men, and 26.6 (17.0–41.7 per 100,000 among women. No difference in average prognosis was found between TIA and stroke in the population. Weighted risk of stroke among TIA patients was 9.7% (6.5–14.3%, 11.1% (7.5–16.1%, and 12.3% (8.4–17.7% at 2, 30, and 90 days, respectively. The risk of stroke was higher among male patients with a history of TIA than among female patients with a history of TIA (OR: 2.469; 95% CI: 1.172–5.201; P = 0.018, and higher among TIA patients with hypertension than among TIA patients without hypertension (OR: 2.671; 1.547–4.613; P < 0.001. It can be concluded that there are an estimated 1.35 million TIA patients nationwide, with 0.31 million new cases of TIA annually in China. TIA patients were not better managed prior to a stroke event. Early risk of stroke among TIA patients is high. Sex and hypertension may be stroke-associated prognostic factors among TIA patients. TIA clinics and surveillance should be integrated into the national health-care system.

  14. The prevalence and significance of displacement for wilderness recreation management and research

    Science.gov (United States)

    Ingrid E. Schneider

    2007-01-01

    The concept of visitor displacement has important implications for wilderness management and research. Research on actual displacement of wilderness visitors is extremely limited, but this displacement likely follows patterns found for general recreationists: visitors employ a variety of coping responses and displacement is prevalent. Understanding if and when visitors...

  15. Evaluation of the radiotherapy management of ocular surface squamous neoplasia in a high HIV prevalence setting- a retrospective review.

    Science.gov (United States)

    Ndlovu, Ntokozo; Ndarukwa, Sandra; Kadzatsa, Webster; Rusakaniko, Simbarashe

    2016-01-01

    This article evaluates a single institute's radiotherapy management of OSSN, a previously regarded as rare malignancy, for possible future development of strategies to clearly define the role of adjuvant radiotherapy in improving treatment outcomes. A retrospective review of 153 patients treated from January 2003 to December 2009. There was no difference in OSSN prevalence by gender (male to female ratio 1.07). Of 80/153 patients tested 79 (98.8 %) were HIV positive. Most patients (62.9 %) had prior orbital exenteration. Moderately and poorly differentiated grade (82.3 %) was associated with significantly higher stage and incidence of positive regional lymph nodes. External beam therapy dose mostly used was 60Gy in 30 fractions at 200 cGy per fraction in 5 fractions per week (34.8 %). (90)Strontium therapy was given to 13.5 % (60Gy in 6 fractions at 10Gy per fraction weekly). Favourable response (complete and partial) was seen in about 80 % of patients associated with higher total doses. Regional lymph node positivity was associated with poorer outcome. Adjuvant radiotherapy could have an important role in the management of patients presenting with locally advanced OSSN who are mostly HIV positive in developing countries. Prospective studies to evaluate the role of radiotherapy with or without chemotherapy in the management of OSSN in these settings are warranted.

  16. Prevalence, incidence and determinants of herpes simplex virus type 2 infection among HIV-seronegative women at high-risk of HIV infection: a prospective study in Beira, Mozambique

    NARCIS (Netherlands)

    Meque, Ivete; Dubé, Karine; Feldblum, Paul J.; Clements, Archie C. A.; Zango, Arlinda; Cumbe, Fidelina; Chen, Pai Lien; Ferro, Josefo J.; van de Wijgert, Janneke H.

    2014-01-01

    To estimate the prevalence, incidence and determinants of herpes simplex type 2 (HSV-2) infection, and associations between HSV-2 and incident HIV infection, among women at higher risk for HIV infection in Beira, Mozambique. Between 2009 and 2012, 411 women aged 18-35 years at higher risk of HIV

  17. End-stage renal disease in India and Pakistan: incidence, causes, and management.

    Science.gov (United States)

    Sakhuja, Vinay; Kohli, Harbir S

    2006-01-01

    Chronic renal failure is a devastating medical, social, and economic problem for patients and their families in India and Pakistan. Reliable data on the true incidence and prevalence of end-stage renal disease (ESRD) in India and Pakistan are lacking because no national registries exist. Among reported cases, chronic glomerulonephritis is the most common cause, accounting for more than one third of patients, while diabetic nephropathy accounts for approximately 20% of all patients in India. Delayed diagnosis and failure to institute measures to slow the progression of renal failure have resulted in a predominantly young ESRD population, with a median age of 44 years. Because of financial constraints, less than one third of all patients referred to a tertiary care center receive any kind of renal replacement therapy. Most hemodialysis patients who stop treatment and die do so because of cost constraints within the first three months, and approximately 5% of patients are started on ambulatory peritoneal dialysis. Renal transplantation is the cheapest option, but < 10% of all patients with ESRD have a transplant. Cyclosporine, azathioprine, and prednisolone continue to be the backbone of post-transplant immunosuppression, but cyclosporine is stopped in a significant proportion of patients at one year post-transplant to cut down costs. Living related donor transplants constitute 70% of all transplants; two thirds of the donors are females, while more than three fourths of all recipients are males. Spouses account for 20% of donors from within families. Almost 30% of transplanted kidneys are donated by living unrelated donors, while cadaver donors account for only 2%. More resources must be mobilized to care for these patients; early detection of renal disease must be facilitated, and measures to delay ESRD must be implemented.

