High laboratory cost predicted per tuberculosis case diagnosed with increased case finding without a triage strategy.

Science.gov (United States)

Dunbar, R; Naidoo, P; Beyers, N; Langley, I

2017-09-01

Cape Town, South Africa. To model the effects of increased case finding and triage strategies on laboratory costs per tuberculosis (TB) case diagnosed. We used a validated operational model and published laboratory cost data. We modelled the effect of varying the proportion with TB among presumptive cases and Xpert cartridge price reductions on cost per TB case and per additional TB case diagnosed in the Xpert-based vs. smear/culture-based algorithms. In our current scenario (18.3% with TB among presumptive cases), the proportion of cases diagnosed increased by 8.7% (16.7% vs. 15.0%), and the cost per case diagnosed increased by 142% (US$121 vs. US$50). The cost per additional case diagnosed was US$986. This would increase to US$1619 if the proportion with TB among presumptive cases was 10.6%. At 25.9-30.8% of TB prevalence among presumptive cases and a 50% reduction in Xpert cartridge price, the cost per TB case diagnosed would range from US$50 to US$59 (comparable to the US$48.77 found in routine practice with smear/culture). The operational model illustrates the effect of increased case finding on laboratory costs per TB case diagnosed. Unless triage strategies are identified, the approach will not be sustainable, even if Xpert cartridge prices are reduced.

Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy

DEFF Research Database (Denmark)

Schlütter, Jacob Mørup; Johansen, Gry; Helmig, Rikke Bek

2016-01-01

We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the fir...... masses, vague bladder symptoms or radiating pelvic pain. The diagnosis is readily made by color Doppler imaging. Elective Caesarean section should be the preferred mode of delivery to avoid rupture of the aneurysm during labor.......We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first...

Correlation between weather and incidence of selected ophthalmological diagnoses: a database analysis

Directory of Open Access Journals (Sweden)

Kern C

2016-08-01

Full Text Available Christoph Kern, Karsten Kortüm, Michael Müller, Florian Raabe, Wolfgang Johann Mayer, Siegfried Priglinger, Thomas Christian Kreutzer University Eye Hospital Munich, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany Purpose: Our aim was to correlate the overall patient volume and the incidence of several ophthalmological diseases in our emergency department with weather data. Patients and methods: For data analysis, we used our clinical data warehouse and weather data. We investigated the weekly overall patient volume and the average weekly incidence of all encoded diagnoses of “conjunctivitis”, “foreign body”, “acute iridocyclitis”, and “corneal abrasion”. A Spearman’s correlation was performed to link these data with the weekly average sunshine duration, temperature, and wind speed. Results: We noticed increased patient volume in correlation with increasing sunshine duration and higher temperature. Moreover, we found a positive correlation between the weekly incidences of conjunctivitis and of foreign body and weather data. Conclusion: The results of this data analysis reveal the possible influence of external conditions on the health of a population and can be used for weather-dependent resource allocation. Keywords: corneal injury, trauma, uveitis, conjunctivitis, weather

Incidence of epilepsy in Ferrara, Italy.

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Cesnik, Edward; Pedelini, Francesco; Faggioli, Raffaella; Monetti, Vincenza Cinzia; Granieri, Enrico; Casetta, Ilaria

2013-12-01

Few studies have been carried out in the same area at different times, allowing an assessment of the incidence of epilepsy (E.), including all ages, over time. The available data on temporal trend show a decrease in E. incidence in childhood and an increase in the elderly. We sought to update the incidence of E. in the province of Ferrara, where a previous study estimated an incidence rate of 33.1 per 100,000, 35.8, if standardized to the European population. Newly diagnosed patients aged up to 14 years were drawn from a community-based prospective multi-source registry, and adult onset E. cases were collected through multiple overlapping sources of case collection. Cases were included and classified according to ILAE recommendations. During the study period (2007-2008), 141 newly diagnosed cases (66 men and 75 women) living in the study area were identified. The crude incidence rate was 46.1 per 100,000 person-years (95 % CI 39.0-54.5), 35.5 (95 % CI 28.0-43.0) if adjusted to the European population. The incidence of childhood and adolescence epilepsy was 57.0 per 100,000 person-years (95 % CI 33.8-90.0), lower than that reported in our previous study, and it was 44.8 (95 % CI 37.4-53.6) for adult onset E., which is significantly higher as compared to our previous study. The overall incidence of E. in northern Italy is stable over time. We detected a significant decrease in incidence of childhood and adolescence E. and an increase in adult-onset E. The burden of epilepsy will increase as the population continues to age.

First diagnosed lethal case of lyssavirus infection in Primorsky krai

OpenAIRE

Leonova, G.; Chentsova, I.; Petukhova, S.; Somova, L.; Belikov, S.; Kondratov, I.; Kryilova, N.; Plekhova, N.; Pavlenko, E.; Romanova, E.; Matsak, V.; Smirnov, G.; Novikov, D.

2010-01-01

The paper provides data of comprehensive study of lethal case of lyssavirus infection first diagnosed in Yakovlevsky municipal district in Primorsky Krai. The data of epidemiologic analysis (contact with a rattle mouse), clinical picture and results of virologic, morphological and molecular genetic tests allow attributing this case to lyssavirus infection. This is the first diagnosed case of lyssavirus infection in the Siberia and Far East.

Risk factors for incident delirium in an acute general medical setting: a retrospective case-control study.

Science.gov (United States)

Tomlinson, Emily Jane; Phillips, Nicole M; Mohebbi, Mohammadreza; Hutchinson, Alison M

2017-03-01

To determine predisposing and precipitating risk factors for incident delirium in medical patients during an acute hospital admission. Incident delirium is the most common complication of hospital admission for older patients. Up to 30% of hospitalised medical patients experience incident delirium. Determining risk factors for delirium is important for identifying patients who are most susceptible to incident delirium. Retrospective case-control study with two controls per case. An audit tool was used to review medical records of patients admitted to acute medical units for data regarding potential risk factors for delirium. Data were collected between August 2013 and March 2014 at three hospital sites of a healthcare organisation in Melbourne, Australia. Cases were 161 patients admitted to an acute medical ward and diagnosed with incident delirium between 1 January 2012 and 31 December 2013. Controls were 321 patients sampled from the acute medical population admitted within the same time range, stratified for admission location and who did not develop incident delirium during hospitalisation. Identified using logistic regression modelling, predisposing risk factors for incident delirium were dementia, cognitive impairment, functional impairment, previous delirium and fracture on admission. Precipitating risk factors for incident delirium were use of an indwelling catheter, adding more than three medications during admission and having an abnormal sodium level during admission. Multiple risk factors for incident delirium exist; patients with a history of delirium, dementia and cognitive impairment are at greatest risk of developing delirium during hospitalisation. Nurses and other healthcare professionals should be aware of patients who have one or more risk factors for incident delirium. Knowledge of risk factors for delirium has the potential to increase the recognition and understanding of patients who are vulnerable to delirium. Early recognition and

Cancer incidence among waiters

DEFF Research Database (Denmark)

Reijula, Jere; Kjaerheim, Kristina; Lynge, Elsebeth

2015-01-01

AIMS: To study cancer risk patterns among waiters in the Nordic countries. METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were...... diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS: The SIR of all cancers in waiters, in the five countries combined...... INCIDENCE IN SOME CANCER SITES CAN LIKELY BE EXPLAINED BY HIGHER ALCOHOL CONSUMPTION, THE PREVALENCE OF SMOKING AND OCCUPATIONAL EXPOSURE TO TOBACCO SMOKE HOPEFULLY, THE INCIDENCE OF CANCER AMONG WAITERS WILL DECREASE IN THE FUTURE, DUE TO THE BANNING OF TOBACCO SMOKING IN RESTAURANTS AND BARS IN THE NORDIC...

Five cases of neurocysticercosis diagnosed in Sydney.

Science.gov (United States)

Walker, J; Chen, S; Packham, D; McIntyre, P

1991-12-01

Cysticercosis, once rare in Australia, is now more frequently diagnosed. This change reflects the countries of origin of new immigrants and the destinations of Australians travelling. Five cases of neurocysticercosis diagnosed at Westmead Hospital in Sydney are described. Two involved Australians, a father and son who had visited eastern and southeastern Asia 10 years before presentation. The other three included immigrants from Chile and India and a visitor from Timor. Ages ranged from 5 to 57 years. Three individuals presented after focal seizures involving the upper limb, one had a long standing history of neurological dysfunction and one suffered from persistent headaches. In all cases computed tomographic scanning (CT) or magnetic resonance imaging (MRI) revealed cystic brain lesions and three of the five were seropositive as well. Four were treated with praziquantel and in one the lesions regressed significantly following treatment. However, the lesion in one case had decreased in size prior to treatment and that in the untreated individual also became smaller.

The role of metformin and statins in the incidence of epithelial ovarian cancer in type 2 diabetes: a cohort and nested case-control study.

Science.gov (United States)

Urpilainen, E; Marttila, M; Hautakoski, A; Arffman, M; Sund, R; Ilanne-Parikka, P; Arima, R; Kangaskokko, J; Puistola, U; Läärä, E; Hinkula, M

2018-02-07

To obtain evidence of the effects of metformin and statins on the incidence of ovarian cancer in women with type 2 diabetes (T2D). A retrospective cohort study and nested case-control study. The data were obtained from a diabetes database (FinDM) combining information from several nationwide registers. A cohort of 137 643 women over 40 years old and diagnosed with T2D during 1996-2011 in Finland. In full cohort analysis Poisson regression was used to estimate the hazard ratios (HR) in relation to ever use of metformin, insulin other oral anti-diabetic medication or statins. In the nested case-control analysis 20 controls were matched to each case of ovarian cancer. Conditional logistic regression was used to estimate HRs in relation to medication use and cumulative use of different medications. The estimates were adjusted for age and duration of T2D. Incidence of ovarian cancer. In all, 303 women were diagnosed with ovarian cancer during the follow up. Compared with other forms of oral anti-diabetic medication, metformin (HR 1.02, 95% CI: 0.72-1.45) was not found to be associated with the incidence of ovarian cancer. Neither was there evidence for statins to affect the incidence (HR 0.99, 95% CI: 0.78-1.25). In nested case-control analysis the results were essentially similar. No evidence of an association between the use of metformin or statins and the incidence of ovarian cancer in women with T2D was found. No evidence found for metformin or statins reducing the incidence of ovarian cancer. © 2018 Royal College of Obstetricians and Gynaecologists.

Incidence of malignancy in females presenting with breast lumps in OPD: a study of 277 cases

International Nuclear Information System (INIS)

Chaudhary, I.A.; Qureshi, S.K.; Rasul, S.

2003-01-01

Objective: To find the incidence of malignancy in females presenting with breast lumps in surgical out patient and to find out the age related incidence of benign and malignant diseases in these patients. Patients and Methods: All cases reporting to surgical outdoor with breast lumps were included and underwent investigation for the breast lumps to determine the histopathological diagnosis. Results: A total of 277 cases were studied. 24.2% breast lumps were malignant and 75.8% were benign. The incidence of malignancy increases from 0% in 2nd decade to 38.9% in 5th and 100% in 9th decade of life. The probability of diagnosing a breast lump as a malignant is one in three in 4th decade, two in five in 5th decade and more than one in two there after. Fibrocystic disease (33.8%) and Fibro adenoma (27.1%) was the commonest finding among the benign lumps. Among malignant lumps infiltrating duct carcinoma (68.7%) is the commonest finding. Conclusion: There is a significantly high incidence of malignant breast lumps after the 3rd decade of life and it increases subsequently. It is recommended that the surgeon managing a case of breast lump in a patient above 30 years should be highly suspicious and cautious so that early detection and management of malignant lumps be carried out. (author)

Incidence of end-stage renal disease attributed to diabetes among persons with diagnosed diabetes --- United States and Puerto Rico, 1996-2007.

Science.gov (United States)

2010-10-29

During 2007, approximately 110,000 persons in the United States and Puerto Rico began treatment for end-stage renal disease (ESRD) (i.e., kidney failure requiring dialysis or transplantation). Diabetes is the leading cause of ESRD in the United States, accounting for 44% of new cases in 2007. Although the number of persons initiating treatment for kidney failure each year who have diabetes listed as a primary cause (ESRD-D) has increased since 1996, ESRD-D incidence among persons with diagnosed diabetes has declined since 1996. To determine whether this decline occurred in every U.S. region and in every state, CDC analyzed 1996-2007 data from the U.S. Renal Data System (USRDS) and the Behavioral Risk Factor Surveillance System (BRFSS). During the period, the age-adjusted rate of ESRD-D among persons with diagnosed diabetes declined 35% overall, from 304.5 to 199.1 per 100,000 persons with diagnosed diabetes, and declined in all U.S. regions and in most states. No state showed a significant increase in the age-adjusted ESRD-D rate. Continued awareness of risk factors for kidney failure and interventions to improve diabetes care are needed to sustain and improve these trends.

Case report patients diagnosed with rheumatoid arthritis

OpenAIRE

Váňová, Tereza

2012-01-01

Title of bachelors thesis: Case report patients diagnosed with rheumatoid arthritis Summary: The work is focused on diseases rheumatoid arthritis and its physiotherapy care. It consists of two parts. Part of the general anatomy of the joint contains a general, deals with the disease rheumatoid arthritis, its diagnosis, treatment and comprehensive rehabilitation treatment. Part has its own special case report physiotherapy sessions on this topic. Key words: rheumatoid arthritis, comprehensive ...

Incidence of tuberculosis and the predictive value of ELISPOT and Mantoux tests in Gambian case contacts.

Directory of Open Access Journals (Sweden)

Philip C Hill

2008-01-01

Full Text Available Studies of Tuberculosis (TB case contacts are increasingly being utilised for understanding the relationship between M. tuberculosis and the human host and for assessing new interventions and diagnostic tests. We aimed to identify the incidence rate of new TB cases among TB contacts and to relate this to their initial Mantoux and ELISPOT test results.After initial Mantoux and ELISPOT tests and exclusion of co-prevalent TB cases, we followed 2348 household contacts of sputum smear positive TB cases. We visited them at 3 months, 6 months, 12 months, 18 months and 24 months, and investigated those with symptoms consistent with TB. Those who were diagnosed separately at a government clinic had a chest x-ray. Twenty six contacts were diagnosed with definite TB over 4312 person years of follow-up (Incidence rate 603/100,000 person years; 95% Confidence Interval, 370-830. Nine index and secondary case pairs had cultured isolates available for genotyping. Of these, 6 pairs were concordant and 3 were discordant. 2.5% of non-progressors were HIV positive compared to 12% of progressors (HR 6.2; 95% CI 1.7-22.5; p = 0.010. 25 secondary cases had initial Mantoux results, 14 (56% were positive ; 21 had initial ELISPOT results, 11 (52% were positive; 15 (71% of 21 tested were positive by one or the other test. Of the 6 contacts who had concordant isolates with their respective index case, 4 (67% were Mantoux positive at recruitment, 3 (50% were ELISPOT positive; 5 (83% were positive by one or other of the two tests. ELISPOT positive contacts, and those with discordant results, had a similar rate of progression to those who were Mantoux positive. Those negative on either or both tests had the lowest rate of progression.The incidence rate of TB disease in Gambian TB case contacts, after screening for co-prevalent cases, was 603/100,000 person years. Since initial ELISPOT test and Mantoux tests were each positive in only just over half of cases, but 71% were

Incidence and predictors of mental health disorder diagnoses among people who inject drugs in a Canadian setting.

Science.gov (United States)

Reddon, Hudson; Pettes, Tyler; Wood, Evan; Nosova, Ekaterina; Milloy, Michael-John; Kerr, Thomas; Hayashi, Kanna

2018-04-01

Limited attention has been given to the predictors of mental health diagnoses among people who inject drugs (PWID) in community settings. Therefore, we sought to longitudinally examine the prevalence, incidence and predictors of mental disorder diagnosis among a community-recruited cohort of PWID. Data were derived from two prospective cohort studies of PWID (VIDUS and ACCESS) in Vancouver, Canada between December 2005 and May 2015. We used multivariable extended Cox regression to identify factors independently associated with self-reported mental disorder diagnosis during follow-up among those without a history of such diagnoses at baseline. Among the 923 participants who did not report a mental disorder at baseline, 206 (22.3%) reported a first diagnosis of a mental disorder during follow-up for an incidence density of 4.29 [95% confidence interval (CI) 3.72-4.91] per 100 person-years. In the multivariable analysis, female sex [adjusted hazards ratio (AHR) = 1.74, 95% CI 1.29-2.33], experiencing non-fatal overdose (AHR = 2.33, 95% CI 1.38-3.94), accessing any drug or alcohol treatment (AHR = 1.68, 95% CI 1.24-2.27), accessing any community health or social services (AHR = 1.53, 95% CI 1.02-2.28) and experiencing violence (AHR = 1.60, 95% CI 1.12-2.29) were independently associated with a mental disorder diagnosis at follow-up. We observed a high prevalence and incidence of mental disorders among our community-recruited sample of PWID. The validity and implication of these diagnoses for key substance use and public health outcomes are an urgent priority. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Incidence of dementia and major subtypes in Europe

DEFF Research Database (Denmark)

Fratiglioni, L; Launer, L J; Andersen, K

2000-01-01

The authors examined the association of incident dementia and subtypes with age, sex, and geographic area in Europe. Incidence data from eight population-based studies carried out in seven European countries were compared and pooled. The pooled data included 835 mild to severe dementia cases and 42......,996 person-years of follow-up. In all studies a higher proportion of cases were diagnosed with AD (60 to 70% of all demented cases) than vascular dementia (VaD). The incidence of dementia and AD continued to increase with age up to age 85 years, after which rates increased in women but not men....... There was a large variation in VaD incidence across studies. In the pooled analysis, the incidence rates increased with age without any substantial difference between men and women. Surprisingly, higher incidence rates of dementia and AD were found in the very old in northwest countries than in southern countries...

Intraabdominal actinomycosis resulting in a difficult to diagnose intraperitoneal mass: A case report.

Science.gov (United States)

Tsujimura, Naoto; Takemoto, Hiroyoshi; Nakahara, Yujiro; Wakasugi, Masaki; Matsumoto, Takashi; Nishioka, Kiyonori; Takachi, Kou; Oshima, Satoshi; Yoshida, Kyotaro

2018-01-01

Actinomycosis is a chronic suppurative granulomatous disease caused by Actinomyces israelii. Preoperative confirmed diagnosis is very difficult, so most cases are diagnosed preoperatively as malignant tumors. We report a case of intraabdominal actinomycosis which was difficult to diagnose preoperatively. A woman, 60 years old, experienced discomfort in her lower right abdomen. She complained of nausea and anorexia and visited our hospital. Laboratory blood tests, abdominal CT, and abdominal MRI led to a diagnosis of a uterine sarcoma or primary intestinal mass, and she underwent surgery. Her histopathological diagnosis was intraabdominal actinomycosis. Actinomycosis is a chronic purulent granulomatous inflammation caused by Actinomyces israelii. No clinical symptoms or laboratory findings are characteristic of abdominal actinomycosis, so this disorder is very difficult to diagnose preoperatively. Therefore, many cases are diagnosed as malignant tumors and undergo surgery. After surgery, long-term antibiotic treatment (penicillin) is usually administered. We reported a case of intraabdominal actinomycosis that resulted in a difficult to diagnose intraperitoneal mass. When a large intraperitoneal mass is found, actinomycosis needs to be included as one of differential diagnoses. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Incidence of End-Stage Renal Disease Attributed to Diabetes Among Persons with Diagnosed Diabetes - United States and Puerto Rico, 2000-2014.

Science.gov (United States)

Burrows, Nilka Rios; Hora, Israel; Geiss, Linda S; Gregg, Edward W; Albright, Ann

2017-11-03

During 2014, 120,000 persons in the United States and Puerto Rico began treatment for end-stage renal disease (ESRD) (i.e., kidney failure requiring dialysis or transplantation) (1). Among these persons, 44% (approximately 53,000 persons) had diabetes listed as the primary cause of ESRD (ESRD-D) (1). Although the number of persons initiating ESRD-D treatment each year has increased since 1980 (1,2), the ESRD-D incidence rate among persons with diagnosed diabetes has declined since the mid-1990s (2,3). To determine whether ESRD-D incidence has continued to decline in the United States overall and in each state, the District of Columbia (DC), and Puerto Rico, CDC analyzed 2000-2014 data from the U.S. Renal Data System and the Behavioral Risk Factor Surveillance System. During that period, the age-standardized ESRD-D incidence among persons with diagnosed diabetes declined from 260.2 to 173.9 per 100,000 diabetic population (33%), and declined significantly in most states, DC, and Puerto Rico. No state experienced an increase in ESRD-D incidence rates. Continued awareness of risk factors for kidney failure and interventions to improve diabetes care might sustain and improve these trends.

Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults

DEFF Research Database (Denmark)

Nielsen, Eigil Husted; Feldt-Rasmussen, Ulla; Poulsgaard, Lars

2011-01-01

We studied the incidence of craniopharyngioma in Denmark during the period 1985-2004 and estimated worldwide incidence rates (IR) of craniopharyngioma based on a literature review. Craniopharyngioma patients diagnosed during the period 1985-2004 were identified from the Danish National Patient...... PubMed and, if appropriate, were included in a weighted analysis estimating overall and children's IRs of craniopharyngioma. IRs are given as new cases per million per year. We identified 189 patients with new verified (162) or probable craniopharyngioma. The overall WHO World-standardised incidence...

Autopsy interrogation of emergency medicine dispute cases: how often are clinical diagnoses incorrect?

Science.gov (United States)

Liu, Danyang; Gan, Rongchang; Zhang, Weidi; Wang, Wei; Saiyin, Hexige; Zeng, Wenjiao; Liu, Guoyuan

2018-01-01

Emergency medicine is a 'high risk' specialty. Some diseases develop suddenly and progress rapidly, and sudden unexpected deaths in the emergency department (ED) may cause medical disputes. We aimed to assess discrepancies between antemortem clinical diagnoses and postmortem autopsy findings concerning emergency medicine dispute cases and to figure out the most common major missed diagnoses. Clinical files and autopsy reports were retrospectively analysed and interpreted. Discrepancies between clinical diagnoses and autopsy diagnoses were evaluated using modified Goldman classification as major and minor discrepancy. The difference between diagnosis groups was compared with Pearson χ 2 test. Of the 117 cases included in this study, 71 of cases (58 class I and 13 class II diagnostic errors) were revealed as major discrepancies (60.7%). The most common major diagnoses were cardiovascular diseases (54 cases), followed by pulmonary diseases, infectious diseases and so on. The difference of major discrepancy between the diagnoses groups was significant (ppay special attention to in practice. This study reaffirmed the necessity and usefulness of autopsy in auditing death in EDs. © 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.

Evaluation of algorithms to identify incident cancer cases by using French health administrative databases.

Science.gov (United States)

Ajrouche, Aya; Estellat, Candice; De Rycke, Yann; Tubach, Florence

2017-08-01

Administrative databases are increasingly being used in cancer observational studies. Identifying incident cancer in these databases is crucial. This study aimed to develop algorithms to estimate cancer incidence by using health administrative databases and to examine the accuracy of the algorithms in terms of national cancer incidence rates estimated from registries. We identified a cohort of 463 033 participants on 1 January 2012 in the Echantillon Généraliste des Bénéficiaires (EGB; a representative sample of the French healthcare insurance system). The EGB contains data on long-term chronic disease (LTD) status, reimbursed outpatient treatments and procedures, and hospitalizations (including discharge diagnoses, and costly medical procedures and drugs). After excluding cases of prevalent cancer, we applied 15 algorithms to estimate the cancer incidence rates separately for men and women in 2012 and compared them to the national cancer incidence rates estimated from French registries by indirect age and sex standardization. The most accurate algorithm for men combined information from LTD status, outpatient anticancer drugs, radiotherapy sessions and primary or related discharge diagnosis of cancer, although it underestimated the cancer incidence (standardized incidence ratio (SIR) 0.85 [0.80-0.90]). For women, the best algorithm used the same definition of the algorithm for men but restricted hospital discharge to only primary or related diagnosis with an additional inpatient procedure or drug reimbursement related to cancer and gave comparable estimates to those from registries (SIR 1.00 [0.94-1.06]). The algorithms proposed could be used for cancer incidence monitoring and for future etiological cancer studies involving French healthcare databases. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

[A pediatric case of HIV who diagnosed by virtue of disseminated cryptococcus infection].

Science.gov (United States)

Acar, Manolya; Sütçü, Murat; Aktürk, Hacer; Hançerli Törün, Selda; Karagöz, Nurinisa; Beka, Hayati; Yekeler, Ensar; Ağaçfidan, Ali; Salman, Nuran; Somer, Ayper

2016-07-01

Cryptococcus neoformans is an important opportunistic pathogen that causes serious mortality and morbidity in AIDS patients. Although its incidence has decreased with proper antiretroviral treatment (ART), it is still a major concern in areas with low socioeconomic HIV endemic countries with poor sources of therapy. In our country, pediatric HIV infection and so, HIV-related opportunistic infections are very rare. In order to pay attention to this unusual collaboration; herein, we presented a pediatric case who was diagnosed with HIV and disseminated cryptococcus infection concomitantly. A 6.5-year-old previously healthy girl has admitted to our hospital with the complaints of prolonged fever, cough and hemoptysis. On her physical examination she had oral candidiasis, generalized lymphadenopathy and hepatosplenomegaly. Laboratory findings were as follows; white blood cell count: 3170 µL (neutrophil: 2720 µL, lymphocyte: 366 µL), hemoglobin level: 7.8 gr/dl, hematocrit: 25.5% platelets: 170.000 µL, CRP: 15.2 mg/L and serum IgG level: 1865 mg/dl. Her anti-HIV test yielde,d positive result and confirmed by Western blot assay, together with a high viral load (HIV-RNA: 3.442.000 copies/ml). She was started ART (lamivudine, zidovudine and lopinavir/ritonavir combination) with the diagnosis of stage 3 HIV infection (AIDS). Posteroanterior chest radiograph showed mediastinal extension and nodular parenchyma. Since the patient was suspected to have pulmonary tuberculosis based on the clinical and radiological findings, empirical antituberculosis therapy was started. Because of the insistance of fever, three different blood specimens, bone marrow and gastric aspirates were collected for culture, in which all of them yielded C.neoformans growth. She was then diagnosed as disseminated cryptococcosis and treated with liposomal amphotericin B and fluconazole successfully. Although pediatric HIV infection is usually diagnosed secondary to maternal disease, it can rarely be

Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy.

Science.gov (United States)

Harper, C G; Giles, M; Finlay-Jones, R

1986-01-01

A recent necropsy study has shown that 80% of patients with the Wernicke-Korsakoff syndrome were not diagnosed as such during life. Review of the clinical signs of these cases revealed that only 16% had the classical clinical triad and 19% had no documented clinical signs. The incidence of clinical signs in this and other retrospective pathological studies is very different from that of prospective clinical studies. This discrepancy may relate to "missed" clinical signs but the magnitude of the difference suggests that at least some cases of the Wernicke-Korsakoff syndrome may be the end result of repeated subclinical episodes of vitamin B1 deficiency. In order to make the diagnosis, clinicians must maintain a high index of suspicion in the "at risk" group of patients, particularly alcoholics. Investigations of thiamine status may be helpful and if the diagnosis is suspected, parenteral thiamine should be given. PMID:3701343

Incidence of eating disorders in Navarra (Spain).

Science.gov (United States)

Lahortiga-Ramos, Francisca; De Irala-Estévez, Jokin; Cano-Prous, Adrián; Gual-García, Pilar; Martínez-González, Miguel Angel; Cervera-Enguix, Salvador

2005-03-01

To estimate the overall annual incidence and age group distribution of eating disorders in a representative sample of adolescent female residents of Navarra, Spain. We studied a representative sample of 2734 adolescent Navarran females between 13 and 22 years of age who were free of any eating disorder at the start of our study. Eighteen months into the study, we visited the established centers and the eating attitudes test (EAT-40) and eating disorder inventory (EDI) Questionnaires were administered to the entire study population. We obtained a final response of 92%. All adolescents whose EAT score was over 21 points and a randomized sample of those who scored 21 or below, were interviewed. Any person meeting the DSM-IV diagnostic criteria for Anorexia Nervosa (AN), Bulimia Nervosa (BN) or eating disorder not otherwise specified (EDNOS) was considered a case. We detected 90 new cases of eating disorders. Taking into consideration the randomly selected group whose EAT score was 21 points or below, we estimated the overall weighted incidence of eating disorders to be 4.8% (95% CI: 2.8-6.8), after 18 months of observation, in which EDNOS predominated with an incidence of 4.2% (95% CI: 2.0-6.3). The incidence of AN was 0.3% (95% CI: 0.2-0.5), while that of BN was also found to be 0.3% (95% CI: 0.2-0.5). The highest incidence was observed in the group of adolescents between 15 and 16 years of age. The overall incidence of ED in a cohort of 2509 adolescents after 18 months of follow-up was 4.8% (95% CI: 2.8-6.8), with EDNOS outweighing the other diagnoses. The majority of new cases of eating disorders were diagnosed between ages 15 and 16.

The Epidemiology of Pheochromocytoma - Is the Incidence Increasing?

DEFF Research Database (Denmark)

Ebbehoj, A; Søndergaard, Esben; Trolle, Christian

with pheochromocytoma, but the true incidence, morbidity and mortality associated with pheochromocytoma remains to be fully elucidated. Materials and methods The cohort of potential cases of pheochromocytoma patients was identified with a data extract on relevant diagnoses from the National Patient Registry covering...

A comparison between criteria for diagnosing atopic eczema in infants

DEFF Research Database (Denmark)

Jøhnke, H; Vach, W; Norberg, L A

2005-01-01

Research Centre (DARC) criteria developed for this study and doctor-diagnosed visible eczema with typical morphology and atopic distribution. Additionally, the U.K. diagnostic criteria based on a questionnaire were used at 1 year of age. Agreement between the four criteria was analysed at each time point...... the four criteria demonstrated that cumulative incidences showed better agreement than point prevalence values. CONCLUSIONS: Agreement between different criteria for diagnosing AE was acceptable, but the mild cases constituted a diagnostic problem, although they were in the minority. Repeated examinations...

Estimated prevalence and incidence of diagnosed ADHD and health care utilization in adults in Sweden – a longitudinal population-based register study

Directory of Open Access Journals (Sweden)

Polyzoi M

2018-05-01

Full Text Available Maria Polyzoi,1 Ewa Ahnemark,2 Emma Medin,1,3 Ylva Ginsberg4,5 1PAREXEL International, Stockholm, Sweden; 2Medical Affairs Department, Shire Sweden AB, Stockholm, Sweden; 3Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; 4Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; 5Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden Background: Although the worldwide prevalence of attention-deficit/hyperactivity disorder (ADHD in adults is estimated to be between 2% and 5%, it is considered to be underdiagnosed. This register study explored the prevalence of diagnosed ADHD and incidence of newly diagnosed ADHD in Swedish adults over time, and assessed comorbidities and pharmacologic treatment. Methods: National Patient Register data were used to estimate the overall prevalence of adults (≥18 years with a registered ADHD diagnosis from 2006 to 2011, and the incidence of newly registered diagnoses from 2007 to 2011. Data from the Prescribed Drug Register were used to estimate the mean dose of the most frequently prescribed ADHD medication. Results: The estimated annual prevalence (N=44,364 of diagnosed ADHD increased from 0.58 per 1,000 persons in 2006 to 3.54 per 1,000 persons in 2011. The estimated annual incidence of newly diagnosed ADHD (N=24,921 increased from 0.39 per 1,000 persons to 0.90 per 1,000 persons between 2007 and 2011. At least one comorbidity was diagnosed in 52.6% of adults with ADHD (54.0% of newly diagnosed adults, with anxiety, substance use disorders, and depression being the most common. Among all adults with ADHD, 78.9% (65.7% of newly diagnosed adults were prescribed ADHD medication and one-third were prescribed more than one add-on medication. Osmotic release oral system methylphenidate was the most commonly used medication. The mean daily dose was 51.5 mg, and was

Incidence of Achalasia in South Australia Based on Esophageal Manometry Findings.

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Duffield, Jaime A; Hamer, Peter W; Heddle, Richard; Holloway, Richard H; Myers, Jennifer C; Thompson, Sarah K

2017-03-01

Achalasia is a disorder of esophageal motility with a reported incidence of 0.5 to 1.6 per 100,000 persons per year in Europe, Asia, Canada, and America. However, estimates of incidence values have been derived predominantly from retrospective searches of databases of hospital discharge codes and personal communications with gastroenterologists, and are likely to be incorrect. We performed a cohort study based on esophageal manometry findings to determine the incidence of achalasia in South Australia. We collected data from the Australian Bureau of Statistics on the South Australian population. Cases of achalasia diagnosed by esophageal manometry were identified from the 3 adult manometry laboratory databases in South Australia. Endoscopy reports and case notes were reviewed for correlations with diagnoses. The annual incidence of achalasia in the South Australian population was calculated for the decade 2004 to 2013. Findings were standardized to those of the European Standard Population based on age. The annual incidence of achalasia in South Australia ranged from 2.3 to 2.8 per 100,000 persons. The mean age at diagnosis was 62.1 ± 18.1 years. The incidence of achalasia increased with age (Spearman rho, 0.95; P achalasia in South Australia to be 2.3 to 2.8 per 100,000 persons and to increase with age. South Australia's relative geographic isolation and the population's access to manometry allowed for more accurate identification of cases than hospital code analyses, with a low probability of missed cases. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Retrospective Analysis of 513 Cases Diagnosed with Rib Fracture Secondary to Blunt Thorax Trauma

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Serdar Ozkan

2017-05-01

Full Text Available Aim: This study aimed to analyze blunt chest trauma cases who were diagnosed with rib fracture and to examine the regional differences likely to appear in trauma cases and treatment approaches. Material and Method: 513 cases who applied to the Emergency Service and Department of Thoracic Surgery between October 2013 and December 2014 due to blunt trauma and were diagnosed with rib fracture were retrospectively examined. The cases were evaluated in terms of etiological factors, thoracic, and other system injuries accompanying the rib fracture, prognosis, and the treatments applied. Results: Isolated rib fracture was present in 266 of the cases. Thoracic organ injuries such as pneumothorax, hemothorax, hemopneumothorax, lung contusion, or laceration and sternal fracture accompanying the rib fracture were present in 247 of the cases. While one or two rib fractures were detected in 298 cases, six or more rib fractures were present in 28 cases. 78.2% of hemothorax cases, 85.3% of pneumothorax cases, 95.4% of hemopneumothorax cases, 81.8% of bilateral pneumothorax cases, 26% of bilateral hemothorax cases, and 71.4% of bilateral hemopneumothorax cases were treated by applying tube thoracostomy. 129 cases diagnosed with thoracic organ injury in addition to rib fracture but not subjected to surgical intervention, and 266 cases diagnosed with isolated rib fracture were discharged with full recovery after appropriate medical treatment. Discussion: Most of the rib fractures occurring due to blunt trauma are treated successfully with medical treatments and conservative approaches and do not need advanced surgical treatments.

Cervical cancer incidence in Denmark over six decades (1943-2002)

DEFF Research Database (Denmark)

Kyndi, Marianne; Frederiksen, Kirsten; Kruger Kjaer, Susanne

2006-01-01

INTRODUCTION: The purpose of the study was to describe developments in the incidence of invasive cervical cancer in Denmark, focusing on histological types, over a period of 60 years. We also describe developments in the incidence of carcinoma in situ and mortality. MATERIAL AND METHODS: The study...... is based on the Danish Cancer Registry database of 39,623 reported cases of invasive cervical cancer diagnosed among Danish women in the period 1943-2002. The most important variables and measures are age-specific and age-standardized incidence and estimated annual percent changes in incidence. RESULTS...

A CYTOLOGICALLY DIAGNOSED CASE OF GIANT FIBROADENOMA: A CASE REPORT

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Metta Raja Gopal

2015-02-01

Full Text Available Fibroadenomas are benign solid tumors which occur most frequently in child bearing age with 68% occurrence in adolescents. Giant fibroadenomas are uncommon variants of fibroadenomas usually presenting in adolescents characterized by massive and rapid enlargement of bre ast tissue which may be quite alarming to the young girls. We present a case of giant fibroadenoma diagnosed by FNAC in the 14 yr adolescent who presented with large unilateral left breast enlargement which grew rapidly over a period of 10 months.

Increasing Incidence of Canine Leptospirosis in Switzerland

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Andrea Major

2014-07-01

Full Text Available A marked increase in canine leptospirosis was observed in Switzerland over 10 years with a peak incidence of 28.1 diagnosed cases/100,000 dogs/year in the most affected canton. With 95% affected dogs living at altitudes <800 m, the disease presented a seasonal pattern associated with temperature (r2 0.73 and rainfall (r2 0.39, >90% cases being diagnosed between May and October. The increasing yearly incidence however was only weakly correlated with climatic data including number of summer (r2 0.25 or rainy days (r2 0.38. Serovars Australis and Bratislava showed the highest seropositivity rates with 70.5% and 69.1%, respectively. Main clinical manifestations included renal (99.6%, pulmonary (76.7%, hepatic (26.0%, and hemorrhagic syndromes (18.2%, leading to a high mortality rate (43.3%. Similar to the human disease, liver involvement had the strongest association with negative outcome (OR 16.3. Based on these data, canine leptospirosis presents similar features and severity as the human infection for which it therefore can be considered a model. Its re-emergence in a temperate country with very high incidence rates in canines should thus be viewed as a warning and emphasize the need for increased awareness in other species.

Cancer incidence predictions in the North of Portugal: keeping population-based cancer registration up to date.

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Castro, Clara; Antunes, Luís; Lunet, Nuno; Bento, Maria José

2016-09-01

Decision making towards cancer prevention and control requires monitoring of trends in cancer incidence and accurate estimation of its burden in different settings. We aimed to estimate the number of incident cases in northern Portugal for 2015 and 2020 (all cancers except nonmelanoma skin and for the 15 most frequent tumours). Cancer cases diagnosed in 1994-2009 were collected by the North Region Cancer Registry of Portugal (RORENO) and corresponding population figures were obtained from Statistics Portugal. JoinPoint regression was used to analyse incidence trends. Population projections until 2020 were derived by RORENO. Predictions were performed using the Poisson regression models proposed by Dyba and Hakulinen. The number of incident cases is expected to increase by 18.7% in 2015 and by 37.6% in 2020, with lower increments among men than among women. For most cancers considered, the number of cases will keep rising up to 2020, although decreasing trends of age-standardized rates are expected for some tumours. Cervix was the only cancer with a decreasing number of incident cases in the entire period. Thyroid and lung cancers were among those with the steepest increases in the number of incident cases expected for 2020, especially among women. In 2020, the top five cancers are expected to account for 82 and 62% of all cases diagnosed in men and women, respectively. This study contributes to a broader understanding of cancer burden in the north of Portugal and provides the basis for keeping population-based incidence estimates up to date.

Challenges in diagnosing tuberculosis in children

DEFF Research Database (Denmark)

Rahman, Nadia; Pedersen, Karin Kæreby; Rosenfeldt, Vibeke

2012-01-01

Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country.......Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country....

True incidence of vestibular schwannoma?

DEFF Research Database (Denmark)

Stangerup, Sven-Eric; Tos, Mirko; Thomsen, Jens

2010-01-01

The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging.......The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging....

Cancer incidence in Spain, 2015.

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

2017-07-01

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

Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case-control study.

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Farquhar, Cynthia M; Li, Zhuoyang; Lensen, Sarah; McLintock, Claire; Pollock, Wendy; Peek, Michael J; Ellwood, David; Knight, Marian; Homer, Caroline Se; Vaughan, Geraldine; Wang, Alex; Sullivan, Elizabeth

2017-10-05

Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Case-control study. Sites in Australia and New Zealand with at least 50 births per year. Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. Data were collected using the Australasian Maternity Outcomes Surveillance System. Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. © 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.

Incidence and histological features of colorectal cancer in the ...

African Journals Online (AJOL)

Incidence and histological features of colorectal cancer in the Northern Cape province, South Africa. ... This is a retrospective review of all cases of primary adenocarcinoma of the colon or rectum diagnosed by the two pathology laboratories operating in the Northern Cape between January 2002 and February 2009.

Identification and medical utilization of incident cases of alcohol dependence: A population-based case-control study.

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Pan, Chun-Hung; Li, Min-Shan; Yang, Tien-Wey; Huang, Ming-Chyi; Su, Sheng-Shiang; Hung, Yen-Ni; Chen, Chiao-Chicy; Kuo, Chian-Jue

2018-05-05

Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010. For this nested case-control study, four controls were matched for age and sex with each case based on risk-set sampling. We measured various dimensions of medical utilization before AD was diagnosed, including department visited, physical comorbidity, and medication used. Conditional logistic regression was used for estimating the variables associated with AD. Patients living in less urbanized areas who were unemployed were more likely to develop AD. The highest proportions (34.2%) of AD cases were identified in the internal medicine department, followed by the emergency (22.3%) and psychiatry (18.7%) departments. AD patients had a higher risk of comorbid chronic hepatic disease (adjusted RR = 2.72, p identification of AD than controls. AD patients also had greater numbers of hospital admissions than controls, including non-psychiatric and psychiatric hospitalizations. Outpatient visit numbers were similar for AD patients and controls. The findings indicate that clinicians providing care in diverse medical settings should be prepared to screen for unhealthy alcohol use and to mitigate its detrimental effects. Copyright © 2018 Elsevier B.V. All rights reserved.

Incidence of anogenital warts in Germany: a population-based cohort study

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Mikolajczyk Rafael T

2010-12-01

Full Text Available Abstract Background Human papilloma virus (HPV types 6 and 11 account for 90 percent of anogenital warts (AGW. Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. The aim of this study was to estimate incidence rates of AGW in Germany, stratified by age, sex, and region. Additionally, the medical practitioner (gynaecologist, dermatologist, urologist etc. who made the initial diagnosis of AGW was assessed. Methods Retrospective cohort study in a population aged 10 to 79 years in a population-based healthcare insurance database. The database included more than 14 million insurance members from all over Germany during the years 2004-2006. A case of AGW was considered incident if a disease-free period of twelve months preceded the diagnosis. To assess regional variation, analyses were performed by federal state. Results The estimated incidence rate was 169.5/100,000 person-years for the German population aged 10 to 79 years. Most cases occurred in the 15 to 40 years age group. The incidence rate was higher and showed a peak at younger ages in females than in males. The highest incidence rates for both sexes were observed in the city-states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by a gynaecologist (71.7%, whereas in males, AGW were most frequently diagnosed by a dermatologist (44.8% or urologist (25.1%. Conclusions Incidence of AGW in Germany is comparable with findings for other countries. As expected, most cases occurred in the younger age groups. The frequency of diagnoses of AGW differs between sexes and women and men receive treatment by doctors of different specialties.

A prenatally diagnosed case of sirenomelia with dextrocardia and omphalocele.

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Cavaliere, Alessandro; Dinatale, Angela; Cardinale, Giovanna; Ermito, Santina; La Galia, Tindara; Circosta, Barbara; Imbruglia, Laura; Rapisarda, Giusi

2009-07-01

Sirenomelia (Mermaid syndrome) is a rare anomaly of caudal region of the body, presented with fusion of the lower limbs. Genito-urinary, gastro-intestinal, neural tube and vertebral anomalies are found in most cases. We present a case of sirenomelia diagnosed in the first tri-mester, associated with dextrocardia, and omphalocele First trimester diagnosis of sirenomielia is possible and early diagnosis gives the parents the option of early pregnancy termination.

Coding response to a case-mix measurement system based on multiple diagnoses.

Science.gov (United States)

Preyra, Colin

2004-08-01

To examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model. Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002. Disaggregated trends in hospital case-mix growth are examined for five years following the adoption of an inpatient classification system making extensive use of combinations of secondary diagnoses. Hospital case mix is decomposed into base and complexity components. The longitudinal effects of coding variation on a standard hospital payment model are examined in terms of payment accuracy and impact on adjustment factors. Introduction of the refined case-mix system provided incentives for hospitals to increase reporting of secondary diagnoses and resulted in growth in highest complexity cases that were not matched by increased resource use over time. Despite a pronounced coding response on the part of hospitals, the increase in measured complexity and case mix did not reduce the unexplained variation in hospital unit cost nor did it reduce the reliance on the teaching adjustment factor, a potential proxy for case mix. The main implication was changes in the size and distribution of predicted hospital operating costs. Jurisdictions introducing extensive refinements to standard diagnostic related group (DRG)-type payment systems should consider the effects of induced changes to hospital coding practices. Assessing model performance should include analysis of the robustness of classification systems to hospital-level variation in coding practices. Unanticipated coding effects imply that case-mix models hypothesized to perform well ex ante may not meet expectations ex post.

Coding Response to a Case-Mix Measurement System Based on Multiple Diagnoses

Science.gov (United States)

Preyra, Colin

2004-01-01

Objective To examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model. Data Sources Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002. Study Design Disaggregated trends in hospital case-mix growth are examined for five years following the adoption of an inpatient classification system making extensive use of combinations of secondary diagnoses. Hospital case mix is decomposed into base and complexity components. The longitudinal effects of coding variation on a standard hospital payment model are examined in terms of payment accuracy and impact on adjustment factors. Principal Findings Introduction of the refined case-mix system provided incentives for hospitals to increase reporting of secondary diagnoses and resulted in growth in highest complexity cases that were not matched by increased resource use over time. Despite a pronounced coding response on the part of hospitals, the increase in measured complexity and case mix did not reduce the unexplained variation in hospital unit cost nor did it reduce the reliance on the teaching adjustment factor, a potential proxy for case mix. The main implication was changes in the size and distribution of predicted hospital operating costs. Conclusions Jurisdictions introducing extensive refinements to standard diagnostic related group (DRG)-type payment systems should consider the effects of induced changes to hospital coding practices. Assessing model performance should include analysis of the robustness of classification systems to hospital-level variation in coding practices. Unanticipated coding effects imply that case-mix models hypothesized to perform well ex ante may not meet expectations ex post. PMID:15230940

Incidence and Risk Factors for Placenta Accreta/Increta/Percreta in the UK: A National Case-Control Study

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Fitzpatrick, Kathryn E.; Sellers, Susan; Spark, Patsy; Kurinczuk, Jennifer J.; Brocklehurst, Peter; Knight, Marian

2012-01-01

Background Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors. Methods A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women. Results The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR) 14.41, 95%CI 5.63–36.85), other previous uterine surgery (aOR 3.40, 95%CI 1.30–8.91), an IVF pregnancy (aOR 32.13, 95%CI 2.03–509.23) and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58–254.96) had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13–1.50 for every one year increase in age). Conclusions Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly. PMID:23300807

Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study.

Directory of Open Access Journals (Sweden)

Kathryn E Fitzpatrick

Full Text Available Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors.A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women.The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR 14.41, 95%CI 5.63-36.85, other previous uterine surgery (aOR 3.40, 95%CI 1.30-8.91, an IVF pregnancy (aOR 32.13, 95%CI 2.03-509.23 and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58-254.96 had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13-1.50 for every one year increase in age.Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly.

Subarachnoid haemorrhage in Sweden 1987-2002 : regional incidence and case fatality rates

NARCIS (Netherlands)

Koffijberg, H.; Buskens, E.; Granath, F.; Adami, J.; Ekbom, A.; Rinkel, G. J. E.; Blomqvist, P.

Background: Incidence estimates of subarachnoid haemorrhage (SAH) in Sweden vary, which may be caused by regional variations. Reliable estimates of age-specific case fatality rates are lacking. We analysed regional incidence rates and case fatality rates of SAH in Sweden. Methods: The Swedish

A prenatally diagnosed case of sirenomelia with dextrocardia and omphalocele

Science.gov (United States)

Cavaliere, Alessandro; Dinatale, Angela; Cardinale, Giovanna; Ermito, Santina; La Galia, Tindara; Circosta, Barbara; Imbruglia, Laura; Rapisarda, Giusi

2009-01-01

Objective: Sirenomelia (Mermaid syndrome) is a rare anomaly of caudal region of the body, presented with fusion of the lower limbs. Genito-urinary, gastro-intestinal, neural tube and vertebral anomalies are found in most cases. Methods: We present a case of sirenomelia diagnosed in the first tri-mester, associated with dextrocardia, and omphalocele Conclusion: First trimester diagnosis of sirenomielia is possible and early diagnosis gives the parents the option of early pregnancy termination PMID:22439043

Incidence and prevalence of epilepsy in Denmark

DEFF Research Database (Denmark)

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

2007-01-01

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...... system and inclusion of outpatients. From 1995 to 2002 the incidence rate was reasonable constant with an average of 83.3 new cases per 100,000 person-years at risk, except for patients over 60 years of age where we observed an increase in incidence with calendar time. The age-specific incidence rates...... 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...

Cervical cancer incidence in elderly women

DEFF Research Database (Denmark)

Lynge, Elsebeth; Lönnberg, Stefan; Törnberg, Sven

2017-01-01

Aim: In many countries, the age-specific pattern of cervical cancer incidence is currently bipolar with peaks at for instance 45 and 65 years of age. Consequently, a large proportion of cervical cancer cases are presently diagnosed in women above the screening age. The purpose of the study...... was to determine whether this bipolar pattern in age-specific incidence of cervical cancer reflects underlying biology or can be explained by the fact that the data come from birth cohorts with different screening histories. Methods: Combination of historical data on cervical screening and population-based cancer...... incidence data from Denmark 1943–2013, Finland and Norway 1953–2013, and Sweden 1958–2013. Results: Since the implementation of screening, the incidence of cervical cancer has decreased for each successive birth cohort. All birth cohorts showed a unipolar age-specific pattern. In unscreened women in Denmark...

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

Science.gov (United States)

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

2005-01-01

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

A prenatally diagnosed pentalogy of cantrell case with encephalocele: A rare variant

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Melih Atahan Güven

2009-06-01

Full Text Available AIM: The aim of this study is to present a prenatally diagnosed and postnatally confirmed Pentalogy of Cantrell case also with neural tube defect. CASE: Characteristic features of Cantrell Pentalogy are omphalocele due to the defect of anterior diaphragm and lower sternum, absence of pericardium and cardiac anomaly. We are presenting here a case with encephalocele and omphalocele containing the heart with atrioventricular septal defect detected during prenatal ultrasonography. There is no consanguinity and history of drug usage or toxin exposure during pregnancy. As these malformations cause a very low chance of survival, pregnancy was terminated after an informed consent. Postmortem genetic evaluation of the fetus confirmed the prenatal findings. CONCLUSION: It is easy to diagnose omphalocele during pregnancy but if it associates with heart anomalies, Cantrell Pentalogy must be remembered. Encephalocele and other types of neural tube defects very rarely associate with this disorder and there were fewer than 20 cases reported in the literature.

Incidence and risk factors of AIDS-defining cancers in a cohort of HIV-positive adults: Importance of the definition of incident cases.

Science.gov (United States)

Suárez-García, Inés; Jarrín, Inmaculada; Iribarren, José Antonio; López-Cortés, Luis Fernando; Lacruz-Rodrigo, José; Masiá, Mar; Gómez-Sirvent, Juan Luis; Hernández-Quero, José; Vidal, Francesc; Alejos-Ferreras, Belén; Moreno, Santiago; Del Amo, Julia

2013-05-01

The aim of this study was to investigate the incidence and risk factors for the development of AIDS-defining cancers (ADCs); and to investigate the effect of making different assumptions on the definition of incident cases. A multicentre cohort study was designed. Poisson regression was used to assess incidence and risk factors. To account for misclassification, incident cases were defined using lag-times of 0, 14 and 30 days after enrolment. A total of 6393 HIV-positive subjects were included in the study. The incidences of ADCs changed as the lag periods were varied from 0 to 30 days. Different risk factors emerged as the definition of incident cases was changed. For a lag time of 0, the risk of Kaposi sarcoma [KS] and non-Hodgkin lymphoma [NHL] increased at CD4 counts sex with men had a higher risk of KS. KS and NHL were not associated with viral load, gender, or hepatitis B or C. The results were similar for a lag-time of 14 and 30 days; however, hepatitis C was significantly associated with NHL. This analysis shows the importance of the definition of incident cases in cohort studies. Alternative definitions gave different incidence estimates, and may have implications for the analysis of risk factors. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Correlation between bone scan findings and serum PSA level in prostate cancer patients in Bangladesh: both newly diagnosed and hormonally treated cases

International Nuclear Information System (INIS)

Yasmeen, S.; Nasreen, F.; Kabir, M.F.

2007-01-01

who received treatment for their prostate cancer. All patients underwent a bone scan and serum PSA measurement. Results: Only 6% of 242 patients with newly diagnosed prostate cancer had positive bone scan on initial evaluation. Scans were positive in 0 of 112 with PSA level below 10 ng/ml, 5 of 76 with PSA level between 10 to 20 ng/ml and 09 of 54 with PSA level above 30 ng/ml. In newly diagnosed cases the sensitivity of PSA in predicting bony mets was found to be appreciably high and did not decrease notably with the increase of cut off value from 10ng/ml to 30ng/ml. From this study it was evident that PSA level between 10-30ng/ml has optimum sensitivity and specificity in newly diagnosed cases. In case of patients on hormone therapy bone scan was positive in 49 cases at PSA level 20ng/ml. PSA alone would have failed to detect a significant number of patients in hormonally treated cases indicating a low sensitivity in this group. Conclusion: Patients with newly diagnosed and untreated prostate cancer should undergo bone scintigraphy if there is bone pain. Recent reports discourage the routine use of a bone scan when serum PSA is <20ng/ml. In newly diagnosed cases, the incidence of bone metastasis increased with the increasing level of serum PSA. The likelihood of bone metastasis is low in newly diagnosed cases when PSA level is low. In hormonally treated cases bone scan was positive even when the PSA level was low. PSA is a major predictor for positive bone scan. About two third of the patients analyzed were in the low risk group and elimination of a bone scan in these patients would result in considerable economic saving. Serum PSA level may remain low even in presence of metastases in hormonally treated cases. For assessment of hormonally treated cases bone scan should be done. (author)

Pituitary carcinoma diagnosed on fine needle aspiration: Report of a case and review of pathogenesis

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Yakoushina Tatiana

2010-01-01

Full Text Available Pituitary carcinoma (PC is a very rare entity (0.2% of all pituitary tumors, with only about 140 cases reported in English literature. There are no reliable histological, immunohistochemical or ultrastructural features distinguishing pituitary adenoma (PA from PC. By definition, a diagnosis of PC is made after a patient with PA develops non-contiguous central nervous system (CNS or systemic metastases. To date, only three cases of PC have been reportedly diagnosed on fine needle aspiration (FNA. Two of the reported cases were diagnosed on FNA of the cervical lymph nodes and one on FNA of the vertebral bone lesion. Herein, we present a case of PC, diagnosed on FNA of the liver lesion. In this case, we describe cytologic features of PC and compare them to histologic features of the tumor in the pituitary. Clinical behavior of tumor, pathogenesis of metastasis and immunochemical and prognostic markers will also be described.

Incidence trends and mortality rates of gastric cancer in Israel.

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Lavy, Ron; Kapiev, Andronik; Poluksht, Natan; Halevy, Ariel; Keinan-Boker, Lital

2013-04-01

Gastric cancer is the fourth most common malignancy worldwide. The incidence trends and mortality rates of gastric cancer in Israel have not been studied in depth. The aim of our study was to try and investigate the aforementioned issues in Israel in different ethnic groups. This retrospective study is based on the data of The Israel National Cancer Registry and The Central Bureau of Statistics. Published data from these two institutes were collected, summarized, and analyzed in this study. Around 650 new cases of gastric cancer are diagnosed yearly in Israel. While we noticed a decline during the period 1990-2007 in the incidence in the Jewish population (13.6-8.9 and 6.75-5.42 cases per 100,000 in Jewish men and women, respectively), an increase in the Arab population was noticed (7.7-10.2 and 3.7-4.2 cases per 100,000 in men and women, respectively). Age-adjusted mortality rates per 10,000 cases of gastric cancer decreased significantly, from 7.21 in 1990 to 5.46 in 2007, in the total population. The 5-year relative survival showed a slight increase for both men and women. There is a difference in the incidence and outcome of gastric cancer between the Jewish and Arab populations in Israel. The grim prognosis of gastric cancer patients in Israel is probably due to the advanced stage at which gastric cancer is diagnosed in Israel.

Acanthamoeba keratitis: study of the 5-year incidence in Israel.

