WorldWideScience

Sample records for increased standardized incidence

  1. Increased standardized incidence ratio of breast cancer in female electronics workers

    Directory of Open Access Journals (Sweden)

    Lin Yi-Ping

    2007-06-01

    Full Text Available Abstract Background In 1994, a hazardous waste site, polluted by the dumping of solvents from a former electronics factory, was discovered in Taoyuan, Taiwan. This subsequently emerged as a serious case of contamination through chlorinated hydrocarbons with suspected occupational cancer. The objective of this study was to determine if there was any increased risk of breast cancer among female workers in a 23-year follow-up period. Methods A total of 63,982 female workers were retrospectively recruited from the database of the Bureau of Labor Insurance (BLI covering the period 1973–1997; the data were then linked with data, up to 2001, from the National Cancer Registry at the Taiwanese Department of Health, from which standardized incidence ratios (SIRs for different types of cancer were calculated as compared to the general population. Results There were a total of 286 cases of breast cancer, and after adjustment for calendar year and age, the SIR was close to 1. When stratified by the year 1974 (the year in which the regulations on solvent use were promulgated, the SIR of the cohort of workers who were first employed prior to 1974 increased to 1.38 (95% confidence interval, 1.11–1.70. No such trend was discernible for workers employed after 1974. When 10 years of employment was considered, there was a further increase in the SIR for breast cancer, to 1.62. Those workers with breast cancer who were first employed prior to 1974 were employed at a younger age and for a longer period. Previous qualitative studies of interviews with the workers, corroborated by inspection records, showed a short-term high exposure to chlorinated alkanes and alkenes, particularly trichloroethylene before 1974. There were no similar findings on other types of cancer. Conclusion Female workers with exposure to trichloroethylene and/or mixture of solvents, first employed prior to 1974, may have an excess risk of breast cancer.

  2. Increasing incidence of pyogenic spondylodiscitis

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  3. Increase of Prostate Cancer Incidence in Martinique

    Directory of Open Access Journals (Sweden)

    Dominique Belpomme

    2011-01-01

    Full Text Available Prostate cancer incidence is steadily increasing in many developed countries. Because insular populations present unique ethnic, geographical, and environmental characteristics, we analyzed the evolution of prostate cancer age-adjusted world standardized incidence rates in Martinique in comparison with that of metropolitan France. We also compared prostate cancer incidence rates, and lifestyle-related and socioeconomic markers such as life expectancy, dietary energy, and fat supply and consumption, with those in other Caribbean islands, France, UK, Sweden, and USA. The incidence rate of prostate cancer in Martinique is one of the highest reported worldwide; it is continuously growing since 1985 in an exponential mode, and despite a similar screening detection process and lifestyle-related behaviour, it is constantly at a higher level than in metropolitan France. However, Caribbean populations that are genetically close to that of Martinique have generally much lower incidence of prostate cancer. We found no correlation between prostate cancer incidence rates, life expectancy, and diet westernization. Since the Caribbean African descent-associated genetic susceptibility factor would have remained constant during the 1980–2005, we suggest that in Martinique some environmental change including the intensive use of carcinogenic organochlorine pesticides might have occurred as key determinant of the persisting highly growing incidence of prostate cancer.

  4. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  5. Worldwide Increasing Incidences of Cutaneous Malignant Melanoma

    International Nuclear Information System (INIS)

    Godar, D. E.

    2011-01-01

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

  6. Increasing incidence and survival in oral cancer

    DEFF Research Database (Denmark)

    Karnov, Kirstine Kim Schmidt; Grønhøj, Christian; Jensen, David Hebbelstrup

    2017-01-01

    Background: Oral carcinomas (OCs) make up a significant proportion of head and neck carcinomas (HNCs) and are an important cause of morbidity and mortality globally. The purpose of this population-based study was to determine trends in incidence and survival in OC in the Danish population from 1980...... to 2014. Material and methods: This study covered all patients registered in the nationwide Danish cancer registry (DCR) in the period 1980–2014. Age-adjusted incidence rate (AAIR) per 100,000 and annual percentage change (APC) were evaluated. Also, 5-year overall survival (OS) was calculated with Cox......-standardized incidence of OC during the last 30 years in Denmark, and also an improvement in survival. The 5-year OS was significantly better in recent years even when we adjusted the analysis for relevant covariates....

  7. Worldwide Increasing Incidences of Cutaneous Malignant Melanoma

    Directory of Open Access Journals (Sweden)

    Dianne E. Godar

    2011-01-01

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

  8. Increased Incidence of Critical Illness in Psoriasis.

    Science.gov (United States)

    Marrie, Ruth Ann; Bernstein, Charles N; Peschken, Christine A; Hitchon, Carol A; Chen, Hui; Garland, Allan

    Psoriasis is associated with an increased risk of comorbid disease. Despite the recognition of increased morbidity in psoriasis, the effects on health care utilisation remain incompletely understood. Little is known about the risk of intensive care unit (ICU) admission in persons with psoriasis. To compare the incidence of ICU admission and post-ICU mortality rates in a psoriasis population compared with a matched population without psoriasis. Using population-based administrative data from Manitoba, Canada, we identified 40 930 prevalent cases of psoriasis and an age-, sex-, and geographically matched cohort from the general population (n = 150 210). We compared the incidence of ICU admission between populations using incidence rates and Cox regression models adjusted for age, sex, socioeconomic status, and comorbidity and compared mortality after ICU admission. Among incident psoriasis cases (n = 30 150), the cumulative 10-year incidence of ICU admission was 5.6% (95% confidence interval [CI], 5.3%-5.8%), 21% higher than in the matched cohort (incidence rate ratio, 1.21; 95% CI, 1.15-1.27). In the prevalent psoriasis cohort, crude mortality in the ICU was 11.5% (95% CI, 9.9%-13.0%), 32% higher than observed in the matched population admitted to the ICU (8.7%; 95% CI, 8.3%-9.1%). Mortality rates after ICU admission remained elevated at all time points in the psoriasis cohort compared with the matched cohort. Psoriasis is associated with an increased risk for ICU admission and with an increased risk of mortality post-ICU admission.

  9. Increasing Incidence of Juvenile Thyrotoxicosis in Denmark

    DEFF Research Database (Denmark)

    Kjær, R. H.; Andersen, M. S.; Hansen, D.

    2015-01-01

    Aim: The aim of this study was to determine in a Danish nationwide study whether the incidence rate (IR) of thyrotoxicosis in children below 15 years of age has increased between 1998 and 2012 and to compare the results with previously published national data from 1982 to 1988. Furthermore, we...

  10. Increasing Incidence of Canine Leptospirosis in Switzerland

    Directory of Open Access Journals (Sweden)

    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.

  11. [The incidence of human papilloma virus associated vulvar cancer in younger women is increasing and wide local excision with sentinel lymph node biopsie has become standard].

    Science.gov (United States)

    Fehr, Mathias K

    2011-10-01

    Sentinel lymph node (SLN) dissections have been shown to be sensitive for the evaluation of nodal basins for metastatic disease and are associated with decreased short-term and long-term morbidity when compared with complete lymph node dissection. There has been increasing interest in the use of SLN technology in gynecologic cancers. This review assesses the current evidence-based literature for the use of SLN dissections in gynecologic malignancies. Recent literature continues to support the safety and feasibility of SLN biopsy for early stage vulvar cancer with negative predictive value approaching 100 % and low false negative rates. Alternatively, for endometrial cancer most studies have reported low false-negative rates, with variable sensitivities and have reported low detection rates of the sentinel node. Studies examining the utility of SLN biopsy in early-stage cervical cancer remain promising with detection rates, sensitivities, and false-negative rates greater than 90 % for stage 1B1 tumors. SLN dissections have been shown to be effective and safe in certain, select vulvar cancer patients and can be considered an alternative surgical approach for these patients. For endometrial and cervical cancer, SLN dissection continues to have encouraging results and however needs further investigation.

  12. Possible etiologies of increased incidence of gastroschisis.

    Science.gov (United States)

    Souther, Christina; Puapong, Devin P; Woo, Russell; Johnson, Sidney M

    2017-11-01

    Gastroschisis incidence has increased over the past decade nationally and in Hawaii. Pesticides have been implicated as potential causative factors for gastroschisis, and use of restricted use pesticides (RUPs) is widespread in Hawaii. This study was conducted to characterize gastroschisis cases in Hawaii and determine whether RUP application correlates with gastroschisis incidence. Gastroschisis patients treated in Hawaii between September, 2008 and August, 2015 were mapped by zip code along with RUP use. Spatial analysis software was used to identify patients' homes located within the pesticide application zone and agricultural land use areas. 71 gastroschisis cases were identified. 2.8% of patients were from Kauai, 64.8% from Oahu, 16.9% from Hawaii, 14.1% from Maui, and 1.4% from Molokai. RUPs have been used on all of these islands. 78.9% of patients lived in zip codes overlapping agricultural land use areas. 85.9% of patients shared zip codes with RUP-use areas. The majority of gastroschisis patients were from RUP-use areas, supporting the idea that pesticides may contribute to the development of gastroschisis, although limited data on specific releases make it difficult to apply these findings. As more RUP-use data become available to the public, these important research questions can be investigated further.

  13. Annual incidence and standardized incidence ratio of cerebrovascular accidents in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Mok, C C; Ho, L Y; To, C H

    2009-01-01

    To study the annual incidence and standardized incidence ratio (SIR) of cerebrovascular accident (CVA) in patients with systemic lupus erythematosus (SLE). The annual incidence of CVA from 1999 to 2007 in a longitudinal cohort of SLE patients was calculated each year and compared with that of the regional population within the same study period. Age-specific SIRs and outcome of CVA in SLE patients were also studied. In 2007, there were 490 SLE patients in our cohort. The mean annual incidence of CVA between 1999 and 2007 was 6.45/1000 patients and no obvious trend over time was observed. Of the 20 CVAs in patients with SLE, 18 (90%) were ischaemic stroke whereas two (10%) were haemorrhagic stroke. The mean SIR of all types of CVA in SLE patients was 2.02 [95% confidence interval (CI) 1.30-3.81; p = 0.002]. The SIR of ischaemic stroke decreased with age and the stroke incidence was no longer significantly higher than that of the population in patients aged >or= 60 years. Haemorrhagic stroke occurred mainly in younger SLE patients. The duration of hospitalization and the mortality rate for CVA was non-significantly higher in SLE than in non-SLE patients. The incidence of CVA in SLE remained constant over the 8 years between 1999 and 2007. Younger SLE patients are at substantially increased risk of CVA compared to age-matched population. The duration of hospitalization and the mortality rate for CVA are similar in SLE and non-SLE patients.

  14. Increasing incidence of testicular cancer--birth cohort effects.

    Science.gov (United States)

    Ekbom, A; Akre, O

    1998-01-01

    The incidence of testicular cancer is rising in most Western populations. A collaborative study between nine population-based cancer registries in countries around the Baltic Sea was utilized in order to analyze in detail geographic variations and temporal trends in the occurrence of testicular cancer. There were 34,309 cases registered up until 1989 starting in Denmark in 1942 and most recently in Latvia in 1977. From the descriptive epidemiology it was obvious that there was a substantial variation in the age-standardized incidence amounting to about a 10-fold difference between the different countries ranging from 0.8 per 100,000 person-years in Lithuania to 7.6 per 100,000 person-years in Denmark. Previous studies have indicated that this increase is due to birth cohort effects. A more detailed analysis was therefore performed in those six countries with a sufficiently long period of cancer registration; Poland, former East Germany, Norway, Finland, Denmark and Sweden. This analysis showed that birth cohort is a more important determinant of testicular cancer risk than year of diagnosis. In Poland, former East Germany and Finland, there was an increasing risk for all birth cohorts. Among men born in Denmark, Norway or Sweden between 1930 and 1945, this increasing trend in risk was interrupted in these birth cohorts but followed thereafter by an uninterrupted increase by birth cohort. In conclusion, life time exposure to environmental factors which are associated with the incidence of testicular cancer appear to be more related to birth cohort than to year of diagnosis. Because testicular cancer typically occurs at an early age, major etiological factors therefore need to operate early in life, perhaps even in utero.

  15. The increasing incidence of adolescent bariatric surgery.

    Science.gov (United States)

    Zwintscher, Nathan P; Azarow, Kenneth S; Horton, John D; Newton, Christopher R; Martin, Matthew J

    2013-12-01

    Morbid obesity continues to be a significant problem within the United States, as overweight/obesity rates are nearing 33%. Bariatric surgery has had success in treating obesity in adults and is becoming a viable treatment option for obese adolescents. We studied 1615 inpatient admissions for children ≤20 years of age undergoing a bariatric procedure for morbid obesity in 2009 using the Kids' Inpatient Database (KID). Patients had a principal diagnosis of obesity and a bariatric procedure listed as one of their first 5 procedures. Procedures (open gastric bypass, laparoscopic gastric bypass, sleeve gastrectomy, laparoscopic gastroplasty, and laparoscopic gastric band) and complications were defined by ICD-9 codes. There were 90 open gastric bypasses, 906 laparoscopic gastric bypasses, 150 sleeve gastrectomies, 18 laparoscopic gastroplasties, and 445 laparoscopic gastric bandings. The length of stay for each procedure was 2.44, 2.20, 2.33, 1.10, and 1.02 days, respectively (PBariatric surgery is an increasingly utilized option for the treatment of morbid obesity among adolescents. The procedures can be performed safely as evidenced by low complication rates. Additional long-term follow-up is necessary. © 2013.

  16. Increased venous thrombosis incidence in pregnancies after in vitro fertilization

    DEFF Research Database (Denmark)

    Hansen, Anette Tarp; Kesmodel, U S; Juul, S

    2014-01-01

    STUDY QUESTION Is venous thrombosis risk increased in pregnancies after in vitro fertilization? SUMMARY ANSWER The venous thrombosis incidence was significantly increased in pregnancies after in vitro fertilization; especially in the first trimester and in the first 6 weeks post-partum. WHAT...... IS KNOWN ALREADY In vitro fertilization without pregnancy is not associated with increased venous thrombosis incidence. STUDY DESIGN, SIZE, DURATION This national register-based cohort study covered the period from 1995 to 2005. PARTICIPANTS/MATERIALS, SETTING, METHODS All Danish pregnancies conceived...... by in vitro fertilization (n = 18 787) were included. Venous thrombosis incidence rates in pregnancies after in vitro fertilization were compared with venous thrombosis incidence rates in reference pregnancies, by calculating incidence rate ratios. MAIN RESULTS AND THE ROLE OF CHANCE In total, 48 cases were...

  17. Increasing incidence of thyroid cancer in the Commonwealth of Pennsylvania.

    Science.gov (United States)

    Bann, Darrin V; Goyal, Neerav; Camacho, Fabian; Goldenberg, David

    2014-12-01

    The incidence of thyroid cancer in the United States has increased rapidly and Pennsylvania is the state with the highest rate of thyroid cancer in the country, although the factors driving this increase are unknown. Moreover, it remains unclear whether the increase in thyroid cancer represents a true increase in disease or is the result of overdiagnosis. To compare the increase in thyroid cancer incidence and tumor characteristics in Pennsylvania with the rest of the United States and gain insight into the factors influencing the increased incidence of thyroid cancer. In a population-based study, data on thyroid cancer from the Surveillance Epidemiology and End Results 9 (SEER-9) registry and the Pennsylvania Cancer Registry (PCR) from 1985 through 2009 were collected and reviewed for information regarding sex, race, histologic type of thyroid cancer, staging, and tumor size at diagnosis. International Classification of Diseases for Oncology, Third Edition code C739 (thyroid carcinoma) was used to identify 110,615 records in the SEER-9 registry and 29,030 records in the PCR. Average annual percent change (AAPC) in thyroid cancer incidence across various demographic groups in Pennsylvania. The AAPC for thyroid cancer in Pennsylvania was 7.1% per year (95% CI, 6.3%-7.9%) vs 4.2% (95% CI, 3.7%-4.7%) per year in the remainder of the United States, and trends in incidence were significantly different (P Pennsylvania than in the rest of the nation, as is the rate of tumors that are larger and higher stage at diagnosis. These findings suggest that rising disease burden has contributed to the increased incidence of thyroid cancer. Etiologic factors promoting the rise in thyroid cancer in Pennsylvania must be investigated and may provide insight into the drivers of the national increase in thyroid cancer.

  18. Increasing incidence of hip fracture in Chiang Mai, Thailand.

    Science.gov (United States)

    Wongtriratanachai, Prasit; Luevitoonvechkij, Sirichai; Songpatanasilp, Thawee; Sribunditkul, Siripoj; Leerapun, Taninnit; Phadungkiat, Sompant; Rojanasthien, Sattaya

    2013-01-01

    Hip fracture is a major health problem in Thailand. This study attempted to examine the incidence, related factors, and trends of hip fracture in Chiang Mai, Thailand. All hip fracture data among patients aged 50 yr or older were collected from hospitals in Chiang Mai, Thailand from August 1, 2006 to July 3, 2007. Data from the 1997 Chiang Mai hip fracture study were used for comparison. In the study period, 690 hip fractures were reported: 203 males and 487 females (male to female ratio was 1 to 2.4), with a mean age of 76.7 yr. The estimated cumulative incidence was 181.0 per 100,000, and the adjusted incidence was 253.3 (males: 135.9; females: 367.9). A simple fall was the most common mechanism (79%) of fracture, and 80% of the hip fractures occurred in patients aged 70 yr or older. The highest incidence of hip fracture was observed in patients older than 85 yr (1239). At 6 mo postfracture, most patients (61%) used a walking aid. Compared with the 1997 data, hip fracture incidence had increased by an average of 2% per yr, and the incidence of hip fracture had increased significantly from August 1, 2006 to July 31, 2007, especially in patients older than 75 yr. In patients older than 84 yr, the incidence increased by a factor of 2. Urgent strategies for the prevention and treatment of osteoporosis, and hence hip fracture, are needed. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  19. Increased Incidence of T-Cell Malignancies in Patients with Chronic Lymphocytic Leukemia

    OpenAIRE

    Choi, Goda; van den Broek, Esther C; Stam, Olga CG; van Noesel, C.J.M.; Tonino, Sanne H.; Kater, Armon P.

    2015-01-01

    We present a patient with chemotherapy-refractory Chronic Lymphocytic Leukemia (CLL) in whom postmortem examination showed hepatosplenomegaly, with both multiple small-cellular CLL lesions and large-cellular, monoclonal T-cell infiltrates. Following this case, the co-incidence of T-cell malignancies and CLL was studied using Dutch and American cancer registry databases. Analysis showed an excess risk for T-cell malignancies in CLL patients, with increased standardized incidence ratios compare...

  20. Increasing incidence of Crohn's disease in Victorian children.

    Science.gov (United States)

    Phavichitr, Nopaorn; Cameron, Donald J S; Catto-Smith, Anthony G

    2003-03-01

    The incidence of Crohn's disease has been increasing in Western communities, but there are no published studies which have examined this change in children in Australia. The centralization of pediatric gastroenterology services in Victoria provides an opportunity to examine these changes within one state. We undertook a retrospective study over a 31-year period of all children aged 16 years or less initially diagnosed with Crohn's disease at either the Royal Children's Hospital, or Monash Medical Center, Melbourne, Victoria. We identified 351 patients who met the diagnostic criteria between 1971 and 2001. The incidence of Crohn's disease in children aged 16 years or less rose from 0.128 to 2.0 per 100,000 per year over the three decades (r = 0.964, P Victorian children. The pattern of disease has also changed with colonic disease now more frequent, and inflammatory indices less abnormal. The increased use of endoscopy has established the frequent involvement of the upper gastrointestinal tract.

  1. Ozone depletion, related UVB changes and increased skin cancer incidence

    Science.gov (United States)

    Kane, R. P.

    1998-03-01

    Stratospheric ozone at middle latitudes shows a seasonal variation of about +/-20%, a quasi-biennial oscillation of 1-10% range and a long-term variation in which the level was almost steady up to about 1979 and declined thereafter to the present day by about 10%. These variations are expected to be reflected in solar UVB observed at the ground, but in an opposite direction. Thus UVB should have had a long-term increase of about 10-20%, which should cause an increase in skin cancer incidence of about 20-40%. Skin cancer incidence has increased all over the world, e.g. about 90% in USA during 1974-1990. It is popularly believed that this increase in skin cancer incidence is related to the recent ozone depletion. This seems to be incorrect, for two reasons. Firstly, the observed skin cancer increase is too large (90%) compared with the expected value (40%) from ozone depletion. Secondly, cancer does not develop immediately after exposure to solar UVB. The sunburns may occur within hours; but cancer development and detection may take years, even decades. Hence the observed skin cancer increase since 1974 (no data available for earlier periods) must have occurred due to exposure to solar UVB in the 1950s and 1960s, when there was no ozone depletion. Thus, the skin cancer increase must be attributed to harmful solar UVB levels existing even in the 1960s, accentuated later not by ozone depletion (which started only much later, by 1979) but by other causes, such as a longer human life span, better screening, increasing tendencies of sunbathing at beaches, etc., in affluent societies. On the other hand, the recent ozone depletion and the associated UVB increases will certainly take their toll; only that the effects will not be noticed now but years or decades from now. The concern for the future expressed in the Montreal Protocol for reducing ozone depletion by controlling CFC production is certainly justified, especially because increased UVB is harmful to animal and

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

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

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

  3. Increasing Incidence of Hospitalization for Stroke and Transient Ischemic Attack in Young Adults

    DEFF Research Database (Denmark)

    Tibaek, Maiken; Dehlendorff, Christian; Jørgensen, Henrik S

    2016-01-01

    BACKGROUND: Studies have reported increasing incidence of ischemic stroke in adults younger than 50 to 55 years. Information on temporal trends of other stroke subtypes and transient ischemic attack (TIA) is sparse. The aim of this study was to investigate temporal trends of the incidence...... of hospitalizations for TIA and stroke including sex- and subtype-specific trends in young adults aged 15 to 30 years. METHODS AND RESULTS: From the Danish National Patient Register, we identified all cases of first-ever stroke and TIA (age 15-30 years) in Denmark, who were hospitalized during the study period...... of 1994 to 2012. Incidence rates and estimated annual percentage changes (EAPCs) were estimated by using Poisson regression. During the study period, 4156 cases of first-ever hospitalization for stroke/TIA were identified. The age-standardized incidence rates of hospitalizations for stroke increased...

  4. Increasing incidence of hypothyroidism within one year after radioiodine therapy for toxic diffuse goiter

    International Nuclear Information System (INIS)

    Von Hofe, S.E.; Dorfman, S.G.; Carrette, R.F.; Young, R.L.

    1978-01-01

    Patients treated with 10 mCi of I-131 for toxic diffuse goiter in the period January 1974--June 1976 were evaluated for development of hypothyroidism. Fifty percent were hypothyroid within 3 months and 69 percent within 1 year of treatment. Our data suggest that there is a higher incidence of hypothyroidism after standard doses of I-131 in the 1970s as contrasted with treatment groups in the 1950s and 1960s. The pathophysiology of this increased incidence is not known with certainty; however, infrequent use of thionamide medication, together with recent increases in dietary iodine, may render the gland more radiosensitive

  5. Increasing incidence of hypotension in the emergency department

    DEFF Research Database (Denmark)

    Holler, Jon G; Henriksen, Daniel P; Mikkelsen, Søren

    2016-01-01

    BACKGROUND: The epidemiology of hypotension as presenting symptom among patients in the Emergency Department (ED) is not clarified. The aim of this study was to describe the incidence, etiology, and overall mortality of hypotensive patients in the ED. METHODS: Population-based cohort study......,000 person years at risk (pyar) and etiological characteristics by means of the International Classification of Diseases, Tenth Revision (ICD-10), as well as 7-day, 30-day, and 90-day all-cause mortality. RESULTS: We identified 3,268 of 438,198 (1 %) cases with a mean overall IR of 125/100,000 pyar (95 % CI......: 121-130). The IR increased 28 % during the period (from 113 to 152 cases per 100,000 pyar). Patients ≥65 years had the highest IR compared to age

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

    Science.gov (United States)

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

    2016-10-01

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

  7. Congenital Hypothyroidism: Increased Incidence in Yazd Province, Iran

    Directory of Open Access Journals (Sweden)

    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

  8. Trends in the incidence of nonmelanoma skin cancer in Denmark 1978-2007: Rapid incidence increase among young Danish women

    DEFF Research Database (Denmark)

    Birch-Johansen, Fatima; Jensen, Allan; Mortensen, Lone

    2010-01-01

    Nonmelanoma skin cancer (NMSC) is the most common cancer among Caucasian populations worldwide, and incidence rates are increasing. However, NMSC data are not routinely collected by cancer registries, but Denmark has extensive registration of NMSC in two nationwide population-based registries. We...... assessed incidence trends of NMSC in Denmark from 1978 to 2007. Data for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) were obtained from the Danish Cancer Registry and the Danish Registry of Pathology. For both genders, age-specific incidence rates and overall incidence rates, age...

  9. Increased incidence of adult pneumococcal pneumonia during school holiday periods

    Science.gov (United States)

    Rodrigo, Chamira; Bewick, Thomas; Sheppard, Carmen; Greenwood, Sonia; McKeever, Tricia M.; Slack, Mary; Lim, Wei Shen

    2017-01-01

    Child contact is a recognised risk factor for adult pneumococcal disease. Peaks in invasive pneumococcal disease incidence observed during winter holidays may be related to changes in social dynamics. This analysis was conducted to examine adult pneumococcal community-acquired pneumonia (CAP) incidence during school holiday periods. Between September 2008 and 2013, consecutive adults admitted to hospitals covering the Greater Nottingham area with a diagnosis of CAP were studied. Pneumococcal pneumonia was detected using culture and antigen detection methods. Of 2221 adults studied, 575 (25.9%) were admitted during school holidays and 643 (29.0%) had pneumococcal CAP. CAP of pneumococcal aetiology was significantly more likely in adults admitted during school holidays compared to term time (35.3% versus 26.7%; adjusted OR 1.38, 95% CI 1.11–1.72, p=0.004). Over the 5-year period, the age-adjusted incidence of hospitalised pneumococcal CAP was higher during school holidays compared to term time (incident rate ratio 1.35, 95% CI 1.14–1.60, pholidays compared to term time (42.0% versus 33.7%, OR 1.43, 95% CI 1.00–2.03, p=0.046). Further study of transmission dynamics in relation to these findings and to identify appropriate intervention strategies is warranted. PMID:28326311

  10. 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...

  11. Increasing incidence of type 2 diabetes in New Zealand children Auckland, New Zealand.

    Science.gov (United States)

    Sjardin, Natalia; Reed, Peter; Albert, Ben; Mouat, Fran; Carter, Phillipa J; Hofman, Paul; Cutfield, Wayne; Gunn, Alistair; Jefferies, Craig

    2018-04-24

    It is important to understand whether type 2 diabetes mellitus (T2DM) is increasing in childhood for health-care planning and clinical management. The aim of this study is to examine the incidence of T2DM in New Zealand children, aged Auckland, New Zealand. Retrospective analysis of prospectively collected data from a population-based referral cohort from 1995 to 2015. Hundred and four children presented with T2DM over the 21-year period. The female:male ratio was 1.8:1, at mean (standard deviation) age 12.9 (1.9) years, body mass index standard deviation score +2.3 (0.5), blood sugar 15.3 (8.5) mmol/L, HbA1c 76 (28) mmol/mol. At diagnosis, 90% had acanthosis nigricans and 48% were symptomatic. In all, 33% were Maori, 46% Pacific Island, 15% Asian/Middle Eastern and 6% European. There was a progressive secular increase of 5% year on year in incidence. The overall annual incidence of T2DM <15 years of age was 1.5/100 000 (1.2-1.9) (95% confidence interval), with higher rates in Pacific Island (5.9/100 000) and Maori (4.1/100 000). The incidence of T2DM in children <15 years of age in New Zealand has increased progressively at 5%/year over the last 21 years. The risk was disproportionately associated with girls and children from high-risk ethnic groups. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  12. Is Global Warming likely to cause an increased incidence of Malaria?

    Science.gov (United States)

    Nabi, SA; Qader, SS

    2009-01-01

    The rise in the average temperature of earth has been described as global warming which is mainly attributed to the increasing phenomenon of the greenhouse effect. It is believed that global warming can have several harmful effects on human health, both directly and indirectly. Since malaria is greatly influenced by climatic conditions because of its direct relationship with the mosquito population, it is widely assumed that its incidence is likely to increase in a future warmer world. This review article discusses the two contradictory views regarding the association of global warming with an increased incidence of malaria. On one hand, there are many who believe that there is a strong association between the recent increase in malaria incidence and global warming. They predict that as global warming continues, malaria is set to spread in locations where previously it was limited, due to cooler climate. On the other hand, several theories have been put forward which are quite contrary to this prediction. There are multiple other factors which are accountable for the recent upsurge of malaria: for example drug resistance, mosquito control programs, public health facilities, and living standards. PMID:21483497

  13. Incidence of Diarrhea in Hospitalized Patients with Standard Enteral Formula

    Directory of Open Access Journals (Sweden)

    Shabbu Ahmadi bonakdar

    2014-10-01

    Conclusion: Evaluation of patients receiving Milatech standard formula showed that diarrhea wasn’t seen in hospitalized patients. Diarrhea was reported by the nurses may refer to other diarrhea genic causes including of long length of stay, entral duration or medical side effects or infections.

  14. Incidence of Cancers of the Lower Stomach Increasing among Younger Americans

    Science.gov (United States)

    ... News & Events Cancer Currents Blog Cancer Currents Blog Incidence of Cancers of the Lower Stomach Increasing among ... younger individuals, she added. Risk Factors and Shifting Incidence Rates Two of the main causes of noncardia ...

  15. Incidence of Type 1 Diabetes is Not Increasing in a Population-Based Cohort in Olmsted County, Minnesota, USA

    Science.gov (United States)

    Cartee, Amanda K.; Owens, Lisa A.; Lahr, Brian D.; Yawn, Barbara P.; Murray, Joseph A.; Kudva, Yogish C.

    2016-01-01

    Context Worldwide studies show that the type 1 diabetes (T1D) incidence is increasing by 3% annually. Objectives We investigated the recent incidence of T1D in a US Midwestern county to determine whether this increase has been sustained and compare to celiac disease (CD) incidence. The prevalence of (CD), an associated autoimmune disease, within the cohort was also investigated. Design A broad search strategy was used to identify all cases of T1D in Olmsted County, Minnesota, between January 1,1994 and December 31, 2010 using the Rochester Epidemiology Project. Diagnosis and residency status were confirmed through the medical record. Incidence rates were directly standardized to the 2010 United States population. Poisson regression was used to test for a change in incidence rate. Clinical charts were reviewed to confirm case status. Setting Population-based study in Olmsted County, Minnesota. Main Outcome Measure The trend in T1D incidence in a population-based study in a Midwestern US county. Results There were 233 incident cases of T1D. Directly adjusting for age and sex with respect to the 2010 US white population, the overall annual incidence of T1D was 9.2 (95% CI, 8.0-10.4) per 100,000 people per year among all ages and 19.9 (95% CI, 16.6-23.2) per 100,000 per people per year for those younger than 20 years. There was no significant increase in the incidence of T1D over time (P=.45). Despite the overall stability in annual incidence, there was an initial increasing trend followed by a plateau. Of the 109 T1D patients (46%) tested for CD, 12% had biopsy-proven CD. Conclusions The incidence of T1D has stopped increasing in Olmsted County, Minnesota, in the most recent decade. Further studies are needed to confirm this finding and explore reasons for this plateau. PMID:27492913

  16. Increasing incidence of bacterial resistance to antibiotics by isolates ...

    African Journals Online (AJOL)

    Antibiotic sensitivity testing was performed on sensitivity test agar (Biotec, UK) using the disc diffusion method in accordance with the National Committee for Clinical Laboratory Standards (5). The results were compared with a previous study in 1993. A total of 336 urinary isolates were identified, with the coliforms being the ...

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  18. Increasing Incidence of Infants with Low Birth Weight in Oman

    Science.gov (United States)

    Islam, M. Mazharul

    2015-01-01

    This review article provides an overview of the levels, trends and some possible explanations for the increasing rate of low birth weight (LBW) infants in Oman. LBW data from national health surveys in Oman, and published reports from Oman’s Ministry of Health and the World Health Organization were collected and assessed between January and August 2014. Oman’s LBW rate has been increasing since the 1980s. It was approximately 4% in 1980 and had nearly doubled (8.1%) by 2000. Since then, it has shown a slow but steady rise, reaching 10% in recent times. High rates of consanguinity, premature births, number of increased pregnancies at an older maternal age and changing lifestyles are some important factors related to the increasing rate of LBW in Oman. The underlying causes of this increase need to be understood and addressed in obstetric policies and practices in order to reduce the rate of LBW in Oman. PMID:26052449

  19. Increasing Incidence of Infants with Low Birth Weight in Oman

    Directory of Open Access Journals (Sweden)

    M. Mazharul Islam

    2015-05-01

    Full Text Available This review article provides an overview of the levels, trends and some possible explanations for the increasing rate of low birth weight (LBW infants in Oman. LBW data from national health surveys in Oman, and published reports from Oman’s Ministry of Health and the World Health Organization were collected and assessed between January and August 2014. Oman’s LBW rate has been increasing since the 1980s. It was approximately 4% in 1980 and had nearly doubled (8.1% by 2000. Since then, it has shown a slow but steady rise, reaching 10% in recent times. High rates of consanguinity, premature births, number of increased pregnancies at an older maternal age and changing lifestyles are some important factors related to the increasing rate of LBW in Oman. The underlying causes of this increase need to be understood and addressed in obstetric policies and practices in order to reduce the rate of LBW in Oman.

  20. Food intolerance and allergy: increased incidence or contemporary inadequate diets?

    NARCIS (Netherlands)

    Skypala, Isabel; Vlieg-Boerstra, Berber

    2014-01-01

    The role of nutrients in the study of allergic disease has been studied for many years, but recent evidence suggests that it is the quality and variety of the whole diet which affects the development of food allergy. This review seeks to understand whether food allergy prevalence is increasing and

  1. Increasing annual incidence of vestibular schwannoma and age at diagnosis

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Tos, Mirko; Caye-Thomasen, Per

    2004-01-01

    in 2001. In the first years large and giant tumours dominated, in contrast to recent years in which intrameatal and small tumours dominated. The median age at the time of diagnosis has been almost unchanged through the period (median 55 years). If the decreasing size of the tumour and the increasing...

  2. The increasing incidence of anal cancer: can it be explained by trends in risk groups?

    NARCIS (Netherlands)

    van der Zee, R. P.; Richel, O.; de Vries, H. J. C.; Prins, J. M.

    2013-01-01

    Anal cancer incidence is gradually increasing. The cause of this increase is not exactly known. This systematic literature review aimed to investigate the trend in time of anal cancer incidence and to find an explanation for the supposed increase. The TRIP database and PubMed were searched for

  3. The Epidemiology of Pheochromocytoma: Increasing incidence and changing clinical presentation

    DEFF Research Database (Denmark)

    Ebbehoj, A; Søndergaard, Esben; Trolle, Christian

    2017-01-01

    –2015. In 1977–2006 paroxysmal symptoms and secondary hypertension were the primary causes leading to the diagnosis (34 and 21%, respectively), while incidentalomas were the leading cause of diagnosis 2007–2015 (57%). Patients diagnosed 2007–2015 were older (P... diagnosed in 1977–2006 in a secondary analysis using the Wilcoxon–Mann–Whitney test.We identified 183 confirmed cases of pheochromocytoma. A significant increasing trend (P

  4. The increasing incidence of snowboard-related trauma

    Science.gov (United States)

    Hayes, John R.; Groner, Jonathan I.

    2013-01-01

    Purpose To investigate injuries among children and adolescents who participate in downhill sports. Methods We collected trauma registry data (January 1999–May 2006) from a level 1 pediatric trauma center with an average snowfall of 28 in (71 cm)/y. Cases were analyzed for injury mechanism, injury type, organ injured, Injury Severity Score, age, sex, and whether or not an operation was required. Results There were 57 snowboarders and 22 skiers admitted during the study period. Forty-one (72%) of snowboarders and 16 (73%) of skiers required operations; 32 (56%) of snowboarders and 9 (41%) of skiers sustained fractures; and 14 (25%) of snowboarders and 6 (27%) of skiers sustained abdominal injuries. (P = NS for all comparisons). Serious splenic injuries were more common in snowboarders (14% vs 4%), but the difference was not statistically significant. All skiing injuries occurred at recreational facilities (commercial skiing areas), whereas 12% of snowboard injuries occurred at home, other residence, or public parks (P = .08). The most striking finding is the rising number of snowboarding injuries and the relatively stable rate of skiing injuries (see graph). Conclusions As the popularity of snowboarding rises, snowboarding injuries in children are increasing. Pediatric surgeons should be wary of the “snowboard spleen.” PMID:18485968

  5. Increased sexually transmitted infection incidence in a low risk population: identifying the risk factors.

    LENUS (Irish Health Repository)

    Shiely, Frances

    2010-04-01

    Between 1994 and 2006, the incidence of sexually transmitted infections (STIs) in Ireland has increased by over 300%. Recent literature would suggest that this figure is an underestimation of the true scale of infection. Our objective was to determine the risk factors associated with STI diagnosis in a population with a rapidly increasing STI incidence.

  6. Bevacizumab increases the incidence of cardiovascular events in patients with metastatic breast or colorectal cancer

    Directory of Open Access Journals (Sweden)

    Ioannis Kapelakis

    2017-05-01

    Conclusions: The addition of bevacizumab to conventional chemotherapy for metastatic breast or colorectal cancer increases the incidence of cardiovascular events, which is mainly due to the increased prevalence of myocardial infarction and thromboembolic events.

  7. Non-thyroid cancer incidence in Belarusian residents exposed to Chernobyl fallout in childhood and adolescence: Standardized Incidence Ratio analysis, 1997–2011

    Science.gov (United States)

    Ostroumova, Evgenia; Hatch, Maureen; Brenner, Alina; Nadyrov, Eldar; Veyalkin, Ilya; Polyanskaya, Olga; Yauseyenka, Vasilina; Polyakov, Semion; Levin, Leonid; Zablotska, Lydia; Rozhko, Alexander; Mabuchi, Kiyohiko

    2016-01-01

    Background While an increased risk of thyroid cancer from post-Chernobyl exposure to Iodine-131 (I-131) in children and adolescents has been well-documented, risks of other cancers or leukemia as a result of residence in radioactively contaminated areas remain uncertain. Methods We studied non-thyroid cancer incidence in a cohort of about 12,000 individuals from Belarus exposed under age of 18 years to Chernobyl fallout (median age at the time of Chernobyl accident of 7.9 years). During 15 years of follow-up from1997 through 2011, 54 incident cancers excluding thyroid were identified in the study cohort with 142,968 person-years at risk. We performed Standardized Incidence Ratio (SIR) analysis of all solid cancers excluding thyroid (n=42), of leukemia (n=6) and of lymphoma (n=6). Results We found no significant increase in the incidence of non-thyroid solid cancer (SIR=0.83, 95% Confidence Interval [CI]: 0.61; 1.11), lymphoma (SIR=0.66, 95% CI: 0.26; 1.33) or leukemia (SIR=1.78, 95% CI: 0.71; 3.61) in the study cohort as compared with the sex-, age- and calendar-time-specific national rates. These findings may in part reflect the relatively young age of study subjects (median attained age of 33.4years), and long latency for some radiation-related solid cancers. Conclusions We found no evidence of statistically significant increases in solid cancer, lymphoma and leukemia incidence 25 years after childhood exposure in the study cohort; however, it is important to continue follow-up non-thyroid cancers in individuals exposed to low-level radiation at radiosensitive ages. PMID:26851723

  8. Increasing Incidence of Hospitalization for Stroke and Transient Ischemic Attack in Young Adults: A Registry-Based Study.

    Science.gov (United States)

    Tibæk, Maiken; Dehlendorff, Christian; Jørgensen, Henrik S; Forchhammer, Hysse B; Johnsen, Søren P; Kammersgaard, Lars P

    2016-05-11

    Studies have reported increasing incidence of ischemic stroke in adults younger than 50 to 55 years. Information on temporal trends of other stroke subtypes and transient ischemic attack (TIA) is sparse. The aim of this study was to investigate temporal trends of the incidence of hospitalizations for TIA and stroke including sex- and subtype-specific trends in young adults aged 15 to 30 years. From the Danish National Patient Register, we identified all cases of first-ever stroke and TIA (age 15-30 years) in Denmark, who were hospitalized during the study period of 1994 to 2012. Incidence rates and estimated annual percentage changes (EAPCs) were estimated by using Poisson regression. During the study period, 4156 cases of first-ever hospitalization for stroke/TIA were identified. The age-standardized incidence rates of hospitalizations for stroke increased significantly (EAPC 1.83% [95% CI 1.11-2.55%]) from 11.97/100 000 person-years (PY) in 1994 to 16.77/100 000 PY in 2012. TIA hospitalizations increased from 1.93/100 000 PY in 1994 to 5.81/100 000 PY in 2012 and after 2006 more markedly in men than in women (EAPC 16.61% [95% CI 10.45-23.12%]). The incidence of hospitalizations for ischemic stroke was markedly lower among men, but increased significantly from 2006 (EAPC 14.60% [95% CI 6.22-23.63%]). The incidences of hospitalizations for intracerebral hemorrhage and subarachnoid hemorrhage remained stable during the study period. The incidence rates of first-time hospitalizations for ischemic stroke and TIA in young Danish adults have increased substantially since the mid 1990s. The increase was particularly prominent in the most recent years. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. Increased Kawasaki Disease Incidence Associated With Higher Precipitation and Lower Temperatures, Japan, 1991-2004.

    Science.gov (United States)

    Abrams, Joseph Y; Blase, Jennifer L; Belay, Ermias D; Uehara, Ritei; Maddox, Ryan A; Schonberger, Lawrence B; Nakamura, Yosikazu

    2018-06-01

    Kawasaki disease (KD) is an acute febrile vasculitis, which primarily affects children. The etiology of KD is unknown; while certain characteristics of the disease suggest an infectious origin, genetic or environmental factors may also be important. Seasonal patterns of KD incidence are well documented, but it is unclear whether these patterns are caused by changes in climate or by other unknown seasonal effects. The relationship between KD incidence and deviations from expected temperature and precipitation were analyzed using KD incidence data from Japanese nationwide epidemiologic surveys (1991-2004) and climate data from 136 weather stations of the Japan Meteorological Agency. Seven separate Poisson-distributed generalized linear regression models were run to examine the effects of temperature and precipitation on KD incidence in the same month as KD onset and the previous 1, 2, 3, 4, 5 and 6 months, controlling for geography as well as seasonal and long-term trends in KD incidence. KD incidence was negatively associated with temperature in the previous 2, 3, 4 and 5 months and positively associated with precipitation in the previous 1 and 2 months. The model that best predicted variations in KD incidence used climate data from the previous 2 months. An increase in total monthly precipitation by 100 mm was associated with increased KD incidence (rate ratio [RR] 1.012, 95% confidence interval [CI]: 1.005-1.019), and an increase of monthly mean temperature by 1°C was associated with decreased KD incidence (RR 0.984, 95% CI: 0.978-0.990). KD incidence was significantly affected by temperature and precipitation in previous months independent of other unknown seasonal factors. Climate data from the previous 2 months best predicted the variations in KD incidence. Although fairly minor, the effect of temperature and precipitation independent of season may provide additional clues to the etiology of KD.

  10. 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.

  11. Factors influencing incidence of acute grade 2 morbidity in conformal and standard radiation treatment of prostate cancer

    International Nuclear Information System (INIS)

    Hanks, Gerald E.; Schultheiss, Timothy E.; Hunt, Margie A.; Epstein, Barry

    1995-01-01

    Purpose: The fundament hypothesis of conformal radiation therapy is that tumor control can be increased by using conformal treatment techniques that allow a higher tumor dose while maintaining an acceptable level of complications. To test this hypothesis, it is necessary first to estimate the incidence of morbidity for both standard and conformal fields. In this study, we examine factors that influence the incidence of acute grade 2 morbidity in patients treated with conformal and standard radiation treatment for prostate cancer. Methods and Materials: Two hundred and forty-seven consecutive patients treated with conformal technique are combined with and compared to 162 consecutive patients treated with standard techniques. The conformal technique includes special immobilization by a cast, careful identification of the target volume in three dimensions, localization of the inferior border of the prostate using the retrograde urethrogram, and individually shaped portals that conform to the Planning Target Volume (PTV). Univariate analysis compares differences in the incidence of RTOG-EORTC grade two acute morbidity by technique, T stage, age, irradiated volume, and dose. Multivariate logistic regression includes these same variables. Results: In nearly all categories, the conformal treatment group experienced significantly fewer acute grade 2 complications than the standard treatment group. Only volume (prostate ± whole pelvis) and technique (conformal vs. standard) were significantly related to incidence of morbidity on multivariate analysis. When dose is treated as a continuous variable (rather than being dichotomized into two levels), a trend is observed on multivariate analysis, but it does not reach significant levels. The incidence of acute grade 2 morbidity in patients 65 years or older is significantly reduced by use of the conformal technique. Conclusion: The conformal technique is associated with fewer grade 2 acute toxicities for all patients. This

  12. Why is the age-standardized incidence of low-trauma fractures rising in many elderly populations?

    Science.gov (United States)

    Kannus, Pekka; Niemi, Seppo; Parkkari, Jari; Palvanen, Mika; Heinonen, Ari; Sievänen, Harri; Järvinen, Teppo; Khan, Karim; Järvinen, Markku

    2002-08-01

    Low-trauma fractures of elderly people are a major public health burden worldwide, and as the number and mean age of older adults in the population continue to increase, the number of fractures is also likely to increase. Epidemiologically, however, an additional concern is that, for unknown reasons, the age-standardized incidence (average individual risk) of fracture has also risen in many populations during the recent decades. Possible reasons for this rise include a birth cohort effect, deterioration in the average bone strength by time, and increased average risk of (serious) falls. Literature provides evidence that the rise is not due to a birth cohort effect, whereas no study shows whether bone fragility has increased during this relatively short period of time. This osteoporosis hypothesis could, however, be tested if researchers would now repeat the population measurements of bone mass and density that were made in the late 1980s and the 1990s. If such studies proved that women's and men's age-standardized mean values of bone mass and density have declined over time, the osteoporosis hypothesis would receive scientific support. The third explanation is based on the hypothesis that the number and/or severity of falls has risen in elderly populations during the recent decades. Although no study has directly tested this hypothesis, a great deal of indirect epidemiologic evidence supports this contention. For example, the age-standardized incidence of fall-induced severe head injuries, bruises and contusions, and joint distortions and dislocations has increased among elderly people similarly to the low-trauma fractures. The fall hypothesis could also be tested in the coming years because the 1990s saw many research teams reporting age- and sex-specific incidences of falling for elderly populations, and the same could be done now to provide data comparing the current incidence rates of falls with the earlier ones.

  13. Technical Review of Law Enforcement Standards and Guides Relative to Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.

    2009-03-24

    In an effort to locate potential law enforcement-related standards that support incident management, a team from the Pacific Northwest National Laboratory (PNNL) contacted representatives from the National Institute of Standards-Office of Law Enforcement Standards (NIST-OLES), National Institute of Justice (NIJ), Federal Bureau of Investigation (FBI), Secret Service, ASTM International committees that have a law enforcement focus, and a variety of individuals from local and regional law enforcement organizations. Discussions were held with various state and local law enforcement organizations. The NIJ has published several specific equipment-related law enforcement standards that were included in the review, but it appears that law enforcement program and process-type standards are developed principally by organizations that operate at the state and local level. Input is provided from state regulations and codes and from external non-government organizations (NGOs) that provide national standards. The standards that are adopted from external organizations or developed independently by state authorities are available for use by local law enforcement agencies on a voluntary basis. The extent to which they are used depends on the respective jurisdictions involved. In some instances, use of state and local disseminated standards is mandatory, but in most cases, use is voluntary. Usually, the extent to which these standards are used appears to depend on whether or not jurisdictions receive certification from a “governing” entity due to their use and compliance with the standards. In some cases, these certification-based standards are used in principal but without certification or other compliance monitoring. In general, these standards appear to be routinely used for qualification, selection for employment, and training. In these standards, the term “Peace Officer” is frequently used to refer to law enforcement personnel. This technical review of national law

  14. Merkel cell carcinoma: Current US incidence and projected increases based on changing demographics.

    Science.gov (United States)

    Paulson, Kelly G; Park, Song Youn; Vandeven, Natalie A; Lachance, Kristina; Thomas, Hannah; Chapuis, Aude G; Harms, Kelly L; Thompson, John A; Bhatia, Shailender; Stang, Andreas; Nghiem, Paul

    2018-03-01

    Merkel cell carcinoma (MCC) incidence rates are rising and strongly age-associated, relevant for an aging population. Determine MCC incidence in the United States and project incident cases through the year 2025. Registry data were obtained from the SEER-18 Database, containing 6600 MCC cases. Age- and sex-adjusted projections were generated using US census data. During 2000-2013, the number of reported solid cancer cases increased 15%, melanoma cases increased 57%, and MCC cases increased 95%. In 2013, the MCC incidence rate was 0.7 cases/100,000 person-years in the United States, corresponding to 2488 cases/year. MCC incidence increased exponentially with age, from 0.1 to 1.0 to 9.8 (per 100,000 person-years) among age groups 40-44 years, 60-64 years, and ≥85 years, respectively. Due to aging of the Baby Boomer generation, US MCC incident cases are predicted to climb to 2835 cases/year in 2020 and 3284 cases/year in 2025. We assumed that the age-adjusted incidence rate would stabilize, and thus, the number of incident cases we projected might be an underestimate. An aging population is driving brisk increases in the number of new MCC cases in the United States. This growing impact combined with the rapidly evolving therapeutic landscape warrants expanded awareness of MCC diagnosis and management. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Increasing Incidence of Linezolid-Intermediate or -Resistant, Vancomycin-Resistant Enterococcus faecium Strains Parallels Increasing Linezolid Consumption▿

    OpenAIRE

    Scheetz, Marc H.; Knechtel, Stephanie A.; Malczynski, Michael; Postelnick, Michael J.; Qi, Chao

    2008-01-01

    Clinical enterococcal resistance to linezolid is defined by the presence of the G2576T mutation. We evaluated the incidence of genetically proven linezolid resistance among vancomycin-resistant Enterococcus faecium strains and linezolid consumption for a possible association. A relationship was found (r2 = 0.73, P = 0.03) and predicts increasing resistance with current trends of linezolid use.

  16. Climate variability and increase in intensity and magnitude of dengue incidence in Singapore

    OpenAIRE

    Hii, Yien Ling; Rocklöv, Joacim; Ng, Nawi; Tang, Choon Siang; Pang, Fung Yin; Sauerborn, Rainer

    2009-01-01

    Introduction: Dengue is currently a major public health burden in Asia Pacific Region. This study aims to establish an association between dengue incidence, mean temperature and precipitation and further discuss how weather predictors influence the increase in intensity and magnitude of dengue in Singapore during the period 2000-2007. Materials and methods: Weekly dengue incidence data, daily mean temperature and precipitation and the midyear population data in Singapore during 2000-2007 were...

  17. The Increasing Incidence of Thyroid Cancer: The Influence of Access to Care

    Science.gov (United States)

    Sikora, Andrew G.; Tosteson, Tor D.

    2013-01-01

    Background The rapidly rising incidence of papillary thyroid cancer may be due to overdiagnosis of a reservoir of subclinical disease. To conclude that overdiagnosis is occurring, evidence for an association between access to health care and the incidence of cancer is necessary. Methods We used Surveillance, Epidemiology, and End Results (SEER) data to examine U.S. papillary thyroid cancer incidence trends in Medicare-age and non–Medicare-age cohorts over three decades. We performed an ecologic analysis across 497 U.S. counties, examining the association of nine county-level socioeconomic markers of health care access and the incidence of papillary thyroid cancer. Results Papillary thyroid cancer incidence is rising most rapidly in Americans over age 65 years (annual percentage change, 8.8%), who have broad health insurance coverage through Medicare. Among those under 65, in whom health insurance coverage is not universal, the rate of increase has been slower (annual percentage change, 6.4%). Over three decades, the mortality rate from thyroid cancer has not changed. Across U.S. counties, incidence ranged widely, from 0 to 29.7 per 100,000. County papillary thyroid cancer incidence was significantly correlated with all nine sociodemographic markers of health care access: it was positively correlated with rates of college education, white-collar employment, and family income; and negatively correlated with the percentage of residents who were uninsured, in poverty, unemployed, of nonwhite ethnicity, non-English speaking, and lacking high school education. Conclusion Markers for higher levels of health care access, both sociodemographic and age-based, are associated with higher papillary thyroid cancer incidence rates. More papillary thyroid cancers are diagnosed among populations with wider access to healthcare. Despite the threefold increase in incidence over three decades, the mortality rate remains unchanged. Together with the large subclinical reservoir of

  18. Non-thyroid cancer incidence in Belarusian residents exposed to Chernobyl fallout in childhood and adolescence: Standardized Incidence Ratio analysis, 1997–2011

    International Nuclear Information System (INIS)

    Ostroumova, Evgenia; Hatch, Maureen; Brenner, Alina; Nadyrov, Eldar; Veyalkin, Ilya; Polyanskaya, Olga; Yauseyenka, Vasilina; Polyakov, Semion; Levin, Leonid

    2016-01-01

    Background: While an increased risk of thyroid cancer from post-Chernobyl exposure to Iodine-131 (I-131) in children and adolescents has been well-documented, risks of other cancers or leukemia as a result of residence in radioactively contaminated areas remain uncertain. Methods: We studied non-thyroid cancer incidence in a cohort of about 12,000 individuals from Belarus exposed under age of 18 years to Chernobyl fallout (median age at the time of Chernobyl accident of 7.9 years). During 15 years of follow-up from1997 through 2011, 54 incident cancers excluding thyroid were identified in the study cohort with 142,968 person-years at risk. We performed Standardized Incidence Ratio (SIR) analysis of all solid cancers excluding thyroid (n=42), of leukemia (n=6) and of lymphoma (n=6). Results: We found no significant increase in the incidence of non-thyroid solid cancer (SIR=0.83, 95% Confidence Interval [CI]: 0.61; 1.11), lymphoma (SIR=0.66, 95% CI: 0.26; 1.33) or leukemia (SIR=1.78, 95% CI: 0.71; 3.61) in the study cohort as compared with the sex-, age- and calendar-time-specific national rates. These findings may in part reflect the relatively young age of study subjects (median attained age of 33.4 years), and long latency for some radiation-related solid cancers. Conclusions: We found no evidence of statistically significant increases in solid cancer, lymphoma and leukemia incidence 25 years after childhood exposure in the study cohort; however, it is important to continue follow-up non-thyroid cancers in individuals exposed to low-level radiation at radiosensitive ages. - Highlights: • We monitor cancers in a Belarusian cohort of exposed as children due to Chernobyl. • No increase in solid cancer rates was found as compared to the national rates. • An elevation of leukemia rates was detected, although statistically insignificant. • Results are consistent with those in a cohort of exposed as children in Ukraine. • Further monitoring of cancer situation

  19. Non-thyroid cancer incidence in Belarusian residents exposed to Chernobyl fallout in childhood and adolescence: Standardized Incidence Ratio analysis, 1997–2011

    Energy Technology Data Exchange (ETDEWEB)

    Ostroumova, Evgenia, E-mail: ostroumovae@iarc.fr [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive, MSC 9776, Bethesda, 20892 MD (United States); Hatch, Maureen, E-mail: hatchm@mail.nih.gov [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive, MSC 9776, Bethesda, 20892 MD (United States); Brenner, Alina, E-mail: brennera@mail.nih.gov [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive, MSC 9776, Bethesda, 20892 MD (United States); Nadyrov, Eldar, E-mail: nadyrov2006@rambler.ru [The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040 (Belarus); Veyalkin, Ilya, E-mail: veyalkin@mail.ru [The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040 (Belarus); Polyanskaya, Olga, E-mail: polyanskaya@tut.by [The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040 (Belarus); Yauseyenka, Vasilina, E-mail: yaus@mail.ru [The Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel 246040 (Belarus); Polyakov, Semion, E-mail: spolyakov@belcmt.by [State Institution “Republican Scientific and Practical Center for Medical Technologies, Informatization, Administration and Management of Health”, 7-a Petrus Brovka Street, Minsk 220600 (Belarus); Levin, Leonid, E-mail: llevin@omr.med.by [Cancer Registry, State Establishment “N.N.Alexandrov National Cancer Center of Belarus for Oncology and Medical Radiology”, P.O., Lesnoy 223040 (Belarus); and others

    2016-05-15

    Background: While an increased risk of thyroid cancer from post-Chernobyl exposure to Iodine-131 (I-131) in children and adolescents has been well-documented, risks of other cancers or leukemia as a result of residence in radioactively contaminated areas remain uncertain. Methods: We studied non-thyroid cancer incidence in a cohort of about 12,000 individuals from Belarus exposed under age of 18 years to Chernobyl fallout (median age at the time of Chernobyl accident of 7.9 years). During 15 years of follow-up from1997 through 2011, 54 incident cancers excluding thyroid were identified in the study cohort with 142,968 person-years at risk. We performed Standardized Incidence Ratio (SIR) analysis of all solid cancers excluding thyroid (n=42), of leukemia (n=6) and of lymphoma (n=6). Results: We found no significant increase in the incidence of non-thyroid solid cancer (SIR=0.83, 95% Confidence Interval [CI]: 0.61; 1.11), lymphoma (SIR=0.66, 95% CI: 0.26; 1.33) or leukemia (SIR=1.78, 95% CI: 0.71; 3.61) in the study cohort as compared with the sex-, age- and calendar-time-specific national rates. These findings may in part reflect the relatively young age of study subjects (median attained age of 33.4 years), and long latency for some radiation-related solid cancers. Conclusions: We found no evidence of statistically significant increases in solid cancer, lymphoma and leukemia incidence 25 years after childhood exposure in the study cohort; however, it is important to continue follow-up non-thyroid cancers in individuals exposed to low-level radiation at radiosensitive ages. - Highlights: • We monitor cancers in a Belarusian cohort of exposed as children due to Chernobyl. • No increase in solid cancer rates was found as compared to the national rates. • An elevation of leukemia rates was detected, although statistically insignificant. • Results are consistent with those in a cohort of exposed as children in Ukraine. • Further monitoring of cancer situation

  20. Increasing incidence of base of tongue cancers from 2000 to 2010 due to HPV

    DEFF Research Database (Denmark)

    Garnaes, E; Kiss, K; Andersen, L

    2015-01-01

    for all (n=210) BSCCs registered in the Danish Head and Neck Cancer Group (DAHANCA) and the Danish Pathology Data Bank, and genotyped all HPV-positive specimens with amplicon-based next-generation sequencing. RESULTS: The overall crude incidence of BSCCs increased significantly significant increase......BACKGROUND: We assessed the development in the number of new base of tongue squamous-cell carcinoma (BSCC) cases per year in eastern Denmark from 2000 to 2010 and whether HPV may explain any observable increased incidence. METHODS: We performed HPV DNA PCR and p16 immunohistochemistry analysis...

  1. Rapid Increase in Scrub Typhus Incidence in Mainland China, 2006-2014.

    Science.gov (United States)

    Wu, Yi-Cheng; Qian, Quan; Magalhaes, Ricardo J Soares; Han, Zhi-Hai; Haque, Ubydul; Weppelmann, Thomas A; Hu, Wen-Biao; Liu, Yun-Xi; Sun, Yan-Song; Zhang, Wen-Yi; Li, Shen-Long

    2016-03-01

    Scrub typhus is a vector-borne disease, which has recently reemerged in China. In this study, we describe the distribution and incidence of scrub typhus cases in China from 2006 to 2014 and quantify differences in scrub typhus cases with respect to sex, age, and occupation. The results of our study indicate that the annual incidence of scrub typhus has increased during the study period. The number of cases peaked in 2014, which was 12.8 times greater than the number of cases reported in 2006. Most (77.97%) of the cases were reported in five provinces (Guangdong, Yunnan, Anhui, Fujian, and Shandong). Our study also demonstrates that the incidence rate of scrub typhus was significantly higher in females compared to males (P scrub typhus incidence, but also document an expansion in the geographic distribution throughout the country. © The American Society of Tropical Medicine and Hygiene.

  2. Increased incidence of gonorrhoea and chlamydia in Greenland 1990-2012

    DEFF Research Database (Denmark)

    Johansen, Mila Broby; Koch, Anders; Wohlfahrt, Jan

    2017-01-01

    BACKGROUND: Since the 1970s, Greenland has presented the highest reported incidence rates of the sexually transmitted infections (STIs) gonorrhoea and chlamydia in the Arctic regions. OBJECTIVE: This study aims to describe sex- and age-specific incidence rates of gonorrhoea and chlamydia from 1990...... to 2012 in Greenland, and to evaluate if changes in case definitions, diagnostic procedures and implementation of STI interventions during the period coincide with rate changes. DESIGN: Gonorrhoea and chlamydia cases were identified from the national STI surveillance. For 1990-2008, STI cases were...... to sex, age and calendar period. RESULTS: Gonorrhoea and chlamydia incidence rates have increased since 1995 to reach 2,555 per 100,000 person-years (PY) for gonorrhoea and 6,403 per 100,000 PY for chlamydia in 2012. From 2006 to 2012, the incidence rates among young adults aged 15-19 years were 8...

  3. Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality.

    Science.gov (United States)

    Burns, Jonathan K; Tomita, Andrew; Kapadia, Amy S

    2014-03-01

    Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia. The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level. We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates. One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03). Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.

  4. Stable incidence of HIV diagnoses among Danish MSM despite increased engagement in unsafe sex

    DEFF Research Database (Denmark)

    Cowan, Susan Alice; Gerstoft, Jan; Haff, Jakob

    2012-01-01

    Since introduction of highly active antiretroviral therapy (HAART), the prevalence of Danish HIV-positive men who have sex with men (MSM) has increased substantially. In contrast, the incidence of MSM diagnosed with HIV has not increased, and this paradox has been the focus of intensive debate....

  5. Increased Incidence of Campylobacter spp. Infection and High Rates among Children, Israel

    Science.gov (United States)

    Lerner, Larisa; Valinsky, Lea; Moran-Gilad, Jacob; Nissan, Israel; Agmon, Vered; Peretz, Chava

    2013-01-01

    During 1999–2010, the annual incidence of Campylobacter spp. infection in Israel increased from 31.04 to 90.99 cases/100,000 population, a yearly increase of 10.24%. Children 26-fold higher than for the 30–<50 age group. PMID:24188185

  6. Increased incidence of bowel cancer after non-surgical treatment of appendicitis.

    Science.gov (United States)

    Enblad, Malin; Birgisson, Helgi; Ekbom, Anders; Sandin, Fredrik; Graf, Wilhelm

    2017-11-01

    There is an ongoing debate on the use of antibiotics instead of appendectomy for treating appendicitis but diagnostic difficulties and longstanding inflammation might lead to increased incidence of bowel cancer in these patients. The aim of this population-based study was to investigate the incidence of bowel cancer after non-surgical treatment of appendicitis. Patients diagnosed with appendicitis but lacking the surgical procedure code for appendix removal were retrieved from the Swedish National Inpatient Register 1987-2013. The cohort was matched with the Swedish Cancer Registry and the standardised incidence ratios (SIR) with 95% confidence interval (95% CI) for appendiceal, colorectal and small bowel cancers were calculated. Of 13 595 patients with non-surgical treatment of appendicitis, 352 (2.6%) were diagnosed with appendiceal, colorectal or small bowel cancer (SIR 4.1, 95% CI 3.7-4.6). The largest incidence increase was found for appendiceal (SIR 35, 95% CI 26-46) and right-sided colon cancer (SIR 7.5, 95% CI 6.6-8.6). SIR was still elevated when excluding patients with less than 12 months since appendicitis and the incidence of right-sided colon cancer was elevated five years after appendicitis (SIR 3.5, 95% CI 2.1-5.4). An increased incidence of bowel cancer was found after appendicitis with abscess (SIR 4.6, 95% CI 4.0-5.2), and without abscess (SIR 3.5, 95% CI 2.9-4.1). Patients with non-surgical treatment of appendicitis have an increased short and long-term incidence of bowel cancer. This should be considered in the discussion about optimal management of patients with appendicitis. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  7. Increasing incidence of fluoroquinolone-resistant Mycobacterium tuberculosis in Mumbai, India.