  18. Incidence and management of Kaposi sarcoma in renal transplant recipients: the Greek experience.

    Science.gov (United States)

    Zavos, G; Moris, D; Vernadakis, S; Bokos, J; Lionaki, S; Mamarelis, G; Panagiotellis, K; Zavvos, V; Boletis, I

    2014-11-01

    One of the most common malignancies in kidney transplant recipients is Kaposi sarcoma. The incidence of Kaposi sarcoma, which develops after renal transplantation, is 400-500 times higher than that in the general population. The aims of this study were to review the experience with Kaposi sarcoma in the highest-volume transplantation Unit in Greece and to analyze clinical characteristics and response to treatment, with respect to both the patients' survival and the renal graft function. The records of 2008 renal graft recipients between March 1983 and December 2012 were retrospectively reviewed. Kaposi sarcoma was diagnosed based on clinical, laboratory, radiological, endoscopic, and histopathologic examinations. The disease was staged according to the classification of Al-Khader et al. The prevalence of Kaposi sarcoma was 1.2% in our renal transplant population. Of these, 1006 recipients underwent living-donor renal transplantation, whereas 1002 received their graft from deceased donors. Post-transplantation malignancy developed in 153 patients, among which, Kaposi sarcoma has been found in 24 cases. Of the 24 cases of Kaposi sarcoma, lesions were mainly cutaneous in 14 cases, visceral and cutaneous in 8, and concomitant visceral and lymph node involvement was observed in 2 patients. With regard to the final outcome, 20 patients (83.3%) showed remission of the disease, whereas 4 patients with visceral involvement (16.6%) did not respond to chemotherapy and discontinuation of immunosuppression and died. Moreover, 8 deaths occurred due to apparently unrelated causes. Kaposi sarcoma is an important part (15.7%) of all post-transplantation neoplasias in our series. Furthermore, our findings confirmed the previously described close association between human herpesvirus-8 and post-transplantation Kaposi sarcoma. Reduction of immunosuppression or discontinuation of calcineurin inhibitors results in remission of the disease in most of the cases. Prognosis in patients with

  19. Incidence rate and prevalence of major risk factors for ectopic pregnancy in the Pakistani population: mini-review

    Directory of Open Access Journals (Sweden)

    Sabira Sultana

    2015-05-01

    Full Text Available Ectopic pregnancy is the complication of pregnancy in which the product of conception implants outside the uterine cavity i.e. in the uterine tubes, cervix, ovaries and abdomen. It is lifethreatening emergency and a major cause of maternal morbidity and mortality. The incidence rate is 0.5%-1.5% of all pregnancies. Even though its incidence rate is drop off when compared with earlier decades, it is still the foremost causes of maternal morbidity and mortality in the first trimester of pregnancy, especially in developing countries. In Pakistan, it varies from 1:1 124 to 1:130 pregnancies. Risk factors associated to ectopic pregnancy are pelvic inflammatory disease, past history of miscarriages, age, parity, infertility, previous ectopic pregnancy, induction of ovulation and intrauterine device usage. The aim of this study is to review the published literature concerning the disease knowledge and major risk factors associated to ectopic pregnancy in Pakistan.

  20. Prevalence and incidence of toxoplasmosis: a retrospective analysis of mother-child examinations, Styria, Austria, 1995 to 2012.

    Science.gov (United States)

    Berghold, Christian; Herzog, Sereina Annik; Jakse, Heidelinde; Berghold, Andrea

    2016-08-18

    In Austria, mandatory screening for the prevention of congenital toxoplasmosis stipulates a serological test for antibodies against Toxoplasma gondii as early as possible in pregnancy. In the case of a seronegative result, subsequent tests at intervals of 8 weeks are requested. We analysed serological data from Styria, an Austrian federal state, to determine the seroprevalence and incidence of Toxoplasma infections. The study included 353,599 tests from 103,316 women during 158,571 pregnancies from 1995 to 2012. The age-adjusted seroprevalence decreased from 43.3% in 1995 to 31.5% in 2012, with a yearly decline of 0.84% (95% confidence interval (CI): 0. 79 -0.88). The intergravid incidence showed an annual decrease of 4.2%. The average yearly incidence of intragravid and intergravid seroconversions was 0.52% (95% CI 0.45-0.61) and 0.72% (95% CI 0.67-0.77), respectively. If the difference between these rates (p < 0.001) can be explained by the effect of primary prevention such as avoiding raw meat and taking hygiene precautions when encountering cats or preparing vegetables, only ca two of seven (28%) infections were avoided by hygiene measures taken by pregnant women. Primary prevention may therefore have its limits. This article is copyright of The Authors, 2016.

  1. Explanation and Elaboration of the Standards of Reporting of Neurological Disorders Checklist: A Guideline for the Reporting of Incidence and Prevalence Studies in Neuroepidemiology.