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Graffi, Shmuel; Peretz, Avi; Jabaly, Haneen; Koiefman, Anna; Naftali, Modi

2013-11-01

Acanthamoeba keratitis (AK) is not a notifiable disease in Israel, so there are no accurate incidence rates for this condition in Israel. The aim of this study was to estimate the incidence of AK in Israel for the years 2008-2012. We distributed a survey questionnaire to laboratory managers in Israel. The laboratories were affiliated to medical institutes that either provided ophthalmology services or served community ophthalmology clinics. Our questionnaire requested survey respondents to provide information regarding the methods used to diagnose AK, and the number of positive and negative cultures for Acanthamoebae species performed for each of the years from 2008 to 2012. Six laboratories used non-nutrient agar with Escherichia coli as the culture medium, one used calcofluor-white staining with fluorescent microscopy, and two used PCR for diagnosing AK. Twenty-three AK cases were identified, to give an estimated incidence of 1/1 668 552. AK is mostly attributable to the use of contact lenses. As contact lenses are popular in Israel, we expected a higher incidence rate. A lower than expected incidence rate may indicate insufficient awareness of AK in Israel.

Metastatic prostate cancer in transsexual diagnosed after three decades of estrogen therapy.

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Turo, Rafal; Jallad, Samer; Prescott, Stephen; Cross, William Richard

2013-01-01

The incidence of prostate cancer in transsexual patients is very low with only few reported cases. Many years before presenting with prostate cancer, these patients receive hormone ablation as a part of their gender therapy. Their disease is already defined as castrate resistant, and the treatment and follow-up of such patients remains a challenge. We report a case of a male-to-female transgender woman who was diagnosed with metastatic prostate cancer, 31 years post-feminization.

Metastatic prostate cancer in transsexual diagnosed after three decades of estrogen therapy

OpenAIRE

Turo, Rafal; Jallad, Samer; Prescott, Stephen; Cross, William Richard

2013-01-01

The incidence of prostate cancer in transsexual patients is very low with only few reported cases. Many years before presenting with prostate cancer, these patients receive hormone ablation as a part of their gender therapy. Their disease is already defined as castrate resistant, and the treatment and follow-up of such patients remains a challenge. We report a case of a male-to-female transgender woman who was diagnosed with metastatic prostate cancer, 31 years post-feminization.

Lung cancer: Incidence and survival in Rabat, Morocco.

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Lachgar, A; Tazi, M A; Afif, M; Er-Raki, A; Kebdani, T; Benjaafar, N

2016-12-01

Lung cancer is the most common cancer worldwide, but epidemiologic data from developing countries are lacking. This article reports lung cancer incidence and survival in Rabat, the capital of Morocco. All lung cancer cases diagnosed between 2005 and 2008 were analyzed using data provided by the Rabat Cancer Registry. The standardized rate was reported using age adjustment with respect to the world standard population, and the observed survival rates were calculated using the Kaplan-Meier method. Three hundred fifty-one cases were registered (314 males and 37 females), aged 27-90 years (median, 59 years). The most common pathological type was adenocarcinoma (40.2%) followed by squamous cell carcinoma (31.9%); the majority of cases were diagnosed at stage IV (52%). The age-standardized incidence rate was 25.1 and 2.7 per 100,000 for males and females, respectively, and the overall observed survival rates at 1 and 5 years were 31.7% and 3.4%, respectively. The clinical stage of disease was the only independent predictor of survival. The survival rate of lung cancer in Rabat is very poor. This finding explains the need for measures to reduce the prevalence of tobacco and to improve diagnostic and therapeutic facilities for lung cancer. Copyright © 2016. Published by Elsevier Masson SAS.

Incidence of type 1 diabetes in China, 2010-13: population based study.

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Weng, Jianping; Zhou, Zhiguang; Guo, Lixin; Zhu, Dalong; Ji, Linong; Luo, Xiaoping; Mu, Yiming; Jia, Weiping

2018-01-03

To estimate the incidence of type 1 diabetes in all age groups in China during 2010-13. Population based, registry study using data from multiple independent sources. National registration system in all 505 hospitals providing diabetes care, and communities of patients with diabetes in 13 areas across China, covering more than 133 million person years at risk, approximately 10% of the whole population. 5018 people of all ages with newly diagnosed type 1 diabetes and resident in the study areas from 1 January 2010 to 31 December 2013. Incidence of type 1 diabetes per 100 000 person years by age, sex, and study area. Type 1 diabetes was doctor diagnosed and further validated by onsite follow-up. Completeness of case ascertainment was assessed using the capture mark recapture method. 5018 cases of newly diagnosed type 1 diabetes were ascertained: 1239 participants were aged China was 1.01 (95% confidence interval 0.18 to 1.84). Incidence per 100 000 persons years by age group was 1.93 (0.83 to 3.03) for 0-14 years, 1.28 (0.45 to 2.11) for 15-29 years, and 0.69 (0.00 to 1.51) for ≥30 years, with a peak in age group 10-14 years. The incidence in under 15s was positively correlated with latitude (r=0.88, PChina occurred among adults. The incidence of type 1 diabetes in Chinese children was among the lowest reported in the study. 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.

Low incidence of limb-girdle muscular dystrophy type 2C revealed by a mutation study in Japanese patients clinically diagnosed with DMD

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Maruyama Koichi

2010-03-01

Full Text Available Abstract Background Limb-girdle muscular dystrophy type 2C (LGMD2C is an autosomal recessive muscle dystrophy that resembles Duchenne muscular dystrophy (DMD. Although DMD is known to affect one in every 3500 males regardless of race, a widespread founder mutation causing LGMD2C has been described in North Africa. However, the incidence of LGMD2C in Japanese has been unknown because the genetic background remains uncharacterized in many patients clinically diagnosed with DMD. Methods We enrolled 324 patients referred to the Kobe University Hospital with suspected DMD. Mutations in the dystrophin or the SGCG genes were analyzed using not only genomic DNA but also cDNA. Results In 322 of the 324 patients, responsible mutations in the dystrophin were successfully revealed, confirming DMD diagnosis. The remaining two patients had normal dystrophin expression but absence of γ-sarcoglycan in skeletal muscle. Mutation analysis of the SGCG gene revealed homozygous deletion of exon 6 in one patient, while the other had a novel single nucleotide insertion in exon 7 in one allele and deletion of exon 6 in the other allele. These mutations created a stop codon that led to a γ-sarcoglycan deficiency, and we therefore diagnosed these two patients as having LGMD2C. Thus, the relative incidence of LGMD2C among Japanese DMD-like patients can be calculated as 1 in 161 patients suspected to have DMD (2 of 324 patients = 0.6%. Taking into consideration the DMD incidence for the overall population (1/3,500 males, the incidence of LGMD2C can be estimated as 1 per 560,000 or 1.8 per million. Conclusions To the best of our knowledge, this is the first study to demonstrate a low incidence of LGMD2C in the Japanese population.

Relationships between diagnoses of sexually transmitted infections and urinary tract infections among male service members diagnosed with urethritis, active component, U.S. Armed Forces, 2000-2013.

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2014-07-01

A previous MSMR report found that 42.8% of all incident (first-time) urinary tract infections (UTIs) in males, but only 0.4% of such UTIs in females, were diagnosed as "urethritis, unspecified" (ICD-9: 597.80). This study explored the possibility that many of the diagnoses of urethritis in males represented sexually transmitted infections (STIs), even though ICD-9: 597.80 is explicitly reserved for cases of urethritis that are deemed to not be sexually transmitted. Examined were relationships between diagnoses of urethritis, diagnoses of STIs, and recurrent diagnoses of UTIs. Male service members who received a diagnosis of "urethritis, unspecified" (ICD-9: 597.80) had an increased risk of a subsequent UTI diagnosis, especially of "urethritis, unspecified," compared to all male service members. Most service members who were diagnosed with "urethritis, unspecified" had no documented diagnoses of an STI in their Military Health System health records; however, recurrent UTIs were more common among service members who did have documented STIs. The most commonly diagnosed STIs in this study were "other non-gonococcal urethritis" (which includes that caused by Chlamydia trachomatis) and gonorrhea.

A Population-Based Study of the Incidence of Burning Mouth Syndrome

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Kohorst, John J.; Bruce, Alison J.; Torgerson, Rochelle R.; Schenck, Louis A.; Davis, Mark D. P.

2015-01-01

Objective To calculate the incidence of burning mouth syndrome (BMS) in Olmsted County, Minnesota, from 2000 to 2010. Patients and Methods Using the medical record linkage system of the Rochester Epidemiology Project, we identified newly diagnosed cases of BMS from January 1, 2000, through December 31, 2010. Diagnoses were confirmed through the presence of burning pain symptoms of the oral mucosa with normal oral examination findings and no associated clinical signs. Incidence was estimated using decennial census data for Olmsted County. Results In total, 169 incident cases were identified, representing an annual age- and sex-adjusted incidence of BMS of 11.4 per 100,000 person-years. Age-adjusted incidence was significantly higher in women than men (18.8 [95% CI, 16.4–22.9] vs 3.7 [95% CI, 2.6–5.7] per 100,000 person-years [P<.001]). Postmenopausal women aged 50 to 89 years had the highest disease incidence, with the maximal rate in women aged 70 to 79 years (70.3 per 100,000 person-years). After age 50 years, BMS incidence in men and women significantly increased across age-groups (P=.02). Olmsted County study participants were predominantly white, which is a study limitation. In addition, diagnostic criteria for identifying BMS in the present study may not apply for all situations because no diagnostic criteria are universally recognized for identifying BMS. Conclusion To our knowledge, this is the first population-based incidence study of BMS reported to date. The data show that BMS is an uncommon disease highly associated with female sex and advancing age. PMID:25176397

Increase in depression diagnoses and prescribed antidepressants among young girls

DEFF Research Database (Denmark)

Skovlund, Charlotte Wessel; Kessing, Lars Vedel; Mørch, Lina Steinrud

2017-01-01

AIMS: To analyse trends in depression diagnoses and antidepressant use according to age and gender. METHODS: Nationwide cohort study including all women and men of 10-49 years living in Denmark during 2000-2013. The Psychiatric Registry and Prescription Registry provided data on depression...... diagnoses and antidepressant medication, respectively. Incidence rates as well as 1-year prevalence rates were calculated. RESULTS: The incidence and 1-year prevalence rates of depression diagnoses increased during 2000-2013. The women/men rates were 2.0 for both 1-year prevalence of depressions diagnoses...... and antidepressant use. For adolescent girls, the absolute increase was 3 per 1000 for depression diagnoses and 8 per 1000 for first use of antidepressants, compared to boys who had an increase of 1.1 and 3 per 1000, respectively. Before puberty, boys and girls had almost the same incidence rates of both depression...

Cancer incidence among Danish brewery workers

DEFF Research Database (Denmark)

Thygesen, Lau Caspar; Albertsen, Katrine; Johansen, Christoffer

2005-01-01

in a brewery between 1939 and 1963. From the original cohort of 14,313 workers, it was possible to identify 13,051 brewery workers (91.2%). The identified brewery workers were linked to the Danish Cancer Registry for any cancer diagnoses during 1943-1999. The incidence rate of all Danish men was applied...... to calculate the expected number of cancers, standardised incidence ratios for age and time trend (O/E) were computed. A total of 3,928 cases of cancer were observed compared to 2,835.8 expected (O/E, 1.39; 95%-CI, 1.34-1.43). Significantly elevated risk of cancers was seen for cancer sites such as the buccal...

East-West gradient in the incidence of inflammatory bowel disease in Europe

DEFF Research Database (Denmark)

Burisch, J.; Pedersen, N; Cukovic-Cavka, S

2014-01-01

OBJECTIVE: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe. The reasons for these changes remain unknown. The aim of this study was to investigate whether an East-West gradient in the incidence of IBD in Europe exists. DESIGN: A prospective, uniformly diagnosed...... treatment as rescue therapy. Of all European CD patients, 20% received only 5-aminosalicylates as induction therapy. CONCLUSIONS: An East-West gradient in IBD incidence exists in Europe. Among this inception cohort-including indolent and aggressive cases-international guidelines for diagnosis and initial...

Case studies of hydrogen sulphide occupational exposure incidents in the UK.

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Jones, Kate

2014-12-15

The UK Health and Safety Executive has investigated several incidents of workplace accidents involving hydrogen sulphide exposure in recent years. Biological monitoring has been used in some incidents to determine the cause of unconsciousness resulting from these incidents and as a supporting evidence in regulatory enforcement. This paper reports on three case incidents and discusses the use of biological monitoring in such cases. Biological monitoring has a role in identifying hydrogen sulphide exposure in incidents, whether these are occupational or in the wider environment. Sample type, time of collection and sample storage are important factors in the applicability of this technique. For non-fatal incidents, multiple urine samples are recommended at two or more time points between the incident and 15 h post-exposure. For routine occupational monitoring, post-shift samples should be adequate. Due to endogenous levels of urinary thiosulphate, it is likely that exposures in excess of 12 ppm for 30 min (or 360 ppm/min equivalent) would be detectable using biological monitoring. This is within the Acute Exposure Guideline Level 2 (the level of the chemical in air at or above which there may be irreversible or other serious long-lasting effects or impaired ability to escape) for hydrogen sulphide. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

[Clinical analysis of 138 multiple primary cancers diagnosed of digestive system malignant tumor initially].

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Lyu, J M; Xiong, H C; Wu, B; Zhou, X Q; Hu, J

2018-02-23

Objective: To study the clinical characteristics, strategy of treatment and prognosis of multiple primary cancers(MPC) diagnosed of digestive system malignant tumor firstly. Methods: From January, 2000 to December, 2015, the clinical, follow-up and prognostic data of 138 MPC patients diagnosed of digestive system malignant tumor firstly were retrospectively analyzed. Results: 138 cases were found in 10 580 cases with malignant tumors, and the incidence was 1.30%. There were 129 cases of duplex primary cancers, 8 cases of triple primary cancers and 1 case of quintuple primary cancers. The repetitive primary cancer was occurred in digestive system (61cases, 44.2%) most frequently, with the next in respiratory system (46 cases, 33.3%). 52.2% (72 cases) suffered second primary cancer in 2 years after first primary cancer diagnosed, and 75.4% (104 cases) in 5 years. The median overall survival in patients with all cancer lesions radically treated was 168 months, better than any other treatment (68 months, P digestive system malignant tumor most frequently occurred in the digestive system and respiratory system. More concern should be attracted in follow-up, especially in the first 5 years. The key to improve patient' prognosis was radical treatment to every primary cancer.

Cancer incidence in men with Klinefelter syndrome.

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Hasle, H.; Mellemgaard, A.; Nielsen, J.; Hansen, J.

1995-01-01

Many case reports have suggested an association between Klinefelter syndrome (KS) and cancer, but studies of the cancer incidence in larger groups of men with KS are lacking. A cohort of 696 men with KS was established from the Danish Cytogenetic Register. Information on the cancer incidence in the cohort was obtained from the Danish Cancer Registry and compared with the expected number calculated from the age, period and site specific cancer rates for Danish men. A total of 39 neoplasms were diagnosed (relative risk = 1.1). Four mediastinal tumours were observed (relative risk = 67); all four were malignant germ cell tumours. No cases of breast cancer or testis cancer were observed. One case of prostate cancer occurred within a previously irradiated field. No excess of leukaemia or lymphoma was found. An increased risk of cancer occurred in the age group 15-30 years (relative risk = 2.7). All six tumours in this group were germ cell tumours or sarcomas. The overall cancer incidence is not increased and no routine cancer screening seems to be justified. A considerably elevated risk of mediastinal germ cell tumours occurs in the period from early adolescence until the age of 30. PMID:7841064

Trends in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma Incidence, Vermont 1999-2013.

Science.gov (United States)

Owosho, Adepitan A; Wiley, Rashidah; Stansbury, Tessie; Gbadamosi, Semiu O; Ryder, Jon S

2018-02-09

This study examines trends in age-adjusted incidence rates of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) in comparison to oral cavity proper squamous cell carcinoma (OSCC) in the population of Vermont from 1999 to 2013. Data on cases of oral and pharynx cancers diagnosed in Vermont between 1999 and 2013 were obtained from the Vermont cancer registry. The age-adjusted incidence rates and annual percentage change of HPV-related OPSCC and OSCC were calculated using Joinpoint trend analysis. Four hundred and thirty-one cases of HPV-related OPSCC were diagnosed from 1999 to 2013. Males constituted 83% (P < 0.0001) of the cases and the 6th decade of life marked the highest incidence. The overall age-adjusted incidence rates for HPV-related OPSCC significantly increased (from 2.39 to 3.86 per 100,000, P < 0.0001). In males, it significantly increased (from 3.62 to 6.93 per 100,000, P < 0.0001), while in females it remained stable (from 1.18 to 1.02 per 100,000, P = 0.28) during 1999-2013. The average rate of HPV-related OPSCC significantly increased by 4.4% annually (P = 0.004). In males the average rate significantly increased by 5.3% annually (P = 0.001) and in females the rate increased by 0.37% annually (P = 0.87). In contrast, age-adjusted overall incidence rates for OSCC significantly decreased (from 3.99 to 3.35 per 100,000, P = 0.018). The overall rate of OSCC decreased by 0.96% annually (P = 0.37) and the highest incidence of cases was in the 7th decade of life. In conclusion, there was an increasing trend of HPV-related OPSCC, specifically in males, and there appears to be a decreasing trend of OSCC in Vermont.

Is oral cancer incidence among patients with oral lichen planus/oral lichenoid lesions underestimated?

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Gonzalez-Moles, M A; Gil-Montoya, J A; Ruiz-Avila, I; Bravo, M

2017-02-01

Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are considered potentially malignant disorders with a cancer incidence of around 1% of cases, although this estimation is controversial. The aim of this study was to analyze the cancer incidence in a case series of patients with OLP and OLL and to explore clinicopathological aspects that may cause underestimation of the cancer incidence in these diseases. A retrospective study was conducted of 102 patients diagnosed with OLP (n = 21, 20.58%) or OLL (n = 81) between January 2006 and January 2016. Patients were informed of the risk of malignization and followed up annually. The number of sessions programmed for each patient was compared with the number actually attended. Follow-up was classified as complete (100% attendance), good (75-99%), moderate (25-74%), or poor (<25% attendance) compliance. Cancer was developed by four patients (3.9%), three males and one male. One of these developed three carcinomas, which were diagnosed at the follow-up visit (two in lower gingiva, one in floor of mouth); one had OLL and the other three had OLP. The carcinoma developed in mucosal areas with no OLP or OLL involvement in three of these patients, while OLP and cancer were diagnosed simultaneously in the fourth. Of the six carcinomas diagnosed, five (83.3%) were T1 and one (16.7%) T2. None were N+, and all patients remain alive and disease-free. The cancer incidence in OLP and OLL appears to be underestimated due to the strict exclusion criteria usually imposed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Incidence of basilar invagination in patients with tonsillar herniation ? a case control craniometrical study

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Andrei F Joaquim

2014-09-01

Full Text Available A retrospective case-control study based on craniometrical evaluation was performed to evaluate the incidence of basilar invagination (BI. Patients with symptomatic tonsillar herniation treated surgically had craniometrical parameters evaluated based on CT scan reconstructions before surgery. BI was diagnosed when the tip of the odontoid trespassed the Chamberlain’s line in three different thresholds found in the literature: 2, 5 or 6.6 mm. In the surgical group (SU, the mean distance of the tip of the odontoid process above the Chamberlain’s line was 12 mm versus 1.2 mm in the control (CO group (p<0.0001. The number of patients with BI according to the threshold used (2, 5 or 6.6 mm in the SU group was respectively 19 (95%, 16 (80% and 15 (75% and in the CO group it was 15 (37%, 4 (10% and 2 (5%.

The incidence of eating disorders in the UK in 2000-2009: findings from the General Practice Research Database.

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Micali, Nadia; Hagberg, Katrina W; Petersen, Irene; Treasure, Janet L

2013-05-28

Few studies have investigated the incidence of eating disorders (EDs). Important questions about changes in the incidence of diagnosed disorders in recent years, disorder and gender-specific onset and case detection remain unanswered. Understanding changes in incidence is important for public health, clinical practice and service provision. The aim of this study was to estimate the annual (age-specific, gender-specific and subtype-specific) incidence of diagnosed ED: anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in primary care over a 10-year period in the UK (2000-2009); to examine the changes within the study period; and to describe peak age at diagnosis. Register-based study. Primary care. Data were obtained from a primary care register, the General Practice Research Database, which contains anonymised records representing about 5% of the UK population. All patients with a first-time diagnosis of AN, BN and EDNOS were identified. Annual crude and age-standardised incidence rates were calculated. A total of 9072 patients with a first-time diagnosis of an ED were identified. The age-standardised annual incidence rate of all diagnosed ED for ages 10-49 increased from 32.3 (95% CI 31.7 to 32.9) to 37.2 (95% CI 36.6 to 37.9) per 100 000 between 2000 and 2009. The incidence of AN and BN was stable; however, the incidence of EDNOS increased. The incidence of the diagnosed ED was highest for girls aged 15-19 and for boys aged 10-14. The age-standardised incidence of ED increased in primary care between 2000 and 2009. New diagnoses of EDNOS increased, and EDNOS is the most common ED in primary care.

Incidence and prognosis of stroke in young adults: a population-based study in Ferrara, Italy.

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Groppo, Elisabetta; De Gennaro, Riccardo; Granieri, Gino; Fazio, Patrik; Cesnik, Edward; Granieri, Enrico; Casetta, Ilaria

2012-02-01

The reported annual incidence of juvenile stroke ranges from 9 to 47 cases per 100,000 inhabitants. We sought to estimate the incidence of first-ever stroke in young adults through a population-based stroke registry in a well-defined and stable population. We planned to collect all cases of new stroke in people aged 15-44 years in Ferrara, Italy, over the period 2002-2007. During the surveillance period, a first-ever stroke was diagnosed in 39 patients, giving a mean annual crude incidence rate of 12.1 cases per 100,000 person-years (95% CI 8.6-16.5), 9.1 when adjusted to the European population. The overall 30-day case fatality rate was 7.7, 21.4% for hemorrhagic stroke. The incidence rate was in the range of estimates detected in western countries. The case-fatality rate was lower than that reported in less recent studies. The stroke subtype predicted the probability of death and the outcome.

Longitudinal associations between different dementia diagnoses and medication use jointly accounting for dropout.

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Agogo, George O; Ramsey, Christine M; Gnjidic, Danijela; Moga, Daniela C; Allore, Heather

2018-04-18

ABSTRACTBackground:Longitudinal studies of older adults are characterized by high dropout rates, multimorbid conditions, and multiple medication use, especially proximal to death. We studied the association between multiple medication use and incident dementia diagnoses including Alzheimer's disease (AD), vascular dementia (VD), and Lewy-body dementia (LBD), simultaneously accounting for dropout. Using the National Alzheimer's Coordinating Center data with three years of follow-up, a set of covariate-adjusted models that ignore dropout was fit to complete-case data, and to the whole-cohort data. Additionally, covariate-adjusted joint models with shared random effects accounting for dropout were fit to the whole-cohort data. Multiple medication use was defined as polypharmacy (⩾ five medications), hyperpolypharmacy (⩾ ten medications), and total number of medications. Incident diagnoses were 2,032 for AD, 135 for VD, and 139 for LBD. Percentages of dropout at the end of follow-up were as follows: 71.8% for AD, 81.5% for VD, and 77.7% for LBD. The odds ratio (OR) estimate for hyperpolypharmacy among those with LBD versus AD was 2.19 (0.78, 6.15) when estimated using complete-case data and 3.00 (1.66, 5.40) using whole-cohort data. The OR reduced to 1.41 (0.76, 2.64) when estimated from the joint model accounting for dropout. The OR for polypharmacy using complete-case data differed from the estimates using whole-cohort data. The OR for dementia diagnoses on total number of medications was similar, but non-significant when estimated using complete-case data. Reasons for dropout should be investigated and appropriate statistical methods should be applied to reduce bias in longitudinal studies among high-risk dementia cohorts.

Incidence of dementia in elderly Latin Americans: Results of the Maracaibo Aging Study.

Science.gov (United States)

Maestre, Gladys E; Mena, Luis J; Melgarejo, Jesus D; Aguirre-Acevedo, Daniel C; Pino-Ramírez, Gloria; Urribarrí, Milady; Chacon, Inara J; Chávez, Carlos A; Falque-Madrid, Luis; Gaona, Ciro A; Terwilliger, Joseph D; Lee, Joseph H; Scarmeas, Nikolaos

2018-02-01

There are few longitudinal studies of dementia in developing countries. We used longitudinal data from the Maracaibo Aging Study to accurately determine the age- and sex-specific incidence of dementia in elderly Latin Americans. The Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) was used to diagnose dementia, which was classified as Alzheimer's disease, vascular dementia, or other. Age- and sex-specific incidence was estimated as the number of new cases of dementia divided by person-years (p-y) of follow-up. The incidence of all dementia diagnoses was 9.10 per 1000 p-y (95% confidence interval [CI] 7.13-11.44; 8026 total p-y), 5.18 for Alzheimer's disease (95% CI 3.72-7.03; 7916 total p-y), and 3.35 for vascular dementia (95% CI 2.19-4.91; 7757 total p-y). Among Maracaibo Aging Study participants younger than 65 years, the incidence of dementia was higher than that of US Whites. Among individuals older than 65 years, the incidence was comparable to the mean of previous incidence estimates for other populations worldwide. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Trends in breast cancer incidence among women with type-2 diabetes in British general practice

DEFF Research Database (Denmark)

Bronsveld, Heleen K; Peeters, Paul J H L; de Groot, Mark C H

2017-01-01

Aims: To quantify breast cancer incidence in women with type-2 diabetes and assess age-standardized trends in invasive breast cancer incidence over time and by age groups. Methods: A population-based cohort study was conducted using the British general practice database (Clinical Practice Research...... Datalink) using data from 1989 to 2012. All adult women prescribed anti-hyperglycemic medication were selected and matched (1:1) on age and clinical practice to a reference cohort without diabetes. Results: During approximately 1.6 million person years (py), 2371 breast cancer cases were diagnosed...... that observed in the reference cohort (148, 95%CI:141-156); with an incidence rate ratio (IRR) of 1.01 (95%CI:0.94-1.08, p. >. 0.05). Conclusions: Currently, around 2880 women with type-2 diabetes are diagnosed with breast cancer per year in the United Kingdom. However, breast cancer incidence remained stable...

The incidence of eating disorders in the UK in 2000–2009: findings from the General Practice Research Database

Science.gov (United States)

Micali, Nadia; Hagberg, Katrina W; Petersen, Irene; Treasure, Janet L

2013-01-01

Objectives Few studies have investigated the incidence of eating disorders (EDs). Important questions about changes in the incidence of diagnosed disorders in recent years, disorder and gender-specific onset and case detection remain unanswered. Understanding changes in incidence is important for public health, clinical practice and service provision. The aim of this study was to estimate the annual (age-specific, gender-specific and subtype-specific) incidence of diagnosed ED: anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in primary care over a 10-year period in the UK (2000–2009); to examine the changes within the study period; and to describe peak age at diagnosis. Design Register-based study. Setting Primary care. Data were obtained from a primary care register, the General Practice Research Database, which contains anonymised records representing about 5% of the UK population. Participants All patients with a first-time diagnosis of AN, BN and EDNOS were identified. Primary outcome Annual crude and age-standardised incidence rates were calculated. Results A total of 9072 patients with a first-time diagnosis of an ED were identified. The age-standardised annual incidence rate of all diagnosed ED for ages 10–49 increased from 32.3 (95% CI 31.7 to 32.9) to 37.2 (95% CI 36.6 to 37.9) per 100 000 between 2000 and 2009. The incidence of AN and BN was stable; however, the incidence of EDNOS increased. The incidence of the diagnosed ED was highest for girls aged 15–19 and for boys aged 10–14. Conclusions The age-standardised incidence of ED increased in primary care between 2000 and 2009. New diagnoses of EDNOS increased, and EDNOS is the most common ED in primary care. PMID:23793681

Intramedullary disorders diagnosed by MRI. Clinical course in 23 cases

International Nuclear Information System (INIS)

Nagata, Kensei; Ohashi, Teruaki; Ishibashi, Kazumasa; Hirohashi, Akiyuki; Sato, Kimiaki

1996-01-01

We report the clinical course of 23 cases with intramedullary disorders diagnosed by MRI. Spinal vascular disease was the most common, and occurred in 11 cases, intramedullary tumor occurred in 6, and multiple sclerosis, myelitis, spinal edema each in 2. The characteristic MRI findings of the intramedullary disorders were spinal cord swelling on T1 weighted image and changes in the intensity on the T2 weighted image. Surgical treatment was performed in 5 of the 11 with spinal vascular disease and in 6 with an intra-medullary tumor. One patient with AV malformation underwent embolization of the spinal artery. The other 11 received conservative treatment. The period of follow-up ranged from 6 months to 9 years after onset. Complete recovery from symptoms was achieved in only 2 patients, some recovery was achieved in 8, no change in 10, and deterioration occurred in 3. In conclusion, it has become easy to diagnose intramedullary disorders by utilizing MRI. However, an accurate qualitative diagnosis is difficult except for spinal vascular disease. Complete recovery from the symptoms of intramedullary disorders remains difficult to achieve by available treatments. (author)

Intramedullary disorders diagnosed by MRI. Clinical course in 23 cases

Energy Technology Data Exchange (ETDEWEB)

Nagata, Kensei; Ohashi, Teruaki; Ishibashi, Kazumasa; Hirohashi, Akiyuki; Sato, Kimiaki [Kurume Univ., Fukuoka (Japan). School of Medicine

1996-09-01

We report the clinical course of 23 cases with intramedullary disorders diagnosed by MRI. Spinal vascular disease was the most common, and occurred in 11 cases, intramedullary tumor occurred in 6, and multiple sclerosis, myelitis, spinal edema each in 2. The characteristic MRI findings of the intramedullary disorders were spinal cord swelling on T1 weighted image and changes in the intensity on the T2 weighted image. Surgical treatment was performed in 5 of the 11 with spinal vascular disease and in 6 with an intra-medullary tumor. One patient with AV malformation underwent embolization of the spinal artery. The other 11 received conservative treatment. The period of follow-up ranged from 6 months to 9 years after onset. Complete recovery from symptoms was achieved in only 2 patients, some recovery was achieved in 8, no change in 10, and deterioration occurred in 3. In conclusion, it has become easy to diagnose intramedullary disorders by utilizing MRI. However, an accurate qualitative diagnosis is difficult except for spinal vascular disease. Complete recovery from the symptoms of intramedullary disorders remains difficult to achieve by available treatments. (author)

Incidencia de nuevos diagnósticos de VIH en España, 2004-2009 Incidence of new HIV diagnoses in Spain, 2004-2009

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Mercedes Díez

2012-04-01

Full Text Available Objetivo: Describir la incidencia de nuevos diagnósticos de infección por el virus de la inmunodeficiencia humana (VIH y su tendencia. Métodos: Se incluyeron los nuevos diagnósticos de VIH notificados en 2009 en las 15 comunidades autónomas con sistemas de información (64% de la población española. Para analizar las tendencias durante 2004-2009 se incluyeron las nueve comunidades con datos en ese periodo. Se obtuvo información clínico-epidemiológica de las hojas de notificación de casos y se realizaron distribuciones de nuevos diagnósticos y diagnóstico tardío según distintas variables. Para evaluar las tendencias se ajustó un modelo de Poisson. Resultados: En 2009 se notificaron 2.264 nuevos diagnósticos de VIH, la mayoría en hombres (80%. La mediana de edad al diagnóstico fue de 36 años (rango intercuartílico 29-43 y el 37,6% de los casos eran inmigrantes, destacando los latinoamericanos y los subsaharianos. La categoría de transmisión más común (42,5% fue la de hombres que tienen sexo con hombres, seguida de la heterosexual (34,5% y la parenteral (8,1%. Al diagnóstico, la mediana de CD4/µl era de 347 (rango intercuartílico: 152-555 y un 50,2% tenían Objective: To describe the incidence of new HIV diagnoses and its trend in Spain. Methods: All new HIV diagnoses notified to the case-registries of 15 autonomous regions (64% of the total Spanish population in 2009 were analyzed. To evaluate trends from 2004 to 2009, data from only nine regions were available. Clinical-epidemiological data were obtained from the notification forms. Distributions of new HIV diagnoses and late diagnoses according to several variables were performed. The Poisson distribution was used to evaluate trends. Results: In 2009, 2264 new HIV diagnoses were notified, mostly in men (80%. The median age at diagnosis was 36 years (interquartile range 29-43 and 37.6% of affected individuals were immigrants, mostly from Latin-America and sub

Imported dengue cases, weather variation and autochthonous dengue incidence in Cairns, Australia.

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Xiaodong Huang

Full Text Available BACKGROUND: Dengue fever (DF outbreaks often arise from imported DF cases in Cairns, Australia. Few studies have incorporated imported DF cases in the estimation of the relationship between weather variability and incidence of autochthonous DF. The study aimed to examine the impact of weather variability on autochthonous DF infection after accounting for imported DF cases and then to explore the possibility of developing an empirical forecast system. METHODOLOGY/PRINCIPAL FINDS: Data on weather variables, notified DF cases (including those acquired locally and overseas, and population size in Cairns were supplied by the Australian Bureau of Meteorology, Queensland Health, and Australian Bureau of Statistics. A time-series negative-binomial hurdle model was used to assess the effects of imported DF cases and weather variability on autochthonous DF incidence. Our results showed that monthly autochthonous DF incidences were significantly associated with monthly imported DF cases (Relative Risk (RR:1.52; 95% confidence interval (CI: 1.01-2.28, monthly minimum temperature ((oC (RR: 2.28; 95% CI: 1.77-2.93, monthly relative humidity (% (RR: 1.21; 95% CI: 1.06-1.37, monthly rainfall (mm (RR: 0.50; 95% CI: 0.31-0.81 and monthly standard deviation of daily relative humidity (% (RR: 1.27; 95% CI: 1.08-1.50. In the zero hurdle component, the occurrence of monthly autochthonous DF cases was significantly associated with monthly minimum temperature (Odds Ratio (OR: 1.64; 95% CI: 1.01-2.67. CONCLUSIONS/SIGNIFICANCE: Our research suggested that incidences of monthly autochthonous DF were strongly positively associated with monthly imported DF cases, local minimum temperature and inter-month relative humidity variability in Cairns. Moreover, DF outbreak in Cairns was driven by imported DF cases only under favourable seasons and weather conditions in the study.

Cancer incidence in eastern Morocco: cancer patterns and incidence trends, 2005-2012.

Science.gov (United States)

Elidrissi Errahhali, Manal; Elidrissi Errahhali, Mounia; Ouarzane, Meryem; Boulouiz, Redouane; Bellaoui, Mohammed

2017-08-29

Cancer is one of the major health problems worldwide. In this article, we present for the first time the cancer incidence trends, the distribution and the socioeconomic profile of incident cancer cases in Eastern Morocco over a period of eight years. Retrospective descriptive study of patients diagnosed with cancer at the Hassan II Regional Oncology Center (ROC) since it was created in October 2005 until December 2012. During the study period, the ROC was the only hospital specialized in cancer care in Eastern Morocco. A total of 7872 incident cases of cancer were registered in Eastern Morocco. Among these incident cases 5220 cases were women and 2652 were men, with a female to male ratio of 1.97. The mean age at diagnosis was 58 years for males and 52 for females and 94% of the patients aged over 30 years. For both sexes combined and for all cancer sites, breast cancer was the commonest followed by cervix uteri, colon-rectum, lung, nasopharynx, and stomach cancers. The most common cancer in women was breast cancer, followed respectively by cervix uteri cancer, colon-rectum cancer, ovary cancer, and stomach cancer. In men, the lung cancer ranked first, followed respectively by colon-rectum cancer, nasopharynx cancer, prostate cancer, and stomach cancer. For most cancers, crude incidence rates (CR) have increased significantly. The CR for all cancers combined has increased from 56.6 to 80.3 per 100,000 females and from 32.3 to 42.6 per 100,000 males during the study period. Patients profile analysis showed that 79% of cancer patients were from urban areas, 83% were unemployed and 85% had no health insurance. The distribution of cancers in Eastern Morocco is different from those observed in other regions of Morocco. Unlike most countries, women were much more affected with cancer than men in Eastern Morocco. More importantly, the rates of many cancers are rising. Therefore, our data justify the need to develop effective programs for cancer control and prevention in

Interesting cases which were difficult to diagnose by CT

International Nuclear Information System (INIS)

Ueki, Koji; Okubo, Koichi; Shinohara, Shinji

1981-01-01

Computed tomography (CT) clinically provides us with much more useful diagnostic informations regarding the localization, size, shape, extent and inner structure of the lesions and then in some cases the specific diagnosis can be also obtained by CT alone. However, it is usually difficult to define the longitudinal extent of the lesions, their relation to adjacent tissues, the originated site in enormous lesion and histological type also. At CT examination, it is essential to recognize these drawback and limitation on CT. From these points of view, six interesting cases (i.e. pericardial diverticulum, hepatoma with retroperitoneal metastasis, cholangiohepatoma, afferent loop syndrome, invagination and retroperitoneal malignant schwannoma) which were difficult to diagnose by CT and proved ultimately with operation or autopsy were illustrated with some reviews. (author)

Incidence of early-onset dementia in Mar del Plata.

Science.gov (United States)

Sanchez Abraham, M; Scharovsky, D; Romano, L M; Ayala, M; Aleman, A; Sottano, E; Etchepareborda, I; Colla Machado, C; García, M I; Gonorazky, S E

2015-03-01

Early-onset dementia (EOD) is defined as dementia with onset before the age of 65 years. EOD is increasingly recognised as an important clinical and social problem with devastating consequences for patients and caregivers. Determine the annual crude incidence rate and the specific incidence rates by sex and age in patients with EOD, and the standardised rate using the last national census of the population of Argentina (NCPA), from 2010. Hospital Privado de Comunidad, Mar del Plata, Argentina, attends a closed population and is the sole healthcare provider for 17 614 people. Using the database pertaining to the Geriatric Care department, we identified all patients diagnosed with EOD between 1 January, 2005 and 31 December, 2011. EOD was defined as dementia diagnosed in patients younger than 65. The study period yielded 14 patients diagnosed with EOD out of a total of 287 patients evaluated for memory concerns. The crude annual incidence of EOD was 11 per 100 000/year (CI 95%: 6.25-19.1): 17 per 100 000 (CI 95%: 7.2-33.1) in men and 8 per 100 000 (CI 95%: 3.4-17.2) in women. We observed a statistically significant increase when comparing incidence rates between patients aged 21 to <55 years and ≥ 55 to <65 years (3 vs 22 per 100 000, P=.0014). The rate adjusted by NCPA census data was 5.8 cases of EOD habitants/year. This study, conducted in a closed population, yielded an EOD incidence rate of 11 per 100 000 inhabitants/year. To the best of our knowledge, this is the first prospective epidemiological study in Argentina and in Latin America. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

The incidence and prevalence of acromegaly, a nationwide study from 1955 through 2013.

Science.gov (United States)

Hoskuldsdottir, Gudrun Thuridur; Fjalldal, Sigridur Bara; Sigurjonsdottir, Helga Agusta

2015-12-01

Acromegaly is a rare disease with complications and increased mortality. The incidence and prevalence of acromegaly worldwide is not well known. To gather information on patients diagnosed with acromegly in Iceland over 59 years. Information was retrospectively gathered about patients diagnosed with acromegaly from 1955 through 2013. Incidence was calculated from the total Icelandic population. Information was gathered from medical records at Landspitali National University Hospital, Iceland, housing the only endocrine department in the country, at the largest hospital outside of Reykjavik (Sjúkrahúsið á Akureyri, Akureyri Hospital) and the largest private outpatient clinic in Reykjavik, where some of the patients received follow-up care. Further, information on patients were sought from all endocrinologists treating adult patients in Iceland. All patients diagnosed with acromegaly during the study period were included. Fifty-two patients (32 men) were diagnosed during the study period. The average age at diagnosis was 44.5 years. Nine patients had died. Symptoms had been present for more than 3 years in most cases. Twenty-five patients had hypertension (48 %). Follow up information was available for 48 patients, 63 % were considered cured after treatment. The incidence of acromegaly in Iceland during the study period was much higher than earlier reports have indicated. During the last 9 years of the study 7.7 patients were diagnosed per million per year. At diagnosis, 38 % had developed hypertension and 10 % were diagnosed during follow up. This indicates the importance of endocrine disorders in the aetiology of hypertension.

Incidence and sources of native and prosthetic joint infection: a community based prospective survey

NARCIS (Netherlands)

Kaandorp, C. J.; Dinant, H. J.; van de Laar, M. A.; Moens, H. J.; Prins, A. P.; Dijkmans, B. A.

1997-01-01

To determine the incidence and sources of bacterial arthritis in the Amsterdam health district and the maximum percentage of cases that theoretically would be preventable. Patients with bacterial arthritis diagnosed between 1 October 1990 and 1 October 1993 were prospectively reported to the study

Neuroautonomic evaluation of patients with unexplained syncope: incidence of complex neurally mediated diagnoses in the elderly

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Rafanelli M

2014-02-01

Full Text Available Martina Rafanelli, Alessandro Morrione, Annalisa Landi, Emilia Ruffolo, Valentina M Chisciotti, Maria A Brunetti, Niccolò Marchionni, Andrea Ungar Syncope Unit, Cardiology and Geriatric Medicine, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy Background: The incidence of syncope increases in individuals over the age of 70 years, but data about this condition in the elderly are limited. Little is known about tilt testing (TT, carotid sinus massage (CSM, or supine and upright blood pressure measurement related to age or about patients with complex diagnoses, for example, those with a double diagnosis, ie, positivity in two of these three tests. Methods: A total of 873 consecutive patients of mean age 66.5±18 years underwent TT, CSM, and blood pressure measurement in the supine and upright positions according to the European Society of Cardiology guidelines on syncope.1 Neuroautonomic evaluation was performed if the first-line evaluation (clinical history, physical examination, electrocardiogram was suggestive of neurally mediated syncope, or if the first-line evaluation was suggestive of cardiac syncope but this diagnosis was excluded after specific diagnostic tests according to European Society of Cardiology guidelines on syncope, or if certain or suspected diagnostic criteria were not present after the first-line evaluation. Results: A diagnosis was reached in 64.3% of cases. TT was diagnostic in 50.4% of cases, CSM was diagnostic in 11.8% of cases, and orthostatic hypotension was present in 19.9% of cases. Predictors of a positive tilt test were prodromal symptoms and typical situational syncope. Increased age and a pathologic electrocardiogram were predictors of carotid sinus syndrome. Varicose veins and alpha-receptor blockers, nitrates, and benzodiazepines were associated with orthostatic hypotension. Twenty-three percent of the patients had a complex diagnosis. The most frequent association was

Rocky mountain spotted fever in the United States, 2000-2007: interpreting contemporary increases in incidence.

Science.gov (United States)

Openshaw, John J; Swerdlow, David L; Krebs, John W; Holman, Robert C; Mandel, Eric; Harvey, Alexis; Haberling, Dana; Massung, Robert F; McQuiston, Jennifer H

2010-07-01

Rocky Mountain spotted fever (RMSF), a potentially fatal tick-borne infection caused by Rickettsia rickettsii, is considered a notifiable condition in the United States. During 2000 to 2007, the annual reported incidence of RMSF increased from 1.7 to 7 cases per million persons from 2000 to 2007, the highest rate ever recorded. American Indians had a significantly higher incidence than other race groups. Children 5-9 years of age appeared at highest risk for fatal outcome. Enzyme-linked immunosorbent assays became more widely available beginning in 2004 and were used to diagnose 38% of cases during 2005-2007. The proportion of cases classified as confirmed RMSF decreased from 15% in 2000 to 4% in 2007. Concomitantly, case fatality decreased from 2.2% to 0.3%. The decreasing proportion of confirmed cases and cases with fatal outcome suggests that changes in diagnostic and surveillance practices may be influencing the observed increase in reported incidence rates.

Trends in the incidence of chronic fatigue syndrome and fibromyalgia in the UK, 2001-2013: a Clinical Practice Research Datalink study.

Science.gov (United States)

Collin, Simon M; Bakken, Inger J; Nazareth, Irwin; Crawley, Esther; White, Peter D

2017-06-01

Objective Trends in recorded diagnoses of chronic fatigue syndrome (CFS, also known as 'myalgic encephalomyelitis' (ME)) and fibromyalgia (FM) in the UK were last reported more than ten years ago, for the period 1990-2001. Our aim was to analyse trends in incident diagnoses of CFS/ME and FM for the period 2001-2013, and to investigate whether incidence might vary by index of multiple deprivation (IMD) score. Design Electronic health records cohort study. Setting NHS primary care practices in the UK. Participants Participants: Patients registered with general practices linked to the Clinical Practice Research Datalink (CPRD) primary care database from January 2001 to December 2013. Main outcome measure Incidence of CFS/ME, FM, post-viral fatigue syndrome (PVFS), and asthenia/debility. Results The overall annual incidence of recorded cases of CFS/ME was 14.8 (95% CI 14.5, 15.1) per 100,000 people. Overall annual incidence per 100,000 people for FM was 33.3 (32.8-33.8), for PVFS 12.2 (11.9, 12.5), and for asthenia/debility 7.0 (6.8, 7.2). Annual incidence rates for CFS/ME diagnoses decreased from 17.5 (16.1, 18.9) in 2001 to 12.6 (11.5, 13.8) in 2013 (annual percent change -2.8% (-3.6%, -2.0%)). Annual incidence rates for FM diagnoses decreased from 32.3 (30.4, 34.3) to 27.1 (25.5, 28.6) in 2007, then increased to 38.2 (36.3, 40.1) per 100,000 people in 2013. Overall annual incidence of recorded fatigue symptoms was 2246 (2242, 2250) per 100,000 people. Compared with the least deprived IMD quintile, incidence of CFS/ME in the most deprived quintile was 39% lower (incidence rate ratio (IRR) 0.61 (0.50, 0.75)), whereas rates of FM were 40% higher (IRR 1.40 (0.95, 2.06)). Conclusion These analyses suggest a gradual decline in recorded diagnoses of CFS/ME since 2001, and an increase in diagnoses of fibromyalgia, with opposing socioeconomic patterns of lower rates of CFS/ME diagnoses in the poorest areas compared with higher rates of FM diagnoses.

The geography of prostate cancer incidence in Norway: Are the patterns real?

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Asbjørn Aase

2009-10-01

Full Text Available  SUMMARYThe etiology of prostate cancer is to a large extent unknown. There are striking international variations inincidence, which may indicate that factors that show geographical variations can provide further cluesabout etiology. A problem with using incidence data for comparisons in time and space is that the numberof cases reported may be affected by the intensity of diagnosing, since many of the cases are latent andasymptomatic. The purpose of this study is to adjust the observed pattern of prostate cancer in communesand counties of Norway for variations which may be due to diagnostic artefacts. It is assumed that a largeproportion of local cancers may be an indication of more intensive diagnosing. Data of prostate cancerincidence for 1982-91 with tumours specified by degree of spread were provided by the Cancer Registry. Aregression function relating total incidence to % local tumours was used to predict the SIRs adjusted forvariations in % local tumours. The maps comparing incidence patterns before and after adjustement showthat a large part of the significant deviations from the national mean persists, and that the pattern of negativedeviations in the far north is even strengthened. A significant positive correlation between the ratio ofincidence to mortality against % local tumours is found, which supports the main hypothesis of the study.

Incidence of eye cancer in Taiwan: an 18-year review.

Science.gov (United States)

Cheng, C-Y; Hsu, W-M

2004-02-01

To describe the incidence and histologic patterns of eye cancers in Chinese in Taiwan. Beginning in 1979, cases of cancer in Taiwan were reported to the Taiwan National Cancer Registry. Information on all Chinese patients diagnosed with eye malignancies under the International Classification of Disease, Ninth Revision, site 190, was retrieved for analysis from the data bank of the Taiwan National Cancer Registry. In all, 733 cases with primary eye cancers were identified from 1979 to 1996, an 18-year period. The average annual age-standardized incidence of eye cancers was 2.46 per million population (2.57 for male and 2.33 for female). For cases less than 15 years of age, the most common eye malignancy was retinoblastoma (86.0%), followed by rhabdomyosarcoma (3.9%) and lymphoma (2.8%). For cases 15 years of age or older, the most common eye malignancy was melanoma (28.6%), followed by squamous cell sarcoma (21.0%) and lymphoma (20.8%). The time trends of the incidence of eye cancers were relatively stable over the 18-year period in Taiwan. Retinobalstoma, melanoma, and lymphoma were the three most common eye cancers in this Chinese population.

Challenges of information security incident learning: An industrial case study in a Chinese healthcare organization.

Science.gov (United States)

He, Ying; Johnson, Chris

2017-12-01

Security incidents can have negative impacts on healthcare organizations, and the security of medical records has become a primary concern of the public. However, previous studies showed that organizations had not effectively learned lessons from security incidents. Incident learning as an essential activity in the "follow-up" phase of security incident response lifecycle has long been addressed but not given enough attention. This paper conducted a case study in a healthcare organization in China to explore their current obstacles in the practice of incident learning. We interviewed both IT professionals and healthcare professionals. The results showed that the organization did not have a structured way to gather and redistribute incident knowledge. Incident response was ineffective in cycling incident knowledge back to inform security management. Incident reporting to multiple stakeholders faced a great challenge. In response to this case study, we suggest the security assurance modeling framework to address those obstacles.

A French multicenter study of over 700 patients with 22q11 deletions diagnosed using FISH or aCGH.

Science.gov (United States)

Poirsier, Céline; Besseau-Ayasse, Justine; Schluth-Bolard, Caroline; Toutain, Jérôme; Missirian, Chantal; Le Caignec, Cédric; Bazin, Anne; de Blois, Marie Christine; Kuentz, Paul; Catty, Marie; Choiset, Agnès; Plessis, Ghislaine; Basinko, Audrey; Letard, Pascaline; Flori, Elisabeth; Jimenez, Mélanie; Valduga, Mylène; Landais, Emilie; Lallaoui, Hakima; Cartault, François; Lespinasse, James; Martin-Coignard, Dominique; Callier, Patrick; Pebrel-Richard, Céline; Portnoi, Marie-France; Busa, Tiffany; Receveur, Aline; Amblard, Florence; Yardin, Catherine; Harbuz, Radu; Prieur, Fabienne; Le Meur, Nathalie; Pipiras, Eva; Kleinfinger, Pascale; Vialard, François; Doco-Fenzy, Martine

2016-06-01

Although 22q11.2 deletion syndrome (22q11.2DS) is the most recurrent human microdeletion syndrome associated with a highly variable phenotype, little is known about the condition's true incidence and the phenotype at diagnosis. We performed a multicenter, retrospective analysis of postnatally diagnosed patients recruited by members of the Association des Cytogénéticiens de Langue Française (the French-Speaking Cytogeneticists Association). Clinical and cytogenetic data on 749 cases diagnosed between 1995 and 2013 were collected by 31 French cytogenetics laboratories. The most frequent reasons for referral of postnatally diagnosed cases were a congenital heart defect (CHD, 48.6%), facial dysmorphism (49.7%) and developmental delay (40.7%). Since 2007 (the year in which array comparative genomic hybridization (aCGH) was introduced for the routine screening of patients with intellectual disability), almost all cases have been diagnosed using FISH (96.1%). Only 15 cases (all with an atypical phenotype) were diagnosed with aCGH; the deletion size ranged from 745 to 2904 kb. The deletion was inherited in 15.0% of cases and was of maternal origin in 85.5% of the latter. This is the largest yet documented cohort of patients with 22q11.2DS (the most commonly diagnosed microdeletion) from the same population. French cytogenetics laboratories diagnosed at least 108 affected patients (including fetuses) per year from among a national population of ∼66 million. As observed for prenatal diagnoses, CHDs were the most frequently detected malformation in postnatal diagnoses. The most common CHD in postnatal diagnoses was an isolated septal defect.

To Take Care of Them: An Ethical Case Study of the Canal Incident

Science.gov (United States)

2013-06-14

opinions, emotional responses, and systems such as ethical relativism ,87 divine command theory,88 utilitarianism,89 deontology,90 and virtue ethics .91...TO TAKE CARE OF THEM: AN ETHICAL CASE STUDY OF THE CANAL INCIDENT A... ETHICAL CASE STUDY OF THE CANAL INCIDENT 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Emmitt Maxwell Furner II 5d. PROJECT

Case of physiotherapy care for patient with rheumatoid arthritis diagnosed

OpenAIRE

Koukalová, Martina

2014-01-01

Title of bachelor's thesis: Case of physiotherapy care for patient with rheumatoid arthritis diagnosed Objectives: The aim of this thesis is to show using of physiotherapeutistic methods on patient with rheumatoid arthritis. One part of this thesis is casuistry of patient with rheumatoid arthritis. The summary: The thesis is divided into two parts, the theoretical part and the special part. The theoretical part is focused on issue of rheumatoid arthritis, its characteristic, division, diagnos...

A Rare Case of Malonic Aciduria Diagnosed by Newborn Screening in Qatar

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Mamatha Ramaswamy

2017-03-01

Full Text Available Malonic aciduria is a rare autosomal recessive organic acid disorder. With the widespread use of tandem mass spectrometry for analysis of the amino acid/acylcarnitine profile on dried blood spots for newborn screening (NBS, this condition can be readily diagnosed and can be included in the organic acid screen in NBS programs. In Qatar, we report the first case of an asymptomatic baby screened and diagnosed with malonic aciduria through NBS. This patient has a genetic variant of malonyl-CoA decarboxylase that has not been previously reported in the literature. This condition should be differentiated from a similar disorder, combined malonic and methylmalonic aciduria. The clinical phenotype of malonic aciduria is variable and the pathophysiology is not fully understood. There is no established guidance or recommendations regarding the appropriate treatment regimen, dietary therapy or regular follow-up of these patients. Most available evidence for treatment is based on a single study or case report.

Incidence of occult leiomyosarcoma in presumed morcellation cases: a database study.

Science.gov (United States)

Rodriguez, Ana M; Asoglu, Mehmet R; Sak, Muhammet Erdal; Tan, Alai; Borahay, Mostafa A; Kilic, Gokhan S

2016-02-01

Our objective was to estimate the incidence of uterine leiomyosarcoma in patients with leiomyomas following laparoscopic supracervical hysterectomy and myomectomy procedures. For this study, we analyzed records of 13,964 women aged 25-64 years who underwent laparoscopic supracervical hysterectomies or myomectomies for leiomyomas from 2002 to 2011 using Clinformatics DataMart. Patient records were divided into two groups: history of laparoscopic supracervical hysterectomy and history of myomectomy. Subjects were tracked to identify diagnosis of leiomyosarcoma within 1 year of the procedure. We analyzed data from the 25-39, 40-49, and 50-64 age brackets. Evidence was obtained from a cohort study from national private insurance claims in the US. Our results showed the incidence of occult leiomyosarcoma developing within 1 year following supracervical hysterectomy using a laparoscopic-assisted approach are 9.8, 10.7, and 33.4 per 10,000 for the 25-39, 40-49, and 50-64 age brackets, respectively; the overall incidence rate is 13.1 per 10,000. The incidence rate of occult leiomyosarcoma developing within 1 year following myomectomy using a laparoscopic-assisted approach are 0.0, 33.8, and 90.1 per 10,000 for the 25-39, 40-49, and 50-64 age brackets, respectively; the overall incidence rate is 17.3 per 10,000. Our analysis shows the overall risk of being diagnosed with occult leiomyosarcoma is 12.9 per 10,000 in laparoscopic-assisted supracervical hysterectomy and myomectomy for patients younger than 49. There is no evidence of occult leiomyosarcoma 1 year after operation for patients younger than 40 who underwent laparoscopic myomectomy. Copyright © 2015. Published by Elsevier Ireland Ltd.

Rocky Mountain Spotted Fever in the United States, 2000–2007: Interpreting Contemporary Increases in Incidence

Science.gov (United States)

Openshaw, John J.; Swerdlow, David L.; Krebs, John W.; Holman, Robert C.; Mandel, Eric; Harvey, Alexis; Haberling, Dana; Massung, Robert F.; McQuiston, Jennifer H.

2010-01-01

Rocky Mountain spotted fever (RMSF), a potentially fatal tick-borne infection caused by Rickettsia rickettsii, is considered a notifiable condition in the United States. During 2000 to 2007, the annual reported incidence of RMSF increased from 1.7 to 7 cases per million persons from 2000 to 2007, the highest rate ever recorded. American Indians had a significantly higher incidence than other race groups. Children 5–9 years of age appeared at highest risk for fatal outcome. Enzyme-linked immunosorbent assays became more widely available beginning in 2004 and were used to diagnose 38% of cases during 2005–2007. The proportion of cases classified as confirmed RMSF decreased from 15% in 2000 to 4% in 2007. Concomitantly, case fatality decreased from 2.2% to 0.3%. The decreasing proportion of confirmed cases and cases with fatal outcome suggests that changes in diagnostic and surveillance practices may be influencing the observed increase in reported incidence rates. PMID:20595498

Incidence of hyperthyroidism in Sweden.