    Science.gov (United States)

    Agrawal, D; Udwadia, Z F; Rodriguez, C; Mehta, A

    2009-01-01

    Tertiary referral centre, private hospital, Mumbai, India. To analyse the incidence of fluoroquinolone (FQ) resistant Mycobacterium tuberculosis (TB) in our laboratory from 1995 to 2004. Retrospective review and analysis of the drug susceptibility test records of all M. tuberculosis culture-positive samples from our Microbiology Department from 1995 to 2004. FQ resistance has increased exponentially in our laboratory, from 3% in 1996 to 35% in 2004. The incidence of multidrug-resistant tuberculosis has also increased during the same period, from 33% in 1995 to 56% in 2004. The incidence of FQ-resistant M. tuberculosis is gradually increasing to alarming levels. This may be due to widespread use of this vital group of drugs in the treatment of community-acquired infections. We urge that these broad spectrum antibiotics be used judiciously, and ideally be reserved for treatment of resistant TB in TB-endemic areas.

  8. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  9. Identifying aspects of neighbourhood deprivation associated with increased incidence of schizophrenia.

    Science.gov (United States)

    Bhavsar, Vishal; Boydell, Jane; Murray, Robin; Power, Paddy

    2014-06-01

    Several studies have found an association between area deprivation and incidence of schizophrenia. However, not all studies have concurred and definitions of deprivation have varied between studies. Relative deprivation and inequality seem to be particularly important, but which aspects of deprivation or how this effect might operate is not known. The Lambeth Early Onset case register is a database of all cases of first episode psychosis aged 16 to 35years from the London Borough of Lambeth, a highly urban area. We identified 405 people with first onset schizophrenia who presented between 2000 and 2007. We calculated the overall incidence of first onset schizophrenia and tested for an association with area-level deprivation, using a multi-domain index of deprivation (IMD 2004). Specific analyses into associations with individual sub-domains of deprivation were then undertaken. Incidence rates, directly standardized for age and gender, were calculated for Lambeth at two geographical levels (small and large neighbourhood level). The Poisson regression model predicting incidence rate ratios for schizophrenia using overall deprivation score was statistically significant at both levels after adjusting for ethnicity, ethnic density, population density and population turnover. The incidence rate ratio for electoral ward deprivation was 1.03 (95% CI=1.004-1.04) and for the super output area deprivation was 1.04 (95% CI=1.02-1.06). The individual domains of crime, employment deprivation and educational deprivation were statistically significant predictors of incidence but, after adjusting for the other domains as well as age, gender, ethnicity and population density, only crime and educational deprivation, remained statistically significant. Low income, poor housing and deprived living environment did not predict incidence. In a highly urban area, an association was found between area-level deprivation and incidence of schizophrenia, after controlling for age, gender

  10. 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.

  11. Climate variability and increase in intensity and magnitude of dengue incidence in Singapore.

    Science.gov (United States)

    Hii, Yien Ling; Rocklöv, Joacim; Ng, Nawi; Tang, Choon Siang; Pang, Fung Yin; Sauerborn, Rainer

    2009-11-11

    Dengue is currently a major public health burden in Asia Pacific Region. This study aims to establish an association between dengue incidence, mean temperature and precipitation, and further discuss how weather predictors influence the increase in intensity and magnitude of dengue in Singapore during the period 2000-2007. Weekly dengue incidence data, daily mean temperature and precipitation and the midyear population data in Singapore during 2000-2007 were retrieved and analysed. We employed a time series Poisson regression model including time factors such as time trends, lagged terms of weather predictors, considered autocorrelation, and accounted for changes in population size by offsetting. The weekly mean temperature and cumulative precipitation were statistically significant related to the increases of dengue incidence in Singapore. Our findings showed that dengue incidence increased linearly at time lag of 5-16 and 5-20 weeks succeeding elevated temperature and precipitation, respectively. However, negative association occurred at lag week 17-20 with low weekly mean temperature as well as lag week 1-4 and 17-20 with low cumulative precipitation. As Singapore experienced higher weekly mean temperature and cumulative precipitation in the years 2004-2007, our results signified hazardous impacts of climate factors on the increase in intensity and magnitude of dengue cases. The ongoing global climate change might potentially increase the burden of dengue fever infection in near future.

  12. Increasing incidence of thyroid cancer in the Nordic countries with main focus on Swedish data.

    Science.gov (United States)

    Carlberg, Michael; Hedendahl, Lena; Ahonen, Mikko; Koppel, Tarmo; Hardell, Lennart

    2016-07-07

    Radiofrequency radiation in the frequency range 30 kHz-300 GHz was evaluated to be Group 2B, i.e. 'possibly' carcinogenic to humans, by the International Agency for Research on Cancer (IARC) at WHO in May 2011. Among the evaluated devices were mobile and cordless phones, since they emit radiofrequency electromagnetic fields (RF-EMF). In addition to the brain, another organ, the thyroid gland, also receives high exposure. The incidence of thyroid cancer is increasing in many countries, especially the papillary type that is the most radiosensitive type. We used the Swedish Cancer Register to study the incidence of thyroid cancer during 1970-2013 using joinpoint regression analysis. In women, the incidence increased statistically significantly during the whole study period; average annual percentage change (AAPC) +1.19 % (95 % confidence interval (CI) +0.56, +1.83 %). Two joinpoints were detected, 1979 and 2001, with a high increase of the incidence during the last period 2001-2013 with an annual percentage change (APC) of +5.34 % (95 % CI +3.93, +6.77 %). AAPC for all men during 1970-2013 was +0.77 % (95 % CI -0.03, +1.58 %). One joinpoint was detected in 2005 with a statistically significant increase in incidence during 2005-2013; APC +7.56 % (95 % CI +3.34, +11.96 %). Based on NORDCAN data, there was a statistically significant increase in the incidence of thyroid cancer in the Nordic countries during the same time period. In both women and men a joinpoint was detected in 2006. The incidence increased during 2006-2013 in women; APC +6.16 % (95 % CI +3.94, +8.42 %) and in men; APC +6.84 % (95 % CI +3.69, +10.08 %), thus showing similar results as the Swedish Cancer Register. Analyses based on data from the Cancer Register showed that the increasing trend in Sweden was mainly caused by thyroid cancer of the papillary type. We postulate that the whole increase cannot be attributed to better diagnostic procedures. Increasing exposure to ionizing

  13. Chernobyl-Related Cancer and Precancerous Lesions: Incidence Increase vs. Late Diagnostics

    Science.gov (United States)

    Jargin, Sergei V.

    2014-01-01

    The reported incidence of thyroid cancer in children and adolescents in Soviet Union before the Chernobyl accident was lower than in other developed countries. This is not clearly recognizable from the literature because comparisons of the high incidence figures 4 years after the accident and later have been made with those from the first years after the accident, when the registered incidence had already started to increase. Considering the low pre-accident registered incidence, there was an accumulated pool of undiagnosed thyroid tumors before the accident. The percentage of more advanced cancers, larger in size and less differentiated, was higher after the accident, when the pool of neglected cancers was diagnosed due to the screening and improved diagnostics. Some of these advanced tumors found by screening were interpreted as aggressive radiogenic cancers. The same tendency might be true also for other cancers, e.g. renal cell carcinoma. Furthermore, the screening-effect, false-positivity and registration of non-exposed patients as Chernobyl victims has obviously contributed to the registered incidence increase of malignancy. PMID:25249833

  14. Increased incidence of thyroid cancer in Navarra (Spain). Evolution and clinical characteristics, 1986-2010.

    Science.gov (United States)

    Rojo Álvaro, Jorge; Bermejo Fraile, Begoña; Menéndez Torre, Edelmiro; Ardanaz, Eva; Guevara, Marcela; Anda Apiñániz, Emma

    The latest published studies show an increased incidence of thyroid cancer worldwide. The aim of this study was to analyze the changes in the incidence of thyroid cancer in Navarra and its clinical presentation regarding sex, histological subtype and size over the last 25 years. Thyroid cancer incidence rates were calculated on the basis of data from the Cancer Registry of Navarra during 1986-2010. Clinical data were obtained from the historical cohort of the Hospital Registry of Cancer of Navarra, which includes all the new cases of differentiated thyroid carcinoma diagnosed and treated in the public health network of this Community in that period. The overall incidence of thyroid cancer in Navarra increased over the last 25 years, with an increase in the adjusted rate in men from 2.24 (1986-1990) to 5.85 (2006-2010) per 100,000 population/year (P<.001) and in women from 9.05 to 14.04, respectively (P<.001). This increase occurs only in papillary carcinoma. The clinical characteristics of 739 patients with differentiated thyroid cancer were studied. The mean age at diagnosis increased over the years and the predominance of women (about 80%) remains stable. Mean tumor size decreased over the five-year periods from 30.9 to 22.5mm (P<.001), the proportion of microcarcinomas (T1a) increased from 8.8% to 30% (P<.001) and, despite this increase, there were no statistical differences in the TNM stage at diagnosis during the study period. The distribution of histological variants of papillary and follicular carcinoma did not change over 25 years. During the period studied, the incidence of thyroid cancer increased in Navarra in both sexes. The increase occurred only in papillary carcinoma, without changes in the distribution of his histological variants. The increase in the proportion of T1a tumors is remarkable, but the TNM stage distribution was maintained. These results suggest an increase in the diagnosis of thyroid microcarcinomas due to changes in clinical practice

  15. Increased incidence of cervical intraepithelial neoplasia in young women in the Mitte district, Berlin, Germany.

    Science.gov (United States)

    Blohmer, J U; Schmalisch, G; Klette, I; Grineisen, Y; Kohls, A; Guski, H; Lichtenegger, W

    1999-01-01

    To investigate whether the incidence of cervical intraepithelial neoplasia (CIN), in particular of high grade CIN, increased in Berlin during the period 1970-1989 and whether the ages of women with CIN had decreased. In the former German Democratic Republic, which had a highly centralized public health system, all gynecologic operations performed on women living in the Mitte district of Berlin were carried out during the period 1970-1989 (when the Berlin Wall fell) in the gynecologic clinic of the Charité Hospital. The incidence of all CIN increased from year to year over the observation period: 0.04% (1970-1971), 0.10% (1980-1981), 0.39% (1988-1989). There was a particularly high increase in the incidence of high grade intraepithelial neoplasms (CIN 3): 0.016% (1970-1971), 0.056% (1980-1981), 0.25% (1988-1989). With a virtually unchanged age distribution for women in the Mitte district of Berlin, the median age of women with CIN 3 decreased significantly from 1970 to 1989, from 39.5 (1970) to 33 (1989) (P < .001). The increase in the incidence of CIN, especially of high grade CIN, as well as the reduction in age for onset of the disease, makes high participation in screening necessary, above all among young women.

  16. Increased incidence of gang rape in Benin-City, Nigeria: Is this a ...

    African Journals Online (AJOL)

    Increased incidence of gang rape in Benin-City, Nigeria: Is this a forensic epidemic? ... creates so much negative impact on the legal outcome. There is a need to provide a holistic support to the victims and to review Nigerian laws on sexual offences for the good of all. Keywords: Gang-Rape, Sexual violence, Forensic, Ep ...

  17. Investigation of the possible increased incidence of cancer in West Cumbria

    International Nuclear Information System (INIS)

    Rubery, E.D.

    1985-01-01

    The report of the Black Advisory Group on an investigation of the possible increased incidence of cancer in West Cumbria is briefly considered. The Advisory Group was unable to reach definite conclusions as to whether there is a link between discharges of radioactive material from BNFL Sellafield and the incidence of cancer due to uncertainties in the available epidemiological data and the radiation dose estimate data. The implementation of ten recommendations of the Black Advisory Group are briefly described covering epidemiological, radiation protection and organisational matters in an effort to clarify the situation and to enhance public safety. (U.K.)

  18. Increasing Incidence of Severe Epstein-Barr Virus-Related Infectious Mononucleosis: Surveillance Study

    Science.gov (United States)

    Tattevin, Pierre; Le Tulzo, Yves; Minjolle, Sophie; Person, Arnaud; Chapplain, Jean Marc; Arvieux, Cedric; Thomas, Remi; Michelet, Christian

    2006-01-01

    Older patients are more susceptible to severe Epstein-Barr virus (EBV)-related infectious mononucleosis (IM). This condition may increase in industrialized countries where primary EBV infection occurs later in life. Between 1990 and 2004, 38 patients were admitted to our department with EBV-related IM. Two patients died. The annual incidence increased significantly (r = 0.623; P = 0.013). PMID:16672427

  19. Cutaneous squamous cell carcinoma in norway 1963–2011: increasing incidence and stable mortality

    International Nuclear Information System (INIS)

    Robsahm, Trude E; Helsing, Per; Veierød, Marit B

    2015-01-01

    The incidence of cutaneous squamous cell carcinoma (SCC) is rapidly increasing in white populations, causing high morbidity and health-care costs. Few studies, however, have described the trends for SCC, as population-based data with a long follow-up are limited. In Norway we have this opportunity and we aimed to describe SCC incidence, mortality and survival rates, according to sex, age, stage, primary anatomical location, and geographical region, for the period 1963–2011, for estimation of future health-care needs. Data were retrieved from the Cancer Registry of Norway. Age-adjusted SCC incidence and mortality rates and 5-year relative survival (in percent) were calculated for 5-year calendar periods. A joinpoint regression model identified the annual percentage change (APC) in rates over the 50-year period. The age-adjusted incidence rate increased ninefold in females and sixfold in males from 1963 to 2011, with APCs of 5.6% (95% confidence interval, CI 4.5, 7.3) and 3.3% (95% CI 1.3, 5.3) in females and males, respectively. SCC incidence rose in all age groups, anatomical locations (except ears in females), and geographical regions, though restricted to localized tumors. Most striking increase was seen in the age group 70–79, in face and head locations and among residents in southern Norway. SCC mortality and survival rates remained relatively stable. Our findings underline an increasing need for SCC treatment in Norway, especially considering the aging population. The findings also call for the creation of particular guidelines for primary prevention of SCC

  20. Increasing incidence of diabetes after gestational diabetes: a long-term follow-up in a Danish population

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  1. Daytime napping and increased risk of incident respiratory diseases: symptom, marker, or risk factor?

    Science.gov (United States)

    Leng, Yue; Wainwright, Nick W J; Cappuccio, Francesco P; Surtees, Paul G; Hayat, Shabina; Luben, Robert; Brayne, Carol; Khaw, Kay-Tee

    2016-07-01

    We have identified a strong association between daytime napping and increased mortality risk from respiratory diseases, but little is known about the relationship between daytime napping and respiratory morbidity. Data were drawn from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort. Participants reported napping habits during 1998-2000 and were followed up for respiratory disease hospital admissions until March 2009. Cox proportional hazards regression was used to examine the association between daytime napping and respiratory disease incidence risk. The study sample included 10,978 men and women with a mean age of 61.9 years, and a total of 946 incident respiratory disease cases were recorded. After adjustment for age, sex, social class, education, marital status, employment status, nightshift work, body mass index, physical activity, smoking, alcohol intake, self-reported general health, hypnotic drug use, habitual sleep duration, and preexisting health conditions, daytime napping was associated with an increase in the overall respiratory disease incidence risk (hazard ratio (HR) = 1.32, 95% confidence interval (CI) 1.15, 1.52 for napping respiratory diseases, especially for the risk of chronic lower respiratory diseases (HR = 1.52, 95% CI: 1.18, 1.96 for napping respiratory disease incidence risk. Further studies are required to confirm these findings and help understand potential mechanisms. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

  2. Increasing incidence of Rocky Mountain spotted fever among the American Indian population in the United States.

    Science.gov (United States)

    Holman, Robert C; McQuiston, Jennifer H; Haberling, Dana L; Cheek, James E

    2009-04-01

    To examine trends of Rocky Mountain spotted fever (RMSF) incidence among American Indians compared with other race groups, a retrospective analysis of national RMSF surveillance data reported to the National Electronic Telecommunications System for Surveillance and the Tickborne Rickettsial Disease Case Report Forms system were used. The RMSF incidence for American Indians, which was comparable to those for other race groups during 1990-2000, increased at a disproportionate rate during 2001-2005. The average annual incidence of RMSF reported among American Indians for 2001-2005 was 16.8 per 1,000,000 persons compared with 4.2, 2.6, and 0.5 for white, black, and Asian/Pacific Islander persons, respectively. Most cases in American Indians were reported from Oklahoma (113.1 cases per 1,000,000), North Carolina (60.0), and Arizona (17.2). The incidence of RMSF increased dramatically among American Indians disproportionately to trends for other race groups. Education about tick-borne disease and prevention measures should be addressed for high-risk American Indian populations.

  3. Incidence of tissue coring during transseptal catheterization when using electrocautery and a standard transseptal needle.

    Science.gov (United States)

    Greenstein, Eugene; Passman, Rod; Lin, Albert C; Knight, Bradley P

    2012-04-01

    The application of radiofrequency electrocautery to a standard, open-ended transseptal needle has been used to facilitate transseptal puncture (TSP). The purpose of this study was to determine the incidence of cardiac tissue coring when this technique is used. A model using excised swine hearts submerged in a saline-filled basin was developed to simulate TSP with electrocautery and a standard transseptal needle. Punctures were performed without the use of electrocautery and by delivering radiofrequency energy to the transseptal needle using a standard electrocautery pen at 3 target sites (fossa ovalis, non-fossa ovalis septum, and aorta). The tissue of the submerged heart was gently tented, and the needle was advanced on delivery of radiofrequency. The devices were retracted, and the needle was flushed in a collection basin. None of the TSPs without cautery caused tissue coring. For TSPs using electrocautery, the frequency of coring was at least 21% for any puncture permutation used in the study and averaged 37% at septal sites (Pelectrocautery and a standard open-ended Brockenbrough needle resulted in coring of the septal tissue in 35% of cases (33 of 96 punctures).

  4. Is the development of nuclear energy likely to increase the incidence of genetic diseases for mankind

    International Nuclear Information System (INIS)

    Leonard, A.

    1976-01-01

    In a normal human population a relatively high number of individuals (+10%) are bearing genetic and chromosomal deficiencies. As a result of the difficulties encountered when carrying out valid epidemiological investigations, the observations made on the descent of irradiated subjects have not demonstrated that an exposure for a man to ionizing radiations increases the incidence of his deficiencies. That explains the need of having to use the results of experiments conducted on animals in order to evaluate this kind of hazard for mankind. The analysis of these experimental data allows us to conclude that under normal conditions of exploitation the expected development of the nuclear energy is not likely to increase significantly the incidence of genetic deficiencies for mankind. (G.C.)

  5. Assessing cutoff values for increased exercise blood pressure to predict incident hypertension in a general population.

    Science.gov (United States)

    Lorbeer, Roberto; Ittermann, Till; Völzke, Henry; Gläser, Sven; Ewert, Ralf; Felix, Stephan B; Dörr, Marcus

    2015-07-01

    Cutoff values for increased exercise blood pressure (BP) are not established in hypertension guidelines. The aim of the study was to assess optimal cutoff values for increased exercise BP to predict incident hypertension. Data of 661 normotensive participants (386 women) aged 25-77 years from the Study of Health in Pomerania (SHIP-1) with a 5-year follow-up were used. Exercise BP was measured at a submaximal level of 100 W and at maximum level of a symptom-limited cycle ergometry test. Cutoff values for increased exercise BP were defined at the maximum sum of sensitivity and specificity for the prediction of incident hypertension. The area under the receiver-operating characteristic curve (AUC) and net reclassification index (NRI) were calculated to investigate whether increased exercise BP adds predictive value for incident hypertension beyond established cardiovascular risk factors. In men, values of 160  mmHg (100  W level; AUC = 0.7837; NRI = 0.534, P AUC = 0.7677; NRI = 0.340, P = 0.003) were detected as optimal cutoff values for the definition of increased exercise SBP. A value of 190  mmHg (AUC = 0.8347; NRI = 0.519, P < 0.001) showed relevance for the definition of increased exercise SBP in women at the maximum level. According to our analyses, 190 and 210  mmHg are clinically relevant cutoff values for increased exercise SBP at the maximum exercise level of cycle ergometry test for women and men, respectively. In addition, for men, our analyses provided a cutoff value of 160  mmHg for increased exercise SBP at the 100  W level.

  6. Study for the development of a standardized system of incidents in radiotherapy

    International Nuclear Information System (INIS)

    Ribeiro, A.LC.; Silva, A.L. da; Moreira, J.G.R.; Silva, K.R.R. da

    2017-01-01

    Radiotherapy is a modality that, along with surgery, has become essential for the success of cancer treatment. Over the years, radiotherapy has been improved to increase the effectiveness of the chances of cure. The objective of this study was to capture data from on-site visits in two clinics that offer the radiotherapy service in the state of Rio de Janeiro. After observing that each clinic had similar procedures, however, with some different methods and in view of these data obtained, a model was developed for an institutional system of incident record with the purpose of sharing results to assist in the improvement of safety protocols to mitigate possible accidents in one or more units. We conclude that this system has everything to fulfill the proposal of assisting in learning incidents. However, it is primary and updates will be of utmost importance for your improvement

  7. Increasing incidence of nutritional rickets: a population-based study in Olmsted County, Minnesota.

    Science.gov (United States)

    Thacher, Tom D; Fischer, Philip R; Tebben, Peter J; Singh, Ravinder J; Cha, Stephen S; Maxson, Julie A; Yawn, Barbara P

    2013-02-01

    To determine temporal trends in incidence and risk factors of nutritional rickets in a community-based population. Rochester Epidemiology Project data were used to identify all children (aged rickets, vitamin D deficiency, hypovitaminosis D, rachitis, osteomalacia, genu varum, genu valgum, craniotabes, hypocalcemia, hypocalcemic seizure, and tetany. Record abstraction was performed to select individuals with radiographic confirmation of rickets. Age- and sex-matched controls were identified for the evaluation of risk factors. The main outcome measure was radiographic evidence of rickets without identifiable inherited, genetic, or nonnutritional causes. Incidence rates were calculated using Rochester Epidemiology Project census data. Of 768 children with eligible diagnostic codes, 23 had radiographic evidence of rickets; of these, 17 children had nutritional rickets. All 17 children were younger than 3 years, and 13 (76%) were of nonwhite race/ethnicity. Clinical presentation included poor growth (n=12), leg deformity (n=8), motor delay (n=5), leg pain (n=3), weakness (n=3), and hypocalcemia or tetany (n=2). The incidence of nutritional rickets in children younger than 3 years was 0, 2.2, 3.7, and 24.1 per 100,000 for the decades beginning in 1970, 1980, 1990, and 2000, respectively (P=.003 for incidence trend). Nutritional rickets was associated with black race, breast-feeding, low birth weight, and stunted growth (Prickets remains rare, but its incidence has dramatically increased since 2000. Not all cases of rickets can be attributed to vitamin D deficiency. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  8. Increase in the incidence of type 1 diabetes in Israeli children following the Second Lebanon War.

    Science.gov (United States)

    Zung, Amnon; Blumenfeld, Orit; Shehadeh, Naim; Dally Gottfried, Orna; Tenenbaum Rakover, Yardena; Hershkovitz, Eli; Gillis, David; Zangen, David; Pinhas-Hamiel, Orit; Hanukoglu, Aaron; Rachmiel, Marianna; Shalitin, Shlomit

    2012-06-01

    Type 1 diabetes is an autoimmune disease occurring in genetically susceptible individuals. The precipitating cause is unclear. Recently, the Second Lebanon War exposed a large civilian population in northern Israel to significant psychological stress in the form of repeated barrages of missile attacks. We hypothesized that trends in regional incidence of type 1 diabetes before and after the war would reflect an association with stress. All type 1 diabetes patients aged 0-17 yr who were reported to the Israel Juvenile Diabetes Register (n = 1822) in the four pre-war (2002-2005) and two post-war years (2006-2007) were included in the study. The patients were stratified by gender, age, ethnicity, family history of type 1 diabetes, season at diagnosis, and region of residency, namely, those who lived in the northern regions that were attacked and those in other regions. The post-war incidence of type 1 diabetes was increased in the northern regions (rate ratio, RR = 1.27; p = 0.037), with no change in the other regions. This change was more prominent in males (RR = 1.55; p = 0.005) but similar in summer and winter, in different ages, and in different ethnic groups. There was no change in the proportion of new patients with a family history of the disease. For the first time in a large population, we found a positive association between the trauma of war and an increase in the incidence of type 1 diabetes in children and adolescents. The increase in incidence was not associated with genetic susceptibility to the disease. © 2011 John Wiley & Sons A/S.

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

    Science.gov (United States)

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

    2009-06-29

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

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

    Directory of Open Access Journals (Sweden)

    Vilppula Anitta

    2009-06-01

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

  11. 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

  12. Increasing Dengue Incidence in Singapore over the Past 40 Years: Population Growth, Climate and Mobility.

    Directory of Open Access Journals (Sweden)

    Claudio Jose Struchiner

    Full Text Available In Singapore, the frequency and magnitude of dengue epidemics have increased significantly over the past 40 years. It is important to understand the main drivers for the rapid increase in dengue incidence. We studied the relative contributions of putative drivers for the rise of dengue in Singapore: population growth, climate parameters and international air passenger arrivals from dengue endemic countries, for the time period of 1974 until 2011. We used multivariable Poisson regression models with the following predictors: Annual Population Size; Aedes Premises Index; Mean Annual Temperature; Minimum and Maximum Temperature Recorded in each year; Annual Precipitation and Annual Number of Air Passengers arriving from dengue-endemic South-East Asia to Singapore. The relative risk (RR of the increase in dengue incidence due to population growth over the study period was 42.7, while the climate variables (mean and minimum temperature together explained an RR of 7.1 (RR defined as risk at the end of the time period relative to the beginning and goodness of fit associated with the model leading to these estimates assessed by pseudo-R2 equal to 0.83. Estimating the extent of the contribution of these individual factors on the increasing dengue incidence, we found that population growth contributed to 86% while the residual 14% was explained by increase in temperature. We found no correlation with incoming air passenger arrivals into Singapore from dengue endemic countries. Our findings have significant implications for predicting future trends of the dengue epidemics given the rapid urbanization with population growth in many dengue endemic countries. It is time for policy-makers and the scientific community alike to pay more attention to the negative impact of urbanization and urban climate on diseases such as dengue.

  13. Incidence of nonarteritic anterior ischemic optic neuropathy: increased risk among diabetic patients

    Science.gov (United States)

    Lee, Michael S; Grossman, Daniel; Arnold, Anthony C.; Sloan, Frank A

    2011-01-01

    Objective Previous studies have identified a higher prevalence of diabetes mellitus (DM) among patient cohorts with non-arteritic anterior ischemic optic neuropathy (NAION). We sought to determine the development of incident NAION among a group of newly diagnosed patients with DM and to estimate the incidence of NAION among the elderly. Design Medicare 5% database study. Participants 25,515 patients with DM and an equal number of age- and gender-matched non-diabetics. Methods Query of Medicare 5% claims files identified patients with new diagnosis of DM in 1994. A randomly selected control group was created using one-to-one propensity score matching. Patients with a diagnosis of giant cell arteritis, pre-existing DM, and age 95 years were excluded. Patients with DM and controls were followed for the development of NAION over the following 4,745 days. Main Outcome Measures Incidence of anterior ischemic optic neuropathy (AION) among patients with and without DM. Results Each group was 85% White, 11% Black, and 4% other race, aged 76.4 years, and 40% male with a mean followup time of 7.6 years. In the diabetes group, 188 individuals developed AION (0.7%) compared to 131 individuals (0.5%; p<0.01) in the control group. In unadjusted Cox regression analysis, having diabetes mellitus was associated with a 43% increased risk (Hazard ratio [HR]: 1.431; 95% confidence interval [CI]: 1.145,1.789) of developing AION. After adjusting for other covariates, the risk of developing AION among individuals with DM was reduced to 40% (HR: 1.397; 95% CI: 1.115,1.750). Male gender increased an individual's risk of developing AION by 32% (HR: 1.319; 95% CI: 1.052,1.654). No other covariate was statistically significantly associated with developing AION. The annual incidence of NAION was 82 per 100,000. Conclusions DM significantly increased the risk of the diagnosis NAION. The incidence of NAION among patients older than 67 years may be higher than previously reported. PMID:21439645

  14. Increase of Stroke Incidence in Young Adults in a Middle-Income Country: A 10-Year Population-Based Study.

    Science.gov (United States)

    Cabral, Norberto Luiz; Freire, Aracélli Tavares; Conforto, Adriana Bastos; Dos Santos, Nayara; Reis, Felipe Ibiapina; Nagel, Vivian; Guesser, Vanessa V; Safanelli, Juliana; Longo, Alexandre L

    2017-11-01

    The incidence of stroke is on the rise in young adults in high-income countries. However, there is a gap of knowledge about trends in stroke incidence in young adults from low- and middle-income countries. We aimed to measure trends in incidence of ischemic stroke (IS) and intracerebral hemorrhage (IH) in young people from 2005 to 2015 in Joinville, Brazil. We retrospectively ascertained all first-ever IS subtypes and IH that occurred in Joinville in the periods of 2005 to 2006, 2010 to 2011, and 2014 to 2015. Poisson regression was used to calculate incidence rate ratios of all strokes, IS, and IH. We also compared the prevalence of risk factors and extension of diagnostic work-up across the 3 periods. For 10 years, we registered 2483 patients (7.5% aged incidence significantly increased by 62% (incidence rate ratios, 1.62; 95% confidence interval, 1.10-2.40) in subjects incidence rate ratios, 1.29; 95% confidence interval, 1.04-1.60). Incidence of IS increased by 66% (incidence rate ratios, 1.66; 95% confidence interval, 1.09-2.54), but there was no significant change in incidence of IH in subjects incidence is rising in young adults in Joinville, Brazil, because of increase in rates of ischemic but not hemorrhagic strokes. We urgently need better policies of cardiovascular prevention in the young. © 2017 American Heart Association, Inc.

  15. Outsourcing cleaning services increases MRSA incidence: Evidence from 126 english acute trusts.

    Science.gov (United States)

    Toffolutti, Veronica; Reeves, Aaron; McKee, Martin; Stuckler, David

    2017-02-01

    There has been extensive outsourcing of hospital cleaning services in the NHS in England, in part because of the potential to reduce costs. Yet some argue that this leads to lower hygiene standards and more infections, such as MRSA and, perhaps because of this, the Scottish, Welsh, and Northern Irish health services have rejected outsourcing. This study evaluates whether contracting out cleaning services in English acute hospital Trusts (legal authorities that run one or more hospitals) is associated with risks of hospital-borne MRSA infection and lower economic costs. By linking data on MRSA incidence per 100,000 hospital bed-days with surveys of cleanliness among patient and staff in 126 English acute hospital Trusts during 2010-2014, we find that outsourcing cleaning services was associated with greater incidence of MRSA, fewer cleaning staff per hospital bed, worse patient perceptions of cleanliness and staff perceptions of availability of handwashing facilities. However, outsourcing was also associated with lower economic costs (without accounting for additional costs associated with treatment of hospital acquired infections). Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Solar Passive Modification Increase Radiation Safety Standards Inside Accelerator Building

    International Nuclear Information System (INIS)

    Eid, A. F.; Keshk, A. B.

    2010-01-01

    Irradiation processing by accelerated electrons is considering one of the most important and useful industrial irradiation treatments. It is depending on two principle attachment elements which are architecture of irradiation building and the accelerator characteristic that was arranged inside irradiation building. Negative environmental measurements were recorded inside the main building and were exceeded the international standards (humidity, air speed, high thermal effects and ozone concentration). The study showed that it is essential to improve the natural environmental standards inside the main irradiation building in order to improve the work environment and to reduce ozone concentration from 220 ppb to international standard. The main goals and advantages were achieved by using environmental architecture (desert architecture) indoor the irradiation building. The work depends on passive solar system which is economic, same architectural elements, comfort / health, and radiation safety, and without mechanical means. The experimental work was accomplished under these modifications. The registered results of various environmental concentrations have proved their normal standards.

  17. The need for a rapid and comprehensive adoption of the revised European standard population in cancer incidence comparisons.

    Science.gov (United States)

    Crocetti, Emanuele; Dyba, Tadek; Martos, Carmen; Randi, Giorgia; Rooney, Roisin; Bettio, Manola

    2017-09-01

    As cancer incidence varies according to age, it is important to rule out differences in age structures in any comparison. A common way of adjusting for these differences is using direct age standardization, which applies age-specific weights from a standard population. Eurostat has recently introduced a revised European standard population (RESP). The effect of using the new standard, in comparison with that introduced in 1976 [European standard population (ESP)], is evaluated. Cancer incidence data for prostate and testis cancer for Denmark, Finland, Sweden, Norway, and Iceland from the NORDCAN web site, and for Ireland and Italy-Genoa from Cancer Incidence in five Continents-X, were analyzed. Incidence rates were directly age standardized using ESP and RESP. The RESP conferred greater weight to adults and the elderly than the ESP. For prostate cancer, age-standardized rates computed with RESP are consistently higher by between 50 and 60% than those computed with ESP. However, the use of RESP, instead of ESP, has little impact on the pattern of time trends, the relative ranking of countries, the values of relative risks, or the percentage differences between age-standardized rates. For testis cancer, RESP and ESP provide very similar results because this cancer is more common in young men. Both ESP and RESP are in circulation. It is, therefore, important that European cancer registries reach consensus on a single standard to use to avoid erroneous comparisons of data computed with different standards. Given that Eurostat recently introduced RESP and is using this standard for data collected from the European Union Member States, it would make sense to rally behind RESP.

  18. The incidence of acute urinary retention secondary to BPH is increasing among California men.

    Science.gov (United States)

    Groves, H K; Chang, D; Palazzi, K; Cohen, S; Parsons, J K

    2013-09-01

    Current epidemiological patterns of adverse events of clinical BPH remain unclear. We investigated trends in acute urinary retention (AUR) associated with BPH in a large, population-based cohort. We utilized the California Office of Statewide Health Planning and Development Database to examine 3 724 016 emergency room (ER) visits in California among men aged  50 years from 2007 to 2010. Outcomes included AUR for which BPH was the primary diagnosis, AUR for which BPH was a secondary diagnosis and urethral catheterization for AUR. We generated adjusted odds ratios (ORadj) using multivariate logistic regression to determine longitudinal trends. A total of 17 023 men presented with a diagnosis of BPH-associated AUR, the unadjusted incidence of which increased from 4.00 per 1000 ER visits in 2007 to 5.23 per 1000 ER visits in 2010 (PBPH-associated AUR increased substantially in a large and ethnically diverse male population of the United States.

  19. Novel surgical performance evaluation approximates Standardized Incidence Ratio with high accuracy at simple means.

    Science.gov (United States)

    Gabbay, Itay E; Gabbay, Uri

    2013-01-01

    Excess adverse events may be attributable to poor surgical performance but also to case-mix, which is controlled through the Standardized Incidence Ratio (SIR). SIR calculations can be complicated, resource consuming, and unfeasible in some settings. This article suggests a novel method for SIR approximation. In order to evaluate a potential SIR surrogate measure we predefined acceptance criteria. We developed a new measure - Approximate Risk Index (ARI). "Number Needed for Event" (NNE) is the theoretical number of patients needed "to produce" one adverse event. ARI is defined as the quotient of the group of patients needed for no observed events Ge by total patients treated Ga. Our evaluation compared 2500 surgical units and over 3 million heterogeneous risk surgical patients that were induced through a computerized simulation. Surgical unit's data were computed for SIR and ARI to evaluate compliance with the predefined criteria. Approximation was evaluated by correlation analysis and performance prediction capability by Receiver Operating Characteristics (ROC) analysis. ARI strongly correlates with SIR (r(2) = 0.87, p 0.9) 87% sensitivity and 91% specificity. ARI provides good approximation of SIR and excellent prediction capability. ARI is simple and cost-effective as it requires thorough risk evaluation of only the adverse events patients. ARI can provide a crucial screening and performance evaluation quality control tool. The ARI method may suit other clinical and epidemiological settings where relatively small fraction of the entire population is affected. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications

    International Nuclear Information System (INIS)

    Halliwell, O.T.; Yadegafar, G.; Lane, C.; Dewbury, K.C.

    2008-01-01

    Aim: To assess whether patients taking aspirin were more likely to experience bleeding complications after transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and methods: Three hundred and eighty-seven patients taking aspirin who underwent prostate biopsy over a 3.5 year period and 731 patients not taking aspirin over a 2 year period returned a questionnaire assessing the incidence and severity of bleeding complications. Results: Patients taking aspirin had a significantly higher cumulative incidence of haematuria and rectal bleeding, but not of haemospermia. They also had a longer mean duration of bleeding, but no increase in bleeding severity. Severe bleeding was very uncommon in both groups and no patients required intervention for bleeding complications. Conclusion: Aspirin exacerbates minor bleeding complications in patients undergoing TRUS guided biopsy of the prostate, but in this large group of aspirin-taking patients no dangerous bleeding complications were encountered. It may be that the risks associated with aspirin cessation outweigh the risks of haemorrhagic complications

  1. Persistent increase in the incidence of acute male urethritis diagnosed in general practices in France

    Science.gov (United States)

    Massari, Véronique; Dorléans, Yves; Flahault, Antoine

    2006-01-01

    Background At-risk sexual behaviour seems to have increased in Europe, possibly due to the reassuring efficacy of highly active antiretroviral treatments. Aim To follow, from 1990 to 2003, in France, the trends in the incidence of acute male urethritis diagnosed in general practice, a marker of at-risk sexual behaviour. Design of study Electronic disease surveillance. Setting General practices located all over mainland France. Method The GPs of the French Sentinelles network reported, via online computer systems, the acute urethritis cases they diagnosed, and for each case the characteristics of the patients. Results After a striking decrease between 1990 and 1995 from 460 per 100 000 men aged 15–64 years (95% confidence interval [CI] = 390 to 520) to 180 (95% CI = 150 to 200), when antiretroviral drugs became available on the French market, the incidence of acute male urethritis stopped decreasing. Between 1996 and 2003, it may have risen again from 190 per 100 000 men (95% CI = 160 to 210) to 325 per 100 000 men (95% CI = 280 to 370) aged 15–64 years. The percentage of homosexual/bisexual men among the cases reported was higher than in the general population (10% versus 4%, Purethritis, shows that the sexual health of men has worsened in France, and calls for urgent new preventive measures. PMID:16464324

  2. Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications

    Energy Technology Data Exchange (ETDEWEB)

    Halliwell, O.T. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)], E-mail: hallo99@doctors.org.uk; Yadegafar, G. [Public Health Sciences and Medical Statistics Division, School of Medicine, Southampton General Hospital, Southampton University, Southampton (United Kingdom); Lane, C.; Dewbury, K.C. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)

    2008-05-15

    Aim: To assess whether patients taking aspirin were more likely to experience bleeding complications after transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and methods: Three hundred and eighty-seven patients taking aspirin who underwent prostate biopsy over a 3.5 year period and 731 patients not taking aspirin over a 2 year period returned a questionnaire assessing the incidence and severity of bleeding complications. Results: Patients taking aspirin had a significantly higher cumulative incidence of haematuria and rectal bleeding, but not of haemospermia. They also had a longer mean duration of bleeding, but no increase in bleeding severity. Severe bleeding was very uncommon in both groups and no patients required intervention for bleeding complications. Conclusion: Aspirin exacerbates minor bleeding complications in patients undergoing TRUS guided biopsy of the prostate, but in this large group of aspirin-taking patients no dangerous bleeding complications were encountered. It may be that the risks associated with aspirin cessation outweigh the risks of haemorrhagic complications.

  3. Increasing injuries as trampoline parks expand within Australia: a call for mandatory standards.

    Science.gov (United States)

    Sharwood, Lisa N; Adams, Susan; Blaszkow, Tracy; Eager, David

    2018-04-01

    To quantify an apparent increase in indoor trampoline park related injuries in children and young people across Australia, and to understand the implications for current regulatory standards. Retrospective analyses of three state-based Injury Surveillance databases, identifying children and adolescents presenting to emergency departments between the years 2005 and 2017, who had sustained injuries during trampolining activity at an indoor trampoline park. Across the three datasets, 487 cases were identified. No cases were recorded prior to 2012, the year the first indoor trampoline park opened. At least half occurred among those aged 10-14 years. In Victoria, 58% were male, with 52% in Queensland and 60% in Western Australia being male, respectively. Hospital admission rates in these states were 15%, 11.7% and 14.5%, respectively. The most frequent injury types were dislocations, sprains and strains, followed by fractures, with some head and spinal injuries. Across several states in Australia, the incidence of indoor trampoline park related injuries is concerning, as these venues are increasing in number. Some injuries can be serious and result in lifelong disability for children or adolescents. Implications for public health: National safety standards that apply to indoor trampoline park operators are not currently mandatory; injury prevention efforts would be assisted if such standards were mandatory. © 2018 The Authors.

  4. Increased T2 signal intensity in the distal clavicle: incidence and clinical implications

    International Nuclear Information System (INIS)

    Fiorella, D.; Helms, C.A.; Speer, K.P.

    2000-01-01

    Objective. The objectives of the current study were (1) to quantify the incidence of increased T2 signal in the distal clavicle and (2) to assess the clinical significance of this finding in patients with chronic acromioclavicular (AC) joint pain.Design and patients. Eight patients (five male and three female, 15-41 years of age) with disabling shoulder pain localized to the AC joint and marked increased T2 signal in the distal clavicle are presented. These eight patients underwent MR examination over a 25 month period (August 1996 to September 1998). The dictated reports of all shoulder MR examinations conducted over this same time period were reviewed retrospectively for the presence of signal abnormality in the distal cla-vicle. Clinical data and, in five patients, findings at shoulder arthroscopy or open surgery, were correlated with the results of MR imaging. One patient underwent arthroscopy on both shoulders.Results. The selected eight patients each presented clinically with disabling shoulder pain localized to the AC joint. One patient is presented twice, as both shoulders were symptomatic (n=9). Plain film examination (9/9) failed to indicate a structural cause of shoulder pain in any of the patients. MR examination demonstrated abnormally increased T2 signal in the distal clavicle in all nine cases and no other cause for AC joint pain. Three patients responded to a course of conservative therapy. Six experienced refractory pain despite conservative therapy. Resection of the distal clavicle was performed in five of the six cases. All patients who underwent resection of the distal clavicle experienced complete resolution of AC joint pain. A retrospective review of the dictated reports for all shoulder MR imaging examinations performed at out institution over a 25 month period (August 1996 to September 1998; n=761) demonstrated a 12.5% incidence of abnormally increased T2 signal in the distal clav-icle.Conclusions. Increased T2 signal in the distal clavicle

  5. Increased T2 signal intensity in the distal clavicle: incidence and clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Fiorella, D.; Helms, C.A. [Dept. of Radiology, Duke Univ., Durham, NC (United States); Speer, K.P. [Dept. of Orthopedic Surgery, Duke Univ., Durham, NC (United States)

    2000-12-01

    Objective. The objectives of the current study were (1) to quantify the incidence of increased T2 signal in the distal clavicle and (2) to assess the clinical significance of this finding in patients with chronic acromioclavicular (AC) joint pain.Design and patients. Eight patients (five male and three female, 15-41 years of age) with disabling shoulder pain localized to the AC joint and marked increased T2 signal in the distal clavicle are presented. These eight patients underwent MR examination over a 25 month period (August 1996 to September 1998). The dictated reports of all shoulder MR examinations conducted over this same time period were reviewed retrospectively for the presence of signal abnormality in the distal cla-vicle. Clinical data and, in five patients, findings at shoulder arthroscopy or open surgery, were correlated with the results of MR imaging. One patient underwent arthroscopy on both shoulders.Results. The selected eight patients each presented clinically with disabling shoulder pain localized to the AC joint. One patient is presented twice, as both shoulders were symptomatic (n=9). Plain film examination (9/9) failed to indicate a structural cause of shoulder pain in any of the patients. MR examination demonstrated abnormally increased T2 signal in the distal clavicle in all nine cases and no other cause for AC joint pain. Three patients responded to a course of conservative therapy. Six experienced refractory pain despite conservative therapy. Resection of the distal clavicle was performed in five of the six cases. All patients who underwent resection of the distal clavicle experienced complete resolution of AC joint pain. A retrospective review of the dictated reports for all shoulder MR imaging examinations performed at out institution over a 25 month period (August 1996 to September 1998; n=761) demonstrated a 12.5% incidence of abnormally increased T2 signal in the distal clav-icle.Conclusions. Increased T2 signal in the distal clavicle

  6. Safety and Health Standard 110: Incident/accident reporting and investigation

    Energy Technology Data Exchange (ETDEWEB)

    Sones, K. [West Kootenay Power, BC (Canada)

    1999-10-01

    Incident/accident reporting requirements in effect at West Kootenay Power are discussed. Details provided include definitions of low risk, high risk, and critical events, the incidents to be reported, the nature of the reports, the timelines, the investigation to be undertaken for each type of incident/accident, counselling services available to employees involved in serious incidents, and the procedures to be followed in accidents involving serious injury to non-employees. The emphasis is on the `critical five` high risk events and the procedures relating to them.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Cancer in adolescents and young adults in north Netherlands (1989-2003) : increased incidence, stable survival and high incidence of second primary tumours

    NARCIS (Netherlands)

    van Gaal, J. C.; Bastiaannet, E.; Schaapveld, M.; Otter, R.; Kluin-Nelemans, J. C.; de Bont, E. S. J. M.; van der Graaf, W. T. A.

    Background: Lack of survival improvement in adolescents and young adults (AYA) with cancer has led to increased awareness of this young population. Design: We carried out a population-based study of incidence and survival of primary tumours and second primary tumours in patients aged 12-24 in north

  9. Increasing incidence of Geomyces destructans fungus in bats from the Czech Republic and Slovakia.

    Directory of Open Access Journals (Sweden)

    Natália Martínková

    Full Text Available BACKGROUND: White-nose syndrome is a disease of hibernating insectivorous bats associated with the fungus Geomyces destructans. It first appeared in North America in 2006, where over a million bats died since then. In Europe, G. destructans was first identified in France in 2009. Its distribution, infection dynamics, and effects on hibernating bats in Europe are largely unknown. METHODOLOGY/PRINCIPAL FINDINGS: We screened hibernacula in the Czech Republic and Slovakia for the presence of the fungus during the winter seasons of 2008/2009 and 2009/2010. In winter 2009/2010, we found infected bats in 76 out of 98 surveyed sites, in which the majority had been previously negative. A photographic record of over 6000 hibernating bats, taken since 1994, revealed bats with fungal growths since 1995; however, the incidence of such bats increased in Myotis myotis from 2% in 2007 to 14% by 2010. Microscopic, cultivation and molecular genetic evaluations confirmed the identity of the recently sampled fungus as G. destructans, and demonstrated its continuous distribution in the studied area. At the end of the hibernation season we recorded pathologic changes in the skin of the affected bats, from which the fungus was isolated. We registered no mass mortality caused by the fungus, and the recorded population decline in the last two years of the most affected species, M. myotis, is within the population trend prediction interval. CONCLUSIONS/SIGNIFICANCE: G. destructans was found to be widespread in the Czech Republic and Slovakia, with an epizootic incidence in bats during the most recent years. Further development of the situation urgently requires a detailed pan-European monitoring scheme.

  10. Relating increasing hantavirus incidences to the changing climate: the mast connection

    Directory of Open Access Journals (Sweden)

    Maes Piet

    2009-01-01

    Full Text Available Abstract Background Nephropathia epidemica (NE, an emerging rodent-borne viral disease, has become the most important cause of infectious acute renal failure in Belgium, with sharp increases in incidence occurring for more than a decade. Bank voles are the rodent reservoir of the responsible hantavirus and are known to display cyclic population peaks. We tried to relate these peaks to the cyclic NE outbreaks observed since 1993. Our hypothesis was that the ecological causal connection was the staple food source for voles, being seeds of deciduous broad-leaf trees, commonly called "mast". We also examined whether past temperature and precipitation preceding "mast years" were statistically linked to these NE outbreaks. Results Since 1993, each NE peak is immediately preceded by a mast year, resulting in significantly higher NE case numbers during these peaks (Spearman R = -0.82; P = 0.034. NE peaks are significantly related to warmer autumns the year before (R = 0.51; P Conclusion NE peaks in year 0 are induced by abundant mast formation in year-1, facilitating bank vole survival during winter, thus putting the local human population at risk from the spring onwards of year 0. This bank vole survival is further promoted by higher autumn temperatures in year-1, whereas mast formation itself is primed by higher summer temperatures in year-2. Both summer and autumn temperatures have been rising to significantly higher levels during recent years, explaining the virtually continuous epidemic state since 2005 of a zoonosis, considered rare until recently. Moreover, in 2007 a NE peak and an abundant mast formation occurred for the first time within the same year, thus forecasting yet another record NE incidence for 2008. We therefore predict that with the anticipated climate changes due to global warming, NE might become a highly endemic disease in Belgium and surrounding countries.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    of these changes on the prevalence of IHD is not known. METHODS AND RESULTS: Changes in incidence and prevalence in 2000-2009 are presented, using nationwide data from public registers. An incident case is defined as a subject registered with a diagnosis of IHD/AMI and without a prior diagnosis for the past 20...... years (beginning in 1980). A prevalent case is defined as a subject surviving the first year after the incident diagnosis. Regarding IHD, age-standardised incidence rates declined significantly from 2000 to 2009 for both sexes (females 445 to 340/100,000, males 822 to 678/100,000), reflecting...

  12. Second cancer incidence risk estimates using BEIR VII models for standard and complex external beam radiotherapy for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Donovan, E. M.; James, H.; Bonora, M.; Yarnold, J. R.; Evans, P. M. [Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton SM2 5PT (United Kingdom); Physics Department, Ipswich Hospital NHS Foundation Trust, Ipswich IP4 5PD (United Kingdom); Department of Academic Radiotherapy, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton SM2 5PT, United Kingdom and School of Radiotherapy, University of Milan, Milan 20122 (Italy); Department of Academic Radiotherapy, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton SM2 5PT (United Kingdom); Centre for Vision Speech and Signal Processing, University of Surrey, Guildford GU2 7XH (United Kingdom)

    2012-10-15

    contralateral breast doses and LAR were comparable to WBRT, despite their added complexity. The smaller irradiated volume of the ABPI plan contributed to a halving of LAR for contralateral breast compared with the other plan types. Daily image guided radiotherapy (IGRT) for a left breast protocol using kilovoltage CBCT contributed <10% to LAR for the majority of organs, and did not exceed 22% of total organ dose. Conclusions: Phantom measurements and calculations of LAR from the BEIR VII models predict that complex breast radiotherapy techniques do not increase the theoretical risk of second cancer incidence for organs distant from the treated breast, or the contralateral breast where appropriate plan constraints are applied. Complex SIB treatments are predicted to increase the risk of second cancer incidence in the lungs compared to standard whole breast radiotherapy; this is outweighed by the threefold reduction in 5 yr local recurrence risk for patients of high risk of recurrence, and young age, from the use of radiotherapy. APBI may have a favorable impact on risk of second cancer in the contralateral breast and lung for older patients at low risk of recurrence. Intensive use of IGRTincreased the estimated values of LAR but these are dominated by the effect of the dose from the radiotherapy, and any increase in LAR from IGRT is much lower than the models' uncertainties.

  13. Second cancer incidence risk estimates using BEIR VII models for standard and complex external beam radiotherapy for early breast cancer

    International Nuclear Information System (INIS)

    Donovan, E. M.; James, H.; Bonora, M.; Yarnold, J. R.; Evans, P. M.

    2012-01-01

    contralateral breast doses and LAR were comparable to WBRT, despite their added complexity. The smaller irradiated volume of the ABPI plan contributed to a halving of LAR for contralateral breast compared with the other plan types. Daily image guided radiotherapy (IGRT) for a left breast protocol using kilovoltage CBCT contributed <10% to LAR for the majority of organs, and did not exceed 22% of total organ dose. Conclusions: Phantom measurements and calculations of LAR from the BEIR VII models predict that complex breast radiotherapy techniques do not increase the theoretical risk of second cancer incidence for organs distant from the treated breast, or the contralateral breast where appropriate plan constraints are applied. Complex SIB treatments are predicted to increase the risk of second cancer incidence in the lungs compared to standard whole breast radiotherapy; this is outweighed by the threefold reduction in 5 yr local recurrence risk for patients of high risk of recurrence, and young age, from the use of radiotherapy. APBI may have a favorable impact on risk of second cancer in the contralateral breast and lung for older patients at low risk of recurrence. Intensive use of IGRTincreased the estimated values of LAR but these are dominated by the effect of the dose from the radiotherapy, and any increase in LAR from IGRT is much lower than the models’ uncertainties.

  14. Increased incidence rate of trauma- and stressor-related disorders in Denmark following the Breivik attacks in Norway

    DEFF Research Database (Denmark)

    Hansen, Bertel Teilfeldt; Dinesen, Peter T; Østergaard, Søren D

    2017-01-01

    BACKGROUND: On 22 July 2011, Anders Breivik killed 77 adults and children in Norway. Having recently documented increases in the incidence of trauma- and stressor-related disorders in Denmark after the 9/11 attacks, we hypothesized that the Breivik attacks-due to their geographic proximity......-would be followed by even larger increases in Denmark. METHODS: Using population-based data from the Danish Psychiatric Central Research Register (1995-2012), we conducted an intervention analysis of the change in the incidence of trauma- and stressor-related disorders after the Breivik attacks. RESULTS......: The incidence rate increased by 16% over the following 1½ years after the Breivik attacks, corresponding to 2736 additional cases. In comparison, 9/11 was followed by a 4% increase. We also present evidence of a subsequent surge in incidence stimulated by media attention. CONCLUSION: This study bolsters...

  15. Increased Incidence Rate of Trauma- and Stressor-related Disorders in Denmark After the Breivik Attacks in Norway.

    Science.gov (United States)

    Hansen, Bertel T; Dinesen, Peter T; Østergaard, Søren D

    2017-11-01

    On 22 July 2011, Anders Breivik killed 77 adults and children in Norway. Having recently documented increases in the incidence of trauma- and stressor-related disorders in Denmark after the 9/11 attacks, we hypothesized that the Breivik attacks-due to their geographic proximity-would be followed by even larger increases in Denmark. Using population-based data from the Danish Psychiatric Central Research Register (1995-2012), we conducted an intervention analysis of the change in the incidence of trauma- and stressor-related disorders after the Breivik attacks. The incidence rate increased by 16% over the following 1½ years after the Breivik attacks, corresponding to 2736 additional cases. In comparison, 9/11 was followed by a 4% increase. We also present evidence of a subsequent surge in incidence stimulated by media attention. This study bolsters previous findings on extra-national consequences of terrorism and indicates that geographic proximity and media coverage may exacerbate effects.

  16. Increased incidence of tuberculosis in zimbabwe, in association with food insecurity, and economic collapse: an ecological analysis.

    Science.gov (United States)

    Burke, Stephen J; Lass, Elliot; Thistle, Paul; Katumbe, Lovemore; Jetha, Arif; Schwarz, Dan; Bolotin, Shelly; Barker, R D; Simor, Andrew; Silverman, Michael

    2014-01-01

    Zimbabwe underwent a socioeconomic crisis and resultant increase in food insecurity in 2008-9. The impact of the crisis on Tuberculosis (TB) incidence is unknown. Prospective databases from two mission hospitals, which were geographically widely separated, and remained open during the crisis, were reviewed. At the Howard Hospital (HH) in northern Zimbabwe, TB incidence increased 35% in 2008 from baseline rates in 2003-2007 (pcrisis at HH showed a decrease of 33% in TB incidence between 2009 to 2010 (pcrisis years of 2008/2009 (pcrisis in this high HIV prevalence country.

  17. Increasing incidence of injuries and fatalities inflicted by wild animals in Kashmir.

    Science.gov (United States)

    Nabi, Dar G; Tak, Shafaat Rashid; Kangoo, K A; Halwai, Manzoor A

    2009-01-01

    To clarify the causes of the increased incidence of injuries inflicted by wild animals in Kashmir, and to suggest preventive measures. A retrospective study reviewed records of these injuries. Data were collected from the hospital in Srinagar and from the Wildlife Protection Department of Kashmir. A total of 203 attacks (26 deaths and 177 near-fatal injuries) were recorded from January 2005 to October 2007, involving 145 (71.5%) male and 58 (28.5%) female victims. The attacking animal was a black bear in 104 (51.2%), a leopard in 18 (8.8%), a wolf in 7 (3.4%) and unidentified in 74 (36.4%) cases; 130 (64%) of these attacks occurred in southern Kashmir. The steady increase in human population in areas close to jungle results in deforestation and destruction of wildlife habitat. The reduction in monkeys and deer (the staple food of leopards) causes these dangerous predators to search for food in the areas occupied by humans, who may then be attacked. Treatment of these cases requires a multidisciplinary approach, including an orthopaedic surgeon, plastic surgeon, microbiologist and psychiatrist, to achieve best cosmetic and functional results.

  18. Twenty years of childhood coeliac disease in The Netherlands: A rapidly increasing incidence

    NARCIS (Netherlands)

    George, E.K.; Mearin, M.L.; Franken, H.C.M.; Houwen, R.H.J.; Hirasing, R.A.; Vandenbroucke, J.P.

    1997-01-01

    Background - The incidence of coeliac disease varies internationally. Aims - To assess the incidence of childhood coeliac disease in The Netherlands and to study the clinical features and the presence of associated disorders. Subjects - Identified cases of childhood coeliac disease in The

  19. Increased incidence of Mycoplasma pneumoniae infections detected by laboratory-based surveillance in Denmark in 2010

    DEFF Research Database (Denmark)

    Rasmussen, J N; Voldstedlund, M; Andersen, R L

    2010-01-01

    In Denmark recurrent epidemics of Mycoplasma pneumoniae infections have been described since the 1950s at intervals of approximately four to six years. The latest epidemic occurred in 2004/05 followed by two years of high incidence and more than three years of low incidence. Due to a recent incre...

  20. Increased incidence of coronary heart disease associated with "double burden" in a cohort of Italian women.

    Science.gov (United States)

    D'Ovidio, Fabrizio; d'Errico, Angelo; Scarinzi, Cecilia; Costa, Giuseppe

    2015-06-01

    Objective of this study was to assess the risk of coronary heart disease (CHD) associated with the combination of employment status and child care among women of working age, also examining the sex of the offspring. Only two previous studies investigated the effect of double burden on CHD, observing an increased risk among employed women with high domestic burden or providing child care, although the relative risks were marginally or not significant. The study population was composed of all women 25-50 years old at 2001 census, living in Turin in families composed only by individuals or couples, with or without children (N = 109,358). Subjects were followed up during 2002-2010 for CHD incidence and mortality through record-linkage of the cohort with the local archives of mortality and hospital admissions. CHD risk was estimated by multivariate Poisson regression models. Among employed women, CHD risk increased significantly by 29% for each child in the household (IRR = 1.29) and by 39% for each son (IRR = 1.39), whereas no association with the presence of children was found among non-employed women or among employed women with daughters. When categorized, the presence of two or more sons significantly increased CHD risk among employed women (IRR = 2.23), compared to those without children. The study found a significant increase in CHD risk associated with the presence of two or more sons in the household, but not daughters, among employed women. This is a new finding, which should be confirmed in other studies, conducted also in countries where the division of domestic duties between males and females is more balanced, such as the European Nordic countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Technology standards and increasing returns: Microsoft versus Nokia and Linux

    NARCIS (Netherlands)

    Millar-Schijf, Carla C.J.M.; Millar, P.H.; Choi, C.J.

    2010-01-01

    The purpose of this article is to advance theory on the concept of increasing returns by reviewing different strands of literature (Arthur, 1994; Liebowitz and Margolis, 1990; 1994; David, 1990) and to develop the concept of a 'critical mass' strategy which incorporates both technological effects

  2. 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.

  3. Increasing Incidence and Unique Clinical Characteristics of Spinning-Induced Rhabdomyolysis.

    Science.gov (United States)

    Cutler, Todd S; DeFilippis, Ersilia M; Unterbrink, Michelle E; Evans, Arthur T

    2016-09-01

    To compare outcomes of spinning-induced rhabdomyolysis to those with exertional rhabdomyolysis from other physical activities. Retrospective cohort study. Academic medical center, single-center. A retrospective chart review was conducted on patients evaluated from December 2010 through November 2014. Patients were selected by ICD-9 code for rhabdomyolysis. Patients were included if the reason for admission was rhabdomyolysis caused by exertion. Cases of rhabdomyolysis caused by trauma or drugs were excluded. Muscle group involvement, admission, and peak creatine kinase levels, time from activity to hospitalization, length of hospital stay, and incidence of complications. Twenty-nine cases were reviewed with 14 admissions secondary to spinning. Median admission creatine kinase (73 000 IU/L vs 29 000 IU/L, P = 0.02) and peak creatine kinase levels were significantly higher in the spinning group (81 000 IU/L vs 31 000 IU/L, P = 0.007). Hospital admissions for spinning-induced rhabdomyolysis increased over time. Health care providers should be aware of the potential dangers of spinning-related rhabdomyolysis especially in otherwise healthy young people.

  4. THE SEASONAL INCREASE OF ENTEROVIRAL INFECTION INCIDENCE IN THE NOVGOROD OBLAST

    Directory of Open Access Journals (Sweden)

    M. A. Bichurina

    2012-01-01

    Full Text Available Abstract. The analysis of epidemic process and definition of the etiology of the seasonal increase of serosal meningitis incidence in the Novgorod oblast in September-November, 2008 has been carried out. It was shown that in the specified period 73 persons had enteroviral meningitis. The proportion of children under 17 years old in the group of patients was 89.9%. The etiological agents of disease (enteroviruses ECHO 6 и ECHO 30 were detected by the virological and molecular-biological methods. It was established that two genetic variants of ECHO 6 and one variant of ECHO 30 co-circulated in the Novgorod oblast. The last virus variant was closely related to the strain isolated from enteroviral meningitis patients in Nizhniy Novgorod in 2007. The obtained data support the idea about necessity of systematic epidemiological and virological surveillance on enteroviral infection to get new information about circulation of non-poliomyelitis enteroviruses in the population and to define peculiarities of epidemic process development.

  5. Increased incidence of malignant melanoma of the skin in workers in a telecommunications industry.

    Science.gov (United States)

    De Guire, L; Theriault, G; Iturra, H; Provencher, S; Cyr, D; Case, B W

    1988-12-01

    In 1982 physicians at a hospital melanoma clinic in Montreal noticed that among their patients there had been seven men working in a single telecommunications company. This raised suspicions that working in that industry might be associated with development of malignant melanoma of the skin (MMS). A preliminary gross comparison with general population rates indicated that there was an increased risk in this working group. To estimate the risk of MMS more accurately, a standardised incidence ratio (SIR) was calculated based on the rates of MMS in the local population of the Greater Metropolitan Montreal Area for the years 1976-83. During that period, among workers in all plants for the company, 10 male cases of MMS were observed for an expected number of 3.7 (SIR = 2.7; 95% CI = 1.31-5.02). No cases were observed among female workers (expected = 1.3). The excess was significant among cases with a short latency (less than 20 years since beginning of employment). There was no apparent pattern of exposure based on job titles or departments.