    Science.gov (United States)

    Bennett, Derrick A; Brayne, Carol; Feigin, Valery L; Barker-Collo, Suzanne; Brainin, Michael; Davis, Daniel; Gallo, Valentina; Jetté, Nathalie; Karch, André; Kurtzke, John F; Lavados, Pablo M; Logroscino, Giancarlo; Nagel, Gabriele; Preux, Pierre-Marie; Rothwell, Peter M; Svenson, Lawrence W

    2015-01-01

    Incidence and prevalence studies of neurological disorders play an extremely important role in hypothesis-generation, assessing the burden of disease and planning of health services. However, the assessment of disease estimates is hindered by the poor quality of reporting for such studies. We developed the Standards of Reporting of Neurological Disorders (STROND) guideline in order to improve the quality of reporting of neurological disorders from which prevalence, incidence, and outcomes can be extracted for greater generalisability. The guideline was developed using a 3-round Delphi technique in order to identify the 'basic minimum items' important for reporting, as well as some additional 'ideal reporting items.' An e-consultation process was then used in order to gauge opinion by external neuroepidemiological experts on the appropriateness of the items included in the checklist. The resultant 15 items checklist and accompanying recommendations were developed using a similar process and structured in a similar manner to the Strengthening of the Reporting of Observational Studies in Epidemiology checklist for ease of use. This paper presents the STROND checklist with an explanation and elaboration for each item, as well as examples of good reporting from the neuroepidemiological literature. The introduction and use of the STROND checklist should lead to more consistent, transparent and contextualised reporting of descriptive neuroepidemiological studies that should facilitate international comparisons, and lead to more accessible information for multiple stakeholders, ultimately supporting better healthcare decisions for neurological disorders.

  2. Factors Associated to Prevalence and Incidence of Carbapenem-Resistant Enterobacteriaceae Fecal Carriage: A Cohort Study in a Mexican Tertiary Care Hospital.

    Directory of Open Access Journals (Sweden)

    Pedro Torres-Gonzalez

    Full Text Available Carbapenem-resistant Enterobacteriaceae (CRE infections have emerged as a serious threat to health worldwide. They are associated with increased morbidity and mortality and are capable of silently colonizing the gastrointestinal tract. Because of this, there is great interest to characterize the epidemiology of CRE carriage and acquisition in healthcare facilities. The aim of this study was to determine the prevalence and factors associated with CRE fecal carriage (CRE-fc, and risk factors for incident cases.A cohort study was conducted at a tertiary care hospital from January 1st to April 30th, 2014 during a CRE outbreak. Weekly rectal swabs were performed in patients considered at risk until discharge. CRE-fc prevalence was 10.9% (CI 95% 7.7-14.7 among 330 patients. Treatment with carbapenems (OR 2.54, CI 95% 1.15-5.62; transfer from an institution (OR 2.16, CI 95% 1.02-4.59; multi-drug resistant infection within the previous six months (OR 2.81, CI 95% 1.47-5.36; intensive care unit admission (OR 0.42, CI 95% 0.20-0.88; hematologic malignancy (OR 4.02, CI 95% 1.88-8.06; invasive procedures (OR 2.18, CI 95% 1.10-4.32; and sharing a room with a known CRE carrier (OR 3.0, CI 95% 1.43-6.31 were independently associated factors for CRE-fc. Risk factors associated with CRE-fc incidence were determined for 87 patients initially negative and with subsequent screening; the incidence rate was 2.5 cases, per 1000 person-years (CI 95% 1.5-3.9. Independently associated risk factors were carbapenem treatment (HR 2.68, CI 95% 1.03-6.98, hematologic malignancy (HR 5.74, 95% CI 2.46-13.4 and a mean daily colonization pressure ≥10% (HR 5.03, IC 95% 1.77-14.28. OXA-48-like (OXA-232 and CTX-M-15 were the predominantly identified mechanisms of resistance.We found an elevated incidence and prevalence of CRE-fc in our hospital. Hematologic patients need to be considered a population at risk, and antibiotic stewardship along with infection control programs need to

  3. Subclavian Vein Stenosis/Occlusion Following Transvenous Cardiac Pacemaker and Defibrillator Implantation: Incidence, Pathophysiology and Current Management

    Directory of Open Access Journals (Sweden)

    Brian O'Leary

    2015-08-01

    Full Text Available Subclavian vein stenosis is a common, but usually asymptomatic, complication following cardiac device placement. In addition to reviewing the literature on incidence, pathogenesis and management options for this important clinical problem, we describe two cases of symptomatic subclavian vein occlusion following pacemaker/defibrillator placement and successful treatment with venoplasty and stenting.