Science.gov (United States)

Abraham-Nordling, Mirna; Byström, Kristina; Törring, Ove; Lantz, Mikael; Berg, Gertrud; Calissendorff, Jan; Nyström, Helena Filipsson; Jansson, Svante; Jörneskog, Gun; Karlsson, F Anders; Nyström, Ernst; Ohrling, Hans; Orn, Thomas; Hallengren, Bengt; Wallin, Göran

2011-12-01

The incidence of hyperthyroidism has been reported in various countries to be 23-93/100,000 inhabitants per year. This extended study has evaluated the incidence for ~40% of the Swedish population of 9 million inhabitants. Sweden is considered to be iodine sufficient country. All patients including children, who were newly diagnosed with overt hyperthyroidism in the years 2003-2005, were prospectively registered in a multicenter study. The inclusion criteria are as follows: clinical symptoms and/or signs of hyperthyroidism with plasma TSH concentration below 0.2 mIE/l and increased plasma levels of free/total triiodothyronine and/or free/total thyroxine. Patients with relapse of hyperthyroidism or thyroiditis were not included. The diagnosis of Graves' disease (GD), toxic multinodular goiter (TMNG) and solitary toxic adenoma (STA), smoking, initial treatment, occurrence of thyroid-associated eye symptoms/signs, and demographic data were registered. A total of 2916 patients were diagnosed with de novo hyperthyroidism showing the total incidence of 27.6/100,000 inhabitants per year. The incidence of GD was 21.0/100,000 and toxic nodular goiter (TNG=STA+TMNG) occurred in 692 patients, corresponding to an annual incidence of 6.5/100,000. The incidence was higher in women compared with men (4.2:1). Seventy-five percent of the patients were diagnosed with GD, in whom thyroid-associated eye symptoms/signs occurred during diagnosis in every fifth patient. Geographical differences were observed. The incidence of hyperthyroidism in Sweden is in a lower range compared with international reports. Seventy-five percent of patients with hyperthyroidism had GD and 20% of them had thyroid-associated eye symptoms/signs during diagnosis. The observed geographical differences require further studies.

Analysis of a radiological incident and lessons to be learned: a case of industrial radiographic incident in great Britain

International Nuclear Information System (INIS)

Croft, J.; Lefaure, Ch.

2000-01-01

This note describes a case study to provide feedback analysis and lessons to be learned from a radiological incident. This one occurred in the UK. It has been published in the European ALARA Newsletter no. 2 (January 1997) and has been selected from the IRID database (Ionising Radiation Incident Database) managed by the Health and Safety Executive, National Radiological Protection Board and Environmental Agency. (authors)

Case of physiotherapy care for patient diagnosed with rheumatoid arthritis

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Šedková, Štěpánka

2013-01-01

Title of bachelor's thesis: Case of physiotherapy care for patient diagnosed with rheumatoid arthritis Objectives: The aim is to emphasize the use of physiotherapy as a part of comprehensive treatment of a patient with rheumatoid arthritis. The thesis includes a detailed casuistry of a patient with rheumatoid arthritis. Methods: The thesis is divided into a general part and a special part. The general part is focused on description of rheumatoid arthritis. It discusses characteristics of the ...

Incidence and survival in non-hereditary amyloidosis in Sweden

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Hemminki Kari

2012-11-01

Full Text Available Abstract Background Amyloidosis is a heterogeneous disease caused by deposition of amyloid fibrils in organs and thereby interfering with physiological functions. Hardly any incidence data are available and most survival data are limited to specialist clinics. Methods Amyloidosis patients were identified from the Swedish Hospital Discharge and Outpatients Registers from years 2001 through 2008. Results The incidence of non-hereditary amyloidosis in 949 patients was 8.29 per million person-years and the diagnostic age with the highest incidence was over 65 years. Secondary systemic amyloidosis showed an incidence of 1 per million and a female excess and the largest number of subsequent rheumatoid arthritis deaths; the median survival was 4 years. However, as rheumatoid arthritis deaths also occurred in other diagnostic subtypes, the incidence of secondary systemic amyloidosis was likely to be about 2.0 per million. The median survival of patients with organ-limited amyloidosis was 6 years. Most myeloma deaths occurred in patients diagnosed with unspecified or ‘other’ amyloidosis. These subtypes probably accounted for most of immunoglobulin light chain (AL amyloidosis cases; the median survival time was 3 years. Conclusions The present diagnostic categorization cannot single out AL amyloidosis in the Swedish discharge data but, by extrapolation from myeloma cases, an incidence of 3.2 per million could be ascribed to AL amyloidosis. Similarly, based on rheumatoid arthritis death rates, an incidence of 2.0 could be ascribed to secondary systemic amyloidosis.

Incidence of urinary tract infections in infants with antenatally diagnosed hydronephrosis-A retrospective single center study.

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Visuri, Sofia; Jahnukainen, Timo; Taskinen, Seppo

2017-09-01

To evaluate the incidence of urinary tract infections (UTIs) in infants with antenatal hydronephrosis (AHN). A cohort of AHN patients admitted to our institution between 2003 and 2013 were identified. Altogether 192 patients with nonrefluxing hydronephrosis (HN, n=135), nonrefluxing hydroureteronephrosis (HUN, n=21), or vesicoureteral reflux (VUR, n=36) were identified. Patients with complex anomalies or neonatal decompression of the urinary tract were excluded. Information about UTIs diagnosed among the AHN patients was collected and compared with data from 58 controls. During the median follow-up time of 2.6 (0.3-11.2) years, 24 (13%) patients (15 (10%) males and 9 (19%) females) and 2 (3%) controls experienced at least one UTI (p=0.033). Eighteen (69%) UTIs were febrile. The males had the first UTI at significantly younger age than the females (0.3, 0.0-1.7years vs. 1.0, 0.4-4.8years, p=0.010). UTI was detected in 15 (63%) patients with grade 4-5 VUR, in 8 (6%) patients with HN, and in one (5%) patient with HUN (p-values 0.999 against the controls). None of the patients with grade≤3 VUR had UTI. Fifty-eight percent of the patients with UTI were on antimicrobial prophylaxis. In five (12%) cases UTI appeared within one week after voiding cystourethrography (VCUG). Infants with AHN and grade 4-5 VUR had the highest risk of UTI. UTIs tented to be more common in females than in males; however, males experienced UTI at younger age than females. VCUG caused UTI in 2.3% in our material. III. Copyright © 2017 Elsevier Inc. All rights reserved.

Incidence of colorectal cancer in young patients.

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Campos, Fábio Guilherme C M DE; Figueiredo, Marleny Novaes; Monteiro, Mariane; Nahas, Sérgio Carlos; Cecconello, Ivan

2017-01-01

Sporadic colorectal cancer (CRC) is traditionally diagnosed after de sixth decade of life, although a small percentage of cases are diagnosed in patients under 40 years of age, and incidence is increasing. There exists a great volume of controversy regarding clinical outcome of young patients diagnosed with colorectal cancer (CRC) when compared to elder counterparts. Our aims were to evaluate the rate of CRC in young patients, to review the pertaining literature and to discuss outcomes and clinical prognosis. A retrospective review involving patients with CRC was undertaken, focusing on age at diagnosis. The information extracted from this literature review showed a trend towards a decreased incidence in older people with an opposite effect among adolescents and young adults. Moreover, biological aggressiveness in young adults diagnosed with CRC has not been fully recognized, although it is usually diagnosed later and in association with adverse histological features. Besides that, these features don't affect outcome. These apparent increase in CRC incidence among young patients during the last decades raises the need for a greater suspicious when evaluating common symptoms in this group. Thus, educational programs should widespread information for both population and physicians to improve prevention and early diagnosis results. RESUMO O câncer colorretal (CCR) esporádico é tradicionalmente diagnosticado após a sexta década de vida, embora uma pequena porcentagem de casos seja diagnosticada em doentes abaixo dos 40 anos de idade, e a incidência está aumentando. Existe uma grande controvérsia a respeito da evolução clínica de doentes jovens portadores de CCR em comparação aos mais idosos. Os objetivos deste estudo foram avaliar a prevalência de CCR em doentes jovens, rever a literatura pertinente e discutir suas características mais importantes nesta faixa etária. Para tanto realizou-se revisão da literatura envolvendo doentes com CCR com foco na

The impact of socio-economic status on incidence of AIDS cases in Brazilian

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Márcia Regina Godoy

2013-12-01

Full Text Available In recent years, many researchers have devoted attention to the issue of the importance of social indicators in disease reduction. The objective of this paper is to analyze the statistical association between the reported AIDS cases and some socioeconomic variables. We analyzed a sample of 1,994 Brazilian municipalities with AIDS cases reported in 1991 and 2000. The variables analyzed are: AIDS incidence rate per capita, illiteracy rate, Gini Index, per capita income, access to electricity and television, life expectancy at birth. The approach used in this study was econometric panel data model. The results of this analysis show that socioeconomic variables are important for understanding the incidence of AIDS cases in Brazil, and are important for the design of public policies to combat the increasing incidence of HIV / AIDS, also show a distinct pattern to found in the literature for African countries.

The incidence of acute myeloid leukemia in Calgary, Alberta, Canada: a retrospective cohort study

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Andrea Christine Shysh

2017-08-01

Full Text Available Abstract Background The incidence rate of acute myeloid leukemia (AML was determined in the Calgary Metropolitan Area, a major Canadian city. Methods Data from all patients diagnosed with AML between January 1, 2011 and December 31, 2015 were retrieved from a single, centralized cancer cytogenetics laboratory for bone marrow samples, the sole diagnostic facility of its kind in Southern Alberta. Results The calculated incidence rate was 2.79 cases per 100,000 person-years with a median age of 60, slightly lower than previously published data. The age-standardized incidence rate for Canada was 3.46 cases per 100,000 person-years. The higher value is reflective of Calgary’s younger population compared to the rest of Canada. Higher male incidence and greatest incidence occurring at approximately the age of 85 is similar to data from other developed countries. The lower incidence rates and median age of diagnosis, in comparison with that of other high-income nations, may be due to differences in the proportion of aging citizens in the population. Conclusion This is the first published incidence rate of acute myeloid leukemia (AML in Canada across all age groups.

[Use of hospital discharge records to estimate the incidence of malignant mesotheliomas].

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Stura, Antonella; Gangemi, Manuela; Mirabelli, Dario

2007-01-01

cancer registries usually adopt strategies for active case finding. Interest in using administrative sources of data is rising to assess the usefullness of Hospital discharge records (HDR) to supplement the traditional methods of case finding of the malignant mesothelioma (MM) Registry of the Piedmont Region. HDRs have been used since 1996. We assessed the number of cases identified only through HDRs and their influence on MM incidence. cases identified through HDRs were about 10% of those with histologic confirmation of the diagnosis, 34% of those with cytologic confirmation, and 72% of those without morphologic examination. Cases diagnosed in hospitals located outside the region would have been easily (50%) missed. The age-standardised (standard: Italian pop. at the 1981 census) incidence rate of pleural MM increases from 2.2 to 2.7 per 100,000 per year among men, and from 1.1 to 1.2 among women, when including all cases identified from HDRs, irrespective of their diagnostic confirmation. Peritoneal MM incidence estimates are unaffected. Overall without access to the hospital discharge files, 179 cases out of 954 would not have been registered between 1996 and 2001. In the same calendar period 59 cases identified by means of active search by the Registry have not been found in the hospital discharge files. HDRs are useful in addition, but not in substitution, to active search of MM cases.

Thoracic outlet syndrome: Case report

International Nuclear Information System (INIS)

Marquez, Juan Camilo; Acosta, Mauricio Fernando; Uribe Jorge Ricardo

2009-01-01

We report a case of vascular thoracic outlet syndrome in a young man, diagnosed with upper limb arteriography, leading to repeated arterio-arterial emboli originating from a post-stenotic subclavian artery aneurysm. It is of our interest due to its low incidence and the small number of cases reported that have been diagnosed by arteriography. The thoracic outlet is the path through which vascular and neural structures goes from the neck to the axilla, and it has three anatomical strictures, that when pronounced, can compress the brachial plexus or subclavian vessels, leading to different symptoms and signs.

Incidence rate of ovarian cancer cases in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001–2008

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Alghamdi IG

2014-06-01

Full Text Available Ibrahim G Alghamdi,1,2 Issam I Hussain,1 Mohamed S Alghamdi,3 Mansour M Alghamdi,4 Ahlam A Dohal,4 Mohammed A El-Sheemy51School of Life Sciences, University of Lincoln, Brayford Pool, Lincoln, UK; 2Al-Baha University, Kingdom of Saudia Arabia; 3Ministry of Health, General Directorate of Health Affairs, Al-Baha, Kingdom of Saudi Arabia; 4King Fahad Specialist Hospital–Dammam, Kingdom of Saudi Arabia; 5Department of Research and Development, Lincoln Hospital, United Lincolnshire Hospitals, National Health Service Trust, Lincoln, UKPurpose: This study provides descriptive epidemiological data, such as the percentage of cases diagnosed, crude incidence rate (CIR, and age-standardized incidence rate (ASIR of ovarian cancer in Saudi Arabia from 2001–2008. Patients and methods: A retrospective descriptive epidemiological analysis of all ovarian cancer cases recorded in the Saudi Cancer Registry (SCR from January 2001–December 2008 was performed. The data were analyzed using descriptive statistics, analysis of variance tests, Poisson regression, and simple linear modeling.Results: A total of 991 ovarian cancer cases were recorded in the SCR from January 2001–December 2008. The region of Riyadh had the highest overall ASIR at 3.3 cases per 100,000 women, followed by the Jouf and Asir regions at 3.13 and 2.96 cases per 100,000 women. However, Hail and Jazan had the lowest rates at 1.4 and 0.6 cases per 100,000 women, respectively. Compared to Jazan, the incidence rate ratio for the number of ovarian cancer cases was significantly higher (P<0.001 in the Makkah region at 6.4 (95% confidence interval [CI]: 4.13–9.83, followed by Riyadh at 6.3 (95% CI: 4.10–9.82, and the eastern region of Saudi Arabia at 4.52 (95% CI: 2.93–6.98. The predicted annual CIR and ASIR for ovarian cancer in Saudi Arabia could be defined by the equations 0.9 + (0.07× years and 1.71 + (0.09× years, respectively.Conclusion: We observed a slight increase in the CIRs and

Congenital Hypothyroidism: Increased Incidence in Yazd Province, Iran

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M. Noori-Shadkam

2012-07-01

Full Text Available Introduction: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation. Its worldwide incidence is estimated to be one in 2500-5500 births. Assessment of thyroid gland in neonates is critical. The aims of this study were to demonstrate the incidence of CH in neonates born in Yazd province, Iran in 1389 (2010 and compare the results with other reported studies and investigate biochemical characteristics of affected infants. Materials & Methods: This is an analytical descriptive cross-sectional study. The study was conducted on all infants (13022 births born in 1389 (March 2010-March 2011. Thyroid stimulating hormone (TSH was measured using ELISA technique. Results: Forty five infants suffered from congenital hypothyroidism with an overall incidence of one in 289 live births. Twenty five of the diagnosed infants were males (incidence 1:261 and twenty were females (incidence 1:325. The incidence of CH in boys was more than girls (P-value = 0.295. The highest incidence of CH was observed in spring followed by summer and the lowest incidence was in autumn followed by winter (P-value=0.000. Conclusion: The CH incidence was 10.3 to 13.8 times more than other countries. The highest CH incidence was in spring followed by summer and the lowest incidence was in autumn followed by winter. It is important that a larger size of cases need to be screened and more information on the aetiology of the affected infants to be obtained

Cancer Incidence following Expansion of HIV Treatment in Botswana.

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Dryden-Peterson, Scott; Medhin, Heluf; Kebabonye-Pusoentsi, Malebogo; Seage, George R; Suneja, Gita; Kayembe, Mukendi K A; Mmalane, Mompati; Rebbeck, Timothy; Rider, Jennifer R; Essex, Myron; Lockman, Shahin

2015-01-01

The expansion of combination antiretroviral treatment (ART) in southern Africa has dramatically reduced mortality due to AIDS-related infections, but the impact of ART on cancer incidence in the region is unknown. We sought to describe trends in cancer incidence in Botswana during implementation of the first public ART program in Africa. We included 8479 incident cases from the Botswana National Cancer Registry during a period of significant ART expansion in Botswana, 2003-2008, when ART coverage increased from 7.3% to 82.3%. We fit Poisson models of age-adjusted cancer incidence and counts in the total population, and in an inverse probability weighted population with known HIV status, over time and estimated ART coverage. During this period 61.6% of cancers were diagnosed in HIV-infected individuals and 45.4% of all cancers in men and 36.4% of all cancers in women were attributable to HIV. Age-adjusted cancer incidence decreased in the HIV infected population by 8.3% per year (95% CI -14.1 to -2.1%). However, with a progressively larger and older HIV population the annual number of cancers diagnosed remained constant (0.0% annually, 95% CI -4.3 to +4.6%). In the overall population, incidence of Kaposi's sarcoma decreased (4.6% annually, 95% CI -6.9 to -2.2), but incidence of non-Hodgkin lymphoma (+11.5% annually, 95% CI +6.3 to +17.0%) and HPV-associated cancers increased (+3.9% annually, 95% CI +1.4 to +6.5%). Age-adjusted cancer incidence among individuals without HIV increased 7.5% per year (95% CI +1.4 to +15.2%). Expansion of ART in Botswana was associated with decreased age-specific cancer risk. However, an expanding and aging population contributed to continued high numbers of incident cancers in the HIV population. Increased capacity for early detection and treatment of HIV-associated cancer needs to be a new priority for programs in Africa.

Confounding factors in diagnosing brain death: a case report

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Login Ivan S

2002-06-01

Full Text Available Abstract Background Brain death is strictly defined medically and legally. This diagnosis depends on three cardinal neurological features: coma, absent brainstem reflexes, and apnea. The diagnosis can only be made, however, in the absence of intoxication, hypothermia, or certain medical illnesses. Case presentation A patient with severe hypoxic-ischemic brain injury met the three cardinal neurological features of brain death but concurrent profound hypothyroidism precluded the diagnosis. Our clinical and ethical decisions were further challenged by another facet of this complex case. Although her brain damage indicated a hopeless prognosis, we could not discontinue care based on futility because the only known surrogate was mentally retarded and unable to participate in medical planning. Conclusion The presence of certain medical conditions prohibits a diagnosis of brain death, which is a medicolegal diagnosis of death, not a prediction or forecast of future outcome. While prognostication is important in deciding to withdraw care, it is not a component in diagnosing brain death.

Krukenberg tumors diagnosed during pregnancy simultaneously with advanced gastric cancer; A case report

International Nuclear Information System (INIS)

You, Myung Won; Jung, Yoon Young; Shin, Jung Hwan; Hong, Young Ok

2015-01-01

Krukenberg tumors recognized during pregnancy are rarely reported. The preoperative diagnosis can be challenging because of the confusing morphological features and symptoms during pregnancy. Here, we report a case of a 29-year-old pregnant woman at 29 weeks gestation presenting with bilateral solid ovarian masses, which were later diagnosed as metastatic ovarian cancer originating from advanced gastric cancer. This case suggests that Krukenberg tumors should be considered when bilateral ovarian solid masses are encountered regardless of pregnancy

Krukenberg tumors diagnosed during pregnancy simultaneously with advanced gastric cancer; A case report

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You, Myung Won; Jung, Yoon Young; Shin, Jung Hwan; Hong, Young Ok [Eulji Hospital, Eulji University School of Medicine, Seoul (Korea, Republic of)

2015-06-15

Krukenberg tumors recognized during pregnancy are rarely reported. The preoperative diagnosis can be challenging because of the confusing morphological features and symptoms during pregnancy. Here, we report a case of a 29-year-old pregnant woman at 29 weeks gestation presenting with bilateral solid ovarian masses, which were later diagnosed as metastatic ovarian cancer originating from advanced gastric cancer. This case suggests that Krukenberg tumors should be considered when bilateral ovarian solid masses are encountered regardless of pregnancy.

INCIDENCE OF ALLERGIC FUNGAL SINUSITIS AMONG PATIENTS WITH CHRONIC RHINOSINUSITIS

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Vivek Gupta

2017-09-01

Full Text Available BACKGROUND This study aims to evaluate the incidence of allergic fungal sinusitis among patients with chronic rhinosinusitis. Chronic rhinosinusitis (CRS is a widely prevalent condition globally as well as in India. Fungal rhinosinusitis is classified into two subgroups: three invasive forms (acute necrotizing, chronic invasive, granulomatous invasive, and two noninvasive forms (fungal ball and allergic fungal. MATERIALS AND METHODS Patients attending the Department of ENT at Adesh institute of medical science & research, Bathinda (Punjab between Jan 2016 and Dec 2016 one year duration 82 cases were included in this retrospective analysis with features suggestive of chronic rhinosinusitis. Based on clinical, endoscopic and radiological parameters, 82 cases were diagnosed to have rhinosinusitis. In these cases, postoperatively after HPE examination, 16 cases were confirmed to have mycotic infection. RESULTS Out of 16 cases, In Allergic fungal rhino sinusitis(AFRS, Aspergillus flavus (A. flavus was the most common fungus isolated ten cases (71.42%.. In fungal ball, A. flavus was isolated in two cases (14.25% and Aspergillus niger (A. niger was isolated in two cases (14.25%. In invasive fungal rhinosinusitis (IFRS mucormycosis was isolated in two cases (12.5%. CONCLUSION The incidence of ARFS is about 12.2% of chronic rhinosinusitis. The commonest age group is second & third decade

Incidence, Mortality, and Predictive Factors of Hepatocellular Carcinoma in Primary Biliary Cirrhosis

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Kenichi Hosonuma

2013-01-01

Full Text Available Background. The study aims to analyze in detail the incidence, mortality using the standardized incidence ratio (SIR, and standardized mortality ratio (SMR of hepatocellular carcinoma (HCC in primary biliary cirrhosis (PBC, because no large case studies have focused on the detailed statistical analysis of them in Asia. Methods. The study cohorts were consecutively diagnosed at Gunma University and its affiliated hospitals. Age- or sex-specific annual cancer incidence and deaths were obtained from Japanese Cancer Registry and Death Registry as a reference for the comparison of SIR or SMR of HCC. Moreover, univariate analyses and multivariate analyses were performed to clarify predictive factors for the incidence of HCC. Results. The overall 179 patients were followed up for a median of 97 months. HCC had developed in 13 cases. SIR for HCC was 11.6 (95% confidence interval (CI, 6.2–19.8 and SMR for HCC was 11.2 (95% CI, 5.4–20.6 in overall patients. The serum albumin levels were a predictive factor for the incidence of HCC in overall patients. Conclusions. The incidence and mortality of HCC in PBC patients were significantly higher than those in Japanese general population. PBC patients with low serum albumin levels were populations at high risk for HCC.

Paracoccidioidomycosis in southern Rio Grande do Sul: a retrospective study of histopathologically diagnosed cases

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Silvana Pereira de Souza

2014-01-01

Full Text Available Paracoccidioidomycosis (PCM is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and is endemic to Brazil. The aim of this study was to perform a retrospective analysis of the PCM cases in the countryside south of Rio Grande do Sul, Brazil. The files from four histopathology laboratories located in the city of Pelotas were obtained, and all of the epidemiological and clinical data from the PCM diagnosed cases were collected for analysis. A total of 123 PCM cases diagnosed between 1966 and 2009 were selected. Of these patients, 104 (84.5% were male, and 17 were female. The patients ranged from 02 to 92 years of age. Fifty-two cases (41.9% were obtained from the oral pathology laboratory, and the remaining 71 cases (58.1% were obtained from the three general pathology laboratories. Of all of the patients studied, 65.2% lived in rural zones and worked in agriculture or other related fields. Data on the evolution of this disease was available for 43 cases, and the time frame ranged from 20 to 2920 days (mean = 572.3 days. An accurate diagnosis performed in less than 30 days only occurred in 21% of the cases. PCM is endemic to the countryside of Rio Grande do Sul. Therefore, it is recommended that PCM be included as a differential diagnosis, mainly for individuals between 30 and 60 years of age, living in rural zones and who have respiratory signs and associated-oropharyngeal lesions.

Validation of administrative hospital data for identifying incident pancreatic and periampullary cancer cases: a population-based study using linked cancer registry and administrative hospital data in New South Wales, Australia.

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Creighton, Nicola; Walton, Richard; Roder, David; Aranda, Sanchia; Currow, David

2016-07-01

Informing cancer service delivery with timely and accurate data is essential to cancer control activities and health system monitoring. This study aimed to assess the validity of ascertaining incident cases and resection use for pancreatic and periampullary cancers from linked administrative hospital data, compared with data from a cancer registry (the 'gold standard'). Analysis of linked statutory population-based cancer registry data and administrative hospital data for adults (aged ≥18 years) with a pancreatic or periampullary cancer case diagnosed during 2005-2009 or a hospital admission for these cancers between 2005 and 2013 in New South Wales, Australia. The sensitivity and positive predictive value (PPV) of pancreatic and periampullary cancer case ascertainment from hospital admission data were calculated for the 2005-2009 period through comparison with registry data. We examined the effect of the look-back period to distinguish incident cancer cases from prevalent cancer cases from hospital admission data using 2009 and 2013 as index years. Sensitivity of case ascertainment from the hospital data was 87.5% (4322/4939), with higher sensitivity when the cancer was resected (97.9%, 715/730) and for pancreatic cancers (88.6%, 3733/4211). Sensitivity was lower in regional (83.3%) and remote (85.7%) areas, particularly in areas with interstate outflow of patients for treatment, and for cases notified to the registry by death certificate only (9.6%). The PPV for the identification of incident cases was 82.0% (4322/5272). A 2-year look-back period distinguished the majority (98%) of incident cases from prevalent cases in linked hospital data. Pancreatic and periampullary cancer cases and resection use can be ascertained from linked hospital admission data with sufficient validity for informing aspects of health service delivery and system-level monitoring. Limited tumour clinical information and variation in case ascertainment across population subgroups are

Geography of breast cancer incidence according to age & birth cohorts.

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Gregorio, David I; Ford, Chandler; Samociuk, Holly

2017-06-01

Geographic variation in breast cancer incidence across Connecticut was examined according to age and birth cohort -specific groups. We assigned each of 60,937 incident breast cancer cases diagnosed in Connecticut, 1986-2009, to one of 828 census tracts around the state. Global and local spatial statistics estimated rate variation across the state according to age and birth cohorts. We found the global distribution of incidence rates across places to be more heterogeneous for younger women and later birth cohorts. Concurrently, the spatial scan identified more locations with significantly high rates that pertained to larger proportions of at-risk women within these groups. Geographic variation by age groups was more pronounced than by birth cohorts. Geographic patterns of cancer incidence exhibit differences within and across age and birth cohorts. With the continued insights from descriptive epidemiology, our capacity to effectively limit spatial disparities in cancer will improve. Copyright © 2017 Elsevier Ltd. All rights reserved.

Recent declines in cancer incidence: related to the Great Recession?

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Gomez, Scarlett Lin; Canchola, Alison J; Nelson, David O; Keegan, Theresa H M; Clarke, Christina A; Cheng, Iona; Shariff-Marco, Salma; DeRouen, Mindy; Catalano, Ralph; Satariano, William A; Davidson-Allen, Kathleen; Glaser, Sally L

2017-02-01

In recent years, cancer case counts in the U.S. underwent a large, rapid decline-an unexpected change given population growth for older persons at highest cancer risk. As these declines coincided with the Great Recession, we examined whether they were related to economic conditions. Using California Cancer Registry data from California's 30 most populous counties, we analyzed trends in cancer incidence during pre-recession (1996-2007) and recession/recovery (2008-2012) periods for all cancers combined and the ten most common sites. We evaluated the recession's association with rates using a multifactorial index that measured recession impact, and modeled associations between case counts and county-level unemployment rates using Poisson regression. Yearly cancer incidence rate declines were greater during the recession/recovery (3.3% among males, 1.4% among females) than before (0.7 and 0.5%, respectively), particularly for prostate, lung, and colorectal cancers. Lower case counts, especially for prostate and liver cancer among males and breast cancer, melanoma, and ovarian cancer among females, were associated with higher unemployment rates, irrespective of time period, but independent of secular effects. The associations for melanoma translated up to a 3.6% decrease in cases with each 1% increase in unemployment. Incidence declines were not greater in counties with higher recession impact index. Although recent declines in incidence of certain cancers are not differentially impacted by economic conditions related to the Great Recession relative to pre-recession conditions, the large recent absolute declines in the case counts of some cancer may be attributable to the large declines in unemployment in the recessionary period. This may occur through decreased engagement in preventive health behaviors, particularly for clinically less urgent cancers. Continued monitoring of trends is important to detect any rises in incidence rates as deferred diagnoses come to

Mortality and secular trend in the incidence of bipolar disorder

DEFF Research Database (Denmark)

Medici, Clara Reece; Videbech, Poul; Gustafsson, Lea Nørgreen

2015-01-01

BACKGROUND: The world-wide interest in bipolar disorder is illustrated by an exponential increase in publications on the disorder registered in Pubmed since 1990. This inspired an investigation of the epidemiology of bipolar disorder. METHODS: This was a register-based cohort study. All first......-ever diagnoses of bipolar disorder (International Classification of Diseases-10: F31) were identified in the nationwide Danish Psychiatric Central Research Register between 1995 and 2012. Causes of death were obtained from The Danish Register of Causes of Death. Age- and gender standardized incidence rates......, standardized mortality ratio (SMR) and Kaplan-Meier survival estimates were calculated. RESULTS: We identified 15,334 incident cases of bipolar disorder. The incidence rate increased from 18.5/100,000 person-years (PY) in 1995 to 28.4/100,000 PY in 2012. The mean age at time of diagnosis decreased...

Chronic kidney disease in Nigeria: an evaluation of the spatial accessibility to healthcare for diagnosed cases in Edo State

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Osaretin Oviasu

2016-05-01

Full Text Available Chronic kidney disease (CKD is a growing problem in Nigeria, presenting challenges to the nation’s health and economy. This study evaluates the accessibility to healthcare in Edo State of CKD patients diagnosed between 2006 and 2009. Using cost analysis techniques within a geographical information system, an estimated travel time to the hospital was used to examine the spatial accessibility of diagnosed patients to available CKD healthcare in the state. The results from the study indicated that although there was an annual rise in the number of diagnosed cases, there were no significant changes in the proportion of patients that were diagnosed at the last stage of CKD. However, there were indications that the travel time to the hospital for CKD treatment might be a contributing factor to the number of diagnosed CKD cases. This implies that the current structure for CKD management within the state might not be adequate.

Clinical outcomes for young people with screening-detected and clinically-diagnosed rheumatic heart disease in Fiji.

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Engelman, Daniel; Mataika, Reapi L; Ah Kee, Maureen; Donath, Susan; Parks, Tom; Colquhoun, Samantha M; Carapetis, Jonathan R; Kado, Joseph H; Steer, Andrew C

2017-08-01

Echocardiographic screening is under consideration as a disease control strategy for rheumatic heart disease (RHD). However, clinical outcomes of young people with screening-detected RHD are unknown. We aimed to describe the outcomes for a cohort with screening-detected RHD, in comparison to patients with clinically-diagnosed RHD. A retrospective cohort study included all young people with screening-detected RHD in the Central Division of Fiji in the primary cohort. Screen-negative and clinically-diagnosed comparison groups were matched 1:1 to the primary cohort. Data were collected on mortality, clinical complications and healthcare utilisation from the electronic and paper health records and existing databases. Seventy participants were included in each group. Demographic characteristics of the groups were similar (median age 11years, 69% female, median follow-up 7years). There were nine (12.9%) RHD-related deaths in the clinically-diagnosed group and one (1.4%) in the screening-detected group (Incident Rate Ratio: 9.6, 95% CI 1.3-420.6). Complications of RHD were observed in 39 (55.7%) clinically-diagnosed cases, four (20%) screening-detected cases and one (1.4%) screen-negative case. There were significant differences in the cumulative complication curves of the groups (pFiji. The prognosis of clinically-diagnosed RHD remains poor, with very high mortality and complication rates. Further studies in other settings will inform RHD screening policy. Comprehensive control strategies are required for disease prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

Experience of a monographic tuberculosis unit: the first 500 cases.

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González-Moreno, Juan; García-Gasalla, Mercedes; Cifuentes Luna, Carmen; Mir Villadrich, Isabel; Pareja Bezares, Antonio; Navarro Fernández, Verónica; Serrano Bujalance, Araceli; Pérez Seco, M Cruz; Payeras Cifre, Antonio

2013-10-01

Tuberculosis (TB) remains a highly prevalent and potentially severe disease. However, since 2002 the annual incidence has been decreasing both worldwide and in Spain, where the incidence varies widely between regions. The main objective of this study is to describe the experience of a monographic TB unit in a second level hospital. A descriptive study was carried out which included all cases of TB diagnosed in a monographic unit of a secondary hospital between 2003 and 2011. Demographic, clinical, epidemiological and microbiological data were recorded. We analyzed 500 TB cases and found an increasing annual incidence in all subgroups, including native and immigrant populations. Most cases (63.8%) were male, with a median age of 36 years (range 8 months-90 years). In total, 39.8% of patients were foreign born. Coinfection with human immunodeficiency virus was found in 11% of cases. The pulmonary form was most frequently diagnosed (63.8%). Overall mortality was 5.8% with no significant differences between groups (including foreign born and human immunodeficiency virus positive patients). Although TB incidence is globally decreasing, in our study we found an increasing number of cases in recent years in all subgroups, which can be explained by this being a monographic unit with an intensive contact tracing program. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

Invasive cancer incidence - Puerto Rico, 2007-2011.

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O'Neil, Mary Elizabeth; Henley, S Jane; Singh, Simple D; Wilson, Reda J; Ortiz-Ortiz, Karen J; Ríos, Naydi Pérez; Torres Cintrón, Carlos R; Luna, Guillermo Tortolero; Zavala Zegarra, Diego E; Ryerson, A Blythe

2015-04-17

Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifying new trends and patterns of cancer incidence, Puerto Rico Central Cancer Registry staff and CDC analyzed data from Puerto Rico included in U.S. Cancer Statistics (USCS) for 2007-2011, the most recent data available. This is the first report of invasive cancer incidence rates for 2007-2011 among Puerto Rican residents by sex, age, cancer site, and municipality. Cancer incidence rates in Puerto Rico were compared with those in the U.S. population for 2011. A total of 68,312 invasive cancers were diagnosed and reported in Puerto Rico during 2007-2011. The average annual incidence rate was 330 cases per 100,000 persons. The cancer sites with the highest cancer incidence rates included prostate (152), female breast (84), and colon and rectum (43). Cancer incidence rates varied by municipality, particularly for prostate, lung and bronchus, and colon and rectum cancers. In 2011, cancer incidence rates in Puerto Rico were lower for all cancer sites and lung and bronchus, but higher for prostate and thyroid cancers, compared with rates within the U.S. Identifying these variations can aid evaluation of factors associated with high incidence, such as cancer screening practices, and development of targeted cancer prevention and control efforts. Public health professionals can monitor cancer incidence trends and use these findings to evaluate the impact of prevention efforts, such as legislation prohibiting tobacco use in the workplace and public places and the Puerto Rico Cessation Quitline in decreasing lung and other tobacco-related cancers.

Case report physiotherapy care of a patient diagnosed with polyarthritis with early rheumatoid arthritis

OpenAIRE

Michálková, Kateřina

2013-01-01

Title of bachelor's thesis: Case report physiotherapy care of a patient diagnosed with polyarthritis with early rheumatoid arthritis. Summary: The bachelor thesis deals with polyarthritis disease with early rheumatoid arthritis and its physiotherapy care. It consists of two parts. The general part contains a general joint anatomy, deals with the major problems of disease and polyarthritis rheumatoid arthritis, its diagnosis, treatment and physiotherapy care. Special part includes a case repor...

Increasing incidence of colorectal cancer in the province of Salamanca: comparison of two periods: 2004-2006 and 2010-2012

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Héctor Miguel Marcos-Prieto

Full Text Available Objectives: To compare incidence, mortality and epidemiological characteristics of patients diagnosed with colorectal cancer (CRC in the province of Salamanca over two different periods: 2010-2012 and 2004-2006. Methods: Retrospective observational study. We include all diagnosed cases of CRC according to histopathological criteria from 01/01/2004 to 31/12/2006 and from 01/01/2010 to 31/12/2012. The studied variables were sex, age, date of diagnosis and tumor location. Cumulative incidence and specific incidence in different age groups were measured and compared between the two periods. The age rates were adjusted to the standard world population so that the results could be compared with those of other populations. Results: We detected 38% more cases of CRC in the 2010-2012 period than in 2004-2006. Variables distribution (sex, age at diagnosis and location was similar in both groups. More than twice as many colonoscopies were performed in 2010-2012 than in 2004-2006. Population mortality due to CRC also increased, although much less importantly than the incidence of this condition. Conclusions: There has been a clear increase in CRC incidence in the province of Salamanca from 2004-2006 to 2010-2012 which is not related to the ageing of the population. The remarkable increase in colonoscopies may have been an important factor for the increased detection.

Impact of socioeconomic status and ethnic enclave on cervical cancer incidence among Hispanics and Asians in California.

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Froment, Marie-Anne; Gomez, Scarlett L; Roux, Audrey; DeRouen, Mindy C; Kidd, Elizabeth A

2014-06-01

This study aimed to evaluate the incidence of cervical cancer by nativity [United States (US) versus non-US], neighborhood socioeconomic status and ethnic enclave among Hispanics and Asians in California. Using data from the California Cancer Registry, information on all primary invasive cervical cancer (Cca) patients diagnosed in California from January 1, 1990 through December 31, 2004 was obtained. We analyzed the influence of enclave, socioeconomic status and nativity on Cca incidence. Among the 22,189 Cca cases diagnosed between 1990 and 2004, 50% were non-Hispanic white, 39% Hispanic and 11% Asian women, and 63% US-born. Seventy percent of the Cca cases were squamous cell carcinoma, 19% adenocarcinoma and 11% other histologies. Higher incidence of Cca was observed in high enclave (76%) and low socioeconomic status (70%) neighborhoods. By ethnic group, US-born women showed lower rates of squamous cell carcinoma compared to foreign-born women. Hispanics living in low socioeconomic and high enclave had 12.7 times higher rate of Cca than those living in high socioeconomic, low enclave neighborhoods. For Asian women incidence rates were 6 times higher in the low socioeconomic, high enclave neighborhoods compared to those living in high socioeconomic, low enclave neighborhoods. More targeted outreach to increase Pap smear screening and human papilloma virus vaccination for women living in high enclave neighborhoods can help decrease the incidence of Cca in these groups of women. Copyright © 2014 Elsevier Inc. All rights reserved.

A Case of Fundus Oculi Albinoticus Diagnosed as Angelman Syndrome by Genetic Testing

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Yurie Fukiyama

2018-02-01

Full Text Available Purpose: To report a case of fundus oculi albinoticus diagnosed as Angelman syndrome (AS via genetic testing. Case Report: This study reports on a 4-year-old boy. Since he had been having respiratory disturbance since birth, he underwent a complete physical examination to investigate the cause. The results indicated that he had various brain congenital abnormalities, such as a thin corpus callosum, as well as hydronephrosis, an atrial septal defect, and skin similar to patients with fundus oculi albinoticus. Examination revealed bilateral fundus oculi albinoticus, mild iridic hypopigmentation, optic atrophy, and poor visual tracking. Genetic testing revealed a deletion in the Prader-Willi syndrome/AS region on chromosome 15, and together with the results of methylation analysis, his condition was diagnosed as AS. Follow-up examinations revealed no change in the fundus oculi albinoticus and optic atrophy, nor did they indicate poor visual tracking. Conclusions: When fundus oculi albinoticus and optic atrophy are observed in patients with multiple malformations, AS should be considered as a differential diagnosis.

Acute bacterial meningitis cases diagnosed by culture and PCR in a children's hospital throughout a 9-Year period (2000-2008) in Athens, Greece.

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Papavasileiou, Konstantina; Papavasileiou, Eleni; Tzanakaki, Georgina; Voyatzi, Aliki; Kremastinou, Jenny; Chatzipanagiotou, Stylianos

2011-04-01

Acute bacterial meningitis is one of the most severe infectious diseases, affecting mainly infants and, secondarily, older children and adolescents. Diagnosis in the early stages is often difficult and despite treatment with appropriate antibiotic therapy, the case fatality rate remains high. In the present study, the incidence of bacterial meningitis was registered in a general pediatric hospital in Athens, Greece, during a 9-year period (2000-2008), and the use of molecular methods in the diagnosis of bacterial meningitis versus the conventional cultural methods was evaluated. The impact of vaccination against meningitis-causing bacteria on the incidence of bacterial meningitis was also assessed. From a total of 1833 children hospitalized with suspected clinical symptoms and signs of meningitis, all cerebrospinal fluid (CSF) and blood samples were analyzed by white blood cell (WBC) count, measurement of glucose, protein, and C-reactive protein (CRP) levels, as well as by conventional bacteriologic culture methods. If samples showed altered CSF markers that were consistent with meningitis in general, they were further investigated by PCR for bacterial pathogens. Of the 1833 patients, 289 (15.76%) were found to be positive for meningitis after CSF examination, based on white blood cell count and differentiation, glucose, protein, and CRP. Fifty-six of the 289 (19.37%) had confirmed bacterial meningitis, as diagnosed by either culture and/or PCR. Of these 56 cases, 44 (78.6%) were detected only by PCR, and 12 cases (21.4%) were confirmed by PCR and culture. The predominant microorganism was Neisseria meningitidis serogroup B (n = 40; 71.4%), followed by Streptococcus pneumoniae not typed [NT] (n = 7; 12.5%), Streptococcus spp. (n =4; 7.1%), Haemophilus influenzae NT (n = 2; 3.6%), and S. pneumoniae serotype 3, Streptococcus group B, and S. pneumoniae serotype 18C (each n = 1; 1.8%). In Greece, according to data from the National Meningitis Reference

Chikungunya virus infection: report of the first case diagnosed in Rio de Janeiro, Brazil

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Isabella Gomes Cavalcanti de Albuquerque

2012-02-01

Full Text Available Initially diagnosed in Africa and Asia, the Chikungunya virus has been detected in the last three years in the Caribbean, Italy, France, and the United States of America. Herein, we report the first case for Rio de Janeiro, Brazil, in 2010.

Characteristics of cirrhosis undiagnosed during life: a comparative analysis of 73 undiagnosed cases and 149 diagnosed cases of cirrhosis, detected in 4929 consecutive autopsies

DEFF Research Database (Denmark)

Graudal, Niels; Leth, Peter Mygind; Mårbjerg, Lone

1991-01-01

In 4929 consecutive autopsies performed during a period of 4 years, 222 cases (4.5%) of cirrhosis were found, of which 149 (3%) were detected while the patients were alive (diagnosed cirrhosis) and 73 (1.5%) were not detected while the patients were living (undiagnosed cirrhosis). Fifty-three of ......In 4929 consecutive autopsies performed during a period of 4 years, 222 cases (4.5%) of cirrhosis were found, of which 149 (3%) were detected while the patients were alive (diagnosed cirrhosis) and 73 (1.5%) were not detected while the patients were living (undiagnosed cirrhosis). Fifty......-three of the 73 undiagnosed patients appeared to be completely without signs of cirrhosis (silent cirrhosis). In the diagnosed group, 70% of patients died from hepatic causes, in contrast to 16% in the undiagnosed group. At autopsy, the following complications of cirrhosis were found more frequently...

Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

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Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

2018-05-01

Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

Incidence and survival for Merkel cell carcinoma in Queensland, Australia, 1993-2010.

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Youlden, Danny R; Soyer, H Peter; Youl, Philippa H; Fritschi, Lin; Baade, Peter D

2014-08-01

Merkel cell carcinoma (MCC) is an uncommon but highly invasive form of skin cancer. The mechanisms that cause MCC are yet to be fully determined. To compare the incidence and survival rates of MCC in Queensland, Australia, known to be a high-risk area, with MCC incidence and survival elsewhere in the world. We also analyzed incidence trends and differences in survival by key demographic and clinical characteristics. Retrospective cohort study of population-based administrative data for MCC collected by the Queensland Cancer Registry and supplemented with detailed histopathologic data. Deidentified records were obtained of all Queensland residents diagnosed as having MCC during the period from 1993 to 2010. A subsample of histopathologic records were reviewed by a senior dermatopathologist to determine the potential for misclassification. A total of 879 eligible cases of MCC were included in the study. Incidence rates were directly age standardized to the 2000 United States Standard Population. Trends were examined using Joinpoint software with results expressed in terms of the annual percentage change. The period method was used to calculate 5-year relative survival, and adjusted hazard ratios were obtained from multivariate Poisson models. There were 340 cases of MCC diagnosed in Queensland between 2006 and 2010, corresponding to an incidence rate of 1.6 per 100,000 population. Men (2.5 per 100,000) had higher incidence than women (0.9 per 100,000), and rates peaked at 20.7 per 100,000 for persons 80 years or older. The overall incidence of MCC increased by an average of 2.6% per year from 1993 onwards. Relative survival was 41% after 5 years, with significantly better survival found for those younger than 70 years at diagnosis (56%-60%), those with tumors on the face or ears (51%), and those with stage I lesions (49%). Incidence rates for MCC in Queensland are at least double those of any that have been previously published elsewhere in the world. It is likely

Case report: Isolated unilateral pulmonary vein atresia diagnosed on 128-slice multidetector CT

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Rashmi Dixit

2011-01-01

Full Text Available Unilateral pulmonary venous atresia is an uncommon entity that is generally believed to be congenital. Most patients present in infancy or childhood with recurrent chest infections or hemoptysis. Pulmonary angiography is usually used for definitive diagnosis. However, the current multislice CT scanners may obviate the need for pulmonary angiography. We report two cases diagnosed using 128-slice CT angiography. On the CT angiography images both these cases demonstrated absent pulmonary veins on the affected side, with a small pulmonary artery and prominent bronchial or other systemic arterial supply.

Use of profile and oblique incidence in scintigraphy in the osteo-articular pathology

International Nuclear Information System (INIS)

Saidi, L.; Langlet, D.; Fayolle, S.; Benada, A.; Prigent, A.

1997-01-01

The focal lesions observed in the osseous scintigraphy are sometimes difficult to interpret, notably, in sportsmen. Due to its high sensitivity this examination allows the diagnosis of small lesions even when these are not detectable by radiography. In exchange, its specificity is low. Sometimes, it is difficult to localize the osseous piece afflicted with high anatomic precision, making use of only the anterior and posterior incidences. We intended to test the profit of profile and oblique (3/4) incidences to specify the topography of afflicted zone and its anatomic relations with the neighbouring structures. The aim of this work is to illustrate by selected examples the use of this complement of imaging. The utilised camera is the DST-XL of SOPHA MEDICAL VISION (SMV) equipped with a UHR-BE collimator placed as closely as possible to the zone to be explored in a patient installed in dorsal decubitus. The acquisition is achieved by means of a 3-phase classical protocol. The activity injected is 8-13 MBq/Kg of 99m Tc-HMDP. The tardy images are effected at around 3 hours after the injection of tracer, with an 128/128 matrix and an acquisition time dependent of the region to be examined. The standard incidences are done on anterior and posterior faces and the complementary incidences in profile and oblique (3/4 anterior) positions. The profile and oblique incidences allowed to correct the diagnostic hypothesis deduced from anterior and posterior incidences. A table is given with the diagnoses obtained from standard incidences and the final diagnoses based on profile and oblique incidences for six types of clinic lesions. The conclusion is drawn that the selected examples are particularly demonstrative of the profit which the profile and oblique incidences brings about in making finer the topographic and sometimes etiological diagnosis. In numerous cases it allowed adopting a more specific therapeutic attitude towards the pathology identified in this way, notably in

Incidence trends in head and neck squamous cell carcinoma in Slovenia, 1983-2009: role of human papillomavirus infection.

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Strojan, Primož; Zadnik, Vesna; Šifrer, Robert; Lanišnik, Boštjan; Didanović, Vojislav; Jereb, Sara; Poljak, Mario; Kocjan, Boštjan J; Gale, Nina

2015-12-01

An increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) was observed in several population-based registries and has been attributed to human papillomavirus (HPV) infection. In the present study, we aimed to assess the contribution of HPV infection to the burden of mucosal head and neck squamous cell carcinoma (HNSCC) in Slovenia. For this purpose, data from the nationwide Cancer Registry of Slovenia for cases diagnosed between 1983 and 2009 were analyzed to determine time trends of age-adjusted incidence rates and survival in terms of annual percentage change (APC) for HNSCC in potentially HPV-related and HPV-unrelated sites. In addition, determination of p16 protein, HPV DNA and E6/E7 mRNA was performed in a cohort of OPSCC patients identified from the prospective database for the years 2007-2008. In total, 2,862 cases of HNSCC in potentially HPV-related sites and 7,006 cases in potentially HPV-unrelated sites were identified with decreased incidence observed over the time period in both groups (-0.58; 95 % CI -1.28 to -0.13 and -0.90; 95 % CI -1.23 to -0.57). Regardless of the group, incidence trends for both genders showed a significant decrease in men and increase in women. In a cohort of 99 OPSCC patients diagnosed between 2007 and 2008, 20 (20.2 %) patients had HPV positive tumors and exhibited a superior outcome compared to HPV-negative patients. In conclusion, results of the epidemiologic and histopathologic study confirmed that HPV infection had no major impact on the incidence trends in the Slovenian patients with HNSCC and, specifically, OPSCC during the studied period.

Wilms tumor in adult: case report

International Nuclear Information System (INIS)

Albuquerque, Mauro Guimaraes; Vieira, Sabas Carlos; Rego, Cristiane Fortes Napoleao do; Fortes, Emanuel Augusto de C.; Santana, Gerusia Ibiapina

2004-01-01

Wilms' tumor is the renal tumor with the higher incidence on the childhood, however it rarely occurs in adults.The incidence in this group is estimated at about 1% of all the cases and they have an obscure prognosis. In this report is related a new case in a 52 years old man presenting intensive abdominal pain associated by weightiness. Abdominal ultrasound revealed expansive and complex lesion with indefinite contour in the left flank. Computed tomography of abdomen demonstrated solid lesion on antero-superior pole of the left kidney invading para-vertebral musculature, peri and para-renal spaces. Total nephrectomy and the histopathologic analysis were realized. A nephroblastoma (Wilms' tumor) in stage II without anaplasia was diagnosed by the anatomopathological studies.Local radiotherapy was applied. Thereafter was diagnosed pulmonary and hepatic metastasis, and then initiated the chemotherapy with adriamycin, actinomycin and vincristine. The prognosis of Wilms' tumor is worse in adult and it requires an aggressive therapeutic and follow up. (author)

Demographics and Incidence of Histologically Confirmed Intracranial Tumors: A Five-year, Two-center Prospective Study

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Dzhenkov, Deyan L; Kitanova, Martina; Ghenev, Peter; Tonchev, Anton B

2017-01-01

Introduction Intracranial tumors (ICTs) are a diverse group of malignancies that pose an immediate threat to patients' lives, no matter their local or metastatic origin, benign or malignant nature. These lesions have severe clinical courses and need to be diagnosed and treated as soon as possible, with pathological verification being the pivotal moment in the process of determining curative modalities. Aim The aim of this study was to compare the incidence of histologically confirmed ICTs in Eastern Bulgaria, based on their type (primary, metastatic, and non-volume occupying lesions (NVOL)), their respective subtypes, and incidence in a descriptive manner. Materials and Methods For a period of five full calendar years (January 1st, 2012 – December 31st, 2016), all histologically confirmed cases of intracranial tumors were prospectively collected from two individual tertiary healthcare institutions. The cases were then statistically analyzed in a descriptive manner, and incidences of primary, metastatic, and NVOL were compared with regards to their specific origins, types, and subtypes. Metastatic tumors were further segregated relative to their intracranial metastatic location. Results The total number of individual ICTs registered in the set timeframe was 822. Primary ICTs represented a total of 66.12% of the histologically confirmed cases, with the most common entries being tumors from a glial and meningeal origin, 30.90% were histologically confirmed as metastatic ICTs, from which the most common entries were of pulmonary origin, and the other 2.94% were NVOL. On behalf of their intracranial metastatic location, metastatic tumors were located predominantly in the supratentorial region, represented as a total of 87.80%, while the other 12.20% were located in the subtentorial region. Based on the descriptive analysis, the annual incidence per 100,000 capita of all ICTs is 9.12, comprised of 6.03 per 100,000 for primary ICTs, 2.82 per 100,000 for metastatic

[Observations on human parvovirus B19 infection diagnosed in 2011].

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Mihály, Ilona; Trethon, András; Arányi, Zsuzsanna; Lukács, Adrienne; Kolozsi, Tímea; Prinz, Gyula; Marosi, Anikó; Lovas, Nóra; Dobner, Ilona Sarolta; Prinz, Géza; Szalai, Zsuzsanna; Pék, Tamás

2012-12-09

The incidence of human parvovirus B19 infection is unknown. A retrospective analysis of clinical and laboratory findings was carried out in patients diagnosed with human parvovirus B19 infection in 2011 in a virologic laboratory of a single centre in Hungary. Clinical and laboratory data of patients with proven human parvovirus B19 infection were analysed using in- and out-patient files. In 2011, 72 patients proved to have human parvovirus B19 infection with the use of enzyme immunoassay. The clinical diagnoses of these patients were as follows: human parvovirus B19 infection (30.6%), transient aplastic crisis (16.7%), arthritis (8.3%) and acute hepatitis (4.1%). Symptoms of each of the four phases of the infection occurred in various combinations with the exception of the monophase of cheek exanthema. This occurred without the presence of other symptoms in some cases. Leading symptoms and signs were exanthema (in 74.6% of cases), haematological disorders (in 69% of cases), fever (in 54.9% of cases) and arthritis (in 33.8% of cases). Several atypical dermatological symptoms were also observed. Acute arthritis without exanthema was noted in 8 patients. Of the 72 patients with proven human parvovirus B19 infection there were 7 pregnant women, and one of them had hydrops foetalis resulting spontaneous abortion. In 16 patients (22.5%) human parvovirus B19 IgG was undetectable despite an optimal time for testing. The observations of this study may contribute to a better recognition of clinical symptoms of human parvovirus B19 infection.

The impact of alternative diagnoses on the utility of influenza-like illness case definition to detect the 2009 H1N1 pandemic.

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Rumoro, Dino P; Bayram, Jamil D; Silva, Julio C; Shah, Shital C; Hallock, Marilyn M; Gibbs, Gillian S; Waddell, Michael J

2012-01-01

To investigate the impact of excluding cases with alternative diagnoses on the sensitivity and specificity of the Centers for Disease Control and Prevention's (CDC) influenza-like illness (ILI) case definition in detecting the 2009 H1N1 influenza, using Geographic Utilization of Artificial Intelligence in Real-Time for Disease Identification and Alert Notification, a disease surveillance system. Retrospective cross-sectional study design. Emergency department of an urban tertiary care academic medical center. 1,233 ED cases, which were tested for respiratory viruses from September 5, 2009 to May 5, 2010. The main outcome measures were positive predictive value, negative predictive value, sensitivity, specificity, and accuracy of the ILI case definition (both including and excluding alternative diagnoses) to detect H1N1. There was a significant decrease in sensitivity (chi2 = 9.09, p < 0.001) and significant improvement in specificity (chi2 = 179, p < 0.001), after excluding cases with alternative diagnoses. When early detection of an influenza epidemic is of prime importance, pursuing alternative diagnoses as part of CDC's ILI case definition may not be warranted for public health reporting due to the significant decrease in sensitivity, in addition to the resources required for detecting these alternative diagnoses.

Prognostic value of interferon-γ release assays, a population-based study from a TB low-incidence country

DEFF Research Database (Denmark)

Hermansen, Thomas Stig; Lillebaek, Troels; Langholz Kristensen, Kristina

2016-01-01

individuals and data on all TB cases in Denmark from 2005 to 2012 and determined the predictive value of the QFT for coprevalent TB (0-90 days after testing) and incident TB (>90 days). RESULTS: Coprevalent TB was diagnosed in 10.7% (183/1703) and 0.3% (38/13 463) cases with a positive and negative QFT......, respectively. For the QFT-positive cases, coprevalent TB was more frequent among persons 35  years (19.3% vs 7.2%, pvalues (PPV...