  6. Post-voiding residual urine and capacity increase in orthotopic urinary diversion: Standard vs modified technique

    Directory of Open Access Journals (Sweden)

    Bančević Vladimir

    2010-01-01

    Full Text Available Background/Aim. Ever since the time when the first orthotopic urinary diversion (pouch was performed there has been a constant improvement and modification of surgical techniques. The aim has been to create a urinary reservoir similar to normal bladder, to decrease incidence of postoperative complications and provide an improved life quality. The aim of this study was to compare postvoiding residual urine (PVR and capacity of the pouch constructed by standard or modified technique. Methods. In this prospective and partially retrospective clinical study we included 79 patients. In the group of 41 patients (group ST pouch was constructed using 50-70 cm of the ileum (standard technique. In the group of 38 patients (group MT pouch was constructed using 25-35 cm of the ileum (modified technique. Postoperatively, PVR and pouch capacity were measured using ultrasound in a 3-, 6- and 12-month period. Results. Postoperatively, an increase in PVR and pouch capacity was noticed in both groups. Twelve months postoperatively, PVR was significantly smaller in the group MT than in the group ST [23 (0-90 mL vs 109 (0-570 mL, p < 0,001]. In the same period the pouch capacity was significantly smaller in the MT group than in the ST group [460 (290-710 mL vs 892 (480-2 050 mL, p < 0.001]. Conclusion. Postoperatively, an increase in PVR and pouch capacity was noticed during a 12-month period. A year following the operation the pouch created from a shorter ileal segment reached capacity of the 'normal' bladder with small PVR. The pouch created by standard technique developed an unnecessary large PVR and capacity.

  7. The incidence of necrotizing enterocolitis is increased following probiotic administration to preterm pigs

    DEFF Research Database (Denmark)

    Cilieborg, Malene Skovsted; Thymann, Thomas; Siggers, Richard Harvey

    2011-01-01

    with controls (n = 14). All pigs received parenteral nutrition for 2 d followed by enteral formula feeding until tissue collection on d 5. Compared with control pigs, intestinal weight was lower and NEC incidence was higher in both groups given probiotics (64–67 vs. 14%; P... immature gut immune system and low NEC incidence in the control group. It remains to be determined whether similar adverse responses to probiotics occur in preterm infants...

  8. Increased incidence of cancer observed in HIV/hepatitis C virus-coinfected patients versus HIV-monoinfected.

    Science.gov (United States)

    Meijide, Héctor; Pértega, Sonia; Rodríguez-Osorio, Iria; Castro-Iglesias, Ángeles; Baliñas, Josefa; Rodríguez-Martínez, Guillermo; Mena, Álvaro; Poveda, Eva

    2017-05-15

    Cancer is a growing problem in persons living with HIV infection (PLWH) and hepatitis C virus (HCV) coinfection could play an additional role in carcinogenesis. Herein, all cancers in an HIV-mono and HIV/HCV-coinfected cohort were evaluated and compared to identify any differences between these two populations. A retrospective cohort study was conducted including all cancers in PLWH between 1993 and 2014. Cancers were classified in two groups: AIDS-defining cancer (ADC) and non-AIDS-defining cancer (NADC). Cancer incidence rates were calculated and compared with that observed in the Spanish general population (GLOBOCAN, 2012), computing the standardized incidence ratios (SIRs). A competing risk approach was used to estimate the probability of cancer after HIV diagnosis. Cumulative incidence in HIV-monoinfected and HIV/HCV-coinfected patients was also compared using multivariable analysis. A total of 185 patients (117 HIV-monoinfected and 68 HIV/HCV) developed cancer in the 26 580 patient-years cohort, with an incidence rate of 696 cancers per 100 000 person-years, higher than in the general population (SIR = 3.8). The incidence rate of NADC in HIV/HCV-coinfected patients was 415.0 (SIR = 3.4), significantly higher than in monoinfected (377.3; SIR = 1.8). After adjustments, HIV/HCV-coinfected patients had a higher cumulative incidence of NADC than HIV-monoinfected (adjusted hazard ratio = 1.80), even when excluding hepatocellular carcinomas (adjusted hazard ratio = 1.26). PLWH have a higher incidence of NADC than the general population and HCV-coinfection is associated with a higher incidence of NADC. These data justify the need for prevention strategies in these two populations and the importance of eradicating HCV.

  9. Increasing incidence of statin prescribing for the elderly without previous cardiovascular conditions:  A nation wide register study

    DEFF Research Database (Denmark)

    Kildemoes, Helle Wallach; Andersen, Morten

    Supported by the growing evidence of the beneficial effects of statins in a range of conditions, statin utilization has increased considerably in most Western countries over the last decade. Objectives To estimate to what extent a widening of indication scope for statins accounts for the increasing...... Danish statin utilization during 1996-2005, applying treatment incidence as a measure of changing prescribing behaviour Methods From three nationwide registers, we retrieved individual records on demographics, dispensed prescription drugs and hospital discharges. Danish inhabitants were followed...... for seven cardiovascular conditions, corresponding to a hierarchy of statin indications. Poisson regression analyses were applied to quantify the incidence growth, according to age and indication.  Results Treatment incidence increased from 4/1000 person years in 2000 to 17/1000 in 2005, the increase being...

  10. Toward a Common Standard: The Role of Law Enforcement at WMD Incidents

    Science.gov (United States)

    2013-09-01

    installations, hospital laboratories and industrial plants throughout the city that employ radioactive materials in their work.15 The NYPD’s many other...27 Jeff Ryan and Jan Glarum, Biosecurity and Bioterrorism: Containing and Preventing Biological...each man receives during any particular job. The specially coded badges undergo laboratory analysis after each incident so that policemen threatened

  11. Epidemiology of Trichomoniasis in South Korea and Increasing Trend in Incidence, Health Insurance Review and Assessment 2009-2014.

    Science.gov (United States)

    Joo, So-Young; Goo, Youn-Kyoung; Ryu, Jae-Sook; Lee, Sang-Eun; Lee, Won Kee; Chung, Dong-Il; Hong, Yeonchul

    2016-01-01

    Trichomoniasis, which is caused by Trichomonas vaginalis, is one of the most common non-viral sexually transmitted infections; however, limited population-based data are available that describe patterns and trends of the disease. We summarized insurance claims of trichomoniasis cases reported during 2009-2014 to South Korea Health Insurance Review and Assessment Service. The average annual incidence in South Korea was 276.8 persons per 100,000 population, and a substantial sex-associated variation was observed. The incidence rate among female subjects trended upward over 6 years, that is, it increased from 501 in 2009 to 625.8 in 2014 per 100,000 female population, which indicates a 25% overall increase. This trend was sharpest in the ≥60 years group of female population. However, a 66% decrease in incidence rates was observed among male subjects (23.7 in 2009 to 15.7 in 2014 per 100,000 male population). Further, substantial decrease was observed in the ≥40 years groups of male population. The incidence of trichomoniasis varied across regions and was the highest in Jeju province of South Korea. Overall, as the incidence of trichomoniasis appears to have increased in South Korea during 2009-2014, the disease burden is increasing; hence, there is a need to better understand the disease transmission.

  12. Increase in breast cancer incidence among older women in Mumbai: 30-year trends and predictions to 2025.

    Science.gov (United States)

    Dikshit, Rajesh P; Yeole, B B; Nagrani, Rajini; Dhillon, P; Badwe, R; Bray, Freddie

    2012-08-01

    Increasing trends in the incidence of breast cancer have been observed in India, including Mumbai. These have likely stemmed from an increasing adoption of lifestyle factors more akin to those commonly observed in westernized countries. Analyses of breast cancer trends and corresponding estimation of the future burden are necessary to better plan rationale cancer control programmes within the country. We used data from the population-based Mumbai Cancer Registry to study time trends in breast cancer incidence rates 1976-2005 and stratified them according to younger (25-49) and older age group (50-74). Age-period-cohort models were fitted and the net drift used as a measure of the estimated annual percentage change (EAPC). Age-period-cohort models and population projections were used to predict the age-adjusted rates and number of breast cancer cases circa 2025. Breast cancer incidence increased significantly among older women over three decades (EAPC = 1.6%; 95% CI 1.1-2.0), while lesser but significant 1% increase in incidence among younger women was observed (EAPC = 1.0; 95% CI 0.2-1.8). Non-linear period and cohort effects were observed; a trends-based model predicted a close-to-doubling of incident cases by 2025 from 1300 mean cases per annum in 2001-2005 to over 2500 cases in 2021-2025. The incidence of breast cancer has increased in Mumbai during last two to three decades, with increases greater among older women. The number of breast cancer cases is predicted to double to over 2500 cases, the vast majority affecting older women. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. The increasing incidence of infective endocarditis in Denmark, 1994-2011

    DEFF Research Database (Denmark)

    Erichsen, Purnima; Gislason, Gunnar H; Bruun, Niels Eske

    2016-01-01

    BACKGROUND: Little updated population-based evidence exists of temporal trends in infective endocarditis (IE). METHODS: For the 1994-2011 period, we used Danish nationwide registries to identify cases with first-time IE and to estimate the population size. We calculated the incidence rate of IE...

  14. Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section.

    LENUS (Irish Health Repository)

    Higgins, Mary F

    2013-11-01

    Placenta accreta, morbid adherence to the uterus to the myometrium, is commonest in association with placenta previa in women previously delivered by caesarean section (CS). It has become proportionally a greater cause of major maternal morbidity and mortality as the frequency of other serious obstetric complications has declined. The aim of this study was to examine the incidence of placenta accreta in the context of a rising caesarean delivery rate.

  15. Increased availability of paracetamol in Sweden and incidence of paracetamol poisoning: using laboratory data to increase validity of a population-based registry study.

    Science.gov (United States)

    Gedeborg, Rolf; Svennblad, Bodil; Holm, Lennart; Sjögren, Hans; Bardage, Carola; Personne, Mark; Sjöberg, Gunilla; Feltelius, Nils; Zethelius, Björn

    2017-05-01

    To estimate the incidence trend and outcome of paracetamol poisoning, in relation to increased availability of paracetamol from non-pharmacy outlets in 2009. Patients' serum paracetamol results over 14 years (2000-2013) from 20 (out of 21) regions in Sweden were linked to national registers of hospital care, cause of death, and prescriptions. Paracetamol poisonings were defined by serum paracetamol levels, hospital diagnoses, or cause of death. The change in incidence of poisonings following increased availability of paracetamol was analysed by using segmental regression of time series. Of the 12 068 paracetamol poisonings, 85% were classified as intentional self-harm. Following increased availability from non-pharmacy outlets, there was a 40.5% increase in the incidence of paracetamol poisoning, from 11.5/100 000 in 2009 to 16.2/100 000 in 2013. Regression analyses indicated a change in the trend (p paracetamol did not influence the result. All-cause mortality at 30 days (3.2%) did not change over time. The incidence of paracetamol poisoning in Sweden has increased since 2009, contrasting the decreased incidence in the period of 2007-2009. The change in trend was temporally associated with the introduction of availability of paracetamol from non-pharmacy outlets but did not appear to be related to sales volume of paracetamol or general trends in self-harm or suicides. © 2017 Commonwealth of Australia. Pharmacoepidemiology and Drug Safety © 2017 John Wiley & Sons, Ltd. © 2017 Commonwealth of Australia. Pharmacoepidemiology and Drug Safety © 2017 John Wiley & Sons, Ltd.

  16. Decreasing fertility rate correlates with the chronological increase and geographical variation in incidence of Kawasaki disease in Japan.

    Directory of Open Access Journals (Sweden)

    Yoshiro Nagao

    Full Text Available BACKGROUND: Kawasaki disease (KD is a common cause of acquired paediatric heart disease in developed countries. KD was first identified in the 1960s in Japan, and has been steadily increasing since it was first reported. The aetiology of KD has not been defined, but is assumed to be infection-related. The present study sought to identify the factor(s that mediate the geographical variation and chronological increase of KD in Japan. METHODS AND FINDINGS: Based upon data reported between 1979 and 2010 from all 47 prefectures in Japan, the incidence and mean patient age at the onset of KD were estimated. Using spatial and time-series analyses, incidence and mean age were regressed against climatic/socioeconomic variables. Both incidence and mean age of KD were inversely correlated with the total fertility rate (TFR; i.e., the number of children that would be born to one woman. The extrapolation of a time-series regressive model suggested that KD emerged in the 1960s because of a dramatic decrease in TFR in the 1940s through the 1950s. CONCLUSIONS: Mean patient age is an inverse surrogate for the hazard of contracting the aetiologic agent. Therefore, the observed negative correlation between mean patient age and TFR suggests that a higher TFR is associated with KD transmission. This relationship may be because a higher TFR facilitates sibling-to-sibling transmission. Additionally, the observed inverse correlation between incidence and TFR implies a paradoxical "negative" correlation between the incidence and the hazard of contracting the aetiologic agent. It was hypothesized that a decreasing TFR resulted in a reduced hazard of contracting the agent for KD, thereby increasing KD incidence.

  17. Impact of increasing alanine aminotransferase levels within normal range on incident diabetes

    OpenAIRE

    Chong-Shan Wang; Ting-Tsung Chang; Wei-Jen Yao; Shan-Tair Wang; Pesus Chou

    2012-01-01

    Abnormal alanine aminotransferase level (ALT) levels might be associated with type 2 diabetes, but whether higher ALT levels within the normal range predict the risk is unknown. Methods: We followed a community-based cohort of 3446 individuals who were ≥35 years old without diabetes and hepatitis B or C in southern Taiwan for 8 years (1997–2004) to study the risk for type 2 diabetes with different normal ALT levels. Results: Among the 337 incident diabetes cases, 16.0% were from those w...

  18. The Incidence of Necrotizing Enterocolitis Is Increased Following Probiotic Administration to Preterm Pigs

    DEFF Research Database (Denmark)

    Cilieborg, Malene Skovsted; Thymann, Thomas; Siggers, Richard

    2011-01-01

    Preterm birth and necrotizing enterocolitis (NEC) is associated with inappropriate gut colonization and immunity, which may be improved by probiotic bacteria. Using a preterm pig model of NEC, we investigated the effects of probiotics on intestinal structure, function, microbiology, and immunology...... with controls (n = 14). All pigs received parenteral nutrition for 2 d followed by enteral formula feeding until tissue collection on d 5. Compared with control pigs, intestinal weight was lower and NEC incidence was higher in both groups given probiotics (64–67 vs. 14%; P...

  19. Treatment for retinopathy of prematurity in Denmark in a ten-year period (1996-2005): Is the incidence increasing?

    DEFF Research Database (Denmark)

    Slidsborg, C.; Olesen, H.B.; Jensen, Peter Koch

    2008-01-01

    about neonatal parameters. These parameters, along with birth in the latter half of the period (2001-2005), were analyzed as risk factors for retinopathy of prematurity. The national registry for blind and visually impaired children was accessed to obtain information about visual impairment attributable...... and 2001 to 2005. Of all of the early-detected, visually impaired children, 16% had not been treated for retinopathy of prematurity and were considered screening failures. CONCLUSIONS. The incidence of retinopathy of prematurity treatment in Denmark has more than doubled during the past half...... contributed to the increased incidence in the latter half of the period. Of the study population, 0.6% were registered as visually impaired because of retinopathy of prematurity within 2 years after birth (early-detected visual impairment). The incidences were not significantly different between 1996 to 2000...

  20. Impact of a standardized hand hygiene program on the incidence of nosocomial infection in very low birth weight infants.

    Science.gov (United States)

    Capretti, Maria Grazia; Sandri, Fabrizio; Tridapalli, Elisabetta; Galletti, Silvia; Petracci, Elisabetta; Faldella, Giacomo

    2008-08-01

    This study examined the effects of a standardized hand hygiene program on the rate of nosocomial infection (NI) in very low birth weight (VLBW) infants (birth weight hand hygiene program was implemented using antimicrobial soap (4% chlorhexidine gluconate) and alcohol-based hand rubs. NI after 72 hours of life was detected in 16 of the 85 VLBW infants in the first period and in 5 of the 80 VLBW infants in the second period. The rate of central venous catheter colonization was significantly lower in the second period (5.8%) than in the first period (16.6%). In our NICU, the incidence of NI in VLBW infants was significantly reduced after the introduction of a standardized handwashing protocol. In our experience, a proper hand hygiene program can save approximately 10 NI episodes/year, at a cost of $10,000 per episode. Therefore, improving hand hygiene practice is a cost-effective program in the NICU.

  1. Increased incidence and disparity of diagnosis of retinoblastoma patients in Guatemala

    Science.gov (United States)

    Bendfeldt, Giovana; Lou, Hong; Giron, Veronica; Garrido, Claudia; Valverde, Patricia; Barnoya, Margarita; Castellanos, Mauricio

    2014-01-01

    Analysis of 327 consecutive cases at a pediatric referral hospital of Guatemala reveals that retinoblastoma accounts for 9.4% of all cancers and the estimated incidence is 7.0 cases/million children, higher than the United States or Europe. The number of familial cases is low, and there is a striking disparity in indigenous children due to late diagnosis, advanced disease, rapid progression and elevated mortality. Nine germline mutations in 18 patients were found; two known and five new mutations. Hypermethylation of RB1 was identified in 13% of the tumors. An early diagnosis program could identify cases at an earlier age and improve outcome of retinoblastoma in this diverse population. PMID:24814393

  2. Increased situation awareness in major incidents-radio frequency identification (RFID) technique: a promising tool.

    Science.gov (United States)

    Jokela, Jorma; Rådestad, Monica; Gryth, Dan; Nilsson, Helené; Rüter, Anders; Svensson, Leif; Harkke, Ville; Luoto, Markku; Castrén, Maaret

    2012-02-01

    In mass-casualty situations, communications and information management to improve situational awareness is a major challenge for responders. In this study, the feasibility of a prototype system that utilizes commercially available, low-cost components, including Radio Frequency Identification (RFID) and mobile phone technology, was tested in two simulated mass-casualty incidents. The feasibility and the direct benefits of the system were evaluated in two simulated mass-casualty situations: one in Finland involving a passenger ship accident resulting in multiple drowning/hypothermia patients, and another at a major airport in Sweden using an aircraft crash scenario. Both simulations involved multiple agencies and functioned as test settings for comparing the disaster management's situational awareness with and without using the RFID-based system. Triage documentation was done using both an RFID-based system, which automatically sent the data to the Medical Command, and a traditional method using paper triage tags. The situational awareness was measured by comparing the availability of up-to date information at different points in the care chain using both systems. Information regarding the numbers and status or triage classification of the casualties was available approximately one hour earlier using the RFID system compared to the data obtained using the traditional method. The tested prototype system was quick, stable, and easy to use, and proved to work seamlessly even in harsh field conditions. It surpassed the paper-based system in all respects except simplicity of use. It also improved the general view of the mass-casualty situations, and enhanced medical emergency readiness in a multi-organizational medical setting. The tested technology is feasible in a mass-casualty incident; further development and testing should take place.

  3. Increased serum ferritin levels are independently related to incidence of prediabetes in adult populations.

    Science.gov (United States)

    Meng, G; Yang, H; Bao, X; Zhang, Q; Liu, L; Wu, H; Du, H; Xia, Y; Shi, H; Guo, X; Liu, X; Li, C; Su, Q; Gu, Y; Fang, L; Yu, F; Sun, S; Wang, X; Zhou, M; Jia, Q; Guo, Q; Song, K; Huang, G; Wang, G; Wu, Y; Niu, K

    2017-04-01

    To comprehensively and exhaustively assess the relationship between serum ferritin levels and incidence of prediabetes in a prospective study. This prospective cohort study (n=7380) with a mean follow-up of 3.07 years (range: 1-7, 95% CI: 3.03-3.12) was conducted in Tianjin, China. Blood fasting glucose, oral glucose tolerance test, serum ferritin levels and other potentially confounding factors were measured at baseline and at each year of follow-up. Adjusted Cox proportional hazards regression models were used to assess the gender-specific relationship between baseline and mean serum ferritin quintiles and prediabetes. The incidence of prediabetes was 85 per 1000 person-years among men and 44 per 1000 person-years among women during follow-up (from 2007 to 2014). After adjusting for potential confounders, hazard ratios (95% CI) for prediabetes across baseline ferritin quintiles were: for men, 1.00, 1.13 (0.90-1.40), 1.20 (0.97-1.48), 1.41 (1.14-1.73) and 1.73 (1.41-2.11); and for women, 1.00, 1.01 (0.74-1.38), 0.68 (0.48-0.96), 0.84 (0.61-1.15) and 1.07 (0.80-1.45), respectively. Similar results were also observed for mean ferritin levels. Both baseline and mean serum ferritin levels were significantly and linearly related to prediabetes in men, whereas U-shaped relationships were observed between baseline and mean serum ferritin and prediabetes in women. The relationship between prediabetes risk and mean serum ferritin levels may be more stable than one with baseline serum ferritin levels. Copyright © 2016. Published by Elsevier Masson SAS.

  4. Increased Incidence of Benign Pancreatic Pathology following Pancreaticoduodenectomy for Presumed Malignancy over 10 Years despite Increased Use of Endoscopic Ultrasound

    Directory of Open Access Journals (Sweden)

    Shadi S. Yarandi

    2014-01-01

    Full Text Available Despite using imaging studies, tissue sampling, and serologic tests about 5–10% of surgeries done for presumed pancreatic malignancies will have benign findings on final pathology. Endoscopic ultrasound (EUS is used with increasing frequency to study pancreatic masses. The aim of this study is to examine the effect of EUS on prevalence of benign diseases undergoing Whipple over the last decade. Patients who underwent Whipple procedure for presumed malignancy at Emory University Hospital from 1998 to 2011 were selected. Demographic data, history of smoking and drinking, history of diabetes and pancreatitis, imaging data, pathology reports, and tumor markers were extracted. 878 patients were found. 95 (10.82% patients had benign disease. Prevalence of benign finding had increased over the recent years despite using more EUS. Logistic regression models showed that abdominal pain (OR: 5.829, 95% CI 2.681–12.674, P ≤ 0.001 and alcohol abuse (OR: 3.221, CI 95%: 1.362–7.261, P: 0.002 were predictors of benign diseases. Jaundice (OR: 0.221, 95% CI: 0.084–0.58, P: 0.002, mass (OR: 0.145, 95% CI: 0.043–0.485, P: 0.008, and ductal dilation (OR: 0.297, 95% CI 0.134–0.657, P: 0.003 were associated with malignancy. Use of imaging studies, ERCP, and EUS has not decreased the percentage of benign findings after surgery for presumed pancreatic malignancy.

  5. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study.

    Science.gov (United States)

    Zhang, Ming; Wang, Bingyuan; Liu, Yu; Sun, Xizhuo; Luo, Xinping; Wang, Chongjian; Li, Linlin; Zhang, Lu; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Zhao, Jingzhi; Hu, Dongsheng

    2017-03-01

    Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China. We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m 2 ) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2]. Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], P trend  index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index. Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.

  6. Increasing incidence of hospital-acquired and healthcare-associated bacteremia in northeast Thailand: a multicenter surveillance study.

    Directory of Open Access Journals (Sweden)

    Maliwan Hongsuwan

    Full Text Available Little is known about the epidemiology of nosocomial bloodstream infections in public hospitals in developing countries. We evaluated trends in incidence of hospital-acquired bacteremia (HAB and healthcare-associated bacteremia (HCAB and associated mortality in a developing country using routinely available databases.Information from the microbiology and hospital databases of 10 provincial hospitals in northeast Thailand was linked with the national death registry for 2004-2010. Bacteremia was considered hospital-acquired if detected after the first two days of hospital admission, and healthcare-associated if detected within two days of hospital admission with a prior inpatient episode in the preceding 30 days.A total of 3,424 patients out of 1,069,443 at risk developed HAB and 2,184 out of 119,286 at risk had HCAB. Of these 1,559 (45.5% and 913 (41.8% died within 30 days, respectively. Between 2004 and 2010, the incidence rate of HAB increased from 0.6 to 0.8 per 1,000 patient-days at risk (p<0.001, and the cumulative incidence of HCAB increased from 1.2 to 2.0 per 100 readmissions (p<0.001. The most common causes of HAB were Acinetobacter spp. (16.2%, Klebsiella pneumoniae (13.9%, and Staphylococcus aureus (13.9%, while those of HCAB were Escherichia coli (26.3%, S. aureus (14.0%, and K. pneumoniae (9.7%. There was an overall increase over time in the proportions of ESBL-producing E. coli causing HAB and HCAB.This study demonstrates a high and increasing incidence of HAB and HCAB in provincial hospitals in northeast Thailand, increasing proportions of ESBL-producing isolates, and very high associated mortality.

  7. The increasing incidence of paranasal organizing hematoma: a 20-year experience of 23 cases at a single center.

    Science.gov (United States)

    Kim, Jong Seung; Oh, Jong Seok; Kwon, Sam Hyun

    2016-06-01

    Sinonasal organized hematoma is a rare, benign disease that can be locally aggressive and may be mistaken for malignancy. Because of its rarity, the clinical characteristics are not well known. The aim of this study is to investigate the distinguishing features of organized hematoma with an emphasis on incidence change. In this retrospective study, we reviewed the records of 23 patients with organized hematoma confirmed histopathologically among 5,378 patients who underwent endoscopic sinus surgery performed by a single surgeon from January 1995 to December 2014 at a tertiary care center. Clinical symptoms, endoscopic photography, computed tomography, and operative findings were reviewed. We also reviewed the relevant literature. Age, sex, site, origin subsite and histopathology were investigated. A statistical review was performed using R 3.1.2 to examine incidence change. The most common complaint was frequent epistaxis and nasal obstruction (52.1%). Of the 23 patients, eight were women and 15 were men with an age range of 18 to 75 years. (mean 38.9 years). Nine of these hematomas occurred on the right side and 14 on the left side. The predominant occurrence site was the antrum (65%), followed by the septum (17.3%), inferior turbinate (8%), and ethmoid sinus (8%). The incidence steadily increased over 20 years. Investigation of the clinical characteristics and incidence change of organized hematoma can provide useful information. Through analysis of the 23 cases in our study, the age distribution was found to be bimodal and the incidence of organizing hematoma was observed to steadily increase. Clinicians should be aware of these characteristics to avoid misdiagnoses of malignant tumors.

  8. Outsourcing cleaning services increases MRSA incidence: Evidence from 126 English Acute Trusts

    OpenAIRE

    Toffolutti, V; Reeves, A; McKee, M; Stuckler, D

    2016-01-01

    : There has been extensive outsourcing of hospital cleaning services in the NHS in England, in part because of the potential to reduce costs. Yet some argue that this leads to lower hygiene standards and more infections, such as MRSA and, perhaps because of this, the Scottish, Welsh, and Northern Irish health services have rejected outsourcing. This study evaluates whether contracting out cleaning services in English acute hospital Trusts (legal authorities that run one or more hospitals) is ...

  9. Increasing incidence of malaria in the Negro River basin, Brazilian Amazon.

    Science.gov (United States)

    Cabral, A C; Fé, N F; Suárez-Mutis, M C; Bóia, M N; Carvalho-Costa, F A

    2010-08-01

    Malaria in Brazil is virtually restricted to the Amazon Region, where it has a heterogeneous geographic distribution. We reviewed secondary data in order to describe the regional and temporal distribution of 8018 malaria cases seen between 2003 and 2007 in Santa Isabel do Rio Negro, a municipality in the northwest Brazilian Amazon. A significant rise in malaria incidence, mainly in the Yanomami Indian reservation, was observed during this time. Anopheline breeding sites were also mapped and entomological data were obtained through the capture of larval and adult mosquitoes. Thirty-three potential breeding sites were identified in the urban and periurban areas, 28 of which were positive for anopheline larvae. Anopheles darlingi specimens were captured in both intra- and peridomicile locations in the urban areas. Demographic data were also assessed via a sectional survey, revealing that the majority of dwellings were vulnerable to mosquitoes. This study suggests that urban and periurban areas of this municipality are highly susceptible to epidemic malaria, which is endemic in the Yanomami Indian reservation near the city. In addition, transmission can be perpetuated autochthonously in the urban area, drawing attention to the continuous need for preventative measures such as controlling adult and aquatic stages of mosquitoes and improving housing.

  10. Alzheimer's Disease Increases the Incidence of Hospitalization Due to Fall-related Bone Fracture in Elderly Chinese

    Directory of Open Access Journals (Sweden)

    Fang Li

    2016-12-01

    Conclusion: On the basis of our findings, we conclude that AD may increase the incidence of hospitalization due to falls and bone fracture. We also found that AD has no effect on fracture location, but larger studies are needed to confirm this finding. Physicians and family members should emphasize the possibility of falls and bone fracture in patients with AD. Our findings suggest that preventing falls in AD patients may reduce the number of hospitalized AD patients.

  11. Comment on the article titled "Increased Incidence of Amyotrophic Lateral Sclerosis in Polymyositis: A Nationwide Cohort Study".

    Science.gov (United States)

    Parperis, Konstantinos

    2017-10-03

    With interest, I read the recent article in Arthritis Care and Research titled "Increased Incidence of Amyotrophic Lateral Sclerosis in Polymyositis: A Nationwide Cohort Study" (1). Tseng at al (1) conducted a retrospective cohort study in Taiwan, exploring a link between amyotrophic lateral sclerosis (ALS) and polymyositis (PM). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Cumulative incidence, distribution, and determinants of catastrophic health expenditure in Nepal: results from the living standards survey.

    Science.gov (United States)

    Ghimire, Mamata; Ayer, Rakesh; Kondo, Masahide

    2018-02-14

    Nepal has committed to the global community to achieve universal health coverage by 2030. Nevertheless, Nepal still has a high proportion of out-of-pocket health payment and a limited risk-pooling mechanism. Out-of-pocket payment for the healthcare services could result in catastrophic health expenditure (CHE). Evidence is required to effectively channel the efforts to lower those expenses in order to achieve universal health coverage. However, little is known about CHE and its determinants in a broad national context in Nepal. Therefore, this study was conducted to explore the cumulative incidence, distribution, and determinants of CHE in Nepal. Data were obtained from the nationally representative survey, the Nepal Living Standards Survey-third undertaken in 2010/11. Information from 5988 households was used for the analyses. Households were classified as having CHE when their out-of-pocket health payment was greater than or equal to 40% of their capacity to pay. Remaining households were classified as not having CHE. Logistic regression analyses were used to identify determinants of CHE. Based on household-weighted sample, the cumulative incidence of CHE was 10.3% per month in Nepal. This incidence was concentrated in the far-western region and households in the poorer expenditure quartiles. Multivariable logistic regression revealed that households were more likely to face CHE if they; consisted of chronically ill member(s), have a higher burden of acute illness and injuries, have elderly (≥60 years) member(s), belonged to the poor expenditure quartile, and were located in the far-western region. In contrast, households were less likely to incur CHE when their household head was educated. Having children (≤5 years) in households did not significantly affect catastrophic health expenditure. This study identified a high cumulative incidence of CHE. CHE was disproportionately concentrated in the poor households and households located in the far

  13. Increasing incidence of Dirofilaria immitis in dogs in USA with focus on the southeast region 2013-2016.

    Science.gov (United States)

    Drake, Jason; Wiseman, Scott

    2018-01-17

    A recent American Heartworm Society (AHS) survey on the incidence of adult heartworm infections in dogs in the United States of America showed a 21.7% increase in the average cases per veterinary clinic from 2013 to 2016. The analysis reported here was performed to see if heartworm testing results available via the Companion Animal Parasite Council (CAPC) aligned with the AHS survey and whether changes in heartworm preventive dispensing accounts for the increased incidence. The resistance of Dirofilaria immitis to macrocyclic lactones (MLs) has been previously reported. An analysis of 7-9 million heartworm antigen tests reported annually to the Companion Animal Parasite Council (CAPC) from 2013 to 2016 was conducted and compared to the 2016 AHS survey. A state-by-state analysis across the southeastern USA was also performed. National heartworm preventive dispensing data were obtained from Vetstreet LLC and analyzed. All oral, topical and injectable heartworm preventives were included in this analysis, with injectable moxidectin counting as six doses. Positive antigen tests increased by 15.28% from 2013 to 2016, similar to the 21.7% increase reported by the AHS survey. Incidence in the southeastern USA increased by17.9% while the rest of USA incidence increased by 11.4%. State-by-state analysis across the southeastern USA revealed an increased positive test frequency greater than 10% in 9 of 12 states evaluated. During this time, the overall proportion of dogs receiving heartworm prophylaxis remained relatively unchanged. Approximately 2/3 of the dogs in the USA received no heartworm prevention each year. These CAPC data show the rate of positive heartworm tests increasing significantly (P USA from 2013 to 2016, with a higher rate of increase in the southeastern USA than nationally. Only 1/3 of dogs in the USA were dispensed one or more doses of heartworm prevention annually by veterinarians, averaging 8.6 monthly doses/year. Veterinarians and pet owners should

  14. Standard regulation of obligatory immunoprevention of flu in a control system of incidence of health workers

    Directory of Open Access Journals (Sweden)

    A. E. Zobov

    2016-01-01

    Full Text Available In article the interconnected provisions of the federal legislation and regulations of federal executive authorities regulating a question of obligatory immunization of health workers against flu in aspect of legal consequences of refusal of her are considered. The analysis of the existing regulations and materials of jurisprudence concerning carrying out obligatory vaccination of health workers against flu is carried out. By results of the analysis it is shown that today a problematic issue is absence of the accurate standardly consolidated criteria of reference of these or those categories of medical personnel to group of the subjects of obligatory immunization performing works with sick infectious diseases and, respectively, against flu. It doesn’t allow the management of the medical organizations to differentiate specifically mentioned professions and positions owing to what the requirement about obligatory carrying out preventive inoculations against flu of those health workers whose obligatory vaccination isn’t provided actually is compulsion to vaccination. Therefore, the subsequent discharge from work in case of refusal it работни from carrying out an inoculation strikes at his rights (as in this case, for example, time of discharge isn’t subject to payment and inclusion in the length of service granting the right for the annual paid vacation and is illegal.It is offered to accept as such criterion the labor function fixed by the statutory act of authorized federal executive authority for concrete positions of employees of the medical organizations providing performance of work with sick infectious diseases. The recommendations to heads of the medical organizations concerning the publication of local acts on the organization of vaccinal prevention of flu and adoption of administrative decisions after written refusals of vaccination are provided.

  15. Less efficient oculomotor performance is associated with increased incidence of head impacts in high school ice hockey.

    Science.gov (United States)

    Kiefer, Adam W; DiCesare, Christopher; Nalepka, Patrick; Foss, Kim Barber; Thomas, Staci; Myer, Gregory D

    2018-01-01

    To evaluate associations between pre-season oculomotor performance on visual tracking tasks and in-season head impact incidence during high school boys ice hockey. Prospective observational study design. Fifteen healthy high school aged male hockey athletes (M=16.50±1.17years) performed two 30s blocks each of a prosaccade and self-paced saccade task, and two trials each of a slow, medium, and fast smooth pursuit task (90°s -1 ; 180°s -1 ; 360°s -1 ) during the pre-season. Regular season in-game collision data were collected via helmet-mounted accelerometers. Simple linear regressions were used to examine relations between oculomotor performance measures and collision incidence at various impact thresholds. The variability of prosaccade latency was positively related to total collisions for the 20g force cutoff (p=0.046, adjusted R 2 =0.28). The average self-paced saccade velocity (p=0.020, adjusted R 2 =0.37) and variability of smooth pursuit gaze velocity (p=0.012, adjusted R 2 =0.47) were also positively associated with total collisions for the 50g force cutoff. These results provide preliminary evidence that less efficient oculomotor performance on three different oculomotor tasks is associated with increased incidence of head impacts during a competitive ice hockey season. The variability of prosaccade latency, the average self-paced saccade velocity and the variability of gaze velocity during predictable smooth pursuit all related to increased head impacts. Future work is needed to further understand player initiated collisions, but this is an important first step toward understanding strategies to reduce incidence of injury risk in ice hockey, and potentially contact sports more generally. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  16. Linfogranuloma venério: aumento na incidência sugere surto mundial da doença Lymphogranuloma venereum: increased incidence suggests diseases world outbreak

    Directory of Open Access Journals (Sweden)

    Bruno de Lucia Hernani

    2007-06-01

    , this disease has been notified by other European countries, North America and Australia. This increased incidence seems like an outbreak and common features in these reports were: MSM, Caucasian race / ethnicity, mean age above 35 years, predominantly (>70% co-infected with HIV. Complaints included anorectal pain, tenesmus and constipation. After these reports, many countries started doing active research in their people. The lack of a specific diagnostic test has complicated LGV case ascertainment. In the absence of laboratory confirmation of L serovars, patients with symptoms suggestive of LGV should be presumptively treated with antibacterial therapy for 3 weeks. If routine LGV serovar typing is unavailable, most authors proposed administration of syndromic LGV treatment for MSM with anorectal chlamydia and either proctitis detected by proctoscopic examination, more than 10 white blood cells/high-power field detected on an anorectal smear specimen, or HIV seropositivity. We believed the incidence of LGV is also increasing in Brazil, and new cases are not being diagnosed because the ignorance about this world outbreak. We suggest that anal ulcer or proctitis in anal sex practitioners must have a high suspicious of LGV infection.

  17. The Effects of Increased Accountability Standards on Graduation Rates for Students with Disabilities

    Science.gov (United States)

    Moore, Mitzi Lee

    2012-01-01

    This research sought to determine if unintended effects of increased accountability standards on graduation rates for students with disabilities existed. Data from one southeastern state were utilized in order to determine if graduation rates were impacted as a result of higher accountability standards. In addition, administrator attitudes on…

  18. Is Global Warming Likely to Cause an Increased Incidence of Malaria?

    African Journals Online (AJOL)

    The rise in the average temperature of earth has been described as global warming which is mainly attributed to the increasing phenomenon of the greenhouse effect. It is believed that global warming can have several harmful effects on human health, both directly and indirectly. Since malaria is greatly influenced by ...

  19. Increased incidences of multidrug-resistant gonorrhea in Taiwanese men: Experiences from a single institute

    Directory of Open Access Journals (Sweden)

    Yu-Hua Lin

    2016-06-01

    Conclusion: Genital discharge swab culture is a more effective method than urine culture to detect gonorrhea in patients with dysuria and urethral discharge. The increasing numbers of antibiotic-resistant N. gonorrhoeae strains is a major problem in treating gonococcal urethritis.

  20. Benefit Analysis of Implementation of Alternative SO2 Quality Standards on Acute Respiratory Syndrome (ARI Incidence Reduction in Indonesia

    Directory of Open Access Journals (Sweden)

    Muhamad Nizar

    2014-12-01

    Full Text Available Indonesia Quality Standard (QS for ambient SO2 for 1 hour time average i.e. 900 μg/m3(equivalent to 360μg/m3in24 hour time average regulated in the Government Regulation No. 41 of 1999 is the most loose compared to the ambient SO2 standards of other countries in the world including WHO QS guideline. This QS is not expected to guarantee the protection of public health in Indonesia. Therefore more stringent QS alternative for ambient SO2 is required. This research examines benefit values in public health aspect if Indonesia tightens its ambient SO2 QS. Two alternative QS for SO2 are used i.e196 μg/m3(equivalent to 78μg/m3in24 hour time average referring to U.S. EPA and 750μg/m3(equivalent to 360μg/m3in24 hour time average referring to PUSARPEDAL. First step is to map distribution of SO2 ambient concentrations in Indonesia. The result indicates that Provinces of Jakarta and Banten have exceeded both alternative QS while Provinces of Yogyakarta, West Java, Central Java, East Java, Bali, and North Sumatra only exceed the alternative QS of 196μg/m3. From the public health aspect, by attaining to the alternative QS of 750μg/m3, Jakarta and Banten will reduce incidence of ARI by 95% and 98%. By attaining to the alternative QS of 196μg/m3, East Java, Bali and North Sumatra will reduce the incidence of ARI by 59%, 51%, and 5%.

  1. Increased incidence of postoperative infections during prophylaxis with cephalothin compared to doxycycline in intestinal surgery

    DEFF Research Database (Denmark)

    Baatrup, Gunnar; Nilsen, Roy M; Svensen, Rune

    2009-01-01

    BACKGROUND: The antibiotics used for prophylaxis during surgery may influence the rate of surgical site infections. Tetracyclines are attractive having a long half-life and few side effects when used in a single dose regimen. We studied the rate of surgical site infections during changing regimens...... controls. The registration included time periods when the regimen was changed from doxycycline to cephalothin and back again. RESULTS: The SSI in the colorectal department increased from 19% to 30% (p=0.002) when doxycycline was substituted with cephalothin and decreased to 17% when we changed back...... to doxycycline (p=0.005). In the gynaecology department the surgical site infection rate did not increase significantly. Subgroup analysis showed major changes in infections in rectal resections from 20% to 35% (p=0.02) and back to 12% (p=0.003). CONCLUSION: Doxycycline combined with metronidazole...

  2. [Increasing incidence of community-acquired pneumonia caused by atypical microorganisms].

    Science.gov (United States)

    Tazón-Varela, M A; Alonso-Valle, H; Muñoz-Cacho, P; Gallo-Terán, J; Piris-García, X; Pérez-Mier, L A

    2017-09-01

    Knowing the most common microorganisms in our environment can help us to make proper empirical treatment decisions. The aim is to identify those microorganisms causing community-acquired pneumonia. An observational, descriptive and prospective study was conducted, including patients over 14 years with a clinical and radiographic diagnosis of community-acquired pneumonia during a 383 consecutive day period. A record was made of sociodemographic variables, personal history, prognostic severity scales, progress, and pathogenic agents. The aetiological diagnosis was made using blood cultures, detection of Streptococcus pneumoniae and Legionella pneumophila urinary antigens, sputum culture, influenza virus and Streptococcus pyogenes detection. Categorical variables are presented as absolute values and percentages, and continuous variables as their means and standard deviations. Of the 287 patients included in the study (42% women, mean age 66±22 years), 10.45% died and 70% required hospital admission. An aetiological diagnosis was achieved in 43 patients (14.98%), with 16 microorganisms found in 59 positive samples. The most frequently isolated pathogen was Streptococcus pneumonia (24/59, 41%), followed by gram-negative enteric bacilli, Klebsiella pneumonia, Escherichia coli, Serratia marcescens and Enterobacter cloacae isolated in 20% of the samples (12/59), influenza virus (5/59, 9%), methicillin-resistant Staphylococcus aureus (3/59, 5%), Pseudomonas aeruginosa (2/59, 3%), Moraxella catarrhalis (2/59, 3%), Legionella pneumophila (2/59, 3%), and Haemophilus influenza (2/59, 3%). Polymicrobial infections accounted for 14% (8/59). A high percentage of atypical microorganisms causing community-acquired pneumonia were found. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Socioeconomic Status Accounts for Rapidly Increasing Geographic Variation in the Incidence of Poor Fetal Growth

    Science.gov (United States)

    Ball, Stephen J.; Jacoby, Peter; Zubrick, Stephen R.

    2013-01-01

    Fetal growth is an important risk factor for infant morbidity and mortality. In turn, socioeconomic status is a key predictor of fetal growth; however, other sociodemographic factors and environmental effects may also be important. This study modelled geographic variation in poor fetal growth after accounting for socioeconomic status, with a fixed effect for socioeconomic status and a combination of spatially-correlated and spatially-uncorrelated random effects. The dataset comprised 88,246 liveborn singletons, aggregated within suburbs in Perth, Western Australia. Low socioeconomic status was strongly associated with an increased risk of poor fetal growth. An increase in geographic variation of poor fetal growth from 1999–2001 (interquartile odds ratio among suburbs = 1.20) to 2004–2006 (interquartile odds ratio = 1.40) indicated a widening risk disparity by socioeconomic status. Low levels of residual spatial patterns strengthen the case for targeting policies and practices in areas of low socioeconomic status for improved outcomes. This study indicates an alarming increase in geographic inequalities in poor fetal growth in Perth which warrants further research into the specific aspects of socioeconomic status that act as risk factors. PMID:23799513

  4. Smoking increases the incidence of complicated diverticular disease of the sigmoid colon.

    Science.gov (United States)

    Turunen, P; Wikström, H; Carpelan-Holmström, M; Kairaluoma, P; Kruuna, O; Scheinin, T

    2010-01-01

    The aim of this study was to establish whether smoking is associated with complicated diverticular disease and adverse outcomes of operative treatment of diverticular disease. Smoking has been associated with increased rate of perforations in acute appendicitis as well as failure of colonic anastomosis in patients resected for colonic tumours. It has also been suggested that smoking is a risk factor for complicated diverticular disease of the colon. Retrospective investigation of records of 261 patients electively operated for diverticular disease in Helsinki University Central Hospital during a period of five years. The smokers underwent sigmoidectomy at a younger age than the non-smokers (p = 0.001) and they had an increased rate of perforations (p = 0.040) and postoperative recurrent diverticulitis episodes (p = 0.019). We conclude that smoking increases the likelihood of complications in diverticulosis coli. The development of complicated disease also seems to proceed more rapidly in smokers.Key words: Sigmoid resection; laparoscopy; laparoscopic sigmoidectomy; smoking and diverticular disease; complicated diverticular disease; diverticulitis.

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

    Science.gov (United States)

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

    2017-04-01

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

  6. Increased incidence of preeclampsia in mothers of advanced age conceiving by oocyte donation.

    Science.gov (United States)

    Dior, Uri P; Laufer, Neri; Chill, Henry H; Granovsky-Grisaru, Sorina; Yagel, Simcha; Yaffe, Haim; Gielchinsky, Yuval

    2018-05-01

    The aim of this study was to evaluate the risk of preeclampsia in women of advanced age who conceived through donated oocytes as compared with natural conceptions. A historical prospective study of singleton live births of parturients ≥ 45 years of age at four university hospitals was conducted. For the purpose of the study, the population was divided by the mode of conception into two groups: oocyte donation and natural conception. The main outcome variable in this study was preeclampsia. Secondary outcomes included pregnancy-induced hypertension and Small for Gestational Age. Two hundred and seventy pregnancies were achieved naturally and 135 women conceived by oocyte donation. Mean age at delivery for the natural conception and oocyte donation groups was 45.7 and 47.8, respectively. Preeclampsia complicated 3 out of 270 (1.1%) natural conception pregnancies and 17 out of 135 (12.6%) oocyte donation conceptions. After adjusting for confounders, oocyte donation pregnancies were found to be associated with a 12-fold increased risk for preeclampsia (P = 0.001). Among oocyte donation pregnancies, the risk of preeclampsia was not affected by parity or age. A substantially increased risk for preeclampsia was found in oocyte donation pregnancies, suggesting that the foreign oocyte may play a specific biologic role in the development of preeclampsia after the age of 45.

  7. Incidence of Ichthyophonus hoferi in Puget Sound fishes and its increase with age of Pacific herring

    Science.gov (United States)

    Hershberger, P.K.; Stick, K.; Bui, B.; Carroll, C.; Fall, B.; Mork, C.; Perry, J.A.; Sweeney, E.; Wittouck, J.; Winton, J.; Kocan, R.

    2002-01-01

    A recent decrease in the mean age of adult Pacific herring Clupea pallasi in Puget Sound was associated with a high prevalence of Ichthyophonus hoferi, a protistan parasite that can be highly pathogenic to Pacific herring. In Puget Sound, high intensities of I. hoferiinfection may be maintained in older cohorts of Pacific herring because the prevalence ofI. hoferi increased with age from 12% among juveniles to 58% among the oldest, age-6 and older cohorts. Low intensities of I. hoferi infection in the region may be maintained in alternative fish hosts, such as surf smelt Hypomesus pretiosus, Puget Sound rockfishSebastes emphaeus, Pacific tomcod Microgadus proximus, and speckled sanddabCithanichthys stigmaeus.

  8. An Increase in the Incidence of Infective Endocarditis in England since 2008: A secular trend interrupted time series analysis

    Science.gov (United States)

    Dayer, Mark J; Jones, Simon; Prendergast, Bernard; Baddour, Larry M.; Lockhart, Peter B; Thornhill, Martin H

    2017-01-01

    Background Antibiotic prophylaxis (AP) administered prior to invasive procedures in patients at risk of developing infective endocarditis (IE) has historically been the focus of IE prevention. Recent changes in AP guidelines in the US and Europe have substantially reduced the numbers for whom AP is recommended. In the UK, the National Institute for Health and Care Excellence (NICE) guidelines recommended complete cessation of AP in March 2008. We report the impact of these guidelines on AP prescribing; in addition, IE incidence was examined following the introduction of the guidelines. Methods We analyzed English AP prescribing data from January 2004 to March 2013 and hospital discharge episode statistics for patients with a primary diagnosis of IE from January 2000 to March 2013. Findings AP prescribing rates fell dramatically after introduction of the NICE guidance (10,935 prescriptions/month vs. 2,236 prescriptions/month, p<0·0001). Commencing in March 2008, there was also a significant increase in the number of IE cases/month (0·11 cases/10million/month, CI 0·05–0·16, p<0·0001) above the projected historical trend. By March 2013, there were an additional 35 cases/month than would have been expected if the previous trend had continued. This increase in IE incidence was significant for both ‘high-risk’ and ‘lower-risk’ individuals. Interpretation Although our data do not establish a causal relationship, there has been a substantial reduction in AP prescribing and a significant increase in IE incidence in England since introduction of the NICE guidelines in 2008. Funding Different aspects of this study were supported by Heart Research UK and Simplyhealth [Grant Ref: RG2632/13/14] and NIDCR R03 grant [Ref: 1R03DE023092-01] from the National Institutes for Health. PMID:25467569

  9. An increased incidence of overt hypothyroidism after iodine fortification of salt in Denmark: A prospective population study

    DEFF Research Database (Denmark)

    Pedersen, Inge Bulow; Laurberg, Peter; Knudsen, Nils

    2007-01-01

    , n = 225,707, urinary iodine = 61 mu g/liter). Data were obtained 1) before IF (1997-1998), 2) during voluntary IF (1999-2000), 3) during early (2001-2002) and 4) during late (2003-2005) period with mandatory IF. Results: The overall incidence rate of hypothyroidism increased during the study period...... 7 yr after IF had been introduced. Methods: A computer- based register was used to identify continuously all new cases of overt hypothyroidism in two subcohorts with previous moderate and mild iodine deficiency (ID), respectively (Aalborg, n = 310,124, urinary iodine = 45 mu g/liter; and Copenhagen...

  10. Increasing incidence but decreasing in-hospital mortality of adult Staphylococcus aureus bacteraemia between 1981 and 2000

    DEFF Research Database (Denmark)

    Benfield, Thomas; Espersen, F; Frimodt-Møller, N

    2007-01-01

    Staphylococcus aureus is a leading cause of bacteraemia. This study analysed temporal trends from 18,702 adult cases of S. aureus bacteraemia in Denmark between 1981 and 2000. After stratification for mode of acquisition, 57% of cases were hospital-acquired (HA), 28% were community-acquired (CA...... associated with S. aureus bacteraemia declined significantly between 1981 and 2000, but incidence rates doubled, so that the total number of deaths increased. These data emphasise the public health importance of S. aureus bacteraemia and the need for further preventive measures and improved care in order...

  11. Increased caries-incidence by oral inoculation of cariogenic bacteria in rats after dietary fluoride

    Energy Technology Data Exchange (ETDEWEB)

    Clark, W.B.; Kreitzman, S.N.; Howell, T.H.

    1976-04-01

    The authors had previously observed that dietary NaF administered to rats during the formative and eruptive stages of tooth development does not significantly reduce the enamel solubility in acid buffer solution. They hypothesized that NaF reduces the cariogenicity of the bacterial flora. In order to test this hypothesis, rats from the same litter were divided into three groups all of which received a cariogenic diet. Group one received no fluoride. Groups two and three were supplemented with 50 ppm NaF, from day 1 to day 21. In the first study, one of the 21-day-old NaF-supplemented groups was inoculated by smears of fecal material from the control animals that did not receive NaF supplement. The second NaF group was not inoculated and served as control. In a second study, cariogenic Strep. mutans 6715 was used as the inoculum in place of the fecal smear. In both studies, the inoculation of a NaF group increased the caries to about 70% of the control group, while the mean scores on the non-inoculated NaF group were about 50% of the control group. These results indicate that alteration of the transmissible flora may be an important factor in the cariostatic action of dietary fluoride in experimental animals. This observation supports the suggestion that fluoride may alter the cariogenic flora.

  12. Increased Incidence of Interatrial Block in Younger Adults with Cryptogenic Stroke and Patent Foramen Ovale

    Directory of Open Access Journals (Sweden)

    P.E. Cotter

    2011-04-01

    Full Text Available Background: Stroke is often unexplained in younger adults, although it is often associated with a patent foramen ovale (PFO. The reason for the association is not fully explained, and mechanisms other than paradoxical embolism may be involved. Young stroke patients with PFO have more atrial vulnerability than those without PFO. It is plausible that stretching of the interatrial septum may disrupt the interatrial conduction pathways causing interatrial block (IAB. IAB is associated with atrial fibrillation, dysfunctional left atria and stroke. Methods: Electrocardiogram (ECG characteristics of prospectively recruited young patients (≤55 years of age with unexplained stroke (TOAST and A-S-C-O were compared with control data. All stroke cases underwent bubble contrast transthoracic and transoesophageal echography. IAB was defined as a P-wave duration of ≧110 ms. ECG data were converted to electronic format and analysed in a blind manner. Results: Fifty-five patients and 23 datasets were analysed. Patients with unexplained stroke had longer P-wave duration (p = 0.013 and a greater prevalence of IAB (p = 0.02 than healthy controls. Case status was an independent predictor of P-wave duration in a significant multivariate model. There was a significant increase in the proportion of cases with a PFO with IAB compared with cases without PFO and with controls (p = 0.005. Conclusions: Young patients with unexplained stroke, particularly those with PFO, exhibit abnormal atrial electrical characteristics suggesting atrial arrhythmia or atrial dysfunction as a possible mechanism of stroke.

  13. Increase in specific density of levobupivacaine and fentanyl solution ensures lower incidence of inadequate block.

    Science.gov (United States)

    Djeno, Ivana Tudorić; Duzel, Viktor; Ajduk, Marko; Oremus, Zrinka Safarić; Zupcić, Miroslav; Dusper, Silva; Jukić, Dubravko; Husedzinović, Ino

    2012-06-01

    The clinical presentation of a subarachnoid block (SAB) is dependent upon the intrathecal spread of local anesthetic (LA). Intrathecal distribution depends on the chemical and physical characteristics of LA, puncture site, technique used, patient anatomical characteristics and hydrodynamic properties of cerebrospinal fluid. We tried to determine whether a combined glucose/LA solution can render a clinically significant difference in sensory block distribution and motor block intensity.This was a controlled, randomized and double blinded study. The surgical procedures were stripping of the great or small saphenous vein and extirpation of remaining varicose veins. The study included 110 patients distributed into two groups: Hyperbaric (7.5 mg levobupivacaine (1.5 ml 0.5% Chirocaine) + 50 microg Fentanyl (0.5 ml Fentanil) and 1 ml 10% glucose (Pliva)) vs. Hypobaric (7.5 mg levobupivacaine (1.5 ml 0.5% Chirocaine) + 50 microg Fentanyl (0.5 ml Fentanil) and 1 ml 0.9% NaCl (Pliva, Zagreb)) adding to a total volume of 3.5 ml per solution. Spinal puncture was at L3-L4 level. Spinal block distribution was assessed in five minute intervals and intensity of motor block was assessed according to the modified Bromage scale. Pain was assessed with the Visual Analogue Scale. A statistically significant difference in sensory block distribution, motor block intensity and recovery time was established between hyperbaric and hypobaric solutions. By increasing the specific density of anesthetic solution, a higher sensory block, with lesser variability, a diminished influence of Body Mass Index, decreased motor block intensity and faster recovery time may be achieved.

  14. LOW OXYGENATION STATUS INCREASES NAUSEA-VOMITING INCIDENCE IN HEMODIALYSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    Cornelia DY Nekada

    2017-08-01

    Full Text Available Background and Objective: Data from Indonesia Basic Health Research (2013 states that the chronic renal failure in Indonesia is increasing, especially in Yogyakarta with the prevalence of chronic renal failure of 0,3%. If the patients of chronic renal failure are in End Stage Renal Disease (ESRD, the kidney needs replacement therapy to help its function. This therapy is called Continuous Renal Replacement Therapy (CRRT or Hemodialysis (HD. Hemodialysis therapy may influence to the imbalance of oxyhemoglobin in the blood. Patients undergoing hemodialysis may experience intradialytic nausea and vomiting. The objective of this study is to identify whether there is a relationship between pre-dialysis oxygenation status through oxygen saturation (SpO2 and respiratory rate (RR examination and the intradialytic nausea-vomiting occurrence. Method: This research is a comparative research with analytical cross sectional design. This research was conducted in hemodialysis room in Public Hospital of Panembahan Senopati Bantul. The subject of the research was taken using total sampling, by paying attention to research ethics. The total research subjects are 183 respondents. The researchers measured the oxygen saturation and patients’ respiratory rate and examined the intradialytic nausea and vomiting complaints. Result: The analysis result of Fisher’s exact in this research shows p value of 0,000 both in bivariate analysis of oxygen saturation to the nausea and vomiting occurrence and in bivariate analysis of the respiratory rate to the nausea and vomiting occurrence. The multivariate analysis employing regression logistic shows that the OR of oxygen saturation is 73,57, this means that the measurement of the abnormal oxygen saturation has the chance of seventy three times more to the nausea and vomiting occurrence, if compared to the patients with normal oxygen saturation. Conclusion and Suggestion: Intradialytic nausea and vomiting is one of the causes

  15. Increased Incidence of Urolithiasis and Bacteremia During Proteus mirabilis and Providencia stuartii Coinfection Due to Synergistic Induction of Urease Activity

    Science.gov (United States)

    Armbruster, Chelsie E.; Smith, Sara N.; Yep, Alejandra; Mobley, Harry L. T.

    2014-01-01

    Background. Catheter-associated urinary tract infections (CaUTIs) are the most common hospital-acquired infections worldwide and are frequently polymicrobial. The urease-positive species Proteus mirabilis and Providencia stuartii are two of the leading causes of CaUTIs and commonly co-colonize catheters. These species can also cause urolithiasis and bacteremia. However, the impact of coinfection on these complications has never been addressed experimentally. Methods. A mouse model of ascending UTI was utilized to determine the impact of coinfection on colonization, urolithiasis, and bacteremia. Mice were infected with P. mirabilis or a urease mutant, P. stuartii, or a combination of these organisms. In vitro experiments were conducted to assess growth dynamics and impact of co-culture on urease activity. Results. Coinfection resulted in a bacterial load similar to monospecies infection but with increased incidence of urolithiasis and bacteremia. These complications were urease-dependent as they were not observed during coinfection with a P. mirabilis urease mutant. Furthermore, total urease activity was increased during co-culture. Conclusions. We conclude that P. mirabilis and P. stuartii coinfection promotes urolithiasis and bacteremia in a urease-dependent manner, at least in part through synergistic induction of urease activity. These data provide a possible explanation for the high incidence of bacteremia resulting from polymicrobial CaUTI. PMID:24280366

  16. Partial meniscectomy is associated with increased risk of incident radiographic osteoarthritis and worsening cartilage damage in the following year

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, Frank W. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); University of Erlangen-Nuremberg, Department of Radiology, Erlangen (Germany); Kwoh, C.K. [University of Arizona Arthritis Center and University of Arizona College of Medicine, Tucson, AZ (United States); Hannon, Michael J.; Grago, Jason [University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, PA (United States); Hunter, David J. [University of Sydney, Department of Rheumatology, Royal North Shore Hospital and Kolling Institute, St Leonards (Australia); Eckstein, Felix [Paracelsus Medical University, Institute of Anatomy, Salzburg (Austria); Boudreau, Robert M. [University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA (United States); Englund, Martin [Lund University, Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund, Lund (Sweden); Guermazi, Ali [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States)

    2017-01-15

    To assess whether partial meniscectomy is associated with increased risk of radiographic osteoarthritis (ROA) and worsening cartilage damage in the following year. We studied 355 knees from the Osteoarthritis Initiative that developed ROA (Kellgren-Lawrence grade ≥ 2), which were matched with control knees. The MR images were assessed using the semi-quantitative MOAKS system. Conditional logistic regression was applied to estimate risk of incident ROA. Logistic regression was used to assess the risk of worsening cartilage damage in knees with partial meniscectomy that developed ROA. In the group with incident ROA, 4.4 % underwent partial meniscectomy during the year prior to the case-defining visit, compared with none of the knees that did not develop ROA. All (n = 31) knees that had partial meniscectomy and 58.9 % (n = 165) of the knees with prevalent meniscal damage developed ROA (OR = 2.51, 95 % CI [1.73, 3.64]). In knees that developed ROA, partial meniscectomy was associated with an increased risk of worsening cartilage damage (OR = 4.51, 95 % CI [1.53, 13.33]). The probability of having had partial meniscectomy was higher in knees that developed ROA. When looking only at knees that developed ROA, partial meniscectomy was associated with greater risk of worsening cartilage damage. (orig.)

  17. Implicating the H63D polymorphism in the HFE gene in increased incidence of solid cancers: a meta-analysis.

    Science.gov (United States)

    Shen, L L; Gu, D Y; Zhao, T T; Tang, C J; Xu, Y; Chen, J F

    2015-10-29

    A number of previous studies have demonstrated that the HFE H63D polymorphism is associated with increased risk of incidence multiple types of cancer, including colorectal cancer, breast cancer, liver cancer, pancreatic cancer, and gynecological malignant tumors. However, the clinical outcomes were inconsistent. Therefore, this meta-analysis was conducted to summarize the effect of the H63D variant on the incidence of solid tumor. PubMed and EMBASE databases were searched for articles associating the HFE H63D polymorphism with cancer risk. The relationships were evaluated by calculating the pooled odds ratios (ORs) with 95% confidence intervals (CIs). A total of 28 studies, including 7728 cancer cases and 11,895 controls, were identified. Statistically significant associations were identified between the HFE H63D polymorphism and solid cancer risk (CG vs CC, OR = 1.14, 95%CI = 1.07-1.23, P HFE H63D polymorphism may play a critical role in the increased aggressiveness of hepatocellular carcinoma and pancreatic cancer.

  18. Increased incidence of urolithiasis and bacteremia during Proteus mirabilis and Providencia stuartii coinfection due to synergistic induction of urease activity.

    Science.gov (United States)

    Armbruster, Chelsie E; Smith, Sara N; Yep, Alejandra; Mobley, Harry L T

    2014-05-15

    Catheter-associated urinary tract infections (CaUTIs) are the most common hospital-acquired infections worldwide and are frequently polymicrobial. The urease-positive species Proteus mirabilis and Providencia stuartii are two of the leading causes of CaUTIs and commonly co-colonize catheters. These species can also cause urolithiasis and bacteremia. However, the impact of coinfection on these complications has never been addressed experimentally. A mouse model of ascending UTI was utilized to determine the impact of coinfection on colonization, urolithiasis, and bacteremia. Mice were infected with P. mirabilis or a urease mutant, P. stuartii, or a combination of these organisms. In vitro experiments were conducted to assess growth dynamics and impact of co-culture on urease activity. Coinfection resulted in a bacterial load similar to monospecies infection but with increased incidence of urolithiasis and bacteremia. These complications were urease-dependent as they were not observed during coinfection with a P. mirabilis urease mutant. Furthermore, total urease activity was increased during co-culture. We conclude that P. mirabilis and P. stuartii coinfection promotes urolithiasis and bacteremia in a urease-dependent manner, at least in part through synergistic induction of urease activity. These data provide a possible explanation for the high incidence of bacteremia resulting from polymicrobial CaUTI.