  4. Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children

    NARCIS (Netherlands)

    Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C

    BACKGROUND: Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. METHODS: In this prospective observational cohort study, the incidence of artifacts in

  5. Principles of Emergency Department facility design for optimal management of mass-casualty incidents.

    Science.gov (United States)

    Halpern, Pinchas; Goldberg, Scott A; Keng, Jimmy G; Koenig, Kristi L

    2012-04-01

    The Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational aspects of MCI management have been well described, the architectural/structural principles have not. Further, there are limited reports of the testing of ED design components in actual MCI events. The objective of this study is to outline the important infrastructural design components for optimization of ED response to an MCI, as developed, implemented, and repeatedly tested in one urban medical center. In the authors' experience, the most important aspects of ED design for MCI have included external infrastructure and promoting rapid lockdown of the facility for security purposes; an ambulance bay permitting efficient vehicle flow and casualty discharge; strategic placement of the triage location; patient tracking techniques; planning adequate surge capacity for both patients and staff; sufficient command, control, communications, computers, and information; well-positioned and functional decontamination facilities; adequate, well-located and easily distributed medical supplies; and appropriately built and functioning essential services. Designing the ED to cope well with a large casualty surge during a disaster is not easy, and it may not be feasible for all EDs to implement all the necessary components. However, many of the components of an appropriate infrastructural design add minimal cost to the normal expenditures of building an ED. This study highlights the role of design and infrastructure in MCI preparedness in order to assist planners in improving their ED capabilities. Structural optimization calls for a paradigm shift in the concept of structural and operational ED design, but may be necessary in order to maximize surge capacity, department resilience, and patient and

  6. Delayed Chemotherapy-Induced Nausea and Vomiting: Pathogenesis, Incidence, and Current Management.

    Science.gov (United States)

    Rapoport, Bernardo L

    2017-01-01

    Even when chemotherapy-induced nausea and vomiting (CINV) can be effectively controlled in the acute phase, it may still occur in the delayed phase. Identifying at-risk patients is complex and requires consideration of clinical, personal, demographic, and behavioral factors. Delayed CINV has a significant detrimental effect on patients' daily life and is responsible for significant healthcare resource utilization. Patients who do not experience acute CINV are not necessarily exempt from delayed CINV, and healthcare professionals have been shown to underestimate the incidence of delayed CINV. Failure to protect against CINV during the first cycle of chemotherapy is the most significant independent risk factor for delayed CINV during subsequent cycles. Addition of a neurokinin-1 receptor antagonist to antiemetic prophylactic regimens involving a 5-hydroxytryptamine type 3 receptor antagonist and a corticosteroid helps to ameliorate delayed CINV, particularly vomiting. Netupitant and rolapitant are second-generation neurokinin-1 receptor antagonists that provide effective prophylaxis against delayed chemotherapy-induced vomiting and also have an antinausea benefit. All of the neurokinin-1 receptor antagonists with the exception of rolapitant inhibit or induce cytochrome P450 3A4 (CYP3A4), and a reduced dose of dexamethasone (a CYP3A4 substrate) should be administered with aprepitant or netupitant; by contrast, this is not necessary with rolapitant. Here we review specific challenges associated with delayed CINV, its pathophysiology, epidemiology, treatment, and outcomes relative to acute CINV, and its management within the larger context of overall CINV.

  7. Acute ureterolithiasis: Incidence of secondary signs on unenhanced helical CT and influence on patient management

    Energy Technology Data Exchange (ETDEWEB)

    Ege, G. E-mail: gurkanege@yahoo.com; Akman, H.; Kuzucu, K.; Yildiz, S

    2003-12-01

    AIM: The purpose of this study was to determine the incidence of secondary signs associated with ureteral stones on unenhanced helical computed tomography (CT) of patients with acute renal colic, and to correlate these with patient management and outcome. MATERIALS AND METHODS: One hundred and ten patients with ureterolithiasis were evaluated prospectively for the secondary signs of obstruction on unenhanced helical CT. Our attention was focused primarily on the presence or absence of seven secondary signs on unenhanced helical CT, including hydronephrosis, unilateral renal enlargement, perinephric oedema, unilateral absence of the white pyramid, hydroureter, periureteral oedema and lateroconal fascial thickening. RESULTS: Of the 110 patients, 91 (82.7%) had hydroureter, 88 (80%) had hydronephrosis, 65 (59%) had periureteric oedema and 63 (57.2%) had unilateral renal enlargement. Ninety stones passed spontaneously and 21 required intervention. CONCLUSION: Secondary signs of urinary tract obstruction are useful and supportive findings in interpretation of the CT examination. In our experience, the most reliable signs indicating ureteral obstruction are hydroureter, hydronephrosis, periureteral oedema and unilateral renal enlargement, respectively. In addition, stones larger than 6 mm, located within the proximal two thirds of the ureter, and seen associated with five or more the secondary signs of obstruction, are more likely to require endoscopic removal and/or lithotripsy.