Hepatoblastoma incidence in Taiwan: A population-based study

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Giun-Yi Hung

2018-06-01

Full Text Available Background: The incidence of hepatoblastoma is not well known in Taiwan. The goal of this study was to investigate the incidence rates of hepatoblastoma by age and sex. Methods: The data of patients with hepatoblastoma diagnosed from 1995 to 2012 were obtained from the population-based Taiwan Cancer Registry. Incidence rates of hepatoblastoma according to sex and age were analyzed. This study employed the published methods of International Agency for Research on Cancer to calculate the age-standardized incidence rates (ASIRs, standard errors, 95% confidence intervals (CIs, and standardized incidence rate ratios (SIRRs. Results: In total, 211 patients were diagnosed with hepatoblastoma during the 18-year study period. The ASIR was 0.76 per million person-years. Hepatoblastoma was predominantly diagnosed in children (n = 184, 87.2%. By contrast, adolescents/adults (n = 10, 4.7% and elderly people (n = 17, 8.1% were rarely affected. The incidence peaked at ages 0–4 years with corresponding ASIR of 7.3 per million person-years. A significant male predilection was only found in children and elderly people, with male-to-female SIRRs of 1.23 and 1.89, respectively. During 1995–2012, the overall incidence of hepatoblastoma significantly increased only in children (annual percent change: 7.4%, 95% CI 3.9%–11.1%, p < 0.05 and specifically in boys (annual percent change: 6.5%, 95% CI 1.9%–11.2%, p < 0.05. Conclusion: Only 27 patients aged ≥ 15 years with hepatoblastoma were identified in this study, the existence of adult hepatoblastoma still requires novel molecular tools to elucidate. The association between the upward trend of hepatoblastoma incidence in boys and increased survival of prematurity in Taiwan warrants further investigations. Keywords: Hepatoblastoma, Incidence, Taiwan

Trends in the Incidence of Cervical Cancer in Jordan, 2000–2013

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Ghazi Sharkas

2017-01-01

Full Text Available Objectives. To determine the incidence of cervical cancer in Jordan and assess its trend in over a 14-year period (2000–2013. Methods. This descriptive study was based on secondary analysis of cervical cancer data that are registered in the Jordan Cancer Registry (JCR. Results. A total of 591 women were diagnosed with cervical cancer in Jordan during the period 2000–2013. The age at diagnosis ranged between 15 and 97 years, with a median of 50 years. The average age standardized rate (ASR was 2.0/100,000 women. The incidence of cervical cancer started to decrease after 2006 but it remained relatively constant between 2008 and 2013. Over the 14-year period, ASR for cervical cancer decreased by 28.6% from 2.1 per 100,000 women in 2000 to 1.5 per 100,000 women in 2013. About 46.5% of the cases were of squamous cell carcinoma morphology. Early cancer constituted about 60% of the cases, regional cases constituted 9.6%, and distant metastatic cases constituted 10.7%. Conclusions. The incidence of cervical cancer in Jordan is low compared to regional estimates and remained relatively constant between 2008 and 2013. Implementation of screening measures could lead to better case finding, early diagnosis, and prevention of cervical cancer.

Defining disease phenotypes using national linked electronic health records: a case study of atrial fibrillation.

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Katherine I Morley

Full Text Available National electronic health records (EHR are increasingly used for research but identifying disease cases is challenging due to differences in information captured between sources (e.g. primary and secondary care. Our objective was to provide a transparent, reproducible model for integrating these data using atrial fibrillation (AF, a chronic condition diagnosed and managed in multiple ways in different healthcare settings, as a case study.Potentially relevant codes for AF screening, diagnosis, and management were identified in four coding systems: Read (primary care diagnoses and procedures, British National Formulary (BNF; primary care prescriptions, ICD-10 (secondary care diagnoses and OPCS-4 (secondary care procedures. From these we developed a phenotype algorithm via expert review and analysis of linked EHR data from 1998 to 2010 for a cohort of 2.14 million UK patients aged ≥ 30 years. The cohort was also used to evaluate the phenotype by examining associations between incident AF and known risk factors.The phenotype algorithm incorporated 286 codes: 201 Read, 63 BNF, 18 ICD-10, and four OPCS-4. Incident AF diagnoses were recorded for 72,793 patients, but only 39.6% (N = 28,795 were recorded in primary care and secondary care. An additional 7,468 potential cases were inferred from data on treatment and pre-existing conditions. The proportion of cases identified from each source differed by diagnosis age; inferred diagnoses contributed a greater proportion of younger cases (≤ 60 years, while older patients (≥ 80 years were mainly diagnosed in SC. Associations of risk factors (hypertension, myocardial infarction, heart failure with incident AF defined using different EHR sources were comparable in magnitude to those from traditional consented cohorts.A single EHR source is not sufficient to identify all patients, nor will it provide a representative sample. Combining multiple data sources and integrating information on treatment and

Osteogenesis Imperfecta Diagnosed from Mandibular and Lower Limb Fractures: A Case Report.

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Kobayashi, Yoshikazu; Satoh, Koji; Mizutani, Hideki

2016-06-01

Osteogenesis imperfecta (OI) is a congenital disease characterized by bone fragility and low bone mass. Despite the variety of its manifestation and severity, facial fractures occur very infrequently. Here, we report a case of an infant diagnosed with OI after mandibular and lower limb fractures. A boy aged 1 year and 3 months was brought to his neighboring hospital with a complaint of facial injury. He was transferred to our hospital to undergo operation 3 days later. Computed tomography images revealed multiple mandibular fractures including complete fracture in the symphysis and dislocated condylar fracture on the right side. Open reduction and internal fixation with absorbable implants was performed 7 days after injury. He fractured his right lower limb 2 months later. He was diagnosed with OI type IA by an orthopedist. He will be administered bone-modifying agents if he suffers from frequent fractures.

Thyroid cancer incidence in Lithuania over the period of 1978-2003

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Kulakiene, I.; Kuprionis, G.; Makstiene, J.

2004-01-01

Full text: In areas not associated with nuclear fallout, the annual incidence of thyroid cancer ranges between 2.0-3.8 cases per 100 000 in women and 1.2-2.6 per 100 000 in men. The incidence of thyroid cancers in Belarus and Ukraine rose just 4 years after the Chernobyl accident in 1986. Though, the radioactive clouds passed over Lithuania but it is still unclear whether the rise in incidence of thyroid cancer in our patients is due to this irradiation or iodine deficiency or due to increased diagnostic activity. Population-based data on thyroid carcinomas was obtained from the Lithuanian Cancer Registry to analyse the incidence of thyroid cancers in Lithuania for the period of 1978-2003. The incidence rate (IR) was calculated based on the number of newly diagnosed cases in the calendar year per 100 000 inhabitants depending on sex. Additionally we analysed the association between histopathological types of thyroid carcinoma, disease severity as expressed by TNM classification (according to ICD-10), age and gender. For this purpose our database included a total of 354 cases of thyroid carcinoma (47 males-13.3% and 307 females-86.7%) admitted to the Kaunas Medical University Hospital during the period of 2001-July 2003. Since 1990 a significant rise of the thyroid cancer incidence affecting mainly women of > 40 years of age have been observed. 78 newly diagnosed cases of thyroid cancer (18 male and 60 female) were registered in 1990. The IR value is 1.0 in men and 3.1 in women. During the period from 1991 to 1995 the IR varied from 1.1 to 1.7 in men and from 3.6 to 5.8 in women. The increase in the number of cancer cases in women was observed year by year between 1996-2000, reaching 138 (IR 7.1), while the increase in men was not so obvious during the same period. Thyroid cancer incidence is still increasing and was 9.8 for women and 2.7 for men in the year 2001. In spite of increased incidence of thyroid cancer, morbidity between 1992-2000 did not increase

Amyloidosis diagnosed in cytology specimen of pleural effusion: A case report.

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Manur, Rashmi; Lamzabi, Ihab

2018-06-01

Amyloidosis is a rare condition resulting from extracellular deposition of amyloid, a fibrillary material derived from various precursor proteins. Involvement of the pleura by amyloidosis is a rare but serious complication. Pleural amyloidosis is primarily diagnosed by identifying amyloid deposition by histology on pleural biopsy specimens. Hereby, we report a case of systemic amyloidosis where we were able to identify amyloid in a pleural effusion specimen sent for cytopathology evaluation. A 59-year-old male with newly diagnosed multiple myeloma and systemic amyloidosis underwent therapeutic thoracentesis. The H&E stained cell block sections revealed a single, less than one millimeter focus of waxy material surrounded by a rim of reactive mesothelial cells suspicious for amyloid deposit in a background of fibrin, lymphocytes, and reactive mesothelial cells. The focus stained salmon pink with Congo-red special stain and showed apple-green birefringence under polarized light. Our finding suggests that pleural involvement in patients with systemic amyloidosis can be identified on effusion specimens and avert the need for more invasive procedures like pleural or pulmonary parenchymal biopsies. © 2017 Wiley Periodicals, Inc.

Imported brucellosis: A case series and literature review.

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Norman, Francesca F; Monge-Maillo, Begoña; Chamorro-Tojeiro, Sandra; Pérez-Molina, Jose-Antonio; López-Vélez, Rogelio

2016-01-01

Brucellosis is one of the main neglected zoonotic diseases. Several factors may contribute to the epidemiology of brucellosis. Imported cases, mainly in travellers but also in recently arrived immigrants, and cases associated with imported products, appear to be infrequently reported. Cases of brucellosis diagnosed at a referral unit for imported diseases in Europe were described and a review of the literature on imported cases and cases associated with contaminated imported products was performed. Most imported cases were associated with traditional risk factors such as travel/consumption of unpasteurized dairy products in endemic countries. Cases associated with importation of food products or infected animals also occurred. Although a lower disease incidence of brucellosis has been reported in developed countries, a higher incidence may still occur in specific populations, as illustrated by cases in Hispanic patients in the USA and in Turkish immigrants in Germany. Imported brucellosis appears to present with similar protean manifestations and both classical and infrequent modes of acquisition are described, leading on occasions to mis-diagnoses and diagnostic delays. Importation of Brucella spp. especially into non-endemic areas, or areas which have achieved recent control of both animal and human brucellosis, may have public health repercussions and timely recognition is essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Trend pattern of the incidence of thyroid cancer in Murcia Region (Spain) from 1984 to 2008].

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Chirlaque, María Dolores; Moldenhauer, Fernando; Salmerón, Diego; Navarro, Carmen

2014-01-01

To study the trend pattern of the incidence of thyroid cancer. We selected incident cases of thyroid cancer occurring in the Region of Murcia (Spain) in 1984-2008. The variables gathered were age, sex, date of diagnosis, and morphology. We calculated incidence rates and the annual percentage of change using Bayesian age-period-cohort models. During the study period, 1414 cases were diagnosed, representing an increase in adjusted rates from 2.9/100000 in 1984-1988 to 7.3 in 2004-2008. The incidence was 3.5 times higher in women than in men and the most frequent morphology was papillary carcinoma (67.7%). An increasing trend was found in both genders; these increments were more pronounced in papillary carcinoma. In women, the incidence increased with age, calendar year, and in those born in 1945-1963. The incidence of papillary microcarcinoma increased four-fold in women. Thyroid cancer used to be a rare cancer but has become an emerging tumor. The greatest changes were found in papillary thyroid cancer, including a gradual increase in the proportion of microcarcinoma. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Incidence and Mortality Rates and Clinical Characteristics of Type 1 Diabetes among Children and Young Adults in Cochabamba, Bolivia

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Elizabeth Duarte Gómez

2017-01-01

Full Text Available Objectives. To determine incidence, mortality, and clinical status of youth with diabetes at the Centro Vivir con Diabetes, Cochabamba, Bolivia, with support from International Diabetes Federation Life for a Child Program. Methods. Incidence/mortality data analysis of all cases (<25 year (y diagnosed January 2005–February 2017 and cross-sectional data (December 2015. Results. Over 12.2 years, 144 cases with type 1 diabetes (T1D were diagnosed; 43.1% were male. Diagnosis age was 0.3–22.2 y; peak was 11-12 y. 11.1% were <5 y; 29.2%, 5–<10 y; 43.1%, 10–<15 y; 13.2%, 15–<20 y; and 3.5%, 20–<25 y. The youngest is being investigated for monogenic diabetes. Measured incidence in Cercado Province (Cochabamba Department was 2.2/100,000 children < 15 y/y, with ≈80% ascertainment, giving total incidence of 2.7/100,000 children < 15 y/y. Two had died. Crude mortality rate was 2.3/1000 patient years. Clinical data on 141 cases <35 y: mean/median HbA1c was 8.5/8.2% (69/62 mmol/mol, levels higher in adolescents. Three were on renal replacement therapy; four others had substantial renal impairment. Elevated BMI, triglycerides, and cholesterol were common: 19.1%, 18.3%, and 39.1%, respectively. Conclusions. Bolivia has low T1D incidence. Reasonable glycemic control is being achieved despite limited resources; however, some have serious complications and adverse cardiovascular risk factor profiles. Further attention is needed for complications.

A case of ureteral tumor diagnosed by computed tomography

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Hirakawa, Shinji; Adachi, Botaro; Hamamoto, Ryuichi; Nishimoto, Kazuhiko; Goto, Hajime

1980-01-01

A 66-year-old woman, visited Tottori University Hospital with the chief complaint of asymptomatic macrohematuria on Oct. 4, 1979. RP showed right hydroureteronephrosis due to right lower ureteral stenosis. Computed tomography (CT) was employed to investigate the right lower ureter, which showed a tumor in the right lower ureter, confined within the ureteral wall. Diagnosis of the right ureteral tumor with right hydroureteronephrosis was made and under general anesthesia right complete nephroureterectomy was performed on Oct. 26, 1979. So, the accuracy of the preoperative diagnosis was confirmed by the operation. CT has been supposed to be disadvantageous in the diagnosis of ureteral lesions, since ureter is thin, and the ureteral wall is also thin. However as was demonstrated in this case, a sizeable tumor of ureter could be diagnosed accurately by CT. (author)

Timing of entry to care by newly diagnosed HIV cases before and after the 2010 New York State HIV testing law.

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Gordon, Daniel E; Bian, Fuqin; Anderson, Bridget J; Smith, Lou C

2015-01-01

Prompt entry to care after HIV diagnosis benefits the infected individual and reduces the likelihood of further transmission of the virus. The New York State HIV Testing Law of 2010 requires diagnosing providers to refer persons newly diagnosed with HIV to follow-up medical care. This study used routinely collected HIV-related laboratory data from the New York State HIV surveillance system to assess whether the fraction of newly diagnosed cases entering care within 90 days of diagnosis increased after the implementation of the law. Laboratory data on 23,302 newly diagnosed cases showed that entry to care within 90 days rose steadily from 72.0% in 2007 to 85.4% in 2012. The rise was observed across all race/ethnic groups, ages, transmission risk groups, sexes, and regions of residence. Logistic regression analyses of entry to care pre-law and post-law, controlling for demographic characteristics, transmission risk, and geographic area, indicate that percentage of newly diagnosed cases entering care within 90 days grew more rapidly in the post-law period. This is consistent with a positive effect of the law on entry to care.

Locating People Diagnosed With HIV for Public Health Action: Utility of HIV Case Surveillance and Other Data Sources.

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Padilla, Mabel; Mattson, Christine L; Scheer, Susan; Udeagu, Chi-Chi N; Buskin, Susan E; Hughes, Alison J; Jaenicke, Thomas; Wohl, Amy Rock; Prejean, Joseph; Wei, Stanley C

Human immunodeficiency virus (HIV) case surveillance and other health care databases are increasingly being used for public health action, which has the potential to optimize the health outcomes of people living with HIV (PLWH). However, often PLWH cannot be located based on the contact information available in these data sources. We assessed the accuracy of contact information for PLWH in HIV case surveillance and additional data sources and whether time since diagnosis was associated with accurate contact information in HIV case surveillance and successful contact. The Case Surveillance-Based Sampling (CSBS) project was a pilot HIV surveillance system that selected a random population-based sample of people diagnosed with HIV from HIV case surveillance registries in 5 state and metropolitan areas. From November 2012 through June 2014, CSBS staff members attempted to locate and interview 1800 sampled people and used 22 data sources to search for contact information. Among 1063 contacted PLWH, HIV case surveillance data provided accurate telephone number, address, or HIV care facility information for 239 (22%), 412 (39%), and 827 (78%) sampled people, respectively. CSBS staff members used additional data sources, such as support services and commercial people-search databases, to locate and contact PLWH with insufficient contact information in HIV case surveillance. PLWH diagnosed surveillance than were PLWH diagnosed ≥1 year ago ( P = .002), and the benefit from using additional data sources was greater for PLWH with more longstanding HIV infection ( P surveillance cannot provide accurate contact information, health departments can prioritize searching additional data sources, especially for people with more longstanding HIV infection.

Incidence of lactase deficiency (LD) in gastroduodenal ulcer and gastric carcinoma

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Bahk, Yong Whee; Ahn, Kwan Shik; Kim, Chung Ja

1974-01-01

Lactase deficiency (LD) has been described in associated with peptic ulcer disease of the upper gastrointestinal tract, but little has been known as to the incidence of LD in the patients with ulcer disease of the upper GI tract or with gastric carcinoma. The purpose of the present study is to investigate the incidence of LD in gastric and/or duodenal ulcer disease and in gastric carcinoma, and to hypothesize the possible effect of these diseases on LD. Clinical materials consisted of 40 cases of active duodenal ulcer disease, 19 cases of benign gastric ulcer, 5 cases of multiple ulcers both in the stomach and duodenum, and 32 cases of gastric carcinoma. We used the lactose-barium test in diagnosing LD. X-ray findings were assessed according to the criteria described by Laws et al. and Preger and Amberg in the small-bowel film obtained at 30 minutes after the ingestion of some 200 ml of lactose-barium meal which contained 50 gm of lactose. Our clinical study revealed that the incidence of LD in duodenal ulcer was 50%, in gastric ulcer 57.9%, in gastric and duodenal ulcer 60%, and in gastric carcinoma 46.9%. The difference of incidence between each disease were statistically not significant, but the difference between the disease group and normal control was highly significant. The incidence of LD in disease group was nearly twice as high as that of normal control (27.7%). It is speculated that high incidence of LD in peptic ulcer disease of upper GI tract in particular may be associated with high acidity, the analog of which is found in Zollinger-Ellison syndrome. But high acidity is not a prominent feature in gastric carcinoma which is attended by almost equally high incidence of LD. It is therefore likely that the intolerability to lactose is caused by much complicated mechanism of versatile factors

Incidence of lactase deficiency (LD) in gastroduodenal ulcer and gastric carcinoma

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Bahk, Yong Whee; Ahn, Kwan Shik; Kim, Chung Ja [St. Mary' s Hospital, Catholic Medical College, Seoul (Korea, Republic of)

1974-04-15

Lactase deficiency (LD) has been described in associated with peptic ulcer disease of the upper gastrointestinal tract, but little has been known as to the incidence of LD in the patients with ulcer disease of the upper GI tract or with gastric carcinoma. The purpose of the present study is to investigate the incidence of LD in gastric and/or duodenal ulcer disease and in gastric carcinoma, and to hypothesize the possible effect of these diseases on LD. Clinical materials consisted of 40 cases of active duodenal ulcer disease, 19 cases of benign gastric ulcer, 5 cases of multiple ulcers both in the stomach and duodenum, and 32 cases of gastric carcinoma. We used the lactose-barium test in diagnosing LD. X-ray findings were assessed according to the criteria described by Laws et al. and Preger and Amberg in the small-bowel film obtained at 30 minutes after the ingestion of some 200 ml of lactose-barium meal which contained 50 gm of lactose. Our clinical study revealed that the incidence of LD in duodenal ulcer was 50%, in gastric ulcer 57.9%, in gastric and duodenal ulcer 60%, and in gastric carcinoma 46.9%. The difference of incidence between each disease were statistically not significant, but the difference between the disease group and normal control was highly significant. The incidence of LD in disease group was nearly twice as high as that of normal control (27.7%). It is speculated that high incidence of LD in peptic ulcer disease of upper GI tract in particular may be associated with high acidity, the analog of which is found in Zollinger-Ellison syndrome. But high acidity is not a prominent feature in gastric carcinoma which is attended by almost equally high incidence of LD. It is therefore likely that the intolerability to lactose is caused by much complicated mechanism of versatile factors.

Unilateral Osteomyelitis of the Clavicle in Childhood:A Case Report

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Arezou Hemmati

2017-08-01

Full Text Available Infection of clavicle is a rare complication in children that is difficult to diagnose. The exact incidence is unknown. We report a case of osteomyelitis of the clavicle without any long term disability.

Aumento da incidência de carcinoma basocelular em hospital universitário: 1999 a 2009 Increase in the incidence of basal cell carcinoma in a university hospital between 1999 and 2009

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Juliano Vilaverde Schmitt

2011-04-01

Full Text Available A incidência do carcinoma basocelular vem aumentando em todos os países. Realizou-se estudo ecológico de 5169 laudos de carcinoma basocelular, da FMB-Unesp, entre janeiro/1999 e dezembro/2009. O incremento médio da incidência para o período foi de 90,6%, projetando-se um diagnóstico para cada 15 pacientes encaminhados à dermatologia. Tal tendência se manteve, mesmo quando indexada pelo número de laudos histopatológicos, movimento hospitalar, atendimentos da dermatologia e população de Botucatu.The incidence of basal cell carcinoma is increasing worldwide. An ecological study was conducted using the pathology reports from 5169 cases of basal cell carcinoma diagnosed at the Botucatu School of Medicine, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP between January 1999 and December 2009. The mean increase in the incidence of basal cell carcinoma over this period was 90.6%, suggesting that one case of basal cell carcinoma could be expected for every 15 patients referred to dermatology. This trend was also found when the incidence was indexed according to the absolute number of histopathology exams, the total number of hospital consultations, the total number of dermatological consultations and the population of the town of Botucatu

The need for genetic study to diagnose some cases of distal renal tubular acidosis.

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Heras Benito, Manuel; Garcia-Gonzalez, Miguel A; Valdenebro Recio, María; Molina Ordás, Álvaro; Callejas Martínez, Ramiro; Rodríguez Gómez, María Astrid; Calle García, Leonardo; Sousa Silva, Lisbeth; Fernández-Reyes Luis, María José

We describe the case of a young woman who was diagnosed with advanced kidney disease, with an incidental finding of nephrocalcinosis of unknown aetiology, having been found asymptomatic throughout her life. The genetic study by panels of known genes associated with tubulointerstitial disease allowed us to discover autosomal dominant distal renal tubular acidosis associated with a de novo mutation in exon 14 of the SLC4A1 gene, which would have been impossible to diagnose clinically due to the advanced nature of the kidney disease when it was discovered. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Regional comparison of cancer incidence

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Obralic, N.; Gavrankapetanovic, F.; Dizdarevic, Z.; Duric, O.; Sisic, F.; Selak, I.; Balta, S.; Nakas, B.

2004-01-01

Background. Due to specific war and post-war situation in Balkan region, differences in the number, type, development, biological course, treatment of malignant tumours and its outcome are possible. In order to perceive the situation realistically, it is necessary to gather continuously exact data about malignant tumours and compare them with the data from other European and world countries.The aim of the study was to collect and analyse the data on cancer incidence in the region of Sarajevo city, which represents a symbol of difficult times in the recent past, and to compare it to the incidence in the neighbouring countries. Patients and methods. Data on all newly diagnosed cancer cases, permanent residents of Sarajevo Canton, in the years 1999 and 2000 were collected. Crude incidence rate has been calculated according to the years observed, gender and localizations of the disease The data were compared to the cancer registries of Slovenia and Croatia and were observed in the light of specific local situation. Results. The crude cancer incidence of all sites but skin was the highest in both years and by both genders in Croatia. The incidence of the most common tumours (lung and breast cancer) was similar in all three countries. The differences in the incidence between both genders in the Sarajevo canton were registered in laryngeal and urinary bladder cancer, as well as in bone and cartilage sarcoma. Cervical cancer had extremely high incidence and was high up on the incidence list in the Sarajevo canton, which correlates with the data in developing countries. The incidence of other tumours in the post-war period is reaching expected numbers. Conclusions. It is difficult to identify whether the war and post-war stress, irregular and insufficient nutrition during and after the siege of the city of Sarajevo or some other factor influenced the cancer incidence among exposed population. The prevalence of smoking in the whole region is extremely high, in Bosnia and

Squamous cell carcinoma of the breast in the United States: incidence, demographics, tumor characteristics, and survival.

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Yadav, Siddhartha; Yadav, Dhiraj; Zakalik, Dana

2017-07-01

Squamous cell carcinoma of breast accounts for less than 0.1% of all breast cancers. The purpose of this study is to describe the epidemiology and survival of this rare malignancy. Data were extracted from the National Cancer Institute's Surveillance, Epidemiology and End Results Registry to identify women diagnosed with squamous cell carcinoma of breast between 1998 and 2013. SEER*Stat 8.3.1 was used to calculate age-adjusted incidence, age-wise distribution, and annual percentage change in incidence. Kaplan-Meier curves were plotted for survival analysis. Univariate and multivariate Cox proportional hazard regression model was used to determine predictors of survival. A total of 445 cases of squamous cell carcinoma of breast were diagnosed during the study period. The median age of diagnosis was 67 years. The overall age-adjusted incidence between 1998 and 2013 was 0.62 per 1,000,000 per year, and the incidence has been on a decline. Approximately half of the tumors were poorly differentiated. Stage II was the most common stage at presentation. Majority of the cases were negative for expression of estrogen and progesterone receptor. One-third of the cases underwent breast conservation surgery while more than half of the cases underwent mastectomy (unilateral or bilateral). Approximately one-third of cases received radiation treatment. The 1-year and 5-year cause-specific survival was 81.6 and 63.5%, respectively. Excluding patient with metastasis or unknown stage at presentation, in multivariate Cox proportional hazard model, older age at diagnosis and higher tumor stage (T3 or T4) or nodal stage at presentation were significant predictors of poor survival. Our study describes the unique characteristics of squamous cell carcinoma of breast and demonstrates that it is an aggressive tumor with a poor survival. Older age and higher tumor or nodal stages at presentation were independent predictors of poor survival for loco-regional stages.

Burden and seasonality of testicular torsion in tropical Africa: Analysis of incident cases in a Nigerian community

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Jibril O. Bello

2018-03-01

Full Text Available Introduction: Children, adolescents and young adults in tropical Africa occasionally presents to the emergency department with testicular torsion. However, no estimates of the burden of the condition is available and there is also sparse evidence of a seasonal variation in incidence. Objective: To determine the incidence and seasonality of the condition in a Nigerian community. Subjects and methods: A retrospective review of incident cases of testicular torsion occurring in a typical tropical sub-Saharan African community between January 2011 and December 2016 was performed. Incidence rates were calculated and trend analysis performed to evaluate for seasonality. Results: Twenty-three patients were seen during the study period and the average annual incidence of testicular torsion among ‘at risk’ males (<40 years was 2.7/100,000. Testicular salvage rate was 81%. Cases occurred 91% higher than average during the cold season (November to January. Trend analysis revealed a significant seasonal difference in the number of cases seen (p = 0.045 and Post Hoc tests (Tukey further showed that this is attributable to the seasonal difference between the cold season and the warmer early rains period (p = 0.036. Conclusion: The burden of testicular torsion found in the studied tropical sub-Saharan community is comparable to other regions of the world and seasonal variation in incidence does occur with a significant increase in cases during the cold season. Keywords: Testicular torsion, Seasonality, Disease burden, Orchiopexy, Orchiectomy

Neuropathic pain: A personal case reflection on a critical incident

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Balaji P Duraisamy

2011-01-01

Full Text Available Neuropathic pain is a distressing symptom for the patient and a difficult symptom for the physician to treat. There is lack of evidence-based clinical guidelines for the management of malignant neuropathic pain. The case reflection is a personal account of what has been learnt from a critical incident in a particular patient in the management of neuropathic pain. Psychological issues are known to increase pain percetion and affect the quality of life. The case reflection explores problem areas, defines lacunae in knowledge, and demonstrates active learning of the management of neuropathic pain through reflective practice.

Space-time distribution of the ALS incident cases by onset type in the Health District of Ferrara, Italy.

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Govoni, V; Della Coletta, E; Cesnik, E; Casetta, I; Tugnoli, V; Granieri, E

2015-04-01

An ecological study in the resident population of the Health District (HD) of Ferrara, Italy, has been carried out to establish the distribution in space and time of the amyotrophic lateral sclerosis (ALS) incident cases according to the disease onset type and gender in the period 1964-2009. The hypothesis of a uniform distribution was assumed. The incident cases of spinal onset ALS and bulbar onset ALS were evenly distributed in space and time in both men and women. The spinal onset ALS incident cases distribution according to gender was significantly different from the expected in the extra-urban population (20 observed cases in men 95% Poisson confidence interval 12.22-30.89, expected cases in men 12.19; six observed cases in women 95% Poisson confidence interval 2.20-13.06, expected cases in women 13.81), whereas no difference was found in the urban population. The spinal onset ALS incidence was higher in men than in women in the extra-urban population (difference between the rates = 1.53, 95% CI associated with the difference 0.52-2.54), whereas no difference between sexes was found in the urban population. The uneven distribution according to gender of the spinal onset ALS incident cases only in the extra-urban population suggests the involvement of a gender related environmental risk factor associated with the extra-urban environment. Despite some limits of the spatial analysis in the study of rare diseases, the results appear consistent with the literature data. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

CT-MPR invaluable in diagnosing odontogenic maxillary sinusitis

International Nuclear Information System (INIS)

Aoki, Hideaki; Shimazu, Kaoru; Kamada, Morito; Shiroyama, Akihiro; Mouri, Daisuke; Yamashita, Masashi; Kawasaki, Yasunori; Koseki, Takakazu; Mouri, Manabu

2001-01-01

In everyday examination, it is usual to encounter odontogenic maxillary sinusitis patients. Odontogenic maxillary sinusitis is generally best diagnosed by dental X-ray imaging. Many medical facilities not having a dental X-ray unit use coronal computed tomography (CT) images to diagnose odontogenic maxillary sinusitis. Coronal CT imaging causes artifacts, however due to dental prosthesises. Computed tomography-Multiplanar reformation (CT-MPR) imaging has proved useful in evaluating the paranasal sinus because it is not influenced by dental prosthesises. We evaluated the usefulness of CT-MPR for diagnosing odontogenic maxillary sinusitis by retrospectively analyzing 16 patients, with the following results. We couldn't diagnose all cases of odontogenic maxillary sinusitis in posteroanterior and Waters projection images. Panoramic radiography is needed to diagnose odontogenic maxillary sinusitis. Dental X-ray imaging missed some cases, but all cases were diagnosed by CT-MPR imaging, giving a 100% diagnosestic rate. CT-MPR imaging is thus at least as valuable or better than dental X-ray imaging in diagnosing odontogenic maxillary sinusitis. (author)

Cancer Incidence in Saudi Arabia: 2012 Data from the Saudi Cancer Registry

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Bazarbashi, Shouki; Al Eid, Haya; Minguet, Joan

2017-09-27

Background: In order to most appropriately allocate healthcare and research funding for cancer, it is important to have accurate population-based incidence data. The Saudi Cancer Registry (SCR) provides such information, covering the time period from 1994 to the present day. The current report concerns an overview of cancer incidence statistics for Saudi Arabia in 2012. Methods: The SCR collects data from healthcare facilities throughout the Kingdom of Saudi Arabia. All newly diagnosed cases of cancer are recorded, with information on site and histology. For the present report, age-standardised and age-specific incidence rates (ASR, AIR, respectively) were calculated, with attention to gender-specific and regional differences. Results: The total number of incident cases of cancer identified by the SCR in 2012 was 14,336, with 6,791 (47.5%) among males and 7,545 (52.6%) among females. Of this total, 11,034 cases (76.9%) occurred in patients of Saudi origin. For Saudi males, the overall ASR (inc. all cancer sites) was 78.1 per 100,000 people, while that for females was 86.7. Incidence varied by region, with the Eastern region and Riyadh displaying the highest ASRs for both males and females, and Hail and Jazan displaying the lowest. Incidence varied by gender, with colorectal cancer (13.3%), non-Hodgkin lymphoma (NHL; 8.4%), and leukaemia (8.2%) being the most common types in males, and breast (25.8%), thyroid (11.7%), and colorectal cancers (9.3%) being the most common in females. Conclusions: This analysis of cancer incidence in Saudi Arabia demonstrated significant differences according to gender, age, and region of the Kingdom. The data should help ensure the most appropriate allocation of resources, with the aim of minimising the healthcare burden associated with cancer. Creative Commons Attribution License

[Incidence of childhood type I diabetes in Extremadura, Spain, 2003-2007].

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Gimeno Benítez, A; Luengo Pérez, L M; Suero Villa, P; Suero Villa, S; Sánchez Vega, J

2014-01-01

Studies have shown an increasing incidence of type I diabetes in children in Europe over the last 20 years. The present study was conducted to evaluate the incidence and development of type I diabetes in children under 15 years of age in Extremadura in the period 2003-2007. The study applied the capture-recapture method using the national hospital discharge database as primary source. Data were collected from children under 15 years of age diagnosed with diabetes type I during the study period. Secondary data source were insulin prescriptions from the public health system. Rates were standardised and a Poisson regression was used to assess the development of the disease during the study period. The overall adjusted incidence rate was 25.2/100.000 (95%CI: 21.8-28.6) with 100% completeness; no significant differences were observed by sex or provinces. Age group rates were 20.2/100.000 (95%CI: 10.1-30.3) for aged 0-4 years, 24.8/100.000 (95%CI: 20.1-29.4) for aged 5-9 years, and 30.0/100.000 (95%CI: 25.8-34.1) for aged 10-14 years, with a RR of 1.67 (95%CI: 1.18-2.36; P=.004) for 10-14 year olds relative to 0-4 year olds. The number of cases among children aged 0-4 years increased from 5 cases in 2003 to 15 cases in 2006, although this increase was not significantly different. The overall rates of incidence of type I diabetes were higher than the expected incidence values in Extremadura. Careful surveillance is required to confirm the increased trend in the incidence of type I diabetes observed among children aged 0-4 years. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Variation in worldwide incidence of amyotrophic lateral sclerosis: a meta-analysis.

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Marin, Benoît; Boumédiene, Farid; Logroscino, Giancarlo; Couratier, Philippe; Babron, Marie-Claude; Leutenegger, Anne Louise; Copetti, Massimilano; Preux, Pierre-Marie; Beghi, Ettore

2017-02-01

To assess the worldwide variation of amyotrophic lateral sclerosis (ALS) incidence, we performed a systematic review and meta-analysis of population-based data published to date. We reviewed Medline and Embase up to June 2015 and included all population-based studies of newly diagnosed ALS cases, using multiple sources for case ascertainment. ALS crude and standardized incidence (on age and sex using the US 2010 population) were calculated. Random effect meta-analysis and meta-regression were performed using the subcontinent as the main study level covariate. Sources of heterogeneity related to the characteristics of the study population and the study methodology were investigated. Among 3216 records, 44 studies were selected, covering 45 geographical areas in 11 sub-continents. A total of 13 146 ALS cases and 825 million person-years of follow-up (PYFU) were co-nsidered. The overall pooled worldwide crude ALS incidence was at 1.75 (1.55-1.96)/100 000 PYFU; 1.68 (1.50-1.85)/100 000 PYFU after standardization. Heterogeneity was identified in ALS standardized incidence between North Europe [1.89 (1.46-2.32)/100 000 PYFU] and East Asia [0.83 (0.42-1.24)/100 000 PYFU, China and Japan P = 0.001] or South Asia [0.73 (0.58-0.89)/100 000/PYFU Iran, P = 0.02]. Conversely, homogeneous rates have been reported in populations from Europe, North America and New Zealand [pooled ALS standardized incidence of 1.81 (1.66-1.97)/100 000 PYFU for those areas]. This review confirms a heterogeneous distribution worldwide of ALS, and sets the scene to sustain a collaborative study involving a wide international consortium to investigate the link between ancestry, environment and ALS incidence. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association

Time trend in Alzheimer diagnoses and the association between distance to an Alzheimer clinic and Alzheimer diagnosis

DEFF Research Database (Denmark)

Jørgensen, Terese Sara Høj; Torp-Pedersen, Christian; Gislason, Gunnar H

2015-01-01

BACKGROUND: Centralization of specialized health care in Denmark has caused increased geographical distance to health-care providers, which may be a barrier for Alzheimer patients to seek health care. We examined the incidence of Alzheimer diagnosis in Denmark between 2000 and 2009 and investigated...... the association between patients' distance to Alzheimer clinics and Alzheimer diagnoses. METHODS: Data of all individuals aged 65+ years were collected from Danish national registers. Incidences of Alzheimer diagnoses were analysed with joinpoint regression and hazard ratios (HRs) for Alzheimer diagnoses were...... analysed with Cox regressions. RESULTS: The annual incidence of Alzheimer diagnoses increased with 32.5% [95% confidence interval (CI): 7.1-63.8] among individuals aged 65-74 years from 2000 to 2002 and with 29.1% (95% CI: 11.0-50.2) among individuals aged 75+ years from 2000 to 2003. For both groups...

Estimated incidence of pertussis in people aged <50 years in the United States

Science.gov (United States)

Chen, Chi-Chang; Balderston McGuiness, Catherine; Krishnarajah, Girishanthy; Blanchette, Christopher M.; Wang, Yuanyuan; Sun, Kainan; Buck, Philip O.

2016-01-01

ABSTRACT The introduction of pertussis vaccination in the United States (US) in the 1940s has greatly reduced its burden. However, the incidence of pertussis is difficult to quantify, as many cases are not laboratory-confirmed or reported, particularly in adults. This study estimated pertussis incidence in a commercially insured US population aged pertussis or cough illness using International Classification of Diseases (ICD-9) codes, a commercial outpatient laboratory database for patients with a pertussis laboratory test, and the Centers for Disease Control influenza surveillance database. US national pertussis incidence was projected using 3 methods: (1) diagnosed pertussis, defined as a claim for pertussis (ICD-9 033.0, 033.9, 484.3) during 2008–2013; (2) based on proxy pertussis predictive logistic regression models; (3) using the fraction of cough illness (ICD-9 033.0, 033.9, 484.3, 786.2, 466.0, 466.1, 487.1) attributed to laboratory-confirmed pertussis, estimated by time series linear regression models. Method 1 gave a projected annual incidence of diagnosed pertussis of 9/100,000, which was highest in those aged pertussis of 649/100,000, approximately 58–93 times higher than method 1 depending on the year. These estimations, which are consistent with considerable underreporting of pertussis in people aged pertussis burden. PMID:27246119

PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

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A. Bostak

2006-11-01

Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.

An evidence-based case of acoustic/vestibular schwannoma

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Girish Gupta

2015-01-01

Full Text Available A vestibular schwannoma, often called an acoustic neuroma/schwannoma, is a benign primary intracranial tumor of the myelin-forming cells of the vestibulo-cochlear nerve (8 th cranial nerve. This tumor arises from the Schwann cells responsible for the myelin sheath that helps keep peripheral nerves insulated. [1] Approximately, 3000 cases are diagnosed each year in the United States with a prevalence of about 1 in 100,000 worldwide. It comprises 5-10% of all intracranial neoplasms in adults. Incidence peaks in the fifth and sixth decades and both sexes are affected equally. Studies in Denmark published in 2004 show the incidence of 17.4/million. Most acoustic neuromas are diagnosed in patients between the ages of 30 and 60, and men and women appear to be affected equally. [2] The case illustrated here is a rare one of acoustic/vestibular schwannoma a surgical conditions, treated with Lycopodium, which produced improvement on both subjective and objective parameters.

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

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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 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.

Burden and incidence of human papillomavirus-associated cancers and precancerous lesions in Denmark

DEFF Research Database (Denmark)

Svahn, Malene F; Munk, Christian; von Buchwald, Christian

2016-01-01

the study period, and almost identical incidence rates were seen for women and men in the youngest birth cohorts. The current burden of HPV-associated lesions amounted to more than 5000 cases, the vast majority (85%) being severe precancerous lesions. The highest risk for HPV-associated cancers......AIM: The aim of the study was to investigate the incidence of human papillomavirus (HPV)-associated cancers in Denmark between 1978 and 2011, estimate the current absolute annual number (burden) of HPV-associated cancers (HPVaCa) and their precancerous lesions, and assess whether...... there is socioeconomic inequality in the risk of HPV-associated cancers. METHODS: From four nationwide population-based registries, information was collected on HPVaCa diagnosed during 1978-2011 and age-standardised incidence rate for each site by calendar year and birth cohort was calculated. Furthermore, the current...

Report from two cases of vesicular varices secondary to thrombosis of the aorta vein, diagnosed by ultrasound Doppler color and pressed

International Nuclear Information System (INIS)

Triana R, Gustavo; Romero E, Javier; Prada, Mario; Uribe, Tomas

1999-01-01

We report two cases of gallbladder varices diagnosed by ultrasound. The first one is a 71-year-old patient who was diagnosed with liver cirrhosis of unknown etiology. The second patient is a 27-year-old woman who was diagnosed with a hypercoagulability state. Both of them were evaluated with Doppler ultrasound of the esplenoportal circulation, gallbladder varices associated with complete portal vein thrombosis were found

Socioeconomic patterning in the incidence and survival of teenage and young adult men aged between 15 and 24 years diagnosed with non-seminoma testicular cancer in northern england.

Science.gov (United States)

McNally, Richard J Q; Basta, Nermine O; Errington, Steven; James, Peter W; Norman, Paul D; Hale, Juliet P; Pearce, Mark S

2015-12-01

Previous research from developed countries has shown a marked increase in the incidence of testicular cancer in the past 50 years. This has also been demonstrated in northern England, along with improving 5-year survival. The present study aims to determine if socioeconomic factors may play a role in both etiology and survival from non-seminoma testicular cancer. We extracted all 214 cases of non-seminoma testicular cancer diagnosed in teenage and young adult men aged between 15 and 24 years during 1968 to 2006 from the Northern Region Young Persons' Malignant Disease Registry, which is a population-based specialist regional registry. Negative binomial regression was used to examine the relationship between incidence and both the Townsend deprivation score (and component variables) and small-area population density. Cox regression was used to analyze the relationship between survival and both deprivation and population density. Decreased incidence was associated with living in areas of higher household overcrowding for young adults aged between 20 and 24 years (relative risk per 1% increase in household overcrowding = 0.79; 95% CI: 0.66-0.94) but no association was detected for young people aged between 15 and 19 years. Community-level household unemployment was associated with worse survival (hazard ratio per 1% increase in household unemployment = 1.04; 95% CI: 1.00-1.08). This study has shown that increased risk of non-seminoma testicular cancer in teenage and young adult men may be associated with some aspect of more advantaged living. In contrast, greater deprivation is linked with worse survival prospects. The study was ecological by design and so these area-based results may not necessarily apply to individuals. Copyright © 2015 Elsevier Inc. All rights reserved.

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

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

2015-06-08

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

Medical treatment of radiation damages and medical emergency planning in case of nuclear power plant incidents and accidents

International Nuclear Information System (INIS)

Ohlenschlaeger, L.

1981-03-01

Medical measures in case of radiation damages are discussed on the basis of five potential categories of radiation incidents and accidents, respectively, viz. contaminations, incorporations, external local and general radiation over-exposures, contaminated wounds, and combinations of radiation damages and conventional injuries. Considerations are made for diagnostic and therapeutic initial measures especially in case of minor and moderate radiation accidents. The medical emergency planning is reviewed by means of definations used in the practical handling of incidents or accidents. The parameters are: extent of the incident or accident, number of persons involved, severity of radiation damage. Based on guiding symptoms the criteria for the classification into minor, moderate or severe radiation accidents are discussed. Reference is made to the Medical Radiation Protection Centers existing in the Federal Republic of Germany and the possibility of getting advices in case of radiation incidents and accidents. (orig.) [de

A Case of Multiple Splenic Lymph angiomas Diagnosed by Percutaneous Needle Biopsy

Energy Technology Data Exchange (ETDEWEB)

Ki, Seung Seog; Jeong, Sook Hyang; Yoon, Chang Jin; Chang, Se Jung; Choi, Joon Hyuk; Ha, Ji Su; Kim, Soon Je [KEPCO Medical foundation Hanil General Hospital, Seoul (Korea, Republic of); Lee, Hye Seung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

2007-06-15

Lymphangioma of the spleen is an extremely rare disease in adults, and performing splenectomy has been considered necessary for its diagnosis and treatment, but the diagnosis of an isolated splenic mass lesion without performing splenectomy is a challenging problem. Herein, we report on a case of multiple splenic lymphangiomas that were found incidentally in a 56-year-old female; these lesions were diagnosed by percutaneous splenic biopsy without splenectomy. We suggest that this approach is a reasonable option for benign looking-appearing splenic tumors because splenectomy and its postsplenectomy complications can be avoided

A Case of Multiple Splenic Lymph angiomas Diagnosed by Percutaneous Needle Biopsy

International Nuclear Information System (INIS)

Ki, Seung Seog; Jeong, Sook Hyang; Yoon, Chang Jin; Chang, Se Jung; Choi, Joon Hyuk; Ha, Ji Su; Kim, Soon Je; Lee, Hye Seung

2007-01-01

Lymphangioma of the spleen is an extremely rare disease in adults, and performing splenectomy has been considered necessary for its diagnosis and treatment, but the diagnosis of an isolated splenic mass lesion without performing splenectomy is a challenging problem. Herein, we report on a case of multiple splenic lymphangiomas that were found incidentally in a 56-year-old female; these lesions were diagnosed by percutaneous splenic biopsy without splenectomy. We suggest that this approach is a reasonable option for benign looking-appearing splenic tumors because splenectomy and its postsplenectomy complications can be avoided

Infant brain tumors: incidence, survival, and the role of radiation based on Surveillance, Epidemiology, and End Results (SEER) Data.

Science.gov (United States)

Bishop, Andrew J; McDonald, Mark W; Chang, Andrew L; Esiashvili, Natia

2012-01-01

To evaluate the incidence of infant brain tumors and survival outcomes by disease and treatment variables. The Surveillance, Epidemiology, and End Results (SEER) Program November 2008 submission database provided age-adjusted incidence rates and individual case information for primary brain tumors diagnosed between 1973 and 2006 in infants less than 12 months of age. Between 1973 and 1986, the incidence of infant brain tumors increased from 16 to 40 cases per million (CPM), and from 1986 to 2006, the annual incidence rate averaged 35 CPM. Leading histologies by annual incidence in CPM were gliomas (13.8), medulloblastoma and primitive neuroectodermal tumors (6.6), and ependymomas (3.6). The annual incidence was higher in whites than in blacks (35.0 vs. 21.3 CPM). Infants with low-grade gliomas had the highest observed survival, and those with atypical teratoid rhabdoid tumors (ATRTs) or primary rhabdoid tumors of the brain had the lowest. Between 1979 and 1993, the annual rate of cases treated with radiation within the first 4 months from diagnosis declined from 20.5 CPM to incidence of infant brain tumors has been stable since 1986. Survival outcomes varied markedly by histology. For infants with medulloblastoma and ATRTs, improved survival was observed in patients treated with both surgery and early radiation compared with those treated with surgery alone. Copyright © 2012 Elsevier Inc. All rights reserved.

A late-diagnosed phenylketonuria case presenting with autism spectrum disorder in early childhood.

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Mazlum, Betül; Anlar, Banu; Kalkanoğlu-Sivri, H Serap; Karlı-Oğuz, Kader; Özusta, Şeniz; Ünal, Fatih

2016-01-01

Phenylketonuria is one of the most prevalent autosomal recessive hereditary disorders in Turkey. If untreated, it results in severe brain damage and can also be associated with autism in certain patients. We present a three-year old boy who exhibited the symptoms of autism and was subsequently diagnosed with phenylketonuria. This case illustrates that because the majority of autism cases are idiopathic, an occasional patient with a metabolic disorder might be overlooked especially in the era of newborn screening. We also discuss the possible pathogenetic processes leading to autistic symptoms in phenylketonuria, and wish to draw attention to the possibility of cases missed in the screening program because of less than 100% coverage or insufficient food intake before blood sampling. Clinicians should keep in mind the possibility of treatable disorders in children with autism even when such disorders appear unlikely.

Escitalopram in Preschool-Age Children Diagnosed with ‎Obsessive ‎Compulsive‏ ‏Disorder: A Case Report‎

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Kemal Utku Yazici

2016-02-01

Full Text Available When a literature review on pediatric obsessive-compulsive disorder (OCD is ‎performed, it is observed that there is a dearth of research on preschool period OCD ‎cases. Although cognitive behavioral therapy is recommended as the first line of ‎treatment in preschool OCD cases when patients do not show adequate response to ‎CBT, psychopharmacological treatment offers an alternative. The first line used in ‎psychopharmacological treatment is selective serotonin reuptake inhibitors (SSRI’s. ‎However, no SSRI’s (or any other drug group have been approved by the FDA for this ‎age group. Moreover, studies related to psychopharmacology in preschool OCD are very ‎limited in the literature, consisting mostly of case reports related to sertraline and ‎fluoxetine. In those studies, it is reported that sertraline and fluoxetine are effective in ‎preschool OCD and generally well-tolerated. In this paper, we discussed the treatment ‎and six-month follow-up period of a 3.5 year-old (42 months female diagnosed with ‎OCD and for whom escitalopram was used. In the literature, there is a retrospective case ‎series related to this subject consisting of eleven cases, where improvement in symptoms ‎is reported with escitalopram treatment in the five of six cases diagnosed with OCD. As ‎far as we could find in literature, our paper is the second report on this subject. Our case ‎also included the youngest patient to receive escitalopram for preschool period OCD ‎and report its benefits.‎

Incidence of metachronous gastric cancer in the remnant stomach after synchronous multiple cancer surgery.

Science.gov (United States)

Nozaki, Isao; Hato, Shinji; Kobatake, Takaya; Ohta, Koji; Kubo, Yoshirou; Nishimura, Rieko; Kurita, Akira

2014-01-01

In the preoperative evaluation for gastric cancer, high-resolution endoscopic technologies allow us to detect small accessory lesions. However, it is not known if the gastric remnant after partial gastrectomy for synchronous multiple gastric cancers has a greater risk for metachronous cancer. The purpose of this study was to determine the incidence of metachronous cancer in this patient subset compared with that after solitary cancer surgery. Data on a consecutive series of 1,281 patients gastrectomized for early gastric cancer from 1991 to 2007 were analyzed retrospectively. The 715 gastric remnants after distal gastrectomy were periodically surveyed by endoscopic examination in Shikoku Cancer Center. Among those surveyed cases, 642 patients were pathologically diagnosed with solitary lesion (SO group) and 73 patients with synchronous multiple lesions (MU group) at the time of the initial surgery. In the follow-up period, 15 patients in the SO group and 3 patients in the MU group were diagnosed as having metachronous cancer in the gastric remnant. The cumulative 4-year incidence rate was 1.9 % in the SO group and 5.5 % in the MU group. The difference did not reach the significant level by the log-rank test. The incidence of metachronous cancer is higher after multiple cancer surgery; however, the difference is not statistically significant.

Incidence and transmission patterns of tuberculosis among indigenous populations in Brazil

Directory of Open Access Journals (Sweden)

Eunice Atsuko Cunha

2014-02-01

Full Text Available Approximately 10% of the Brazilian indigenous population lives in the state of Mato Grosso do Sul (MS, where a large number of new cases of tuberculosis (TB are reported. This study was conducted to assess TB occurrence, transmission and the utility of TB diagnosis based on the Ogawa-Kudoh (O-K culture method in this remote population. The incidence of TB was estimated by a retrospective review of the surveillance data maintained by the Notifiable Diseases Surveillance System for the study region. The TB transmission pattern among indigenous people was assessed by genotyping Mycobacterium tuberculosis isolates using the IS 6110 restriction fragment length polymorphism (RFLP technique. Of the 3,093 cases identified from 1999-2001, 610 (~20% were indigenous patients (average incidence: 377/100,000/year. The use of the O-K culture method increased the number of diagnosed cases by 34.1%. Of the genotyped isolates from 52 indigenous patients, 33 (63.5% belonged to cluster RFLP patterns, indicating recently transmitted TB. These results demonstrate high, on-going TB transmission rates among the indigenous people of MS and indicate that new efforts are needed to disrupt these current transmissions.

Using the critical incident technique in community-based participatory research: a case study.

Science.gov (United States)

Belkora, Jeffrey; Stupar, Lauren; O'Donnell, Sara

2011-01-01

Successful community-based participatory research involves the community partner in every step of the research process. The primary study for this paper took place in rural, Northern California. Collaborative partners included an academic researcher and two community based resource centers that provide supportive services to people diagnosed with cancer. This paper describes our use of the Critical Incident Technique (CIT) to conduct Community-based Participatory Research. We ask: Did the CIT facilitate or impede the active engagement of the community in all steps of the study process? We identified factors about the Critical Incident Technique that were either barriers or facilitators to involving the community partner in every step of the research process. Facilitators included the CIT's ability to accommodate involvement from a large spectrum of the community, its flexible design, and its personal approach. Barriers to community engagement included training required to conduct interviews, depth of interview probes, and time required. Overall, our academic-community partners felt that our use of the CIT facilitated community involvement in our Community-Based Participatory Research Project, where we used it to formally document the forces promoting and inhibiting successful achievement of community aims.

Nationwide analysis on the impact of socioeconomic land use factors and incidence of urothelial carcinoma.

Science.gov (United States)

Brandt, Maximilian P; Gust, Kilian M; Mani, Jens; Vallo, Stefan; Höfner, Thomas; Borgmann, Hendrik; Tsaur, Igor; Thomas, Christian; Haferkamp, Axel; Herrmann, Eva; Bartsch, Georg

2018-02-01

Incidence rates for urothelial carcinoma (UC) have been reported to differ between countries within the European Union (EU). Besides occupational exposure to chemicals, other substances such as tobacco and nitrite in groundwater have been identified as risk factors for UC. We investigated if regional differences in UC incidence rates are associated with agricultural, industrial and residential land use. Newly diagnosed cases of UC between 2003 and 2010 were included. Information within 364 administrative districts of Germany from 2004 for land use factors were obtained and calculated as a proportion of the total area of the respective administrative district and as a smoothed proportion. Furthermore, information on smoking habits was included in our analysis. Kulldorff spatial clustering was used to detect different clusters. A negative binomial model was used to test the spatial association between UC incidence as a ratio of observed versus expected incidence rates, land use and smoking habits. We identified 437,847,834 person years with 171,086 cases of UC. Cluster analysis revealed areas with higher incidence of UC than others (p=0.0002). Multivariate analysis including significant pairwise interactions showed that the environmental factors were independently associated with UC (psocioeconomic factors based on agricultural, industrial and residential land use may be associated with UC incidence rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

Four Cases of Parkinson Disease Diagnosed During the Postpartum Period.

Science.gov (United States)

Maltête, David; Grangeon, Lou; Le Goff, Floriane; Ozel, Gulden; Fetter, Damien; Ahtoy, Patrick; Temgoua, Olivier; Rouillé, Audrey; Lefaucheur, Romain

2017-07-01

There is little experience with the effect of pregnancy on Parkinson disease because the number of women with Parkinson disease who are of childbearing age is small. We report four cases beginning during the postpartum period and discuss the potential contribution of different factors that may influence the occurrence of Parkinson disease in this time period. Four women aged 29-35 years developed arm tremor, shoulder pain, dizziness, or decreased dexterity of the hand in the first few days or months after childbirth. They were initially diagnosed with postpartum depression or psychogenic parkinsonism. Finally, dopamine transporter imaging confirmed the diagnosis of young-onset Parkinson disease. Early-onset Parkinson disease may present in postpartum women. In women with atypical motor symptoms in addition to depression, this diagnosis should be considered.

Socio-economic inequalities in the incidence of four common cancers: a population-based registry study.

Science.gov (United States)

Tweed, E J; Allardice, G M; McLoone, P; Morrison, D S

2018-01-01

To investigate the relationship between socio-economic circumstances and cancer incidence in Scotland in recent years. Population-based study using cancer registry data. Data on incident cases of colorectal, lung, female breast, and prostate cancer diagnosed between 2001 and 2012 were obtained from a population-based cancer registry covering a population of approximately 2.5 million people in the West of Scotland. Socio-economic circumstances were assessed based on postcode of residence at diagnosis, using the Scottish Index of Multiple Deprivation (SIMD). For each cancer, crude and age-standardised incidence rates were calculated by quintile of SIMD score, and the number of excess cases associated with socio-economic deprivation was estimated. 93,866 cases met inclusion criteria, comprising 21,114 colorectal, 31,761 lung, 23,757 female breast, and 15,314 prostate cancers. Between 2001 and 2006, there was no consistent association between socio-economic circumstances and colorectal cancer incidence, but 2006-2012 saw an emerging deprivation gradient in both sexes. The incidence rate ratio (IRR) for colorectal cancer between most deprived and least deprived increased from 1.03 (95% confidence interval [CI] 0.91-1.16) to 1.24 (95% CI 1.11-1.39) during the study period. The incidence of lung cancer showed the strongest relationship with socio-economic circumstances, with inequalities widening across the study period among women from IRR 2.66 (95% CI 2.33-3.05) to 2.91 (95% CI 2.54-3.33) in 2001-03 and 2010-12, respectively. Breast and prostate cancer showed an inverse relationship with socio-economic circumstances, with lower incidence among people living in more deprived areas. Significant socio-economic inequalities remain in cancer incidence in the West of Scotland, and in some cases are increasing. In particular, this study has identified an emerging, previously unreported, socio-economic gradient in colorectal cancer incidence among women as well as men. Actions

In-hospital Mobility Variations across Primary Diagnoses among Older Adults

Science.gov (United States)

Valiani, Vincenzo; Gao, Shiyao; Chen, Zhiguo; Swami, Sunil; Harle, Christopher A.; Lipori, Gigi; Sourdet, Sandrine; Wu, Samuel; Nayfield, Susan G.; Sabbá, Carlo; Pahor, Marco; Manini, Todd M.