  19. Increasing incidence of mucormycosis in a large Spanish hospital from 2007 to 2015: Epidemiology and microbiological characterization of the isolates.

    Directory of Open Access Journals (Sweden)

    Jesús Guinea

    Full Text Available We studied 19 cases of proven/probable mucormycosis diagnosed from 2007 to 2015 in our hospital and assessed the microbiological characteristics of the isolates. We recorded the incidence of mucormycosis and clinical and microbiological data of infected patients. Isolates were identified to molecular level and tested for their antifungal susceptibility to azoles, amphotericin B, and liposomal amphotericin B according to the CLSI M-38 A2 procedure. The incidence of mucormycosis in cases/100,000 hospital admissions during 2007-2015 increased significantly with respect to that reported in 1988-2006 (3.3 vs. 1.2; P<0.05. Patients mainly had hematological malignancies (52.6% and/or trauma/surgical wounds (52.6% and had received antifungal agents before the diagnosis of mucormycosis in 68% of cases. Diagnosis was by isolation (n = 17/19 and/or direct staining (n = 17/18 of Mucorales fungi in clinical samples. Identification was by panfungal PCR in patients with negative results in culture and in direct staining. The microorganisms identified were Lichtheimia spp. (42%, Rhizopus spp. (21%, Cunninghamella bertholletiae (16%, and others (21%. Liposomal amphotericin B was always more active than the other drugs against all the microorganisms except C. bertholletiae. All patients received antifungal treatment with 1 or more antifungal agents, mainly liposomal amphotericin B (17/19. Mortality was 47.4%, although this was significantly lower in the 11 patients in whom debridement was performed (18% vs. 87.5% (P = 0.015. The incidence of mucormycosis has risen in recent years. The proportion of cases with soft tissue involvement was high, and Lichtheimia was the most frequently involved species. The highest antifungal activity was observed with liposomal amphotericin B.

  20. Confirmation of the reported association of clonal chromosomal mosaicism with an increased risk of incident hematologic cancer.

    Directory of Open Access Journals (Sweden)

    Ursula M Schick

    Full Text Available Chromosomal abnormalities provide clinical utility in the diagnosis and treatment of hematologic malignancies, and may be predictive of malignant transformation in individuals without apparent clinical presentation of a hematologic cancer. In an effort to confirm previous reports of an association between clonal mosaicism and incident hematologic cancer, we applied the anomDetectBAF algorithm to call chromosomal anomalies in genotype data from previously conducted Genome Wide Association Studies (GWAS. The genotypes were initially collected from DNA derived from peripheral blood of 12,176 participants in the Group Health electronic Medical Records and Genomics study (eMERGE and the Women's Health Initiative (WHI. We detected clonal mosaicism in 169 individuals (1.4% and large clonal mosaic events (>2 mb in 117 (1.0% individuals. Though only 9.5% of clonal mosaic carriers had an incident diagnosis of hematologic cancer (multiple myeloma, myelodysplastic syndrome, lymphoma, or leukemia, the carriers had a 5.5-fold increased risk (95% CI: 3.3-9.3; p-value = 7.5×10(-11 of developing these cancers subsequently. Carriers of large mosaic anomalies showed particularly pronounced risk of subsequent leukemia (HR = 19.2, 95% CI: 8.9-41.6; p-value = 7.3×10(-14. Thus we independently confirm the association between detectable clonal mosaicism and hematologic cancer found previously in two recent publications.

  1. Increasing incidence of early onset Type 1 (insulin-dependent) diabetes mellitus: a study of Danish male birth cohorts

    DEFF Research Database (Denmark)

    Green, A.; Andersen, Per Kragh; Svendsen, A.J.

    1992-01-01

    To provide information of the incidence trends of Type 1 (insulin-dependent) diabetes mellitus we performed a cohort study of a series of Danish male birth cohorts. All male livebirths in Denmark between 1 January 1949 and 31 December 1964, were investigated regarding the development of Type 1...... of 1705 diabetic subjects were identified of whom 23 were not representative of idiopathic Type 1 diabetes. The cumulative rate of Type 1 diabetes development during the first 20 years of life increased from 2.37 to 2.90 per 1000 for the first eight and last eight birth cohorts, respectively. A log...... diabetes during the first 20 years of life using the files of the Danish Conscript Board, supplemented by a search in the Danish National Registry of Deaths. Diagnosis was verified and clinical information obtained from medical records. The material is estimated to be more than 95% complete. A total...

  2. 75 FR 49363 - Deposit Insurance Regulations; Permanent Increase in Standard Coverage Amount; Advertisement of...

    Science.gov (United States)

    2010-08-13

    ... Insurance Regulations; Permanent Increase in Standard Coverage Amount; Advertisement of Membership... Procedure Act The FDIC believes that good cause exists for issuing the final rule without providing an... the public interest.'' \\8\\ The FDIC also finds good cause for issuing the final rule without a 30-day...

  3. Diet-Induced Obesity Is Associated with an Impaired NK Cell Function and an Increased Colon Cancer Incidence

    Directory of Open Access Journals (Sweden)

    Ina Bähr

    2017-01-01

    Full Text Available Obesity is associated with an increased colon cancer incidence, but underlying mechanisms remained unclear. Previous studies showed altered Natural killer (NK cell functions in obese individuals. Therefore, we studied the impact of an impaired NK cell functionality on the increased colon cancer risk in obesity. In vitro investigations demonstrated a decreased IFN-γ secretion and cytotoxicity of human NK cells against colon tumor cells after NK cell preincubation with the adipokine leptin. In addition, leptin incubation decreased the expression of activating NK cell receptors. In animal studies, colon cancer growth was induced by injection of azoxymethane (AOM in normal weight and diet-induced obese rats. Body weight and visceral fat mass were increased in obese animals compared to normal weight rats. AOM-treated obese rats showed an increased quantity, size, and weight of colon tumors compared to the normal weight tumor group. Immunohistochemical analyses demonstrated a decreased number of NK cells in spleen and liver in obesity. Additionally, the expression levels of activating NK cell receptors were lower in spleen and liver of obese rats. The results show for the first time that the decreased number and impaired NK cell function may be one cause for the higher colon cancer risk in obesity.

  4. Can Standards Increase Consumer Welfare? Evidence from a Change in Clothes Washer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xiaomei [North Carolina State Univ., Raleigh, NC (United States); Roberts, Michael J. [North Carolina State Univ., Raleigh, NC (United States); Univ. of Hawaii, Manoa, HI (United States); Yang, Hung-Chia [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Dale, Larry [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-12-08

    We study prices and sales of individual clothes washer models before, during and after a 2007 standard that banned manufacture (but not sale) of low-e ciency units and increased the threshold for Energy Star certi cation. While quantities sold of washer models banned from manufacture decreased sharply, prices for banned models increased only modestly. At the same time, sales of higher-e ciency units rose markedly while prices for high-e ciency units declined. On average, washer e ciency increased but prices changed little. A simple welfare analysis indicates that consumer welfare loss from banned washers was far outweighed by gains from lower-priced high-e ciency units. While a full cost-bene t analysis is not feasible with the available data, we estimate a lower-bound gain in consumer surplus equal to 6-16 percent of total sales. This result may accord with earlier theoretical research that shows quality standards can increase welfare in monopolistically competitive industries that possess increasing returns to scale (Ronnen, 1991). Thus, if energy e ciency is a close proxy for quality, energy e ciency standards may increase competition, market e ciency and welfare.

  5. Increasing Incidence and Prevalence of World Health Organization Groups 1 to 4 Pulmonary Hypertension: A Population-Based Cohort Study in Ontario, Canada.

    Science.gov (United States)

    Wijeratne, D Thiwanka; Lajkosz, Katherine; Brogly, Susan B; Lougheed, M Diane; Jiang, Li; Housin, Ahmad; Barber, David; Johnson, Ana; Doliszny, Katharine M; Archer, Stephen L

    2018-02-01

    The World Health Organization recognizes 5 groups of pulmonary hypertension (PH), categorized by pathogenesis or comorbidity: 1-pulmonary arterial hypertension 2-left-heart disease, 3-lung disease and hypoxia 4-chronic thromboembolic disease, and 5-miscellaneous. The epidemiology of PH, apart from group 1, is largely unknown. We describe incidence, prevalence, comorbidities, mortality and prescribing patterns for groups 1 to 4 PH from 1993 to 2012. Case definitions are based on hospitalizations and emergency department visits, using the Institute for Clinical Evaluative Sciences data, which comprises linked databases of universal coverage health service records for Ontario residents. This cohort included 50 529 patients with PH. The annual incidence of adult PH increased from 2003 to 2012 from 24.1 to 28.7 cases/100 000 population and the annual prevalence from 1993 to 2012 from 99.8 to 127.3 cases/100 000 population, respectively. The most common form of adult PH was group 2, alone (34.2%) or combined with group 3 PH (29.3%). A diagnosis of PH increased the 1-year standardized mortality ratio 7.2-fold. Mortality in adults with PH was 13.0%, 36.4%, and 62.4%, at 30 days, 1 year, and 5 years, respectively. Mortality was highest in groups 2 and 3 and lowest in group 1. PH was present in only 3.6% of people with left heart disease, 0.7% with lung disease, and 1.4% with thromboembolic disease, suggesting that PH is a relatively rare complication of these common diseases. Children (age<16 years) accounted for 3.6% of the cohort. In children group 1 PH was most common (65.2%), and 5-year mortality was lower (21.4%) than in adults. Group 1-specific PH therapies were increasingly prescribed over time and paradoxically were often used in patients who seemed to have group 2, PH based on diagnostic codes indicating left heart disease. The incidence and prevalence of adult PH are increasing. Groups 2 and 3 are the most common and lethal forms of PH. This study identifies an

  6. Increased incidence of myelodysplastic syndrome and acute myeloid leukemia following breast cancer treatment with radiation alone or combined with chemotherapy: a registry cohort analysis 1990-2005

    International Nuclear Information System (INIS)

    Kaplan, Henry G; Malmgren, Judith A; Atwood, Mary K

    2011-01-01

    Our objective was to measure myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML) risk associated with radiation and/or chemotherapy breast cancer (BC) treatment. Our study cohort was composed of BC patients diagnosed from 1990 to 2005 and followed up for blood disorders, mean length of follow up = 7.17 years, range 2-18 years. 5790 TNM stage 0-III patients treated with surgery alone, radiation and/or chemotherapy were included. Patients without surgery (n = 111), with stem cell transplantation (n = 98), unknown or non-standard chemotherapy regimens (n = 94), lost to follow up (n = 66) or 'cancer status unknown' (n = 67) were excluded. Rates observed at our community based cancer care institution were compared to SEER incidence data for rate ratio (RR) calculations. 17 cases of MDS/AML (10 MDS/7 AML) occurred during the follow up period, crude rate .29% (95% CI = .17, .47), SEER comparison RR = 3.94 (95% CI = 2.34, 6.15). The RR of MDS in patients age < 65 comparing our cohort incidence to SEER incidence data was 10.88 (95% CI = 3.84, 24.03) and the RR of AML in patients age < 65 was 5.32 (95% CI = 1.31, 14.04). No significant increased risk of MDS or AML was observed in women ≥ 65 or the surgery/chemotherapy-only group. A RR of 3.32 (95% CI = 1.42, 6.45) was observed in the surgery/radiation-only group and a RR of 6.32 (95% CI = 3.03, 11.45) in the surgery/radiation/chemotherapy group. 3 out of 10 MDS cases died of disease at an average 3.8 months post diagnosis and five of seven AML cases died at an average 9 months post diagnosis. An elevated rate of MDS and AML was observed among breast cancer patients < 65, those treated with radiation and those treated with radiation and chemotherapy compared to available population incidence data. Although a small number of patients are affected, leukemia risk associated with treatment and younger age is significant

  7. HIV incidence on the increase among homosexual men attending an Amsterdam sexually transmitted disease clinic: using a novel approach for detecting recent infections

    NARCIS (Netherlands)

    Dukers, Nicole H. T. M.; Spaargaren, Joke; Geskus, Ronald B.; Beijnen, Jos; Coutinho, Roel A.; Fennema, Han S. A.

    2002-01-01

    Objective: Dramatic increases have occurred in sexually transmitted diseases (STD) and in sexual risk behaviour among homosexual men in Amsterdam and internationally. We investigated whether these trends indicate a resurgence of the HIV epidemic. Methods: HIV incidence was determined among

  8. Increase in incidence of hyperthyroidism predominantly occurs in young people after iodine fortification of salt in Denmark.

    Science.gov (United States)

    Bülow Pedersen, Inge; Laurberg, Peter; Knudsen, Nils; Jørgensen, Torben; Perrild, Hans; Ovesen, Lars; Rasmussen, Lone Banke

    2006-10-01

    To prevent goiter and nodular hyperthyroidism, iodine fortification (IF) of salt was introduced in Denmark in 1998. We prospectively registered all new cases of overt hyperthyroidism in two areas of Denmark before and for the first 6 yr after iodine fortification. We used a computer-based register of all new cases of hyperthyroidism in two population subcohorts with moderate iodine deficiency (Aalborg, n = 310,124) and mild iodine deficiency (Copenhagen, n = 225,707), respectively. Data were obtained 1) before IF (1997-1998); 2) during voluntary IF (1999-2000); 3) during the early (2001-2002) period of mandatory IF; and 4) during the late (2003-2004) period with mandatory IF. The overall incidence rate of hyperthyroidism increased [baseline, 102.8/100,000/year; voluntary IF, 122.8; early mandatory IF, 140.7; late mandatory IF, 138.7 (P for trend Hyperthyroidism increased in both sexes (P hyperthyroidism. Contrary to current concepts, many of the new cases were observed in young subjects, and are presumably of autoimmune origin. Furthermore, monitoring is expected to show a decrease in the number of elderly subjects suffering from nodular hyperthyroidism.

  9. Case Study: Nutritional and Lifestyle Support to Reduce Infection Incidence in an International-Standard Premier League Soccer Player.

    Science.gov (United States)

    Ranchordas, Mayur K; Bannock, Laurent; Robinson, Scott L

    2016-04-01

    Professional soccer players are exposed to large amounts of physiological and psychological stress, which can increase infection risk and threaten availability for training and competition. Accordingly, it is important for practitioners to implement strategies that support player well-being and prevent illness. This case study demonstrates how a scientifically supported and practically applicable nutrition and lifestyle strategy can reduce infection incidence in an illness-prone professional soccer player. In the 3 months before the intervention, the player had 3 upper-respiratory tract infections (URTIs) and subsequently missed 3 competitive matches and 2 weeks' training. He routinely commenced morning training sessions in the fasted state and was estimated to be in a large daily energy deficit. Throughout the 12-week intervention, the amount, composition, and timing of energy intake was altered, quercetin and vitamin D were supplemented, and the player was provided with a daily sleep and hygiene protocol. There was a positive increase in serum vitamin D 25(OH) concentration from baseline to Week 12 (53 n·mol-1 to 120 n·mol-1) and salivary immunoglobulin-A (98 mg·dl-1 to 135 mg·dl-1), as well as a decline in the number of URTI symptoms (1.8 ± 2.0 vs. 0.25 ± 0.5 for Weeks 0-4 and Weeks 8-12, respectively). More important, he maintained availability for all training and matches over the 12-week period. We offer this case study as a real-world applied example for other players and practitioners seeking to deploy nutrition and lifestyle strategies to reduce risk of illness and maximize player availability.

  10. The effect of genetic bottlenecks and inbreeding on the incidence of two major autoimmune diseases in standard poodles, sebaceous adenitis and Addison's disease.

    Science.gov (United States)

    Pedersen, Niels C; Brucker, Lynn; Tessier, Natalie Green; Liu, Hongwei; Penedo, Maria Cecilia T; Hughes, Shayne; Oberbauer, Anita; Sacks, Ben

    2015-01-01

    Sebaceous adenitis (SA) and Addison's disease (AD) increased rapidly in incidence among Standard Poodles after the mid-twentieth century. Previous attempts to identify specific genetic causes using genome wide association studies and interrogation of the dog leukocyte antigen (DLA) region have been non-productive. However, such studies led us to hypothesize that positive selection for desired phenotypic traits that arose in the mid-twentieth century led to intense inbreeding and the inadvertent amplification of AD and SA associated traits. This hypothesis was tested with genetic studies of 761 Standard, Miniature, and Miniature/Standard Poodle crosses from the USA, Canada and Europe, coupled with extensive pedigree analysis of thousands more dogs. Genome-wide diversity across the world-wide population was measured using a panel of 33 short tandem repeat (STR) loci. Allele frequency data were also used to determine the internal relatedness of individual dogs within the population as a whole. Assays based on linkage between STR genomic loci and DLA genes were used to identify class I and II haplotypes and disease associations. Genetic diversity statistics based on genomic STR markers indicated that Standard Poodles from North America and Europe were closely related and reasonably diverse across the breed. However, genetic diversity statistics, internal relatedness, principal coordinate analysis, and DLA haplotype frequencies showed a marked imbalance with 30 % of the diversity in 70 % of the dogs. Standard Poodles with SA and AD were strongly linked to this inbred population, with dogs suffering with SA being the most inbred. No single strong association was found between STR defined DLA class I or II haplotypes and SA or AD in the breed as a whole, although certain haplotypes present in a minority of the population appeared to confer moderate degrees of risk or protection against either or both diseases. Dogs possessing minor DLA class I haplotypes were half as

  11. Increasing Incidence of Plasmodium knowlesi Malaria following Control of P. falciparum and P. vivax Malaria in Sabah, Malaysia

    Science.gov (United States)

    William, Timothy; Rahman, Hasan A.; Jelip, Jenarun; Ibrahim, Mohammad Y.; Menon, Jayaram; Grigg, Matthew J.; Yeo, Tsin W.; Anstey, Nicholas M.; Barber, Bridget E.

    2013-01-01

    Background The simian parasite Plasmodium knowlesi is a common cause of human malaria in Malaysian Borneo and threatens the prospect of malaria elimination. However, little is known about the emergence of P. knowlesi, particularly in Sabah. We reviewed Sabah Department of Health records to investigate the trend of each malaria species over time. Methods Reporting of microscopy-diagnosed malaria cases in Sabah is mandatory. We reviewed all available Department of Health malaria notification records from 1992–2011. Notifications of P. malariae and P. knowlesi were considered as a single group due to microscopic near-identity. Results From 1992–2011 total malaria notifications decreased dramatically, with P. falciparum peaking at 33,153 in 1994 and decreasing 55-fold to 605 in 2011, and P. vivax peaking at 15,857 in 1995 and decreasing 25-fold to 628 in 2011. Notifications of P. malariae/P. knowlesi also demonstrated a peak in the mid-1990s (614 in 1994) before decreasing to ≈100/year in the late 1990s/early 2000s. However, P. malariae/P. knowlesi notifications increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70%, 24% and 1% respectively of malaria notifications, compared to 30%, 31% and 35% in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly. Conclusions A significant recent increase has occurred in P. knowlesi notifications following reduced transmission of the human Plasmodium species, and this trend threatens malaria elimination. Determination of transmission dynamics and risk factors for knowlesi malaria is required to guide measures to control this rising incidence. PMID:23359830

  12. Decline eccentric squats increases patellar tendon loading compared to standard eccentric squats.

    Science.gov (United States)

    Kongsgaard, M; Aagaard, P; Roikjaer, S; Olsen, D; Jensen, M; Langberg, H; Magnusson, S P

    2006-08-01

    Recent studies have shown excellent clinical results using eccentric squat training on a 25 degrees decline board to treat patellar tendinopathy. It remains unknown why therapeutic management of patellar tendinopathy using decline eccentric squats offer superior clinical efficacy compared to standard horizontal eccentric squats. This study aimed to compare electromyography activity, patellar tendon strain and joint angle kinematics during standard and decline eccentric squats. Thirteen subjects performed unilateral eccentric squats on flat-and a 25 degrees decline surface. During the squats, electromyography activity was obtained in eight representative muscles. Also, ankle, knee and hip joint goniometry was obtained. Additionally, patellar tendon strain was measured in vivo using ultrasonography as subjects maintained a unilateral isometric 90 degrees knee angle squat position on either flat or 25 degrees decline surface. Patellar tendon strain was significantly greater (Psquat position on the decline surface compared to the standard surface. The stop angles of the ankle and hip joints were significantly smaller during the decline compared to the standard squats (Psquats (Psquats. The use of a 25 degrees decline board increases the load and the strain of the patellar tendon during unilateral eccentric squats. This finding likely explains previous reports of superior clinical efficacy of decline eccentric squats in the rehabilitative management of patellar tendinopathy.

  13. Follow-up on the problem of increased incidence of thyroid carcinoma from the effects of childhood irradiation

    International Nuclear Information System (INIS)

    Wilkins, R.T.; Sandifer, S.H.

    1979-01-01

    There has been widespread concern in both the medical and lay community on how to deal with the problem of the increased incidence of thyroid cancer in patients irradiated in the head and neck during childhood, including the difficult question of whether all of these patients should be recalled and screened. Such an approach is not deemed logistically feasible and the desired benefits of the program which hinge on treatment through early detection are nullified by the protracted nature of the disease. The iatrogenic nature of the problem has raised ethical questions concerning professional duty and responsibility. The principle of similar treatment for similar cases seems fairest and most justifiable in pursuit of the goal of equal access to health care. The most effective plan appears to be a carefully devised public education campaign. Informing practicing physicians not already aware of the problem should be an important part of this effort. The responsibility for seeking treatment would be left to the patient who would see his personal physician or be recommended to a previously designated physician in his area

  14. Increasing Incidence and Age at Diagnosis among Children with Type 1 Diabetes Mellitus over a 20-Year Period in Auckland (New Zealand)

    Science.gov (United States)

    Derraik, José G. B.; Reed, Peter W.; Jefferies, Craig; Cutfield, Samuel W.; Hofman, Paul L.; Cutfield, Wayne S.

    2012-01-01

    Background We aimed to evaluate the incidence of type 1 diabetes mellitus in children Auckland region (New Zealand) over 20 years (1990–2009). Methods We performed a retrospective review of all patients Auckland over 20 years. Contrary to other studies, age at diagnosis has increased and the greatest rise in incidence occurred in children 10–14 yr. There was little change in BMI SDS in this population, providing no support for the ‘accelerator hypothesis’. PMID:22389717

  15. 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

    Directory of Open Access Journals (Sweden)

    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

  16. Fast Food Intake Increases the Incidence of Metabolic Syndrome in Children and Adolescents: Tehran Lipid and Glucose Study.

    Directory of Open Access Journals (Sweden)

    Golaleh Asghari

    Full Text Available The aim of the study was to evaluate the association between fast food consumption and incidence of metabolic syndrome (MetS and its components among children and adolescents over a 3.6 year follow-up. Dietary data of 424 healthy subjects, aged 6-18 years, was collected using a valid and reliable food frequency questionnaire. Metabolic syndrome was defined according to the Cook et al criteria. Consumption of fast foods including hamburgers, sausages, bologna (beef, and fried potatoes was calculated and further categorized to quartiles. Multiple logistic regression models were used to estimate the incidence of MetS and its components in each quartile of fast food intake. The incidence of MetS was 11.3% after a 3.6 year follow up. In the fully adjusted model, compared to the lowest quartile of fast food intake, individuals in the highest had odds ratios of 2.96 (95% CI: 1.02-8.63; P for trend<0.001, 2.82 (95% CI: 1.01-7.87; P for trend = 0.037, and 2.58 (95% CI: 1.01-6.61; P for trend = 0.009 for incidence of MetS, hypertriglyceridemia, and abdominal obesity, respectively. No significant association was found between fast food intakes and other components of MetS. Fast food consumption is associated with the incidence of MetS, abdominal obesity, and hypertriglyceridemia in Tehranian children and adolescents.

  17. Increasing incidence and age at diagnosis among children with type 1 diabetes mellitus over a 20-year period in Auckland (New Zealand.

    Directory of Open Access Journals (Sweden)

    José G B Derraik

    Full Text Available BACKGROUND: We aimed to evaluate the incidence of type 1 diabetes mellitus in children <15 years of age (yr in the Auckland region (New Zealand over 20 years (1990-2009. METHODS: We performed a retrospective review of all patients <15 yr diagnosed with type 1 diabetes, from an unselected complete regional cohort. RESULTS: There were 884 new cases of type 1 diabetes, and age at diagnosis rose from 7.6 yr in 1990/1 to 8.9 yr in 2008/9 (r(2 = 0.31, p = 0.009. There was a progressive increase in type 1 diabetes incidence among children <15 yr (p<0.0001, reaching 22.5 per 100,000 in 2009. However, the rise in incidence did not occur evenly among age groups, being 2.5-fold higher in older children (10-14 yr than in the youngest group (0-4 yr. The incidence of new cases of type 1 diabetes was highest in New Zealand Europeans throughout the study period in all age groups (p<0.0001, but the rate of increase was similar in New Zealand Europeans and Non-Europeans. Type 1 diabetes incidence and average annual increase were similar in both sexes. There was no change in BMI SDS shortly after diagnosis, and no association between BMI SDS and age at diagnosis. CONCLUSIONS: There has been a steady increase in type 1 diabetes incidence among children <15 yr in Auckland over 20 years. Contrary to other studies, age at diagnosis has increased and the greatest rise in incidence occurred in children 10-14 yr. There was little change in BMI SDS in this population, providing no support for the 'accelerator hypothesis'.

  18. Increasing risk behaviour can outweigh the benefits of antiretroviral drug treatment on the HIV incidence among men-having-sex-with-men in Amsterdam

    Directory of Open Access Journals (Sweden)

    Zhu Yifan

    2011-05-01

    Full Text Available Abstract Background The transmission through contacts among MSM (men who have sex with men is one of the dominating contributors to HIV prevalence in industrialized countries. In Amsterdam, the capital of the Netherlands, the MSM risk group has been traced for decades. This has motivated studies which provide detailed information about MSM's risk behavior statistically, psychologically and sociologically. Despite the era of potent antiretroviral therapy, the incidence of HIV among MSM increases. In the long term the contradictory effects of risk behavior and effective therapy are still poorly understood. Methods Using a previously presented Complex Agent Network model, we describe steady and casual partnerships to predict the HIV spreading among MSM. Behavior-related parameters and values, inferred from studies on Amsterdam MSM, are fed into the model; we validate the model using historical yearly incidence data. Subsequently, we study scenarios to assess the contradictory effects of risk behavior and effective therapy, by varying corresponding values of parameters. Finally, we conduct quantitative analysis based on the resulting incidence data. Results The simulated incidence reproduces the ACS historical incidence well and helps to predict the HIV epidemic among MSM in Amsterdam. Our results show that in the long run the positive influence of effective therapy can be outweighed by an increase in risk behavior of at least 30% for MSM. Conclusion We recommend, based on the model predictions, that lowering risk behavior is the prominent control mechanism of HIV incidence even in the presence of effective therapy.

  19. Improvements done at Heavy Water Plant (Manuguru) to increase the standards of environmental protection

    International Nuclear Information System (INIS)

    Rama Rao, V.V.S.; Gupta, R.V.; Pandey, B.L.

    1997-01-01

    The Heavy Water Plant at Manuguru is designed to produce 185 MTY of nuclear grade heavy water based on bithermal H 2 S-H 2 O exchange process and handles large inventory of H 2 S gas (about 400 MT). As H 2 S gas is very toxic, corrosive and hazardous in nature, extreme care has been taken in the design of plant, selection of equipment and materials adhering to stringent fabrication procedures and codes to ensure the production of heavy water in a safe manner. This paper highlights the improvements done at Heavy Water Plant (Manuguru) to increase the standards of environmental protection. The safety assessment of a hazardous plant is a continuous process. Apart from the extreme care taken in the design, construction, commissioning and operation of the plant, review of each and every safety related unusual occurrence by various levels of review committees as stipulated and speedy implementation of the recommendations goes in a long way in increasing the standards of environmental protection

  20. Increasing incidence and age at diagnosis among children with type 1 diabetes mellitus over a 20-year period in Auckland (New Zealand).

    Science.gov (United States)

    Derraik, José G B; Reed, Peter W; Jefferies, Craig; Cutfield, Samuel W; Hofman, Paul L; Cutfield, Wayne S

    2012-01-01

    We aimed to evaluate the incidence of type 1 diabetes mellitus in children Auckland region (New Zealand) over 20 years (1990-2009). We performed a retrospective review of all patients new cases of type 1 diabetes, and age at diagnosis rose from 7.6 yr in 1990/1 to 8.9 yr in 2008/9 (r(2) = 0.31, p = 0.009). There was a progressive increase in type 1 diabetes incidence among children new cases of type 1 diabetes was highest in New Zealand Europeans throughout the study period in all age groups (pNew Zealand Europeans and Non-Europeans. Type 1 diabetes incidence and average annual increase were similar in both sexes. There was no change in BMI SDS shortly after diagnosis, and no association between BMI SDS and age at diagnosis. There has been a steady increase in type 1 diabetes incidence among children Auckland over 20 years. Contrary to other studies, age at diagnosis has increased and the greatest rise in incidence occurred in children 10-14 yr. There was little change in BMI SDS in this population, providing no support for the 'accelerator hypothesis'.

  1. Exponentially increasing incidences of cutaneous malignant melanoma in Europe correlate with low personal annual UV doses and suggests 2 major risk factors.

    Science.gov (United States)

    Merrill, Stephen J; Ashrafi, Samira; Subramanian, Madhan; Godar, Dianne E

    2015-01-01

    For several decades the incidence of cutaneous malignant melanoma (CMM) steadily increased in fair-skinned, indoor-working people around the world. Scientists think poor tanning ability resulting in sunburns initiate CMM, but they do not understand why the incidence continues to increase despite the increased use of sunscreens and formulations offering more protection. This paradox, along with lower incidences of CMM in outdoor workers, although they have significantly higher annual UV doses than indoor workers have, perplexes scientists. We found a temporal exponential increase in the CMM incidence indicating second-order reaction kinetics revealing the existence of 2 major risk factors. From epidemiology studies, we know one major risk factor for getting CMM is poor tanning ability and we now propose the other major risk factor may be the Human Papilloma Virus (HPV) because clinicians find β HPVs in over half the biopsies. Moreover, we uncovered yet another paradox; the increasing CMM incidences significantly correlate with decreasing personal annual UV dose, a proxy for low vitamin D3 levels. We also discovered the incidence of CMM significantly increased with decreasing personal annual UV dose from 1960, when it was almost insignificant, to 2000. UV and other DNA-damaging agents can activate viruses, and UV-induced cytokines can hide HPV from immune surveillance, which may explain why CMM also occurs in anatomical locations where the sun does not shine. Thus, we propose the 2 major risk factors for getting CMM are intermittent UV exposures that result in low cutaneous levels of vitamin D3 and possibly viral infection.

  2. Increasing Incidence and Recurrence Rate of Venous Thromboembolism in Paediatric Oncology Patients in One Single Centre Over 25 Years

    NARCIS (Netherlands)

    Klaassen, Irene L. M.; van Els, Anne L.; van de Wetering, Marianne D.; van Ommen, C. Heleen

    2017-01-01

    Venous thromboembolism (VTE) is a serious complication in paediatric oncology patients. To identify the incidence, risk factors and recurrence rate of VTE in paediatric oncology patients, an observational, retrospective cohort study of all consecutive children (≤18 years) with malignancies, treated

  3. Rising incidence of Enterococcus species in microbiological specimens from orthopedic patients correlates to increased use of cefuroxime

    DEFF Research Database (Denmark)

    Siesing, Peter Christian; Alva-Jørgensen, Jens Peter; Brodersen, Jakob

    2013-01-01

    Enterococci are emerging causes of severe infections, including wound and bone infections in orthopedic patients. The main purpose of this study was to determine whether there was a correlation between the incidence of enterococci in tissue samples (biopsies) from orthopedic patients and consumpt...

  4. Fast Food Intake Increases the Incidence of Metabolic Syndrome in Children and Adolescents: Tehran Lipid and Glucose Study.

    Science.gov (United States)

    Asghari, Golaleh; Yuzbashian, Emad; Mirmiran, Parvin; Mahmoodi, Behnaz; Azizi, Fereidoun

    2015-01-01

    The aim of the study was to evaluate the association between fast food consumption and incidence of metabolic syndrome (MetS) and its components among children and adolescents over a 3.6 year follow-up. Dietary data of 424 healthy subjects, aged 6-18 years, was collected using a valid and reliable food frequency questionnaire. Metabolic syndrome was defined according to the Cook et al criteria. Consumption of fast foods including hamburgers, sausages, bologna (beef), and fried potatoes was calculated and further categorized to quartiles. Multiple logistic regression models were used to estimate the incidence of MetS and its components in each quartile of fast food intake. The incidence of MetS was 11.3% after a 3.6 year follow up. In the fully adjusted model, compared to the lowest quartile of fast food intake, individuals in the highest had odds ratios of 2.96 (95% CI: 1.02-8.63; P for trendobesity, respectively. No significant association was found between fast food intakes and other components of MetS. Fast food consumption is associated with the incidence of MetS, abdominal obesity, and hypertriglyceridemia in Tehranian children and adolescents.

  5. Increase in HCV incidence among men who have sex with men in Amsterdam most likely caused by sexual transmission

    NARCIS (Netherlands)

    van de Laar, T.J.W.; van der Bij, A.K.; Prins, M.; Bruisten, S.M.; Brinkman, K.; Ruys, T.A.; van der Meer, J.T.M.; de Vries, H.J.C.; Mulder, J.W.; van Agtmael, M.; Jurriaans, S.; Wolthers, K.C.; Coutinho, R.A.

    2007-01-01

    We retrospectively screened 1836 men who have sex with men (MSM) participating in the Amsterdam Cohort Studies (1984-2003) for hepatitis C virus (HCV) antibodies. HCV incidence was 0.18/100 person-years (PY) in human immunodeficiency virus (HIV)-positive MSM (8/4408 PY [95% confidence interval {CI},

  6. Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013

    DEFF Research Database (Denmark)

    Ganestam, Ann; Kallemose, Thomas; Troelsen, Anders

    2016-01-01

    PURPOSE: The purpose of this study is to investigate the incidence of acute Achilles tendon rupture in Denmark from 1994 to 2013 with focus on sex, age, geographical areas, seasonal variation and choice of treatment. METHODS: The National Patient Registry was retrospectively searched to find the ...

  7. Development of standardized methodology for identifying toxins in clinical samples and fish species associated with tetrodotoxin-borne poisoning incidents

    Directory of Open Access Journals (Sweden)

    Tai-Yuan Chen

    2016-01-01

    Full Text Available Tetrodotoxin (TTX is a naturally occurring toxin in food, especially in puffer fish. TTX poisoning is observed frequently in South East Asian regions. In TTX-derived food poisoning outbreaks, the amount of TTX recovered from suspicious fish samples or leftovers, and residual levels from biological fluids of victims are typically trace. However, liquid chromatography–mass spectrometry and liquid chromatography–tandem mass spectrometry methods have been demonstrated to qualitatively and quantitatively determine TTX in clinical samples from victims. Identification and validation of the TTX-originating seafood species responsible for a food poisoning incident is needed. A polymerase chain reaction-based method on mitochondrial DNA analysis is useful for identification of fish species. This review aims to collect pertinent information available on TTX-borne food poisoning incidents with a special emphasis on the analytical methods employed for TTX detection in clinical laboratories as well as for the identification of TTX-bearing species.

  8. [Effectiveness of the transparent sterile dressing vs standard to fix the peripheral venous catheter (PVC) on the incidence of phlebitis. A randomized controlled trial].

    Science.gov (United States)

    Forni, Cristiana; D'Alessandro, Fabio; Gambino, Orazio; Amodeo, Alfredo; Pignotti, Elettra; Zanotti, Enrichetta; Tremosini, Morena; Trofa, Carmela; Sabattini, Tania; Matino, Federica; Genco, Rossana; Schiavone, Miguel; Bombino, Caterina; Mini, Sandra; Rocchegiani, Laura; Notarnicola, Teresa; Capezzali, Daniela; Boschi, Rita; Loro, Loretta

    2012-01-01

    Effectiveness of the transparent sterile dressing vs standard to fix the peripheral venous catheter (PVC), on the incidence of phlebitis. A randomized controlled trial. The type of dressing could contribute to the incidence of phlebitis, infiltration and accidental removals but the results of the studies are contrasting and samples are limited. To compare the effectiveness of a transparent polyurethane sterile dressing on the rate of phlebitis associated to peripheral venous catheter (PVC) vs a non sterile sticking plaster in use in current practice (standard dressing). Randomized controlled trial. Participants. 1061 PVCs (703 patients, adults and children) at a research orthopedic hospital in the north of Italy; 540 PVCs allocated to receive the sterile and 521 the standard dressing. 96 PVCs were excluded for phlebitis, 48 (9.6%) in the sterile and 48 (10.1%) in the standard dressing group, RR 0.96 (95%CI 0.697 - 1.335). Accidental removal of the PVCs was more frequent with the sterile dressing (9.6% vs 6.3%) but the number of catheters removed without complications was larger in the standard dressing group (48.9% vs 54.9% P=0.0503). Eighty-five PVCs were replaced for detachment of the dressing (50, 9.2% sterile and 35, 6.7% standard dressing). The cheapest transparent sterile dressing costs 32 cents while the standard 9 cents. A sticking non sterile plasters is not influential on the rate of phlebitis and ensures an good fix of the PVC compared the transparent sterile dressing to of polyurethane film.

  9. Globalization quickly increased need for moving from local to international standards

    Energy Technology Data Exchange (ETDEWEB)

    Cappelli, Cataldo

    2005-07-01

    'Standardization' quickly changed in the past few years, due to the market's globalization that needs international standards as important instruments in eliminating technical barriers to trade. The 'Petroleum Sector' chose moving to international standards jointly processed by the International Organization for Standardization (ISO) and the American Petroleum Institute (API) that played the role of historical reference. Taking into account that oil industry wants only one Standard worldwide used, also Europe decided for adopting these ISO Standards as European Standards. The result is much better considering that also Russia and China seem to adopt these ISO documents as their national standards. It is so becoming much more significant the 'motto' that ISO TC 67 'Materials, equipment and offshore structures for petroleum, petrochemical and natural gas industries' adopted for its standardization activities: 'Do it once, do it right, do it internationally'. Examples of such international Standards worldwide used as National Standards are: ISO 11960:2004 - 'Steel pipes for use as casing or tubing for wells' and; ISO/DIS 3183 - 'Steel pipe for pipeline transportation systems' (under preparation). Standardization has so grown from technical to management tool and countries are also moving, including standards in more areas of its legislations. (author)

  10. Globalization quickly increased need for moving from local to international standards

    Energy Technology Data Exchange (ETDEWEB)

    Cappelli, Cataldo

    2005-07-01

    'Standardization' quickly changed in the past few years, due to the market's globalization that needs international standards as important instruments in eliminating technical barriers to trade. The 'Petroleum Sector' chose moving to international standards jointly processed by the International Organization for Standardization (ISO) and the American Petroleum Institute (API) that played the role of historical reference. Taking into account that oil industry wants only one Standard worldwide used, also Europe decided for adopting these ISO Standards as European Standards. The result is much better considering that also Russia and China seem to adopt these ISO documents as their national standards. It is so becoming much more significant the 'motto' that ISO TC 67 'Materials, equipment and offshore structures for petroleum, petrochemical and natural gas industries' adopted for its standardization activities: 'Do it once, do it right, do it internationally'. Examples of such international Standards worldwide used as National Standards are: ISO 11960:2004 - 'Steel pipes for use as casing or tubing for wells' and; ISO/DIS 3183 - 'Steel pipe for pipeline transportation systems' (under preparation). Standardization has so grown from technical to management tool and countries are also moving, including standards in more areas of its legislations. (author)

  11. Open Heart Surgery Does Not Increase the Incidence of Ipsilateral Ischemic Stroke in Patients with Asymptomatic Severe Carotid Stenosis.

    Science.gov (United States)

    Castaldo, John E; Yacoub, Hussam A; Li, Yuebing; Kincaid, Hope; Jenny, Donna

    2017-10-01

    We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis. In this retrospective cohort study, we compared 113 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both from 2007 to 2011 with data collected from 2001 to 2006 from a similar group of patients. Our aim was to assess whether the practice change led to a greater incidence of stroke. A total of 7350 consecutive patients undergoing OHS during the specified time period were screened. Of these, 3030 had OHS between 2007 and 2011 but none were combined with carotid artery surgery (new cohort). The remaining 4320 had OHS before 2007 and 44 had combined procedures (old cohort). Of patients undergoing OHS during the 10-year period of observation, 230 had severe (>80%) carotid stenosis. In the old cohort (before 2007), carotid stenosis was associated with perioperative stroke in 2.5% of cases. None of the 113 patients having cardiac procedures after 2007 received combined carotid artery surgery; only 1 of these patients harboring severe carotid stenosis had an ischemic stroke (.9%) during the perioperative period. The difference in stroke incidence between the 2 cohorts was statistically significant (P = .002). The incidence of stroke in patients with severe carotid artery stenosis undergoing OHS was lower after combined surgery was discontinued. Combined carotid and OHS itself seems to be an important risk factor for stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. The incidence of bilateral cryptorchidism is increased and the fertility potential is reduced in sons born to mothers who have smoked during pregnancy

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Cortes, D; Petersen, B L

    2006-01-01

    Recent studies have demonstrated a high prevalence of cryptorchidism, decreasing semen quality and increasing incidence of testicular cancer. These changes seem to be interrelated, and may be symptoms of a common underlying entity with foundations in fetal life. We investigated the influence...

  13. Meningococcal disease in The Netherlands, 1958-1990: a steady increase in the incidence since 1982 partially caused by new serotypes and subtypes of Neisseria meningitidis

    NARCIS (Netherlands)

    Scholten, R. J.; Bijlmer, H. A.; Poolman, J. T.; Kuipers, B.; Caugant, D. A.; van Alphen, L.; Dankert, J.; Valkenburg, H. A.

    1993-01-01

    In order to explain a threefold increase in the incidence of meningococcal disease in the Netherlands during the 1980s, we serotyped and subtyped Neisseria meningitidis isolates recovered between 1958 and 1990 from > 3,000 patients with systemic disease. No single strain could be held responsible

  14. No increase in the incidence of acute kidney injury in a population-based annual temporal trends epidemiology study.

    Science.gov (United States)

    Kashani, Kianoush; Shao, Min; Li, Guangxi; Williams, Amy W; Rule, Andrew D; Kremers, Walter K; Malinchoc, Michael; Gajic, Ognjen; Lieske, John C

    2017-09-01

    Recent literature suggests an increase in the incidence of acute kidney injury (AKI). We evaluated population-based trends of AKI over the course of nine years, using a validated electronic health record tool to detect AKI. All adult residents (18 years of age and older) of Olmsted County, Minnesota (MN), admitted to the Mayo Clinic Hospital between 2006 and 2014 were included. The incidence rate of AKI was calculated and temporal trends in the annual AKI incident rates assessed. During the nine-year study period, 10,283, and 41,847 patients were admitted to the intensive care unit or general ward, with 1,740 and 2,811 developing AKI, respectively. The unadjusted incidence rates were 186 and 287 per 100,000 person years in 2006 and reached 179 and 317 per 100,000 person years in 2014. Following adjustment for age and sex, there was no significant change in the annual AKI incidence rate during the study period with a Relative Risk of 0.99 per year (95% confidence interval 0.97-1.01) for intensive care unit patients and 0.993 per year (0.98-1.01) for the general ward patients. Similar results were obtained when the ICD-9 codes or administrative data for dialysis-requiring AKI was utilized to determine incident cases. Thus, despite the current literature that suggests an epidemic of AKI, we found that after adjusting for age and sex the incidence of AKI in the general population remained relatively stable over the last decade. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  15. Increasing Incidence in Relapsing-Remitting MS and High Rates among Young Women in Finland: A Thirty-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Marja-Liisa Sumelahti

    2014-01-01

    Full Text Available Object. Gender and disease course specific incidences were studied in high- and medium-risk regions of MS in Finland. Methods. Age- and gender-specific incidences with 95% CIs were calculated in 10-year periods from 1981 to 2010. Poser diagnostic criteria were used and compared with the McDonald criteria from 2001 to 2010. Association between age and diagnostic delay over time was assessed by using the Kruskal-Wallis test. Results. 1419 (89% RRMS and 198 (11% PPMS cases were included. RRMS incidence increased with the female to male ratio (F/M from 4,2/105 (F/M 1.9 to 9,7 (2.3, while that of PPMS decreased from 1,2 (1.6 to 0,7 (1.2. The use of McDonald criteria did not change the conclusion. The decreasing diagnostic delay and age at diagnosis in RRMS were associated within the 10-year periods and contrasted those in PPMS. Increasing female risk in RRMS was observed in the high-risk region. Conclusion. Increasing RRMS incidence and high female ratios shown in each age group indicate gender-specific influences acting already from childhood. A more precise definition of the risk factors and their action in MS is needed to provide a better understanding of underlying pathological processes and a rationale for the development of new preventive and treatment strategies.

  16. Still Human: A Call for Increased Focus on Ethical Standards in Cadaver Research.

    Science.gov (United States)

    Bach, Michelle C

    2016-12-01

    Research on human cadavers is an important mechanism of scientific progress and comprises a large industry in the United States. However, despite its importance and influence, there is little ethical or regulatory oversight of cadaver-based research. This lack of transparency raises important ethical questions. Thus, this paper serves as a call for ethicists and regulators to pay increased attention to cadaver research. I argue that cadaver research ought to be considered a subset of human subjects research and held accountable to higher ethical standards. After describing current practices, I argue that oversight of cadaver research as a form of human subjects research is appropriate because cadaver research is similar to other types of human research, participants in cadaver research incur risks of harm, and a current lack of oversight has allowed the cadaver industry to entice research participation through ethically questionable practices. This paper urges greater dialogue among human subjects research ethicists and regulators about what constitutes appropriate protections for participants in cadaver research.

  17. Development of Standardized Power Electronic Components, Subsystems, and Systems for Increased Modularity and Scalability

    Energy Technology Data Exchange (ETDEWEB)

    Chakraborty, S.; Pink, C.; Price, J.; Kroposki, B.; Kern, G.

    2007-11-01

    Power electronics devices hold substantial promise for making distributed energy applications more efficient and cost effective. This project is motivated towards developing and testing inverters that will allow distributed energy systems to provide ancillary services such as voltage and VAR regulation, and increased grid reliability by seamlessly transitioning between grid-tied and stand-alone operation modes. The objectives of this project are to identify system integration and optimization issues and technologies and to provide solutions through research, analysis, and testing of power electronic interfaces for distributed energy applications that are cost-competitive and have substantially faster response times than conventional technologies. In addition, the testing of power electronics interfaces will develop a technical basis for performance assessment for distributed energy systems, subsystems, and components that will finally create a foundation for standardized measurements and test procedures. The ultimate goal for this research is to advance the potential benefits of distributed energy to provide ancillary services, enhance power system reliability, and allow customer choice.

  18. The incidence of second primary tumors in thyroid cancer patients is increased, but not related to treatment of thyroid cancer

    NARCIS (Netherlands)

    Verkooijen, Robbert B. T.; Smit, Jan W. A.; Romijn, Johannes A.; Stokkel, Marcel P. M.

    2006-01-01

    The aim of the present study is to assess the prevalence of second primary tumors in patients treated for thyroid cancer. Furthermore, we wanted to assess the standardized risk rates for all second primary tumors, but especially for breast cancer, as data in the literature indicate an excessive risk

  19. Introduction of sugammadex as standard reversal agent: Impact on the incidence of residual neuromuscular blockade and postoperative patient outcome

    Directory of Open Access Journals (Sweden)

    Thomas Ledowski

    2013-01-01

    Full Text Available Background: The aim of this prospective audit was to investigate clinical practice related to muscle relaxant reversal and the impact made by the recent introduction of sugammadex on patient outcome at a tertiary teaching hospital. Methods: Data from all patients intubated at our institution during two epochs of seven consecutive days each was collected prospectively. Directly prior to extubation, the train-of-four (TOF ratio was assessed quantitatively by an independent observer. Postoperative outcome parameters were complications in the recovery room and radiological diagnosed atelectasis or pneumonia within 30 days. Results: Data from 146 patients were analysed. Three reversal strategies were used: no reversal, neostigmine or sugammadex. The TOF ratio was less than 0.7 in 17 patients (nine no reversal, eight neostigmine and less than 0.9 in 47 patients (24 no reversal, 19 neostigmine, four sugammadex. Those reversed with sugammadex showed fewer episodes of postoperative oxygen desaturation (15% vs. 33%; P<0.05. TOF ratios of less than 0.7 ( P<0.05 and also <0.9 ( P<0.01 were more likely associated with X-ray results consistent with postoperative atelectasis or pneumonia. Conclusions: Our results suggest a significant impact of residual paralysis on patient outcome. The use of sugammadex resulted in the lowest incidence of residual paralysis.

  20. Increasing the regional availability of the Standardized Precipitation Index: an operational approach

    Directory of Open Access Journals (Sweden)

    Monica Cristina Meschiatti

    Full Text Available ABSTRACT The need to use a length of rainfall records of at least 30 years to calculate the Standardized Precipitation Index (SPI limits its application in several Drought Early Warning Systems of developing countries. Therefore, in order to increase the number of weather stations in which the SPI may be applied, this study quantified the difference among SPI values derived from calibration periods (CP smaller than 30 years in respect to those computed from the 30-year period of 1985 – 2014 in the State of São Paulo, Brazil (time scales ranging from 1 to 12 months were considered. The correlation, agreement and consistency of SPI values derived from CP ranging from the last 30 to 21 years have been evaluated. The Kolmogorov-Smirnov/Lilliefors test indicated, for all CP, that the 2-parameter gamma distribution may be used to calculate the SPI in the State of São Paulo. The normality test indicated that, even for the period of 1985 – 2014, the normally assumption of the SPI series is not always met. However, it was observed no remarkable difference in the rejection rates of the normality assumption obtained from the different CP. Finally, both absolute mean error and the modified index of agreement indicated a high consistence among SPI values derived from the calibration period of 1991 – 2014 (24 years in respect to those derived from the 30-year period. Accordingly, it is possible to use weather stations with rainfall records starting in 1991 (or earlier to calculate, in operational mode, the SPI in the State of São Paulo.

  1. Antibiotics in early life alter the gut microbiome and increase disease incidence in a spontaneous mouse model of autoimmune insulin-dependent diabetes.

    Science.gov (United States)

    Candon, Sophie; Perez-Arroyo, Alicia; Marquet, Cindy; Valette, Fabrice; Foray, Anne-Perrine; Pelletier, Benjamin; Milani, Christian; Milani, Cristian; Ventura, Marco; Bach, Jean-François; Chatenoud, Lucienne

    2015-01-01

    Insulin-dependent or type 1 diabetes is a prototypic autoimmune disease whose incidence steadily increased over the past decades in industrialized countries. Recent evidence suggests the importance of the gut microbiota to explain this trend. Here, non-obese diabetic (NOD) mice that spontaneously develop autoimmune type 1 diabetes were treated with different antibiotics to explore the influence of a targeted intestinal dysbiosis in the progression of the disease. A mixture of wide spectrum antibiotics (i.e. streptomycin, colistin and ampicillin) or vancomycin alone were administered orally from the moment of conception, treating breeding pairs, and during the postnatal and adult life until the end of follow-up at 40 weeks. Diabetes incidence significantly and similarly increased in male mice following treatment with these two antibiotic regimens. In NOD females a slight yet not significant trend towards an increase in disease incidence was observed. Changes in gut microbiota composition were assessed by sequencing the V3 region of bacterial 16S rRNA genes. Administration of the antibiotic mixture resulted in near complete ablation of the gut microbiota. Vancomycin treatment led to increased Escherichia, Lactobacillus and Sutterella genera and decreased members of the Clostridiales order and Lachnospiraceae, Prevotellaceae and Rikenellaceae families, as compared to control mice. Massive elimination of IL-17-producing cells, both CD4+TCRαβ+ and TCRγδ+ T cells was observed in the lamina propria of the ileum and the colon of vancomycin-treated mice. These results show that a directed even partial ablation of the gut microbiota, as induced by vancomycin, significantly increases type 1 diabetes incidence in male NOD mice thus prompting for caution in the use of antibiotics in pregnant women and newborns.

  2. Antibiotics in early life alter the gut microbiome and increase disease incidence in a spontaneous mouse model of autoimmune insulin-dependent diabetes.

    Directory of Open Access Journals (Sweden)

    Sophie Candon

    Full Text Available Insulin-dependent or type 1 diabetes is a prototypic autoimmune disease whose incidence steadily increased over the past decades in industrialized countries. Recent evidence suggests the importance of the gut microbiota to explain this trend. Here, non-obese diabetic (NOD mice that spontaneously develop autoimmune type 1 diabetes were treated with different antibiotics to explore the influence of a targeted intestinal dysbiosis in the progression of the disease. A mixture of wide spectrum antibiotics (i.e. streptomycin, colistin and ampicillin or vancomycin alone were administered orally from the moment of conception, treating breeding pairs, and during the postnatal and adult life until the end of follow-up at 40 weeks. Diabetes incidence significantly and similarly increased in male mice following treatment with these two antibiotic regimens. In NOD females a slight yet not significant trend towards an increase in disease incidence was observed. Changes in gut microbiota composition were assessed by sequencing the V3 region of bacterial 16S rRNA genes. Administration of the antibiotic mixture resulted in near complete ablation of the gut microbiota. Vancomycin treatment led to increased Escherichia, Lactobacillus and Sutterella genera and decreased members of the Clostridiales order and Lachnospiraceae, Prevotellaceae and Rikenellaceae families, as compared to control mice. Massive elimination of IL-17-producing cells, both CD4+TCRαβ+ and TCRγδ+ T cells was observed in the lamina propria of the ileum and the colon of vancomycin-treated mice. These results show that a directed even partial ablation of the gut microbiota, as induced by vancomycin, significantly increases type 1 diabetes incidence in male NOD mice thus prompting for caution in the use of antibiotics in pregnant women and newborns.

  3. [Possible cause of the increased incidence of lung cancer in 1987 in the 10th District of Budapest (1975-1989)].

    Science.gov (United States)

    Abrahám, E; Karácsonyi, L; Dinya, E

    1990-12-30

    In 1975 in one of the major industrial districts of Budapest some longitudinal epidemiological examinations were carried out with the aim of, among others, determination of connection between environmental injuries and lung cancer incidence in connection with determination of lung cancer risk groups. Between 1975-1989 out of the environmental injuries the most important was the radioactive contamination observed due to the atomic power station catastrophe in Chernobil (1986). In 1987 the incidence of lung cancer increased. The increase was significant among the 50-69-year-old women, and expressly among the heavy smokers. In 1987, especially among women, but also in both sexes, the ratio among the major cell types of lung cancer shifted towards micro-cellular ones. In 1988 and 1989 lung cancer incidence has decreased. In view of the above a hypothesis was raised: patients who have previously suffered immunobiological hurt, could not prevent the increased radioactive burden and got ill with lung cancer earlier, than it should have been happened without this increased burden. For clarification this question further examinations are considered to be necessary.

  4. Increased incidence and recurrence rates of nonmelanoma skin cancer in patients with non-Hodgkin lymphoma: a Rochester Epidemiology Project population-based study in Minnesota.

    Science.gov (United States)

    Brewer, Jerry D; Shanafelt, Tait D; Khezri, Farzaneh; Sosa Seda, Ivette M; Zubair, Adeel S; Baum, Christian L; Arpey, Christopher J; Cerhan, James R; Call, Timothy G; Roenigk, Randall K; Smith, Carin Y; Weaver, Amy L; Otley, Clark C

    2015-02-01

    Cutaneous malignancy is associated with worse outcomes in patients with chronic lymphocytic leukemia (CLL). We sought to identify the incidence and recurrence rate of nonmelanoma skin cancer (NMSC) in patients with non-Hodgkin lymphoma (NHL). NMSC incidence was calculated and Cox proportional hazards models were used to evaluate associations with risk of recurrence for patients with NHL between 1976 and 2005 who were in the Rochester Epidemiology Project research infrastructure. We identified 282 patients with CLL or small lymphocytic lymphoma and 435 with non-CLL NHL. The incidence of basal cell carcinoma and squamous cell carcinoma was 1829.3 (95% confidence interval [CI] 1306.7-2491.1) and 2224.9 (95% CI 1645.9-2941.6), respectively, in patients with CLL. The cumulative recurrence rate at 8 years after treatment with Mohs micrographic surgery was 8.3% (95% CI 0.0%-22.7%) for basal cell carcinoma and 13.4% (95% CI 0.0%-25.5%) for squamous cell carcinoma in patients with CLL. This was a retrospective cohort study. After Mohs micrographic surgery and standard excision of NMSC, patients with NHL had a skin cancer recurrence rate that was higher than expected. Careful treatment and monitoring of patients with NHL and NMSC are warranted. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Increasing mumps incidence rates among children and adolescents in the Republic of Korea: age–period–cohort analysis

    Directory of Open Access Journals (Sweden)

    Young-June Choe

    2017-04-01

    Conclusions: The increase in mumps seen in Korea may have been affected by the birth cohort exposed to the Rubini strain; however other factors may have contributed to the increase in non-exposed cohorts.

  6. Increased incidence of transient homogeneous immunoglobulins in irradiated and reconstituted C57BL/KaLwRij mice treated with 2'-deoxyguanosine

    International Nuclear Information System (INIS)

    Akker, Th.W. van den; Gillen, A.P.; Bril, H.; Brenner, R.; Radl, J.

    1983-01-01

    Prolonged administration of micromolar amounts of 2'-deoxyguanosine (dGuo) to lethally irradiated and reconstituted mice led to an increased incidence of transient homogeneous immunoglobulins (H-Ig) in their sera. Analysis of the heavy and light chain isotype distribution among the H-Ig revealed more of the IgG2b and IgG3 isotypes and less of the IgM isotype and the lambda light chain containing H-Ig in the dGuo-treated group as compared to the control group. The increased incidence of H-Ig was preceded by a decreased suppressor T cell generation and activation in the dGuo treated group. These data indicate that deficient suppressor T cell plays an important role in the development of transient H-Ig. (author)

  7. Increased incidence of adrenal gland injury in blunt abdominal trauma: a computed tomography-based study from Pakistan

    Directory of Open Access Journals (Sweden)

    Aziz Muhammad Usman

    2014-02-01

    Full Text Available 【Abstract】Objective: To determine the frequency of adrenal injuries in patients presenting with blunt abdominal trauma by computed tomography (CT. Methods: During a 6 month period from January 1, 2011 to June 30, 2011, 82 emergency CT examinations were performed in the setting of major abdominal trauma and retrospectively reviewed for adrenal gland injuries. Results: A total of 7 patients were identified as having adrenal gland injuries (6 males and 1 female. Two patients had isolated adrenal gland injuries. In the other 5 patients with nonisolated injuries, injuries to the liver (1 case, spleen (1 case, retroperitoneum (2 cases and mesentery (4 cases were identified. Overall 24 cases with liver injuries (29 %, 11 cases with splenic injuries (13%, 54 cases with mesenteric injuries (65%, 14 cases (17% with retroperitoneal injuries and 9 cases with renal injuries were identified. Conclusion: Adrenal gland injury is identified in 7 patients (11.7% out of a total of 82 patients who underwent CT after major abdominal trauma. Most of these cases were nonisolated injuries. Our experience indicates that adrenal injury resulting from trauma is more common than suggested by other reports. The rise in incidence of adrenal injuries could be attributed to the mode of injury.

  8. The electronics in fluorescent bulbs and light emitting diodes (LED), rather than ultraviolet radiation, cause increased malignant melanoma incidence in indoor office workers and tanning bed users.

    Science.gov (United States)

    Milham, Samuel; Stetzer, Dave

    2018-07-01

    The epidemiology of cutaneous malignant melanoma (CMM) has a number of facets that do not fit with sunlight and ultraviolet light as the primary etiologic agents. Indoor workers have higher incidence and mortality rates of CMM than outdoor workers; CMM occurs in body locations never exposed to sunlight; CMM incidence is increasing in spite of use of UV blocking agents and small changes in solar radiation. Installation of two new fluorescent lights in the milking parlor holding area of a Minnesota dairy farm in 2015 caused an immediate drop in milk production. This lead to measurement of body amperage in humans exposed to modern non-incandescent lighting. People exposed to old and new fluorescent lights, light emitting diodes (LED) and compact fluorescent lights (CFL) had body amperage levels above those considered carcinogenic. We hypothesize that modern electric lighting is a significant health hazard, a carcinogen, and is causing increasing CMM incidence in indoor office workers and tanning bed users. These lights generate dirty electricity (high frequency voltage transients), radio frequency (RF) radiation, and increase body amperage, all of which have been shown to be carcinogenic. This could explain the failure of ultraviolet blockers to stem the malignant melanoma pandemic. Tanning beds and non-incandescent lighting could be made safe by incorporating a grounded Faraday cage which allows passage of ultraviolet and visible light frequencies and blocks other frequencies. Modern electric lighting should be fabricated to be electrically clean. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Study for the development of a standardized system of incidents in radiotherapy; Estudo para desenvolvimento de um sistema Institucional padronizado de incidentes em radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, A.LC.; Silva, A.L. da; Moreira, J.G.R.; Silva, K.R.R. da, E-mail: andhreluiz@gmail.com, E-mail: arnaldolimasilva@yahoo.com.br, E-mail: josegustavo.rmoreira@gmail.com, E-mail: karine.ramosrocha@gmail.com [Universidade do Grande Rio (UNIGRANRIO), Duque de Caxias, RJ (Brazil). Tecnologia em Radiologia; Teixeira, F.C.S., E-mail: flavia@cnen.gov.br [Comissão Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil)

    2017-07-01

    Radiotherapy is a modality that, along with surgery, has become essential for the success of cancer treatment. Over the years, radiotherapy has been improved to increase the effectiveness of the chances of cure. The objective of this study was to capture data from on-site visits in two clinics that offer the radiotherapy service in the state of Rio de Janeiro. After observing that each clinic had similar procedures, however, with some different methods and in view of these data obtained, a model was developed for an institutional system of incident record with the purpose of sharing results to assist in the improvement of safety protocols to mitigate possible accidents in one or more units. We conclude that this system has everything to fulfill the proposal of assisting in learning incidents. However, it is primary and updates will be of utmost importance for your improvement.

  10. Interaction between shock coils increased the incidence of inappropriate therapies and lead failure in implantable cardioverter defibrillator.

    Science.gov (United States)

    El Garhy, Mohammad; Ohlow, Marc-Alexander; Lauer, Bernward

    Shock coil interaction in patients with multiple implantable cardioverter defibrillator (ICD) leads is occasionally observed. We aimed to evaluate the incidence of shock coil interaction and its clinical relevance. All ICD patients (646 patients) who came to follow up control in our ICD ambulance between January 1, 2011, and December 31, 2011 in the department of cardiology in Bad Berka hospital were retrospectively evaluated in this study. All baseline demographic, clinical, and procedural characteristics and postoperative chest x ray in postero-anterior and lateral view as well as clinical and ICD follow up data were evaluated. Among 646 patients 42 had multiple ICD leads (6.5%) of whom 36 patients (5.5% of total cohort patients and 85.7% of patients with multiple ICD leads) had shock coil interaction and presented the study group (Group I). The control group (Group II) consisted of 610 patients without coil-coil interaction including patients with single shock lead (604 patients) or patients with multiple leads but without interaction between shock coils (6 patients). Inappropriate anti-tachycardia therapies and RV lead revisions were more frequent in patients with interaction between shock coils (Group I vs Group II: 27.7% and 5.7%; p = 0.049 and 30.6% vs 6.4; p = 0.0001, respectively). Interaction between shock coils may be one of possible causes of lead failure and resulted in inappropriate therapies and subsequent lead revision. Copyright © 2018 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.