  8. Incidence, risk factors and management of severe post-transsphenoidal epistaxis.

    Science.gov (United States)

    De Los Reyes, Kenneth M; Gross, Bradley A; Frerichs, Kai U; Dunn, Ian F; Lin, Ning; Rincon-Torroella, Jordina; Annino, Donald J; Laws, Edward R

    2015-01-01

    Among the major complications of transsphenoidal surgery, less attention has been given to severe postoperative epistaxis, which can lead to devastating consequences. In this study, we reviewed 551 consecutive patients treated over a 4 year period by the senior author to evaluate the incidence, risk factors, etiology and management of immediate and delayed post-transsphenoidal epistaxis. Eighteen patients (3.3%) developed significant postoperative epistaxis - six immediately and 12 delayed (mean postoperative day 10.8). Fourteen patients harbored macroadenomas (78%) and 11 of 18 (61.1%) had complex nasal/sphenoid anatomy. In the immediate epistaxis group, 33% had acute postoperative hypertension. In the delayed group, one had an anterior ethmoidal pseudoaneurysm, and one had restarted anticoagulation on postoperative day 3. We treated the immediate epistaxis group with bedside nasal packing followed by operative re-exploration if conservative measures were unsuccessful. The delayed group underwent bedside nasal hemostasis; if unsuccessful, angiographic embolization was performed. After definitive treatment, no patients had recurrent epistaxis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Urinary incontinence 4 and 12 years after first delivery: risk factors associated with prevalence, incidence, remission, and persistence in a cohort of 236 women.

    Science.gov (United States)

    Pizzoferrato, Anne-Cécile; Fauconnier, Arnaud; Quiboeuf, Emeline; Morel, Karine; Schaal, Jean-Patrick; Fritel, Xavier

    2014-11-01

    Our aim was to study risk factors associated with prevalence, incidence, and remission of UI 4 and 12 years after first delivery. Seven hundred seventy-four nulliparous women who gave birth in 1996 in two French maternity units at term received a questionnaire about their urinary symptoms in 2000 and again in 2008. Two hundred thirty-six women returned a questionnaire about UI 4 and 12 years after first delivery. Four groups of women were built: (A) women continent 4 and 12 years after first delivery; (B) women continent at 4 and incontinent at 12 years; (C) women incontinent at 4 and continent at 12 years; and (D) women incontinent at 4 and 12 years. Multivariate logistic regressions were used to determine risk factors of UI prevalence (groups B + D vs. A + C), incidence (B vs. A), remission (C vs. D), and onset of UI (D vs. Factors associated with UI 12 years after first pregnancy were: BMI (OR = 1.17 [95%CI: 1.04-1.32], by 1 kg/m(2) ) and increasing BMI (1.43 [1.19-1.73]), first child's weight (1.08 [1.001-1.16], by 100 g) and UI during first pregnancy (3.77 [1.83-7.76]). Factors associated with UI incidence were age at first delivery (0.86 [0.75-0.98]) and high BMI (1.24 [1.05-1.45]). Increasing BMI, UI during first pregnancy, and heavy first child reduce the likelihood of UI remission (0.37 [0.20-0.68], 0.11 [0.02-0.63], and 0.73[0.59-0.91], respectively). UI during first pregnancy could be indicative of individual susceptibility to UI. Obesity appears to be a modifiable factor for remission of UI in women. © 2013 Wiley Periodicals, Inc.

  10. Seasonality and shift in age-specific malaria prevalence and incidence in Binko and Carrière villages close to the lake in Selingué, Mali.

    Science.gov (United States)

    Touré, Mahamoudou; Sanogo, Daouda; Dembele, Soumaila; Diawara, Sory Ibrahima; Oppfeldt, Karen; Schiøler, Karin L; Haidara, Dade Ben; Traoré, Sékou F; Alifrangis, Michael; Konradsen, Flemming; Doumbia, Seydou

    2016-04-18

    Malaria transmission in Mali is seasonal and peaks at the end of the rainy season in October. This study assessed the seasonal variations in the epidemiology of malaria among children under 10 years of age living in two villages in Selingué: Carrière, located along the Sankarani River but distant from the hydroelectric dam, and Binko, near irrigated rice fields, close to the dam. The aim of this study was to provide baseline data, seasonal pattern and age distribution of malaria incidence in two sites situated close to a lake in Selingué. Geographically, Selingué area is located in the basin of Sakanrani and belongs to the district of Yanfolila in the third administrative region of Mali, Sikasso. Two cross-sectional surveys were conducted in October 2010 (end of transmission season) and in July 2011 (beginning of transmission season) to determine the point prevalence of asymptomatic parasitaemia, and anaemia among the children. Cumulative incidence of malaria per month was determined in a cohort of 549 children through active and passive case detection from November 2010 through October 2011. The number of clinical episodes per year was determined among the children in the cohort. Logistic regression was used to determine risk factors for malaria. The prevalence of malaria parasitaemia varied significantly between villages with a strong seasonality in Carrière (52.0-18.9 % in October 2010 and July 2011, respectively) compared with Binko (29.8-23.8 % in October 2010 and July 2011, respectively). Children 6-9 years old were at least twice more likely to carry parasites than children up to 5 years old. For malaria incidence, 64.8-71.9 % of all children experienced at least one episode of clinical malaria in Binko and Carrière, respectively. The peak incidence was observed between August and October (end of the rainy season), but the incidence remained high until December. Surprisingly, the risk of clinical malaria was two- to nine-fold higher among

  11. Serum uric acid does not predict incident metabolic syndrome in a population with high prevalence of obesity.

    Science.gov (United States)

    Ferrara, L A; Wang, H; Umans, J G; Franceschini, N; Jolly, S; Lee, E T; Yeh, J; Devereux, R B; Howard, B V; de Simone, G