2016-01-01

Objectives To examine the relationship between primary diagnoses and mobility impairment and recovery among hospitalized older adults. Design Prospective cohort study. Setting UF Health Shands Hospital, an 852-bed level I trauma center located in Gainesville, Florida. Participants 18,551 older adults (≥65 years) with 29,148 hospitalizations between 1/2009 and 4/2014. Measurements Incident and discharge mobility impairment and recovery were assessed using the Braden activity subscale score that was recorded by the nursing staff at every shift change–approximately three times per day. Primary diagnosis ICD-9 codes were used as predictors and re-categorized by using the Agency for Health Care Research and Quality Clinical Classification Software. Results Out of the 15,498 hospital records where the patient was initially observed to “walk frequently”, 3,186 (20.6%) developed incident mobility impairment (chair-fast or bedfast). Primary diagnoses with a surgical or invasive procedure were the most prevalent (77.2 %) among the hospital observations with incident mobility impairment; otherwise primary diagnoses without surgery were much more associated with discharge mobility impairment (59%). The highest incidence of mobility impairment occurred in patients with heart valve disorders and aortic and peripheral/visceral artery aneurysms (6.24 and 6.05 events per 30 person-days, respectively); septicemia showed the highest incidence rate for mobility limitation at discharge (0.94 events per 30 person-days). Mobility impairment was observed in 13,650 (46.8% of total) records at admission and 5,930 (43.44%) were observed to recover to a state of walking occasionally or frequently. Osteoarthritis and cancer of gastrointestinal organs/peritoneum had the highest incidence rate for mobility recovery (7.68 and 5.63 events per 30 person-days respectively). Conclusions Approximately 1 out of 5 patients who were mobile at admission became significantly impaired during

Conversion to dementia in mild cognitive impairment diagnosed with DSM-5 criteria and with Petersen's criteria.

Science.gov (United States)

Marcos, G; Santabárbara, J; Lopez-Anton, R; De-la-Cámara, C; Gracia-García, P; Lobo, E; Pírez, G; Menchón, J M; Palomo, T; Stephan, B C M; Brayne, C; Lobo, A

2016-05-01

In a background of revision of criteria for states of increased risk for progression to dementia, we compare the conversion rate to dementia and Alzheimer's disease (AD) of mild cognitive impairment (MCI) as diagnosed using DSM-5 (DSM-5-MCI) and Petersen's (P-MCI) criteria. A population representative cohort of 4057 dementia-free individuals 55+ years of age was followed up at 2.5 and 4.5 years in Zaragoza, Spain (ZARADEMP). Using the Geriatric Mental State- AGECAT for assessment, research psychiatrists diagnosed DSM-5-MCI and P-MCI following operationalized criteria. 'Conversion rate' (CR), 'annual conversion rate' (ACR), and incidence rate (IR) were calculated along with incidence rate ratio (IRR) to compare the performance of the intermediate cognitive definitions. At 4.5-year follow-up, in individuals aged 65+ years, ACRs for non-cases, P-MCI, and DSM-5-MCI were 0.8, 1.9 and 3.4, respectively, for global dementia. The IRRs were 2.9 and 5.3 for P-MCI and DSM5-MCI, respectively, being the non-cases the reference category. The corresponding values were slightly lower for AD. Conversion rate to dementia and AD was higher using DSM-5-MCI criteria than using Petersen's criteria. However, prediction of the construct still has some way to go, as most MCI individuals did not convert at 4.5-year follow-up. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A case of the Behcet's disease diagnosed by the panniculits after mesotherapy.

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Babacan, Taner; Onat, Ahmet Mesut; Pehlivan, Yavuz; Comez, Gazi; Tutar, Ediz

2010-11-01

We herein report a case of 32-year-old woman who developed erythematous, indurated plaques, nodules on her lower back, hips and inguinal areas which had started after immunotherapy on the injection sites. She had a history of recurrent oral aphthous-like ulcers for 2 years and also had abdominal pain for 2 months. Colonoscopy revealed multiple aphthous ulcers on intestine. Diagnosis of lobular panniculitis was confirmed by histopathological finding of the skin biopsy and she was diagnosed as Behcet's disease. Eruptions due to mesotherapy accepted as hypersensitivity reaction. Before employing this technique, patients should be carefully examined for Behcet's pathognomonic clinical findings.

[Incidence of postoperative venous thromboembolism after thoracic surgery and its characteristic: a single center, prospective cohort study].

Science.gov (United States)

Song, C F; Li, H; Tian, B; Chen, S; Miao, J B; Fu, Y L; You, B; Chen, Q R; Li, T; Hu, X X; Zhang, W Q; Hu, B

2018-04-01

Objective: To evaluate the incidence of postoperative venous thromboembolism (VTE) after thoracic surgery and its characteristic. Methods: This was a single-center, prospective cohort study. Patients undergoing major thoracic surgeries between July 2016 and March 2017 at Department of Thoracic Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University were enrolled in this study. Besides the routine examination, all patients were screened for deep venous thrombosis (DVT) by using noninvasive duplex lower-extremity ultrasonography after surgery. CT pulmonary angiography (CTPA) was carried out if patients had one of the following conditions including typical symptoms of PE, high Caprini score (>9 points) or new diagnosed postoperative DVT. Caprini risk assessment model was used to detect high risk patients. No patients received any prophylaxis of VTE before surgery. Further data was analyzed for identifying the incidence of postoperative VTE. The t -test, χ 2 test or Wilcoxon rank-sum test was used to analyze the quantitative data and classification data, respectively. Results: Totally 345 patients who undergoing major thoracic surgery were enrolled in this study including 145 benign diseases and 200 malignant diseases.There were 207 male and 138 female, aging from 15 to 85 years. Surgery procedures included 285 lung surgeries, 27 esophagectomies, 22 mediastinal surgeries and 11 other procedures. The overall incidence of VTE was 13.9% (48 of 345) after major thoracic surgery including 39 patients with newly diagnosed DVT (81.2%), 1 patient with PE (2.1%) and 8 patients with DVT+ PE (16.7%). The median time of VTE detected was 4.5 days postoperative. There were 89.6% (43/48) VTE cases diagnosed in 1 week. The incidence of VTE was 9.0% in patients with benign diseases, while 17.5% in malignant diseases (χ 2 =5.112, P patients with pulmonary diseases was 12.6%, among that, in patients with lung cancer and benign lung diseases was 16.4% and 7.5 % (χ 2

High incidence of athletic pubalgia symptoms in professional athletes with symptomatic femoroacetabular impingement.

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Hammoud, Sommer; Bedi, Asheesh; Magennis, Erin; Meyers, William C; Kelly, Bryan T

2012-10-01

The purpose of this study was to identify the incidence of symptoms consistent with athletic pubalgia (AP) in athletes requiring surgical treatment for femoroacetabular impingement (FAI) and the frequency of surgical treatment of both AP and FAI in this group of patients. Thirty-eight consecutive professional athletes, with a mean age of 31 years, underwent arthroscopic surgery for symptomatic FAI that limited their ability to play competitively. In all cases a cam and/or focal rim osteoplasty with labral refixation or debridement was performed. In 1 case concomitant intramuscular lengthening of the psoas was performed. Retrospective data regarding prior AP surgery and return to play were collected. Thirty-two percent of patients had previously undergone AP surgery, and 1 patient underwent AP surgery concomitantly with surgical treatment of FAI. No patient returned to his previous level of competition after isolated AP surgery. Thirty-nine percent had AP symptoms that resolved with FAI surgery alone. Of the 38 patients, 36 returned to their previous level of play; all 12 patients with combined AP and FAI surgery returned to professional competition. The mean duration before return to play was 5.9 months (range, 3 to 9 months) after arthroscopic surgery. There is a high incidence of symptoms of AP in professional athletes with FAI of the hip. This study draws attention to the overlap of these 2 diagnoses and highlights the importance of exercising caution in diagnosing AP in a patient with FAI. Level IV, therapeutic, retrospective case series. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The incidence of duodenal and gastric ulcers in a large health maintenance organization.

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Kurata, J H; Honda, G D; Frankl, H

1985-06-01

We report the incidence of peptic ulcers (duodenal, pyloric canal, gastric, and combined) verified by radiologic, endoscopic, or surgical evidence in a large Health Maintenance Organization (HMO) in Los Angeles, California. For members age 15 and above, the peptic ulcer incidence rate was 0.86 per 1,000 person-years (p-y) (males 1.10, females 0.63). The male to female sex ratio was 1.7. Two hundred twenty-two duodenal, 17 pyloric canal, 89 gastric, and 21 combined first-time diagnosed ulcer cases were located. For duodenal and pyloric canal ulcer, the incidence rate for members age 15 and above was 0.58 per 1,000 p-y (males 0.76, females 0.40). For gastric ulcer, the incidence rate for members age 15 and above was 0.21 per 1,000 p-y (males 0.23, females 0.18). The combined ulcer rate was 0.05 per 1,000 p-y (males 0.07, females 0.02). Gastric ulcer rates were two times higher in 1980 than in 1977. Peptic ulcer age-specific incidence rates increased with age. Incidence rates were much lower than those reported in previous studies, but the gastric to duodenal ulcer ratio and the age and sex relation to ulcer incidence were similar to those previously reported.

Incidence of medically attended influenza infection and cases averted by vaccination, 2011/12 and 2012/13 influenza seasons

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Jackson, Michael L.; Jackson, Lisa A.; Kieke, Burney; McClure, David; Gaglani, Manjusha; Murthy, Kempapura; Malosh, Ryan; Monto, Arnold; Zimmerman, Richard K.; Foppa, Ivo M.; Flannery, Brendan; Thompson, Mark G.

2018-01-01

Background We estimated the burden of outpatient influenza and cases prevented by vaccination during the 2011/12 and 2012/13 influenza seasons using data from the United States Influenza Vaccine Effectiveness (US Flu VE) Network. Methods We defined source populations of persons who could seek care for acute respiratory illness (ARI) at each of the five US Flu VE Network sites. We identified all members of the source population who were tested for influenza during US Flu VE influenza surveillance. Each influenza-positive subject received a sampling weight based on the proportion of source population members who were tested for influenza, stratified by site, age, and other factors. We used the sampling weights to estimate the cumulative incidence of medically attended influenza in the source populations. We estimated cases averted by vaccination using estimates of cumulative incidence, vaccine coverage, and vaccine effectiveness. Results Cumulative incidence of medically attended influenza ranged from 0.8% to 2.8% across sites during 2011/12 and from 2.6% to 6.5% during the 2012/13 season. Stratified by age, incidence ranged from 1.2% among adults 50 years of age and older in 2011/12 to 10.9% among children 6 months to 8 years of age in 2012/13. Cases averted by vaccination ranged from 4 to 41 per 1,000 vaccinees, depending on the study site and year. Conclusions The incidence of medically attended influenza varies greatly by year and even by geographic region within the same year. The number of cases averted by vaccination varies greatly based on overall incidence and on vaccine coverage. PMID:26271827

Squamous cell lung carcinoma presenting as melena: a case report and review of the literature

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Ibrahim Azar

2017-10-01

Full Text Available Lung cancer has a predilection to widely metastasize to the liver, bone, brain and adrenal glands. Metastasis of primary lung tumors to the stomach is infrequent, with only sporadic cases reported. Most cases are asymptomatic and diagnosed post-mortem on autopsy. The incidence of symptomatic gastrointestinal metastases is extremely rare. Herein, we describe a case of gastric metastasis by squamous cell lung carcinoma, presenting as melena and diagnosed by esophagogastroduodenoscopy. To the best of our knowledge, only twenty other cases in the English literature have reported symptomatic gastric metastasis of lung cancer diagnosed by endoscopic biopsy. A brief review of the literature shows gastric metastasis of lung cancer to have a predilection to occur most frequently in male smokers with the most common type of tumor likely to be squamous cell carcinoma.

Measurement of asbestos bodies in lung tissue of autopsy cases diagnosed with primary lung cancer

International Nuclear Information System (INIS)

Idei, Yuka; Kamada, Satoe; Matsumoto, Shoji; Ohnishi, Kazuo; Kitazawa, Riko; Kitazawa, Sohei

2007-01-01

To investigate the relation between asbestos-related lung cancer and the concentration of asbestos bodies in lung tissue, we analyzed the concentration in 24 autopsy cases diagnosed with primary lung cancer, with regard to the gender, age, histological type of lung cancer and occupation of each case. The asbestos bodies were measured according to Kohyama's method. Positive cases (more than 5,000 bodies per 1 g of dry lung tissue) were further analyzed for asbestosis and pleural plaques by chest X-ray and chest CT. Two cases exhibited more than 5,000 bodies, five cases between 1,000 and 5,000, and seventeen cases less than 1,000. The occupation of the two positive cases was not informative: one demonstrated neither asbestosis nor pleural plaques, and the other showed only pleural plaques. Although the number of cases of asbestos-related lung cancer is minimal among all lung cancer cases, the number of the former may exceed that of mesothelioma patients. Not only physicians but also radiologists, surgeons and pathologists need to collaborate in the diagnosis of asbestos-related lung cancer. (author)

Cancer incidence and mortality in the Bucaramanga metropolitan area, 2003-2007.

Science.gov (United States)

Uribe, Claudia; Osma, Sonia; Herrera, Víctor

2012-10-01

Cancer is an important cause of morbidity and mortality worldwide. Population-based cancer registries (PBCRs) make possible to estimate the burden of this condition. To estimate cancer incidence and mortality rates in the Bucaramanga Metropolitan Area (BMA) during 2003-2007. Incident cases of invasive cancer diagnosed during 2003-2007 were identified from the Bucaramanga Metropolitan Area PBCR (BMA-PBCR). Population counts and mortality were obtained from the Colombian National Administrative Department of Statistics (NADS). We estimated total and cancer-specific crude incidence and mortality rates by age group and sex, as well as age-standardized (Segi's world population) incidence (ASIR(W)) and mortality (ASMR(W)) rates. Statistical analyses were conducted using CanReg4 and Stata/IC 10.1. We identified 8,225 new cases of cancer excluding non-melanoma skin cancer (54.3% among women). Of all cases, 6,943 (84.4%) were verified by microscopy and 669 (8.1%) were detected only by death certificate. ASIR(W) for all invasive cancers was 162.8 per 100,000 women and 177.6 per 100,000 men. Breast, cervix, colorectal, stomach and thyroid were the most common types of cancer in women. In men, the corresponding malignancies were prostate, stomach, colorectal, lung and lymphoma. ASMR(W) was 84.5 per 100,000 person-years in women and 106.2 per 100,000 person-years in men. Breast and stomach cancer ranked first as causes of death in those groups, respectively. Overall, mortality rates in our region are higher than national estimates possibly due to limited effectiveness of secondary prevention strategies. Our work emphasizes the importance of maintaining high-quality, nationwide PBCRs.

Anatomy of an incident disclosure: the importance of dialogue.

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Iedema, Rick; Allen, Suellen

2012-10-01

Disclosure of health care incidents to patients and family members, as an ethical imperative, is becoming increasingly prevalent. The experiences of a woman whose husband died forms the basis for a case study of how she and her family and friends were able to renegotiate clinicians' understandings of what had gone wrong and influence their views of what needed to be done in response. The case was constructed in late 2010 using the replicated single-case approach, which involved repeated checking and correcting details of an interview with the patient's wife. Her husband, diagnosed with multiple myeloma in 2006, was hospitalized in January 2009 following a hip replacement. While in the hospital, he received a vasopressin overdose. He died in February 2009. THE DISCLOSURE PROCESS: The basis of the disclosure was the drug error, yet the patient's wife informed the caller (the head of the ICU), "You've got a greater problem than a drug error... you've got a massive, big communication problem here." The disclosure process, which unfolded in a series of phone calls and meetings, enabled the patient's wife and her family not only to ask questions but to put forward their knowledge, views, and concerns, and it moved from "disclosing an incident" (the vasopressin overdose) to addressing repeated communication failures and inappropriate behaviors. As a result, the disclosure process became a genuine dialogue that informed the clinicians as much as the family. This case study expands our understanding of what is possible as part of disclosure communication. Patients and family members can and should play a critical role in quality improvement and patient safety, given their knowledge and questions about the trajectory of care and their passion for ensuring that similar incidents do not recur to harm others.

First-Ever Stroke and Transient Ischemic Attack Incidence and 30-Day Case-Fatality Rates in a Population-Based Study in Argentina

DEFF Research Database (Denmark)

Bahit, M Cecilia; Coppola, Mariano L; Riccio, Patricia M

2016-01-01

BACKGROUND AND PURPOSE: Epidemiological data about stroke are scarce in low- and middle-income Latin-American countries. We investigated annual incidence of first-ever stroke and transient ischemic attack (TIA) and 30-day case-fatality rates in a population-based setting in Tandil, Argentina....... METHODS: We prospectively identified all first-ever stroke and TIA cases from overlapping sources between January 5, 2013, and April 30, 2015, in Tandil, Argentina. We calculated crude and standardized incidence rates. We estimated 30-day case-fatality rates. RESULTS: We identified 334 first-ever strokes.......1% (95% CI, 14.2-36.6) for intracerebral hemorrhage, and 1.9% (95% CI, 0.4-5.8) for TIA. CONCLUSIONS: This study provides the first prospective population-based stroke and TIA incidence and case-fatality estimate in Argentina. First-ever stroke incidence was lower than that reported in previous Latin...

Case-Based Teaching of Fatal Incidents in Outdoor Education Teacher Preparation Courses

Science.gov (United States)

North, Chris; Brookes, Andrew

2017-01-01

This article examines the use of case-based approaches to fatal incidents in outdoor education (OE) with a view to fatality prevention. Fatalities are rare in OE and therefore it is nearly impossible for teachers to learn how to avoid fatalities from their own past experiences. It is, however, possible to learn from the mistakes of others through…

Goiania incident case study

International Nuclear Information System (INIS)

Petterson, J.S.

1988-06-01

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

Cancer Incidence in Patients with Acromegaly: A cohort study and meta-analysis of the literature

DEFF Research Database (Denmark)

Dal, Jakob; Leisner, Michelle Z; Hermansen, Kasper

2018-01-01

-2010) including 529 acromegaly cases was performed. Incident cancer diagnoses and mortality were compared to national rates estimating standardized incidence ratios (SIRs). A meta-analysis of cancer SIRs from 23 studies (including the present one) was performed. Results: The cohort study identified 81 cases...... in acromegaly (SIR 1.3 [95% CI: 1.1-1.6]), cancer-specific mortality was not. The meta-analysis yielded a SIR of overall cancer of 1.5 [95% CI: 1.2-1.8]. SIRs were elevated for colorectal cancer: 2.6 [95% CI: 1.7-4.0], thyroid cancer: 9.2 [95% CI: 4.2-19.9], breast cancer: 1.6 [1.1-2.3], gastric cancer: 2.0 [95......% CI: 1.4-2.9], and urinary tract cancer: 1.5 [95% CI: 1.0-2.3]). In general, cancer SIR was higher in single-center studies and in studies with meta-analysis...

Fatty liver incidence and predictive variables

International Nuclear Information System (INIS)

Tsuneto, Akira; Seto, Shinji; Maemura, Koji; Hida, Ayumi; Sera, Nobuko; Imaizumi, Misa; Ichimaru, Shinichiro; Nakashima, Eiji; Akahoshi, Masazumi

2010-01-01

Although fatty liver predicts ischemic heart disease, the incidence and predictors of fatty liver need examination. The objective of this study was to determine fatty liver incidence and predictive variables. Using abdominal ultrasonography, we followed biennially through 2007 (mean follow-up, 11.6±4.6 years) 1635 Nagasaki atomic bomb survivors (606 men) without fatty liver at baseline (November 1990 through October 1992). We examined potential predictive variables with the Cox proportional hazard model and longitudinal trends with the Wilcoxon rank-sum test. In all, 323 (124 men) new fatty liver cases were diagnosed. The incidence was 19.9/1000 person-years (22.3 for men, 18.6 for women) and peaked in the sixth decade of life. After controlling for age, sex, and smoking and drinking habits, obesity (relative risk (RR), 2.93; 95% confidence interval (CI), 2.33-3.69, P<0.001), low high-density lipoprotein-cholesterol (RR, 1.87; 95% CI, 1.42-2.47; P<0.001), hypertriglyceridemia (RR, 2.49; 95% CI, 1.96-3.15; P<0.001), glucose intolerance (RR, 1.51; 95% CI, 1.09-2.10; P=0.013) and hypertension (RR, 1.63; 95% CI, 1.30-2.04; P<0.001) were predictive of fatty liver. In multivariate analysis including all variables, obesity (RR, 2.55; 95% CI, 1.93-3.38; P<0.001), hypertriglyceridemia (RR, 1.92; 95% CI, 1.41-2.62; P<0.001) and hypertension (RR, 1.31; 95% CI, 1.01-1.71; P=0.046) remained predictive. In fatty liver cases, body mass index and serum triglycerides, but not systolic or diastolic blood pressure, increased significantly and steadily up to the time of the diagnosis. Obesity, hypertriglyceridemia and, to a lesser extent, hypertension might serve as predictive variables for fatty liver. (author)

Effect of a culture-based screening algorithm on tuberculosis incidence in immigrants and refugees bound for the United States: a population-based cross-sectional study.

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Liu, Yecai; Posey, Drew L; Cetron, Martin S; Painter, John A

2015-03-17

Before 2007, immigrants and refugees bound for the United States were screened for tuberculosis (TB) by a smear-based algorithm that could not diagnose smear-negative/culture-positive TB. In 2007, the Centers for Disease Control and Prevention implemented a culture-based algorithm. To evaluate the effect of the culture-based algorithm on preventing the importation of TB to the United States by immigrants and refugees from foreign countries. Population-based, cross-sectional study. Panel physician sites for overseas medical examination. Immigrants and refugees with TB. Comparison of the increase of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees by the culture-based algorithm with the decline of reported cases among foreign-born persons within 1 year after arrival in the United States from 2007 to 2012. Of the 3 212 421 arrivals of immigrants and refugees from 2007 to 2012, a total of 1 650 961 (51.4%) were screened by the smear-based algorithm and 1 561 460 (48.6%) were screened by the culture-based algorithm. Among the 4032 TB cases diagnosed by the culture-based algorithm, 2195 (54.4%) were smear-negative/culture-positive. Before implementation (2002 to 2006), the annual number of reported cases among foreign-born persons within 1 year after arrival was relatively constant (range, 1424 to 1626 cases; mean, 1504 cases) but decreased from 1511 to 940 cases during implementation (2007 to 2012). During the same period, the annual number of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees bound for the United States by the culture-based algorithm increased from 4 to 629. This analysis did not control for the decline in new arrivals of nonimmigrant visitors to the United States and the decrease of incidence of TB in their countries of origin. Implementation of the culture-based algorithm may have substantially reduced the incidence of TB among newly arrived, foreign-born persons in

Investigation of excess thyroid cancer incidence in Los Alamos County

Energy Technology Data Exchange (ETDEWEB)

Athas, W.F.

1996-04-01

Los Alamos County (LAC) is home to the Los Alamos National Laboratory, a U.S. Department of Energy (DOE) nuclear research and design facility. In 1991, the DOE funded the New Mexico Department of Health to conduct a review of cancer incidence rates in LAC in response to citizen concerns over what was perceived as a large excess of brain tumors and a possible relationship to radiological contaminants from the Laboratory. The study found no unusual or alarming pattern in the incidence of brain cancer, however, a fourfold excess of thyroid cancer was observed during the late-1980`s. A rapid review of the medical records for cases diagnosed between 1986 and 1990 failed to demonstrate that the thyroid cancer excess had resulted from enhanced detection. Surveillance activities subsequently undertaken to monitor the trend revealed that the excess persisted into 1993. A feasibility assessment of further studies was made, and ultimately, an investigation was conducted to document the epidemiologic characteristics of the excess in detail and to explore possible causes through a case-series records review. Findings from the investigation are the subject of this report.

Investigation of excess thyroid cancer incidence in Los Alamos County

International Nuclear Information System (INIS)

Athas, W.F.

1996-04-01

Los Alamos County (LAC) is home to the Los Alamos National Laboratory, a U.S. Department of Energy (DOE) nuclear research and design facility. In 1991, the DOE funded the New Mexico Department of Health to conduct a review of cancer incidence rates in LAC in response to citizen concerns over what was perceived as a large excess of brain tumors and a possible relationship to radiological contaminants from the Laboratory. The study found no unusual or alarming pattern in the incidence of brain cancer, however, a fourfold excess of thyroid cancer was observed during the late-1980's. A rapid review of the medical records for cases diagnosed between 1986 and 1990 failed to demonstrate that the thyroid cancer excess had resulted from enhanced detection. Surveillance activities subsequently undertaken to monitor the trend revealed that the excess persisted into 1993. A feasibility assessment of further studies was made, and ultimately, an investigation was conducted to document the epidemiologic characteristics of the excess in detail and to explore possible causes through a case-series records review. Findings from the investigation are the subject of this report

Acute Myocardial Infarction Population Incidence and Mortality Rates, and 28-day Case-fatality in Older Adults. The REGICOR Study.

Science.gov (United States)

Vázquez-Oliva, Gabriel; Zamora, Alberto; Ramos, Rafel; Marti, Ruth; Subirana, Isaac; Grau, María; Dégano, Irene R; Marrugat, Jaume; Elosua, Roberto

2017-11-22

Our aims were to determine acute myocardial infarction (AMI) incidence and mortality rates, and population and in-hospital case-fatality in the population older than 74 years; variability in clinical characteristics and AMI management of hospitalized patients, and changes in the incidence and mortality rates, case-fatality, and management by age groups from 1996 to 1997 and 2007 to 2008. A population-based AMI registry in Girona (Catalonia, Spain) including individuals with suspected AMI older than 34 years. The incidence rate increased with age from 169 and 28 cases/100 000 per year in the group aged 35 to 64 years to 2306 and 1384 cases/100 000 per year in the group aged 85 to 94 years, in men and women, respectively. Population case-fatality also increased with age, from 19% in the group aged 35 to 64 years to 84% in the group aged 85 to 94 years. A lower population case-fatality was observed in the second period, mainly explained by a lower in-hospital case-fatality. The use of invasive procedures and effective drugs decreased with age but increased in the second period in all ages up to 84 years. Acute myocardial infarction incidence, mortality, and case-fatality increased exponentially with age. There is still a gap in the use of invasive procedures and effective drugs between younger and older patients. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

The incidence of inflammatory bowel disease in Northern China: a prospective population-based study.

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Hong Yang

Full Text Available AIMS & BACKGROUNDS: Although inflammatory bowel diseases (IBD are emerging and increasing in China, epidemiologic data are rarely available. This study was to investigate the epidemiological and clinical characteristics of IBD in Northern China. METHODS: This is a prospective, population-based study of incidence of IBD in Daqing, Heilongjiang province of Northern China from March 1, 2012 to February 28, 2013. All incident patients with IBD were clinically identified by IBD specialist group from five main General Hospitals covering the healthcare service for 1,343,364 residents in the urban areas of Daqing. IBD cases included in this study were followed-up for three months for diagnosis confirmation. RESULTS: A total of 27 new IBD cases including 25 cases of ulcerative colitis (UC and 2 cases of Crohn's disease (CD were identified. The population at risk was 1,343,364 person years. Age-adjusted incidence for total IBD, CD and UC were 1.77, 0.13, and 1.64 per 100,000 population, respectively. A male predominance was found in CD patients (male to female ratio was 2 ∶ 0. In contrast, no obvious gender predominance was found in UC patients (male to female ratio was 1 ∶ 1.1. CD patients were diagnosed at an average age of 39.5 years. The main disease phenotypes of UC were distal colitis with a 24% of proctitis and 56% of left-sided colitis. The mean diagnostic age of UC patients was 48.9 years. CONCLUSIONS: This is the first report on the incidence of IBD in the Northern Chinese population. A lower incidence of IBD, similar male predominance for CD, similar disease phenotype of UC, and lower disease activity was observed in Daqing compared to that in Southern China.

Analysis of Leukemia incidence (1997-2007) in vicinity area of a nuclear installation

International Nuclear Information System (INIS)

Jin Rong; Sun Quanfu; Liu Fen; Zhang Xu; Xing Ru; Xu Xinmei; Li Xiaoliang; Su Xu

2012-01-01

Objective: To investigate the leukemia incidence among residents in the vicinity area of a nuclear installation. Methods: The data were collected by the retrospective survey. Diagnosis is based on the medical records in all the relevant hospitals. The study area was those residential areas within 10 km of radium surrounding the installation. All residents who had lived in the study area for six months and over were recruited into the study group. Results: The survey ascertained 643 newly diagnosed leukemia cases in the study area during 1997 to 2007. The crude rate was 2.51/100000, and its standardized rate to national population structure was 2.53/100000. The incidence rate in the study area was slightly lower than that in the whole city. No increase trend was detected during the period. Conclusions: No significant difference of the leukemia incidence rate was found between the vicinity area of the nuclear installation and the whole city. (authors)

The added value of using mutational profiling in addition to cytology in diagnosing aggressive pancreaticobiliary disease: review of clinical cases at a single center

Science.gov (United States)

2014-01-01

Background This study aimed to better understand the supporting role that mutational profiling (MP) of DNA from microdissected cytology slides and supernatant specimens may play in the diagnosis of malignancy in fine-needle aspirates (FNA) and biliary brushing specimens from patients with pancreaticobiliary masses. Methods Cytology results were examined in a total of 30 patients with associated surgical (10) or clinical (20) outcomes. MP of DNA from microdissected cytology slides and from discarded supernatant fluid was analyzed in 26 patients with atypical, negative or indeterminate cytology. Results Cytology correctly diagnosed aggressive disease in 4 patients. Cytological diagnoses for the remaining 26 were as follows: 16 negative (9 false negative), 9 atypical, 1 indeterminate. MP correctly determined aggressive disease in 1 false negative cytology case and confirmed a negative cytology diagnosis in 7 of 7 cases of non-aggressive disease. Of the 9 atypical cytology cases, MP correctly diagnosed 7 as positive and 1 as negative for aggressive disease. One specimen that was indeterminate by cytology was correctly diagnosed as non-aggressive by MP. When first line malignant (positive) cytology results were combined with positive second line MP results, 12/21 cases of aggressive disease were identified, compared to 4/21 cases identified by positive cytology alone. Conclusions When first line cytology results were uncertain (atypical), questionable (negative), or not possible (non-diagnostic/indeterminate), MP provided additional information regarding the presence of aggressive disease. When used in conjunction with first line cytology, MP increased detection of aggressive disease without compromising specificity in patients that were difficult to diagnose by cytology alone. PMID:25084836

Incidence of neuralgic amyotrophy (Parsonage Turner syndrome in a primary care setting--a prospective cohort study.

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Nens van Alfen

Full Text Available Neuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting.In a prospective cohort study during the year 2012 we registered all new cases of neck, shoulder or arm complaints from two large primary care centers serving a population of 14,118. Prior to study, general practitioners received a short training on how to diagnose classic neuralgic amyotrophy. Neuralgic amyotrophy was defined according to published criteria irrespective of family history. Only patients with a classic phenotype were counted as definite cases. After inclusion, patients with suspected neuralgic amyotrophy who had not yet seen a neurologist were offered neurologic evaluation for diagnostic confirmation.Of the 492 patients identified with new onset neck, shoulder or arm complaints, 34 were suspected of having neuralgic amyotrophy. After neurologic evaluation the diagnosis was confirmed in 14 patients. This amounts to a one-year incidence rate for classic neuralgic amyotrophy of 1 per 1000.Our findings suggest that neuralgic amyotrophy is 30-50 times more common than previously thought. Unawareness of the disorder and its clinical presentation seems the most likely explanation for this difference. An incidence rate of 1 per 1000 and the long-term sequelae many patients suffer warrant more vigilance in diagnosing the disorder, to pave the way for timely treatment and prevent complications.

Incidence and Prevalence of Celiac Disease and Dermatitis Herpetiformis in the UK Over Two Decades: Population-Based Study

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West, Joe; Fleming, Kate M; Tata, Laila J; Card, Timothy R; Crooks, Colin J

2014-01-01

OBJECTIVES: Few studies have quantified the incidence and prevalence of celiac disease (CD) and dermatitis herpetiformis (DH) nationally and regionally by time and age groups. Understanding this epidemiology is crucial for hypothesizing about causes and quantifying the burden of disease. METHODS: Patients with CD or DH were identified in the Clinical Practice Research Datalink between 1990 and 2011. Incidence rates and prevalence were calculated by age, sex, year, and region of residence. Incidence rate ratios (IRR) adjusted for age, sex, and region were calculated with Poisson regression. RESULTS: A total of 9,087 incident cases of CD and 809 incident cases of DH were identified. Between 1990 and 2011, the incidence rate of CD increased from 5.2 per 100,000 (95% confidence interval (CI), 3.8–6.8) to 19.1 per 100,000 person-years (95% CI, 17.8–20.5; IRR, 3.6; 95% CI, 2.7–4.8). The incidence of DH decreased over the same time period from 1.8 per 100,000 to 0.8 per 100,000 person-years (average annual IRR, 0.96; 95% CI, 0.94–0.97). The absolute incidence of CD per 100,000 person-years ranged from 22.3 in Northern Ireland to 10 in London. There were large regional variations in prevalence for CD but not DH. CONCLUSIONS: We found a fourfold increase in the incidence of CD in the United Kingdom over 22 years, with large regional variations in prevalence. This contrasted with a 4% annual decrease in the incidence of DH, with minimal regional variations in prevalence. These contrasts could reflect differences in diagnosis between CD (serological diagnosis and case finding) and DH (symptomatic presentation) or the possibility that diagnosing and treating CD prevents the development of DH. PMID:24667576

Pitfalls in diagnosing limbic encephalitis - a case report.

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Kerling, F; Blümcke, I; Stefan, H

2008-11-01

The syndrome of limbic encephalitis (LE) is characterized by subacute onset of temporal lobe epilepsy, loss of short-term memory, cognitive confusion and psychiatric symptoms. We report a patient with pharmacoresistant epilepsy who underwent presurgical video-electroencephalogram (EEG)-monitoring with normal psychiatric and neuropsychological findings. Magnetic resonance imaging (MRI) revealed a hyperintense lesion within the right amygdala but no contrast enhancement. Analysis of cerebrospinal fluid (CSF) showed pleocytosis and positive oligoclonal bands, but all tests for neurotropic viruses or borrelia antibodies were negative. Presurgical evaluation identified a right mesiotemporal focus. As a tumour was the most likely differential diagnosis, we performed selective amygdalohippocampectomy of the right hemisphere. Subsequent histopathological examination revealed the surprising diagnosis of LE. As a consequence, tumour screening was initiated and a testicular carcinoma with high anti-Ma2-antibody titres was detected. Following surgical and chemotherapeutical treatment, the patient was seizure-free and Ma2-antibodies decreased below detection limits. Conclusion - This case report highlights that LE has to be considered even in patients with atypical clinical presentation, i.e. without neuropsychological deficits, if CSF analysis reveals an inflammatory response. When LE is diagnosed, extensive tumour search is mandatory to detect and treat the paraneoplastic origin of LE. Therapeutic strategies of LE include surgical treatment as well as early immunosuppression.

Worldwide incidence of hepatocellular carcinoma cases attributable to major risk factors.

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Baecker, Aileen; Liu, Xing; La Vecchia, Carlo; Zhang, Zuo-Feng

2018-05-01

To facilitate regionally specific liver cancer prevention and control, this study estimates the fraction of hepatocellular carcinoma (HCC) cases attributable to five major liver cancer risk factors by geographic region. Prevalence estimates of major HCC risk factors, including chronic infection with hepatitis B and hepatitis C, alcohol drinking, tobacco smoking, obesity, and diabetes, were extracted for each country from the literature, along with recent incidence and risk estimate data, to calculate regionally specific population attributable fractions. Overall, 44% of HCC cases worldwide were attributable to chronic hepatitis B infection, with the majority of cases occurring in Asia. Hepatitis C was responsible for 21% of cases. Lifestyle risk factors such as alcohol drinking and obesity were responsible for a larger percentage of cases in North America and Western, Central, and Eastern Europe. In addition, strong sex disparities were observed when looking at lifestyle risk factors, particularly tobacco smoking, in Asia and Africa. Prominent risk factors for HCC vary depending on the region. Our findings provide useful data for developing regionally specific guidelines for liver cancer prevention and control worldwide.

Stress fractures of the ankle malleoli diagnosed by ultrasound: a report of 6 cases

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Bianchi, Stefano; Luong, Dien Hung

2014-01-01

To present the ultrasound appearance of stress fractures (SF) of the ankle malleoli. We present a retrospective review of 6 patients (4 women and 2 men, with an age range of 24-52 years, mean age of 39 years) in which ultrasound diagnosed, together with the clinical findings, an SF of the ankle malleoli. For all of these patients ultrasound was the first imaging technique applied because of a clinical suspicion of soft tissue injuries following excessive exertion. Patients were subsequently examined using standard radiographs and/or MRI. At ultrasound patients showed thickening of the periosteum in all patients, calcified bone callus was evident in 3 out of 6 patients. Cortical irregularities and subcutaneous oedema were found in all but one patient. Colour Doppler showed local hypervascular changes in all patients. Local compression with the transducers during real-time scanning increased pain in all cases. Ultrasound, together with the clinical findings, can diagnose an SF of the ankle malleoli. We suggest that sonologists should include malleolar SF in their differential diagnosis, particularly in the case of perimalleolar pain from over-solicitation. They must also include, as part of every ultrasound examination of the ankle, the evaluation of both malleoli and should be aware of the ultrasound appearance of malleolar SF. If the diagnosis remains uncertain, an MRI should be prescribed. (orig.)

Stress fractures of the ankle malleoli diagnosed by ultrasound: a report of 6 cases

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Bianchi, Stefano [CIM SA, Cabinet Imagerie Medicale, Geneve (Switzerland); Luong, Dien Hung [CIM SA, Cabinet Imagerie Medicale, Geneve (Switzerland); University of Montreal, Department of Physical Medicine and Rehabilitation, Montreal (Canada)

2014-06-15

To present the ultrasound appearance of stress fractures (SF) of the ankle malleoli. We present a retrospective review of 6 patients (4 women and 2 men, with an age range of 24-52 years, mean age of 39 years) in which ultrasound diagnosed, together with the clinical findings, an SF of the ankle malleoli. For all of these patients ultrasound was the first imaging technique applied because of a clinical suspicion of soft tissue injuries following excessive exertion. Patients were subsequently examined using standard radiographs and/or MRI. At ultrasound patients showed thickening of the periosteum in all patients, calcified bone callus was evident in 3 out of 6 patients. Cortical irregularities and subcutaneous oedema were found in all but one patient. Colour Doppler showed local hypervascular changes in all patients. Local compression with the transducers during real-time scanning increased pain in all cases. Ultrasound, together with the clinical findings, can diagnose an SF of the ankle malleoli. We suggest that sonologists should include malleolar SF in their differential diagnosis, particularly in the case of perimalleolar pain from over-solicitation. They must also include, as part of every ultrasound examination of the ankle, the evaluation of both malleoli and should be aware of the ultrasound appearance of malleolar SF. If the diagnosis remains uncertain, an MRI should be prescribed. (orig.)

Temporal trend of amyotrophic lateral sclerosis incidence in southern Europe: a population study in the health district of Ferrara, Italy.

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Govoni, Vittorio; Cesnik, Edward; Casetta, Ilaria; Tugnoli, Valeria; Tola, Maria Rosaria; Granieri, Enrico

2012-08-01

Data about the temporal trend of amyotrophic lateral sclerosis (ALS) incidence in southern Europe are scarce. Incidence studies on ALS have been carried out in the health district of Ferrara, Italy, since 1960s. We expanded the previous studies from 1964 to 2009. The study was prospective with a subsequent retrospective intensive survey of multiple sources of case ascertainment. All patients with a definite and probable ALS according to the original El Escorial criteria were selected. There were 130 incident cases in the years 1964-2009 giving an average annual crude incidence of 1.82 per 100,000 population (95% CI 1.53-2.17). An incidence increase during the study period was estimated in women (χ(2) test for trend = 7.19, p < 0.01) and in the elderly (χ(2) test for trend = 7.803, p < 0.01). The age-adjusted incidence was stable over time in both women (1.19 per 100,000, 95% CI 0.90-1.52) and men (1.45 per 100,000, 95% CI 0.12-1.84). The annual number of new ALS cases in the study population followed the Poisson distribution in both sexes as well as in the elderly group of the population. The present findings suggest that ALS incidence is nearly stable over time. The crude incidence increase we estimated over time among women is mainly explained by population ageing. The increasing incidence in the elderly population was likely the consequence of an increasing precision in ALS diagnosis in the elderly since the increasing attention and care over time of neurologic elderly patients that likely concern elderly women more than previous time periods rather than better case ascertainment of diagnosed patients. The present findings do not support the role of specific environmental factors in ALS pathogenesis.

Two 238Pu inhalation incidents

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

1978-06-01

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

Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses.

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Hoorweg, Beatrijs Bn; Willemsen, Robert Ta; Cleef, Lotte E; Boogaerts, Tom; Buntinx, Frank; Glatz, Jan Fc; Dinant, Geert Jan

2017-11-01

Observational study of patients with chest pain in primary care: determination of incidence, referral rate, diagnostic tests and (agreement between) working and final diagnoses. 118 general practitioners (GPs) in the Netherlands and Belgium recorded all patient contacts during  2weeks. Furthermore, patients presenting with chest pain were registered extensively. A follow-up form was filled in after 30 days. 22 294 patient contacts were registered. In 281 (1.26%), chest pain was a reason for consulting the GP (mean age for men 54.4/women 53 years). In this cohort of 281 patients, in 38.1% of patients, acute coronary syndrome (ACS) was suspected at least temporarily during consultation, 40.2% of patients were referred to secondary care and 512 diagnostic tests were performed by GPs and consulted specialists. Musculoskeletal pain was the most frequent working (26.1%) and final diagnoses (33.1%). Potentially life-threatening diseases as final diagnosis (such as myocardial infarction) accounted for 8.4% of all chest pain cases. In 23.1% of cases, a major difference between working and final diagnoses was found, in 0.7% a severe disease was initially missed by the GP. Chest pain was present in 281 patients (1.26% of all consultations). Final diagnoses were mostly non-life-threatening. Nevertheless, in 8.4% of patients with chest pain, life-threatening underlying causes were identified. This seems reflected in the magnitude and wide variety of diagnostic tests performed in these patients by GPs and specialists, in the (safe) overestimation of life-threatening diseases by GPs at initial assessment and in the high referral rate we found. © 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.

Difficult diagnoses in the skeletal radiology

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Freyschmidt, Juergen

2013-01-01

The book on difficult diagnoses in the skeletal radiology discusses the path from symptom to diagnoses including image interpretation. Specific case studies concern the skull, the spinal cord, pelvis, shoulder and chest, upper and lower extremities. The used radiological techniques include projecting radiography, computerized tomography, scintiscanning, PET/CT, NNR imaging and ultrasonography.

Changing incidence patterns of hepatocellular carcinoma among age groups in Taiwan.

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Hung, Giun-Yi; Horng, Jiun-Lin; Yen, Hsiu-Ju; Lee, Chih-Ying; Lin, Li-Yih

2015-12-01

This study examined and compared the incidence patterns of hepatocellular carcinoma among age groups in Taiwan, 30 years after a universal hepatitis B virus immunization program was launched. Data for hepatocellular carcinoma diagnosed in 2003-2011 were collected from the population-based Taiwan Cancer Registry. Age-standardized incidence rates were calculated to analyze and compare the changes in incidence rates and trends. More specific analyses were performed on four age groups separated by sex. A total of 82,856 patients were diagnosed with hepatocellular carcinoma in 2003-2011 in Taiwan, yielding an age-standardized incidence rate of 32.97 per 100,000 person-years. Hepatocellular carcinoma was predominantly diagnosed in middle-aged adults (50.1%) and elderly people (49.1%), in contrast to the low incidences in children (0.04%) and adolescents and young adults (0.8%). Striking variations in trends were found for children (annual percent change: -16.6%, 2003-2010) and adolescents and young adults (annual percent change: -7.9%, 2003-2011). The incidence rate of hepatocellular carcinoma in children decreased to zero in 2011; only a slight decline in trends occurred for the middle-aged group (annual percent change: -2%, 2003-2011), and a slight upward trend was observed for elderly people (1.3%), specifically in women (1.7%). In Taiwan, hepatitis B virus-related hepatocellular carcinoma was nearly eradicated in children in 2011. The findings on age-specific incidence patterns and trends of hepatocellular carcinoma suggest that different control strategies for treating this devastating disease in the future be made according to age. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Declining trend in the incidence of biopsy-verified coeliac disease in the adult population of Finland, 2005-2014.

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Virta, L J; Saarinen, M M; Kolho, K-L

2017-12-01

The frequency of coeliac disease (CD) has been on the rise over the past decades, especially in Western Europe, but current trends are unclear. To research the recent temporal changes in the incidence of adult, biopsy-verified coeliac disease and dermatitis herpetiformis (DH) in Finland, a country with a high frequency of coeliac disease. All coeliac disease and DH cases diagnosed at age 20-79 years during 2005-2014 were retrieved from a nationwide database documenting all applicants for monthly compensation to cover the extra cost of maintaining a gluten-free diet. This benefit is granted on the basis of histology, not socioeconomic status. Temporal trends in the annual incidences were estimated using Poisson regression analyses. The total incidence of coeliac disease decreased from 33/100 000 during the years 2005-2006 to 29/100 000 during 2013-2014. The mean annual incidence of coeliac disease was nearly twice as high among women as among men, 42 vs 22 per 100 000, respectively. For middle- and old-aged women, the average rate of decrease in incidence was 4.8% (95% CI 3.9-5.7) per year and for men 3.0% (1.8-4.1) (P for linear trend adults, the rate of change remained low and nonsignificant throughout the period 2005-2014. Although the awareness of coeliac disease has increased during the past decades, the incidence of biopsy-verified diagnoses is not increasing, which suggests that exposure to yet unidentified triggering factors for coeliac disease has plateaued among the Finnish adult population. © 2017 John Wiley & Sons Ltd.

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

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

2016-04-01

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

Biology is Destiny: A Case of Adrenocortical Carcinoma Diagnosed and Resected at Inception in a Patient Under Close Surveillance for Lung Cancer.

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Miron, Benjamin; Ristau, Benjamin T; Tomaszewski, Jeffrey J; Jones, Josh; Milestone, Bart; Wong, Yu-Ning; Uzzo, Robert G; Edmondson, Donna; Scott, Walter; Kutikov, Alexander

2016-11-01

Adrenocortical carcinoma (ACC) is a rare malignancy that is generally associated with a poor prognosis whose existence dictates the management of incidental renal masses. We report a case of ACC diagnosed and treated at its apparent inception in a patient undergoing close surveillance imaging of a prior malignancy. Despite timely detection and resection of a localized ACC this patient rapidly progressed to systemic disease. This case highlights the rapid growth kinetics of ACC and puts into perspective the challenges associated with the established treatment paradigm for patients diagnosed with an adrenal mass.

Biology is Destiny: A Case of Adrenocortical Carcinoma Diagnosed and Resected at Inception in a Patient Under Close Surveillance for Lung Cancer

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Benjamin Miron

2016-11-01

Full Text Available Adrenocortical carcinoma (ACC is a rare malignancy that is generally associated with a poor prognosis whose existence dictates the management of incidental renal masses. We report a case of ACC diagnosed and treated at its apparent inception in a patient undergoing close surveillance imaging of a prior malignancy. Despite timely detection and resection of a localized ACC this patient rapidly progressed to systemic disease. This case highlights the rapid growth kinetics of ACC and puts into perspective the challenges associated with the established treatment paradigm for patients diagnosed with an adrenal mass.

Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14.

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Michael J Maze

2016-12-01

Full Text Available The sole report of annual leptospirosis incidence in continental Africa of 75-102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012-2014.Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4-6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7% confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%, Sejroe 3 (15.8%, Grippotyphosa 2 (10.5%, Icterohaemorrhagiae 2 (10.5%, Pyrogenes 2 (10.5%, Djasiman 1 (5.3%, Tarassovi 1 (5.3%. We estimated that the annual incidence of leptospirosis was 11-18 cases per 100,000 population. This was a significantly lower incidence than 2007-08 (p<0.001.We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology.

Parental history of psychiatric diagnoses and unipolar depression: a Danish National Register-based cohort study.

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Musliner, K L; Trabjerg, B B; Waltoft, B L; Laursen, T M; Mortensen, P B; Zandi, P P; Munk-Olsen, T

2015-10-01

Depression is known to run in families, but the effects of parental history of other psychiatric diagnoses on depression rates are less well studied. Few studies have examined the impact of parental psychopathology on depression rates in older age groups. We established a population-based cohort including all individuals born in Denmark after 1954 and alive on their 10th birthday (N = 29 76 264). Exposure variables were maternal and paternal history of schizophrenia, bipolar disorder, depression, anxiety or 'other' psychiatric diagnoses. Incidence rate ratios (IRRs) were estimated using Poisson regressions. Parental history of any psychiatric diagnosis increased incidence rates of outpatient (maternal: IRR 1.88, p history. IRRs for parental history of non-affective disorders remained relatively stable across age groups, while IRRs for parental affective disorders (unipolar or bipolar) decreased with age from 2.29-3.96 in the youngest age group to 1.53-1.90 in the oldest group. IRR estimates for all parental diagnoses were similar among individuals aged ⩾41 years (IRR range 1.51-1.90). Parental history of any psychiatric diagnosis is associated with increased incidence rates of unipolar depression. In younger age groups, parental history of affective diagnoses is more strongly associated with rates of unipolar depression than non-affective diagnoses; however, this distinction disappears after age 40, suggesting that parental psychopathology in general, rather than any one disorder, confers risk for depression in middle life.

Are current case-finding methods under-diagnosing tuberculosis among women in Myanmar? An analysis of operational data from Yangon and the nationwide prevalence survey.

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Khan, M S; Khine, T M; Hutchison, C; Coker, R J; Hane, K M; Innes, A L; Aung, S

2016-03-03

Although there is a large increase in investment for tuberculosis control in Myanmar, there are few operational analyses to inform policies. Only 34% of nationally reported cases are from women. In this study, we investigate sex differences in tuberculosis diagnoses in Myanmar in order to identify potential health systems barriers that may be driving lower tuberculosis case finding among women. From October 2014 to March 2015, we systematically collected data on all new adult smear positive tuberculosis cases in ten township health centres across Yangon, the largest city in Myanmar, to produce an electronic tuberculosis database. We conducted a descriptive cross-sectional analysis of sex differences in tuberculosis diagnoses at the township health centres. We also analysed national prevalence survey data to calculate additional case finding in men and women by using sputum culture when smear microscopy was negative, and estimated the sex-specific impact of using a more sensitive diagnostic tool at township health centres. Overall, only 514 (30%) out of 1371 new smear positive tuberculosis patients diagnosed at the township health centres were female. The proportion of female patients varied by township (from 21% to 37%, p = 0.0172), month of diagnosis (37% in February 2015 and 23% in March 2015 p = 0.0004) and age group (26% in 25-64 years and 49% in 18-25 years, p Myanmar, found that substantially fewer women than men were diagnosed in all study townships. The sex ratio of newly diagnosed cases varied by age group, month of diagnosis and township of diagnosis. Low sensitivity of tuberculosis diagnosis may lead to a potential under-diagnosis of tuberculosis among women.

Extremely long posterior communicating artery diagnosed by MR angiography: report of two cases.

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Uchino, Akira; Suzuki, Chihiro; Tanaka, Masahiko

2015-07-01

We report two cases of an extremely long left posterior communicating artery (PCoA) diagnosed by magnetic resonance (MR) angiography. The PCoA arose from the normal point of the supraclinoid internal carotid artery and fused with the posterior cerebral artery (PCA) at its posterior ambient segment, forming an extremely long PCoA and extremely long precommunicating segment of the PCA. To our knowledge, this is the first report of such variation. Careful observation of MR angiographic images is important for detecting rare arterial variations. To identify these anomalous arteries on MR angiography, partial maximum-intensity-projection images are useful.

Report from Mongolia – How much do we know about the incidence of rare cases in less developed countries: a case series

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Dünser Martin W

2008-11-01

Full Text Available Abstract Introduction Case reports are important instruments to describe rare disease conditions and give a rough estimation of their global incidence. Even though collected in international databases, most case reports are published by clinicians from industrialized nations and little is known about the incidence of rare cases in less developed countries, which are home to 75% of the world's population. Case presentation We present seven patients who suffered from diseases which are either considered to be rare or have not yet been described before according to international databases, but occurred during a 5-month period in one intensive care unit of a less developed country. During the observation period, patients with a spontaneous infratentorial subdural hematoma (Asian, female, 41 years, general exanthema and acute renal failure after diesel ingestion (Asian, male, 30 years, transient cortical blindness complicating hepatic encephalopathy (Asian, female, 49 years, Fournier gangrene complicating acute necrotizing pancreatitis (Asian, male, 37 years, acute renal failure due to acetic acid intoxication (Asian, male, 42 years, haemolytic uremic syndrome following septic abortion (Asian, female, 45 years, and a metal needle as an unusual cause of chest pain (Asian, male, 41 years were treated. According to the current literature, all seven disease conditions are considered either rare or have so far not yet been reported. Conclusion The global incidence of rare cases may be underestimated by contemporary international databases. Diseases which are currently considered to be rare in industrialized nations may occur at a higher frequency in less developed countries. Reasons may not only be a geographically different burden of certain diseases, limited diagnostic and therapeutic facilities, but also a relevant publication bias.

Challenges with diagnosing and investigating suspected active tuberculosis disease in military trainees.

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Chang, David; Webber, Bryant J; Hetrick, Steven M; Owen, Jerry B; Blasi, Audra A; Steele, Bernadette M; Yun, Heather C

2017-08-01

Between 1 January 2010 and 31 December 2016, a total of 14 U.S. and international military personnel in training at Joint Base San Antonio-Lackland, TX, were hospitalized due to suspected pulmonary tuberculosis (TB); of these, five personnel were diagnosed with active TB disease. Only one TB case had pulmonary symptoms, but these symptoms were not suggestive of TB. The incidence rate in the training population was 1.89 per 100,000 population (95% CI: 0.81, 4.42), with a higher rate when restricted to international military students attending the Defense Language Institute English Language Center. No instances of TB transmission were identified. The variety of atypical presentations and their resulting diagnostic and public health challenges prompted this retrospective review of all hospitalized cases. This case series highlights both the importance of a high index of clinical suspicion when TB is being considered in close congregate settings as well as the risk of overreliance on acid-fast bacilli staining and nucleic acid amplification testing for ruling out active pulmonary disease in young, otherwise healthy trainees. Practical solutions are suggested.

Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

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Olsen, J.; Jorgensen, T. R.; Kofoed, K.

2012-01-01

Background: Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number...... of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods: New anogenital cancer patients were identified from the Danish...... Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004-2007 was compared with that by an age-and sex-matched cohort without cancer. Hospital costs attributable to four...

High incidence of tuberculosis, low sensitivity of current diagnostic scheme and prolonged culture positivity in four colombian prisons. A cohort study.

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Zulma Vanessa Rueda

Full Text Available OBJECTIVE: To determine the incidence of pulmonary tuberculosis (TB in inmates, factors associated with TB, and the time to sputum smear and culture conversion during TB treatment. METHODS: Prospective cohort study. All prisoners with respiratory symptoms (RS of any duration were evaluated. After participants signed consent forms, we collected three spontaneous sputum samples on consecutive days. We performed auramine-rhodamine staining, culturing with the thin-layer agar method, Löwestein-Jensen medium and MGIT, susceptibility testing for first-line drugs; and HIV testing. TB cases were followed, and the times to smear and culture conversion to negative were evaluated. RESULTS: Of 9,507 prisoners held in four prisons between April/30/2010 and April/30/2012, among them 4,463 were screened, 1,305 were evaluated for TB because of the lower RS of any duration, and 72 were diagnosed with TB. The annual incidence was 505 cases/100,000 prisoners. Among TB cases, the median age was 30 years, 25% had <15 days of cough, 12.5% had a history of prior TB, and 40.3% had prior contact with a TB case. TB-HIV coinfection was diagnosed in three cases. History of prior TB, contact with a TB case, and being underweight were risk factors associated with TB. Overweight was a protective factor. Almost a quarter of TB cases were detected only by culture; three cases were isoniazid resistant, and two resistant to streptomycin. The median times to culture conversion was 59 days, and smear conversion was 33. CONCLUSIONS: The TB incidence in prisons is 20 times higher than in the general Colombian population. TB should be considered in inmates with lower RS of any duration. Our data demonstrate that patients receiving adequate anti-TB treatment remain infectious for prolonged periods. These findings suggest that current recommendations regarding isolation of prisoners with TB should be reconsidered, and suggest the need for mycobacterial cultures during follow-up.