  11. Increased incidence of pseudarthrosis after unilateral instrumented transforaminal lumbar interbody fusion in patients with lumbar spondylosis: Clinical article.

    Science.gov (United States)

    Gologorsky, Yakov; Skovrlj, Branko; Steinberger, Jeremy; Moore, Max; Arginteanu, Marc; Moore, Frank; Steinberger, Alfred

    2014-10-01

    Transforaminal lumbar interbody fusion (TLIF) with segmental pedicular instrumentation is a well established procedure used to treat lumbar spondylosis with or without spondylolisthesis. Available biomechanical and clinical studies that compared unilateral and bilateral constructs have produced conflicting data regarding patient outcomes and hardware complications. A prospective cohort study was undertaken by a group of neurosurgeons. They prospectively enrolled 80 patients into either bilateral or unilateral pedicle screw instrumentation groups (40 patients/group). Demographic data collected for each group included sex, age, body mass index, tobacco use, and Workers' Compensation/litigation status. Operative data included segments operated on, number of levels involved, estimated blood loss, length of hospital stay, and perioperative complications. Long-term outcomes (hardware malfunction, wound dehiscence, and pseudarthrosis) were recorded. For all patients, preoperative baseline and 6-month postoperative scores for Medical Outcomes 36-Item Short Form Health Survey (SF-36) outcomes were recorded. Patient follow-up times ranged from 37 to 63 months (mean 52 months). No patients were lost to follow-up. The patients who underwent unilateral pedicle screw instrumentation (unilateral cohort) were slightly younger than those who underwent bilateral pedicle screw instrumentation (bilateral cohort) (mean age 42 vs. 47 years, respectively; p = 0.02). No other significant differences were detected between cohorts with regard to demographic data, mean number of lumbar levels operated on, or distribution of the levels operated on. Estimated blood loss was higher for patients in the bilateral cohort, but length of stay was similar for patients in both cohorts. The incidence of pseudarthrosis was significantly higher among patients in the unilateral cohort (7 patients [17.5%]) than among those in the bilateral cohort (1 patient [2.5%]) (p = 0.02). Wound dehiscence occurred for

  12. Potential association between the recent increase in campylobacteriosis incidence in the Netherlands and proton-pump inhibitor use - an ecological study.

    Science.gov (United States)

    Bouwknegt, M; van Pelt, W; Kubbinga, M E; Weda, M; Havelaar, A H

    2014-08-14

    The Netherlands saw an unexplained increase in campylobacteriosis incidence between 2003 and 2011, following a period of continuous decrease. We conducted an ecological study and found a statistical association between campylobacteriosis incidence and the annual number of prescriptions for proton pump inhibitors (PPIs), controlling for the patient's age, fresh and frozen chicken purchases (with or without correction for campylobacter prevalence in fresh poultry meat). The effect of PPIs was larger in the young than in the elderly. However, the counterfactual population-attributable fraction for PPIs was largest for the elderly (ca 45% in 2011) and increased at population level from 8% in 2004 to 27% in 2011. Using the regression model and updated covariate values, we predicted a trend break for 2012, largely due to a decreased number of PPI prescriptions, that was subsequently confirmed by surveillance data. Although causality was not shown, the biological mechanism, age effect and trend-break prediction suggest a substantial impact of PPI use on campylobacteriosis incidence in the Netherlands. We chose the ecological study design to pilot whether it is worthwhile to further pursue the effect of PPI on campylobacteriosis and other gastrointestinal pathogens in prospective cohort studies. We now provide strong arguments to do so.

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

    Science.gov (United States)

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

    2015-06-01

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

  14. No Contribution of GAD-65 and IA-2 Autoantibodies around Time of Diagnosis to the Increasing Incidence of Juvenile Type 1 Diabetes

    DEFF Research Database (Denmark)

    Thorsen, Steffen U.; Pipper, Christian B.; Mortensen, Henrik B.

    2016-01-01

    Aims. A new perspective on autoantibodies as pivotal players in the pathogenesis of type 1 diabetes (T1D) has recently emerged. Our key objective was to examine whether increased levels of autoantibodies against the β-cell autoantigens glutamic acid decarboxylase (isoform 65) (GADA) and insulinoma...... associated antigen-2A (IA-2A) mirrored the 3.4% annual increase in incidence of T1D. Methods. From the Danish Childhood Diabetes Register, we randomly selected 500 patients and 500 siblings for GADA and IA-2A analysis (1997 through 2005). Blood samples were taken within three months after onset. A robust log...

  15. Increased incidence of syphilis in men who have sex with men and risk management strategies, Germany, 2015.

    Science.gov (United States)

    Jansen, Klaus; Schmidt, Axel J; Drewes, Jochen; Bremer, Viviane; Marcus, Ulrich

    2016-10-27

    In Germany, the number of reported syphilis cases increased between 11% and 22% per year between 2010 and 2014. We analysed syphilis surveillance data and data of four behavioural surveys on men who have sex with men (MSM) in Germany (2003, 2007, 2010, 2013) to assess if this rise is ongoing and to find possible explanations for it. Syphilis notifications increased in 2015 by 19% to a total of 6,834. This was mainly due to increasing notifications in MSM of all age groups in larger German cities. Data from the behavioural surveys on MSM in Germany showed a simultaneous increase of selective condom use as HIV-status-bases risk management strategy and the number of syphilis cases. MSM diagnosed with HIV reported condomless anal intercourse with non-steady partners more frequent than MSM not diagnosed with HIV or untested for HIV, but the latter also reported higher frequencies of this behaviour in the more recent surveys. Transmission in HIV-positive MSM probably plays an important, but not exclusive role, for the syphilis dynamics in Germany. A risk adapted routine screening for sexually active MSM and potentially innovative approaches to increase early screening and treatment of syphilis such as internet counselling, home sampling, home testing and broadening venue-based (rapid) testing, should be critically evaluated to effectively reduce syphilis infections. This article is copyright of The Authors, 2016.

  16. Peripheral Inflammation Increases the Damage in Animal Models of Nigrostriatal Dopaminergic Neurodegeneration: Possible Implication in Parkinson's Disease Incidence

    Directory of Open Access Journals (Sweden)

    A. Machado

    2011-01-01

    Full Text Available Inflammatory processes described in Parkinson’s disease (PD and its animal models appear to be important in the progression of the pathogenesis, or even a triggering factor. Here we review that peripheral inflammation enhances the degeneration of the nigrostriatal dopaminergic system induced by different insults; different peripheral inflammations have been used, such as IL-1β and the ulcerative colitis model, as well as insults to the dopaminergic system such as 6-hydroxydopamine or lipopolysaccharide. In all cases, an increased loss of dopaminergic neurons was described; inflammation in the substantia nigra increased, displaying a great activation of microglia along with an increase in the production of cytokines such as IL-1β and TNF-α. Increased permeability or disruption of the BBB, with overexpression of the ICAM-1 adhesion molecule and infiltration of circulating monocytes into the substantia nigra, is also involved, since the depletion of circulating monocytes prevents the effects of peripheral inflammation. Data are reviewed in relation to epidemiological studies of PD.

  17. Do increases in subsidized housing reduce the incidence of homelessness? Vidence from the low-income housing tax credit

    OpenAIRE

    Jackson, Osborne; Kawano, Laura

    2015-01-01

    We examine the impact of subsidized housing on homelessness using the Low-Income Housing Tax Credit (LIHTC), the largest place-based housing program in the United States. To generate quasi-experimental variation in housing placements, we exploit a discontinuous increase in the amount of tax credits available to projects placed in certain high-poverty neighborhoods. Using data from the U.S. Census and HUD, we find that LIHTC project installation has no significant impact on neighborhood homele...

  18. Nitrite inhalant use among young gay and bisexual men in Vancouver during a period of increasing HIV incidence

    Directory of Open Access Journals (Sweden)

    Mattheis Kelly

    2007-03-01

    Full Text Available Abstract Background Nitrite inhalants ("poppers" are peripheral vasodilators which, since the beginning of the epidemic, have been known to increase risk for acquiring HIV infection among men who have sex with men (MSM. However, few studies in recent years have characterized use. From 1999 to 2004, new HIV diagnoses among MSM in British Columbia increased 78%, prompting us to examine the prevalence and correlates of this modifiable HIV risk factor. Methods Self-administered questionnaires were completed between October 2002 and May 2004 as part of an open cohort study of HIV-seronegative young MSM. We measured nitrite inhalant use during the previous year and use during sexual encounters with casual partners specifically. Correlates of use were identified using odds ratios. Results Among 354 MSM surveyed, 31.6% reported any use during the previous year. Nitrite inhalant use during sexual encounters was reported by 22.9% of men and was strongly associated with having casual partners, with greater numbers of casual partners (including those with positive or unknown serostatus and with anal intercourse with casual partners. Nitrite inhalant use was not associated with non-use of condoms with casual sexual partners per se. Conclusion Contemporary use of nitrite inhalants amongst young MSM is common and a strong indicator of anal intercourse with casual sexual partners. Since use appears to increase the probability of infection following exposure to HIV, efforts to reduce the use of nitrite inhalants among MSM should be a very high priority among HIV prevention strategies.

  19. Video Modeling of SBIRT for Alcohol Use Disorders Increases Student Empathy in Standardized Patient Encounters.

    Science.gov (United States)

    Crisafio, Anthony; Anderson, Victoria; Frank, Julia

    2018-04-01

    The purpose of this study was to assess the usefulness of adding video models of brief alcohol assessment and counseling to a standardized patient (SP) curriculum that covers and tests acquisition of this skill. The authors conducted a single-center, retrospective cohort study of third- and fourth-year medical students between 2013 and 2015. All students completed a standardized patient (SP) encounter illustrating the diagnosis of alcohol use disorder, followed by an SP exam on the same topic. Beginning in August 2014, the authors supplemented the existing formative SP exercise on problem drinking with one of two 5-min videos demonstrating screening, brief intervention, and referral for treatment (SBIRT). P values and Z tests were performed to evaluate differences between students who did and did not see the video in knowledge and skills related to alcohol use disorders. One hundred ninety-four students were included in this analysis. Compared to controls, subjects did not differ in their ability to uncover and accurately characterize an alcohol problem during a standardized encounter (mean exam score 41.29 vs 40.93, subject vs control, p = 0.539). However, the SPs' rating of students' expressions of empathy were significantly higher for the group who saw the video (81.63 vs 69.79%, p videos would improve students' recognition and knowledge of alcohol-related conditions. However, feedback from the SPs produced the serendipitous finding that the communication skills demonstrated in the videos had a sustained effect in enhancing students' professional behavior.

  20. Increased incidence and clinical correlation of persistently abnormal technetium pyrophosphate myocardial scintigrams following acute myocardial infarction in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Nicod, P.; Lewis, S.E.; Corbett, J.C.; Buja, L.M.; Henderson, G.; Raskin, P.; Rude, R.E.; Willerson, J.T.

    1982-01-01

    Persistently abnormal /sup 99m/Tc stannous pyrophosphate myocardial scintigrams (PPi+) appear to be associated with a relatively poor prognosis after acute myocardial infarction (AMI). To assess the incidence and implications of PPi+, we performed a retrospective analysis in 29 patients with and 25 patients without diabetes mellitus who had abnormal myocardial scintigrams within 4 days of AMI and who had follow-up scintigrams at least 3 months after hospital discharge. There were no significant differences between patients with and without diabetes as regards age, incidence of transmural or nontransmural AMI, or degree of left ventricular dysfunction after AMI. Persistently abnormal PPi+ occurred more commonly in patients with diabetes than in nondiabetic patients (18 of 29, 62%, compared to 3 of 25, 12%; p less than 0.001). Patients with chronic PPi+ had more frequent cardiac complications following hospital discharge (p less than 0.005) including death, recurrent AMI, unstable angina, and intractable congestive heart failure. Postmortem analysis in two patients with diabetes and chronic PPi+ revealed marked myocytolysis. Thus, patients with diabetes mellitus have an increased incidence of post-AMI persistently abnormal technetium (PPi+) scintigrams and relatively poor prognosis following myocardial infarction

  1. Is vaccenic acid (18:1t n-7) associated with an increased incidence of hip fracture? An explanation for the calcium paradox.

    Science.gov (United States)

    Hamazaki, Kei; Suzuki, Nobuo; Kitamura, Kei-Ichiro; Hattori, Atsuhiko; Nagasawa, Tetsuro; Itomura, Miho; Hamazaki, Tomohito

    2016-06-01

    High calcium intake may increase hip fracture (HF) incidence. This phenomenon, known as the calcium paradox, might be explained by vaccenic acid (18:1t n-7, VA), the highly specific trans fatty acid (TFA) present in dairy products. First, we ecologically investigated the relationship between 18:1 TFA intake and HF incidence using data from 12 to 13 European countries collected before 2000; then we measured the effects of VA and elaidic acid (18:1t n-9, EA) on osteoblasts from goldfish scales (tissues very similar to mammalian bone), with alkaline phosphatase as a marker; and finally we measured the effect of VA on mRNA expression in the scales for the major bone proteins type I collagen and osteocalcin. HF incidence was significantly correlated with 18:1 TFA intake in men (r=0.57) and women (r=0.65). Incubation with 1μmol/L VA and EA for 48h significantly decreased alkaline phosphatase activity by 25% and 21%, respectively. Incubation of scales with 10μmol/L VA for 48h significantly decreased mRNA expression for type I collagen and osteocalcin (by about 50%). In conclusion, VA may be causatively related to HF and could explain the calcium paradox. It may be prudent to reduce 18:1 TFA intake, irrespective of trans positions, to prevent HF. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Poppers use and Sexual Partner Concurrency Increase the HIV Incidence of MSM: a 24-month Prospective Cohort Survey in Shenyang, China.

    Science.gov (United States)

    Chu, Zhen-Xing; Xu, Jun-Jie; Zhang, Yong-Hui; Zhang, Jing; Hu, Qing-Hai; Yun, Ke; Wang, Hong-Yi; Jiang, Yong-Jun; Geng, Wen-Qing; Shang, Hong

    2018-01-08

    The use of poppers is highly prevalent in MSM, but little is known about the association between their use and HIV incidence in China. A prospective cohort study was conducted from 2011 to 2013 in MSM in Shenyang. 475(79.6%) of eligible HIV-negative MSM participated in this prospective survey and near one fourth MSM (23.4%) ever used poppers. About one-third of the participants had condomless anal intercourse, half had multiple sexual partners and 10.5% were syphilis positive. The HIV incidence densities were15.5 (95% CI:9.4-23.4)/100 PY[person-years]) and 4.6 (95% CI:2.9-7.0)/100 PY in poppers-users and non-poppers-users, respectively. Predictors of HIV seroconversion included poppers-using-behavior, having had more than two male partners, practicing group sex, unprotected anal intercourse(UAI) with male partners, and baseline syphilis positivity (all P poppers, high-risk-sexual behaviors and syphilis infection significantly increase the HIV incidence among Shenyang MSM. It is essential for policy makers to add poppers to the official controlled illicit drug list to reduce HIV transmission among the MSM community. A comprehensive strategy should also be implemented to control both their high-risk-sexual behaviors and risk of syphilis infection, since these may represent novel ways to prevent new HIV infections in these MSM.

  3. Increasing incidence of penicillin- and cefotaxime-resistant Streptococcus pneumoniae causing meningitis in India: Time for revision of treatment guidelines?

    Science.gov (United States)

    Verghese, Valsan Philip; Veeraraghavan, Balaji; Jayaraman, Ranjith; Varghese, Rosemol; Neeravi, Ayyanraj; Jayaraman, Yuvaraj; Thomas, Kurien; Mehendale, Sanjay M

    2017-01-01

    Pneumococcal meningitis is a life-threatening infection, requiring prompt diagnosis and effective treatment. Penicillin resistance in pneumococcal infections is a concern. Here, we present the antibiotic susceptibility profile of pneumococcal meningeal isolates from January 2008 to August 2016 to elucidate treatment guidelines for pneumococcal meningitis. Invasive pneumococcal isolates from all age groups, were included in this study. Minimum inhibitory concentrations for the isolates were identified by agar dilution technique and VITEK System 2. Serotyping of isolates was done by co-agglutination technique. Out of 830 invasive pneumococcal isolates, 167 (20.1%) isolates were from meningeal infections. Cumulative penicillin resistance in pneumococcal meningitis was 43.7% and cefotaxime non-susceptibility was 14.9%. Penicillin resistance amongst meningeal isolates in those younger than 5 years, 5-16 years of age and those aged 16 years and older was 59.7%, 50% and 27.3%, respectively, with non-susceptibility to cefotaxime in the same age groups being 18%, 22.2% and 10.4%. Penicillin resistance amongst pneumococcal meningeal isolates increased from 9.5% in 2008 to 42.8% in 2016, whereas cefotaxime non-susceptibility increased from 4.7% in 2008 to 28.5% in 2016. Serotypes 14, 19F, 6B, 6A, 23F, 9V and 5 were the most common serotypes causing meningitis, with the first five accounting for over 75% of resistant isolates. The present study reports increasing penicillin resistance and cefotaxime non-susceptibility to pneumococcal meningitis in our setting. This highlights the need for empiric therapy with third-generation cephalosporins and vancomycin for all patients with meningitis while awaiting results of culture and susceptibility testing.

  4. Increasing incidence of statin treatmentamong the elderly and those withoutprevious cardiovascular conditions. A nationwide register study

    DEFF Research Database (Denmark)

    Kildemoes, Helle Wallach; Andersen, Morten

      Background: Supported by the growing evidence of the beneficial effects of statins in a range of conditions, statin utilization has increased considerably in most Western countries over the last decade. Objectives: To estimate to what extent a widening of indication scope for statins accounts...... with discharge diagnoses and surgical procedures performed during 1977-2005. The disease status for all cohort members was assigned by means of disease markers for seven cardiovascular conditions, corresponding to a hierarchy of broad indications for statin therapy. Using the indication hierarchy, we computed...

  5. Higher CD3(+) and CD34(+) cell doses in the graft increase the incidence of acute GVHD in children receiving BMT for thalassemia.

    Science.gov (United States)

    Gaziev, J; Isgrò, A; Marziali, M; Daniele, N; Gallucci, C; Sodani, P; Simone, M D; Adorno, G; Paciaroni, K; Andreani, M; Lanti, A; Del Proposto, G; Testi, M; De Angelis, G; Roveda, A; Alfieri, C; Saltarelli, F; Lucarelli, G

    2012-01-01

    We evaluated the incidence of GVHD, risk factors and the impact of graft composition on acute GVHD (aGVHD) in 92 children who underwent BMT for thalassemia following busulfan/cyclophosphamide (BUCY)-based conditioning regimens and GVHD prophylaxis with CSA/short-MTX and methylprednisolone. The incidence of grade 2-4 and 3-4 aGVHD was 35% (95% confidence interval (CI) 25-44) and 9% (95% CI 4-16), respectively. We found that CD3(+) and CD34(+) cell doses above the median were associated with high incidence of grade 2-4 aGVHD (49 vs 20%, P=0.005 and 46 vs 23%, P=0.021, respectively). In multivariate analysis, high CD3(+) (hazard ratio (HR) 4.6; 95% CI 1.4-14.7; P=0.010) and CD34(+) (HR 4.3; 95% CI 1.4-12.7; P=0.011) cell doses were associated with grade 2-4 aGVHD. We further examined the effect of CD3(+) and CD34(+) cell doses on aGVHD using quartile cutoff points and found a minimum threshold for CD3(+) (38 × 10(6)/kg) and CD34(+) (4 × 10(6)/kg) cells above which the incidence of grade 2-4 aGVHD is significantly increased. This study shows for the first time a positive correlation between the number of CD3(+) and CD34(+) cells and aGVHD in children receiving sibling BMT, and indicates that using tailored and more intensive post transplant immunosuppression may permit to better control aGVHD.

  6. Increased incidence of peptic ulcer disease in central serous chorioretinopathy patients: a population-based retrospective cohort study.

    Science.gov (United States)

    Chen, San-Ni; Lian, Iebin; Chen, Yi-Chiao; Ho, Jau-Der

    2015-02-01

    To investigate peptic ulcer disease and other possible risk factors in patients with central serous chorioretinopathy (CSR) using a population-based database. In this population-based retrospective cohort study, longitudinal data from the Taiwan National Health Insurance Research Database were analyzed. The study cohort comprised 835 patients with CSR and the control cohort comprised 4175 patients without CSR from January 2000 to December 2009. Conditional logistic regression was applied to examine the association of peptic ulcer disease and other possible risk factors for CSR, and stratified Cox regression models were applied to examine whether patients with CSR have an increased chance of peptic ulcer disease and hypertension development. The identifiable risk factors for CSR included peptic ulcer disease (adjusted odd ratio: 1.39, P = 0.001) and higher monthly income (adjusted odd ratio: 1.30, P = 0.006). Patients with CSR also had a significantly higher chance of developing peptic ulcer disease after the diagnosis of CSR (adjusted odd ratio: 1.43, P = 0.009). Peptic ulcer disease and higher monthly income are independent risk factors for CSR. Whereas, patients with CSR also had increased risk for peptic ulcer development.

  7. A virtual experimenter to increase standardization for the investigation of placebo effects

    Directory of Open Access Journals (Sweden)

    Bjoern Horing

    2016-07-01

    Full Text Available Abstract Background Placebo effects are mediated by expectancy, which is highly influenced by psychosocial factors of a treatment context. These factors are difficult to standardize. Furthermore, dedicated placebo research often necessitates single-blind deceptive designs where biases are easily introduced. We propose a study protocol employing a virtual experimenter – a computer program designed to deliver treatment and instructions – for the purpose of standardization and reduction of biases when investigating placebo effects. Methods To evaluate the virtual experimenter’s efficacy in inducing placebo effects via expectancy manipulation, we suggest a partially blinded, deceptive design with a baseline/retest pain protocol (hand immersions in hot water bath. Between immersions, participants will receive an (actually inert medication. Instructions pertaining to the medication will be delivered by one of three metaphors: The virtual experimenter, a human experimenter, and an audio/text presentation (predictor “Metaphor”. The second predictor includes falsely informing participants that the medication is an effective pain killer, or correctly informing them that it is, in fact, inert (predictor “Instruction”. Analysis will be performed with hierarchical linear modelling, with a sample size of N = 50. Results from two pilot studies are presented that indicate the viability of the pain protocol (N = 33, and of the virtual experimenter software and placebo manipulation (N = 48. Discussion It will be challenging to establish full comparability between all metaphors used for instruction delivery, and to account for participant differences in acceptance of their virtual interaction partner. Once established, the presence of placebo effects would suggest that the virtual experimenter exhibits sufficient cues to be perceived as a social agent. He could consequently provide a convenient platform to investigate effects of

  8. Approaches to Increasing Ethical Compliance in China with Drug Trial Standards of Practice

    DEFF Research Database (Denmark)

    Rosenberg, Jacob

    2016-01-01

    . With recent reports of scientific misconduct from China, there is an urgent need to find approaches to compel researchers to adhere to ethical research practices. This problem does not call for a simple solution, but if forces are joined with governmental regulations, education in ethics issues for medical......Zeng et al.'s Ethics Review highlights some of the challenges associated with clinical research in China. They found that only a minority of published clinical trials of anti-dementia drugs reported that they fulfilled the basic ethical principles as outlined in the Declaration of Helsinki...... researchers, and strong reinforcement by Chinese journal editors not to publish studies with these flaws, then research ethics and publication standards will probably improve. Other solutions to foster ethical practice of drug trials are discussed including Chinese initiatives directed at managing conflict...

  9. Cancer incidence in blood transfusion recipients

    DEFF Research Database (Denmark)

    Hjalgrim, Henrik; Edgren, Gustaf; Rostgaard, Klaus

    2007-01-01

    of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred......, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. CONCLUSIONS: The marked increase in cancer risk shortly after a blood transfusion may...

  10. A Systematic Review: The Next Generation Science Standards and the Increased Cultural Diversity

    Science.gov (United States)

    Asowayan, Alaa A.; Ashreef, Samaar Y.; Omar, Sozan H.

    2017-01-01

    This systematic review aims to explore the effect of NGSS on students' academic excellence. Specifically, considering increased cultural diversity, it is appropriate to identify student's science-related values, respectful features of teachers' cultural competence, and underlying challenges and detect in what ways these objectives are addressed by…

  11. A comparison of temperature increases produced by "premium" and "standard" diamond burs: An in-vitro study.

    Science.gov (United States)

    Segal, Pnina; Sap, Danny; Ben-Amar, Ariel; Levartovsky, Shifra; Matalon, Shlomo

    2016-02-01

    Vital tooth preparations may cause irreversible thermal damage to the pulp. The manufacturing techniques of dental burs may decrease heat production and minimize the risk of overheating and trauma to the dental pulp. Strauss (Raanana, Israel) has introduced "premium" diamond burs, claiming superior efficiency and longevity. We sought to determine the safest preparation methods by performing a comparison of intrapulpal temperature increases caused with "standard" and "premium" burs. Three types of diamond burs (F1R, F21R, and K2) were tested on extracted human teeth (n = 8 teeth per bur type). Premium and standard manufacturing techniques were compared for each bur type (n = 24 teeth per group; total 48 teeth). An intrapulpal thermocouple was used to measure the temperature during the procedure. Comparisons were analyzed with the t test and one-way ANOVA. P ≤ .05 was considered significant. All premium burs demonstrated lower temperature increases compared to the standard burs (P ≤ .001 for F21R and K2, P = .086 for F1R). The temperature increases with premium burs were similar for different bur shapes, but the temperature increases with standard burs depended on the bur shape (P pulp tissue damage, and thus reduce postoperative pulp-associated complications.

  12. Body weight considerations in the B6C3F1 mouse and the use of dietary control to standardize background tumor incidence in chronic bioassays

    International Nuclear Information System (INIS)

    Leakey, Julian E.A.; Seng, John E.; Allaben, William T.

    2003-01-01

    In B6C3F 1 mice, the rate of body growth influences susceptibility to liver neoplasia and large variations in body weight can complicate the interpretation of bioassay data. The relationship between body weight and liver tumor incidence was calculated for historical control populations of male and female ad libitum-fed mice (approx. 2750 and 2300 animals, respectively) and in populations of male and female mice which had been subjected to forced body weight reduction due to either dietary restriction or exposure to noncarcinogenic chemicals (approx. 1600 and 1700, respectively). Resulting tumor risk data were then used to construct idealized weight curves for male and female B6C3F 1 mice; these curves predict a terminal background liver tumor incidence of 15-20%. Use of dietary control to manipulate body growth of male B6C3F 1 mice to fit the idealized weight curve was evaluated in a 2-year bioassay of chloral hydrate. Cohorts of mice were successfully maintained at weights approximating their idealized target weights throughout the study. These mice exhibited less body weight variation than their ad libitum-fed counterparts (e.g., standard deviations of body weight were 1.4 and 3.4 g for respective control groups at 36 weeks). Historical control body weight and tumor risk data from the two male mouse populations were utilized to predict background liver tumor rates for each experimental group of the chloral hydrate study. The predicted background tumor rates closely matched the observed rates for both the dietary controlled and ad libitum-fed chloral hydrate control groups when each mouse was evaluated according to either its weekly food consumption or its weekly change in body weight

  13. Impact of an Immunization Campaign to Control an Increased Incidence of Serogroup B Meningococcal Disease in One Region of Quebec, Canada.

    Science.gov (United States)

    De Wals, Philippe; Deceuninck, Geneviève; Lefebvre, Brigitte; Tsang, Raymond; Law, Dennis; De Serres, Gaston; Gilca, Vladimir; Gilca, Rodica; Boulianne, Nicole

    2017-05-01

    Invasive meningococcal disease (IMD) incidence increased in Quebec, starting in 2003, and was caused by a serogroup B sequence type 269 clone. The Saguenay-Lac-Saint-Jean (SLSJ) region was particularly affected with a rate of 3.4 per 100000 person-years in 2006-2013. In May 2014, an immunization campaign was launched in SLSJ, using the 4-component protein-based meningococcal vaccine (MenB-4C). We aimed to evaluate the impact of the campaign 2 years after its initiation. Immunization registry data and serogroup B invasive meningococcal disease (B-IMD) cases notified to public health authorities and confirmed by culture or polymerase chain reaction from July 1996 to December 2016 were analyzed, including a multivariate Poisson regression model of incidence rates. By the end of the campaign, 82% of the 59000 targeted SLSJ residents between 2 months and 20 years of age had been immunized. Following the initiation of the campaign, no B-IMD case occurred among vaccinees, whereas 2 cases were reported among unvaccinated adult SLSJ residents, and a third case in an unvaccinated child who had stayed in the region during the week prior to disease onset, in 2015. B-IMD incidence decreased in all other regions in the years 2015-2016 but sporadic cases continued to occur. A multivariate analysis showed a significant effect of the campaign in the SLSJ region (relative B-IMD risk: 0.22; P = .04). Results suggest a high level of protection provided by MenB-4C following mass vaccination at regional level. This, along with reassuring safety data, supports the current recommendations for MenB-4C use for controlling outbreaks caused by clones covered by the vaccine. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  14. Standardization of process for increased production of pure and potent tetanus toxin

    Directory of Open Access Journals (Sweden)

    Chellamani Muniandi

    2013-09-01

    Full Text Available When stationary pot culture was replaced by submerged cultivation of Clostridium tetani, an anaerobic organism, in afermentor using a vibromixer and optimum supply of sterile air to the headspace of the fermentor to flush out the accumulatedgases, a significant increase in the tetanus toxin yield in a short time cultivation (about 5 to 6 days against8 days was noticed. It was found that under optimal conditions of temperature, vibromixing, surface aeration, and analkaline pH favored toxin release. Furthermore, to enhance the production volume, fermentor culture is more suitable.The tetanus toxin was produced with good Limes flocculation (Lf titre and high antigenic purity. Under optimal conditions,the papain digest broth was successfully substituted in place of N.Z Case for the production of pure and potenttetanus toxin. J Microbiol Infect Dis 2013; 3(3: 133-139Key words: Clostridium tetani, modified mueller miller medium, papain digest, limes flocculation

  15. Mice Deficient in Both Mn Superoxide Dismutase and Glutathione Peroxidase-1 Have Increased Oxidative Damage and a Greater Incidence of Pathology but No Reduction in Longevity

    Science.gov (United States)

    Zhang, Yiqiang; Ikeno, Yuji; Qi, Wenbo; Chaudhuri, Asish; Li, Yan; Bokov, Alex; Thorpe, Suzanne R.; Baynes, John W.; Epstein, Charles; Richardson, Arlan

    2009-01-01

    To test the impact of increased mitochondrial oxidative stress as a mechanism underlying aging and age-related pathologies, we generated mice with a combined deficiency in two mitochondrial-localized antioxidant enzymes, Mn superoxide dismutase (MnSOD) and glutathione peroxidase-1 (Gpx-1). We compared life span, pathology, and oxidative damage in Gpx1−/−, Sod2+/−Gpx1+/−, Sod2+/−Gpx1−/−, and wild-type control mice. Oxidative damage was elevated in Sod2+/−Gpx1−/− mice, as shown by increased DNA oxidation in liver and skeletal muscle and increased protein oxidation in brain. Surprisingly, Sod2+/−Gpx1−/− mice showed no reduction in life span, despite increased levels of oxidative damage. Consistent with the important role for oxidative stress in tumorigenesis during aging, the incidence of neoplasms was significantly increased in the older Sod2+/−Gpx1−/− mice (28–30 months). Thus, these data do not support a significant role for increased oxidative stress as a result of compromised mitochondrial antioxidant defenses in modulating life span in mice and do not support the oxidative stress theory of aging. PMID:19776219

  16. Body size and longitudinal body weight changes do not increase mortality in incident peritoneal dialysis patients of the Brazilian peritoneal dialysis multicenter study

    Science.gov (United States)

    da Silva Fernandes, Natália Maria; Bastos, Marcus Gomes; Franco, Márcia Regina Gianotti; Chaoubah, Alfredo; da Glória Lima, Maria; Divino-Filho, José Carolino; Qureshi, Abdul Rashid

    2013-01-01

    OBJECTIVES: To determine the roles of body size and longitudinal body weight changes in the survival of incident peritoneal dialysis patients. PATIENTS AND METHODS: Patients (n = 1911) older than 18 years of age recruited from 114 dialysis centers (Dec/2004-Oct/2007) and participating in the Brazilian Peritoneal Dialysis Multicenter Cohort Study were included. Clinical and laboratory data were collected monthly (except if the patient received a transplant, recovered renal function, was transferred to hemodialysis, or died). RESULTS: Survival analyses were performed using Kaplan-Meier survival curves and Cox proportional hazards. Total follow-up was 34 months. The mean age was 59 years (54% female). The weight category percentages were as follows: underweight: 8%; normal: 51%; overweight: 29%; and obese 12%. The multivariate model showed a higher risk of death for a body mass index 30 kg/m2. Patients were divided into five categories according to quintiles of body weight changes during the first year of dialysis: +7.1%. Patients in the lowest quintile had significantly higher mortality, whereas no negative impact was observed in the other quintiles. CONCLUSION: These findings suggest that overweight/obesity and a positive body weight variation during the first year of peritoneal dialysis therapy do not increase mortality in incident dialysis patients in Brazil. PMID:23420157

  17. Comparison of Unmanned Aerial Vehicle Technology Versus Standard Practice in Identification of Hazards at a Mass Casualty Incident Scenario by Primary Care Paramedic Students.

    Science.gov (United States)

    Jain, Trevor; Sibley, Aaron; Stryhn, Henrik; Hubloue, Ives

    2018-01-31

    Introduction The proliferation of unmanned aerial vehicles (UAV) has the potential to change the situational awareness of incident commanders allowing greater scene safety. The aim of this study was to compare UAV technology to standard practice (SP) in hazard identification during a simulated multi-vehicle motor collision (MVC) in terms of time to identification, accuracy and the order of hazard identification. A prospective observational cohort study was conducted with 21 students randomized into UAV or SP group, based on a MVC with 7 hazards. The UAV group remained at the UAV ground station while the SP group approached the scene. After identifying hazards the time and order was recorded. The mean time (SD, range) to identify the hazards were 3 minutes 41 seconds (1 minute 37 seconds, 1 minute 48 seconds-6 minutes 51 seconds) and 2 minutes 43 seconds (55 seconds, 1 minute 43 seconds-4 minutes 38 seconds) in UAV and SP groups corresponding to a mean difference of 58 seconds (P=0.11). A non-parametric permutation test showed a significant (P=0.04) difference in identification order. Both groups had 100% accuracy in hazard identification with no statistical difference in time for hazard identification. A difference was found in the identification order of hazards. (Disaster Med Public Health Preparedness. 2018;page 1 of 4).

  18. The evolution of the epidemiological landscape of head and neck cancer in Italy: Is there evidence for an increase in the incidence of potentially HPV-related carcinomas?

    Directory of Open Access Journals (Sweden)

    Paolo Boscolo-Rizzo

    Full Text Available The current study aimed to investigate the incidence and survival patterns of HNSCCs arising from different anatomic sites, potentially related (the oropharynx or unrelated (the oral cavity, the larynx/hypopharynx to HPV, to provide clues on possible growing impact of HPV in the epidemiology of HNSCC in Italy. Epidemiological data were retrieved from ten long-term Cancer Registries covering a population of 7.8 million inhabitants. Trends were described by means of the estimated annual percent change (APC stratified by age and gender, and compared between HPV-related and HPV-unrelated anatomical sites. The data regarding 28,295 HNSCCs diagnosed in Italy between 1988 and 2012 were analyzed. In males, the incidence rate (IR of cancers arising from sites unrelated to HPV infection significantly decreased in all age groups (APC:-3.31 for larynx/hypopharynx; APC:-1.77 for oral cavity, whereas stable IR were observed for cancers arising from sites related to HPV infection. In females, IR for cancers from HPV-related sites increased significantly over the observed period; the largest increment was noted in those over 60 (APC:2.92% who also showed a significantly lower number of HNSCCs from the larynx/hypopharynx (APC:- 0.84 and a significantly higher number of oral cavity tumors (APC = 2.15. The five-year relative survival remained largely unchanged in the patients with laryngeal/hypopharyngeal SCC and, conversely, significantly improved in the patients with SCC at HPV-related sites. The trends observed suggest a potential increasing impact of HPV infection on the epidemiology of HNSCC in Italy, but to a lesser extent and with a different pattern from that observed in other Western countries.

  19. Design incentives to increase vehicle size created from the U.S. footprint-based fuel economy standards

    International Nuclear Information System (INIS)

    Whitefoot, Kate S.; Skerlos, Steven J.

    2012-01-01

    The recently amended U.S. Corporate Average Fuel Economy (CAFE) standards determine fuel-economy targets based on the footprint (wheelbase by track width) of vehicles such that larger vehicles have lower fuel-economy targets. This paper considers whether these standards create an incentive for firms to increase vehicle size by presenting an oligopolistic-equilibrium model in which automotive firms can modify vehicle dimensions, implement fuel-saving technology features, and trade off acceleration performance and fuel economy. Wide ranges of scenarios for consumer preferences are considered. Results suggest that the footprint-based CAFE standards create an incentive to increase vehicle size except when consumer preference for vehicle size is near its lower bound and preference for acceleration is near its upper bound. In all other simulations, the sales-weighted average vehicle size increases by 2–32%, undermining gains in fuel economy by 1–4 mpg (0.6–1.7 km/L). Carbon-dioxide emissions from these vehicles are 5–15% higher as a result (4.69×10 11 –5.17×10 11 kg for one year of produced vehicles compared to 4.47×10 11 kg with no size changes), which is equivalent to adding 3–10 coal-fired power plants to the electricity grid each year. Furthermore, results suggest that the incentive is larger for light trucks than for passenger cars, which could increase traffic safety risks. - Highlights: ► New U.S. fuel-economy standards may create an incentive to increase vehicle size. ► We model firms as choosing vehicle designs and prices in oligopolistic equilibrium. ► Vehicle size increases 2–32% for 20 out of 21 scenarios of consumer preferences. ► Increases in size reduce fuel economy gains from 5–13%, resulting in 5–15% higher CO 2 emissions. ► Incentive is larger for trucks than cars, which may increase traffic safety risks.

  20. Indoor fire in a nursing home : evaluation of the medical response to a mass casualty incident based on a standardized protocol

    NARCIS (Netherlands)

    Koning, S. W.; Ellerbroek, P. M.; Leenen, L. P. H.

    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent

  1. CYP1A1 gene polymorphisms increase lung cancer risk in a high-incidence region of Spain: a case control study

    Directory of Open Access Journals (Sweden)

    San Jose Carmen

    2010-08-01

    Full Text Available Abstract Background A rural region in south-west Spain has one of the highest lung cancer incidence rates of the country, as revealed by a previous epidemiological 10-year follow-up study. The present work was undertaken to ascertain the role of CYP1A1 gene polymorphisms and their interaction with tobacco smoking in the development of the disease in this location. Methods One-hundred-and-three cases of lung cancer and 265 controls participated in the study. The participants were screened for the presence of four CYP1A1 polymorphisms, namely MspI, Ile462Val, T3205C, and Thr461Asn. Lung cancer risk was estimated as odds ratios (OR and 95% confidence intervals (CI using unconditional logistic regression models adjusting for age, sex, and smoking. Results The distribution of the variant CYP1A1 alleles was different from that described for other Caucasian populations, with CYP1A1*2A showing an uncommonly high frequency (p CYP1A1*2B allele (carrying MspI and Ile462Val mutations was strongly associated with high lung cancer risk (OR = 4.59, CI:1.4-12.6, p p p = 0.04. Moreover, the Thr461Asn polymorphism was found to be associated with SCLC in a Caucasian population for the first time to our knowledge (OR = 8.33, CI: 1.3-15.2, p = 0.04. Conclusion The results suggest that CYP1A1 polymorphisms contribute to increase lung cancer susceptibility in an area with an uncommon high incidence rate.

  2. Police Incident Blotter (Archive)

    Data.gov (United States)

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

  3. Haloperidol and Rimonabant Increase Delay Discounting in Rats Fed High-Fat and Standard-Chow Diets

    Science.gov (United States)

    Boomhower, Steven R.; Rasmussen, Erin B.

    2016-01-01

    The dopamine and endocannabinoid neurotransmitter systems have been implicated in delay discounting, a measure of impulsive choice, and obesity. The current study was designed to determine the extent to which haloperidol and rimonabant affected delay discounting in rats fed standard-chow and high-fat diets. Sprague-Dawley rats were allowed to free-feed under a high-fat diet (4.73 kcal/g) or a standard-chow diet (3.0 kcal/g) for three months. Then, operant sessions began in which rats (n = 9 standard chow; n = 10 high-fat) chose between one sucrose pellet delivered immediately vs. three sucrose pellets after a series of delays. In another condition, carrot-flavored pellets replaced sucrose pellets. After behavior stabilized, acute injections of rimonabant (0.3-10 mg/kg) and haloperidol (0.003-0.1 mg/kg) were administered i.p. before some choice sessions in both pellet conditions. Haloperidol and rimonabant increased discounting in both groups of rats by decreasing percent choice for the larger reinforcer and area-under-the-curve (AUC) values. Rats in the high-fat diet condition demonstrated increased sensitivity to haloperidol compared to chow-fed controls: haloperidol increased discounting in both dietary groups in the sucrose condition,, but only in the high-fat-fed rats in the carrot-pellet condition. These findings indicate that blocking D2 and CB1 receptors results in increased delay discounting, and that a high-fat diet may alter sensitivity to dopaminergic compounds using the delay-discounting task. PMID:25000488

  4. No Contribution of GAD-65 and IA-2 Autoantibodies around Time of Diagnosis to the Increasing Incidence of Juvenile Type 1 Diabetes: A 9-Year Nationwide Danish Study

    Directory of Open Access Journals (Sweden)

    Steffen U. Thorsen

    2016-01-01

    Full Text Available Aims. A new perspective on autoantibodies as pivotal players in the pathogenesis of type 1 diabetes (T1D has recently emerged. Our key objective was to examine whether increased levels of autoantibodies against the β-cell autoantigens glutamic acid decarboxylase (isoform 65 (GADA and insulinoma associated antigen-2A (IA-2A mirrored the 3.4% annual increase in incidence of T1D. Methods. From the Danish Childhood Diabetes Register, we randomly selected 500 patients and 500 siblings for GADA and IA-2A analysis (1997 through 2005. Blood samples were taken within three months after onset. A robust log-normal regression model was used. Nine hundred children and adolescents had complete records and were included in the analysis. Cochran-Armitage test for trend was used to evaluate changes in prevalence of autoantibody positivity by period. Results. No significant changes in levels of GADA and IA-2A were found over our 9-year study period. No trends in autoantibody positivity—in either patients or siblings—were found. Levels of GADA and IA-2A were significantly associated with HLA risk groups and GADA with age. Conclusion. The prevalence of positivity and the levels of GADA and IA-2A have not changed between 1997 and 2005 in newly diagnosed patients with T1D and their siblings without T1D.

  5. The incident guidelines for nuclear power stations of the FRG - an example illustrating the degradation of safety standards for nuclear power plants

    International Nuclear Information System (INIS)

    1984-01-01

    The 'Guidelines for the Assessment of the Design of Nuclear Power Plants Against Incidents', i.e. the Federal German Incident Guidelines, have been the subject of an official hearing of experts before the Committee of Internal Affairs of the German Bundestag on February 22, 1984. The report in hand presents the official invitation to the meeting, the list of questions posed, written statements given by critics, and an appendix with the full text of the Incident Guidelines, as of August 12, 1983. (orig./HP) [de

  6. Cyber Incidents Involving Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Robert J. Turk

    2005-10-01

    The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Management Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this

  7. Does the evidence about health risks associated with nitrate ingestion warrant an increase of the nitrate standard for drinking water?

    Science.gov (United States)

    van Grinsven, Hans JM; Ward, Mary H; Benjamin, Nigel; de Kok, Theo M

    2006-01-01

    Several authors have suggested that it is safe to raise the health standard for nitrate in drinking water, and save money on measures associated with nitrate pollution of drinking water resources. The major argument has been that the epidemiologic evidence for acute and chronic health effects related to drinking water nitrate at concentrations near the health standard is inconclusive. With respect to the chronic effects, the argument was motivated by the absence of evidence for adverse health effects related to ingestion of nitrate from dietary sources. An interdisciplinary discussion of these arguments led to three important observations. First, there have been only a few well-designed epidemiologic studies that evaluated ingestion of nitrate in drinking water and risk of specific cancers or adverse reproductive outcomes among potentially susceptible subgroups likely to have elevated endogenous nitrosation. Positive associations have been observed for some but not all health outcomes evaluated. Second, the epidemiologic studies of cancer do not support an association between ingestion of dietary nitrate (vegetables) and an increased risk of cancer, because intake of dietary nitrate is associated with intake of antioxidants and other beneficial phytochemicals. Third, 2–3 % of the population in Western Europe and the US could be exposed to nitrate levels in drinking water exceeding the WHO standard of 50 mg/l nitrate, particularly those living in rural areas. The health losses due to this exposure cannot be estimated. Therefore, we conclude that it is not possible to weigh the costs and benefits from changing the nitrate standard for drinking water and groundwater resources by considering the potential consequences for human health and by considering the potential savings due to reduced costs for nitrate removal and prevention of nitrate pollution. PMID:16989661

  8. Does the evidence about health risks associated with nitrate ingestion warrant an increase of the nitrate standard for drinking water?

    Science.gov (United States)

    van Grinsven, Hans J M; Ward, Mary H; Benjamin, Nigel; de Kok, Theo M

    2006-09-21

    Several authors have suggested that it is safe to raise the health standard for nitrate in drinking water, and save money on measures associated with nitrate pollution of drinking water resources. The major argument has been that the epidemiologic evidence for acute and chronic health effects related to drinking water nitrate at concentrations near the health standard is inconclusive. With respect to the chronic effects, the argument was motivated by the absence of evidence for adverse health effects related to ingestion of nitrate from dietary sources. An interdisciplinary discussion of these arguments led to three important observations. First, there have been only a few well-designed epidemiologic studies that evaluated ingestion of nitrate in drinking water and risk of specific cancers or adverse reproductive outcomes among potentially susceptible subgroups likely to have elevated endogenous nitrosation. Positive associations have been observed for some but not all health outcomes evaluated. Second, the epidemiologic studies of cancer do not support an association between ingestion of dietary nitrate (vegetables) and an increased risk of cancer, because intake of dietary nitrate is associated with intake of antioxidants and other beneficial phytochemicals. Third, 2-3 % of the population in Western Europe and the US could be exposed to nitrate levels in drinking water exceeding the WHO standard of 50 mg/l nitrate, particularly those living in rural areas. The health losses due to this exposure cannot be estimated. Therefore, we conclude that it is not possible to weigh the costs and benefits from changing the nitrate standard for drinking water and groundwater resources by considering the potential consequences for human health and by considering the potential savings due to reduced costs for nitrate removal and prevention of nitrate pollution.

  9. Does the evidence about health risks associated with nitrate ingestion warrant an increase of the nitrate standard for drinking water?

    Directory of Open Access Journals (Sweden)

    Benjamin Nigel

    2006-09-01

    Full Text Available Abstract Several authors have suggested that it is safe to raise the health standard for nitrate in drinking water, and save money on measures associated with nitrate pollution of drinking water resources. The major argument has been that the epidemiologic evidence for acute and chronic health effects related to drinking water nitrate at concentrations near the health standard is inconclusive. With respect to the chronic effects, the argument was motivated by the absence of evidence for adverse health effects related to ingestion of nitrate from dietary sources. An interdisciplinary discussion of these arguments led to three important observations. First, there have been only a few well-designed epidemiologic studies that evaluated ingestion of nitrate in drinking water and risk of specific cancers or adverse reproductive outcomes among potentially susceptible subgroups likely to have elevated endogenous nitrosation. Positive associations have been observed for some but not all health outcomes evaluated. Second, the epidemiologic studies of cancer do not support an association between ingestion of dietary nitrate (vegetables and an increased risk of cancer, because intake of dietary nitrate is associated with intake of antioxidants and other beneficial phytochemicals. Third, 2–3 % of the population in Western Europe and the US could be exposed to nitrate levels in drinking water exceeding the WHO standard of 50 mg/l nitrate, particularly those living in rural areas. The health losses due to this exposure cannot be estimated. Therefore, we conclude that it is not possible to weigh the costs and benefits from changing the nitrate standard for drinking water and groundwater resources by considering the potential consequences for human health and by considering the potential savings due to reduced costs for nitrate removal and prevention of nitrate pollution.

  10. Mesenchymal stem cells from cortical bone demonstrate increased clonal incidence, potency, and developmental capacity compared to their bone marrow–derived counterparts

    Directory of Open Access Journals (Sweden)

    Daniel Blashki

    2016-08-01

    Full Text Available In this study, we show that matrix dense cortical bone is the more potent compartment of bone than bone marrow as a stromal source for mesenchymal stem cells as isolated from adult rats. Lineage-depleted cortical bone-mesenchymal stem cells demonstrated >150-fold enrichment of colony forming unit–fibroblasts per cell incidence. compared to lineage-depleted bone marrow-mesenchymal stem cells, corresponding to a 70-fold increase in absolute recovered colony forming unit–fibroblasts. The composite phenotype Lin−/CD45−/CD31−/VLA-1+/Thy-1+ enriched for clonogenic mesenchymal stem cells solely from cortical bone–derived cells from which 70% of clones spontaneously differentiated into all lineages of bone, cartilage, and adipose. Both populations generated vascularized bone tissue within subcutaneous implanted collagen scaffolds; however, cortical bone–derived cells formed significantly more osteoid than bone marrow counterparts, quantified by histology. The data demonstrate that our isolation protocol identifies and validates mesenchymal stem cells with superior clonal, proliferative, and developmental potential from cortical bone compared to the bone marrow niche although marrow persists as the typical source for mesenchymal stem cells both in the literature and current pre-clinical therapies.

  11. AS03 adjuvanted AH1N1 vaccine associated with an abrupt increase in the incidence of childhood narcolepsy in Finland.

    Directory of Open Access Journals (Sweden)

    Hanna Nohynek

    Full Text Available BACKGROUND: Narcolepsy is a chronic sleep disorder with strong genetic predisposition causing excessive daytime sleepiness and cataplexy. A sudden increase in childhood narcolepsy was observed in Finland soon after pandemic influenza epidemic and vaccination with ASO3-adjuvanted Pandemrix. No increase was observed in other age groups. METHODS: Retrospective cohort study. From January 1, 2009 to December 31, 2010 we retrospectively followed the cohort of all children living in Finland and born from January 1991 through December 2005. Vaccination data of the whole population was obtained from primary health care databases. All new cases with assigned ICD-10 code of narcolepsy were identified and the medical records reviewed by two experts to classify the diagnosis of narcolepsy according to the Brighton collaboration criteria. Onset of narcolepsy was defined as the first documented contact to health care because of excessive daytime sleepiness. The primary follow-up period was restricted to August 15, 2010, the day before media attention on post-vaccination narcolepsy started. FINDINGS: Vaccination coverage in the cohort was 75%. Of the 67 confirmed cases of narcolepsy, 46 vaccinated and 7 unvaccinated were included in the primary analysis. The incidence of narcolepsy was 9.0 in the vaccinated as compared to 0.7/100,000 person years in the unvaccinated individuals, the rate ratio being 12.7 (95% confidence interval 6.1-30.8. The vaccine-attributable risk of developing narcolepsy was 1:16,000 vaccinated 4 to 19-year-olds (95% confidence interval 1:13,000-1:21,000. CONCLUSIONS: Pandemrix vaccine contributed to the onset of narcolepsy among those 4 to 19 years old during the pandemic influenza in 2009-2010 in Finland. Further studies are needed to determine whether this observation exists in other populations and to elucidate potential underlying immunological mechanism. The role of the adjuvant in particular warrants further research before drawing

  12. Post-event reviews: Using a quantitative approach for analysing incident response to demonstrate the value of business continuity programmes and increase planning efficiency.

    Science.gov (United States)

    Vaidyanathan, Karthik

    2017-01-01

    Business continuity management is often thought of as a proactive planning process for minimising impact from large-scale incidents and disasters. While this is true, and it is critical to plan for the worst, consistently validating plan effectiveness against smaller disruptions can enable an organisation to gain key insights about its business continuity readiness, drive programme improvements, reduce costs and provide an opportunity to quantitatively demonstrate the value of the programme to management. This paper describes a post mortem framework which is used as a continuous improvement mechanism for tracking, reviewing and learning from real-world events at Microsoft Customer Service & Support. This approach was developed and adopted because conducting regular business continuity exercises proved difficult and expensive in a complex and distributed operations environment with high availability requirements. Using a quantitative approach to measure response to incidents, and categorising outcomes based on such responses, enables business continuity teams to provide data-driven insights to leadership, change perceptions of incident root cause, and instil a higher level of confidence towards disaster response readiness and incident management. The scope of the framework discussed here is specific to reviewing and driving improvements from operational incidents. However, the concept can be extended to learning and evolving readiness plans for other types of incidents.

  13. Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy

    Directory of Open Access Journals (Sweden)

    Tan Murly BM

    2009-03-01

    Full Text Available Abstract Background Women at increased (genetic risk of breast cancer have to weigh the personal pros and cons of prophylactic mastectomy (PM as an option to reduce their cancer risk. So far, no routine referral to a psychologist has been investigated for women considering PM. Aim of this study was to asses: 1 the acceptance of the offer of a standard psychological consultation as part of pre-surgical decision-making in high-risk women, 2 reasons for PM and reasons for postponing it, 3 the need for additional psychological interventions, and factors associated, and 4 the frequency of psychiatric/psychological treatment history. Methods During a 30 months period, women at high risk considering PM were offered a psychological consultation. The content of these, and follow-up, consultations were analyzed. Results Most women (70 out of 73 accepted the psychological consultation, and 81% proceeded with PM. Main reasons for undergoing PM were to reduce anxiety about cancer, and to reduce the cancer risk. Uncertainty about surgery and the need for further information were the reasons given most frequently for postponing PM. Additional psychological support was given to 31% before and 14% after PM. The uptake of additional support was significantly higher in women with a BRCA1/2 mutation. A history of psychiatric/psychological treatment was present in 36%, mainly consisting of depression and grief after death of a mother. Conclusion The uptake-rate of the standard psychological consultation indicates a high level of acceptability of this service for women deciding about PM. Since anxiety is one of the main reasons for considering PM, and depression and grief were present in a third, a standard consultation with a psychologist for high-risk women considering PM may be indicated. This may help them arrive at an informed decision, to detect and manage psychological distress, and to plan psychological support services.

  14. Lay-screeners and use of WHO growth standards increase case finding of hospitalized Malawian children with severe acute malnutrition.

    Science.gov (United States)

    LaCourse, Sylvia M; Chester, Frances M; Preidis, Geoffrey; McCrary, Leah M; Maliwichi, Madalitso; McCollum, Eric D; Hosseinipour, Mina C

    2015-02-01

    Strategies to effectively identify and refer children with severe acute malnutrition (SAM) to Nutritional Rehabilitation units (NRU) can reduce morbidity and mortality. From December 2011 to May 2012, we conducted a prospective study task-shifting inpatient malnutrition screening of Malawian children 6-60 months to lay-screeners and evaluated World Health Organization (WHO) criteria vs. the National Center for Health Statistics (NCHS) guidelines for SAM. Lay-screeners evaluated 3116 children, identifying 368 (11.8%) with SAM by WHO criteria, including 210 (6.7%) who met NCHS criteria initially missed by standard clinician NRU referrals. Overall case finding increased by 56.7%. Mid-upper arm circumference (MUAC) and bipedal edema captured 86% (181/210) NCHS/NRU-eligible children and 89% of those who died (17/19) meeting WHO criteria. Mortality of NCHS/NRU-eligible children was 10 times greater than those without SAM (odds ratio 10.5, 95% confidence interval 5.4-20.6). Ward-based lay-screeners and WHO guidelines identified high-risk children with SAM missed by standard NRU referral. MUAC and edema detected the majority of NRU-eligible children. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Incidents with hazardous radiation sources

    International Nuclear Information System (INIS)

    Schoenhacker, Stefan

    2016-01-01

    Incidents with hazardous radiation sources can occur in any country, even those without nuclear facilities. Preparedness for such incidents is supposed to fulfill globally agreed minimum standards. Incidents are categorized in incidents with licensed handling of radiation sources as for material testing, transport accidents of hazardous radiation sources, incidents with radionuclide batteries, incidents with satellites containing radioactive inventory, incidents wit not licensed handling of illegally acquired hazardous radiation sources. The emergency planning in Austria includes a differentiation according to the consequences: incidents with release of radioactive materials resulting in restricted contamination, incidents with release of radioactive materials resulting in local contamination, and incidents with the hazard of e@nhanced exposure due to the radiation source.

  16. Pediatric inflammatory bowel disease: Increasing incidence, decreasing surgery rate, and compromised nutritional status: A prospective population-based cohort study 2007-2009

    DEFF Research Database (Denmark)

    Jakobsen, Christian; Paerregaard, Anders; Munkholm, Pia

    2011-01-01

    Background: The aim was to evaluate the incidence, treatment, surgery rate, and anthropometry at diagnosis of children with inflammatory bowel disease (IBD). Methods: Patients diagnosed between January 1, 2007 to December 31, 2009 in Eastern Denmark, Funen, and Aarhus were included from a backgro......Background: The aim was to evaluate the incidence, treatment, surgery rate, and anthropometry at diagnosis of children with inflammatory bowel disease (IBD). Methods: Patients diagnosed between January 1, 2007 to December 31, 2009 in Eastern Denmark, Funen, and Aarhus were included from...... a background population of 668,056 children evaluation of incidence, treatment, and surgery rate, a subcohort from Eastern Denmark was extracted for comparison with a previously published population-based cohort from the same geographical area (1998–2006). Results: In all, 130 children...... in the rate of initiating immunomodulators (IM) within the first year (29.0/100 person-years versus 69.2, P nutritional status at diagnosis compared with the general...

  17. Incidence of acute hepatitis B in different ethnic groups in a low-endemic country, 1992-2009: Increased risk in second generation migrants

    NARCIS (Netherlands)

    Whelan, Jane; Sonder, Gerard; Heuker, José; van den Hoek, Anneke

    2012-01-01

    Background: The Netherlands is a low-incidence country for acute hepatitis B (HBV) infection (1.2/100,000 in 2010), where it is typically acquired in adulthood through injecting drug use or homosexual exposure. Recently, the number of heterosexually acquired acute infections in the Netherlands has

  18. Excessive Atrial Ectopy and Short Atrial Runs Increase the Risk of Stroke Beyond Incident Atrial Fibrillation

    DEFF Research Database (Denmark)

    Larsen, Bjørn Strøier; Kumarathurai, Preman; Falkenberg, Julie

    2015-01-01

    .3% had diagnosed AF before their stroke. The incidence of stroke in subjects with ESVEA and a CHA2DS2-VASc (congestive heart failure, hypertension, age 75 years or older, diabetes mellitus, previous stroke or transient ischemic attack, vascular disease, age 65 to 74 years, female) score of ≥2 was 2...

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  20. The incidence of type 1 diabetes is still increasing in The Netherlands, but has stabilised in children under five (Young DUDEs-1)

    NARCIS (Netherlands)

    Spaans, Engelina A. J. M.; Gusdorf, Lisette M. A.; Groenier, Klaas H.; Brand, Paul L. P.; Veeze, Henk J.; Reeser, Hans M.; Bilo, Henk J. G.; Kleefstra, Nanne

    AIM: This study described the incidence and prevalence of type 1 diabetes in children in The Netherlands in 2010-2011 and to compare these results with earlier studies. METHODS: This was a retrospective nationwide cohort study of Dutch children aged 14 years or younger. Patients were identified

  1. Wheelchair incidents

    NARCIS (Netherlands)

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

    2002-01-01

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

  2. Standardized toxicity testing may underestimate ecotoxicity: Environmentally relevant food rations increase the toxicity of silver nanoparticles to Daphnia.

    Science.gov (United States)

    Stevenson, Louise M; Krattenmaker, Katherine E; Johnson, Erica; Bowers, Alexandra J; Adeleye, Adeyemi S; McCauley, Edward; Nisbet, Roger M

    2017-11-01

    Daphnia in the natural environment experience fluctuations in algal food supply, with periods when algal populations bloom and seasons when Daphnia have very little algal food. Standardized chronic toxicity tests, used for ecological risk assessment, dictate that Daphnia must be fed up to 400 times more food than they would experience in the natural environment (outside of algal blooms) for a toxicity test to be valid. This disconnect can lead to underestimating the toxicity of a contaminant. We followed the growth, reproduction, and survival of Daphnia exposed to 75 and 200 µg/L silver nanoparticles (AgNPs) at 4 food rations for up to 99 d and found that AgNP exposure at low, environmentally relevant food rations increased the toxicity of AgNPs. Exposure to AgNP at low food rations decreased the survival and/or reproduction of individuals, with potential consequences for Daphnia populations (based on calculated specific population growth rates). We also found tentative evidence that a sublethal concentration of AgNPs (75 µg/L) caused Daphnia to alter energy allocation away from reproduction and toward survival and growth. The present findings emphasize the need to consider resource availability, and not just exposure, in the environment when estimating the effect of a toxicant. Environ Toxicol Chem 2017;36:3008-3018. © 2017 SETAC. © 2017 SETAC.

  3. Increased Incidence of Herpes Zoster and Postherpetic Neuralgia in Adult Patients following Traumatic Brain Injury: A Nationwide Population-Based Study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Yi-Ching Tung

    Full Text Available The aims of this study were to estimate the incidences of herpes zoster (HZ and postherpetic neuralgia (PHN in patients after traumatic brain injury (TBI. Furthermore, we aimed to explore the risk factors of the development of HZ and PHN in patients after TBI. This population-based, longitudinal analysis was conducted using the Taiwan National Health Insurance Research Database (consisting of 1,000,000 beneficiaries from 1996 to 2010. Using the longitudinal National Health Insurance Research Database, we conducted a retrospective population-based cohort study to evaluate the incidence of HZ and PHN in adult TBI patients and controls. Kaplan-Meier analysis and Cox regression were used to compare differences in the development of HZ and PHN. The effects of gender, comorbidity and surgery on the risk of HZ and PHN development were assessed by subgroup analyses. Over a 15-year follow-up, the cumulative incidence of HZ in 28,234 TBI patients (604.00/100,000 person-years was significantly higher than 34,085 controls (322.21/100,000 person-years (P<0.0001, by log-rank test. Females showed a significantly higher incidence of HZ than males (p for interaction = 0.0010. The time to HZ development in the follow-up period was 5.9 years in TBI patients compared to 9.9 years in the control set (p <0.0001. TBI patients were 2.93 and 2.11 times likely to develop HZ and PHN, respectively, than the general population. The incidences of HZ and PHN in TBI patients were also significantly greater than for controls in the CCI = 0 subgroup. To our knowledge, this is the first population-based cohort study to reveal that TBI is an independent risk factor for HZ and PHN in TBI patients, especially in females. Physician should pay attention to the possibility of HZ and PHN in TBI patients and be aware that HZ vaccination early after brain trauma may lower the incidence of HZ and PHN.

