Exploring Spatial and Temporal Distribution of Cutaneous Leishmaniasis in the Americas, 2001-2011.

PubMed

Maia-Elkhoury, Ana Nilce Silveira; E Yadón, Zaida; Idali Saboyá Díaz, Martha; de Fátima de Araújo Lucena, Francisca; Gerardo Castellanos, Luis; J Sanchez-Vazquez, Manuel

2016-11-01

Cases reported in the period of 2001-2011 from 14/18 CL endemic countries were included in this study by using two spreadsheet to collect the data. Two indicators were analyzed: CL cases and incidence rate. The local regression method was used to analyze case trends and incidence rates for all the studied period, and for 2011 the spatial distribution of each indicator was analyzed by quartile and stratified into four groups. From 2001-2011, 636,683 CL cases were reported by 14 countries and with an increase of 30% of the reported cases. The average incidence rate in the Americas was 15.89/100,000 inhabitants. In 2011, 15 countries reported cases in 180 from a total of 292 units of first subnational level. The global incidence rate for all countries was 17.42 cases per 100,000 inhabitants; while in 180 administrative units at the first subnational level, the average incidence rate was 57.52/100,000 inhabitants. Nicaragua and Panama had the highest incidence but more cases occurred in Brazil and Colombia. Spatial distribution was heterogeneous for each indicator, and when analyzed in different administrative level. The results showed different distribution patterns, illustrating the limitation of the use of individual indicators and the need to classify higher-risk areas in order to prioritize the actions. This study shows the epidemiological patterns using secondary data and the importance of using multiple indicators to define and characterize smaller territorial units for surveillance and control of leishmaniasis.

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

PubMed

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 <50 years of age and only 9% present with stage I disease. Average age increased from 53 to 56.4 years (p=0.0001), CR (per 105 women) increased from 39 (ASR: 35.2) to 55.4 (ASR: 43.4), AAPC for CR was 5.0 (p=0.001) and ASR was 3.1 (p=0.001). Rates increased from 50 years. Predicted ASpR is 174 in 50-59 years, 231 in > 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.

Prostate cancer incidence in Australia correlates inversely with solar radiation.

PubMed

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 INTERNATIONAL © 2011 BJU INTERNATIONAL.

Epidemiological survey of X-linked bulbar and spinal muscular atrophy, or Kennedy disease, in the province of Reggio Emilia, Italy.

PubMed

Guidetti, D; Sabadini, R; Ferlini, A; Torrente, I

2001-01-01

Commencing with the work carried out during the epidemiological survey of amyotrophic lateral sclerosis in the period 1980-1992 and the pathology follow-up, we carried out a perspective incidence, prevalence and mortality survey of X-linked bulbar and spinal muscular atrophy (X-BSMA) in the province of Reggio Emilia in Northern Italy. Based on 11 patients (eight familial and three sporadic cases), the mean incidence per year for the period 1980 through 1997, as evaluated at the onset of symptoms, was 0.09 cases/100,000 for the total population and 0.19 cases/100,000 for the male population. On December 31, 1997, the prevalence rate was 1.6/100,000 for the total population and 3.3/100,000 for the male population. In the 18-year period of 1980-1997, the average yearly mortality rate was: 0.03 cases/100,000 per year for the total population and 0.06 cases/ 100,000 for the male population. The average age at onset was 44.8 +/- 10.1, and the average survival period was 27.3 +/- 2.3 years. The average age of the prevalence day was 58.9 +/- 14.9, and the average age at death was 71.3 +/- 4.7 years. Whereas the incidence rate of X-BSMA in the province of Reggio Emilia is 16 times lower that of amyotrophic lateral sclerosis (ALS), the incidence rate of progressive bulbar palsy in the male population is only slightly higher than X-BSMA; and the prevalence rate of ALS for males is two times the prevalence rate for X-BSMA, with overlapping of confidence intervals. X-BSMA is a rare disease, which is probably under-diagnosed, but due to the long survival period of this disease its frequency is not negligible. Because of the presence of sporadic cases or non-evident familial cases, it is appropriate to consider this diagnostic possibility in making a diagnosis of ALS in patients in whom lower motor neuron dysfunction or bulbar onset predominates.

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

PubMed

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

2018-02-09

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

The Dynamic Prediction of Antisocial Behavior among Forensic Psychiatric Patients: A Prospective Field Study

ERIC Educational Resources Information Center

Quinsey, Vernon L.; Jones, G. Brian; Book, Angela S.; Barr, Kirsten N.

2006-01-01

Staff ratings of 595 supervised forensic psychiatric patients on the Proximal Risk Factor Scale and the Problem Identification Checklist were completed monthly for an average of 33 months. During the follow-up, there were 265 incidents, 86 of which were violent. The average ratings, excluding those from the index month, differentiated patients who…

Claims incidence of work-related disorders of the upper extremities: Washington state, 1987 through 1995.

PubMed

Silverstein, B; Welp, E; Nelson, N; Kalat, J

1998-12-01

This study examined the claim incidence rate, cost, and industry distribution of work-related upper extremity disorders in Washington. Washington State Fund workers' compensation claims from 1987 to 1995 were abstracted and categorized into general and specific disorders of gradual or sudden onset. Accepted claims included 100,449 for hand/wrist disorders (incidence rate: 98.2/10,000 full-time equivalents; carpal tunnel syndrome rate: 27.3), 30,468 for elbow disorders (incidence rate: 29.7; epicondylitis rate: 11.7), and 55,315 for shoulder disorders (incidence rate: 54.0; rotator cuff syndrome rate: 19.9). Average direct workers' compensation claims costs (medical treatment and indemnity) were $15,790 (median: $6774) for rotator cuff syndrome, $12,794 for carpal tunnel syndrome (median: $4190), and $6593 for epicondylitis (median: $534). Construction and food processing were among the industries with the highest rate ratios for all disorders (> 4.0). Upper extremity disorders represent a large and costly problem in Washington State industry. Industries characterized by manual handling and repetitive work have high rate ratios. The contingent workforce appears to be at high risk.

The Incidence of Primary Systemic Vasculitis in Jerusalem: A 20-year Hospital-based Retrospective Study.

PubMed

Nesher, Gideon; Ben-Chetrit, Eli; Mazal, Bracha; Breuer, Gabriel S

2016-06-01

The incidence of primary systemic vasculitides varies among different geographic regions and ethnic origins. The aim of this study was to examine the incidence rates of vasculitides in the Jerusalem Jewish population, and to examine possible trends in incidence rates over a 20-year period. The clinical databases of inpatients at the 2 medical centers in Jerusalem were searched for patients with vasculitis diagnosed between 1990-2009. Individual records were then reviewed by one of the authors. The significance of trends in incidence rates throughout the study period was evaluated by Pearson correlation coefficient. The average annual incidence rate of polyarteritis nodosa was 3.6/million adults (95% CI 1.6-4.7). Incidence rates did not change significantly during this period (r = 0.39, p = 0.088). The incidence of granulomatosis with polyangiitis (GPA) was 4.1 (2.2-5.9) for the whole period, during which it increased significantly (r = 0.53, p < 0.05). The incidence of microscopic polyangiitis (MPA) was lower: 2.3 (1.2-3.5)/million. It also increased significantly (r = 0.55, p < 0.05). The incidence of eosinophilic granulomatosis with polyangiitis was 1.2 (0.4-1.9), which remained stable throughout the study period. The incidence of Takayasu arteritis was 2.1/million (95% CI 1.2-2.9), and it also remained stable. Giant cell arteritis (GCA) incidence was 8.1 (5.7-10.6)/100,000 population aged 50 years or older. In sharp contrast with other vasculitides, its incidence decreased significantly throughout the study period (r = -0.61, p < 0.01). The incidence rates of vasculitides in the Jewish population of Jerusalem are in the lower range of global incidence rates. While GPA and MPA incidence are increasing, GCA incidence is decreasing.

Epidemiology, Incidence and Mortality of Bladder Cancer and their Relationship with the Development Index in the World.

PubMed

Mahdavifar, Neda; Ghoncheh, Mahshid; Pakzad, Reza; Momenimovahed, Zohre; Salehiniya, Hamid

2016-01-01

Bladder cancer is an international public health problem. It is the ninth most common cancer and the fourteenth leading cause of death due to cancer worldwide. Given aging populations, the incidence of this cancer is rising. Information on the incidence and mortality of the disease, and their relationship with level of economic development is essential for better planning. The aim of the study was to investigate bladder cancer incidence and mortality rates, and their relationship with the the Human Development Index (HDI) in the world. Data were obtained from incidence and mortality rates presented by GLOBOCAN in 2012. Data on HDI and its components were extracted from the global bank site. The number and standardized incidence and mortality rates were reported by regions and the distribution of the disease were drawn in the world. For data analysis, the relationship between incidence and death rates, and HDI and its components was measured using correlation coefficients and SPSS software. The level of significance was set at 0.05. In 2012, 429,793 bladder cancer cases and 165,084 bladder death cases occurred in the world. Five countries that had the highest age-standardized incidence were Belgium 17.5 per 100,000, Lebanon 16.6/100,000, Malta 15.8/100,000, Turkey 15.2/100,000, and Denmark 14.4/100,000. Five countries that had the highest age-standardized death rates were Turkey 6.6 per 100,000, Egypt 6.5/100,000, Iraq 6.3/100,000, Lebanon 6.3/100,000, and Mali 5.2/100,000. There was a positive linear relationship between the standardized incidence rate and HDI (r=0.653, P<0.001), so that there was a positive correlation between the standardized incidence rate with life expectancy at birth, average years of schooling, and the level of income per person of population. A positive linear relationship was also noted between the standardized mortality rate and HDI (r=0.308, P<0.001). There was a positive correlation between the standardized mortality rate with life expectancy at birth, average years of schooling, and the level of income per person of population. The incidence of bladder cancer in developed countries and parts of Africa was higher, while the highest mortality rate was observed in the countries of North Africa and the Middle East. The program for better treatment in developing countries to reduce mortality from the cancer and more detaiuled studies on the etiology of are essential.

Deforestation, drainage network, indigenous status, and geographical differences of malaria in the State of Amazonas.

PubMed

Terrazas, Wagner Cosme Morhy; Sampaio, Vanderson de Souza; de Castro, Daniel Barros; Pinto, Rosemary Costa; de Albuquerque, Bernardino Cláudio; Sadahiro, Megumi; Dos Passos, Ricardo Augusto; Braga, José Ueleres

2015-09-30

Malaria is a major public health problem worldwide. In Brazil, an average of 420,000 cases of malaria have been reported annually in the last 12 years, of which 99.7 % occurred in the Amazon region. This study aimed to analyse the distribution of malaria in the State of Amazonas and the influence of indigenous malaria in this scenario, to evaluate the correlation between incidence rates and socio-economic and environmental factors, and to evaluate the performance of health surveillance services. This ecological study used secondary data obtained from the SIVEP-MALARIA malaria surveillance programme. The relationship between demographic, socio-economic and environmental factors, the performance of health surveillance services and the incidence of malaria in Amazonas, a multiple linear regression model was used. The crude rate of malaria in Amazonas was 4142.72 cases per 100,000 inhabitants between 2003 and 2012. The incidence rates for the indigenous and non-indigenous populations were 12,976.02 and 3749.82, respectively, with an indigenous population attributable fraction of only 8 %. The results of the linear regression analysis indicated a negative correlation between the two socio-economic indicators (municipal human development index (MHDI) and poverty rate) and the incidence of malaria in the period. With regard to the environmental indicators (average annual deforestation rate and percentage of areas under the influence of watercourses), the correlation with the incidence rate was positive. The findings underscore the importance of implementing economic and social development policies articulated with strategic actions of environmental protection and health care for the population.

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

PubMed

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 variations in mortality. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Leprosy in Brazil and its association with characteristics of municipalities: ecological study, 2009-2011.

PubMed

Freitas, Lúcia R S; Duarte, Elisabeth C; Garcia, Leila P

2014-10-01

To analyse the ecological association between the demographic and socio-economic characteristics of the Brazilian municipalities and average leprosy incidence rate in the period 2009-2011. An ecological study taking the Brazilian municipalities as its units of analysis. The local empirical Bayes estimation method was used to obtain smoothed incidence rates (SIR) for leprosy. The mean, median, first quartile (Q1) and third quartile (Q3) of the SIR were calculated per 100 000 inhabitants. Hierarchical log-linear negative binomial regression models were used to estimate the incidence rate ratios (IRR). In the period 2009-2011, the average SIR of leprosy in Brazil was 20.2 per 100 000 inhabitants, and the median incidence rate among municipalities was 9.1 per 100 000 inhabitants. Significantly higher adjusted IRR were identified for large municipalities (IRR = 1.67) compared to small municipalities, as well as in municipalities with higher illiteracy rates (IRR = 2.15), more urbanised municipalities (IRR = 1.53), those with greater social inequality as per the Gini index (IRR = 1.26), high percentage of households with inadequate sanitation (IRR = 1.63), higher average number of people per room (IRR = 1.41), high proportions of Family Health Programme coverage (IRR = 1.29), high percentage of household contacts investigated (IRR = 2.30) and those with percentage of cases with grade 2 disability considered to be the medium (IRR = 1.26). In this study, SIR was significantly associated with municipalities with low socio-economic status. Disease control activities need to be focused on these municipalities, and investments need to be made in improving the population's living conditions. © 2014 John Wiley & Sons Ltd.

The Relationship Between Monthdisease Incidence Rate and Climatic Factor of Classical Swine Fever

NASA Astrophysics Data System (ADS)

Wang, Hongbin; Xu, Danning; Xiao, Jianhua; Zhang, Ru; Dong, Jing

The Swine Fever is a kind of acute, highly infective epidemic disease of animals; it is name as Classical Swine Fever (CSF) by World animal Health organization. Meteorological factors such as temperature, air pressure and rainfall affect the epidemic of CSF significantly through intermediary agent and CSF viral directly. However there is significant difference among different region for mode of effects. Accordingly, the analyze must adopt different methods. The dependability between incidence rate each month of CSF and meteorological factors from 1999 to 2004 was analyzed in this paper. The function of meteorological factors on CSF was explored and internal law was expected to be discovered. The correlation between the incidence rate of Swine Fever and meteorological factors, thus the foundation analysis of the early warning and the decision-making was made, the result indicated that the incidence rate of CSF has negative correlation with temperature, rainfall, cloudage; relative humidity has positive correlation with disease; for air pressure, except average air pressure of one month, other air pressure factors have positive correlation with disease; for wind speed, except Difference among moths of wind speed and average temperature of one month. have positive correlation with disease, other wind speed factors has negative correlation with disease.

Incidence of depression and anxiety: the Stirling County Study.

PubMed Central

Murphy, J M; Olivier, D C; Monson, R R; Sobol, A M; Leighton, A H

1988-01-01

Prevalence studies in psychiatric epidemiology out-number incidence investigations by a wide margin. This report gives descriptive information about the incidence of depression and anxiety disorders in a general population. Using data gathered in a 16-year follow-up of an adult sample selected as part of the Stirling County Study (Canada), the incidence of these types of disorders was found to be approximately nine cases per 1,000 persons per year. The data suggest that for every man who became ill for the first time with one of these disorders, three women became ill. Incidence tended to be higher among relatively young persons. These incidence rates are consistent with prevalence rates of approximately 10 per cent to 15 per cent for depression and anxiety disorders aggregated together, given an estimated average duration of illness of about 10 years. It is concluded that these incidence rates are fairly realistic in view of evidence that disorders of these types tend to be chronic. PMID:3258479

Atrial fibrillation and cognitive decline-the role of subclinical cerebral infarcts: the atherosclerosis risk in communities study.

PubMed

Chen, Lin Y; Lopez, Faye L; Gottesman, Rebecca F; Huxley, Rachel R; Agarwal, Sunil K; Loehr, Laura; Mosley, Thomas; Alonso, Alvaro

2014-09-01

The mechanism underlying the association of atrial fibrillation (AF) with cognitive decline in stroke-free individuals is unclear. We examined the association of incident AF with cognitive decline in stroke-free individuals, stratified by subclinical cerebral infarcts (SCIs) on brain MRI scans. We analyzed data from 935 stroke-free participants (mean age±SD, 61.5±4.3 years; 62% women; and 51% black) from 1993 to 1995 through 2004 to 2006 in the Atherosclerosis Risk in Communities Study, a biracial community-based prospective cohort study. Cognitive testing (including the digit symbol substitution and the word fluency tests) was performed in 1993 to 1995, 1996 to 1998, and 2004 to 2006 and brain MRI scans in 1993 to 1995 and 2004 to 2006. During follow-up, there were 48 incident AF events. Incident AF was associated with greater annual average rate of decline in digit symbol substitution (-0.77; 95% confidence interval, -1.55 to 0.01; P=0.054) and word fluency (-0.80; 95% confidence interval, -1.60 to -0.01; P=0.048). Among participants without SCIs on brain MRI scans, incident AF was not associated with cognitive decline. In contrast, incident AF was associated with greater annual average rate of decline in word fluency (-2.65; 95% confidence interval, -4.26 to -1.03; P=0.002) among participants with prevalent SCIs in 1993 to 1995. Among participants who developed SCIs during follow-up, incident AF was associated with a greater annual average rate of decline in digit symbol substitution (-1.51; 95% confidence interval, -3.02 to -0.01; P=0.049). The association of incident AF with cognitive decline in stroke-free individuals can be explained by the presence or development of SCIs, raising the possibility of anticoagulation as a strategy to prevent cognitive decline in AF. © 2014 American Heart Association, Inc.

Severe bronchiolitis and respiratory syncytial virus among young children in Hawaii.

PubMed

Yorita, Krista L; Holman, Robert C; Steiner, Claudia A; Effler, Paul V; Miyamura, Jill; Forbes, Susan; Anderson, Larry J; Balaraman, Venkataraman

2007-12-01

Lower respiratory tract infections are a leading cause of hospitalization and mortality among children worldwide. Our objective was to describe the incidence and epidemiology of severe bronchiolitis, respiratory syncytial virus (RSV), and pneumonia among children in Hawaii. Retrospective analysis of the patient-linked hospital discharge data associated with bronchiolitis, RSV, and pneumonia among Hawaii residents younger than 5 years of age during 1997 through 2004 using the Hawaii State Inpatient Database. During 1997 through 2004, the average annual incidence rates for bronchiolitis, RSV, and pneumonia were 3.8, 2.7, and 6.8 per 1000 children younger than 5 years, respectively. The incidence of each condition was higher for infants younger than 1 year (15.1, 9.8, and 15.9 per 1000 infants, respectively) than the incidence for children 1-4 years of age, and higher for boys compared with girls. The incidence of each condition was highest among Native Hawaiian and other Pacific Islander children compared with children of other race groups living in Hawaii. Most hospitalizations occurred during the months of October through February. Estimated median hospital charges were $4806 (bronchiolitis), $5465 (RSV) and $5240 (pneumonia), with overall average annual charges of $11.5 million. The incidence and hospitalization rates for bronchiolitis, RSV, and pneumonia among children younger than 5 years of age in Hawaii were low; the corresponding hospitalization rates were lower than those for the general U.S. population. However, the hospitalization rates for each condition among Hawaiian and other Pacific Islander children were much higher than those for other race groups or for the U.S. population.

Spatial distribution estimation of malaria in northern China and its scenarios in 2020, 2030, 2040 and 2050.

PubMed

Song, Yongze; Ge, Yong; Wang, Jinfeng; Ren, Zhoupeng; Liao, Yilan; Peng, Junhuan

2016-07-07

Malaria is one of the most severe parasitic diseases in the world. Spatial distribution estimation of malaria and its future scenarios are important issues for malaria control and elimination. Furthermore, sophisticated nonlinear relationships for prediction between malaria incidence and potential variables have not been well constructed in previous research. This study aims to estimate these nonlinear relationships and predict future malaria scenarios in northern China. Nonlinear relationships between malaria incidence and predictor variables were constructed using a genetic programming (GP) method, to predict the spatial distributions of malaria under climate change scenarios. For this, the examples of monthly average malaria incidence were used in each county of northern China from 2004 to 2010. Among the five variables at county level, precipitation rate and temperature are used for projections, while elevation, water density index, and gross domestic product are held at their present-day values. Average malaria incidence was 0.107 ‰ per annum in northern China, with incidence characteristics in significant spatial clustering. A GP-based model fit the relationships with average relative error (ARE) = 8.127 % for training data (R(2) = 0.825) and 17.102 % for test data (R(2) = 0.532). The fitness of GP results are significantly improved compared with those by generalized additive models (GAM) and linear regressions. With the future precipitation rate and temperature conditions in Special Report on Emission Scenarios (SRES) family B1, A1B and A2 scenarios, spatial distributions and changes in malaria incidences in 2020, 2030, 2040 and 2050 were predicted and mapped. The GP method increases the precision of predicting the spatial distribution of malaria incidence. With the assumption of varied precipitation rate and temperature, and other variables controlled, the relationships between incidence and the varied variables appear sophisticated nonlinearity and spatially differentiation. Using the future fluctuated precipitation and the increased temperature, median malaria incidence in 2020, 2030, 2040 and 2050 would significantly increase that it might increase 19 to 29 % in 2020, but currently China is in the malaria elimination phase, indicating that the effective strategies and actions had been taken. While the mean incidences will not increase even reduce due to the incidence reduction in high-risk regions but the simultaneous expansion of the high-risk areas.

Communicating the risk of injury in schoolboy rugby: using Poisson probability as an alternative presentation of the epidemiology.

PubMed

Parekh, Nikesh; Hodges, Stewart D; Pollock, Allyson M; Kirkwood, Graham

2012-06-01

The communication of injury risk in rugby and other sports is underdeveloped and parents, children and coaches need to be better informed about risk. A Poisson distribution was used to transform population based incidence of injury into average probabilities of injury to individual players. The incidence of injury in schoolboy rugby matches range from 7 to 129.8 injuries per 1000 player-hours; these rates translate to average probabilities of injury to a player of between 12% and 90% over a season. Incidence of injury and average probabilities of injury over a season should be published together in all future epidemiological studies on school rugby and other sports. More research is required on informing and communicating injury risks to parents, staff and children and how it affects monitoring, decision making and prevention strategies.

Time Series Modelling of Syphilis Incidence in China from 2005 to 2012

PubMed Central

Zhang, Xingyu; Zhang, Tao; Pei, Jiao; Liu, Yuanyuan; Li, Xiaosong; Medrano-Gracia, Pau

2016-01-01

Background The infection rate of syphilis in China has increased dramatically in recent decades, becoming a serious public health concern. Early prediction of syphilis is therefore of great importance for heath planning and management. Methods In this paper, we analyzed surveillance time series data for primary, secondary, tertiary, congenital and latent syphilis in mainland China from 2005 to 2012. Seasonality and long-term trend were explored with decomposition methods. Autoregressive integrated moving average (ARIMA) was used to fit a univariate time series model of syphilis incidence. A separate multi-variable time series for each syphilis type was also tested using an autoregressive integrated moving average model with exogenous variables (ARIMAX). Results The syphilis incidence rates have increased three-fold from 2005 to 2012. All syphilis time series showed strong seasonality and increasing long-term trend. Both ARIMA and ARIMAX models fitted and estimated syphilis incidence well. All univariate time series showed highest goodness-of-fit results with the ARIMA(0,0,1)×(0,1,1) model. Conclusion Time series analysis was an effective tool for modelling the historical and future incidence of syphilis in China. The ARIMAX model showed superior performance than the ARIMA model for the modelling of syphilis incidence. Time series correlations existed between the models for primary, secondary, tertiary, congenital and latent syphilis. PMID:26901682

Time Series Modelling of Syphilis Incidence in China from 2005 to 2012.

PubMed

Zhang, Xingyu; Zhang, Tao; Pei, Jiao; Liu, Yuanyuan; Li, Xiaosong; Medrano-Gracia, Pau

2016-01-01

The infection rate of syphilis in China has increased dramatically in recent decades, becoming a serious public health concern. Early prediction of syphilis is therefore of great importance for heath planning and management. In this paper, we analyzed surveillance time series data for primary, secondary, tertiary, congenital and latent syphilis in mainland China from 2005 to 2012. Seasonality and long-term trend were explored with decomposition methods. Autoregressive integrated moving average (ARIMA) was used to fit a univariate time series model of syphilis incidence. A separate multi-variable time series for each syphilis type was also tested using an autoregressive integrated moving average model with exogenous variables (ARIMAX). The syphilis incidence rates have increased three-fold from 2005 to 2012. All syphilis time series showed strong seasonality and increasing long-term trend. Both ARIMA and ARIMAX models fitted and estimated syphilis incidence well. All univariate time series showed highest goodness-of-fit results with the ARIMA(0,0,1)×(0,1,1) model. Time series analysis was an effective tool for modelling the historical and future incidence of syphilis in China. The ARIMAX model showed superior performance than the ARIMA model for the modelling of syphilis incidence. Time series correlations existed between the models for primary, secondary, tertiary, congenital and latent syphilis.

Invasive cancer incidence - Puerto Rico, 2007-2011.

PubMed

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

2015-04-17

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

Renal cell cancer in Israel: sex and ethnic differences in incidence and mortality, 1980-2004.

PubMed

Tarabeia, Jalal; Kaluski, Dorit Nitzan; Barchana, Micha; Dichtiar, Rita; Green, Manfred S

2010-06-01

The causes of renal cell cancer (RCC) remain largely unexplained. While the incidence is generally higher in men than in women, little has been reported on ethnic differences. We examine trends in RCC incidence and mortality rates among Israeli Arab and Jewish populations and compared with the rates in other countries. Age-adjusted RCC incidence and mortality rates in Israel, during 1980-2004, were calculated by sex and population group, using the National Cancer Registry. They were compared with the United States based on the Surveillance Epidemiology and End Results [SEER] program and the IARC database for international comparisons. While RCC incidence rates in Israel are similar to the United States and the European average, the rates are significantly higher among Israeli Jews than Arabs. Men are affected more than women. Incidence rates over the last 24 years have increased among all men and Jewish women, but not among Arab women. Among men, the incidence rate ratio for Jews to Arabs declined from 3.96 in 1980-1982 to 2.34 in 2001-2004, whereas for women there was no change. The mortality rates were higher among Jews than Arab and among men than women. There were no significant change in the mortality rates and rate ratios. Our findings demonstrate marked ethnic differences in RCC in Israel. The lower incidence among Arabs stands in contrast to the higher prevalence of potential risk factors for RCC in this population group. Genetic factors, diet and other lifestyle factors could play protective roles. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Safety performance factor.

PubMed

Venkataraman, Naray

2008-01-01

Workplace safety performance is computed using frequency rate (FR) and severity rate (SR). Only work time lost due to occupational incidents that need to be reported is counted. FR and SR are the 2 most important safety performance indicators that are applied universally; however, calculations differ from country to country. All injuries and time lost should be considered while calculating safety performance. The extent of severity does not matter as every incident is counted. So, a new factor has to be defined; it should be based on the hours or days lost due to each occupational incident, irrespective of its severity. The new safety performance factor is defined as the average human-hour unit lost due to occupational accidents/incidents, including fatalities, first-aid incidents, bruises and cuts. The formula is simple and easy to apply.

Epidemiology of traumatic spinal cord injuries in Austria 2002-2012.

PubMed

Majdan, Marek; Brazinova, Alexandra; Mauritz, Walter

2016-01-01

The aim of this study was to analyse the epidemiological patterns (mortality, incidence of non-fatal cases and overall incidence), of traumatic spinal cord injuries (TSCI) in 2002-2012 in Austria. TSCI-related deaths and hospital admissions in Austria 2002-2012 were obtained from Statistics Austria and analysed. Mortality rates, as well as non-fatal and overall incidence rates were calculated and compared across the age spectrum and by sex. Additionally, the main causes and demographic characteristics of victims were analysed. The crude overall incidence rate of TSCI was 16.96, CI 95 % 16.95-16.97 and the standardized incidence rate was 13.98, CI 95 % 13.97-13.99 per million (annual average rate). An annual increase in fatality rates was observed occurring mostly in the age group >65 years (Kendall's Tau = 0.1). Falls (mortality rate 19.58, CI 95 % 19.57-19.59) and injuries at home (incidence rate 56.57, CI 95 % 56.56-56.58) were the principal causes of fatal and non-fatal TSCI, respectively. Injuries to the neck region were the most common. All indicators were the highest for the age group >65 years: non-fatal incidence rate 23.55, CI 95 % 23.54-23.56; mortality rate 21.4, CI 95 % 21.39-21.41; and overall incidence rate 47.9, CI 95 % 47.89-47.91. A clear male dominance was observed (incidence rate ratio 1.9, CI 95 % 1.4-2.7). The population >65 years has been at the highest risk of TSCI in Austria for the analysed period and therefore preventive activities should be focused on this group. The increasing overall incidence of TSCI was driven by the increasing mortality rates that were highest in the age group >65 years. We advocate harmonization of epidemiological reporting especially regarding aetiology of TSCI in order to better inform policy makers and prevention.

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

PubMed

Orchard, John W; Kountouris, Alex; Sims, Kevin

2016-01-01

T20 (Twenty20 or 20 over) cricket has emerged in the last decade as the most popular form of cricket (in terms of spectator attendances). International consensus cricket definitions, first published in 2005, were updated in 2016 to better reflect the rise to prominence of T20 cricket. Injury incidence and prevalence rates were calculated using the new international methods and units for elite senior male Australian cricketers over the past decade (season 2006-2007 to season 2015-2016 inclusive). Over the past 10 seasons, average match injury incidence, for match time-loss injuries, was 155 injuries/1,000 days of play, with the highest daily rates in 50-over cricket, followed by 20-over cricket and First-Class matches. Annual injury incidence was 64 injuries/100 players per season, and average annual injury prevalence was 12.5% (although fast bowlers averaged 20.6%, much higher than other positions). The most common injury was the hamstring strain (seasonal incidence 8.7 injuries/100 players per season). The most prevalent injury was lumbar stress fractures (1.9% of players unavailable at all times owing to these injuries, which represents 15% of all missed playing time). The hamstring strain has emerged from being one of the many common injuries in elite cricket a decade ago to being clearly the most common injury in the sport at the elite level. This is presumably in association with increased T20 cricket. Lumbar stress fractures in fast bowlers are still the most prevalent injury in the sport of cricket at the elite level, although these injuries are more associated with high workloads arising from the longer forms of the game. Domestic and international matches have very similar match injury incidence rates across the formats, but injury prevalence is higher in international players as they play for most of the year without a substantial off-season.

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

PubMed Central

Orchard, John W; Kountouris, Alex; Sims, Kevin

2016-01-01

Background T20 (Twenty20 or 20 over) cricket has emerged in the last decade as the most popular form of cricket (in terms of spectator attendances). International consensus cricket definitions, first published in 2005, were updated in 2016 to better reflect the rise to prominence of T20 cricket. Methods Injury incidence and prevalence rates were calculated using the new international methods and units for elite senior male Australian cricketers over the past decade (season 2006–2007 to season 2015–2016 inclusive). Results Over the past 10 seasons, average match injury incidence, for match time-loss injuries, was 155 injuries/1,000 days of play, with the highest daily rates in 50-over cricket, followed by 20-over cricket and First-Class matches. Annual injury incidence was 64 injuries/100 players per season, and average annual injury prevalence was 12.5% (although fast bowlers averaged 20.6%, much higher than other positions). The most common injury was the hamstring strain (seasonal incidence 8.7 injuries/100 players per season). The most prevalent injury was lumbar stress fractures (1.9% of players unavailable at all times owing to these injuries, which represents 15% of all missed playing time). Discussion The hamstring strain has emerged from being one of the many common injuries in elite cricket a decade ago to being clearly the most common injury in the sport at the elite level. This is presumably in association with increased T20 cricket. Lumbar stress fractures in fast bowlers are still the most prevalent injury in the sport of cricket at the elite level, although these injuries are more associated with high workloads arising from the longer forms of the game. Domestic and international matches have very similar match injury incidence rates across the formats, but injury prevalence is higher in international players as they play for most of the year without a substantial off-season. PMID:28008292

Trends in Personal Belief Exemption Rates Among Alternative Private Schools: Waldorf, Montessori, and Holistic Kindergartens in California, 2000–2014

PubMed Central

Bednarczyk, Robert A.; Richards, Jennifer L.; Allen, Kristen E.; Warraich, Gohar J.; Omer, Saad B.

2017-01-01

Objectives. To evaluate trends in rates of personal belief exemptions (PBEs) to immunization requirements for private kindergartens in California that practice alternative educational methods. Methods. We used California Department of Public Health data on kindergarten PBE rates from 2000 to 2014 to compare annual average increases in PBE rates between schools. Results. Alternative schools had an average PBE rate of 8.7%, compared with 2.1% among public schools. Waldorf schools had the highest average PBE rate of 45.1%, which was 19 times higher than in public schools (incidence rate ratio = 19.1; 95% confidence interval = 16.4, 22.2). Montessori and holistic schools had the highest average annual increases in PBE rates, slightly higher than Waldorf schools (Montessori: 8.8%; holistic: 7.1%; Waldorf: 3.6%). Conclusions. Waldorf schools had exceptionally high average PBE rates, and Montessori and holistic schools had higher annual increases in PBE rates. Children in these schools may be at higher risk for spreading vaccine-preventable diseases if trends are not reversed. PMID:27854520

Trends in Personal Belief Exemption Rates Among Alternative Private Schools: Waldorf, Montessori, and Holistic Kindergartens in California, 2000-2014.

PubMed

Brennan, Julia M; Bednarczyk, Robert A; Richards, Jennifer L; Allen, Kristen E; Warraich, Gohar J; Omer, Saad B

2017-01-01

To evaluate trends in rates of personal belief exemptions (PBEs) to immunization requirements for private kindergartens in California that practice alternative educational methods. We used California Department of Public Health data on kindergarten PBE rates from 2000 to 2014 to compare annual average increases in PBE rates between schools. Alternative schools had an average PBE rate of 8.7%, compared with 2.1% among public schools. Waldorf schools had the highest average PBE rate of 45.1%, which was 19 times higher than in public schools (incidence rate ratio = 19.1; 95% confidence interval = 16.4, 22.2). Montessori and holistic schools had the highest average annual increases in PBE rates, slightly higher than Waldorf schools (Montessori: 8.8%; holistic: 7.1%; Waldorf: 3.6%). Waldorf schools had exceptionally high average PBE rates, and Montessori and holistic schools had higher annual increases in PBE rates. Children in these schools may be at higher risk for spreading vaccine-preventable diseases if trends are not reversed.

Trends in diabetes incidence from 1992 to 2015 and projections for 2024: A Portuguese General Practitioner's Network study.

PubMed

de Sousa-Uva, Mafalda; Antunes, L; Nunes, B; Rodrigues, A P; Simões, J A; Ribeiro, R T; Boavida, J M; Matias-Dias, C

2016-10-01

Diabetes is known as a major cause of morbidity and mortality worldwide. Portugal is known as the European country with the highest prevalence of this disease. While diabetes prevalence data is updated annually in Portugal, the General Practitioner's (GP) Sentinel Network represents the only data source on diabetes incidence. This study describes the trends in Diabetes incidence, between 1992 and 2015, and estimate projections for the future incidence rates in Portugal until 2024. An ecological time-series study was conducted using data from GP Sentinel Network between 1992 and 2015. Family doctors reported all new cases of Diabetes in their patients' lists. Annual trends were estimated through Poisson regression models as well as the future incidence rates (until 2024), sex and age group stratified. Incidence rate projections were adjusted to the distribution of the resident Portuguese population given Statistics Portugal projections. The average increase in Diabetes incidence rate was in total 4.29% (CI95% 3.80-4.80) per year under study. Until 1998-2000, the annual incidence rate was higher in women, and from 1998-2000 to 2013-2015 turn out to be higher in men. The incidence rate projected for 2022-2024 was 972.77/10(5) inhabitants in total, and 846.74/10(5) and 1114.42/10(5), respectively, in women and men. This is the first study in Portugal to estimate diabetes incidence rate projections. The disturbing reported projections seem realistic if things continue as in the past. Actually, effective public health policies will need to be undertaken to minimize this alarming future scenario. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

The Prevalence and Incidence of Juvenile Rheumatiod Arthritis in an Urban Black Population.

ERIC Educational Resources Information Center

Hochberg, Marc C.; And Others

1983-01-01

Research conducted in an urban Black population in Baltimore, Maryland, suggests that the Black race is not associated with significantly increased risk of development of juvenile rheumatiod arthritis. The prevalence rate was estimated as 0.26 per 1,000 and the average annual incidence as 6.6 per 100,000/year. (GC)

[Pneumonia in the adult population in continental Portugal -- incidence and mortality in hospitalized patients from 1998 to 2000].

PubMed

Froes, Filipe

2003-01-01

To characterise the incidence and mortality in adult inpatients with community-acquired pneumonia at a global and regional level in mainland Portugal. We used the clinical database belonging to the Ministry of Health's Instituto de Gestão e Informática Financeira (Institute of Financial Management and Informatics), which contains the encoded information from the discharge letters from all hospitalisations at National Health Service institutions in mainland Portugal. We conducted a retrospective analysis of all hospitalisations in 1998, 1999 and 2000 with a main diagnosis of pneumonia on admission (ICD9: 480 to 486 and 487.0), excluding patients infected with the human immunodeficiency virus. From 1998 to 2000, hospitalisation of adults with pneumonia represented about 3% of the total number of admissions. We determined an average annual incidence of 2.66 hospitalisations for pneumonia per 1,000 adult inhabitants and of 9.78 per 1,000 inhabitants aged > or =65. The average age of the adults interned was 70, with 71.6% of the patients aged > or =65. We believe that 25 to 50% of adults with community-acquired pneumonia are hospitalised. The mortality rate of adults hospitalised was 17.3%, with no significant difference between the sexes. Mortality rose to 21.5% and 24.8% in individuals aged > or =65 and > or =75, respectively. On average, 2.8% of the adults admitted were given mechanical ventilation and their mortality rate was 43.9%. The incidence of hospitalisations for community-acquired pneumonia and its mortality differed from region to region in mainland Portugal. The annual incidence of admissions for pneumonia per 1,000 adult inhabitants in the central region was double that in the northern region and the Algarve and the mortality rate increased from north to south of the country, with a difference of more than 50% in the Algarve in relation to the northern region. The incidence of hospitalisations for community-acquired pneumonia is comparable to the figures published in the international literature, though the hospital mortality rate is higher. We feel that it is essential to conduct more studies with a view to a more detailed characterisation of the situation in Portugal and a better understanding of the reasons for the discrepancies between the regions. This would possibly also enable us to implement measures to reduce the mortality rate.

Incidence of stomach cancer in oman and the other gulf cooperation council countries.

PubMed

Al-Mahrouqi, Haitham; Parkin, Lianne; Sharples, Katrina

2011-07-01

Stomach cancer is the most common cancer among males in Oman and the second most frequent among females from 1997 to 2007. Reports have suggested the rate is higher in Oman than in the other GCC countries. This study aims to describe the epidemiology of stomach cancer in Oman and to explore the apparent differences in the incidence of stomach cancer between Oman and the other Gulf Cooperation Council (GCC) countries. Data were obtained from the Omani National Cancer Registry (1997 - 2007) and from Gulf Centre for Cancer Registration reports (1998 - 2004). The annual average age-adjusted incidence rates for stomach cancer in Oman were 10.1 per 100,000 for males and 5.6 per 100,000 for females between 1997 and 2007. The age-adjusted incidence varied by region within Oman, and the incidence rate was higher in Oman than in most other GCC countries between 1998 and 2004. Further investigation of the completeness and accuracy of cancer registration is essential for exploration of variations in stomach cancer rates in the GCC countries.

Incidence of Stomach Cancer in Oman and the Other Gulf Cooperation Council Countries

PubMed Central

Al-Mahrouqi, Haitham; Parkin, Lianne; Sharples, Katrina

2011-01-01

Objectives Stomach cancer is the most common cancer among males in Oman and the second most frequent among females from 1997 to 2007. Reports have suggested the rate is higher in Oman than in the other GCC countries. This study aims to describe the epidemiology of stomach cancer in Oman and to explore the apparent differences in the incidence of stomach cancer between Oman and the other Gulf Cooperation Council (GCC) countries. Methods Data were obtained from the Omani National Cancer Registry (1997 - 2007) and from Gulf Centre for Cancer Registration reports (1998 - 2004). Results The annual average age-adjusted incidence rates for stomach cancer in Oman were 10.1 per 100,000 for males and 5.6 per 100,000 for females between 1997 and 2007. The age-adjusted incidence varied by region within Oman, and the incidence rate was higher in Oman than in most other GCC countries between 1998 and 2004. Conclusion Further investigation of the completeness and accuracy of cancer registration is essential for exploration of variations in stomach cancer rates in the GCC countries. PMID:22043430

Exploring Spatial and Temporal Distribution of Cutaneous Leishmaniasis in the Americas, 2001–2011

PubMed Central

E. Yadón, Zaida; Idali Saboyá Díaz, Martha; de Fátima de Araújo Lucena, Francisca; Gerardo Castellanos, Luis; J. Sanchez-Vazquez, Manuel

2016-01-01

Leishmaniasis is an important health problem in several countries in the Americas and cases notification is limited and underreported. In 2008, the Pan American Health Organization (PAHO/WHO) met with endemic countries to discuss the status and need of improvement of systems region-wide. The objective is to describe the temporal and spatial distribution of cutaneous leishmaniasis (CL) cases reported to PAHO/WHO by the endemic countries between 2001 and 2011 in the Americas. Methods Cases reported in the period of 2001–2011 from 14/18 CL endemic countries were included in this study by using two spreadsheet to collect the data. Two indicators were analyzed: CL cases and incidence rate. The local regression method was used to analyze case trends and incidence rates for all the studied period, and for 2011 the spatial distribution of each indicator was analyzed by quartile and stratified into four groups. Results From 2001–2011, 636,683 CL cases were reported by 14 countries and with an increase of 30% of the reported cases. The average incidence rate in the Americas was 15.89/100,000 inhabitants. In 2011, 15 countries reported cases in 180 from a total of 292 units of first subnational level. The global incidence rate for all countries was 17.42 cases per 100,000 inhabitants; while in 180 administrative units at the first subnational level, the average incidence rate was 57.52/100,000 inhabitants. Nicaragua and Panama had the highest incidence but more cases occurred in Brazil and Colombia. Spatial distribution was heterogeneous for each indicator, and when analyzed in different administrative level. The results showed different distribution patterns, illustrating the limitation of the use of individual indicators and the need to classify higher-risk areas in order to prioritize the actions. This study shows the epidemiological patterns using secondary data and the importance of using multiple indicators to define and characterize smaller territorial units for surveillance and control of leishmaniasis. PMID:27824881

Trends in incidence of breast cancer among women under 40 in seven European countries: a GRELL cooperative study.

PubMed

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.

Epidemiological features of and changes in incidence of infectious diseases in China in the first decade after the SARS outbreak: an observational trend study.

PubMed

Yang, Shigui; Wu, Jie; Ding, Cheng; Cui, Yuanxia; Zhou, Yuqing; Li, Yiping; Deng, Min; Wang, Chencheng; Xu, Kaijin; Ren, Jingjing; Ruan, Bing; Li, Lanjuan

2017-07-01

The model of infectious disease prevention and control changed significantly in China after the outbreak in 2003 of severe acute respiratory syndrome (SARS), but trends and epidemiological features of infectious diseases are rarely studied. In this study, we aimed to assess specific incidence and mortality trends of 45 notifiable infectious diseases from 2004 to 2013 in China and to investigate the overall effectiveness of current prevention and control strategies. Incidence and mortality data for 45 notifiable infectious diseases were extracted from a WChinese public health science data centre from 2004 to 2013, which covers 31 provinces in mainland China. We estimated the annual percentage change in incidence of each infectious disease using joinpoint regression. Between January, 2004, and December, 2013, 54 984 661 cases of 45 infectious diseases were reported (average yearly incidence 417·98 per 100 000). The infectious diseases with the highest yearly incidence were hand, foot, and mouth disease (114·48 per 100 000), hepatitis B (81·57 per 100 000), and tuberculosis (80·33 per 100 000). 132 681 deaths were reported among the 54 984 661 cases (average yearly mortality 1·01 deaths per 100 000; average case fatality 2·4 per 1000). Overall yearly incidence of infectious disease was higher among males than females and was highest among children younger than 10 years. Overall yearly mortality was higher among males than females older than 20 years and highest among individuals older than 80 years. Average yearly incidence rose from 300·54 per 100 000 in 2004 to 483·63 per 100 000 in 2013 (annual percentage change 5·9%); hydatid disease (echinococcosis), hepatitis C, and syphilis showed the fastest growth. The overall increasing trend changed after 2009, and the annual percentage change in incidence of infectious disease in 2009-13 (2·3%) was significantly lower than in 2004-08 (6·2%). Although the overall incidence of infectious diseases was increasing from 2004, the rate levelled off after 2009. Effective prevention and control strategies are needed for diseases with the highest incidence-including hand, foot, and mouth disease, hepatitis B, and tuberculosis-and those with the fastest rates of increase (including hydatid disease, hepatitis C, and syphilis). Chinese Ministry of Science and Technology, National Natural Science Foundation (China). Copyright © 2017 Elsevier Ltd. All rights reserved.

Safety survey of Iran's mines and comparison to some other countries.

PubMed

Bagherpour, Raheb; Yarahmadi, Reza; Khademian, Amir; Almasi, Seied Najmedin

2017-03-01

The increasing development of mining activities in Iran makes it necessary to have a closer look at the safety issues. Analysis of different incidents and damages in mines can be helpful for the adoption of suitable approaches to prevent the incidents. In this study, safety statistics of Iran's mines in 2011 and 2012 were assessed and important incidents and injuries happening to employees for 12 different groups of minerals were evaluated and eventually compared to the situation of some other countries. According to the obtained results, the average incidence probability in Iran's mines was calculated to be 0.18 for 2011 and the incidence probability of coal, copper and iron ore mines was greater than others. The injury rate of Iran's mines was 106 and 164 out of 10,000 persons for 2011 and 2012, respectively, and the maximum values of injury rate belonged to coal, dimension stone and aggregate mines. Also, it turned out that the fatal rate per 100 tons of production had the highest values in chromite and coal mines. Besides, comparison of injury rate and the fatal rate in Iran and some countries showed that the safety situation in Iran's mines was in a fair condition.

The Semipalatinsk nuclear test site: a first analysis of solid cancer incidence (selected sites) due to test-related radiation.

PubMed

Gusev, B I; Rosenson, R I; Abylkassimova, Z N

1998-10-01

Since 1956, cancer incidences have been analysed in several rayons of the Semipalatinsk oblast, with cross-sectional analyses being conducted every 5 years. Data on different tumor localizations were recorded within a heavily contaminated so-called main area of nine villages (estimated average effective equivalent dose about 2000 mSv) and a so-called control area (estimated average effective equivalent dose about 70 mSv), each including approximately 10000 persons. Up to 1970, the excess cancer incidence in the exposed villages was observed to have increased; after 1970, a decrease was noted, followed by a second increase in the late 1980s. The main sites of excess cancer included the esophagus, stomach, and liver. Up to 1970, the esophagus cancer incidence was predominant, but it decreased thereafter, while the incidence of stomach and liver cancers increased. The second peak of excess cancer rates was mainly due to lung, breast, and thyroid carcinomas.

Childhood acute leukemias are frequent in Mexico City: descriptive epidemiology.

PubMed

Pérez-Saldivar, María Luisa; Fajardo-Gutiérrez, Arturo; Bernáldez-Ríos, Roberto; Martínez-Avalos, Armando; Medina-Sanson, Aurora; Espinosa-Hernández, Laura; Flores-Chapa, José de Diego; Amador-Sánchez, Raquel; Peñaloza-González, José Gabriel; Alvarez-Rodríguez, Francisco Javier; Bolea-Murga, Victoria; Flores-Lujano, Janet; Rodríguez-Zepeda, María Del Carmen; Rivera-Luna, Roberto; Dorantes-Acosta, Elisa María; Jiménez-Hernández, Elva; Alvarado-Ibarra, Martha; Velázquez-Aviña, Martha Margarita; Torres-Nava, José Refugio; Duarte-Rodríguez, David Aldebarán; Paredes-Aguilera, Rogelio; Del Campo-Martínez, María de Los Ángeles; Cárdenas-Cardos, Rocío; Alamilla-Galicia, Paola Hillary; Bekker-Méndez, Vilma Carolina; Ortega-Alvarez, Manuel Carlos; Mejia-Arangure, Juan Manuel

2011-08-17

Worldwide, acute leukemia is the most common type of childhood cancer. It is particularly common in the Hispanic populations residing in the United States, Costa Rica, and Mexico City. The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City. Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in 2006 and 2007 with leukemia, as determined by using the International Classification of Childhood Cancer. The average annual incidence rates (AAIR), and the standardized average annual incidence rates (SAAIR) per million children were calculated. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico (used as a reference of socio-economic level). Although a total of 610 new cases of leukemia were registered during 2006-2007, only 228 fit the criteria for inclusion in this study. The overall SAAIR was 57.6 per million children (95% CI, 46.9-68.3); acute lymphoblastic leukemia (ALL) was the most frequent type of leukemia, constituting 85.1% of the cases (SAAIR: 49.5 per million), followed by acute myeloblastic leukemia at 12.3% (SAAIR: 6.9 per million), and chronic myeloid leukemia at 1.7% (SAAIR: 0.9 per million). The 1-4 years age group had the highest SAAIR for ALL (77.7 per million). For cases of ALL, 73.2% had precursor B-cell immunophenotype (SAAIR: 35.8 per million) and 12.4% had T-cell immunophenotype (SAAIR 6.3 per million). The peak ages for ALL were 2-6 years and 8-10 years. More than half the children (58.8%) were classified as high risk. There was a positive correlation between the average number of persons per household and the incidence of the pre-B immunophenotype (Pearson's r, 0.789; P = 0.02). The frequency of ALL in Mexico City is among the highest in the world, similar to those found for Hispanics in the United States and in Costa Rica.

Child health in arid areas of Ethiopia: longitudinal study of the morbidity in infectious diseases.

PubMed

Lindtjørn, B; Alemu, T; Bjorvatn, B

1992-01-01

We describe the incidence of some childhood infections in drought prone areas of southern Ethiopia. Our results are based on 24 months' biweekly observations of 828 children aged 0-5 years in the pastoralist community of Dubluk and the agricultural community of Elka. An average of 23% of the children in Dubluk and 13% in Elka were sick during any 2-week period. Diarrhoeal diseases represented the main cause of morbidity, but the yearly number of diarrhoeal episodes were lower than previously reported from Ethiopia. Respiratory tract infections and to a lesser extent diarrhoeal diseases, showed highest incidence rates during the main dry season. The highest incidence of lower respiratory tract infections coincided with an outbreak of measles. In Dubluk, children who lived near to the wells had higher incidence rates than those who lived further away, probably reflecting the importance of crowding on transmission rates. In Elka, literacy of mothers was associated with reduced incidence of both diarrhoeal and respiratory tract infections, whereas the use of open pit latrines was associated with increased diarrhoeal incidence. The decline in disease incidence in this region during the last months of our study may reflect an improvement of nutritional status.

[Incidence of tuberculosis at the local level: Marianao Municipality, Havana City, Cuba (1990-2000)].

PubMed

D'fana Valdés, Jorgelina; Cambell, Shirley; Armas Pérez, Luisa; Fraginal, Bárbaro; González Ochoa, Edilberto

2003-01-01

For the elimination of tuberculosis (TB) is necessary the surveillance of the incidence rate at the local level, as this is the first level of access to the health service. This study is aimed at providing a description of the spread and trend of the tuberculosis incidence rates in Marianao Municipality, Habana City by healthcare areas and age groups throughout the 1990-2000 period. The time series for the 1990-1994 and 1995-2000 incidence rates were analyzed employing a two parameter exponential smoothing method. The total percentage and annual average of variation was estimated. The healthcare areas were stratified. In 1990-1994, the rate rose from 11.1 to 25.8 per 105 inhabitants (33% of increase by year), having been most noticeable in Carlos J. Finlay and Portuondo health areas (respectively annual average 112.7% y 36.2% increases). Taking into account that the control program was strengthened in 1995, the rates dropped by 47.6% in this municipality during the 1995-2000 period. The Finlay and Portuondo areas respectively lowered their rates by 79.9% y 39.7% while the Gonzalez Coro area showed a 58.3% rise and 27 de Noviembre area had no major change. The age and above 60 group had the higher percentage of cases, recording 49.8% of the total and only one case among children under age 15 for the period. During this same period, only six cases of tuberculosis/human inmunodeficiency virus were diagnosed. The 27 de Noviembre area was the only one found to be at the unsatisfactory level according to the stratification. An initially upward trend, followed by a downward trend in tuberculosis was found to exist in the Marianao Municipality throughout the period studied. This disease was predominant among older adults.

Adolescent homicide victimization in Johannesburg, South Africa: incidence and epidemiological characteristics (2001-2009).

PubMed

Swart, Lu-Anne; Seedat, Mohamed; Nel, Juan

2016-09-01

This study describes the incidence and epidemiological characteristics of adolescent homicides (15-19 years) in Johannesburg, South Africa. A retrospective population-based study was conducted on cases drawn from the National Injury Mortality Surveillance System. A total of 590 adolescent homicides were registered for 2001-2009 corresponding to an average annual homicide rate of 23.4/100,000. The average annual rate was 39.8/100,000 for males and 7.9/100,000 for females. Black and coloured adolescents had the highest homicide rates. There was a considerable decline in the firearm homicide rates over the study period. In contrast, sharp instrument and blunt force homicides increased. Public places were the predominant scenes for male deaths, while female homicides occurred primarily in residential locations. Most male homicides took place over weekend nights. Alcohol was a prominent feature of homicides. The high homicide rates reported in this study underscore the need to develop interventions directed specifically at adolescents. Prevention efforts are required to pay particular attention to black and coloured adolescent males, and to address the availability of weapons and alcohol use among adolescents.

Longitudinal variation in pressure injury incidence among long-term aged care facilities.

PubMed

Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Westbrook, Johanna I

2018-05-04

To examine variation in pressure injury (PI) incidence among long-term aged care facilities and identify resident- and facility-level factors that explain this variation. Longitudinal incidence study using routinely-collected electronic care management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. About 6556 people aged 65 years and older who were permanent residents in 60 long-term care facilities between December 2014 and November 2016. Risk-adjusted PI incidence rates over eight study quarters. Incidence density over the study period was 1.33 pressure injuries per 1000 resident days (95% confidence interval (CI) = 1.29-1.37). Funnel plots were used to identify variation among facilities. On average, 14% of facilities had risk-adjusted PI rates that were higher than expected in each quarter (above 95% funnel plot control limits). Ten percent of facilities had persistently high rates in any three or more consecutive quarters (n = 6). The variation between facilities was only partly explained by resident characteristics in multilevel regression models. Residents were more likely to have higher-pressure injury rates in facilities in regional areas compared with major city areas (adjusted incidence rate ratio = 1.25, 95% CI = 1.04-1.51), and facilities with persistently high rates were more likely to be located in areas with low socioeconomic status (P = 0.038). There is considerable variation among facilities in PI incidence. This study demonstrates the potential of routinely-collected care management data to monitor PI incidence and to identify facilities that may benefit from targeted intervention.

Plasmodium falciparum incidence relative to entomologic inoculation rates at a site proposed for testing malaria vaccines in western Kenya.

PubMed

Beier, J C; Oster, C N; Onyango, F K; Bales, J D; Sherwood, J A; Perkins, P V; Chumo, D K; Koech, D V; Whitmire, R E; Roberts, C R

1994-05-01

Relationships between Plasmodium falciparum incidence and entomologic inoculation rates (EIRs) were determined for a 21-month period in Saradidi, western Kenya, in preparation for malaria vaccine field trials. Children, ranging in age from six months to six years and treated to clear malaria parasites, were monitored daily for up to 12 weeks to detect new malaria infections. Overall, new P. falciparum infections were detected in 77% of 809 children. The percentage of children that developed infections per two-week period averaged 34.7%, ranging from 7.3% to 90.9%. Transmission by vector populations was detected in 86.4% (38 of 44) of the two-week periods, with daily EIRs averaging 0.75 infective bites per person. Periods of intense transmission during April to August, and from November to January, coincided with seasonal rains. Relationships between daily malaria attack rates and EIRs indicated that an average of only 7.5% (1 in 13) of the sporozoite inoculations produced new infections in children. Regression analysis demonstrated that EIRs accounted for 74% of the variation in attack rates. One of the components of the EIR, the human-biting rate, alone accounted for 68% of the variation in attack rates. Thus, measurements of either the EIR or the human-biting rate can be used to predict corresponding attack rates in children. These baseline epidemiologic studies indicate that the intense transmission patterns of P. falciparum in Saradidi will provide excellent conditions for evaluating malaria vaccine efficacy.

[Analysis of liver cancer incidence and trend in China].

PubMed

Zuo, Tingting; Zheng, Rongshou; Zeng, Hongmei; Zhang, Siwei; Chen, Wanqing

2015-09-01

The national population-based cancer registration data were used to analyze the liver cancer incidence and trend in China, in order to provide advise for making further strategy on liver cancer prevention and control. Liver cancer data of 2011 were retrieved from the database of the National Cancer Registry. The incident cases of liver cancer were estimated using age-specific rate by urban or rural areas and gender according to the national population in 2011. Liver cancer incidence data from 22 cancer registries were used to analyze the incidence trend during 2000-2011. The estimates of new cases of liver cancer were about 356 thousand in China in 2011. The incidence rate was 26.39/10(5,) and the age-standardized incidence rates by Chinese standard population and by world population were 19.48/10(5) and 19.10/10(5,) respectively.There was an increasing trend of incidence rate of liver cancer in China during 2000-2011 with an average annual percentage change(AAPC) of 1.0% (95%CI: 0.5%-1.4%), 1.2% (95%CI: 0.7%-1.8%)in urban areas and 1.1% (95%CI: 0.5%-1.8%) in rural areas. After age standardization, the incidence rate was significantly decreased, with an AAPC of -1.8% (95%CI: -2.4% to -1.2%), -1.6% (95%CI: -2.2% to -0.9%) in urban and -1.4% (95%CI: -2.5% to -0.3%) in rural areas. Liver cancer is a common cancer in China. As changing in people's dietary habits and implementing neonatal HBV vaccination for years, the exposure to risk factors is reducing, and age-standardized incidence rate is decreasing. While cardinal number of population is big and aging population is growing rapidly in the country, trend of incidence rate is increasing, and the burden of liver cancer is still high in China.

Spatial Analysis of Hospital Incidence and in Hospital Mortality of Abdominal Aortic Aneurysms in Germany: Secondary Data Analysis of Nationwide Hospital Episode (DRG) Data.

PubMed

Kuehnl, Andreas; Salvermoser, Michael; Erk, Alexander; Trenner, Matthias; Schmid, Volker; Eckstein, Hans-Henning

2018-06-01

This study aimed to analyze the spatial distribution and regional variation of the hospital incidence and in hospital mortality of abdominal aortic aneurysms (AAA) in Germany. German DRG statistics (2011-2014) were analysed. Patients with ruptured AAA (rAAA, I71.3, treated or not) and patients with non-ruptured AAA (nrAAA, I71.4, treated by open or endovascular aneurysm repair) were included. Age, sex, and risk standardisation was done using standard statistical procedures. Regional variation was quantified using systematic component of variation. To analyse spatial auto-correlation and spatial pattern, global Moran's I and Getis-Ord Gi* were calculated. A total of 50,702 cases were included. Raw hospital incidence of AAA was 15.7 per 100,000 inhabitants (nrAAA 13.1; all rAAA 2.7; treated rAAA 1.6). The standardised hospital incidence of AAA ranged from 6.3 to 30.3 per 100,000. Systematic component of variation proportion was 96% in nrAAA and 55% in treated rAAA. Incidence rates of all AAA were significantly clustered with above average values in the northwestern parts of Germany and below average values in the south and eastern regions. Standardised mortality of nrAAA ranged from 1.7% to 4.3%, with that of treated rAAA ranging from 28% to 52%. Regional variation and spatial distribution of standardised mortality was not different from random. There was significant regional variation and clustering of the hospital incidence of AAA in Germany, with higher rates in the northwest and lower rates in the southeast. There was no significant variation in standardised (age/sex/risk) mortality between counties. Copyright © 2018. Published by Elsevier B.V.

Analysis of the solar radiation data for Beer Sheva, Israel, and its environs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kudish, A.I.; Ianetz, A.

The solar radiation climate of Beer Sheva, Israel, is reported upon in detail. The database utilized in this analysis consisted of global radiation on a horizontal surface, normal incidence beam radiation, and global radiation on a south-facing surface tilted at 40{degree}. Monthly-average hourly and daily values are reported for each of these three types of measured radiations, together with the calculated monthly-average daily values for the components of the global radiation, viz. the horizontal beam and diffuse radiations. The monthly-average hourly and daily clearness index values have also been calculated and analyzed. Monthly-average daily frequency distributions of the clearness indexmore » values are reported for each month. The solar radiation climate of Beer Sheva has also been compared to those reported for a number of countries in this region. The annual-average daily global radiation incident on a horizontal surface is 18.91 MG/m{sup 2} and that for normal incidence beam radiation is 21.17 MG/m{sup 2}. The annual-average daily fraction of the horizontal global radiation that is beam is 0.72. The annual-average daily value for the clearness index is 0.587 and the average frequency of clear days annually is 58.6%. The authors conclude, based upon the above analysis, that Beer Sheva and its environs are characterized by relatively high, average-daily irradiation rates, both global and beam, and a relatively high frequency of clear days.« less

Characteristics relating to the interiorization of acquired immunodeficiency syndrome in Brazil: a cross-sectional study.

PubMed

Vieira, Gabriel de Deus; Dos Reis, Ana Raquel Paz; Augusto, Francisco Ormidiel Teles de Alcântara; Martins, Karina Reis; Kern, Paulo Roberto Fernandes; de Souza, Thairini Fuza; Basano, Sérgio de Almeida; Camargo, Luís Marcelo Aranha; de Sousa, Camila Maciel

2015-07-11

In recent years there has been changes in the social and geographic profile of acquired immunodeficiency syndrome (AIDS). The aim of this study was to evaluate the internalization of AIDS in the state of Rondônia, Brazil. In Rondônia, 1473 AIDS cases were reported, with an average annual incidence of 15.8/100,000 persons (42.7 % women). The most common mode of viral transmission was sexual (96.5 %), and the majority of the individuals had not completed their primary education (64.8 %). There was heterogeneity in relation to case distribution, involving almost all of the municipalities in the state. The average annual mortality rate was 2.5/100,000 persons. Rondônia has a higher incidence of AIDS than the national average and the northern region. Efforts to provide access to treatment and follow-up of these individuals should be implemented, prioritizing areas where the incidence is higher and decentralizing the treatment of patients with AIDS in the state.

Incidence Rates of Clinical Mastitis among Canadian Holsteins Classified as High, Average, or Low Immune Responders

PubMed Central

Miglior, Filippo; Mallard, Bonnie A.

2013-01-01

The objective of this study was to compare the incidence rate of clinical mastitis (IRCM) between cows classified as high, average, or low for antibody-mediated immune responses (AMIR) and cell-mediated immune responses (CMIR). In collaboration with the Canadian Bovine Mastitis Research Network, 458 lactating Holsteins from 41 herds were immunized with a type 1 and a type 2 test antigen to stimulate adaptive immune responses. A delayed-type hypersensitivity test to the type 1 test antigen was used as an indicator of CMIR, and serum antibody of the IgG1 isotype to the type 2 test antigen was used for AMIR determination. By using estimated breeding values for these traits, cows were classified as high, average, or low responders. The IRCM was calculated as the number of cases of mastitis experienced over the total time at risk throughout the 2-year study period. High-AMIR cows had an IRCM of 17.1 cases per 100 cow-years, which was significantly lower than average and low responders, with 27.9 and 30.7 cases per 100 cow-years, respectively. Low-AMIR cows tended to have the most severe mastitis. No differences in the IRCM were noted when cows were classified based on CMIR, likely due to the extracellular nature of mastitis-causing pathogens. The results of this study demonstrate the desirability of breeding dairy cattle for enhanced immune responses to decrease the incidence and severity of mastitis in the Canadian dairy industry. PMID:23175290

Incidence rates of clinical mastitis among Canadian Holsteins classified as high, average, or low immune responders.

PubMed

Thompson-Crispi, Kathleen A; Miglior, Filippo; Mallard, Bonnie A

2013-01-01

The objective of this study was to compare the incidence rate of clinical mastitis (IRCM) between cows classified as high, average, or low for antibody-mediated immune responses (AMIR) and cell-mediated immune responses (CMIR). In collaboration with the Canadian Bovine Mastitis Research Network, 458 lactating Holsteins from 41 herds were immunized with a type 1 and a type 2 test antigen to stimulate adaptive immune responses. A delayed-type hypersensitivity test to the type 1 test antigen was used as an indicator of CMIR, and serum antibody of the IgG1 isotype to the type 2 test antigen was used for AMIR determination. By using estimated breeding values for these traits, cows were classified as high, average, or low responders. The IRCM was calculated as the number of cases of mastitis experienced over the total time at risk throughout the 2-year study period. High-AMIR cows had an IRCM of 17.1 cases per 100 cow-years, which was significantly lower than average and low responders, with 27.9 and 30.7 cases per 100 cow-years, respectively. Low-AMIR cows tended to have the most severe mastitis. No differences in the IRCM were noted when cows were classified based on CMIR, likely due to the extracellular nature of mastitis-causing pathogens. The results of this study demonstrate the desirability of breeding dairy cattle for enhanced immune responses to decrease the incidence and severity of mastitis in the Canadian dairy industry.

Incidence and duration of group B Streptococcus by serotype among male and female college students living in a single dormitory.

PubMed

Foxman, Betsy; Gillespie, Brenda; Manning, Shannon D; Howard, Laura J; Tallman, Patricia; Zhang, Lixin; Marrs, Carl F

2006-03-15

Group B Streptococcus causes a variety of morbid and sometimes fatal conditions affecting individuals of all age groups. There are nine known serotypes of this Gram-positive coccus but few estimates of the incidence and duration of its colonization and none by serotype in the literature. In 2001, the authors conducted a prospective cohort study among 257 men and women living in a single dormitory in Ann Arbor, Michigan. The 3-week incidence with any serotype was 11.3% (+/-3.9%) among women and 8.8% (+/-3.0%) among men; 3-week incidence rates were highest for serotype V (4.7% for women and 3.5% for men) and type Ia (2.3% for women and 2.4% for men), with no significant differences by gender. The estimated average duration of any group B Streptococcus colonization was longer for women (13.7 weeks) than men (8.5 weeks); serotype Ia was carried an average of 6.5 weeks longer in women, and serotype III was carried 4.9 weeks longer. Colonization with more than one serotype occurred significantly less than would be expected by chance (p < 0.001). Based on the overall incidence, transmission occurred between roommate pairs at the rate expected. Group B Streptococcus colonization is frequent and dynamic, but it is not transmitted by casual contact.

Epidemiologic Measures for Quantifying the Incidence of Concussion in National Collegiate Athletic Association Sports.

PubMed

Kerr, Zachary Y; Roos, Karen G; Djoko, Aristarque; Dalton, Sara L; Broglio, Steven P; Marshall, Stephen W; Dompier, Thomas P

2017-03-01

Injury rates compare the relative frequency of sport-related concussions across groups. However, they may not be intuitive to policy makers, parents, or coaches in understanding the likelihood of concussion. To describe 4 measures of incidence (athlete-based rate, athlete-based risk, team-based rate, and team-based risk) during the 2011-2012 through 2014-2015 academic years.  Descriptive epidemiology study. Aggregate injury and exposure data collected from the National Collegiate Athletic Association Injury Surveillance Program in 13 sports (men's baseball, basketball, football, ice hockey, lacrosse, soccer, and wrestling and women's basketball, ice hockey, lacrosse, soccer, softball, and volleyball). Collegiate student-athletes. Sport-related concussion data from the National Collegiate Athletic Association Injury Surveillance Program during the 2011-2012 through 2014-2015 academic years were analyzed. We calculated concussion rates per 1000 athlete-exposures (AEs), concussion risk, average number of concussions per team, and percentage of teams with at least 1 concussion. During the 2011-2012 through 2014-2015 academic years, 1485 concussions were sustained by 1410 student-athletes across 13 sports. Concussion rates ranged from 0.09/1000 AEs in men's baseball to 0.89/1000 AEs in men's wrestling. Concussion risk ranged from 0.74% in men's baseball to 7.92% in men's wrestling. The average ± SD number of concussions per team ranged from 0.25 ± 0.43 in men's baseball to 5.63 ± 5.36 in men's football. The percentage of teams with a concussion ranged from 24.5% in men's baseball to 80.6% in men's football.   Although men's wrestling had a higher concussion rate and risk, men's football had the largest average number of concussions per team and the largest percentage of teams with at least 1 concussion. The risk of concussion, average number of concussions per team, and percentage of teams with concussions may be more intuitive measures of incidence for decision makers. Calculating these additional measures is feasible within existing injury surveillance programs, and this method can be applied to other injury types.