    2014-12-01

    To evaluate whether uric acid (UA) predicts 4-yr incidence of metabolic syndrome (MetS) in non-diabetic participants of the Strong Heart Study (SHS) cohort. In this population-based prospective study we analyzed 1499 American Indians (890 women), without diabetes or MetS, controlled during the 4th SHS exam and re-examined 4 years later during the 5th SHS exam. Participants were divided into sex-specific tertiles of UA and the first two tertiles (group N) were compared with the third tertile (group H). Body mass index (BMI = 28.3 ± 7 vs. 31.1 ± 7 kg/m(2)), fat-free mass (FFM = 52.0 ± 14 vs. 54.9 ± 11 kg), waist-to-hip ratio, HOMA-IR (3.66 vs. 4.26), BP and indices of inflammation were significantly higher in group H than in group N (all p < 0.001). Incident MetS at the time of the 5th exam was more frequent in group H than group N (35 vs. 28%, OR 1.44 (95% CI = 1.10-1.91; p < 0.01). This association was still significant (OR = 1.13, p = 0.04) independently of family relatedness, sex, history of hypertension, HOMA-IR, central adiposity and renal function, but disappeared when fat-free mass was included in the model. In the SHS, UA levels are associated to parameters of insulin resistance and to indices of inflammation. UA levels, however, do not predict incident MetS independently of the initial obesity-related increased FFM. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Prevalence of syphilis and HIV infection during pregnancy in incarcerated women and the incidence of congenital syphilis in births in prison in Brazil.

    Science.gov (United States)

    Domingues, Rosa Maria Soares Madeira; Leal, Maria do Carmo; Pereira, Ana Paula Esteves; Ayres, Barbara; Sánchez, Alexandra Roma; Larouzé, Bernard

    2017-11-21

    This study aimed to estimate the prevalence of syphilis and HIV infection during pregnancy, the mother to child transmission of syphilis and the incidence of congenital syphilis in incarcerated women in Brazil; to compare these rates to those observed in pregnant women outside of jail; and to verify the maternal factors associated with syphilis infection during pregnancy in free and incarcerated women. We used data from two nationwide studies conducted during the period 2011-2014. The Birth in Brazil study included 23,894 free women cared for in 266 hospitals. The Maternal and Infant Health in Prisons study included 495 incarcerated pregnant women or mothers living with their children, according to a census conducted in 33 female prisons. The same case definitions and data collection methods were used in both studies. The chi-square test was used to compare the characteristics of incarcerated and free women with a significance of 0.05. For incarcerated women, the estimated prevalence of syphilis during pregnancy was 8.7% (95%CI: 5.7-13.1) and for HIV infection 3.3% (95%CI: 1.7-6.6); the estimated mother to child transmission of syphilis was 66.7% (95%CI: 44.7-83.2) and the incidence of congenital syphilis was 58.1 per 1,000 living newborns (95%CI: 40.4-82.8). Incarcerated women had a greater prevalence of syphilis and HIV infection during pregnancy, lower quality of antenatal care and higher levels of social vulnerability. Syphilis infection showed to be an indicator of social vulnerability in free women, but not in incarcerated women. Health initiatives in prison are necessary to reduce healthcare inequalities and should include adequate antenatal and birth care.

  13. Prevalence and management of familial hypercholesterolemia in patients with coronary artery disease: The heredity survey.

    Science.gov (United States)

    Faggiano, Pompilio; Pirillo, Angela; Griffo, Raffaele; Ambrosetti, Marco; Pedretti, Roberto; Scorcu, Giampaolo; Werren, Marika; Febo, Oreste; Malfatto, Gabriella; Favretto, Giuseppe; Sarullo, Filippo; Antonini-Canterin, Francesco; Zobbi, Gianni; Temporelli, Pierluigi; Catapano, Alberico L

    2018-02-01

    Familial hypercholesterolemia (FH) is a genetic disorder characterized by high levels of low density lipoprotein cholesterol (LDL-C) predisposing to premature cardiovascular disease. Its prevalence varies and has been estimated around 1 in 200-500. The Heredity survey evaluated the prevalence of potential FH and the therapeutic approaches among patients with established coronary artery disease (CAD) or peripheral artery disease (PAD) in which it is less well documented. Data were collected in patients admitted to programs of rehabilitation and secondary prevention in Italy. Potential FH was estimated using Dutch Lipid Clinic Network (DLCN) criteria. Potential FH was defined as having a total score≥6. Among the 1438 consecutive patients evaluated, the prevalence of potential FH was 3.7%. The prevalence was inversely related to age, with a putative prevalence of 1:10 in those with Definite FH (DLCN score>8) had the highest percentages of patients after an ACS (75% vs 52.5% in the whole study population). At discharge, most patients were on high intensity statin therapy, but despite this, potential FH group still had a higher percentage of patients with LDL-C levels not at target and having a distance from the target higher than 50%. Among patients with established coronary heart disease, the prevalence of potential FH is higher than in the general population; the results suggest that a correct identification of potential FH, especially in younger patients, may help to better manage their high cardiovascular risk. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  14. Contemporary, age-based trends in the incidence and management of patients with early-stage kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Filson, Christopher P; Litwin, Mark S