  4. Incidence of pancreatic cancer in Denmark

    DEFF Research Database (Denmark)

    Weble, Tanja Cruusberg; Bjerregaard, Jon Kroll; Kissmeyer, Peter

    2017-01-01

    BACKGROUND: The aim of this study was to monitor the evolution of the incidence of pancreatic cancer in Denmark over 70 years. We also compared registrations of pancreatic cancer in a nationwide population-based database, the Danish Cancer Registry, and a clinical database, the Danish Pancreatic...... Cancer Database, in 2012-2013. MATERIAL AND METHODS: Registrations of pancreatic cancer from the Danish Cancer Registry over 1943-2012 were used to calculate age-specific incidence rates per 100 000 person years by sex and age in 5-year period, weighted by the Segi World Standard Population for age...... standardization. We used absolute numbers from the Cancer Registry and the Pancreatic Cancer Database, including distribution of topography of cancers registered in 2012-2013, to compare registration in the two data sources. RESULTS: The incidence rates of pancreatic cancer among Danish men increased until 1968...

  5. Spatially Extensive Standardized Surveys Reveal Widespread, Multi-Decadal Increase in East Antarctic Adélie Penguin Populations.

    Science.gov (United States)

    Southwell, Colin; Emmerson, Louise; McKinlay, John; Newbery, Kym; Takahashi, Akinori; Kato, Akiko; Barbraud, Christophe; DeLord, Karine; Weimerskirch, Henri

    2015-01-01

    Seabirds are considered to be useful and practical indicators of the state of marine ecosystems because they integrate across changes in the lower trophic levels and the physical environment. Signals from this key group of species can indicate broad scale impacts or response to environmental change. Recent studies of penguin populations, the most commonly abundant Antarctic seabirds in the west Antarctic Peninsula and western Ross Sea, have demonstrated that physical changes in Antarctic marine environments have profound effects on biota at high trophic levels. Large populations of the circumpolar-breeding Adélie penguin occur in East Antarctica, but direct, standardized population data across much of this vast coastline have been more limited than in other Antarctic regions. We combine extensive new population survey data, new population estimation methods, and re-interpreted historical survey data to assess decadal-scale change in East Antarctic Adélie penguin breeding populations. We show that, in contrast to the west Antarctic Peninsula and western Ross Sea where breeding populations have decreased or shown variable trends over the last 30 years, East Antarctic regional populations have almost doubled in abundance since the 1980's and have been increasing since the earliest counts in the 1960's. The population changes are associated with five-year lagged changes in the physical environment, suggesting that the changing environment impacts primarily on the pre-breeding age classes. East Antarctic marine ecosystems have been subject to a number of changes over the last 50 years which may have influenced Adélie penguin population growth, including decadal-scale climate variation, an inferred mid-20th century sea-ice contraction, and early-to-mid 20th century exploitation of fish and whale populations.

  6. Spatially Extensive Standardized Surveys Reveal Widespread, Multi-Decadal Increase in East Antarctic Adélie Penguin Populations.

    Directory of Open Access Journals (Sweden)

    Colin Southwell

    Full Text Available Seabirds are considered to be useful and practical indicators of the state of marine ecosystems because they integrate across changes in the lower trophic levels and the physical environment. Signals from this key group of species can indicate broad scale impacts or response to environmental change. Recent studies of penguin populations, the most commonly abundant Antarctic seabirds in the west Antarctic Peninsula and western Ross Sea, have demonstrated that physical changes in Antarctic marine environments have profound effects on biota at high trophic levels. Large populations of the circumpolar-breeding Adélie penguin occur in East Antarctica, but direct, standardized population data across much of this vast coastline have been more limited than in other Antarctic regions. We combine extensive new population survey data, new population estimation methods, and re-interpreted historical survey data to assess decadal-scale change in East Antarctic Adélie penguin breeding populations. We show that, in contrast to the west Antarctic Peninsula and western Ross Sea where breeding populations have decreased or shown variable trends over the last 30 years, East Antarctic regional populations have almost doubled in abundance since the 1980's and have been increasing since the earliest counts in the 1960's. The population changes are associated with five-year lagged changes in the physical environment, suggesting that the changing environment impacts primarily on the pre-breeding age classes. East Antarctic marine ecosystems have been subject to a number of changes over the last 50 years which may have influenced Adélie penguin population growth, including decadal-scale climate variation, an inferred mid-20th century sea-ice contraction, and early-to-mid 20th century exploitation of fish and whale populations.

  7. Are self-reported unhealthy food choices associated with an increased risk of breast cancer? Prospective cohort study using the British Food Standards Agency nutrient profiling system.

    Science.gov (United States)

    Deschasaux, Mélanie; Julia, Chantal; Kesse-Guyot, Emmanuelle; Lécuyer, Lucie; Adriouch, Solia; Méjean, Caroline; Ducrot, Pauline; Péneau, Sandrine; Latino-Martel, Paule; Fezeu, Léopold K; Fassier, Philippine; Hercberg, Serge; Touvier, Mathilde

    2017-06-08

    French authorities are considering the implementation of a simplified nutrition labelling system on food products to help consumers make healthier food choices. One of the most documented candidates (Five-Colour Nutrition Label/Nutri-score) is based on the British Food Standards Agency Nutrient Profiling System (FSA-NPS), a score calculated for each food/beverage using the 100 g amount of energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits and vegetables. To assess its potential public health relevance, studies were conducted on the association between the nutritional quality of the diet, measured at the individual level by an energy-weighted mean of all FSA-NPS scores of foods usually consumed (FSA-NPS dietary index (FSA-NPS DI)), and the risk of chronic diseases. The present study aimed at investigating the relationship between the FSA-NPS DI and breast cancer risk. Prospective study. Population based, NutriNet-Santé cohort, France. 46 864 women aged ≥35 years who completed ≥3 24-hour dietary records during their first 2 year of follow-up. Associations between FSA-NPS DI and breast cancer risk (555 incident breast cancers diagnosed between 2009 and 2015) were characterised by multivariable-adjusted Cox proportional hazard models. A higher FSA-NPS DI (lower nutritional quality of the diet) was associated with an increased breast cancer risk (HR 1-point increment =1.06 (1.02-1.11), p=0.005; HR Q5vs.Q1 =1.52 (1.11-2.08), p trend=0.002). Similar trends were observed in premenopausal and postmenopausal women (HR 1-point increment =1.09 (1.01-1.18) and 1.05 (1.00-1.11), respectively).This study was based on an observational cohort using self-reported dietary data, thus residual confounding cannot be entirely ruled out. Finally, this holistic approach does not allow investigating which factors in the diet most specifically influence breast cancer risk. These results suggested that unhealthy food choices, as characterised by the FSA-NPS, may

  8. Microbial Transglutaminase Used in Bread Preparation at Standard Bakery Concentrations Does Not Increase Immunodetectable Amounts of Deamidated Gliadin.

    Science.gov (United States)

    Heil, Andreas; Ohsam, Jürgen; van Genugten, Bernard; Diez, Oscar; Yokoyama, Keiichi; Kumazawa, Yoshiyuki; Pasternack, Ralf; Hils, Martin

    2017-08-16

    The effect of standard bakery concentrations of microbial transglutaminase (MTG) in wheat bread preparation on the immunoreactivity of sera of celiac disease (CD) patients was investigated. Immunoblotting using monoclonal antibodies specific to unmodified and/or deamidated gliadin showed no differences between control bread and MTG bread. Deamidation of gliadin could not be detected at standard MTG concentrations. Sera of CD patients were characterized using anti-gliadin and anti-deamidated gliadin peptide (DGP) enzyme-linked immunosorbent assay and grouped into DGP high- and low-titer pools. The recognition pattern obtained after using both CD sera pools for immunoblotting did not reveal differences between control and MTG-treated bread protein extracts. Our results indicate that MTG treatment of wheat bread prepared with typical MTG concentrations used in standard bakery processes does not lead to immunodetectable amounts of CD immunotoxic deamidated gliadins.

  9. Lundby revisited: first incidence of mental disorders 1947-1997

    DEFF Research Database (Denmark)

    Bogren, Mats; Mattisson, Cecilia; Horstmann, Vibeke

    2007-01-01

    OBJECTIVE: To investigate how first incidence of various mental disorders changed between the periods of 1947-1972 to 1972-1997 in the Lundby cohort. METHOD: First-incidence rates of mental disorders were calculated for two 25 year periods and ten 5 year periods. RESULTS: From 1947-1972 to 1972......-1997 a decrease in almost all age- and sex-specific incidences of neurotic and organic brain disorders was observed, whereas incidence rates of psychotic disorders increased consistently in male subjects but decreased in most age intervals in female subjects. For both sexes the age-standardized 5 year period...... incidences of neurotic disorders decreased after 1972, fluctuated for psychotic disorders 1947-1997 and decreased steadily for organic disorders 1947-1997. CONCLUSIONS: The reduction in neurotic and organic brain disorder incidences may be linked to structural changes in society and medical advances...

  10. Incidents analysis

    International Nuclear Information System (INIS)

    Francois, P.

    1996-01-01

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

  11. Incidents analysis

    Energy Technology Data Exchange (ETDEWEB)

    Francois, P

    1997-12-31

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

  12. Dietary standards for school catering in France: serving moderate quantities to improve dietary quality without increasing the food-related cost of meals.

    Science.gov (United States)

    Vieux, Florent; Dubois, Christophe; Allegre, Laëtitia; Mandon, Lionel; Ciantar, Laurent; Darmon, Nicole

    2013-01-01

    To assess the impact on food-related cost of meals to fulfill the new compulsory dietary standards for primary schools in France. A descriptive study assessed the relationship between the level of compliance with the standards of observed school meals and their food-related cost. An analytical study assessed the cost of series of meals published in professional journals, and complying or not with new dietary standards. The costs were based on prices actually paid for food used to prepare school meals. Food-related cost of meals. Parametric and nonparametric tests from a total of 42 and 120 series of 20 meals in the analytical and descriptive studies, respectively. The descriptive study indicated that meeting the standards was not related to cost. The analytical study showed that fulfilling the frequency guidelines increased the cost, whereas fulfilling the portion sizes criteria decreased it. Series of meals fully respecting the standards (ie, frequency and portion sizes) cost significantly less (-0.10 €/meal) than series not fulfilling them, because the standards recommend smaller portion sizes. Introducing portion sizes rules in dietary standards for school catering may help increase dietary quality without increasing the food cost of meals. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  13. Increased incidence of murine graft-versus-host disease after allogeneic bone marrow transplantation by previous infusion of syngeneic bone marrow cells

    International Nuclear Information System (INIS)

    Waer, M.; Ang, K.K.; van der Schueren, E.; Vandeputte, M.

    1984-01-01

    Different groups of BALB/c mice received supralethal total-body irradiation (TBI; 8.5 Gy, day 0). When 30 x 10(6) allogeneic (C57B1) bone marrow (BM) cells were infused with or without 10 x 10(6) syngeneic (BALB/c) bM cells on day 1, many animals (60%) died from graft-versus-host disease (GVHD). Typing of peripheral blood leukocytes for donor antigens showed that, respectively, 22/22 and 17/21 of the mice in both groups became chimeric. When syngeneic bone marrow was given on day 1 and allogeneic bone marrow on day 2 after TBI, a similar number of animals (21/23) became chimeric, but GVHD occurred more frequently in this group (25/26 mice, P less than 0.01). When the syngeneic bone marrow cells were replaced by spleen cells, or when the transplantation of allogeneic bone marrow was delayed till days 3 or 6 after TBI, almost all mice rejected the allogeneic BM graft and became long-term survivors. BALB/c mice receiving 30 x 10(6) C57B1 BM cells after 17 daily fractions of 0.2 Gy of total lymphoid irradiation (TLI), showed a high incidence of chimerism (15/17) and in none of the latter animals was GVHD observed. Despite the high incidence of GVHD in the mice receiving allogeneic BM after TBI and syngeneic BM transplantation, as compared with mice prepared with TLI which do not develop GVHD, suppressor cells were as easily induced after TBI and syngeneic BM transplantation as after TLI

  14. Limiting global-mean temperature increase to 1.5–2 °C could reduce the incidence and spatial spread of dengue fever in Latin America

    Science.gov (United States)

    Harris, Ian; Osborn, Timothy J.; Steiner São Bernardo, Christine; Peres, Carlos A.; Lake, Iain R.

    2018-01-01

    The Paris Climate Agreement aims to hold global-mean temperature well below 2 °C and to pursue efforts to limit it to 1.5 °C above preindustrial levels. While it is recognized that there are benefits for human health in limiting global warming to 1.5 °C, the magnitude with which those societal benefits will be accrued remains unquantified. Crucial to public health preparedness and response is the understanding and quantification of such impacts at different levels of warming. Using dengue in Latin America as a study case, a climate-driven dengue generalized additive mixed model was developed to predict global warming impacts using five different global circulation models, all scaled to represent multiple global-mean temperature assumptions. We show that policies to limit global warming to 2 °C could reduce dengue cases by about 2.8 (0.8–7.4) million cases per year by the end of the century compared with a no-policy scenario that warms by 3.7 °C. Limiting warming further to 1.5 °C produces an additional drop in cases of about 0.5 (0.2–1.1) million per year. Furthermore, we found that by limiting global warming we can limit the expansion of the disease toward areas where incidence is currently low. We anticipate our study to be a starting point for more comprehensive studies incorporating socioeconomic scenarios and how they may further impact dengue incidence. Our results demonstrate that although future climate change may amplify dengue transmission in the region, impacts may be avoided by constraining the level of warming. PMID:29844166

  15. Incidence of epilepsy in Ferrara, Italy.

    Science.gov (United States)

    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.

  16. Creating a standardized process to offer the standard of care: continuous process improvement methodology is associated with increased rates of sperm cryopreservation among adolescent and young adult males with cancer.

    Science.gov (United States)

    Shnorhavorian, Margarett; Kroon, Leah; Jeffries, Howard; Johnson, Rebecca

    2012-11-01

    There is limited literature on strategies to overcome the barriers to sperm banking among adolescent and young adult (AYA) males with cancer. By standardizing our process for offering sperm banking to AYA males before cancer treatment, we aimed to improve rates of sperm banking at our institution. Continuous process improvement is a technique that has recently been applied to improve health care delivery. We used continuous process improvement methodologies to create a standard process for fertility preservation for AYA males with cancer at our institution. We compared rates of sperm banking before and after standardization. In the 12-month period after implementation of a standardized process, 90% of patients were offered sperm banking. We demonstrated an 8-fold increase in the proportion of AYA males' sperm banking, and a 5-fold increase in the rate of sperm banking at our institution. Implementation of a standardized process for sperm banking for AYA males with cancer was associated with increased rates of sperm banking at our institution. This study supports the role of standardized health care in decreasing barriers to sperm banking.

  17. Female breast cancer incidence and mortality in China, 2013

    Science.gov (United States)

    Zuo, Ting‐Ting; Zheng, Rong‐Shou; Zeng, Hong‐Mei; Zhang, Si‐Wei

    2017-01-01

    Background Breast cancer is the most common cancer among women. Population‐based cancer registration data from the National Central Cancer Registry were used to analyze and evaluate the incidence and mortality rates in China in 2013, providing scientific information for cancer prevention and control. Methods Pooled data were stratified by area (urban/rural), gender, and age group. National new cases and deaths were estimated using age‐specific rates and the corresponding population in 2013. The Chinese population in 2000 and Segi's world population were used to calculate age‐standardized rates. Results The estimated number of new breast cancer cases was about 278 800 in China in 2013. The crude incidence, age‐standardized rate of incidence by Chinese standard population, and age‐standardized rate of incidence by world standard population were 42.02/100 000, 30.41/100 000, and 28.42/100 000, respectively. The estimated number of breast cancer deaths was about 64 600 in China in 2013. The crude mortality, age‐standardized rate of mortality by Chinese standard population, and age‐standardized rate of mortality by world standard population were 9.74/100 000, 6.54/100 000, and 6.34/100 000, respectively. Both incidence and mortality were higher in urban than in rural areas. Age‐specific breast cancer incidence significantly increased with age, particularly after age 20, and peaked at 50–55 years, while age‐specific mortality increased rapidly after 25 years, peaking at 85+ years. Conclusions Breast cancer is the most common cancer in Chinese women, especially women in urban areas. Comprehensive measures are needed to reduce the heavy burden of breast cancer. PMID:28296260

  18. Constitutive expression of tert in thymocytes leads to increased incidence and dissemination of T-cell lymphoma in Lck-Tert mice.

    Science.gov (United States)

    Canela, Andrés; Martín-Caballero, Juan; Flores, Juana M; Blasco, María A

    2004-05-01

    Here we describe a new mouse model with constitutive expression of the catalytic subunit of telomerase (Tert) targeted to thymocytes and peripheral T cells (Lck-Tert mice). Two independent Lck-Tert mouse lines showed higher incidences of spontaneous T-cell lymphoma than the corresponding age-matched wild-type controls, indicating that constitutive expression of Tert promotes lymphoma. Interestingly, T-cell lymphomas in Lck-Tert mice were more disseminated than those in wild-type controls and affected both lymphoid and nonlymphoid tissues, while nonlymphoid tissues were never affected with lymphoma in age-matched wild-type controls. Importantly, these roles of Tert constitutive expression in promoting tumor progression and dissemination were independent of the role of telomerase in telomere length maintenance, since telomere length distributions on a single-cell basis were identical in Lck-Tert and wild-type thymocytes. Finally, Tert constitutive expression did not interfere with telomere capping in Lck-Tert primary thymocytes, although it resulted in greater chromosomal instability upon gamma irradiation in Lck-Tert primary lymphocytes than in controls, suggesting that Tert overexpression may interfere with the cellular response to DNA damage.

  19. Low incidence of clonality in cold water corals revealed through the novel use of a standardized protocol adapted to deep sea sampling

    Science.gov (United States)

    Becheler, Ronan; Cassone, Anne-Laure; Noël, Philippe; Mouchel, Olivier; Morrison, Cheryl L.; Arnaud-Haond, Sophie

    2017-11-01

    Sampling in the deep sea is a technical challenge, which has hindered the acquisition of robust datasets that are necessary to determine the fine-grained biological patterns and processes that may shape genetic diversity. Estimates of the extent of clonality in deep-sea species, despite the importance of clonality in shaping the local dynamics and evolutionary trajectories, have been largely obscured by such limitations. Cold-water coral reefs along European margins are formed mainly by two reef-building species, Lophelia pertusa and Madrepora oculata. Here we present a fine-grained analysis of the genotypic and genetic composition of reefs occurring in the Bay of Biscay, based on an innovative deep-sea sampling protocol. This strategy was designed to be standardized, random, and allowed the georeferencing of all sampled colonies. Clonal lineages discriminated through their Multi-Locus Genotypes (MLG) at 6-7 microsatellite markers could thus be mapped to assess the level of clonality and the spatial spread of clonal lineages. High values of clonal richness were observed for both species across all sites suggesting a limited occurrence of clonality, which likely originated through fragmentation. Additionally, spatial autocorrelation analysis underlined the possible occurrence of fine-grained genetic structure in several populations of both L. pertusa and M. oculata. The two cold-water coral species examined had contrasting patterns of connectivity among canyons, with among-canyon genetic structuring detected in M. oculata, whereas L. pertusa was panmictic at the canyon scale. This study exemplifies that a standardized, random and georeferenced sampling strategy, while challenging, can be applied in the deep sea, and associated benefits outlined here include improved estimates of fine grained patterns of clonality and dispersal that are comparable across sites and among species.

  20. Improved safety of the system 80+TM standard plants design through increased diversity and redundancy of safety systems

    International Nuclear Information System (INIS)

    Matzie, Regis A.; Carpentino, Frederick L.; Robertson, James E.

    1996-01-01

    Safely systems in the System 80+ TM Standard Plant are designed with more redundancy, diversity and simplicity than earlier nuclear power plant designs. These gains were accomplished by an evolutionary process that preserved the desirable and proven features in currently operating nuclear plants, while improving reliability and defense-in-depth. The System 80+ safety systems are the primary contributors to a core damage frequency that is more than 100 times lower than 1980's vintage U. S. designs, including the predecessor System 80 R standard nuclear steam supply system (NSSS) design. The System 80+ design includes significant improvements to the safety injection system, emergency feedwater system, shutdown cooling system, containment spray system, reactor coolant gas vent system, and to their vital support systems. These improvements enhance performance for traditional design basis events and significantly reduce the probability of a severe accident. The System 80+ design also incorporates safety systems to mitigate a severe accident. The added systems include the rapid depressurization system, the in-containment refueling water storage tank, the cavity flooding system. These systems fully address the U. S. Nuclear Regulatory Commission's (US NRC) severe accident policy. The System 80+ safety systems are integrated with the System 80+ Nuclear Island (NI) design. The NI general arrangement provides quadrant separation of the safety systems for protection from fire and flooding, and large equipment pull spaces and lay down areas for maintenance. This paper will describe the System 80+ safety systems advanced design features, the improved accident prevention and mitigation capabilities, and startup, operating and maintenance benefits

  1. Global incidence and outcome of testicular cancer

    Science.gov (United States)

    Shanmugalingam, Thurkaa; Soultati, Aspasia; Chowdhury, Simon; Rudman, Sarah; Van Hemelrijck, Mieke

    2013-01-01

    Background Testicular cancer is a rare tumor type accounting for 1% of malignancies in men. It is, however, the most common cancer in young men in Western populations. The incidence of testicular cancer is increasing globally, although a decline in mortality rates has been reported in Western countries. It is important to identify whether the variations in trends observed between populations are linked to genetic or environmental factors. Methods Age-standardized incidence rates and age-standardized mortality rates for testicular cancer were obtained for men of all ages in ten countries from the Americas, Asia, Europe, and Oceania using the Cancer Incidence in Five Continents (CI5plus) and World Health Organization (WHO) mortality databases. The annual percent change was calculated using Joinpoint regression to assess temporal changes between geographical regions. Results Testicular cancer age-standardized incidence rates are highest in New Zealand (7.8), UK (6.3), Australia (6.1), Sweden (5.6), USA (5.2), Poland (4.9), and Spain (3.8) per 100,000 men. India, China, and Colombia had the lowest incidence (0.5, 1.3, and 2.2, respectively) per 100,000 men. The annual percent changes for overall testicular cancer incidence significantly increased in the European countries Sweden 2.4%, (2.2; 2.6); UK 2.9%, (2.2; 3.6); and Spain 5.0%, (1.7; 8.4), Australia 3.0%, (2.2; 3.7), and China 3.5%, (1.9; 5.1). India had the lowest overall testicular cancer incidence −1.7%, (−2.5; −0.8). Annual percent changes for overall testicular cancer mortality rates were decreasing in all study populations, with the greatest decline observed in Sweden −4.2%, (−4.8; −3.6) and China −4.9%, (−6.5; −3.3). Conclusion Testicular cancer is increasing in incidence in many countries; however, mortality rates remain low and most men are cured. An understanding of the risks and long-term side effects of treatment are important in managing men with this disease. PMID:24204171

  2. Should modest elevations in prostate-specific antigen, International Prostate Symptom Score, or their rates of increase over time be used as surrogate measures of incident benign prostatic hyperplasia?

    Science.gov (United States)

    Schenk, Jeannette M; Hunter-Merrill, Rachel; Zheng, Yingye; Etzioni, Ruth; Gulati, Roman; Tangen, Catherine; Thompson, Ian M; Kristal, Alan R

    2013-09-01

    Although surrogate measures of benign prostatic hyperplasia (BPH) are often used in epidemiologic studies, their performance characteristics are unknown. Using data from the Prostate Cancer Prevention Trial (n = 5,986), we evaluated prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS), and their rates of change as predictors of incident BPH. BPH (n = 842 cases) was defined as medical or surgical treatment or at least 2 IPSS of 15 or higher. Proportional hazards models were used to measure the associations of baseline PSA, IPSS, and their velocities over 2 years with BPH risk, and time-dependent receiver-operating characteristic curves were used to measure their discriminatory performance. Unit increases in PSA, IPSS, and IPSS velocity were associated with 34%, 35%, and 29% (all P specificity were both above 75%. We concluded that moderate elevations in PSA, IPSS, or their rates of change should not be used as surrogate measures of incident BPH.

  3. Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy

    NARCIS (Netherlands)

    M.B.M. Tan; E.M.A. Bleiker (Eveline); M.B.E. Menke-Pluymers (Marian); A.R. van Gool (Arthur); S. van Dooren (Silvia); B.N. van Geel (Bert); M.M.A. Tilanus-Linthorst (Madeleine); C.C.M. Bartels (Carina); J.G.M. Klijn (Jan); C.T. Brekelmans (Cecile); C.M. Seynaeve (Caroline)

    2009-01-01

    textabstractBackground: Women at increased (genetic) risk of breast cancer have to weigh the personal pros and cons of prophylactic mastectomy (PM) as an option to reduce their cancer risk. So far, no routine referral to a psychologist has been investigated for women considering PM. Aim of this

  4. Ovary cancer incidence and mortality in China, 2011.

    Science.gov (United States)

    Wei, Kuangrong; Li, Yuanming; Zheng, Rongshou; Zhang, Siwei; Liang, Zhiheng; Cen, Huishan; Chen, Wanqing

    2015-02-01

    To evaluate and analyze ovary cancer incidence and mortality in China in 2011 using ovary cancer data from population-based cancer registration in China, and to provide scientific information for its control and prevention. Invasive cases of ovary cancer were extracted and analyzed from the overall Chinese cancer database in 2011, which were based on data from 177 population-based cancer registries distributing in 28 provinces. The crude, standardized, and truncated incidences and mortalities et al. were calculated and new and deaths cases from ovary cancer throughout China and in different regions in 2011 were estimated using Chinese practical population. The estimates of new ovary cancer cases and deaths were 45,223 and 18,430, respectively, in China in 2011. The crude incidence rate, age-standardized rate by Chinese standard population (ASR-C) and age-standardized rate by world standard population (ASR-W) incidence were 6.89/100,000, 5.35/100,000 and 5.08/100,000, respectively; the crude, ASR-C and ASR-W mortalities were 2.81/100,000, 2.01/100,000 and 1.99/100,000, respectively. The incidence and mortality in urban areas were higher than those in rural areas. The age-specific incidence and mortality increased rapidly from age 35-39 and peaked at age 60-64 or 75-79 years. After age 45 or 55, the age-specific incidence and death rates in urban were much higher than those in rural areas. Compared with GLOBOCAN 2012 data, the ovary cancer incidence in China in 2011 was at middle level, but its mortality was at low level worldwide.

  5. Hepatoblastoma incidence in Taiwan: A population-based study

    Directory of Open Access Journals (Sweden)

    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

  6. The effect of climate variability on urinary stone attacks: increased incidence associated with temperature over 18 °C: a population-based study.

    Science.gov (United States)

    Park, Hyoung Keun; Bae, Sang Rak; Kim, Satbyul E; Choi, Woo Suk; Paick, Sung Hyun; Ho, Kim; Kim, Hyeong Gon; Lho, Yong Soo

    2015-02-01

    The aim of this study was to evaluate the effect of seasonal variation and climate parameters on urinary tract stone attack and investigate whether stone attack is increased sharply at a specific point. Nationwide data of total urinary tract stone attack numbers per month between January 2006 and December 2010 were obtained from the Korean Health Insurance Review and Assessment Service. The effects of climatic factors on monthly urinary stone attack were assessed using auto-regressive integrated moving average (ARIMA) regression method. A total of 1,702,913 stone attack cases were identified. Mean monthly and monthly average daily urinary stone attack cases were 28,382 ± 2,760 and 933 ± 85, respectively. The stone attack showed seasonal trends of sharp incline in June, a peak plateau from July to September, and a sharp decline after September. The correlation analysis showed that ambient temperature (r = 0.557, p r = 0.513, p stone attack cases. However, after adjustment for trends and seasonality, ambient temperature was the only climate factor associated with the stone attack cases in ARIMA regression test (p = 0.04). Threshold temperature was estimated as 18.4 °C. Risk of urinary stone attack significantly increases 1.71% (1.02-2.41 %, 95% confidence intervals) with a 1 °C increase of ambient temperature above the threshold point. In conclusion, monthly urinary stone attack cases were changed according to seasonal variation. Among the climates variables, only temperature had consistent association with stone attack and when the temperature is over 18.4 °C, urinary stone attack would be increased sharply.

  7. Increased Incidence and Altered Risk Demographics of Childhood Lead Poisoning: Predicting the Impacts of the CDC’s 5 µg/dL Reference Value in Massachusetts (USA)

    Science.gov (United States)

    Handler, Phoebe; Brabander, Daniel

    2012-01-01

    In May 2012, the CDC adopted a new sliding scale reference value for childhood lead poisoning, reducing the former 10 µg/dL benchmark by half. Using Massachusetts (MA) as a model state, we estimated the change in the population of 9–47 month-olds at risk for lead poisoning. We then examined the impact of the 5 µg/dL reference value on the demographic characteristics of lead risk in MA communities. We find that the new CDC benchmark will lead to a 1470% increase in childhood lead poisoning cases among 9–47 month-olds in MA, with nearly 50% of the examined communities experiencing an increased prevalence of lead poisoning. Further, the top 10 MA communities with BLLs ≥5 µg/dL have significantly fewer foreign-born residents and significantly larger white populations than the highest risk communities formerly identified by the MA Childhood Lead Poisoning Prevention Program. The CDC’s new 5 µg/dL lead poisoning benchmark will drastically increase the number of children with elevated BLLs and alter the distribution and demographics high-risk communities in MA. PMID:23202824

  8. Safety-evaluation report related to the license renewal and power increase for the National Bureau of Standards Reactor (Docket No. 50-184)

    International Nuclear Information System (INIS)

    1983-09-01

    This Safety Evaluation Report for the application filed by the National Bureau of Standards (NBS) for an increase in power from 10 MWt to 20 MWt and for a renewal of the Operating License TR-5 to continue to operate the test reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located in Gaithersburg, Maryland, on the site of the National Bureau of Standards, which is a bureau of the Department of Commerce. The staff concludes that the NBS reactor can operate at the 20 MWt power level without endangering the health and safety of the public

  9. Zoledronic acid preserves bone structure and increases survival but does not limit tumour incidence in a prostate cancer bone metastasis model.

    Directory of Open Access Journals (Sweden)

    Tzong-Tyng Hung

    Full Text Available BACKGROUND: The bisphosphonate, zoledronic acid (ZOL, can inhibit osteoclasts leading to decreased osteoclastogenesis and osteoclast activity in bone. Here, we used a mixed osteolytic/osteoblastic murine model of bone-metastatic prostate cancer, RM1(BM, to determine how inhibiting osteolysis with ZOL affects the ability of these cells to establish metastases in bone, the integrity of the tumour-bearing bones and the survival of the tumour-bearing mice. METHODS: The model involves intracardiac injection for arterial dissemination of the RM1(BM cells in C57BL/6 mice. ZOL treatment was given via subcutaneous injections on days 0, 4, 8 and 12, at 20 and 100 µg/kg doses. Bone integrity was assessed by micro-computed tomography and histology with comparison to untreated mice. The osteoclast and osteoblast activity was determined by measuring serum tartrate-resistant acid phosphatase 5b (TRAP 5b and osteocalcin, respectively. Mice were euthanased according to predetermined criteria and survival was assessed using Kaplan Meier plots. FINDINGS: Micro-CT and histological analysis showed that treatment of mice with ZOL from the day of intracardiac injection of RM1(BM cells inhibited tumour-induced bone lysis, maintained bone volume and reduced the calcification of tumour-induced endochondral osteoid material. ZOL treatment also led to a decreased serum osteocalcin and TRAP 5b levels. Additionally, treated mice showed increased survival compared to vehicle treated controls. However, ZOL treatment did not inhibit the cells ability to metastasise to bone as the number of bone-metastases was similar in both treated and untreated mice. CONCLUSIONS: ZOL treatment provided significant benefits for maintaining the integrity of tumour-bearing bones and increased the survival of tumour bearing mice, though it did not prevent establishment of bone-metastases in this model. From the mechanistic view, these observations confirm that tumour-induced bone lysis is not a

  10. Serological response of pigs to a standard and increased dose of foot-and-mouth disease vaccine

    International Nuclear Information System (INIS)

    Sims, L.D.; Dyrting, K.C.; Wong, K.W.

    2000-01-01

    Two randomly allocated age-matched groups of 17 conventionally reared pigs derived from vaccinated sows were vaccinated at 10 and 14 weeks of age with a commercially available foot-and-mouth disease vaccine, using either a 1 mL dose or a 3 mL dose. A control group of four pigs was left unvaccinated. Pigs were monitored at regular intervals from birth to 26 weeks of age for antibodies to FMD Type O virus using a liquid phase blocking ELISA. At 12 weeks post vaccination, significantly more pigs vaccinated twice with 3 mL of vaccine had developed antibodies against Type O foot-and-mouth disease virus (at an ELISA titre of 90 or greater) than those vaccinated twice with 1 mL of vaccine (chi-squared test, p = 0.006). Overall, the response to vaccination was poor in both groups of pigs. Four weeks after the first dose of vaccine only four pigs had detectable antibody against the virus. Twelve weeks after the second dose of vaccine only 60% of pigs given the 3 mL dose and 15% of pigs given the 1 mL dose had ELISA titres of 90 or greater. Maternal antibody is considered to have played a role in this poor response, as it was present in 27 of the 34 vaccinated pigs at the time of first vaccination. Two pigs in the unvaccinated control group developed a low level antibody response (antibody titre <90). Infection with field virus was considered a highly unlikely cause of this. These results show, that under field conditions using a widely adopted protocol not all pigs vaccinated develop antibody to foot-and-mouth disease. This, in part, may explain why vaccination programmes against this disease in Hong Kong seem to have a limited impact. The results also suggest, that an increased dose of vaccine has a positive effect on the humoral immune response against FMD virus and may improve protection against this disease. Timing of vaccination needs to be re-evaluated to reduce the impact of maternally derived antibodies. (author)

  11. Clozapine usage increases the incidence of pneumonia compared with risperidone and the general population: a retrospective comparison of clozapine, risperidone, and the general population in a single hospital over 25 months.

    Science.gov (United States)

    Stoecker, Zachary R; George, Wales T; O'Brien, Jeffrey B; Jancik, Jon; Colon, Eduardo; Rasimas, Joseph J

    2017-05-01

    The aim of this study was to determine whether the incidence of pneumonia in patients taking clozapine was more frequent compared with those taking risperidone or no atypical antipsychotics at all before admission to a tertiary care medical center. This was a retrospective, case-matched study of 465 general medicine patients over a 25 month period from 1 July 2010 to 31 July 2012. Detailed electronic medical records were analyzed to explore the association between the use of two atypical antipsychotics and incidence of pneumonia. Of the 155 patients in the clozapine group, 54 (34.8%) had documented pneumonia compared with 22 (14.2%) in the risperidone group and 18 (11.6%) in the general population group. Clozapine, when compared with the untreated general population, was associated with an increased risk of pneumonia (odds ratio=4.07; 95% confidence interval=2.25-7.36). There was, however, no significant increase in the risk of pneumonia associated with the use of risperidone (odds ratio=1.26; 95% confidence interval=0.65-2.45). Clozapine use is associated with increased risk of pneumonia that may be related to immunologic factors or side effects of sedation and drooling that make aspiration more likely, although causative mechanisms require further investigation. These findings suggest that providers should use added caution in choosing candidates for clozapine therapy.

  12. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.

    1992-01-01

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

  13. 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....

  14. [Increase in the incidence of invasive pneumococcal disease caused by serotype 19A prior to the implementation of the expanded pneumococcal vaccines].

    Science.gov (United States)

    González Martínez, F; Saavedra Lozano, J; Navarro Gómez, M L; Santos Sebastián, M M; Rodríguez Fernández, R; González Sánchez, M; Hernández-Sampelayo Matos, T

    2013-11-01

    To describe the epidemiology, clinical syndromes and microbiological characteristics of serotype 19A as the main cause of invasive pneumococcal disease (IPD) in children admitted to a tertiary hospital in Spain. A retrospective (1998-2004) and prospective (2005-2009) study was conducted on children with IPD produced by serotype 19A. The study was divided into three periods (P): P1 (1998-2001) when PCV7 had not been commercialized; P2 (2002-2005) with 40% vaccine coverage among children; and P3 (2006-2009) when the vaccine was added to the Childhood Immunization Schedule in Madrid. A total of 155 isolates of Streptococcus pneumoniae (SP) producing IPD were analysed, with 21 of them being serotype 19A (14%). An increased prevalence of serotype 19A was found: 2/45 cases (4.4%) in P1, 3/41 cases (7.3%) in P2 and 16/69 cases (23.2%) in P3. It occurred mostly in children younger than 2 years (16/21; 76%). This serotype was the main cause of meningitis (5/20; 25%), pleural empyema (3/22; 14%) and bacteraemic mastoiditis (2/4; 50%). Thirteen isolates (61.5%) had an MIC ≥ 0.12μ/ml for penicillin in extra-meningeal infections, and 3 of the 5 isolates causing meningitis (60%) had an MIC ≥ 1μ/ml for cefotaxime. Serotype 19A was the main causal agent of IPD in the PCV7 era (P3), with high antibiotic resistance rates. This serotype was responsible for all types of IPD, being the main cause of meningitis. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  15. Incident users of antipsychotics

    DEFF Research Database (Denmark)

    Baandrup, Lone; Kruse, Marie

    2016-01-01

    PURPOSE: In Denmark, as well as in many other countries, consumption of antipsychotics is on the rise, partly due to increasing off-label use. The aim of this study was to analyze and quantify the extent of off-label use and polypharmacy in incident users of antipsychotic medication, and to examine...

  16. 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...

  17. Global Incidence and Mortality for Prostate Cancer: Analysis of Temporal Patterns and Trends in 36 Countries.

    Science.gov (United States)

    Wong, Martin C S; Goggins, William B; Wang, Harry H X; Fung, Franklin D H; Leung, Colette; Wong, Samuel Y S; Ng, Chi Fai; Sung, Joseph J Y

    2016-11-01

    Prostate cancer (PCa) is a leading cause of mortality and morbidity globally, but its specific geographic patterns and temporal trends are under-researched. To test the hypotheses that PCa incidence is higher and PCa mortality is lower in countries with higher socioeconomic development, and that temporal trends for PCa incidence have increased while mortality has decreased over time. Data on age-standardized incidence and mortality rates in 2012 were retrieved from the GLOBOCAN database. Temporal patterns were assessed for 36 countries using data obtained from Cancer incidence in five continents volumes I-X and the World Health Organization mortality database. Correlations between incidence or mortality rates and socioeconomic indicators (human development index [HDI] and gross domestic product [GDP]) were evaluated. The average annual percent change in PCa incidence and mortality in the most recent 10 yr according to join-point regression. Reported PCa incidence rates varied more than 25-fold worldwide in 2012, with the highest incidence rates observed in Micronesia/Polynesia, the USA, and European countries. Mortality rates paralleled the incidence rates except for Africa, where PCa mortality rates were the highest. Countries with higher HDI (r=0.58) and per capita GDP (r=0.62) reported greater incidence rates. According to the most recent 10-yr temporal data available, most countries experienced increases in incidence, with sharp rises in incidence rates in Asia and Northern and Western Europe. A substantial reduction in mortality rates was reported in most countries, except in some Asian countries and Eastern Europe, where mortality increased. Data in regional registries could be underestimated. PCa incidence has increased while PCa mortality has decreased in most countries. The reported incidence was higher in countries with higher socioeconomic development. The incidence of prostate cancer has shown high variations geographically and over time, with smaller

  18. The incidence of congenital hypotyroidism is increasing

    DEFF Research Database (Denmark)

    Leunbach, Tina Lund; Christensen, Pia Sønderby; Kristensen, Kurt

    2017-01-01

    The prognosis of primary congenital hypothyroidism, which has potentially devastating effects on neurodevelopment, has been almost eradicated after the implementation of the neonatal screening programme. Although early facilitation with substitution of levothyroxine is preventative, caution shoul...

  19. Cancer incidence among Nordic airline cabin crew.

    Science.gov (United States)

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

    2012-12-15

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

  20. [Incidence and mortality of female breast cancer in China, 2014].

    Science.gov (United States)

    Li, H; Zheng, R S; Zhang, S W; Zeng, H M; Sun, K X; Xia, C F; Yang, Z X; Chen, W Q; He, J

    2018-03-23

    rate of mortality by world standard population (ASRMW) of breast cancer were 9.90/100 000, 6.53/100 000, and 6.35/100 000, respectively, with a cumulative mortality rate of 0.69%. The crude mortality rates and ASRMC in urban areas were 11.48 per 100 000 and 7.04 per 100 000, respectively, whereas those were 7.93 per 100 000 and 5.79 per 100 000 in rural areas. The incidence and mortality rates of breast cancer were higher in areas than those in rural areas. The age-specific incidence rates of breast cancer increased greatly after 20 years old and peaked at the age group of 55-60. The age-specific mortality rates increased rapidly with age, particularly after 25 years old. They remained at a relative stable level from 55 to 65 years of age, and then increased dramatically and peaked in the age group of 85 and above. Conclusions: Breast cancer is still one of the most common malignant tumor threatening to famale health in China. The disease is more prevalent in urban areas at the age group of 55-60. Comprehensive prevention and control strategies referring to local status and age groups should be carried out to reduce the burden of breast cancer.

  1. The power of the age standardized incidence rate to discover the gene link between cancer diseases: development of a new epidemiological method to save money, time, and effort for genetic scientists.

    Science.gov (United States)

    Alghamdi, Ibrahim G; Hussain, Issam I; Alghamdi, Mohamed S; El-Sheemy, Mohammed A

    2015-01-01

    This study provides an incipient epidemiological rule using the concept of direct method of standardization to determine the genetic link between cancer diseases. The overall 8 or 10 years age standardized incidence rate (ASIR) for both cancer diseases, for example (A) and (B) should be calculated for all regions of the country. A line chart should be used to display the overall ASIR trend of both diseases (A and B). Pearson's correlation can be used to determine the strength of the association between the overall ASIRs of both diseases. The overlap or opposite direction of the overall ASIR trend of both diseases (A and B) should be determined and studied for possible associations between cancer diseases. If the trend of the overall 8 or 10 years ASIR of a disease (A) follows that of disease (B) in all regions of the country, then the genes of patients with both diseases (A and B) will be highly homogeneous, and they should be studied in the region with the highest and lowest overall ASIR for both diseases (A and B). In addition, if there is an opposite direction or overlapping trend for both diseases (A and B) in certain regions of the country or among specific groups of people with the same demographic characteristics, then the genes of patients will be investigated for both diseases to identify the potential gene link between cancer diseases. This study revealed that the overall ASIR trends of female breast cancer, prostate cancer, and ovarian cancer are very similar in all regions of Saudi Arabia and England. Our epidemiological evidence helps to save money, time, and effort for testing the potential gene link between cancer diseases.

  2. The power of the age standardized incidence rate to discover the gene link between cancer diseases: development of a new epidemiological method to save money, time, and effort for genetic scientists

    Science.gov (United States)

    Alghamdi, Ibrahim G; Hussain, Issam I; Alghamdi, Mohamed S; El-Sheemy, Mohammed A

    2015-01-01

    Background This study provides an incipient epidemiological rule using the concept of direct method of standardization to determine the genetic link between cancer diseases. Methods The overall 8 or 10 years age standardized incidence rate (ASIR) for both cancer diseases, for example (A) and (B) should be calculated for all regions of the country. A line chart should be used to display the overall ASIR trend of both diseases (A and B). Pearson’s correlation can be used to determine the strength of the association between the overall ASIRs of both diseases. The overlap or opposite direction of the overall ASIR trend of both diseases (A and B) should be determined and studied for possible associations between cancer diseases. Results If the trend of the overall 8 or 10 years ASIR of a disease (A) follows that of disease (B) in all regions of the country, then the genes of patients with both diseases (A and B) will be highly homogeneous, and they should be studied in the region with the highest and lowest overall ASIR for both diseases (A and B). In addition, if there is an opposite direction or overlapping trend for both diseases (A and B) in certain regions of the country or among specific groups of people with the same demographic characteristics, then the genes of patients will be investigated for both diseases to identify the potential gene link between cancer diseases. Conclusion This study revealed that the overall ASIR trends of female breast cancer, prostate cancer, and ovarian cancer are very similar in all regions of Saudi Arabia and England. Our epidemiological evidence helps to save money, time, and effort for testing the potential gene link between cancer diseases. PMID:25878508

  3. An immune-modulating diet increases the regulatory T cells and reduces T helper 1 inflammatory response in Leishmaniosis affected dogs treated with standard therapy.

    Science.gov (United States)

    Cortese, Laura; Annunziatella, Mariangela; Palatucci, Anna Teresa; Lanzilli, Sarah; Rubino, Valentina; Di Cerbo, Alessandro; Centenaro, Sara; Guidetti, Gianandrea; Canello, Sergio; Terrazzano, Giuseppe

    2015-12-03

    Clinical appearance and evolution of Canine Leishmaniosis (CL) are the consequence of complex interactions between the parasite and the genetic and immunological backgrounds. We investigated the effect of an immune-modulating diet in CL. Dogs were treated with anti- Leishmania pharmacological therapy combined with standard diet (SD Group) or with the immune-modulating diet (IMMD Group). CD3+ CD4+ Foxp3+ Regulatory T cells (Treg) and CD3+ CD4+ IFN-γ + T helper 1 (Th1) were analyzed by flow cytometry. All sick dogs showed low platelet number at diagnosis (T0). A platelet increase was observed after six months (T6) SD Group, with still remaining in the normal range at twelve months (T12). IMMD Group showed an increase in platelet number becoming similar to healthy dogs at T6 and T12. An increase of CD4/CD8 ratio was revealed in SD Group after three months (T3), while at T6 and at T12 the values resembled to T0. The increase in CD4/CD8 ratio at T3 was maintained at T6 and T12 in IMMD Group. A reduction in the percentage of Treg of all sick dogs was observed at T0. A recovery of Treg percentage was observed only at T3 in SD Group, while this effect disappeared at T6 and T12. In contrast, Treg percentage became similar to healthy animals in IMDD Group at T3, T6 and T12. Sick dogs showed an increase of Th1 cells at T0 as compared with healthy dogs. We observed the occurrence of a decrease of Th1 cells from T3 to T12 in SD Group, although a trend of increase was observed at T6 and T12. At variance, IMMD Group dogs showed a progressive decrease of Th1 cells, whose levels became similar to healthy controls at T6 and T12. The immune-modulating diet appears to regulate the immune response in CL during the standard pharmacological treatment. The presence of nutraceuticals in the diet correlates with the decrease of Th1 cells and with the increase of Treg in sick dogs. Therefore, the administration of the specific dietary supplement improved the clinical response to the

  4. Safety evaluation report related to the license renewal and power increase for the National Bureau of Standards reactor (Docket No. 50-184)

    International Nuclear Information System (INIS)

    Bernard, H.

    1984-03-01

    Supplement 1 to the Safety Evaluation Report (SER) related to the renewal of the operating license and for a power increase (10 MWt to 20 MWt) for the research reactor at the National Bureau of Standards (NBS) facility has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports on the review of the licensee's emergency plan, which had not been reviewed at the time the Safety Evaluation Report (NUREG-1007) was published, and the review of the NBS application by the Advisory Committee on Reactor Safeguards, which was completed subsequent to the publication of the SER

  5. The power of the age standardized incidence rate to discover the gene link between cancer diseases: development of a new epidemiological method to save money, time, and effort for genetic scientists

    Directory of Open Access Journals (Sweden)

    Alghamdi IG

    2015-03-01

    Full Text Available Ibrahim G Alghamdi,1,2 Issam I Hussain,1 Mohamed S Alghamdi,3 Mohammed A El-Sheemy4 1School of Life Sciences, University of Lincoln, Lincoln, UK; 2College of Medicine, University of Al-Baha, Al-Baha, Saudi Arabia; 3Ministry of Health, General Directorate of Health Affairs Al-Baha, Al-Baha, Saudi Arabia; 4Lincoln Hospital, Research and Development United, Lincolnshire Hospitals NHS Trust, Lincoln, UK Background: This study provides an incipient epidemiological rule using the concept of direct method of standardization to determine the genetic link between cancer diseases. Methods: The overall 8 or 10 years age standardized incidence rate (ASIR for both cancer diseases, for example (A and (B should be calculated for all regions of the country. A line chart should be used to display the overall ASIR trend of both diseases (A and B. Pearson’s correlation can be used to determine the strength of the association between the overall ASIRs of both diseases. The overlap or opposite direction of the overall ASIR trend of both diseases (A and B should be determined and studied for possible associations between cancer diseases. Results: If the trend of the overall 8 or 10 years ASIR of a disease (A follows that of disease (B in all regions of the country, then the genes of patients with both diseases (A and B will be highly homogeneous, and they should be studied in the region with the highest and lowest overall ASIR for both diseases (A and B. In addition, if there is an opposite direction or overlapping trend for both diseases (A and B in certain regions of the country or among specific groups of people with the same demographic characteristics, then the genes of patients will be investigated for both diseases to identify the potential gene link between cancer diseases. Conclusion: This study revealed that the overall ASIR trends of female breast cancer, prostate cancer, and ovarian cancer are very similar in all regions of Saudi Arabia and England

  6. Extreme Levels of HbA1c Increase Incident ESRD Risk in Chinese Patients with Type 2 Diabetes: Competing Risk Analysis in National Cohort of Taiwan Diabetes Study

    Science.gov (United States)

    Liu, Chiu-Shong; Huang, Chiu-Ching; Lin, Wen-Yuan; Chiang, Jen-Huai; Lin, Cheng-Chieh; Li, Tsai-Chung

    2015-01-01

    Background Whether HbA1c is a predictor of end-stage renal disease (ESRD) in type 2 diabetes patients remains unclear. This study evaluated relationship between HbA1c and ESRD in Chinese patients with type 2 diabetes. Methods Patients aged ≥ 30 years who were free of ESRD (n = 51 681) were included from National Diabetes Care Management Program from 2002–2003. Extended Cox proportional hazard model with competing risk of death served to evaluate association between HbA1c level and ESRD. Results A total of 2613 (5.06%) people developed ESRD during a follow-up period of 8.1 years. Overall incidence rate of ESRD was 6.26 per 1000 person-years. Patients with high levels of HbA1c had a high incidence rate of ESRD, from 4.29 for HbA1c of  6.0%–6.9% to 10.33 for HbA1c ≥ 10.0% per 1000 person-years. Patients with HbA1c HbA1c  of 6.0%–6.9%. A J-shaped relationship between HbA1c level and ESRD risk was observed. After adjustment, patients with HbA1c HbA1c of 6.0%–6.9%. Conclusions Diabetes care has focused on preventing hyperglycemia, but not hypoglycemia. Our study revealed that HbA1c level ≥ 7.0% was linked with increased ESRD risk in type 2 diabetes patients, and that HbA1c HbA1c targets and improve outcomes without increasing the risk to this population. Clinicians need to pay attention to HbA1c results on diabetic nephropathy. PMID:26098901

  7. Incidence and mortality of lung cancer: global trends and association with socioeconomic status.

    Science.gov (United States)

    Wong, Martin C S; Lao, Xiang Qian; Ho, Kin-Fai; Goggins, William B; Tse, Shelly L A

    2017-10-30

    We examined the correlation between lung cancer incidence/mortality and country-specific socioeconomic development, and evaluated its most recent global trends. We retrieved its age-standardized incidence rates from the GLOBOCAN database, and temporal patterns were assessed from global databases. We employed simple linear regression analysis to evaluate their correlations with Human Development Index (HDI) and Gross Domestic Product (GDP) per capita. The average annual percent changes (AAPC) of the trends were evaluated from join-point regression analysis. Country-specific HDI was strongly correlated with age-standardized incidence (r = 0.70) and mortality (r = 0.67), and to a lesser extent GDP (r = 0.24 to 0.55). Among men, 22 and 30 (out of 38 and 36) countries showed declining incidence and mortality trends, respectively; whilst among women, 19 and 16 countries showed increasing incidence and mortality trends, respectively. Among men, the AAPCs ranged from -2.8 to -0.6 (incidence) and -3.6 to -1.1 (mortality) in countries with declining trend, whereas among women the AAPC range was 0.4 to 8.9 (incidence) and 1 to 4.4 (mortality) in countries with increasing trend. Among women, Brazil, Spain and Cyprus had the greatest incidence increase, and all countries in Western, Southern and Eastern Europe reported increasing mortality. These findings highlighted the need for targeted preventive measures.

  8. Trends in incidence of lung cancer in Croatia from 2001 to 2013: gender and regional differences.

    Science.gov (United States)

    Siroglavić, Katarina Josipa; Polić Vižintin, Marina; Tripković, Ingrid; Šekerija, Mario; Kukulj, Suzana

    2017-10-31

    To provide an overview of the lung cancer incidence trends in the City of Zagreb (Zagreb), Split-Dalmatia County (SDC), and Croatia in the period from 2001 to 2013. Incidence data were obtained from the Croatian National Cancer Registry. For calculating incidence rates per 100 000 population, we used population estimates for the period 2001-2013 from the Croatian Bureau of Statistics. Age-standardized rates of lung cancer incidence were calculated by the direct standardization method using the European Standard Population. To describe incidence trends, we used joinpoint regression analysis. Joinpoint analysis showed a statistically significant decrease in lung cancer incidence in men in all regions, with an annual percentage change (APC) of -2.2% for Croatia, 1.9% for Zagreb, and -2.0% for SDC. In women, joinpoint analysis showed a statistically significant increase in the incidence for Croatia, with APC of 1.4%, a statistically significant increase of 1.0% for Zagreb, and no significant change in trend for SDC. In both genders, joinpoint analysis showed a significant decrease in age-standardized incidence rates of lung cancer, with APC of -1.3% for Croatia, -1.1% for Zagreb, and -1.6% for SDC. There was an increase in female lung cancer incidence rate and a decrease in male lung cancer incidence rate in Croatia in 2001-20013 period, with similar patterns observed in all the investigated regions. These results highlight the importance of smoking prevention and cessation policies, especially among women and young people.

  9. Lightning incidents in Mongolia

    Directory of Open Access Journals (Sweden)

    Myagmar Doljinsuren

    2015-11-01

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

  10. A randomized controlled trial of increased dose and frequency of albendazole with standard dose DEC for treatment of Wuchereria bancrofti microfilaremics in Odisha, India.

    Science.gov (United States)

    Kar, Shantanu Kumar; Dwibedi, Bhagirathi; Kerketa, Anna Salomi; Maharana, Antaryami; Panda, Sudanshu S; Mohanty, Prafulla Chandra; Horton, John; Ramachandran, Cherubala P

    2015-03-01

    Although current programmes to eliminate lymphatic filariasis have made significant progress it may be necessary to use different approaches to achieve the global goal, especially where compliance has been poor and 'hot spots' of continued infection exist. In the absence of alternative drugs, the use of higher or more frequent dosing with the existing drugs needs to be explored. We examined the effect of higher and/or more frequent dosing with albendazole with a fixed 300 mg dose of diethylcarbamazine in a Wuchereria bancrofti endemic area in Odisha, India. Following screening, 104 consenting adults were randomly assigned to treatment with the standard regimen annually for 24 months (S1), or annually with increased dose (800 mg albendazole)(H1) or with increased frequency (6 monthly) with either standard (S2) or increased (H2) dose. Pre-treatment microfilaria counts (GM) ranged from 348 to 459 mf/ml. Subjects were followed using microfilaria counts, OG4C3 antigen levels and ultrasound scanning for adult worm nests. Microfilarial counts tended to decrease more rapidly with higher or more frequent dosing at all time points. At 12 months, Mf clearance was marginally greater with the high dose regimens, while by 24 months, there was a trend to higher Mf clearance in the arm with increased frequency and 800 mg of albendazole (76.9%) compared to other arms, (S1:64%, S2:69.2% & H1:73.1%). Although higher and/or more frequent dosing showed a trend towards a greater decline in antigenemia and clearance of "nests", all regimens demonstrated the potential macrofilaricidal effect of the combination. The higher doses of albendazole did not result in a greater number or more severe side effects. The alternative regimens could be useful in the later stages of existing elimination programmes or achieving elimination more rapidly in areas where programmes have yet to start.

  11. Four Weekly Ayahuasca Sessions Lead to Increases in “Acceptance” Capacities: A Comparison Study With a Standard 8-Week Mindfulness Training Program

    Science.gov (United States)

    Soler, Joaquim; Elices, Matilde; Dominguez-Clavé, Elisabeth; Pascual, Juan C.; Feilding, Amanda; Navarro-Gil, Mayte; García-Campayo, Javier; Riba, Jordi

    2018-01-01

    Background: The therapeutic effects of the Amazonian plant tea ayahuasca may relate to its ability to enhance mindfulness capacities. Ayahuasca induces a modified state of awareness through the combined action of its active principles: the psychedelic N,N-dimethyltryptamine (DMT) and a series of centrally acting β-carbolines, mainly harmine and tetrahydroharmine. To better understand the therapeutic potential of ayahuasca, here we compared the impact on mindfulness capacities induced by two independent interventions: (a) participation in four ayahuasca sessions without any specific purpose related to improving mindfulness capacities; and (b) participation in a standard mindfulness training course: 8 weeks mindfulness-based stress reduction (MBSR), with the specific goal of improving these skills. Methods: Participants of two independent groups completed two self-report instruments: The Five Facet Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). The MINDSENS Composite Index was also calculated, including those EQ and FFMQ items that have proven to be the most sensitive to meditation practice. Group A (n = 10) was assessed before and after the last of four closely spaced consecutive ayahuasca sessions. Group B (n = 10) was assessed before and after completion of a standard 8-week MBSR course. Results: MBSR training led to greater increases in overall mindfulness scores after the 8-week period. MBSR but not ayahuasca led to increases in the MINDSENS Composite Index. However, the ayahuasca sessions induced comparable increases in the Non-Judging subscale of the FFMQ, specifically measuring “acceptance.” Improving this capacity allows for a more detached and less judgmental stance toward potentially distressing thoughts and emotions. Results: The present findings suggest that a small number of ayahuasca sessions can be as effective at improving acceptance as more lengthy and costly interventions. Future studies should address the benefits of

  12. Four Weekly Ayahuasca Sessions Lead to Increases in "Acceptance" Capacities: A Comparison Study With a Standard 8-Week Mindfulness Training Program.

    Science.gov (United States)

    Soler, Joaquim; Elices, Matilde; Dominguez-Clavé, Elisabeth; Pascual, Juan C; Feilding, Amanda; Navarro-Gil, Mayte; García-Campayo, Javier; Riba, Jordi

    2018-01-01

    Background: The therapeutic effects of the Amazonian plant tea ayahuasca may relate to its ability to enhance mindfulness capacities. Ayahuasca induces a modified state of awareness through the combined action of its active principles: the psychedelic N,N- dimethyltryptamine (DMT) and a series of centrally acting β-carbolines, mainly harmine and tetrahydroharmine. To better understand the therapeutic potential of ayahuasca, here we compared the impact on mindfulness capacities induced by two independent interventions: (a) participation in four ayahuasca sessions without any specific purpose related to improving mindfulness capacities; and (b) participation in a standard mindfulness training course: 8 weeks mindfulness-based stress reduction (MBSR), with the specific goal of improving these skills. Methods: Participants of two independent groups completed two self-report instruments: The Five Facet Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). The MINDSENS Composite Index was also calculated, including those EQ and FFMQ items that have proven to be the most sensitive to meditation practice. Group A ( n = 10) was assessed before and after the last of four closely spaced consecutive ayahuasca sessions. Group B ( n = 10) was assessed before and after completion of a standard 8-week MBSR course. Results: MBSR training led to greater increases in overall mindfulness scores after the 8-week period. MBSR but not ayahuasca led to increases in the MINDSENS Composite Index. However, the ayahuasca sessions induced comparable increases in the Non-Judging subscale of the FFMQ, specifically measuring "acceptance." Improving this capacity allows for a more detached and less judgmental stance toward potentially distressing thoughts and emotions. Results: The present findings suggest that a small number of ayahuasca sessions can be as effective at improving acceptance as more lengthy and costly interventions. Future studies should address the benefits of

  13. Four Weekly Ayahuasca Sessions Lead to Increases in “Acceptance” Capacities: A Comparison Study With a Standard 8-Week Mindfulness Training Program

    Directory of Open Access Journals (Sweden)

    Joaquim Soler

    2018-03-01

    Full Text Available Background: The therapeutic effects of the Amazonian plant tea ayahuasca may relate to its ability to enhance mindfulness capacities. Ayahuasca induces a modified state of awareness through the combined action of its active principles: the psychedelic N,N-dimethyltryptamine (DMT and a series of centrally acting β-carbolines, mainly harmine and tetrahydroharmine. To better understand the therapeutic potential of ayahuasca, here we compared the impact on mindfulness capacities induced by two independent interventions: (a participation in four ayahuasca sessions without any specific purpose related to improving mindfulness capacities; and (b participation in a standard mindfulness training course: 8 weeks mindfulness-based stress reduction (MBSR, with the specific goal of improving these skills.Methods: Participants of two independent groups completed two self-report instruments: The Five Facet Mindfulness Questionnaire (FFMQ and the Experiences Questionnaire (EQ. The MINDSENS Composite Index was also calculated, including those EQ and FFMQ items that have proven to be the most sensitive to meditation practice. Group A (n = 10 was assessed before and after the last of four closely spaced consecutive ayahuasca sessions. Group B (n = 10 was assessed before and after completion of a standard 8-week MBSR course.Results: MBSR training led to greater increases in overall mindfulness scores after the 8-week period. MBSR but not ayahuasca led to increases in the MINDSENS Composite Index. However, the ayahuasca sessions induced comparable increases in the Non-Judging subscale of the FFMQ, specifically measuring “acceptance.” Improving this capacity allows for a more detached and less judgmental stance toward potentially distressing thoughts and emotions.Results: The present findings suggest that a small number of ayahuasca sessions can be as effective at improving acceptance as more lengthy and costly interventions. Future studies should address the

  14. Using an ACTIVE teaching format versus a standard lecture format for increasing resident interaction and knowledge achievement during noon conference: a prospective, controlled study

    Science.gov (United States)

    2014-01-01

    Background The traditional lecture is used by many residency programs to fulfill the mandate for regular didactic sessions, despite limited evidence to demonstrate its effectiveness. Active teaching strategies have shown promise in improving medical knowledge but have been challenging to implement within the constraints of residency training. We developed and evaluated an innovative structured format for interactive teaching within the residency noon conference. Methods We developed an ACTIVE teaching format structured around the following steps: assemble (A) into groups, convey (C) learning objectives, teach (T) background information, inquire (I) through cases and questions, verify (V) understanding, and explain (E) answer choices and educate on the learning points. We conducted a prospective, controlled study of the ACTIVE teaching format versus the standard lecture format, comparing resident satisfaction, immediate knowledge achievement and long-term knowledge retention. We qualitatively assessed participating faculty members’ perspectives on the faculty development efforts and the feasibility of teaching using the ACTIVE format. Results Sixty-nine internal medicine residents participated in the study. Overall, there was an improvement in perceived engagement using the ACTIVE teaching format (4.78 vs. 3.80, P teaching format (overall absolute score increase of 11%, P = 0.04) and a trend toward improvement in long-term knowledge retention. Faculty members felt adequately prepared to use the ACTIVE teaching format, and enjoyed teaching with the ACTIVE teaching format more than the standard lecture. Conclusions A structured ACTIVE teaching format improved resident engagement and initial knowledge, and required minimal resources. The ACTIVE teaching format offers an exciting alternative to the standard lecture for resident noon conference and is easy to implement. PMID:24985781

  15. Major incidents in Kenya: the case for emergency services development and training.

    Science.gov (United States)

    Wachira, Benjamin W; Smith, Wayne

    2013-04-01

    Kenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality. This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.

  16. Long-Term Visual Training Increases Visual Acuity and Long-Term Monocular Deprivation Promotes Ocular Dominance Plasticity in Adult Standard Cage-Raised Mice.