Anterior Cutaneous Nerve Entrapment Syndrome in a Pediatric Patient Previously Diagnosed With Functional Abdominal Pain: A Case Report.

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DiGiusto, Matthew; Suleman, M-Irfan

2018-03-23

Chronic abdominal pain is common in children and adolescents but challenging to diagnose, because practitioners may be concerned about missing serious occult disease. Abdominal wall pain is an often ignored etiology for chronic abdominal pain. Anterior cutaneous nerve entrapment syndrome causes abdominal wall pain but is frequently overlooked. Correctly diagnosing patients with anterior cutaneous nerve entrapment syndrome is important because nerve block interventions are highly successful in the remittance of pain. Here, we present the case of a pediatric patient who received a diagnosis of functional abdominal pain but experienced pain remittance after receiving a trigger-point injection and transverse abdominis plane block.

A case of craniomandibular osteopathy in a Welsh corgi

International Nuclear Information System (INIS)

Nagaya, Y.; Murakami, M.; Tarui, S.; Takahashi, S.; Yagi, S.; Morita, N.; Takahashi, C.

2003-01-01

By clinical findings and computed tomography (CT), a 4-month-old female Welsh corgi with facial swelling was diagnosed as having craniomandibular osteopathy. Steroid therapy effectively managed the case. Whereas terriers, including the West Highland White Terrier, are said to be of higher incidence of this condition, the development of its symptoms in corgis is very rare

Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

International Nuclear Information System (INIS)

Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang

2009-01-01

Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)

2009-12-15

Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

Incidence of herpes simplex virus type 2 infection in 5 sexually transmitted disease (STD) clinics and the effect of HIV/STD risk-reduction counseling.

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Gottlieb, Sami L; Douglas, John M; Foster, Mark; Schmid, D Scott; Newman, Daniel R; Baron, Anna E; Bolan, Gail; Iatesta, Michael; Malotte, C Kevin; Zenilman, Jonathan; Fishbein, Martin; Peterman, Thomas A; Kamb, Mary L

2004-09-15

The seroincidence of herpes simplex virus type 2 (HSV-2) infection was determined among 1766 patients attending sexually transmitted disease (STD) clinics and enrolled in a randomized, controlled trial of human immunodeficiency virus (HIV)/STD risk-reduction counseling (RRC). Arm 1 received enhanced RRC (4 sessions); arm 2, brief RRC (2 sessions); and arm 3, the control arm, brief informational messages. The overall incidence rate was 11.7 cases/100 person-years (py). Independent predictors of incidence of HSV-2 infection included female sex; black race; residence in Newark, New Jersey; new HSV-2 infections were diagnosed clinically. Incidence rates were 12.9 cases/100 py in the control arm, 11.8 cases/100 py in arm 2, and 10.3 cases/100 py in arm 1 (hazard ratio, 0.8 [95% confidence interval, 0.6-1.1], vs. controls). The possible benefit of RRC in preventing acquisition of HSV-2 infection offers encouragement that interventions more specifically tailored to genital herpes may be useful and should be an important focus of future studies.

[Report of Cancer Incidence and Mortality in China, 2014].

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Chen, W Q; Li, H; Sun, K X; Zheng, R S; Zhang, S W; Zeng, H M; Zou, X N; Gu, X Y; He, J

2018-01-23

Objective: The registration data of local cancer registries in 2014 were collected by National Central Cancer Registry (NCCR)in 2017 to estimate the cancer incidence and mortality in China. Methods: The data submitted from 449 registries were checked and evaluated, and the data of 339 registries out of them were qualified and selected for the final analysis. Cancer incidence and mortality were stratified by area, gender, age group and cancer type, and combined with the population data of 2014 to estimate cancer incidence and mortality in China. The age composition of standard population of Chinese census in 2000 and Segi's population were used for age-standardized incidence and mortality in China and worldwide, respectively. Results: Total covered population of 339 cancer registries (129 in urban and 210 in rural) in 2014 were 288 243 347 (144 061 915 in urban and 144 181 432 in rural areas). The mortality verified cases (MV%) were 68.01%. Among them, 2.19% cases were identified through death certifications only (DCO%), and the mortality to incidence ratio was 0.61. There were about 3, 804, 000 new cases diagnosed as malignant cancer and 2, 296, 000 cases dead in 2014 in the whole country. The incidence rate was 278.07/100, 000 (males 301.67/100, 000, females 253.29/100, 000) in China, age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population were 190.63/100, 000 and 186.53/100, 000, respectively, and the cumulative incidence rate (0-74 age years old) was 21.58%. The cancer incidence and ASIRC in urban areas were 302.13/100, 000 and 196.58/100, 000, respectively, whereas in rural areas, those were 248.94/100, 000 and 182.64/100, 000, respectively. The cancer mortality in China was 167.89/100, 000 (207.24/100, 000 in males and 126.54/100, 000 in females), age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population were 106.98/100, 000 and 106.09/100, 000, respectively. And

High HIV incidence in men who have sex with men following an early syphilis diagnosis: is there room for pre-exposure prophylaxis as a prevention strategy?

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Girometti, Nicolò; Gutierrez, Angela; Nwokolo, Nneka; McOwan, Alan; Whitlock, Gary

2017-08-01

HIV pre-exposure prophylaxis (PrEP) is becoming a pivotal strategy for HIV prevention. Understanding the impact of risk factors for HIV transmission to identify those at highest risk would favour the implementation of PrEP, currently limited by costs. In this service evaluation, we estimated the incidence of bacterial STIs in men who have sex with men (MSM) diagnosed with early syphilis attending a London sexual health clinic according to their HIV status. In addition, we estimated the incidence of HIV infection in HIV-negative MSM, following a diagnosis of early syphilis. We undertook a retrospective case note review of all MSM patients diagnosed with early syphilis between January and June 2014. A number of sexual health screens and diagnoses of chlamydia, gonorrhoea and HIV were prospectively analysed following the syphilis diagnosis. 206 MSM were diagnosed with early syphilis. 110 (53%) were HIV-negative at baseline, 96 (47%) were HIV-positive. Only age (37 vs 32 years, p=0.0005) was significantly different according to HIV status of MSM at baseline. In HIV-negative versus HIV-positive MSM, incidence of rectal chlamydia infection at follow-up was 27 cases vs 50/100 person-years of follow-up (PYFU) (p=0.0039), 33 vs 66/100 PYFU (p=0.0044) for rectal gonorrhoea and 10 vs 26/100 PYFU (p=0.0044) for syphilis reinfection, respectively. Total follow-up for 110 HIV-negative MSM was 144 person-years. HIV incidence was 8.3/100 PYFU (CI 4.2 to 14). A diagnosis of early syphilis carries a high risk of consequent HIV seroconversion and should warrant prioritised access to prevention measures such as PrEP and regular STI screening to prevent HIV transmission. 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/.

Stroke incidence and 30-day and six-month case fatality rates in Udine, Italy: a population-based prospective study.

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Janes, Francesco; Gigli, Gian Luigi; D'Anna, Lucio; Cancelli, Iacopo; Perelli, Anna; Canal, Giessica; Russo, Valentina; Zanchettin, Barbara; Valente, Mariarosaria

2013-10-01

Stroke incidence in high-income countries is reported to decrease, and new data on stroke incidence and outcome are needed to design stroke services and to ameliorate stroke management. This study is part of a two-year prospective community-based registry of all cerebrovascular events in the district of Udine (153,312 inhabitants), Friuli-Venezia Giulia region, northeast of Italy, between 1 April 2007 and 31 March 2009. Overlapping sources for case finding were used, combining hot and cold pursuit. We identified 784 stroke cases, 640 (81.6%) incident. The crude overall annual incidence rate per 100,000 residents was 256 (95% confidence interval 241-271) for all strokes and 209 (95% confidence interval 195-223) for first-ever strokes. Incidence rate for first-ever strokes was 181 (95% confidence interval 155-211) after adjustment to the 2007 Italian population and 104 (95% confidence interval 88-122) compared with the European standard population. Incidence rates for first-ever strokes was 215 (196-235) for women, 202 (183-223) for men. Crude annual incidence rates per 100,000 population were 167 (153-178) for ischemic stroke, 31 (26-37) for intracerebral hemorrhage, 8.1 (5.7-11.4) for sub-arachnoid hemorrhage, and 4.6 (2.8-7.1) for undetermined stroke. Overall case fatality rates for first-ever stroke were 20.6% at 28 days and 30.2% at 180 days. Our study shows incidence rates higher than previously reported in our region but not supporting the view of higher incidence rates in Northern than in Southern Italy. Results contribute to time-trends analysis on epidemiology, useful for dimensioning services in Italy and show the persistence of a gap between the outcome of stroke in Italy and that of the best performing European countries, urging to adopt better stroke management plans. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

A prenatally diagnosed case of sirenomelia with polydactyly and vestigial tail.

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Guven, M A; Uzel, M; Ceylaner, S; Coskun, A; Ceylaner, G; Gungoren, A

2008-01-01

We are presenting a prenatally diagnosed case with sirenomelia, vestigial tail and polydactyly. A 30-year-old woman at 16 weeks of gestation with dichorionic twins was admitted to the hospital. Prenatal ultrasound demonstrated fusion of the lower limbs in one member and normal femurs, tibias and fibulas, and normal vertebras in the second twin, suggesting the diagnosis of sirenomelia. The twins were delivered vaginally at 35 weeks after spontaneous onset of labor. The affected newborn died after 24 hours and postnatal examination revealed unseparated lower limbs with extreme retroversion, bilateral pes equinus, unilateral postaxial polydactyly, a vestigial tail on the sacral region, a large and wide penis and anal atresia. There is only one previous report of sirenomelia with vestigial tail in the literature. However, a large, wide penis and polydactyly have not been reported before in association with this anomaly.

Incidence of cord around the neck and its effects on labour and neonatal outcome

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Khushboo Joshi

2017-01-01

Full Text Available Background: The umbilical cord is a narrow tube-like structure that connects the developing baby to the placenta. Most of the nuchal cords diagnosed in early pregnancy get spontaneously uncoiled. This study was carried out to show that such natural occurrence does not have significant effect on pregnancy, labour and neonates if proper intra-partum foetal heart rate (FHR monitoring could be provided by a caregiver. Materials and Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Sardar Patel Medical College, Bikaner (Rajasthan. For completing 100 cases with nuchal cord, we had to observe 506 cases and by which we took out the incidence of nuchal cord and which was separately categorised into single, double, triple and four and more than four groups. Results: The present study showed mean cord length also increases with number of loops (50.93 cm in single loop as compared to 72.33 cm in cases with four loops and showed that patients having tight nuchal cord have higher incidence of caesarean as well as forceps delivery, but these were not statistically significant (P = 0.56 and P= 0.57 and Apgar score <7 at 1 min, FHR deceleration and meconium staining of liquor were statistically higher significant (P = 0.001,P= 0.0001 and P= 0.001, respectively. Conclusion: At present, expertise to diagnose multiple and tight loops on ultrasound are limited, which should be the aim for future. Multicentric and large studies are further required in association with more specific and sensitive diagnostic aid for tight and multiple loops so as to provide the best perinatal management with good foetal outcome.

Incidence of benign prostate hypertrophy in Danish men with and without HIV infection

DEFF Research Database (Denmark)

Ahlström, Magnus Glindvad; Kronborg, Gitte; Larsen, Carsten S

2015-01-01

-associated risk factors influence risk of BPH diagnoses in families of HIV-infected individuals, we estimated risk of BPH in fathers of HIV-infected men and fathers of the comparison cohort. METHODS: In a nationwide, population-based, matched cohort study, we calculated incidence rates and used Poisson regression......BACKGROUND: Information on risk of benign prostate hypertrophy (BPH) in HIV-infected men is sparse. We aimed to estimate the incidence of being diagnosed with BPH among HIV-infected men compared with an age and sex-matched comparison cohort from the background population. To exclude that family...... procedure for BPH in DNHR. RESULTS: We identified 4633 HIV-infected men, 46 330 comparison cohort individuals, 1585 fathers of HIV-infected men and 20 449 fathers of the comparison cohort. Incidence rate of being diagnosed with BPH was 37.0 [95% confidence interval (95% CI) 31.5-43.1] per 10 000 person...

Ethnicity and incidence of Hodgkin lymphoma in Canadian population

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Spinelli John J

2009-05-01

Full Text Available Abstract Background Research has shown that ethnicity is a significant predictor of Hodgkin lymphoma (HL. Variations in cancer incidence among ethnic groups in the same country can lead to important information in the search for etiological factors. Other risk factors important in the etiology of HL are medical history and exposure to pesticides. In this report we investigated the association between ethnicity and HL in the presence of medical history, and exposure to pesticides. Methods The data resulting from a matched population-based case-control study conducted in six provinces of Canada (Ontario, Quebec, Manitoba, Saskatchewan, Alberta, and British Columbia was analyzed to determine whether or not there was any association between ethnicity and incidence of HL when adjusted for personal medical history and pesticide exposure. Information on ethnicity, personal medical history, and pesticide exposure was collected by questionnaires via mail on 316 men diagnosed with HL; and on 1506 controls. A conditional logistic regression was utilized and results were presented as odds ratios and 95% confidence intervals. Results In our study population, the distribution of ethnic groups was: 38.5% North American, 15% British, 8.4% Western European, 8.2% Eastern European, 1.7% Asian, 1.4% Scandinavian and 27% of other ethnic origin. Compared to North Americans (i the risk of HL was greater among the Eastern European descendents (Odds Ratio (ORadj: 1.82; 95% confidence interval (CI: 1.02, 3.25 and Western European (ORadj: 1.62; 95% CI: 0.95–2.76 descent population (borderline significance at 5% level; and (ii the risk of HL was lower in Asian descents. Diagnosis with measles (ORadj: 0.72, 95% C.I.: 0.53–0.98 and/or positive history of allergy desensitization shots (ORadj: 0.55, 95% C.I.: 0.30–0.99 were negatively associated with the incidence of HL, while diagnosis with acne (ORadj: 2.12, 95% C.I.: 1.19–3.78, shingles (ORadj: 2.41, 95% C.I.: 1.38�

The Effect of Combined Aspirin and Clopidogrel Treatment on Cancer Incidence.

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Leader, Avi; Zelikson-Saporta, Ravit; Pereg, David; Spectre, Galia; Rozovski, Uri; Raanani, Pia; Hermoni, Doron; Lishner, Michael

2017-07-01

Multiple studies have shown an association between aspirin treatment and a reduction in newly diagnosed cancer. Conversely, there are conflicting clinical and laboratory data on the effect of combined clopidogrel and aspirin therapy on cancer incidence, including analyses suggesting an increased cancer risk. No large-scale cohort study has been performed to address this issue in a heterogeneous real-world scenario. We investigated the effect of clopidogrel and aspirin on cancer incidence compared with aspirin alone and no antiplatelet therapy. A population-based historical cohort study of subjects aged ≥50 years covered by Clalit Health Services, an Israeli health maintenance organization, was performed. Patients treated with the newer antiplatelet drugs, prasugrel or ticagrelor, which, like clopidogrel, inhibit adenosine diphosphate receptors, and those with prior cancer were excluded. Prescription records of antiplatelet medication were retrieved. The cohort included 183,912 subjects diagnosed with 21,974 cancer cases based upon the International Classification of Diseases, Ninth Revision. Dual aspirin and clopidogrel was prescribed in 9.6%, while 49% received aspirin alone and 41% used neither. Compared with nonusers, there was a lower risk of cancer in subjects exposed to aspirin with (hazard ratio [HR] 0.46; 95% confidence interval [CI], 0.44-0.49) or without clopidogrel (HR 0.54; 95% CI, 0.52-0.56), on long-term follow-up. Combined treatment was associated with a lower cancer risk than the aspirin-only group (HR 0.92; 95% CI, 0.86-0.97). Dual clopidogrel and aspirin treatment is safe regarding the cancer risk. This study generates the hypothesis that clopidogrel may reduce cancer incidence. Copyright © 2017 Elsevier Inc. All rights reserved.

Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing.

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Françoise Ducimetière

Full Text Available BACKGROUND: The exact overall incidence of sarcoma and sarcoma subtypes is not known. The objective of the present population-based study was to determine this incidence in a European region (Rhone-Alpes of six million inhabitants, based on a central pathological review of the cases. METHODOLOGY/PRINCIPAL FINDINGS: From March 2005 to February 2007, pathology reports and tumor blocks were prospectively collected from the 158 pathologists of the Rhone-Alpes region. All diagnosed or suspected cases of sarcoma were collected, reviewed centrally, examined for molecular alterations and classified according to the 2002 World Health Organization classification. Of the 1287 patients screened during the study period, 748 met the criteria for inclusion in the study. The overall crude and world age-standardized incidence rates were respectively 6.2 and 4.8 per 100,000/year. Incidence rates for soft tissue, visceral and bone sarcomas were respectively 3.6, 2.0 and 0.6 per 100,000. The most frequent histological subtypes were gastrointestinal stromal tumor (18%; 1.1/100,000, unclassified sarcoma (16%; 1/100,000, liposarcoma (15%; 0.9/100,000 and leiomyosarcoma (11%; 0.7/100,000. CONCLUSIONS/SIGNIFICANCE: The observed incidence of sarcomas was higher than expected. This study is the first detailed investigation of the crude incidence of histological and molecular subtypes of sarcomas.

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

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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.

Vesical Leiomyoma: Presentation of a clinical case

International Nuclear Information System (INIS)

Rodriguez Carballo, Michel; Gonzalez Gonzalez, Gonzalo Antonio; Sanchez Falcon Ania

2009-01-01

The vesical leiomyoma is a tumor of mesenchymal origin, and extremely rare. Most of them are diagnosed casually after the pathologic study of samples collected after surgery. Few cases were found in the reviewed literature, leading us to think of the scarce incidence of this kind of tumors. We present a case treated in our service, of an 18-years-old female patient, assisting to our consultation presenting a polaquiuria, ardor and mictional effort. The complementary exams led to the surgical treatment and follow up of the patient

Incidence, clinical features and para-clinical findings of achalasia in Algeria: Experience of 25 years

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Tebaibia, Amar; Boudjella, Mohammed Amine; Boutarene, Djamel; Benmediouni, Farouk; Brahimi, Hakim; Oumnia, Nadia

2016-01-01

AIM To investigate the incidence of achalasia in Algeria and to determine its clinical and para-clinical profile. To evaluate the impact of continuing medical education (CME) on the incidence of this disease. METHODS From 1990 to 2014, 1256 patients with achalasia were enrolled in this prospective study. A campaign of CME on diagnosis involving different regions of the country was conducted between 1999 and 2003. Annual incidence and prevalence were calculated by relating the number of diagnosed cases to 105 inhabitants. Each patient completed a standardized questionnaire, and underwent upper endoscopy, barium swallow and esophageal manometry. We systematically looked for Allgrove syndrome and familial achalasia. RESULTS The mean annual incidence raised from 0.04 (95%CI: 0.028-0.052) during the 1990s to 0.27/105 inhabitants/year (95%CI: 0.215-0.321) during the 2000s. The incidence of the disease was two and half times higher in the north and the center compared to the south of the country. One-hundred-and-twenty-nine (10%) were children and 97 (7.7%) had Allgrove syndrome. Familial achalasia was noted in 18 different families. Patients had dysphagia (99%), regurgitation (83%), chest pain (51%), heartburn 24.5% and weight loss (70%). The lower esophageal sphincter was hypertensive in 53% and hypotensive in 0.6%. CONCLUSION The mean incidence of achalasia in Algeria is at least 0.27/105 inhabitants. A good impact on the incidence of CME was noted. A gradient of incidence between different regions of the country was found. This variability is probably related to genetic and environmental factors. The discovery of an infantile achalasia must lead to looking for Allgrove syndrome and similar cases in the family. PMID:27784974

Trends in childhood type 1 diabetes mellitus incidence in Beijing from 1995 to 2010: a retrospective multicenter study based on hospitalization data.

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Gong, Chunxiu; Meng, Xi; Jiang, Yuwu; Wang, Xinli; Cui, Hong; Chen, Xiaobo

2015-03-01

The incidence of type 1 diabetes mellitus (T1DM) is increasing rapidly worldwide for children of every age group. A retrospective analysis of hospital registration data from five tertiary hospitals in Beijing, China, identified 485 patients (210 boys, 275 girls) younger than 15 years of age with newly diagnosed T1DM between 1995 and 2010. From 1995 to 2010, the incidence of T1DM in patients 1995 to 2010, with rates growing at an accelerated pace since 2006. Based on recent trends, we project continued rapid growth in the number of new childhood T1DM cases in Beijing.

Long-term exposure to air pollution and the incidence of Parkinson's disease: A nested case-control study.

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Chiu-Ying Chen

Full Text Available Previous studies revealed that chronic exposure to air pollution can significantly increase the risk of the development of Parkinson's disease (PD, but this relationship is inconclusive as large-scale prospective studies are limited and the results are inconsistent. Therefore, the purpose of this study was to ascertain the adverse health effects of air pollution exposure in a nationwide population using a longitudinal approach.We conducted a nested case-control study using the National Health Insurance Research Dataset (NHIRD, which consisted of 1,000,000 beneficiaries in the National Health Insurance Program (NHI in the year 2000 and their medical records from 1995 to 2013 and using public data on air pollution concentrations from monitoring stations across Taiwan released from the Environmental Protection Administration to identify people with ages ≥ 40 years living in areas with monitoring stations during 1995-1999 as study subjects. Then, we excluded subjects with PD, dementia, stroke and diabetes diagnosed before Jan. 1, 2000 and obtained 54,524 subjects to follow until Dec. 31, 2013. In this observational period, 1060 newly diagnosed PD cases were identified. 4240 controls were randomly selected from those without PD using a matching strategy for age, sex, the year of PD diagnosis and the year of entering the NHI program at a ratio of 1:4. Ten elements of air pollution were examined, and multiple logistic regression models were used to measure their risks in subsequent PD development.The incidence of PD in adults aged ≥ 40 years was 1.9%, and the median duration for disease onset was 8.45 years. None of the chemical compounds (SO2, O3, CO, NOx, NO, NO2, THC, CH4, or NMHC significantly affected the incidence of PD except for particulate matter. PM10 exposure showed significant effects on the likelihood of PD development (T3 level: > 65μg/m3 versus T1 level: ≤ 54μg/m3; OR = 1.35, 95% CI = 1.12-1.62, 0.001 ≤ P < 0.01. In addition

Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007–08 and 2012–14

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Maze, Michael J.; Biggs, Holly M.; Rubach, Matthew P.; Galloway, Renee L.; Cash-Goldwasser, Shama; Allan, Kathryn J.; Halliday, Jo E. B.; Hertz, Julian T.; Saganda, Wilbrod; Lwezaula, Bingileki F.; Cleaveland, Sarah; Mmbaga, Blandina T.; Maro, Venance P.; Crump, John A.

2016-01-01

Background The sole report of annual leptospirosis incidence in continental Africa of 75–102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012–2014. Methodology and Principal Findings Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4–6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7%) confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%), Sejroe 3 (15.8%), Grippotyphosa 2 (10.5%), Icterohaemorrhagiae 2 (10.5%), Pyrogenes 2 (10.5%), Djasiman 1 (5.3%), Tarassovi 1 (5.3%). We estimated that the annual incidence of leptospirosis was 11–18 cases per 100,000 population. This was a significantly lower incidence than 2007–08 (p<0.001). Conclusions We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology. PMID:27911902

Eosinophilic esophageal myositis diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: a case report.

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Igarashi, Ryo; Irisawa, Atsushi; Shibukawa, Goro; Yamabe, Akane; Fujisawa, Mariko; Sato, Ai; Maki, Takumi; Arakawa, Noriyuki; Yoshida, Yoshitsugu; Yamamoto, Shogo; Ikeda, Tsunehiko

2016-10-01

Eosinophilic esophagitis (EoE) is diagnosed by microscopic findings of eosinophilic infiltration into the squamous epithelium. In contrast, another disease concept termed "eosinophilic esophageal myositis (EoEM)" has been proposed, whereby there is eosinophilic infiltration into the muscularis propria instead. A 60-year-old man was referred to our hospital for chest pain, dysphagia, and several episodes of esophageal food impaction. Although EoE was suspected based on clinical features, biopsy specimens showed no mucosal eosinophilic infiltration. Endoscopic ultrasound (EUS) showed thickening of the muscularis propria layer and subsequent EUS-guided fine-needle aspiration biopsy (EUS-FNA) revealed eosinophilic infiltration into the muscularis propria. Although the patient's symptoms gradually improved after steroid administration, complete remission was not achieved after 1 year of treatment. This case may reflect a disorder distinct from typical EoE based on eosinophilic infiltration of the muscularis propria but not the squamous epithelium, and we, therefore, diagnosed it as EoEM using the EUS-FNA findings as reference.

Meckel-Gruber syndrome: Report of two cases

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C Panduranga

2012-01-01

Full Text Available Meckel-Gruber syndrome (MKS is an autosomal recessive disorder, characterized by a combination of renal cysts and variably associated with features including developmental anomalies of the central nervous system (typically encephalocele, hepatic ductal dysplasia, cysts, and polydactyly. It is a rare syndrome with highest incidence in Gujarati Indians and Finnish population. We report two such cases of MKS in non-Gujarati Indian which were diagnosed by neonatal autopsy.

Characteristics of boys with the so-called true undescended testis diagnosed at the third postnatal month--a population-based case-control study.

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Mavrogenis, Stelios; Urbán, Robert; Czeizel, Andrew E

2015-07-01

Undescended testis (cryptorchidism) is a common congenital abnormality of male genital organs diagnosed at birth followed with frequent postnatal descensus. However, the so-called isolated true undescended testis (ITUT) diagnosed at the third postnatal month seems to be an independent defect-entity, and this hypothesis was planned to confirm or reject in the study. The evaluation of birth outcomes and maternal socio-demographic data of cases with ITUT in the population-based large dataset of the Hungarian Congenital Abnormality Registry. There was a higher rate of preterm birth and particularly of low birthweight in 2052 cases with ITUT compared to 24,814 population male controls without any defects. The rate of twins was not higher in cases with older mothers, higher birth order and lower socio-economic status. The comparison of data of boys with undescended testis diagnosed at birth found in the previous study and with ITUT in this study confirmed our hypothesis. Undescended testis can be differentiated into two subgroups: boys with frequent postnatal descensus mainly after preterm delivery and boys with ITUT without postnatal testis descensus with frequent intrauterine growth restriction, older mothers with higher birth order and low socio-economic status.

A primary intestinal lymphangiectasia patient diagnosed by capsule endoscopy and confirmed at surgery: a case report.

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Fang, You-Hong; Zhang, Bing-Ling; Wu, Jia-Guo; Chen, Chun-Xiao

2007-04-21

Intestinal lymphangiectasia (IL) is a rare disease characterized by dilated lymphatic vessles in the intestinal wall and small bowel mesentery which induce loss of protein and lymphocytes into bowel lumen. Because it most often occurs in the intestine and cannot be detected by upper gastroendoscopy or colonoscopy, and the value of common image examinations such as X-ray and computerized tomography (CT) are limited, the diagnosis of IL is difficult, usually needing the help of surgery. Capsule endoscopy is useful in diagnosing intestinal diseases, such as IL. We here report a case of IL in a female patient who was admitted for the complaint of recurrent edema accompanied with diarrhea and abdominal pain over the last twenty years, and aggravated ten days ago. She was diagnosed by M2A capsule endoscopy as a primary IL and confirmed by surgical and pathological examination.

Ovarian echinococcosis in a 4-year old girl - case report | Stanev ...

African Journals Online (AJOL)

Hydatid disease of the genital organs is very rare with an incidence of 0.2%. This disease has no specific symptoms and findings. It is usually diagnosed intraoperatively. We present a case of a four-year old girl with ovarian echinococcosis, who had earlier been operated on in the Clinic of Pediatric Surgery University ...

Wilms tumor in adult: case report; Tumor de Wilms em adulto: relato de caso

Energy Technology Data Exchange (ETDEWEB)

Albuquerque, Mauro Guimaraes; Vieira, Sabas Carlos; Rego, Cristiane Fortes Napoleao do [Universidade Estadual do Piaui (UESPI), Teresina, PI (Brazil); Fortes, Emanuel Augusto de C.; Santana, Gerusia Ibiapina [Hospital Sao Marcos, Teresina, PI (Brazil)]. E-mail: sabasvieira@uol.com.br

2004-07-01

Wilms' tumor is the renal tumor with the higher incidence on the childhood, however it rarely occurs in adults.The incidence in this group is estimated at about 1% of all the cases and they have an obscure prognosis. In this report is related a new case in a 52 years old man presenting intensive abdominal pain associated by weightiness. Abdominal ultrasound revealed expansive and complex lesion with indefinite contour in the left flank. Computed tomography of abdomen demonstrated solid lesion on antero-superior pole of the left kidney invading para-vertebral musculature, peri and para-renal spaces. Total nephrectomy and the histopathologic analysis were realized. A nephroblastoma (Wilms' tumor) in stage II without anaplasia was diagnosed by the anatomopathological studies.Local radiotherapy was applied. Thereafter was diagnosed pulmonary and hepatic metastasis, and then initiated the chemotherapy with adriamycin, actinomycin and vincristine. The prognosis of Wilms' tumor is worse in adult and it requires an aggressive therapeutic and follow up. (author)

Cancer incidence in North West Algeria (Mascara) 2000-2010: results from a population-based cancer registry

Science.gov (United States)

Benarba, Bachir; Meddah, Boumedienne; Hamdani, Houria

2014-01-01

Cancer is a leading cause of death worldwide accounting for 7.4 million deaths. Cancer has become a major public health concern in Algeria. The aim of the present study was to estimate cancer incidence in Mascara Province based on the population-based cancer registry. We analyzed data from the cancer registry of Mascara covering all cancer cases diagnosed by all methods and included in the registry from 1st January 2000 to 31st December 2010. The results are presented as incidence rates of cases by site, sex, age, and crude rate. Age-standardized rates per 100,000 person-years (ASRs) were calculated, using the direct method of standardization to the world population. A total of 1875 cases of invasive cancer were recorded. The mean age of diagnosis for all cancers was 52.66 ± 0.5 in men and 59.18 ± 0.6 in women. The ASR for all cancers in females was 27.8 per 100,000, and that for males was 23.6 per 100,000. The most important finding of the present study was the high incidence of liver cancer among males and females in Mascara. Among females, breast cancer was the most frequently reported followed by Cervix uteri, liver and colon. The most frequent cancer types in males were lung, colon, esophagus and stomach and liver. Cancer incidence in Mascara province was lower than that reported in other national and regional registries. Findings of the present study revealed high incidence of liver cancer in the province, the highest in Algeria, suggesting high prevalence of risk factors. PMID:26417294

Creutzfeldt-Jakob disease: a case report and differential diagnoses.

Science.gov (United States)

Kojima, Gotaro; Tatsuno, Brent K; Inaba, Michiko; Velligas, Stephanie; Masaki, Kamal; Liow, Kore K

2013-04-01

Sporadic Creutzfeldt-Jakob disease is a rare neurodegenerative disorder of unknown etiology that causes rapidly progressive dementia. This disease is uniformly fatal and most patients die within 12 months. Clinical findings include myoclonus, visual disturbances, and cerebellar and pyramidal/extrapyramidal signs in addition to rapidly progressive cognitive and functional impairment. These findings are all non-specific and it is often difficult and challenging to diagnose premortem because of low awareness and clinical suspicion. We present a 66-year-old woman with a 5-month history of rapidly progressive dementia. After a series of extensive diagnostic examinations and continuous follow-up, she was diagnosed with probable sporadic Creutzfeldt-Jakob disease based on Centers for Disease Control and Prevention (CDC) criteria, with key findings of rapidly progressive dementia, blurry vision, extrapyramidal signs (cogwheel rigidity), and abnormal hyperintensity signals on diffusion-weighted MRI. Her symptoms progressively worsened and she died 7 months after the onset. The postmortem brain autopsy demonstrated the presence of abnormal protease-resistant prion protein by Western Blot analysis. A literature review was performed on differential diagnoses that present with rapidly progressive dementia and thereby mimic sporadic Creutzfeldt-Jakob disease. These include Alzheimer's disease, dementia with Lewy Bodies, frontotemporal dementia, meningoencephalitis, corticobasal degeneration, progressive supranuclear palsy, CADASIL, and paraneoplastic encephalomyelitis.

Trends in colorectal cancer incidence among younger adults-Disparities by age, sex, race, ethnicity, and subsite.

Science.gov (United States)

Crosbie, Amanda B; Roche, Lisa M; Johnson, Linda M; Pawlish, Karen S; Paddock, Lisa E; Stroup, Antoinette M

2018-06-22

Millennials (ages 18-35) are now the largest living generation in the US, making it important to understand and characterize the rising trend of colorectal cancer incidence in this population, as well as other younger generations of Americans. Data from the New Jersey State Cancer Registry (n = 181 909) and Surveillance, Epidemiology, and End Results program (n = 448 714) were used to analyze invasive CRC incidence trends from 1979 to 2014. Age, sex, race, ethnicity, subsite, and stage differences between younger adults (20-49) and screening age adults (≥50) in New Jersey (NJ) were examined using chi-square; and, we compared secular trends in NJ to the United States (US). Whites, men, and the youngest adults (ages 20-39) are experiencing greater APCs in rectal cancer incidence. Rates among younger black adults, overall, were consistently higher in both NJ and the US over time. When compared to older adults, younger adults with CRC in NJ were more likely to be: diagnosed at the late stage, diagnosed with rectal cancer, male, non-white, and Hispanic. Invasive CRC incidence trends among younger adults were found to vary by age, sex, race, ethnicity, and subsite. Large, case-level, studies are needed to understand the role of genetics, human papillomavirus (HPV), and cultural and behavioral factors in the rise of CRC among younger adults. Provider and public education about CRC risk factors will also be important for preventing and reversing the increasing CRC trend in younger adults. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Irritable bowel syndrome: The incidence of concurrent psychopathology

OpenAIRE

Margie H Wilson; Anita D Stuart; H Gertie Pretorius

1999-01-01

The goal of this study was to improve understanding of the association between physiology and psychology in Functional Gastrointestinal disorders by considering the co-morbidity of lrritable Bowel Syndrome and psychopathology in a sector of the South African population. A comparison was made between the incidence of concurrent psychopathology in a sample of 48 white female patients, aged 25 to 55 years and diagnosed with lrritable Bowel Syndrome and the incidence of psychopathology in a contr...

Thyroid cancer in Belarus after the Chernobyl accident: Incidence, prognosis of progress, risk assessment

International Nuclear Information System (INIS)

Buglova, E.; Kenigsberg, J.; Golovneva, A.; Demidchik, E.

1997-01-01

Starting from 1990, an increasing number of persons, suffering from thyroid cancer was diagnosed in Belarus. These persons were exposed to radiation in 1986 due to the Chernobyl Accident and were children and adolescents at the time of the accident. This paper gives an overview of the total number of thyroid cancer cases observed in Belarus after the Chernobyl accident among the persons exposed to radiation under 18 years of age. Duration of the latent period and background incidence rate are under discussion. Based on the most reliable data about thyroid doses and incidence rate among the persons exposed to radiation under 6 years of age, the estimation of risk coefficient for radiation induced thyroid cancer was carried out. For childhood exposure from I-131, the excess absolute risk per 10,0000 PYGy was 4.5 (author)

[The estimated incidence and case fatality rate of ischemic and hemorrhagic cerebrovascular disease in 2002 in Catalonia].

Science.gov (United States)

Marrugat, Jaume; Arboix, Adrià; García-Eroles, Lluís; Salas, Teresa; Vila, Joan; Castell, Conxa; Tresserras, Ricard; Elosua, Roberto

2007-06-01

The aim of this study was to obtain an estimate of the incidence of cerebrovascular disease (CVD) in the Spanish population in 2002. The study involved data on patients aged over 24 years for the year 2002 contained in both the death register and the Minimum Basic Data Set from 65 of the 84 Catalan general hospitals (i.e., 90.7% of all acute hospital beds in Catalonia). Total and age-adjusted mortality rates, cumulative incidence, and hospitalization rates, and the 28-day case fatality rate for CVD in the Catalan population were calculated after cases of traumatic and transient disease had been excluded. The unadjusted CVD mortality rate per 100,000 population aged over 24 years in Catalonia was 92 in men and 119 in women. The age-adjusted rates were 58 (95% confidence interval or CI, 56-61) and 43 (95% CI, 41-44), respectively. The cumulative incidence of CVD per 100,000 population was 218 (95% CI, 214-221) in men and 127 (95% CI, 125-128) in women. The unadjusted 28-day case fatality rate in the population was 36.2%: 30.3% in men and 42.0% in women. Some 62.5% of patients (57.2% of men and 66.4% of women) died from CVD outside hospital. These findings indicate that CVD mortality and incidence rates in Catalonia are among the lowest in developed countries. More than half of the deaths that took place within 28 days after the onset of symptoms occurred outside hospital.

Thoraco-amniotic shunting for fetal pleural effusion--a case series.

LENUS (Irish Health Repository)

Walsh, J

2011-11-15

Fetal pleural effusion is a rare occurrence, with an incidence of 1 per 10-15,000 pregnancies. The prognosis is related to the underlying cause and is often poor. There is increasing evidence that in utero therapy with thoraco-amniotic shunting improves prognosis by allowing lung expansion thereby preventing hydrops and pulmonary hypoplasia. This is a review of all cases of fetal pleural effusion managed over an eight year period the National Maternity Hospital Dublin. Over the nine year period there were 21 cases of fetal pleural effusion giving an overall incidence of 1 per 9281 deliveries. Of these, 15 underwent thoraco-amniotic shunting. There were associated anomalies diagnosed in 5 (33%) of cases. The overall survival in our cohort was 53%. The presence of hydrops was a poor prognostic factor, with survival in cases with hydrops of 33% (3\\/9) compared to 83% (5\\/6) in those cases without associated hydrops.

Case of acute orbital myositis which was difficult to diagnose at first

Energy Technology Data Exchange (ETDEWEB)

Yamamoto, Kiyoshi; Terabayashi, Tadasu; Mori, Hiroshi; Niida, Hirohito; Sugiyama, Yoshiaki; Nakagawa, Masato

1988-02-01

We report a case of acute orbital myositis. A 61-year-old woman exhibited acute orbital pain, diplopia, and left proptosis. Examination revealed a 5-mm left proptosis, left chemosis, and limitations in all directions of the movement of the left eye. Visual acuity was unimpaired, however, and the neurological examination was otherwise normal. CT demonstrated a left inferior orbital mass. We suspected an acute orbital pseudotumor based on the rapid onset and the clinical symptoms. We treated her with systemic corticosteroids. Four weeks later CT documented a reduced left orbital mass; there seemed to be left only an inferior rectus muscle enlargement. We diagnosed acute orbital myositis, a subgroup of orbital pseudotumors, based upon the rapid clinical presentation, the CT features, and the resolution after treatment with systemic corticosteroids.

Cooperation of the site and public fire and safety services in case of an incident

International Nuclear Information System (INIS)

Bauch, M.

1997-01-01

This report describes the cooperation between the site and the public fire and safety services in case of an incident. As an example, the measures and facilities of the Hoechst site of the Hoechst AG and the organisational and technical background are presented. (orig.) [de

Nodular fasciitis of the face diagnosed by US-guided core needle biopsy: a case report

International Nuclear Information System (INIS)

Lee, Sang Kwon; Kwon, Sun Young

2006-01-01

We report here on a case of nodular fasciitis (NF) that was diagnosed by ultrasonography (US)-guided core needle biopsy in a 31-year-old man, and we include the US and computed tomographic (CT) findings and the histopathologic findings at US-guided core needle biopsy (CNB). We suggest that high-resolution US is useful for the detailed evaluation of NF in the superficial regions, such as the face, and US-guided CNB is useful for the definitive histologic diagnosis of NF without causing scarring

Epidemiology of infections by HIV, Syphilis, Gonorrhea and Lymphogranuloma Venereum in Barcelona City: a population-based incidence study.

Science.gov (United States)

Martí-Pastor, Marc; García de Olalla, Patricia; Barberá, Maria-Jesús; Manzardo, Christian; Ocaña, Inma; Knobel, Hernando; Gurguí, Mercè; Humet, Victoria; Vall, Martí; Ribera, Esteban; Villar, Judit; Martín, Gemma; Sambeat, Maria A; Marco, Andres; Vives, Alvaro; Alsina, Mercè; Miró, Josep M; Caylà, Joan A

2015-10-05

The aim of this study was to determine the evolution of HIV infection, gonorrhea, syphilis and lymphogranuloma venereum (LGV), and their epidemiological characteristics in Barcelona city. Population-based incidence study of all newly occurring diagnoses of HIV infection, syphilis, gonorrhea and LGV detected in Barcelona between January 2007 and December 2011. A descriptive analysis was performed. The annual incidence rates per 100,000 inhabitants were calculated by sex, sexual conduct and educational level. To estimate global sex-specific rates we used the Barcelona city census; for the calculation of rates by sexual conduct and educational level we used estimates of the Barcelona Health Interview Survey. Trends were analysed using the chi-squared test for linear trend. HIV. 66.8 % of the HIV cases were men who had sex with men (MSM). The incidence rates in MSM over the study period were from 692.67/100,000 to 909.88/100,000 inh. Syphilis. 74.2 % of the syphilis cases were MSM. The incidence rates in MSM were from 224.9/100,000 to 891.97/100,000 inh. and the MSM with a university education ranged from 196.3/100,000 to 1020.8/100,000. Gonorrhea. 45.5 % of the gonorrhea cases were MSM. The incidence rates in MSM were from 164.24/100,000 to 404.79/100,000 inh. and the MSM with university education ranged from 176.7/100,000 to 530.1/100,000 inh.. Lymphogranuloma venereum (LGV). 95.3 % of the LGV cases are MSM. The incidence rates in MSM were from 24.99/100,000 to 282.99/100,000 inh. and the MSM with university education ranged from 9.3/100,000 to 265/100,000 inh. An increase in cases of STI was observed. These STI mainly affected MSM with a university education. Continuing to monitor changes in the epidemiology of STI, and identifying the most affected groups should permit redesigning preventive programs, with the goal of finding the most efficient way to reach these population groups.

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.

Temporal Trends and Future Prediction of Breast Cancer Incidence Across Age Groups in Trivandrum, South India.

Science.gov (United States)

Mathew, Aleyamma; George, Preethi Sara; Arjunan, Asha; Augustine, Paul; Kalavathy, Mc; Padmakumari, G; Mathew, Beela Sarah

2016-01-01

Increasing breast cancer (BC) incidence rates have been reported from India; causal factors for this increased incidence are not understood and diagnosis is mostly in advanced stages. Trivandrum exhibits the highest BC incidence rates in India. This study aimed to estimate trends in incidence by age from 2005- 2014, to predict rates through 2020 and to assess the stage at diagnosis of BC in Trivandrum. BC cases were obtained from the Population Based Cancer Registry, Trivandrum. Distribution of stage at diagnosis and incidence rates of BC [Age-specific (ASpR), crude (CR) and age-standardized (ASR)] are described and employed with a joinpoint regression model to estimate average annual percent changes (AAPC) and a Bayesian model to estimate predictive rates. BC accounts for 31% (2681/8737) of all female cancers in Trivandrum. Thirty-five percent (944/2681) are 60 years and overall CR is 80 (ASR: 57) for 2019- 20. BC, mostly diagnosed in advanced stages, is rising rapidly in South India with large increases likely in the future; particularly among post-menopausal women. This increase might be due to aging and/or changes in lifestyle factors. Reasons for the increased incidence and late stage diagnosis need to be studied.

A RARE CASE OF THIAZIDE-INDUCED BENIGN GYNAECOMASTIA

Directory of Open Access Journals (Sweden)

Sandeep Yamsani

2017-02-01

Full Text Available BACKGROUND Gynaecomastia is a common disorder of the endocrine system in which there is a noncancerous enlargement of the male breast. The incidence of drug-induced gynaecomastia is about 4-10%. One among them are the thiazide group of diuretics, which result in gynaecomastia by inhibition of androgen synthesis. The present case study is about a 75-year-old patient who is a known case of diabetes and hypertension with primary complaints of bilateral breast enlargement diagnosed with a rare presentation of hydrochlorothiazide adverse drug reaction gynaecomastia.¹

Incidence and mechanisms of longitudinal stent deformation associated with Biomatrix, Resolute, Element, and Xience stents: Angiographic and case-by-case review of 1,800 PCIs.

Science.gov (United States)

Arnous, Samer; Shakhshir, Nizar; Wiper, Andrew; Ordoubadi, Farzin-Farth; Williams, Paul; Clarke, Bernard; Mahadavan, Vaikom; El-Omar, Magdi; Mamas, Mamas; Fraser, Douglas

2015-11-15

There is conflicting evidence regarding the incidence of longitudinal stent deformation (LSD) in contemporary practice. To assess the incidence and mechanism of LSD across commonly used DES platforms, we performed a case-by-case review of 1,800 PCI cases involving 450 consecutive procedures using Biomatrix Flex, Resolute Integrity, Promus Element, and Xience V stents, respectively, between January 2009 and December 2011. LSD was detected in a higher proportion with Promus Element [15 (3.1%)] compared with other platforms (Xience V [4 (0.9%)], Biomatrix [3 (0.7%)], Resolute [3 (0.7%)]; P = 0.002). LSD was characterized as guide catheter/guide extension induced, or as impact from secondary devices such as postdilatation balloons or IVUS catheters. The incidence of guide catheter/guide extension LSD was similar across platforms; (Promus Element [5 (1.1%)], Xience V [4 (0.9%)], Biomatrix [3 (0.7%)], Resolute [3 (0.7%)]; P = 0.85). Secondary device LSD occurred exclusively with Promus Element (9/450 cases [2%] (P stent was more difficult in cases of secondary device LSD (6/9 compared with 0/12 treated cases; P stent (OR 5.53 CI[1.54-19.85]), Guideliner use (OR 22.09 CI[4.73-103]), postdilation balloons (OR 5.47 CI[1.31-22.81]) and number of stents deployed (OR 2.06 CI[1.45-2.9]. LSD is more common than previously reported. LSD by a guide catheter/guide extension occurred equally with all platforms, however, LSD associated with secondary devices only occurred with the Element stent. These findings have important implications regarding current and future stent designs. © 2015 Wiley Periodicals, Inc.

A first study on the incidence and prevalence of IBD in Malaysia--results from the Kinta Valley IBD Epidemiology Study.

Science.gov (United States)

Hilmi, Ida; Jaya, Fauziah; Chua, Andrew; Heng, Wong Choon; Singh, Harjinder; Goh, Khean-Lee

2015-05-01

Inflammatory bowel disease [IBD] is known to be rare in the Asia Pacific region but epidemiological studies are scarce. Kinta Valley [Ipoh] was chosen as the sample population. Malaysia has a multiethnic population consisting of Malays, Chinese, and Indians. New cases over 2 years were prospectively captured as well as all known existing cases. Total numbers of the population as a whole and of each ethnic group were obtained. Incidence, prevalence, and mean incidence over two decades were then calculated. There were 10 new cases of IBD diagnosed from April 2011 to April 2013. The crude incidence rates of IBD, ulcerative colitis [UC], and Crohn's disease[CD], respectively, were 0.68, 0.46, and 0.20 per 100,000 persons. The highest incidence was among the Indians, 1.91 compared with 0.35 and 0.63 per 100,000 persons among the Malays and the Chinese, respectively. The mean incidence of IBD has increased steadily from 0.07 to 0.69 per 100,000 person-years over the past two decades. The UC:CD ratio was 8:1 from 1990 to 2000 and 3.6:1 from 2000 to 2010. The prevalence rates of IBD, UC, and CD, respectively, were 9.24, 6.67, and 2.17 per 100,000 persons. The highest prevalence also was among the Indians: 24.91 compared with 7.00 and 6.90 per 100,000 persons among the Malay and Chinese races, respectively. The incidence and prevalence rates of IBD are low in Malaysia but the incidence appears to be increasing and marked racial differences exist. As in other Asian countries, the incidence of CD is increasing at a more rapid rate relative to UC. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

[Idiopathic normal pressure hydrocephalus: High incidence in people over 80 years of age].

Science.gov (United States)

Aragonès, Josep Maria; Altimiras, Jacint; Alonso, Francisco; Roura, Pere; Alfonso, Sebastián; Bajo, Lorena

Idiopathic normal pressure hydrocephalus is usually observed in adults over 60 years of age. The highest incidence of cases is between 70 and 80 years-old, and it could be under-diagnosed in over 80 year-olds. A description is presented on the overall incidence and age group incidence, the delay in the diagnosis, and main outcomes. A descriptive study was performed on patients with idiopathic normal pressure hydrocephalus, in the population of Osona County during the years 2010-2015. The annual incidence rate was 4.43 per 100,000 inhabitants. The incidence increased with age; from 8.09 per 100,000 in the 60 to 69 years age group, to 23.61 per 100,000 in the 70-79 years age group of, and to 37.02 per 100,000 in the 80-89 years age. The delay in the diagnosis was 15.01 ± 10.35 months. All the patients improved after surgery, but only 73.3% of the patients maintained the improvement after one year. Idiopathic normal pressure hydrocephalus is an age related disease and probably underdiagnosed in the elderly. An early diagnosis and a clinical suspicion are essential in patients over 80 years old. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Moebius syndrome: case report

OpenAIRE

Fontenelle, Lucia; Araujo, Alexandra Prufer de Q.C.; Fontana, Rosiane S.

2001-01-01

Nos últimos anos, temos tido oportunidade de diagnosticar maior número de casos da síndrome de Moebius, possivelmente como resultado de aumento real da sua incidência - já que numerosos fatores ambientais vêm sendo relacionados à gênese dessa síndrome. Dos casos avaliados em dois ambulatórios especializados, vale a pena registrar um deles devido à associação incomum com heterotopia cortical, dentre outras malformações.In the last few years we have been able to diagnose a larger number of case...

[Imported histoplasmosis in Navarra: presentation of four cases].

Science.gov (United States)

Navascués, Ana; Rodríguez, Irene; Repáraz, Jesús; Salvo, Soledad; Gil-Setas, Alberto; Martínez Peñuela, José María

2011-01-01

Histoplasmosis is a fungal infection caused by the dimorphic fungi Histoplasma capsulatum. Its incidence in Spain has increased in recent years, mainly due to the increased presence of immigrants from Latin America and increased travel to the continent for tourism and cooperation. Our aim was to review the clinical characteristics of cases of histoplasmosis diagnosed in our hospital during the last six years. We diagnosed 4 cases from 4 patients from South America, 3 of whom were HIV positive and 1 diagnosed with dermatomyositis was treated with immunosuppressive drugs. The laboratory diagnosis was carried out by histological and microbiological study, by culture and specific PCR directly on the sample. As it is an imported infection there needs to be a high level of suspicion and a detailed history taken to get a diagnosis. This infection requires a differential diagnosis between febrile syndrome in immunosuppressed patients, both HIV positive and immunosuppressive therapy, which originate from endemic areas, or who have a history of staying in them. Copyright © 2010 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

Trends in Stroke Incidence and 28-Day Case Fatality in a Nationwide Stroke Registry of a Multiethnic Asian Population.

Science.gov (United States)

Tan, Chuen Seng; Müller-Riemenschneider, Falk; Ng, Sheryl Hui Xian; Tan, Pei Zheng; Chan, Bernard P L; Tang, Kok-Foo; Ahmad, Aftab; Kong, Keng He; Chang, Hui Meng; Chow, Khuan Yew; Koh, Gerald Choon-Huat; Venketasubramanian, Narayanaswamy

2015-10-01

This study investigated trends in stroke incidence and case fatality overall and according to sex, age, ethnicity, and stroke subtype in a multiethnic Asian population. The Singapore Stroke Registry identifies all stroke cases in all public hospitals using medical claims, hospital discharge summaries, and death registry data. Age-standardized incidence rates and 28-day case-fatality rates were calculated for individuals aged ≥15 years between 2006 and 2012. To estimate the annual percentage change of the rates, a linear regression model was fitted to the log rates, and a Wald test was performed to test for trend. P values Chinese (-2.64; 95% CI, -3.15 to -2.13), Indians (-3.78; 95% CI, -5.93 to -1.58), and others (-12.73; 95% CI, -18.93 to -6.06) compared with Malays (2.58; 95% CI, 1.17 to 4.02); and in ischemic stroke subtype (ischemic: -2.43; 95% CI, -3.13 to -1.73; hemorrhagic: -1.02; 95% CI, -2.04 to 0.01). Subgroup-specific findings for case fatality were similar. This is the first countrywide hospital-based registry study in a multiethnic Asian population, and it revealed marked overall reductions in stroke incidence and case fatality. However, it also identified important population groups with less favorable trends, especially younger adults and those of Malay ethnicity. © 2015 American Heart Association, Inc.

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

. Incidence peaked nine weeks after rainfall (r (2) = 0.34, p = 0.0002). From 2009 incidence was measured at a centrally based project clinic. The proportion of under nine-year-old resident attendees diagnosed with malaria decreased significantly from 48% in 2009, to 35% in 2010 and 25% in 2011. At the same...

Ciguatera incidence in the US Virgin Islands has not increased over a 30-year time period despite rising seawater temperatures.

Science.gov (United States)

Radke, Elizabeth G; Grattan, Lynn M; Cook, Robert L; Smith, Tyler B; Anderson, Donald M; Morris, J Glenn

2013-05-01

Ciguatera fish poisoning is the most common marine food poisoning worldwide. It has been hypothesized that increasing seawater temperature will result in increasing ciguatera incidence. In St. Thomas, US Virgin Islands, we performed an island-wide telephone survey (N = 807) and a medical record review of diagnosed ciguatera cases at the emergency department of the sole hospital and compared these data with comparable data sources collected in 1980. Annual incidence from both recent data sources remained high (12 per 1,000 among adults in the telephone survey). However, the combined data sources suggest that incidence has declined by 20% or more or remained stable over 30 years, whereas seawater temperatures were increasing. Illness was associated with lower education levels, higher levels of fish consumption, and having previous episodes of ciguatera; population shifts from 1980 to 2010 in these factors could explain an incidence decline of approximately 3 per 1,000, obscuring effects from rising seawater temperature.

Incidence of interval cancers in faecal immunochemical test colorectal screening programmes in Italy.

Science.gov (United States)

Giorgi Rossi, Paolo; Carretta, Elisa; Mangone, Lucia; Baracco, Susanna; Serraino, Diego; Zorzi, Manuel

2018-03-01

Objective In Italy, colorectal screening programmes using the faecal immunochemical test from ages 50 to 69 every two years have been in place since 2005. We aimed to measure the incidence of interval cancers in the two years after a negative faecal immunochemical test, and compare this with the pre-screening incidence of colorectal cancer. Methods Using data on colorectal cancers diagnosed in Italy from 2000 to 2008 collected by cancer registries in areas with active screening programmes, we identified cases that occurred within 24 months of negative screening tests. We used the number of tests with a negative result as a denominator, grouped by age and sex. Proportional incidence was calculated for the first and second year after screening. Results Among 579,176 and 226,738 persons with negative test results followed up at 12 and 24 months, respectively, we identified 100 interval cancers in the first year and 70 in the second year. The proportional incidence was 13% (95% confidence interval 10-15) and 23% (95% confidence interval 18-25), respectively. The estimate for the two-year incidence is 18%, which was slightly higher in females (22%; 95% confidence interval 17-26), and for proximal colon (22%; 95% confidence interval 16-28). Conclusion The incidence of interval cancers in the two years after a negative faecal immunochemical test in routine population-based colorectal cancer screening was less than one-fifth of the expected incidence. This is direct evidence that the faecal immunochemical test-based screening programme protocol has high sensitivity for cancers that will become symptomatic.

[Lung Abscess Diagnosed as Adenocarcinoma by Needle Biopsy;Report of a Case].

Science.gov (United States)

Shomura, Shin; Suzuki, Hitoshi; Yada, Masaki; Kondo, Chiaki

2015-07-01

We report a case of lung abscess misdiagnosed as adenocarcinoma based on cytologic findings of the sample obtained from needle biopsy. A 45-year-old man consulted our hospital because of fever, wet cough and an abnormal shadow on a chest X-ray film. A chest computed tomography revealed gradually enlarging pulmonary mass in the left S6 infiltrating the S5. A diagnosis of lung cancer was suspected and surgery was performed. Pathological findings of the specimen showed atypical cells with a large nucleus and a gross papillary neoplasm by needle biopsy. The patient underwent left lower lobectomy and partial resection of upper lobe with standard nodal dissection. The final diagnosis was a lung abscess with pneumonia without evidence of malignancy. When an indeterminate pulmonary tumor must be diagnosed during an operation, we should perform partial resection if possible.