Epidemiologic Measures for Quantifying the Incidence of Concussion in National Collegiate Athletic Association Sports

PubMed Central

Kerr, Zachary Y.; Roos, Karen G.; Djoko, Aristarque; Dalton, Sara L.; Broglio, Steven P.; Marshall, Stephen W.; Dompier, Thomas P.

2017-01-01

Context: Injury rates compare the relative frequency of sport-related concussions across groups. However, they may not be intuitive to policy makers, parents, or coaches in understanding the likelihood of concussion. Objective: To describe 4 measures of incidence (athlete-based rate, athlete-based risk, team-based rate, and team-based risk) during the 2011–2012 through 2014–2015 academic years. Design: Descriptive epidemiology study. Setting: Aggregate injury and exposure data collected from the National Collegiate Athletic Association Injury Surveillance Program in 13 sports (men's baseball, basketball, football, ice hockey, lacrosse, soccer, and wrestling and women's basketball, ice hockey, lacrosse, soccer, softball, and volleyball). Patients or Other Participants: Collegiate student-athletes. Main Outcome Measure(s): Sport-related concussion data from the National Collegiate Athletic Association Injury Surveillance Program during the 2011–2012 through 2014–2015 academic years were analyzed. We calculated concussion rates per 1000 athlete-exposures (AEs), concussion risk, average number of concussions per team, and percentage of teams with at least 1 concussion. Results: During the 2011–2012 through 2014–2015 academic years, 1485 concussions were sustained by 1410 student-athletes across 13 sports. Concussion rates ranged from 0.09/1000 AEs in men's baseball to 0.89/1000 AEs in men's wrestling. Concussion risk ranged from 0.74% in men's baseball to 7.92% in men's wrestling. The average ± SD number of concussions per team ranged from 0.25 ± 0.43 in men's baseball to 5.63 ± 5.36 in men's football. The percentage of teams with a concussion ranged from 24.5% in men's baseball to 80.6% in men's football. Conclusions: Although men's wrestling had a higher concussion rate and risk, men's football had the largest average number of concussions per team and the largest percentage of teams with at least 1 concussion. The risk of concussion, average number of concussions per team, and percentage of teams with concussions may be more intuitive measures of incidence for decision makers. Calculating these additional measures is feasible within existing injury surveillance programs, and this method can be applied to other injury types. PMID:27331336

Increased incidence of penile cancer and high-grade penile intraepithelial neoplasia in Denmark 1978-2008: a nationwide population-based study.

PubMed

Baldur-Felskov, Birgitte; Hannibal, Charlotte Gerd; Munk, Christian; Kjaer, Susanne K

2012-02-01

To assess the trends in incidence of penile cancer during 1978-2008 and high-grade penile intraepithelial neoplasia (PIN2/3) during 1998-2008 in Denmark. Using two nationwide registries, we estimated age- and period-specific incidence rates. Log-linear Poisson regression analysis was used to estimate average annual percentage change (AAPC) and 95% confidence intervals (CI). We identified 1,488 men with penile cancer and 285 men with PIN2/3. The incidence of penile cancer increased from 1.0 to 1.3 per 100,000 men-years in 1978-1979 to 2006-2008; this represented an AAPC of 0.8% (95% CI: 0.17-1.37). Squamous cell carcinoma (SCC) was the most common histological type (91.7%). The median age at diagnosis was 67 years, and the age-specific incidence rate of penile SCC increased with increasing age. The incidence rate of PIN2/3 increased significantly (0.5 to 0.9 per 100,000 men-years) in 1998-1999 to 2006-2008, and this represented an AAPC of 7.1% (95% CI: 3.30-11.05). The incidence of penile cancer increased in 1978-2008 in Denmark, and the same applied to PIN2/3 in 1998-2008. A high prevalence of human papillomavirus (HPV) and a low circumcision rate in Denmark may partly explain our results.

Colder environments are associated with a greater cancer incidence in the female population of the United States.

PubMed

Sharma, Ankit; Sharma, Tanu; Panwar, Mahaveer S; Sharma, Devesh; Bundel, Rashmi; Hamilton, Ryan T; Radosevich, James A; Mandal, Chandi C

2017-10-01

Cancer incidence and/or mortality among individuals varies with diet, socio-culture, ethnicity, race, gender, and age. Similarly, environmental temperature modulates many biological functions. To study the effect of environment temperature on cancer incidence, the US population was selected. Because, county-wise cancer incidence rate data of various anatomical site-specific cancers and different races/ethnicities for both males and females are available. Moreover, the differences amongst the aforementioned factors among individuals are much less, as compared to the world population. Statistical analysis showed a negative correlation between the average annual temperature and cancer incidence rate at all anatomical sites and individually for 13 types (out of 16 types) of anatomical site-specific cancer incidence rates (e.g. uterine, bladder, thyroid, breast, esophagus, ovary, melanoma, non-Hodgkin lymphoma, leukemia, brain, pancreas, etc.) for females. Further analysis found a similar inverse trend in all races/ethnicities of the female population but not in all male races/ethnicities or anatomical site-specific cancers. Moreover, the majority of the counties having the top-most cancer incidence rate in females are located above the latitude 36.5°N. These findings indicate that living in a cold county in the United States might have a higher risk of cancer irrespective of cancer type (except cervical and liver) and races/ethnicities for females but not in all such cases for the male population.

Increasing trends in the incidence and prevalence rates of type 1 diabetes among children and adolescents in the Netherlands.

PubMed

Fazeli Farsani, Soulmaz; Souverein, Patrick C; van der Vorst, Marja M J; Knibbe, Catherijne A J; Herings, Ron M C; de Boer, Anthonius; Mantel-Teeuwisse, Aukje K

2016-02-01

To assess the trends in the incidence and prevalence rates of type 1 diabetes (T1D) among children and adolescents in the Netherlands. A population-based cohort study was conducted in the Dutch PHARMO record linkage system (1998-2011). All children and adolescents aged ≤19 yr with at least one insulin dispensing (as a proxy for T1D) were identified and the numbers of incident and prevalent cases (numerators) were calculated. Overall age-adjusted (0-19 yr) incidence and prevalence rates together with age- and sex-specific rates of T1D and their 95% confidence intervals (CI) were calculated using data from the Dutch Central Bureau of Statistics as denominator. Trends over time were assessed using Joinpoint regression software (National Cancer Institute, Bethesda, MD, USA). In 2011, the overall age-adjusted incidence and prevalence rates of T1D were 25.2/100 000 (95% CI, 23.7-26.8) person-years (PY) and 174.4/100 000 (95% CI, 170.2-178.5) children, respectively. The average annual percentage change (AAPC) in the overall age-adjusted incidence and prevalence rate was 3.7% (95% CI, 1.8-5.7) and 3.8% (95% CI, 2.4-5.2), respectively. While during the study period the largest increases in the incidence and prevalence rates of T1D were observed for the oldest age groups (10-14 and 15-19 yr), a decreasing trend was detected for the 0- to 4-yr-old category (with AAPCs of -1.8 (95% CI, -9.9 to 7.1) and -6.9% (95% CI, -11.5 to -2.1) for incidence and prevalence, respectively). Age-adjusted incidence (1999-2011) and prevalence rates (1998-2011) of T1D in Dutch children (aged 0-19 yr) continued to increase and a shift was observed to a later onset of the disease. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The specific absorption rate of tissues in rats exposed to electromagnetic plane waves in the frequency range of 0.05-5 GHz and SARwb in free-moving rats.

PubMed

Chen, Bingxin; Wang, Jiamin; Qi, Hongxin; Zhang, Jie; Chen, Shude; Wang, Xianghui

2017-03-01

As electromagnetic exposure experiments can only be performed on small animals, usually rats, research on the characteristics of specific absorption rate (SAR) distribution in the rat has received increasing interest. A series of calculations, which simulated the SAR in a male rat anatomical model exposed to electromagnetic plane waves ranging from 0.05 to 5 GHz with different incidence and polarization, were conducted. The whole-body-averaged SAR (SARwb) and the tissue-averaged SAR (SARavg) in 20 major tissues were determined. Results revealed that incidence has great impact on SAR in the rat at higher frequencies owing to the skin effect and the effect on SARavg in tissues is much more apparent than that on SARwb; while polarization plays an important role under lower frequencies. Not only the incidence, but also the polarization in the rat keeps changing when the rat is in free movement. Thus, this article discussed a convenient way to obtain relatively accurate SARwb in a free-moving rat.

Prostate cancer incidence and agriculture practices in Georgia, 2000-2010.

PubMed

Welton, Michael; Robb, Sara W; Shen, Ye; Guillebeau, Paul; Vena, John

2015-01-01

Georgia has prostate cancer incidence rates consistently above the national average. A notable portion of Georgia's economy is rooted in agricultural production, and agricultural practices have been associated with an increased risk of prostate cancer. Statistical analyses considered county age-adjusted prostate cancer incidence rates as the outcome of interest and three agricultural variables (farmland as percent of county land, dollars spent per county acre on agriculture chemicals, and dollars spent per county acre on commercial fertilizers) as exposures of interest. Multivariate linear regression models analyzed for each separately. Data were obtained from National Cancer Institute Surveillance, Epidemiology and End Results (SEER) 2000-2010, United States Department of Agriculture (USDA) 1987 Agriculture Survey, and 2010 US Census. In counties with equal to or greater than Georgia counties' median percent African-American population (27%), dollars per acre spent on agriculture chemicals was significantly associated (P = 0.04) and dollars spent of commercial fertilizers was moderately associated (P = 0.07) with elevated prostate cancer incidence rates. There was no association between percent of county farmland and prostate cancer rates. This study identified associations between prostate cancer incidence rates, agriculture chemical expenditure, and commercial fertilizer expenditure in Georgia counties with a population comprised of more than 27% of African Americans.

The prevalence of painful incidents among young recreational gymnasts

PubMed Central

Coates, Chrystal; McMurtry, C Meghan; Lingley-Pottie, Patricia; McGrath, Patrick J

2010-01-01

BACKGROUND: Although children experience pain during their daily life, research has generally focused on medical pain. Sport-related pain has not been widely studied in children and research has not examined the occurrence of painful incidents in gymnastics. The prevalence of painful incidents among children in recreational gymnastics classes and accompanying coach responses were recorded. METHODS: Sixty-one children between five and 10 years of age were observed at a gymnastics club. A checklist was used to record painful incidents as well as coach and child responses. RESULTS: The rate of painful incidents was 0.17 per child per hour observed. The floor apparatus was the most common site of incidents, while bumping into equipment was the most common incident. Based on observer ratings, most incidents were mild to moderate in severity and, on average, the child’s reaction to these mild to moderate incidents lasted for 8.5 s. Forty per cent of the children had a mild to moderate painful experience. Coaches reacted to more than 60% of the painful incidents, usually asking how the child was and what had happened. A significant difference was found between the mean severity ratings of painful incidents that were followed by coach response and incidents followed by no response. CONCLUSION: Most children who attend recreational gymnastics classes will likely experience at least one mild to moderate painful experience for every 6 h of class. Coaches are more inclined to react to a painful incident than not. Moreover, a difference was found that suggests coaches responded to more painful incidents. PMID:20577661

Endometrial Cancer Trends by Race and Histology in the USA: Projecting the Number of New Cases from 2015 to 2040.

PubMed

Gaber, Charles; Meza, Rafael; Ruterbusch, Julie J; Cote, Michele L

2016-10-17

The aim of this study is to explore incidence and incidence-based mortality trends for endometrial cancer in the USA and project future incident cases, accounting for differences by race and histological subtype. Data on age-adjusted and age-specific incidence and mortality rates of endometrial cancer were obtained from the Surveillance, Epidemiology, and End Results 18 registries. Trends in rates were analyzed using Joinpoint regression, and average annual percent change (AAPC) in recent years (2006-2011) was computed for histological subtypes by race. Age, histological, and race-specific rates were applied to US Census Bureau population census estimates to project new cases from 2015 to 2040, accounting for observed AAPC trends, which were progressively attenuated for the future years. The annual number of cases is projected to increase substantially from 2015 to 2040 across all racial groups. Considerable variation in incidence and mortality trends was observed both between and within racial groups when considering histology. As the US population undergoes demographic changes, incidence of endometrial cancer is projected to rise. The increase will occur in all racial groups, but larger increases will be seen in aggressive histology subtypes that disproportionately affect black women.

Using Baidu Search Index to Predict Dengue Outbreak in China

NASA Astrophysics Data System (ADS)

Liu, Kangkang; Wang, Tao; Yang, Zhicong; Huang, Xiaodong; Milinovich, Gabriel J.; Lu, Yi; Jing, Qinlong; Xia, Yao; Zhao, Zhengyang; Yang, Yang; Tong, Shilu; Hu, Wenbiao; Lu, Jiahai

2016-12-01

This study identified the possible threshold to predict dengue fever (DF) outbreaks using Baidu Search Index (BSI). Time-series classification and regression tree models based on BSI were used to develop a predictive model for DF outbreak in Guangzhou and Zhongshan, China. In the regression tree models, the mean autochthonous DF incidence rate increased approximately 30-fold in Guangzhou when the weekly BSI for DF at the lagged moving average of 1-3 weeks was more than 382. When the weekly BSI for DF at the lagged moving average of 1-5 weeks was more than 91.8, there was approximately 9-fold increase of the mean autochthonous DF incidence rate in Zhongshan. In the classification tree models, the results showed that when the weekly BSI for DF at the lagged moving average of 1-3 weeks was more than 99.3, there was 89.28% chance of DF outbreak in Guangzhou, while, in Zhongshan, when the weekly BSI for DF at the lagged moving average of 1-5 weeks was more than 68.1, the chance of DF outbreak rose up to 100%. The study indicated that less cost internet-based surveillance systems can be the valuable complement to traditional DF surveillance in China.

Effect of Climatic Factors on Hand, Foot, and Mouth Disease in South Korea, 2010-2013.

PubMed

Kim, Bryan Inho; Ki, Hyunok; Park, Sunhee; Cho, Eunhi; Chun, Byung Chul

2016-01-01

Hand, foot, and mouth disease (HFMD) causes characteristic blisters and sores mainly in infants and children, and has been monitored in South Korea through sentinel surveillance since 2009. We described the patterns of HFMD occurrence and analyzed the effect of climatic factors on national HFMD incidence. Weekly clinically diagnosed HFMD case rates (per 1,000 outpatients) in sentinel sites and weekly climatic factors, such as average temperature, relative humidity, duration of sunshine, precipitation, and wind speed from 2010 to 2013, were used in this study. A generalized additive model with smoothing splines and climatic variables with time lags of up to 2 weeks were considered in the modeling process. To account for long-term trends and seasonality, we controlled for each year and their corresponding weeks. The autocorrelation issue was also adjusted by using autocorrelation variables. At an average temperature below 18°C, the HFMD rate increased by 10.3% for every 1°C rise in average temperature (95% confidence interval (CI): 8.4, 12.3%). We also saw a 6.6% increase in HFMD rate (95% CI: 3.6, 9.7%) with every 1% increase in relative humidity under 65%, with a 1.5% decrease in HFMD rate observed (95% CI: 0.4, 2.7%) with each 1% humidity increase above 65%. Modeling results have shown that average temperature and relative humidity are related to HFMD rate. Additional research on the environmental risk factors of HFMD transmission is required to understand the underlying mechanism between climatic factors and HFMD incidence.

Prevalence and incidence of epilepsy in a well-defined population of Northern Italy.

PubMed

Giussani, Giorgia; Franchi, Carlotta; Messina, Paolo; Nobili, Alessandro; Beghi, Ettore

2014-10-01

To calculate prevalence and incidence of epilepsy using administrative records. Claim records from the administrative district of Lecco, Northern Italy (population 311,637; 2001 census), collected during the years 2000-2008, were the data source. Patients of all ages were included. Based on previous findings from our group, the most accurate algorithm to detect epilepsy was the combination of electroencephalography (EEG) (ad hoc code) (at least one during the study period) and antiepileptic drugs (AEDs) (ATC code) (taken in 2008). Using this algorithm, the prevalence of epilepsy for the year 2008 was calculated. The reference population for prevalence was the population residing in the study area during the year 2008. Incident epilepsy cases were a subset of prevalent cases among patients not traced in the years 2000 through 2003. Average annual incidence rates were calculated for 2004 through 2008, taking for reference the person-years of exposure in the resident population. We calculated crude, adjusted (using positive and negative predictive values), and standardized (to the Italian and World population) prevalence and incidence. In 2008, 1,504 patients met the inclusion criteria, giving a prevalence of 4.57 per 1,000 (women 4.26; men 4.89). Prevalence tended to rise slightly with age. There were 864 incident cases, giving an average annual incidence of 53.41 per 100,000 (women 50.98; men 55.95). Incidence rates peaked in the elderly. The adjusted prevalence was 4.42 and the adjusted incidence 47.05. Standardized prevalence and incidence were, respectively, 4.30 per 1,000 and 48.35 per 100,000 (Italian population) and 3.79 per 1,000 and 44.74 per 100,000 (World population). The prevalence of epilepsy in the Lecco district was comparable to other studies, whereas the incidence was among the highest. With adjustments, administrative records are a cost-effective instrument to monitor epilepsy frequency. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

[Comparison of predictive effect between the single auto regressive integrated moving average (ARIMA) model and the ARIMA-generalized regression neural network (GRNN) combination model on the incidence of scarlet fever].

PubMed

Zhu, Yu; Xia, Jie-lai; Wang, Jing

2009-09-01

Application of the 'single auto regressive integrated moving average (ARIMA) model' and the 'ARIMA-generalized regression neural network (GRNN) combination model' in the research of the incidence of scarlet fever. Establish the auto regressive integrated moving average model based on the data of the monthly incidence on scarlet fever of one city, from 2000 to 2006. The fitting values of the ARIMA model was used as input of the GRNN, and the actual values were used as output of the GRNN. After training the GRNN, the effect of the single ARIMA model and the ARIMA-GRNN combination model was then compared. The mean error rate (MER) of the single ARIMA model and the ARIMA-GRNN combination model were 31.6%, 28.7% respectively and the determination coefficient (R(2)) of the two models were 0.801, 0.872 respectively. The fitting efficacy of the ARIMA-GRNN combination model was better than the single ARIMA, which had practical value in the research on time series data such as the incidence of scarlet fever.

A Survey of Injuries Affecting Pre-Professional Ballet Dancers.

PubMed

Caine, Dennis; Bergeron, Glen; Goodwin, Brett J; Thomas, Jessica; Caine, Caroline G; Steinfeld, Sam; Dyck, Kevin; André, Suzanne

2016-01-01

A cross-sectional design was employed retrospectively to evaluate injuries self-reported by 71 pre-professional ballet dancers over one season. Some of the descriptive findings of this survey were consistent with those of previous research and suggest particular demographic and injury trends in pre-professional ballet. These results include gender distribution, mean age and age range of participants, training hours, injury location, acute versus overuse injuries, as well as average number of physiotherapy treatments per dancer. Other results provide information that was heretofore unreported or inconsistent with previous investigations. These findings involved proportion of dancers injured, average number of injuries per dancer, overall injury incidence during an 8.5 month period, incidence rate by technique level, mean time loss per injury, proportion of recurrent injury, and activity practiced at time of injury. The results of univariate analyses revealed several significant findings, including a decrease in incidence rate of injury with increased months of experience in the pre-professional program, dancers having lower injury risk in rehearsal and performance than in class, and a reduced risk of injury for dancers at certain technique levels. However, only this latter finding remained significant in multivariate analysis. The results of this study underscore the importance of determining injury rates by gender, technique level, and activity setting in addition to overall injury rates. They also point to the necessity of looking at both overall and individual dancer-based injury risks.

Spatial Analysis of Skin Cancer Incidence in Iran.

PubMed

Pakzad, Reza; Ghoncheh, Mahshid; Pournamdar, Zahra; Pakzad, Iraj; Momenimovahed, Zohre; Salehiniya, Hamid; Makhsosi, Behnam Reza

2016-01-01

Skin cancer is one of the most common cancers worldwide, including in Iran. Variations in its incidence rate among geographical areas are due to various contributing factors. Since there has been a lack of studies on this topic in our country, the present spatial analysis of skin cancer incidence in Iran in 2009 was conducted using data from the cancer registry system for the country. The reported incidences of the disease were standardized on the basis of the World Health Organization population and the direct method. Then the data were inserted into the GIS software, and finally, using the analysis of hot spots (Getis-Ord Gi), high-risk areas were drawn. Provinces that were 1.9 SD higher or lower than the national average were considered hot spots or cold spots, with significance at the level of 0.05. In 2009, a total of 9,964 cases of skin cancer occurred, 3,696 in women and 6,268 in men (standardized incidence rates of 15.8 and 22.6, respectively). The results of the study showed that in men and women, the disease demonstrated high incidence in the central provinces and desert regions. In women, Yazd Province and in men, Qom Province had significant hot spots (p =0.05). While Isfahan, Markazi, Tehran and Kurdistan provinces were expected to be hot spots, the differences from the national average were not significant at the 0.05 level. As well, the provinces of Sistan Va Baluchistan, Kerman, and Hormozgan were identified as cold or low-risk disease regions (p <0.05). The central provinces of the country due to hot weather conditions, more solar radiation, and closer vicinity to the central desert of Iran demonstrated higher incidence rates for skin cancer, so further epidemiological studies into the etiology and early detection are essential in these areas.

Primary Vulvo-Vaginal Cancers: Trends in Incidence and Mortality in Poland (1999-2012).

PubMed

Banas, Tomasz; Pitynski, Kzimierz; Jach, Robert; Knafel, Anna; Ludwin, Artur; Juszczyk, Grzegorz; Nieweglowska, Dorota

2015-01-01

The aim of this study was to determine the incidence, mortality rates and trends of vulvar and vaginal cancers in Poland. Data were retrieved from the Polish National Cancer Registry. Age-standardised rates (ASRs) of cancer incidence and mortality were calculated by direct standardisation, and joinpoint regression was performed to describe the trends using the average annual percent change (AAPC). From 1999 to 2012, the number of diagnosed cases of vulvar cancer was 5,958, and the ASRs of incidence varied from 0.99 to 1.18, with a significant trend towards a decrease (AAPC -0.78; p < 0.05). The ASR of mortality varied from 0.39 to 0.62, with a slight but insignificant increase in trend (AAPC 0.72; p > 0.05). The ASR of vaginal cancer incidence varied from 0.21 to 0.31, while the ASR of mortality ranged from 0.09 to 0.22. This study also proved a significantly falling trend in vaginal cancer mortality (AAPC -4.69; p < 0.05) and a decreasing trend in vaginal cancer incidence (AAPC -1.67; p > 0.05). The rarity of vulvar and vaginal cancers as well as the decline in their incidence rates should not discourage further research on the epidemiology and treatment of these conditions. © 2015 S. Karger AG, Basel.

[Epidemiology of diabetes type 1 in children aged 0-14 in Podlasie Province in years 2005-2012].

PubMed

Peczyńska, Joanna; Peczyńska, Jadwiga; Jamiołkowska, Milena; Polkowska, Agnieszka; Zasim, Aneta; Łuczyński, Włodzimierz; Głowińska-Olszewska, Barbara; Bossowski, Artur

2016-01-01

Epidemiological studies performed during last decades in many European countries and in the world proved increasing incidence rate of diabetes, especially diabetes type 1 in children (DMT1). In Europe there is one of the highest diabetes incidence rate. The aim of the study was to estimate the incidence rate of diabetes type 1 in children aged 0-14 years in North-East Poland during 2005-2012 years and to analyse this rates in relation to age, gender and season of the diabetes onset. The study was performed among patients staying under care of outpatient diabetes clinic of the Department of Pediatric, Endocrinologym Diabetology with Cardilogy Division, medical University of Białystok, Poland. The DMT1 incidence rate was calculated as the number of all newly diagnosed cases per 100 000 persons 0-14 aged matched. During the studied 8-years- period DMT1 was diagnosed in 306 children aged 0-14 years, 159 boys and 147 girls, in Podlasie Province. The highest number of new cases was found in 2011: 49, and 2012: 47, with the lowest number in 2005 and 2009: 32 each year. The average incidence rate in the studied period was 20,84/100 000 population, aged matched. The lowest incidence rate was found in 0-4 yrs old group: 14,59 /100 000, in 5-9 years old group was: 22,04/100 000, and was highest in 10-14 years old group: 24,94/100 000. The highest increase in incidence rate was noted in the youngest group: from 9,14/100 000 in 2005, to 23,45/100 000 in 2012. The greatest number of new recognisions was found in from November to March, and the lowest number from June to August. 1. The DMT1 incidence rate among children aged 0-14 years, in Podlasie Province, during 2005-2012 years was 20,84/100 000. 2. Increase in incidence rate was observed in the studied period from 15,23/100 000 in 2005 to 26,71/100 000 in 2012. The highest increase in incidence rate, 2,5 times, was fund in the youngest group, aged 0-4 years. 3. The seasonal incidence of New onset was observed with the greater number in autumn-winter months. © Polish Society for Pediatric Endocrinology and Diabetology.

Changing trends of chronic myeloid leukemia in greater Mumbai, India over a period of 30 years

PubMed Central

Dikshit, Rajesh P.; Nagrani, Rajini; Yeole, Balkrishna; Koyande, Shravani; Banawali, Shripad

2011-01-01

Background: Little is known about burden of chronic myeloid leukemia (CML) in India. There is a recent interest to observe incidence and mortality because of advent of new diagnostic and treatment policies for CML. Materials and Methods: We extracted data from the oldest population-based cancer registry of Mumbai for 30 years period from 1976−2005 to observe incidence and mortality rates of CML. We classified the data into four age groups 0–14, 15–29, 30–54 and 55–74 to observe incidence rates in the respective age groups. Results: The age specific rates were highest for the age group of 55–74 years. No significant change in trends of CML was observed for 30 years period. However, there was a significant reduction in incidence rate for recent 15-years period (Estimated average annual percentage change=-3.9). No significant reduction in mortality rate was observed till 2005. Conclusion: The study demonstrates that age-specific rates for CML are highest in age group of 55-74 years, although they are lower compared to western populations. Significant reduction in incidence of CML in recent periods might be because of reduced misclassification of leukemias. The data of CML has to be observed for another decade to witness reduction in mortality because of changes in treatment management. PMID:22174498

Geographical mapping and Bayesian spatial modeling of malaria incidence in Sistan and Baluchistan province, Iran.

PubMed

Zayeri, Farid; Salehi, Masoud; Pirhosseini, Hasan

2011-12-01

To present the geographical map of malaria and identify some of the important environmental factors of this disease in Sistan and Baluchistan province, Iran. We used the registered malaria data to compute the standard incidence rates (SIRs) of malaria in different areas of Sistan and Baluchistan province for a nine-year period (from 2001 to 2009). Statistical analyses consisted of two different parts: geographical mapping of malaria incidence rates, and modeling the environmental factors. The empirical Bayesian estimates of malaria SIRs were utilized for geographical mapping of malaria and a Poisson random effects model was used for assessing the effect of environmental factors on malaria SIRs. In general, 64,926 new cases of malaria were registered in Sistan and Baluchistan Province from 2001 to 2009. Among them, 42,695 patients (65.8%) were male and 22,231 patients (34.2%) were female. Modeling the environmental factors showed that malaria incidence rates had positive relationship with humidity, elevation, average minimum temperature and average maximum temperature, while rainfall had negative effect on malaria SIRs in this province. The results of the present study reveals that malaria is still a serious health problem in Sistan and Baluchistan province, Iran. Geographical map and related environmental factors of malaria can help the health policy makers to intervene in high risk areas more efficiently and allocate the resources in a proper manner. Copyright © 2011 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

The incidence and epidemiology of eldercide in the city of Johannesburg, South Africa.

PubMed

Buthelezi, Sizakele; Swart, Lu-Anne; Seedat, Mohamed

2017-11-01

The current study describes the incidence and epidemiological characteristics of eldercide (homicides among victims aged 60 years and older) in Johannesburg for the period 2001 to 2010. A retrospective population-based study was conducted on cases drawn from the National Injury Mortality Surveillance System. A total of 557 eldercides were recorded by NIMSS for the study period with an average annual rate of 23.1 per 100 000. The average annual rate for males was 42.4 per 100 000 and 8.9 per 100 000 for females. There was little variation in the rates by race. Eldercide victims were predominantly male (77.4%), black (48.3%) or white (43.2%), and were mainly killed by firearms (44.8%) or the use of blunt force (27.8%), in a private residence (66.0%), on a week day (53.8%) and during the day (56.1%). The study also found that the characteristics of eldercide varied across males and females, and across black and white race groups. The high incidence of eldercides points to the need for interventions that give special attention to the risk configurations and circumstances associated with these violent deaths. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

[Mammary gland tumor induction in rats by N-nitroso-N-methylurea and N-methyl-N1-nitro-N-nitrosoguanidine].

PubMed

Eliseev, V V; Vlasov, N N

1980-01-01

Cancer of the mammary gland was induced in female non-inbred rats under the local effect of N-nitroso-N-methylurea (NMU) and N-methyl-N-nitro-N-nitrosoguanidine (MNNG). During 10 weeks 2.5 mg of the substance in 0.2 ml of saline was injected in the region of the third mammary gland once a week. Under NMU exposure a primary tumor arose 3 months following the initiation of the experiment, the average latent period being 5.8 months, the incidence rate--76.7%. All tumors of this series were adenocarcinomas, in 5 cases there were noted sites of fibroadenomatosis with malignification along the tumor node margins. MNNG produced a primary tumor at the 7th month of the experiment, an average latent period--8.3 months, the incidence rate--56.7%. Tumors were mostly adenocarcinomas.

[Baseline Incidence of HPV-Associated Invasive and in Situ Cancers in Germany Prior to Potential Vaccination Effects].

PubMed

Sophia Rudolph, Christiane Ermina; Katalinic, Alexander

2018-06-22

Vaccines against human papillomaviruses are covered by statutory health insurances in Germany since March 2007. A reduction of cervical and other HPV-associated cancers is expected. Incidence rates of HPV-associated cancers preceding the introduction of vaccines are unknown. These, however, are important for assessing the effects of HPV vaccines. The aim of the present study was to bridge this knowledge gap. Based on cancer registry data from seven federal states, average yearly incidence rates for cervical, anogenital, oropharyngeal cancers and cancers of the oral cavity were calculated for the period 2003 to 2007. Additionally, estimated numbers of cases give an overview on the total burden of disease caused by HPV-associated cancers in Germany. Incidence trends from 2003 to 2013 are also presented. In Germany, 11,686 cases of invasive HPV-associated cancers occurred yearly before the introduction of HPV vaccines. The most common sites are cervical cancers for women (4,387 cases) and oropharyngeal cancers for men (2,770 cases) with age-standardized incidence rates of 8.8 and 5.9 cases per 100,000 persons, respectively. The age-standardized incidence rate for in situ cervical cancers amounts to 23.5 cases per 100 000 women. Incidence trends show significant increases of invasive vulvar, penile and anorectal cancers. This work presents robust incidence data of HPV-associated cancers in Germany prior to the introduction of the HPV vaccine. Effects of HPV vaccines on the incidence of HPV-associated cancers can be estimated for Germany earliest in 2019. © Georg Thieme Verlag KG Stuttgart · New York.

Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

EPA Pesticide Factsheets

This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has been estimated from the average annual rate of change in each state. This map is limited to the 14 states where Lyme disease is most common, where annual rates are consistently above 10 cases per 100,000. Connecticut, New York, and Rhode Island had too much year-to-year variation in reporting practices to allow trend calculation. For more information: www.epa.gov/climatechange/science/indicators

Childhood acute leukemias are frequent in Mexico City: descriptive epidemiology

PubMed Central

2011-01-01

Background Worldwide, acute leukemia is the most common type of childhood cancer. It is particularly common in the Hispanic populations residing in the United States, Costa Rica, and Mexico City. The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City. Methods Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in 2006 and 2007 with leukemia, as determined by using the International Classification of Childhood Cancer. The average annual incidence rates (AAIR), and the standardized average annual incidence rates (SAAIR) per million children were calculated. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico (used as a reference of socio-economic level). Results Although a total of 610 new cases of leukemia were registered during 2006-2007, only 228 fit the criteria for inclusion in this study. The overall SAAIR was 57.6 per million children (95% CI, 46.9-68.3); acute lymphoblastic leukemia (ALL) was the most frequent type of leukemia, constituting 85.1% of the cases (SAAIR: 49.5 per million), followed by acute myeloblastic leukemia at 12.3% (SAAIR: 6.9 per million), and chronic myeloid leukemia at 1.7% (SAAIR: 0.9 per million). The 1-4 years age group had the highest SAAIR for ALL (77.7 per million). For cases of ALL, 73.2% had precursor B-cell immunophenotype (SAAIR: 35.8 per million) and 12.4% had T-cell immunophenotype (SAAIR 6.3 per million). The peak ages for ALL were 2-6 years and 8-10 years. More than half the children (58.8%) were classified as high risk. There was a positive correlation between the average number of persons per household and the incidence of the pre-B immunophenotype (Pearson's r, 0.789; P = 0.02). Conclusions The frequency of ALL in Mexico City is among the highest in the world, similar to those found for Hispanics in the United States and in Costa Rica. PMID:21846410

Incidence of thyroid cancer surrounding Three Mile Island nuclear facility: the 30-year follow-up.

PubMed

Levin, Roger J; De Simone, Nicole F; Slotkin, Jaime F; Henson, Baker L

2013-08-01

Original data reported a potential increased incidence of thyroid cancer surrounding the Three Mile Island (TMI) nuclear facility. A causal link to the accident, however, was indeterminate. Our objective was to determine if data 30 years later will change original conclusions, explore thyroid cancer incidence rates near nuclear power plants, and better understand effects of chronic low level radiation. Retrospective cross-sectional study. Retrospective data for specific Pennsylvania counties were provided by the Pennsylvania Cancer Registry Dataset for thyroid cancer using the Epidemiological Query and Mapping System search engine. Our study examines thyroid cancer incidence from 1985 through 2009 analyzed by year, county, and age. Thirty years after the TMI accident, an increased incidence of thyroid cancer is seen in counties south of TMI and in high-risk age groups. The average incidence rates from 1990 through 2009 were greater than expected in York, Lancaster, Adams, and Chester Counties. Thyroid cancer incidence since the TMI accident was greater than expected in the counties analyzed when compared to local and national population growth. This supports a link to chronic low level radiation exposure and thyroid cancer development. Despite these findings, a direct correlation to the accident remains uncertain as incidence rates may coincide with other factors, and original data were limited. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Cancer incidence in northern Sweden before and after the Chernobyl nuclear power plant accident.

PubMed

Alinaghizadeh, Hassan; Tondel, Martin; Walinder, Robert

2014-08-01

Sweden received about 5 % of the total release of (137)Cs from the Chernobyl nuclear power plant accident in 1986. The distribution of the fallout mainly affected northern Sweden, where some parts of the population could have received an estimated annual effective dose of 1-2 mSv per year. It is disputed whether an increased incidence of cancer can be detected in epidemiological studies after the Chernobyl nuclear power plant accident outside the former Union of Soviet Socialist Republics. In the present paper, a possible exposure-response pattern between deposition of (137)Cs and cancer incidence after the Chernobyl nuclear power plant accident was investigated in the nine northernmost counties of Sweden (2.2 million inhabitants in 1986). The activity of (137)Cs from the fallout maps at 1986 was used as a proxy for the received dose of ionizing radiation. Diagnoses of cancer (ICD-7 code 140-209) from 1980 to 2009 were received from the Swedish Cancer Registry (273,222 cases). Age-adjusted incidence rate ratios, stratified by gender, were calculated with Poisson regression in two closed cohorts of the population in the nine counties 1980 and 1986, respectively. The follow-up periods were 1980-1985 and 1986-2009, respectively. The average surface-weighted deposition of (137)Cs at three geographical levels; county (n = 9), municipality (n = 95) and parish level (n = 612) was applied for the two cohorts to study the pre- and the post-Chernobyl periods separately. To analyze time trends, the age-standardized total cancer incidence was calculated for the general Swedish population and the population in the nine counties. Joinpoint regression was used to compare the average annual percent change in the general population and the study population within each gender. No obvious exposure-response pattern was seen in the age-adjusted total cancer incidence rate ratios. A spurious association between fallout and cancer incidence was present, where areas with the lowest incidence of cancer before the accident coincidentally had the lowest fallout of (137)Cs. Increasing the geographical resolution of exposure from nine county averages to 612 parish averages resulted in a two to three times higher value of variance in the regression model. There was a secular trend with an increase in age-standardized incidence of cancer in both genders from 1980 to 2009, but significant only in females. This trend was stronger and statistically significant for both genders in the general Swedish population compared to the nine counties. In conclusion, using both high quality cancer registry data and high resolution exposure maps of (137)Cs deposition, it was not possible to distinguish an effect of (137)Cs on cancer incidence after the Chernobyl nuclear power plant accident in Sweden.

Changing incidence of psychotic disorders among the young in Zurich.

PubMed

Ajdacic-Gross, Vladeta; Lauber, Christoph; Warnke, Inge; Haker, Helene; Murray, Robin M; Rössler, Wulf

2007-09-01

There is controversy over whether the incidence rates of schizophrenia and psychotic disorders have changed in recent decades. To detect deviations from trends in incidence, we analysed admission data of patients with an ICD-8/9/10 diagnosis of psychotic disorders in the Canton Zurich / Switzerland, for the period 1977-2005. The data was derived from the central psychiatric register of the Canton Zurich. Ex-post forecasting with ARIMA (Autoregressive Integrated Moving Average) models was used to assess departures from existing trends. In addition, age-period-cohort analysis was applied to determine hidden birth cohort effects. First admission rates of patients with psychotic disorders were constant in men and showed a downward trend in women. However, the rates in the youngest age groups showed a strong increase in the second half of the 1990's. The trend reversal among the youngest age groups coincides with the increased use of cannabis among young Swiss in the 1990's.

Machinery-related occupational fatalities in the United States, 1980 to 1989.

PubMed

Pratt, S G; Kisner, S M; Helmkamp, J C

1996-01-01

The National Traumatic Occupational Fatalities surveillance system identified machinery-related incidents as the second leading cause of traumatic occupational fatalities in the United States between 1980 and 1989. These incidents resulted in 8,505 civilian worker deaths and an average annual fatality rate of .80 per 100,000 workers. Workers aged 65 years and older had 5.8 times the fatality rate of workers aged 16 to 64 years (4.06 vs. 70). The highest industry-specific rate was noted in agriculture, forestry, and fishing (7.47). Tractors and other agricultural machinery were associated with nearly 9 of every 10 fatal machinery-related incidents involving workers aged 65 or older. Although numerous studies of agricultural machinery-related fatalities are found in the literature, detailed analyses of machinery-related fatalities in the construction industry as well as analyses of work situations and risk factors associated with fatal injuries are needed.

Spatial analysis of county-based gonorrhoea incidence in mainland China, from 2004 to 2009.

PubMed

Yin, Fei; Feng, Zijian; Li, Xiaosong

2012-07-01

Gonorrhoea is one of the most common sexually transmissible infections in mainland China. Effective spatial monitoring of gonorrhoea incidence is important for successful implementation of control and prevention programs. The county-level gonorrhoea incidence rates for all of mainland China was monitored through examining spatial patterns. County-level data on gonorrhoea cases between 2004 and 2009 were obtained from the China Information System for Disease Control and Prevention. Bayesian smoothing and exploratory spatial data analysis (ESDA) methods were used to characterise the spatial distribution pattern of gonorrhoea cases. During the 6-year study period, the average annual gonorrhoea incidence was 12.41 cases per 100000 people. Using empirical Bayes smoothed rates, the local Moran test identified one significant single-centre cluster and two significant multi-centre clusters of high gonorrhoea risk (all P-values <0.01). Bayesian smoothing and ESDA methods can assist public health officials in using gonorrhoea surveillance data to identify high risk areas. Allocating more resources to such areas could effectively reduce gonorrhoea incidence.

Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force.

PubMed

Pignone, Michael; Rich, Melissa; Teutsch, Steven M; Berg, Alfred O; Lohr, Kathleen N

2002-07-16

To assess the effectiveness of different colorectal cancer screening tests for adults at average risk. Recent systematic reviews; Guide to Clinical Preventive Services, 2nd edition; and focused searches of MEDLINE from 1966 through September 2001. The authors also conducted hand searches, reviewed bibliographies, and consulted context experts to ensure completeness. When available, the most recent high-quality systematic review was used to identify relevant articles. This review was then supplemented with a MEDLINE search for more recent articles. One reviewer abstracted information from the final set of studies into evidence tables, and a second reviewer checked the tables for accuracy. Discrepancies were resolved by consensus. For average-risk adults older than 50 years of age, evidence from multiple well-conducted randomized trials supported the effectiveness of fecal occult blood testing in reducing colorectal cancer incidence and mortality rates compared with no screening. Data from well-conducted case-control studies supported the effectiveness of sigmoidoscopy and possibly colonoscopy in reducing colon cancer incidence and mortality rates. A nonrandomized, controlled trial examining colorectal cancer mortality rates and randomized trials examining diagnostic yield supported the use of fecal occult blood testing plus sigmoidoscopy. The effectiveness of barium enema is unclear. Data are insufficient to support a definitive determination of the most effective screening strategy. Colorectal cancer screening reduces death from colorectal cancer and can decrease the incidence of disease through removal of adenomatous polyps. Several available screening options seem to be effective, but the single best screening approach cannot be determined because data are insufficient.

Spatiotemporal analysis of brucellosis incidence in Iran from 2011 to 2014 using GIS.

PubMed

Pakzad, Reza; Pakzad, Iraj; Safiri, Saeid; Shirzadi, Mohammad Reza; Mohammadpour, Marzieh; Behroozi, Abbas; Sullman, Mark J M; Janati, Ali

2018-02-01

To investigate the distribution and trends associated with brucellosis incidence rates in Iran from 2011 to 2014. The reported incidence rates of brucellosis for the years 2011-2014 were collected and entered into GIS 10.1. The Cochran-Armitage test for linear trends, choropleth maps, hot-spot analysis, and high-low clustering analysis were used to investigate patterns of the disease over the study period and by season, and to identify high-risk areas and any clustering of the disease. The significance level was set at p<0.05. A total of 68493 cases of brucellosis were reported during the study period, giving an average brucellosis incidence rate for this period of 38.67/100000. In 2011, the highest rate of brucellosis was observed in Koohrang County of Chaharmahal-Bakhtiari Province, with 317/100 000. In the subsequent years, 2012-2014, Charuymaq County of East-Azerbaijan Province had incidence rates of 384, 534, and 583/100000, respectively. However, the incidence rate of the disease did not follow a linear trend (p<0.001). The maximum and minimum incidence rates of the disease occurred in mid-summer and mid-winter, respectively. The results of the hot-spot analysis showed that the distribution of the disease was highest in the mountainous areas of Iran, particularly along the Zagros mountain range and in most cities near the Zagros Mountains (p<0.01). In addition, the cluster analysis showed a clustering pattern in these high incidence areas (p<0.01). There were significant differences in the geographic distribution of brucellosis, with the incidence rates being highest in most of the cities in the west and north-west of the country. The incidence of this disease also increased during the summer. It is important to take these patterns into account when allocating resources to combat this disease and to ensure that health programs and other interventions focus on the areas of greatest need. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

[Incidence and survival of esophageal cancer with different histological types in Linzhou between 2003 and 2012].

PubMed

Liu, S Z; Yu, L; Chen, Q; Quan, P L; Cao, X Q; Sun, X B

2017-05-06

Objective: To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012. Methods: All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi's population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change (EAPC) was calculated. 5-year survival rate was calculated with Kaplan-Meier model. Results: There were 8 229 esophageal cancer cases in Linzhou during 2003-2012. The average annual incidence rate was 80.08/100 000 (8 229/10 276 481). Among all esophageal cancer cases, 7 019 (85.3%) were diagnosed as esophageal squamous cell carcinoma (ESCC). In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100 000 and 81.85/100 000 in 2003, 67.97/100 000 and 68.63/100 000 in 2012. JoinPoint regression model showed that EAPC was-12.9% (95 %CI: -16.4%--9.1%) for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5% (95 %CI: -9.2%--1.6%) for esophageal cancer between 2007 and 2012,-5.4% (95 %CI: -7.0%--3.9%) for esophageal cancer in female between 2006 and 2012,-4.9% (95 %CI: -9.5%--0.1%) for ESCC between 2007 and 2012. The 5-year prevalence of esophageal cancer was 215.49 per 100 000 (2 337/1 084 493), and 5 489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6% (95 %CI: 33.5%-35.6%). Conclusion: Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was ESCC. ESCC had a similar decreasing trend with esophageal cancer.

Age-specific and sex-specific prevalence and incidence of mild cognitive impairment, dementia, and Alzheimer dementia in blacks and whites: a report from the Einstein Aging Study.

PubMed

Katz, Mindy J; Lipton, Richard B; Hall, Charles B; Zimmerman, Molly E; Sanders, Amy E; Verghese, Joe; Dickson, Dennis W; Derby, Carol A

2012-01-01

As the population ages, the need to characterize rates of cognitive impairment and dementia within demographic groups defined by age, sex, and race becomes increasingly important. There are limited data available on the prevalence and incidence of amnestic mild cognitive impairment (aMCI) and nonamnestic mild cognitive impairment (naMCI) from population-based studies. The Einstein Aging Study, a systematically recruited community-based cohort of 1944 adults aged 70 or older (1168 dementia free at baseline; mean age, 78.8 y; average follow-up, 3.9 y), provides the opportunity to examine the prevalence and incidence rates for dementia, Alzheimer dementia (AD), aMCI, and naMCI by demographic characteristics. Dementia prevalence was 6.5% (4.9% AD). Overall dementia incidence was 2.9/100 person-years (2.3/100 person-years for AD). Dementia and AD rates increased with age but did not differ by sex. Prevalence of aMCI was 11.6%, and naMCI prevalence was 9.9%. aMCI incidence was 3.8 and naMCI incidence was 3.9/100 person-years. Rates of aMCI increased significantly with age in men and in blacks; sex, education, and race were not significant risk factors. In contrast, naMCI incidence did not increase with age; however, blacks were at higher risk compared with whites, even when controlling for sex and education. Results highlight the public health significance of preclinical cognitive disease.

Increasing incidence of invasive Haemophilus influenzae disease in adults, Utah, USA.

PubMed

Rubach, Matthew P; Bender, Jeffrey M; Mottice, Susan; Hanson, Kimberly; Weng, Hsin Y C; Korgenski, Kent; Daly, Judy A; Pavia, Andrew T

2011-09-01

Since the introduction of the Haemophilus influenzae type b vaccine, the incidence of invasive H. influenzae type b disease among children has fallen dramatically, but the effect on invasive H. influenzae disease among adults may be more complex. In this population-based study we examined the epidemiology and outcomes of invasive disease caused by typeable and nontypeable H. influenzae among Utah adults during 1998-2008. The overall incidence increased over the study period from 0.14/100,000 person-years in 1998 to 1.61/100,000 person-years in 2008. The average incidence in persons >65 years old was 2.74/100,000 person-years, accounting for 51% of cases and 67% of deaths. The incidence was highest for nontypeable H. influenzae (0.23/100,000 person-years), followed by H. influenzae type f (0.14/100,000 person-years). The case-fatality rate was 22%. The incidence of invasive H. influenzae in Utah adults appears to be increasing. Invasive H. influenzae infection disproportionately affected the elderly and was associated with a high mortality rate.

Effect of latitude on the rate of change in incidence of Lyme disease in the United States

PubMed Central

Tuite, Ashleigh R.; Greer, Amy L.

2013-01-01

Background Tick-borne illnesses represent an important class of emerging zoonoses, with climate change projected to increase the geographic range within which tick-borne zoonoses might become endemic. We evaluated the impact of latitude on the rate of change in the incidence of Lyme disease in the United States, using publicly available data. Methods We estimated state-level year-on-year incidence rate ratios (IRRs) for Lyme disease for the period 1993 to 2007 using Poisson regression methods. We evaluated between-state heterogeneity in IRRs using a random-effects meta-analytic approach. We identified state-level characteristics associated with increasing incidence using random-effects meta-regression. Results The incidence of Lyme disease in the US increased by about 80% between 1993 and 2007 (IRR per year 1.049, 95% CI [confidence interval] 1.048 to 1.050). There was marked between-state heterogeneity in the average incidence of Lyme disease, ranging from 0.008 per 100 000 person-years in Colorado to 75 per 100 000 in Connecticut, and significant between-state heterogeneity in temporal trends (p < 0.001). In multivariable meta-regression models, increasing incidence showed a linear association with state latitude and population density. These 2 factors explained 27% of the between-state variation in IRRs. No independent association was identified for other state-level characteristics. Interpretation Lyme disease incidence increased in the US as a whole during the study period, but the changes were not uniform. Marked increases were identified in northern-most states, whereas southern states experienced stable or declining rates of Lyme disease. PMID:25077101

An update on the prevalence and incidence of epilepsy among older adults.

PubMed

Ip, Queeny; Malone, Daniel C; Chong, Jenny; Harris, Robin B; Labiner, David M

2018-01-01

To estimate the prevalence and incidence of epilepsy among beneficiaries of Arizona Medicare aged 65 and over. An analysis of Medicare administrative claims data for 2009-2011 for the State of Arizona was conducted. Epilepsy was defined as a beneficiary who had either≥one claim with diagnostic code of 345.xx (epilepsy) or at least two claims with diagnosis code of 780.3x (seizure) ≥30days apart. Stroke-related and psychiatric comorbidities were determined by diagnostic codes. Average annual prevalence and incidence were calculated and stratified by demographic characteristics and comorbidities. Odds ratios (OR) and 95% confidence intervals (CI) were calculated as measures of effect for prevalence and incidence and the chi-square statistic was calculated to compare the proportions of epilepsy cases with and without comorbidities (alpha=0.05). The overall average annual prevalence and incidence over the study period was 15.2/1000 and 6.1/1000, respectively. Relative to the 65-69 age group and White beneficiaries, the highest prevalence was observed for beneficiaries 85 years or older (19.8/1000, OR 1.66, 95% CI 1.53-1.81) and Native Americans (21.2/1000, OR 1.42, 95% CI 1.25-1.62). In contrast, the highest incidence rates were observed for beneficiaries 85 years and older (8.5/1000, OR 1.82, 95% CI 1.60-2.07) and for Black beneficiaries (8.7/1000, OR 1.44, 95% CI 1.12-1.86). The incidence rate for Native Americans was not significantly different from that for White beneficiaries (6.2/1000, OR 1.02, 95% CI 0.81-1.29). More than one quarter of all cases (25.7%) and 31% of incident cases had either stroke-related and/or psychiatric comorbidities (all p-values < 0.001). Epilepsy is a significant neurological disease among Medicare beneficiaries 65 years and older. Beneficiaries aged 85 and older and Black and Native Americans experienced higher rates of epilepsy than other demographic subgroups compared to White beneficiaries. Copyright © 2017 Elsevier B.V. All rights reserved.

Cervical Cancer Incidence in Young U.S. Females After Human Papillomavirus Vaccine Introduction.

PubMed

Guo, Fangjian; Cofie, Leslie E; Berenson, Abbey B

2018-05-30

Since 2006, human papillomavirus vaccine has been recommended for young females in the U.S. This study aimed to compare cervical cancer incidence among young women before and after the human papillomavirus vaccine was introduced. This cross-sectional study used data from the National Program for Cancer Registries and Surveillance, Epidemiology, and End Results Incidence-U.S. Cancer Statistics 2001-2014 database for U.S. females aged 15-34 years. This study compared the 4-year average annual incidence of invasive cervical cancer in the 4 years before human papillomavirus vaccine was introduced (2003-2006) and the 4 most recent years in the vaccine era (2011-2014). Joinpoint regression models of cervical incidence from 2001 to 2014 were fitted to identify the discrete joints (year) that represent statistically significant changes in the direction of the trend after the introduction of human papillomavirus vaccination in 2006. Data were collected in 2001-2014, released, and analyzed in 2017. The 4-year average annual incidence rates for cervical cancer in 2011-2014 were 29% lower than that in 2003-2006 (6.0 vs 8.4 per 1,000,000 people, rate ratio=0.71, 95% CI=0.64, 0.80) among females aged 15-24 years, and 13.0% lower among females aged 25-34 years. Joinpoint analyses of cervical cancer incidence among females aged 15-24 years revealed a significant joint at 2009 for both squamous cell carcinoma and non-squamous cell carcinoma. Among females aged 25-34 years, there was no significant decrease in cervical cancer incidence after 2006. A significant decrease in the incidence of cervical cancer among young females after the introduction of human papillomavirus vaccine may indicate early effects of human papillomavirus vaccination. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Temporal trends in the epidemiology of cervical cancer in South Africa (1994-2012).

PubMed

Olorunfemi, Gbenga; Ndlovu, Ntombizodwa; Masukume, Gwinyai; Chikandiwa, Admire; Pisa, Pedro T; Singh, Elvira

2018-05-22

Cervical cancer (CC) is the leading cause of cancer death among female South Africans (SA). Improved access to reproductive health services following multi-ethnic democracy in 1994, HIV epidemic, and the initiation of CC population-based screening in early 2000's have influenced the epidemiology of CC in SA. We therefore evaluated the trends in CC age-standardized incidence (ASIR) (1994 - 2009) and mortality rates (ASMR) (2004 - 2012) using data from the South African National Cancer Registry and the Statistics South Africa, respectively. Five-year relative survival rates and average percent change (AAPC) stratified by ethnicity and age-groups was determined. The average annual CC cases and mortalities were 4,694 (75,099 cases/16years) and 2,789 (25,101 deaths/9years) respectively. The ASIR was 22.1/100,000 in 1994 and 23.3/100,000 in 2009, with an average annual decline in incidence of 0.9% per annum (AAPC = -0.9%, P-value<0.001). The ASMR decreased slightly by 0.6% per annum from 13.9/100,000 in 2004 to 13.1/100,000 in 2012 (AAPC = -0.6%, P-value < 0.001). In 2012, ASMR was 5.8-fold higher in Blacks than in Whites. The 5-year survival rates were higher in Whites and Indians/Asians (60-80%) than in Blacks and Coloureds (40-50%). The incidence rate increased (AAPC range: 1.1% to 3.1%, P-value<0.001) among young women (25-34 years) from 2000 to 2009. Despite interventions, there were minimal changes in overall epidemiology of CC in SA but there were increased CC rates among young women and ethnic disparities in CC burden. A review of the CC national policy and directed CC prevention and treatment are required to positively impact the burden of CC in SA. This article is protected by copyright. All rights reserved. © 2018 UICC.

Influence of occupational safety management on the incidence rate of occupational accidents in the Spanish industrial and ornamental stone mining.

PubMed

Sanmiquel, Lluís; Rossell, Josep M; Vintró, Carla; Freijo, Modesto

2014-01-01

Mines are hazardous and workers can suffer many types of accidents caused by fire, flood, explosion or collapse. Injury incidence rates in mining are considerably higher than those registered by other economic sectors. One of the main reasons for this high-level incidence rate is the existence of a large number of dangerous workplaces. This work analyzes the influence that occupational safety management had on the accidents that took place in Spanish mining of industrial and ornamental stone during the period 2007-2008. Primary data sources are: (a) Results from a statistical study of the occupational health and safety management practices of 71 quarries defined by a questionnaire of 41 items; and (b) Occupational accidents registered in the Spanish industrial and ornamental stone mining throughout the period 2007-2008. The obtained results indicate that workplaces with a low average score in the analysis of occupational safety management have a higher incidence rate of accidents. Studies on mining workplaces are very important to help detect occupational safety concerns. Results from this study help raise awareness and will encourage the adoption of appropriate measures to improve safety.

Reported incidence and precipitating factors of work-related stress and mental ill-health in the United Kingdom (1996-2001).

PubMed

Cherry, Nicola M; Chen, Yiqun; McDonald, J Corbett

2006-09-01

Work-related mental ill-health appears to be increasing. Population-based data on incidence are scarce but in the United Kingdom occupational physicians and psychiatrists report these conditions to voluntary surveillance schemes. To estimate the incidence of work-related stress and mental illness reported 1996-2001 by occupational physicians and 1999-2001 by psychiatrists. Estimated annual average incidence rates were calculated by sex, occupation and industry against appropriate populations at risk. An in-house coding scheme was used to classify and analyse data on precipitating events. An estimated annual average of 3,624 new cases were reported by psychiatrists, and 2,718 by occupational physicians; the rates were higher for men in reports based on the former and for women on the latter. Most diagnoses were of anxiety/depression or work-related stress, with post-traumatic stress accounting for approximately 10% of cases reported by psychiatrists. High rates of ill-health were seen among professional and associated workers and in those in personal and protective services. Factors (such as work overload) intrinsic to the job and issues with interpersonal relations were the most common causes overall. The steep increase in new cases of work-related mental ill-health reported by occupational physicians since 1996 may reflect a greater willingness by workers to seek help but may also signify an increasing dissonance between workers' expectations and the work environment. Greater expertise is needed to improve the workplace by adjustment of job demands, improvement of working relations, increasing workers' capacities and management of organizational change.

Incidence of and risk factors for glaucoma in lost-to-follow-up normal-tension glaucoma suspect patients.

PubMed

Lim, Jong Hoon; Park, Jun Sang; Lee, So Yeon; Hong, Young Jae

2016-05-25

To investigate the incidence and risk factors of glaucoma in normal-tension glaucoma (NTG) suspect patients who had been lost-to-follow-up for at least 24 months. Seventy-two eyes of 72 NTG suspect patients who returned to the hospital after at least 24 months of follow-up loss were enrolled in this study between January 2009 and June 2013. The data were collected retrospectively. The incidence of glaucoma was investigated using a comprehensive glaucoma evaluation in lost-to-follow-up NTG suspect patients. The patients were classified into the glaucoma group, who developed glaucoma during the study period, and the glaucoma suspect group, who did not, to analyse the risk factors for glaucoma. The number of patients who developed glaucoma was 7 (9.7 %) out of the 72 NTG suspect patients who had been mean lost-to-follow-up for 44 months. The rate of progression from suspected to glaucoma was 2.6 %/year. In the glaucoma group, the baseline intraocular pressure (IOP) was 18.43 ± 2.44 mmHg, and the average retinal nerve fiber layer (RNFL) thickness was 78.14 ± 7.60 μm; in the glaucoma suspect group, the baseline IOP was 14.95 ± 2.47 mmHg, and the average RNFL thickness was 92.55 ± 7.65 μm. The study results showed that the glaucoma group had higher baseline IOP and a thinner average RNFL (p = 0.003; p < 0.001). The results of the multivariable logistic regression analysis showed that the risk factors for glaucoma were high baseline IOP (OR = 1.63; p = 0.037) and a thin average RNFL (OR = 0.841; p = 0.004). The incidence of glaucoma in the lost-to-follow-up NTG suspect patients was 9.7 % for approximately 44 months, at a rate of 2.6 %/year. The risk factors for glaucoma in these patients were high baseline IOP and a thin average RNFL.

Geographic and ethnic disparities in osteoporotic fractures.

PubMed

Cauley, Jane A; Chalhoub, Didier; Kassem, Ahmed M; Fuleihan, Ghada El-Hajj

2014-06-01

Osteoporotic fractures are a major worldwide epidemic. Here, we review global variability, ethnic differences and secular changes in osteoporotic fractures. Worldwide, age-standardized incidence rates of hip fracture vary >200-fold in women and >140-fold in men when comparing the country in which incidence rates are the highest with that in which they are the lowest. Median age-standardized rates are highest in North America and Europe, followed by Asia, Middle East, Oceania, Latin America and Africa. Globally, rates of hip fracture are greater in women than in men, with an average ratio of ∼2:1. The incidence of radiographic vertebral fractures is much higher than that of hip fractures, whereas the incidence rates of clinical vertebral fractures mirror hip fracture rates in most countries. Methodological challenges of defining and ascertaining vertebral fractures limit the interpretation of these data. Secular declines in hip fracture rates have been reported in populations from North America, Europe and Oceania. These declines are especially notable in women, suggesting that reproductive factors might contribute to this reduction. By contrast, hip fracture rates are increasing in parts of Asia and Latin America. Global indicators of health, education and socioeconomic status are positively correlated with fracture rates suggesting that lifestyles in developed countries might contribute to hip fracture. Improvements in fracture assessment, in particular for nonhip fractures, and identification of factors that contribute to this variability might substantially influence our understanding of osteoporotic fracture aetiology and provide new avenues for prevention.

Incidence of amyotrophic lateral sclerosis among American Indians and Alaska natives.

PubMed

Gordon, Paul H; Mehal, Jason M; Holman, Robert C; Rowland, Lewis P; Rowland, Andrew S; Cheek, James E

2013-04-01

More thorough evaluation of amyotrophic lateral sclerosis (ALS) and motor neuron disease in unique populations could provide clues to etiologies for these idiopathic conditions, and educational programs for American Indian and Alaska Native (AI/AN) people and health care professionals on reservations could improve awareness, understanding, diagnosis, and treatment. In the ongoing search for susceptibility genes, studying particular racial groups, such as AI/ANs,might facilitate the identification of new mutations. To provide better understanding of ALS and secondarily of motor neuron disease among AI/AN people by estimating the incidence and prevalence among AI/ANs served by the Indian Health Service health care system. Analysis of electronic records for AI/ANs with ALS and with motor neuron disease separately for the calendar years 2002-2009 using inpatient and outpatient visit data from the Indian Health Service, which provides health care to eligible AI/ANs nationwide. Cases were defined by at least 2 inpatient or outpatient visits with the diagnosis. Crude and age-adjusted incidence and prevalence rates were calculated. Seventy-one AI/ANs were diagnosed with ALS, yielding an average annual crude incidence rate of 0.63 cases per 100 000 and an age-adjusted incidence of 0.92. The median age at onset was 56.0 years and was higher among women than men (62.0 vs 55.0 years; P=.06). Age-specific incidence increased to 70 to 74 years. The crude and age-adjusted point prevalence rates were 2.00 and 4.12, respectively. The crude and age-adjusted incidence rates for motor neuron disease were 1.08 and 1.50, respectively. The annual rates were unchanged across the study period. The incidence of ALS among AI/ANs appears to be lower than that reported for white populations, a finding congruent with reports of other minority populations. Community-based studies are important to confirm these findings and to examine reasons for the low rate of ALS among AI/ANs.

Association between thermal environment and Salmonella in fecal samples from dairy cattle in midwestern United States

PubMed Central

Likavec, Tasha; Pires, Alda F.A.; Funk, Julie A.

2016-01-01

The objective of this study was to describe the association between thermal measures in the barn environment (pen temperature and humidity) and fecal shedding of Salmonella in dairy cattle. A repeated cross-sectional study was conducted within a commercial dairy herd located in the midwestern United States. Five pooled fecal samples were collected monthly from each pen for 9 mo and submitted for microbiological culture. Negative binomial regression methods were used to test the association [incidence rate ratio (IRR)] between Salmonella pen status (the count of Salmonella-positive pools) and thermal environmental parameters [average temperature and temperature humidity index (THI)] for 3 time periods (48 h, 72 h, and 1 wk) before fecal sampling. Salmonella was cultured from 10.8% [39/360; 95% confidence interval (CI): 7.8% to 14.5%] of pooled samples. The highest proportion of positive pools occurred in August. The IRR ranged from 1.26 (95% CI: 1.15 to 1.39, THI 1 wk) to 4.5 (95% CI: 2.13 to 9.51, heat exposure 1 wk) across all thermal parameters and lag time periods measured. For example, the incidence rate of Salmonella-positive pools increased by 54% for every 5°C increment in average temperature (IRR = 1.54; 95% CI: 1.29 to 1.85) and 29% for every 5-unit increase in THI (IRR = 1.29; 95% CI: 1.16 to 1.42) during the 72 h before sampling. The incidence rate ratio for pens exposed to higher temperatures (> 25°C) was 4.5 times (95% CI: 2.13 to 9.51) the incidence rate ratio for pens exposed to temperatures < 25°C in the 72 h before sampling. Likewise, the incidence rate ratio for pens exposed to THI > 70 was 4.23 times greater (95% CI: 2.1 to 8.28) than when the THI was < 70 in the 72 h before sampling. An association was found between the thermal environment and Salmonella shedding in dairy cattle. Further research is warranted in order to fully understand the component risks associated with the summer season and increased Salmonella shedding. PMID:27408330

Lung cancer trend in England for the period of 2002 to 2011 and projections of future burden until 2020.

PubMed

Olajide, Olufemi O; Field, John K; Davies, Michael M P A; Marcus, Michael W

2015-08-01

Lung cancer is the most common cancer in the world, therefore creating a huge public health concern. The aim of this study is to determine the change in age-standardised incidence rate trend of lung cancer in England between 2002 and 2011 and use these findings to anticipate the potential burden of the disease by gender in the year 2020. Lung cancer incidence data (ICD-10 code C33-34) from 2002 and 2011 and mid-year population estimates for the same period were obtained from Office of National Statistics. Age-standardised incidence rates were calculated, by gender and region. Poisson regression analysis was used to describe the time incidence trend and projections were estimated up to year 2020. A total of 318, 417 lung cancer cases were identified. Incidence rates decreased in men by an average annual percentage change (AAPC) of -1.0% and increased in women by +1.9%. Projection analysis showed that by year 2020, provided the rates remain the same, English women will have the same lung cancer incidence rates as their male counterparts. This study demonstrated that there would be 5,848 excess lung cancer cases by 2020 with female population accounting for 85% (4,996) of the excess cases. Therefore, in addition to the development of high quality preventive intervention strategies, future public health also needs to prioritise targets at the implementation phase, in a manner that engage women living in regions that have demonstrated very high AAPC values.

[Epidemiology and etiology of bacillary dysentery in Xinjiang Uigur Autonomous Region, 2004-2014].

PubMed

Zhang, J; Mahemuti, Mahemuti; Xia, Y D; Mutalifu, Mutalifu; Muheyati, Muheyati; Li, F; Gu, B S; Li, X L

2016-11-10

Objective: To understand the epidemiological and etiological characteristics of bacillary dysentery in Xinjiang Uigur Autonomous Region (Xinjiang) during 2004-2014, and provide evidence for the prevention and control of bacillary dysentery. Methods: Descriptive epidemiological analysis was conducted by using the incidence data of bacillary dysentery in Xinjiang during 2004-2014 and the serotyping and the antibiotic susceptibility test of the pathogens isolated were performed. Results: A total of 123 238 cases of bacillary dysentery were reported in Xinjiang from 2004 to 2014. The average annual incidence of bacillary dysentery ranged from 25.91 per 100 000 to 76.04 per 100 000 and the average annual mortality ranged from 0.00 to 46.90 per 100 000. The incidence of bacillary dysentery was higher in eastern Xinjiang than other areas. The incidence peak was during July-September. The incidence of bacillary dysentery in males was higher than that in females. The incidence was highest in infants and young children under five years old. Most cases were children outside child care settings, farmers and students. Shigella flexneri was the predominant pathogen and F2a was the most frequently detected subtype. The isolated strains were highly resistant to streptomycin, penicillin, doxycycline and tetracycline. The resistant rates to penicillin, tetracycline, doxycycline and streptomycin increased with year. Up to 71.43% of the strains were resistant to more than five antibiotics. Conclusion: The incidence of bacillary dysentery was in decrease in Xinjiang from 2004 to 2014, but in some area, the incidence of bacterial dysentery was higher than national average level. It is necessary to strengthen the surveillance and conduct targeted prevention and control in areas and population at high risk and in season with high incidence. The serious drug resistance and multi drug resistance of the pathogens have posed challenge to the prevention and treatment of bacillary dysentery in Xinjiang.

Trends in Clinical Diagnoses of Rocky Mountain Spotted Fever among American Indians, 2001–2008

PubMed Central

Folkema, Arianne M.; Holman, Robert C.; McQuiston, Jennifer H.; Cheek, James E.