    Science.gov (United States)

    Hosang, Leon; Yusifov, Rashad; Löwel, Siegrid

    2018-01-01

    For routine behavioral tasks, mice predominantly rely on olfactory cues and tactile information. In contrast, their visual capabilities appear rather restricted, raising the question whether they can improve if vision gets more behaviorally relevant. We therefore performed long-term training using the visual water task (VWT): adult standard cage (SC)-raised mice were trained to swim toward a rewarded grating stimulus so that using visual information avoided excessive swimming toward nonrewarded stimuli. Indeed, and in contrast to old mice raised in a generally enriched environment (Greifzu et al., 2016), long-term VWT training increased visual acuity (VA) on average by more than 30% to 0.82 cycles per degree (cyc/deg). In an individual animal, VA even increased to 1.49 cyc/deg, i.e., beyond the rat range of VAs. Since visual experience enhances the spatial frequency threshold of the optomotor (OPT) reflex of the open eye after monocular deprivation (MD), we also quantified monocular vision after VWT training. Monocular VA did not increase reliably, and eye reopening did not initiate a decline to pre-MD values as observed by optomotry; VA values rather increased by continued VWT training. Thus, optomotry and VWT measure different parameters of mouse spatial vision. Finally, we tested whether long-term MD induced ocular dominance (OD) plasticity in the visual cortex of adult [postnatal day (P)162-P182] SC-raised mice. This was indeed the case: 40-50 days of MD induced OD shifts toward the open eye in both VWT-trained and, surprisingly, also in age-matched mice without VWT training. These data indicate that (1) long-term VWT training increases adult mouse VA, and (2) long-term MD induces OD shifts also in adult SC-raised mice.

  17. Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food and the Effect of Increasing Use of Culture-Independent Diagnostic Tests on Surveillance - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2013-2016.

    Science.gov (United States)

    Marder, Ellyn P; Cieslak, Paul R; Cronquist, Alicia B; Dunn, John; Lathrop, Sarah; Rabatsky-Ehr, Therese; Ryan, Patricia; Smith, Kirk; Tobin-D'Angelo, Melissa; Vugia, Duc J; Zansky, Shelley; Holt, Kristin G; Wolpert, Beverly J; Lynch, Michael; Tauxe, Robert; Geissler, Aimee L

    2017-04-21

    Foodborne diseases represent a substantial public health concern in the United States. CDC's Foodborne Diseases Active Surveillance Network (FoodNet) monitors cases reported from 10 U.S. sites* of laboratory-diagnosed infections caused by nine enteric pathogens commonly transmitted through food. This report describes preliminary surveillance data for 2016 on the nine pathogens and changes in incidences compared with 2013-2015. In 2016, FoodNet identified 24,029 infections, 5,512 hospitalizations, and 98 deaths caused by these pathogens. The use of culture-independent diagnostic tests (CIDTs) by clinical laboratories to detect enteric pathogens has been steadily increasing since FoodNet began surveying clinical laboratories in 2010 (1). CIDTs complicate the interpretation of FoodNet surveillance data because pathogen detection could be affected by changes in health care provider behaviors or laboratory testing practices (2). Health care providers might be more likely to order CIDTs because these tests are quicker and easier to use than traditional culture methods, a circumstance that could increase pathogen detection (3). Similarly, pathogen detection could also be increasing as clinical laboratories adopt DNA-based syndromic panels, which include pathogens not often included in routine stool culture (4,5). In addition, CIDTs do not yield isolates, which public health officials rely on to distinguish pathogen subtypes, determine antimicrobial resistance, monitor trends, and detect outbreaks. To obtain isolates for infections identified by CIDTs, laboratories must perform reflex culture † ; if clinical laboratories do not, the burden of culturing falls to state public health laboratories, which might not be able to absorb that burden as the adoption of these tests increases (2). Strategies are needed to preserve access to bacterial isolates for further characterization and to determine the effect of changing trends in testing practices on surveillance.

  18. The incidence and mortality of lung cancer and their relationship to development in Asia.

    Science.gov (United States)

    Pakzad, Reza; Mohammadian-Hafshejani, Abdollah; Ghoncheh, Mahshid; Pakzad, Iraj; Salehiniya, Hamid

    2015-12-01

    Lung cancer is the deadliest cancer worldwide and the most common cancer in Asia. It is necessary to get information on epidemiology and inequalities related to incidence and mortality of the cancer to use for planning and further research. This study aimed to investigate epidemiology and inequality of incidence and mortality from lung cancer in Asia. The study was conducted based on data from the world data of cancer and the World Bank [including the Human Development Index (HDI) and its components]. The incidence and mortality rates, and cancer distribution maps were drawn for Asian countries. To analyze data, correlation test between incidence and death rates, and HDI and its components at significant was used in the significant level of 0.05 using SPSS software. A total of 1,033,881 incidence (71.13% were males and 28.87% were females. Sex ratio was 2.46) and 936,051 death (71.45% in men and 28.55% in women. The sex ratio was 2.50) recorded in Asian countries in 2012. Five countries with the highest standardized incidence and mortality rates of lung cancer were Democratic Republic of Korea, China, Armenia, Turkey, and Timor-Leste, respectively. Correlation between HDI and standardized incidence rate was 0.345 (P=0.019), in men 0.301 (P=0.042) and in women 0.3 (P=0.043); also between HDI and standardized mortality rate 0.289 (P=0.052), in men 0.265 (P=0.075) and in women 0.200 (P=0.182). The incidence of lung cancer has been increasing in Asia. It is high in men. Along with development, the incidence and mortality from lung cancer increases. It seems necessary to study reasons and factors of increasing the incidence and mortality of lung cancer in Asian countries.

  19. Prostate cancer incidence rates in Africa.

    Science.gov (United States)

    Chu, Lisa W; Ritchey, Jamie; Devesa, Susan S; Quraishi, Sabah M; Zhang, Hongmei; Hsing, Ann W

    2011-01-01

    African American men have among the highest prostate cancer incidence rates in the world yet rates among their African counterparts are unclear. In this paper, we compared reported rates among black men of Sub-Saharan African descent using data from the International Agency for Research on Cancer (IARC) and the National Cancer Institute Surveillance, Epidemiology, and End Results Program for 1973-2007. Although population-based data in Africa are quite limited, the available data from IARC showed that rates among blacks were highest in the East (10.7-38.1 per 100,000 man-years, age-adjusted world standard) and lowest in the West (4.7-19.8). These rates were considerably lower than those of 80.0-195.3 observed among African Americans. Rates in Africa increased over time (1987-2002) and have been comparable to those for distant stage in African Americans. These patterns are likely due to differences between African and African American men in medical care access, screening, registry quality, genetic diversity, and Westernization. Incidence rates in Africa will likely continue to rise with improving economies and increasing Westernization, warranting the need for more high-quality population-based registration to monitor cancer incidence in Africa.

  20. Colorectal cancer incidence in 5 Asian countries by subsite: An analysis of Cancer Incidence in Five Continents (1998-2007).

    Science.gov (United States)

    Park, Hye-Min; Woo, Hyeongtaek; Jung, Sun Jae; Jung, Kyu-Won; Shin, Hai-Rim; Shin, Aesun

    2016-12-01

    Colorectal cancer is the fourth most common cancer in Asia. However, the trends in colorectal cancer incidence by subsite have not been analyzed across Asian countries. We used the most recent, high quality data from 6 cancer registries for two 5-year periods, 1998-2002 and 2003-2007, from Cancer Incidence in Five Continents to estimate colorectal cancer incidence by subsite in 5 Asian countries. Cases with overlapping lesions or otherwise unspecified colon cancer were re-distributed as proximal or distal colon cancer. Age-standardized incidence rates (ASRs) per 100,000 population and incidence rate ratios from 1998 to 2002 to 2003-2007 were calculated for each subsite. For 2003-2007, men in Miyagi, Japan, had the highest ASR for cancer in the proximal colon, distal colon and rectum. Men of Jewish ancestry in Israel had a high ASR for proximal and distal colon cancer, but the lowest ASR for rectal cancer. The proportion of rectal cancer was highest among Korean men (51.39%) and lowest among Israeli women (26.6%). From 1998-2002 to 2003-2007, rectal cancer incidence did not significantly change in most registries, except for men in Miyagi, Japan, and both sexes in Korea. However, during the same period cancer incidence in the proximal and distal colon increased in most registries. In conclusion, there was substantial variation in subsite distributions of colorectal cancer in Asian registries and increases in overall incidence of colorectal cancer could be attributed to increases in colon cancer. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Epidemiology of biological-exposure incidents among Spanish healthcare workers.

    Science.gov (United States)

    Monge, V; Mato, G; Mariano, A; Fernández, C; Fereres, J

    2001-12-01

    To determine the frequency and the epidemiological characteristics of biological-exposure incidents occurring among healthcare personnel. Prospective surveillance study. Participating Spanish primary-care and specialty centers from January 1994 to December 1997. 70 centers in 1994, 87 in 1995, 97 in 1996, and 104 in 1997. Absolute and relative frequencies were calculated for several variables (position held, area of care, type of injuring object, activity, etc) and for the different categories of each variable. There were 20,235 registered incidents. Annual incidence rates were as follows: 1994, 51 per 1,000; 1995, 58 per 1,000, 1996, 54 per 1,000; and 1997, 59 per 1,000. Mean age of accident victims was as follows: 1994, 35.68 (standard deviation [SD], 16.26); 1995, 33.6 (SD, 11.9); 1996,38.2 (SD, 17.27); and 1997, 36.7 (SD, 16.33) years. Of the 20,235 incidents, 15,860 (80.7%) occurred to women; 50% (9,833) accidents were among nursing staff. The type of incident most frequently reported was percutaneous injury (81.1%). The highest frequency of accidents was seen in medical and surgical areas (28% and 25.6%, respectively). Blood and blood products were the most commonly involved material (87.6%). Administration of intramuscular or intravenous medication was the activity associated with the highest accident rate (20.3%). The most frequent immediate action in response was rinsing and disinfecting (65.6%). The incident registry was highly stable in terms of incidence rates over the observation period and served to highlight the large number of incidents recorded each year. The potential implications of the results are the need to explore reasons for increased exposures in certain areas, with the aim of focusing prevention efforts, and, similarly, to establish the factors associated with diminished incidence rates to model successful measures.

  2. Standardized deceased donor kidney donation rates in the UK reveal marked regional variation and highlight the potential for increasing kidney donation: a prospective cohort study†

    Science.gov (United States)

    Summers, D. M.; Johnson, R. J.; Hudson, A. J.; Collett, D.; Murphy, P.; Watson, C. J. E.; Neuberger, J. M.; Bradley, J. A.

    2014-01-01

    Background The UK has implemented a national strategy for organ donation that includes a centrally coordinated network of specialist nurses in organ donation embedded in all intensive care units and a national organ retrieval service for deceased organ donors. We aimed to determine whether despite the national approach to donation there is significant regional variation in deceased donor kidney donation rates. Methods The UK prospective audit of deaths in critical care was analysed for a cohort of patients who died in critical care between April 2010 and December 2011. Multivariate logistic regression was used to identify the factors associated with kidney donation. The logistic regression model was then used to produce risk-adjusted funnel plots describing the regional variation in donation rates. Results Of the 27 482 patients who died in a critical care setting, 1528 (5.5%) became kidney donors. Factors found to influence donation rates significantly were: type of critical care [e.g. neurointensive vs general intensive care: OR 1.53, 95% confidence interval (CI) 1.34–1.75, P69 vs age 18–39 yr: OR 0.2, 0.15–0.25, Pdonation rates for the 20 UK kidney donor regions showed marked variation. The overall standardized donation rate ranged from 3.2 to 7.5%. Four regions had donation rates of >2 standard deviations (sd) from the mean (two below and two above). Regional variation was most marked for donation after circulatory death (DCD) kidney donors with 9 of the 20 regions demonstrating donation rates of >2 sd from the mean (5 below and 4 above). Conclusions The marked regional variation in kidney donation rates observed in this cohort after adjustment for factors strongly associated with donation rates suggests that there is considerable scope for further increasing kidney donation rates in the UK, particularly DCD. PMID:24335581

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

    Science.gov (United States)

    Miranda, J Jaime; López-Rivera, Luis A; Quistberg, D Alex; Rosales-Mayor, Edmundo; Gianella, Camila; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Paca, Ada

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    J Jaime Miranda

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

  6. Poster - 27: Incident Learning Practices in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina [The Ottawa Hospital Cancer Centre, Mississauga Halton/Central West Regional Cancer Center, Odette Cancer Centre, Cancer Care Ontario (Canada)

    2016-08-15

    Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

  7. Poster - 27: Incident Learning Practices in Ontario

    International Nuclear Information System (INIS)

    Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina

    2016-01-01

    Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

  8. Path tortuosity in everyday movements of elderly persons increases fall prediction beyond knowledge of fall history, medication use, and standardized gait and balance assessments.

    Science.gov (United States)

    Kearns, William D; Fozard, James L; Becker, Marion; Jasiewicz, Jan M; Craighead, Jeffrey D; Holtsclaw, Lori; Dion, Charles

    2012-09-01

    We hypothesized that variability in voluntary movement paths of assisted living facility (ALF) residents would be greater in the week preceding a fall compared with residents who did not fall. Prospective, observational study using telesurveillance technology. Two ALFs. The sample consisted of 69 older ALF residents (53 female) aged 76.9 (SD ± 11.9 years). Daytime movement in ALF common use areas was automatically tracked using a commercially available ultra-wideband radio real-time location sensor network with a spatial resolution of approximately 20 cm. Movement path variability (tortuosity) was gauged using fractal dimension (fractal D). A logistic regression was performed predicting movement related falls from fractal D, presence of a fall in the prior year, psychoactive medication use, and movement path length. Fallers and non-fallers were also compared on activities of daily living requiring supervision or assistance, performance on standardized static and dynamic balance, and stride velocity assessments gathered at the start of a 1-year fall observation period. Fall risk due to cognitive deficit was assessed by the Mini Mental Status Examination (MMSE), and by clinical dementia diagnoses from participant's activities of daily living health record. Logistic regression analysis revealed odds of falling increased 2.548 (P = .021) for every 0.1 increase in fractal D, and having a fall in the prior year increased odds of falling by 7.36 (P = .006). There was a trend for longer movement paths to reduce the odds of falling (OR .976 P = .08) but it was not significant. Number of psychoactive medications did not contribute significantly to fall prediction in the model. Fallers had more variable stride-to-stride velocities and required more activities of daily living assistance. High fractal D levels can be detected using commercially available telesurveillance technologies and offers a new tool for health services administrators seeking to reduce falls at their

  9. The incidence and mortality of prostate cancer and its relationship with development in Asia

    OpenAIRE

    Pakzad, Reza; Mohammadian-Hafshejani, Abdollah; Ghoncheh, Mahshid; Pakzad, Iraj; Salehiniya, Hamid

    2015-01-01

    Purpose Prostate cancer is a common cancer in men in the world. It is rapidly increasing. This study investigated the incidence and mortality of prostate cancer and the relationship with the Human Development Index (HDI) and its dimensions in Asia in 2012. Methods The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). The standardized incidence and mortality rates of prostate cancer were calculated for Asian countries. Th...

  10. Prostate cancer incidence in Australia correlates inversely with solar radiation.

    Science.gov (United States)

    Loke, Tim W; Seyfi, Doruk; Sevfi, Doruk; Khadra, Mohamed

    2011-11-01

    What's known on the subject? and What does the study add? Increased sun exposure and blood levels of vitamin D have been postulated to be protective against prostate cancer. This is controversial. We investigated the relationship between prostate cancer incidence and solar radiation in non-urban Australia, and found a lower incidence in regions receiving more sunlight. In landmark ecological studies, prostate cancer mortality rates have been shown to be inversely related to ultraviolet radiation exposure. Investigators have hypothesised that ultraviolet radiation acts by increasing production of vitamin D, which inhibits prostate cancer cells in vitro. However, analyses of serum levels of vitamin D in men with prostate cancer have failed to support this hypothesis. This study has found an inverse correlation between solar radiation and prostate cancer incidence in Australia. Our population (previously unstudied) represents the third group to exhibit this correlation. Significantly, the demographics and climate of Australia differ markedly from those of previous studies conducted on men in the United Kingdom and the United States. • To ascertain if prostate cancer incidence rates correlate with solar radiation among non-urban populations of men in Australia. • Local government areas from each state and territory were selected using explicit criteria. Urban areas were excluded from analysis. • For each local government area, prostate cancer incidence rates and averaged long-term solar radiation were obtained. • The strength of the association between prostate cancer incidence and solar radiation was determined. • Among 70 local government areas of Australia, age-standardized prostate cancer incidence rates for the period 1998-2007 correlated inversely with daily solar radiation averaged over the last two decades. •  There exists an association between less solar radiation and higher prostate cancer incidence in Australia. © 2011 THE AUTHORS. BJU

  11. National Fire Incident Reporting System (NFIRS)

    Data.gov (United States)

    Department of Homeland Security — The National Fire Incident Reporting System (NFIRS) is a reporting standard that fire departments use to uniformly report on the full range of their activities, from...

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

    Science.gov (United States)

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

    2017-01-01

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

  13. Effects of a mixed media education intervention program on increasing knowledge, attitude, and compliance with standard precautions among nursing students: A randomized controlled trial.

    Science.gov (United States)

    Xiong, Peng; Zhang, Jun; Wang, Xiaohui; Wu, Tat Leong; Hall, Brian J

    2017-04-01

    Standard precautions (SPs) are considered fundamental protective measures to manage health care-associated infections and to reduce occupational health hazards. This study intended to assess the effectiveness of a mixed media education intervention to enhance nursing students' knowledge, attitude, and compliance with SPs. A randomized controlled trial with 84 nursing students was conducted in a teaching hospital in Hubei, China. The intervention group (n = 42) attended 3 biweekly mixed media education sessions, consisting of lectures, videos, role-play, and feedback with 15-20 minutes of individual online supervision and feedback sessions following each class. The control group learned the same material through self-directed readings. Pre- and posttest assessments of knowledge, attitudes, and compliance were assessed with the Knowledge with Standard Precautions Questionnaire, Attitude with Standard Precautions Scale, and the Compliance with Standard Precautions Scale, respectively. The Standard Bacterial Colony Index was used to assess handwashing effectiveness. At 6-week follow-up, performance on the Knowledge with Standard Precautions Questionnaire, Attitude with Standard Precautions Scale, and Compliance with Standard Precautions Scale were significantly improved in the intervention group compared with the control group (P media education intervention is effective in improving knowledge, attitude, and compliance with SPs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Increasing incidence of premature thelarche in the Central Region of Denmark - Challenges in differentiating girls less than 7 years of age with premature thelarche from girls with precocious puberty in real-life practice

    DEFF Research Database (Denmark)

    Sømod, Mia Elbek; Vestergaard, Esben Thyssen; Kristensen, Kurt

    2016-01-01

    . Diagnoses were validated and the girls were categorized to the groups PP (n = 27) and PT (n = 164). Anthropometry, Tanner stages, ethnicity, bone age, and biochemistry, were recorded. Conventional variables for diagnosing PP were compared between the groups at time of referral to identify parameters...... predictive for the diagnosis. RESULTS: The referral rate of PT increased from 1998-2013. Girls with PT and PP differed with regards to age at referral, body mass index standard deviation scores (BMISDS), ethnicity, bone age advancement, basal luteinizing hormone (LH), gonadotropin releasing hormone (Gn...... was the variable which best discriminated PT from PP. Third, stimulated LH in 1-3 years old girls with PT is similar to stimulated LH in 5-7 years old girls with PP. Age, BMISDS, ethnicity, bone age, stimulated gonadotropins and LH/FSH and SHBG are all useful variables for differentiating PP from PT. However...

  15. Use of G-CSF to hasten neutrophil recovery after auto-SCT for AML is not associated with increased relapse incidence: a report from the Acute Leukemia Working Party of the EBMT.

    Science.gov (United States)

    Czerw, T; Labopin, M; Gorin, N-C; Giebel, S; Blaise, D; Dumas, P-Y; Foa, R; Attal, M; Schaap, N; Michallet, M; Bonmati, C; Veelken, H; Mohty, M

    2014-07-01

    Application of G-CSF in AML is controversial as leukemic blasts may express receptors interacting with the cytokine, which may stimulate leukemia growth. We retrospectively analyzed the impact of G-CSF use to accelerate neutrophil recovery after auto-SCT on outcome. Adults with AML in first CR autografted between 1994 and 2010 were included. Nine hundred and seventy two patients were treated with G-CSF after auto-SCT whereas 1121 were not. BM and PB were used as a source of stem cells in 454 (22%) and 1639 (78%) cases, respectively. The incidence of relapse at 5 years in the BM-auto-SCT group was 38% for patients receiving post-transplant G-CSF and 43% for those not treated with G-CSF, P=0.46. In the PB-auto-SCT cohort, respective probabilities were 48% and 49%, P=0.49. No impact of the use of G-CSF could be demonstrated with respect to the probability of leukemia-free survival: in the BM-auto-SCT group, 51% for G-CSF(+) and 48% for G-CSF(-), P=0.73; in PB-auto-SCT group, 42% for G-CSF(+) and 43% for G-CSF(-), P=0.83. Although G-CSF administration significantly shortened the neutropenic phase, no beneficial effect was observed with regard to non-relapse mortality. In patients with AML, the use of G-CSF after auto-SCT is not associated with increased risk of relapse irrespective of the source of stem cells used.

  16. The incidence and mortality of prostate cancer and its relationship with development in Asia.

    Science.gov (United States)

    Pakzad, Reza; Mohammadian-Hafshejani, Abdollah; Ghoncheh, Mahshid; Pakzad, Iraj; Salehiniya, Hamid

    2015-12-01

    Prostate cancer is a common cancer in men in the world. It is rapidly increasing. This study investigated the incidence and mortality of prostate cancer and the relationship with the Human Development Index (HDI) and its dimensions in Asia in 2012. The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). The standardized incidence and mortality rates of prostate cancer were calculated for Asian countries. The correlation between incidence, mortality rates, and the HDI and its components were assessed with the use of the correlation test, using SPSS software. There was a total of 191,054 incidences and 81,229 death were recorded in Asian countries in 2012. Among the Asian countries, the five countries with the highest standardized incidence rates of prostate cancer were Israel, Turkey, Lebanon, Singapore, and Japan, and the five countries with the highest standardized mortality rates were Turkey, Lebanon, Timor-Leste, Armenia, and the Philippines. The correlation between standardized incidence rate of prostate cancer and the HDI was 0.604 (P ≤ 0.001), with life expectancy at birth 0.529 (P = 0.002), with mean years of schooling 0.427 (P = 0.001), and with level of income per each person of the population 0.349 (P = 0.013). Also, between the standardized mortality rate and the HDI, it was 0.228 (P = 0.127). A significant and positive correlation was observed between the standardized incidence rate of prostate cancer, and the HDI and its dimensions, such as life expectancy at birth, mean years of schooling, and income level of the population per each person of population. However, there was no significant correlation between the standardized mortality rate, and the HDI and its dimensions.

  17. Incidents Associated with Gas Operation

    Directory of Open Access Journals (Sweden)

    Szer J.

    2017-06-01

    Full Text Available This article shows incidents associated with the use of gas as an energy carrier. It presents selected incidents which have occurred in Poland and around the world in recent decades. Based on this, consequences of gas and air mixture explosions were analysed as well. The article presents the main causes of gas incidents which have taken place, as per instances which are similar worldwide. Incidents associated with the use of gas are not frequent, but at the same time very tragic as they often lead to illness or even death. In Poland, in the last twenty years, construction area disasters caused by gas explosions account for only 5% of all which have occurred, but the number of fatalities resulting from these cases is approximately 14%. The number of individuals injured reached 39% of all construction disaster victims. Considering all these facts, it is necessary to undertake wide preventive measures in order to increase safety in the use of gaseous fuels.

  18. Cancer incidence in kidney transplant recipients: a study protocol

    International Nuclear Information System (INIS)

    Pita-Fernandez, Salvador; Valdes-Cañedo, Francisco; Pertega-Diaz, Sonia; Seoane-Pillado, Maria Teresa; Seijo-Bestilleiro, Rocio

    2009-01-01

    Different publications show an increased incidence of neoplasms in renal transplant patients. The objective of this study is to determine the incidence of cancer in the recipients of renal transplants performed in the A Coruña Hospital (Spain) during the period 1981–2007. During the study period 1967 kidney transplants were performed, corresponding to 1710 patients. Patients with neoplasms prior to the transplant will be excluded (n = 38). A follow-up study was carried out in order to estimate cancer incidence after transplantation. For each patient, information included donor and recipient characteristics, patients and graft survival and cancer incidence after transplantation. Incident cancer is considered as new cases of cancer after the transplant with anatomopathological confirmation. Their location will be classified according to the ICD-9. The analysis will be calculated using the indirect standardisation method. Age-adjusted cancer incidence rates in the Spanish general population will be obtained from the Carlos III Health Institute, the National Epidemiology Centre of the Ministry of Science and Technology. Crude first, second and third-year post-transplantation cancer incidence rates will be calculated for male and female recipients. The number of cases of cancer at each site will be calculated from data in the clinical records. The expected number of cancers will be calculated from data supplied by the Carlos III Health Institute. For each tumour location we will estimate the standardized incidence ratios (SIRs), using sex-specific cancer incidence rates, by dividing the incidence rate for the transplant patients by the rate of the general population. The 95% confidence intervals of the SIRs and their associated p-values will be calculated by assuming that the observed cancers follow a Poisson distribution. Stratified analysis will be performed to examine the variation in the SIRs with sex and length of follow-up. Competing risk survival analysis

  19. Cancer incidence in Spain, 2015.

    Science.gov (United States)

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

    2017-07-01

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

  20. Epidemiology Characteristics and Trends of Lung Cancer Incidence in Iran.

    Science.gov (United States)

    Almasi, Zeinab; Salehiniya, Hamid; Amoori, Neda; Enayatrad, Mostafa

    2016-01-01

    Lung cancer is one of the most common cancers in the world and a major cause of death from cancer. One of the important indicators to compare the prevalence and incidence of the disease is a change in the trend. The aim of this study was to investigate the changes in the incidence of lung cancer in Iran. This study was conducted based on existing data obtained from a national registry of cancer cases and the Disease Management Center of Ministry of Health in Iran. All cases registered in the country were included during 2003-2008. Incidence rates were reported based on the direct method and standard population of World Health Organization. The study also examined the morphology of common lung cancers. Trends in incidence underwent joinpoint regression analysis. Based on the results of this study, 14,403 cases of lung cancer have been recorded of which 10,582 cases were in men and 3,821 in women. Highest incidence rates were observed in the 80-84 age group. Considerable variation across provinces was evident. In females squamous cell carcinoma (SCC) demonstrated a reduction from 24% to 16% of lesions over the period of study, while adenocarcinoma rose from 21% to 29%. In males a similar reduction in SCC was apparent (42% to 29%, again with increase in AC (13 % to 18%). The results show that the increase in the incidence of lung cancer the trend is that more men than women and in men and may be caused by changes in smoking pattern. The incidence of lung cancer in the North West and West provinces was higher than in other regions.

  1. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir

    2015-01-01

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

  2. Increased height standard deviation scores in response to growth hormone therapy to near-adult height in older children with delayed skeletal maturation: results from the ANSWER Program.

    Science.gov (United States)

    Ross, Judith L; Lee, Peter A; Gut, Robert; Germak, John

    2015-01-01

    A primary goal of recombinant human growth hormone therapy (GHT) in children is attaining normal adult height. In this study, children with growth hormone deficiency (GHD) (including isolated idiopathic growth hormone deficiency [IGHD] and multiple pituitary hormone deficiency [MPHD]), idiopathic short stature (ISS), and Turner syndrome (TS) were evaluated for near-adult height (NAH) and percent achieving NAH within the normal range after approximately 4 years of GHT. Data from the American Norditropin® Web-Enabled Research (ANSWER) Program were analyzed for NAH from age at treatment start (ATS) (i.e., referral age as defined by age at enrollment in the study) to last clinic visit using one of the following two criteria: 1) age ≥18 years, or 2) if male: ≥16 years and height velocity (HV) standard deviation score (HSDS) ≤ -2, and either GHD (n = 201), ISS (n = 19), or TS (n = 41). The main outcome measures included HSDS and corrected HSDS (HSDS-target HSDS) in response to GH treatment, and correlation of ATS with NAH HSDS. Mean (± SD) chronological and bone ages at baseline were 14.0 ± 2.1 years and 11.7 ± 2.0 years, respectively, and mean GHT duration was 4.0 ± 1.6 years. Mean HSDS (baseline to NAH; GHD: -2.7 to -1.0; ISS: -2.8 to -1.4; TS: -3.0 to -1.8) and mean corrected HSDS (baseline to NAH; GHD: -2.1 to -0.3; ISS: -2.1 to -0.6; TS: -1.8 to -0.6) increased across diagnostic indications. Percentages of patients reaching near-adult HSDS > -2 were GHD: 87.6%; ISS: 78.9%; TS: 65.8%. Significant negative correlations were found between ATS and NAH HSDS when analyzed by sex. Despite a relatively advanced childhood age, the majority of GH-treated patients attained mean near-adult HSDS within the normal range (HSDS > -2). Negative correlations of ATS with near-adult HSDS indicate that an earlier age at treatment start would likely have resulted in greater adult height achieved in both male and female patients.

  3. Incidence of type 1 diabetes mellitus in 0 to 14-yr-old children in Croatia--2004 to 2012 study.

    Science.gov (United States)

    Rojnic Putarek, Natasa; Ille, Jasenka; Spehar Uroic, Anita; Skrabic, Veselin; Stipancic, Gordana; Krnic, Nevena; Radica, Ana; Marjanac, Igor; Severinski, Srecko; Svigir, Alen; Bogdanic, Ana; Dumic, Miroslav

    2015-09-01

    The incidence of type 1 diabetes mellitus (T1DM) among children and adolescents increased during the last 50 yr. The T1DM incidence in Croatia was 8.87/100.000/yr over 1995-2003, with an annual increase of 9%, which placed Croatia among countries with moderate risk for T1DM. To investigate incidence rates and trends of T1DM from 2004 to 2012 in 0 to 14-yr-old Croatian children, and to compare the results with previous studies in Croatia and other European countries. T1DM crude incidence rates are estimated for the entire group and three subgroups: 0-4, 5-9, and 10-14 yr. Standardized incidence is calculated using the method of direct standardization according to World Health Organization (WHO) standard world population. The incidence rates by gender, age groups, seasonality, and calendar year, and their interactions were analyzed using Poisson regression model. A total of 1066 cases were ascertained over 2004-2012. The standardized incidence was 17.23/100.000/yr (95% CI: 16.19-18.26), with no significant differences in incidence rates or trends between boys and girls. Statistically significant annual increase of 5.87% (p Croatia, thus placing Croatia among countries with high risk for T1DM. The annual increment of 5.87% is considerably lower than 9.0% reported earlier, but still higher than the European average (3.9%). The increase in incidence ceased in youngest children. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Endometrial and cervical cancer: incidence and mortality among women in the Lodz region

    Directory of Open Access Journals (Sweden)

    Beata Leśniczak

    2015-09-01

    Full Text Available Introduction: By the early 21st century the most common cancer of female genitals in Poland was cervical cancer. Now endometrial cancer ranks first. The aim of this study was to analyse the incidence and mortality of endometrial and cervical cancer among women in the Lodz region. Material and methods: Data on the incidence and mortality of endometrial and cervical cancer among inhabitants of the Lodz region were obtained from the National Cancer Registry and Bulletin of Cancer Cases in the Lodz region. The analysis covered ten consecutive years beginning in 2001. Results : The number of new cases reported in 2010 exceeded that observed in 2001 by 181. The standardized incidence rate of endometrial cancer increased by 6.3, while the standardized incidence rate of cervical cancer decreased by 1.4. Conclusions : In the years 2001-2010, the incidence of endometrial cancer increased by 88.3% and that of cervical cancer decreased by 6.5% among inhabitants of the Lodz region. In the years 2001-2010, mortality of endometrial cancer increased by 24.5% and that of cervical cancer decreased by 12.6%. In 2010, the highest crude incidence rates in the Lodz region of both endometrial and cervical cancer at 39.1 were recorded in the district town of Piotrków.

  5. Training Standardization

    International Nuclear Information System (INIS)

    Agnihotri, Newal

    2003-01-01

    The article describes the benefits of and required process and recommendations for implementing the standardization of training in the nuclear power industry in the United States and abroad. Current Information and Communication Technologies (ICT) enable training standardization in the nuclear power industry. The delivery of training through the Internet, Intranet and video over IP will facilitate this standardization and bring multiple benefits to the nuclear power industry worldwide. As the amount of available qualified and experienced professionals decreases because of retirements and fewer nuclear engineering institutions, standardized training will help increase the number of available professionals in the industry. Technology will make it possible to use the experience of retired professionals who may be interested in working part-time from a remote location. Well-planned standardized training will prevent a fragmented approach among utilities, and it will save the industry considerable resources in the long run. It will also ensure cost-effective and safe nuclear power plant operation

  6. The effect of country wealth on incidence of breast cancer.

    Science.gov (United States)

    Coccia, Mario

    2013-09-01

    The aim of this study is to analyze the relationship between the incidence of breast cancer and income per capita across countries. Data on breast cancer incidence in 52 countries were obtained from GLOBOCAN, along with economic indicators of gross domestic product per capita from the World Bank. Number of computed tomography scanners and magnetic resonance imaging (from World Health Organization) were used as a surrogate for technology and access to screening for cancer diagnosis. Statistical analyses for correlation and regression were performed, along with an analysis of variance (ANOVA). A strong positive association between breast cancer incidence and gross domestic product per capita, Pearson's r = 65.4 %, controlling latitude, density of computed tomography scanners and magnetic resonance imaging was found in countries of temperate zones. The estimated relationship suggests that 1 % higher gross domestic product per capita, within the temperate zones (latitudes), increases the expected age-standardized breast cancer incidence by about 35.6 % (p nations may have a higher incidence of breast cancer independent of geographic location and screening technology.

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

    Science.gov (United States)

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

    2012-06-01

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

  8. Well-kept secret. Despite a lack of clearly defined standards, hospitals are under increasing pressure to publicly report charity-care figures.

    Science.gov (United States)

    Jaklevic, Mary Chris

    2004-06-21

    Because hospitals have wildly divergent policies on reporting how much charity care they deliver, some fear the standards are so lax that they won't be able to defend their tax exemptions in court. Charity-care data are "all over the map," says Susan Sherry, left, deputy director of Community Catalyst.

  9. Consumption of the Soluble Dietary Fibre Complex PolyGlycopleX® Reduces Glycaemia and Increases Satiety of a Standard Meal Postprandially

    Directory of Open Access Journals (Sweden)

    Vicky A. Solah

    2016-05-01

    Full Text Available The effect of consumption of PolyGlycopleX® (PGX® was compared to wheat dextrin (WD in combination with a standard meal, on postprandial satiety and glycaemia in a double-blind, randomised crossover trial, of 14 healthy subjects trained as a satiety panel. At each of six two-hour satiety sessions, subjects consumed one of three different test meals on two separate occasions. The test meals were: a standard meal plus 5 g PGX; a standard meal plus 4.5 g of PGX as softgels; and a standard meal plus 5 g of WD. Subjects recorded fullness using a labelled magnitude scale at 0, 15, 30, 45, 60, 90, and 120 min and the total area under the curve (AUC, mean fullness vs. time was calculated. The meals with PGX (in granular and softgel form gave higher satiety (AUC (477 ± 121 and 454 ± 242 cm·min, than the meal with WD (215 ± 261 cm·min (p < 0.001. Subjects had blood glucose levels measured after the meals with PGX (granules and WD. Glucose response (AUC was significantly lower (p < 0.001 after the PGX meal than for the WD meal.  The high viscosity reported for PGX is a likely mechanism behind the significant satiety and blood glucose modulating effects observed in this study.

  10. Initial laboratory experience with a novel ultrasound probe for standard and single-port robotic kidney surgery: increasing console surgeon autonomy and minimizing instrument clashing.

    Science.gov (United States)

    Yakoubi, Rachid; Autorino, Riccardo; Laydner, Humberto; Guillotreau, Julien; White, Michael A; Hillyer, Shahab; Spana, Gregory; Khanna, Rakesh; Isaac, Wahib; Haber, Georges-Pascal; Stein, Robert J; Kaouk, Jihad H

    2012-06-01

    The aim of this study was to evaluate a novel ultrasound probe specifically developed for robotic surgery by determining its efficiency in identifying renal tumors. The study was carried out using the Da Vinci™ surgical system in one female pig. Renal tumor targets were created by percutaneous injection of a tumor mimic mixture. Single-port and standard robotic partial nephrectomy were performed. Intraoperative ultrasound was performed using both standard laparoscopic probe and the new ProART™ Robotic probe. Probe maneuverability and ease of handling for tumor localization were recorded. The standard laparoscopic probe was guided by the assistant. Significant clashing with robotic arms was noted during the single-port procedure. The novel robotic probe was easily introduced through the assistant trocar, and held by the console surgeon using the robotic Prograsp™ with no registered clashing in the external operative field. The average time for grasping the new robotic probe was less than 10 s. Once inserted and grasped, no limitation was found in terms of instrument clashing during the single-port procedure. This novel ultrasound probe developed for robotic surgery was noted to be user-friendly when performing porcine standard and especially single-port robotic partial nephrectomy. Copyright © 2011 John Wiley & Sons, Ltd.

  11. Incidents with hazardous radiation sources; Zwischenfaelle mit gefaehrlichen Strahlenquellen

    Energy Technology Data Exchange (ETDEWEB)

    Schoenhacker, Stefan [Bundesministerium fuer Inneres, Traiskirchen (Austria). Abt. 1/9 - Zivilschutzschule

    2016-07-01

    Incidents with hazardous radiation sources can occur in any country, even those without nuclear facilities. Preparedness for such incidents is supposed to fulfill globally agreed minimum standards. Incidents are categorized in incidents with licensed handling of radiation sources as for material testing, transport accidents of hazardous radiation sources, incidents with radionuclide batteries, incidents with satellites containing radioactive inventory, incidents wit not licensed handling of illegally acquired hazardous radiation sources. The emergency planning in Austria includes a differentiation according to the consequences: incidents with release of radioactive materials resulting in restricted contamination, incidents with release of radioactive materials resulting in local contamination, and incidents with the hazard of e@nhanced exposure due to the radiation source.

  12. Critical incidents and critical incident stress management (CISM) - an employee assistance programme (EAP) perspective

    OpenAIRE

    Terblanche, Lourie; van Wyk, André

    2014-01-01

    Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic s...

  13. Groundwater uranium and cancer incidence in South Carolina

    Science.gov (United States)

    Wagner, Sara E.; Burch, James B.; Bottai, Matteo; Puett, Robin; Porter, Dwayne; Bolick-Aldrich, Susan; Temples, Tom; Wilkerson, Rebecca C.; Vena, John E.; Hébert, James R.

    2012-01-01

    Objective This ecologic study tested the hypothesis that census tracts with elevated groundwater uranium and more frequent groundwater use have increased cancer incidence. Methods Data sources included: incident total, leukemia, prostate, breast, colorectal, lung, kidney, and bladder cancers (1996–2005, SC Central Cancer Registry); demographic and groundwater use (1990 US Census); and groundwater uranium concentrations (n = 4,600, from existing federal and state databases). Kriging was used to predict average uranium concentrations within tracts. The relationship between uranium and standardized cancer incidence ratios was modeled among tracts with substantial groundwater use via linear or semiparametric regression, with and without stratification by the proportion of African Americans in each area. Results A total of 134,685 cancer cases were evaluated. Tracts with ≥50% groundwater use and uranium concentrations in the upper quartile had increased risks for colorectal, breast, kidney, prostate, and total cancer compared to referent tracts. Some of these relationships were more likely to be observed among tracts populated primarily by African Americans. Conclusion SC regions with elevated groundwater uranium and more groundwater use may have an increased incidence of certain cancers, although additional research is needed since the design precluded adjustment for race or other predictive factors at the individual level. PMID:21080052

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

    DEFF Research Database (Denmark)

    Vind, Ida; Riis, L; Jess, T

    2006-01-01

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

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

    Science.gov (United States)

    Lam, Jennifer O.; Lim, Wei-Yen; Chow, Khuan-Yew; D’Souza, Gypsyamber

    2015-01-01

    In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV). Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968–2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC), 183 anal squamous cell carcinoma (ASCC) and 8,019 invasive cervical cancer (ICC) cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC) and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC) cases were included as comparators. Age-standardized incidence rates (ASR) were determined by gender and ethnicity (Chinese, Malay and Indian). Joinpoint regression was used to evaluate annual percentage change (APC) in incidence. OPSCC incidence increased in both genders (men 1993–2012, APC = 1.9%, pSingapore, but Pap screening programs have led to consistently decreasing incidence. PMID:26720001

  16. Regional trends in breast cancer incidence and mortality in Denmark prior to mammographic screening

    DEFF Research Database (Denmark)

    Andreasen, A H; Andersen, K W; Madsen, Mette

    1994-01-01

    To provide a basis for the evaluation of mammographic screening programmes in Denmark, a study was undertaken of the regional differences in breast cancer incidence and mortality. All 16 regions were followed for the 20 year period, 1970-89, before the start of the first population...... among women below age 60. The mortality was more stable, changing only from 24 to 28 (per 100,000 standardised WSP), but a significant increase occurred in the late 1980s. The study showed regional differences in both incidence and mortality of breast cancer in Denmark. Both the incidence......-based mammographic screening programme in the Copenhagen municipality in 1991. Multiplicative Poisson models were used for the analysis. In general, the incidence increased during this period from 55 to 70 [per 100,000 standardised world standard population (WSP)], and the analysis shows this to be most pronounced...

  17. 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.

  18. Cancer incidence among merchant seafarers

    DEFF Research Database (Denmark)

    Ugelvig Petersen, Kajsa; Volk, Julie; Kaerlev, Linda

    2018-01-01

    on the incidence of specific cancers among both male and female seafarers. Methods: Using records from the Danish Seafarer Registry, all seafarers employed on Danish ships during 1986-1999 were identified, resulting in a cohort of 33 084 men and 11 209 women. Information on vital status and cancer was linked...... to each member of the cohort from the Danish Civil Registration System and the Danish Cancer Registry using the unique Danish personal identification number. SIRs were estimated for specific cancers using national rates. Results: The overall incidence of cancer was increased for both male and female...

  19. Long-Term Visual Training Increases Visual Acuity and Long-Term Monocular Deprivation Promotes Ocular Dominance Plasticity in Adult Standard Cage-Raised Mice

    OpenAIRE

    Hosang, Leon; Yusifov, Rashad; Löwel, Siegrid

    2018-01-01

    Abstract For routine behavioral tasks, mice predominantly rely on olfactory cues and tactile information. In contrast, their visual capabilities appear rather restricted, raising the question whether they can improve if vision gets more behaviorally relevant. We therefore performed long-term training using the visual water task (VWT): adult standard cage (SC)-raised mice were trained to swim toward a rewarded grating stimulus so that using visual information avoided excessive swimming toward ...

  20. Decreasing incidence rates of bacteremia

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: Numerous studies have shown that the incidence rate of bacteremia has been increasing over time. However, few studies have distinguished between community-acquired, healthcare-associated and nosocomial bacteremia. METHODS: We conducted a population-based study among adults with first......-time bacteremia in Funen County, Denmark, during 2000-2008 (N = 7786). We reported mean and annual incidence rates (per 100,000 person-years), overall and by place of acquisition. Trends were estimated using a Poisson regression model. RESULTS: The overall incidence rate was 215.7, including 99.0 for community......-acquired, 50.0 for healthcare-associated and 66.7 for nosocomial bacteremia. During 2000-2008, the overall incidence rate decreased by 23.3% from 254.1 to 198.8 (3.3% annually, p incidence rate of community-acquired bacteremia decreased by 25.6% from 119.0 to 93.8 (3.7% annually, p

  1. 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.

  2. Effluent standards

    Energy Technology Data Exchange (ETDEWEB)

    Geisler, G C [Pennsylvania State University (United States)

    1974-07-01

    At the conference there was a considerable interest in research reactor standards and effluent standards in particular. On the program, this is demonstrated by the panel discussion on effluents, the paper on argon 41 measured by Sims, and the summary paper by Ringle, et al. on the activities of ANS research reactor standards committee (ANS-15). As a result, a meeting was organized to discuss the proposed ANS standard on research reactor effluents (15.9). This was held on Tuesday evening, was attended by members of the ANS-15 committee who were present at the conference, participants in the panel discussion on the subject, and others interested. Out of this meeting came a number of excellent suggestions for changes which will increase the utility of the standard, and a strong recommendation that the effluent standard (15.9) be combined with the effluent monitoring standard. It is expected that these suggestions and recommendations will be incorporated and a revised draft issued for comment early this summer. (author)

  3. Daylight Savings Time Transitions and the Incidence Rate of Unipolar Depressive Episodes.

    Science.gov (United States)

    Hansen, Bertel T; Sønderskov, Kim M; Hageman, Ida; Dinesen, Peter T; Østergaard, Søren D

    2017-05-01

    Daylight savings time transitions affect approximately 1.6 billion people worldwide. Prior studies have documented associations between daylight savings time transitions and adverse health outcomes, but it remains unknown whether they also cause an increase in the incidence rate of depressive episodes. This seems likely because daylight savings time transitions affect circadian rhythms, which are implicated in the etiology of depressive disorder. Therefore, we investigated the effects of daylight savings time transitions on the incidence rate of unipolar depressive episodes. Using time series intervention analysis of nationwide data from the Danish Psychiatric Central Research Register from 1995 to 2012, we compared the observed trend in the incidence rate of hospital contacts for unipolar depressive episodes after the transitions to and from summer time to the predicted trend in the incidence rate. The analyses were based on 185,419 hospital contacts for unipolar depression and showed that the transition from summer time to standard time were associated with an 11% increase (95% CI = 7%, 15%) in the incidence rate of unipolar depressive episodes that dissipated over approximately 10 weeks. The transition from standard time to summer time was not associated with a parallel change in the incidence rate of unipolar depressive episodes. This study shows that the transition from summer time to standard time was associated with an increase in the incidence rate of unipolar depressive episodes. Distress associated with the sudden advancement of sunset, marking the coming of a long period of short days, may explain this finding. See video abstract at, http://links.lww.com/EDE/B179.

  4. Rapidly rising incidence of childhood type 1 diabetes in Chinese population: epidemiology in Shanghai during 1997-2011.

    Science.gov (United States)

    Zhao, Zhuhui; Sun, Chengjun; Wang, Chunfang; Li, Pin; Wang, Wei; Ye, Jun; Gu, Xuefan; Wang, Xiaodong; Shen, Shuixian; Zhi, Dijing; Lu, Zhong; Ye, Rong; Cheng, Ruoqian; Xi, Li; Li, Xiaojing; Zheng, Zhangqian; Zhang, Miaoying; Luo, Feihong

    2014-12-01

    The aim of this study was to investigate incidence trend of childhood type 1 diabetes in Shanghai, a megalopolis in east China. We established a population-based retrospective registry for the disease in the city's registered population during 1997-2011 and collected 622 incident type 1 diabetes in children aged 0-14 years. Standardized incidence rates and 95 % CI were estimated by applying the capture-recapture method and assuming Poisson distribution. Incidence trend was analyzed using the Poisson regression model. The mean annual incidence of childhood type 1 diabetes was 3.1 per 100,000 person-years. We did not observe significant difference in incidence between boys and girls. The incidence is unstable and had a mean annual increase 14.2 % per year during the studied period. A faster annual increase was observed in boys, warmer seasons, and in the outer regions of the city. If present trends continue, the number of new type 1 diabetes cases will double from 2016 to 2020, and prevalent cases will sextuple by 2025. Our results showed the incidence of childhood type 1 diabetes was rising rapidly in Shanghai. More studies are needed to analyze incidence changes in other regions of China for appropriate allocation of healthcare resources.

  5. 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...

  6. Final Environmental Statement related to license renewal and power increase for the National Bureau of Standards Reactor: Docket No. 50-184

    International Nuclear Information System (INIS)

    1982-08-01

    This Final Environmental Statement contains an assessment of the environmental impact associated with renewal of Operating License No. TR-5 for the National Bureau of Standards (NBS) reactor for a period of 20 years at a power level of 20 MW. This reactor is located on the 576-acre NBS site near Gaithersburg in Montgomery County, Maryland, about 20 mi northwest of the center of Washington, DC. The reactor is a high-flux heavy-water-moderated, cooled and reflected test reactor, which first went critical on December 7, 1967. Though the reactor was originally designed for 20-MW operation, it has been operating for 14 years at a maximum authorized power level to 10 MW. Program demand is now great enough to warrant operation at a power level of 20 MW. No additional major changes to the physical plant are required to operate at 20 MW

  7. Including indigestible carbohydrates in the evening meal of healthy subjects improves glucose tolerance, lowers inflammatory markers, and increases satiety after a subsequent standardized breakfast

    DEFF Research Database (Denmark)

    Nilsson, A.C.; Ostman, E.M.; Holst, Jens Juul

    2008-01-01

    Low-glycemic index (GI) foods and foods rich in whole grain are associated with reduced risk of type 2 diabetes and cardiovascular disease. We studied the effect of cereal-based bread evening meals (50 g available starch), varying in GI and content of indigestible carbohydrates, on glucose...... tolerance and related variables after a subsequent standardized breakfast in healthy subjects (n = 15). At breakfast, blood was sampled for 3 h for analysis of blood glucose, serum insulin, serum FFA, serum triacylglycerides, plasma glucagon, plasma gastric-inhibitory peptide, plasma glucagon-like peptide-1...... based bread (ordinary, high-amylose- or beta-glucan-rich genotypes) or an evening meal with white wheat flour bread (WWB) enriched with a mixture of barley fiber and resistant starch improved glucose tolerance at the subsequent breakfast compared with unsupplemented WWB (P

  8. CRITICAL INCIDENTS AND CRITICAL INCIDENT STRESS MANAGEMENT (CISM – AN EMPLOYEE ASSISTANCE PROGRAMME (EAP PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Terblanche, Lourie

    2014-04-01

    Full Text Available Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic stress disorder (PTSD and/or depression. This reality requires management – through the Employee Assistance Programme (EAP – to be able to effectively deal with such critical incidents.

  9. The atherosclerosis of the sinus node artery is associated with an increased history of supra-ventricular arrhythmias: a retrospective study on 541 standard coronary angiograms

    Directory of Open Access Journals (Sweden)

    Michele M. Ciulla

    2015-08-01

    Full Text Available Background. The ischemic damage of the sinus node (SN is a well known cause of cardiac arrhythmias and can be a consequence of any flow abnormality in the sinus node artery (SNA. Accordingly we aimed this retrospective study to: (1 evaluate the suitability of the standard coronary angiography to study the SNA and (2 determine if the percentage of subjects with a positive retrospective history of supra-ventricular arrhythmias (SVA differs in patients with normal and diseased SNA ascertained at the time of coronary angiography.Methods and Results. Out of the 541 coronary angiograms reviewed the SNA was visible for its entire course in 486 cases (89.8%. It was found to arise from the right side of the coronary circulation in 266 cases (54.7% slightly more often than from the left, 219 cases (45.1%. One patient had 2 distinct SNA arising from either side of the coronary circulation. For the second objective, we studied the 333 patients with: (a coronary artery disease (CAD, (b properly evaluable SNA and (c complete clinical history available. In 51 (15.3% a SNA disease was found, 41.2% of them had a positive SVA history, mainly atrial fibrillation (AF, whereas only 7.4% of patients with a positive history of SVA could be found in the non-SNA diseased. This difference was statistically significant (P < 0.001.Conclusions. (1 The evaluation of the SNA is feasible in clinical practice during a standard coronary angiography; (2 this may be relevant since angiographically detectable SNA disease was significantly associated with a positive history of SVA.

  10. Radiological incidents in radiotherapy

    International Nuclear Information System (INIS)

    Hobzova, L.; Novotny, J.

    2008-01-01

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

  11. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2014-01-01

    International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...

  12. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2016-01-01

    International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...

  13. Linux Incident Response Volatile Data Analysis Framework

    Science.gov (United States)

    McFadden, Matthew

    2013-01-01

    Cyber incident response is an emphasized subject area in cybersecurity in information technology with increased need for the protection of data. Due to ongoing threats, cybersecurity imposes many challenges and requires new investigative response techniques. In this study a Linux Incident Response Framework is designed for collecting volatile data…

  14. Time trends and occupational variation in the incidence of testicular cancer in the Nordic countries.

    Science.gov (United States)

    Ylönen, Outi; Jyrkkiö, Sirkku; Pukkala, Eero; Syvänen, Kari; Boström, Peter J

    2018-02-20

    To describe the trends and occupational variation in the incidence of testicular cancer in the Nordic countries utilising national cancer registries, NORDCAN (NORDCAN project/database presents the incidence, mortality, prevalence and survival from >50 cancers in the Nordic countries) and NOCCA (Nordic Occupational Cancer) databases. We obtained the incidence data of testicular cancer for 5-year periods from 1960-1964 to 2000-2014 and for 5-year age-groups from the NORDCAN database. Morphological data on incident cases of seminoma and non-seminoma were obtained from national cancer registries. Age-standardised incidence rates (ASR) were calculated per 100 000 person-years (World Standard). Regression analysis was used to evaluate the annual change in the incidence of testicular cancer in each of the Nordic countries. The risk of testicular cancer in different professions was described based on NOCCA information and expressed as standardised incidence ratios (SIRs). During 2010-2014 the ASR for testicular cancer varied from 11.3 in Norway to 5.8 in Finland. Until 1998, the incidence was highest in Denmark. There has not been an increase in Denmark and Iceland since the 1990s, whilst the incidence is still strongly increasing in Norway, Sweden, and Finland. There were no remarkable changes in the ratio of seminoma and non-seminoma incidences during the past 50 years. There was no increase in the incidences in children and those of pension age. The highest significant excess risks of testicular seminoma were found in physicians (SIR 1.48, 95% confidence interval [CI] 1.07-1.99), artistic workers (SIR 1.47, 95% CI 1.06-1.99) and religious workers etc. (SIR 1.33, 95% CI 1.14-1.56). The lowest SIRs of testicular seminoma were seen amongst cooks and stewards (SIR 0.56, 95% CI 0.29-0.98), and forestry workers (SIR 0.64, 95% CI 0.47-0.86). The occupational category of administrators was the only one with a significantly elevated SIR for testicular non-seminoma (SIR 1.21, 95

  15. Preceding immunosuppressive therapy with antithymocyte globulin and ciclosporin increases the incidence of graft rejection in children with aplastic anaemia who underwent allogeneic bone marrow transplantation from HLA-identical siblings.

    Science.gov (United States)

    Kobayashi, Ryoji; Yabe, Hiromasa; Hara, Junichi; Morimoto, Akira; Tsuchida, Masahiro; Mugishima, Hideo; Ohara, Akira; Tsukimoto, Ichiro; Kato, Koji; Kigasawa, Hisato; Tabuchi, Ken; Nakahata, Tatsutoshi; Ohga, Shoichi; Kojima, Seiji

    2006-12-01

    The incidence of graft rejection was determined in 66 children with acquired aplastic anaemia (AA) following bone marrow transplantation (BMT) from a related donor. Eleven of 65 evaluable patients experienced either early or late rejection. Multivariate analysis identified previous immunosuppressive therapy with antithymocyte-globulin (ATG) and ciclosporin (CsA) as a risk factor for graft rejection (relative risk: 16.6, P = 0.001). Patients who received ATG and CsA had a significantly lower probability of failure-free survival than those who did not (69.7 +/- 6.2% vs. 87.9 +/- 8.0%, P = 0.044). These results suggest that BMT should be instituted immediately in children with severe AA who have human leucocyte antigen-identical siblings.

  16. Cancer incidence and mortality in China, 2013.

    Science.gov (United States)

    Chen, Wanqing; Zheng, Rongshou; Zhang, Siwei; Zeng, Hongmei; Xia, Changfa; Zuo, Tingting; Yang, Zhixun; Zou, Xiaonong; He, Jie

    2017-08-10

    National Central Cancer Registry of China (NCCRC) updated nationwide statistics of cancer incidence and mortality in China using population-based cancer registration data in 2013 from all available cancer registries. In 2016, 255 registries' data were qualified and included in this analysis. We estimated numbers of new cancer cases and deaths in China in 2013 using age-specific rates and corresponding national population stratified by area, sex, age group (0, 1-4, 5-9, 10-14…85+) and cancer type. The world Segi's population was applied for age-standardized rates. All rates were expressed per 100,000 person-year. A total of 3,682,000 new cancer cases and 2,229,300 cancer deaths were estimated in China in 2013. Cancers of lung, female breast, stomach, liver, colon-rectum and esophagus were the most common cancers, accounting for about half of all cancer new cases. Lung cancer, liver cancer, stomach cancer, esophageal cancer, colorectal cancer were the five leading causes of cancer death, accounting for about 60% of all cancer deaths. The cancer patterns showed differences not only between male and female, but also among different geographic regions in China. For overall cancers, the age-standardized incidence rates were stable during the past decades in male, but significantly increased by 2.2% per year in female. Cancer poses a major threat to public health and the cancer burden keep raising in China. The annual updated cancer statistics can provide scientific basis for cancer prevention and control. Copyright © 2017. Published by Elsevier B.V.

  17. Radiation injury vs. recurrent brain metastasis: combining textural feature radiomics analysis and standard parameters may increase {sup 18}F-FET PET accuracy without dynamic scans

    Energy Technology Data Exchange (ETDEWEB)

    Lohmann, Philipp; Stoffels, Gabriele; Stegmayr, Carina; Neumaier, Bernd [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); Ceccon, Garry [University of Cologne, Department of Neurology, Cologne (Germany); Rapp, Marion; Sabel, Michael; Kamp, Marcel A. [Heinrich Heine University Duesseldorf, Department of Neurosurgery, Duesseldorf (Germany); Filss, Christian P. [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen (Germany); Shah, Nadim J. [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); RWTH Aachen University Hospital, Department of Neurology, Aachen (Germany); Juelich-Aachen Research Alliance (JARA) - Section JARA-Brain, Department of Neurology, Juelich (Germany); Langen, Karl-Josef [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen (Germany); Juelich-Aachen Research Alliance (JARA) - Section JARA-Brain, Department of Neurology, Juelich (Germany); Galldiks, Norbert [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); University of Cologne, Department of Neurology, Cologne (Germany); University of Cologne, Center of Integrated Oncology (CIO), Cologne (Germany)

    2017-07-15

    We investigated the potential of textural feature analysis of O-(2-[{sup 18}F]fluoroethyl)-L-tyrosine ({sup 18}F-FET) PET to differentiate radiation injury from brain metastasis recurrence. Forty-seven patients with contrast-enhancing brain lesions (n = 54) on MRI after radiotherapy of brain metastases underwent dynamic {sup 18}F-FET PET. Tumour-to-brain ratios (TBRs) of {sup 18}F-FET uptake and 62 textural parameters were determined on summed images 20-40 min post-injection. Tracer uptake kinetics, i.e., time-to-peak (TTP) and patterns of time-activity curves (TAC) were evaluated on dynamic PET data from 0-50 min post-injection. Diagnostic accuracy of investigated parameters and combinations thereof to discriminate between brain metastasis recurrence and radiation injury was compared. Diagnostic accuracy increased from 81 % for TBR{sub mean} alone to 85 % when combined with the textural parameter Coarseness or Short-zone emphasis. The accuracy of TBR{sub max} alone was 83 % and increased to 85 % after combination with the textural parameters Coarseness, Short-zone emphasis, or Correlation. Analysis of TACs resulted in an accuracy of 70 % for kinetic pattern alone and increased to 83 % when combined with TBR{sub max}. Textural feature analysis in combination with TBRs may have the potential to increase diagnostic accuracy for discrimination between brain metastasis recurrence and radiation injury, without the need for dynamic {sup 18}F-FET PET scans. (orig.)

  18. Addition of interferon-alpha to a standard maturation cocktail induces CD38 up-regulation and increases dendritic cell function

    DEFF Research Database (Denmark)

    Trepiakas, Redas; Pedersen, Anders Elm; Met, Ozcan

    2009-01-01

    Monocyte-derived dendritic cells (DCs) are used as adjuvant cells in cancer immunotherapy and have shown promising results. In order to obtain full functional capacity, these DCs need to be maturated, and the current "gold standard" for this process is maturation with TNF-alpha, IL-1beta, IL-6...... a functional relationship between CD38, IFN-alpha and TLR3. Thus, CD38 appear to be a relevant marker for activation by TLR3 or IFN-alpha. Addition of IFN-alpha to the sDC cocktail results in up-regulation of both CD38 and CD83 and improved capacity for induction of autologous T-cell responses despite few...... other changes in DC phenotype and cytokine secretion. Our observations suggest that IFN-alpha could be included in maturation protocols for clinical grade DCs used for immunotherapy against cancer and should be included if DCs are used for CD8+ T-cell stimulation in vitro....

  19. Incidence and mortality trends of leukemia and lymphoma in Croatia, 1988-2009

    Science.gov (United States)

    Novak, Ina; Jakšić, Ozren; Kuliš, Tomislav; Batinjan, Katarina; Znaor, Ariana

    2012-01-01

    Aim To investigate the time trends of leukemia and lymphoma in Croatia from 1988-2009, compare them with trends in other populations, and identify possible changes. Methods The data sources were the Croatian National Cancer Registry for incidence data, Croatian Bureau of Statistics for the numbers of deaths, and United Nations population estimates. Joinpoint regression analysis using the age-standardized rates was used to analyze incidence and mortality trends. Results Acute lymphoblastic leukemia and chronic lymphocytic leukemia incidence did not significantly change. Acute myeloid leukemia incidence significantly increased in women, with estimated annual percentage change (EAPC) of 2.6% during the whole period, and in men since 1998, with EAPC of 3.2%. Chronic myeloid leukemia incidence significantly decreased in women (EAPC -3.7%) and remained stable in men. Mortality rates were stable for both lymphoid and myeloid leukemia in both sexes. Hodgkin lymphoma non-significantly increased in incidence and significantly decreased in mortality (EAPCs of -5.6% in men and -3.7% in women). Non-Hodgkin lymphoma significantly increased in incidence in women (EAPC 3.2%) and non-significantly in men and in mortality in both men (EAPC 1.6%) and women (EAPC 1.8%). Conclusion While Croatia had similar leukemia and lymphoma incidence trends as the other countries, the mortality trends were less favorable than in Western Europe. The lack of declines of leukemia incidence and non-Hodgkin lymphoma mortality could be attributed to late introduction of optimal therapies. As currently the most up-to-date diagnostics and treatments are available and covered by health insurance, we expect more favorable trends in the future. PMID:22522989

  20. Psychiatric disease incidence among Danish Seventh-day Adventists and Baptists.

    Science.gov (United States)

    Thygesen, Lau Caspar; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Ross, Lone; Kessing, Lars Vedel; Hvidt, Niels Christian

    2013-10-01

    Previous studies suggest that religious practice can have a positive effect on mental health, but may also have potential for harm. In Denmark, unique possibilities are available for studying the influence of religious practice on mental health: Denmark is characterized as a secular society and it is possible to follow members of religious societies in nationwide registers. In this study, we follow a cohort of Danish Seventh-day Adventists (SDA) and Baptists in a nationwide psychiatry register and compare the incidence in this cohort with the general population. We followed a cohort of 5,614 SDA and 3,663 Baptists in the Danish Psychiatric Central Register, which contained information on psychiatric hospitalizations from 1970 to 2009. Psychiatric disease incidence in the cohort was compared with that in the general Danish population as standardized incidence ratios and within-cohort comparisons were made with a Cox model. The cohort had decreased incidence of abuse disorders compared to the general population. Furthermore, among Baptists, decreased incidence of unipolar disorders among men and decreased incidence of schizophrenia among women were observed. Surprisingly, we observed an increased incidence rate of unipolar disorder among women. In this nationwide cohort study with 40 years of follow-up, we observed increased incidence rates of unipolar disorders among women and decreased rates of alcohol- and drug-related psychiatric disorders compared to the general Danish population. We have no mechanistic explanation for the increased incidence of unipolar disorders among women, but discuss several hypotheses that could explain this observation.