    2015-01-01

    Although kidney cancer incidence and nephrectomy rates have risen in tandem, clinical advances have generated new uncertainty regarding the optimal management of patients with small renal tumors, especially the elderly. To clarify existing practice patterns, we assessed contemporary trends in the incidence and management of patients with early-stage kidney cancer. Using Surveillance, Epidemiology, and End Results data, we identified adult patients diagnosed with T1aN0M0 kidney cancer from 2000 to 2010. We determined age-adjusted and age-specific incidence and management rates (i.e., nonoperative, ablation, partial nephrectomy [PN], and radical nephrectomy) per 100,000 adults and determined the average annual percent change (AAPC). Finally, we compared management groups using multinomial logistic regression accounting for patient characteristics, cancer information, and county-level measures for health. From 2000 to 2010, we identified 41,645 adults diagnosed with T1aN0M0 kidney cancer. Overall incidence increased from 3.7 to 7.0 per 100,000 adults (AAPC = 7.0%, Pmanagement and ablation approached nephrectomy rates for those aged 75 to 84 years and became the predominant strategy for patients older than 84 years. Adjusting for clinical, oncological, and environmental factors, older patients less frequently underwent PN and more often received ablative or nonoperative management (P<0.001). As the incidence of early-stage kidney cancer rises, patients are increasingly treated with nonoperative and nephron-sparing strategies, especially among the most elderly. The broader array of treatment options suggests opportunities to better personalize kidney cancer care for seniors. Published by Elsevier Inc.

  15. The incidence and management of postoperative chylothorax after pulmonary resection and thoracic mediastinal lymph node dissection.

    Science.gov (United States)

    Bryant, Ayesha S; Minnich, Douglas J; Wei, Benjamin; Cerfolio, Robert James

    2014-07-01

    Our objective was to determine the incidence and optimal management of chylothorax after pulmonary resection with complete thoracic mediastinal lymph node dissection (MLND). This is a retrospective review of patients who underwent pulmonary resection with MLND. Between January 2000 and December 2012, 2,838 patients underwent pulmonary resection with MLND by one surgeon (RJC). Forty-one (1.4%) of these patients experienced a chylothorax. Univariate analysis showed that lobectomy (p<0.001), a robotic approach (p=0.03), right-sided operations (p<0.001), and pathologic N2 disease (p=0.007) were significantly associated with the development of chylothorax. Multivariate analysis showed that lobectomy (p=0.011), a robotic approach (p=0.032), and pathologic N2 disease (p=0.027) remained predictors. All patients were initially treated with cessation of oral intake and 200 μg subcutaneous somatostatin every 8 hours. If after 48 hours the chest tube output was less than 450 mL/day and the effluent was clear, patients was given a medium-chain triglyceride (MCT) diet and were observed for 48 hours in the hospital. If the chest tube output remained below 450 mL/day, the chest tube was removed, they were discharged home with directions to continue the MCT diet and to return in 2 weeks. Patients were instructed to consume a high-fat meal 24 hours before their clinic appointment. If the patient's chest roentgenogram was clear at that time, they were considered "treated." This approach was successful in 37 (90%) patients. The 4 patients in whom the initial treatment was unsuccessful underwent reoperation with pleurodesis and duct ligation. Chylothorax after pulmonary resection and MLND occurred in 1.4% of patients. Its incidence was higher in those with pathologic N2 disease and those who underwent robotic resection. Nonoperative therapy is almost always effective. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children.

    Science.gov (United States)

    Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C

    2018-02-01

    Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. In this prospective observational cohort study, the incidence of artifacts in anesthesia information management system data was investigated in children undergoing anesthesia for noncardiac procedures. Secondary outcomes included the incidence of artifacts among deviating and nondeviating values, among the anesthesia phases, and among different anesthetic techniques. We included 136 anesthetics representing 10,236 min of anesthesia time. The incidence of artifacts was 0.5% for heart rate (95% CI: 0.4 to 0.7%), 1.3% for oxygen saturation (1.1 to 1.5%), 7.5% for end-tidal carbon dioxide (6.9 to 8.0%), 5.0% for noninvasive blood pressure (4.0 to 6.0%), and 7.3% for invasive blood pressure (5.9 to 8.8%). The incidence of artifacts among deviating values was 3.1% for heart rate (2.1 to 4.4%), 10.8% for oxygen saturation (7.6 to 14.8%), 14.1% for end-tidal carbon dioxide (13.0 to 15.2%), 14.4% for noninvasive blood pressure (10.3 to 19.4%), and 38.4% for invasive blood pressure (30.3 to 47.1%). Not all values in anesthesia information management systems are valid. The incidence of artifacts stored in the present pediatric anesthesia practice was low for heart rate and oxygen saturation, whereas noninvasive and invasive blood pressure and end-tidal carbon dioxide had higher artifact incidences. Deviating values are more often artifacts than values in a normal range, and artifacts are associated with the phase of anesthesia and anesthetic technique. Development of (automatic) data validation systems or solutions to deal with artifacts in data is warranted.