2012-01-01

American Indians are at greater risk for Rocky Mountain spotted fever (RMSF) than the general U.S. population. The epidemiology of RMSF among American Indians was examined by using Indian Health Service inpatient and outpatient records with an RMSF International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis. For 2001–2008, 958 American Indian patients with clinical diagnoses of RMSF were reported. The average annual RMSF incidence was 94.6 per 1,000,000 persons, with a significant increasing incidence trend from 24.2 in 2001 to 139.4 in 2008 (P = 0.006). Most (89%) RMSF hospital visits occurred in the Southern Plains and Southwest regions, where the average annual incidence rates were 277.2 and 49.4, respectively. Only the Southwest region had a significant increasing incidence trend (P = 0.005), likely linked to the emergence of brown dog ticks as an RMSF vector in eastern Arizona. It is important to continue monitoring RMSF infection to inform public health interventions that target RMSF reduction in high-risk populations. PMID:22232466

Trends in clinical diagnoses of Rocky Mountain spotted fever among American Indians, 2001-2008.

PubMed

Folkema, Arianne M; Holman, Robert C; McQuiston, Jennifer H; Cheek, James E

2012-01-01

American Indians are at greater risk for Rocky Mountain spotted fever (RMSF) than the general U.S. population. The epidemiology of RMSF among American Indians was examined by using Indian Health Service inpatient and outpatient records with an RMSF International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis. For 2001-2008, 958 American Indian patients with clinical diagnoses of RMSF were reported. The average annual RMSF incidence was 94.6 per 1,000,000 persons, with a significant increasing incidence trend from 24.2 in 2001 to 139.4 in 2008 (P = 0.006). Most (89%) RMSF hospital visits occurred in the Southern Plains and Southwest regions, where the average annual incidence rates were 277.2 and 49.4, respectively. Only the Southwest region had a significant increasing incidence trend (P = 0.005), likely linked to the emergence of brown dog ticks as an RMSF vector in eastern Arizona. It is important to continue monitoring RMSF infection to inform public health interventions that target RMSF reduction in high-risk populations.

Can Survival Bias Explain the Age Attenuation of Racial Inequalities in Stroke Incidence?: A Simulation Study.

PubMed

Mayeda, Elizabeth Rose; Banack, Hailey R; Bibbins-Domingo, Kirsten; Zeki Al Hazzouri, Adina; Marden, Jessica R; Whitmer, Rachel A; Glymour, M Maria

2018-07-01

In middle age, stroke incidence is higher among black than white Americans. For unknown reasons, this inequality decreases and reverses with age. We conducted simulations to evaluate whether selective survival could account for observed age patterning of black-white stroke inequalities. We simulated birth cohorts of 20,000 blacks and 20,000 whites with survival distributions based on US life tables for the 1919-1921 birth cohort. We generated stroke incidence rates for ages 45-94 years using Reasons for Geographic and Racial Disparities in Stroke (REGARDS) study rates for whites and setting the effect of black race on stroke to incidence rate difference (IRD) = 20/10,000 person-years at all ages, the inequality observed at younger ages in REGARDS. We compared observed age-specific stroke incidence across scenarios, varying effects of U, representing unobserved factors influencing mortality and stroke risk. Despite a constant adverse effect of black race on stroke risk, the observed black-white inequality in stroke incidence attenuated at older age. When the hazard ratio for U on stroke was 1.5 for both blacks and whites, but U only directly influenced mortality for blacks (hazard ratio for U on mortality =1.5 for blacks; 1.0 for whites), stroke incidence rates in late life were lower among blacks (average observed IRD = -43/10,000 person-years at ages 85-94 years versus causal IRD = 20/10,000 person-years) and mirrored patterns observed in REGARDS. A relatively moderate unmeasured common cause of stroke and survival could fully account for observed age attenuation of racial inequalities in stroke.

[Chronic renal disease in Puerto Rico: incidence, prevalence, and mortality in 2000-2008].

PubMed

Rodríguez Ortiz, Ylene D; Miranda, Glenda; Burgos Calderón, Rafael; Depine, Santos; Ojo, Otegbola

2011-01-01

End-Stage Renal Disease (ESRD) is a global public health problem. Although there are strategies for its prevention, the number of cases has increased. In order to understand current situation in Puerto Rico (PR) we review available data, which is presented in a descriptive report of the incidence, prevalence and mortality of ESRD during the period 2000-2008. In addition, we compare the incidence and prevalence rates with regard to other countries. We used 2000-2008 USRDS statistics and the QIRN3 for patients on dialysis. Transplanted patients were excluded. Crude rates of incidence and prevalence in PR were calculated for comparison with the United States and other countries. Percentages were calculated to describe the demographic characteristics and primary diagnosis in 2008. During the period 2000-2008 the incidence rate increased by 21.6 percent; from 286.8 to 348.7 pmp. The prevalence rate increased by 27.3 percent; from 861.2 to 1096.2 pmp. The average annual growth in the incidence and prevalence was 2.4 percent and 3.0 percent respectively. During the same period, diabetes mellitus was the leading cause of ESRD reaching 67.4 percent of total new cases in 2008, while in the U.S. was 44.4 percent. Unadjusted mortality decreased slightly in 2008 to 18.5 percent. PR is the fifth country with the highest incidence of patient on dialysis and the first with ESRD due to diabetes mellitus. ESRD is becoming more common and prevalent in PR. We should be more aggressive in establishing public health strategies to reduce ESRD.

Geographical, meteorological and vectorial factors related to malaria re-emergence in Huang-Huai River of central China.

PubMed

Zhou, Shui S; Huang, Fang; Wang, Jian J; Zhang, Shao S; Su, Yun P; Tang, Lin H

2010-11-24

Malaria still represents a significant public health problem in China, and the cases dramatically increased in the areas along the Huang-Huai River of central China after 2001. Considering spatial aggregation of malaria cases and specific vectors, the geographical, meteorological and vectorial factors were analysed to determine the key factors related to malaria re-emergence in these particular areas. The geographic information of 357 malaria cases and 603 water bodies in 113 villages were collected to analyse the relationship between the residence of malaria cases and water body. Spearman rank correlation, multiple regression, curve fitting and trend analysis were used to explain the relationship between the meteorological factors and malaria incidence. Entomological investigation was conducted in two sites to get the vectorial capacity and the basic reproductive rate to determine whether the effect of vector lead to malaria re-emergence. The distances from household of cases to the nearest water-body was positive-skew distributed, the median was 60.9 m and 74% malaria cases were inhabited in the extent of 60 m near the water body, and the risk rate of people live there attacked by malaria was higher than others(OR = 1.6, 95%CI (1.042, 2.463), P < 0.05). The annual average temperature and rainfall may have close relationship with annual incidence. The average monthly temperature and rainfall were the key factors, and the correlation coefficients are 0.501 and 0.304(P < 0.01), respectively. Moreover, 75.3% changes of monthly malaria incidence contributed to the average monthly temperature (T(mean)), the average temperature of last two months(T(mean₀₁)) and the average rainfall of current month (R(mean)) and the regression equation was Y = -2.085 + 0.839I₁ + 0.998T(mean₀) - 0.86T(mean₀₁) + 0.16R(mean₀). All the collected mosquitoes were Anopheles sinensis. The vectorial capacity and the basic reproductive rate of An. sinensis in two sites were 0.6969, 0.4983 and 2.1604, 1.5447, respectively. The spatial distribution between malaria cases and water-body, the changing of meteorological factors, and increasing vectorial capacity and basic reproductive rate of An. sinensis leaded to malaria re-emergence in these areas.

Geographical, meteorological and vectorial factors related to malaria re-emergence in Huang-Huai River of central China

PubMed Central

2010-01-01

Background Malaria still represents a significant public health problem in China, and the cases dramatically increased in the areas along the Huang-Huai River of central China after 2001. Considering spatial aggregation of malaria cases and specific vectors, the geographical, meteorological and vectorial factors were analysed to determine the key factors related to malaria re-emergence in these particular areas. Methods The geographic information of 357 malaria cases and 603 water bodies in 113 villages were collected to analyse the relationship between the residence of malaria cases and water body. Spearman rank correlation, multiple regression, curve fitting and trend analysis were used to explain the relationship between the meteorological factors and malaria incidence. Entomological investigation was conducted in two sites to get the vectorial capacity and the basic reproductive rate to determine whether the effect of vector lead to malaria re-emergence. Results The distances from household of cases to the nearest water-body was positive-skew distributed, the median was 60.9 m and 74% malaria cases were inhabited in the extent of 60 m near the water body, and the risk rate of people live there attacked by malaria was higher than others(OR = 1.6, 95%CI (1.042, 2.463), P < 0.05). The annual average temperature and rainfall may have close relationship with annual incidence. The average monthly temperature and rainfall were the key factors, and the correlation coefficients are 0.501 and 0.304(P < 0.01), respectively. Moreover, 75.3% changes of monthly malaria incidence contributed to the average monthly temperature (Tmean), the average temperature of last two months(Tmean01) and the average rainfall of current month (Rmean) and the regression equation was Y = -2.085 + 0.839I1 + 0.998Tmean0 - 0.86Tmean01 + 0.16Rmean0. All the collected mosquitoes were Anopheles sinensis. The vectorial capacity and the basic reproductive rate of An. sinensis in two sites were 0.6969, 0.4983 and 2.1604, 1.5447, respectively. Conclusion The spatial distribution between malaria cases and water-body, the changing of meteorological factors, and increasing vectorial capacity and basic reproductive rate of An. sinensis leaded to malaria re-emergence in these areas. PMID:21092326

Incidence and timing of cancer in HIV-infected individuals following initiation of combination antiretroviral therapy.

PubMed

Yanik, Elizabeth L; Napravnik, Sonia; Cole, Stephen R; Achenbach, Chad J; Gopal, Satish; Olshan, Andrew; Dittmer, Dirk P; Kitahata, Mari M; Mugavero, Michael J; Saag, Michael; Moore, Richard D; Mayer, Kenneth; Mathews, W Christopher; Hunt, Peter W; Rodriguez, Benigno; Eron, Joseph J

2013-09-01

Cancer is an important cause of morbidity and mortality in individuals infected with human immunodeficiency virus (HIV), but patterns of cancer incidence after combination antiretroviral therapy (ART) initiation remain poorly characterized. We evaluated the incidence and timing of cancer diagnoses among patients initiating ART between 1996 and 2011 in a collaboration of 8 US clinical HIV cohorts. Poisson regression was used to estimate incidence rates. Cox regression was used to identify demographic and clinical characteristics associated with cancer incidence after ART initiation. At initiation of first combination ART among 11 485 patients, median year was 2004 (interquartile range [IQR], 2000-2007) and median CD4 count was 202 cells/mm(3) (IQR, 61-338). Incidence rates for Kaposi sarcoma (KS) and lymphomas were highest in the first 6 months after ART initiation (P < .001) and plateaued thereafter, while incidence rates for all other cancers combined increased from 416 to 615 cases per 100 000 person-years from 1 to 10 years after ART initiation (average 7% increase per year; 95% confidence interval, 2%-13%). Lower CD4 count at ART initiation was associated with greater risk of KS, lymphoma, and human papillomavirus-related cancer. Calendar year of ART initiation was not associated with cancer incidence. KS and lymphoma rates were highest immediately following ART initiation, particularly among patients with low CD4 cell counts, whereas other cancers increased with time on ART, likely reflecting increased cancer risk with aging. Our results underscore recommendations for earlier HIV diagnosis followed by prompt ART initiation along with ongoing aggressive cancer screening and prevention efforts throughout the course of HIV care.

LEUKEMIA, LYMPHOMA AND MULTIPLE MYELOMA MORTALITY (1950–1999) AND INCIDENCE (1969–1999) IN THE ELDORADO URANIUM WORKERS COHORT

PubMed Central

Zablotska, Lydia B.; Lane, Rachel S.D.; Frost, Stanley E.; Thompson, Patsy A.

2014-01-01

Uranium workers are chronically exposed to low levels of radon decay products (RDP) and gamma (γ) radiation. Risks of leukemia from acute and high doses of γ-radiation are well-characterized, but risks from lower doses and dose-rates and from RDP exposures are controversial. Few studies have evaluated risks of other hematologic cancers in uranium workers. The purpose of this study was to analyze radiation-related risks of hematologic cancers in the cohort of Eldorado uranium miners and processors first employed in 1932–1980 in relation to cumulative RDP exposures and γ-ray doses. The average cumulative RDP exposure was 100.2 working level months and the average cumulative whole-body γ-radiation dose was 52.2 millisievert. We identified 101 deaths and 160 cases of hematologic cancers in the cohort. Overall, male workers had lower mortality and cancer incidence rates for all outcomes compared with the general Canadian male population, a likely healthy worker effect. No statistically significant association between RDP exposure or γ-ray doses, or a combination of both, and mortality or incidence of any hematologic cancer was found. We observed consistent but non-statistically significant increases in risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma (HL) incidence and non-Hodgkin lymphoma (NHL) mortality with increasing γ-ray doses. These findings are consistent with recent studies of increased risks of CLL and NHL incidence after γ-radiation exposure. Further research is necessary to understand risks of other hematologic cancers from low-dose exposures to γ-radiation. PMID:24583244

The epidemiology of amyotrophic lateral sclerosis in Reggio Emilia, Italy.

PubMed

Bonvicini, Francesca; Vinceti, Marco; Marcello, Norina; Rodolfi, Rossella; Rinaldi, Manuela

2008-12-01

Incidence and mortality rates of amyotrophic lateral sclerosis (ALS) vary between countries, and in some studies appear to increase over time. We performed a study to assess ALS incidence in a northern Italy area over a 10-year period. We identified the new cases of probable or definite ALS diagnosed among residents in Reggio Emilia province between 1996 and 2005 using several sources of data, such as death certificates, clinical records, hospital discharge registers and drug prescriptions. A total of 94 newly-diagnosed patients were identified. The average standardized incidence in the period was 2.0 and 1.0 cases/100,000/year, using the Italian and the world population, respectively, as reference. There was no variation in rates over time. Incidence was 1.3 in males and 0.8 in females. No cases were observed in patients under 35 years of age. Incidence increased after the age of 55 years, reaching a peak in the group aged 70-74 years and declining thereafter. We concluded that ALS incidence in this population was similar to that observed in other Italian regions and European countries, and no variation was identified during the study period.

Racial and Ethnic Disparities in the Incidence and Trends of Soft Tissue Sarcoma Among Adolescents and Young Adults in the United States, 1995-2008.

PubMed

Hsieh, Mei-Chin; Wu, Xiao-Cheng; Andrews, Patricia A; Chen, Vivien W

2013-09-01

The aim of this study was to examine racial/ethnic disparities in the incidence rates and trends of soft tissue sarcoma (STS) by gender, age, and histological type among adolescents and young adults (AYAs) aged 15-29 years. The 1995-2008 incidence data from 25 population-based cancer registries, covering 64% of the United States population, were obtained from the North American Association of Central Cancer Registries. The Surveillance, Epidemiology and End Results AYA site recode and International Classification of Diseases for Oncology, 3rd Edition, were adopted to categorize STS histological types and anatomic groups. Age-adjusted incidence rates and average annual percent change (AAPC) were calculated. The incidence of all STSs combined was 34% higher in males than females (95% CI: 1.28, 1.39), 60% higher among blacks than whites (95% CI: 1.52, 1.68), and slightly higher among Hispanics than whites. Compared with whites, blacks had significantly higher incidence of fibromatous neoplasms, and Hispanics had significantly higher incidence of liposarcoma. Whites were more likely to be diagnosed with synovial sarcoma than blacks. Black and Hispanic males had significantly higher Kaposi sarcoma incidence than white males. The AAPC of all STSs combined showed a significant decrease from 1995 to 2008 (AAPC=-2.1%; 95% CI: -3.2%, -1.0%). However, after excluding Kaposi sarcoma, there was no significant trend. The incidence rates of STS histological types in AYAs vary among racial/ethnic groups. The declining trends of STS are due mainly to decreasing incidence of Kaposi sarcoma in all races/ethnicities. Research to identify factors associated with racial/ethnic disparities in AYA STS is necessary.

Breast cancer in South-Eastern European countries since 2000: Rising incidence and decreasing mortality at young and middle ages.

PubMed

Dimitrova, Nadya; Znaor, Ariana; Agius, Dominic; Eser, Sultan; Sekerija, Mario; Ryzhov, Anton; Primic-Žakelj, Maja; Coebergh, Jan Willem

2017-09-01

Marked variations exist in the incidence and mortality trends of major cancers in South-Eastern European (SEE) countries which have now been detailed by age for breast cancer (BC) to seek clues for improvement. We brought together and analysed data from 14 cancer registries (CRs), situated in SEE countries or directly adjacent. Age-standardised rate at world standard (ASRw) and truncated incidence and mortality rates during 2000-2010 by year, and for four age groups, were calculated. Average annual percentage change of rates was estimated using Joinpoint regression. Annual incidence rates increased significantly in countries and age groups, by 2-4% (15-39 years), 2-5% (40-49), 1-4% (50-69) and 1-6% (at 70+). Mortality rates decreased significantly in all age-groups in most countries, but increased up to 5% annually above age 55 in Ukraine, Serbia, Moldova and Cyprus. The BC data quality was evaluated by internationally agreed indicators which appeared suboptimal for Moldova, Bosnia and Herzegovina and Romania. The observed variations of incidence trends reflect the influence of risk factors, as well as levels of early detection activities (screening). While mortality rates were mostly decreasing, probably due to improved cancer care and introduction of more effective systemic treatment regimens, the worrying increasing mortality trends in the 55-plus age groups in some countries have to be addressed by health professionals and policymakers. In order to assess and monitor the effects of cancer control activities in the region, the CRs need substantial investments. Copyright © 2017 Elsevier Ltd. All rights reserved.

SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, R; Wang, J

2014-06-15

Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, includingmore » 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy.« less

Association of Medicare's Bundled Payment Reform With Changes in Use of Vitamin D Among Patients Receiving Maintenance Hemodialysis: An Interrupted Time-Series Analysis.

PubMed

Spoendlin, Julia; Schneeweiss, Sebastian; Tsacogianis, Theodore; Paik, Julie M; Fischer, Michael A; Kim, Seoyoung C; Desai, Rishi J

2018-06-08

Medicare's 2011 prospective payment system (PPS) was introduced to curb overuse of separately billable injectable drugs. After epoietin, intravenous (IV) vitamin D analogues are the biggest drug cost drivers in hemodialysis (HD) patients, but the association between PPS introduction and vitamin D therapy has been scarcely investigated. Interrupted time-series analyses. Adult US HD patients represented in the US Renal Data System between 2008 and 2013. PPS implementation. The cumulative dose of IV vitamin D analogues (paricalcitol equivalents) per patient per calendar quarter in prevalent HD patients. The average starting dose of IV vitamin D analogues and quarterly rates of new vitamin D use (initiations/100 person-months) in incident HD patients within 90 days of beginning HD therapy. Segmented linear regression models of the immediate change and slope change over time of vitamin D use after PPS implementation. Among 359,600 prevalent HD patients, IV vitamin D analogues accounted for 99% of the total use, and this trend was unchanged over time. PPS resulted in an immediate 7% decline in the average dose of IV vitamin D analogues (average baseline dose = 186.5 μg per quarter; immediate change = -13.5 μg [P < 0.001]; slope change = 0.43 per quarter [P = 0.3]) and in the starting dose of IV vitamin D analogues in incident HD patients (average baseline starting dose = 5.22 μg; immediate change = -0.40 μg [P < 0.001]; slope change = -0.03 per quarter [P = 0.03]). The baseline rate of vitamin D therapy initiation among 99,970 incident HD patients was 44.9/100 person-months and decreased over time, even before PPS implementation (pre-PPS β = -0.46/100 person-months [P < 0.001]; slope change = -0.19/100 person-months [P = 0.2]). PPS implementation was associated with an immediate change in initiation levels (by -4.5/100 person-months; P < 0.001). Incident HD patients were restricted to those 65 years or older. PPS implementation was associated with a 7% reduction in the average dose and starting dose of IV vitamin D analogues and a 10% reduction in the rate of vitamin D therapy initiation. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Measuring the inefficiency of allowing self-pollinated alfalfa progeny into breeding nurseries

USDA-ARS?s Scientific Manuscript database

Although alfalfa is generally considered an outcrossing species the incidence of self-pollination during insect pollination can be substantial with an observed average 30% selfing rate. Despite this, alfalfa breeders utilizing space plant evaluation nurseries make no attempt to discriminate self-pol...

Annual Report to the Nation on the Status of Cancer, 1975–2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco Control

PubMed Central

Thun, Michael J.; Ries, Lynn A. G.; Howe, Holly L.; Weir, Hannah K.; Center, Melissa M.; Ward, Elizabeth; Wu, Xiao-Cheng; Eheman, Christie; Anderson, Robert; Ajani, Umed A.; Kohler, Betsy; Edwards, Brenda K.

2008-01-01

Background The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information on cancer occurrence and trends in the United States. This year’s report includes trends in lung cancer incidence and death rates, tobacco use, and tobacco control by state of residence. Methods Information on invasive cancers was obtained from the NCI, CDC, and NAACCR and information on mortality from the CDC's National Center for Health Statistics. Annual percentage changes in the age-standardized incidence and death rates (2000 US population standard) for all cancers combined and for the top 15 cancers were estimated by joinpoint analysis of long-term (1975–2005) trends and by least squares linear regression of short-term (1996–2005) trends. All statistical tests were two-sided. Results Both incidence and death rates from all cancers combined decreased statistically significantly (P < .05) in men and women overall and in most racial and ethnic populations. These decreases were driven largely by declines in both incidence and death rates for the three most common cancers in men (lung, colorectum, and prostate) and for two of the three leading cancers in women (breast and colorectum), combined with a leveling off of lung cancer death rates in women. Although the national trend in female lung cancer death rates has stabilized since 2003, after increasing for several decades, there is prominent state and regional variation. Lung cancer incidence and/or death rates among women increased in 18 states, 16 of them in the South or Midwest, where, on average, the prevalence of smoking was higher and the annual percentage decrease in current smoking among adult women was lower than in the West and Northeast. California was the only state with decreasing lung cancer incidence and death rates in women. Conclusions Although the decrease in overall cancer incidence and death rates is encouraging, large state and regional differences in lung cancer trends among women underscore the need to maintain and strengthen many state tobacco control programs. PMID:19033571

Incidence of stroke in young adults in the Reggio Emilia area, northern Italy.

PubMed

Guidetti, D; Baratti, M; Zucco, R G; Greco, G; Terenziani, S; Vescovini, E; Sabadini, R; Bondavalli, M; Masini, L; Salvarani, C

1993-01-01

A retrospective epidemiological study on the first episode of stroke in young adults aged 15-44 years was carried out in the territory of the Local Health Unit No. 9 in Reggio Emilia (46,491 km2), Italy, from 1987 to 1989. 29 patients were identified: 17 were affected with cerebral infarction and 12 with hemorrhage. All young patients were discharged with diagnostic codes 430-438 according to the International Classification of Disease, i.e. the criteria of the World Health Organisation for stroke definition. All patients had computed tomography or necropsy. The average annual incidence rate per 100,000 population aged 15-44 for all strokes was 13.6 and the 95% confidence interval (CI 95%) was 9.1-19.6. The general population of the same age on January 1, 1987, was 69,845 and 71,920 on December 31, 1989; the incidence rate of stroke was 14.0 for males (CI 95% 7.9-2.3) and 13.2 (CI 95% 7.1-22.2) for females. The average annual incidence rates were 8.0 (CI 95% 4.7-12.2) for cerebral infarction (8.4, CI 95% 3.9-16 for males, 7.6, CI 95% 3.3-14.9 for females), 5.6 (CI 95% 2.9-9.9) for cerebral hemorrhage and 2.8 (CI 95% 1.0-6.1) for both subarachnoid (SAH) and intracerebral hemorrhage (ICH). Based on angiography or necropsy findings, aneurysms or arteriovenous malformations were present in 83% of the patients with SAH and in 66% of the patients with ICH. The 1-month fatality ratio was 0 for cerebral infarction, 50% for SAH and 33% for ICH.(ABSTRACT TRUNCATED AT 250 WORDS)

Testicular cancer: marked birth cohort effects on incidence and a decline in mortality in southern Netherlands since 1970.

PubMed

Verhoeven, Rob; Houterman, Saskia; Kiemeney, Bart; Koldewijn, Evert; Coebergh, Jan Willem

2008-02-01

The aim of our study was to interpret the changing incidence, and to describe the mortality of patients with testicular cancer in the south of the Netherlands between 1970 and 2004. On the basis of data from the Eindhoven Cancer Registry and Statistics Netherlands, 5-year moving average standardised incidence and mortality rates were calculated. An age-period-cohort (APC) Poisson regression analysis was performed to disentangle time and birth cohort effects on incidence. The incidence rate remained stable for all ages at about 3 per 100,000 person-years until 1989 but increased annually thereafter by 4% to 6 in 2004. This increase can almost completely be attributed to an increase in localised tumours. The largest increase was found for seminoma testicular cancer (TC) patients aged 35-39 and non-seminoma TC patients aged 20-24 years. Relatively more localised and tumours with lymph node metastases were detected in the later periods. APC analysis showed the best fit with an age-cohort model. An increase in incidence of TC was found for birth cohorts since 1950. The mortality rate dropped from 1.0 per 100,000 person-years in 1970 to 0.3 in 2005, with a steep annual decline of 12% in the period 1979-1986. In conclusion, the increase in incidence of TC was strongly correlated with birth cohorts since 1945. The increase in incidence is possibly caused by in utero or early life exposure to a yet unknown risk factor. There was a steep decline in mortality in the period 1979-1986. (c) 2007 Wiley-Liss, Inc.

Head and neck squamous cell cancers in the United States are rare and the risk now is higher among white individuals compared with black individuals.

PubMed

Fakhry, Carole; Krapcho, Martin; Eisele, David W; D'Souza, Gypsyamber

2018-05-15

The increasing incidence of oropharyngeal squamous cell cancer (OPSCC) is well established. However, up-to-date incidence estimates and trends for head and neck squamous cell cancers (HNSCCs) overall, including major anatomic sites, and nonoropharyngeal (non-OP) HNSCCs by sex, race, and age in the United States are not well described. A retrospective analysis of incident HNSCCs during 1992 through 2014 using the Surveillance, Epidemiology, and End Results database was performed to evaluate the incidence of HNSCCs overall, OPSCC, and non-OP HNSCC (those of the larynx, oral cavity, hypopharynx, nasopharynx, and nasal cavity). Incidence rates were calculated overall and by subgroups of interest, and incidence rate ratios were used to compare rates between groups. The incidence rates presented were per 100,000 population and were age adjusted to the 2000 US standard population (19 age groups; Census P25-1130). The annual percent change (APC) was modeled with and without joinpoints. The incidence of HNSCC overall declined (average APC [aAPC], -0.8; P<.001) despite significant increases in the incidence of OPSCCs, most notably between 2000 and 2014 (APC, 2.1; P<.001). Significant declines in incidence were observed for all non-OP HNSCC sites for both women and men (P<.001 each). Among women, the risk of OPSCC also significantly decreased (aAPC, -0.8; P = .002), whereas the risk among men was stable during 1992 through 2001 (APC, 0.4; P = .42) and then significantly increased from 2001 to 2014 (APC, 2.7; P<.001). Decreases in the risk of non-OP HNSCC were especially large for black women (aAPC, -2.6; P<.001) and men (aAPC, -3.0; P<.001). Although the incidence of HNSCC previously was highest among black individuals, since 2009 its incidence has been higher among white compared with black individuals. The incidence of HNSCC is declining, especially for non-OP HNSCC and among black individuals. Cancer 2018;124:2125-33. © 2018 American Cancer Society. © 2018 American Cancer Society.

[Hyponatremia associated with SSRI/NRSI: Descriptive and comparative epidemiological study of the incidence rates of the notified cases from the data of the French National Pharmacovigilance Database and the French National Health Insurance].

PubMed

Revol, R; Rault, C; Polard, E; Bellet, F; Guy, C

2018-06-01

Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are frequently prescribed. These antidepressants can potentially induce serious hyponatremia through the SIADH syndrome. That seems to concern all molecules of these classes but the individual risk of each molecule is not well known. The aims of the study were to compare the incidence rate of each molecule in order to identify the existence of molecules more at risk of inducing hyponatremia and to characterize a profile of patients at risk for hyponatremia during a treatment with a SSRI or a SNRI. The cases of hyponatremia under SSRI/SNRI were extracted from the French pharmacovigilance database (BPNV). The exposition to the different SSRIs/SNRIs in the French population was estimated from the French National Health Insurance database (SNIIRAM) using a sampled database (Echantillon Généralistes des Bénéficiaires). The study ran from 01/01/2011 to 31/12/2013. The primary study endpoint was the incidence rate of notifications of the hyponatremia cases in patients treated by SSRI/SNRI and recorded into the BNPV database, related to the average annual number of corresponding treatments initiated during the same period. The number of cases of hyponatremia included in the study was 169 for 3 749 800 adult patients initiating treatment. The incidence rate of cases was 1.64 for 100 000 persons per year (PY). The standardized incidence rates between the different molecules showed no difference except for duloxetine (2.79/100 000 PY p > 0.03). Identified risk factors were age, with a large increase of incidence rate from 75 years old (incidence 12.5 higher) and female gender. Comparison of the incidence rates from spontaneous reports indicates a greater risk of hyponatremia for duloxetine for 2011-2013. This result needs to be confirmed by other studies. The advanced age and female sex are risk factors, irrespective of the molecule. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Application of Poisson kriging to the mapping of cholera and dysentery incidence in an endemic area of Bangladesh.

PubMed

Ali, Mohammad; Goovaerts, Pierre; Nazia, Nushrat; Haq, M Zahirul; Yunus, Mohammad; Emch, Michael

2006-10-13

Disease maps can serve to display incidence rates geographically, to inform on public health provision about the success or failure of interventions, and to make hypothesis or to provide evidences concerning disease etiology. Poisson kriging was recently introduced to filter the noise attached to rates recorded over sparsely populated administrative units. Its benefit over simple population-weighted averages and empirical Bayesian smoothers was demonstrated by simulation studies using county-level cancer mortality rates. This paper presents the first application of Poisson kriging to the spatial interpolation of local disease rates, resulting in continuous maps of disease rate estimates and the associated prediction variance. The methodology is illustrated using cholera and dysentery data collected in a cholera endemic area (Matlab) of Bangladesh. The spatial analysis was confined to patrilineally-related clusters of households, known as baris, located within 9 kilometers from the Matlab hospital to avoid underestimating the risk of disease incidence, since patients far away from the medical facilities are less likely to travel. Semivariogram models reveal a range of autocorrelation of 1.1 km for dysentery and 0.37 km for cholera. This result translates into a cholera risk map that is patchier than the dysentery map that shows a large zone of high incidence in the south-central part of the study area, which is quasi-urban. On both maps, lower risk values are found in the Northern part of the study area, which is also the most distant from the Matlab hospital. The weaker spatial continuity of cholera versus dysentery incidence rates resulted in larger kriging variance across the study area. The approach presented in this paper enables researchers to incorporate the pattern of spatial dependence of incidence rates into the mapping of risk values and the quantification of the associated uncertainty. Differences in spatial patterns, in particular the range of spatial autocorrelation, reflect differences in the mode of transmission of cholera and dysentery. Our risk maps for cholera and dysentery incidences should help identifying putative factors of increased disease incidence, leading to more effective prevention and remedial actions in endemic areas.

Application of Poisson kriging to the mapping of cholera and dysentery incidence in an endemic area of Bangladesh

PubMed Central

Ali, Mohammad; Goovaerts, Pierre; Nazia, Nushrat; Haq, M Zahirul; Yunus, Mohammad; Emch, Michael

2006-01-01

Background Disease maps can serve to display incidence rates geographically, to inform on public health provision about the success or failure of interventions, and to make hypothesis or to provide evidences concerning disease etiology. Poisson kriging was recently introduced to filter the noise attached to rates recorded over sparsely populated administrative units. Its benefit over simple population-weighted averages and empirical Bayesian smoothers was demonstrated by simulation studies using county-level cancer mortality rates. This paper presents the first application of Poisson kriging to the spatial interpolation of local disease rates, resulting in continuous maps of disease rate estimates and the associated prediction variance. The methodology is illustrated using cholera and dysentery data collected in a cholera endemic area (Matlab) of Bangladesh. Results The spatial analysis was confined to patrilineally-related clusters of households, known as baris, located within 9 kilometers from the Matlab hospital to avoid underestimating the risk of disease incidence, since patients far away from the medical facilities are less likely to travel. Semivariogram models reveal a range of autocorrelation of 1.1 km for dysentery and 0.37 km for cholera. This result translates into a cholera risk map that is patchier than the dysentery map that shows a large zone of high incidence in the south-central part of the study area, which is quasi-urban. On both maps, lower risk values are found in the Northern part of the study area, which is also the most distant from the Matlab hospital. The weaker spatial continuity of cholera versus dysentery incidence rates resulted in larger kriging variance across the study area. Conclusion The approach presented in this paper enables researchers to incorporate the pattern of spatial dependence of incidence rates into the mapping of risk values and the quantification of the associated uncertainty. Differences in spatial patterns, in particular the range of spatial autocorrelation, reflect differences in the mode of transmission of cholera and dysentery. Our risk maps for cholera and dysentery incidences should help identifying putative factors of increased disease incidence, leading to more effective prevention and remedial actions in endemic areas. PMID:17038192

MEASUREMENT OF RADON CONCENTRATION IN DWELLINGS IN THE REGION OF HIGHEST LUNG CANCER INCIDENCE IN INDIA.

PubMed

Zoliana, B; Rohmingliana, P C; Sahoo, B K; Mishra, R; Mayya, Y S

2016-10-01

Indoor radon/thoron concentration has been measured in Aizawl district, Mizoram, India, which has the highest lung cancer incidence rates among males and females in India. Simultaneously, radon flux emanated from the surrounding soil of the dwellings was observed in selected places. The annual average value of concentration of radon(thoron) of Aizawl district is 48.8(22.65) Bq m -3 with a geometric standard deviation of 1.25(1.58). Measured radon flux from the soil has an average value of 22.6 mBq m -2 s -1 These results were found to be much below the harmful effect or action level as indicated by the World Health Organisation. On the other hand, food habit and high-level consumption of tobacco and its products in the district have been found to increase the risk of lung cancer incidence in the district. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Trends Analysis of rhBMP2 Utilization in Single-Level Anterior Lumbar Interbody Fusion in the United States

PubMed Central

Lao, Lifeng; Cohen, Jeremiah R.; Buser, Zorica; Brodke, Darrel S.; Yoon, S. Tim; Youssef, Jim A.; Park, Jong-Beom; Meisel, Hans-Joerg; Wang, Jeffrey C.

2017-01-01

Study Design: Retrospective case study. Objective: To evaluate the trends and demographics of recombinant human bone morphogenetic protein 2 (rhBMP2) utilization in single-level anterior lumbar interbody fusion (ALIF) in the United States. Methods: Patients who underwent single-level ALIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Fort Wayne, IN), a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were analyzed for each patient. Results: A total of 921 patients were identified who underwent a single-level ALIF in this study. The average rate of single-level ALIF with rhBMP2 utilization increased (35%-48%) from 2005 to 2009, but sharply decreased to 16.7% in 2010 and 15.0% in 2011. The overall incidence of single-level ALIF without rhBMP2 (0.20 cases per 100 000 patients) was more than twice of the incidence of single-level ALIF with rhBMP2 (0.09 cases per 100 000 patients). The average rate of single-level ALIF with rhBMP2 utilization is highest in West (41.4%), followed by Midwest (33.3%), South (26.5%) and Northeast (22.2%). The highest incidence of single-level ALIF with rhBMP2 was observed in the group aged less than 65 years (compared with any other age groups, P < .001), with an incidence of 0.21 per 100 000 patients. Conclusions: The incidence of rhBMP2 utilization in single-level ALIF increased from 2006 to 2009, but decreased in 2010 and 2011. The Northeast region had the lowest incidence of rhBMP2 utilization. The group aged less than 65 years trended to have the higher incidence of single-level ALIF with rhBMP2 utilization. PMID:29662743

Trends Analysis of rhBMP2 Utilization in Single-Level Anterior Lumbar Interbody Fusion in the United States.

PubMed

Lao, Lifeng; Cohen, Jeremiah R; Buser, Zorica; Brodke, Darrel S; Yoon, S Tim; Youssef, Jim A; Park, Jong-Beom; Meisel, Hans-Joerg; Wang, Jeffrey C

2018-04-01

Retrospective case study. To evaluate the trends and demographics of recombinant human bone morphogenetic protein 2 (rhBMP2) utilization in single-level anterior lumbar interbody fusion (ALIF) in the United States. Patients who underwent single-level ALIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Fort Wayne, IN), a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were analyzed for each patient. A total of 921 patients were identified who underwent a single-level ALIF in this study. The average rate of single-level ALIF with rhBMP2 utilization increased (35%-48%) from 2005 to 2009, but sharply decreased to 16.7% in 2010 and 15.0% in 2011. The overall incidence of single-level ALIF without rhBMP2 (0.20 cases per 100 000 patients) was more than twice of the incidence of single-level ALIF with rhBMP2 (0.09 cases per 100 000 patients). The average rate of single-level ALIF with rhBMP2 utilization is highest in West (41.4%), followed by Midwest (33.3%), South (26.5%) and Northeast (22.2%). The highest incidence of single-level ALIF with rhBMP2 was observed in the group aged less than 65 years (compared with any other age groups, P < .001), with an incidence of 0.21 per 100 000 patients. The incidence of rhBMP2 utilization in single-level ALIF increased from 2006 to 2009, but decreased in 2010 and 2011. The Northeast region had the lowest incidence of rhBMP2 utilization. The group aged less than 65 years trended to have the higher incidence of single-level ALIF with rhBMP2 utilization.

[Association between distribution of bacillary dysentery and meteorological factors in Beijing, 2004-2015].

PubMed

Du, Z; Zhang, J; Lu, J X; Lu, L P

2018-05-10

Objective: To analyze the distribution characteristics of bacillary dysentery in Beijing during 2004-2015 and evaluate the influence of meteorological factors on the temporal and spatial distribution of bacillary dysentery. Methods: The incidence data of bacterial dysentery and meteorological data in Beijing from 2004 to 2015 were collected. Descriptive epidemiological analysis was conducted to study the distribution characteristics of bacterial dysentery. Linear correlation analysis and multiple linear regression analysis were carried out to investigate the relationship between the incidence of bacillary dysentery and average precipitation, average air temperature, sunshine hours, average wind speed, average air pressure, gale and rain days. Results: A total of 280 704 cases of bacterial dysentery, including 36 deaths, were reported from 2004 to 2015 in Beijing, the average annual incidence was 130.15/100 000. The annual incidence peak was mainly between May and October, the cases occurred during this period accounted for 80.75 % of the total, and the incidence was highest in age group 0 year. The population distribution showed that most cases were children outside child care settings and students, and the sex ratio of the cases was 1.22∶1. The reported incidence of bacillary dysentery was positively associated with average precipitation, average air temperature and rain days with the correlation coefficients of 0.931, 0.878 and 0.888, but it was negatively associated with the average pressure, the correlation coefficient was -0.820. Multiple linear regression equation for fitting analysis of bacillary dysentery and meteorological factors was Y =3.792+0.162 X (1). Conclusion: The reported incidence of bacillary dysentery in Beijing was much higher than national level. The annual incidence peak was during July to August, and the average precipitation was an important meteorological factor influencing the incidence of bacillary dysentery.

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study.

PubMed

Fitzmaurice, Christina; Akinyemiju, Tomi F; Al Lami, Faris Hasan; Alam, Tahiya; Alizadeh-Navaei, Reza; Allen, Christine; Alsharif, Ubai; Alvis-Guzman, Nelson; Amini, Erfan; Anderson, Benjamin O; Aremu, Olatunde; Artaman, Al; Asgedom, Solomon Weldegebreal; Assadi, Reza; Atey, Tesfay Mehari; Avila-Burgos, Leticia; Awasthi, Ashish; Ba Saleem, Huda Omer; Barac, Aleksandra; Bennett, James R; Bensenor, Isabela M; Bhakta, Nickhill; Brenner, Hermann; Cahuana-Hurtado, Lucero; Castañeda-Orjuela, Carlos A; Catalá-López, Ferrán; Choi, Jee-Young Jasmine; Christopher, Devasahayam Jesudas; Chung, Sheng-Chia; Curado, Maria Paula; Dandona, Lalit; Dandona, Rakhi; das Neves, José; Dey, Subhojit; Dharmaratne, Samath D; Doku, David Teye; Driscoll, Tim R; Dubey, Manisha; Ebrahimi, Hedyeh; Edessa, Dumessa; El-Khatib, Ziad; Endries, Aman Yesuf; Fischer, Florian; Force, Lisa M; Foreman, Kyle J; Gebrehiwot, Solomon Weldemariam; Gopalani, Sameer Vali; Grosso, Giuseppe; Gupta, Rahul; Gyawali, Bishal; Hamadeh, Randah Ribhi; Hamidi, Samer; Harvey, James; Hassen, Hamid Yimam; Hay, Roderick J; Hay, Simon I; Heibati, Behzad; Hiluf, Molla Kahssay; Horita, Nobuyuki; Hosgood, H Dean; Ilesanmi, Olayinka S; Innos, Kaire; Islami, Farhad; Jakovljevic, Mihajlo B; Johnson, Sarah Charlotte; Jonas, Jost B; Kasaeian, Amir; Kassa, Tesfaye Dessale; Khader, Yousef Saleh; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khang, Young-Ho; Khosravi, Mohammad Hossein; Khubchandani, Jagdish; Kopec, Jacek A; Kumar, G Anil; Kutz, Michael; Lad, Deepesh Pravinkumar; Lafranconi, Alessandra; Lan, Qing; Legesse, Yirga; Leigh, James; Linn, Shai; Lunevicius, Raimundas; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Mantovani, Lorenzo G; McMahon, Brian J; Meier, Toni; Melaku, Yohannes Adama; Melku, Mulugeta; Memiah, Peter; Mendoza, Walter; Meretoja, Tuomo J; Mezgebe, Haftay Berhane; Miller, Ted R; Mohammed, Shafiu; Mokdad, Ali H; Moosazadeh, Mahmood; Moraga, Paula; Mousavi, Seyyed Meysam; Nangia, Vinay; Nguyen, Cuong Tat; Nong, Vuong Minh; Ogbo, Felix Akpojene; Olagunju, Andrew Toyin; Pa, Mahesh; Park, Eun-Kee; Patel, Tejas; Pereira, David M; Pishgar, Farhad; Postma, Maarten J; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rawaf, Salman; Rawaf, David Laith; Roshandel, Gholamreza; Safiri, Saeid; Salimzadeh, Hamideh; Sanabria, Juan Ramon; Santric Milicevic, Milena M; Sartorius, Benn; Satpathy, Maheswar; Sepanlou, Sadaf G; Shackelford, Katya Anne; Shaikh, Masood Ali; Sharif-Alhoseini, Mahdi; She, Jun; Shin, Min-Jeong; Shiue, Ivy; Shrime, Mark G; Sinke, Abiy Hiruye; Sisay, Mekonnen; Sligar, Amber; Sufiyan, Muawiyyah Babale; Sykes, Bryan L; Tabarés-Seisdedos, Rafael; Tessema, Gizachew Assefa; Topor-Madry, Roman; Tran, Tung Thanh; Tran, Bach Xuan; Ukwaja, Kingsley Nnanna; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Weiderpass, Elisabete; Williams, Hywel C; Yimer, Nigus Bililign; Yonemoto, Naohiro; Younis, Mustafa Z; Murray, Christopher J L; Naghavi, Mohsen

2018-06-02

The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territories, and the average annual age-standardized death rates decreased within that timeframe in 143 of 195 countries or territories. Large disparities exist between countries in cancer incidence, deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments for noncommunicable disease and cancer control.

Rates of workplace aggression in the emergency department and nurses' perceptions of this challenging behaviour: A multimethod study.

PubMed

Hyland, Simone; Watts, Joanne; Fry, Margaret

2016-08-01

Over the last 10 years, the rate of people presenting with challenging behaviour to emergency departments (EDs) has increased and is recognised as a frequent occurrence facing clinicians today. Challenging behaviour often includes verbal aggression, physical aggression, intimidation and destruction of property. The aim of this research was to (i) identify the characteristics and patterns of ED-reported incidents of challenging behaviour and (ii) explore emergency nurses' perceptions of caring for patients displaying challenging behaviour. This was a multi-method study conducted across two metropolitan Sydney district hospitals. Phase 1 involved a 12-month review of the hospital's incident management database. Phase 2 involved a survey of emergency nurses' perceptions of caring for patients displaying challenging behaviour. Over 12 months there were 34 incidents of aggression documented and the perpetrators were often male (n=18; 53.0%). The average age was 34.5 years. The majority of reported incidents (n=33; 90.1%) involved intimidation, verbal assault and threatening behaviour. The median time between patient arrival and incident was 109.5min (IQR 192min). The median length of stay for patients was 302.5min (IQR 479min). There was no statistical difference between day of arrival and time of actual incident (t-test p=0.235), length of stay (t-test p=0.963) or ED arrival to incident time (t-test p=0.337). The survey (n=53; 66.2%) identified the average ED experience was 12.2 years (SD 9.8 years). All participants surveyed had experienced verbal abuse and/or physical abuse. Participants (n=52) ranked being spat at (n=37; 71.1%) the most difficult to manage. Qualitative survey open-ended comments were analysed and organised thematically. The survey identified three themes which were (i) increasing security, (ii) open access and (iii) rostering imbalance. The study provides insight into emergency nurses' reported perceptions of patients who display challenging behaviour. All emergency nurse participants reported being regularly exposed to challenging behaviour and this involved both physical and verbal abuse. This was in contrast to a low incident hospital reporting rate. ED clinicians need to be better supported with targeted educational programmes, appropriate ED architecture and reporting mechanism that are not onerous. Copyright © 2016 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Incidence of laryngeal cancer and exposure to acid mists.

PubMed Central

Steenland, K; Schnorr, T; Beaumont, J; Halperin, W; Bloom, T

1988-01-01

To determine the relation between exposure to acid mist and laryngeal cancer, the smoking habits, drinking habits, and incidence of laryngeal cancer of 879 male steelworkers exposed to acid mists during pickling operations was ascertained. Sulphuric acid mist was the primary exposure for most men in this cohort. These men had all worked in a pickling operation for a minimum of six months before 1965, with an average duration of exposure of 9.5 years. Exposures to sulphuric acid in the 1970s averaged about 0.2 mg/m3, and earlier exposures were probably similar. Interviews were conducted with all cohort members or their next of kin in 1986 and medical records of decedents were reviewed. Nine workers were identified who had been diagnosed as having laryngeal cancer, using a conservative case definition that required medical record confirmation for any case among decedents and confirmation by a physician for any case among live individuals. Using data from national surveys of cancer incidence as referent rates, 3.44 laryngeal cancers would have been expected. Excess smoking by the exposed cohort compared with the United States population resulted in an upward adjustment of the expected number of cases of laryngeal cancer to 3.92. The standardised incidence rate ratio for laryngeal cancer was 2.30 (9/3.92), with a one sided p value of 0.01 (assuming a Poisson distribution). The finding of excess laryngeal cancer in this cohort is consistent with four other studies published since 1981. PMID:3203082

Incidence and Burden of Pertussis Among Infants Less Than 1 Year of Age

PubMed Central

Martin, Carolyn K.; Krishnarajah, Girishanthy; Becker, Laura K.; Buikema, Ami; Tan, Tina Q.

2017-01-01

Background: Infant-specific pertussis data, especially among neonates, are limited and variable. This study (NCT01890850) provides overall and age-specific pertussis incidence and associated health care utilization and costs among commercially insured infants in the US. Methods: Nearly 1.2 million infants born from 2005 to 2010 with commercial health plan coverage were followed during their first 12 months of life. Pertussis cases were identified from medical claims (International Classification of Diseases, 9th revision, Clinical Modification code: 033.0, 033.9, 484.3), and incidence rates were calculated. Each pertussis case was then matched to 10 comparators, so pertussis-related health care utilization and costs before and after the index date could be assessed. Results: The overall pertussis incidence rate among infants <12 months of age was 117.7/100,000 person-years; infants 3 months of age had the highest incidence rate (247.7/100,000 person-years). Infants diagnosed with pertussis were significantly more likely to have prior diagnoses of upper respiratory infection, cough and wheezing-related illnesses than comparators (P < 0.001). Pertussis cases were more likely to be hospitalized within 14 days after the index date (31.8% vs. 0.5%; P < 0.001) and their adjusted health care costs during follow-up were 2.82 times higher than comparators (P < 0.001; 95% confidence interval: 2.08–3.81). The incremental cost of pertussis during the 12-month follow-up period averaged $8271 (P < 0.001). The average incremental cost varied substantially by age, ranging from $18,781 (P < 0.001) to $3772 (P = 0.02) among infants 1 month and 7–12 months of age, respectively. Conclusions: The health burden of pertussis, particularly in the youngest infants, remains substantial, highlighting the need to intensify efforts to protect this most vulnerable population. PMID:27902648

Rocky Mountain spotted fever in the United States, 1997-2002.

PubMed

Chapman, Alice S; Murphy, Staci M; Demma, Linda J; Holman, Robert C; Curns, Aaron T; McQuiston, Jennifer H; Krebs, John W; Swerdlow, David L

2006-01-01

Rocky Mountain spotted fever (RMSF) is the most commonly reported fatal tick-borne disease in the United States. During 1997-2002, 3,649 cases of RMSF were reported to the Centers for Disease Control and Prevention via the National Electronic Telecommunications System for Surveillance; 2,589 case report forms, providing supplemental information, were also submitted. The average annual RMSF incidence during 1997-2002 was 2.2 cases/million persons. The annual incidence increased during 1997-2002 to a rate of 3.8 cases/million persons in 2002. The incidence was lowest among persons aged<5 and 10-29 years, and highest among adults aged 60-69 years. The overall case-fatality rate was 1.4%; the rate peaked in 1998 at 2.9% and declined to 0.7% in 2001 and 2002. Children<5 years of age had a case-fatality rate (5%) that was significantly greater than the rates for age groups<60 years of age, except for that for 40-49 years of age. Continued national surveillance is needed to assess the effectiveness of prevention efforts and early treatment in decreasing severe morbidity and mortality associated with RMSF.

[Statistics for initial admission for schizophrenia in hospitals in Costa Rica].

PubMed

Handal, N; Dodds, J H

1997-06-01

The factors that influence hospital admissions for schizophrenia in Costa Rica were investigated in people of both sexes who were admitted for the first time with this diagnosis (codes 295.0 to 295.9 of the International Classification of Diseases, Ninth Revision) in the period 1979 to 1981. Annual incidence rates were calculated using the number of hospitalized cases and the total population of the country. The average annual incidence was found to be 48.2 cases per 100000 inhabitants. High frequencies of first admissions were seen among males 40 to 44 years of age and females 45 to 49. Incidence was highest among unmarried women, followed by divorced women. There was a significant inverse relationship between educational attainment and rates of admission for schizophrenia, and incidence rates were highest among unemployed women and housewives. The association between rate of hospitalization for schizophrenia and 10 characteristics of the cantons was studied by means of logistic regression. Only two variables-the distance between the canton's principal town and the hospital and the volume of coffee harvest per resident-showed a direct significant association with admission rates for schizophrenia. The cantons which had the highest number of births of children who were diagnosed as schizophrenic in adulthood were those closest to the psychiatric hospital and those that had a low level of industrial or agricultural activity, low population density, and high proportions of single or divorced persons.

Epidemiology of pediatric primary malignant central nervous system tumors in Iran: a 10 year report of National Cancer Registry.

PubMed

Beygi, Sara; Saadat, Soheil; Jazayeri, Seyed Behzad; Rahimi-Movaghar, Vafa

2013-08-01

CNS tumors are the leading cause of cancer related deaths among children and adolescents. Nonetheless, the incidence of pediatric CNS tumors in developing countries is poorly understood. We aimed to provide epidemiologic features of primary malignant CNS tumors in Iranian children 0-19 years of age using National Cancer Registry (NCR) data bank. The data recorded by NCR over a 10 year period (2000-2010) were reviewed. Of 1948 tumor cases, 93.3% were located in brain, 5.1% were found in the spinal cord & cauda equina, and 1.6% affected cranial nerves and other parts of the nervous system. The overall average annual age specific incidence rate was 1.43 per 100,000. Males were more likely to develop CNS tumors (1.65 per 100,000) compared to females (1.21 per 100,000, p<0.01). Children under 5 years of age had the highest age specific incidence rate (1.86 per 100,000). Astrocytic tumors with the incidence rate of 0.61 per 100,000 were the most frequent specific histology followed by embryonal (0.38 per 100,000), and ependymal tumors (0.10 per 100,000). With regard to the histological distribution of tumors, some unique features including the high proportion of unspecified malignant neoplasms (7.6%) were noted. The overall incidence rate was markedly lower than western findings. Major differences were also observed in incidence rates of specific histologies. Although the discrepancies may be attributable to diversity in classification schemes and registration practices, a real ethnic and geographical variation in predisposition to development of pediatric CNS cancers is strongly suggested. Copyright © 2013 Elsevier Ltd. All rights reserved.

Epidemiology of enteric disease in C-EnterNet’s pilot site – Waterloo region, Ontario, 1990 to 2004

PubMed Central

Keegan, Victoria A; Majowicz, Shannon E; Pearl, David L; Marshall, Barbara J; Sittler, Nancy; Knowles, Lewinda; Wilson, Jeffery B

2009-01-01

OBJECTIVE: The objective of the present study was to describe the epidemiology of reportable enteric illness in Ontario’s Waterloo region, including comparing calculated incidence rates with published rates, and adjusting for under-reporting to determine the number of community cases, where published data were available. METHODS: Descriptive analyses were performed on reportable disease data for 13 enteric diseases collected in the Waterloo region from 1990 to 2004. Poisson and negative binomial regression analyses were used to investigate differences in incidence rates among age, sex, the 15 years of data and seasons. Disease-specific incidence rates were calculated and compared with the literature, where possible. Under-reporting ratios from the literature were applied to estimate the number of cases of campylobacteriosis, nontyphoidal salmonellosis and verotoxigenic Escherichia coli infection at the community level. RESULTS: Over the study period, the average annual age- and sex-adjusted incidence rates per 100,000 population were highest for campylobacteriosis (49.69 cases), followed by giardiasis (31.87 cases) and nontyphoidal salmonellosis (25.97 cases). The incidence of most enteric illnesses peaked in the summer. The highest incidence occurred in young children, followed by adults in their 20s. Diarrhea (85.4%) was the most frequently reported symptom, food (57.4%) was the most commonly reported probable source, and home (41.7%) and travel (37.0%) were the two most frequently reported risk settings. CONCLUSIONS: Enteric illness was a significant health burden in the Waterloo region from 1990 to 2004. Because reportable disease data are subject to under-reporting, it is likely that the true burden is greater than estimated in the present study. PMID:20808465

Contemporary, age-based trends in the incidence and management of patients with early-stage kidney cancer.

PubMed

Tan, Hung-Jui; Filson, Christopher P; Litwin, Mark S

2015-01-01

Although kidney cancer incidence and nephrectomy rates have risen in tandem, clinical advances have generated new uncertainty regarding the optimal management of patients with small renal tumors, especially the elderly. To clarify existing practice patterns, we assessed contemporary trends in the incidence and management of patients with early-stage kidney cancer. Using Surveillance, Epidemiology, and End Results data, we identified adult patients diagnosed with T1aN0M0 kidney cancer from 2000 to 2010. We determined age-adjusted and age-specific incidence and management rates (i.e., nonoperative, ablation, partial nephrectomy [PN], and radical nephrectomy) per 100,000 adults and determined the average annual percent change (AAPC). Finally, we compared management groups using multinomial logistic regression accounting for patient characteristics, cancer information, and county-level measures for health. From 2000 to 2010, we identified 41,645 adults diagnosed with T1aN0M0 kidney cancer. Overall incidence increased from 3.7 to 7.0 per 100,000 adults (AAPC = 7.0%, P<0.001). Over the study interval, rates of PN (AAPC = 13.1%, P<0.001) increased substantially, becoming the most used treatment by 2010. Among the elderly, rates of nonoperative management and ablation approached nephrectomy rates for those aged 75 to 84 years and became the predominant strategy for patients older than 84 years. Adjusting for clinical, oncological, and environmental factors, older patients less frequently underwent PN and more often received ablative or nonoperative management (P<0.001). As the incidence of early-stage kidney cancer rises, patients are increasingly treated with nonoperative and nephron-sparing strategies, especially among the most elderly. The broader array of treatment options suggests opportunities to better personalize kidney cancer care for seniors. Published by Elsevier Inc.

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

PubMed Central

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

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

PubMed

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.

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.

PubMed

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

2011-06-21

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.

[Temporal-spatial analysis of bacillary dysentery in the Three Gorges Area of China, 2005-2016].

PubMed

Zhang, P; Zhang, J; Chang, Z R; Li, Z J

2018-01-10

Objective: To analyze the spatial and temporal distributions of bacillary dysentery in Chongqing, Yichang and Enshi (the Three Gorges Area) from 2005 to 2016, and provide evidence for the disease prevention and control. Methods: The incidence data of bacillary dysentery in the Three Gorges Area during this period were collected from National Notifiable Infectious Disease Reporting System. The spatial-temporal scan statistic was conducted with software SaTScan 9.4 and bacillary dysentery clusters were visualized with software ArcGIS 10.3. Results: A total of 126 196 cases were reported in the Three Gorges Area during 2005-2016, with an average incidence rate of 29.67/100 000. The overall incidence was in a downward trend, with an average annual decline rate of 4.74%. Cases occurred all the year round but with an obvious seasonal increase between May and October. Among the reported cases, 44.71% (56 421/126 196) were children under 5-year-old, the cases in children outside child care settings accounted for 41.93% (52 918/126 196) of the total. The incidence rates in districts of Yuzhong, Dadukou, Jiangbei, Shapingba, Jiulongpo, Nanan, Yubei, Chengkou of Chongqing and districts of Xiling and Wujiagang of Yichang city of Hubei province were high, ranging from 60.20/100 000 to 114.81/100 000. Spatial-temporal scan statistic for the spatial and temporal distributions of bacillary dysentery during this period revealed that the temporal distribution was during May-October, and there were 12 class Ⅰ clusters, 35 class Ⅱ clusters, and 9 clusters without statistical significance in counties with high incidence. All the class Ⅰ clusters were in urban area of Chongqing (Yuzhong, Dadukou, Jiangbei, Shapingba, Jiulongpo, Nanan, Beibei, Yubei, Banan) and surrounding counties, and the class Ⅱ clusters transformed from concentrated distribution to scattered distribution. Conclusions: Temporal and spatial cluster of bacillary dysentery incidence existed in the three gorges area during 2005-2016. It is necessary to strengthen the bacillary dysentery prevention and control in urban areas of Chongqing and Yichang.

Incidence and risk factors of workplace violence on psychiatric staff

PubMed Central

Ridenour, Marilyn; Lanza, Marilyn; Hendricks, Scott; Hartley, Dan; Rierdan, Jill; Zeiss, Robert; Amandus, Harlan

2015-01-01

BACKGROUND A study by Hesketh et al. found that 20% of psychiatric nurses were physically assaulted, 43% were threatened with physical assault, and 55% were verbally assaulted at least once during the equivalent of a single work week. From 2005 through 2009, the U.S. Department of Justice reported that mental health occupations had the second highest average annual rate of workplace violence, 21 violent crimes per 1,000 employed persons aged 16 or older. OBJECTIVE An evaluation of risk factors associated with patient aggression towards nursing staff at eight locked psychiatric units. PARTICIPANTS Two-hundred eighty-four nurses in eight acute locked psychiatric units of the Veterans Health Administration throughout the United States between September 2007 and September 2010. METHODS Rates were calculated by dividing the number of incidents by the total number of hours worked by all nurses, then multiplying by 40 (units of incidents per nurse per 40-hour work week). Risk factors associated with these rates were analyzed using generalized estimating equations with a Poisson model. RESULTS Combining the data across all hospitals and weeks, the overall rate was 0.60 for verbal aggression incidents and 0.19 for physical aggression, per nurse per week. For physical incidents, the evening shift (3 pm – 11 pm) demonstrated a significantly higher rate of aggression than the day shift (7 am – 3 pm). Weeks that had a case-mix with a higher percentage of patients with personality disorders were significantly associated with a higher risk of verbal and physical aggression. CONCLUSION Healthcare workers in psychiatric settings are at high risk for aggression from patients. PMID:24894691

Tuberculosis Incidence in Elderly in Serbia: Key Trends in Socioeconomic Transition

PubMed Central

Pešut, Dragica P.; Gledović, Zorana B.; Grgurević, Anita D.; Nagorni-Obradović, Ljudmila M.; Adžić, Tatjana N.

2008-01-01

Aim To examine tuberculosis incidence rates among the elderly in Central Serbia in 1992-2006 period, which was characterized by socioeconomic crisis and migration of population. Methods We analyzed all reported active tuberculosis cases in a 15-year period, especially among patients aged ≥65, according to the Annual Reports of the Institute of Lung Diseases and Tuberculosis in Belgrade and Central Tuberculosis Register. Population estimates with extrapolations were based on 1991 and 2002 census data. Results Total tuberculosis incidence rates showed a slight but non-significant decreasing trend (P = 0.535), and no significant increase was found in patients aged ≥65 years (P = 0.064), with an average age-specific incidence rate for the elderly of 64.0 (95% confidence interval, 60.7-67.4). The increase was significant in patients aged ≥70 years (y = 49.3549 + 2.1186x; P = 0.001), both in men (y = 62.8666 + 2.3977x; P = 0.005) and even more prominently in women (y = 39.8240 + 1.9150x; P < 0.001). The proportion of tuberculosis cases in the elderly peaked in 2005, with 35% of all tuberculosis cases. Conclusion High incidence rates and increasing time trend of tuberculosis in the elderly in Central Serbia is a serious problem, especially among those aged 70 years and over, who might present a target group for active case-finding of the disease. PMID:19090606

Leukemia, lymphoma and multiple myeloma mortality (1950-1999) and incidence (1969-1999) in the Eldorado uranium workers cohort.

PubMed

Zablotska, Lydia B; Lane, Rachel S D; Frost, Stanley E; Thompson, Patsy A

2014-04-01

Uranium workers are chronically exposed to low levels of radon decay products (RDP) and gamma (γ) radiation. Risks of leukemia from acute and high doses of γ-radiation are well-characterized, but risks from lower doses and dose-rates and from RDP exposures are controversial. Few studies have evaluated risks of other hematologic cancers in uranium workers. The purpose of this study was to analyze radiation-related risks of hematologic cancers in the cohort of Eldorado uranium miners and processors first employed in 1932-1980 in relation to cumulative RDP exposures and γ-ray doses. The average cumulative RDP exposure was 100.2 working level months and the average cumulative whole-body γ-radiation dose was 52.2 millisievert. We identified 101 deaths and 160 cases of hematologic cancers in the cohort. Overall, male workers had lower mortality and cancer incidence rates for all outcomes compared with the general Canadian male population, a likely healthy worker effect. No statistically significant association between RDP exposure or γ-ray doses, or a combination of both, and mortality or incidence of any hematologic cancer was found. We observed consistent but non-statistically significant increases in risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma (HL) incidence and non-Hodgkin lymphoma (NHL) mortality with increasing γ-ray doses. These findings are consistent with recent studies of increased risks of CLL and NHL incidence after γ-radiation exposure. Further research is necessary to understand risks of other hematologic cancers from low-dose exposures to γ-radiation. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

[Prevalence of acute coronary heart disease among farmers in Panyu, Guangzhou: a 20-year population-based study].

PubMed

Deng, Mulan; Li, He; Shi, Meiling; He, Yongquan; Liao, Jianyong; Yang, Jie; Jiang, Xiaxing; Guo, Chengye; Mai, Jingzhuang; Liu, Xiaoqing

2014-03-01

To monitor the incidence change of acute coronary heart events in the all-ages farmers in Panyu District, Guangzhou City during 1991-2001 and 2010-2011. The surveillance on the same defined population as that from the PRC-USA cooperative epidemiologic project on the cardiovascular and pulmonary diseases 30-year ago was carried out in Panyu, Guangzhou in 1991-2001 and 2010-2011. The crude incidence of acute coronary events and the age-standardized incidence rate were calculated by the year, gender and age, and standardized with the world standard population age distribution. Incidences at the two different periods were compared. The annual average changing rate of the incidence was obtained by the regression analysis methods. In the 11 consecutive years of 1991-2001, a upward trend on the incidence of acute coronary events among the farmers in women in Panyu District was found (P < 0.05). The incidence of the acute coronary events in the year of 2010-2011 was significantly higher than that in the year of 1991 to 2001 [34.06 per 100 000 (age-adjusted rate as 28.50 per 100 000) versus 16.14 per 100 000 (age-adjusted rate as 16.57 per 100 000), P < 0.05]. The age-adjusted rate increased by 83.04%. Peak incidence of acute coronary events in males was noticed in 75-79 age group, and in 80-84 age group in females. Comparing to the period of 1991-2001, the largest incidence increases appeared in the age groups of 35-39 and 75-79 years in males, while in the age groups of 50-54 and 65-69 years in females. Up to 47.37% (36/76) events occurred on the age group older than 75 years, raised by 40.44% comparing to that in 1991-2001 (33.73%, 56/166). The incidence of acute coronary events among farmers in Panyu District is at middle or low level of China but there is an increasing trend in acute coronary incidence from 1991 to 2011. Our results suggest that the prevention and treatment on acute coronary syndrome should be strengthened, and especially on the age group with the largest increase of disease incidence.

Epidemiology of human leptospirosis in Malaysia, 2004-2012.

PubMed

Benacer, Douadi; Thong, Kwai Lin; Min, Ng Choung; Bin Verasahib, Khebir; Galloway, Renee L; Hartskeerl, Rudy A; Souris, Marc; Mohd Zain, Siti Nursheena

2016-05-01

Leptospirosis is an emerging disease, especially in countries with a tropical climate such as Malaysia. A dramatic increase in the number of cases has been reported over the last decade; however, information on the epidemiological trends of this disease is lacking. The objective of this study is to provide an epidemiological description of human leptospirosis cases over a 9-year period (2004-2012) and disease relationship with meteorological, geographical, and demographical information. A retrospective study was undertaken to describe the patterns of human leptospirosis cases and their association with intrinsic (sex, age, and ethnicity) and extrinsic (location, rainfall, and temperature) factors. Data was grouped according to age, sex, ethnicity, seasonality and geographical distribution, and analyzed using statistical tools to understand the influence of all the different factors on disease incidence. A total of 12,325 cases of leptospirosis were reported between 2004 and 2012 with an upward trend in disease incidence, with the highest in 2012. Three hundred thirty-eight deaths were reported with an overall case fatality rate of 2.74%, with higher incidence in males (9696; 78.7%) compared with female patients (2629; 21.3%), and overall male to female ratio of 3.69:1. Patients aged cohorts between 30-39 years old (16.22 per 100,000 population) had the highest disease incidence while the lowest incidence occurred between <1 to 9 years old (3.44 per 100,000 population). The average incidence was highest amongst Malays (10.97 per 100,000 population), followed by Indians (7.95 per 100,000 population). Stratification according to geographical distribution showed that the state of Malacca had the highest average disease incidence (11.12 per 100,000 population) followed by Pahang (10.08 per 100,000 population). The states of Terengganu, Kelantan, and Perak recorded similar rates of incidence (≈8.00 per 100,000 population), while Johor with the least number of reported cases (1.80 per 100,000 population). Positive relationships were recorded between the number of reported cases with the number of raining days per month and monthly average temperature (p-value<0.05). However, no significant association was noted between rainfall volume and number of reported Leptospirosis cases. This collaborative efforts between medical, academic and governmental institutions has enabled the construction of this comprehensive database that is essential to understand the disease trends in Malaysia and add insights into the prevention and control of this disease. Copyright © 2016 Elsevier B.V. All rights reserved.

Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil.