Incidence, severity and prognosis associated with hypernatremia in dogs and cats.

Science.gov (United States)

Ueda, Y; Hopper, K; Epstein, S E

2015-01-01

Hypernatremia has been associated with substantial morbidity and death in human patients. The incidence and importance of hypernatremia in dogs and cats has not been determined. To describe the incidence of and prognosis associated with hypernatremia in dogs and cats at a university teaching hospital. A total of 16,691 dogs and 4,211 cats with measured blood or serum sodium concentration. Retrospective study. Medical records of animals with a blood or serum sodium concentration measured during a 60-month period were reviewed to determine the severity of hypernatremia and its associated case fatality rate. Cases with moderate (11-15 mmol/L above the reference range) or severe hypernatremia (≥16 mmol/L above the reference range) were further reviewed. A total of 957 dogs (5.7%) and 338 cats (8.0%) were diagnosed with hypernatremia. Case fatality rates of dogs and cats with hypernatremia was 20.6 and 28.1%, respectively compared to 4.4 and 4.5% with a normal blood or serum sodium concentration (P dogs and 38.5% of cats presented with community-acquired hypernatremia, and 50% of dogs and 61.5% of cats developed hospital-acquired hypernatremia. Hypernatremia was found infrequently in this population but was associated with increased case fatality rates in dogs and cats. Presence and severity of hypernatremia might be useful as a prognostic indicator. Copyright © 2014 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Decreasing incidence of type 2 diabetes mellitus in the United States, 2007-2012: Epidemiologic findings from a large US claims database.

Science.gov (United States)

Weng, Wayne; Liang, Yuanjie; Kimball, Edward S; Hobbs, Todd; Kong, Sheldon X; Sakurada, Brian; Bouchard, Jonathan

2016-07-01

To explore epidemiological trends in type 2 diabetes mellitus (T2D) in the US between 2007 and 2012 using a large US claims database, with a particular focus on demographics, prevalence, newly-diagnosed cases, and comorbidities. Truven Health MarketScan® Databases were used to identify patients with claims evidence of T2D in the years 2007 and 2012. Newly-diagnosed T2D was characterized by an absence of any T2D claims or related drug claims for 6months preceding the index claim. Demographic and comorbidity characteristics of the prevalent and new-onset T2D groups were compared and analyzed descriptively for trends over time. The overall prevalence of T2D remained stable from 2007 (1.24 million cases/15.07 million enrolled; 8.2%) to 2012 (2.04 million cases/24.52 million enrolled; 8.3%), while the percentage of newly-diagnosed cases fell dramatically from 2007 (152,252 cases; 1.1%) to 2012 (147,011 cases; 0.65%). The mean age of patients with prevalent T2D was similar in 2007 (60.6y) and 2012 (60.0y), while the mean age of newly-diagnosed T2D patients decreased by 3years from 2007 (57.7y) to 2012 (54.8y). Hypertension and hyperlipidemia were the most common comorbidities, evident in 50-75% of T2D patients, and increased markedly from 2007 to 2012 in both prevalent and new-onset T2D populations. Cardiovascular disease decreased slightly in prevalent (-0.9%) and new-onset (-2.8%) cases. This large US health claims database analysis suggests stabilization in prevalence and declining incidence of T2D over a recent 5-year period, a downward shift in age at T2D diagnosis, but increases in several comorbidities. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Use of a case-mix approach to study the trends in the incidence of second primary cancers.

Science.gov (United States)

Gass, Boris; Marrer, Emilie; Bara, Simona; Ligier, Karine; Molinié, Florence; Colonna, Marc; Daubisse-Marliac, Laetitia; Trétarre, Brigitte; Lapôtre-Ledoux, Bénédicte; Woronoff, Anne-Sophie; Guizard, Anne-Valérie; Bouvier, Véronique; Troussard, Xavier; Gaiddon, Christian; Klein, Delphine; Velten, Michel; Jégu, Jérémie

2018-05-01

To analyze trends in second primary cancer (SPC) incidence by using a case-mix approach to standardize on first cancer site distribution. Cases registered by 13 French cancer registries between 1989 and 2010 and followed-up until June 2013 were included. The person-year approach was used to compute standardized incidence ratios (SIRs) of metachronous SPC. Usual SIRs and cancer site-specific weighted SIRs called "case-mix SIRs" (cmSIRs) were estimated by sex and calendar period of first cancer diagnosis. Calendar trends in SIRs and cmSIRs were compared. More than 2.9 million person-years at risk were included. Among males, SIRs dropped from 1.49 to 1.23 between 1989-1994 and 2005-2010, while cmSIRs decreased from 1.40 to 1.27. This difference seems mainly related to a stronger representation of prostate cancers (at lower risk of SPC) and a weaker contribution of bladder and head and neck cancers (at higher risk of SPC) in recent periods of diagnosis. Among females, both SIRs and cmSIRs have remained stable at around 1.22 and 1.21, respectively. The cmSIR is an indicator that is not influenced by changes in first cancer site distribution. Its use should be encouraged to assess second cancer incidence control. Copyright © 2018 Elsevier Inc. All rights reserved.

Incidence of Hospital Acquired Thrombosis (HAT) in a Tertiary Care Hospital.

LENUS (Irish Health Repository)

Khan, MI

2017-04-01

Venous thromboembolism (VTE) is a major cause of preventable morbidity and mortality in hospitalized patients. In spite of guidelines, VTE prophylaxis continues to be underutilised, and hospital acquired thrombosis (HAT) continues to be a problem. This study was conducted to estimate the incidence of HAT in a tertiary referral centre and to examine whether VTE risk assessment and thromboprophylaxis (TP) were implemented. Patients 18 years and above, with a radiologically-confirmed acute VTE during the study period of 15 weeks were included. Acute VTE was diagnosed in 100 patients and HAT was diagnosed in 48. There were 12,024 admissions over the study period, therefore the incidence of HAT was 0.4%. TP was prescribed in only 35% of patients, and 65% did not receive any or appropriate TP. Hospitals without active implementation of a formal risk assessment tool and TP policy are likely to continue to have increased incidence of HAT.

Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study.

Science.gov (United States)

Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

2015-01-01

Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. This was an observational study. Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6-232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2-142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere's disease among the 76 PVD patients. We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo.

Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study

Science.gov (United States)

Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

2015-01-01

Objective Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. Design This was an observational study. Setting and participants Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. Outcome The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. Results The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6–232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2–142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere’s disease among the 76 PVD patients. Conclusion We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo. PMID:25931828

Decline in overall, smear-negative and HIV-positive TB incidence while smear-positive incidence stays stable in Guinea-Bissau 2004-2011

DEFF Research Database (Denmark)

Lemvik, G; Rudolf, F; Vieira, F

2014-01-01

OBJECTIVE: To calculate Tuberculosis (TB) incidence rates in Guinea-Bissau over an 8-year period. METHODS: Since 2003, a surveillance system has registered all TB cases in six suburban districts of Bissau. In this population-based prospective follow-up study, 1205 cases of pulmonary TB were...... identified between January 2004 and December 2011. Incidence rates were calculated using census data from the Bandim Health and Demographic Surveillance System (HDSS). RESULTS: The overall incidence of pulmonary TB was 279 per 100 000 person-years of observation; the male incidence being 385, and the female...... 191. TB incidence rates increased significantly with age in both sexes, regardless of smear or HIV status. Despite a peak with unknown cause of 352 per 100 000 in 2007, the overall incidence of pulmonary TB declined over the period. The incidence of HIV infected TB cases declined significantly from...

Impact of patient position on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials.

Science.gov (United States)

Alexiou, Vangelis G; Ierodiakonou, Vrettos; Dimopoulos, George; Falagas, Matthew E

2009-12-01

The aim of this study is to summarize the effect of position (prone and semirecumbent 45 degrees ) of mechanically ventilated patients on the incidence of ventilator-associated pneumonia (VAP) and other outcomes. A systematic search for randomized control trials (RCTs) was done. We estimated pooled odds ratios (ORs) and 95% confidence intervals (CIs) using fixed effects model or random effects model, where appropriate. For continuous variables, we calculated the estimation of weighted mean differences. We analyzed data extracted from 3 RCTs studying the semirecumbent 45 degrees and 4 RCTs studying the prone position with a total of 337 and 1018 patients, respectively. The odds of developing clinically diagnosed VAP were significantly lower among patients in the semirecumbent 45 degrees position compared to patients in the supine position (OR = 0.47; 95% CI, 0.27-0.82; 337 patients). The comparison of prone vs supine position group showed a moderate trend toward better outcomes regarding the incidence of clinically diagnosed VAP among patients in the prone position (OR = 0.80; 95% CI, 0.60-1.08; 1018 patients). The subanalysis regarding the incidence of microbiologically documented VAP, the length of intensive care unit stay, and the duration of mechanical ventilation showed that patients in the semirecumbent 45 degrees position have a moderate trend toward better clinical outcomes. This meta-analysis provides additional evidence that the usual practice of back-rest elevation of 15 degrees to 30 degrees is not sufficient to prevent VAP in mechanically ventilated patients. Patients positioned semirecumbently 45 degrees have significantly lower incidence of clinically diagnosed VAP compared to patients positioned supinely. On the other hand, the incidence of clinically diagnosed VAP among patients positioned pronely does not differ significantly from the incidence of clinically diagnosed VAP among patients positioned supinely.

Environmental tobacco smoke and breast cancer incidence

International Nuclear Information System (INIS)

Gammon, M.D.; Eng, S.M.; Teitelbaum, S.L.; Britton, J.A.; Kabat, G.C.; Hatch, Maureen; Paykin, A.B.; Neugut, A.I.; Santella, R.M.

2004-01-01

To evaluate whether environmental tobacco smoke (ETS) influences breast cancer incidence, data from a population-based case-control study were analyzed. Respondents with available ETS information assessed by in-person questionnaires included 1356 newly diagnosed cases and 1383 controls. Relative to nonsmokers who reported no residential ETS exposure throughout the life course, the odds ratios (OR) for breast cancer were not substantially elevated in relation to ETS exposure, active smoking, or a joint measure of active and passive smoking (OR, 1.15, 95% CI, 0.90, 1.48). An increased OR, however, was noted among nonsmokers who lived with a smoking spouse for over 27 years (2.10, 95% CI, 1.47, 3.02), although no dose-response was evident. Also, among women with hormone-receptor-positive tumors only, the OR for both active and passive smoking was increased (1.42 for ER + PR + , 95% CI, 1.00, 2.00). Our data suggest that if there is an effect for ETS on breast cancer, that effect is restricted to selected subgroups of women, such as those with long-term exposure from a smoking spouse

Incidence of hypersensitivity and anaphylaxis with sugammadex.

Science.gov (United States)

Min, K Chris; Woo, Tiffany; Assaid, Christopher; McCrea, Jacqueline; Gurner, Deborah M; Sisk, Christine McCrary; Adkinson, Franklin; Herring, W Joseph

2018-06-01

To evaluate the incidence of hypersensitivity and anaphylaxis after administration of sugammadex. Retrospective analysis. Sugammadex clinical development program and post-marketing experience. Surgical patients and healthy volunteers who received sugammadex or placebo/comparator with anesthesia and/or neuromuscular blockade (NMB). Sugammadex administered as 2.0 mg/kg at reappearance of the second twitch, 4.0 mg/kg at 1-2 post-tetanic count, or 16.0 mg/kg at 3 min after rocuronium 1.2 mg/kg. Three analytical methods were used: 1) automated MedDRA queries; 2) searches of adverse events (AEs) consistent with treatment-related hypersensitivity reactions as diagnosed by the investigator; and 3) a retrospective adjudication of AEs suggestive of hypersensitivity by a blinded, independent adjudication committee (AC). In addition, a search of all post-marketing reports of events of hypersensitivity was performed, and events were retrospectively adjudicated by an independent AC. Anaphylaxis was determined according to Sampson Criterion 1. The pooled dataset included 3519 unique subjects who received sugammadex and 544 who received placebo. The automated MedDRA query method showed no apparent increase in hypersensitivity or anaphylaxis with sugammadex as compared to placebo or neostigmine. Similarly, there was a low overall incidence of AEs of treatment-related hypersensitivity (sugammadex and placebo or neostigmine. Finally, the retrospective adjudication of AEs suggestive of hypersensitivity showed a low incidence of hypersensitivity (0.56% and 0.21% for sugammadex 2 mg/kg and 4 mg/kg, respectively), with an incidence similar to subjects who received placebo (0.55%). There were no confirmed cases of anaphylaxis in the pooled studies. During post-marketing use, spontaneous reports of anaphylaxis occurred with approximately 0.01% of sugammadex doses. Subjects who received sugammadex with general anesthesia and/or NMB had a low overall incidence of

MULTIPLE MYELOMA PRESENTED AS AN ANTERIOR CHEST WALL MASS DIAGNOSED BY CYTOLOGICAL EXAMINATION : A CASE REPORT

Directory of Open Access Journals (Sweden)

Parvathi

2015-02-01

Full Text Available Myeloma is a malignancy of terminally differentiated B cells (plasma cells that produce a complete and / or partial monoclonal immunoglobulin protein. Myeloma accounts for approximately 1% of all malignancies and 10% of haematological tumors. It becomes difficult to arrive at early diagnosis because myeloma manifests itself in different forms. The disease usually presents as bone pains, pathological fractures and anemia but can also present as swelling in jaw, orbit, rib, sternoclavicular area, scalp, paraspinal region and tonsil. We present a case of multiple myeloma in 63 year old male which presented as a soft tissue mass on anterior chest wall and diagnosed by FNAC . This case is presented because diagnosis was made on cytology and not many cases have been reported in literature where FNAC helped in making the diagnosis. This increases the hope of early diagnosis so that treatment can be advocated

Public transportation and tuberculosis transmission in a high incidence setting.

Science.gov (United States)

Zamudio, Carlos; Krapp, Fiorella; Choi, Howard W; Shah, Lena; Ciampi, Antonio; Gotuzzo, Eduardo; Heymann, Jody; Seas, Carlos; Brewer, Timothy F

2015-01-01

Tuberculosis (TB) transmission may occur with exposure to an infectious contact often in the setting of household environments, but extra-domiciliary transmission also may happen. We evaluated if using buses and/or minibuses as public transportation was associated with acquiring TB in a high incidence urban district in Lima, Peru. Newly diagnosed TB cases with no history of previous treatment and community controls were recruited from August to December 2008 for a case-control study. Crude and adjusted odd ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression to study the association between bus/minibus use and TB risk. One hundred forty TB cases and 80 controls were included. The overall use of buses/minibuses was 44.9%; 53.3% (72/135) among cases and 30.4% (24/79) among controls [OR: 3.50, (95% CI: 1.60-7.64)]. In the TB group, 25.7% (36/140) of subjects reported having had a recent household TB contact, and 13% (18/139) reported having had a workplace TB contact; corresponding figures for controls were 3.8% (3/80) and 4.1% (3/73), respectively[OR: 8.88 (95% CI: 2.64-29.92), and OR: 3.89 (95% CI: 1.10-13.70)]. In multivariate analyses, age, household income, household contact and using buses/minibuses to commute to work were independently associated with TB [OR for bus/minibus use: 11.8 (95% CI: 1.45-96.07)]. Bus/minibus use to commute to work is associated with TB risk in this high-incidence, urban population in Lima, Peru. Measures should be implemented to prevent TB transmission through this exposure.

Incidence and Predictors of Infective Endocarditis in Mitral Valve Prolapse: A Population-Based Study

Science.gov (United States)

Katan, Ognjen; Michelena, Hector I.; Avierinos, Jean-Francois; Mahoney, Douglas W.; DeSimone, Daniel C.; Baddour, Larry M.; Suri, Rakesh M.; Enriquez-Sarano, Maurice

2016-01-01

Objective To determine the incidence and predictors of infective endocarditis in a population-based cohort of mitral valve prolapse(MVP) patients. Patients and methods We identified all adult Olmsted County residents with MVP diagnosed by echocardiography from January 1989 to December 1998 and cross-matched them with the Rochester Epidemiologic Project-identified Olmsted County cases of infective endocarditis(IE) from January 1986 to December 2006. We retrospectively analyzed and de-novo confirmed each IE case using the modified Duke criteria. Results There were 896 Olmsted County residents with echocardiographic MVP diagnosis, mean age 53±21 years, 565(63%) women. Mean follow-up was 11±5 years. The 15-year cohort-risk of IE after MVP diagnosis was 1.1±0.4%; incidence of 86.6[95% CI, 43.3–173.2]cases per 100,000 person-years; age- and sex-adjusted relative-risk of IE in MVP of 8.1[95% CI: 3.6–18.0] compared to the County general population(PMVP patients with ≥moderate mitral regurgitation(289.5[108.7–771.2] cases per 100,000 person-years, P=.02 compared to MVP adults is higher than previously reported in case-control tertiary care-center studies. MVP patients with ≥moderate mitral regurgitation or a flail leaflet are at notable risk of developing IE as compared to those without mitral regurgitation. PMID:26856780

The Incidence of Eating Disorders in a Danish Nationwide Register Study Associations with Suicide Risk and Mortality

OpenAIRE

Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte; Thornton, Laura M.; Mortensen, Preben Bo; Bulik, Cynthia M.

2015-01-01

Our aim was to characterize the incidence rates and cumulative incidence of anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS), and examine associations among eating disorder diagnoses, suicide attempts, and mortality. Individuals born in Denmark between 1989 and 2006 were included (N=966,141, 51.3% male). Eating disorders diagnoses (AN, Broad AN, BN, EDNOS) were drawn from the Danish Psychiatric Central Research Register (PCRR) and Danish Nationa...

Rising incidence of Merkel cell carcinoma

DEFF Research Database (Denmark)

Lyhne, Dorte; Lock-Andersen, Jørgen; Dahlstrøm, Karin

2011-01-01

Abstract Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark, and to investi......Abstract Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark......, and to investigate the incidence. We suggest guidelines for treatment. First we reviewed the medical records of 51 patients diagnosed with MCC from 1995 until 2006 in eastern Denmark. The nation-wide incidence of MCC was extracted from the Danish Cancer Registry for the calculations for the period 1986-2003. We...... reviwed published papers about MCC based on a MEDLINE search. Fourteen of the 51 patients developed recurrence, and 37 (73%) died during the study period. Mean follow-up was 13 months (range 1-122). A total of 153 patients were identified in the Danish Cancer Registry, and showed that incidence rates had...

Incidence and phenotypic characteristics of pediatric IBD in northeastern Slovenia, 2002-2010.

Science.gov (United States)

Urlep, Darja; Trop, Tina K; Blagus, Rok; Orel, Rok

2014-03-01

The purpose of the present study was to determine the incidence of inflammatory bowel disease (IBD) and its subgroups in children in northeastern Slovenia (NE Slovenia) during the period 2002-2010, and to assess the phenotypic characteristics at the diagnosis and during the follow-up. A retrospective investigation was conducted on a cohort of newly diagnosed children and adolescents with IBD ages 0 to 18 years between 2002 and 2010 and residing in NE Slovenia. The phenotypic characteristics were determined at presentation and during follow-up. The location of Crohn disease (CD) and ulcerative colitis (UC) was assessed according to the Paris classification at diagnosis, and later in patients who had a follow-up period >2 years. The type of therapy at diagnosis and during follow-up, and the need for surgery were determined. The study covered approximately one-third of the total pediatric population (0-18 years). In total, 107 cases of IBD were diagnosed during the study period. The mean annual incidence (per 100,000) was 7.6 (95% confidence interval [CI] 6.3-9.2) for all IBD, 4.6 (95% CI 3.6-5.9) for CD, and 2.8 (95% CI 1.9-3.8) for UC. The incidences of total IBD, CD, and UC increased from 5.7 (3.8-8.2), 3.9 (2.3-6.1), and 1.8 (0.8-3.5) in the period 2002-2004, respectively, to 8.9 (6.3-12.2), 5.0 (3.1-7.6), and 3.4 (1.9-5.6) in the period 2008-2010, respectively. During the follow-up, the proportion of complicated CD disease behavior (stricturing/penetrating) had doubled. A total of 18.5% of patients with CD underwent bowel surgery. The incidence of childhood IBD in the northeastern part of the country is high and comparable with that reported from the developed western countries of Europe, and is probably still increasing. This increase may be the result of changes in the lifestyle, especially in dietary habits during the last 20 years.

[Incidence and clinical risk factors for the development of diabetes mellitus in women with previous gestational diabetes].

Science.gov (United States)

Domínguez-Vigo, P; Álvarez-Silvares, E; Alves-Pérez M T; Domínguez-Sánchez, J; González-González, A

2016-04-01

Gestational diabetes is considered a variant of diabetes mellitus as they share a common pathophysiological basis: insulin resistance in target and insufficient secretion of it by pancreatic p-cell bodies. Pregnancy is a unique physiological situation provides an opportunity to identify future risk of diabetes mellitus. To determine the long-term incidence of diabetes mellitus in women who have previously been diagnosed with gestational diabetes and identifying clinical risk factors for developing the same. nested case-control cohort study. 671 patients between 1996 and 2009 were diagnosed with gestational diabetes were selected. The incidence of diabetes mellitus was estimated and 2 subgroups were formed: Group A or cases: women who develop diabetes mellitus after diagnosis of gestational diabetes. Group B or control: random sample of 71 women with a history of gestational diabetes in the follow-up period remained normoglycemic. Both groups were studied up to 18 years postpartum. By studying Kaplan Meier survival of the influence of different gestational variables it was obtained in the later development of diabetes mellitus with time parameter and COX models for categorical variables were applied. Significant variables were studied by multivariate Cox analysis. In all analyzes the Hazard ratio was calculated with confidence intervals at 95%. The incidence of diabetes mellitus was 10.3% in patients with a history of gestational diabetes. They were identified as risk factors in the index pregnancy to later development of diabetes mellitus: greater than 35 and younger than 27 years maternal age, BMI greater than 30 kg/m2, hypertensive disorders of pregnancy, insulin therapy, poor metabolic control and more than a complicated pregnancy with gestational diabetes. Clinical factors have been identified in the pregnancy complicated by gestational diabetes that determine a higher probability of progression to diabetes mellitus in the medium and long term.

Gaucher's disease diagnosed by splenectomy.

Science.gov (United States)

Adas, Mine; Adas, Gokhan; Karatepe, Oguzhan; Altiok, Merih; Ozcan, Deniz

2009-08-01

Splenectomy continues to find common therapeutic indications for hematologic disorders. In addition, recently it is also performed in surgical clinics to assist diagnose of some illnesses. Gaucher's disease, especially Type I, is the most frequently encountered lysosomal storage disorder in man. Manifestations of it are highly variable. The most frequently found symptoms include splenomegaly with anaemia and thrombocytopenia, mostly due to hypersplenism, hepatomegaly and bone disease. Four patients were reported in the present study. Three of them were easily diagnosed with Gaucher's disease via bone marrow cytology, and one with Gaucher's disease was detected by pathological examination following the splenectomy. For the pouse of diagnosis of the Gaucher's disease, performing surgery is generally not necessary. However, for the cases of difficult to diagnose by classical methods, the corect diagnosis of Gaucher's disease can only be made by a special operation.

THE ANALYSIS OF CANCER INCIDENCE AND MORTALITY AMONG THE POPULATION OF THE MOSCOW REGION IN 2014

Directory of Open Access Journals (Sweden)

A. N. Gurov

2015-01-01

Full Text Available Rationale: Analysis of the cancer incidence and mortality in the population is of major importance for planning of measures aimed at improvement of organization of medical care to cancer patients, ensuring high quality and availability of this type of medical care.Aim: To evaluate cancer-related incidence and mortality rates and structure among the population of the Moscow Region depending on patient gender and tumor localization.Materials and methods: The estimation and analysis of incidence and mortality rates was performed based on the Reporting Form of the Federal Statistic Surveillance #7 “Information on disorders related to malignant tumors” in the Moscow Region in 2014. For mortality analysis, including that among pediatric patients, we used data from the State Statistics Service of the Moscow Region.Results: In 2014, there were 25 600 new cases of malignancies diagnosed in the Moscow Region, that corresponded to the incidence rate of 363.2 per 100,000 of the population. The leading types of newly diagnosed tumors in men were prostate cancer, as well as tracheal, bronchial and lung cancers (54.2 and 47.0 per 100,000 of male population, respectively. In women, the highest incidence rates were found for breast and skin cancers (86.0 and 58.9 per 100,000 of female population, respectively. According to the data from Rosstat, in 2014, the overall cancer mortality rate in the Moscow Region was 228.1 per 100,000 of the population. Among the causes of cancer mortality in men, the leading one was tracheal, bronchial and lung cancer (22.2%, followed by stomach cancer (13.3% and prostate cancer (8.1%. In women, the leading cause of cancer mortality was breast cancer (16.6%, followed by ovarian, uterine and cervical cancers (14.1% and stomach cancer (11.4%.Conclusion: Based on the results of medical and statistical analysis of cancer incidence and mortality rates, the main direction of improvement of medical care to cancer patients and the ways

Validation of cardiovascular diagnoses in the Greenlandic Hospital Discharge Register for epidemiological use

DEFF Research Database (Denmark)

Tvermosegaard, Maria; Ronn, Pernille Falberg; Pedersen, Michael Lynge

2018-01-01

not previously been validated specifically. The objective of the study was to validate diagnoses of CVD in GHDR. The study was conducted as a validation study with primary investigator comparing information in GHDR with information in medical records. Diagnoses in GHDR were considered correct and thus valid......Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In Greenland, valid estimates of prevalence and incidence of CVD do not exist and can only be calculated if diagnoses of CVD in the Greenlandic Hospital Discharge Register (GHDR) are correct. Diagnoses of CVD in GHDR have...... if they matched the diagnoses or the medical information in the medical records. A total of 432 online accessible medical records with a cardiovascular diagnosis according to GHDR from Queen Ingrid's Hospital from 2001 to 2013 (n=291) and from local health care centres from 2007 to 2013 (n=141) were reviewed...

Risk Factors Correlated with Incidence of Low Birth Weight Cases

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Anjas Dwi Purwanto

2017-01-01

Full Text Available The infant with Low Birth Weight (LBW was one of the risk factors that contributed to the high infant mortality, especially in the neonatal period. About 17% from 25 millions birth each year in the world are infant with LBW. LBW could be caused by multifactor that were maternal factors (maternal age, birth interval, parity, anemia, social-economic and behaviour, fetus factor, placental factor, and environmental factor. The research aims was to analyze the risk factors correlated with incidence of LBW. This research was an observational  research with case-control design. The number of samples in this research were 120 mothers who delivered in working area of RSIA Kendangsari in 2014. The subjects were selected used systematic random method. The independent variabels in this research were maternal age, education level, employment status, birth interval, parity, age pregnancy, multiple pregnancy, hypertension, and anemia, while the dependent variable in this research was LBW. Based on correlation analysis used Chi-square test showed there were not significant correlation (p>0,05 between birth interval and parity with LBW cases and there were significant correlations (p<0,05 between age pregnancy, hypertension during pregnancy and anemia with LBW cases. Odds Ratio (OR were 13,571 on age pregnancy, 2,224 on multiple pregnancy,2,753 on hypertension and 4,030 on anemia. The conlusion showed that the risk factors of LBW cases were age pregnancy, multiple pregnancy, hypertension and anemia. While maternal age, education level, employment status, birth intervaland parity were not had any correlation with LBW cases. Keywords: LBW, risk factors, babies, maternal, pregnancy

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

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

International Nuclear Information System (INIS)

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

1994-01-01

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

COMORBIDITY DIAGNOSES IN ALCOHOL DEPENDENT PATIENTS: DIFFERENCES AND DILEMMAS

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Maja Rus-Makovec

2002-11-01

Full Text Available Background. In the presented study we followed the diagnostic procedures of comorbidity in alcohol dependent patients of in-patient treatment. The aim of the study was to evaluate the incidence of dual/triple diagnoses with alcohol dependent patients and to incorporate the diagnostic procedures in rutine work and in treatment planning.Material and methods. We were following the basic parameters of treatment of 469 patients (366 male, 102 female from July 1999 to July 2001. The diagnostic criteria according to ICD-10 were applied after at least four weeks of sobriety.Results. The most frequent additional diagnoses found were nicotine dependency, depressive and personal disorders. Main gender differences were found in diagnosis of depressive disorders and in dependency or abuse of prescripted drugs. Comparison of our results with literature data showed the greatest differences in diagnoses of cognitive, depressive, anxious data and dependency of other psychoactive substances.Conclusions. The comparison between the two time periods shows that stuff sensibility to diagnostic procedures of comorbidity states influences the frequency of diagnostic categories. The literature data review leads to impression of inconsistent diagnosing regarding the context and phylosophy of treatment context, stuff education and patient population.

Incidence of acute kidney injury in the neonatal intensive care unit

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Doaa Youssef

2015-01-01

Full Text Available The aim of this work is to study the incidence of acute kidney injury (AKI in neonates admitted to the neonatal intensive care unit (NICU over a six-month period from September 2011 to March 2012. This prospective study was performed on 250 neonates admitted to the NICU at the Children′s Hospital, Faculty of Medicine, Zagazig University. All neonates were subjected to detailed history taking, including pre-natal, natal and post-natal history, with stress on symptoms suggestive of AKI. All neonates were examined thoroughly and the following investigations were performed: Blood urea nitrogen (BUN, serum creatinine, sodium, potassium, calcium, complete blood count, C-reactive protein, arterial blood gases, urine sodium and urine creatinine. AKI was diagnosed in 27 cases (10.8%, including 12 females and 15 males. 40.7% of the AKI cases were born after full-term pregnancy while 59.3% were pre-term babies. 29.6% of the AKI cases had oliguria, and there was male sex predominance, with a male-female ratio of 1.3:1. The cause of AKI was pre-renal in 96.3% and intrinsic renal in 3.7% of the cases. The predisposing factors for AKI were sepsis in 63% of the cases, respiratory distress syndrome in 55.6%, mechanical ventilation in 51.9%, peri-natal asphyxia in 18.5%, dehydration in 14.8%, surgical operation in 11.1%, congenital heart disease in 7.4%, sub-galeal hematoma in 3.7%, polycythemia in 3.7% and intra-ventricular hemorrhage in 3.7% of the cases. Our data suggest that pre-renal failure was the most common form of AKI in our patients. Early recognition of risk factors such as sepsis, peri-natal asphyxia or peri-operative problems and rapid effective treatment of contributing conditions will reduce the incidence of AKI in the neonatal period.

Incidence of acute kidney injury in the neonatal intensive care unit.

Science.gov (United States)

Youssef, Doaa; Abd-Elrahman, Hadeel; Shehab, Mohamed M; Abd-Elrheem, Mohamed

2015-01-01

The aim of this work is to study the incidence of acute kidney injury (AKI) in neonates admitted to the neonatal intensive care unit (NICU) over a six-month period from September 2011 to March 2012. This prospective study was performed on 250 neonates admitted to the NICU at the Children's Hospital, Faculty of Medicine, Zagazig University. All neonates were subjected to detailed history taking, including pre-natal, natal and post-natal history, with stress on symptoms suggestive of AKI. All neonates were examined thoroughly and the following investigations were performed: Blood urea nitrogen (BUN), serum creatinine, sodium, potassium, calcium, complete blood count, C-reactive protein, arterial blood gases, urine sodium and urine creatinine. AKI was diagnosed in 27 cases (10.8%), including 12 females and 15 males. 40.7% of the AKI cases were born after full-term pregnancy while 59.3% were pre-term babies. 29.6% of the AKI cases had oliguria, and there was male sex predominance, with a male-female ratio of 1.3:1. The cause of AKI was pre-renal in 96.3% and intrinsic renal in 3.7% of the cases. The predisposing factors for AKI were sepsis in 63% of the cases, respiratory distress syndrome in 55.6%, mechanical ventilation in 51.9%, peri-natal asphyxia in 18.5%, dehydration in 14.8%, surgical operation in 11.1%, congenital heart disease in 7.4%, sub-galeal hematoma in 3.7%, polycythemia in 3.7% and intra-ventricular hemorrhage in 3.7% of the cases. Our data suggest that pre-renal failure was the most common form of AKI in our patients. Early recognition of risk factors such as sepsis, peri-natal asphyxia or peri-operative problems and rapid effective treatment of contributing conditions will reduce the incidence of AKI in the neonatal period.

CT findings of primary squamous cell carcinoma of the stomach: a case report

International Nuclear Information System (INIS)

Kim, Kyoung Min; Lee, Chang Hee; Kim, Kyeong Ah; Park, Cheol Min

2008-01-01

Primary squamous cell carcinoma is a rare tumor of the stomach with an incidence ranging from 0.04% to 0.4% of all diagnosed gastric cancers. We report a case of squamous cell carcinoma in the stomach associated with hypertrophic gastropathy and observed as a huge mass and wall thickening on the greater curvature site by a multidetector CT

High prevalence of tuberculosis diagnosed during autopsy ...

African Journals Online (AJOL)

The primary aims of tuberculosis (TB) control programmes is early diagnosis and prompt treatment of infectious cases to limit transmission. Failure to diagnose and adequately treat TB could lead to premature death and unrecognized transmission of Mycobacterium tuberculosis. The proportion of missed TB cases has not ...

Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

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Olsen Jens

2012-12-01

Full Text Available Abstract Background Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups and DAGS (Danish Outpatient Groups System charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004–2007 was compared with that by an age- and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis. Results The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. The total number of new cases of these four cancers in Denmark is about 270 per year. In comparison, the total number of new cases cervical cancer is around 390 per year. The total cost of anogenital cancer to the hospital sector was estimated to be 7.6 million Euros per year. Costs associated with anal and vulvar cancer constituted the majority of the costs. Conclusions Anogenital cancer incurs considerable costs to the Danish hospital sector. It is expected that the current

78 FR 38949 - Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response

Science.gov (United States)

2013-06-28

... exposed to various forms of cyber attack. In some cases, attacks can be thwarted through the use of...-3383-01] Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response... systems will be successfully attacked. When a successful attack occurs, the job of a Computer Security...

Questionnaire-based survey on the distribution and incidence of canine babesiosis in countries of Western Europe

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Halos Lénaïg

2014-01-01

Full Text Available The incidence of canine babesiosis may vary considerably from one country to another depending on the distribution of the causative parasite species and their specific vectors. The aim of the present study was to evaluate the clinical occurrence of canine babesiosis diagnosed in European veterinary clinics and propose an updated map of the disease distribution in Western Europe. Questionnaires were sent to companion animal veterinary clinics in Spain, France, Benelux, Germany and Austria. The annual number of babesiosis cases in 2010, the number of practitioners in the clinic and the location of the clinic were recorded. The total numbers of dogs and practitioners in each country were used for definition of the reference populations and the annual incidence of canine babesiosis was calculated by dividing the total number of reported babesiosis cases by the total number of dogs in the veterinary practices involved in the study. Data were georeferenced for distribution map construction. The overall annual incidence of clinical babesiosis amongst the investigated dog population was 0.7%, with significant variations amongst countries and regions. Three epidemiological situations were described: (i Spain, with co-existence of several species of piroplasms and patchy distribution of babesiosis, (ii France, with overall presence of babesiosis due to Babesia canis and local variations and (iii Benelux, Germany and Austria, with overall low prevalence of the disease associated with localised description related either to imported cases or to small autochthonous foci of B. canis infection.

Questionnaire-based survey on the distribution and incidence of canine babesiosis in countries of Western Europe

Science.gov (United States)

Halos, Lénaïg; Lebert, Isabelle; Abrial, David; Danlois, Fabien; Garzik, Karin; Rodes, Daniel; Schillmeier, Monika; Ducrot, Christian; Guillot, Jacques

2014-01-01

The incidence of canine babesiosis may vary considerably from one country to another depending on the distribution of the causative parasite species and their specific vectors. The aim of the present study was to evaluate the clinical occurrence of canine babesiosis diagnosed in European veterinary clinics and propose an updated map of the disease distribution in Western Europe. Questionnaires were sent to companion animal veterinary clinics in Spain, France, Benelux, Germany and Austria. The annual number of babesiosis cases in 2010, the number of practitioners in the clinic and the location of the clinic were recorded. The total numbers of dogs and practitioners in each country were used for definition of the reference populations and the annual incidence of canine babesiosis was calculated by dividing the total number of reported babesiosis cases by the total number of dogs in the veterinary practices involved in the study. Data were georeferenced for distribution map construction. The overall annual incidence of clinical babesiosis amongst the investigated dog population was 0.7%, with significant variations amongst countries and regions. Three epidemiological situations were described: (i) Spain, with co-existence of several species of piroplasms and patchy distribution of babesiosis, (ii) France, with overall presence of babesiosis due to Babesia canis and local variations and (iii) Benelux, Germany and Austria, with overall low prevalence of the disease associated with localised description related either to imported cases or to small autochthonous foci of B. canis infection. PMID:24626325

International variations and trends in renal cell carcinoma incidence and mortality.

Science.gov (United States)

Znaor, Ariana; Lortet-Tieulent, Joannie; Laversanne, Mathieu; Jemal, Ahmedin; Bray, Freddie

2015-03-01

Renal cell carcinoma (RCC) incidence rates are higher in developed countries, where up to half of the cases are discovered incidentally. Declining mortality trends have been reported in highly developed countries since the 1990s. To compare and interpret geographic variations and trends in the incidence and mortality of RCC worldwide in the context of controlling the future disease burden. We used data from GLOBOCAN, the Cancer Incidence in Five Continents series, and the World Health Organisation mortality database to compare incidence and mortality rates in more than 40 countries worldwide. We analysed incidence and mortality trends in the last 10 yr using joinpoint analyses of the age-standardised rates (ASRs). RCC incidence in men varied in ASRs (World standard population) from approximately 1/100,000 in African countries to >15/100,000 in several Northern and Eastern European countries and among US blacks. Similar patterns were observed for women, although incidence rates were commonly half of those for men. Incidence rates are increasing in most countries, most prominently in Latin America. Although recent mortality trends are stable in many countries, significant declines were observed in Western and Northern Europe, the USA, and Australia. Southern European men appear to have the least favourable RCC mortality trends. Although RCC incidence is still increasing in most countries, stabilisation of mortality trends has been achieved in many highly developed countries. There are marked absolute differences and opposing RCC mortality trends in countries categorised as areas of higher versus lower human development, and these gaps appear to be widening. Renal cell cancer is becoming more commonly diagnosed worldwide in both men and women. Mortality is decreasing in the most developed settings, but not in low- and middle-income countries, where access to and the availability of optimal therapies are likely to be limited. Copyright © 2014 European Association of

A Suitable Approach to Estimate Cancer Incidence in Area without Cancer Registry

International Nuclear Information System (INIS)

Mitton, N.; Colonna, M.; Colonna, M.

2011-01-01

Objective. Use of cancer cases from registries and PMSI claims database to estimate Department-specific incidence of four major cancers. Methods. Case extraction used principal diagnosis then surgery codes. PMSI cases/registry cases ratios for 2004 were modelled then Department-specific incidence for 2007 estimated using these ratios and 2007 PMSI cases. Results. For 2007, only colon-rectum and breast cancer estimations were satisfactorily validated for infra national incidence not ovary and kidney cancers. For breast, the estimated national incidence was 50,578 cases and the incidence rate 98.6 cases per 100,000 person per year. For colon-rectum, incidence was 21,172 in men versus 18,327 in women and the incidence rate 38 per 100,000 versus 24.8. For ovary, the estimated incidence was 4,637 and the rate 8.6 per 100,000. For kidney, incidence was 6,775 in men versus 3,273 in women and the rate 13.3 per 100.000 versus 5.2. Conclusion. Incidence estimation using PMSI patient identifiers proved encouraging though still dependent on the assumption of uniform cancer treatments and coding.

Comparative analysis of the incidence of bladder cancer in the communities of Andalusia, Catalonia and Madrid in 2011.

Science.gov (United States)

Cózar, J M; Miñana, B; Palou-Redorta, J; Medina, R A; de la Rosa-Kehrmann, F; Lozano-Palacio, F; Ribal-Caparrós, M J; Hernández-Fernández, C; Castiñeiras-Fernández, J J; Requena, M J; Moreno-Sierra, J; Carballido-Rodríguez, J; Baena-González, V

2015-09-01

To determine the incidence of bladder cancer (BC) in the autonomous communities that include the largest number of cases in the national hospital BC registry (Andalusia, Catalonia and Madrid) and report the clinical, pathological and diagnostic differences and similarities of BC in these regions. An observational epidemiological study was performed in 2011 in 12 public hospitals with reference population areas according to the National Health System (Spain). Demographic and clinical variables were collected from new cases and relapses, with histopathologic confirmation of BC. The raw incidence rate was calculated using the number of diagnosed cases in all the participating centers compared with the aggregate total population assigned to each center. The raw rates by age and sex were obtained from the National Institute of Statistics (2011) by weighting the assigned population with the distribution by age and sex. The 3 autonomous communities recorded 51% of the 4285 cases included in the national registration, with relapses corresponding to 42.8% of these cases. The raw annual incidence rate for new episodes was 22.6 (95% CI: 20.7; 24.6) in Andalusia, 23.5 (95% CI: 20.9; 26.0) in Catalonia and 22.0 (95% CI: 19.9; 24.1) in Madrid. Except for the larger proportion of smokers and lower tumor grade of lesions in Andalusia, the 3 autonomous communities studied are similar in terms of clinical characteristics, comorbidities, patient symptoms and diagnostic processes for BC. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Nursing diagnoses determined by first year students: a vignette study.

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Hakverdioğlu Yönt, Gülendam; Korhan, Esra Akın; Erdemir, Firdevs; Müller-Staub, Maria

2014-02-01

The study aimed to determine the ability of first year students in identifying nursing diagnoses. In a descriptive evaluation study, an expert-validated vignette containing 18 nursing diagnoses was used. The students determined 15 nursing diagnoses. The highest percentages of diagnoses identified were disturbed sleep pattern and nutrition imbalance. Students also considered medical diagnoses as nursing diagnoses: hypertension and tachycardia. Despite the fact that students were only at the end of their first semester and had limited clinical experience, they successfully identified the majority of nursing diagnoses. Patient case study vignettes are recommended for education. To foster students' knowledge and experience, it is also suggested that evaluating nursing diagnoses in clinical practicals becomes a requirement. © 2013 NANDA International, Inc.

Incidence of type 1 (insulin-dependent) diabetes mellitus in subjects 0-14 years of age in the Comunidad of Madrid, Spain.

Science.gov (United States)

Serrano Ríos, M; Moy, C S; Martín Serrano, R; Minuesa Asensio, A; de Tomás Labat, M E; Zarandieta Romero, G; Herrera, J

1990-07-01

A retrospective, population-based registry was established in the Comunidad of Madrid, Spain (total population: 4,780,572; under age 15: 1,105,243) to investigate the epidemiology of Type 1 (insulin-dependent) diabetes mellitus. Included were all cases diagnosed with diabetes between 1985 and 1988, with age onset less than 15 years, and using insulin at discharge from hospital. Using the capture-recapture method employing hospital records as the primary source and membership files of the Spanish Diabetic Association as the secondary source, the ascertainment was 90%. The overall annual incidence was estimated to be 11.3/100,000 (Poison 95% confidence interval: 10.3-12.4). There was no temporal increase in incidence, nor was there a significant sex difference in incidence rates, either overall or by year. The seasonal onset pattern showed the highest incidence in winter (December-February) and lowest in summer (June-August) (r = 7.36, p less than 0.05). The age-adjusted (world standard) incidence of 10.9/100,000 was inconsistent with the hypothesis of a north-south gradient in diabetes risk.

Increased Frequency of Encopresis in a Child Diagnosed With Attention Deficit/Hyperactivity Disorder and Encopresis After Atomoxetine Use: A Case Report.

Science.gov (United States)

Yektaş, Çiğdem; Cansiz, Mehmet Akif; Tufan, Ali Evren

2016-01-01

Attention deficit hyperactivity disorder (ADHD) is among the most frequently reported coexisting psychiatric conditions in children with encopresis. Some case reports state that atomoxetine-a selective presynaptic norepinephrine reuptake inhibitor-approved for treatment of ADHD is also effective in the treatment of coexisting encopresis. Contrasting those reports, here we present a case diagnosed with ADHD and secondary encopresis without constipation whose encopretic symptoms increased after atomoxetine treatment and discuss possible mechanisms.

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.

Two cases of cystic lesions in the parotid region diagnosed by CT sialogram

International Nuclear Information System (INIS)

Kubo, Masahiko; Ukai, Kotaro; Itoh, Hiroshi; Miyoshi, Yasuro; Itoh, Yukiko; Kohdera, Urara; Taki, Norio; Furukawa, Yuichi.

1985-01-01

This is a case report of two patients with cystic lesions in the parotid region. The diagnostic value of CT sialogram is discussed. A 62-year-old male had a swelling in the left parotid region which felt cystic on manual palpation. A CT sialogram clearly demonstrated a cystic mass superficial to the parotid gland. Histologically, the mass was an epidermoid cyst. A 9-year-old male had pain and swelling in the right parotid region which was not reduced by antibiotic therapy. An extraparotid abscess was diagnosed by CT sialogram 14 days after the onset. CT sialogram is effective in differentiating intrinsic from extrinsic parotid lesions and also shows the relationship of the tumor mass to the facial nerve and helps to differentiate between benign and malignant neoplasms. (author)

A case of acute orbital myositis which was difficult to diagnose at first

International Nuclear Information System (INIS)

Yamamoto, Kiyoshi; Terabayashi, Tadasu; Mori, Hiroshi; Niida, Hirohito; Sugiyama, Yoshiaki; Nakagawa, Masato

1988-01-01

We report a case of acute orbital myositis. A 61-year-old woman exhibited acute orbital pain, diplopia, and left proptosis. Examination revealed a 5-mm left proptosis, left chemosis, and limitations in all directions of the movement of the left eye. Visual acuity was unimpaired, however, and the neurological examination was otherwise normal. CT demonstrated a left inferior orbital mass. We suspected an acute orbital pseudotumor based on the rapid onset and the clinical symptoms. We treated her with systemic corticosteroids. Four weeks later CT documented a reduced left orbital mass; there seemed to be left only an inferior rectus muscle enlargement. We diagnosed acute orbital myositis, a subgroup of orbital pseudotumors, based upon the rapid clinical presentation, the CT features, and the resolution after treatment with systemic corticosteroids. (author)

Improvement in 5-year mortality in incident rheumatoid arthritis compared with the general population-closing the mortality gap.

Science.gov (United States)

Lacaille, Diane; Avina-Zubieta, J Antonio; Sayre, Eric C; Abrahamowicz, Michal

2017-06-01

Excess mortality in rheumatoid arthritis (RA) is expected to have improved over time, due to improved treatment. Our objective was to evaluate secular 5-year mortality trends in RA relative to general population controls in incident RA cohorts diagnosed in 1996-2000 vs 2001-2006. We conducted a population-based cohort study, using administrative health data, of all incident RA cases in British Columbia who first met RA criteria between January 1996 and December 2006, with general population controls matched 1:1 on gender, birth and index years. Cohorts were divided into earlier (RA onset 1996-2000) and later (2001-2006) cohorts. Physician visits and vital statistics data were obtained until December 2010. Follow-up was censored at 5 years to ensure equal follow-up in both cohorts. Mortality rates, mortality rate ratios and HRs for mortality (RA vs controls) using proportional hazard models adjusting for age, were calculated. Differences in mortality in RA versus controls between earlier and later incident cohorts were tested via interaction between RA status (case/control) and cohort (earlier/later). 24 914 RA cases and controls experienced 2747 and 2332 deaths, respectively. Mortality risk in RA versus controls differed across incident cohorts for all-cause, cardiovascular diseases (CVD) and cancer mortality (interactions pyears was observed in people with RA onset before, but not after, 2000. 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/.

Risk factors for breast cancer in a population with high incidence rates

International Nuclear Information System (INIS)

Wrensch, Margaret; Peskin-Mentzer, Roni; Quesenberry, Charles P Jr; Souders-Mason, Virginia; Spence, Linda; Suzuki, Marisa; Gould, Mary; Chew, Terri; Farren, Georgianna; Barlow, Janice; Belli, Flavia; Clarke, Christina; Erdmann, Christine A; Lee, Marion; Moghadassi, Michelle

2003-01-01

This report examines generally recognized breast cancer risk factors and years of residence in Marin County, California, an area with high breast cancer incidence and mortality rates. Eligible women who were residents of Marin County diagnosed with breast cancer in 1997–99 and women without breast cancer obtained through random digit dialing, frequency-matched by cases' age at diagnosis and ethnicity, participated in either full in-person or abbreviated telephone interviews. In multivariate analyses, 285 cases were statistically significantly more likely than 286 controls to report being premenopausal, never to have used birth control pills, a lower highest lifetime body mass index, four or more mammograms in 1990–94, beginning drinking after the age of 21, on average drinking two or more drinks per day, the highest quartile of pack-years of cigarette smoking and having been raised in an organized religion. Cases and controls did not significantly differ with regard to having a first-degree relative with breast cancer, a history of benign breast biopsy, previous radiation treatment, age at menarche, parity, use of hormone replacement therapy, age of first living in Marin County, or total years lived in Marin County. Results for several factors differed for women aged under 50 years or 50 years and over. Despite similar distributions of several known breast cancer risk factors, case-control differences in alcohol consumption suggest that risk in this high-risk population might be modifiable. Intensive study of this or other areas of similarly high incidence might reveal other important risk factors proximate to diagnosis

Diagnosing delirium in very elderly intensive care patients.

Science.gov (United States)

Heriot, Natalie R; Levinson, Michele R; Mills, Amber C; Khine, Thinn Thinn; Gellie, Anthea L; Sritharan, Gaya

2017-02-01

To determine the incidence of delirium in elderly intensive care patients and to compare incidence using two retrospective chart-based diagnostic methods and a hospital reporting measure (ICD-10). Retrospective study. An ICU in a large metropolitan private hospital in Melbourne, Australia. English-speaking participants (n=348) 80+ years, admitted to ICU for >24 hours. Medical files of ICU patients admitted October 2009-October 2012 were retrospectively assessed for delirium using the Inouye chart review method, DSM-IV diagnostic criteria and ICD-10 coding data. General patient characteristics, first onset of delirium symptoms, source of delirium information, administration of delirium medication, hospital and ICU length of stay, 90 day mortality were documented. Delirium was found in 11-29% of patients, the highest incidence identified by chart review. Patients diagnosed with delirium had higher 90 day mortality, and those meeting criteria for all three methods had longer hospital and ICU length of stay. ICU delirium in the elderly is often under-reported and strategies are needed to improve staff education and diagnosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

The incidence of type 1 diabetes in Republic of Srpska (Bosnia and Herzegovina) and Slovenia in the period 1998-2010.

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Radosevic, Bojana; Bukara-Radujkovic, Gordana; Miljkovic, Vesna; Pejicic, Snjezana; Bratina, Natasa; Battelino, Tadej

2013-06-01

To establish and compare the incidence and trends of type 1 diabetes mellitus (T1DM) in Republic of Srpska and Slovenia in age group 0-18 yr from 1998 to 2010. The subjects (413 newly diagnosed T1DM patients in the Republic of Srpska and 664 in Slovenia) were grouped into the age groups: 0-4, 5-9, 10-14, and 15-18 yr. Confidence intervals (CI) for crude incidence rates were estimated assuming numbers of cases were counts from the Poisson distribution. Gender and age-specific standardization was done according to the EURODIAB criteria. Statistical analysis used Poisson-regression models to analyze difference rate between countries and to investigate the incidence trend. Case ascertainment was estimated to be 99.95% for the Republic of Srpska and 100% for Slovenia by using the capture-recapture method. The standardized incidence of T1DM for age group 0-18 yr in the Republic of Srpska was 7.5/100 000/yr (95% CI: 6.8-8.3). For the same period and the same age group incidence in Slovenia was 12.5/100 000/yr (95% CI: 11.5-13.5). Annual increase in the incidence in the Republic of Srpska was 2.3% (95% CI: -0.3 to 5.0%), whereas in Slovenia 4.3% (95% CI: 2.2-6.5%). The incidence for age group 0-18 yr standardized to the world population is remarkably higher in Slovenia than in the Republic of Srpska. Further follow-up and investigations are needed to explain the high difference in incidence of T1DM between the two geographically related countries. © 2012 John Wiley & Sons A/S.

Childhood onset diagnoses in a case series of teens at clinical high risk for psychosis.

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Mazzoni, Paola; Kimhy, David; Khan, Shamir; Posner, Kelly; Maayan, Lawrence; Eilenberg, Mara; Messinger, Julie; Kestenbaum, Clarice; Corcoran, Cheryl

2009-12-01

REASONS: Schizophrenia is typically an adult neurodevelopmental disorder that has its antecedents in childhood and adolescence. Little is known about disorders "usually first diagnosed in infancy, childhood and adolescence" (e.g., childhood-onset disorders) in "prodromal" teens at heightened clinical risk for psychotic disorder. Childhood-onset disorders were prevalent in putatively prodromal teens, including anxiety and disruptive disorders, attention-deficit/hyperactivity disorder (ADHD), and, surprisingly, elimination disorders. These may reflect developmental antecedents in psychotic disorders such as schizophrenia. A case series of 9 teens (ages 13-17) identified as prodromal to psychosis were evaluated with the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). Childhood-onset diagnoses commonly endorsed (threshold or subthreshold) included ADHD (5/9), oppositional defiant disorder (5/9), enuresis or encopresis (4/9), conduct disorder (2/9), separation anxiety (3/9), and transient tic disorder (2/9). Enuresis was identified in 3 of the 4 older teens (ages 15-17). An understanding of the childhood-onset disorders that occur in teens at risk for psychotic illnesses, such as schizophrenia, can shed light on the pathophysiology of schizophrenia and potentially inform early identification and intervention.

Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study.

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Wang, Zhiqiang; Hoy, Wendy E; Si, Damin

2010-08-17

Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among Aboriginal participants in a remote community. Six hundred and eighty six (686) Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI). One hundred and twenty four (124) new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3), adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5) for people who were overweight and 4.7 (95% CI: 3.0, 7.4) for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.

Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study

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Wang Zhiqiang

2010-08-01

Full Text Available Abstract Background Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG and impaired glucose tolerance (IGT among Aboriginal participants in a remote community. Methods Six hundred and eighty six (686 Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI. Results One hundred and twenty four (124 new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3, adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5 for people who were overweight and 4.7 (95% CI: 3.0, 7.4 for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Conclusions Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.

Targeted/exome sequencing identified mutations in ten Chinese patients diagnosed with Noonan syndrome and related disorders

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Shanshan Xu

2017-10-01

Full Text Available Abstract Background Noonan syndrome (NS and Noonan syndrome with multiple lentigines (NSML are autosomal dominant developmental disorders. NS and NSML are caused by abnormalities in genes that encode proteins related to the RAS-MAPK pathway, including PTPN11, RAF1, BRAF, and MAP2K. In this study, we diagnosed ten NS or NSML patients via targeted sequencing or whole exome sequencing (TS/WES. Methods TS/WES was performed to identify mutations in ten Chinese patients who exhibited the following manifestations: potential facial dysmorphisms, short stature, congenital heart defects, and developmental delay. Sanger sequencing was used to confirm the suspected pathological variants in the patients and their family members. Results TS/WES revealed three mutations in the PTPN11 gene, three mutations in RAF1 gene, and four mutations in BRAF gene in the NS and NSML patients who were previously diagnosed based on the abovementioned clinical features. All the identified mutations were determined to be de novo mutations. However, two patients who carried the same mutation in the RAF1 gene presented different clinical features. One patient with multiple lentigines was diagnosed with NSML, while the other patient without lentigines was diagnosed with NS. In addition, a patient who carried a hotspot mutation in the BRAF gene was diagnosed with NS instead of cardiofaciocutaneous syndrome (CFCS. Conclusions TS/WES has emerged as a useful tool for definitive diagnosis and accurate genetic counseling of atypical cases. In this study, we analyzed ten Chinese patients diagnosed with NS and related disorders and identified their correspondingPTPN11, RAF1, and BRAF mutations. Among the target genes, BRAF showed the same degree of correlation with NS incidence as that of PTPN11 or RAF1.

Did the Chernobyl atomic plant accident have an influence on the incidence of thyroid carcinoma in the province of Olsztyn?