  17. Analysis of eighty-four commercial aviation incidents - Implications for a resource management approach to crew training

    Science.gov (United States)

    Murphy, M. R.

    1980-01-01

    A resource management approach to aircrew performance is defined and utilized in structuring an analysis of 84 exemplary incidents from the NASA Aviation Safety Reporting System. The distribution of enabling and associated (evolutionary) and recovery factors between and within five analytic categories suggests that resource management training be concentrated on: (1) interpersonal communications, with air traffic control information of major concern; (2) task management, mainly setting priorities and appropriately allocating tasks under varying workload levels; and (3) planning, coordination, and decisionmaking concerned with preventing and recovering from potentially unsafe situations in certain aircraft maneuvers.

  18. Prevalence of Chagas disease in pregnant women and incidence of congenital transmission in Santa Cruz de la Sierra, Bolivia.

    Science.gov (United States)

    Salas Clavijo, N A; Postigo, J R; Schneider, D; Santalla, J A; Brutus, L; Chippaux, J-P

    2012-10-01

    Congenital transmission of Chagas disease stand out as a major public health problem since the vector control was performed in all endemic areas and has shown its effectiveness. An epidemiological study was performed in three maternity hospitals of the city of Santa Cruz de la Sierra, Bolivia from 2006 to 2008. The serological screening for Trypanosoma cruzi infection was carried out in 15,767 pregnant women. Chagas infection was detected in 3725 women (23.6%), who gave birth to 125 newborns infected by T. cruzi at birth, representing an incidence of 790 per 100,000 births during a period of 16 months and a vertical transmission rate by 3.4%. There was a significant difference between hospitals that might be explained by socio-economic origins of mothers and diagnostic constraints. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. What do we know about neurogenic bladder prevalence and management in developing countries and emerging regions of the world?

    Science.gov (United States)

    Przydacz, Mikolaj; Denys, Pierre; Corcos, Jacques

    2017-09-01

    To summarize information on Neurogenic Bladder (NB) epidemiology, management and access to patient treatment in developing countries and emerging regions of the world in order to propose future interventions and help governmental as well as non-governmental organizations design their action plans. Different search methods were used to gather the maximum available data. They included strategic searches; reference checks; grey literature searches (reports, working papers, government documents, civil society information); contacting professional societies, registries, and authors; requesting unpublished data from organizations; and browsing related websites and journals. The incidence and prevalence rates of NB in developing countries are difficult to establish because epidemiological reports are few and far between. The frequency of bladder dysfunction in neurologically impaired populations can be approximately estimated in some of these countries. Similar information paucity affects diagnostic and therapeutic approaches to NB patients living in less-developed regions of the world. The assessment and management of NB seems to vary markedly between countries, and care of patients from emerging regions of the world is often inadequate. Strong concerted efforts are needed on the part of international scientific societies, non-governmental organizations and local governments to work together to change the prognosis for these patients and to improve their quality of life. Copyright © 2017. Published by Elsevier Masson SAS.

  20. Incidental durotomy in lumbar spine surgery - incidence, risk factors and management

    Directory of Open Access Journals (Sweden)

    Adam D.

    2015-03-01

    Full Text Available Incidental durotomy is a common complication of lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra and postoperative management, there is no consensus. Our objective was to report our experience with incidental durotomy in patients who were operated on for lumbar disc herniation, lumbar spinal stenosis and revision surgeries. Between 2009 and 2012, 1259 patients were operated on for degenerative lumbar disorders. For primary operations, the surgical approach was mino-open, interlamar, uni- or bilateral, as for recurrences, the removal of the compressive element was intended: the epidural scar and the disc fragment. 863 patients (67,7% were operated on for lumbar disc herniation, 344 patients (27,3% were operated on for lumbar spinal stenosis and 52 patients (5% were operated for recurrences. The operations were performed by neurosurgeons with the same professional degree but with different operative volume. Unintentional durotomy occurred in 20 (2,3% of the patients with herniated disc, in 14 (4,07% of the patients with lumbar spinal stenosis and in 12 (23% of the patients who were operated on for recurrences. The most frequent risk factors were: obesity, revised surgery and the physician’s low operative volume. Intraoperative dural fissures were repaired through suture (8 cases, by applying muscle, fat graft or by applying curaspon, tachosil. There existed 4 CSF fistulas which were repaired at reoperation. Incidental dural fissures during operations for degenerative lumbar disorders must be recognized and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased medical costs. Preventing, identifying and treating unintentional durotomies can be best achieved by respecting a neat surgical technique and a standardized treatment protocol.

  1. Surgical site infections following transcatheter apical aortic valve implantation: incidence and management.

    Science.gov (United States)

    Baillot, Richard; Fréchette, Éric; Cloutier, Daniel; Rodès-Cabau, Josep; Doyle, Daniel; Charbonneau, Éric; Mohammadi, Siamak; Dumont, Éric

    2012-11-13

    The present study was undertaken to examine the incidence and management of surgical site infection (SSI) in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI). From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES) at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ) as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Five (3.2%) patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI) and were considered as organ/space SS