PubMed

Harling, Guy; Lima Neto, Antonio S; Sousa, Geziel S; Machado, Marcia M T; Castro, Marcia C

2017-05-25

Tuberculosis (TB) remains a public health problem, despite recent achievements in reducing incidence and mortality rates. In Brazil, these achievements were above the worldwide average, but marked by large regional heterogeneities. In Fortaleza (5th largest city in Brazil), the tuberculosis cure rate has been declining and treatment abandonment has been increasing in the past decade, despite a reduction in incidence and an increase in directly observed therapy (DOT). These trends put efforts to eliminate tuberculosis at risk. We therefore sought to determine social and programmatic determinants of tuberculosis incidence and treatment abandonment in Fortaleza. We analyzed sociodemographic and clinical data for all new tuberculosis cases notified in the Notifiable Diseases Information System (SINAN) from Fortaleza between 2007 and 2014. We calculated incidence rates for 117 neighborhoods in Fortaleza, assessed their spatial clustering, and used spatial regression models to quantify associations between neighborhood-level covariates and incidence rates. We used hierarchical logistic regression models to evaluate how individual- and neighborhood-level covariates predicted tuberculosis treatment abandonment. There were 12,338 new cases reported during the study period. Case rates across neighborhoods were significantly positively clustered in two low-income areas close to the city center. In an adjusted model, tuberculosis rates were significantly higher in neighborhoods with lower literacy, higher sewerage access and homicide rates, and a greater proportion of self-reported black residents. Treatment was abandoned in 1901 cases (15.4%), a rate that rose by 71% between 2007 and 2014. Abandonment was significantly associated with many individual sociodemographic and clinical factors. Notably, being recommended for DOT was protective for those who completed DOT, but associated with abandonment for those who did not. Low socioeconomic status areas have higher tuberculosis rates, and low socioeconomic individuals have higher risk of treatment abandonment, in Fortaleza. Treatment abandonment rates are growing despite the advent of universal DOT recommendations in Brazil. Proactive social policies, and active contact tracing to find missed cases, may help reduce the tuberculosis burden in this setting.

Disinfection Byproducts in Drinking Water and Evaluation of Potential Health Risks of Long-Term Exposure in Nigeria.

PubMed

Benson, Nsikak U; Akintokun, Oyeronke A; Adedapo, Adebusayo E

2017-01-01

Levels of trihalomethanes (THMs) in drinking water from water treatment plants (WTPs) in Nigeria were studied using a gas chromatograph (GC Agilent 7890A with autosampler Agilent 7683B) equipped with electron capture detector (ECD). The mean concentrations of the trihalomethanes ranged from zero in raw water samples to 950  μ g/L in treated water samples. Average concentration values of THMs in primary and secondary disinfection samples exceeded the standard maximum contaminant levels. Results for the average THMs concentrations followed the order TCM > BDCM > DBCM > TBM. EPA-developed models were adopted for the estimation of chronic daily intakes (CDI) and excess cancer incidence through ingestion pathway. Higher average intake was observed in adults (4.52 × 10 -2  mg/kg-day), while the ingestion in children (3.99 × 10 -2  mg/kg-day) showed comparable values. The total lifetime cancer incidence rate was relatively higher in adults than children with median values 244 and 199 times the negligible risk level.

[Impact and forecasting of hepatitis A immunization in French armed forces, 1990-2004].

PubMed

Richard, V; Haus, R; Verret, C; Molinier, S; Hugard, L; Nicand, E; Spiegel, A; Buisson, Y

2006-10-01

Hepatitis A is a public health problem specially for migrants or travellers from industrialized countries with a low hepatitis A endemic level. French armed forces adopted an immunization strategy which first targeted overseas forces and subsequently was extended to all armed forces. In this work we studied the impact of this policy. Epidemiological surveillance data from 1990 to 2004 was analyzed by Poisson regression and exponential models of decrease used to forecast future rates. From the 826 cases of hepatitis A reported during the study period, 266 (32.2%) occurred in overseas forces and 560 (67.8%) in forces stationed in France. Three periods could be identified in the decline of annual incidence: before 1994, with an average rate of 23.2 per 100,000; from 1994 to 1998: 10.2; and after 1998: 1.2 for all French armed forces. For overseas armed forces, the average rate was 117 per 100,000 before 1994 and 17.1 from 1994 to 1998 (p<0.001). For armed forces stationed in France, the average rate was 12.2 per 100,000 before 1998 and 0.9 after (p<0.001). For overseas armed forces, models clearly described the declining incidence subsequent to targeted immunization in 1995 and for armed forces stationed in France, the decline with generalized immunization starting in 1998. The impact of immunization against hepatitis A virus was significant both in an overseas population and in a population staying in France where the risk level can be considered low due to the low endemic rate in France. These results suggest that immunization should be proposed not only for travellers but also for the general population based on real knowledge of the situation and cost-effectiveness analyses.

The impact of a new standard labor protocol on maternal and neonatal outcomes.

PubMed

Wang, Dingran; Ye, Shenglong; Tao, Liyuan; Wang, Yongqing

2017-12-01

To analyze the clinical outcomes following the implementation of a new standard labor procedure. This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under an old standard labor protocol. The following maternal and perinatal outcomes were compared in the two groups: the indications for a cesarean section and the incidence of cesarean section, postpartum hemorrhage, fetal distress, neonatal asphyxia and pediatric intervention. We also compared the average number of days spent in the hospital, the incidence of medical disputes and hospitalization expenses. The cesarean section rates for the study and control groups were 19.29% (401/2079) and 33.53% (753/2246), respectively (P < 0.05). The main indications for a cesarean section in the study group were arrest of the active phase of labor, fetal distress and intrapartum fever; the percentages of each indication were significantly different from those of the control group (P < 0.001). The rates of postpartum hemorrhage in the study group and control group were 7.74% (130/1678) and 8.1% (121/1493), respectively (P = 0.710). The incidence rates of severe perineal lacerations were 0.48% (8/1678) for the study group and 0.2% (3/1493) for the control group (P = 0.187). The rates of forceps use were 4.29% (72/1678) in the study group and 2.41% (36/1493) in the control group (P = 0.004). The incidence rate of fetal distress in the study group was 6.24% (169/2709) and 4.67% (105/2246) (P = 0.006) in the control group. No significant difference was observed in the incidence of neonatal asphyxia and pediatric interventions between the two groups (0.74% (20/2709) vs. 8.12% (220/2709) and 17 (0.76%) vs. 161 (7.17%), respectively). The average length of hospital stay was 4.74 ± 1.15 and 2.13 ± 1.23 days (P < 0.01). The incidence of medical disputes was significantly different between the two groups: 1.44% (30/2079) in the study group and 0.53% (12/2246) in the control group (P < 0.01). The hospitalization expenses were 5401.29 ± 296.33 yuan in the study group and 5253.53 ± 3655.79 yuan in the control group (P = 0.06). The implementation of the new labor protocol reduced the cesarean section rate without negatively impacting maternal and neonatal outcomes. In practice, bed turnover and the hospital utilization rate should be better controlled, patient-doctor communication should be strengthened and the quality of obstetrical service should be improved.

Incidence and Clinical Outcomes of Inflammatory Bowel Disease in South Korea, 2011-2014: A Nationwide Population-Based Study.

PubMed

Jung, Yoon Suk; Han, Minkyung; Kim, Won Ho; Park, Sohee; Cheon, Jae Hee

2017-08-01

The incidence of inflammatory bowel disease (IBD) is increasing in East Asia; however, population-based data from this region are lacking. We conducted a nationwide, population-based study to examine the incidence and disease course of IBD in South Korea. Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD [10,049 with ulcerative colitis (UC) and 5595 with Crohn's disease (CD)] from 2011 to 2014. During the study period, the average annual incidence of UC was 5.0 per 10 5 , while that of CD was 2.8 per 10 5 . Among patients with UC, the cumulative rates of surgery 1 and 4 years after diagnosis were 1.0 and 2.0%; those among patients with CD were 9.0 and 13.9%, respectively. The 1- and 4-year cumulative rates of moderate- to high-dose corticosteroid use were, respectively, 26.6 and 45.2% among patients with UC, and 29.9 and 50.8% among those with CD. Similarly, the 1- and 4-year cumulative rates of immunomodulator use were 14.1 and 26.4% among patients with UC, and 58.3 and 76.1% among those with CD, respectively. With regard to biologic use, the 1- and 4-year cumulative rates were 3.0 and 9.0% among patients with UC, and 11.1 and 31.7% among those with CD, respectively. The recent incidence of IBD in South Korea has been the highest in East Asia. Patients who had been diagnosed recently with IBD showed lower rates of surgery and higher rates of immunomodulator and biologic use compared to those reported ever in South Korea.

[Tuberculosis in Havana City, 1995-1999].

PubMed

Sevy Court, José I; Peláez Sánchez, Otto; Arteaga Yero, Ana L; Armas Pérez, Luisa; Borroto Gutiérrez, Susana; González Ochoa, C Edilberto

2003-06-01

Tuberculosis is a worldwide health problem getting a prioritized attention by the Cuban National Health System. To describe the main indicators of the Cuban Tuberculosis Control Program. Based on surveillance data from the Provincial Center of Hygiene and Epidemiology, the health care network and strategies of the tuberculosis control program were reviewed; incidence rates, case finding indicators, diagnosis and case management were described. Eight subjects with respiratory symptoms were found per 1,000 attending general medical care services. The incidence rates of all tuberculosis types declined from 16.4 in 1995 to 12.0 x 10(5) people in 1999. Pulmonary tuberculosis incidence rate was reduced from 15.1 in1995 to 10.4 x 10(5) in 1999, whereas extrapulmonary tuberculosis had an increment from 1.3 to 1.6 x 10(5) in the same period. Of all new cases, 40-50 % were diagnosed at multispecialty clinics, 67.6% were diagnosed by positive smears, 15.2 % by positive cultures, 13.8 % by clinical and X-rays evidences only; and 0.9 % and 1.5 % were respectively diagnosed by biopsy and necropsy. There was an increase in the incidence rate in the age group 15-64 years in 1996 and 1997 but it declined again in 1998 and 1999. The age group 64 years and over showed a rate reduction from 1995 to 1999. In general, incidence rates diminished in the overall period. The average delay between onset of symptoms and diagnosis improved from 42 days in 1995 to 28.6 days in 1999. There seems to be a halt in reporting trends of new cases in 1996. Tuberculosis indicators reveal satisfactory changes in the study period.

The epidemiological characteristics of measles and difficulties of measles elimination in Hang Zhou, China

PubMed Central

Liu, Shijun; Xu, Erping; Zhang, Xiaoping; Liu, Yan; Du, Jian; Wang, Jun; Che, Xinren; Gu, Wenwen

2013-01-01

Objective: Following the national proclaim of Measles Elimination 2012, plenty of activities for controlling the incidence had practiced in Hangzhou. However, the incidence did not decrease to low degree and remained perform as gap to the elimination target. The present study aimed to describe the epidemiological characteristics of measles, and proposed reasonable method to the target in Hangzhou.  Method: Cases were collected by the National Notifiable Diseases Surveillance System (NNDSS) from 2004 to 2011. The descriptive epidemiology was employed to analyze characteristics of measles.  Results: A total of 4712 confirmed cases were enrolled by the NNDSS with 7.87 per 100,000 people of incidence rate on average from 2004 to 2011. Individuals lived urban districts had higher risk of measles than counties. Infants aged <1 year observed the highest incidence rate with 239.35/100,000, and the age-specific incidence rate declined along with aged-group but reversed at adults. 52.20% of cases were floating cases and the measles vaccination was significantly different from the local cases (χ2=51.65,p <0.001). February to June was the epidemic period for measles incidence with 81.88% of cases reported in cluster.  Conclusion: The descriptive characteristics of measles suggested that factors included infant and adult individual, floating population, and living urban area might be relate to the elimination target. More efforts were need to ensure susceptible population had accepted qualified measles vaccination.  PMID:23732896

Cancer incidence in Songkhla, southern Thailand, 1990-1994.

PubMed

Thongsuksai, P; Sriplung, H; Phungrassami, T; Prechavittayakul, P

1997-01-01

A population-based cancer registry of Songkhla was established by the Cancer Unit of Songklanagarind Hospital under the support of the IARC in 1990. The province is in the southern region of Thailand and has a population of 1.2 million. This study presents the average annual incidence rate of the provincial total and of the district level covering 1990-1994. It is aimed at providing a comprehensive picture of descriptive epidemiology of cancer in the province. Data were collected from all hospitals in the provinces. Analysis was done under the program provided by IARC. There were 3,973 invasive cancer cases in the period. The age-standardized rate for all cancers was 116.7 in males and 88.7 in females. Lung, oral cavity, liver, and esophagus were the main leading sites in males while the cervix and breast were outstanding in females. By comparison, the incidence of most cancers were lower than other registries in Thailand except for two cancer sites. The incidence of male oral cavity and esophagus cancers in males (ASR 10.7 and 8.5 respectively) were considerably higher. Na Mom, Hat Yai, Sadao and Muang were districts having a high incidence of cancer.

Incidence of malignant mesothelioma in Germany 2009-2013.

PubMed

Lehnert, Martin; Kraywinkel, Klaus; Heinze, Evelyn; Wiethege, Thorsten; Johnen, Georg; Fiebig, Julia; Brüning, Thomas; Taeger, Dirk

2017-02-01

The malignant mesothelioma is a rare malignancy and mainly caused by occupational exposure to asbestos. German cancer registries are providing a national database to investigate temporal and regional patterns of mesothelioma incidence. These may be of interest for healthcare planning and for surveillance programs aiming at the formerly exposed workforce. We analyzed population-based incidence data of malignant mesothelioma by site, type, sex, age, as well as district and state of patient's residence. Age-standardized incidence rates (AIRs40+) were calculated according to the European standard population truncated to the age of 40 years and older. We present rates at national, state, and district level and trends of incidence of northern states of Germany. In total, 7,547 malignant mesotheliomas were reported to German cancer registries diagnosed between 2009 and 2013-90% located to the pleura. On average, 1,198 men and 312 women were affected each year. We estimated AIR40+ of 4.77 in 100,000 German men and 0.98 in 100,000 German women. Regional clusters were predominantly located to the seaports of West Germany. The highest regional AIR40+ was 20 per 100,000 men. Corresponding rates in northeast Germany were between 2 and 4 per 100,000 men. Regional clusters of high incidence indicate districts with former shipyards and steel industry, but predominantly in the western part of Germany. The West-to-East difference corresponds to patterns of mortality. Twenty years after banning asbestos in Germany, Bremen and Hamburg are presenting the highest mesothelioma incidence but show steadily decreasing trends.

Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial.

PubMed

Katzman, W B; Vittinghoff, E; Kado, D M; Lane, N E; Ensrud, K E; Shipp, K

2016-03-01

Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture. We used data from the Fracture Intervention Trial among 3038 women 55-81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD. Mean baseline kyphosis was 48° (SD = 12) (range 7-83). At baseline, 962 (32%) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95% CI 2.8-4.6, p < 0.0005), adjusting for age and femoral neck BMD. Before adjusting for prevalent fracture, each 10° greater kyphosis was associated with 22% increase (95% CI 8-38%, p = 0.001) in annualized rate of new radiographic vertebral fracture, adjusting for age and femoral neck BMD. After additional adjustment for prevalent fracture, estimated increased annualized rate was attenuated and no longer significant, 8% per 10° kyphosis (95% CI -4 to 22%, p = 0.18). While greater kyphosis increased the rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture.

Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial

PubMed Central

Vittinghoff, E.; Kado, D. M.; Lane, N. E.; Ensrud, K. E.; Shipp, K.

2016-01-01

Summary Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. Introduction Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture. Methods We used data from the Fracture Intervention Trial among 3038 women 55–81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD. Results Mean baseline kyphosis was 48° (SD = 12) (range 7–83). At baseline, 962 (32 %) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95 % CI 2.8–4.6, p < 0.0005), adjusting for age and femoral neck BMD. Before adjusting for prevalent fracture, each 10° greater kyphosis was associated with 22 % increase (95 % CI 8–38 %, p = 0.001) in annualized rate of new radiographic vertebral fracture, adjusting for age and femoral neck BMD. After additional adjustment for prevalent fracture, estimated increased annualized rate was attenuated and no longer significant, 8 % per 10° kyphosis (95 % CI −4 to 22 %, p = 0.18). Conclusions While greater kyphosis increased the rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. PMID:26782685

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

PubMed

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

2014-08-01

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

Incidence and economics of clinical mastitis in five Holstein herds in the Czech Republic.

PubMed

Wolfová, Marie; Stípková, Miloslava; Wolf, Jochen

2006-11-17

Data on clinical mastitis (CM) collected between 1996 and 2003 on five Holstein dairy farms in the Czech Republic were analyzed. Lactational incidences of CM, averaged across farms and calculated only from cows with complete lactations, were 0.35, 0.45 and 0.57 for the first, second and third plus subsequent lactations, respectively. The mean numbers of CM cases per cow and lactation were 0.63, 0.94 and 1.22, and the incidence of CM cases per cow-year at risk were 0.68, 1.00 and 1.27 for the first, second and third plus subsequent lactations, respectively. Longitudinal analysis of CM prevalence based on daily records showed the highest proportion of infected cows in the first 10 days of lactation. The within-farm incidence of CM cases per cow per year, averaged over lactations, ranged from 0.53 to 1.56 with a mean value of 0.94 in the whole data set. Direct financial losses from CM per cow per year within farm ranged from 43.63 to 84.84 euros. They included losses from discarded milk, cost for drugs, veterinary service, herdsman's time, cost for an extra milking machine and cost for antibiotic drying of cows. The economic value of CM incidence (change in direct losses per cow per year when increasing CM incidence by one case above the average value) ranged from 58.3 to 80.1 euros per CM case per cow per year with the mean value of 62.6 euros per CM case per cow per year in the total data set. Daily prevalence rate of CM was shown to be the best among various indicators of CM susceptibility, because it accounted for the censored character of the data and for repeated cases of CM within lactations. In order to reduce the incidence of clinical mastitis for dairy cattle in the Czech Republic, we recommend that it should be included as a goal in the breeding program.

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

PubMed

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.

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

PubMed Central

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

2014-01-01

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

Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study.

PubMed

Khosravi Shadmani, Fatemeh; Ayubi, Erfan; Khazaei, Salman; Sani, Mohadeseh; Mansouri Hanis, Shiva; Khazaei, Somayeh; Soheylizad, Mokhtar; Mansori, Kamyar

2017-01-01

Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran. This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province. We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC. Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.

Disease burden of community acquired pneumonia among children under 5 y old in China: A population based survey.

PubMed

Li, Yan; An, Zhijie; Yin, Dapeng; Liu, Yanmin; Huang, Zhuoying; Ma, Yujie; Li, Hui; Li, Qi; Wang, Huaqing

2017-07-03

To obtain the baseline data on the incidence and cost of community acquired pneumonia among under-5 children for future studies, and provide evidence for shaping China's strategies regarding pneumococcal conjugate vaccine (PCV). Three townships from Heilongjiang, Hebei and Gansu Province and one community in Shanghai were selected as study areas. A questionnaire survey was conducted to collect data on incidence and cost of pneumonia among children under 5 y old in 2012. The overall incidence of clinically diagnosed pneumonia in children under 5 y old was 2.55%. The incidence in urban area was 7.97%, higher than that in rural areas (1.68%). However, no difference was found in the incidences of chest X-ray confirmed pneumonia between urban and rural areas (1.67% vs 1.23%). X-ray confirmed cases in rural and urban areas respectively accounted for 73.45% and 20.93% of all clinically diagnosed pneumonia. The hospitalization rate of all cases was 1.40%. Incidence and hospitalization rate of pneumonia decreased with age, with the highest rates found among children younger than one year and the lowest among children aged 4 (incidence: 4.25% vs 0.83%; hospitalization: 2.75% vs 0.36%). The incidence was slightly higher among boys (2.92% vs 2.08%). The total cost due to pneumonia for the participants was 1138 733 CNY. The average cost and median cost was 5722 CNY and 3540 CNY separately. Multivariate analysis showed that the only factor related to higher cost was hospitalization. The disease burden was high for children under 5 y old, especially the infant. PCV has not been widely used among children, and thus further health economics evaluation on introducing PCV into National Immunization Program should be conducted.

Foodborne botulism in Poland in 2014

PubMed

Czerwiński, Michał; Czarkowski, Mirosław P; Kondej, Barbara

The aim of the study is to assess the epidemiology of foodborne botulism in Poland in 2014 compared to previous years. We reviewed (1) surveillance data published in the annual bulletin “Infectious diseases and poisonings in Poland in 2014” and in previous publications, and (2) unpublished data retrieved from botulism case reports for 2014 sent to the Department of Epidemiology NIPH-NIH by Sanitary-Epidemiological Stations. In 2014, a total of 29 foodborne botulism cases (including 17 laboratory confirmed) was reported; the annual incidence rate (0.08 per 100,000 population) increased slightly in comparison to previous year, but was similar to the median incidence for years 2008 to 2012. The highest incidence in the country was reported in Lubelskie province (0.33). Incidence in rural areas (0.09) was only slightly higher than the incidence in urban areas (0.06). Men, had more than 4 times higher incidence than women; the highest incidence rate (0.31) was observed among men in the age group of 20-24 years. Most cases were associated with consumption of different types of commercially canned meat. Home-made vegetable meat preserves were also a common vehicle. All cases were hospitalized. Two deaths related to the disease were reported. Since 2008, the epidemiological situation of foodborne botulism in the country remains stable with an average 30 cases per year and corresponding incidence rate of 0.08 per 100,000 population. However, in 2014 draws attention a significant number of cases with undetermined food vehicle and relatively high percentage of cases with no laboratory confirmation. Therefore, it is important to enhance epidemiological investigation as well as laboratory capacity for surveillance.

Impact of Community-Based Approach as Policy Tool: World Health Organization-Designated Safe Communities of Korea and Health Action Zones of the United Kingdom.

PubMed

Kang, Changhyun; Shin, Jihyung; Matthews, Bob

2016-02-01

The aim of this study is to ascertain and identify the effectiveness of area-based initiatives as a policy tool mediated by societal and individual factors in the five World Health Organization (WHO)-designated Safe Communities of Korea and the Health Action Zones of the United Kingdom (UK). The Korean National Hospital discharge in-depth injury survey from the Korea Centers for Disease Control and Prevention and causes of death statistics by the Statistics Korea were used for all analyses. The trend and changes in injury rate and mortality by external causes were compared among the five WHO-designated Safe Communities in Korea. The injury incident rates decreased at a greater level in the Safe Communities compared with the national average. Similar results were shown for the changes in unintentional injury incident rates. In comparison of changes in mortality rate by external causes between 2005 and 2011, the rate increase in Safe Communities was higher than the national average except for Jeju, where the mortality rate by external causes decreased. When the Healthy Action Zones of the UK and the WHO Safe Communities of Korea were examined, the outcomes were interpreted differently among the compared index, regions, and time periods. Therefore, qualitative outcomes, such as bringing the residents' attention to the safety of the communities and promoting participation and coordination of stakeholders, should also be considered as important impacts of the community-based initiatives.

Diagnostic labels of NANDA-I in a southern region of Spain

PubMed Central

González-Rodríguez, Rafael; Martelo-Baro, María de los Ángeles; Bas-Sarmiento, Pilar

2017-01-01

ABSTRACT Objective: to determine the incidence of NANDA-I diagnostic labels (North American Nursing Diagnosis Association-International) and to establish the distribution of cases of assistance and the associated labels, according to sociodemographic variables (age and sex). Method: descriptive, cross-sectional epidemiological study of labels of NANDA-I, under ecological design. The distribution of labels was analyzed according to sex and age; the corresponding frequencies were calculated and for each label the incidence were calculated rates with aggregate data from the attended cases. Results: the total number of cases of care under study was 9,928 (41.65% men and 58.35% women). The identified labels were 16,456 (7,084 men and 9,372 women); average of 1.7 labels per case of care; Out of 216 labels proposed by NANDA-I, in its 2012-14 classification, 152 were used, representing 70.4%. The labels with the highest incidence rates per thousand inhabitants were: Anxiety, Willingness to Improve Knowledge and Risk of Infection. Conclusions: the study allowed detecting, through NANDA-I, the answers to the health problems of greater incidence in the users attended. PMID:28614433

Appropriateness of selecting different averaging times for modelling chronic and acute exposure to environmental odours

NASA Astrophysics Data System (ADS)

Drew, G. H.; Smith, R.; Gerard, V.; Burge, C.; Lowe, M.; Kinnersley, R.; Sneath, R.; Longhurst, P. J.

Odour emissions are episodic, characterised by periods of high emission rates, interspersed with periods of low emissions. It is frequently the short term, high concentration peaks that result in annoyance in the surrounding population. Dispersion modelling is accepted as a useful tool for odour impact assessment, and two approaches can be adopted. The first approach of modelling the hourly average concentration can underestimate total odour concentration peaks, resulting in annoyance and complaints. The second modelling approach involves the use of short averaging times. This study assesses the appropriateness of using different averaging times to model the dispersion of odour from a landfill site. We also examine perception of odour in the community in conjunction with the modelled odour dispersal, by using community monitors to record incidents of odour. The results show that with the shorter averaging times, the modelled pattern of dispersal reflects the pattern of observed odour incidents recorded in the community monitoring database, with the modelled odour dispersing further in a north easterly direction. Therefore, the current regulatory method of dispersion modelling, using hourly averaging times, is less successful at capturing peak concentrations, and does not capture the pattern of odour emission as indicated by the community monitoring database. The use of short averaging times is therefore of greater value in predicting the likely nuisance impact of an odour source and in framing appropriate regulatory controls.

Annual Report to the Nation on the Status of Cancer, 1975-2012, featuring the increasing incidence of liver cancer.

PubMed

Ryerson, A Blythe; Eheman, Christie R; Altekruse, Sean F; Ward, John W; Jemal, Ahmedin; Sherman, Recinda L; Henley, S Jane; Holtzman, Deborah; Lake, Andrew; Noone, Anne-Michelle; Anderson, Robert N; Ma, Jiemin; Ly, Kathleen N; Cronin, Kathleen A; Penberthy, Lynne; Kohler, Betsy A

2016-05-01

Annual updates on cancer occurrence and trends in the United States are provided through an ongoing collaboration among the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This annual report highlights the increasing burden of liver and intrahepatic bile duct (liver) cancers. Cancer incidence data were obtained from the CDC, NCI, and NAACCR; data about cancer deaths were obtained from the CDC's National Center for Health Statistics (NCHS). Annual percent changes in incidence and death rates (age-adjusted to the 2000 US Standard Population) for all cancers combined and for the leading cancers among men and women were estimated by joinpoint analysis of long-term trends (incidence for 1992-2012 and mortality for 1975-2012) and short-term trends (2008-2012). In-depth analysis of liver cancer incidence included an age-period-cohort analysis and an incidence-based estimation of person-years of life lost because of the disease. By using NCHS multiple causes of death data, hepatitis C virus (HCV) and liver cancer-associated death rates were examined from 1999 through 2013. Among men and women of all major racial and ethnic groups, death rates continued to decline for all cancers combined and for most cancer sites; the overall cancer death rate (for both sexes combined) decreased by 1.5% per year from 2003 to 2012. Overall, incidence rates decreased among men and remained stable among women from 2003 to 2012. Among both men and women, deaths from liver cancer increased at the highest rate of all cancer sites, and liver cancer incidence rates increased sharply, second only to thyroid cancer. Men had more than twice the incidence rate of liver cancer than women, and rates increased with age for both sexes. Among non-Hispanic (NH) white, NH black, and Hispanic men and women, liver cancer incidence rates were higher for persons born after the 1938 to 1947 birth cohort. In contrast, there was a minimal birth cohort effect for NH Asian and Pacific Islanders (APIs). NH black men and Hispanic men had the lowest median age at death (60 and 62 years, respectively) and the highest average person-years of life lost per death (21 and 20 years, respectively) from liver cancer. HCV and liver cancer-associated death rates were highest among decedents who were born during 1945 through 1965. Overall, cancer incidence and mortality declined among men; and, although cancer incidence was stable among women, mortality declined. The burden of liver cancer is growing and is not equally distributed throughout the population. Efforts to vaccinate populations that are vulnerable to hepatitis B virus (HBV) infection and to identify and treat those living with HCV or HBV infection, metabolic conditions, alcoholic liver disease, or other causes of cirrhosis can be effective in reducing the incidence and mortality of liver cancer. Cancer 2016;122:1312-1337. © 2016 American Cancer Society. © 2016 American Cancer Society.

Annual Report to the Nation on the Status of Cancer, 1975–2012, Featuring the Increasing Incidence of Liver Cancer

PubMed Central

Ryerson, A. Blythe; Eheman, Christie R.; Altekruse, Sean F.; Ward, John W.; Jemal, Ahmedin; Sherman, Recinda L.; Henley, S. Jane; Holtzman, Deborah; Lake, Andrew; Noone, Anne-Michelle; Anderson, Robert N.; Ma, Jiemin; Ly, Kathleen N.; Cronin, Kathleen A.; Penberthy, Lynne; Kohler, Betsy A.

2016-01-01

BACKGROUND Annual updates on cancer occurrence and trends in the United States are provided through an ongoing collaboration among the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This annual report highlights the increasing burden of liver and intrahepatic bile duct (liver) cancers. METHODS Cancer incidence data were obtained from the CDC, NCI, and NAACCR; data about cancer deaths were obtained from the CDC’s National Center for Health Statistics (NCHS). Annual percent changes in incidence and death rates (age-adjusted to the 2000 US Standard Population) for all cancers combined and for the leading cancers among men and women were estimated by joinpoint analysis of long-term trends (incidence for 1992–2012 and mortality for 1975–2012) and short-term trends (2008–2012). In-depth analysis of liver cancer incidence included an age-period-cohort analysis and an incidence-based estimation of person-years of life lost because of the disease. By using NCHS multiple causes of death data, hepatitis C virus (HCV) and liver cancer-associated death rates were examined from 1999 through 2013. RESULTS Among men and women of all major racial and ethnic groups, death rates continued to decline for all cancers combined and for most cancer sites; the overall cancer death rate (for both sexes combined) decreased by 1.5% per year from 2003 to 2012. Overall, incidence rates decreased among men and remained stable among women from 2003 to 2012. Among both men and women, deaths from liver cancer increased at the highest rate of all cancer sites, and liver cancer incidence rates increased sharply, second only to thyroid cancer. Men had more than twice the incidence rate of liver cancer than women, and rates increased with age for both sexes. Among non-Hispanic (NH) white, NH black, and Hispanic men and women, liver cancer incidence rates were higher for persons born after the 1938 to 1947 birth cohort. In contrast, there was a minimal birth cohort effect for NH Asian and Pacific Islanders (APIs). NH black men and Hispanic men had the lowest median age at death (60 and 62 years, respectively) and the highest average person-years of life lost per death (21 and 20 years, respectively) from liver cancer. HCV and liver cancer-associated death rates were highest among decedents who were born during 1945 through 1965. CONCLUSIONS Overall, cancer incidence and mortality declined among men; and, although cancer incidence was stable among women, mortality declined. The burden of liver cancer is growing and is not equally distributed throughout the population. Efforts to vaccinate populations that are vulnerable to hepatitis B virus (HBV) infection and to identify and treat those living with HCV or HBV infection, metabolic conditions, alcoholic liver disease, or other causes of cirrhosis can be effective in reducing the incidence and mortality of liver cancer. PMID:26959385

A failed model-based attempt to implement an evidence-based nursing guideline for fall prevention.

PubMed

Semin-Goossens, Astrid; van der Helm, Jelle M J; Bossuyt, Patrick M M

2003-01-01

An evidence-based nursing guideline had been locally developed in 1993 to reduce fall incidence rates, creating a 30% reduction. Implementation had failed though. Between 1999 and 2001 the guideline was updated. A multifaceted intervention was chosen based on a model for implementing change. The study was performed in 2 wards. All recommendations of Grol's 5-step implementation model were followed. The aim was a reduction of 30% in fall incidence within a year. Data on falls were extracted from nursing records and Incidence Report Forms (IRFs). In a pilot study an average of 9 falls per 1000 patients per day had been recorded in the department of internal medicine and 16 in the neurology ward. Given the desired reduction of 30%, the target averages were 6 and 11 falls respectively. During the intervention year the average incidences were 8 and 13 falls (95% CI: 6-11 and 10-15). There was a changeable pattern over time without any declining trend. The percentage filled in IRFs varied strongly, with an average of 52% in the department of internal medicine and 60% in the neurology department. There has been no durable decrease in monthly falls despite the use of a model-based procedure for implementing change. Neither did we observe any improvement in filling in IRFs. It can be questioned if the nurses themselves did experience patient falls to be troublesome enough. Investigating this is difficult though. Although the most successful strategy still appears to be changing attitudes of nurses in order to increase fall prevention, there is no clear strategy on how to create this successfully.

Incidence of cutaneous malignant melanoma in Iranian provinces and American states matched on ultraviolet radiation exposure: an ecologic study.

PubMed

Moslehi, Roxana; Zeinomar, Nur; Boscoe, Francis P

2018-03-01

Ultraviolet radiation (UVR), with UVB and UVA as the relevant components, is a risk factor for melanoma. Complete ascertainment and registration of melanoma in Iran was conducted in five provinces (Ardabil, Golestan, Mazandaran, Gilan and Kerman) during 1996-2000. The aim of our study was to compare population-based incidence data from these provinces with rates in the United States (US) while standardizing ambient UVR. Population-based rates representing all incident cases of melanoma (1996-2000) across the five Iranian provinces were compared to rates of melanoma among white non-Hispanics in the US. Overall age-standardized rates (ASR) for Iran and the US (per 100,000 person-years adjusted to 2000 world population) and standardized rate ratios (SRR) were calculated. We measured erythemally-weighted average solar UVR exposures (with contributions from both UVB and UVA range) of the five Iranian provinces using data from NASA's Total Ozone Mapping Spectrometer and selected five US states (Kentucky, Utah, Texas, Oklahoma, and Hawaii) with matching UVR exposure to each province. Incidence rates of melanoma during 1996-2000 in each Iranian province were compared to rates among white non-Hispanics in its UVR-matched US state. The overall male and female ASRs of melanoma were 0.60 (95%CI: 0.56-0.64) and 0.46 (95%CI: 0.42-0.49), respectively, for Iran and 22.78 (95%CI: 22.42-23.14) and 16.61 (95%CI: 16.30-16.92) for the US. SRRs of melanoma comparing US to Iran were 37.97 (95%CI: 35.78-40.29) for males and 36.11 (95%CI: 33.69-38.70) for females, indicating significantly higher incidence in the US. ASRs and age-specific rates of melanoma for both genders were significantly lower in each Iranian province compared to its UVR-matched US state. The markedly lower incidence rates of melanoma in Iranian provinces with similar UVR exposures to US states underscore the need for additional comparative studies to decipher the influence of other extrinsic and intrinsic factors on the risk of this malignancy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Tuberculosis in Poland in 2012.

PubMed

Korzeniewska-Koseła, Maria

2014-01-01

To evaluate the main features of TB epidemiology in 2012 in Poland and to compare with the corresponding EU data. Analysis of case- based clinical and demographic data on TB patients from Central TB Register, of data submitted by laboratories on anti-TB drug susceptibility testing results in cases notified in 2012, data from National Institute of Public Health - National Institute of Hygiene on cases of tuberculosis as AIDS-defining disease, from Central Statistical Office on deaths from tuberculosis based on death certificates, data from ECDC report "Tuberculosis Surveillance in Europe, 2014 (situation in 2012). 7 542 TB cases were reported in Poland in 2012. The incidence rate was 19.6 cases per 100 000, with large variability between voivodships from 10.6 to 30.2. The mean annual decrease of TB incidence in 2008-2012 was 2.4%. 6 665 cases had no history of previous treatment; 17.3 per 100 000. The number of all notified pulmonary tuberculosis cases was 7 018; 18.2 per 100 000. The proportion of extrapulmonary tuberculosis among all registered cases was 6.9% (524 cases). In 2012, 36 patients had fibrous-cavernous pulmonary tuberculosis (0.5% of all cases of pulmonary tuberculosis). TB was diagnosed in 95 children (1.3% of all cases, incidence 1.6). The incidence of tuberculosis increased progressively with age to 34.8 among patients 65 years old and older. The mean age of new TB cases was 53.1 years. The incidence among men (27.4) was more than two times higher than among women (12.2). The incidence rate in rural population was lower than in urban; 20.2 vs. 18.6. Bacteriologically confirmed pulmonary cases (4870) constituted 69,4% of all pulmonary TB cases. The number of smear positive pulmonary TB cases was 2 778 (39.6% of all pulmonary cases). In 2012 in the all group of TB patients in Poland there were 276 (3.7%) of homeless and 1 905 (25.3%) of unemployed. There were 48 foreigners registered among all cases of tuberculosis in Poland (0.6%) and 243 cases registered among prisoners (rate 288.0). There were 31 patients with MDR-TB (0.7% of 4659 cases with known anti-TB DST results). TB was initial AIDS indicative disease in 26 cases. There were 640 deaths due to tuberculosis in 2011 (1.7 TB deaths per 100 000). Mortality among males - 2.7 - was four times higher than among females - 0.7. CONCLUSIONS. In Poland in 2012 the incidence of tuberculosis was higher than the average in EU countries. The highest incidence rates occurred in older age groups. The incidence in men was more than 2 times higher than in women. The incidence of tuberculosis in children and the percentage of patients with drug-resistant tuberculosis are lower than average in EU and that is favorable for epidemiological situation of tuberculosis in our country.

An evaluation of rabies vaccination rates among canines and felines involved in biting incidents within the Wellington-Dufferin-Guelph Public Health Department.

PubMed

Bottoms, K; Trotz-Williams, L; Hutchison, S; MacLeod, J; Dixon, J; Berke, O; Poljak, Z

2014-11-01

The objectives of this study were to determine the rate of animal bite incidents occurring in the human population of a local health department, and to determine the proportion of these canines and felines that were not up to date on their rabies vaccination at the time the incident occurred. Data were obtained from animal bite incidents reported to Wellington-Dufferin-Guelph Public Health during 2010 and 2011. Descriptive statistics of 718 eligible reports revealed the average rate of animal biting was 1.55 bites per 1000 residents per year. Approximately 54% of these animals were vaccinated against rabies, 32% were not up to date with their rabies vaccination, and the remaining 14.5% were of unknown status. The unit of analysis was the municipality, and the four outcomes of interest were: (i) number of animal bite incidents per 1000 residents, (ii) number of dog bite incidents per 1000 residents, (iii) proportion of animals involved in bite incidents that were not up to date with their rabies vaccination, and (iv) proportion of dogs that were not up to date. Associations between the outcomes and selected demographic variables were investigated using regression analysis. The number of veterinary clinics per 10,000 residents, and whether the municipality was urban or rural were identified as significant predictors for the number of animal bites per 1000 residents, and the number of dog bites. There were no significant predictors for the proportion of unvaccinated animals or dogs. Spatial clustering and the location of spatial clusters were assessed using the empirical Bayes index and spatial scan test. This analysis identified five municipalities within the health department that have a high rate of biting incidents and a high proportion of animals that were not up to date on their rabies vaccination. Such municipalities are ideal for targeted educational campaigns regarding the importance of vaccination in pets. © 2014 Blackwell Verlag GmbH.

Epidemiology of biopsy-proven glomerulonephritis in Queensland adults.

PubMed

Jegatheesan, Dev; Nath, Karthik; Reyaldeen, Reza; Sivasuthan, Goutham; John, George T; Francis, Leo; Rajmokan, Mohana; Ranganathan, Dwarakanathan

2016-01-01

There is a paucity of data pertaining to the incidence of biopsy-proven glomerulonephritis (GN) in Australia. This retrospective study aims to review the data from all adult native renal biopsies performed in the state of Queensland from 2002 to 2011--comparing results with centres from across the world. Pathology reports of 3697 adult native kidney biopsies were reviewed, of which 2048 had GN diagnoses. Age, gender, clinical indication and histopathology findings were compared. The average age at biopsy was 48 ± 17 years. Male preponderance was noted overall (∼60%), with lupus nephritis being the only individual GN with female predilection. The average rate of biopsy was 12.04 per hundred thousand people per year (php/yr). Nephrotic and nephritic syndromes comprised approximately 75% of all clinical indications that lead to GN diagnoses. IgA nephropathy (1.41 php/yr) was the most common primary GN followed by focal segmental glomerulosclerosis (1.02 php/yr) and crescentic GN (0.73 php/yr). Diabetic nephropathy (0.84 php/yr), lupus nephritis (0.69 php/yr) and amyloidosis (0.19 php/yr) were the most commonly identified secondary GN. IgA nephropathy is the predominant primary GN in Queensland, and nephrotic syndrome the most common indication for a renal biopsy. While crescentic GN incidence has significantly increased with time, focal segmental glomerulosclerosis incidence has not shown any trend. Incidence of GN overall appears to increase with age. The annual rate of biopsy in this study appears lower than previously published in an Australian population. © 2015 Asian Pacific Society of Nephrology.

Heart Rate Response to a Timed Walk & Cardiovascular Outcomes in Older Adults: The Cardiovascular Health Study

PubMed Central

Girotra, Saket; Kitzman, Dalane W.; Kop, Willem J.; Stein, Phyllis K.; Gottdiener, John S.; Mukamal, Kenneth J.

2012-01-01

OBJECTIVES To determine the relationship between heart rate response during low-grade physical exertion (six-minute walk) with mortality and adverse cardiovascular outcomes in the elderly. METHODS Participants in the Cardiovascular Health Study, who completed a six-minute walk test, were included. We used delta heart rate (difference between post-walk heart rate and resting heart rate) as a measure of chronotropic response and examined its association with 1) all-cause mortality and 2) incident coronary heart disease (CHD) event, using multivariable Cox regression models. RESULTS We included 2224 participants (mean age 77±4 years; 60% women, 85% white). The average delta heart rate was 26 beats/min. Participants in the lowest tertile of delta heart rate (<20 beats/min) had higher risk-adjusted mortality (hazard ratio [HR] 1.18; 95% confidence interval [CI][1.00, 1.40]) and incident CHD (HR 1.37; 95% CI[1.05, 1.78]) compared to subjects in the highest tertile (≥30 beats/min), with a significant linear trend across tertiles (P for trend <0.05 for both outcomes). This relationship was not significant after adjustment for distance walked. CONCLUSION Impaired chronotropic response during six-minute walk test was associated with an increased risk of mortality and incident CHD among the elderly. This association was attenuated after adjusting for distance walked. PMID:22722364

Modifiable Lifestyle Risk Factors and Incident Diabetes in African Americans.

PubMed

Joseph, Joshua J; Echouffo-Tcheugui, Justin B; Talegawkar, Sameera A; Effoe, Valery S; Okhomina, Victoria; Carnethon, Mercedes R; Hsueh, Willa A; Golden, Sherita H

2017-11-01

The associations of modifiable lifestyle risk factors with incident diabetes are not well investigated in African Americans (AAs). This study investigated the association of modifiable lifestyle risk factors (exercise, diet, smoking, TV watching, and sleep-disordered breathing burden) with incident diabetes among AAs. Modifiable lifestyle risk factors were characterized among 3,252 AAs in the Jackson Heart Study who were free of diabetes at baseline (2000-2004) using baseline questionnaires and combined into risk factor categories: poor (0-3 points), average (4-7 points), and optimal (8-11 points). Incidence rate ratios (IRR) for diabetes (fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes drugs, or glycosylated hemoglobin A1c ≥6.5%) were estimated using Poisson regression modeling adjusting for age, sex, education, occupation, systolic blood pressure, and BMI. Outcomes were collected 2005-2012 and data analyzed in 2016. Over 7.6 years, there were 560 incident diabetes cases (mean age=53.3 years, 64% female). An average or optimal compared to poor risk factor categorization was associated with a 21% (IRR=0.79, 95% CI=0.62, 0.99) and 31% (IRR=0.69, 95% CI=0.48, 1.01) lower risk of diabetes. Among participants with BMI <30, IRRs for average or optimal compared to poor categorization were 0.60 (95% CI=0.40, 0.91) and 0.53 (95% CI=0.29, 0.97) versus 0.90 (95% CI=0.67, 1.21) and 0.83 (95% CI=0.51, 1.34) among participants with BMI ≥30. A combination of modifiable lifestyle factors are associated with a lower risk of diabetes among AAs, particularly among those without obesity. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Trends of Occupational Fatalities Involving Machines, United States, 1992–2010

PubMed Central

Marsh, Suzanne M.; Fosbroke, David E.

2016-01-01

Background This paper describes trends of occupational machine-related fatalities from 1992–2010. We examine temporal patterns by worker demographics, machine types (e.g., stationary, mobile), and industries. Methods We analyzed fatalities from Census of Fatal Occupational Injuries data provided by the Bureau of Labor Statistics to the National Institute for Occupational Safety and Health. We used injury source to identify machine-related incidents and Poisson regression to assess trends over the 19-year period. Results There was an average annual decrease of 2.8% in overall machine-related fatality rates from 1992 through 2010. Mobile machine-related fatality rates decreased an average of 2.6% annually and stationary machine-related rates decreased an average of 3.5% annually. Groups that continued to be at high risk included older workers; self-employed; and workers in agriculture/forestry/fishing, construction, and mining. Conclusion Addressing dangers posed by tractors, excavators, and other mobile machines needs to continue. High-risk worker groups should receive targeted information on machine safety. PMID:26358658

The impact of breast cancer-specific birth cohort effects among younger and older Chinese populations.

PubMed

Sung, Hyuna; Rosenberg, Philip S; Chen, Wan-Qing; Hartman, Mikael; Lim, Wei-Yen; Chia, Kee Seng; Wai-Kong Mang, Oscar; Tse, Lapah; Anderson, William F; Yang, Xiaohong R

2016-08-01

Historically low breast cancer incidence rates among Asian women have risen worldwide; purportedly due to the adoption of a "Western" life style among younger generations (i.e., the more recent birth cohorts). However, no study has simultaneously compared birth cohort effects between both younger and older women in different Asian and Western populations. Using cancer registry data from rural and urban China, Singapore and the United States (1990-2008), we estimated age-standardized incidence rates (ASR), annual percentage change (EAPC) in the ASR, net drifts, birth cohort specific incidence rates and cohort rate ratios (CRR). Younger (30-49 years, 1943-1977 birth cohorts) and older women (50-79 years; 1913-1957 birth cohorts) were assessed separately. CRRs among Chinese populations were estimated using birth cohort specific rates with US non-Hispanic white women (NHW) serving as the reference population with an assigned CRR of 1.0. We observed higher EAPCs and net drifts among those Chinese populations with lower ASRs. Similarly, we observed the most rapidly increasing cohort-specific incidence rates among those Chinese populations with the lowest baseline CRRs. Both trends were more significant among older than younger women. Average CRRs were 0.06-0.44 among older and 0.18-0.81 among younger women. Rapidly rising cohort specific rates have narrowed the historic disparity between Chinese and US NHW breast cancer populations particularly in regions with the lowest baseline rates and among older women. Future analytic studies are needed to investigate risk factors accounting for the rapid increase of breast cancer among older and younger women separately in Asian populations. © 2016 UICC.

Increasing rates of diabetes amongst status Aboriginal youth in Alberta, Canada

PubMed Central

Oster, Richard T.; Johnson, Jeffrey A.; Balko, Stephanie U.; Svenson, Larry W.; Toth, Ellen L.

2012-01-01

Objectives To track and compare trends in diabetes rates from 1995 to 2007 for Status Aboriginal and general population youth. Study design Longitudinal observational research study (quantitative) using provincial administrative data. Methods De-identified data was obtained from Alberta Health and Wellness administrative databases for Status Aboriginal (First Nations and Inuit people with Treaty status) and general population youth (<20 years). Diabetes cases were identified using the National Diabetes Surveillance System algorithm. Crude annual diabetes prevalence and incidence rates were calculated. The likelihood of being a prevalent case and incident case of diabetes for the 2 populations was compared for the year 2007. Average Annual Percent Changes (AAPC) in prevalence and incidence from 1995 to 2007 were determined and compared between the 2 groups to examine trends over time. Results While the prevalence of diabetes was higher in the general population in 1995, by 2007 there were no between group differences, reflected in the significantly higher AAPC of 6.98 for Status Aboriginal youth. Status Aboriginal males had a lower diabetes risk in 1995 compared with females, and experienced a greater increase in prevalence over the 13 years (AAPC 9.18) so that by 2007 their rates were equivalent to those of the females. Differences in diabetes incidence trends were only observed among male youth, where increases in incidence were greater for Status Aboriginal (AAPC 11.65) compared to general population males (AAPC 4.62) (p = 0.03). Conclusion Youth-onset diabetes is an increasing problem in Alberta, especially among young Status Aboriginal males. PMID:22584517

Geriatric cancer trends in the Middle-East: Findings from Lebanese cancer projections until 2025.

PubMed

Haddad, Fady Gh; Kattan, Joseph; Kourie, Hampig R; El Rassy, Elie; Assi, Tarek; Adib, Salim M

2018-03-01

By 2020, 70% of all cancers will occur in patients aged 65years and older, causing an increase in related morbidity, mortality, and cost. This study projects cancer trends in the elderly population in Lebanon, a country experiencing accelerating aging trends. Findings will guide future policy decisions regarding geriatric oncology in Lebanon and the surrounding Arab world. Cancer incidence rates were derived for men and women 65years and above, divided into three age groups: 65-69years, 70-74years, and 75years and above. Raw data were obtained from the National Cancer Registry reports 2003-2010. The eight consecutive year data were used to project the incidence until 2025 using a logarithmic model. The Average Annual Percent Change in incidence rates was calculated to determine whether it would significantly increase, decrease, or remain stable over time. Incidence rates are projected to increase significantly in all age groups of both genders until 2025. In men, the fastest rise is expected in prostate cancer, followed by bladder, lung, colorectal, and NHL. In women, the rise will be fastest in breast, followed by colorectal, lung, NHL, and ovary. Projected rates increase faster in the "younger" age group 65-69 compared to the "oldest" ≥75, both in men and women. Only kidney and liver cancers continue to rise significantly after 75. Cancer incidence is projected to increase in individuals between 65 and 74years of age. Lebanese and Middle Eastern physicians must implement adapted therapeutic strategies in the management of the increasing caseload among frail, elderly patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Occupational disease among non-governmental employees in Malaysia: 2002-2006.

PubMed

Abas, Adinegara Bin Lutfi; Said, Abdul Razzak Bin Mohd; Mohammed, Mohammed Azman Bin Aziz; Sathiakumar, Nalini

2008-01-01

In the absence of systematic occupational disease surveillance, other data collected by governmental agencies or industry is useful in the identification of occupational diseases and their control. We examined data on occupational diseases reported by non-governmental employees to the national workers' social security organization in Malaysia, 2002-2006. The overall incidence rate of occupational disease was 2.8 per 100,000 workers. There was an increase in the annual number and rates of occupational disease over time. The most frequently reported conditions were hearing impairment (32%) and musculoskeletal disorders (28%). Workers in the non-metallic manufacturing industry had the highest average incidence rate of hearing impairment (12.7 per 100,000 workers) and musculoskeletal disorders (3.5 per 100,000 workers), compared to all other industries. Preventive measures should focus on safety education, engineering control and workplace ergonomics. Enforcing workplace standards and incorporating an ongoing surveillance system will facilitate the control and reduction of occupational disease.

Brain Arterial Diameters as a Risk Factor for Vascular Events.

PubMed

Gutierrez, Jose; Cheung, Ken; Bagci, Ahmet; Rundek, Tatjana; Alperin, Noam; Sacco, Ralph L; Wright, Clinton B; Elkind, Mitchell S V

2015-08-06

Arterial luminal diameters are routinely used to assess for vascular disease. Although small diameters are typically considered pathological, arterial dilatation has also been associated with disease. We hypothesize that extreme arterial diameters are biomarkers of the risk of vascular events. Participants in the Northern Manhattan Study who had a time-of-flight magnetic resonance angiography were included in this analysis (N=1034). A global arterial Z-score, called the brain arterial remodeling (BAR) score, was obtained by averaging the measured diameters within each individual. Individuals with a BAR score <-2 SDs were considered to have the smallest diameters, individuals with a BAR score >-2 and <2 SDs had average diameters, and individuals with a BAR score >2 SDs had the largest diameters. All vascular events were recorded prospectively after the brain magnetic resonance imaging. Spline curves and incidence rates were used to test our hypothesis. The association of the BAR score with death (P=0.001), vascular death (P=0.02), any vascular event (P=0.05), and myocardial infarction (P=0.10) was U-shaped except for ischemic stroke (P=0.74). Consequently, incidence rates for death, vascular death, myocardial infarction, and any vascular event were higher in individuals with the largest diameters, whereas individuals with the smallest diameters had a higher incidence of death, vascular death, any vascular event, and ischemic stroke compared with individuals with average diameters. The risk of death, vascular death, and any vascular event increased at both extremes of brain arterial diameters. The pathophysiology linking brain arterial remodeling to systemic vascular events needs further research. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

[Impact of intrauterine device insertion surgery on women's mental state].

PubMed

Chu, Guang-hua; Zou, Yan; Wang, Xiao-ye; Li, Su-xia; Huang, Zi-rong; Fang, Ai-hua; Tian, Ai-ping

2013-06-01

To evaluate the impact of the intrauterine device (IUD) insertion on the mental state of women. From Jan. 2009 to Jun. 2010, a multi-center clinical observational study was performed. Totally 641 women were selected in the six provinces' 18 family planning service stations and hospitals for IUD insertion surgery study. Analysis of the change of women's mental state which was evaluated by symptom checklist-90 (SCL-90) scale before and after IUD insertion surgery. Before and after IUD insertion surgery, 10 factors' scores in SCL-90 of the observed objects were between 1.1 to 1.2, total scores were 107±27 and 105±25, respectively. Before and after surgery, total average score both were 1.2, the average score of positive items both were 2.1. The difference of the above results were not statistically significance (all P>0.05). Preoperative and postoperative, the rate of positive items was 9.2%-19.6% and 7.7%-17.6%, respectively.In addition to anxiety and fear, the rate of other factors' positive items postoperative was significantly lower than those in the preoperative (all P<0.05). The incidence of the observed objects postoperative of each factor score, "deteriorated" was in the range of 4.9% to 23.0%, "improved" was in the range of 26.3%-50.1%. The incidence of total scores, "deterioration" was 28.8% (166/575), "improved" was 45.6% (262/575). The incidence of the average score of positive items, "deterioration" was 3.7% (21/575), "improved" was 52.3% (301/575). Logistic analysis showed that, in addition to unit level, there were no other significant influencing factors for women' mental state of postoperative (all P>0.05). IUD insertion surgery has no adverse effect on women's mental state.

First report on the nationwide incidence of type 1 diabetes and ketoacidosis at onset in children in Serbia: a multicenter study.

PubMed

Vukovic, Rade; Jesic, Maja D; Vorgucin, Ivana; Stankovic, Sandra; Folic, Nevena; Milenkovic, Tatjana; Sajic, Silvija; Katanic, Dragan; Zivic, Sasa; Markovic, Slavica; Soldatovic, Ivan

2018-05-17

Data regarding incidence of type 1 diabetes (T1DM), as well as data on frequency and severity of diabetic ketoacidosis (DKA) at the time of T1DM diagnosis is of paramount importance for national and regional healthcare planning. The aim of present multicenter study was to provide the first report regarding nationwide annual incidence rates for T1DM in youth in Serbia, as well as prevalence of DKA at the time of diagnosis. Data on all pediatric patients with newly diagnosed T1DM was retrospectively collected from all 15 regional centers for pediatric diabetes in Serbia during the period 2007-2017. During the study period, average-standardized incidence of T1DM in youth < 19 years was 11.82/100,000, and 14.28/100,000 in 0-14 years age group, with an average yearly increase in incidence of 5.9%. High prevalence of DKA (35.1%) at the time of diagnosis was observed, with highest frequency in children aged < 5 years (47.2%). This is the first study reporting the nationwide incidence of T1DM and alarmingly high prevalence of DKA at diagnosis in youth in Serbia. The focus of public health preventive measures should be directed towards the preschoolers, considering the highest frequency and severity of DKA observed in this age group. What is Known: • Knowing regional T1DM incidence is of paramount importance for resource allocation and healthcare services provision. • DKA is the leading cause of acute mortality in youth with T1DM, and public health preventive educational measures could improve early diagnosis and reduce the frequency and severity of DKA at presentation. What is New: • Incidence of pediatric T1DM in Serbia is on the rise, with an average yearly increase of 5.9%. • Worryingly high prevalence of DKA (35.1%) at the time of T1DM diagnosis was observed, with the highest frequency of DKA in children aged < 5 years (47.2%).

Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Technology

PubMed Central

Yang, Ruijie; Wang, Junjie; Zhang, Xile; Sun, Haitao; Gao, Yang; Liu, Lu; Lin, Lei

2014-01-01

Objective. To explore the implementation of incident learning for quality management of radiotherapy in a new established radiotherapy program. Materials and Methods. With reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically established for reporting, investigating, and learning of individual incidents. The incidents that occurred in external beam radiotherapy from February, 2012, to February, 2014, were reported. Results. A total of 28 near misses and 5 incidents were reported. Among them, 5 originated in imaging for planning, 25 in planning, and 1 in plan transfer, commissioning, and delivery, respectively. One near miss/incident was classified as wrong patient, 7 wrong sites, 6 wrong laterality, and 5 wrong dose. Five reported incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, and inadequate training contributed to 19, 15, and 12 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4. Conclusion. Effective implementation of incident learning can reduce the occurrence of near misses/incidents and enhance the culture of safety. PMID:25140309

[Role of placental apoptosis in fetal growth restriction].

PubMed

Liu, Yuan; Gao, Peng; Xie, Yingbo; Wang, Shuyun; Dai, Minsheng; Jiang, Sen

2002-12-01

To determine the relationship of placental cellular apoptosis and pathophysiology of fetal growth restriction (FGR). Placental samples were obtained from 18 pregnancies complicated by FGR and 14 normal pregnancies. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and transmission electron microscopy were used to confirm the occurrence of apoptosis. In FGR group the placental apoptosis rate was (n = 18) 12.1 per thousand, the average placental weight was (236 +/- 24) g, the average birth weight was (2,071 +/- 428) g; In normal group (n = 14), the placental apoptosis rate was 7.3 per thousand, the average placental weight was (354 +/- 63) g, the average birth weight was (3,411 +/- 588) g (P < 0.05). The incidence of apoptosis was significantly higher in placental samples from pregnancies with FGR compared with normal placental samples (P < 0.05). Under transmission election microscopy, apoptosis was obviously compact and the chromatins were formed as mass. These results suggest that apoptosis may play a role in the pathophysiologic mechanisms of FGR.

Real-Time Electronic Tracking of Diarrheal Episodes and Laxative Therapy Enables Verification of Clostridium difficile Clinical Testing Criteria and Reduction of Clostridium difficile Infection Rates.

PubMed

Truong, Cynthia Y; Gombar, Saurabh; Wilson, Richard; Sundararajan, Gopalakrishnan; Tekic, Natasa; Holubar, Marisa; Shepard, John; Madison, Alexandra; Tompkins, Lucy; Shah, Neil; Deresinski, Stan; Schroeder, Lee F; Banaei, Niaz

2017-05-01

Health care-onset health care facility-associated Clostridium difficile infection (HO-CDI) is overdiagnosed for several reasons, including the high prevalence of C. difficile colonization and the inability of hospitals to limit testing to patients with clinically significant diarrhea. We conducted a quasiexperimental study from 22 June 2015 to 30 June 2016 on consecutive inpatients with C. difficile test orders at an academic hospital. Real-time electronic patient data tracking was used by the laboratory to enforce testing criteria (defined as the presence of diarrhea [≥3 unformed stools in 24 h] and absence of laxative intake in the prior 48 h). Outcome measures included C. difficile test utilization, HO-CDI incidence, oral vancomycin utilization, and clinical complications. During the intervention, 7.1% (164) and 9.1% (211) of 2,321 C. difficile test orders were canceled due to absence of diarrhea and receipt of laxative therapy, respectively. C. difficile test utilization decreased upon implementation from an average of 208.8 tests to 143.0 tests per 10,000 patient-days ( P < 0.001). HO-CDI incidence rate decreased from an average of 13.0 cases to 9.7 cases per 10,000 patient-days ( P = 0.008). Oral vancomycin days of therapy decreased from an average of 13.8 days to 9.4 days per 1,000 patient-days ( P = 0.009). Clinical complication rates were not significantly different in patients with 375 canceled orders compared with 869 episodes with diarrhea but negative C. difficile results. Real-time electronic clinical data tracking is an effective tool for verification of C. difficile clinical testing criteria and safe reduction of inflated HO-CDI rates. Copyright © 2017 American Society for Microbiology.

[The development of the incidence of diabetes mellitus I in children 0 to 14 years of age in Malaga (1982-1993)].

PubMed

López Siguero, J P; Martínez-Aedo Ollero, M J; Moreno Molina, J A; Lora Espinosa, A; Martínez Valverde, A

1997-07-01

A prospective study was conducted to assess the evolution of the incidence of type 1 diabetes mellitus (insulin-dependent) in Málaga among children less than 14 years of age between 1982 and 1993. The capture-recapture method was chosen for estimating the probability of ascertainment and two sources were used: The hospital registry and Málaga Diabetes Association members. We detected 437 children and the ascertainment achieved was 98.8%. The average annual incidence was 14.3/10(5) and the prevalence at the end of the period was 0.78 patients/10(3). During the last 6 years of the observation period, the incidence rose by 42%. The highest incidence was found among children between 10 and 13 years of age in both sexes. The age of onset and female/male ratio increased during the study period. There was an inverse relationship with monthly temperature. In comparison with other European epidemiological studies, we found a higher incidence and increased rate of growth of the incidence of type 1 diabetes mellitus during the observation period.

Do pregnancy characteristics contribute to rising childhood cancer incidence rates in the United States?

PubMed

Kehm, Rebecca D; Osypuk, Theresa L; Poynter, Jenny N; Vock, David M; Spector, Logan G

2018-03-01

Since 1975, childhood cancer incidence rates have gradually increased in the United States; however, few studies have conducted analyses across time to unpack this temporal rise. The aim of this study was to test the hypothesis that increasing cancer incidence rates are due to secular trends in pregnancy characteristics that are established risk factors for childhood cancer incidence including older maternal age, higher birthweight, and lower birth order. We also considered temporal trends in sociodemographic characteristics including race/ethnicity and poverty. We conducted a time series county-level ecologic analysis using linked population-based data from Surveillance, Epidemiology, and End Results cancer registries (1975-2013), birth data from the National Center for Health Statistics (1970-2013), and sociodemographic data from the US Census (1970-2010). We estimated unadjusted and adjusted average annual percent changes (AAPCs) in incidence of combined (all diagnoses) and individual types of cancer among children, ages 0-4 years, from Poisson mixed models. There was a statistically significant unadjusted temporal rise in incidence of combined childhood cancers (AAPC = 0.71%; 95% CI = 0.55-0.86), acute lymphoblastic leukemia (0.78%; 0.49-1.07), acute myeloid leukemia (1.86%; 1.13-2.59), central nervous system tumors (1.31%; 0.94-1.67), and hepatoblastoma (2.70%; 1.68-3.72). Adjustment for county-level maternal age reduced estimated AAPCs between 8% (hepatoblastoma) and 55% (combined). However, adjustment for other county characteristics did not attenuate AAPCs, and AAPCs remained significantly above 0% in models fully adjusted for county-level characteristics. Although rising maternal age may account for some of the increase in childhood cancer incidence over time, other factors, not considered in this analysis, may also contribute to temporal trends. © 2017 Wiley Periodicals, Inc.

Attenuated Heart Rate Recovery After Exercise Testing and Risk of Incident Hypertension in Men.

PubMed

Jae, Sae Young; Bunsawat, Kanokwan; Fadel, Paul J; Fernhall, Bo; Choi, Yoon-Ho; Park, Jeong Bae; Franklin, Barry A

2016-09-01

Although attenuated heart rate recovery (HRR) and reduced heart rate (HR) reserve to maximal exercise testing are associated with adverse cardiovascular outcomes, their relation to incident hypertension in healthy normotensive populations is unclear. We examined the hypothesis that both attenuated HRR and reduced HR reserve to exercise testing are associated with incident hypertension in men. A total of 1,855 participants were selected comprising of healthy, initially normotensive men who underwent peak or symptom-limited treadmill testing at baseline. HRR was calculated as the difference between peak HR during exercise testing and the HR at 2 minutes after exercise cessation. HR reserve was calculated as the percentage of HR reserve (peak HR - resting HR)/(220 - age - resting HR) × 100. During an average 4-year follow-up, 179 (9.6%) men developed hypertension. Incident hypertension was associated with HRR quartiles (Q1 (<42 (bpm)) 12.5%, Q2 (43-49 bpm) 8.5%, Q3 (50-56 bpm) 9.3%, and Q4 (>57 bpm) 8.3%; P = 0.05 for trend). The relative risk (RR) of the incident hypertension in the slowest HRR quartile vs. the fastest HRR quartile was 1.78 (95% confidence interval (CI): 1.14-2.78) after adjustment for confounders. Every 1 bpm increment in HRR was associated with a 2% (RR 0.98, 95% CI: 0.97-0.99) lower risk of incident hypertension after adjusting for potential confounders. In contrast, reduced HR reserve did not predict the risk of incident hypertension. Slow HRR after exercise testing is independently associated with the development of hypertension in healthy normotensive men. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Tuberculosis in migrants in low-incidence countries: epidemiology and intervention entry points.

PubMed

Lönnroth, K; Mor, Z; Erkens, C; Bruchfeld, J; Nathavitharana, R R; van der Werf, M J; Lange, C

2017-06-01

As tuberculosis (TB) rates continue to decline in native populations in most low TB incidence countries, the proportion of TB patients born outside their country of residence ('foreign-born') increases. Some low-incidence countries have experienced a substantial increase in TB rates related to recent increases in the number of asylum seekers and other migrants from TB-endemic countries. However, average TB rates among the foreign-born in low-incidence countries declined moderately in 2009-2015. TB in foreign-born individuals is commonly the result of reactivation of latent infection with Mycobacterium tuberculosis acquired outside the host country. Transmission is generally low in low-incidence countries, and transmission from migrants to the native population is often modest. Variations in levels and trends in TB notifications among the foreign-born are likely explained by differences and fluctuations in the number and profile of migrants, as well as by variations in TB control, health and social policies in the host countries. To optimise TB care and prevention in migrants from endemic to low-incidence countries, we propose a framework for identifying possible TB care and prevention interventions before, during and after migration. Universal access to high-quality care along the entire migration pathway is critical. Screening for active TB and latent tuberculous infection should be tailored to the TB epidemiology, adapted to the needs of specific migrant groups and linked to treatment. Ultimately, the long-term TB elimination goal can be reached only if global health and socio-economic inequalities are dramatically reduced. Low-incidence countries, most of which are among the wealthiest nations, need to contribute through international assistance.

[Environment and health in Taranto, southern Italy: epidemiological studies and public health recommendations].

PubMed

Comba, Pietro; Pirastu, Roberta; Conti, Susanna; De Santis, Marco; Iavarone, Ivano; Marsili, Giovanni; Mincuzzi, Antonia; Minelli, Giada; Manno, Valerio; Minerba, Sante; Musmeci, Loredana; Rashid, Ivan; Soggiu, Eleonora; Zona, Amerigo

2012-01-01

in Taranto IPS (Italian polluted site, made up of 2 municipalities) the Decree defining site boundaries lists the presence of a refinery, a steel plant, a harbour area and waste landfills together with illegal dumping sites. Previous environmental and epidemiological investigations in the area documented the presence of environmental contamination and increased mortality from respiratory and cardiovascular diseases as well as a number of cancer sites; for these same health outcomes the cohort study of residents showed increased risk both in terms of mortality and morbidity. to describe the health status of residents in Taranto IPS analyzing different health indicators available at municipal level, i.e. mortality (2003-2009), mortality time trend (1980-2008) and cancer incidence (2006-2007). the analyses were carried out for residents in Taranto IPS. Mortality update (SENTIERI Project, 2003-2009) regards 63 single or grouped causes (all ages, both genders); for a selection of causes 0-1 and 0-14 age classes were analyzed (both genders combined). Standardized mortality ratio crude (SMR) and deprivation adjusted together with 90% confidence intervals (90%CI) were computed using regional rates for comparison. Mortality time trend (1980-2008, triennial intervals) were analyzed calculating standardized rates (0-99 years, both genders, per 100,000, Italian population at 2001 Census as reference) and 90%CI. Time trends were computed for all causes, all neoplasms (and lung cancer), cardiovascular diseases (and ischemic heart diseases), respiratory diseases (also acute and chronic) and all causes infant mortality (both genders combined). For cancer incidence (2006-2007) Standardized incidence ratio (SIR) and 90%CI were calculated for both genders; incidence rates of cancer registries of the macroarea South and Islands (2005-2007) and rates of Taranto Province excluding SIN municipalities (2006-2007) were used for comparison. in Taranto IPS mortality among men is in excess in both periods (SENTIERI Project 1995-2002 and 2003-2009) for all causes, all neoplasms (including lung and pleural cancer), dementia, cardiovascular diseases (including hypertension and ischemic heart diseases), respiratory diseases (including the acute ones) and digestive diseases (including liver cirrhosis). All causes infant mortality is in excess in both periods. Time trends show that Taranto IPS rates are higher than regional average in the majority of time intervals for most causes in both genders. Rates are often higher than national average form any triennial intervals. Among males, over the whole period, mortality in Taranto IPS is higher than regional and national average for causes as lung cancer, diseases of the respiratory system, including the chronic ones. Among females, since the early Nineties, lung cancer and ischemic heart diseases are in excess in Taranto IPS. Also infant mortality is higher for the whole period in Taranto IPS than regional and national averages. Cancer incidence results show excesses for cancer sites already indicated by mortality data. mortality analyzed in the context of SENTIERI Project (1995-2002 and 2003-2009), time trend mortality (1980-2008) and cancer incidence (2006- 2007) show, in both genders, excesses for causes for which an etiologic role of environmental exposure present in Taranto IPS are either ascertained or suspected on the basis of a priori evaluation of the epidemiological evidence. The finding of excess infant mortality is of the utmost importance in public health terms. Most diseases showing an increased risk have multifactorial etiology, therefore interventions of proven efficacy, such as smoking cessation, food education, measures for cardiovascular risk reduction and breast cancer and colon screening programmes should be planned. To build a climate of confidence and trust between citizens and public institutions study results and public health actions are to be communicated objectively and transparently.