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Bandurska-Stankiewicz, Elżbieta; Aksamit-Białoszewska, Ewa; Stankiewicz, Aleksander; Shafie, Danuta

2010-01-01

A study of incidence rates of thyroid carcinoma was conducted in Olsztyn province from 1 January 1994 to 31 December 2003 within its former boundaries, in spite of Poland's new administrative division. The criteria for register entry were as follows: residence in Olsztyn province, newly-diagnosed case of thyroid malignancy in the given calendar year, and histopathological verification in the Department of Anatomical Pathology of the District Specialist Hospital in Olsztyn. The study of selected risk factors comprised patients included in the register of thyroid carcinoma. For that purpose a questionnaire was prepared which covered information about the Chernobyl accident: place of residence, time of carcinoma diagnosis after the accident, and iodine prophylaxis during the accident. The control group consisted of 589 healthy subjects selected based on age and place of residence. In the years 1993-2003, 462 (395 women and 67 men) cases of thyroid cancer were registered. The questionnaire study comprised 297 patients with thyroid carcinoma and 589 healthy subjects. Study subjects from both the affected and control groups stayed mainly in their place of residence during the Chernobyl accident (97.28% v. 94.24%). Thyroid carcinoma was diagnosed on average 13.58 ± 2.61 years after irradiation. There were no significant differences in iodine prophylaxis during the Chernobyl accident. Lugol's solution was given to 31% of patients and 34% of healthy respondents. 1. It cannot be stated that the Chernobyl disaster had any influence on the incidence rate of thyroid carcinoma in the province of Olsztyn. 2. Iodine prophylaxis using Lugol's solution could have an influence on lack of significant increase of the thyroid carcinoma incidence rate in the age group 1-18 years.

Trisomy 9 Mosaicism Diagnosed In Utero

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Hironori Takahashi

2010-01-01

Full Text Available We present three cases of trisomy 9 mosaicism diagnosed by amniocentesis with ongoing pregnancies after referral to our center due to fetal abnormalities. Two cases were associated with severe fetal growth restriction (FGR, each of which resulted in an intrauterine fetal demise (IUFD in the third trimester. The other case involved mild FGR with a congenital diaphragmatic hernia and resulted in a live birth with severe development delay. A major prenatal finding of trisomy 9 mosaicism is FGR. Fetuses with trisomy 9 mosaicism can rarely survive in the case of severe FGR.

Gallbladder cancer: incidence and survival in a high-risk area of Chile.

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Bertran, Enriqueta; Heise, Katy; Andia, Marcelo E; Ferreccio, Catterina

2010-11-15

We assessed population incidence rates 1998-2002 and 5-year survival rates of 317 primary gallbladder cancer (GBC) entered in the population-based cancer registry in Valdivia. We analyzed GBC incidence (Poisson regression) and GBC survival (Cox regression). Cases were identified by histology (69.4%), clinical work-up (21.8%), or death certificate only (8.8%). Main symptoms were abdominal pain (82.8%), jaundice (53.6%) nausea (42.6%), and weight loss (38.2%); at diagnosis, 64% had Stage TNM IV. In the period, 4% of histopathological studies from presumptively benign cholecystectomies presented GBC. GBC cases were mainly females (76.0%), urban residents (70.3%), Hispanic (83.7%) of low schooling Mapuche 25.0, Hispanic 16.2 (p = 0.09). The highest SIRs were in Mapuche (269.2) and Hispanic women (199.6) with 8 years of schooling. Low schooling, female and urban residence were independent risk factors. By December 31, 2007, 6 (1.9%) cases were living, 280 (88.3%) died from GBC, 32 (10.1%) were lost of follow-up. Kaplan Meier Global 5-year survival was: 10.3%, 85% at stage I and 1.9% at stage IV; median survival: 3.4 months. Independent poor prognostic factors were TNM IV, jaundice and nonincidental diagnoses. Our results suggest that women of Mapuche ancestry with low schooling (>50 years) are at the highest risk of presenting and dying from GBC and should be the target for early detection programs.

Pulmonary symptoms and diagnoses are associated with HIV in the MACS and WIHS cohorts.

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Gingo, Matthew R; Balasubramani, Goundappa K; Rice, Thomas B; Kingsley, Lawrence; Kleerup, Eric C; Detels, Roger; Seaberg, Eric C; Greenblatt, Ruth M; Holman, Susan; Huang, Laurence; Sutton, Sarah H; Bertolet, Marnie; Morris, Alison

2014-04-30

Several lung diseases are increasingly recognized as comorbidities with HIV; however, few data exist related to the spectrum of respiratory symptoms, diagnostic testing, and diagnoses in the current HIV era. The objective of the study is to determine the impact of HIV on prevalence and incidence of respiratory disease in the current era of effective antiretroviral treatment. A pulmonary-specific questionnaire was administered yearly for three years to participants in the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS). Adjusted prevalence ratios for respiratory symptoms, testing, or diagnoses and adjusted incidence rate ratios for diagnoses in HIV-infected compared to HIV-uninfected participants were determined. Risk factors for outcomes in HIV-infected individuals were modeled. Baseline pulmonary questionnaires were completed by 907 HIV-infected and 989 HIV-uninfected participants in the MACS cohort and by 1405 HIV-infected and 571 HIV-uninfected participants in the WIHS cohort. In MACS, dyspnea, cough, wheezing, sleep apnea, and incident chronic obstructive pulmonary disease (COPD) were more common in HIV-infected participants. In WIHS, wheezing and sleep apnea were more common in HIV-infected participants. Smoking (MACS and WIHS) and greater body mass index (WIHS) were associated with more respiratory symptoms and diagnoses. While sputum studies, bronchoscopies, and chest computed tomography scans were more likely to be performed in HIV-infected participants, pulmonary function tests were no more common in HIV-infected individuals. Respiratory symptoms in HIV-infected individuals were associated with history of pneumonia, cardiovascular disease, or use of HAART. A diagnosis of asthma or COPD was associated with previous pneumonia. In these two cohorts, HIV is an independent risk factor for several respiratory symptoms and pulmonary diseases including COPD and sleep apnea. Despite a higher prevalence of chronic respiratory symptoms

Incidence and clinical characteristics of ciguatera fish poisoning in Guadeloupe (French West Indies) between 2013 and 2016: a retrospective cases-series.

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Boucaud-Maitre, Denis; Vernoux, Jean-Paul; Pelczar, Stéphane; Daudens-Vaysse, Elise; Aubert, Lyderic; Boa, Sylvie; Ferracci, Serge; Garnier, Robert

2018-02-15

This retrospective case study analysed the incidence and symptoms of ciguatera fish poisoning (ciguatera) in Guadeloupe (French West Indies) between 2013 and 2016. Cases attending the emergency departments of the two public hospitals and the reports received by the regional health authority in charge of monitoring (ARS) were compiled. Two hundred and thirty-four cases of poisoning were observed, with a mean annual incidence of 1.47/10,000 (95% CI): 1.29-1.66), i.e 5 times higher than the previously reported incidence (1996-2006). The main species described as being responsible for poisoning were fish from the Carangidae family (n = 47) (jack), followed by fish from the Lutjanidae family (n = 27) (snapper), Serranidae family (n = 15) (grouper), Sphyraenidae family (n = 12) (barracuda), and Mullidae family (n = 12) (goatfish). One case of lionfish ciguatera was observed. 93.9% of patients experienced gastrointestinal symptoms, 76.0% presented neurological signs (mainly paresthesia, dysesthesia and pruritus) and 40.3% presented cardiovascular symptoms (bradycardia and/or hypotension). A high frequency (61.4%) of hypothermia (body temperature ciguatera poisoning throughout the Caribbean region must be improved, notably after reef disturbance due to Irma and Maria major cyclones.

A Case-control Study of Diphtheria in the High Incidence City of Hyderabad, India.

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Allam, Ramesh Reddy; Uthappa, Chengappa Kechamada; Duerst, Rebecca; Sorley, Evan; Udaragudi, Prasada Rao; Kampa, Shankar; Dworkin, Mark S

2016-03-01

India accounts for approximately 72% of reported diphtheria cases globally, the majority of which occur in the state of Andhra Pradesh. The aim of this study is to better understand lack of knowledge on diphtheria vaccination and to determine factors associated with diphtheria and low knowledge and negative attitudes. We performed a 1:1 case-control study of hospitalized diphtheria cases in Hyderabad. Eligible case patients were 10 years of age or older, resided within the city of Hyderabad and were diagnosed with diphtheria per the case definition. Patients admitted to the hospital for nonrespiratory communicable diseases and residing in the same geographic region as that of cases were eligible for enrolment as controls : There were no statistical differences in disease outcome by gender, education, economic status and mean room per person sleeping in the house in case and control subjects. Not having heard of diphtheria (adjusted odds ratio: 3.56; 95% confidence intervals: 1.58-8.04] and not believing that vaccines can prevent people from getting diseases (adjusted odds ratio: 3.99; 95% confidence intervals: 1.18-13.45) remained significantly associated with diphtheria on multivariate analysis. To reduce the burden of diphtheria in India, further efforts to educate the public about diphtheria should be considered.

The Correlation Between Indoor Air Pollution with the Incident of Toddler’s Pneumonia

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Ni Nyoman Dayu Mahalastri

2014-09-01

Full Text Available ABSTRACT Pneumonia is a serious health problem in the world, including in Indonesia. Based on the results of Riskesdas 2007, pneumonia was the second ranking cause of death in the proportion of children aged 1–4 years and is under the diarrhea which ranks first. Environmental factors or conditions of the house, especially the air quality in the house is said to be one of the factors that can trigger pneumonia in infants. This study was conducted to determine the correlation of indoor air quality factors with the incidence of toddler’s pneumonia. Type of this study is observational analytic and use case control design. The population of case group was all toddlers who become visitors Mojo Health Center in January 2014 until March 2014 and was diagnosed with pneumonia. While population of control group was all toddlers who become visitors Mojo Health Center in January 2014 until March 2014 and was diagnosed with diseases other than pneumonia. The number of respondents in this study were 60 respondents. The selection of the sample with simple random sampling method. The variables studied were cigarette smoke exposure in the house, size of ventilation and residential density. The results of the analysis using Epi Info StatCalc indicate that exposure to cigarette smoke in the house (OR = 4.00, size of ventilation (OR = 4.03, and residential density (OR = 4.38 has an correlation with incidence of toddler’s pneumonia. It is expected that the public can avoid air pollution in the house in order to prevent toddlers from pneumonia. Keywords: cigarette smoke, size of ventilation, residential density, air quality,                 toddler’s Pneumonia

Neighborhood disadvantage and racial disparities in colorectal cancer incidence: a population-based study in Louisiana.

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Danos, Denise M; Ferguson, Tekeda F; Simonsen, Neal R; Leonardi, Claudia; Yu, Qingzhao; Wu, Xiao-Cheng; Scribner, Richard A

2018-05-01

Colorectal cancer (CRC) continues to demonstrate racial disparities in incidence and survival in the United States. This study investigates the role of neighborhood concentrated disadvantage in racial disparities in CRC incidence in Louisiana. Louisiana Tumor Registry and U.S. Census data were used to assess the incidence of CRC diagnosed in individuals 35 years and older between 2008 and 2012. Neighborhood concentrated disadvantage index (CDI) was calculated based on the PhenX Toolkit protocol. The incidence of CRC was modeled using multilevel binomial regression with individuals nested within neighborhoods. Our study included 10,198 cases of CRC. Adjusting for age and sex, CRC risk was 28% higher for blacks than whites (risk ratio [RR] = 1.28; 95% confidence interval [CI] = 1.22-1.33). One SD increase in CDI was associated with 14% increase in risk for whites (RR = 1.14; 95% CI = 1.10-1.18) and 5% increase for blacks (RR = 1.05; 95% CI = 1.02-1.09). After controlling for differential effects of CDI by race, racial disparities were not observed in disadvantaged areas. CRC incidence increased with neighborhood disadvantage and racial disparities diminished with mounting disadvantage. Our results suggest additional dimensions to racial disparities in CRC outside of neighborhood disadvantage that warrants further research. Copyright © 2018 Elsevier Inc. All rights reserved.

Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany

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Garbe Edeltraut

2011-08-01

Full Text Available Abstract Background Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM. Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. Methods We analysed hospitalisation diagnoses for oesophageal bleeding (OB and upper gastrointestinal bleeding (UGIB from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided or "unspecific" (origin of bleeding not provided coding. We studied regional (former East versus West Germany differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Results Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32 for specific and 0.67 (95% CI 0.60-0.74 for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51 for specific and 0.83 (95% CI 0.80-0.87 for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. Conclusions During the study

Clinical, endoscopic and histopathological profiles of parasitic duodenitis cases diagnosed by upper digestive endoscopy

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Reinaldo Benevides dos Santos

2011-12-01

Full Text Available CONTEXT: Intestinal parasites induce detectable histopathological changes, which have been studied in groups with known diagnosis of parasitic disease. There is no available study with a larger base without previous diagnosis. OBJECTIVE: To describe clinical and histopathological findings of parasitosis diagnosed by endoscopic biopsy in patients submitted to upper digestive endoscopy. METHODS: Recorded biopsies archive at "Complexo Hospitalar Professor Edgar Santos" , a general teaching Hospital in the state of Bahia, Northeast Brazil, from January 1995 to January 2009, were reviewed. One thousand ten duodenal biopsy reports were found. Reports positive for parasites had their specimens reviewed and photographed. All blocks of biopsy selected as case were retrieved and reviewed by an experienced pathologist. Clinical, laboratorial and endoscopic data were collected. RESULTS: Eleven biopsies showed parasites, including cases of Cryptosporidium sp. and Strongyloides stercoralis. Vomiting (91%, abdominal pain (78%, diarrhea (78% and weight loss (78% were usual symptoms. Seventy-five percent had duodenal mucosa changes on endoscopy, while 25% have no changes. Anemia and low serum albumin were important laboratorial data. HIV infection association was observed. Villus atrophy and reactive epithelium were usual in Strongyloides cases. CONCLUSIONS: No endoscopic or histopathologic finding was pathognomonic. One percent of duodenal endoscopic biopsies showed parasites.

The incidence of eating disorders in a Danish register study: Associations with suicide risk and mortality

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Zerwas, Stephanie; Tidselbak Larsen, Janne; Petersen, Liselotte

2015-01-01

Our aim was to characterize the incidence rates and cumulative incidence of anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS), and examine associations among eating disorder diagnoses, suicide attempts, and mortality. Individuals born in Denmark...

Kryptorchismus bei Hund und Katze - Definition, Prävalenz, Diagnose und Therapie

DEFF Research Database (Denmark)

Goericke-Pesch, Sandra Kathrin; Wehrend, Axel

2013-01-01

Cryptorchidism is defined as maldescensus testis. This means that one or both testicles are not located in the scrotum at six months of age, but abdominal, inguinal or ectopic. Ectopic testes can be localised suprafascially, perineally or crurally. Physiologically, descensus testis is finished...... about 35-40 days after birth in the dog and at the time of birth in the torn. Delayed descent is diagnosed when testis are located in the scrotum at a later point of time. Whereas cryptorchidism in the dog is undoubtedly multifactorial with breed-specific involvement of one or more genes (mono......-/polygenic), epigenetic and environment-associated factors, heredity in the cat is still unclear although an increased incidence is reported in Persians, Ragdolls and European Shorthair. The diagnosis can be confirmed by palpation (in case of inguinal testes) or by ultrasound. GnRH and hCG stimulation tests can be used...

Incidence, clinical presentation, and outcome of progressive multifocal leukoencephalopathy in HIV-infected patients during the highly active antiretroviral therapy era: a nationwide cohort study

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Engsig, Frederik Neess; Hansen, Ann-Brit Eg; Omland, Lars Haukali

2009-01-01

BACKGROUND: Human immunodeficiency virus (HIV) infection predisposes to progressive multifocal leukoencephalopathy (PML). Here, we describe the incidence, presentation, and prognosis of PML in HIV-1-infected patients during the period before highly active antiretroviral therapy (HAART) (1995...... at presentation and follow-up. RESULTS: Among 4,649 patients, we identified 47 patients with PML. The incidence rates were 3.3, 1.8, and 1.3 cases per 1000 person-years at risk in 1995-1996, 1997-1999, and 2000-2006, respectively. The risk of PML was significantly associated with low CD4(+) cell count, and 47......% of cases were diagnosed by means of brain biopsy or polymerase chain reaction analysis for JC virus. The predominant neurological symptoms at presentation were coordination disturbance, cognitive defects, and limb paresis. Thirty-five patients died; the median survival time was 0.4 years (95% confidence...

Incidence of eating disorders in Danish psychiatric secondary healthcare 1970-2008

DEFF Research Database (Denmark)

Gammelmark, Carina; Jensen, Signe Ow; Plessen, Kerstin J

2015-01-01

OBJECTIVE: Is an increased focus on eating disorders during the past few decades reflected by increasing occurrence in the psychiatric health service system. METHOD: All first-time diagnoses of eating disorders identified in the Danish Central Psychiatric Research Register 1970-2008 constitute...... the present research database. Age-standardized rates per 100,000 inhabitants were calculated and autoregressive models were fitted for males and females separately as well as for in- and outpatients. RESULTS: The incidence of eating disorders diagnosed in Danish psychiatric secondary healthcare has increased...... considerably during a nearly 40-year period of observation both within the general category of eating disorders and also specifically for anorexia nervosa. The steepest increase is seen within females aged 15-19 years, where the highest incidences are also found. Anorexia nervosa constitutes the vast majority...

Unravelling the incidence and etiology of chronic idiopathic axonal polyneuropathy

NARCIS (Netherlands)

Visser, N.A.

2016-01-01

Chronic idiopathic axonal polyneuropathy (CIAP) is a sensory or sensorimotor polyneuropathy that has a slowly progressive course without severe disability. CIAP is diagnosed in a significant proportion of patients with polyneuropathy, but precise figures on the incidence of polyneuropathy and CIAP

Incidence of status epilepticus in southern Europe: a population study in the health district of Ferrara, Italy.

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Govoni, Vittorio; Fallica, Elisa; Monetti, Vincenza Cinzia; Guerzoni, Franco; Faggioli, Raffaella; Casetta, Ilaria; Granieri, Enrico

2008-01-01

The epidemiologic features of status epilepticus (SE) are still in the course of definition. We carried out an intensive survey of multiple sources of case material in the resident population of the health district of Ferrara, Italy, in 2003. Information was collected on age, gender, duration, seizure type and etiology of SE. The age- adjusted annual incidence rate of SE was 27.2/100,000 (95% CI = 19.4-36.9) and it was higher in men (41.7/100,000, 95% CI = 26.9-61.7) than in women (12.3/100,000, 95% CI = 6.9-20.4). The incidence was higher in the elderly (older than 60 years, 39.2/100,000) than in younger adults in the age group 20-59 years (14.7/100,000). The age-specific incidence showed a bimodal distribution peaking in the youngest (0-4 years) and in the oldest age group (75+ years). Cerebrovascular disease was the most frequent etiologic factor (45%). Epilepsy had previously been diagnosed in 40% of the patients. The case fatality was 5%. The study found a higher incidence of SE than that expected on the basis of the previous European studies suggesting that the risk of SE in southern Europe is higher and more similar to that estimated in population studies in the United States. The case fatality was lower than that reported in previous South-European population studies despite the similar clinical features of the patients. Indirect evidence suggests that several factors related to the SE management could have positively influenced the outcome. Copyright 2007 S. Karger AG, Basel.

ADHD: the impact when not diagnosed

OpenAIRE

Souza,Isabella de; Mattos,Paulo; Pina,Camila; Fortes,Didia

2008-01-01

ADHD is a highly prevalent disorder in childhood with social, academic and familial difficulties when not diagnosed and treated correctly. The aim of this case report is to demonstrate the impairment of ADHD among generations of the same family.

Pulmonary veno-occlusive disease Report of case and revision of the literature

International Nuclear Information System (INIS)

Jimenez Q, Andres; Palacios, Diana; Camacho D, Fidel

2008-01-01

The real incidence of veno-occlusive pulmonary disease (VOPD) is unknown because it is largely under diagnosed or is not classified as primary pulmonary hypertension, being in fact a variant of the primary disease, primarily affecting post-capillary pulmonary vasculature. It is also known as isolated pulmonary venous sclerosis, obstructive disease of the pulmonary veins or primary pulmonary hypertension of the venous type. VOPD is the result of multiple aggressors associated to a great variety of risk factors. The diagnosis of the disease requires clinical, radiological and pathological features. Vasodilators, immunosuppressants, anticoagulation and oxygen have been proposed as treatments with a poor prognosis, and with reported survival limited by the scarce reporting of cases. We report a case of veno-occlusive pulmonary disease which was diagnosed in this institution.

Kansas City Cardiomyopathy Questionnaire Score Is Associated With Incident Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure: Chronic Renal Insufficiency Cohort Study.

Science.gov (United States)

Mishra, Rakesh K; Yang, Wei; Roy, Jason; Anderson, Amanda H; Bansal, Nisha; Chen, Jing; DeFilippi, Christopher; Delafontaine, Patrice; Feldman, Harold I; Kallem, Radhakrishna; Kusek, John W; Lora, Claudia M; Rosas, Sylvia E; Go, Alan S; Shlipak, Michael G

2015-07-01

Chronic kidney disease is a risk factor for heart failure (HF). Patients with chronic kidney disease without diagnosed HF have an increased burden of symptoms characteristic of HF. It is not known whether these symptoms are associated with occurrence of new onset HF. We studied the association of a modified Kansas City Cardiomyopathy Questionnaire with newly identified cases of hospitalized HF among 3093 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study who did not report HF at baseline. The annually updated Kansas City Cardiomyopathy Questionnaire score was categorized into quartiles (Q1-4) with the lower scores representing the worse symptoms. Multivariable-adjusted repeated measure logistic regression models were adjusted for demographic characteristics, clinical risk factors for HF, N-terminal probrain natriuretic peptide level and left ventricular hypertrophy, left ventricular systolic and diastolic dysfunction. Over a mean (±SD) follow-up period of 4.3±1.6 years, there were 211 new cases of HF hospitalizations. The risk of HF hospitalization increased with increasing symptom quartiles; 2.62, 1.85, 1.14, and 0.74 events per 100 person-years, respectively. The median number of annual Kansas City Cardiomyopathy Questionnaire assessments per participant was 5 (interquartile range, 3-6). The annually updated Kansas City Cardiomyopathy Questionnaire score was independently associated with higher risk of incident HF hospitalization in multivariable-adjusted models (odds ratio, 3.30 [1.66-6.52]; P=0.001 for Q1 compared with Q4). Symptoms characteristic of HF are common in patients with chronic kidney disease and are associated with higher short-term risk for new hospitalization for HF, independent of level of kidney function, and other known HF risk factors. © 2015 American Heart Association, Inc.

Trends in incidence, case-fatality and recurrence of myocardial infarction in the Danish MONICA population 1982-1991

DEFF Research Database (Denmark)

Davidsen, M; Brønnum-Hansen, H; Jørgensen, Torben

2001-01-01

BACKGROUND: Growing awareness of risk factors for myocardial infarction (MI), continuous mass campaigns on lifestyle factors, increasing use of heart rehabilitation and improved treatment should imply decreases in the incidence, case-fatality and recurrence rates of MI. The purpose of the study...

Cancer in adolescents: Incidences and trends during 1995-2009 in Taiwan.

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Hung, Giun-Yi; Chen, Chao-Chun; Horng, Jiun-Lin; Lin, Li-Yih

2016-03-01

This study aimed to describe cancer incidence rates and trends specifically for adolescents aged 15-19 years during 1995-2009 in Taiwan. The incidence counts and census data were obtained from the population-based Taiwan Cancer Registry. During the 15-year study period, 4122 adolescents were diagnosed with cancer. The overall incidence rate was 155.2 per million person-years. Other epithelial tumors were the most frequently diagnosed cancer group (23.7%), followed by leukemias (18.0%) and lymphomas (13.9%). When compared to rates in Western countries, a significantly low rate of lymphomas was found. Moreover, rates of the subtypes of melanomas and nasopharyngeal carcinomas being 1/10- and 4-times rates in Western countries were the most striking variations. During 1995-2009, the overall rate of adolescent cancer did not significantly change. However, the most significant upward and declining trends in incidence rates were found for male germ cell neoplasms (annual percent change, APC, 6.4%) and hepatic tumors (APC, -11.1%), respectively. Further investigation and enhancement of the public discourse of possible lifestyle and environmental risk factors associated with increasing trends of certain adolescent cancers should be carried out in Taiwan. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Blunt traumatic rupture of the pericardium with cardiac herniation: two cases diagnosed using computed tomography

International Nuclear Information System (INIS)

Schir, F.; Thony, F.; Coulomb, M.; Chavanon, O.; Perez-Moreira, I.; Blin, D.

2001-01-01

Traumatic ruptures of the pericardium with cardiac herniation are infrequent, and their radiological pattern little familiar, so that they are often missed preoperatively. Few reports have emphasised the use of a CT scan as a tool for diagnosis and CT scan signs have not been well documented. We report on two cases of traumatic herniation of the heart for which a CT scan brought a major contribution for diagnosis. We describe the presence of an empty pericardial sac on CT slices which allowed us to diagnose the cardiac herniation. These observations demonstrate that CT scans can contribute to the diagnosis of pericardial rupture with cardiac herniation. (orig.)

Where Lies the Fault in Diagnosing Dhat Syndrome among Females? Understanding through a Case Study.

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Kar, Sujita Kumar; Singh, Amit

2017-01-01

Dhat syndrome is a culture-bound syndrome of South-East Asia, common in young men. However, similar entity has also been described in female patients who attribute their symptoms to nonpathological or physiological vaginal discharge. The current diagnostic system for psychiatric illnesses does not encompass Dhat syndrome in females, and so these group of patients receive alternative diagnoses such as somatoform disorder or depression. As a result of which the focus of unique Dhat syndrome-centered management gets weakened, affecting the clinical outcome. This case study focuses on the diagnostic dilemmas related to Dhat syndrome in females and pitfalls in the current diagnostic system.

Associations among ancestry, geography and breast cancer incidence, mortality, and survival in Trinidad and Tobago.

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Warner, Wayne A; Morrison, Robert L; Lee, Tammy Y; Williams, Tanisha M; Ramnarine, Shelina; Roach, Veronica; Slovacek, Simeon; Maharaj, Ravi; Bascombe, Nigel; Bondy, Melissa L; Ellis, Matthew J; Toriola, Adetunji T; Roach, Allana; Llanos, Adana A M

2015-11-01

Breast cancer (BC) is the most common newly diagnosed cancer among women in Trinidad and Tobago (TT) and BC mortality rates are among the highest in the world. Globally, racial/ethnic trends in BC incidence, mortality and survival have been reported. However, such investigations have not been conducted in TT, which has been noted for its rich diversity. In this study, we investigated associations among ancestry, geography and BC incidence, mortality and survival in TT. Data on 3767 incident BC cases, reported to the National Cancer Registry of TT, from 1995 to 2007, were analyzed in this study. Women of African ancestry had significantly higher BC incidence and mortality rates ( 66.96; 30.82 per 100,000) compared to women of East Indian ( 41.04, MORTALITY: 14.19 per 100,000) or mixed ancestry ( 36.72, MORTALITY: 13.80 per 100,000). Geographically, women residing in the North West Regional Health Authority (RHA) catchment area followed by the North Central RHA exhibited the highest incidence and mortality rates. Notable ancestral differences in survival were also observed. Women of East Indian and mixed ancestry experienced significantly longer survival than those of African ancestry. Differences in survival by geography were not observed. In TT, ancestry and geographical residence seem to be strong predictors of BC incidence and mortality rates. Additionally, disparities in survival by ancestry were found. These data should be considered in the design and implementation of strategies to reduce BC incidence and mortality rates in TT. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Cytomegalovirus peritonitis after kidney transplantation diagnosed through histopathological examination.

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Hotta, Kiyohiko; Fukasawa, Yuichiro; Wada, Yoshiki; Fukuzawa, Nobuyuki; Seki, Toshimori; Harada, Hiroshi

2017-08-01

Among organ transplant recipients, cytomegalovirus (CMV) commonly results in various types of infection such as pneumonitis, hepatitis, and enterocolitis. However, CMV peritonitis is very rare and difficult to diagnose owing to lack of visible clinical signs. We present a case of a 35-year-old female kidney recipient who developed abdominal pain and urinary retention caused by CMV peritonitis. To our knowledge, this is the first case report of CMV peritonitis after organ transplantation to be diagnosed through histopathological examination. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Two diagnoses become one? Rare case report of anorexia nervosa and Cushing’s syndrome

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Sawicka N

2013-03-01

Full Text Available Nadia Sawicka,* Maria Gryczyńska,* Jerzy Sowiński, Monika Tamborska-Zedlewska, Marek Ruchała Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland*These authors contributed equally to this workAbstract: Hypothalamic-pituitary-adrenal axis impairment in anorexia nervosa is marked by hypercortisolemia, and psychiatric disorders occur in the majority of patients with Cushing’s syndrome. Here we report a patient diagnosed with anorexia nervosa who also developed Cushing’s syndrome. A 26-year-old female had been treated for anorexia nervosa since she was 17 years old, and also developed depression and paranoid schizophrenia. She was admitted to the Department of Endocrinology, Metabolism, and Internal Medicine with a preliminary diagnosis of Cushing’s syndrome. Computed tomography revealed a 27 mm left adrenal tumor, and she underwent laparoscopic adrenalectomy. She was admitted to hospital 6 months after this procedure, at which time she did not report any eating or mood disorder. This is a rare case report of a patient with anorexia nervosa in whom Cushing’s syndrome was subsequently diagnosed. Diagnostic difficulties were caused by the signs and symptoms presenting in the course of both disorders, ie, hypercortisolemia, osteoporosis, secondary amenorrhea, striae, hypokalemia, muscle weakness, and depression.Keywords: anorexia nervosa, Cushing’s syndrome, adrenalectomy, osteoporosis

Cancer incidence in Holocaust male survivors-An Israeli cohort study.

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Keinan-Boker, Lital; Goldbourt, Uri

2016-12-01

Previous studies, often using proxy exposure assessment and not controlling for individual risk factors, suggested higher cancer risk in Holocaust survivors. We have used individual-level data from a male cohort of Israeli civil servants recruited in 1963 to investigate cancer incidence in Holocaust survivors, controlling for potential confounders. The analysis included 4,669 Europe-born subjects; 689 exposed = E (immigrated to Israel after 1939 and reported of being in Nazi camps during World War II); 2,307 potentially exposed = PE (immigrated to Israel after 1939 and reported of not being in Nazi camps); and 1,673 non-exposed = NE (immigrated to Israel prior to 1939). Vital status and cancer incidence in the cohort were determined based on national registries. Socioeconomic level, health behaviors and cancer incidence were compared between the groups and Cox proportional hazards regression models adjusting for potential confounders assessed hazard risk ratios for cancer by exposure status. All-cause mortality was studied as a competing risk. In total, 241, 682, and 522 cancer cases were diagnosed in the E, PE, and NE, respectively. Compared with the NE, all-site cancer incidence was higher in the E (HR = 1.13, 95%CI 0.97-1.32) but not in the PE. All-cause mortality competed with all-site invasive cancer incidence in the E group (HR = 1.18, 95%CI 1.02-1.38). Colorectal and lung cancer seemed to be positively though non-significantly associated with the exposure while prostate cancer was not. Male Holocaust survivors may be at a weakly increased risk for all-site, colorectal and lung cancer. The role of age at exposure and residual confounding should be further investigated. © 2016 UICC.

Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident.

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Timler, Dariusz; Bogusiak, Katarzyna; Kasielska-Trojan, Anna; Neskoromna-Jędrzejczak, Aneta; Gałązkowski, Robert; Szarpak, Łukasz

2016-02-01

The aim of the study was to verify the effectiveness of short text messages (short message service, or SMS) as an additional notification tool in case of fire or a mass casualty incident in a hospital. A total of 2242 SMS text messages were sent to 59 hospital workers divided into 3 groups (n=21, n=19, n=19). Messages were sent from a Samsung GT-S8500 Wave cell phone and Orange Poland was chosen as the telecommunication provider. During a 3-month trial period, messages were sent between 3:35 PM and midnight with no regular pattern. Employees were asked to respond by telling how much time it would take them to reach the hospital in case of a mass casualty incident. The mean reaction time (SMS reply) was 36.41 minutes. The mean declared time of arrival to the hospital was 100.5 minutes. After excluding 10% of extreme values for declared arrival time, the mean arrival time was estimated as 38.35 minutes. Short text messages (SMS) can be considered an additional tool for notifying medical staff in case of a mass casualty incident.

Introduction of a prehospital critical incident monitoring system--pilot project results.

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Stella, Julian; Davis, Anna; Jennings, Paul; Bartley, Bruce

2008-01-01

Hospital medical incident monitoring improves preventable morbidity and mortality rates. Error management systems have been adopted widely in this setting. Data relating to incident monitoring in the prehospital setting is limited. Implementation of an incident monitoring process in a prehospital setting. This is a prospective, descriptive study of the pilot phase of the implementation of an incident monitoring process in a regional prehospital setting, with a focus on trauma care. Paramedics and emergency department staff submitted anonymous incident reports, and a chart review was performed on patients who met major trauma criteria. Selected trauma cases were analyzed by a structured interview/debriefing process to elucidate undocumented incidents. A project committee coded and logged all incidents and developed recommendations. Of 4,429 ambulance responses, 41 cases were analyzed. Twenty-four (58.5%; 95% CI = 49.7-67.4%) were reported anonymously, and the rest were major trauma patients. A total of 77 incidents were identified (mean per case = 1.8; CI = 1.03-2.57). Anonymous cases revealed 26 incidents (mean = 1.1; CI = 0.98-1.22); eight trauma debriefings revealed 38 incidents (mean = 4.8; CI = 0.91-8.69) and nine trauma chart reviews revealed 13 incidents (mean = 1.6; CI = 1.04-2.16). A total of 56 of 77 (72.7%; CI = 65.5-80.0%) incidents related to system inadequacies, and 15 (57.7%; CI = 46.7-68.6%) anonymously reported incidents related to resource problems. A total of 35 of 77 (45.5%; CI = 40.4-50.5%) incidents had minimal or no impact on the patients' outcomes. Thirty-four of 77 (44.2%; CI = 39.3-49.1%) incidents were considered mitigated by circumstance. Incident monitoring led to generalized feedback in most cases (65 of 77; 84.4%; CI = 77.6-91.3%); in three cases (3.9%; CI = 3.7-4.1%), specific education occurred; two cases were reported to an external body (2.6%; CI = 2.5-2.7%); three cases resulted in remedial action (3.9%; CI = 3.7-4.1%); four for

Incidence of sleep disorders in patients with Alzheimer disease

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Einstein Francisco Camargos

2011-12-01

Full Text Available Objective: To determine the incidence of sleep disorder at a follow-up examination from 1 to 4 years, in demented patients diagnosed at first visit, besides analyzing associated demographic and comorbidities characteristics. Methods: A total of 122 elderly patients aged 60 years or older and diagnosed with dementia (Alzheimer and other were followed in a reference geriatric center for dementia. The clinical protocols included interviews with patient and caregiver, complete physical examination, laboratory and imaging tests. Criteria for the diagnosis of sleep disorder included complain of insomnia from the patient or caregiver using the Neuropsychiatric Inventory nighttime. Results: The incidence density of sleep disorder among dements was 18.7/100 person/years. The risk of developing sleep disorder within the first and fourth years of follow-up was 9.8% and 50.9%, respectively. Multivariate Cox regression analysis revealed that educational level less than 8 years and report of aggressiveness at baseline were an independent predictor of sleep disorder, increased risk in 3.1 (95%CI: 1.30-9.22 and 2.1 times (95%CI: 1.16-4.17, respectively. Conclusion: The incidence of sleep disorder in demented patients was elevated, and was particularly associated to low educational level and aggressiveness at admission.

Incidence and Major Metabolic Risk Factors of Metabolic Syndrome ...

African Journals Online (AJOL)

The study involved 300 (92 males and 208 females) type 2 diabetic patients and was conducted at the Tamale Teaching/Regional Hospital from June 2006 to May 2007. Metabolic syndrome was diagnosed using the National Cholesterol Education Programme, Adult Treatment Panel III (2001) criteria. The incidence of the ...

Critical incident analysis through narrative reflective practice: A case study

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Thomas S. C. Farrell

2013-01-01

Full Text Available Teachers can reflect on their practices by articulating and exploring incidents they consider critical to themselves or others. By talking about these critical incidents, teachers can make better sense of seemingly random experiences that occur in their teaching because they hold the real inside knowledge, especially personal intuitive knowledge, expertise and experience that is based on their accumulated years as language educators teaching in schools and classrooms. This paper is about one such critical incident analysis that an ESL teacher in Canada revealed to her critical friend and how both used McCabe’s (2002 narrative framework for analyzing an important critical incident that occurred in the teacher’s class.

Infant Brain Tumors: Incidence, Survival, and the Role of Radiation Based on Surveillance, Epidemiology, and End Results (SEER) Data

International Nuclear Information System (INIS)

Bishop, Andrew J.; McDonald, Mark W.; Chang, Andrew L.; Esiashvili, Natia

2012-01-01

Purpose: To evaluate the incidence of infant brain tumors and survival outcomes by disease and treatment variables. Methods and Materials: The Surveillance, Epidemiology, and End Results (SEER) Program November 2008 submission database provided age-adjusted incidence rates and individual case information for primary brain tumors diagnosed between 1973 and 2006 in infants less than 12 months of age. Results: Between 1973 and 1986, the incidence of infant brain tumors increased from 16 to 40 cases per million (CPM), and from 1986 to 2006, the annual incidence rate averaged 35 CPM. Leading histologies by annual incidence in CPM were gliomas (13.8), medulloblastoma and primitive neuroectodermal tumors (6.6), and ependymomas (3.6). The annual incidence was higher in whites than in blacks (35.0 vs. 21.3 CPM). Infants with low-grade gliomas had the highest observed survival, and those with atypical teratoid rhabdoid tumors (ATRTs) or primary rhabdoid tumors of the brain had the lowest. Between 1979 and 1993, the annual rate of cases treated with radiation within the first 4 months from diagnosis declined from 20.5 CPM to <2 CPM. For infants with medulloblastoma, desmoplastic histology and treatment with both surgery and upfront radiation were associated with improved survival, but on multivariate regression, only combined surgery and radiation remained associated with improved survival, with a hazard ratio for death of 0.17 compared with surgery alone (p = 0.005). For ATRTs, those treated with surgery and upfront radiation had a 12-month survival of 100% compared with 24.4% for those treated with surgery alone (p = 0.016). For ependymomas survival was higher in patients treated in more recent decades (p = 0.001). Conclusion: The incidence of infant brain tumors has been stable since 1986. Survival outcomes varied markedly by histology. For infants with medulloblastoma and ATRTs, improved survival was observed in patients treated with both surgery and early radiation

Ainhum - A Rare Case Report.

Science.gov (United States)

Prabhu, Ravi; Kannan, Narayanasamy Subbaraju; Vinoth, Sundaresan; Praveen, Chinnappan Balasubramanian

2016-04-01

The term 'AINHUM' is derived from the African word meaning 'to saw or cut'. True ainhum otherwise called dactylolysis spontanea is a condition involving soft tissue or digits with constricting rings commonly presenting in fifth toes, usually bilateral. It is to be differentiated from Pseudo-ainhum that occurs secondary to some hereditary and nonhereditary diseases that lead to annular constriction of digits. We report a rare case of true ainhum involving the left fourth toe only. It is a very rare case and a very few were reported worldwide. The highest incidence of ainhum has been reported in South Africa and South America. It is rarely reported in India. Ainhum when diagnosed and treated in early stages can be prevented from progressing to mutilating deformities.

Stage-specific incidence rates and trends of prostate cancer by age, race, and ethnicity, United States, 2004-2014.

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Li, Jun; Siegel, David A; King, Jessica B

2018-05-01

Current literature shows different findings on the contemporary trends of distant-stage prostate cancer incidence, in part, due to low study population coverage and wide age groupings. This study aimed to examine the stage-specific incidence rates and trends of prostate cancer by age (5-year grouping), race, and ethnicity using nationwide cancer registry data. Data on prostate cancer cases came from the 2004-2014 United States Cancer Statistics data set. We calculated stage-specific incidence and 95% confidence intervals by age (5-year age grouping), race, and ethnicity. To measure the changes in rates over time, we calculated annual percentage change (APC). We identified 2,137,054 incident prostate cancers diagnosed during 2004-2014, with an age-adjusted incidence rate of 453.8 per 100,000. Distant-stage prostate cancer incidence significantly decreased during 2004-2010 (APC = -1.2) and increased during 2010-2014 (APC = 3.3). Significant increases in distant prostate cancer incidence also occurred in men aged older than or equal to 50 years except men aged 65-74 and older than or equal to 85 years, in men with white race (APC = 3.9), and non-Hispanic ethnicity (APC = 3.5). Using data representing over 99% of U.S. population, we found that incidence rates of distant-stage prostate cancer significantly increased during 2010-2014 among men in certain ages, in white, and with non-Hispanic ethnicity. Published by Elsevier Inc.

Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study

Science.gov (United States)

Farquhar, Cynthia M; Li, Zhuoyang; McLintock, Claire; Pollock, Wendy; Peek, Michael J; Ellwood, David; Knight, Marian; Vaughan, Geraldine; Wang, Alex; Sullivan, Elizabeth

2017-01-01

Objective Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Design Case–control study. Setting Sites in Australia and New Zealand with at least 50 births per year. Participants Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. Methods Data were collected using the Australasian Maternity Outcomes Surveillance System. Primary and secondary outcome measures Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). Results The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. PMID:28982832

Incidence of environmental and genetic factors causing congenital cataract in Children of Lahore.

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Naz, Shagufta; Sharif, Saima; Badar, Hafsa; Rashid, Farzana; Kaleem, Afshan; Iqtedar, Mehwish

2016-07-01

To check the incidence of environmental and genetic factors causing congenital cataract in infants. The descriptive study was conducted at Layton Rahmatullah Benevolent Trust, Lahore, Pakistan, from October 2013 to April 2014, and comprised children under 15 years of age who had rubella syndrome, herpes simplex, birth trauma, trisomy 21, Nance-Horan syndrome or Lowe's syndrome. Of the 38,000 cases examined, 120(0.3%) patients were diagnosed with congenital cataract. Of them, 52(43.33%)were aged between 2 and 5 years,22(18.33%) <11 years and 10(8.33%) ?15 years. Bilateral congenital cataract was observed in 91(75.83%) patients and unilateral congenital cataract in 29(24.17%). Environmental factors caused 72(62.07%) cases and genetic factors caused 44(37.93%).. Congenital cataract predominated in boys compared to girls. Early diagnosis and adequate therapy requires specific technology, as well as long-term and permanent care..

Analysis of vaginal microenvironment in 435 cases with nonneoplastic epithelial disorders of vulva

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Lan XIE

2016-03-01

Full Text Available Objective 　To explore the relationship of vaginal micro-ecological condition with the nonneoplastic epithelial disorders of vulva (NNEDV in order to provide clues on diagnosis and treatment of NNEDV. Methods 　The outpatient data of 435 cases of NNEDV as diagnosed by biopsy, collected from Jan. 2012 to Jun. 2015 at the Second Affiliated Hospital of Chongqing Medical University, were retrospectively analyzed to evaluate their vaginal microflora. Results 　Fifty-four of the 435 patients (12.4% were proved to harbor normal vaginal microflora, and in 381 patients imbalanced vaginal microflora was found (87.6%, and among them the pathogens were clearly diagnosed in 161 cases, accounting for 37.0% (161/435; the incidence of bacterial vaginosis (BV and vulvovaginal candidiasis (VVC was 13.1% and 10.4%, respectively, and it was significantly higher than the incidence of other vaginitis (P<0.05. Conclusion 　Most of NNEDV patients are suffering from unbalanced vaginal micro-ecological imbalance, and vaginitis such as BV and VVC may be associated with the NNEDV. DOI: 10.11855/j.issn.0577-7402.2016.02.10

Incidence of intracranial bleeds in new users of low-dose aspirin

DEFF Research Database (Denmark)

Cea Soriano, Lucía; Gaist, David; Soriano-Gabarró, Montse

2017-01-01

(median 5.58 years). Incident cases of ICB were identified and validated through linkage to hospitalization data and/or review of THIN records with free-text comments. Incidence rates with 95% confidence intervals (CI) were calculated. RESULTS: 881 incident cases of ICB were identified: 407 cases...

Exposure to ambient air pollution and the incidence of dementia: A population-based cohort study.

Science.gov (United States)

Chen, Hong; Kwong, Jeffrey C; Copes, Ray; Hystad, Perry; van Donkelaar, Aaron; Tu, Karen; Brook, Jeffrey R; Goldberg, Mark S; Martin, Randall V; Murray, Brian J; Wilton, Andrew S; Kopp, Alexander; Burnett, Richard T

2017-11-01

Emerging studies have implicated air pollution in the neurodegenerative processes. Less is known about the influence of air pollution, especially at the relatively low levels, on developing dementia. We conducted a population-based cohort study in Ontario, Canada, where the concentrations of pollutants are among the lowest in the world, to assess whether air pollution exposure is associated with incident dementia. The study population comprised all Ontario residents who, on 1 April 2001, were 55-85years old, Canadian-born, and free of physician-diagnosed dementia (~2.1 million individuals). Follow-up extended until 2013. We used population-based health administrative databases with a validated algorithm to ascertain incident diagnosis of dementia as well as prevalent cases. Using satellite observations, land-use regression model, and an optimal interpolation method, we derived long-term average exposure to fine particulate matter (≤2.5μm in diameter) (PM 2.5 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ), respectively at the subjects' historical residences based on a population-based registry. We used multilevel spatial random-effects Cox proportional hazards models, adjusting for individual and contextual factors, such as diabetes, brain injury, and neighborhood income. We conducted various sensitivity analyses, such as lagging exposure up to 10years and considering a negative control outcome for which no (or weaker) association with air pollution is expected. We identified 257,816 incident cases of dementia in 2001-2013. We found a positive association between PM 2.5 and dementia incidence, with a hazard ratio (HR) of 1.04 (95% confidence interval (CI): 1.03-1.05) for every interquartile-range increase in exposure to PM 2.5 . Similarly, NO 2 was associated with increased incidence of dementia (HR=1.10; 95% CI: 1.08-1.12). No association was found for O 3 . These associations were robust to all sensitivity analyses examined. These estimates translate to 6.1% of

Increased Incidence of Spinal Abscess and Substance Abuse after Implementation of State Mandated Prescription Drug Legislation.

Science.gov (United States)

Nagar, Vittal R; Springer, Joe E; Salles, Sara

2015-10-01

To investigate the incidence of spinal abscess and substance abuse in a tertiary care hospital after state legislation titled "House Bill 1" (HB1) mandated stricter regulation of prescription drugs of abuse in Kentucky in 2012. A retrospective case series study design was used to review the incidence of spinal abscess and drug abuse diagnoses admissions from 2010 to 2014. Variances in the incidence of spinal abscess and substance abuse were plotted across this time frame. The incidence of intraspinal abscess increased 1.56-fold in 2011 (n = 26) and 2012 (n = 25) relative to 2010 (n = 16). However, in 2013, the year following implementation of HB1 legislation, the incidence of intraspinal abscess increased 2.38-fold (n = 38) and then 4.19-fold (n = 67) in 2014. The incidence of intraspinal abscess in subjects with drug abuse diagnosis remained constant between 2010 (n = 3) and 2012 (n = 3). However, it increased twofold (n = 7) in 2013 and then ninefold (n = 27) in 2014. A correlation coefficient (rSAD ) of 0.775 revealed a strong association between the increase incidence of intraspinal abscess and diagnosis of drug abuse. The results of this retrospective study demonstrate an increased incidence of intraspinal abscess associated with drug abuse after passage of HB1 legislation regulating prescriptions of controlled medications in Kentucky. This increased incidence may be related to individuals relying on nonprescription drugs of abuse due to more highly regulated access to controlled prescription medications. However, additional factors unrelated to HB1 legislation must be taken into account. Wiley Periodicals, Inc.

Mucocele of the Appendix: Reports of a case for TAC

International Nuclear Information System (INIS)

Patino Osorio, Maria Olga

1992-01-01

The Mucocele of the appendix is a not very frequent entity and its diagnose pre-operative it is strange. To make diagnose in early form, it is important since lagoons of these lesions are wicked and their quick identification reduces the incidence of pseudo mixoma peritonea. Classically the diagnosis of the mucocele of the appendix is made by laparotomy when being suspected a appendicitis process inflammatory. They have been used for their diagnosis the simple badge of the abdomen, the colon for enema, the ultrasound, the computerized tomography and the gammagraphy with gallium-67 among others. This article describes a case, where the impression pre-operative diagnostic was made and in way non invasive

Sigmoid-vaginal fistula during bevacizumab treatment diagnosed by fistulography.

Science.gov (United States)

Hayashi, C; Takada, S; Kasuga, A; Shinya, K; Watanabe, M; Kano, H; Takayama, T

2016-12-01

There have been several reports describing rectovaginal fistula development after bevacizumab treatment, and these fistulas were diagnosed by CT scan or colonoscopy. We report a case of sigmoid-vaginal fistula diagnosed by fistulography. The case is a 53-year-old woman who was treated for chronic myelogenous leukaemia and gynaecological cancers 8 years previously. At 52 years of age, she was diagnosed with colon cancer and had a partial colectomy performed. One year after surgery, colon cancer recurred, and she was treated with anticancer agents, including bevacizumab. During chemotherapy, she complained of a foul smelling discharge from the vagina. Fistulography revealed a sigmoid-vaginal fistula. This is the first report of vaginal fistulography performed on a patient who was treated with bevacizumab. Fistulography may be useful for detecting sigmoid-vaginal fistula. © 2016 John Wiley & Sons Ltd.

Diagnosing Paroxysmal Atrial Fibrillation in Patients With Ischemic Strokes and Transient Ischemic Attacks Using Echocardiographic Measurements of Left Atrium Function

DEFF Research Database (Denmark)

Skaarup, Kristoffer Grundtvig; Christensen, Hanne Krarup; Høst, Nis

2016-01-01

Twenty-five to 35 percentage of stroke cases are cryptogenic, and it has been demonstrated that paroxysmal atrial fibrillation (AF) is the causal agent in up to 25% of these incidents. The purpose of this study was to investigate if left atrial (LA) parameters have value for diagnosing paroxysmal...... with paroxysmal AF. However, the atrial measurements evaluating LA function (min LA volume and LA emptying fraction) were significantly different (LA emptying fraction: 45% ± 10% vs 50% ± 10%, p = 0.004; minimal LA volume: 30.2 ml ± 17.3 ml vs 24 ml ± 10 ml, p = 0.035 in patients with paroxysmal AF, even after...

A Case of Fetal Herpes Simplex Encephalitis Diagnosed Prenatally by Ultrasonography in the Third Trimester

International Nuclear Information System (INIS)

Lee, Mi Bum; Kim, Yu Ri; Hwang, Han Sung; Park, Yong Won; Kim, Young Han

2007-01-01

Almost all reported incidences of herpes simplex virus (HSV) infection in newborns result as a complication of rupture of the amniotic membranes or the delivery of the baby, but infection via the placenta and amniotic membranes is rare. Ventriculomegaly was detected at 36 weeks of gestation by prenatal ultrasonography, and an emergency cesarean section was then performed at 36 weeks of gestation. We report a case of herpes simplex encephalitis detected at 36 weeks of gestation by prenatal ultrasonography, which was confirmed by a postnatal serologic test and CSF test with a brief review of literature

A Case of Fetal Herpes Simplex Encephalitis Diagnosed Prenatally by Ultrasonography in the Third Trimester

Energy Technology Data Exchange (ETDEWEB)

Lee, Mi Bum; Kim, Yu Ri; Hwang, Han Sung; Park, Yong Won; Kim, Young Han [Yonsei University College of Medicine, Seoul (Korea, Republic of)

2007-12-15

Almost all reported incidences of herpes simplex virus (HSV) infection in newborns result as a complication of rupture of the amniotic membranes or the delivery of the baby, but infection via the placenta and amniotic membranes is rare. Ventriculomegaly was detected at 36 weeks of gestation by prenatal ultrasonography, and an emergency cesarean section was then performed at 36 weeks of gestation. We report a case of herpes simplex encephalitis detected at 36 weeks of gestation by prenatal ultrasonography, which was confirmed by a postnatal serologic test and CSF test with a brief review of literature

Incidence of endometrial hyperplasia in 100 cases presenting with polymenorrhagia/menorrhagia in perimenupausal women

International Nuclear Information System (INIS)

Takreem, A.; Razaq, S.

2009-01-01

To study the Incidence of endometrial hyperplasia in perimenupausal women presenting with polymenorrhagia/menorrhagia. This observational study was conducted at Gynae 'B' unit of Khyber Teaching Hospital Peshawar from January 2000 to December 2001. One hundred consecutive patients who presented at Gynaecology OPD with Polymenorrhagia/ Menorrhagia were registered and incidence of endometrial hyperplasia evaluated in them. All women were above 45 years of age. Post-menopausal bleeding cases were excluded from the study. Out of 100 patients, 15 patients were found to have endometrial hyperplasia, 10 patients (66.6%) simple cystic hyperplasia, 3 patients (20.0%) had adenomotous hyperplasia, 2 patients (13.3%) had atypical hyperplasia, 8 patients (53.3%) with menorrhagia, 1 (6.6%) with polymenorrhagia, and 6 patients (40.0%) with polymenorrhoea. Duration of symptoms was from 4 months to 1 year. Thirteen (86.6%) patients were treated medically, 5 patients (33.33%) needed surgical treatment following medical treatment, 2 patients (13.3%) underwent Total Abdominal Hysterectomy (TAH) and Bilateral Salpingooophorectomy (BSO) who were 51-53 years of age with atypical hyperplasia. endometrial hyperplasia is a pre-malignant condition; if treated in time, incidence can be reduced and early treatment can increase life expectancy and quality in women over age of 45 years. (author)

Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is ...

African Journals Online (AJOL)

Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is Pre and Post Counseling Still Being Adequately Practiced? ... A case of attempted suicide in a recently diagnosed HIV positive subject without adequate counseling is reported. Subject ... Key Words: Suicide Attempt, HIV/AIDS, Pre and Post test Counseling.

ACE Inhibitor-Induced Angioedema of the Intestine: Case Report, Incidence, Pathophysiology, Diagnosis and Management

Directory of Open Access Journals (Sweden)

Gavin Oudit

2001-01-01

Full Text Available A case report of fosinopril-induced angioedema of the intestine with a chronic course accompanied by multiple acute exacerbations is described. Angiotensin-converting enzyme (ACE inhibitor-induced angioedema of the intestine (AIAI occurs in a minority of patients taking an ACE inhibitor. The clinical presentation encompasses acute abdominal symptoms, pronounced bowel edema and ascites with occasional facial and/or oropharyngeal swelling. AIAI is diagnosed based on the temporal relationship between the symptomatic presentation and drug use, absence of alternative diagnoses including other causes of angioedema, and the prompt resolution of symptoms upon discontinuation of the ACE inhibitor. Prompt radiological investigation (abdominal computerized tomography and/or ultrasound is critical in making an early diagnosis and in preventing unnecessary surgical intervention. There is a female predominance of AIAI, which may reflect the interaction of estradiol with the various pathways involved in the pathophysiology of AIAI. Management of AIAI consists mainly of conservative measures and discontinuation of the ACE inhibitor. Angiotensin II receptor antagonists should not be considered as appropriate alternatives. Awareness and knowledge of AIAI are important because of the increasing use of ACE inhibitors, current delays in making the diagnosis, obvious management strategies once the diagnosis is made and the dysutility of alternative diagnoses, which may lead to considerable morbidity. AIAI must be considered in patients taking ACE inhibitors who develop gastrointestinal complaints irrespective of the duration of the therapy.

HIV Incidence and Predictors of Incident HIV among Men Who Have Sex with Men Attending a Sexual Health Clinic in Melbourne, Australia.

Directory of Open Access Journals (Sweden)

King T Cheung

Full Text Available The aim of this study was to determine the risk factors for HIV infection and the incidence in men who have sex with men (MSM. It is important to identify subgroups of MSM in which preventive interventions such as pre-exposure prophylaxis (PrEP offered at the time of their last negative test would be considered cost-effective.We conducted a retrospective cohort study of MSM attending Melbourne Sexual Health Centre (MSHC during 2007-2013 with at least two HIV tests within 12 months of each other. Demographic characteristics, sexual and other behaviours, and bacterial sexually transmitted infection (STI diagnoses were extracted from the date of the last negative HIV test. HIV incidence rate (IR per 100 person-years for each risk factor was calculated.Of the 13907 MSM who attended MSHC, 5256 MSM had at least two HIV tests and were eligible, contributing 6391 person-years follow-up. 81 new HIV diagnoses were identified within 12 months of an HIV negative test with an incidence of 1.3 (95% CI: 1.0-1.6 per 100 person-years. Significant associations with subsequent HIV infection were: rectal gonorrhea (HIV IR: 3.4 95% CI: 2.1-5.2, rectal chlamydia (HIV IR: 2.6 95% CI: 1.7-3.7, inconsistent condom use (HIV IR: 2.1 95% CI: 1.6-2.7, use of post-exposure prophylaxis (HIV IR: 2.3 95% CI: 1.7-3.1, and injecting drug use (HIV IR: 8.5 95% CI: 3.4-17.5.The incidence of HIV was above 2.0% in subgroups of MSM with specific characteristics at the last HIV negative test. PrEP is considered cost effective at this incidence and could potentially be used along with other preventive interventions for these individuals in more than half of the population.