  1. Radiation injury vs. recurrent brain metastasis: combining textural feature radiomics analysis and standard parameters may increase 18F-FET PET accuracy without dynamic scans.

    Science.gov (United States)

    Lohmann, Philipp; Stoffels, Gabriele; Ceccon, Garry; Rapp, Marion; Sabel, Michael; Filss, Christian P; Kamp, Marcel A; Stegmayr, Carina; Neumaier, Bernd; Shah, Nadim J; Langen, Karl-Josef; Galldiks, Norbert

    2017-07-01

    We investigated the potential of textural feature analysis of O-(2-[ 18 F]fluoroethyl)-L-tyrosine ( 18 F-FET) PET to differentiate radiation injury from brain metastasis recurrence. Forty-seven patients with contrast-enhancing brain lesions (n = 54) on MRI after radiotherapy of brain metastases underwent dynamic 18 F-FET PET. Tumour-to-brain ratios (TBRs) of 18 F-FET uptake and 62 textural parameters were determined on summed images 20-40 min post-injection. Tracer uptake kinetics, i.e., time-to-peak (TTP) and patterns of time-activity curves (TAC) were evaluated on dynamic PET data from 0-50 min post-injection. Diagnostic accuracy of investigated parameters and combinations thereof to discriminate between brain metastasis recurrence and radiation injury was compared. Diagnostic accuracy increased from 81 % for TBR mean alone to 85 % when combined with the textural parameter Coarseness or Short-zone emphasis. The accuracy of TBR max alone was 83 % and increased to 85 % after combination with the textural parameters Coarseness, Short-zone emphasis, or Correlation. Analysis of TACs resulted in an accuracy of 70 % for kinetic pattern alone and increased to 83 % when combined with TBR max . Textural feature analysis in combination with TBRs may have the potential to increase diagnostic accuracy for discrimination between brain metastasis recurrence and radiation injury, without the need for dynamic 18 F-FET PET scans. • Textural feature analysis provides quantitative information about tumour heterogeneity • Textural features help improve discrimination between brain metastasis recurrence and radiation injury • Textural features might be helpful to further understand tumour heterogeneity • Analysis does not require a more time consuming dynamic PET acquisition.

  2. Cancer incidence among Minnesota taconite mining industry workers.

    Science.gov (United States)

    Allen, Elizabeth M; Alexander, Bruce H; MacLehose, Richard F; Nelson, Heather H; Ramachandran, Gurumurthy; Mandel, Jeffrey H

    2015-11-01

    To evaluate cancer incidence among Minnesota taconite mining workers. We evaluated cancer incidence between 1988 and 2010 in a cohort of 40,720 Minnesota taconite mining workers used between 1937 and 1983. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were estimated by comparing numbers of incident cancers with frequencies in the Minnesota Cancer Surveillance System. SIRs for lung cancer by histologic subtypes were also estimated. We adjusted for out-of-state migration and conducted a probabilistic bias analysis for smoking-related cancers. A total of 5700 cancers were identified, including 51 mesotheliomas and 973 lung cancers. The SIRs for lung cancer and mesothelioma were 1.3 (95% CI = 1.2-1.4) and 2.4 (95% CI = 1.8-3.2), respectively. Stomach, laryngeal, and bladder cancers were also elevated. However, adjusting for potential confounding by smoking attenuated the estimates for lung (SIR = 1.1, 95% CI = 1.0-1.3), laryngeal (SIR = 1.2, 95% CI = 0.8-1.6), oral (SIR = 0.9, 95% CI = 0.7-1.2), and bladder cancers (SIR = 1.0, 95% CI = 0.8-1.1). Taconite workers may have an increased risk for certain cancers. Lifestyle and work-related factors may play a role in elevated morbidity. The extent to which mining-related exposures contribute to disease burden is being investigated. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

    Urbonaite, Brone; Zalinkevicius, Rimas; Green, Anders

    2002-01-01

    -based linear trends of the increase in incidence in various age groups and the annual percentage change for both genders was 2.05 (p = 0.0039) and the greatest regression slope is observed for both genders in the 10-14 yr age group. Regression-based linear trends in type 1 diabetes prevalence indicate an even......AIMS/HYPOTHESIS: Our purpose is to analyze interrelations of the incidence, prevalence and mortality of childhood-onset insulin-dependent diabetes mellitus (type 1) in Lithuania. METHODS: Incidence and prevalence rates were based on the national type 1 diabetes register during 1983-98. The cohort...... study was performed to evaluate the standardized mortality ratios. RESULTS: The average incidence of type 1 diabetes during the 16-yr study period was 7.36 per 100,000/yr. For both males and females the highest incidence of type 1 diabetes was recorded in the 10-14 yr age group. The regression...

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

    Science.gov (United States)

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

    2017-11-01

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

  5. 2011 Japanese Nuclear Incident

    Science.gov (United States)

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

  6. Prediction of Safety Incidents

    Data.gov (United States)

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

  7. Marine Animal Incident Database

    Data.gov (United States)

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

  8. Acute incidents during anaesthesia

    African Journals Online (AJOL)

    management of acute incidents and the prevention of ... High or total (complete) spinal blocks in obstetric .... Pain and opioid analgesics lead to delayed ... Step up postoperative care and use ... recognise suprasternal and supraclavicular.

  9. Correspondence optimization in 2D standardized carotid wall thickness map by description length minimization: A tool for increasing reproducibility of 3D ultrasound-based measurements.

    Science.gov (United States)

    Chen, Yimin; Chiu, Bernard

    2016-12-01

    The previously described 2D standardized vessel-wall-plus-plaque thickness (VWT) maps constructed from 3D ultrasound vessel wall measurements using an arc-length (AL) scaling approach adjusted the geometric variability of carotid arteries and has allowed for the comparisons of VWT distributions in longitudinal and cross-sectional studies. However, this mapping technique did not optimize point correspondence of the carotid arteries investigated. The potential misalignment may lead to errors in point-wise VWT comparisons. In this paper, we developed and validated an algorithm based on steepest description length (DL) descent to optimize the point correspondence implied by the 2D VWT maps. The previously described AL approach was applied to obtain initial 2D maps for a group of carotid arteries. The 2D maps were reparameterized based on an iterative steepest DL descent approach, which consists of the following two steps. First, landmarks established by resampling the 2D maps were aligned using the Procrustes algorithm. Then, the gradient of the DL with respect to horizontal and vertical reparameterizations of each landmark on the 2D maps was computed, and the 2D maps were subsequently deformed in the direction of the steepest descent of DL. These two steps were repeated until convergence. The quality of the correspondence was evaluated in a phantom study and an in vivo study involving ten carotid arteries enrolled in a 3D ultrasound interscan variability study. The correspondence quality was evaluated in terms of the compactness and generalization ability of the statistical shape model built based on the established point correspondence in both studies. In the in vivo study, the effect of the proposed algorithm on interscan variability of VWT measurements was evaluated by comparing the percentage of landmarks with statistically significant VWT-change before and after point correspondence optimization. The statistical shape model constructed with optimized

  10. Influence of atmospheric pressure on the incidence of spontaneous pneumothorax.

    Science.gov (United States)

    Díaz, Raúl; Díez, Manuel Mariano; Medrano, María José; Vera, Cristina; Guillamot, Paloma; Sánchez, Ana; Ratia, Tomás; Granell, Javier

    2014-01-01

    This study analyses the relationship between the incidence of idiopathic spontaneous pneumothorax (ISP) and atmospheric pressure (AP). A total of 288 cases of ISP were included, 229 men and 59 women. The AP of the day of diagnosis, of the 3 prior days and the monthly average was registered. The association between the incidence of ISP and AP was analyzed by calculating standardized incidence ratio (SIR) and Poisson regression. The AP on the day of admission (mean±standard deviation) (1,017.9±7 hectopascals [hPa]) was higher than the monthly average AP (1,016.9±4.1 hPa) (P=.005). There was a monthly distribution pattern of ISP with the highest incidence in the months of January, February and September and the lowest in April. When AP was less than 1,014 hPa, there were fewer cases registered than what would statistically have been expected (58/72 cases). In contrast, when the pressure was higher than 1,019 hPa, the registered cases were more than expected (109/82 cases) (SIR=1.25; 95% CI: 1.04 to 1.51). The risk of ISP increased 1.15 times (95% CI: 1.05 to 1.25, P=.001) for each hPa of AP, regardless of sex, age and monthly average AP. A dose-response relationship was observed, with progressive increases in risk (IRR=1.06 when the AP was 1,014-1016 hPa; 1.17 hPa when the AP was 1,016-1,019 hPa and 1.69 when AP was superior to 1,019 hPa) (P for trend=.089). The AP is a risk factor for the onset of idiopathic spontaneous pneumothorax. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  11. Incidence and Mortality of Breast Cancer and their Relationship with the Human Development Index (HDI) in the World in 2012.

    Science.gov (United States)

    Ghoncheh, Mahshid; Mirzaei, Maryam; Salehiniya, Hamid

    2015-01-01

    Breast cancer is the most common malignancy in women worldwide and its incidence is generally increasing. In 2012, it was the second most common cancer in the world. It is necessary to obtain information on incidence and mortality for health planning. This study aimed to investigate the relationship between the human development index (HDI), and the incidence and mortality rates of breast cancer in the world in 2012. This ecologic study concerns incidence rate and standardized mortality rates of the cancer from GLOBOCAN in 2012, and HDI and its components extracted from the global bank site. Data were analyzed using correlation tests and regression with SPSS software (version 15). Among the six regions of WHO, the highest breast cancer incidence rate (67.6) was observed in the PAHO, and the lowest incidence rate was 27.8 for SEARO. There was a direct, strong, and meaningful correlation between the standardized incidence rate and HDI (r=0.725, p≤0.001). Pearson correlation test showed that there was a significant correlation between age-specific incidence rate (ASIR) and components of the HDI (life expectancy at birth, mean years of schooling, and GNP). On the other, a non-significant relationship was observed between ASIR and HDI overall (r=0.091, p=0.241). In total, a significant relationship was not found between age-specific mortality rate (ASMR) and components of HDI. Significant positive correlations exist between ASIR and components of the HDI. Socioeconomic status is directly related to the stage of the cancer and patient's survival. With increasing the incidence rate of the cancer, mortality rate from the cancer does not necessariloy increase. This may be due to more early detection and treatment in developed that developing countries. It is necessary to increase awareness of risk factors and early detection in the latter.

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

    Science.gov (United States)

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

    2012-01-01

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

  13. State Methods for a Cyber Incident

    Science.gov (United States)

    2012-03-01

    Glossary S905 - Incident Submission and Response Standard S910 - Data Breach Notification Standard E-5 Our state characterizes information system...Office of Management and Budget. (2011a). Legislative Language Data Breach Notification. Retrieved September 20, 2010, from http://www.whitehouse.gov...sites/default/files/omb/legislative/letters/ data - breach -notification.pdf Executive Office of the President. Office of Management and Budget

  14. Cancer incidence and mortality in Chukotka, 1997–2010

    Directory of Open Access Journals (Sweden)

    Alexey A. Dudarev

    2013-03-01

    Full Text Available Objectives. The general aim was to assess cancer incidence and mortality among the general population of Chukotka in 1997–2010 and to compare it with the population of Russia. Methods. Cancer data were abstracted from the annual statistical reports of the P.A. Hertzen Research Institute of Oncology in Moscow. The annual number and percent of cases, crude and age-standardized cancer incidence (ASIR and mortality (ASMR rates per 100,000 among men and women in the Chukotka Autonomous Okrug were determined for the period 1997–2010 for incidence and 1999–2010 for mortality. Two years’ data were aggregated to generate temporal trends during the period. In age-standardization, the Segi-Doll world standard population used by the International Agency for Research on Cancer was used. Results. The higher incidence and mortality rate of cancer (all sites combined among men compared to women, which was observed in Russia nationally, was reflected also in Chukotka, although the difference between men and women was not statistically significant. Overall, the patterns of cancer sites are similar between Chukotka and Russia, with cancer of the lung/trachea/bronchus and stomach occupying the top ranks among men. Oesophageal cancer is common in Chukotka but not in Russia, whereas prostate cancer is common in Russia but not in Chukotka. Among women, breast cancer is either the commonest or second commonest cancer in terms of incidence or mortality in both Chukotka and Russia. Cancer of the lung/trachea/bronchi ranks higher in Chukotka than in Russia. The rate of cancer incidence and mortality for all sites combined during the 13-year period was relatively stable in Russia. Dividing the period into two halves, an increase among both men and women was observed in Chukotka for all sites combined, and also for colorectal cancer. Conclusions. This paper presents previously unavailable cancer epidemiological data on Chukotka. They provide a basis for comparative

  15. Cancer incidence and mortality in Chukotka, 1997–2010

    Science.gov (United States)

    Dudarev, Alexey A.; Chupakhin, Valery S.; Odland, Jon Øyvind

    2013-01-01

    Objectives The general aim was to assess cancer incidence and mortality among the general population of Chukotka in 1997–2010 and to compare it with the population of Russia. Methods Cancer data were abstracted from the annual statistical reports of the P.A. Hertzen Research Institute of Oncology in Moscow. The annual number and percent of cases, crude and age-standardized cancer incidence (ASIR) and mortality (ASMR) rates per 100,000 among men and women in the Chukotka Autonomous Okrug were determined for the period 1997–2010 for incidence and 1999–2010 for mortality. Two years’ data were aggregated to generate temporal trends during the period. In age-standardization, the Segi-Doll world standard population used by the International Agency for Research on Cancer was used. Results The higher incidence and mortality rate of cancer (all sites combined) among men compared to women, which was observed in Russia nationally, was reflected also in Chukotka, although the difference between men and women was not statistically significant. Overall, the patterns of cancer sites are similar between Chukotka and Russia, with cancer of the lung/trachea/bronchus and stomach occupying the top ranks among men. Oesophageal cancer is common in Chukotka but not in Russia, whereas prostate cancer is common in Russia but not in Chukotka. Among women, breast cancer is either the commonest or second commonest cancer in terms of incidence or mortality in both Chukotka and Russia. Cancer of the lung/trachea/bronchi ranks higher in Chukotka than in Russia. The rate of cancer incidence and mortality for all sites combined during the 13-year period was relatively stable in Russia. Dividing the period into two halves, an increase among both men and women was observed in Chukotka for all sites combined, and also for colorectal cancer. Conclusions This paper presents previously unavailable cancer epidemiological data on Chukotka. They provide a basis for comparative studies across

  16. Cancer incidence and mortality in Chukotka, 1997-2010.

    Science.gov (United States)

    Dudarev, Alexey A; Chupakhin, Valery S; Odland, Jon Øyvind

    2013-01-01

    The general aim was to assess cancer incidence and mortality among the general population of Chukotka in 1997-2010 and to compare it with the population of Russia. Cancer data were abstracted from the annual statistical reports of the P.A. Hertzen Research Institute of Oncology in Moscow. The annual number and percent of cases, crude and age-standardized cancer incidence (ASIR) and mortality (ASMR) rates per 100,000 among men and women in the Chukotka Autonomous Okrug were determined for the period 1997-2010 for incidence and 1999-2010 for mortality. Two years' data were aggregated to generate temporal trends during the period. In age-standardization, the Segi-Doll world standard population used by the International Agency for Research on Cancer was used. The higher incidence and mortality rate of cancer (all sites combined) among men compared to women, which was observed in Russia nationally, was reflected also in Chukotka, although the difference between men and women was not statistically significant. Overall, the patterns of cancer sites are similar between Chukotka and Russia, with cancer of the lung/trachea/bronchus and stomach occupying the top ranks among men. Oesophageal cancer is common in Chukotka but not in Russia, whereas prostate cancer is common in Russia but not in Chukotka. Among women, breast cancer is either the commonest or second commonest cancer in terms of incidence or mortality in both Chukotka and Russia. Cancer of the lung/trachea/bronchi ranks higher in Chukotka than in Russia. The rate of cancer incidence and mortality for all sites combined during the 13-year period was relatively stable in Russia. Dividing the period into two halves, an increase among both men and women was observed in Chukotka for all sites combined, and also for colorectal cancer. This paper presents previously unavailable cancer epidemiological data on Chukotka. They provide a basis for comparative studies across circumpolar regions and countries. With its small

  17. 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

  18. Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents.

    Science.gov (United States)

    DeFraia, G S

    2015-07-01

    Psychologically traumatic workplace events (known as critical incidents) occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

  19. Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents

    Directory of Open Access Journals (Sweden)

    GS DeFraia

    2015-07-01

    Full Text Available Background: Psychologically traumatic workplace events (known as critical incidents occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. Objective: To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. Methods: Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Results: Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Conclusion: Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

  20. MaquiBright™ standardized maqui berry extract significantly increases tear fluid production and ameliorates dry eye-related symptoms in a clinical pilot trial.

    Science.gov (United States)

    Hitoe, S; Tanaka, J; Shimoda, H

    2014-09-01

    Dry eye symptoms, resulting from insufficient tear fluid generation, represent a considerable burden for a largely underestimated number of people. We concluded from earlier pre-clinical investigations that the etiology of dry eyes encompasses oxidative stress burden to lachrymal glands and that antioxidant MaquiBright™ Aristotelia chilensis berry extract helps restore glandular activity. In this pilot trial we investigated 13 healthy volunteers with moderately dry eyes using Schirmer test, as well as a questionnaire which allows for estimating the impact of dry eyes on daily routines. Study participants were assigned to one of two groups, receiving MaquiBright™ at daily dosage of either 30 mg (N.=7) or 60 mg (N.=6) over a period of 60 days. Both groups presented with significantly (Peye dryness on daily routines was evaluated employing the "Dry Eye-related Quality of life Score" (DEQS), with values spanning from zero (impact) to a maximum score of 60. Participants had comparable baseline values of 41.0±7.7 (30 mg) and 40.2±6.3 (60 mg). With 30 mg treatment the score significantly decreased to 21.8±3.9 and 18.9±3.9, after 30 and 60 days, respectively. With 60 mg treatment the DEQS significantly decreased to 26.9±5.3 and 11.1±2.7, after 30 and 60 days, respectively. Blood was drawn for safety analyses (complete blood rheology and -chemistry) at all three investigative time points without negative findings. In conclusion, while daily supplementation with 30 mg MaquiBright™ is effective, the dosage of 60 significantly increased tear fluid volume at all investigative time points and decreased dry eye symptoms to almost a quarter from initial values after two months treatment.

  1. Changing trends in the incidence (1999-2011 and mortality (1983-2013 of cervical cancer in the Republic of Korea

    Directory of Open Access Journals (Sweden)

    Yoon Park

    2015-05-01

    Full Text Available Cervical cancer is a well-known preventable cancer worldwide. Many countries including Korea have pursued the positive endpoint of a reduction in mortality from cervical cancer. Our aim is to examine changing trends in cervical cancer incidence and mortality after the implementation of a national preventive effort in Korea. Cervical cancer incidence data from 1999 to 2011 and mortality data from 1983 to 2013 were collected from the Korean Statistical Information Service. Yearly age-standardized rates (ASR per 100,000 were compared using two standards: the 2005 Korean population and the world standard population, based on Segi’s world standard for incidence and the World Health Organization for mortality. In Korea, the age-standardized incidence of cervical cancer per 100,000 persons declined from 17.2 in 2000 to 11.8 in 2011. However, the group aged 25 to 29 showed a higher rate in 2011 (ASR, 6.5 than in 2000 (ASR, 3.6. The age-standardized mortality rate per 100,000 persons dropped from 2.81 in 2000 to 1.95 in 2013. In the worldwide comparison, the incidence rates remained close to the average incidence estimate of more developed regions (ASR, 9.9. The decreasing mortality trend in Korea approached the lower rate observed in Australia (ASR, 1.4 in 2010. Although the incidence rate of cervical cancer is continuously declining in Korea, it is still high relative to other countries. Moreover, incidence and mortality rates in females aged 30 years or under have recently increased. It is necessary to develop effective policy to reduce both incidence and mortality, particularly in younger age groups.

  2. Incidence and Mortality of Bladder Cancer and their Relationship with Development in Asia.

    Science.gov (United States)

    Pakzad, Reza; Mohammadian-Hafshejani, Abdollah; Mohammadian, Mahdi; Pakzad, Iraj; Safiri, Saeid; Khazaei, Salman; Salehiniya, Hamid

    2015-01-01

    Over the past decade, bladder cancer was associated with a significant increase. Given the importance of the impact of socioeconomic status on the distribution of cancer incidence and mortality, and the need to information on these parameters for prevention planning, the aim of this study was to evaluate data for bladder cancer and their relationship with human development index (HDI) and its components in Asia in 2012. The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). The incidence and mortality rates were drawn for Asian countries. To analyze data, correlation tests between incidence and death rates, and HDI and its components were employed with a significance level of 0.05 using SPSS software. A total incidence of 696,231 cases (68.7% in males and 31.3% in females, sex ratio of 2.19:1) and 524,465 deaths (67.0% in men and 32.9% in women, sex ratio was 2.03:1) were recorded in Asian countries in 2012. Correlation between HDI and standardized incidence rate was 0.241 overall (p=0.106), 0.236 in men (p=0.114) and -0.250 in women (p=0.094). Also between HDI and standardized mortality rate 0.025 (p=0.871) in men 0.118 (p=0.903) and in women 0.014 (p=0.927). Bladder cancer incidence is higher in developed countries, but the rate is declining, and in less developed and developing countries it is growing. There was no statistically significant correlation between the standardized incidence rate of bladder cancer and the HDI and its dimensions in Asia, except for the level of education.

  3. A modified Wright-Fisher model that incorporates Ne: A variant of the standard model with increased biological realism and reduced computational complexity.

    Science.gov (United States)

    Zhao, Lei; Gossmann, Toni I; Waxman, David

    2016-03-21

    The Wright-Fisher model is an important model in evolutionary biology and population genetics. It has been applied in numerous analyses of finite populations with discrete generations. It is recognised that real populations can behave, in some key aspects, as though their size that is not the census size, N, but rather a smaller size, namely the effective population size, Ne. However, in the Wright-Fisher model, there is no distinction between the effective and census population sizes. Equivalently, we can say that in this model, Ne coincides with N. The Wright-Fisher model therefore lacks an important aspect of biological realism. Here, we present a method that allows Ne to be directly incorporated into the Wright-Fisher model. The modified model involves matrices whose size is determined by Ne. Thus apart from increased biological realism, the modified model also has reduced computational complexity, particularly so when Ne⪡N. For complex problems, it may be hard or impossible to numerically analyse the most commonly-used approximation of the Wright-Fisher model that incorporates Ne, namely the diffusion approximation. An alternative approach is simulation. However, the simulations need to be sufficiently detailed that they yield an effective size that is different to the census size. Simulations may also be time consuming and have attendant statistical errors. The method presented in this work may then be the only alternative to simulations, when Ne differs from N. We illustrate the straightforward application of the method to some problems involving allele fixation and the determination of the equilibrium site frequency spectrum. We then apply the method to the problem of fixation when three alleles are segregating in a population. This latter problem is significantly more complex than a two allele problem and since the diffusion equation cannot be numerically solved, the only other way Ne can be incorporated into the analysis is by simulation. We have

  4. 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.

  5. Incidence of second malignancies for prostate cancer.

    Directory of Open Access Journals (Sweden)

    Mieke Van Hemelrijck

    Full Text Available INTRODUCTION: There is a need to assess risk of second primary cancers in prostate cancer (PCa patients, especially since PCa treatment may be associated with increased risk of second primary tumours. METHODS: We calculated standardized incidence ratios (SIRs for second primary tumours comparing men diagnosed with PCa between 1980 and 2010 in the Canton of Zurich, Switzerland (n = 20,559, and the general male population in the Canton. RESULTS: A total of 1,718 men developed a second primary tumour after PCa diagnosis, with lung and colon cancer being the most common (15 and 13% respectively. The SIR for overall second primary cancer was 1.11 (95%CI: 1.06-1.17. Site-specific SIRs varied from 1.19 (1.05-1.34 to 2.89 (2.62-4.77 for lung and thyroid cancer, respectively. When stratified by treatment, the highest SIR was observed for thyroid cancer (3.57 (1.30-7.76 when undergoing surgery, whereas liver cancer was common when treated with radiotherapy (3.21 (1.54-5.90 and kidney bladder was most prevalent for those on hormonal treatment (3.15 (1.93-4.87. Stratification by time since PCa diagnosis showed a lower risk of cancer for men with PCa compared to the general population for the first four years, but then a steep increase in risk was observed. CONCLUSION: In the Canton of Zurich, there was an increased risk of second primary cancers among men with PCa compared to the general population. Increased diagnostic activity after PCa diagnosis may partly explain increased risks within the first years of diagnosis, but time-stratified analyses indicated that increased risks remained and even increased over time.

  6. Incidence of and breed-related risk factors for gastric dilatation-volvulus in dogs.

    Science.gov (United States)

    Glickman, L T; Glickman, N W; Schellenberg, D B; Raghavan, M; Lee, T L

    2000-01-01

    To compare incidence of and breed-related risk factors for gastric dilatation-volvulus (GDV) among 11 dog breeds (Akita, Bloodhound, Collie, Great Dane, Irish Setter, Irish Wolfhound, Newfoundland, Rottweiler, Saint Bernard, Standard Poodle, and Weimaraner). Prospective cohort study. 1,914 dogs. Owners of dogs that did not have a history of GDV were recruited at dog shows, and the dog's length and height and depth and width of the thorax and abdomen were measured. Information concerning the dogs' medical history, genetic background, personality, and diet was obtained from owners, and owners were contacted by mail and telephone at approximately 1-year intervals to determine whether dogs had developed GDV or died. Incidence of GDV based on the number of dog-years at risk was calculated for each breed, and breed-related risk factors were identified. Incidence of GDV for the 7 large (23 to 45 kg [50 to 99 lb]) and 4 giant (> 45 kg [> 99 lb]) breeds was 23 and 26 cases/1,000 dog-years at risk, respectively. Of the 105 dogs that developed GDV, 30 (28.6%) died. Incidence of GDV increased with increasing age. Cumulative incidence of GDV was 5.7% for all breeds. The only breed-specific characteristic significantly associated with a decreased incidence of GDV was an owner-perceived personality trait of happiness.

  7. Hazmat Yearly Incident Summary Reports

    Data.gov (United States)

    Department of Transportation — Series of Incident data and summary statistics reports produced which provide statistical information on incidents by type, year, geographical location, and others....

  8. Radiation incidents in dentistry

    International Nuclear Information System (INIS)

    Lovelock, D.J.

    1996-01-01

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

  9. International patterns and trends in testicular cancer incidence, overall and by histologic subtype, 1973-2007.

    Science.gov (United States)

    Trabert, B; Chen, J; Devesa, S S; Bray, F; McGlynn, K A

    2015-01-01

    Incidence rates of testicular cancer in Northern European and North American countries have been widely reported, whereas rates in other populations, such as Eastern Europe, Central/South America, Asia, and Africa, have been less frequently evaluated. We examined testicular cancer incidence rates overall and by histologic type by calendar time and birth cohort for selected global populations 1973-2007. Age-standardized incidence rates over succeeding 5-year periods were calculated from volumes 4-9 of Cancer Incidence in Five Continents electronic database (CI5plus) and the newly released CI5X (volume 10) database. Annual percent change over the 35-year period was calculated using weighted least squares regression. Age-period-cohort analyses were performed and observed rates and fitted rate ratios presented by birth cohort. Incidence rates of testicular cancer increased between 1973-1977 and 2003-2007 in most populations evaluated worldwide. Of note, incidence rates in Eastern European countries rose rapidly and approached rates in Northern European countries. Rates in Central and South America also increased and are now intermediate to the high rates among men of European ancestry and low rates among men of Asian or African descent. Some heterogeneity in the trends in seminoma and nonseminoma were observed in Denmark, the United Kingdom, and among US whites, particularly in recent generations, with rapid and uniform increases in the incidence of both histologic types in Slovakia. Reasons for the rising incidence rates among European and American populations remain unexplained; however, changing distributions in the prevalence of risk factors for testicular cancer cannot be ruled out. © 2014 American Society of Andrology and European Academy of Andrology.

  10. Development of a model for recording and evaluating incidents in radiotherapy

    International Nuclear Information System (INIS)

    Ribeiro, A.L.C.; Paiva, E. de; Teixeira, F.C.S.

    2017-01-01

    Radiotherapy has been constantly improving to become increasingly effective, thus contributing to increase the chances of healing patients. In this sense, incident learning gained prominence during successive approaches to patient safety. The objective is to develop a tool for recording and analyzing incidents in radiotherapy and applying it to clinics in Rio de Janeiro in order to implement the policy of quality management and safety culture. Steps were taken that involved the analysis of the process maps for the enrichment of the system (called the Standardized System of Incidents in Radiotherapy - SPIRad) that already has a version in physical form. The proposal is the conversion of this form to a digital tool to be used through the intranet. The next step is to apply it to radiotherapy clinics in Rio de Janeiro and evaluate the results obtained with the objective of possible improvements through feedback from users

  11. Suicide: Incidence or Prevalence? Comments on Hernández-Alvarado et al. Increase in Suicide Rates by Hanging in the Population of Tabasco, Mexico between 2003 and 2012. Int. J. Environ. Res. Public Health 2016, 13, 552

    Directory of Open Access Journals (Sweden)

    Julián Alfredo Fernández-Niño

    2016-07-01

    Full Text Available I recently reviewed the paper published in this journal by Hernández-Alvarado et al., titled “Increase in Suicide Rates by Hanging in the Population of Tabasco, Mexico between 2003 and 2012” [1], and I noticed that the epidemiological concept “prevalence” is not correctly used.[...

  12. Thyroid cancer incidence in the Ukraine after the Chernobyl accident: comparison with spontaneous incidences

    International Nuclear Information System (INIS)

    Sobolev, B.; Kairo, I.; Likhtarev, I.; Heidenreich, W.F.; Jacob, P.; Goulko, G.

    1997-01-01

    The thyroid cancer incidence in the Ukraine among those born in the period 1968-1986 was analyzed with the aim to identify the enhancement due to the Chernobyl accident. Since any Ukrainian data referring to the time period before the accident are scarce and the variation of spontaneous incidences in other countries is immense, the Ukrainian incidences in the period 1986-1989 were used to estimate the baseline risk. Following 1990, the incidence in the southern part of the Ukraine increased by about 30%, independent of age. In the other parts the increase of the incidence depended on age at exposure. In the age group of 9-year-old children, the incidences in three regions defined as the 'high-dose area', the northern, and the middle oblasts, increased by factors of 50, 20, and 6, respectively. These rates (1991-1995) are well above spontaneous rates in other countries. In the age group of 17-year-old juveniles, the incidence increased by a factor of 6 for the 'high dose area' and in the three northern oblasts, whereas in the nine 'middle' oblasts it was similar to the incidence of the 'southern' Ukraine. These rates are within the range found in other countries. (orig.)

  13. [Skin cancer incidence in Zacatecas].

    Science.gov (United States)

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

    2014-01-01

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

  14. Critical incident monitoring in anaesthesia.

    Science.gov (United States)

    Choy, Y C

    2006-12-01

    Critical incident monitoring in anaesthesia is an important tool for quality improvement and maintenance of high safety standards in anaesthetic services. It is now widely accepted as a useful quality improvement technique for reducing morbidity and mortality in anaesthesia and has become part of the many quality assurance programmes of many general hospitals under the Ministry of Health. Despite wide-spread reservations about its value, critical incident monitoring is a classical qualitative research technique which is particularly useful where problems are complex, contextual and influenced by the interaction of physical, psychological and social factors. Thus, it is well suited to be used in probing the complex factors behind human error and system failure. Human error has significant contributions to morbidities and mortalities in anaesthesia. Understanding the relationships between, errors, incidents and accidents is important for prevention and risk management to reduce harm to patients. Cardiac arrests in the operating theatre (OT) and prolonged stay in recovery, constituted the bulk of reported incidents. Cardiac arrests in OT resulted in significant mortality and involved mostly de-compensated patients and those with unstable cardiovascular functions, presenting for emergency operations. Prolonged-stay in the recovery extended period of observation for ill patients. Prolonged stay in recovery was justifiable in some cases, as these patients needed a longer period of post-operative observation until they were stable enough to return to the ward. The advantages of the relatively low cost, and the ability to provide a comprehensive body of detailed qualitative information, which can be used to develop strategies to prevent and manage existing problems and to plan further initiatives for patient safety makes critical incident monitoring a valuable tool in ensuring patient safety. The contribution of critical incident reporting to the issue of patient safety is

  15. Emergency response to mass casualty incidents in Lebanon.

    Science.gov (United States)

    El Sayed, Mazen J

    2013-08-01

    The emergency response to mass casualty incidents in Lebanon lacks uniformity. Three recent large-scale incidents have challenged the existing emergency response process and have raised the need to improve and develop incident management for better resilience in times of crisis. We describe some simple emergency management principles that are currently applied in the United States. These principles can be easily adopted by Lebanon and other developing countries to standardize and improve their emergency response systems using existing infrastructure.

  16. Estimating cardiovascular disease incidence from prevalence: a spreadsheet based model

    Directory of Open Access Journals (Sweden)

    Xue Feng Hu

    2017-01-01

    Full Text Available Abstract Background Disease incidence and prevalence are both core indicators of population health. Incidence is generally not as readily accessible as prevalence. Cohort studies and electronic health record systems are two major way to estimate disease incidence. The former is time-consuming and expensive; the latter is not available in most developing countries. Alternatively, mathematical models could be used to estimate disease incidence from prevalence. Methods We proposed and validated a method to estimate the age-standardized incidence of cardiovascular disease (CVD, with prevalence data from successive surveys and mortality data from empirical studies. Hallett’s method designed for estimating HIV infections in Africa was modified to estimate the incidence of myocardial infarction (MI in the U.S. population and incidence of heart disease in the Canadian population. Results Model-derived estimates were in close agreement with observed incidence from cohort studies and population surveillance systems. This method correctly captured the trend in incidence given sufficient waves of cross-sectional surveys. The estimated MI declining rate in the U.S. population was in accordance with the literature. This method was superior to closed cohort, in terms of the estimating trend of population cardiovascular disease incidence. Conclusion It is possible to estimate CVD incidence accurately at the population level from cross-sectional prevalence data. This method has the potential to be used for age- and sex- specific incidence estimates, or to be expanded to other chronic conditions.

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

    Directory of Open Access Journals (Sweden)

    Jennifer O Lam

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

  18. Browns Ferry charcoal adsorber incident

    International Nuclear Information System (INIS)

    Mays, G.T.

    1979-01-01

    The article reviews the temperature excursion in the charcoal adsorber beds of the Browns Ferry Unit 3 off-gas system that occurred on July 17, 1977. Significant temperature increases were experienced in the charcoal adsorber beds when charcoal fines were ignited by the ignition of a combustible mixture of hydrogen and oxygen in the off-gas system. The Browns Ferry off-gas system is described, and events leading up to and surrounding the incident are discussed. The follow-up investigation by Tennessee Valley Authority and General Electric Company personnel and their recommendations for system and operational modifications are summarized

  19. 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...

  20. Collaboration Between Multistakeholder Standards

    DEFF Research Database (Denmark)

    Rasche, Andreas; Maclean, Camilla

    Public interest in corporate social responsibility (CSR) has resulted in a wide variety of multistakeholder CSR standards in which companies can choose to participate. While such standards reflect collaborative governance arrangements between public and private actors, the market for corporate...... responsibility is unlikely to support a great variety of partly competing and overlapping standards. Increased collaboration between these standards would enhance both their impact and their adoption by firms. This report examines the nature, benefits, and shortcomings of existing multistakeholder standards...

  1. Maximum Credible Incidents

    CERN Document Server

    Strait, J

    2009-01-01

    Following the incident in sector 34, considerable effort has been made to improve the systems for detecting similar faults and to improve the safety systems to limit the damage if a similar incident should occur. Nevertheless, even after the consolidation and repairs are completed, other faults may still occur in the superconducting magnet systems, which could result in damage to the LHC. Such faults include both direct failures of a particular component or system, or an incorrect response to a “normal” upset condition, for example a quench. I will review a range of faults which could be reasonably expected to occur in the superconducting magnet systems, and which could result in substantial damage and down-time to the LHC. I will evaluate the probability and the consequences of such faults, and suggest what mitigations, if any, are possible to protect against each.

  2. Epidemiology of Polymyalgia Rheumatica 2000-2014 and Examination of Incidence and Survival Trends Over 45 Years: A Population-Based Study.

    Science.gov (United States)

    Raheel, Shafay; Shbeeb, Izzat; Crowson, Cynthia S; Matteson, Eric L

    2017-08-01

    To determine time trends in the incidence and survival of polymyalgia rheumatica (PMR) over a 15-year period in Olmsted County, Minnesota, and to examine trends in incidence of PMR in the population by comparing this time period to a previous incidence cohort from the same population base. All cases of incident PMR among Olmsted County, Minnesota residents in 2000-2014 were identified to extend the previous 1970-1999 cohort. Detailed review of all individual medical records was performed. Incidence rates were age- and sex-adjusted to the US white 2010 population. Survival rates were compared with the expected rates in the population of Minnesota. There were 377 incident cases of PMR during the 15-year study period. Of these, 64% were female and the mean age at incidence was 74.1 years. The overall age- and sex-adjusted annual incidence of PMR was 63.9 (95% confidence interval [95% CI] 57.4-70.4) per 100,000 population ages ≥50 years. Incidence rates increased with age in both sexes, but incidence fell after age 80 years. There was a slight increase in incidence of PMR in the recent time period compared to 1970-1999 (P = 0.063). Mortality among individuals with PMR was not significantly worse than that expected in the general population (standardized mortality ratio 0.70 [95% CI 0.57-0.85]). The incidence of PMR has increased slightly in the past 15 years compared to previous decades. Survivorship in patients with PMR is not worse than in the general population. © 2016, American College of Rheumatology.

  3. The incidence of schizophrenia in European immigrants to Canada.

    Science.gov (United States)

    Smith, G N; Boydell, J; Murray, R M; Flynn, S; McKay, K; Sherwood, M; Honer, W G

    2006-10-01

    The risk for schizophrenia in immigrants to Europe is approximately three times that of native-born populations. Discrimination and marginalization may influence the risk for schizophrenia within migrant populations. The primary objective of the present study was to determine whether the risk associated with migration was also evident 100 years ago. A second objective was to determine whether changing social stresses are associated with changes to the incidence of schizophrenia. During the first two decades of the twentieth century, the Provincial Mental Hospital was the sole provider of psychiatric services in British Columbia, Canada. Detailed clinical records have been preserved for 99.5% of 2477 patients who had a psychiatric admission between 1902 and 1913. Diagnoses were made after a detailed file review and 807 patients met DSM-IV criteria for first-episode schizophrenia, schizophreniform disorder, schizoaffective disorder, or psychosis not otherwise specified. Diagnoses had high inter-rater reliability. The incidence of schizophrenia in migrants from Britain or Continental Europe was compared with that in the Canadian-born population using indirect standardization and Poisson models. Migration from Britain or Continental Europe to Canada in the early twentieth century was associated with an increased rate of schizophrenia; IRR=1.54, (95% CI=1.33-1.78). Incidence increased over time in immigrants but not in the native-born population and this increase occurred during a period of economic recession. Migration was a risk factor for schizophrenia a century ago as it is today. This risk occurred in white migrants from Europe and increased during a period of increased social stress.

  4. Trends in cancer incidence in Maputo, Mozambique, 1991-2008.

    Directory of Open Access Journals (Sweden)

    Cesaltina Lorenzoni

    Full Text Available Very limited information is available regarding the incidence of cancer in sub-Saharan Africa. We analyzed changes in cancer patterns from 1991 to 2008 in Maputo (Mozambique.We calculated the rates of incidence of different cancer sites by sex in the 5-year age-group of the population of Maputo city as well as age-standardized rates (ASRs and average annual percentage changes (AAPC.Over the 18-year study period a total of 12,674 cases of cancer (56.9% females were registered with an overall increase in the risk of cancer in both sexes. In males, the most common cancers were those of the prostate, Kaposi sarcoma (KS and the liver. Prostate cancer showed the most dramatic increase over the whole study period (AAPC +11.3%; 95% CI: 9.7-13.0, with an ASR of 61.7 per 105 in 2003-2008. In females, the most frequent cancers were of the uterine cervix, the breast and KS, with the former increasing along the whole study period (AAPC + 4.7%; 95% CI: 3.4-6 with an ASR of 62.0 per 105 in 2003-2008 as well as breast cancer (AAPC +6.5%; 95%CI: 4.3-8.7.Overall, the risk of cancer rose in both sexes during the study period, particularly among cancers associated with westernization of lifestyles (prostate, breast, combined with increasingly rising incidences or limited changes in cancers associated with infection and poverty (uterine cervix, liver. Moreover, the burden of AIDS-associated cancers has shown a marked increase.

  5. Contaminated Mexican steel incident

    International Nuclear Information System (INIS)

    1985-01-01

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

  6. Thyroid Cancer Incidences From Selected South America Population-Based Cancer Registries: An Age-Period-Cohort Study

    Directory of Open Access Journals (Sweden)

    Anne Karin da Mota Borges

    2017-08-01

    Full Text Available Purpose: The incidence of thyroid cancer (TC has increased substantially worldwide. However, there is a lack of knowledge about age-period-cohort (APC effects on incidence rates in South American countries. This study describes the TC incidence trends and analyzes APC effects in Cali, Colombia; Costa Rica; Goiânia, Brazil; and Quito, Ecuador. Materials and Methods: Data were obtained from the Cancer Incidence in Five Continents series, and the crude and age-standardized incidence rates were calculated. Trends were assessed using the estimated annual percentage change, and APC models were estimated using Poisson regression for individuals between age 20 and 79 years. Results: An increasing trend in age-standardized incidence rates was observed among women from Goiânia (9.2%, Costa Rica (5.7%, Quito (4.0%, and Cali (3.4%, and in men from Goiânia (10.0% and Costa Rica (3.4%. The APC modeling showed that there was a period effect in all regions and for both sexes. Increasing rate ratios were observed among women over the periods. The best fit model was the APC model in women from all regions and in men from Quito, whereas the age-cohort model showed a better fit in men from Cali and Costa Rica, and the age-drift model showed a better fit among men from Goiânia. Conclusion: These findings suggest that overdiagnosis is a possible explanation for the observed increasing pattern of TC incidence. However, some environmental exposures may also have contributed to the observed increase.

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

    Science.gov (United States)

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

    2016-08-01

    COPD is the third leading cause of death in the world and its global burden is predicted to increase further. Even though the prevalence of COPD is well studied, only few studies examined the incidence of COPD in a prospective and standardized manner. In a prospective population-based cohort study (Rotterdam Study) enrolling subjects aged ≥45, COPD was diagnosed based on a pre-bronchodilator obstructive spirometry (FEV1/FVC 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.

  8. 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)

  9. The side-on response of a standard long counter to fast neutrons

    International Nuclear Information System (INIS)

    Johnson, F.A.

    1979-01-01

    The response of a standard long counter to neutrons incident into its front face relative to its response to those incident into its side was measured for a range of neutron energies, and an increasing sensitivity to high-energy neutrons incident into the side was evident. The effect of a shadow bar in contributing to an initial degradation in energy of neutrons which then scatter from the surroundings into the counter was suggested by the response of the counter in the side-on orientation as a function of the separation distance of the bar from a source. (Auth.)

  10. 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...

  11. Trends in the incidence of malignant melanoma in Denmark 1978-2007. Incidence on the island of Bornholm compared with the whole country incidence in Denmark

    DEFF Research Database (Denmark)

    Drejøe, Jennifer Berg; Drzewiecki, Krzysztof Tadeusz; Klit, Anders

    2011-01-01

    In Denmark, malignant melanoma is among the most rapidly increasing cancer types. Malignant melanoma accounts for the majority of skin cancer-related deaths. Sunshine is the main cause of the increase seen in melanoma incidence. Within Denmark, Bornholm is the area that receives most sunshine....... It is therefore relevant to compare incidence data between Denmark and Bornholm....

  12. Trends in mouth cancer incidence in Mumbai, India (1995-2009): An age-period-cohort analysis.

    Science.gov (United States)

    Shridhar, Krithiga; Rajaraman, Preetha; Koyande, Shravani; Parikh, Purvish M; Chaturvedi, Pankaj; Dhillon, Preet K; Dikshit, Rajesh P

    2016-06-01

    Despite tobacco control and health promotion efforts, the incidence rates of mouth cancer are increasing across most regions in India. Analysing the influence of age, time period and birth cohort on these secular trends can point towards underlying factors and help identify high-risk populations for improved cancer control programmes. We evaluated secular changes in mouth cancer incidence among men and women aged 25-74 years in Mumbai between 1995 and 2009 by calculating age-specific and age-standardized incidence rates (ASR). We estimated the age-adjusted linear trend for annual percent change (EAPC) using the drift parameter, and conducted an age-period-cohort (APC) analysis to quantify recent time trends and to evaluate the significance of birth cohort and calendar period effects. Over the 15-year period, age-standardized incidence rates of mouth cancer in men in Mumbai increased by 2.7% annually (95% CI:1.9 to 3.4), pMumbai cancer registry indicate a significant linear increase of mouth cancer incidence from 1995 to 2009 in men, which was driven by younger men aged 25-49 years, and a non-significant upward trend in similarly aged younger women. Health promotion efforts should more effectively target younger cohorts. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Patterns and Trends of Liver Cancer Incidence Rates in Eastern and Southeastern Asian Countries (1983-2007) and Predictions to 2030.

    Science.gov (United States)

    Wu, Jie; Yang, Shigui; Xu, Kaijin; Ding, Cheng; Zhou, Yuqing; Fu, Xiaofang; Li, Yiping; Deng, Min; Wang, Chencheng; Liu, Xiaoxiao; Li, Lanjuan

    2018-05-01

    We examined temporal trends in liver cancer incidence rates overall and by histological type from 1983 through 2007. We predict trends in liver cancer incidence rates through 2030 for selected Eastern and Southeastern Asian countries. Data on yearly liver cancer incident cases by age group and sex were drawn from 6 major selected Eastern and Southeastern Asian countries or regions with cancer registries available in the CI5plus database, including China, Japan, Hong Kong Special Administrative Region (SAR), the Philippines, Singapore, and Thailand. We also analyzed data for the United States and Australia for comparative purposes. Age-standardized incidence rates were calculated and plotted from 1983 through 2007. Numbers of new cases and incidence rates were predicted through 2030 by fitting and extrapolating age-period-cohort models. The incidence rates of liver cancer have been decreasing, and decreases will continue in all selected Eastern and Southeastern Asian countries, except for Thailand, whose liver cancer incidence rate will increase due to the increasing incidence rate of intrahepatic cholangiocarcinomas. Even though the incidence rates of liver cancer are predicted to decrease in most Eastern and Southeastern Asian countries, the burden, in terms of new cases, will continue to increase because of population growth and aging. Based on an analysis of data from cancer registries from Asian countries, incidence rates of liver cancer are expected to decrease through 2030 in most Eastern and Southeastern Asian countries. However, in Thailand, the incidence rate of intrahepatic cholangiocarcinomas is predicted to increase, so health education programs are necessary. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

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

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

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

  15. The Estonian study of Chernobyl cleanup workers: II. Incidence of cancer and mortality

    International Nuclear Information System (INIS)

    Rahu, M.; Tekkel, M.; Veidebaum, T.

    1997-01-01

    A cohort of 4,472 men from Estonia who had participated in the cleanup activities in the Chernobyl area sometime between 1986 and 1991 and were followed through 1993 was analyzed with respect to the incidence of cancer and mortality. Incidence and mortality in the cleanup workers were assessed relative to national rates. No increases were found in all cancers (25 incident cases compared to 26.5 expected) or in leukemia (no cases observed, 1.0 expected). Incidence did not differ statistically significantly from expectation for any individual cancer site or type, though lung cancer and non-Hodgkin's lymphoma both occurred slightly more often than expected. A total of 144 deaths were observed [standardized mortality ratio (SMR) = 0.98; 95% confidence interval (CI) = 0.82-1.14] during an average of 6.5 years of follow-up. Twenty-eight deaths (19.4%) were suicides (SMR = 1.52; 95% CI = 1.01-2.19). Exposure to ionizing radiation while at Chernobyl has not caused a detectable increase in the incidence of cancer among cleanup workers from Estonia. At least for the short follow-up period, diseases directly attributable to radiation appear to be of relatively minor importance when compared with the substantial excess of deaths due to suicide. 28 refs., 3 tabs

  16. Incidence Trend and Epidemiology of Common Cancers in the Center of Iran.

    Science.gov (United States)

    Rafiemanesh, Hosein; Rajaei-Behbahani, Narjes; Khani, Yousef; Hosseini, Sayedehafagh; Pournamdar, Zahra; Mohammadian-Hafshejani, Abdollah; Soltani, Shahin; Hosseini, Seyedeh Akram; Khazaei, Salman; Salehiniya, Hamid

    2015-07-13

    Cancer is a major public health problem in Iran and many other parts of the world. The cancer incidence is different in various countries and in country provinces. Geographical differences in the cancer incidence lead to be important to conduct an epidemiological study of the disease. This study aimed to investigate cancer epidemiology and trend in the province of Qom, located in center of Iran. This is an analytical cross-sectional study carried out based on re-analysis cancer registry report and the disease management center of health ministry from 2004 to 2008 in the province of Qom. To describe incidence time trends, we carried out join point regression analysis using the software Join point Regression Program, Version 4.1.1.1. There were 3,029 registered cases of cancer during 5 years studied. Sex ratio was 1.32 (male to female). Considering the frequency and mean standardized incidence, the most common cancer in women were breast, skin, colorectal, stomach, and esophagus, respectively while in men the most common cancers included skin, stomach, colorectal, bladder, and prostate, respectively. There was an increasing and significant trend, according to the annual percentage change (APC) equal to 8.08% (CI: 5.1-11.1) for all site cancer in women. The incidence trend of all cancers was increasing in this area. Hence, planning for identifying risk factors and performing programs for dealing with the disease are essential.

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

    Science.gov (United States)

    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.

  18. Cancer incidence patterns among children and adolescents in Taiwan from 1995 to 2009: a population-based study.

    Science.gov (United States)

    Hung, Giun-Yi; Horng, Jiun-Lin; Lee, Yu-Sheng; Yen, Hsiu-Ju; Chen, Chao-Chun; Lee, Chih-Ying

    2014-11-15

    Currently, little information is available on childhood cancer incidence rates in Eastern Asia. The objective of this study was to report the first population-based cancer surveillance of children and adolescents in Taiwan. Data from the Taiwan Cancer Registry were examined for cancer frequencies and incidence rates among individuals ages birth to 19 years from 1995 to 2009. Types of cancers were grouped according to the International Classification of Childhood Cancer. Rates were compared by sex and age. For further comparisons with other countries, rates were age standardized to the 2000 world standard population in 5-year age groups. Trends in incidence rates also were evaluated. In total, 12,315 individuals were diagnosed with childhood cancers, for an age-standardized incidence rate (ASR) of 132.1 per million person-years from 1995 to 2009. The male-to-female incidence rate ratio was 1.19. Overall, leukemias were the most common cancer (ASR, 39.1 per million person-years), followed by central nervous system neoplasms (15.8 per million person-years), and lymphomas (15.3 per million person-years). During the 15-year study period, the incidence rates increased by 1% annually. Compared with other countries, the rate of hepatic tumors was 2 times greater in Taiwan. The rate of germ cell neoplasms in Taiwan was similar to that in the United States and was 1.3 to 1.9 times greater compared with Canada, Brazil, Israel, and Japan. Based on the current data, the observed increase in overall incidence rates was attributable only marginally to improvements in case ascertainment and diagnostic procedures. The high rates of malignant hepatic tumors and germ cell neoplasms in Taiwan suggest variations in the background risk factors. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  19. Comparative Incidence of Conformational, Neurodegenerative Disorders.

    Directory of Open Access Journals (Sweden)

    Jesús de Pedro-Cuesta

    Full Text Available The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs.We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD. We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD forms, amyotrophic lateral sclerosis (ALS, and sporadic rapidly progressing neurodegenerative dementia (sRPNDd. For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined.Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD, to 1589 and 2589 for AMD and Alzheimer's disease (AD respectively. Age-specific profiles varied from (a symmetrical, inverted V-shaped curves for low incidences to (b those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20-24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration.These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to incidence magnitude and survival might

  20. Comparative Incidence of Conformational, Neurodegenerative Disorders

    Science.gov (United States)

    de Pedro-Cuesta, Jesús; Rábano, Alberto; Martínez-Martín, Pablo; Ruiz-Tovar, María; Alcalde-Cabero, Enrique; Almazán-Isla, Javier; Avellanal, Fuencisla; Calero, Miguel

    2015-01-01

    Background The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs). Methods We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD). We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD) forms, amyotrophic lateral sclerosis (ALS), and sporadic rapidly progressing neurodegenerative dementia (sRPNDd). For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined. Findings Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD), to 1589 and 2589 for AMD and Alzheimer's disease (AD) respectively. Age-specific profiles varied from (a) symmetrical, inverted V-shaped curves for low incidences to (b) those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c) a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20–24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration. Interpretation These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to

  1. Recent Vegetation Fire Incidence in Russia

    OpenAIRE

    Hayasaka, Hiroshi

    2011-01-01

    MODIS hotspot data from NASA have now become a standard means of evaluating vegetation fires worldwide. Remote sensing is the most effective tool for large countries like Russia because it is hard to obtain exact, detailed forest fire data. Accumulated MODIS hotspot data of the nine years from 2002 to 2010 may allow us to assess recent changes in the vegetation fire incidence in Russia. This kind of analysis using various satellites is useful in estimating fire intensity and sever...

  2. Prevalence Incidence Mixture Models

    Science.gov (United States)

    The R package and webtool fits Prevalence Incidence Mixture models to left-censored and irregularly interval-censored time to event data that is commonly found in screening cohorts assembled from electronic health records. Absolute and relative risk can be estimated for simple random sampling, and stratified sampling (the two approaches of superpopulation and a finite population are supported for target populations). Non-parametric (absolute risks only), semi-parametric, weakly-parametric (using B-splines), and some fully parametric (such as the logistic-Weibull) models are supported.

  3. Regional variations of basal cell carcinoma incidence in the U.K. using The Health Improvement Network database (2004-10).

    Science.gov (United States)

    Musah, A; Gibson, J E; Leonardi-Bee, J; Cave, M R; Ander, E L; Bath-Hextall, F

    2013-11-01

    Basal cell carcinoma (BCC) is one of the most common types of nonmelanoma skin cancer affecting the white population; however, little is known about how the incidence varies across the U.K. To determine the variation in BCC throughout the U.K. Data from 2004 to 2010 were obtained from The Health Improvement Network database. European and world age-standardized incidence rates (EASRs and WASRs, respectively) were obtained for country-level estimates and levels of socioeconomic deprivation, while strategic health-authority-level estimates were directly age and sex standardized to the U.K. standard population. Incidence-rate ratios were estimated using multivariable Poisson regression models. The overall EASR and WASR of BCC in the U.K. were 98.6 per 100,000 person-years and 66.9 per 100,000 person-years, respectively. Regional-level incidence rates indicated a significant geographical variation in the distribution of BCC, which was more pronounced in the southern parts of the country. The South East Coast had the highest BCC rate followed by South Central, Wales and the South West. Incidence rates were substantially higher in the least deprived groups and we observed a trend of decreasing incidence with increasing levels of deprivation (P < 0.001). Finally, in terms of age groups, the largest annual increase was observed among those aged 30-49 years. Basal cell carcinoma is an increasing health problem in the U.K.; the southern regions of the U.K. and those in the least deprived groups had a higher incidence of BCC. Our findings indicate an increased incidence of BCC for younger age groups below 49 years. © 2013 British Association of Dermatologists.

  4. Trends in incidence of breast cancer among women under 40 in seven European countries: a GRELL cooperative study.

    Science.gov (United States)

    Leclère, Brice; Molinié, Florence; Trétarre, Brigitte; Stracci, Fabrizio; Daubisse-Marliac, Laetitia; Colonna, Marc

    2013-10-01

    Young women are not usually screened for breast cancer (BC). The trends in incidence in this population may better reflect changes in risk factors. However, studies on this subject are scarce and heterogeneous. The aim of this study was to describe the trends in incidence of BC in women under 40 from 1990 to 2008, using pooled European data. Thirty-seven European population-based cancer registries from Belgium, Bulgaria, France, Italy, Portugal, Spain and Switzerland participated in this study. World age-standardized incidence rates were first analyzed graphically and then using a Poisson regression model, in order to estimate average annual percent changes (AAPCs). The overall incidence rate of BC in the area covered increased linearly during the study period by 1.19% (0.93; 1.46) on average per year. This increase varied between countries from 0.20% (-0.53; 0.64) in Bulgaria to 2.68% (1.97; 3.40) in Portugal. In Italy, after a significant rise of 2.33% (1.14; 3.54) per year, BC incidence began decreasing in 2002 by -2.30% (-4.07; -0.50) yearly. The rise in incidence was greater for women under 35 and for ductal carcinomas. This increase can be due to a rise in risk factors and/or changes in diagnosis and surveillance practices, but we could not clearly distinguish between these two non-exclusive explanations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Cancer Incidence Trend in the Hebei Spirit Oil Spill Area, from 1999 to 2014: An Ecological Study.

    Science.gov (United States)

    Choi, Kyung-Hwa; Park, Myung-Sook; Ha, Mina; Hur, Jong-Il; Cheong, Hae-Kwan

    2018-05-17

    The Hebei Spirit oil spill (HSOS) occurred in the Republic of Korea on 7 December 2007. We aimed to describe the cancer incidence trend in Taean County before and after the oil spill. Five major cancers and leukemia were analyzed. Cancer incidence data were obtained from the Korean National Cancer Center. We compared the standardized incidence rates in Taean with those observed nationwide and selected three coastal areas. Joinpoint regression analysis was used to examine the trends in the average annual percent change and perform comparisons. The incidence rate of prostate cancer increased from 2007 to 2009 at an annual average of 39.3% (95% confidence interval (CI): -25.9, 161.8), 13.5% (95% CI: 11.7, 15.4), and 15.6% (95% CI: 11.9, 19.5), respectively, in Taean, nationwide, and in the coastal areas. The incidence of leukemia among women increased at an annual average of 9.5% (95% CI: -26.6, 63.4) in Taean and 0.6% (95% CI: 0.2, 0.9) nationwide; the rate decreased by 1.9% (95% CI: -12.8, 10.4) in the coastal areas. The trends between Taean County and the coastal areas differed only for prostate cancer ( p = 0.0004). The incidence of prostate cancer among Taean County residents has increased since the HSOS.

  6. Improving freight crash incident management.

    Science.gov (United States)

    2015-06-01

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

  7. Potential allergy and irritation incidents among health care workers.

    Science.gov (United States)

    Alamgir, Hasanat; Yu, Shicheng; Chavoshi, Negar; Ngan, Karen

    2008-07-01

    This study describes the types, causes, and outcomes of potential irritation and allergy incidents among workers in British Columbia's health care industry. Data on occupation-induced allergy and irritation incidents were extracted from a standardized database using the number of productive hours obtained from payroll data as a denominator during a 1-year period from three British Columbia health regions. Younger workers, female workers, facility support service workers, laboratory assistants and technicians, and maintenance and acute care workers were found to be at higher risk for allergy and irritation incidents. Major causes of allergy and irritation incidents included chemicals, blood and body fluids, food and objects, communicable diseases, air quality, and latex. A larger proportion of chemically induced incidents resulted in first aid care only, whereas non-chemical incidents required more emergency room visits.

  8. Barrett esophagus in scleroderma: Increased incidence and radiographic findings

    International Nuclear Information System (INIS)

    Recht, M.P.; Levine, M.S.; Katzka, D.A.; Reynolds, J.C.; Saul, S.H.; Ouyang, A.; Cohen, S.

    1986-01-01

    Thirteen patients with scleroderma underwent esophagography and endoscopy because of symptoms of reflux esophagitis or dysphagia, or both. Five had biopsy-proved Barrett esophagus, and two of those five had esophageal adencarcinomas. In a blinded review of the barium studies, Barrett esophagus was thought to be probable in one case, possible in seven, and unlikely in five. Five of eight patients in the first two groups had Barrett esophagus on endoscopy, but none in the third group had this disease. The author's initial experience, therefore, suggests that a definitive radiologic diagnosis of Barrett esophagus is not possible in most patients with scleroderma. However, endoscopy may be avoided when Barrett esophagus is considered unlikely on esophagography

  9. Chronic diseases in the Western world: Increasing incidence or ...

    African Journals Online (AJOL)

    known diagnoses; or 'diagnostic creep' – people now diagnosed with chronic disease who would not have been a decade or so ago. We know that health declines with age, and populations in the developed world are ageing. With advances in healthcare, people are, for example, living through a heart attack that might ...

  10. The incidence of hospital-treated occupational hand injuries

    DEFF Research Database (Denmark)

    Skov, O

    1994-01-01

    Previous studies have shown that young men have the highest frequency of occupational hand injuries. This study investigated their incidence and severity in relation to age and sex. For occupational hand injuries in general the estimated incidence rate was 17.1 per 1,000 person years. The incidence...... was found to be higher among men than women in all age groups below 60 years. The incidence for minor injuries declines with increasing age, but the rates for significant injuries are independent of age. The higher incidence rate for minor injuries among young patients could be real, but it could also...

  11. Incidence of sexually transmitted infections during pregnancy.

    Directory of Open Access Journals (Sweden)

    Chloe A Teasdale

    Full Text Available Prevalence of sexually transmitted infections (STI is high among pregnant women in certain settings. We estimated STI incidence and compared STI risk in pregnant and non-pregnant women. Data came from the Methods for Improving Reproductive Health in Africa (MIRA study conducted in South Africa and Zimbabwe 2003-2006. Women aged 18-50 years with at least one follow-up visit within 6 months of enrollment were included. Follow-up visits included laboratory testing for pregnancy, chlamydia, gonorrhea, trichomoniasis, and HIV, as well as self-report of hormonal contraceptive (HC use, sexual behaviors and intravaginal practices. All visits were classified according to pregnancy status. Incidence of each STI was calculated using follow-up time. Cox proportional hazards models were fitted using pregnancy as a time-varying exposure and sexual behaviors and intravaginal practices as time-varying covariates. Among 4,549 women, 766 (16.8% had a positive pregnancy test. Median follow-up time was 18 months [IQR: 12-24]. The overall incidence rate of chlamydia was 6.7 per 100 person years (py and 9.9/100py during pregnancy; gonorrhea incidence was 2.7/100py and 4.9/100py during pregnancy; trichomoniasis incidence was 7.1/100py overall and 9.2/100py during pregnancy. Overall HIV incidence was 3.9/100py and 3.8/100py during pregnancy. In crude models, pregnancy increased risk for chlamydia (hazard ratio (HR 1.5, 95%CI: 1.1-1.2, however there was no increased risk of any measured STI in adjusted models. STI Incidence was high during pregnancy however pregnancy did not increase STI risk after adjustment for sexual behaviors. Greater efforts are needed to help pregnant women avoid STIs.