Acute pesticide poisoning among children in South Korea: findings from National Health Insurance claims data, 2006-2009.

PubMed

Lee, Won Jin; Ko, Yousun; Cha, Eun Shil

2014-02-01

The aim of this study was to estimate the incidence of acute pesticide poisoning among children in South Korea and describe the related epidemiologic characteristics. We evaluated the age-standardized rates of incidence of pesticide poisoning among children in South Korea from 2006 through 2009 using National Health Insurance claims data. A total of 1232 children aged 0-14 years were identified from the acute pesticide poisoning cases reported across South Korea during the study period. The annual average age-standardized rate of incidence from acute pesticide poisoning was 3.6 per 100 000. The majority of the cases were identified in the categories of the 1-4-year-old age-group (56.5%), outpatients (80.0%), single-day visit to a hospital (70.4%) and summer occurrence (43.3%). Acute pesticide poisoning is prevalent among children in South Korea; therefore, intervention efforts are needed to reduce the cases of pesticide poisoning among children.

Water quality of the tidal Potomac River and Estuary; hydrologic data report supplement, 1979 through 1981 water years

USGS Publications Warehouse

Coupe, R.H.; Webb, W.E.

1984-01-01

This report is a companion report to the U.S. Geological Survey 1979, 1980, and 1981 Hydrologic Data Reports of the tidal Potomac River and Estuary. It contains values of biochemical oxygen demand and specific rate constants, incident light and light attenuation measurements; numbers of phytoplankton, fecal coliform and fecal streptococci, cross-sectional averages from field measurements of dissolved oxygen, pH, specific conductance , and temperature data; and cross-sectional averages of chlorophyll data. Sewage treatment plant loads are also included. (USGS)

Estimating Ten-Year Trends in Septic Shock Incidence and Mortality in United States Academic Medical Centers Using Clinical Data.

PubMed

Kadri, Sameer S; Rhee, Chanu; Strich, Jeffrey R; Morales, Megan K; Hohmann, Samuel; Menchaca, Jonathan; Suffredini, Anthony F; Danner, Robert L; Klompas, Michael

2017-02-01

Reports that septic shock incidence is rising and mortality rates declining may be confounded by improving recognition of sepsis and changing coding practices. We compared trends in septic shock incidence and mortality in academic hospitals using clinical vs claims data. We identified all patients with concurrent blood cultures, antibiotics, and vasopressors for ≥ two consecutive days, and all patients with International Classification of Diseases, 9th edition (ICD-9) codes for septic shock, at 27 academic hospitals from 2005 to 2014. We compared annual incidence and mortality trends. We reviewed 967 records from three hospitals to estimate the accuracy of each method. Of 6.5 million adult hospitalizations, 99,312 (1.5%) were flagged by clinical criteria, 82,350 (1.3%) by ICD-9 codes, and 44,651 (0.7%) by both. Sensitivity for clinical criteria was higher than claims (74.8% vs 48.3%; P < .01), whereas positive predictive value was comparable (83% vs 89%; P = .23). Septic shock incidence, based on clinical criteria, rose from 12.8 to 18.6 cases per 1,000 hospitalizations (average, 4.9% increase/y; 95% CI, 4.0%-5.9%), while mortality declined from 54.9% to 50.7% (average, 0.6% decline/y; 95% CI, 0.4%-0.8%). In contrast, septic shock incidence, based on ICD-9 codes, increased from 6.7 to 19.3 per 1,000 hospitalizations (19.8% increase/y; 95% CI, 16.6%-20.9%), while mortality decreased from 48.3% to 39.3% (1.2% decline/y; 95% CI, 0.9%-1.6%). A clinical surveillance definition based on concurrent vasopressors, blood cultures, and antibiotics accurately identifies septic shock hospitalizations and suggests that the incidence of patients receiving treatment for septic shock has risen and mortality rates have fallen, but less dramatically than estimated on the basis of ICD-9 codes. Copyright © 2016 American College of Chest Physicians. All rights reserved.

Continuing communicable disease burden in Eritrea.

PubMed

Mufunda, J; Nyarango, P; Kosia, A; Ogbamariam, A; Mebrahtu, G; Usman, A; Gebresillosie, S; Goitom, S; Araya, E; Andemichael, G; Gebremichael, A

2006-03-01

A retrospective study of the national health profile of Eritreans, focusing on acute respiratory tract infection (ARTI), tuberculosis (TB), diarrhoea, sexually transmitted diseases (STDs) and HIV/AIDS, was done on data from 1998 to 2003 through a health information management system. Records were included for patients of all ages receiving outpatient and inpatient hospital services during the study period. All incidence rates were given as cases per 100,000 population. The incidence of ARTI increased from 6,500 cases per annum in 1998 to 8 500 in 2003, representing a 30% increase. Diarrhoea rates remained unchanged, averaging 3,000 cases. For both ARTI and diarrhoea, rates were at least 3 times higher in children under 5 years of age than in those over 5 years of age. The incidences of TB and STDs decreased from 370 and 220 in 1998 to 170 and 80 in 2003, respectively. HIV/AIDS incidence increased from 40 in 1998 to 65 in 2003, reflecting a 60% increase. The case fatality rates (CFRs) for HIV/AIDS and TB were 12% and 2% in 1998, increasing to 14% and 3%, respectively, in 2001. The CFR for ARTI and diarrhea remained low at 0.3%. CFRs were higher in children under 5 years than in those over 5 years for all the diseases but rates declined consistently, probably reflecting the positive impact of the introduction of the integrated management of childhood illness (IMCI). Although the incidence rate of HIV/AIDS was relatively low compared with rates for TB, ARTI and diarrhoea, the HIV/AIDS CFR was relatively high, posing a threat to the gains made in control of infectious diseases. The disease burden from TB and STDs declined over the 6-year study period, while that from ARTI and HIV/AIDS increased. Consequently the overall disease burden from communicable diseases remained unchanged over the study period.

Incidence and survival of hematological cancers among adults ages ≥75 years.

PubMed

Krok-Schoen, Jessica L; Fisher, James L; Stephens, Julie A; Mims, Alice; Ayyappan, Sabarish; Woyach, Jennifer A; Rosko, Ashley E

2018-04-13

Evaluating population-based data of hematologic malignancies (HMs) in older adults provides prognostic information for this growing demographic. Incidence rates and one- and five-year relative survival rates were examined for specific HMs among adults ages ≥75 years using data from the Surveillance, Epidemiology and End Results (SEER) Program. Hematologic malignancy cases (Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), multiple myeloma (MM), acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML)) were reported to one of 18 SEER registries. Recent average annual (2010-2014) incidence rates and incidence trends from 1973 to 2014 were examined for cases ages ≥75 years. One- and five-year relative cancer survival rates were examined for adults ages ≥75 years diagnosed 2007-2013, with follow-up into 2014. From 1973 to 2014, incidence rates increased for NHL, MM, and AML, decreased for HL, and remained relatively stable for ALL, CLL, and CML among adults ages ≥75 years. The highest one- and five-year relative survival rates were observed among adults with CLL ages 75-84 years (1 year: 91.8% (95% CI = 91.8-90.8)) and 5 years: 76.5% (95% CI = 74.2-78.6)). The lowest one- and five-year survival rates were observed among adults with AML ages 75-84 (1 year: 18.2% (95% CI = 74.2-78.6) and 5 years: 2.7% (95% CI = 2.0-3.6)). Survival for older adults ages ≥75 years with HMs is poor, particularly for acute leukemia. Understanding the heterogeneity in HM outcomes among older patients may help clinicians better address the hematological cancer burden and mortality in the aging population. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks.

PubMed

Kim, Hee Jin; Chun, Byung Chul; Kwon, AmyM; Lee, Gyeong-Ho; Ryu, Sungweon; Oh, Soo Yeon; Lee, Jin Beom; Yoo, Se Hwa; Kim, Eui Sook; Kim, Je Hyeong; Shin, Chol; Lee, Seung Heon

2015-10-01

The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. The mean duration of follow-up was 3.9±0.9 years. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ ≥ 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.

Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002–20121

PubMed Central

Strollo, Sara; Lionakis, Michail S.; Adjemian, Jennifer; Steiner, Claudia A.

2017-01-01

Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis–associated hospitalizations in the United States. We extracted data for 33 states for 2002–2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005–2012 for men (annual change –3.9%) and women (annual change –4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease. PMID:27983497

Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002-20121.

PubMed

Strollo, Sara; Lionakis, Michail S; Adjemian, Jennifer; Steiner, Claudia A; Prevots, D Rebecca

2016-01-01

Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis-associated hospitalizations in the United States. We extracted data for 33 states for 2002-2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005-2012 for men (annual change -3.9%) and women (annual change -4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease.

Dose-Rate Effects in Breaking DNA Strands by Short Pulses of Extreme Ultraviolet Radiation.

PubMed

Vyšín, Luděk; Burian, Tomáš; Ukraintsev, Egor; Davídková, Marie; Grisham, Michael E; Heinbuch, Scott; Rocca, Jorge J; Juha, Libor

2018-05-01

In this study, we examined dose-rate effects on strand break formation in plasmid DNA induced by pulsed extreme ultraviolet (XUV) radiation. Dose delivered to the target molecule was controlled by attenuating the incident photon flux using aluminum filters as well as by changing the DNA/buffer-salt ratio in the irradiated sample. Irradiated samples were examined using agarose gel electrophoresis. Yields of single- and double-strand breaks (SSBs and DSBs) were determined as a function of the incident photon fluence. In addition, electrophoresis also revealed DNA cross-linking. Damaged DNA was inspected by means of atomic force microscopy (AFM). Both SSB and DSB yields decreased with dose rate increase. Quantum yields of SSBs at the highest photon fluence were comparable to yields of DSBs found after synchrotron irradiation. The average SSB/DSB ratio decreased only slightly at elevated dose rates. In conclusion, complex and/or clustered damages other than cross-links do not appear to be induced under the radiation conditions applied in this study.

Statistical association between cancer incidence and major-cause mortality, and estimated residential exposure to air emissions from petroleum and chemical plants.

PubMed Central

Kaldor, J; Harris, J A; Glazer, E; Glaser, S; Neutra, R; Mayberry, R; Nelson, V; Robinson, L; Reed, D

1984-01-01

An ecologic study design was used to investigate the relationship between exposure to air emissions produced by the petroleum and chemical industries, and average annual cancer incidence and major cause mortality rates among whites in Contra Costa County, California. Estimates for the exposure to major industrial sources of sulfur dioxide, hydrocarbons and oxides of nitrogen were used to subdivide the county by level of exposure to petroleum refinery and chemical plant emissions. Cancer incidence and major cause mortality rates were then calculated for whites in each of the exposure areas. In both males and females, residential exposure to petroleum and chemical air emissions was associated with an increased incidence of cancer of the buccal cavity and pharynx. In males, age-adjusted incidence rates for cancers of the stomach, lung, prostate and kidney and urinary organs were also associated with petroleum and chemical plant air emission exposures. In both sexes, we found a strong positive association between degree of residential exposure and death rates from cardiovascular disease and cancer, and a less strong positive association between exposure and death rates from cerebrovascular disease. There was also a positive association in men for deaths from cirrhosis of the liver. Although these observed associations occurred across areas of similar socioeconomic and broad occupational class, confounding variables and the "ecologic fallacy" must be considered as possible explanations. In particular, the stronger findings in men suggest an occupational explanation of the cancer incidence trends, and the effect observed in cirrhosis mortality suggests that lifestyle variables such as alcohol consumption were not adequately controlled for. While the public health implications of our findings remain unclear, the evidence presented is sufficient to warrant follow-up studies based on individual data in which possible biases can be more readily controlled. PMID:6734567

Ethnic and geographic variations in the incidence of pancreatitis and post-pancreatitis diabetes mellitus in New Zealand: a nationwide population-based study.

PubMed

Pendharkar, Sayali A; Mathew, Juby; Zhao, Jinfeng; Windsor, John A; Exeter, Daniel J; Petrov, Maxim S

2017-02-17

To determine the incidence of acute pancreatitis (AP), chronic pancreatitis (CP), and post-pancreatitis diabetes mellitus (DP) in New Zealand, and the effect of ethnic and geographic variations. Data were collected from all district health boards in New Zealand by the Ministry of Health (Manatū Hauora). Diagnosis of AP, CP and DP was determined by the International Classification of Diseases-10 codes. Incidence rates per 100,000 population per year were calculated using incident AP, CP and DP cases as the numerator, and the adult resident population of New Zealand as the denominator. Poisson distribution was used to estimate 95% confidence intervals. The district health board domicile codes and corresponding incidence rates were used to map geographical variations for AP, CP and DP. On average, 2,072 new cases of AP, CP and DP were diagnosed in New Zealand every year. The crude incidence of AP was 58.42 [57.55, 59.30], CP - 3.97 [3.74, 4.20], and DP - 7.95 [7.62, 8.27] per 100,000 population per year. Māori had the highest incidence of AP (95.21 [91.74, 98.68] per 100,000 population per year), CP (6.27 [5.37, 7.16] per 100,000 population per year), and DP (18.23 [16.71, 19.76] per 100,000 population per year). Incidence of AP and DP was at least 1.8 and 2.6 times higher in Māori than New Zealand Europeans in every age group, and incidence of DP was at least 1.9 times higher in Pacific people than New Zealand Europeans in every age group. Auckland/Northland had the highest incidence of AP (135.25 [134.82, 135.68] per 100,000 population), and CP (9.03 [8.60, 9.46] per 100,000 population), while Lakes/Waikato had the highest incidence of DP (20.64 [20.21, 21.07] per 100,000 population) in New Zealand. New Zealanders have a very high incidence rate of AP, with Māori having the highest reported incidence of AP worldwide. There is a significant geographic variation in incidence of pancreatic diseases, with the Upper North Island having the highest incidence rates of AP, CP and DP in the country. Future high-quality studies are required to understand the mechanisms of pancreatitis and DP in order to develop preventive and therapeutic strategies that would benefit New Zealanders in general and Māori in particular.

Estimated incidence rate and distribution of tumours in 4,653 cases of archival submissions derived from the Dutch golden retriever population

PubMed Central

2014-01-01

Background A genetic predisposition for certain tumour types has been proven for some dog breeds. Some studies have suggested that this may also be true for the Golden retriever breed. The present study aimed to examine a possible existence of a tumour (type) predisposition in the Dutch population of Golden retrievers by evaluating annual estimated incidence rates compared to incidence rates from previous publications. A second aim was to evaluate whether incidences of various tumours differed as related to the diagnostic method chosen, being either cytology or histology. Results Tumours submitted to Utrecht University during the period 1998–2004 diagnosed either by means of cytology (n = 2,529) or histology (n = 2,124), were related to an average annual Dutch kennel club population of 29,304 Golden retrievers. Combining individual tumours from both the cytological and the histopathological data-set resulted in an annual estimated incidence rate of 2,242 for 100,000 dog-years at risk regarding tumour development in general. The most common cytological tumor diagnoses were ‘fat, possibly lipoma’ (35%), mast cell tumour (21%) and non-Hodgkin lymphoma (10%). The most commonly diagnosed tumours by histology were mast cell tumour (26%), soft tissue sarcomas (11%) and melanoma (8%). Both the cytological and histopathological data-sets, showed variation; in patient age distribution, age of onset and incidence of various tumours. Conclusion Comparing our data with previous reports in non-breed-specified dog populations, the Golden retriever breed shows an increased risk for the development of tumours in general, as well as an increased risk for the development of specific tumour types, including the group of soft tissue sarcomas. Variations in age, location and incidence of various tumours were observed between the two data-sets, indicating a selection bias for diagnostic procedure. PMID:24484635

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

PubMed Central

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. PMID:27936227

Geographical and temporal patterns of rabies post exposure prophylaxis (PEP) incidence in humans in the Mekong River Delta and Southeast Central Coast regions in Vietnam from 2005 to 2015

PubMed Central

Thiem, Vu Dinh; Anh, Dang Duc; Duong, Tran Nhu; Lee, Mihye; Grace, Delia; Nguyen-Viet, Hung

2018-01-01

Background In Vietnam, rabies has been a notifiable disease for more than 40 years. Over the last five years, on average, more than 350,000 people per year have been bitten by dogs and cats while more than 80 human deaths have been reported yearly. No studies have been conducted to evaluate the geographical and temporal patterns of rabies in humans in Vietnam. Therefore, the main objective of this study was to assess the geographical and temporal distributions of rabies post exposure prophylaxis (PEP) incidence in humans in Vietnam from 2005 to 2015. Methods Average incidence rabies (AIR) PEP rates for every 3 or 4 years (2005–2008, 2009–2012 and 2013–2015) were calculated to describe the spatial distribution of rabies PEP. Hotspot analysis was implemented to identify patterns of spatial significance using the Getis-Ord Gi statistic. For temporal pattern analysis, two regions [Mekong River Delta (MRD) and Southeast Central Coast (SCC)], with the highest incidence rates, and the seasonal-decomposition procedure based on loess (STL), were compared to assess their temporal patterns of rabies PEP. Findings We found hotspots in southern Vietnam and coldspots in northern Vietnam during the study period. Rabies cases were limited to specific areas. In addition, the hotspot analysis showed that new risk areas were identified in each period which were not observed in incidence rate maps. The seasonal plots showed seasonal patterns with a strong peak in February/July and a minor peak in October/December in the MRD region. However, in the SCC, a small peak was detected at the early part of each year and a strong peak in the middle of each year. Conclusion Our findings provide insight into understanding the geographical and seasonal patterns of rabies PEP in Vietnam. This study provides evidence to aid policy makers when making decisions and investing resources. Such information may also be utilized to raise public awareness to prevent rabies exposures and reduce unnecessary PEP. PMID:29634746

Nature and frequency of aggressive behaviours among long-term inpatients with schizophrenia: a 6-month report using the modified overt aggression scale.

PubMed

Joyal, Christian C; Gendron, Catherine; Côté, Gilles

2008-07-01

Previous reports of violence rates in psychiatric settings varied substantially. The main goal of this preliminary study was to prospectively record all violent incidents committed by chronic inpatients with schizophrenia (Sz) using a validated instrument. A secondary objective was to confirm that a majority of violent inward incidents were not commonly serious and committed by a minority of recidivistic individuals suffering from neurological damage (ND). The French version of the Modified Overt Aggression Scale was introduced in all wards of a maximum security hospital to describe every violent incident committed by patients (n = 116) with diagnoses of Sz, Sz and ND, or Sz and mental retardation (MR) during a 6-month period (24 hours a day, 7 days a week). Fifty-seven percent of aggressive acts were committed by 15% of patients who were more likely to receive additional diagnoses of ND or MR. Violent patients with Sz and ND were involved in 6 incidents for each individual on average, although most of the incidents were verbal in nature (68%). A high rate (28%) of patients with Sz, without evidence of ND or MR, had assaulted someone at least once during the study period. These results explain in part the high diversity of previous violent rate reviews and support the notion that inward repetitive violence might be more closely related with ND and impulsivity than psychopathology.

Risk factors associated with the incidence rate of clinical mastitis in smallholder dairy cows in the Dar es Salaam region of Tanzania.

PubMed

Kivaria, F M; Noordhuizen, J P T M; Msami, H M

2007-05-01

Smallholder dairy herds around the Dar es Salaam region of Tanzania supply 86% of raw milk consumed by the city dwellers. Previous studies have indicated that clinical mastitis is an important disease affecting smallholder dairy cows and an 18-month questionnaire-based longitudinal field-study was conducted between July 2003 and March 2005 to elucidate risk factors associated with the incidence. A total of 6057 quarter-level observations from 317 lactating cows on 87 randomly selected smallholder dairy herds were analysed at the quarter and cow level using logistic and Poisson regression models, respectively. At the quarter level, the average incidence rate of clinical mastitis was 38.4 cases per 100 quarter-years at risk whereas at the cow level the incidence rate was 43.3 cases per 100 cow-years at risk. The incidence was significantly (P< or =0.001) associated with cow factors (body condition score, parity, stage of lactation, and udder consistency), housing (floor type) conditions and milking (cow and udder preparation) practices. It was concluded that the extrapolation of the classic ten-point mastitis control plan into smallholder dairy herds should be undertaken cautiously. An integrated approach to dairy extension should focus more on the creation of mastitis awareness among smallholder producers and on the improvement of animal nutrition and reproduction indices-factors that may also have a direct impact on milk yield.

Correlation Analysis of Cocoa Consumption Data with Worldwide Incidence Rates of Testicular Cancer and Hypospadias

PubMed Central

Giannandrea, Fabrizio

2009-01-01

The underlying reasons for the increasing occurrence of male reproductive diseases (MRD) such as hypospadias, cryptorchidism, and testicular cancer (TC) over the last decades are still unknown. It has been hypothesized that the risk of MRD is determined in utero and that pregnancy dietary intake could also affect MRD risk in the offspring. Various studies in animals reported that cocoa and theobromine, the main stimulant of cocoa, exert toxic effects on the testis, inducing testicular atrophy and impaired sperm quality. A correlation analysis was conducted to examine the possible role of cocoa consumption on the occurrence of selected MRD during the prenatal and early life period of cases. The incidence rates between 1998–2002 of TC in 18 countries obtained from Cancer Incidence in Five Continents were correlated with the average per-capita consumption of cocoa (kg/capita/year) (FAOSTAT-Database) in these countries from 1965 to 1980, i.e. the period corresponding to the early life of TC cases. In order to test the above correlation in the case of hypospadias, the mean prevalence at birth in 20 countries (1999–2003) with average per-capita consumption of cocoa in these countries in the same period corresponding to pregnancy were used. The consumption of cocoa in the period 1965–80, was most closely correlated with the incidence of TC in young adults (r=0.859; p<0.001). An analogous significant correlation was also observed between early cocoa consumption and the prevalence rates of hypospadias in the period 1999–2003 (r=0.760; p<0.001). Although the ecological approach used in this study cannot provide an answer on the causal relationship between consumption of cocoa in early life and TC and hypospadias, the results are suggestive and indicate the need of further analytic studies to investigate the role of individual exposure to cocoa, particularly during the prenatal and in early life of the patients. PMID:19440400

Correlation analysis of cocoa consumption data with worldwide incidence rates of testicular cancer and hypospadias.

PubMed

Giannandrea, Fabrizio

2009-02-01

The underlying reasons for the increasing occurrence of male reproductive diseases (MRD) such as hypospadias, cryptorchidism, and testicular cancer (TC) over the last decades are still unknown. It has been hypothesized that the risk of MRD is determined in utero and that pregnancy dietary intake could also affect MRD risk in the offspring. Various studies in animals reported that cocoa and theobromine, the main stimulant of cocoa, exert toxic effects on the testis, inducing testicular atrophy and impaired sperm quality. A correlation analysis was conducted to examine the possible role of cocoa consumption on the occurrence of selected MRD during the prenatal and early life period of cases. The incidence rates between 1998-2002 of TC in 18 countries obtained from Cancer Incidence in Five Continents were correlated with the average per-capita consumption of cocoa (kg/capita/year) (FAOSTAT-Database) in these countries from 1965 to 1980, i.e. the period corresponding to the early life of TC cases. In order to test the above correlation in the case of hypospadias, the mean prevalence at birth in 20 countries (1999-2003) with average per-capita consumption of cocoa in these countries in the same period corresponding to pregnancy were used. The consumption of cocoa in the period 1965-80, was most closely correlated with the incidence of TC in young adults (r=0.859; p<0.001). An analogous significant correlation was also observed between early cocoa consumption and the prevalence rates of hypospadias in the period 1999-2003 (r=0.760; p<0.001). Although the ecological approach used in this study cannot provide an answer on the causal relationship between consumption of cocoa in early life and TC and hypospadias, the results are suggestive and indicate the need of further analytic studies to investigate the role of individual exposure to cocoa, particularly during the prenatal and in early life of the patients.

Physical Activity and Different Concepts of Fall Risk Estimation in Older People–Results of the ActiFE-Ulm Study

PubMed Central

Klenk, Jochen; Kerse, Ngaire; Rapp, Kilian; Becker, Clemens; Rothenbacher, Dietrich; Peter, Richard; Denkinger, Michael Dieter

2015-01-01

Objectives To investigate the relationship between physical activity and two measures of fall incidence in an elderly population using person-years as well as hours walked as denominators and to compare these two approaches. Design Prospective cohort study with one-year follow-up of falls using fall calendars. Physical activity was defined as walking duration and recorded at baseline over one week using a thigh-worn uni-axial accelerometer (activPAL; PAL Technologies, Glasgow, Scotland). Average daily physical activity was extracted from these data and categorized in low (0–59 min), medium (60–119 min) and high (120 min and more) activity. Setting The ActiFE Ulm study located in Ulm and adjacent regions in Southern Germany. Participants 1,214 community-dwelling older people (≥65 years, 56.4% men). Measurements Negative-binomial regression models were used to calculate fall rates and incidence rate ratios for each activity category each with using (1) person-years and (2) hours walked as denominators stratified by gender, age group, fall history, and walking speed. All analyses were adjusted either for gender, age, or both. Results No statistically significant association was seen between falls per person-year and average daily physical activity. However, when looking at falls per 100 hours walked, those who were low active sustained more falls per hours walked. The highest incidence rates of falls were seen in low-active persons with slow walking speed (0.57 (95% confidence interval (95% CI): 0.33 to 0.98) falls per 100 hours walked) or history of falls (0.60 (95% CI: 0.36 to 0.99) falls per 100 hours walked). Conclusion Falls per hours walked is a relevant and sensitive outcome measure. It complements the concept of incidence per person years, and gives an additional perspective on falls in community-dwelling older people. PMID:26058056

[Comparative analysis of dynamics of health status indexes among school age children of Ukraine in modern conditions].

PubMed

Саргош, Оксана; Четверикова, Оксана; Беликова, Инна; Катрушов, Александр

In the last time, there is a negative dynamics of indicators of the health of the child population in Ukraine in connection with socio-economic problems. The analysis of the data of the incidence and the prevalence of diseases among the children of the Poltava region in comparison with those of Ukraine for the period 2011-2015. In our work are used data of State statistics of incidence and prevalence of diseases among the child population of Ukraine. Analysis of the health status of children in the Poltava region and the country as a whole shows that due last 5 years there has been a destabilization of children's health - the incidence and prevalence of diseases, despite the positive trend, remain high. In the Poltava region for the period of 2011-2015 years there is a steady natural declining of the population (especially among rural residents), which is due to a decreasing in the birth rate and the increase in mortality. The incidence among children in rural areas of the Poltava region is 1000.8 per 1,000 children, which is lower than the average regional rate (1200.4) and significantly lower than the incidence of children in urban areas (1304.7).

Polycyclic Aromatic Hydrocarbons Concentrations in Drinking Water in Villages along the Huai River in China and Their Association with High Cancer Incidence in Local Population.

PubMed

Pan, En Chun; Sun, Hong; Xu, Qiu Jin; Zhang, Qin; Liu, Lin Fei; Chen, Xiao Dong; Xu, Yan

2015-01-01

This study aims to evaluate the carcinogenic risk of PAHs in the drinking water of counties along the Huai River in China and study their associations with high cancer incidence in local population. We investigated 20 villages with high cancer incidence rates as the risk group and 20 villages with low rates as the control group. Water samples from each village were collected in the winter and summer seasons to analyze the concentrations of 16 PAHs. The carcinogenic risks of the PAHs were calculated for each village using a health risk assessment approach. Results showed that PAHs concentrations in 27.2% of the water samples were higher than the allowable values in China. However, no significant difference in water PAHs concentrations was observed between the risk and control groups (P > 0.05), and no correlation was found between water PAHs concentrations and cancer incidence in these villages. The average upper bound carcinogenic risks were less than 1 × 10(-4) in both groups. In conclusion, PAHs were present in the drinking water of the studied villages, but their carcinogenic risks remained within acceptable limits. PAHs in local drinking water might not be the major environmental cause of the high cancer incidences.

Polycyclic Aromatic Hydrocarbons Concentrations in Drinking Water in Villages along the Huai River in China and Their Association with High Cancer Incidence in Local Population

PubMed Central

Pan, En chun; Sun, Hong; Xu, Qiu jin; Zhang, Qin; Liu, Lin fei; Chen, Xiao dong; Xu, Yan

2015-01-01

This study aims to evaluate the carcinogenic risk of PAHs in the drinking water of counties along the Huai River in China and study their associations with high cancer incidence in local population. We investigated 20 villages with high cancer incidence rates as the risk group and 20 villages with low rates as the control group. Water samples from each village were collected in the winter and summer seasons to analyze the concentrations of 16 PAHs. The carcinogenic risks of the PAHs were calculated for each village using a health risk assessment approach. Results showed that PAHs concentrations in 27.2% of the water samples were higher than the allowable values in China. However, no significant difference in water PAHs concentrations was observed between the risk and control groups (P > 0.05), and no correlation was found between water PAHs concentrations and cancer incidence in these villages. The average upper bound carcinogenic risks were less than 1 × 10−4 in both groups. In conclusion, PAHs were present in the drinking water of the studied villages, but their carcinogenic risks remained within acceptable limits. PAHs in local drinking water might not be the major environmental cause of the high cancer incidences. PMID:26688818

Breast cancer age at diagnosis patterns in four Latin American Populations: A comparison with North American countries.

PubMed

Franco-Marina, Francisco; López-Carrillo, Lizbeth; Keating, Nancy L; Arreola-Ornelas, Hector; Marie Knaul, Felicia

2015-12-01

In the Latin America countries (LAC), one in five breast cancer (BC) cases occur in women younger than 45 years, almost twice the frequency seen in developed countries. Most BC cases in younger women are premenopausal and are generally more difficult to detect at early stages and to treat than postmenopausal cancers. We employ data from four high quality population-based registries located in LAC and assess the extent to which the higher frequency of BC occurring in younger women is due to a younger population structure, compared to that of developed countries. Next, we analyze secular and generational trends of incidence rates in search for additional explanations. Using data from the International Agency for Research on cancer, between 1988 and 2007, the age distribution of BC incident cases for registries located in Brazil, Colombia, Costa Rica, Ecuador is compared to that of USA and Canadian registries, both before and after removing differences in population age structure. An age-period-cohort modelling of incidence rates is also conducted in all compared registries to identify secular and generational effects. BC incident cases in the LAC registries present, on average, at an earlier age than in the USA and Canadian registries and for 2003-2007, between 20 and 27% of cases occur in women aged 20-44. About two thirds of the difference in age distribution between LAC and USA registries is attributable to the younger age distribution in the LAC base populations. The USA registries show the highest age-specific BC incidence rates of all compared aggregated registries, at all ages. However, in all the LAC registries incidence rates are rapidly increasing, fueled by a strong birth cohort effect. This cohort effect may be explained by important reduction in fertility rates occurring during the second half of the 20th century, but also by a greater exposure to other risk factors for BC related to the adoption of life styles more prevalent in developed countries. The younger age at presentation of BC incident cases seen in the analyzed LAC registries, and possibly in many Latin American countries, is not only attributable to their relatively young population age structure but also to the low incidence rates in older women. As more recently born cohorts, with greater exposure to risk factors for postmenopausal BC, reach older age, incidence rates will be more similar to the rates seen in the USA and Canadian registries. There is a need for additional research to identify determinants of the higher BC rate among younger women in these countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

Severe edentulism is a major risk factor influencing stroke incidence in rural Ecuador (The Atahualpa Project).

PubMed

Del Brutto, Oscar H; Mera, Robertino M; Zambrano, Mauricio; Del Brutto, Victor J

2017-02-01

Background There is no information on stroke incidence in rural areas of Latin America, where living conditions and cardiovascular risk factors are different from urban centers. Aim Using a population-based prospective cohort study design, we aimed to assess risk factors influencing stroke incidence in community-dwelling adults living in rural Ecuador. Methods First-ever strokes occurring from 1 June 2012 to 31 May 2016, in Atahualpa residents aged ≥40 years, were identified from yearly door-to-door surveys and other overlapping sources. Poisson regression models adjusted for demographics, cardiovascular risk factors, edentulism and the length of observation time per subject were used to estimate stroke incidence rate ratio as well as factors influencing such incidence. Results Of 807 stroke-free individuals prospectively enrolled in the Atahualpa Project, follow-up was achieved in 718 (89%), contributing 2,499 years of follow-up (average 3.48 ± 0.95 years). Overall stroke incidence rate was 2.97 per 100 person-years of follow-up (95% CI: 1.73-4.2), which increased to 4.77 (95% CI: 1.61-14.1) when only persons aged ≥57 years were considered. Poisson regression models, adjusted for relevant confounders, showed that high blood pressure (IRR: 5.24; 95% CI: 2.55-7.93) and severe edentulism (IRR: 5.06; 95% CI: 2.28-7.85) were the factors independently increasing stroke incidence. Conclusions Stroke incidence in this rural setting is comparable to that reported from the developed world. Besides age and high blood pressure, severe edentulism is a major factor independently predicting incident strokes. Public awareness of the consequences of poor dental care might reduce stroke incidence in rural settings.

Impact of Community-Based Approach as Policy Tool: World Health Organization-Designated Safe Communities of Korea and Health Action Zones of the United Kingdom

PubMed Central

Kang, Changhyun; Shin, Jihyung; Matthews, Bob

2015-01-01

Objectives The aim of this study is to ascertain and identify the effectiveness of area-based initiatives as a policy tool mediated by societal and individual factors in the five World Health Organization (WHO)-designated Safe Communities of Korea and the Health Action Zones of the United Kingdom (UK). Methods The Korean National Hospital discharge in-depth injury survey from the Korea Centers for Disease Control and Prevention and causes of death statistics by the Statistics Korea were used for all analyses. The trend and changes in injury rate and mortality by external causes were compared among the five WHO-designated Safe Communities in Korea. Results The injury incident rates decreased at a greater level in the Safe Communities compared with the national average. Similar results were shown for the changes in unintentional injury incident rates. In comparison of changes in mortality rate by external causes between 2005 and 2011, the rate increase in Safe Communities was higher than the national average except for Jeju, where the mortality rate by external causes decreased. Conclusion When the Healthy Action Zones of the UK and the WHO Safe Communities of Korea were examined, the outcomes were interpreted differently among the compared index, regions, and time periods. Therefore, qualitative outcomes, such as bringing the residents' attention to the safety of the communities and promoting participation and coordination of stakeholders, should also be considered as important impacts of the community-based initiatives. PMID:26981341

Disinfection Byproducts in Drinking Water and Evaluation of Potential Health Risks of Long-Term Exposure in Nigeria

PubMed Central

Akintokun, Oyeronke A.; Adedapo, Adebusayo E.

2017-01-01

Levels of trihalomethanes (THMs) in drinking water from water treatment plants (WTPs) in Nigeria were studied using a gas chromatograph (GC Agilent 7890A with autosampler Agilent 7683B) equipped with electron capture detector (ECD). The mean concentrations of the trihalomethanes ranged from zero in raw water samples to 950 μg/L in treated water samples. Average concentration values of THMs in primary and secondary disinfection samples exceeded the standard maximum contaminant levels. Results for the average THMs concentrations followed the order TCM > BDCM > DBCM > TBM. EPA-developed models were adopted for the estimation of chronic daily intakes (CDI) and excess cancer incidence through ingestion pathway. Higher average intake was observed in adults (4.52 × 10−2 mg/kg-day), while the ingestion in children (3.99 × 10−2 mg/kg-day) showed comparable values. The total lifetime cancer incidence rate was relatively higher in adults than children with median values 244 and 199 times the negligible risk level. PMID:28900447

Changing annual incidence of hypothyroidism after iodine-131 therapy for hyperthyroidism, 1951-1975

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holm, L.E.

1982-02-01

The incidence of hypothyroidism was analyzed in 4,553 hyperthyroid patients treated with I-131 between 1951 and 1975. The average annual rate of hypothyroidism during the first 7 yr after therapy increased continuously for each 5-yr period of treatment, from 3.6% for patients treated between 1951 and 1955 to 7.7% for patients treated during the period from 1971 though 1975 (p less than 0.001). The increase in the incidence of hypothyroidism was seen before the introduction of TSH assays and when allowance was made for thyroid gland size, the age of the patient, and the experience of the radiotherapist. The usemore » of TSH assays has probably resulted in an earlier recognition of hypothyroidism, which may explain why the most marked rise in the incidence of hypothyroidism was observed after the introduction of TSH assays.« less

Changing annual incidence of hypothyroidism after iodine-131 therapy for hyperthyroidism, 1951-1975

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holm, L.E.

1982-02-01

The incidence of hypothyroidism was analyzed in 4,553 hyperthyroid patients treated with I-131 between 1951 and 1975. The average annual rate of hypothyroidism during the first 7 yr after therapy increased continuously for each 5-yr period of treatment, from 3.6% for patients treated between 1951 and 1955 to 7.7% for patients treated during the period from 1971 through 1975 (p<0.001). The increase in the incidence of hypothyroidism was seen before the introduction of TSH assays and when allowance was made for thyroid gland size, the age of the patient, and the experience of the radiotherapist. The use of TSH assaysmore » has probably resulted in an earlier recognition of hypothyroidism, which may explain why the most marked rise in the incidence of hypothyroidism was observed after the introduction of TSH assays.« less

Ethnic and Racial Inequalities in Notified Cases of Tuberculosis in Brazil

PubMed Central

Viana, Paulo Victor de Sousa; Gonçalves, Maria Jacirema Ferreira; Basta, Paulo Cesar

2016-01-01

Objective This study analysed clinical and sociodemographic aspects and follow-up for notified cases of tuberculosis (TB) and explored inequalities in incidence rates and outcome by colour or race and the geographic macro-regions of Brazil. Methods This paper reports the results of a population-based descriptive epidemiological study of all notified cases of TB in Brazil during the period from 01/01/2008 to 31/12/2011. We analysed sociodemographic and clinical variables according to colour or race (white, black, Asian, mixed, and indigenous) and geographic macro-regions of the country (North, Northeast, Central-West, South, and Southeast). Results During the study period, the average incidence of TB in Brazil was 36.7 cases per 100,000 inhabitants, with the highest rates occurring in the North and Southeast regions. The analysis of TB notifications by colour or race revealed that the indigenous population presented the highest incidence rates in all macro-regions except the South, where higher rates were reported in black patients. ‘Cured’ was the most frequently reported treatment outcome for all skin colour categories. The highest cure rate occurred among the indigenous population (76.8%), while the lowest cure rate occurred among the black population (70.7%). Rates of treatment default were highest among blacks (10.5%) and lowest among the indigenous population (6.9%). However, the fatality rate was similar across race categories, varying between 2.8% and 3.8% for whites and the indigenous population, respectively. The lowest cure rates were observed when follow-up was inadequate (58.3%), and the highest was observed when the follow-up was classified as excellent (96.8%). Conclusions This study revealed that—apart from the heterogeneous distribution of TB among the Brazilian macro-regions—ethnic-racial inequalities exist in terms of clinical-epidemiological characteristics and incidence rates as well as follow-up for cases undergoing treatment. The highest rates of TB occurred among the indigenous people. PMID:27176911

[A study on incidence of injury and its socio-economic loss in children and young adults].

PubMed

Wang, S; Guo, C; Zhang, G; Lu, G; Li, L; Lin, H; Fan, C; Huang, G; Zhou, C; Lu, Y

2000-07-01

To study the current status of incidence of injury among children and young adults and the causes of common injuries, and to estimate its socio-economic loss and extent of harmfulness. Pupils in 19 primary and middle schools aged 7 to 18 years, totaling 14,533, were recruited with stratified cluster sampling during 1998 to 1999 in Guangzhou, Maoming, Jiangmen and Shantou. Judgement for injury was based on the following criteria: (1) diagnosed and treated in hospitals or school clinics, (2) a half-day off or more due to injury, and (3) emergency management by pupils' parents or teachers. There were 6 941 pupils suffered from varied injures during the year, with an incidence rate of 47.76% (50.08% for boys and 45.02% for girls). Incidence rate of injury was higher in the middle school pupils (13 - 18 years old, 58.49%) than that in the primary school pupils (7 - 12 years old, 40.08%). The incidence increased significantly with age, with a peak at ages of 13 - 15. Major causes of injuries resulted from falls, injury by sharp articles, collision, traffic injuries and burn/scalds, etc, which usually occurred due to carelessness in sports, playing, walking, bike-riding and working. Frequency of multiple injuries related to the educational level of parents and depended on whether or not an only-child in family. There were 2,173 injured pupils (accounting for 31.3% of the total) visited clinics or emergency department in hospitals and 627 (9.0%) hospitalized for treatment. Twenty-eight percent of the injured pupils were absent from school, with an average absenteeism of 5.6 days. There were 154 injured pupils with transient disability and 53 with permanent disability, with a disability rate of 410.47 per 100,000. Cost for their medical care averaged 81.5 yuan RMB per injured pupil. Injury was a common and frequently-happened incident among children and young adults and could seriously affect their health, development and growth, studying and their future of children and young adults. Health education, safety-promotion and removing hidden danger for injury are the major measures to prevent from injury, and the government and the whole society should pay great attention to injury issues in children and young adults.

Population-based incidence trends of oropharyngeal and oral cavity cancers by sex among the poorest and underprivileged populations

PubMed Central

2014-01-01

Background Oral cancer is an important health issue, with changing incidence in many countries. Oropharyngeal cancer (OPC, in tonsil and oropharygeal areas) is increasing, while oral cavity cancer (OCC, other sites in the mouth) is decreasing. There is the need to identify high risk groups and communities for further study and intervention. The objective of this study was to determine how the incidence of OPC and OCC varied by neighbourhood socioeconomic status (SES) in British Columbia (BC), including the magnitude of any inequalities and temporal trends. Methods ICDO-3 codes were used to identify OPC and OCC cases in the BC Cancer Registry from 1981–2010. Cases were categorized by postal codes into SES quintiles (q1-q5) using VANDIX, which is a census-based, multivariate weighted index based on neighbourhood average household income, housing tenure, educational attainment, employment and family structure. Age-standardized incidence rates were determined for OPC and OCC by sex and SES quintiles and temporal trends were then examined. Results Incidence rates are increasing in both men and women for OPC, and decreasing in men and increasing in women for OCC. This change is not linear or proportionate between different SES quintiles, for there is a sharp and dramatic increase in incidence according to the deprivation status of the neighbourhood. The highest incidence rates in men for both OPC and OCC were observed in the most deprived SES quintile (q5), at 1.7 times and 2.2 times higher, respectively, than men in the least deprived quintile (q1). For OPC, the age-adjusted incidence rates significantly increased in all SES quintiles with the highest increase observed in the most deprived quintile (q5). Likewise, the highest incidence rates for both OPC and OCC in women were observed in the most deprived SES quintile (q5), at 2.1 times and 1.8 times higher, respectively, than women in the least deprived quintile (q1). Conclusion We report on SES disparities in oral cancer, emphasizing the need for community-based interventions that address access to medical care and the distribution of educational and health promotion resources among the most SES deprived communities in British Columbia. PMID:24886308

[Clinical characteristics and changing epidemiology of Clostridium difficile-associated disease (CDAD)].

PubMed

Byun, Tae Jun; Han, Dong Soo; Ahn, Sang Bong; Cho, Hyun Seok; Kim, Tae Yeob; Eun, Chang Soo; Jeon, Yong Cheol; Sohn, Joo Hyun; Kang, Jung Oak

2009-07-01

The spectrum of Clostridium difficile-associated disease (CDAD) ranges from mild diarrhea to life-threatening colitis. Recent studies reported an increase in incidence and severity of CDAD and the presence of severe community-acquired CDAD (CA-CDAD). The aims of this study were to investigate the incidence of CA-CDAD and non-antibiotics-associated CDAD, and to compare the clinical characteristics between hospital-acquired (HA) and CA-CDAD. The medical records of 86 patients who were diagnosed as CDAD in Hanyang University Guri Hospital between January 2005 and October 2007 were retrospectively reviewed. Of the 86 patients (mean age 64 years), 53 patients were women. The most frequently prescribed antibiotics were cephalosporins (67.4%), followed by aminoglycosides (38.4%) and quinolones (14%). Of the 86 patients, the average duration of treatment and recovery time of symptoms were 11.5 days and 4.6 days, respectively. Seven percent of patients experienced relapse treatment. The overall incidence rate of CA-CDAD and non-antibiotics-associated CDAD were 10.5% and 22.1%, respectively. CA-CDAD group had lower rate of antimicrobial exposure whilst showing higher rate of complications compared to HA-CDAD group. Three patients in the CA-CDAD progressed towards a severe complicated clinical course, including septic shock. The incidence rate of CA-CDAD and non-antibiotics-associated CDAD were 10.5% and 22.1%, respectively. CA-CDAD tends to have a higher complication rate compared to HA-CDAD. Community clinicians needs to maintain a high level of suspicion for CDAD, whilst coping with the ever evolving epidemiologic change.

Breast cancer in kurdish women of northern Iraq: incidence, clinical stage, and case control analysis of parity and family risk

PubMed Central

2009-01-01

Background Breast cancer in the Middle-East occurs in relatively young women and frequently presents as advanced disease. A protective effect of multiparity is not apparent, and high familial risk is reported in some countries. This study investigates breast cancer rates and clinical stage related to age in the Kurdish region of Iraq and evaluates risk associated with parity and family history. Findings are compared with nearby countries and the West. Methods Sulaimaniyah Directorate of Health records identified 539 women diagnosed with breast cancer during 2006-2008. Clinical survey forms were completed on 296 patients and on 254 age-matched controls. Age specific incidence rates were calculated from Directorate of Health population estimates. Results Average patient age was 47.4 ± 11 years and 59.5% were pre-menopausal. Diagnosis was at clinical stage 1 for 4.1%, stage 2 for 43.5%, stage 3 for 26.0%, and stage 4 for 8.1% of patients. For 18.2%, stage was unknown. Annual breast cancer incidence rates per 100,000 women peaked at 168.9 at age 55 to 59 and declined to 57.3 at 60 and above. Patients had an average of 5.0 ± 3.3 children compared to 5.4 ± 3.5 for controls, P = 0.16. A first degree family member had breast cancer among 11.1% of patients and 2.1% of controls (P < 0.001) with > 50% of these patients and controls being ≥50 years old. No statistically significant relationship was found between tumor stage and age, P = 0.59. Conclusions In Kurdish Iraq, breast cancer is predominantly a disease of pre-menopausal women having multiple pregnancies. For younger patients, breast cancer incidence was similar to the West and possibly higher than many Middle-Eastern countries, but unlike the West, the estimated rates declined markedly in the elderly. The familial breast cancer risk for both older and younger women was within the general population risk of Western countries. Clinical stages were advanced and indicated delays in diagnosis that were unrelated to patient age. PMID:20003359

Breast cancer in Kurdish women of northern Iraq: incidence, clinical stage, and case control analysis of parity and family risk.

PubMed

Majid, Runnak A; Mohammed, Hazha A; Saeed, Heshu M; Safar, Banaz M; Rashid, Rekawt M; Hughson, Michael D

2009-12-11

Breast cancer in the Middle-East occurs in relatively young women and frequently presents as advanced disease. A protective effect of multiparity is not apparent, and high familial risk is reported in some countries. This study investigates breast cancer rates and clinical stage related to age in the Kurdish region of Iraq and evaluates risk associated with parity and family history. Findings are compared with nearby countries and the West. Sulaimaniyah Directorate of Health records identified 539 women diagnosed with breast cancer during 2006-2008. Clinical survey forms were completed on 296 patients and on 254 age-matched controls. Age specific incidence rates were calculated from Directorate of Health population estimates. Average patient age was 47.4 +/- 11 years and 59.5% were pre-menopausal. Diagnosis was at clinical stage 1 for 4.1%, stage 2 for 43.5%, stage 3 for 26.0%, and stage 4 for 8.1% of patients. For 18.2%, stage was unknown. Annual breast cancer incidence rates per 100,000 women peaked at 168.9 at age 55 to 59 and declined to 57.3 at 60 and above. Patients had an average of 5.0 +/- 3.3 children compared to 5.4 +/- 3.5 for controls, P = 0.16. A first degree family member had breast cancer among 11.1% of patients and 2.1% of controls (P < 0.001) with > 50% of these patients and controls being > or =50 years old. No statistically significant relationship was found between tumor stage and age, P = 0.59. In Kurdish Iraq, breast cancer is predominantly a disease of pre-menopausal women having multiple pregnancies. For younger patients, breast cancer incidence was similar to the West and possibly higher than many Middle-Eastern countries, but unlike the West, the estimated rates declined markedly in the elderly. The familial breast cancer risk for both older and younger women was within the general population risk of Western countries. Clinical stages were advanced and indicated delays in diagnosis that were unrelated to patient age.

Recent trends in incidence of five common cancers in 26 European countries since 1988: Analysis of the European Cancer Observatory.

PubMed

Arnold, Melina; Karim-Kos, Henrike E; Coebergh, Jan Willem; Byrnes, Graham; Antilla, Ahti; Ferlay, Jacques; Renehan, Andrew G; Forman, David; Soerjomataram, Isabelle

2015-06-01

Individual country- and cancer site-specific studies suggest that the age-adjusted incidence of many common cancers has increased in European populations over the past two decades. To quantify the extent of these trends and the recent burden of cancer, here we present a comprehensive overview of trends in population-based incidence of the five common cancers across Europe derived from a new web-based portal of the European cancer registries. Data on incidence for cancers of the colon and rectum, prostate, breast, corpus uteri and stomach diagnosed from 1988 to 2008 were obtained from the European Cancer Observatory for cancer registries from 26 countries. Annual age-standardised incidence rates and average annual percentage changes were calculated. Incidence of four common cancers in eastern and central European countries (prostate, postmenopausal breast, corpus uteri and colorectum) started to approach levels in northern and western Europe, where rates were already high in the past but levelled off in some countries in recent years. Decreases in stomach cancer incidence were seen in all countries. Increasing trends in incidence of the most common cancers, except stomach cancer, are bad news to public health but can largely be explained by well-known changes in society in the past decades. Thus, current and future efforts in primary cancer prevention should not only remain focussed on the further reduction of smoking but engage in the long-term efforts to retain healthy lifestyles, especially avoiding excess weight through balanced diets and regular physical exercise. Copyright © 2013 Elsevier Ltd. All rights reserved.

Lung Cancer Risk and Past Exposure to Emissions from a Large Steel Plant

PubMed Central

Ameling, Caroline; van de Kassteele, Jan; Lijzen, Johannes; Oosterlee, Arie; Keuken, Rinske; Visser, Otto; van Wiechen, Carla

2013-01-01

We studied the spatial distribution of cancer incidence rates around a large steel plant and its association with historical exposure. The study population was close to 600,000. The incidence data was collected for 1995–2006. From historical emission data the air pollution concentrations for polycyclic aromatic hydrocarbons (PAH) and metals were modelled. Data were analyzed using Bayesian hierarchical Poisson regression models. The standardized incidence ratio (SIR) for lung cancer was up to 40% higher than average in postcodes located in two municipalities adjacent to the industrial area. Increased incidence rates could partly be explained by differences in socioeconomic status (SES). In the highest exposure category (approximately 45,000 inhabitants) a statistically significant increased relative risk (RR) of 1.21 (1.01–1.43) was found after adjustment for SES. The elevated RRs were similar for men and women. Additional analyses in a subsample of the population with personal smoking data from a recent survey suggested that the observed association between lung cancer and plant emission, after adjustment for SES, could still be caused by residual confounding. Therefore, we cannot indisputably conclude that past emissions from the steel plant have contributed to the increased risk of lung cancer. PMID:24324501

Characterization of Dementia and Alzheimer’s Disease in an Older Population: Updated Incidence and Life Expectancy With and Without Dementia

PubMed Central

Tom, Sarah E.; Hubbard, Rebecca A.; Crane, Paul K.; Haneuse, Sebastien J.; Bowen, James; McCormick, Wayne C.; McCurry, Susan; Larson, Eric B.

2015-01-01

Objectives. We estimated dementia incidence rates, life expectancies with and without dementia, and percentage of total life expectancy without dementia. Methods. We studied 3605 members of Group Health (Seattle, WA) aged 65 years or older who did not have dementia at enrollment to the Adult Changes in Thought study between 1994 and 2008. We estimated incidence rates of Alzheimer’s disease and dementia, as well as life expectancies with and without dementia, defined as the average number of years one is expected to live with and without dementia, and percentage of total life expectancy without dementia. Results. Dementia incidence increased through ages 85 to 89 years (74.2 cases per 1000 person-years) and 90 years or older (105 cases per 1000 person-years). Life expectancy without dementia and percentage of total life expectancy without dementia decreased with age. Life expectancy with dementia was longer in women and people with at least a college degree. Percentage of total life expectancy without dementia was greater in younger age groups, men, and those with more education. Conclusions. Efforts to delay onset of dementia, if successful, would likely benefit older adults of all ages. PMID:25033130

Cocaine use in the past year is associated with altitude of residence.

PubMed

Fiedler, Kristen K; Kim, Namkug; Kondo, Douglas G; Renshaw, Perry F

2012-06-01

Recently, increased rates of suicide in US counties at higher altitudes have been noted. Because of the documented association between cocaine use and suicide, we hypothesized that there would be a correlation between incidence of cocaine use and altitude of residence. Cocaine use data were obtained from the Substate Substance Abuse Estimates from the 1999-2001 National Surveys on Drug Use and Health. Data related to the percentages of people 12 years or older who used cocaine in the past year. Average elevation for US counties was calculated using the Shuttle Radar Topography Mission elevation data set, and subject region elevation was calculated by averaging the weighted elevations of each region's relevant counties. The correlation between elevation of a substate region and incidence of cocaine use in that region was calculated using Pearson correlation coefficients. A significant correlation exists between mean altitude of a substate region and incidence of cocaine use in that region (r = 0.34; P < 0.0001). Regression analysis controlling for age, sex, race, education level, income, unemployment, and population density was performed. Altitude remained a significant factor (P = 0.007), whereas male sex (P = 0.008) and possessing less than a college education (P < 0.0001) were also significant predictors of self-reported cocaine use in the past year. It is important to note that cocaine use was assessed in isolation of other drugs of abuse, an additional confounding variable. This study demonstrates a significant correlation between altitude of substate region of residence and incidence of cocaine use. It is possible that stress response due to hypoxia is responsible; however, this requires further investigation. However, because other substance use was not assessed, specificity of this association is unknown. In addition, this correlation may help explain the increased rate of suicide in areas of higher elevation.

[Relationship between depression symptoms and stress in occupational populations].

PubMed

Yu, Shan-fa; Yao, San-qiao; Ding, Hui; Ma, Liang-qing; Yang, Yan; Wang, Zhi-hui

2006-03-01

To explore the relationship between the depression symptoms and occupational stress in occupational populations. Depression symptoms were measured by using the center for epidemiological survey-depression scale. The occupational stress instrument were employed to investigate the stressors, personalities, social support, and coping strategies as well as the subject's age, length of service, sex, educational level and marriage status. Chi(2) test was used for analyzing the difference of depression. The multiple covariance analysis was used for testing the difference of stressors, personalities, social support, and coping strategies among the groups with different scores of depression. The variables obtained in the optional prediction equation were identified by multiple stepwise regression analysis. The incidence rate of definite depression symptoms was 40.2%. The total average score was 21.74 +/- 8.99. Henan province had the highest incidence rate of depression symptoms, 43.8%, Hebei 39.4%, and Beijing the lowest, 23.4%. The male workers had the higher incidence rate of depression symptoms, 43. 0% than female, 35.4% (P < 0.01). The older group had the lower incidence rates of depression symptoms, compared with the younger group (P < 0.01). The workers divorced or with the bereft spouse had the higher incidence rate of depression symptoms than the workers married and unmarried (P < 0.05). The workers with middle school education had the higher incidence rates of depression symptoms than those with master degree. Incidence rates in the most occupational groups were more than 30%. The significant difference was shown between the different jobs (P < 0.01). The difference of the adjusted means among three groups of different depression score were analyzed. The results showed the workers with definite depression symptoms had the higher scores than the other two groups in physical factors, role ambiguity, role conflict, job monotony, mental load, responsibility for persons, job future ambiguity, job hazards, type A behavior and work locus of control, and social support (P < 0.05, P < 0.01). The former had the lower scores than the other two groups in the scores of promotion, participation, autonomy, task identity, feedback, friendship opportunity, speed control, training adequacy, challenge, self-esteem, organizational commitment, and coping strategies. Fifteen variables entered the predictive equation of depression score explaining 33.1% of variance. There are serious mental health problems in the occupational population in our country. Stressors and personalities affect the mental health.

Model-Based Evaluation of Strategies to Control Brucellosis in China.

PubMed

Li, Ming-Tao; Sun, Gui-Quan; Zhang, Wen-Yi; Jin, Zhen

2017-03-12

Brucellosis, the most common zoonotic disease worldwide, represents a great threat to animal husbandry with the potential to cause enormous economic losses. Brucellosis has become a major public health problem in China, and the number of human brucellosis cases has increased dramatically in recent years. In order to evaluate different intervention strategies to curb brucellosis transmission in China, a novel mathematical model with a general indirect transmission incidence rate was presented. By comparing the results of three models using national human disease data and 11 provinces with high case numbers, the best fitted model with standard incidence was used to investigate the potential for future outbreaks. Estimated basic reproduction numbers were highly heterogeneous, varying widely among provinces. The local basic reproduction numbers of provinces with an obvious increase in incidence were much larger than the average for the country as a whole, suggesting that environment-to-individual transmission was more common than individual-to-individual transmission. We concluded that brucellosis can be controlled through increasing animal vaccination rates, environment disinfection frequency, or elimination rates of infected animals. Our finding suggests that a combination of animal vaccination, environment disinfection, and elimination of infected animals will be necessary to ensure cost-effective control for brucellosis.

Model-Based Evaluation of Strategies to Control Brucellosis in China

PubMed Central

Li, Ming-Tao; Sun, Gui-Quan; Zhang, Wen-Yi; Jin, Zhen

2017-01-01

Brucellosis, the most common zoonotic disease worldwide, represents a great threat to animal husbandry with the potential to cause enormous economic losses. Brucellosis has become a major public health problem in China, and the number of human brucellosis cases has increased dramatically in recent years. In order to evaluate different intervention strategies to curb brucellosis transmission in China, a novel mathematical model with a general indirect transmission incidence rate was presented. By comparing the results of three models using national human disease data and 11 provinces with high case numbers, the best fitted model with standard incidence was used to investigate the potential for future outbreaks. Estimated basic reproduction numbers were highly heterogeneous, varying widely among provinces. The local basic reproduction numbers of provinces with an obvious increase in incidence were much larger than the average for the country as a whole, suggesting that environment-to-individual transmission was more common than individual-to-individual transmission. We concluded that brucellosis can be controlled through increasing animal vaccination rates, environment disinfection frequency, or elimination rates of infected animals. Our finding suggests that a combination of animal vaccination, environment disinfection, and elimination of infected animals will be necessary to ensure cost-effective control for brucellosis. PMID:28287496

Obstetric hysterectomy: a 14-year experience of Rajavithi Hospital 1989-2002.

PubMed

Kovavisarach, Ekachai

2006-11-01

To review and compare the incidence rate of obstetric hysterectomised patients between two seven-year periods. Theperiods were from October 1, 1988 to September 30, 1995 andfrom October P', 1995 to September 30th, 2002. The data included demographic characteristics, indications, possible risk factors, complications, and operative managements. Retrospective analysis of the data that was collected from medical and labor records of the obstetric hysterectomised patientsfrom October 1, 1995 to September 30, 2002, the second seven-year period, compared with those in Pratumthong and Wattanaruangkowit's study from October 1, 1988 to September 30, 1995, the first seven-year period. Between 1998 and 2002, there were 201, 696 total deliveries with 111 obstetric hysterectomies. A significant increase in the average incidence rate of hysterectomy from 0.42 to 0.76/1000 deliveries and maternal age, placenta previa and blood transfusion in the second period compared with the first period (p < 0.05). Postoperative complications and the other risk factors of obstetric hysterectomy were not significant difference. The present study of obstetric hysterectomy demonstrates a significant increase in the incidence of hysterectomised rate, maternal age, blood transfusion, and placenta previa in the second period compared with the first period.

Examining Play Counts and Measurements of Injury Incidence in Youth Football.

PubMed

Kerr, Zachary Y; Yeargin, Susan W; Djoko, Aristarque; Dalton, Sara L; Baker, Melissa M; Dompier, Thomas P

2017-10-01

  Whereas researchers have provided estimates for the number of head impacts sustained within a youth football season, less is known about the number of plays across which such impact exposure occurs.   To estimate the number of plays in which youth football players participated during the 2013 season and to estimate injury incidence through play-based injury rates.   Descriptive epidemiology study.   Youth football.   Youth football players (N = 2098; age range, 5-15 years) from 105 teams in 12 recreational leagues across 6 states.   We calculated the average number of athlete-plays per season and per game using independent-samples t tests to compare age groups (5-10 years old versus 11-15 years old) and squad sizes (<20 versus ≥20 players); game injury rates per 1000 athlete-exposures (AEs) and per 10 000 athlete-plays; and injury rate ratios (IRRs) with 95% confidence intervals (CIs) to compare age groups.   On average, youth football players participated in 333.9 ± 178.5 plays per season and 43.9 ± 24.0 plays per game. Age groups (5- to 10-year-olds versus 11- to 15-year-olds) did not differ in the average number of plays per season (335.8 versus 332.3, respectively; t 2086.4 = 0.45, P = .65) or per game (44.1 versus 43.7, respectively; t 2092.3 = 0.38, P = .71). However, players from smaller teams participated in more plays per season (373.7 versus 308.0; t 1611.4 = 8.15, P < .001) and per game (47.7 versus 41.4; t 1523.5 = 5.67, P < .001). Older players had a greater game injury rate than younger players when injury rates were calculated per 1000 AEs (23.03 versus 17.86/1000 AEs; IRR = 1.29; 95% CI = 1.04, 1.60) or per 10 000 athlete-plays (5.30 versus 4.18/10 000 athlete-plays; IRR = 1.27; 95% CI = 1.02, 1.57).   A larger squad size was associated with a lower average number of plays per season and per game. Increasing youth football squad sizes may help reduce head-impact exposure for individual players. The AE-based injury rates yielded effect estimates similar to those of play-based injury rates.

Incidence of cutaneous malignant melanoma in Iranian provinces and American states matched on ultraviolet radiation exposure: an ecologic study☆

PubMed Central

Moslehi, Roxana; Zeinomar, Nur; Boscoe, Francis P.

2018-01-01

Objectives Ultraviolet radiation (UVR), with UVB and UVA as the relevant components, is a risk factor for melanoma. Complete ascertainment and registration of melanoma in Iran was conducted in five provinces (Ardabil, Golestan, Mazandaran, Gilan and Kerman) during 1996–2000. The aim of our study was to compare population-based incidence data from these provinces with rates in the United States (US) while standardizing ambient UVR. Methods Population-based rates representing all incident cases of melanoma (1996–2000) across the five Iranian provinces were compared to rates of melanoma among white non-Hispanics in the US. Overall age-standardized rates (ASR) for Iran and the US (per 100,000 person-years adjusted to 2000 world population) and standardized rate ratios (SRR) were calculated. We measured erythemally-weighted average solar UVR exposures (with contributions from both UVB and UVA range) of the five Iranian provinces using data from NASA's Total Ozone Mapping Spectrometer and selected five US states (Kentucky, Utah, Texas, Oklahoma, and Hawaii) with matching UVR exposure to each province. Incidence rates of melanoma during 1996–2000 in each Iranian province were compared to rates among white non-Hispanics in its UVR-matched US state. Results The overall male and female ASRs of melanoma were 0.60 (95%CI: 0.56–0.64) and 0.46 (95%CI: 0.42–0.49), respectively, for Iran and 22.78 (95%CI: 22.42–23.14) and 16.61 (95%CI: 16.30–16.92) for the US. SRRs of melanoma comparing US to Iran were 37.97 (95%CI: 35.78–40.29) for males and 36.11 (95%CI: 33.69–38.70) for females, indicating significantly higher incidence in the US. ASRs and age-specific rates of melanoma for both genders were significantly lower in each Iranian province compared to its UVR-matched US state. Conclusion The markedly lower incidence rates of melanoma in Iranian provinces with similar UVR exposures to US states underscore the need for additional comparative studies to decipher the influence of other extrinsic and intrinsic factors on the risk of this malignancy. PMID:29241156

Lithium in drinking water and the incidence of bipolar disorder: A nation-wide population-based study.

PubMed

Kessing, Lars V; Gerds, Thomas A; Knudsen, Nikoline N; Jørgensen, Lisbeth F; Kristiansen, Søren M; Voutchkova, Denitza; Ernstsen, Vibeke; Schullehner, Jörg; Hansen, Birgitte; Andersen, Per K; Ersbøll, Annette K

2017-11-01

Animal data suggest that subtherapeutic doses, including micro doses, of lithium may influence mood, and lithium levels in drinking water have been found to correlate with the rate of suicide. It has never been investigated whether consumption of lithium may prevent the development of bipolar disorder (primary prophylaxis). In a nation-wide population-based study, we investigated whether long-term exposure to micro levels of lithium in drinking water correlates with the incidence of bipolar disorder in the general population, hypothesizing an inverse association in which higher long-term lithium exposure is associated with lower incidences of bipolar disorder. We included longitudinal individual geographical data on municipality of residence, data from drinking water lithium measurements and time-specific data from all cases with a hospital contact with a diagnosis of mania/bipolar disorder from 1995 to 2013 (N=14 820) and 10 age- and gender-matched controls from the Danish population (N= 140 311). Average drinking water lithium exposure was estimated for all study individuals. The median of the average lithium exposure did not differ between cases with a diagnosis of mania/bipolar disorder (12.7 μg/L; interquartile range [IQR]: 7.9-15.5 μg/L) and controls (12.5 μg/L; IQR: 7.6-15.7 μg/L; P=.2). Further, the incidence rate ratio of mania/bipolar disorder did not decrease with higher long-term lithium exposure, overall, or within age categories (0-40, 41-60 and 61-100 years of age). Higher long-term lithium exposure from drinking water was not associated with a lower incidence of bipolar disorder. The association should be investigated in areas with higher lithium levels than in Denmark. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Incidence of CNS tumors in Appalachian children

PubMed Central

Huang, Bin; Luo, Alice; Durbin, Eric B.; Lycan, Ellen; Tucker, Thomas; Chen, Quan; Horbinski, Craig; Villano, John L.

2017-01-01

Objective Determine whether the risk of astrocytomas in Appalachian children is higher than the national average. Methods We compared the incidence of pediatric brain tumors in Appalachia versus non-Appalachia regions, covering years 2000–2011. The North American Association of Central Cancer Registries (NAACCR) collects population-based data from 55 cancer registries throughout United States and Canada. All invasive primary (i.e. non-metastatic tumors), with age at diagnosis 0–19 years old, were included. Nearly 27,000 and 2,200 central nervous system (CNS) tumors from non-Appalachia and Appalachia, respectively comprise the cohorts. Age-adjusted incidence rates of each main brain tumor subtype were compared. Results The incidence rate of pediatric CNS tumors was 8% higher in Appalachia, 3.31 [95% CI, 3.17–3.45] versus non–Appalachia, 3.06, [95% CI, 3.02–3.09] for the years 2001–2011, all rates are per 100,000 population. Astrocytomas accounted for the majority of this difference, with the rate being 16% higher in Appalachian children, 1.77, [95% CI, 1.67–1.87] versus non-Appalachian children, 1.52, [95% CI, 1.50–1.55]. Among astrocytomas, World Health Organization (WHO) grade I astrocytomas were 41% higher in Appalachia, 0.63 [95% CI, 0.56–0.70] versus non-Appalachia 0.44 [95% CI, 0.43–0.46] for the years 2004–2011. Conclusions and Relevance This is the first study to demonstrate that Appalachian children are at greater risk of CNS neoplasms, and that much of this difference is in WHO grade I astrocytomas, 41% more common. The cause of this increased incidence is unknown and we discuss the importance of this in relation to genetic and environmental findings in Appalachia. PMID:28285334

Incidence of sport-related traumatic brain injury and risk factors of severity: a population-based epidemiologic study.

PubMed

Selassie, Anbesaw W; Wilson, Dulaney A; Pickelsimer, E Elisabeth; Voronca, Delia C; Williams, Nolan R; Edwards, Jonathan C

2013-12-01

Few studies of sport-related traumatic brain injury (TBI) are population-based or rely on directly observed data on cause, demographic characteristics, and severity. This study addresses the epidemiology of sport-related TBI in a large population. Data on all South Carolina hospital and emergency department encounters for TBI, 1998-2011, were analyzed. Annual incidence rate of sport-related TBI was calculated, and rates were compared across demographic groups. Sport-related TBI severity was modeled as a function of demographic and TBI characteristics using logistic regression. A total of 16,642 individuals with sport-related TBI yielded an average annual incidence rate of 31.5/100,000 population with a steady increase from 19.7 in 1998 to 45.6 in 2011. The most common mechanisms of sport-related TBI were kicked in football (38.1%), followed by fall injuries in sports (20.3%). Incidence rate was greatest in adolescents ages 12-18 (120.6/100,000/persons). Severe sport-related TBI was strongly associated with off-road vehicular sport (odds ratio [OR], 4.73; 95% confidence interval [95% CI], 2.92-7.67); repeated head trauma (OR, 4.36; 95% CI, 3.69-5.15); equestrian sport (OR, 2.73; 95% CI, 1.64-4.51); and falls during sport activities (OR, 2.72; 95% CI, 1.67-4.46). The high incidence of sport-related TBI in youth, potential for repetitive mild TBI, and its long-term consequences on learning warrants coordinated surveillance activities and population-based outcome studies. Copyright © 2013 Elsevier Inc. All rights reserved.

Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey.

PubMed

Cheah, Yee Lee; Simpson, Mary Ann; Pomposelli, James J; Pomfret, Elizabeth A

2013-05-01

The incidence of morbidity and mortality after living donor liver transplantation (LDLT) is not well understood because reporting is not standardized and relies on single-center reports. Aborted hepatectomies (AHs) and potentially life-threatening near-miss events (during which a donor's life may be in danger but after which there are no long-term sequelae) are rarely reported. We conducted a worldwide survey of programs performing LDLT to determine the incidence of these events. A survey instrument was sent to 148 programs performing LDLT. The programs were asked to provide donor demographics, case volumes, and information about graft types, operative morbidity and mortality, near-miss events, and AHs. Seventy-one programs (48%), which performed donor hepatectomy 11,553 times and represented 21 countries, completed the survey. The average donor morbidity rate was 24%, with 5 donors (0.04%) requiring transplantation. The donor mortality rate was 0.2% (23/11,553), with the majority of deaths occurring within 60 days, and all but 4 deaths were related to the donation surgery. The incidences of near-miss events and AH were 1.1% and 1.2%, respectively. Program experience did not affect the incidence of donor morbidity or mortality, but near-miss events and AH were more likely in low-volume programs (≤50 LDLT procedures). In conclusion, it appears that independently of program experience, there is a consistent donor mortality rate of 0.2% associated with LDLT donor procedures, yet increased experience is associated with lower rates of AH and near-miss events. Potentially life-threatening near-miss events and AH are underappreciated complications that must be discussed as part of the informed consent process with any potential living liver donor. Copyright © 2012 American Association for the Study of Liver Diseases.

[A retrospective analysis on the pernicious placenta previa from 2008 to 2014].

PubMed

Yu, L; Hu, K J; Yang, H X

2016-03-01

To investigate the incidence changes, clinical characteristics and pregnant outcomes of pernicious placenta previa. A retrospective cohort analysis on 316 cases with placenta previa in the Peking University First Hospital from January 2008 to December 2014. The research group were 60 cases with the patients of placenta previa with the history of cesarean section, and the control group were placenta previa without the history of cesarean section. Compared with the incidence, intraoperative blood loss, the pregnancy outcomes and so on. (1) The average incidence rate of placenta previa during the past 7 years was 10.96 ‰ (316/28 837). And the cases of pernicious placenta previa was 60 (2.08‰, 60/28 837), the incidence of pernicious placenta previa was rising from 2008 to 2014 (0.91‰-3.08‰). (2) There were 145 cases of placenta privia had been translation from other hospitals in the past 7 years. The referral rate of pregnant women with placenta previa was 45.9% (145/316), and the referral rate of pernicious placenta previa (63.3%, 38/60) was significantly higher than that of non-pernicious placenta previa group (41.8%, 107/256; χ(2)=9.080, P=0.003). Referral the outcomes of these patients were good, and no maternal death occurred. (3) The placenta in the research group were mainly adhered in the front wall of the uterine, and the incidence was 38.5% (15/39), higher than that in the group of non-pernicious placenta previa (12.1%, 21/174; χ(2)=57.636, P<0.01). The incidence rate of complicated placenta increased in research group was 53.3% (32/60), higher than that in the group of non-pernicious placenta previa, compared with the control group, there was significant difference (15.6%, 40/256; χ(2)= 39.041, P<0.01). (4) The incidence of blood loss was more than 1 000 ml, blood transfusion rate, the rate of hysterectomy and the rate of asphyxia of newborn in the research group were respectively 41.7% (25/60), 38.3% (23/60), 8.3% (5/60), 15.0% (9/60), and the incidence of the group of non-pernicious placenta previa were respectively 4.7% (12/256), 12.9% (33/256), 1.2% (3/256), 8.6% (22/256), compared those in other two groups, there were not significant difference (P<0.05). The incidence rate of placenta previa increased year by year, patients with placenta previa has a history of cesarean section often combined with placenta in anterior wall of the uterus, and often with poor pregnancy outcomes. Hierarchical referral system is an effective means to reduce the mortality of the pernicious placenta previa.

Decreased rates of shoulder dystocia and brachial plexus injury via an evidence-based practice bundle.

PubMed

Sienas, Laura E; Hedriana, Herman L; Wiesner, Suzanne; Pelletreau, Barbara; Wilson, Machelle D; Shields, Laurence E

2017-02-01

To evaluate whether a standardized approach to identify pregnant women at risk for shoulder dystocia (SD) is associated with reduced incidence of SD and brachial plexus injury (BPI). Between 2011 and 2015, prospective data were collected from 29 community-based hospitals in the USA during implementation of an evidence-based practice bundle, including an admission risk assessment, required "timeout" before operative vaginal delivery (OVD), and low-fidelity SD drills. All women with singleton vertex pregnancies admitted for vaginal delivery were included. Rates of SD, BPI, OVD, and cesarean delivery were compared between a baseline period (January 2011-September 2013) and an intervention period (October 2013-June 2015), during which there was a system-wide average bundle compliance of 90%. There was a significant reduction in the incidence of SD (17.6%; P=0.028), BPI (28.6%; P=0.018), and OVD (18.0%; P<0.001) after implementation of the evidence-based practice bundle. There was a nonsignificant reduction in primary (P=0.823) and total (P=0.396) cesarean rates, but no association between SD drills and incidence of BPI. Implementation of a standard evidence-based practice bundle was found to be associated with a significant reduction in the incidence of SD and BPI. Utilization of low-fidelity drills was not associated with a reduction in BPI. © 2016 International Federation of Gynecology and Obstetrics.

What is the lifetime risk of developing cancer?: the effect of adjusting for multiple primaries

PubMed Central

Sasieni, P D; Shelton, J; Ormiston-Smith, N; Thomson, C S; Silcocks, P B

2011-01-01

Background: The ‘lifetime risk' of cancer is generally estimated by combining current incidence rates with current all-cause mortality (‘current probability' method) rather than by describing the experience of a birth cohort. As individuals may get more than one type of cancer, what is generally estimated is the average (mean) number of cancers over a lifetime. This is not the same as the probability of getting cancer. Methods: We describe a method for estimating lifetime risk that corrects for the inclusion of multiple primary cancers in the incidence rates routinely published by cancer registries. The new method applies cancer incidence rates to the estimated probability of being alive without a previous cancer. The new method is illustrated using data from the Scottish Cancer Registry and is compared with ‘gold-standard' estimates that use (unpublished) data on first primaries. Results: The effect of this correction is to make the estimated ‘lifetime risk' smaller. The new estimates are extremely similar to those obtained using incidence based on first primaries. The usual ‘current probability' method considerably overestimates the lifetime risk of all cancers combined, although the correction for any single cancer site is minimal. Conclusion: Estimation of the lifetime risk of cancer should either be based on first primaries or should use the new method. PMID:21772332

Incidence of ovarian cancer after hysterectomy: a nationwide controlled follow up.

PubMed

Loft, A; Lidegaard, O; Tabor, A

1997-11-01

To estimate the risk of developing ovarian cancer after abdominal (total or subtotal) hysterectomy on benign indication. Prospective historical cohort study with 12.5 years of follow up. Denmark, nationwide. All Danish women (aged 0 to 99 years) having undergone hysterectomy with conservation of at least one ovary for a benign indication from 1977 to 1981 (n = 22,135). Follow up was conducted from 1977 to 1991. The reference group included all Danish women who had not undergone hysterectomy, age-standardised according to the hysterectomy group (n = 2,554,872). Registry data derived from the Danish National Register of Patients (diagnoses and operation codes) and the Civil Registration System (information about general population, including time of death). Incidence rate of ovarian cancer, lifetime risk of ovarian cancer, relative risk of ovarian cancer. Seventy-one women developed ovarian cancer on average 7.0 years after hysterectomy and 10,659 women in the reference group had ovarian cancer diagnosed after on average 6.4 years. The incidence rate of ovarian cancer was 0.27 per 1000 person-years in the group that had undergone hysterectomy and 0.34 per 1000 person-years in the general population (age-standardised). The extrapolated lifetime risk of developing ovarian cancer was 2.1% after hysterectomy and 2.7% in the general population (RR 0.78; 95% CI 0.60-0.96). The risk of ovarian cancer is lower among women who have undergone hysterectomy compared with those who have not. The protection seems to decrease with time.

THE INCIDENCE OF SYMPTOMATIC ACQUIRED LACRIMAL OUTFLOW OBSTRUCTION AMONG RESIDENTS OF OLMSTED COUNTY, MINNESOTA, 1976–2000 (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

PubMed Central

J., John; Woog

2007-01-01

Purpose To define the incidence, clinical characteristics, and outcomes following treatment of symptomatic acquired lacrimal outflow obstruction (SALOO) in Olmsted County, Minnesota, from 1976 to 2000, and to test the hypothesis that the incidence of this disorder increased over this interval. Methods In this retrospective, population-based study, the Rochester Epidemiology Project was used to identify patients above the age of 5 years with SALOO. Patient medical records were reviewed, and the incidence and localization of lacrimal obstruction were determined. Results Five-hundred eighty-seven patients with SALOO were identified, with an average annual incidence rate of 30.47 per 100,000. Nasolacrimal duct obstruction was most common, with an incidence of 20.24 per 100,000. The increase in incidence from 1976–1979 to 1996–2000 was statistically significant (P=.01). Among 397 patients with nasolacrimal duct obstruction, 107 (27%) were male and 290 (73%) female, with a mean age of 59.5 ± 22 years. SALOO and nasolacrimal duct obstruction incidence increased with age. Glaucoma, dry eye, cataract, diabetes mellitus, systemic malignancy, cigarette smoking, and hypertension were noted in 5.5%, 8.7%, 37.5%, 10.9%, 18.5%, 26.4%, and 41.1% of patients, respectively. One hundred eleven patients underwent dacryocystorhinostomy, with a success rate of 94.1%. Conclusions SALOO incidence increased during the study interval, although a possible plateau effect was noted during the last 5 years of the study period. The majority of patients were female above the age of 66 years. The latter finding, in conjunction with US demographic trends, suggests that the frequency of SALOO may continue to increase in the future. External dacryocystorhinostomy appeared to be effective in the management of nasolacrimal duct obstruction. PMID:18427633

Disease burden of community acquired pneumonia among children under 5 y old in China: A population based survey

PubMed Central

Li, Yan; Yin, Dapeng; Liu, Yanmin; Huang, Zhuoying; Ma, Yujie; Li, Hui; Li, Qi; Wang, Huaqing

2017-01-01

ABSTRACT Background: To obtain the baseline data on the incidence and cost of community acquired pneumonia among under-5 children for future studies, and provide evidence for shaping China's strategies regarding pneumococcal conjugate vaccine (PCV). Methods: Three townships from Heilongjiang, Hebei and Gansu Province and one community in Shanghai were selected as study areas. A questionnaire survey was conducted to collect data on incidence and cost of pneumonia among children under 5 y old in 2012. Results: The overall incidence of clinically diagnosed pneumonia in children under 5 y old was 2.55%. The incidence in urban area was 7.97%, higher than that in rural areas (1.68%). However, no difference was found in the incidences of chest X-ray confirmed pneumonia between urban and rural areas (1.67% vs 1.23%). X-ray confirmed cases in rural and urban areas respectively accounted for 73.45% and 20.93% of all clinically diagnosed pneumonia. The hospitalization rate of all cases was 1.40%. Incidence and hospitalization rate of pneumonia decreased with age, with the highest rates found among children younger than one year and the lowest among children aged 4 (incidence: 4.25% vs 0.83%; hospitalization: 2.75% vs 0.36%). The incidence was slightly higher among boys (2.92% vs 2.08%). The total cost due to pneumonia for the participants was 1138 733 CNY. The average cost and median cost was 5722 CNY and 3540 CNY separately. Multivariate analysis showed that the only factor related to higher cost was hospitalization. Conclusions: The disease burden was high for children under 5 y old, especially the infant. PCV has not been widely used among children, and thus further health economics evaluation on introducing PCV into National Immunization Program should be conducted. PMID:28414567

Incidence and survival of adult cancer patients in Taiwan, 2002-2012.

PubMed

Chiang, Chun-Ju; Lo, Wei-Cheng; Yang, Ya-Wen; You, San-Lin; Chen, Chien-Jen; Lai, Mei-Shu

2016-12-01

Little is known about the annual changes in cancer incidence and survival that occurred after the establishment of the long-form cancer registry database in Taiwan. Therefore, this study aimed to investigate the updated incidence and stage-specific relative survival rates (RSRs) among adult cancer patients in Taiwan. Cancer incidence data from 2002 to 2012 were collected using the Taiwan Cancer Registry Database. Age-standardized incidence rates, average annual percent changes (AAPCs), and sex ratios were calculated for adults. Five-year stage-specific RSRs were estimated for cases diagnosed between 2004 and 2008 and were followed up to 2013 for major cancers. The overall age-standardized incidence rates per 100,000 populations increased from 348.39 in 2002 to 401.18 in 2012, and the AAPC was 1.7% (p < 0.05), whereas the male:female ratio was approximately 1:3 during the entire period. Most cancer sites showed a trend of increasing incidence, with the exception of common cancers such as cervix uteri (AAPC = -6.2%, p < 0.05), bladder (AAPC = -2.5%, p < 0.05), stomach (AAPC = -2.4%, p < 0.05), nasopharynx (AAPC = -1.2%, p < 0.05), and liver (AAPC = -1.1%, p < 0.05). The 5-year RSRs for Stage I cancers were greater than 93% for the colon and rectum, female breast, and cervix uteri, whereas RSRs for patients with Stage IV cancers ranged from 2.9% to 38.9%, with patients with liver cancer and those with oral cancer showing the lowest and highest RSRs, respectively. Our study showed increased incidence in most cancers and provided baseline estimates of stage-specific RSRs among the Taiwanese adult population. Continuous surveillance may help politicians to improve health policies and cancer care in Taiwan. Copyright © 2016. Published by Elsevier B.V.

Real-world crude incidence of hypoglycemia in adults with diabetes: Results of the InHypo-DM Study, Canada.

PubMed

Ratzki-Leewing, Alexandria; Harris, Stewart B; Mequanint, Selam; Reichert, Sonja M; Belle Brown, Judith; Black, Jason Edward; Ryan, Bridget L

2018-01-01

Very few real-world studies have been conducted to assess the incidence of diabetes-related hypoglycemia. Moreover, there is a paucity of studies that have investigated hypoglycemia among people taking secretagogues as a monotherapy or in combination with insulin. Accordingly, our research team developed and validated the InHypo-DM Person with Diabetes Mellitus Questionnaire (InHypo-DMPQ) with the aim of capturing the real-world incidence of self-reported, symptomatic hypoglycemia. The questionnaire was administered online to a national sample of Canadians (≥18 years old) with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) treated with insulin and/or insulin secretagogues. Self-report data obtained from the InHypo-DMPQ were descriptively analyzed to ascertain the crude incidence proportions and annualized incidence densities (rates) of 30-day retrospective non-severe and 1-year retrospective severe hypoglycemia, including daytime and nocturnal events. A total of 552 people (T2DM: 83%; T1DM: 17%) completed the questionnaire. Over half (65.2%) of the total respondents reported experiencing at least one event (non-severe or severe) at an annualized crude incidence density of 35.1 events per person-year. The incidence proportion and rate of non-severe events were higher among people with T1DM versus T2DM (77% and 55.7 events per person-year vs 54% and 28.0 events per person-year). Severe hypoglycemia was reported by 41.8% of all respondents, at an average rate of 2.5 events per person-year. The results of the InHypo-DMPQ, the largest real-world investigation of hypoglycemia epidemiology in Canada, suggest that the incidence of hypoglycemia among adults with diabetes taking insulin and/or insulin secretagogues is higher than previously thought.

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

PubMed

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

2012-01-01

To evaluate the incidence of infant brain tumors and survival outcomes by disease and treatment variables. The Surveillance, Epidemiology, and End Results (SEER) Program November 2008 submission database provided age-adjusted incidence rates and individual case information for primary brain tumors diagnosed between 1973 and 2006 in infants less than 12 months of age. Between 1973 and 1986, the incidence of infant brain tumors increased from 16 to 40 cases per million (CPM), and from 1986 to 2006, the annual incidence rate averaged 35 CPM. Leading histologies by annual incidence in CPM were gliomas (13.8), medulloblastoma and primitive neuroectodermal tumors (6.6), and ependymomas (3.6). The annual incidence was higher in whites than in blacks (35.0 vs. 21.3 CPM). Infants with low-grade gliomas had the highest observed survival, and those with atypical teratoid rhabdoid tumors (ATRTs) or primary rhabdoid tumors of the brain had the lowest. Between 1979 and 1993, the annual rate of cases treated with radiation within the first 4 months from diagnosis declined from 20.5 CPM to <2 CPM. For infants with medulloblastoma, desmoplastic histology and treatment with both surgery and upfront radiation were associated with improved survival, but on multivariate regression, only combined surgery and radiation remained associated with improved survival, with a hazard ratio for death of 0.17 compared with surgery alone (p = 0.005). For ATRTs, those treated with surgery and upfront radiation had a 12-month survival of 100% compared with 24.4% for those treated with surgery alone (p = 0.016). For ependymomas survival was higher in patients treated in more recent decades (p = 0.001). The incidence of infant brain tumors has been stable since 1986. Survival outcomes varied markedly by histology. For infants with medulloblastoma and ATRTs, improved survival was observed in patients treated with both surgery and early radiation compared with those treated with surgery alone. Copyright © 2012 Elsevier Inc. All rights reserved.

Resident aggression toward staff at a center for the developmentally disabled.

PubMed

West, Christine A; Galloway, Ellen; Niemeier, Maureen T

2014-01-01

Few studies have examined factors contributing to nonfatal assaults to staff working in residential care facilities. The authors evaluated resident assaults toward direct care/nursing staff at an intermediate Care Facility for Individuals with Mental Retardation (ICF/MR), which included observations of work areas, employee interviews, calculation of injury and assault rates for 2004 to 2007 from Occupational Safety and Health Administration Logs, and review of state ICP/MR guidelines. Most staff interviewed reported having been injured during physical restraint of a resident and the average rate of injury from assault at the center evaluated was higher than the average national rates for the health care and social assistance sector for the same time period. The center lacked policies and developing a post-incident response and evaluation program to assist staff in coping with the consequences of assault and/or occupational injury.

Incidence and Mortality of Liver Cancer and Their Relationship with Development in Asia.

PubMed

Mohammadian, Maryam; Soroush, Ali; Mohammadian-Hafshejani, Abdollah; Towhidi, Farhad; Hadadian, Fatemeh; Salehiniya, Hamid

2016-01-01

Liver cancer (LC) is the sixth world most common cancer and the second leading cause of cancer death. Due to the importance and necessity of awareness about the incidence and mortality of diseases to perform prevention programs, this study focused on data for LC and its relationship with the human development index (HDI) and its components in Asia in 2012. This ecological study was based on GLOBOCAN data for Asian countries. We assessed correlations between standardized incidence rates (SIR) and standardized mortality rates (SMR) of LC with HDI and its components using of SPSS18. A total of 582,420 incident cases and 557,097 deaths were recorded in Asian countries in 2012. The five with the highest SIR were Mongolia, Lao PDR, Vietnam, Republic of Korea and Thailand and those with the highest SMR were Mongolia, Lao PDR, Vietnam, Cambodia and Thailand. A negative relation was observed between HDI and LC for SIR of 0.049 (P=0.748) and for SMR of 0.07 (P=0.645), with life expectancy at birth a positive relation for SIR of 0.061 (P=0.687) and a negative relation for SMR of 0.079 (P=0.603), with the average years of education a negative relation fo SIR of 0.476 (p=0.952) and for SMR of 0.032 (P=0.832), and with the country income level per person a negative relation for SMI of 0.11 (p=0.465) and for SMR of 0.113 (P=0.455). The incidence of LC is more in less developed and developing countries but statistically significant correlations were not found between standardized incidence and mortality rates of LC, and HDI and its dimensions.

Nasopharyngeal carcinoma incidence in North Tunisia: negative trends in adults but not adolescents, 1994-2006.

PubMed

Wided, Ben Ayoub Hizem; Hamouda, Boussen; Hamadi, Hsairi; Mansour, Ben Abdallah

2015-01-01

Nasopharyngeal carcinoma (NPC) is the second most common neoplasm of head and neck in Tunisia. The distribution is bimodal with a first period occurrence between 15 and 20 years old and a second peak at around 50 years of age. Undifferentiated carcinoma of nasopharynx type III (UCNT) is the predominant histological type (93.4%). Data of cancer registry of North Tunisia confirmed that it is an intermediate risk area for NPC with overall ASRs of 3.6 and 1.6/100,000 respectively in males and females. This study aimed to present the evolution of incidence rate of nasopharyngeal carcinoma over a period of 12 years (1994-2006). Data of cancer registry of North Tunisia (NTCR), covering half of the Tunisian population, were used to determine evolution of NPC incidence, calculated by 5 year periods. The estimated annual percentage change (EAPC) was used as an estimate of the trend. To best summarize the behavior or the data trend across years, we used a join-point regression program. Between 1994 and 2006, we observed negative annual average change of standardized incidence in men and women (-3.3% and -2.7%) also for the standardized incidences which showed a rather important decline (26.4% in males and 22.3% in females). The truncated age standardized incidence rate of NPC in adults aged of 30 years old and more (N=1209) decreased by -0.4% per year from 1994 to 2006 over time in north Tunisia dropping from 6.09 to 4.14 person-years. However, the rate was relatively stable during this period among youths aged 0-29 years (N=233) in both sexes. NPC demonstrated a favorable evolution from 1994-2006 probably due to a improvement in socioeconomic conditions.

Use of a prevention index to identify industries at high risk for work-related musculoskeletal disorders of the neck, back, and upper extremity in Washington state, 1990-1998.

PubMed

Silverstein, Barbara; Viikari-Juntura, Eira; Kalat, John

2002-03-01

The prevention of work-related musculoskeletal disorders such as carpal tunnel syndrome and low back disorders has been a focus of international prevention efforts including regulation. This study examines workers compensation claims in Washington State to provide baseline data from which to assess the need and the effects of prevention activities. Washington State Fund workers compensation claims for general and selected specific hand/wrist, elbow, shoulder, and back disorders in 1990-1998 as well as general self-insured compensable (four or more lost workdays) claims data were examined. Payroll hours were used to calculate claims incidence rates per 10,000 full-time equivalent employees (FTEs). We created a prevention index (PI) to rank industries by averaging the ranks of their number of claims and their claims incidence rate. The focus was on non-traumatic soft tissue musculoskeletal disorders (NTST-MSDs). Between 1990-1998, there were 392,925 State Fund accepted claims for NTST-MSDs of the neck, back, and upper extremity resulting in $2.6 billion in direct costs and 20.5 million lost workdays. The average claims incidence rate (CIR) was 355 NTST-MSDs per 10,000 FTEs. The NTST-MSD CIR decreased significantly less than that for all other claims (P = 0.05) but the CIR for upper extremity NTST-MSDs did not significantly decrease over the study period. There were no significant changes in the CIRs for sciatica (4.9 per 10,000 FTEs) and rotator cuff syndrome (15.3 per 10,000 FTEs), whereas the CIR for epicondylitis (10.6 per 10,000 FTEs) increased and for carpal tunnel syndrome (24.5 per 10,000 FTEs) decreased significantly over the study period. Based on the prevention index, the top five industries for combined State Fund and Self-Insured Compensable NTST-MSDs were Trucking and Courier Services (SIC 421), Nursing Homes (SIC 805), Masonry (SIC 174), Air Transportation (SIC 451), and Residential Construction (SIC 152). Using Washington Industrial Classes (WIC), temporary workers in assembly and administrative services were also high on the prevention index. NTST-MSDs continue to be a large and costly problem in Washington State. While the incidence rates for some NTST-MSDs are decreasing, the overall rate is not decreasing as fast as the rate for all other claims. In some cases, the rate is stable (sciatica, rotator cuff syndrome) or increasing (epicondylitis). Heavy manual handling and repetitive work characterize the industries with the highest risk. Copyright 2002 Wiley-Liss, Inc.

Water quality of the tidal Potomac River and Estuary: Hydrologic Data Reports supplement, 1979 through 1981 water years

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coupe, R.H. Jr.; Webb, W.E.

1984-01-01

This report is a companion report to the US Geological Survey 1979, 1980, and 1981 Hydrologic Data Reports of the tidal Potomac River and Estuary. The information included in this report contains values of biochemical oxygen demand and specific-rate constants, incident-light and light-attenuation measurements; numbers of phytoplankton, fecal coliform and fecal streptococci; cross-sectional averages from field measurements of dissolved oxygen, pH, specific conductance, and temperature data; and cross-sectional averages of chlorophyll data. Sewage-treatment plant loads are also included. 29 refs., 4 figs., 3 tabs.

Mode-locked Ti:sapphire laser oscillators pumped by wavelength-multiplexed laser diodes

NASA Astrophysics Data System (ADS)

Sugiyama, Naoto; Tanaka, Hiroki; Kannari, Fumihiko

2018-05-01

We directly pumped a Ti:sapphire laser by combining 478 and 520 nm laser diodes to prevent the effect of absorption loss induced by the pump laser of shorter wavelengths (∼450 nm). We obtain a continuous-wave output power of 660 mW at a total incident pump power of 3.15 W. We demonstrate mode locking using a semiconductor saturable absorber mirror, and 126 fs pulses were obtained at a repetition rate of 192 MHz. At the maximum pump power, the average output power is 315 mW. Shorter mode-locked pulses of 42 and 48 fs were respectively achieved by Kerr-lens mode locking with average output powers of 280 and 360 mW at a repetition rate of 117 MHz.

Incidence Rates of Deliberate Self-Harm in Denmark 1994–2011

PubMed Central

2016-01-01

Abstract. Background: The validity and reliability of suicide statistics have been questioned and few nationwide studies of deliberate self-harm have been presented. Aim: To calculate rates of deliberate self-harm in Denmark in order to investigate trends and assess the reliability of hospital records. Method: A register study based on all individuals recorded with an episode of deliberate self-harm or probable deliberate self-harm in nationwide registers during 1994–2011. Results: A substantial difference in the rates of deliberate self-harm and probable deliberate self-harm was noted for both genders. The average incidence rate of deliberate self-harm for women and men was 130.7 (95% CI = 129.6–131.8) per 100,000 and 86.9 (95% CI = 86.0–87.8) per 100,000, respectively. The rates of deliberate self-harm for women increased from 137.6 (95% CI = 132.9–142.3) per 100,000 in 1994 to 152.7 (95% CI = 147.8–157.5) in 2011. For a subgroup of younger women aged 15–24 years, an almost threefold increase was observed, IRR = 2.5 (95% CI = 2.4–2.7). The most frequently used method was self-poisoning. Conclusion: The rates of deliberate self-harm and probable deliberate self-harm differed significantly. An increased incidence of deliberate self-harm among young Danish women was observed, despite detection bias. An improved registration procedure of suicidal behavior is needed. PMID:27278571

Medical Monitoring During Firefighter Incident Scene Rehabilitation.

PubMed

Barr, David A; Haigh, Craig A; Haller, Jeannie M; Smith, Denise L

2016-01-01

The objective of this study was to retrospectively investigate aspects of medical monitoring, including medical complaints, vital signs at entry, and vital sign recovery, in firefighters during rehabilitation following operational firefighting duties. Incident scene rehabilitation logs obtained over a 5-year span that included 53 incidents, approximately 40 fire departments, and more than 530 firefighters were reviewed. Only 13 of 694 cases involved a firefighter reporting a medical complaint. In most cases, vital signs were similar between firefighters who registered a complaint and those who did not. On average, heart rate was 104 ± 23 beats·min(-1), systolic blood pressure was 132 ± 17 mmHg, diastolic blood pressure was 81 ± 12 mmHg, and respiratory rate was 19 ± 3 breaths·min(-1) upon entry into rehabilitation. At least two measurements of heart rate, systolic blood pressure, diastolic blood pressure, and respiratory rate were obtained for 365, 383, 376, and 160 cases, respectively. Heart rate, systolic and diastolic blood pressures, and respiratory rate decreased significantly (p < 0.001) during rehabilitation. Initial vital signs and changes in vital signs during recovery were highly variable. Data from this study indicated that most firefighters recovered from the physiological stress of firefighting without any medical complaint or symptoms. Furthermore, vital signs were within fire service suggested guidelines for release within 10 or 20 minutes of rehabilitation. The data suggested that vital signs of firefighters with medical symptoms were not significantly different from vital signs of firefighters who had an unremarkable recovery.

The Impact of Celebrity Suicide on Subsequent Suicide Rates in the General Population of Korea from 1990 to 2010.

PubMed

Park, Juhyun; Choi, Nari; Kim, Seog Ju; Kim, Soohyun; An, Hyonggin; Lee, Heon-Jeong; Lee, Yu Jin

2016-04-01

The association between celebrity suicide and subsequent increase in suicide rates among the general population has been suggested. Previous studies primarily focused on celebrity suicides in the 2000s. To better understand the association, this study examined the impacts of celebrity suicides on subsequent suicide rates using the data of Korean celebrity suicides between 1990 and 2010. Nine celebrity suicides were selected by an investigation of media reports of suicide deaths published in three major newspapers in Korea between 1990 and 2010. Suicide mortality data were obtained from the National Statistical Office of Korea. Seasonal autoregressive integrated moving average models with intervention analysis were used to test the impacts of celebrity suicides, controlling for seasonality. Six of the 9 celebrity suicides had significant impacts on suicide rates both in the total population and in the same gender- or the same age-subgroups. The incident that occurred in the 1990s had no significant impact on the overall suicide rates, whereas the majority of the incidents in the 2000s had significant influences for 30 or 60 days following each incident. The influence of celebrity suicide was shown to reach its peak following the suicide death of a renowned actress in 2008. The findings may suggest a link between media coverage and the impact of celebrity suicide. Future studies should focus more on the underlying processes and confounding factors that may contribute to the impact of celebrity suicide on subsequent suicide rates.

The Impact of Celebrity Suicide on Subsequent Suicide Rates in the General Population of Korea from 1990 to 2010

PubMed Central

2016-01-01

The association between celebrity suicide and subsequent increase in suicide rates among the general population has been suggested. Previous studies primarily focused on celebrity suicides in the 2000s. To better understand the association, this study examined the impacts of celebrity suicides on subsequent suicide rates using the data of Korean celebrity suicides between 1990 and 2010. Nine celebrity suicides were selected by an investigation of media reports of suicide deaths published in three major newspapers in Korea between 1990 and 2010. Suicide mortality data were obtained from the National Statistical Office of Korea. Seasonal autoregressive integrated moving average models with intervention analysis were used to test the impacts of celebrity suicides, controlling for seasonality. Six of the 9 celebrity suicides had significant impacts on suicide rates both in the total population and in the same gender- or the same age-subgroups. The incident that occurred in the 1990s had no significant impact on the overall suicide rates, whereas the majority of the incidents in the 2000s had significant influences for 30 or 60 days following each incident. The influence of celebrity suicide was shown to reach its peak following the suicide death of a renowned actress in 2008. The findings may suggest a link between media coverage and the impact of celebrity suicide. Future studies should focus more on the underlying processes and confounding factors that may contribute to the impact of celebrity suicide on subsequent suicide rates. PMID:27051245

Epidemiology of gastroenteritis on cruise ships, 2001-2004.

PubMed

Cramer, Elaine H; Blanton, Curtis J; Blanton, Lenee H; Vaughan, George H; Bopp, Cheryl A; Forney, David L

2006-03-01

The incidence of diarrheal disease among cruise ship passengers declined from 29.2 cases per 100,000 passenger days in 1990 to 16.3 per 100,000 passenger days in 2000. In 2002, the Vessel Sanitation Program of the Centers for Disease Control and Prevention reported 29 outbreaks (3% or more passengers ill) of acute gastroenteritis on cruise ships, an increase from 3 the previous year. This analysis of gastroenteritis on cruise ships, conducted in 2005, details the increase in outbreak incidence rates during 2001 through 2004. Using Gastrointestinal Illness Surveillance System data, investigators evaluated incidence rates of gastroenteritis on cruise ships calling on U.S. ports, carrying 13 or more passengers, by cruise length and reporting region during the study period. The investigators also evaluated the association between inspection scores, and gastroenteritis incidence and the frequency of outbreaks in 2001 through 2004. During the study period, the background and outbreak-associated incidence rates of passengers with acute gastroenteritis per cruise were 25.6 and 85, respectively. Acute gastroenteritis outbreaks per 1000 cruises increased overall from 0.65 in 2001 to 5.46 in 2004; outbreaks increased from 2 in 2001 to a median of 15 per year in 2002-2004. Median ship inspection scores remained relatively constant during the study period (median 95 on a 100-point scale), and were not significantly associated with either gastroenteritis incidence rates (risk ratio, 1.00; 95% confidence interval, 0.98-1.02) or outbreak frequency (Spearman's coefficient, 0.01, p=0.84). Despite good performance on environment health sanitation inspections by cruise ships, the expectation of passenger cases of gastroenteritis on an average 7-day cruise increased from two cases during 1990-2000 to three cases during the study period. This increase, likely attributable to noroviruses, highlights the inability of environmental programs to fully predict and prevent risk factors common to person-to-person and fomite spread of disease.

Salmonella enterica Infections in the United States and Assessment of Coefficients of Variation: A Novel Approach to Identify Epidemiologic Characteristics of Individual Serotypes, 1996-2011.

PubMed

Boore, Amy L; Hoekstra, R Michael; Iwamoto, Martha; Fields, Patricia I; Bishop, Richard D; Swerdlow, David L

2015-01-01

Despite control efforts, salmonellosis continues to cause an estimated 1.2 million infections in the United States (US) annually. We describe the incidence of salmonellosis in the US and introduce a novel approach to examine the epidemiologic similarities and differences of individual serotypes. Cases of salmonellosis in humans reported to the laboratory-based National Salmonella Surveillance System during 1996-2011 from US states were included. Coefficients of variation were used to describe distribution of incidence rates of common Salmonella serotypes by geographic region, age group and sex of patient, and month of sample isolation. During 1996-2011, more than 600,000 Salmonella isolates from humans were reported, with an average annual incidence of 13.1 cases/100,000 persons. The annual reported rate of Salmonella infections did not decrease during the study period. The top five most commonly reported serotypes, Typhimurium, Enteritidis, Newport, Heidelberg, and Javiana, accounted for 62% of fully serotyped isolates. Coefficients of variation showed the most geographically concentrated serotypes were often clustered in Gulf Coast states and were also more frequently found to be increasing in incidence. Serotypes clustered in particular months, age groups, and sex were also identified and described. Although overall incidence rates of Salmonella did not change over time, trends and epidemiological factors differed remarkably by serotype. A better understanding of Salmonella, facilitated by this comprehensive description of overall trends and unique characteristics of individual serotypes, will assist in responding to this disease and in planning and implementing prevention activities.

Predictive power of the DASA-IV: Variations in rating method and timescales.

PubMed

Nqwaku, Mphindisi; Draycott, Simon; Aldridge-Waddon, Luke; Bush, Emma-Louise; Tsirimokou, Alexandra; Jones, Dominic; Puzzo, Ignazio

2018-05-10

This project evaluated the predictive validity of the Dynamic Appraisal of Situational Aggression - Inpatient Version (DASA-IV) in a high-secure psychiatric hospital in the UK over 24 hours and over a single nursing shift. DASA-IV scores from three sequential nursing shifts over a 24-hour period were compared with the mean (average of three scores across the 24-hour period) and peak (highest of the three scores across the 24-hour period) scores across these shifts. In addition, scores from a single nursing shift were used to predict aggressive incidents over each of the following three shifts. The DASA-IV was completed by nursing staff during handover meetings, rating 43 male psychiatric inpatients over a period of 6 months. Data were compared to incident reports recorded over the same period. Receiver operating characteristic (ROC) curves and generalized estimating equations assessed the predictive ability of various DASA-IV scores over 24-hour and single-shift timescales. Scores from the DASA-IV based on a single shift had moderate predictive ability for aggressive incidents occurring the next calendar day, whereas scores based on all three shifts had excellent predictive ability. DASA-IV scores from a single shift showed moderate predictive ability for each of the following three shifts. The DASA-IV has excellent predictive ability for aggressive incidents within a secure setting when data are summarized over a 24-hour period, as opposed to when a single rating is taken. In addition, it has moderate value for predicting incidents over even shorter timescales. © 2018 Australian College of Mental Health Nurses Inc.

Trend of some Tuberculosis Indices in Iran during 25 yr Period (1990-2014).

PubMed

Khazaei, Salman; Ayubi, Erfan; Mansournia, Mohammad Ali; Rafiemanesh, Hossein

2016-01-01

Investigation of tuberculosis (TB)-specific indices including prevalence of TB, mortality of TB cases excluding HIV, HIV/TB mortality, incidence of TB (all forms), HIV/TB incidence as well as case detection and related trends is a crucial step in evaluation of program performance and strategies success. Besides, estimating the number and time of change points for TB incidence can help to detect effective factors in TB control. Therefore, the current study aimed to determine the trend of aforementioned indices in Iran during a 25 yr period (1990 to 2014). Data on trend of TB in Iran was extracted from WHO regional office reports during 1990-2014. For determining the trend of TB indices, Annual Percent Changes (APC) and Average Annual Percent Changes (AAPC) was estimated using segmented regression model. AAPC (95% CI) for HIV/TB mortality and HIV/TB incidence were 11.5 (9.3, 13.6) and 14.8 (13.6, 16.1), respectively, which are sign of increasing trend during the period (P<0.05). Other indices showed significantly decreasing trend (P<0.05), except for case detection rate (P =0.803). The incidence, prevalence, and death rates of TB had shown a decreasing trend in general population, regarded as a useful indicator of achievements of Millennium Development Goals (MDGs) and effectiveness of interventional programs. Increasing trend of incidence and mortality of TB in HIV infected patients, needs conducting more intervention strategies in health care programs.

[Prosthetic joint infection: a prospective study in five Catalonian hospitals].

PubMed

García-Pont, Javier; Blanch-Falp, Jesús; Coll-Colell, Rosa; Rosell-Abaurrea, Francesc; Tapiz-Reula, Alfons; Dorca-Badía, Ester; Masabeu-Urrutia, Angels; Martín-Urda, Anabel; Barrufet-Barque, Pilar; Force-Sanmartín, Lluis

2006-03-01

Prosthetic joint infections are a cause of increasing morbidity and medical expenditure. To determine the incidence and the clinical and the epidemiological characteristics of knee and hip prosthetic infections (PI) in patients undergoing elective surgery in five Catalonian hospitals. To determine the predictive factors of PI. A total of 425 patients operated on between 8 January and 8 July 2001 were prospectively followed for a period of two years. The cumulative incidence, incidence rate and effect measures were determined. Logistic regression was used to identify variables associated with PI. Average age was 71 years and 63.1% were women. Antibiotic prophylaxis with cefazolin was given to 44.7% of the patients, with a mean duration of two days. Prophylaxis was administered during anesthesia induction in 75.6% of the patients. Among the total, 63.4% of the patients were ASA 2. Microbiological confirmation was obtained in all the infected patients; Staphylococcus epidermidis was found in 58%. Fourteen PI were diagnosed, 71% during the first 3 months, with a cumulative incidence of 3.29% and a 3-month incidence rate of 63 patients/10,000 patients/month. Diabetes mellitus was the only variable related to PI in the multivariate analysis: 3.18, 95% CI (1.1-9.9). The cumulative incidence of PI was slightly higher than that seen in other studies. Variations were observed in the antibiotic used for prophylaxis, and the place where it was administered. PI occurred 3.18 times more frequently in diabetic patients.

A prospective randomised study comparing the jubilee dressing method to a standard adhesive dressing for total hip and knee replacements.

PubMed

Burke, Neil G; Green, Connor; McHugh, Gavin; McGolderick, Niall; Kilcoyne, Carol; Kenny, Patrick

2012-08-01

It is important to reduce potential wound complications in total hip and total knee arthroplasty procedures. The purpose of this study was to compare the jubilee dressing method to a standard adhesive dressing. 124 patients (62 total hip replacements and 62 total knee replacements) were randomly selected to have either a standard adhesive dressing or jubilee method dressing. The number of dressing changes, incidence of blistering, leakage, appearance of inflammation, infection rate and the average stay in hospital was recorded for each patient. The jubilee dressing significantly reduced the rate of blistering, leakage and number of dressing changes when compare to a traditional adhesive dressing (p < 0.05). The rate of inflammation and average length of stay in hospital was not significantly different between the two groups. The authors recommend the use of this dressing for total hip and total knee arthroplasty procedures due to the associated lower complication rate. Copyright © 2012 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Sex differences in immune variables and respiratory infection incidence in an athletic population.

PubMed

Gleeson, Michael; Bishop, Nicolette; Oliveira, Marta; McCauley, Tracey; Tauler, Pedro

2011-01-01

The purpose of this study was to examine sex differences in immune variables and upper respiratory tract infection (URTI) incidence in 18-35 year-old athletes engaged in endurance-based physical activity during the winter months. Eighty physically active individuals (46 males, 34 females) provided resting venous blood samples for determination of differential leukocyte counts, lymphocyte subsets and whole blood culture multi-antigen stimulated cytokine production. Timed collections of unstimulated saliva were also made for determination of saliva flow rate, immunoglobulin A (IgA) concentration and IgA secretion rate. Weekly training and illness logs were kept for the following 4 months. Training loads averaged 10 h/week of moderate-vigorous physical activity and were not different for males and females. Saliva flow rates, IgA concentration and IgA secretion rates were significantly higher in males than females (all P < 0.01). Plasma IgA, IgG and IgM concentrations and total blood leukocyte, neutrophil, monocyte and lymphocyte counts were not different between the sexes but males had higher numbers of B cells (P < 0.05) and NK cells (P < 0.001). The production of interleukins 1 beta, 2, 4, 6, 8 and 10, interferon-gamma and tumour necrosis factor-alpha in response to multi-antigen challenge were not significantly different in males and females (all P > 0.05). The average number of weeks with URTI symptoms was 1.7 +/- 2.1 (mean +/- SD) in males and 2.3 +/- 2.5 in females (P = 0.311). It is concluded that most aspects of immunity are similar in men and women in an athletic population and that the observed differences in a few immune variables are not sufficient to substantially affect URTI incidence. Sex differences in immune function among athletes probably do not need to be considered in future mixed gender studies on exercise, infection and immune function unless the focus is on mucosal immunity or NK cells.

Model variations in predicting incidence of Plasmodium falciparum malaria using 1998-2007 morbidity and meteorological data from south Ethiopia.

PubMed

Loha, Eskindir; Lindtjørn, Bernt

2010-06-16

Malaria transmission is complex and is believed to be associated with local climate changes. However, simple attempts to extrapolate malaria incidence rates from averaged regional meteorological conditions have proven unsuccessful. Therefore, the objective of this study was to determine if variations in specific meteorological factors are able to consistently predict P. falciparum malaria incidence at different locations in south Ethiopia. Retrospective data from 42 locations were collected including P. falciparum malaria incidence for the period of 1998-2007 and meteorological variables such as monthly rainfall (all locations), temperature (17 locations), and relative humidity (three locations). Thirty-five data sets qualified for the analysis. Ljung-Box Q statistics was used for model diagnosis, and R squared or stationary R squared was taken as goodness of fit measure. Time series modelling was carried out using Transfer Function (TF) models and univariate auto-regressive integrated moving average (ARIMA) when there was no significant predictor meteorological variable. Of 35 models, five were discarded because of the significant value of Ljung-Box Q statistics. Past P. falciparum malaria incidence alone (17 locations) or when coupled with meteorological variables (four locations) was able to predict P. falciparum malaria incidence within statistical significance. All seasonal AIRMA orders were from locations at altitudes above 1742 m. Monthly rainfall, minimum and maximum temperature was able to predict incidence at four, five and two locations, respectively. In contrast, relative humidity was not able to predict P. falciparum malaria incidence. The R squared values for the models ranged from 16% to 97%, with the exception of one model which had a negative value. Models with seasonal ARIMA orders were found to perform better. However, the models for predicting P. falciparum malaria incidence varied from location to location, and among lagged effects, data transformation forms, ARIMA and TF orders. This study describes P. falciparum malaria incidence models linked with meteorological data. Variability in the models was principally attributed to regional differences, and a single model was not found that fits all locations. Past P. falciparum malaria incidence appeared to be a superior predictor than meteorology. Future efforts in malaria modelling may benefit from inclusion of non-meteorological factors.

Applying Resilience Promotion Training Among Special Forces Police Officers

PubMed Central

Andersen, Judith P.; Papazoglou, Konstantinos; Koskelainen, Mari; Nyman, Markku; Gustafsberg, Harri; Arnetz, Bengt B.

2015-01-01

Police Special Forces (a.k.a. special weapons and tactics [SWAT]) officers are tasked with responding to the most critical situations, including incidents that require specialized skills and equipment beyond typical policing activities. In this study, we tested the feasibility of applying Arnetz and colleagues’ resilience promotion training that was developed for patrol officers to SWAT team officers (n = 18). The resilience promotion training program included psychoeducation focused on police stress and resilience, and the practice of resilience promotion techniques (controlled breathing and imagery) while listening to audio-recorded critical incident scenarios. The aims of this study were to (a) examine if a resilience training program was relevant and accepted by SWAT team officers and (b) assess participants’ physiological stress responses (heart rate, respiration) during the resilience training sessions to note if there were improvements in stress responding over time. Our findings revealed that participants were able to significantly reduce their average heart rate and improve their ability to engage in controlled respiration (i.e., breathing) during simulated critical incidents over the course of the 5-day training. Improvements in stress responding were observed even when the critical incident scenarios became more graphic. Results suggest that an intervention to reduce stress responses of SWAT officers to critical incident scenarios works in a simulated training setting. Translation of these findings to real-world occupational hazards is a recommended next step. PMID:26137394

[Study on the ecological association between natural radioactivity and childhood leukemia in Guangdong province].

PubMed

Ma, Jin-Xiang; Lei, Yi-Xiong; Ye, Tie-Zhen

2008-04-01

This study was undertaken to evaluate the ecological association between terrestrial natural radionuclide, indoor radon concentration, natural radioactivity and leukemia incidence among children under 18 years of age. Data were gathered from the disease surveillance program and literature reading while software SPSS 13.0 was used to calculate the Spearman's correlation. The incidence rates of childhood (0-18 year) leukemia showed significant differences in different places with the highest as 3.13/10(5) in Jiangmen area and the lowest as 0.42/10(5) in Maoming area. The incidence in Jiangmen was 7.45 times higher than that in Maoming. There was a rank correlation between the incidence of childhood leukemia and the mean concentrations of natural radio-nuclides in soil (226Ra and 232Th), with a positive correlation observed for overall leukemia (r(s) = 0.70, P = 0.011; r(s) = 0.66, P= 0.02 for 226 Ra and 232Th respectively) and acute lymphoblastic leukemia (ALL) (r(s) = 0.66, P = 0.019; r(s) = 0.64, P = 0.025 for 226 Ra and 232Th respectively). Associations between the incidence of childhood leukemia and the indoor gamma radiation dose rate, the total annual average effective dose equivalent from natural background radiationwere also analyzed (both r(s) = 0.59, P = 0.042). The natural radioactivity was likely to be a causative factor for childhood leukemia in Guangdong.

A Prospective Study of the Incidence of Juvenile-Onset Recurrent Respiratory Papillomatosis After Implementation of a National HPV Vaccination Program.

PubMed

Novakovic, Daniel; Cheng, Alan T L; Zurynski, Yvonne; Booy, Robert; Walker, Paul J; Berkowitz, Robert; Harrison, Henley; Black, Robert; Perry, Christopher; Vijayasekaran, Shyan; Wabnitz, David; Burns, Hannah; Tabrizi, Sepehr N; Garland, Suzanne M; Elliott, Elizabeth; Brotherton, Julia M L

2018-01-04

Recurrent respiratory papillomatosis is a rare but morbid disease caused by human papillomavirus (HPV) types 6 and 11. Infection is preventable through HPV vaccination. Following an extensive quadrivalent HPV vaccination program (females 12-26 years in 2007-2009) in Australia, we established a method to monitor incidence and demographics of juvenile-onset recurrent respiratory papillomatosis (JORRP) cases. The Australian Paediatric Surveillance Unit undertakes surveillance of rare pediatric diseases by contacting practitioners monthly. We enrolled pediatric otorhinolaryngologists and offered HPV typing. We report findings for 5 years to end 2016. The average annual incidence rate was 0.07 per 100000. The largest number of cases was reported in the first year, with decreasing annual frequency thereafter. Rates declined from 0.16 per 100000 in 2012 to 0.02 per 100000 in 2016 (P = .034). Among the 15 incident cases (60% male), no mothers were vaccinated prepregnancy, 20% had maternal history of genital warts, and 60% were first born; 13/15 were born vaginally. Genotyped cases were HPV-6 (n = 4) or HPV-11 (n = 3). To our knowledge, this is the first report internationally documenting decline in JORRP incidence in children following a quadrivalent HPV vaccination program. © 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.

Prevalence estimates for primary brain tumors in the United States by age, gender, behavior, and histology.

PubMed

Porter, Kimberly R; McCarthy, Bridget J; Freels, Sally; Kim, Yoonsang; Davis, Faith G

2010-06-01

Prevalence is the best indicator of cancer survivorship in the population, but few studies have focused on brain tumor prevalence because of previous data limitations. Hence, the full impact of primary brain tumors on the healthcare system in the United States is not completely described. The present study provides an estimate of the prevalence of disease in the United States, updating an earlier prevalence study. Incidence data for 2004 and survival data for 1985-2005 were obtained by the Central Brain Tumor Registry of the United States from selected regions, modeled under 2 different survival assumptions, to estimate prevalence rates for the year 2004 and projected estimates for 2010. The overall incidence rate for primary brain tumors was 18.1 per 100 000 person-years with 2-, 5-, 10-, and 20-year observed survival rates of 62%, 54%, 45%, and 30%, respectively. On the basis of the sum of nonmalignant and averaged malignant estimates, the overall prevalence rate of individuals with a brain tumor was estimated to be 209.0 per 100 000 in 2004 and 221.8 per 100 000 in 2010. The female prevalence rate (264.8 per 100 000) was higher than that in males (158.7 per 100 000). The averaged prevalence rate for malignant tumors (42.5 per 100 000) was lower than the prevalence for nonmalignant tumors (166.5 per 100 000). This study provides estimates of the 2004 (n = 612 770) and 2010 (n = 688 096) expected number of individuals living with primary brain tumor diagnoses in the United States, providing more current and robust estimates for aiding healthcare planning and patient advocacy for an aging US population.

Incidence of female homicide in the Transkei sub-region of South Africa (1993-2015).

PubMed

Meel, Banwari

2018-05-01

Female homicide is very complex and difficult to research. Xhosa women are poor, illiterate and live in a rural area where they are exposed to a number of risks to their lives. The previous apartheid regimen broke the fabric of the family value system in this region and this came on top of a traditional patriarchal view of women as little more than property. Women are most vulnerable in this traumatised society. To study the incidence of female homicide in the Transkei sub-region of South Africa. A record review was undertaken of all medico-legal autopsies performed from 1993 to 2015 at Mthatha Forensic Pathology Laboratory. In total, 26 972 autopsies were performed on victims of unnatural death between 1993 and 2015. Of these, 6091 (22.58%) were cases of unnatural death among females. Homicide accounted for 1865 (30.61%) of these deaths. The average rate of female homicide during the study period was 12.5 per 100 000. The rate of homicide decreased from 14.25/100 000 (1993) to 9.19/100 000 (2015). The average rate of death was 4.93/100 000 as a result of the use of firearms, 3.75/100 000 for stab injuries and 3.70/100 000 for blunt trauma. The rate of murder was highest (6.55/100 000) in the young age group between 11 and 40 years. Despite a one and half time decrease in the rate of female homicide in the last 23 years (1993-2015) in the Transkei sub-region of South Africa, it is still three times higher than the worldwide rate. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Proposing a Compartmental Model for Leprosy and Parameterizing Using Regional Incidence in Brazil.

PubMed

Smith, Rebecca Lee

2016-08-01

Hansen's disease (HD), or leprosy, is still considered a public health risk in much of Brazil. Understanding the dynamics of the infection at a regional level can aid in identification of targets to improve control. A compartmental continuous-time model for leprosy dynamics was designed based on understanding of the biology of the infection. The transmission coefficients for the model and the rate of detection were fit for each region using Approximate Bayesian Computation applied to paucibacillary and multibacillary incidence data over the period of 2000 to 2010, and model fit was validated on incidence data from 2011 to 2012. Regional variation was noted in detection rate, with cases in the Midwest estimated to be infectious for 10 years prior to detection compared to 5 years for most other regions. Posterior predictions for the model estimated that elimination of leprosy as a public health risk would require, on average, 44-45 years in the three regions with the highest prevalence. The model is easily adaptable to other settings, and can be studied to determine the efficacy of improved case finding on leprosy control.

Statistical modeling of valley fever data in Kern County, California

NASA Astrophysics Data System (ADS)

Talamantes, Jorge; Behseta, Sam; Zender, Charles S.

2007-03-01

Coccidioidomycosis (valley fever) is a fungal infection found in the southwestern US, northern Mexico, and some places in Central and South America. The fungus that causes it ( Coccidioides immitis) is normally soil-dwelling but, if disturbed, becomes air-borne and infects the host when its spores are inhaled. It is thus natural to surmise that weather conditions that foster the growth and dispersal of the fungus must have an effect on the number of cases in the endemic areas. We present here an attempt at the modeling of valley fever incidence in Kern County, California, by the implementation of a generalized auto regressive moving average (GARMA) model. We show that the number of valley fever cases can be predicted mainly by considering only the previous history of incidence rates in the county. The inclusion of weather-related time sequences improves the model only to a relatively minor extent. This suggests that fluctuations of incidence rates (about a seasonally varying background value) are related to biological and/or anthropogenic reasons, and not so much to weather anomalies.

Contagion in Mass Killings and School Shootings.

PubMed

Towers, Sherry; Gomez-Lievano, Andres; Khan, Maryam; Mubayi, Anuj; Castillo-Chavez, Carlos

2015-01-01

Several past studies have found that media reports of suicides and homicides appear to subsequently increase the incidence of similar events in the community, apparently due to the coverage planting the seeds of ideation in at-risk individuals to commit similar acts. Here we explore whether or not contagion is evident in more high-profile incidents, such as school shootings and mass killings (incidents with four or more people killed). We fit a contagion model to recent data sets related to such incidents in the US, with terms that take into account the fact that a school shooting or mass murder may temporarily increase the probability of a similar event in the immediate future, by assuming an exponential decay in contagiousness after an event. We find significant evidence that mass killings involving firearms are incented by similar events in the immediate past. On average, this temporary increase in probability lasts 13 days, and each incident incites at least 0.30 new incidents (p = 0.0015). We also find significant evidence of contagion in school shootings, for which an incident is contagious for an average of 13 days, and incites an average of at least 0.22 new incidents (p = 0.0001). All p-values are assessed based on a likelihood ratio test comparing the likelihood of a contagion model to that of a null model with no contagion. On average, mass killings involving firearms occur approximately every two weeks in the US, while school shootings occur on average monthly. We find that state prevalence of firearm ownership is significantly associated with the state incidence of mass killings with firearms, school shootings, and mass shootings.

Contagion in Mass Killings and School Shootings

PubMed Central

Towers, Sherry; Gomez-Lievano, Andres; Khan, Maryam; Mubayi, Anuj; Castillo-Chavez, Carlos

2015-01-01

Background Several past studies have found that media reports of suicides and homicides appear to subsequently increase the incidence of similar events in the community, apparently due to the coverage planting the seeds of ideation in at-risk individuals to commit similar acts. Methods Here we explore whether or not contagion is evident in more high-profile incidents, such as school shootings and mass killings (incidents with four or more people killed). We fit a contagion model to recent data sets related to such incidents in the US, with terms that take into account the fact that a school shooting or mass murder may temporarily increase the probability of a similar event in the immediate future, by assuming an exponential decay in contagiousness after an event. Conclusions We find significant evidence that mass killings involving firearms are incented by similar events in the immediate past. On average, this temporary increase in probability lasts 13 days, and each incident incites at least 0.30 new incidents (p = 0.0015). We also find significant evidence of contagion in school shootings, for which an incident is contagious for an average of 13 days, and incites an average of at least 0.22 new incidents (p = 0.0001). All p-values are assessed based on a likelihood ratio test comparing the likelihood of a contagion model to that of a null model with no contagion. On average, mass killings involving firearms occur approximately every two weeks in the US, while school shootings occur on average monthly. We find that state prevalence of firearm ownership is significantly associated with the state incidence of mass killings with firearms, school shootings, and mass shootings. PMID:26135941

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

PubMed

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

2017-12-01

The frequency of coeliac disease (CD) has been on the rise over the past decades, especially in Western Europe, but current trends are unclear. To research the recent temporal changes in the incidence of adult, biopsy-verified coeliac disease and dermatitis herpetiformis (DH) in Finland, a country with a high frequency of coeliac disease. All coeliac disease and DH cases diagnosed at age 20-79 years during 2005-2014 were retrieved from a nationwide database documenting all applicants for monthly compensation to cover the extra cost of maintaining a gluten-free diet. This benefit is granted on the basis of histology, not socioeconomic status. Temporal trends in the annual incidences were estimated using Poisson regression analyses. The total incidence of coeliac disease decreased from 33/100 000 during the years 2005-2006 to 29/100 000 during 2013-2014. The mean annual incidence of coeliac disease was nearly twice as high among women as among men, 42 vs 22 per 100 000, respectively. For middle- and old-aged women, the average rate of decrease in incidence was 4.8% (95% CI 3.9-5.7) per year and for men 3.0% (1.8-4.1) (P for linear trend <.001, for both). Similarly, the annual incidence of DH declined. For young adults, the rate of change remained low and nonsignificant throughout the period 2005-2014. Although the awareness of coeliac disease has increased during the past decades, the incidence of biopsy-verified diagnoses is not increasing, which suggests that exposure to yet unidentified triggering factors for coeliac disease has plateaued among the Finnish adult population. © 2017 John Wiley & Sons Ltd.

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

PubMed

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.

Human Brucellosis Trends: Re-emergence and Prospects for Control Using a One Health Approach in Azerbaijan (1983-2009).

PubMed

Kracalik, I T; Abdullayev, R; Asadov, K; Ismayilova, R; Baghirova, M; Ustun, N; Shikhiyev, M; Talibzade, A; Blackburn, J K

2016-06-01

Brucellosis is one of the most common and widely spread zoonotic diseases in the world. Control of the disease in humans is dependent upon limiting the infection in animals through surveillance and vaccination. Given the dramatic economic and political changes that have taken place in the former Soviet Union, which have limited control, evaluating the status of human brucellosis in former Soviet states is crucial. We assessed annual spatial and temporal trends in the epidemiology of human brucellosis in Azerbaijan, 1983-2009, in conjunction with data from a livestock surveillance and control programme (2002-2009). To analyse trends, we used a combination of segmented regression and spatial analysis. From 1983 to 2009, a total of 11 233 cases of human brucellosis were reported. Up to the mid-1990s, the incidence of human brucellosis showed a pattern of re-emergence, increasing by 25% annually, on average. Following Soviet governance, the incidence rates peaked, increasing by 1.8% annually, on average, and subsequently decreasing by 5% annually, on average, during the period 2002-2009. Despite recent national declines in human incidence, we identified geographic changes in the case distribution characterized by a geographic expansion and an increasing incidence among districts clustered in the south-east, compared to a decrease of elsewhere in the country. Males were consistently, disproportionately afflicted (71%) and incidence was highest in the 15 to 19 age group (18.1 cases/100 000). During the period 2002-2009, >10 million small ruminants were vaccinated with Rev1. Our findings highlight the improving prospects for human brucellosis control following livestock vaccination; however, the disease appears to be re-emerging in south-eastern Azerbaijan. Sustained one health measures are needed to address changing patterns of brucellosis in Azerbaijan and elsewhere in the former Soviet Union. © 2015 The Authors. Zoonoses and Public Health Published by Blackwell Verlag GmbH.

Trends and burden of firearm-related hospitalizations in the United States across 2001-2011.

PubMed

Agarwal, Shikhar

2015-05-01

Firearm-related hospitalizations are a major burden to the current health care infrastructure. We examined the trends in the incidence and case-fatality rates of firearm-related hospitalizations over the past decade. We also hypothesized that major national economic perturbations would be partly responsible and correlate temporally with national firearm-related hospitalization trends. We used the 2001-2011 Nationwide Inpatient Sample for analysis. Firearm-related hospitalizations were identified using International Classification of Diseases, 9(th) Revision codes. In addition, we examined the relationship between the US stock market performance (Dow Jones Industrial Average) and the annual firearm-related hospitalization incidence rates. In the last decade, there has been a modest decline in firearm-related hospitalizations, interrupted by spikes in the annual incidence that closely corresponded to periods of national economic instability. In addition, the overall case-fatality rate following firearm-related hospitalization has been stable at ∼8%; the highest rates being present among those who attempted suicide using firearms. Also, there has been an increase in the prevalence of mental health disorders among individuals admitted with firearm-related injuries. Moreover, there was an increase in the length of stay and the cost/charges associated with hospitalization over the last decade. Over 2001-2011, the national incidence of firearm-related hospitalizations has closely tracked the national stock market performance, suggesting that economic perturbations and resultant insecurities might underlie the perpetuation of firearm-related injuries. Although the case-fatality rates have remained stable, the length of stay and hospitalization costs have increased, imposing additional burden on existing health care resources. Copyright © 2015 Elsevier Inc. All rights reserved.

Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality - United States, 2004-2013.

PubMed

Henley, S Jane; Thomas, Cheryll C; Sharapova, Saida R; Momin, Behnoosh; Massetti, Greta M; Winn, Deborah M; Armour, Brian S; Richardson, Lisa C

2016-11-11

Tobacco use causes at least 12 types of cancer and is the leading preventable cause of cancer. Data from the United States Cancer Statistics dataset for 2004-2013 were used to assess incidence and death rates and trends for cancers that can be caused by tobacco use (tobacco-related cancers: oral cavity and pharynx; esophagus; stomach; colon and rectum; liver; pancreas; larynx; lung, bronchus, and trachea; kidney and renal pelvis; urinary bladder; cervix; and acute myeloid leukemia) by sex, age, race, ethnicity, state, county-level poverty and educational attainment, and cancer site. Each year during 2009-2013, on average, 660,000 persons in the United States received a diagnosis of a tobacco-related cancer, and 343,000 persons died from these cancers. Tobacco-related cancer incidence and death rates were higher among men than women; highest among black men and women; higher in counties with low proportion of college graduates or high level of poverty; lowest in the West; and differed two-fold among states. During 2004-2013, incidence of tobacco-related cancer decreased 1.3% per year and mortality decreased 1.6% per year, with decreases observed across most groups, but not at the same rate. Tobacco-related cancer declined during 2004-2013. However, the burden remains high, and disparities persist among certain groups with higher rates or slower declines in rates. The burden of tobacco-related cancers can be reduced through efforts to prevent and control tobacco use and other comprehensive cancer control efforts focused on reducing cancer risk, detecting cancer early, improving cancer treatments, helping more persons survive cancer, improving cancer survivors' quality of life, and better assisting communities disproportionately impacted by cancer.

Incidence of sudden cardiac death in Germany: results from an emergency medical service registry in Lower Saxony

PubMed Central

Martens, Eimo; Sinner, Moritz F.; Siebermair, Johannes; Raufhake, Carsten; Beckmann, Britt M.; Veith, Stefan; Düvel, Dieter; Steinbeck, Gerhard; Kääb, Stefan

2014-01-01

Aims Sudden cardiac death (SCD) is among the most common causes of death in western countries including Germany. Whereas risk stratification and primary prevention is still insufficient, we also lack accurate incidence estimates. Current estimates vary widely (18.6–128/100 000/year), but data on SCD incidence in Germany are missing. Depending on SCD definitions, death needs to occur between 1 and 24 h after the onset of symptoms. Methods and results In the district of Aurich (190 000 inhabitants, Lower Saxony, Germany), emergency medical service (EMS) is provided by a district government operated single carrier and two hospitals. To evaluate all EMS calls in this district from 2002 to 2009, we obtained EMS protocols, medical records, and death certificates for data analysis and adjudication of SCD. We defined SCD according to the definition of the World Health Organization, considering patients with cardiac arrest within ≤1 h after the onset of symptoms. We also required cardiopulmonary resuscitation being performed by EMS personnel. The overall mortality rate in the district of Aurich (1060/100 000/year) corresponded well with the average mortality rate in Germany (1030/100 000/year). During the observation period, we adjudicated 1212 SCD cases, equivalent to an annual rate of 151 SCD cases (81 cases/100 000/year). Rates remained remarkably stable over time, and affected a considerable number of individuals of working age (32/100 000/year). Conclusion Consistent with prior reports, the SCD incidence in a district of Germany is substantial. Despite an elaborate EMS system and advanced medical care, SCD rates remain stable and necessitate improved, individualized risk stratification. PMID:25061228

Incidence of sudden cardiac death in Germany: results from an emergency medical service registry in Lower Saxony.

PubMed

Martens, Eimo; Sinner, Moritz F; Siebermair, Johannes; Raufhake, Carsten; Beckmann, Britt M; Veith, Stefan; Düvel, Dieter; Steinbeck, Gerhard; Kääb, Stefan

2014-12-01

Sudden cardiac death (SCD) is among the most common causes of death in western countries including Germany. Whereas risk stratification and primary prevention is still insufficient, we also lack accurate incidence estimates. Current estimates vary widely (18.6-128/100,000/year), but data on SCD incidence in Germany are missing. Depending on SCD definitions, death needs to occur between 1 and 24 h after the onset of symptoms. In the district of Aurich (190,000 inhabitants, Lower Saxony, Germany), emergency medical service (EMS) is provided by a district government operated single carrier and two hospitals. To evaluate all EMS calls in this district from 2002 to 2009, we obtained EMS protocols, medical records, and death certificates for data analysis and adjudication of SCD. We defined SCD according to the definition of the World Health Organization, considering patients with cardiac arrest within ≤1 h after the onset of symptoms. We also required cardiopulmonary resuscitation being performed by EMS personnel. The overall mortality rate in the district of Aurich (1060/100,000/year) corresponded well with the average mortality rate in Germany (1030/100,000/year). During the observation period, we adjudicated 1212 SCD cases, equivalent to an annual rate of 151 SCD cases (81 cases/100,000/year). Rates remained remarkably stable over time, and affected a considerable number of individuals of working age (32/100,000/year). Consistent with prior reports, the SCD incidence in a district of Germany is substantial. Despite an elaborate EMS system and advanced medical care, SCD rates remain stable and necessitate improved, individualized risk stratification. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.

A FRAX model for the estimation of osteoporotic fracture probability in Portugal.

PubMed

Marques, Andréa; Mota, António; Canhão, Helena; Romeu, José Carlos; Machado, Pedro; Ruano, Afonso; Barbosa, Ana Paula; Dias, António Aroso; Silva, Daniel; Araújo, Domingos; Simões, Eugénia; Aguas, Fernanda; Rosendo, Inês; Silva, Inês; Crespo, Jorge; Alves, José Delgado; Costa, Lúcia; Mascarenhas, Mário; Lourenço, Óscar; Ferreira, Pedro Lopes; Lucas, Raquel; Roque, Raquel; Branco, Jaime Cunha; Tavares, Viviana; Johansson, Helena; Kanis, Jonh; Pereira da Silva, José António

2013-01-01

The objective of this study was to develop a Portuguese version of the World Health Organization fracture risk assessment tool (FRAX®). All cases of hip fracture occurred at or after 40 years of age were extracted from the Portuguese National Hospital Discharge Register from 2006 to 2010. Age and sex-ranked population estimates and mortality rates were obtained from National Statistics. Age- and gender stratified incidences were computed and the average of the five years under consideration was taken. Rates for other major fractures were imputed from the epidemiology of Sweden, as undertaken for most national FRAX® models. All methodological aspects and results were submitted to critical appraisal by a wide panel of national experts and representatives of the different stakeholders, including patients. Hip fracture incidence rates were higher in women than in men and increased with age. The lowest incidence was observed in 40-44 years group (14.1 and 4.0 per 100,000 inhabitants for men and women, respectively). The highest rate was observed among the 95-100 age-group (2,577.6 and 3,551.8/100,000 inhabitants, for men and women, respectively). The estimated ten-year probability for major osteoporotic fracture or hip fracture increased with decreasing T-score and with increasing age. Portugal has one of the lowest fracture incidences among European countries. The FRAX® tool has been successfully calibrated to the Portuguese population, and can now be used to estimate the ten-year risk of osteoporotic fractures in this country. All major stakeholders officially endorsed the Portuguese FRAX® model and co-authored this paper.

[Simulating measles and rubella elimination levels according to social stratification and interaction].

PubMed

Hincapié-Palacio, Doracelly; Ospina-Giraldo, Juan; Gómez-Arias, Rubén D; Uyi-Afuwape, Anthony; Chowell-Puente, Gerardo

2010-02-01

The study was aimed at comparing measles and rubella disease elimination levels in a homogeneous and heterogeneous population according to socioeconomic status with interactions amongst low- and high-income individuals and diversity in the average number of contacts amongst them. Effective reproductive rate simulations were deduced from a susceptibleinfected- recovered (SIR) mathematical model according to different immunisation rates using measles (1980 and 2005) and rubella (1998 and 2005) incidence data from Latin-America and the Caribbean. Low- and high-income individuals' social interaction and their average number of contacts were analysed by bipartite random network analysis. MAPLE 12 (Maplesoft Inc, Ontario Canada) software was used for making the simulations. The progress made in eliminating both diseases between both periods of time was reproduced in the socially-homogeneous population. Measles (2005) would be eliminated in high- and low-income groups; however, it would only be achieved in rubella (2005) if there were a high immunity rate amongst the low-income group. If the average number of contacts were varied, then rubella would not be eliminated, even with a 95 % immunity rate. Monitoring the elimination level in diseases like measles and rubella requires that socio-economic status be considered as well as the population's interaction pattern. Special attention should be paid to communities having diversity in their average number of contacts occurring in confined spaces such as displaced communities, prisons, educational establishments, or hospitals.

Incidence, prevalence, and scale of blinding malnutrition.

PubMed

Sommer, A; Tarwotjo, I; Hussaini, G; Susanto, D; Soegiharto, T

1981-06-27

4595 pre-school-age children in six villages of West Java were examined every 3 months. The incidence of active corneal xerophthalmia was 5 per 1000 per year (95% confidence limits, 2.6-7.5), and the average prevalence during each round of examinations was 12 per 10000. In a randomised, multistage cluster survey of 27084 rural children throughout Indonesia the population-weighted prevalence of active corneal disease among pre-school-age children was 6.4 per 10000 (95% confidence limits 3.2-9.6), 53% of that in the longitudinal study areas. At an adjusted incidence rate of 2.7 per 1000 per year, over 60000 Indonesian children become xerophthalmic every year. By extrapolation of these findings about 500000 new cases of xerophthalmia, half of which lead to blindness, occur each year in India, Bangladesh, the Philippines, and Indonesia combined.

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

PubMed

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

2018-01-01

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

Long-term exposure to residential ambient fine and coarse particulate matter and incident hypertension in post-menopausal women.

PubMed

Honda, Trenton; Eliot, Melissa N; Eaton, Charles B; Whitsel, Eric; Stewart, James D; Mu, Lina; Suh, Helen; Szpiro, Adam; Kaufman, Joel D; Vedal, Sverre; Wellenius, Gregory A

2017-08-01

Long-term exposure to ambient particulate matter (PM) has been previously linked with higher risk of cardiovascular events. This association may be mediated, at least partly, by increasing the risk of incident hypertension, a key determinant of cardiovascular risk. However, whether long-term exposure to PM is associated with incident hypertension remains unclear. Using national geostatistical models incorporating geographic covariates and spatial smoothing, we estimated annual average concentrations of residential fine (PM 2.5 ), respirable (PM 10 ), and course (PM 10-2.5 ) fractions of particulate matter among 44,255 post-menopausal women free of hypertension enrolled in the Women's Health Initiative (WHI) clinical trials. We used time-varying Cox proportional hazards models to evaluate the association between long-term average residential pollutant concentrations and incident hypertension, adjusting for potential confounding by sociodemographic factors, medical history, neighborhood socioeconomic measures, WHI study clinical site, clinical trial, and randomization arm. During 298,383 person-years of follow-up, 14,511 participants developed incident hypertension. The adjusted hazard ratios per interquartile range (IQR) increase in PM 2.5 , PM 10 , and PM 10-2.5 were 1.13 (95% CI: 1.08, 1.17), 1.06 (1.03, 1.10), and 1.01 (95% CI: 0.97, 1.04), respectively. Statistically significant concentration-response relationships were identified for PM 2.5 and PM 10 fractions. The association between PM 2.5 and hypertension was more pronounced among non-white participants and those residing in the Northeastern United States. In this cohort of post-menopausal women, ambient fine and respirable particulate matter exposures were associated with higher incidence rates of hypertension. These results suggest that particulate matter may be an important modifiable risk factor for hypertension. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Incidence and Prevalence of Systemic Lupus Erythematosus in San Francisco County, California: The California Lupus Surveillance Project.

PubMed

Dall'Era, Maria; Cisternas, Miriam G; Snipes, Kurt; Herrinton, Lisa J; Gordon, Caroline; Helmick, Charles G

2017-10-01

Estimates of the incidence and prevalence of systemic lupus erythematosus (SLE) in the US have varied widely. The purpose of this study was to conduct the California Lupus Surveillance Project (CLSP) to determine credible estimates of SLE incidence and prevalence, with a special focus on Hispanics and Asians. The CLSP, which is funded by the Centers for Disease Control and Prevention, is a population-based registry of individuals with SLE residing in San Francisco County, CA, from January 1, 2007 through December 31, 2009. Data sources included hospitals, rheumatologists, nephrologists, commercial laboratories, and a state hospital discharge database. We abstracted medical records to ascertain SLE cases, which we defined as patients who met ≥4 of the 11 American College of Rheumatology classification criteria for SLE. We estimated crude and age-standardized incidence and prevalence, which were stratified by sex and race/ethnicity. The overall age-standardized annual incidence rate was 4.6 per 100,000 person-years. The average annual period prevalence was 84.8 per 100,000 persons. The age-standardized incidence rate in women and men was 8.6 and 0.7 per 100,000 person-years, respectively. This rate was highest among black women (30.5), followed by Hispanic women (8.9), Asian women (7.2), and white women (5.3). The age-standardized prevalence in women per 100,000 persons was 458.1 in blacks, 177.9 in Hispanics, 149.7 in Asians, and 109.8 in whites. Capture-recapture modeling estimated 33 additional incident cases and 147 additional prevalent cases. Comprehensive methods that include intensive case-finding provide more credible estimates of SLE in Hispanics and Asians, and confirm racial and ethnic disparities in SLE. The disease burden of SLE is highest in black women, followed by Hispanic women, Asian women, and white women. © 2017, American College of Rheumatology.

Incidence of utilization- and symptom-defined COPD exacerbations in hospital- and population-recruited patients.

PubMed

Erdal, Marta; Johannessen, Ane; Eagan, Tomas Mikal; Bakke, Per; Gulsvik, Amund; Grønseth, Rune

2016-01-01

The objectives of this study were to estimate the impact of recruitment source and outcome definition on the incidence of acute exacerbations of COPD (AECOPD) and explore possible predictors of AECOPD. During a 1-year follow-up, we performed a baseline visit and four telephone interviews of 81 COPD patients and 132 controls recruited from a population-based survey and 205 hospital-recruited COPD patients. Both a definition based on health care utilization and a symptom-based definition of AECOPD were applied. For multivariate analyses, we chose a negative binomial regression model. COPD patients from the population- and hospital-based samples experienced on average 0.4 utilization-defined and 2.9 symptom-defined versus 1.0 and 5.9 annual exacerbations, respectively. The incidence rate ratios for utilization-defined AECOPD were 2.45 (95% CI 1.22-4.95), 3.43 (95% CI 1.59-7.38), and 5.67 (95% CI 2.58-12.48) with Global Initiative on Obstructive Lung Disease spirometric stages II, III, and IV, respectively. The corresponding incidence rate ratios for the symptom-based definition were 3.08 (95% CI 1.96-4.84), 3.45 (95% CI 1.92-6.18), and 4.00 (95% CI 2.09-7.66). Maintenance therapy (regular long-acting muscarinic antagonists, long-acting beta-2 agonists, inhaled corticosteroids, or theophylline) also increased the risk of AECOPD with both exacerbation definitions (incidence rate ratios 1.65 and 1.73, respectively). The risk of AECOPD was 59%-78% higher in the hospital sample than in the population sample. If externally valid conclusions are to be made regarding incidence and predictors of AECOPD, studies should be based on general population samples or adjustments should be made on account of a likely higher incidence in other samples. Likewise, the effect of different AECOPD definitions should be taken into consideration.

The Experimental Study about the Effect of Operating Conditions on Multi-tube Pulse Detonation Engine Performance

NASA Astrophysics Data System (ADS)

Kim, Jung-Min; Han, Hyung-Seok; Choi, Jeong-Yeol

2018-04-01

This study examines a multi-tube pulse detonation engine (PDE) which has a type of constant volume combustion. We designed and made the multi-tube PDE and then conducted an experiment in various operating frequencies and equivalence ratios. First, experiments with operating frequencies of 40, 80, 120, 160, and 200 Hz resulted in an average thrust and specific impulse 23.14 N and 42.34 s. The next experiment resulted in the equivalence ratio varying from 0.81 to 1.38, which resulted in an average thrust and specific impulse 22.36 N and 40.11 s. The average detonation velocity was 8% lower than that calculated according to C-J theory. The incidence ratios of the detonation wave were stable with the exception of the operating frequency of 200 Hz. However, at 200 Hz, the incidence ratio was less than 50%. We assumed that a low fill fraction occurred for this problem. The thrust of the PDE increased with the operating frequency. However, the thrust increase was at a lower rate than in previous studies, because of a lost thrust output result from the slow response time of the load cell amplifier.

Abortion Incidence and Unintended Pregnancy in Nepal.

PubMed

Puri, Mahesh; Singh, Susheela; Sundaram, Aparna; Hussain, Rubina; Tamang, Anand; Crowell, Marjorie

2016-12-01

Although abortion has been legal under broad criteria in Nepal since 2002, a significant proportion of women continue to obtain illegal, unsafe abortions, and no national estimates exist of the incidence of safe and unsafe abortions. Data were collected in 2014 from a nationally representative sample of 386 facilities that provide legal abortions or postabortion care and a survey of 134 health professionals knowledgeable about abortion service provision. Facility caseloads and indirect estimation techniques were used to calculate the national and regional incidence of legal and illegal abortion. National and regional levels of abortion complications and unintended pregnancy were also estimated. In 2014, women in Nepal had 323,100 abortions, of which 137,000 were legal, and 63,200 women were treated for abortion complications. The abortion rate was 42 per 1,000 women aged 15-49, and the abortion ratio was 56 per 100 live births. The abortion rate in the Central region (59 per 1,000) was substantially higher than the national average. Overall, 50% of pregnancies were unintended, and the unintended pregnancy rate was 68 per 1,000 women of reproductive age. Despite legalization of abortion and expansion of services in Nepal, unsafe abortion is still common and exacts a heavy toll on women. Programs and policies to reduce rates of unintended pregnancy and unsafe abortion, increase access to high-quality contraceptive care and expand safe abortion services are warranted.

Abortion Incidence and Unintended Pregnancy in Nepal

PubMed Central

Puri, Mahesh; Singh, Susheela; Sundaram, Aparna; Hussain, Rubina; Tamang, Anand; Crowell, Marjorie

2017-01-01

CONTEXT Although abortion has been legal under broad criteria in Nepal since 2002, a significant proportion of women continue to obtain illegal, unsafe abortions, and no national estimates exist of the incidence of safe and unsafe abortions. METHODS Data were collected in 2014 from a nationally representative sample of 386 facilities that provide legal abortions or postabortion care and a survey of 134 health professionals knowledgeable about abortion service provision. Facility caseloads and indirect estimation techniques were used to calculate the national and regional incidence of legal and illegal abortion. National and regional levels of abortion complications and unintended pregnancy were also estimated. RESULTS In 2014, women in Nepal had 323,100 abortions, of which 137,000 were legal, and 63,200 women were treated for abortion complications. The abortion rate was 42 per 1,000 women aged 15–49, and the abortion ratio was 56 per 100 live births. The abortion rate in the Central region (59 per 1,000) was substantially higher than the national average. Overall, 50% of pregnancies were unintended, and the unintended pregnancy rate was 68 per 1,000 women of reproductive age. CONCLUSIONS Despite legalization of abortion and expansion of services in Nepal, unsafe abortion is still common and exacts a heavy toll on women. Programs and policies to reduce rates of unintended pregnancy and unsafe abortion, increase access to high-quality contraceptive care and expand safe abortion services are warranted. PMID:28825899

Burden of invasive squamous cell carcinoma of the penis in the United States, 1998-2003.

PubMed

Hernandez, Brenda Y; Barnholtz-Sloan, Jill; German, Robert R; Giuliano, Anna; Goodman, Marc T; King, Jessica B; Negoita, Serban; Villalon-Gomez, Jose M

2008-11-15

Invasive squamous cell carcinoma (SCC) of the penis is rare in the United States. Although human papillomavirus (HPV) infection is an established etiologic agent in at least 40% of penile SCCs, relatively little is known about the epidemiology of this malignancy. Population-based data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program, the Centers for Disease Control and Prevention's National Program for Cancer Registries, and the National Center for Health Statistics were used to examine invasive penile SCC incidence and mortality in the United States. SEER data were used to examine treatment of penile SCC. From 1998 to 2003, 4967 men were diagnosed with histologically confirmed invasive penile SCC in the United States, representing less than 1% of new cancers in men. The annual, average age-adjusted incidence rate was 0.81 cases per 100,000 men, and rates increased steadily with age. Overall, penile SCC incidence was comparable in whites and blacks, but approximately 2-fold lower in Asians/Pacific Islanders. Rates among Hispanics were 72% higher compared with non-Hispanics. Blacks compared with whites and Asians/Pacific Islanders and Hispanics compared with non-Hispanics were diagnosed at significantly younger ages. Higher rates of mortality were also observed among blacks compared with whites and Hispanics compared with non-Hispanics. Penile SCC incidence and mortality were elevated in Southern states and in regions of low socioeconomic status (SES). Some histologic and anatomic site differences were observed by race and ethnicity. Treatment of penile SCC varied with age, stage, and other tumor characteristics. There are considerable disparities in invasive penile cancer incidence and mortality in the United States. Key risk factors for excess incidence include Hispanic ethnicity and residence in the South and in low SES regions. Risks for excess mortality include these factors in addition to black race. Decreases in penile cancer incidence and mortality in the United States may be realized in the future as the indirect result of prophylactic HPV vaccination of females. Further research is needed to better understand the epidemiology of penile cancer including the role of HPV.

Burden of Invasive Squamous Cell Carcinoma of the Penis in the United States, 1998–2003

PubMed Central

Hernandez, Brenda Y.; Barnholtz-Sloan, Jill; German, Robert R.; Giuliano, Anna; Goodman, Marc T.; King, Jessica B.; Negoita, Serban; Villalon-Gomez, Jose M.

2009-01-01

BACKGROUND Invasive squamous cell carcinoma (SCC) of the penis is rare in the United States. Although human papillomavirus (HPV) infection is an established etiologic agent in at least 40% of penile SCCs, relatively little is known about the epidemiology of this malignancy. METHODS Population-based data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program, the Centers for Disease Control and Prevention's National Program for Cancer Registries, and the National Center for Health Statistics were used to examine invasive penile SCC incidence and mortality in the United States. SEER data were used to examine treatment of penile SCC. RESULTS From 1998 to 2003, 4967 men were diagnosed with histologically confirmed invasive penile SCC in the United States, representing less than 1% of new cancers in men. The annual, average age-adjusted incidence rate was 0.81 cases per 100,000 men, and rates increased steadily with age. Overall, penile SCC incidence was comparable in whites and blacks, but approximately 2-fold lower in Asians/Pacific Islanders. Rates among Hispanics were 72% higher compared with non-Hispanics. Blacks compared with whites and Asians/Pacific Islanders and Hispanics compared with non-Hispanics were diagnosed at significantly younger ages. Higher rates of mortality were also observed among blacks compared with whites and Hispanics compared with non-Hispanics. Penile SCC incidence and mortality were elevated in Southern states and in regions of low socioeconomic status (SES). Some histologic and anatomic site differences were observed by race and ethnicity. Treatment of penile SCC varied with age, stage, and other tumor characteristics. CONCLUSIONS There are considerable disparities in invasive penile cancer incidence and mortality in the United States. Key risk factors for excess incidence include Hispanic ethnicity and residence in the South and in low SES regions. Risks for excess mortality include these factors in addition to black race. Decreases in penile cancer incidence and mortality in the United States may be realized in the future as the indirect result of prophylactic HPV vaccination of females. Further research is needed to better understand the epidemiology of penile cancer including the role of HPV. PMID:18980292

A Co2+-doped alumina-rich Mg0.4Al2.4O4 spinel crystal as saturable absorber for a LD pumped Er: glass microchip laser at 1535 nm

NASA Astrophysics Data System (ADS)

Jiang, D. P.; Zou, Y. Q.; Su, L. B.; Tang, H. L.; Wu, F.; Zheng, L. H.; Li, H. J.; Xu, J.

2011-05-01

Co2+-doped Mg0.4Al2.4O4 single crystal up to varnothing28×40 mm3 was successfully grown by the Czochralski method. By using this crystal as saturable absorber, we have demonstrated a diode-end-pumped passively Q-switched Er:glass microchip laser operating at 1535 nm for the first time to the best of our knowledge. The dependences of average output power, repetition rate and pulse energy on the incident pump power were investigated. In the passive Q-switching regime, a maximum average output power of 22.12 mW was obtained at the incident pump power of 410 mW. The narrowest pulse width, the largest pulse energy and the highest peak power were obtained to be about 3.5 ns, 4.8 μJ, and 1.37 kW, respectively.

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

PubMed

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.

Epidemiological study of myasthenia gravis in the province of Reggio Emilia, Italy.

PubMed

Guidetti, D; Sabadini, R; Bondavalli, M; Cavalletti, S; Lodesani, M; Mantegazza, R; Cosi, V; Solime, F

1998-06-01

We carried out a retrospective incidence, prevalence and mortality survey of myasthenia gravis in the province of Reggio Emilia in Northern Italy. Based on 49 patients, the mean incidence per year for the period 1980 through 1994 was 7.8 per 1,000,000. On 31 December 1994 the prevalence rate was 117.5 per 1,000,000 for all patients, either active or recovered (50 cases in a population of 427,493) and 103.4 per 1,000,000 for the active disease. In the 15-year period 1980-1994 the average mortality rate was 1.0 per 1,000,000 per year. The average age at onset was 44.6 +/- 21.0, and the average age at the time of prevalence determination was 51.1 +/- 19.6 for the active disease. At the time of diagnosis, 21 patients (36.8%) were classed in group I according to Osserman's criteria, 31 in group II (54.4%), (19 in group II-A and 12 in group II-B), and the other 5 (8.8%) in group III. Of all the prevalence cases, 6 (12%) were in remission without therapy and 6 with therapy, while most of the others 16 (32%) were classed in group I, 15 (30%) in group II, and 1 (2%) in group III. Thymectomy was performed in 20 patients (35.1%), 12 (21%) had thymoma (malignant in 4 cases), 6 had thymic hyperplasia while in two patients thymic histology was normal. The relation the grade of Osserman's scale at the time of incidence and the presence of thymoma were significant. Higher grades of Osserman's scale were associated were malignant thymoma. Furthermore the relationship between thymectomy and the grade of Osserman's scale at the date of prevalence was significant for the presence of lower grades of Osserman's scale in the patients submitted to thymectomy.

Social Relations at Work and Incident Dementia: 29-Years’ Follow-Up of the Copenhagen Male Study

PubMed Central

Ishtiak-Ahmed, Kazi; Hansen, Åse Marie; Garde, Anne Helene; Mortensen, Erik Lykke; Gyntelberg, Finn; Phung, Thien Kieu Thi; Lund, Rikke; Rod, Naja Hulvej; Prescott, Eva; Waldemar, Gunhild; Westendorp, Rudi; Nabe-Nielsen, Kirsten

2018-01-01

Objective: We investigated whether social relations at work were associated with incident dementia in old age. Methods: One thousand five hundred seventy-two occupationally active men from the Copenhagen Male Study Cohort were followed from 1986 to 2014. Participants underwent a clinical examination at baseline and answered questionnaires on whether they (1) had possibilities to be in contact with coworkers, (2) could get along with coworkers, and (3) were satisfied with supervisor. Poisson regression was used to estimate incidence rate ratios (IRR). Results: Two hundred forty five (15.6%) men were diagnosed with dementia during an average of 15.8 years of follow-up. After adjusting for potential confounders, limited contact with coworkers was associated with a higher risk of dementia (IRR = 2.49, 95% confidence interval [CI] 1.14 to 5.44), but the other two measures were not. Conclusions: Our data partially support that social relations at work are associated with incident dementia. PMID:29189469

Correlation analysis for the attack of bacillary dysentery and meteorological factors based on the Chinese medicine theory of Yunqi and the medical-meteorological forecast model.

PubMed

Ma, Shi-Lei; Tang, Qiao-Ling; Liu, Hong-Wei; He, Juan; Gao, Si-Hua

2013-03-01

To explore the impact of meteorological factors on the outbreak of bacillary dysentery, so as to provide suggestions for disease prevention. Based on the Chinese medicine theory of Yunqi, the descriptive statistics, single-factor correlation analysis and back-propagation artificial neural net-work were conducted using data on five basic meteorological factors and data on incidence of bacillary dysentery in Beijing, China, for the period 1970-2004. The incidence of bacillary dysentery showed significant positive correlation relationship with the precipitation, relative humidity, vapor pressure, and temperature, respectively. The incidence of bacillary dysentery showed a negatively correlated relationship with the wind speed and the change trend of average wind speed. The results of medical-meteorological forecast model showed a relatively high accuracy rate. There is a close relationship between the meteorological factors and the incidence of bacillary dysentery, but the contributions of which to the onset of bacillary dysentery are different to each other.

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

PubMed

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 <  0.0001) in the 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 work together to follow CAPC and AHS guidelines to protect dogs from infection with D. immitis. Lack of preventive use and the emergence of heartworm resistance to MLs could both be impacting the increased rate of positive heartworm tests in dogs.

EPIDEMIOLOGY OF FEMUR FRACTURES IN THE ELDERLY AND COST TO THE STATE OF PARANÁ, BRAZIL.

PubMed

Oliveira, Camila Cristine; Borba, Victoria Zeghbi Cochenski

2017-01-01

To evaluate the incidence and economic impact of femur fractures in the state of Paraná, Brazil . This descriptive study included men and women ≥ 60 years of age with hip fractures which were treated by the Public Health System in emergency care from January 2010 to December 2014. Data were collected from the DATASUS public health database using filters to select patients; results were presented descriptively and as proportions. The standardized incidence of femur fracture was calculated by sex and age for 10,000 inhabitants in Paraná state and in Brazil for the year 2012 . During the study period, 11,226 fractures were registered, 66.8% in women and 33.2% in men. There was a preponderance of fractures in Caucasians and in older age groups. Mortality during hospitalization was 5.9%, higher in males, in patients aged ≥80 years, and in Blacks and Asians. The total cost was R$ 29,393,442.78 and the average cost per hospitalization was R$ 2,618.34. The eastern region of the state had the highest rate of fractures, predominantly in the capital, Curitiba. The standardized incidence rate was higher in females and in the population of Paraná . Femur fractures have a high incidence rate in the elderly population of Paraná and a large economic impact. Level of Evidence II, Prognostic Studies Investigating the effect of a Patient Characterisctic on the Outcome of Disease.

EPIDEMIOLOGY OF FEMUR FRACTURES IN THE ELDERLY AND COST TO THE STATE OF PARANÁ, BRAZIL

PubMed Central

Oliveira, Camila Cristine; Borba, Victoria Zeghbi Cochenski

2017-01-01

ABSTRACT Objectives: To evaluate the incidence and economic impact of femur fractures in the state of Paraná, Brazil . Methods: This descriptive study included men and women ≥ 60 years of age with hip fractures which were treated by the Public Health System in emergency care from January 2010 to December 2014. Data were collected from the DATASUS public health database using filters to select patients; results were presented descriptively and as proportions. The standardized incidence of femur fracture was calculated by sex and age for 10,000 inhabitants in Paraná state and in Brazil for the year 2012 . Results: During the study period, 11,226 fractures were registered, 66.8% in women and 33.2% in men. There was a preponderance of fractures in Caucasians and in older age groups. Mortality during hospitalization was 5.9%, higher in males, in patients aged ≥80 years, and in Blacks and Asians. The total cost was R$ 29,393,442.78 and the average cost per hospitalization was R$ 2,618.34. The eastern region of the state had the highest rate of fractures, predominantly in the capital, Curitiba. The standardized incidence rate was higher in females and in the population of Paraná . Conclusion: Femur fractures have a high incidence rate in the elderly population of Paraná and a large economic impact. Level of Evidence II, Prognostic Studies Investigating the effect of a Patient Characterisctic on the Outcome of Disease. PMID:28955173

Soil zinc content, groundwater usage, and prostate cancer incidence in South Carolina.

PubMed

Wagner, Sara E; Burch, James B; Hussey, Jim; Temples, Tom; Bolick-Aldrich, Susan; Mosley-Broughton, Catishia; Liu, Yuan; Hebert, James R

2009-04-01

Prostate cancer (PrCA) incidence in South Carolina (SC) exceeds the national average, particularly among African Americans (AAs). Though data are limited, low environmental zinc exposures and down-regulation of prostatic zinc transporter proteins among AAs may explain, in part, the racial PrCA disparity. Age-adjusted PrCA rates were calculated by census tract. Demographic data were obtained from the 1990 census. Hazardous waste site locations and soil zinc concentrations were obtained from existing federal and state databases. A geographic information system and Poisson regression were used to test the hypothesis that census tracts with reduced soil zinc concentrations, elevated groundwater use, or more agricultural or hazardous waste sites had elevated PrCA risks. Census tracts with high groundwater use and low zinc concentrations had higher PrCA rate ratios (RR: 1.270; 95% confidence interval: 1.079, 1.505). This effect was not more apparent in areas populated primarily by AAs. Increased PrCA rates were associated with reduced soil zinc concentrations and elevated groundwater use, although this observation is not likely to contribute to SC's racial PrCA disparity. Statewide mapping and statistical modeling of relationships between environmental factors, demographics, and cancer incidence can be used to screen hypotheses focusing on novel PrCA risk factors.

APOE epsilon 4 allele predicts faster cognitive decline in mild Alzheimer disease.

PubMed

Cosentino, S; Scarmeas, N; Helzner, E; Glymour, M M; Brandt, J; Albert, M; Blacker, D; Stern, Y

2008-05-06

To determine whether APOE epsilon 4 predicts rate of cognitive change in incident and prevalent Alzheimer disease (AD). Individuals were recruited from two longitudinal cohort studies-the Washington Heights and Inwood Columbia Aging Project (WHICAP; population-based) and the Predictors Study (clinic-based)--and were followed for an average of 4 years. Three samples of participants diagnosed with AD, with diverse demographic characteristics and baseline cognitive functioning, were studied: 1) 199 (48%) of the incident WHICAP cases; 2) 215 (54%) of the prevalent WHICAP cases; and 3) 156 (71%) of the individuals diagnosed with AD in the Predictors Study. Generalized estimating equations were used to test whether rate of cognitive change, measured using a composite cognitive score in WHICAP and the Mini-Mental State Examination in Predictors, varied as a function of epsilon 4 status in each sample. The presence of at least one epsilon 4 allele was associated with faster cognitive decline in the incident population-based AD group (p = 0.01). Parallel results were produced for the two prevalent dementia samples only when adjusting for disease severity or excluding the most impaired participants from the analyses. APOE epsilon 4 may influence rate of cognitive decline most significantly in the earliest stages of Alzheimer disease.

The rising incidence of intentional ingestion of ethanol-containing hand sanitizers.

PubMed

Gormley, Nicole J; Bronstein, Alvin C; Rasimas, Joseph J; Pao, Maryland; Wratney, Angela T; Sun, Junfeng; Austin, Howard A; Suffredini, Anthony F

2012-01-01

To describe a case of intentional ingestion of hand sanitizer in our hospital and to review published cases and those reported to the American Association of Poison Control Centers' National Poison Data System. A case report, a literature review of published cases, and a query of the National Poison Data System. Medical intensive care unit. Seventeen-yr-old male 37-kg with an intentional ingestion of a hand sanitizer product into his gastrostomy tube. Intubation, ventilation, and hemodialysis. Incidence and outcome of reported cases of unintentional and intentional ethanol containing-hand sanitizer ingestion in the United States from 2005 through 2009. A literature search found 14 detailed case reports of intentional alcohol-based hand sanitizer ingestions with one death. From 2005 to 2009, the National Poison Data System received reports of 68,712 exposures to 96 ethanol-based hand sanitizers. The number of new cases increased by an average of 1,894 (95% confidence interval [CI] 1266-2521) cases per year (p =.002). In 2005, the rate of exposures, per year, per million U.S. residents was 33.7 (95% CI 28.4-39.1); from 2005 to 2009, this rate increased on average by 5.87 per year (95% CI 3.70-8.04; p = .003). In 2005, the rate of intentional exposures, per year, per million U.S. residents, was 0.68 (95% CI 0.17-1.20); from 2005 to 2009, this rate increased on average by 0.32 per year (95% CI 0.11-0.53; p = .02). The number of new cases per year of intentional hand sanitizer ingestion significantly increased during this 5-yr period. Although the majority of cases of hand sanitizer ingestion have a favorable outcome, 288 moderate and 12 major medical outcomes were reported in this National Poison Data System cohort. Increased awareness of the risks associated with intentional ingestion is warranted, particularly among healthcare providers caring for persons with a history of substance abuse, risk-taking behavior, or suicidal ideation.

The Rising Incidence of Intentional Ingestion of Ethanol-Containing Hand Sanitizers

PubMed Central

Gormley, Nicole J.; Bronstein, Alvin C.; Rasimas, Joseph J.; Pao, Maryland; T.Wratney, Angela; Sun, Junfeng; Austin, Howard A.; Suffredini, Anthony F.

2012-01-01

Objective To describe a case of intentional ingestion of hand sanitizer in our hospital and to review published cases and those reported to the American Association of Poison Control Centers’ National Poison Data System (NPDS). Design A case report, a literature review of published cases, and a query of the National Poison Data System (NPDS). Measurements Incidence and outcome of reported cases of unintentional and intentional ethanol containing-hand sanitizer ingestion in the United States from 2005 through 2009. Main Results A literature search found 14 detailed case-reports of intentional alcohol-based hand sanitizer ingestions with one death. From 2005 to 2009, NPDS received reports of 68,712 exposures to 96 ethanol-based hand sanitizers. The number of new cases increased by an average of 1894 (95% CI: 1266, 2521) cases per year (p = 0.002). In 2005, the rate of exposures, per year, per million U.S residents was 33.7 (95% CI: 28.4, 39.1); from 2005 to 2009, this rate increased on average by 5.87 per year (95%CI: 3.70, 8.04; p=0.003). In 2005, the rate of intentional exposures, per year, per million U.S residents, was 0.68 (95%CI: 0.17-1.20); from 2005 to 2009, this rate increased on average by 0.32 per year (95%CI: 0.11,0.53; p=0.02). Conclusions The number of new cases per year of intentional hand sanitizer ingestion significantly increased during this five - year period. While the majority of cases of hand sanitizer ingestion have a favorable outcome, 288 moderate and 12 major medical complications were reported in this NPDS cohort. Increased awareness of the risks associated with intentional ingestion is warranted, particularly among healthcare providers caring for persons with a history of substance abuse, risk-taking behavior or suicidal ideation. PMID:21926580

Foodborne and waterborne pathogenic bacteria in selected Organisation for Economic Cooperation and Development (OECD) countries.

PubMed

Curtis, Dennis; Hill, Arthur; Wilcock, Anne; Charlebois, Sylvain

2014-10-01

The World Ranking Food Safety Performance reports by Charlebois in 2008 and 2010 importantly stimulated international discussion and encouraged efforts to establish realistic international benchmarks for food safety performance among Organisation for Economic Cooperation and Development (OECD) countries. This paper presents the international incidence of 5 common foodborne pathogens and describes the challenges of comparing international data. Data were compiled from surveillance authorities in the countries, such as the Natl. Notifiable Diseases Surveillance System of Australia; the Canadian Notifiable Diseases Surveillance System; the European Food Safety Authority, EFSA; the Ministry of Health, Labour and Welfare of Japan; New Zealand Food Safety Authority; and the U.S. Center for Disease Control and Prevention. The highest average rates in cases per 100000 people over the 12-y period from 2000 to 2011 for Campylobacter spp. (237.47), Salmonella spp. (67.08), Yersinia spp. (12.09), Verotoxigenic/Shiga toxin producing Escherichia coli (3.38), and Listeria monocytogenes (1.06) corresponded, in order, to New Zealand, Belgium, Finland, Canada, and Denmark. Comparatively, annual average rates for these 5 pathogens showed an increase over the 12-y period in 28%, 17%, 14%, 50%, and 6% of the countries for which data were available. Salmonella spp. showed a decrease in 56% of the countries, while incidence of L. monocytogenes was constant in most countries (94%). Variable protocols for monitoring incidence of pathogens among OECD countries remain. Nevertheless, there is evidence of sufficient standardization of monitoring protocols such as the European Surveillance System, which has contributed to reduce this gap. © 2014 Institute of Food Technologists®

Shiga toxigenic Escherichia coli incidence is related to small area variation in cattle density in a region in Ireland.

PubMed

Brehony, C; Cullinan, J; Cormican, M; Morris, D

2018-10-01

Shiga toxigenic Escherichia coli (STEC) are pathogenic E. coli that cause infectious diarrhoea. In some cases infection may be complicated by renal failure and death. The incidence of human infection with STEC in Ireland is the highest in Europe. The objective of the study was to examine the spatial incidence of human STEC infection in a region of Ireland with significantly higher rates of STEC incidence than the national average and to identify possible risk factors of STEC incidence at area level. Anonymised laboratory records (n = 379) from 2009 to 2015 were obtained from laboratories serving three counties in the West of Ireland. Data included location and sample date. Population and electoral division (ED) data were obtained from the Irish 2011 Census of Population. STEC incidence was calculated for each ED (n = 498) and used to map hotspots/coldspots using the Getis-Ord Gi* spatial statistic and significant spatial clustering using the Anselin's Local Moran's I statistic. Multivariable regression analysis was used to consider the importance of a number of potential predictors of STEC incidence. Incidence rates for the seven-year period ranged from 0 to 10.9 cases per 1000. A number of areas with significant local clustering of STEC incidence as well as variation in the spatial distribution of the two main serogroups associated with disease in the region i.e. O26 and O157 were identified. Cattle density was found to be a statistically significant predictor of STEC in the region. GIS analysis of routine data indicates that cattle density is associated STEC infection in this high incidence region. This finding points to the importance of agricultural practices for human health and the importance of a "one-health" approach to public policy in relation to agriculture, health and environment. Copyright © 2018 Elsevier B.V. All rights reserved.

A method for estimating white pine blister rust canker age on limber pine in the central Rocky Mountains

Treesearch

Holly S. J. Kearns; William R. Jacobi; Brian W. Geils

2009-01-01

Epidemiological studies of white pine blister rust on limber pine require a temporal component to explain variations in incidence of infection and mortality. Unfortunately, it is not known how long the pathogen has been present at various sites in the central Rocky Mountains of North America. Canker age, computed from canker length and average expansion rate, can be...

Twenty-three years (1993-2015) of homicide trends in the Transkei region of South Africa.

PubMed

Banwari, Meel

2018-01-01

Background Transkei is regarded as a rural part of South Africa. It was one of the black homelands where rigorous apartheid was practised. The incidence of firearm-related deaths used to be very high, but after the implementation of the Firearm Control Act in 2002, the trend changed. However, the murder rate is still a major public-health problem in this region of South Africa. Objective The aim of this study was to investigate 23 years (1993-2015) of homicide trends in the Transkei region of South Africa. Method A review of records of medico-legal autopsies performed at Mthatha Forensic Pathology Laboratory from 1993 to 2015 was undertaken. Results Between 1993 and 2015, the number of autopsies performed on people who had died unnatural deaths was 24,693. The records of 12,618 (51%) autopsies on victims of homicide between 1993 and 2015 were available for study. The average rate of murder was 85/100,000 of the population in this region. Of these deaths, on average 34/100,000 were caused by sharp-edged instruments, 30/100,000 by gunshot wounds and 21/100,000 by blunt trauma. The rate of murder of males was significantly higher than that of females, with a ratio of 5.7:1, and over the period of 23 years covered by this study, the incidence was highest (30.5/100,000) in the young age group between 21 and 30 years. Conclusion The rate of homicide is very high in the Transkei region of South Africa. It needs urgent intervention to curb unnecessary deaths.

Direct Primary or Secondary Percutaneous Ureteral Stenting: What Is the Most Compliant Option in Patients with Malignant Ureteral Obstructions?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carrafiello, Gianpaolo, E-mail: gcarraf@tin.it; Lagana, Domenico; Lumia, Domenico

2007-09-15

The objective of this study was to analyze three ureteral stenting techniques in patients with malignant ureteral obstructions, considering the indications, techniques, procedural costs, and complications. In the period between June 2003 and June 2006, 45 patients with bilateral malignant ureteral obstructions were evaluated (24 males, 21 females; average age, 68.3; range, 42-87). All of the patients were treated with ureteral stenting: 30 (mild strictures) with direct stenting (insertion of the stent without predilation), 30 (moderate/severe strictures) with primary stenting (insertion of the stent after predilation in a one-stage procedure), and 30 (mild/moderate/severe strictures with infection) with secondary stenting (insertionmore » of the stent after predilation and 2-3 days after nephrostomy). The incidence of complications and procedural costs were compared by a statistical analysis. The primary technical success rate was 98.89%. We did not observe any major complications. The minor complication rate was 11.1%. The incidence of complications for the various techniques was not statistically significantly. The statistical analysis of costs demonstrated that the average cost of secondary stenting ( Euro 637; SD, Euro 115) was significantly higher than that of procedures which involved direct or primary stenting ( Euro 560; SD, Euro 108). We conclude that one-step stenting (direct or primary) is a valid option to secondary stenting in correctly selected patients, owing to the fact that when the procedure is performed by expert interventional radiologists there are high technical success rates, low complication rates, and a reduction in costs.« less

Incidence and mortality of lung cancer: global trends and association with socioeconomic status.

PubMed

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.

Trends in the incidence of cancer in Qidong, China, 1978-2002.

PubMed

Chen, Jian-Guo; Zhu, Jian; Parkin, Donald Maxwell; Zhang, Yong-Hui; Lu, Jian-Hua; Zhu, Yuan-Rong; Chen, Tao-Yang

2006-09-15

A population-based cancer registry was established in Qidong, Jiangsu Province, China, in 1972, and the trends in incidence rates of the major cancer sites have been analyzed for a 25-year period, 1978-2002. Five-year age-specific rates, crude incidence rates, world age-standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculated using annual data on population size, and estimates of its age structure. The indices of histological verification of diagnosis, death certificate only and proportion of mortality to incidence were employed for assessing the registration quality. A total of 51,933 incident cases of cancer were registered in Qidong from years 1978 to 2002, with a male-to-female sex ratio of 1.9:1. Crude incidence increased markedly over the 25-year period (PC and APC of +55.6% and +2.1%, respectively), but ASR showed a slight decrease (-0.4% in males, and -0.3% in females), indicating that the major part of this is due to population ageing. The leading cancer sites in rank were liver (average ASR = 50.8 per 100,000), stomach (26.7), lung (22.7), colon-rectum (8.9), oesophagus (7.4) and breast (5.4). Cancers of liver, lung, colon-rectum and female breast all showed increases in incidence during the study period, with APCs (ASR) of +0.1%, +1.7% and +1.4% for males, and +0.2%, +0.9%, +1.9% and +1.1% for females, while the cancers of stomach (APC: -3.2% in male, and --2.4% in female) and cervix (APC: -4.7%) showed notable declines. Examination of age-specific rates showed declining trends in the younger generations for liver cancer, but increases for cervix cancer. The results underline the increasing importance of cancer as a cause of mortality and morbidity in a population that is ageing and undergoing profound changes in socioeconomic development and lifestyle. The cancers of high lethality that have been common in the Chinese population (liver, stomach, oesophagus) are showing some evidence of decline, at least in younger generations, but they remain major problems. At the same time, the cancers associated with economically "developed" societies -- lung, colon-rectum and female breast -- are showing increases. The population-based cancer registry is an indispensable tool for providing data for planning and evaluation of programmes for cancer control in all societies.

Performance measurement results for a 220 Mbps QPPM optical communication receiver with an EG/G Slik APD

NASA Technical Reports Server (NTRS)

Davidson, Frederic M.; Sun, Xiaoli

1992-01-01

The performance of a 220 Mbps quaternary pulse position modulation (QPPM) optical communication receiver with a 'Slik' silicon avalanche photodiode (APD) and a wideband transimpedance preamplifier in a small hybrid circuit module was measured. The receiver performance had been poor due to the lack of a wideband and low noise transimpedance preamplifier. With the new APB preamplifier module, the receiver achieved a bit error rate (BER) of 10 exp -6 at an average received input optical signal power of 4.2 nW, which corresponds to an average of 80 received (incident) signal photons per information bit.

Australian vaccine preventable disease epidemiological review series: measles 2000-2011.

PubMed

Chiew, May; Dey, Aditi; Martin, Nicolee; Wang, Han; Davis, Stephanie; McIntyre, Peter B

2015-03-31

Since the introduction of measles vaccine to the vaccination schedule, the burden of measles has substantially fallen in Australia. Despite this, a number of recent measles outbreaks have occurred. The aim of this study was to examine the burden of measles in Australia using notification, hospitalisation and mortality data with the objectives of setting a baseline for comparison prior to the introduction of the combined measles-mumps-rubella-varicella vaccine. Data were obtained from the Australian National Notifiable Diseases Surveillance System, the National Hospital Morbidity Database and the National Mortality Database to obtain notification, hospitalisation and death data, respectively from 2000 to 2011. Rates were calculated and compared over time by age group and jurisdiction. Since 1993, measles notifications have fallen considerably in Australia. However, between 2000 and 2011, measles notification rates and hospitalisation rates fluctuated. Between 2000 and 2011, there were 990 measles notifications in Australia. The average annual notification rate was 0.4 per 100,000 population. Children aged 0-4 years were the most susceptible group, particularly infants less than 1 year of age (average annual rate, 1.6 per 100,000 population). High incidence was also observed in adolescents (average annual rate, 0.7 per 100,000 population) and young adults (average annual rate, 0.8 per 100,000 population). Jurisdictional variation occurred with differing patterns of notifications and hospitalisations. Although a marked reduction in measles notifications and hospitalisations has occurred in the past decade, susceptible individuals should be vaccinated to prevent outbreaks and to maintain a low incidence of measles and Australia's elimination status. This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or by email to copyright@health.gov.au.

Doppler sonographic screening of the flow in the basilar artery during head rotation reduces the risk for sudden infant death.

PubMed

Deeg, K-H; Reisig, A

2010-10-01

Position-dependent hypoperfusion of the brain stem may be a risk factor of sudden infant death. From 1998 to 2009 we performed Doppler sonographic flow measurements in the basilar artery of 18 194 newborns, 9322 boys and 8872 girls, in five different positions: the neutral position with the head in the midline and during head rotation to the left and right in a supine or prone position. The peak systolic and the time average flow velocity were measured from the flow profile. The flow velocities during head rotation were converted to % of the flow in the neutral position. A decrease in the velocities during head rotation below 50 % was thought to be abnormal. Biphasic flow, flow oscillating around the zero line or retrograde flow during rotation was considered to be pathological. Head rotations, which had caused abnormal and pathological flow, were avoided. The incidence of SIDS in our study group was evaluated and compared with the incidence in a control group of 3 519 newborns. In 17 929 newborns (98.54 %) the blood flow in the basilar artery was independent of head rotation and body position. In 204 newborns (1.12 %) we found an abnormal decrease under 50 %. Pathological flow alterations could be found in 61 patients (0.33 %). The overall incidence rate of SIDS in the study group was 0.055 ‰ (1:18 194). The incidence rate of SIDS in the control group was 1.14 ‰ (4:3519). The comparison of both groups showed a statistically significant (p < 0.0030) lower incidence rate in the study group. Hypoperfusion of the brain stem may be a significant risk factor of SIDS. © Georg Thieme Verlag KG Stuttgart · New York.

Salmonella enterica Infections in the United States and Assessment of Coefficients of Variation: A Novel Approach to Identify Epidemiologic Characteristics of Individual Serotypes, 1996–2011

PubMed Central

Boore, Amy L.; Hoekstra, R. Michael; Iwamoto, Martha; Fields, Patricia I.; Bishop, Richard D.; Swerdlow, David L.

2015-01-01

Background Despite control efforts, salmonellosis continues to cause an estimated 1.2 million infections in the United States (US) annually. We describe the incidence of salmonellosis in the US and introduce a novel approach to examine the epidemiologic similarities and differences of individual serotypes. Methods Cases of salmonellosis in humans reported to the laboratory-based National Salmonella Surveillance System during 1996–2011 from US states were included. Coefficients of variation were used to describe distribution of incidence rates of common Salmonella serotypes by geographic region, age group and sex of patient, and month of sample isolation. Results During 1996–2011, more than 600,000 Salmonella isolates from humans were reported, with an average annual incidence of 13.1 cases/100,000 persons. The annual reported rate of Salmonella infections did not decrease during the study period. The top five most commonly reported serotypes, Typhimurium, Enteritidis, Newport, Heidelberg, and Javiana, accounted for 62% of fully serotyped isolates. Coefficients of variation showed the most geographically concentrated serotypes were often clustered in Gulf Coast states and were also more frequently found to be increasing in incidence. Serotypes clustered in particular months, age groups, and sex were also identified and described. Conclusions Although overall incidence rates of Salmonella did not change over time, trends and epidemiological factors differed remarkably by serotype. A better understanding of Salmonella, facilitated by this comprehensive description of overall trends and unique characteristics of individual serotypes, will assist in responding to this disease and in planning and implementing prevention activities. PMID:26701276

Trends and differences in tuberculosis incidences and clustering among natives in Denmark, Sweden and Finland: comparison of native incidences and molecular epidemiology among three low-incidence countries.

PubMed

Pedersen, M K; Lillebaek, T; Andersen, A B; Soini, H; Haanperä, M; Groenheit, R; Jonsson, J; Svensson, E

2018-07-01

To compare the epidemiology of tuberculosis (TB) in Denmark, Sweden and Finland, by focusing on the native population in order to identify epidemiologic differences and thus indirectly possible differences in TB control. TB incidence trends from 1990 through 2015 were compared among the countries. In addition, for the periods 2012-2013 and 2014-2015, genotyping data were compared. Genotyping was performed using the 24-locus mycobacterial interspersed repetitive unit-variable number of tandem repeat (MIRU-VNTR) method in Denmark and Sweden. For Finland, spoligotyping in conjunction with the 15-locus MIRU-VNTR method was used for 2012-2013 and translated into the 24-locus MIRU-VNTR when feasible, and for 2014-2015 only MIRU-VNTR was used. Both incidence trends and molecular epidemiology were assessed for native cases. The average annual rate of change in TB incidence for native Danes was -2.4% vs. -6.1% and -6.9% for native Swedes and Finns respectively. In 2012-2013 Denmark had 52 native cases in the largest transmission chain vs. three cases in Sweden and ten in Finland, and during the same period the clustering rate for native Danes was 48.8% vs. 6.5% and 18.2% for native Swedes and Finns respectively. For 2014-2015, a similar pattern was seen. The decline of TB among natives in Denmark is slower than for Sweden and Finland, and it seems Denmark has more active transmission among natives. The focused assessment on basic native TB epidemiology reveals striking differences in TB transmission among otherwise similar low-TB-incidence countries. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Seasonality of Viral Encephalitis and Associated Environmental Risk Factors in Son La and Thai Binh Provinces in Vietnam from 2004 to 2013.

PubMed

Lee, Hu Suk; Nguyen-Viet, Hung; Lee, Mihye; Duc, Phuc Pham; Grace, Delia

2017-01-11

In Vietnam, Japanese encephalitis virus accounts for 12-71% of viral encephalitis (VE) cases followed by enteroviruses and dengue virus among identified pathogens. This study is the first attempt to evaluate the seasonality of VE and associated environmental risk factors in two provinces from 2004 to 2013 using a seasonal trend-decomposition procedure based on loess regression and negative binomial regression models. We found seasonality with a peak of VE in August and June in Son La and Thai Binh, respectively. In Son La, the model showed that for every 1°C increase in average monthly temperature, there was a 4.0% increase in monthly VE incidence. There was a gradual decline in incidence rates as the relative humidity rose to its mean value (80%) and a dramatic rise in incidence rate as the relative humidity rose past 80%. Another model found that a 100 mm rise in precipitation in the preceding and same months corresponded to an increase in VE incidence of 23% and 21%, respectively. In Thai Binh, our model showed that a 1°C increase in temperature corresponded with a 9% increase in VE incidence. Another model found that VE incidence increased as monthly precipitation rose to its mean value of 130 mm but declined gradually as precipitation levels rose beyond that. The last model showed that a monthly increase in duration of sunshine of 1 hour corresponded to a 0.6% increase in VE incidence. The findings may assist clinicians by improving the evidence for diagnosis. © The American Society of Tropical Medicine and Hygiene.

The Children, Intimate Relationships, and Conflictual Life Events (CIRCLE) interview for simultaneous measurement of intimate partner and parent to child aggression.

PubMed

Marshall, Amy D; Feinberg, Mark E; Jones, Damon E; Chote, Daniel R

2017-08-01

Despite substantial rates of parent to child aggression (PCA) and intimate partner aggression (IPA) co-occurrence within families, the co-occurrence of PCA and IPA within incidents of aggression has not previously been examined. To do so, we developed the Children, Intimate Relationships, and Conflictual Life Events (CIRCLE) interview to simultaneously measure incidents of psychological and physical PCA and IPA. The CIRCLE interview was administered quarterly for approximately 1 year to 109 women and 94 men from 111 couples with a first born child approximately 32 months of age at study initiation. Demonstrating the CIRCLE interview's ability to yield new knowledge about the nature of family aggression, we describe the frequency of aggressive incidents, the average number of aggressive behaviors within incidents, the daily occurrence of multiple aggressive incidents, and rates of within-incident PCA and IPA co-occurrence. With the exception of men's physical IPA, aggression scores derived from the CIRCLE interview exhibited a relatively high degree of interpartner reporting concordance, as well as structural validity and convergent validity with common aggression measures. Aggression reports via repeated testing were not influenced by social desirability or attempts to avoid aggression. Participants who perceived enhanced memory for aggression as a function of study participation reported increasing PCA and IPA frequencies over time. In the prediction of child conduct and emotional problems, the CIRCLE interview demonstrated predictive validity and incremental validity over traditional aggression measures. For the first time, within-incident co-occurrence of PCA and IPA was documented and shown to uniquely impact child outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Radiation dose rates now and in the future for residents neighboring restricted areas of the Fukushima Daiichi Nuclear Power Plant

PubMed Central

Harada, Kouji H.; Niisoe, Tamon; Imanaka, Mie; Takahashi, Tomoyuki; Amako, Katsumi; Fujii, Yukiko; Kanameishi, Masatoshi; Ohse, Kenji; Nakai, Yasumichi; Nishikawa, Tamami; Saito, Yuuichi; Sakamoto, Hiroko; Ueyama, Keiko; Hisaki, Kumiko; Ohara, Eiji; Inoue, Tokiko; Yamamoto, Kanako; Matsuoka, Yukiyo; Ohata, Hitomi; Toshima, Kazue; Okada, Ayumi; Sato, Hitomi; Kuwamori, Toyomi; Tani, Hiroko; Suzuki, Reiko; Kashikura, Mai; Nezu, Michiko; Miyachi, Yoko; Arai, Fusako; Kuwamori, Masanori; Harada, Sumiko; Ohmori, Akira; Ishikawa, Hirohiko; Koizumi, Akio

2014-01-01

Radiation dose rates were evaluated in three areas neighboring a restricted area within a 20- to 50-km radius of the Fukushima Daiichi Nuclear Power Plant in August–September 2012 and projected to 2022 and 2062. Study participants wore personal dosimeters measuring external dose equivalents, almost entirely from deposited radionuclides (groundshine). External dose rate equivalents owing to the accident averaged 1.03, 2.75, and 1.66 mSv/y in the village of Kawauchi, the Tamano area of Soma, and the Haramachi area of Minamisoma, respectively. Internal dose rates estimated from dietary intake of radiocesium averaged 0.0058, 0.019, and 0.0088 mSv/y in Kawauchi, Tamano, and Haramachi, respectively. Dose rates from inhalation of resuspended radiocesium were lower than 0.001 mSv/y. In 2012, the average annual doses from radiocesium were close to the average background radiation exposure (2 mSv/y) in Japan. Accounting only for the physical decay of radiocesium, mean annual dose rates in 2022 were estimated as 0.31, 0.87, and 0.53 mSv/y in Kawauchi, Tamano, and Haramachi, respectively. The simple and conservative estimates are comparable with variations in the background dose, and unlikely to exceed the ordinary permissible dose rate (1 mSv/y) for the majority of the Fukushima population. Health risk assessment indicates that post-2012 doses will increase lifetime solid cancer, leukemia, and breast cancer incidences by 1.06%, 0.03% and 0.28% respectively, in Tamano. This assessment was derived from short-term observation with uncertainties and did not evaluate the first-year dose and radioiodine exposure. Nevertheless, this estimate provides perspective on the long-term radiation exposure levels in the three regions. PMID:24567380

An experimental study of microwave scattering from rain- and wind-roughened seas

NASA Technical Reports Server (NTRS)

Bliven, L. F.; Giovanangeli, J.-P.

1993-01-01

This paper investigates radar cross-section (RCS) characteristics of rain- and wind-roughened sea-surfaces. We conducted experiments in laboratory wind-wave tanks using artificial rain. The study includes light rain rates, light wind speeds, and combinations of these. A 36 Ghz scatterometer was operated at 30 deg incidence angle and with vertical polarization. RCS data were obtained not only with the scatterometer pointing up-wind but also as a function of azimuthal angle. We use a scatterometer rain and wind model SRWM-1, which relates the total average RCS in storms to the sum of the average RCS due to rain plus the average RCS due to wind. Implications of the study for operational monitoring of wind in rainy oceanic areas by satellite-borne instruments is discussed.

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

PubMed Central

Brown, James Craig; Lambert, Mike I; Verhagen, Evert; Readhead, Clint; van Mechelen, Willem; Viljoen, Wayne

2013-01-01

Objectives To establish an accurate and comprehensive injury incidence registry of all rugby union-related catastrophic events in South Africa between 2008 and 2011. An additional aim was to investigate correlates associated with these injuries. Design Prospective. Setting The South African amateur and professional rugby-playing population. Participants An estimated 529 483 Junior and 121 663 Senior rugby union (‘rugby’) players (population at risk). Outcome measures Annual average incidences of rugby-related catastrophic injuries by type (cardiac events, traumatic brain and acute spinal cord injuries (ASCIs)) and outcome (full recoveries—fatalities). Playing level (junior and senior levels), position and event (phase of play) were also assessed. Results The average annual incidence of ASCIs and Traumatic Brain Injuries combined was 2.00 per 100 000 players (95% CI 0.91 to 3.08) from 2008 to 2011. The incidence of ASCIs with permanent outcomes was significantly higher at the Senior level (4.52 per 100 000 players, 95% CI 0.74 to 8.30) than the Junior level (0.24 per 100 000 players, 95% CI 0 to 0.65) during this period. The hooker position was associated with 46% (n=12 of 26) of all permanent ASCI outcomes, the majority of which (83%) occurred during the scrum phase of play. Conclusions The incidence of rugby-related catastrophic injuries in South Africa between 2008 and 2011 is comparable to that of other countries and to most other collision sports. The higher incidence rate of permanent ASCIs at the Senior level could be related to the different law variations or characteristics (eg, less regular training) compared with the Junior level. The hooker and scrum were associated with high proportions of permanent ASCIs. The BokSmart injury prevention programme should focus efforts on these areas (Senior level, hooker and scrum) and use this study as a reference point for the evaluation of the effectiveness of the programme. PMID:23447464

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study.

PubMed

Brown, James Craig; Lambert, Mike I; Verhagen, Evert; Readhead, Clint; van Mechelen, Willem; Viljoen, Wayne

2013-01-01

To establish an accurate and comprehensive injury incidence registry of all rugby union-related catastrophic events in South Africa between 2008 and 2011. An additional aim was to investigate correlates associated with these injuries. Prospective. The South African amateur and professional rugby-playing population. An estimated 529 483 Junior and 121 663 Senior rugby union ('rugby') players (population at risk). Annual average incidences of rugby-related catastrophic injuries by type (cardiac events, traumatic brain and acute spinal cord injuries (ASCIs)) and outcome (full recoveries-fatalities). Playing level (junior and senior levels), position and event (phase of play) were also assessed. The average annual incidence of ASCIs and Traumatic Brain Injuries combined was 2.00 per 100 000 players (95% CI 0.91 to 3.08) from 2008 to 2011. The incidence of ASCIs with permanent outcomes was significantly higher at the Senior level (4.52 per 100 000 players, 95% CI 0.74 to 8.30) than the Junior level (0.24 per 100 000 players, 95% CI 0 to 0.65) during this period. The hooker position was associated with 46% (n=12 of 26) of all permanent ASCI outcomes, the majority of which (83%) occurred during the scrum phase of play. The incidence of rugby-related catastrophic injuries in South Africa between 2008 and 2011 is comparable to that of other countries and to most other collision sports. The higher incidence rate of permanent ASCIs at the Senior level could be related to the different law variations or characteristics (eg, less regular training) compared with the Junior level. The hooker and scrum were associated with high proportions of permanent ASCIs. The BokSmart injury prevention programme should focus efforts on these areas (Senior level, hooker and scrum) and use this study as a reference point for the evaluation of the effectiveness of the programme.

Burden and trends of type-specific human papillomavirus infections and related diseases in the latin america and Caribbean region.

PubMed

Parkin, D Maxwell; Almonte, Maribel; Bruni, Laia; Clifford, Gary; Curado, Maria-Paula; Piñeros, Marion

2008-08-19

We present the burden of human papillomavirus (HPV)-related cancers (cancers of the cervix, anogenital region, oral cavity and pharynx) in terms of incidence and mortality, for the countries of the Latin America and Caribbean region. The region is a high-risk area for cancer of the cervix and, although incidence has declined since the 1960s, projected demographic changes imply that the actual burden of new cases will increase by more than 75% in the next 20 years, while the average and at diagnosis will increase. Approximately 65% of cervical cancer cases and 50% of the high risk lesions are associated with HPV-16 and 18. Incidence rates of other HPV-related cancers are significantly lower. The paper also describes the estimated impact of genital warts and the limited data available on the occurrence of HPV infections of the upper aerodigestive tract in the region.

Incidence and cost of non-fatal burns in Iran: a nationwide population-based study.

PubMed

Abouie, Abolfazl; Salamati, Payman; Hafezi-Nejad, Nima; Rahimi-Movaghar, Afarin; Saadat, Soheil; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Rahimi-Movaghar, Vafa

2018-03-01

To determine the incidence and cost of non-fatal burns in Iran; this cross-sectional household survey of a nationally representative sample of 15-64 years old was conducted. Through face-to-face interviews and telephone calls, the data on the demographics, history and cost of burns were collected. The annual incidence rate of burns was estimated 129.85 per 1000 population. Burns occurred higher in younger age, female gender and urban residency. The most common burn description was as follows: unpaid work (activity during burn), home (place of burn), heat and hot substances (mechanism of burn) and upper limb (site of burn). The average total cost of burn includes victims seeking medical care was US$124 per case. The main findings of this study suggest that burns are a major public health concern in Iran. To stop this important health issue, a national program for burn prevention and education must be developed.

The effect of abortion legalization on sexual behavior: evidence from sexually transmitted diseases.

PubMed

Klick, Jonathan; Stratmann, Thomas

2003-06-01

Unwanted pregnancy represents a major cost of sexual activity. When abortion was legalized in a number of states in 1969 and 1970 (and nationally in 1973), this cost was reduced. We predict that abortion legalization generated incentives leading to an increase in sexual activity, accompanied by an increase in sexually transmitted diseases (STDs). Using Centers for Disease Control data on the incidence of gonorrhea and syphilis by state, we test the hypothesis that abortion legalization led to an increase in sexually transmitted diseases. We find that gonorrhea and syphilis incidences are significantly and positively correlated with abortion legalization. Further, we find a divergence in STD rates among early legalizing states and late legalizing states starting in 1970 and a subsequent convergence after the Roe v. Wade decision, indicating that the relation between STDs and abortion is casual. Abortion legalization accounts for about one-fourth of the average disease incidence.

[Fat embolism syndrome after bone fractures].

PubMed

Campo-López, C; Flors-Villaverde, P; Calabuig-Alborch, J R

2012-11-01

To review the incidence, clinical features, diagnosis, therapy and mortality rates of fat embolism syndrome (FES) in a tertiary referral hospital in the last decade. Retrospective and descriptive study of patients diagnosed with post-traumatic FES between january 2001 and december 2011. A total of 19 patients, 16 men and 3 women, with an average age of 27 years were evaluated. All had long bone fractures, multiple in 78.9%, as a result of multiple injuries. Respiratory symptoms were the most frequent (89.5%), followed by neurological symptoms (68.4%) and petechial rash (63.2%). The average time of presentation of the syndrome after admission was 42 hours. All patients underwent early stabilisation of the fracture prior to the embolic event. Steroids prophylaxis was not used in any of the cases. Definitive surgical treatment had mean delay of 7 days. The mean hospital stay was 34 days. The overall incidence of FES was 0.14%, and mortality was 10.5%. Post-traumatic FES mainly affected young patients with multiple injuries and long bone fractures. They all had symptoms of the classic clinical triad (respiratory, neurological, rash) after an initial asymptomatic period of less than 2 days. The overall incidence was low. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Infant Brain Tumors: Incidence, Survival, and the Role of Radiation Based on Surveillance, Epidemiology, and End Results (SEER) Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bishop, Andrew J.; McDonald, Mark W., E-mail: mwmcdona@iupui.edu; Indiana University Health Proton Therapy Center, Bloomington, IN

2012-01-01

Purpose: To evaluate the incidence of infant brain tumors and survival outcomes by disease and treatment variables. Methods and Materials: The Surveillance, Epidemiology, and End Results (SEER) Program November 2008 submission database provided age-adjusted incidence rates and individual case information for primary brain tumors diagnosed between 1973 and 2006 in infants less than 12 months of age. Results: Between 1973 and 1986, the incidence of infant brain tumors increased from 16 to 40 cases per million (CPM), and from 1986 to 2006, the annual incidence rate averaged 35 CPM. Leading histologies by annual incidence in CPM were gliomas (13.8), medulloblastomamore » and primitive neuroectodermal tumors (6.6), and ependymomas (3.6). The annual incidence was higher in whites than in blacks (35.0 vs. 21.3 CPM). Infants with low-grade gliomas had the highest observed survival, and those with atypical teratoid rhabdoid tumors (ATRTs) or primary rhabdoid tumors of the brain had the lowest. Between 1979 and 1993, the annual rate of cases treated with radiation within the first 4 months from diagnosis declined from 20.5 CPM to <2 CPM. For infants with medulloblastoma, desmoplastic histology and treatment with both surgery and upfront radiation were associated with improved survival, but on multivariate regression, only combined surgery and radiation remained associated with improved survival, with a hazard ratio for death of 0.17 compared with surgery alone (p = 0.005). For ATRTs, those treated with surgery and upfront radiation had a 12-month survival of 100% compared with 24.4% for those treated with surgery alone (p = 0.016). For ependymomas survival was higher in patients treated in more recent decades (p = 0.001). Conclusion: The incidence of infant brain tumors has been stable since 1986. Survival outcomes varied markedly by histology. For infants with medulloblastoma and ATRTs, improved survival was observed in patients treated with both surgery and early radiation compared with those treated with surgery alone.« less

[Diabetes related visual disability incidence as an indicator of the quality of ophthalmic and diabetic care].

PubMed

Bandurska-Stankiewicz, Elzbieta; Wiatr, Dorota

2007-01-01

This study was to investigate the incidence of blindness due to diabetes in the years 1989-2003, and to compare the studied coefficients in view of the changes in diabetic and ophthalmic care proceeding in the region. Studies on the incidence of diabetes related blindness were conducted in the Warmia & Mazury Region in the years 1989-2003 among patients with type 1 (DM1) and type 2 (DM2) diabetes. Blindness recognized according to the WHO criteria. The incidence rate (IR) was expressed as the number of new blindness cases per 100,000 population per year. The register covered 274 patients visually disabled due to diabetes, in this 69 with DM1, in average of age 47.1, and 205 with DM2, in average of age 65.6. At the beginning of the observation IR varied with the highest in 1995--4.8/100000 (CI: 3.2-6.3). This period was characterized by limited access of patients to diabetologists and laserotherapy. From 1996 it decreased from 4.3/100000 (CI: 2.8-5.7) to 0.9/100000 (CI: 0.2-1.6) in 2003--a new programme of diabetic care with early detection and treatment of retinopathy was introduced. A growth of funds for basic and outpatient clinic specialist care was observed. Analysis of diabetes related blindness is a good indicator of the quality of diabetic and ophthalmic care.

Increasing incidence of Crohn's disease in Victorian children.

PubMed

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 < 0.01). There was a disproportionate over-representation of children from an urban background (incidence rate ratio 1.66, 95% CI 1.28-2.16). Children currently being diagnosed had on average a lower erythrocyte sedimentation rate (ESR) and higher albumin than in previous decades. The use of flexible endoscopy has increased markedly (1970s: 60%; 1990s: 96%, P < 0.05) and the proportion of children recognized at diagnosis with upper gastrointestinal and colonic involvement has increased significantly. There has been a significant increase in the incidence of Crohn's disease in 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.

Lung and stomach cancer associations with groundwater radon in North Carolina, USA

PubMed Central

Messier, Kyle P; Serre, Marc L

2017-01-01

Abstract Background: The risk of indoor air radon for lung cancer is well studied, but the risks of groundwater radon for both lung and stomach cancer are much less studied, and with mixed results. Methods: Geomasked and geocoded stomach and lung cancer cases in North Carolina from 1999 to 2009 were obtained from the North Carolina Central Cancer Registry. Models for the association with groundwater radon and multiple confounders were implemented at two scales: (i) an ecological model estimating cancer incidence rates at the census tract level; and (ii) a case-only logistic model estimating the odds that individual cancer cases are members of local cancer clusters. Results: For the lung cancer incidence rate model, groundwater radon is associated with an incidence rate ratio of 1.03 [95% confidence interval (CI) = 1.01, 1.06] for every 100 Bq/l increase in census tract averaged concentration. For the cluster membership models, groundwater radon exposure results in an odds ratio for lung cancer of 1.13 (95% CI = 1.04, 1.23) and for stomach cancer of 1.24 (95% CI = 1.03, 1.49), which means groundwater radon, after controlling for multiple confounders and spatial auto-correlation, increases the odds that lung and stomach cancer cases are members of their respective cancer clusters. Conclusion: Our study provides epidemiological evidence of a positive association between groundwater radon exposure and lung cancer incidence rates. The cluster membership model results find groundwater radon increases the odds that both lung and stomach cancer cases occur within their respective cancer clusters. The results corroborate previous biokinetic and mortality studies that groundwater radon is associated with increased risk for lung and stomach cancer. PMID:27639278

Lung and stomach cancer associations with groundwater radon in North Carolina, USA.

PubMed

Messier, Kyle P; Serre, Marc L

2017-04-01

The risk of indoor air radon for lung cancer is well studied, but the risks of groundwater radon for both lung and stomach cancer are much less studied, and with mixed results. Geomasked and geocoded stomach and lung cancer cases in North Carolina from 1999 to 2009 were obtained from the North Carolina Central Cancer Registry. Models for the association with groundwater radon and multiple confounders were implemented at two scales: (i) an ecological model estimating cancer incidence rates at the census tract level; and (ii) a case-only logistic model estimating the odds that individual cancer cases are members of local cancer clusters. For the lung cancer incidence rate model, groundwater radon is associated with an incidence rate ratio of 1.03 [95% confidence interval (CI) = 1.01, 1.06] for every 100 Bq/l increase in census tract averaged concentration. For the cluster membership models, groundwater radon exposure results in an odds ratio for lung cancer of 1.13 (95% CI = 1.04, 1.23) and for stomach cancer of 1.24 (95% CI = 1.03, 1.49), which means groundwater radon, after controlling for multiple confounders and spatial auto-correlation, increases the odds that lung and stomach cancer cases are members of their respective cancer clusters. Our study provides epidemiological evidence of a positive association between groundwater radon exposure and lung cancer incidence rates. The cluster membership model results find groundwater radon increases the odds that both lung and stomach cancer cases occur within their respective cancer clusters. The results corroborate previous biokinetic and mortality studies that groundwater radon is associated with increased risk for lung and stomach cancer. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Mobile phones, cordless phones and rates of brain tumors in different age groups in the Swedish National Inpatient Register and the Swedish Cancer Register during 1998-2015.

PubMed

Hardell, Lennart; Carlberg, Michael

2017-01-01

We used the Swedish Inpatient Register (IPR) to analyze rates of brain tumors of unknown type (D43) during 1998-2015. Average Annual Percentage Change (AAPC) per 100,000 increased with +2.06%, 95% confidence interval (CI) +1.27, +2.86% in both genders combined. A joinpoint was found in 2007 with Annual Percentage Change (APC) 1998-2007 of +0.16%, 95% CI -0.94, +1.28%, and 2007-2015 of +4.24%, 95% CI +2.87, +5.63%. Highest AAPC was found in the age group 20-39 years. In the Swedish Cancer Register the age-standardized incidence rate per 100,000 increased for brain tumors, ICD-code 193.0, during 1998-2015 with AAPC in men +0.49%, 95% CI +0.05, +0.94%, and in women +0.33%, 95% CI -0.29, +0.45%. The cases with brain tumor of unknown type lack morphological examination. Brain tumor diagnosis was based on cytology/histopathology in 83% for men and in 87% for women in 1980. This frequency increased to 90% in men and 88% in women in 2015. During the same time period CT and MRI imaging techniques were introduced and morphology is not always necessary for diagnosis. If all brain tumors based on clinical diagnosis with CT or MRI had been reported to the Cancer Register the frequency of diagnoses based on cytology/histology would have decreased in the register. The results indicate underreporting of brain tumor cases to the Cancer Register. The real incidence would be higher. Thus, incidence trends based on the Cancer Register should be used with caution. Use of wireless phones should be considered in relation to the change of incidence rates.

The impact of alcohol policies on alcohol-attributable diseases in Taiwan-A population-based study.

PubMed

Ying, Yung-Hsiang; Weng, Yung-Ching; Chang, Koyin

2017-11-01

Taiwan has some of the strictest alcohol-related driving laws in the world. However, its laws continue to be toughened to reduce the ever-increasing social cost of alcohol-related harm. This study assumes that alcohol-related driving laws show a spillover effect such that behavioral changes originally meant to apply behind the wheel come to affect drinking behavior in other contexts. The effects of alcohol driving laws and taxes on alcohol-related morbidity are assessed; incidence rates of alcohol-attributable diseases (AAD) serve as our measure of morbidity. Monthly incidence rates of alcohol-attributable diseases were calculated with data from the National Health Insurance Research Database (NHIRD) from 1996 to 2011. These rates were then submitted to intervention analyses using Seasonal Autoregressive Integrated Moving Average models (ARIMA) with multivariate adaptive regression splines (MARS). ARIMA is well-suited to time series analysis while MARS helps fit the regression model to the cubic curvature form of the irregular AAD incidence rates of hospitalization (AIRH). Alcoholic liver disease, alcohol abuse and dependence syndrome, and alcohol psychoses were the most common AADs in Taiwan. Compared to women, men had a higher incidence of AADs and their AIRH were more responsive to changes in the laws governing permissible blood alcohol. The adoption of tougher blood alcohol content (BAC) laws had significant effects on AADs, controlling for overall consumption of alcoholic beverages. Blood alcohol level laws and alcohol taxation effectively reduced alcohol-attributable morbidities with the exception of alcohol dependence and abuse, a disease to which middle-aged, lower income people are particularly susceptible. Attention should be focused on this cohort to protect this vulnerable population. Copyright © 2017 Elsevier B.V. All rights reserved.

Resident Aggression Toward Staff at a Center for the Developmentally Disabled

PubMed Central

West, Christine A.; Galloway, Ellen; Niemeier, Maureen T.

2015-01-01

Few studies have examined factors contributing to nonfatal assaults to staff working in residential care facilities. The authors evaluated resident assaults toward direct care/nursing staff at an Intermediate Care Facility for Individuals with Mental Retardation (ICF/MR), which included observations of work areas, employee interviews, calculation of injury and assault rates for 2004 to 2007 from Occupational Safety and Health Administration Logs, and review of state ICF/MR guidelines. Most staff interviewed reported having been injured during physical restraint of a resident and the average rate of injury from assault at the center evaluated was higher than the average national rates for the health care and social assistance sector for the same time period. The center lacked policies for a safe workplace. The authors recommended review and maintenance of workplace violence prevention policies and developing a post-incident response and evaluation program to assist staff in coping with the consequences of assault and/or occupational injury. PMID:24571051

[The trends by province of tuberculosis in Cuba: 1979-1993].

PubMed

González Ochoa, E; Armas Pérez, L; Machín Gelaber, A

1995-11-01

This study was carried out in order to describe tuberculosis trends in Cuba and its provinces between 1979 and 1993. For this purpose, reports of new cases of all forms of tuberculosis were obtained from the National Statistics Bureau of the Ministry of Public Health. In addition, tuberculosis incidence rates and their trends between 1979 and 1992 were determined. The data were analyzed by means of simple linear and exponential regression models. Finally, the percentage reductions in incidence between 1979 and 1992 were calculated and the observed changes were described in reference to the expected values derived from the regression models. The number of new tuberculosis cases reported in Cuba decreased from 1133 (11.6 per 100,000 population) in 1979 to 633 (5.8 per 100,000) in 1992 (a 44% reduction). In 1993, 788 cases were reported (7.2 per 100,000). In almost all the provinces the incidence tended to decrease between 1979 and 1992, and the average annual number of new case notifications fell between 4.0 and 5.4%, although in some, less than 3%. In 1992, the number of new case notifications in the country was 25% higher than in 1991, and the incidence rates in all the provinces were higher than expected. The incidence in La Habana, the City of Havana, Villa Clara, Cienfuegos, Ciego de Avila, Santiago de Cuba, and Guantánamo exceeded the overall national incidence. In 1993, incidence in the country was 55.6% higher than it had been in 1991 and 24.5% higher than in 1992. Incidence rose in all provinces, and especially in the City of Havana, Matanzas, and Guantánamo. Although incidence remained below 8 cases per 100,000 population between 1992 and 1993, it rose during those years, as it did in other countries. The increase appears to be attributable to the economic crisis that affects the country and to have very little connection to human immunodeficiency virus infection.

Leukemia, lymphoma and multiple myeloma mortality (1950–1999) and incidence (1969–1999) in the Eldorado uranium workers cohort

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zablotska, Lydia B., E-mail: Lydia.Zablotska@ucsf.edu; Lane, Rachel S.D.; Frost, Stanley E.

Uranium workers are chronically exposed to low levels of radon decay products (RDP) and gamma (γ) radiation. Risks of leukemia from acute and high doses of γ-radiation are well-characterized, but risks from lower doses and dose-rates and from RDP exposures are controversial. Few studies have evaluated risks of other hematologic cancers in uranium workers. The purpose of this study was to analyze radiation-related risks of hematologic cancers in the cohort of Eldorado uranium miners and processors first employed in 1932–1980 in relation to cumulative RDP exposures and γ-ray doses. The average cumulative RDP exposure was 100.2 working level months andmore » the average cumulative whole-body γ-radiation dose was 52.2 millisievert. We identified 101 deaths and 160 cases of hematologic cancers in the cohort. Overall, male workers had lower mortality and cancer incidence rates for all outcomes compared with the general Canadian male population, a likely healthy worker effect. No statistically significant association between RDP exposure or γ-ray doses, or a combination of both, and mortality or incidence of any hematologic cancer was found. We observed consistent but non-statistically significant increases in risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma (HL) incidence and non-Hodgkin lymphoma (NHL) mortality with increasing γ-ray doses. These findings are consistent with recent studies of increased risks of CLL and NHL incidence after γ-radiation exposure. Further research is necessary to understand risks of other hematologic cancers from low-dose exposures to γ-radiation. - Highlights: • We analyzed long-term follow-up for hematologic cancers of the Eldorado uranium workers. • Workers were exposed to a unique combination of radon decay products (RDP) and gamma (γ) ray doses. • Exposures to RDP and γ-ray doses were not associated with significantly increased risks of cancers. • Radiation risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma were increased. • Study findings provide additional support for radiation-related risks of CLL.« less

Variation in Adenoma Detection Rate and the Lifetime Benefits and Cost of Colorectal Cancer Screening: A Microsimulation Model

PubMed Central

Meester, Reinier G.S.; Doubeni, Chyke A.; Lansdorp-Vogelaar, Iris; Jensen, Christopher D.; van der Meulen, Miriam P.; Levin, Theodore R.; Quinn, Virginia P.; Schottinger, Joanne E.; Zauber, Ann G.; Corley, Douglas A.; van Ballegooijen, Marjolein

2015-01-01

IMPORTANCE Colonoscopy is the most commonly used colorectal cancer screening test in the United States. Its quality, as measured by adenoma detection rates, varies widely between physicians with unknown consequences for the cost and benefits of screening programs. OBJECTIVE To estimate the lifetime benefits, complications and costs of a colonoscopy screening program at different levels of adenoma detection. DESIGN, SETTING and PARTICIPANTS This study used microsimulation modeling with data from a community-based healthcare system on adenoma detection rate variation and cancer risk among 136 physicians and 57,588 patients for 1998–2010. EXPOSURE Using modeling, no screening was compared to screening initiation with colonoscopy according to adenoma detection rate quintiles (averages 15.3, 21.3, 25.6, 30.9, and 38.7%) at ages 50, 60 and 70 with appropriate surveillance of adenoma patients. MAIN OUTCOMES Estimated lifetime colorectal cancer incidence, mortality, number of colonoscopies, complications and costs per 1,000 patients, all discounted at 3% per year and including 95% confidence intervals from multiway probabilistic sensitivity analysis (95%CI). RESULTS In simulation modeling, among unscreened patients, the lifetime risks of colorectal cancer incidence and mortality were 34.2 (95%CI:25.9–43.6) and 13.4 (95%CI:10.0–17.6) per 1,000, respectively. Among screened patients, simulated lifetime incidence decreased with lower to higher adenoma detection rates (quintile 1 versus 5: 26.6, 95%CI:20.0–34.3 versus 12.5, 95%CI:9.3–16.5) as did mortality (5.7, 95%CI:4.2–7.7 versus 2.3, 95%CI:1.7–3.1). Compared to quintile 1, simulated lifetime incidence and mortality were on average 11.4% (95%CI:10.3–11.9) and 12.8% (95%CI:11.1–13.7) lower, respectively, for every 5 percentage-point higher adenoma detection rate. Total colonoscopies and associated complications were higher from quintile 1 (2,777, 95%CI:2,626–2,943 and 6.0, 95%CI:4.0–8.5) to subsequent quintiles (quintile 5: 3,376, 95%CI:3,081–3,681 and 8.9, 95%CI:6.1–12.0). Estimated net screening costs were, however, lower from quintile 1 (US $2.1 million, 95%CI:1.8–2.4) to quintile 5 (US$1.8 million, 95%CI:1.3–2.3) due to averted cancer treatment costs. Results were stable across sensitivity analyses. CONCLUSIONS-RELEVANCE Using microsimulation modeling, we found that higher adenoma detection was associated with lower lifetime colorectal cancer incidence and mortality without higher overall costs. Future research is needed to assess if increasing adenoma detection would be associated with improved patient outcomes. PMID:26080339

An evaluation of longitudinal changes in serum uric acid levels and associated risk of cardio-metabolic events and renal function decline in gout.

PubMed

Desai, Rishi J; Franklin, Jessica M; Spoendlin-Allen, Julia; Solomon, Daniel H; Danaei, Goodarz; Kim, Seoyoung C

2018-01-01

Gout patients have a high burden of co-morbid conditions including diabetes mellitus (DM), chronic kidney disease (CKD), and cardiovascular disease (CVD). We sought to evaluate the association between changes in serum uric acid (SUA) levels over time and the risk of incident DM, CVD, and renal function decline in gout patients. An observational cohort study was conducted among enrollees of private health insurance programs in the US between 2004 and 2015. Gout patients were included on the index date of a SUA measurement ≥6.8 mg/dl. The exposure of interest was cumulative change in SUA levels from baseline. Hazard ratios (HR) and 95% confidence intervals (CI) for incident DM, incident CVD, and renal function decline (≥30% reduction in glomerular filtration rate) were derived using marginal structural models with stabilized inverse probability weights accounting for baseline confounders (age, gender, co-morbidities, co-medications) and time-varying confounders (serum creatinine, blood urea nitrogen, glycated hemoglobin). Among 26,341 patients with gout, the average age was 62, 75% were men, and the median baseline SUA was 8.6 mg/dl (interquartile range 7.7 to 9.5). The incidence rates/100 person-years (95% CI) were 1.63 (1.51-1.75) for DM, 0.77 (0.70-0.84) for CVD, and 4.32 (4.14-4.49) for renal function decline. The adjusted HR (95% CI) per 3 mg/dl reduction in SUA, corresponding on average to achieving the target level of <6 mg/dl in this population, was 1.04 (0.92-1.17) for DM, 1.07 (0.89-1.29) for CVD, and 0.85 (0.78-0.92) for renal function decline. Reduction in SUA in patients with gout may be associated with a reduced risk of renal function decline, but not with DM or CVD.

Hazardous air pollutants and primary liver cancer in Texas.

PubMed

Cicalese, Luca; Curcuru, Giuseppe; Montalbano, Mauro; Shirafkan, Ali; Georgiadis, Jeremias; Rastellini, Cristiana

2017-01-01

The incidence of hepatocellular carcinoma (HCC), the most common primary liver cancer, is increasing in the US and tripled during the past two decades. The reasons for such phenomenon remain poorly understood. Texas is among continental states with the highest incidence of liver cancer with an annual increment of 5.7%. Established risk factors for HCC include Hepatitis B and C (HBV, HCV) viral infection, alcohol, tobacco and suspected risk factors include obesity and diabetes. While distribution of these risk factors in the state of Texas is similar to the national data and homogeneous, the incidence of HCC in this state is exceptionally higher than the national average and appears to be dishomogeneous in various areas of the state suggesting that other non-recognized risk factors might play a role. No population-based studies are currently available investigating the effect of exposure to Hazardous Air Pollutants (HAPs) as a contributing risk factor for liver cancer. Incidence rate of liver cancer in Texas by counties for the time period between 2002 and 2012 was obtained from the Texas Cancer Registry (TCR). Through Principal Component Analysis (PCA) a subgroup of pollutants, explaining almost all the dataset variability, were identified and used to cluster Texas counties. The analysis generated 4 clusters showing liver cancer rate either higher or lower than national average in association with either high or low levels of HAPs emission in the environment. The study shows that the selected relevant HAPs, 10 among 253 analyzed, produce a significant correlation (P = 0.01-0.05) and some of these have been previously identified as carcinogens. An association between the increased production and consequent exposure to these HAPs and a higher presence of liver cancer in certain counties is suggested. This study provides a new insight on this complex multifactorial disease suggesting that environmental substances might play a role in the etiology of this cancer.

Incidence of malaria and risk factors in Italian travelers to malaria endemic countries.

PubMed

Romi, Roberto; Boccolini, Daniela; D'Amato, Stefania; Cenci, Corrado; Peragallo, Mario; D'Ancona, Fortunato; Pompa, Maria Grazia; Majori, Giancarlo

2010-05-01

Imported malaria has been an increasing problem in Italy in the last three decades of the 1900s, representing the main risk for travelers visiting tropical and sub-tropical countries where malaria is endemic. Even though the total number of imported cases has been declining since 2000, malaria still represents the most frequent notifiable imported disease in Italy. The present study analyzes all the malaria cases reported in Italy in 2000-2006 in order to assess the trend of incidence over the time and reviewing the risk factors for travelers visiting malaria endemic countries. All 2000-2006 case report forms were analyzed. The incidence of malaria in Italian travelers was calculated by continent and by countries most visited, using data provided by the Ministry of Transportation. Out of the 5219 malaria cases reported and confirmed in the study period five were autochthonous and 5214 imported, 1518 of which occurred in Italian citizen and 3696 in foreigners. Between 2000 and 2006 imported malaria cases fell from 977 to 630 respectively, with a total reduction of about 36%. Most of the cases were contracted in Africa (93%) and Plasmodium falciparum was the etiological agent in 83% of the cases, with an annual average fatality rate of about 0.5%. The average of the crude incidence rate (CIR) among Italians was calculated by continent for both global cases (gCIR) and for P. falciparum cases (pfCIR) resulting of 1.2/1000 and 0.9 for Africa, 0.08/1000 and 0.02 for Asia, 0.03/1000 and 0.003 for Central and South America, respectively. The gCIR by continent slightly but decreased constantly over the study period. The different factors which may influence the risk of contracting malaria for travelers visiting endemic countries and the strategy to reduce completely the number of fatal cases were considered and discussed. Copyright 2010 Elsevier Ltd. All rights reserved.

Constraining the H2 column density distribution at z ˜ 3 from composite DLA spectra

NASA Astrophysics Data System (ADS)

Balashev, S. A.; Noterdaeme, P.

2018-07-01

We present the detection of the average H2 absorption signal in the overall population of neutral gas absorption systems at z˜ 3 using composite absorption spectra built from the Sloan Digital Sky Survey-III damped Lyman α catalogue. We present a new technique to directly measure the H2 column density distribution function f_H_2(N) from the average H2 absorption signal. Assuming a power-law column density distribution, we obtain a slope β = -1.29 ± 0.06(stat) ± 0.10 (sys) and an incidence rate of strong H2 absorptions [with N(H2) ≳ 1018 cm-2] to be 4.0 ± 0.5(stat) ± 1.0 (sys) per cent in H I absorption systems with N(H I) ≥1020 cm-2. Assuming the same inflexion point where f_H_2(N) steepens as at z = 0, we estimate that the cosmological density of H2 in the column density range log N(H_2) (cm^{-2})= 18{-}22 is {˜ } 15 per cent of the total. We find one order of magnitude higher H2 incident rate in a sub-sample of extremely strong damped Lyman α absorption systems (DLAs) [log N(H I) (cm^{-2}) ≥ 21.7], which, together with the derived shape of f_H_2(N), suggests that the typical H I-H2 transition column density in DLAs is log N(H)(cm-2) ≳ 22.3 in agreement with theoretical expectations for the average (low) metallicity of DLAs at high-z.

Constraining the H2 column density distribution at z˜3 from composite DLA spectra

NASA Astrophysics Data System (ADS)

Balashev, S. A.; Noterdaeme, P.

2018-04-01

We present the detection of the average H2 absorption signal in the overall population of neutral gas absorption systems at z ˜ 3 using composite absorption spectra built from the Sloan Digital Sky Survey-III damped Lyman-α catalogue. We present a new technique to directly measure the H2 column density distribution function f_H_2(N) from the average H2 absorption signal. Assuming a power-law column density distribution, we obtain a slope β = -1.29 ± 0.06(stat) ± 0.10 (sys) and an incidence rate of strong H2 absorptions (with N(H2) ≳ 1018 cm-2) to be 4.0 ± 0.5(stat) ± 1.0 (sys) % in H I absorption systems with N(H I)≥1020 cm-2. Assuming the same inflexion point where f_H_2(N) steepens as at z = 0, we estimate that the cosmological density of H2 in the column density range log N(H_2) (cm^{-2})= 18-22 is ˜15% of the total. We find one order of magnitude higher H2 incident rate in a sub-sample of extremely strong DLAs (log N(H I) (cm^{-2}) ≥ 21.7), which, together with the the derived shape of f_H_2(N), suggests that the typical H I-H2 transition column density in DLAs is log N(H)(cm-2) ≳ 22.3 in agreement with theoretical expectations for the average (low) metallicity of DLAs at high-z.

Effect of loss control service on reported injury incidence.

PubMed

Nave, Michael E; Veltri, Anthony

2004-01-01

A retrospective analysis evaluated the effectiveness of an insurance carrier's flexible loss control service strategy in reducing workers' compensation policyholders' reported injury and illness claims. To assess the effects of a loss control service strategy on workers' compensation claim frequency rates, on medical-only claim rates, on severity-claim rates, and on claim cost among a group of California employers. Eighty-two small- and medium-sized companies with workers' compensation policies expiring in 1999 were randomly selected from a population of policyholders assigned to loss control consultants for two or more years. Claim performance data were obtained for each company's first expired in-force policy year and its 1999 expired policy year. The retrospective design was combined with a control component based on a randomly selected comparison group of 45 companies whose first policy year with the insurer expired in 1999 and who received safety services from the loss control staff. The flexible loss control consultation service strategy was associated with lower average claim rates and costs. Companies assigned to a loss control consultant for two or more years (the "outcome group") had an average claim rate of 1.24 per $10,000 premium, compared with a rate of 1.62 in the "initial group" and a rate of 1.60 in the "comparison group." The average severity-claim rate of the outcome group was 0.32, compared with the initial-year and comparison-group means of 0.48 and 0.46, respectively. The average medical-only claim rate was 0.92, compared with the initial- and comparison-group means of 1.14 and 1.14. The outcome group's average loss ratio was over 10% lower than that of the initial and comparison groups. Statistical analysis indicated that differences among the groups' claim rates and severity-claim rates were [F=(2,206) 4.938, P=0.008] and [F=(2,206) 8.208, P<0.001], respectively. A loss control service strategy that provides service flexibility and develops partnership between employer and consultant can help reduce the frequency and severity of workers' compensation claims. Barriers to consultation service flexibility, both internal and external, should be identified and removed to enhance service efficacy.

[Estimating the year of eradication of tuberculosis in Japan].

PubMed

Ohmori, M

1991-12-01

The time of eradication of tuberculosis has been discussed for several countries, and based on those results, a new strategic plan and goals have been elaborated. Considering such developments, and in order to make a new tuberculosis control strategy, it is important to determine the point at which eradication of tuberculosis would be achieved in Japan. Styblo proposed the two conventional definitions of eradication of tuberculosis, namely that the incidence of smear-positive tuberculosis has fallen below 1 per million population or that the prevalence of tuberculosis infection in the general population has fallen below 1% and continues to decrease. The bacteriological results of new cases have been reported since 1975 in Japan. However, those results are still of doubtful validity and reliability. Therefore, the author estimated the year of eradication of tuberculosis, according to the criterion that tuberculosis is eradicated when the proportion of the population infected with tubercle bacilli is less than 1%. If the risk of infection is changing at a regular rate, it is possible to estimate the risk of infection at any time in the past and in the future. Once the risk of infection is determined, it is also possible to calculate the age-specific prevalence of infection and the proportion of the population infected with tubercle bacilli at various times in the past and in the future. In Japan, the risk of infection before World War II was assumed to be around 4% and not to vary with calendar year. And based on the data from the prevalence surveys in Okinawa in 1968 and 1973, the risk of infection was estimated 0.3% in 1968 and has declined on average, by 10 to 11% annually. At that time, Okinawa was the only area free from BCG vaccination in Japan. The incidence rate in Japan also has declined, on average, by 10% annually. However, since late 1970s, the annual speed of decline of the incidence rate has been slowed down. Therefore, I assumed that the recent trend of the infection risk is the same as the trend of the recent incidence rate among the 0-29 year age-group. The size of the effect of age on the risk of infection has been discussed. The author also considered age-effects in the model. The weight applied to the risk of infection by age was determined by examining the age-specific positive rate in the 1930s before the era when BCG vaccination was widely used.(ABSTRACT TRUNCATED AT 400 WORDS)

Implementation of a critical incident reporting system in a neurosurgical department.

PubMed

Kantelhardt, P; Müller, M; Giese, A; Rohde, V; Kantelhardt, S R

2011-02-01

Critical incident monitoring is an important tool for quality improvement and the maintenance of high safety standards. It was developed for aviation safety and is now widely accepted as a useful tool to reduce medical care-related morbidity and mortality. Despite this widespread acceptance, the literature has no reports on any neurosurgical applications of critical incident monitoring. We describe the introduction of a mono-institutional critical incident reporting system in a neurosurgical department. Furthermore, we have developed a formula to assess possible counterstrategies. All staff members of a neurosurgical department were advised to report critical incidents. The anonymous reporting form contained a box for the description of the incident, several multiple-choice questions on specific risk factors, place and reason for occurrence of the incident, severity of the consequences and suggested counterstrategies. The incident data was entered into an online documentation system (ADKA DokuPik) and evaluated by an external specialist. For data analysis we applied a modified assessment scheme initially designed for flight safety. Data collection was started in September 2008. The average number of reported incidents was 18 per month (currently 216 in total). Most incidents occurred on the neurosurgical ward (64%). Human error was involved in 86% of the reported incidents. The largest group of incidents consisted of medication-related problems. Accordingly, counterstrategies were developed, resulting in a decrease in the relative number of reported medication-related incidents from 42% (March 09) to 30% (September 09). Implementation of the critical incident reporting system presented no technical problems. The reporting rate was high compared to that reported in the current literature. The formulation, evaluation and introduction of specific counterstrategies to guard against selected groups of incidents may improve patient safety in neurosurgical departments. © Georg Thieme Verlag KG Stuttgart · New York.

Relationships between fire danger and the daily number and daily growth of active incidents burning in the northern Rocky Mountains, USA

Treesearch

Patrick H. Freeborn; Mark A. Cochrane; W. Matt Jolly

2015-01-01

Daily National Fire Danger Rating System (NFDRS) indices are typically associated with the number and final size of newly discovered fires, or averaged over time and associated with the likelihood and total burned area of large fires. Herein we used a decade (2003-12) of NFDRS indices and US Forest Service (USFS) fire reports to examine daily relationships between fire...

Pakistan’s Nuclear Future: Reining in the Risk

DTIC Science & Technology

2009-12-01

Pakistan has developed gaps between average yields and yields obtained by the best farmers; between the best farmers and those obtained by research... yield gap —outputs of the current livestock population compared with the output obtained in more developed systems—at between 60 to 80 percent. The...unprecedented increase in rate of inflation, a significant increase in the incidence of poverty, a widening in the already large regional income gap

Incidence of narcolepsy before and after MF59-adjuvanted influenza A(H1N1)pdm09 vaccination in South Korean soldiers.

PubMed

Kim, Woo Jung; Lee, Sang Don; Lee, Eun; Namkoong, Kee; Choe, Kang-Won; Song, Joon Young; Cheong, Hee Jin; Jeong, Hye Won; Heo, Jung Yeon

2015-09-11

Previous reports mostly from Europe suggested an association between an occurrence of narcolepsy and an influenza A(H1N1)pdm09 vaccine adjuvanted with AS03 (Pandemrix(®)). During the 2009 H1N1 pandemic vaccination campaign, the Korean military performed a vaccination campaign with one type of influenza vaccine containing MF59-adjuvants. This study was conducted to investigate the background incidence rate of narcolepsy in South Korean soldiers and the association of the MF59-adjuvanted vaccine with the occurrence of narcolepsy in a young adult group. To assess the incidence of narcolepsy, we retrospectively reviewed medical records of suspicious cases of narcolepsy in 2007-2013 in the whole 20 military hospitals of the Korean military. The screened cases were classified according to the Brighton Collaboration case definition of narcolepsy. After obtaining the number of confirmed cases of narcolepsy per 3 months in 2007-2013, we compared the crude incidence rate of narcolepsy before and after the vaccination campaign. We included 218 narcolepsy suspicious cases in the initial review, which were screened by the diagnostic code on the computerized disease registry in 2007-2013. Forty-one cases were finally diagnosed with narcolepsy in 2007-2013 (male sex, 95%; median age, 21 years). The average background incidence rate of narcolepsy in Korean soldiers was 0.91 cases per 100,000 persons per year. During the 9 months before vaccination implementation (April to December 2009), 6 narcolepsy cases occurred, whereas during the next 9 months (January to September 2010) including the 3-month vaccination campaign, 5 cases occurred. The incidence of narcolepsy in South Korean soldiers was not increased after the pandemic vaccination campaign using the MF59-adjuvanted vaccine. Our results suggest that the MF59-adjuvanted H1N1 vaccine did not contribute to the occurrence of narcolepsy in this young adult group. Copyright © 2015 Elsevier Ltd. All rights reserved.

Model variations in predicting incidence of Plasmodium falciparum malaria using 1998-2007 morbidity and meteorological data from south Ethiopia

PubMed Central

2010-01-01

Background Malaria transmission is complex and is believed to be associated with local climate changes. However, simple attempts to extrapolate malaria incidence rates from averaged regional meteorological conditions have proven unsuccessful. Therefore, the objective of this study was to determine if variations in specific meteorological factors are able to consistently predict P. falciparum malaria incidence at different locations in south Ethiopia. Methods Retrospective data from 42 locations were collected including P. falciparum malaria incidence for the period of 1998-2007 and meteorological variables such as monthly rainfall (all locations), temperature (17 locations), and relative humidity (three locations). Thirty-five data sets qualified for the analysis. Ljung-Box Q statistics was used for model diagnosis, and R squared or stationary R squared was taken as goodness of fit measure. Time series modelling was carried out using Transfer Function (TF) models and univariate auto-regressive integrated moving average (ARIMA) when there was no significant predictor meteorological variable. Results Of 35 models, five were discarded because of the significant value of Ljung-Box Q statistics. Past P. falciparum malaria incidence alone (17 locations) or when coupled with meteorological variables (four locations) was able to predict P. falciparum malaria incidence within statistical significance. All seasonal AIRMA orders were from locations at altitudes above 1742 m. Monthly rainfall, minimum and maximum temperature was able to predict incidence at four, five and two locations, respectively. In contrast, relative humidity was not able to predict P. falciparum malaria incidence. The R squared values for the models ranged from 16% to 97%, with the exception of one model which had a negative value. Models with seasonal ARIMA orders were found to perform better. However, the models for predicting P. falciparum malaria incidence varied from location to location, and among lagged effects, data transformation forms, ARIMA and TF orders. Conclusions This study describes P. falciparum malaria incidence models linked with meteorological data. Variability in the models was principally attributed to regional differences, and a single model was not found that fits all locations. Past P. falciparum malaria incidence appeared to be a superior predictor than meteorology. Future efforts in malaria modelling may benefit from inclusion of non-meteorological factors. PMID:20553590

Incidence of cancer in children residing in ten jurisdictions of the Mexican Republic: importance of the Cancer registry (a population-based study)

PubMed Central

Fajardo-Gutiérrez, Arturo; Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Palma-Padilla, Virginia; Carreón-Cruz, Rogelio; Ortega-Alvárez, Manuel Carlos; Mejía-Arangure, Juan Manuel

2007-01-01

Background In 1996, Mexico started to register cases of childhood cancer. Here, we describe the incidence of cancer in children, residing in ten Mexican jurisdictions, who were treated by the Instituto Mexicano del Seguro Social (IMSS). Methods New cases of childhood cancer, which were registered prospectively in nine principal Medical Centers of IMSS during the periods 1998–2000 (five jurisdictions) and 1996–2002 (five jurisdictions), were analyzed. Personnel were specifically trained to register, capture, and encode information. For each of these jurisdictions, the frequency, average annual age-standardized incidence (AAS) and average annual incidence per period by sex and, age, were calculated (rates per 1,000,000 children/years). Results In total 2,615 new cases of cancer were registered, with the male/female ratio generally >1, but in some tumors there were more cases in females (retinoblastoma, germ cells tumors). The principal groups of neoplasms in seven jurisdictions were leukemias, central nervous system tumors (CNS tumors), and lymphomas, and the combined frequency for these three groups was 62.6 to 77.2%. Most frequently found (five jurisdictions) was the North American-European pattern (leukemias-CNS tumors-lymphomas). Eight jurisdictions had AAS within the range reported in the world literature. The highest incidence was found for children underless than five year of age. In eight jurisdictions, leukemia had high incidence (>50). The AAS of lymphomas was between 1.9 to 28.6. Chiapas and Guerrero had the highest AAS of CNS tumors (31.9 and 30.3, respectively). The frequency and incidence of neuroblastoma was low. Chiapas had the highest incidence of retinoblastoma (21.8). Germ-cell tumors had high incidence. Conclusion The North American-European pattern of cancers was the principal one found; the overall incidence was within the range reported worldwide. In general but particularly in two jurisdictions (Yucatán and Chiapas), it will be necessary to carry out studies concerning the causes of cancer in children. Due to the little that is known about the incidence of cancer in Mexican children, it will be necessary to develop a national program to establish a cancer registry for the whole of the country. PMID:17445267

[Gastropathy caused by non-steroidal anti-inflammatory agents and its association with Helicobacter pylori].

PubMed

Rodríguez-Hernández, Heriberto; Jacobo-Karam, Janett S; Jáquez-Quintana, Joel O; Avila-Romero, Hilda G; Galván-Román, Liliana; Lara-Miranda, Sandra C; Sánchez-Anguiano, Luis F

2003-01-01

Upper gastrointestinal bleeding that is related with older patients and NSAIDs use. The frequency of peptic ulcer bleeding varies of 15% to 30% of cases. To determine the gastropathy features of patients who receive nonsteroidal anti-inflammatory drug, and its relation with Helicobacter pylori (Hp). Men and women with GU or DU with or without haemorrhage, were included into two groups, NSAIDs users and non users. We determined the incidence rate of peptic ulcer and the frequencies of risk factors as tobacco use, previous peptic ulcer or haemorrhage, concomitant disease presence and its association with Hp infection. We included 434 (67.5%) patients that used NSAIDs and 209 (32.5%) non NSAIDs users control subjects. The average was 62.5 +/- 17.2 years and 49.5 +/- 19.4 years respectively. The annual incidence rate of peptic ulcer in NSAIDs users was 17.5%. Gastrointestinal bleeding was more frequent in NSAIDs users and its relations with Hp infection (23.5%) was smaller than patients without NSAIDs user (47.7%) (OR 0.39 p = 0.0000). The GU was highly frequent in the older people who using NSAIDs. The Hp infection shows lower incidence of gastrointestinal bleeding NSAIDs users.

Second primary cancers of the breast: incidence and risk factors.

PubMed Central

Hislop, T. G.; Elwood, J. M.; Coldman, A. J.; Spinelli, J. J.; Worth, A. J.; Ellison, L. G.

1984-01-01

Between 1946 and 1976 over 9,000 women with breast cancer were seen within one year of diagnosis at the A. Maxwell Evans Clinic (AMEC) in Vancouver, British Columbia. By 1978, 275 had a subsequent diagnosis of a second primary in the contralateral breast: 100 were diagnosed within 1 year, and 175 after 1 year of the first primary. Two separate comparison groups of AMEC patients with unilateral breast cancer were selected to identify risk factors for bilateral breast cancer and to determine the incidence. The average annual incidence rates for a second primary in the contralateral breast were 5.0, 4.1 and 3.0 per 1,000 women for women less than 45 years, 45-54 years, and over 55 years of age at diagnosis of first primary breast cancer, respectively. These rates remained stable for at least 15 years after the diagnosis of the first primary. Two risk factors were found for bilateral cancer within 1 year of the first primary, histologic diagnosis of lobular carcinoma and absence of pathologic involvement of axillary nodes; one risk factor was found for bilateral breast cancer after 1 year of the first primary, family history of breast cancer. PMID:6691900

A national database of incidence and treatment outcomes of status epilepticus in Thailand.

PubMed

Tiamkao, Somsak; Pranbul, Sineenard; Sawanyawisuth, Kittisak; Thepsuthammarat, Kaewjai

2014-06-01

Status epilepticus (SE) is a serious neurological condition. The national database of SE in Thailand and other developing countries is limited in terms of incidence and treatment outcomes. This study was conducted on the prevalence of status epilepticus (SE). The study group comprised of adult inpatients (over 18 years old) with SE throughout Thailand. SE patients were diagnosed and searched based on ICD 10 (G41) from the national database. The database used was from reimbursement documents submitted by the hospitals under the three health insurance systems, namely, the universal health coverage insurance, social security, and government health welfare system during the fiscal year 2010. We found 2190 SE patients receiving treatment at hospitals (5.10/100 000 population). The average age was 50.5 years and 1413 patients were males (64.5%). Mortality rate was 0.6 death/100 000 population or 11.96% of total patients. Significant factors associated with death or a nonimproved status at discharge were type of insurance, hospital level, chronic kidney disease, having pneumonia, having shock, on mechanical ventilator, and having cardiopulmonary resuscitation. In conclusion, the incidence of SE in Thailand was 5.10/100 000 population with mortality rate of 0.6/100 000 population.

Morbidity of direct MR arthrography.

PubMed

Giaconi, Joseph C; Link, Thomas M; Vail, Thomas P; Fisher, Zachary; Hong, Richard; Singh, Ravi; Steinbach, Lynne S

2011-04-01

The purpose of this study was to determine the incidence and severity of arthrographic pain after intraarticular injection of a gadolinium mixture diluted in normal saline for direct MR arthrography. From March 2009 until January 2010, 155 consecutive patients underwent direct MR arthrography; 20 patients were lost to follow-up. Patients were contacted by telephone between 3 and 7 days after joint injection. Using an 11-point numeric pain rating scale, patients were asked to report if they had experienced joint pain that was different or more intense than their preinjection baseline, the severity of pain, the duration of pain, time to onset of pain, and eventual resolution of pain. The incidence of postarthrographic pain was 66% (89/135), with an average intensity of pain of 4.8 ± 2.4 (range, 1-10). Postarthrographic pain lasted an average of 44.4 ± 30.5 hours (range, 6-168 hours). The time to onset of pain after joint injection was on average 16.6 ± 13.1 hours (range, 4-72 hours). There was no significant difference regarding the severity or incidence of postarthrographic pain between groups on the basis of patient age (p = 0.20 and 0.26), patient sex (p = 0.20 and 0.86), contrast mixture contents (p = 0.83 and 0.49), or joint injected (p = 0.51 and 0.47). No patients experienced any other serious side effects. Sixty-six percent of patients who undergo direct MR arthrography will experience a fairly severe delayed onset of pain that completely resolves over the course of several days.

Study on electromagnetic radiation and mechanical characteristics of coal during an SHPB test

NASA Astrophysics Data System (ADS)

Chengwu, Li; Qifei, Wang; Pingyang, Lyu

2016-06-01

Dynamic loads provided by a Split Hopkinson pressure bar are applied in the impact failure experiment on coal with an impact velocity of 4.174-17.652 m s-1. The mechanical property characteristics of coal and an electromagnetic radiation signal can be detected and measured during the experiment. The variation of coal stress, strain, incident energy, dissipated energy and other mechanical parameters are analyzed by the unidimensional stress wave theory. It suggests that with an increase of the impact velocity, the mechanical parameters and electromagnetic radiation increased significantly and the dissipated energy of the coal sample has a high discrete growing trend during the failure process of coal impact. Combined with the received energy of the electromagnetic radiation signal, the relationship between these mechanical parameters and electromagnetic radiation during the failure process of coal burst could be analyzed by the grey correlation model. The results show that the descending order of the gray correlation degree between the mechanical characteristics and electromagnetic radiation energy are impact velocity, maximum stress, the average stress, incident energy, the average strain, maximum strain, the average strain rate and dissipation energy. Due to the correlation degree, the impact velocity and incident energy are relatively large, and the main factor affecting the electromagnetic radiation energy of coal is the energy magnitude. While the relationship between extreme stress and the radiation energy change trend is closed, the stress state of coal has a greater impact on electromagnetic radiation than the strain and destruction which can deepen the research of the coal-rock dynamic disaster electromagnetic monitoring technique.

A meta-analysis of injuries in senior men's professional Rugby Union.

PubMed

Williams, Sean; Trewartha, Grant; Kemp, Simon; Stokes, Keith

2013-10-01

Rugby Union has one of the highest reported incidences of match injuries amongst all professional team sports. The majority of research within this field has focused on elite male cohorts; in this study we present the first meta-analytic review of these data. The aim of this study was to summarise the incidence and severity of injuries in senior men's professional Rugby Union, and determine the overall effects of level of play, new versus recurrent injuries, playing position, type of injuries, location of injuries, severity of injuries, period of match, and injury incident. Electronic databases were searched using keywords 'Rugby Union' and 'inj*'. Fifteen papers addressing injuries in senior men's professional Rugby Union (from 1995 through September 2012) were included in the review. A maximum of ten of these papers provided incidence data that could be modelled via a Poisson mixed-effects generalised linear model, while up to nine studies provided severity data that could be modelled via a general linear mixed model. Magnitude based inferences were used to assess differences between factors. A descriptive analysis was provided for studies that could not be included in the pooled analysis due to incongruent injury definitions. The overall incidence of injuries in senior men's professional Rugby Union matches was 81 per 1,000 player hours (95 % CI 63-105), and 3 per 1,000 player hours (95 % CI 2-4) during training. Estimated mean severity for match injuries was 20 days (95 % CI 14-27), and 22 days (95 % CI 19-24) for training injuries. A higher level of play was associated with a greater incidence of injuries in matches, with no clear difference in severity. New injuries occurred substantially more often than recurrent injuries, while the severity of recurrent injuries was, on average, 10 days (95 % CI 4-17) greater than new injuries. Trivial differences were found in injury incidence and severity between forwards and backs. Muscle/tendon and joint (non-bone)/ligament injuries were the two most prevalent injury groups, whereas fractures and bone stress injuries had the highest average severity. The lower limb was the body region with the highest injury incidence, while upper limb injuries were most severe. The third quarter (40-60 min) of matches had the highest injury rate, and injuries most commonly occurred as a result of being tackled. This meta-analysis confirms match injury incidence rates in professional Rugby Union can be considered high in comparison with other team sports, but similar to other collision sports. In order to markedly reduce overall injury burden, efforts should target lower-limb injury prevention strategies and technique during contact, as these may render the largest effect.

Rectal bleeding after high-dose-rate brachytherapy combined with hypofractionated external-beam radiotherapy for localized prostate cancer: Impact of rectal dose in high-dose-rate brachytherapy on occurrence of grade 2 or worse rectal bleeding

DOE Office of Scientific and Technical Information (OSTI.GOV)

Akimoto, Tetsuo; Katoh, Hiroyuki; Kitamoto, Yoshizumi

2006-06-01

Purpose: To evaluate the incidence of Grade 2 or worse rectal bleeding after high-dose-rate (HDR) brachytherapy combined with hypofractionated external-beam radiotherapy (EBRT), with special emphasis on the relationship between the incidence of rectal bleeding and the rectal dose from HDR brachytherapy. Methods and Materials: The records of 100 patients who were treated by HDR brachytherapy combined with EBRT for {>=}12 months were analyzed. The fractionation schema for HDR brachytherapy was prospectively changed, and the total radiation dose for EBRT was fixed at 51 Gy. The distribution of the fractionation schema used in the patients was as follows: 5 Gy xmore » 5 in 13 patients; 7 Gy x 3 in 19 patients; and 9 Gy x 2 in 68 patients. Results: Ten patients (10%) developed Grade 2 or worse rectal bleeding. Regarding the correlation with dosimetric factors, no significant differences were found in the average percentage of the entire rectal volume receiving 30%, 50%, 80%, and 90% of the prescribed radiation dose from EBRT between those with bleeding and those without. The average percentage of the entire rectal volume receiving 10%, 30%, 50%, 80%, and 90% of the prescribed radiation dose from HDR brachytherapy in those who developed rectal bleeding was 77.9%, 28.6%, 9.0%, 1.5%, and 0.3%, respectively, and was 69.2%, 22.2%, 6.6%, 0.9%, and 0.4%, respectively, in those without bleeding. The differences in the percentages of the entire rectal volume receiving 10%, 30%, and 50% between those with and without bleeding were statistically significant. Conclusions: The rectal dose from HDR brachytherapy for patients with prostate cancer may have a significant impact on the incidence of Grade 2 or worse rectal bleeding.« less

Case-Control Study of Injury Intervention for Preschool Children in Henggang, Shenzhen.

PubMed

Wang, Hong; Liu, Yi-Xin; Deng, Wen-Jiao; Yang, Wei-Jian; Wang, Fang

2015-10-01

To explore effective interventions for child accidental injury prevention and to reduce the incidence of injury. Cluster random sampling method was adopted, and children in 19 kindergartens in Henggang, Shenzhen and their parents were selected as the objects of study. Nineteen kindergartens were randomly divided into intervention group and control group to carry out the injury intervention case-control study. Through a series of interventions, there were certain effects. After the end of the project, the injury incidence rates of the intervention group and the control group were 4.91%, 10.64%, and the difference was significant; the average costs of treatment for injuries of the intervention group and the control group were 168.4 Yuan and 206.8 Yuan, and the difference was statistically significant; compared with before the implementation of the project, the rate of various types of injuries after the end of the project declined, in which, the rate of mechanical injury, pet bites, accidental falls, burns, and traffic accidents decreased significantly. The differences were significant. Injury interventions can effectively prevent and control the occurrence of injury.

[Evaluation on the effects of prevention and control programs regarding typhoid fever and paratyphoid fever in Guizhou province, from 2007 to 2012].

PubMed

Yao, Guanghai; Zou, Zhiting; Wang, Dan; Huang, Yanping; Nie, Wei; Liu, Huihui; Tang, Guangpeng

2014-05-01

This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever, in Guizhou province, from 2007 to 2012, to provide evidence for the improvement of related programs. Data on typhoid fever and paratyphoid including information on epidemics, individual, cases, measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province, from 2007 to 2012. Information related to the average annual incidence, nature of outbreaks, time span before confirmed diagnosis was made, unit which carried the case report, proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excel and EpiInfo software were used for data analysis. In the period of 2007-2009, a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012, 2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former, data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ² = 0.08, P = 0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47% . The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in, input and audited showed increase of 8.44%, 6.76% and 2.40% respectively. Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province, but the potential risk of outbreaks still existed in some areas, suggesting that health education and surveillance programs including laboratory diagnosis, should be strengthened.

Cancer of the gallbladder-Chilean statistics.

PubMed

Villanueva, Luis

2016-01-01

Chile has the world's highest rate of incidence as well as death from cancer of the gallbladder and biliary ducts. The problem is most acute in the southern provinces. These areas constitute the low average income associated with low educational attainment and a high rate of obesity compared with the rest of Chile. We could also include genetic factors related to processes of lithogenesis to these elements which are more common among the Mapuche. This population sub-group could benefit from special government programmes for early diagnosis and treatment of lithiasic disease and for the management of risk factors such as obesity. In this way, we could reduce the mortality rate of gallbladder cancer.

Cancer of the gallbladder—Chilean statistics

PubMed Central

Villanueva Olivares, Luis

2016-01-01

Chile has the world’s highest rate of incidence as well as death from cancer of the gallbladder and biliary ducts. The problem is most acute in the southern provinces. These areas constitute the low average income associated with low educational attainment and a high rate of obesity compared with the rest of Chile. We could also include genetic factors related to processes of lithogenesis to these elements which are more common among the Mapuche. This population sub-group could benefit from special government programmes for early diagnosis and treatment of lithiasic disease and for the management of risk factors such as obesity. In this way, we could reduce the mortality rate of gallbladder cancer. PMID:28105075

Association Between Gun Law Reforms and Intentional Firearm Deaths in Australia, 1979-2013.

PubMed

Chapman, Simon; Alpers, Philip; Jones, Michael

2016-07-19

Rapid-fire weapons are often used by perpetrators in mass shooting incidents. In 1996 Australia introduced major gun law reforms that included a ban on semiautomatic rifles and pump-action shotguns and rifles and also initiated a program for buyback of firearms. To determine whether enactment of the 1996 gun laws and buyback program were followed by changes in the incidence of mass firearm homicides and total firearm deaths. Observational study using Australian government statistics on deaths caused by firearms (1979-2013) and news reports of mass shootings in Australia (1979-May 2016). Changes in intentional firearm death rates were analyzed with negative binomial regression, and data on firearm-related mass killings were compared. Implementation of major national gun law reforms. Changes in mass fatal shooting incidents (defined as ≥5 victims, not including the perpetrator) and in trends of rates of total firearm deaths, firearm homicides and suicides, and total homicides and suicides per 100,000 population. From 1979-1996 (before gun law reforms), 13 fatal mass shootings occurred in Australia, whereas from 1997 through May 2016 (after gun law reforms), no fatal mass shootings occurred. There was also significant change in the preexisting downward trends for rates of total firearm deaths prior to vs after gun law reform. From 1979-1996, the mean rate of total firearm deaths was 3.6 (95% CI, 3.3-3.9) per 100,000 population (average decline of 3% per year; annual trend, 0.970; 95% CI, 0.963-0.976), whereas from 1997-2013 (after gun law reforms), the mean rate of total firearm deaths was 1.2 (95% CI, 1.0-1.4) per 100,000 population (average decline of 4.9% per year; annual trend, 0.951; 95% CI, 0.940-0.962), with a ratio of trends in annual death rates of 0.981 (95% CI, 0.968-0.993). There was a statistically significant acceleration in the preexisting downward trend for firearm suicide (ratio of trends, 0.981; 95% CI, 0.970-0.993), but this was not statistically significant for firearm homicide (ratio of trends, 0.975; 95% CI, 0.949-1.001). From 1979-1996, the mean annual rate of total nonfirearm suicide and homicide deaths was 10.6 (95% CI, 10.0-11.2) per 100,000 population (average increase of 2.1% per year; annual trend, 1.021; 95% CI, 1.016-1.026), whereas from 1997-2013, the mean annual rate was 11.8 (95% CI, 11.3-12.3) per 100,000 (average decline of 1.4% per year; annual trend, 0.986; 95% CI, 0.980-0.993), with a ratio of trends of 0.966 (95% CI, 0.958-0.973). There was no evidence of substitution of other lethal methods for suicides or homicides. Following enactment of gun law reforms in Australia in 1996, there were no mass firearm killings through May 2016. There was a more rapid decline in firearm deaths between 1997 and 2013 compared with before 1997 but also a decline in total nonfirearm suicide and homicide deaths of a greater magnitude. Because of this, it is not possible to determine whether the change in firearm deaths can be attributed to the gun law reforms.

Incidence and course of adolescent deliberate self-harm in Victoria, Australia, and Washington State, USA

PubMed Central

Heerde, Jessica A.; Toumbourou, John W.; Hemphill, Sheryl A.; Herrenkohl, Todd I.; Patton, George C.; Catalano, Richard F.

2015-01-01

Purpose There have been few longitudinal studies of deliberate self-harm (DSH) in adolescents. This cross-national longitudinal study outlines risk and protective factors for DSH incidence and persistence. Methods Seventh and ninth grade students (average ages 13 and 15 years) were recruited as state-representative cohorts, surveyed and then followed-up 12-months later (N = 3,876), using the same methods in Washington State and Victoria, Australia. The retention rate was 99% in both states at follow-up. A range of risk and protective factors for DSH were examined using multivariate analyses. Results The prevalence of DSH in the past year was 1.53% in grade 7 and .91% in grade 9 for males and 4.12% and 1.34% for grade 7 and 9 females, with similar rates across states. In multivariate analyses, incident DSH was lower in Washington State (OR .67, 95% CI .45, 1.00) relative to Victoria 12-months later. Risk factors for incident DSH included being female (OR 1.93, CI 1.35, 2.76), high depressive symptoms (OR 3.52, CI 2.37, 5.21), antisocial behavior (OR 2.42, CI 1.46, 4.00), and lifetime (OR 1.85, CI 1.11, 3.08) and past month (OR 2.70, CI 1.57, 4.64) alcohol use relative to never using alcohol. Conclusions Much self-harm in adolescents resolves over the course of 12 months. Young people who self-harm have high rates of other health risk behaviors associated with family and peer risks that may all be targets for preventive intervention. PMID:26499859

Epidemiology characteristics and trends of incidence and morphology of stomach cancer in Iran.

PubMed

Almasi, Zeinab; Rafiemanesh, Hosein; Salehiniya, Hamid

2015-01-01

Stomach cancer is the fourth most common cancer and the second leading cause of cancer- related death through the world. It is predicted that the number of new cancer cases will be more than 15 million cases by 2020. Regarding the lack of studies on this topic in the country, we have thoroughly examined the patho-epidemiology of stomach cancer in Iran. In this cross- sectional study data were collected retrospectively reviewing all new stomach cancer patients in Cancer Registry Center report of health deputy for Iran during a 6-year period (2003-2008). The study also examined the morphology of common stomach cancers. Trends in incidence and morphology underwent joinpoint regression analysis. During the six-year period, a total of 35,171 cases of stomach cancer were registered. Average age standardized rate for females and males were equal to 7.1 and 15.1 per 100,000 persons, respectively. Most common histological type was adenocarcinoma, NOS with 21,980 cases (62.50%). The annual percentage change (APC) in age-standardized incidence rate (per 100,000) was increase in both females and males at 11.1 (CI: 4.3 to 18.3) and 9.2 (CI: 5.2 to 13.4), respectively. According to our results, the incidence of gastric cancer is increasing in Iran, so further epidemiological studies into the etiology and early detection are essential.

Remotely sensing wheat maturation with radar

NASA Technical Reports Server (NTRS)

Bush, T. F.; Ulaby, F. T.

1975-01-01

The scattering properties of wheat were studied in the 8-18 GHz band as a function of frequency, polarization, incidence angle, and crop maturity. Supporting ground truth was collected at the time of measurement. The data indicate that the radar backscattering coefficient is sensitive to both radar system parameters and crop characteristics particularly at incidence angles near nadir. Linear regression analyses of the radar backscattering coefficient on both time and plant moisture content result in rather good correlation. Furthermore, by calculating the average time rate of change of the radar backscattering coefficient it is found that it undergoes rapid variations shortly before and after the wheat is harvested. Both of these analyses suggest methods for estimating wheat maturity and for monitoring the progress of harvest.

Step edge sputtering yield at grazing incidence ion bombardment.

PubMed

Hansen, Henri; Polop, Celia; Michely, Thomas; Friedrich, Andreas; Urbassek, Herbert M

2004-06-18

The surface morphology of Pt(111) was investigated by scanning tunneling microscopy after 5 keV Ar+ ion bombardment at grazing incidence in dependence of the ion fluence and in the temperature range between 625 and 720 K. The average erosion rate was found to be strongly dependent on the ion fluence and the substrate temperature during bombardment. This dependence is traced back to the variation of step concentration with temperature and fluence. We develop a simple model allowing us to determine separately the constant sputtering yields for terraces and for impact area stripes in front of ascending steps. The experimentally determined yield of these stripes--the step-edge sputtering yield--is in excellent agreement with our molecular dynamics simulations performed for the experimental situation.

Induced abortion: incidence and trends worldwide from 1995 to 2008.

PubMed

Sedgh, Gilda; Singh, Susheela; Shah, Iqbal H; Ahman, Elisabeth; Henshaw, Stanley K; Bankole, Akinrinola

2012-02-18

Data of abortion incidence and trends are needed to monitor progress toward improvement of maternal health and access to family planning. To date, estimates of safe and unsafe abortion worldwide have only been made for 1995 and 2003. We used the standard WHO definition of unsafe abortions. Safe abortion estimates were based largely on official statistics and nationally representative surveys. Unsafe abortion estimates were based primarily on information from published studies, hospital records, and surveys of women. We used additional sources and systematic approaches to make corrections and projections as needed where data were misreported, incomplete, or from earlier years. We assessed trends in abortion incidence using rates developed for 1995, 2003, and 2008 with the same methodology. We used linear regression models to explore the association of the legal status of abortion with the abortion rate across subregions of the world in 2008. The global abortion rate was stable between 2003 and 2008, with rates of 29 and 28 abortions per 1000 women aged 15-44 years, respectively, following a period of decline from 35 abortions per 1000 women in 1995. The average annual percent change in the rate was nearly 2·4% between 1995 and 2003 and 0·3% between 2003 and 2008. Worldwide, 49% of abortions were unsafe in 2008, compared to 44% in 1995. About one in five pregnancies ended in abortion in 2008. The abortion rate was lower in subregions where more women live under liberal abortion laws (p<0·05). The substantial decline in the abortion rate observed earlier has stalled, and the proportion of all abortions that are unsafe has increased. Restrictive abortion laws are not associated with lower abortion rates. Measures to reduce the incidence of unintended pregnancy and unsafe abortion, including investments in family planning services and safe abortion care, are crucial steps toward achieving the Millennium Development Goals. UK Department for International Development, Dutch Ministry of Foreign Affairs, and John D and Catherine T MacArthur Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Decomposition rates and termite assemblage composition in semiarid Africa

USGS Publications Warehouse

Schuurman, G.

2005-01-01

Outside of the humid tropics, abiotic factors are generally considered the dominant regulators of decomposition, and biotic influences are frequently not considered in predicting decomposition rates. In this study, I examined the effect of termite assemblage composition and abundance on decomposition of wood litter of an indigenous species (Croton megalobotrys) in five terrestrial habitats of the highly seasonal semiarid Okavango Delta region of northern Botswana, to determine whether natural variation in decomposer community composition and abundance influences decomposition rates. 1 conducted the study in two areas, Xudum and Santawani, with the Xudum study preceding the Santawani study. I assessed termite assemblage composition and abundance using a grid of survey baits (rolls of toilet paper) placed on the soil surface and checked 2-4 times/month. I placed a billet (a section of wood litter) next to each survey bait and measured decomposition in a plot by averaging the mass loss of its billets. Decomposition rates varied up to sixfold among plots within the same habitat and locality, despite the fact that these plots experienced the same climate. In addition, billets decomposed significantly faster during the cooler and drier Santawani study, contradicting climate-based predictions. Because termite incidence was generally higher in Santawani plots, termite abundance initially seemed a likely determinant of decomposition in this system. However, no significant effect of termite incidence on billet mass loss rates was observed among the Xudum plots, where decomposition rates remained low even though termite incidence varied considerably. Considering the incidences of fungus-growing termites and non-fungus-growing termites separately resolves this apparent contradiction: in both Santawani and Xudum, only fungus-growing termites play a significant role in decomposition. This result is mirrored in an analysis of the full data set of combined Xudum and Santawani data. The determination that natural variation in the abundance of a single taxonomic group of soil fauna, a termite subfamily, determines almost all observed variation in decomposition rates supports the emerging view that biotic influences may be important in many biomes and that consideration of decomposer community composition and abundance may be critical for accurate prediction of decomposition rates. ?? 2005 by the Ecological Society of America.

Using geographic information systems to evaluate cardiac arrest survival.

PubMed

Warden, Craig R; Daya, Mohamud; LeGrady, Lara A

2007-01-01

To evaluate cardiac arrest survival using geographical information systems (GIS) methodology. Patient data were obtained from a fire district Utstein-style adult cardiac arrest registry that also included address data. All incident locations were geocoded and fire station first-due areas were mapped by using the new computer-aided dispatch geographic data. Retrospective assignment of first-due versus second-due fire response unit was done by using a GIS "point-in-polygon" algorithm Survival to hospital admission was the primary outcome measure for incidents responded to by first-due versus second-due apparatus controlling for other potential predictors of survival using logistic regression. Cluster analysis was also performed to evaluate potential areas of high or low rates of survival. There were 461 eligible patients with an average age of 67+/-17 years, 63% were male, 53% had a witnessed arrest, bystander cardiopulmonary resuscitation was performed in 38%, bystander automatic external defibrillator (AED) Page: 1 was used in 0.01%, ventricular fibrillation or ventricular tachycardia were the presenting rhythms in 44%, the average response time was 5.5+/-2.1 minutes, and survival to hospital admission was 17%. There was no significant difference in response time between survivors (4.97 minutes) and non-survivors (5.52 minutes), (difference 0.55 minutes, 95%CI -0.08 to 1.18 min). The number of cardiac arrest calls varied from 1 to 49 for each station and the rate of second-due response varied from 0 to 19%. There was a nonsignificant association of survival to hospital admission for the first-due area cohort: odds ratio 0.70, 95% CI 0.38-1.29. GIS is a new methodology for analyzing EMS incident data. It adds a spatial component of analysis to traditional statistical techniques. No spatial difference was found on patient survival in this analysis.

Injury surveillance in the World Football Tournaments 1998–2012

PubMed Central

Junge, Astrid; Dvorak, Jiri

2013-01-01

Background International sports bodies should protect the health of their athletes, and injury surveillance is an important pre-requisite for injury prevention. The Fédération International de Football Association (FIFA) has systematically surveyed all football injuries in their tournaments since 1998. Aims Analysis of the incidence, characteristics and changes of football injury during international top-level tournaments 1998–2012. Methods All newly incurred football injuries during the FIFA tournaments and the Olympic Games were reported by the team physicians on a standardised injury report form after each match. The average response rate was 92%. Results A total of 3944 injuries were reported from 1546 matches, equivalent to 2.6 injuries per match. The majority of injuries (80%) was caused by contact with another player, compared with 47% of contact injuries by foul play. The most frequently injured body parts were the ankle (19%), lower leg (16%) and head/neck (15%). Contusions (55%) were the most common type of injury, followed by sprains (17%) and strains (10%). On average, 1.1 injuries per match were expected to result in absence from a match or training. The incidence of time-loss injuries was highest in the FIFA World Cups and lowest in the FIFA U17 Women's World Cups. The injury rates in the various types of FIFA World Cups had different trends over the past 14 years. Conclusions Changes in the incidence of injuries in top-level tournaments might be influenced by the playing style, refereeing, extent and intensity of match play. Strict application of the Laws of the Games is an important means of injury prevention. PMID:23632746

Fatal injuries among grounds maintenance workers: United States, 2003--2008.

PubMed

2011-05-06

A total of 1,142 grounds maintenance workers (GMWs) were fatally injured at work during 2003--2008, an average of 190 each year. GMWs accounted for 3.4% of all occupational fatalities, and 31% of those GMWs were Hispanic or Latino. Approximately 83% of the Hispanic or Latino GMWs who died were born outside the United States. In 2008, approximately 1.52 million persons were employed as GMWs, constituting 1.0% of the U.S. workforce. During 2003--2007, an average of 13.3 per 100,000 employed GMWs died each year, compared with an overall rate of 4.0 fatalities per 100,000 U.S. workers. The rate of on-the-job fatal injuries among GMWs has remained elevated relative to other workers for >20 years. This report characterizes events leading to GMW fatalities and differences in fatality characteristics across demographic groups among GMWs, based on an evaluation of 2003--2008 data from the U.S. Department of Labor's Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) program. The report also identifies workplace interventions that might reduce the incidence of fatal injuries. Major events leading to GMW occupational fatalities included transportation incidents (31%), contact with objects and equipment (25%), falls (23%), and traumatic acute exposures to harmful substances or environments (e.g., electrocution and drowning) (16%). To reduce the incidence of such fatalities, employers, trade and worker associations, and policy makers should focus on effective, targeted workplace safety interventions such as frequent hazard identification and training for specific hazards. Diversity among the populations of workers requires use of culture- and language-appropriate training techniques as part of comprehensive injury and illness prevention programs.

The global burden of cholera

PubMed Central

Lopez, Anna Lena; You, Young Ae; Kim, Young Eun; Sah, Binod; Maskery, Brian; Clemens, John

2012-01-01

Abstract Objective To estimate the global burden of cholera using population-based incidence data and reports. Methods Countries with a recent history of cholera were classified as endemic or non-endemic, depending on whether they had reported cholera cases in at least three of the five most recent years. The percentages of the population in each country that lacked access to improved sanitation were used to compute the populations at risk for cholera, and incidence rates from published studies were applied to groups of countries to estimate the annual number of cholera cases in endemic countries. The estimates of cholera cases in non-endemic countries were based on the average numbers of cases reported from 2000 to 2008. Literature-based estimates of cholera case-fatality rates (CFRs) were used to compute the variance-weighted average cholera CFRs for estimating the number of cholera deaths. Findings About 1.4 billion people are at risk for cholera in endemic countries. An estimated 2.8 million cholera cases occur annually in such countries (uncertainty range: 1.4–4.3) and an estimated 87 000 cholera cases occur in non-endemic countries. The incidence is estimated to be greatest in children less than 5 years of age. Every year about 91 000 people (uncertainty range: 28 000 to 142 000) die of cholera in endemic countries and 2500 people die of the disease in non-endemic countries. Conclusion The global burden of cholera, as determined through a systematic review with clearly stated assumptions, is high. The findings of this study provide a contemporary basis for planning public health interventions to control cholera. PMID:22461716

Incidence of fatigue symptoms and diagnoses presenting in UK primary care from 1990 to 2001.

PubMed

Gallagher, Arlene M; Thomas, Janice M; Hamilton, William T; White, Peter D

2004-12-01

Little is known about whether the incidence of symptoms of fatigue presented in primary care, and the consequent diagnoses made, change over time. The UK General Practice Research Database was used to investigate the annual incidence of both fatigue symptoms and diagnoses recorded in UK primary care from 1990 to 2001. The overall incidence of all fatigue diagnoses decreased from 87 per 100 000 patients in 1990 to 49 in 2001, a reduction of 44%, while postviral fatigue syndromes decreased from 81% of all fatigue diagnoses in 1990 to 60% in 2001. Chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) together increased from 9% to 26% of all fatigue diagnoses. The incidence of fibromyalgia increased from less than 1 per 100 000 to 35 per 100 000. In contrast, there was no consistent change in the incidence of all recorded symptoms of fatigue, with an average of 1503 per 100 000, equivalent to 1.5% per year. CFS/ME and fibromyalgia were rarely diagnosed in children and were uncommon in the elderly. All symptoms and diagnoses were more common in females than in males. The overall incidence of fatigue diagnoses in general has fallen, but the incidence rates of the specific diagnoses of CFS/ME and fibromyalgia have risen, against a background of little change in symptom reporting. This is likely to reflect fashions in diagnostic labelling rather than true changes in incidence.

Rural and urban distribution of trauma incidents in Scotland.

PubMed

Morrison, J J; McConnell, N J; Orman, J A; Egan, G; Jansen, J O

2013-02-01

Trauma systems reduce mortality and improve functional outcomes from injury. Regional trauma networks have been established in several European regions to address longstanding deficiencies in trauma care. A perception of the geography and population distribution as challenging has delayed the introduction of a trauma system in Scotland. The characteristics of trauma incidents attended by the Scottish Ambulance Service were analysed, to gain a better understanding of the geospatial characteristics of trauma in Scotland. Data on trauma incidents collected by the Scottish Ambulance Service between November 2008 and October 2010 were obtained. Incident location was analysed by health board region, rurality and social deprivation. The results are presented as number of patients, average annual incidence rates and relative risks. Of the 141,668 incidents identified, 72·1 per cent occurred in urban regions. The risk of being involved in an incident was similar across the most populous regions, and decreased slightly with increasing rurality. Social deprivation was associated with greater numbers and risk. A total of 53·1 per cent of patients were taken to a large general hospital, and 38·6 per cent to a teaching hospital; the distribution was similar for the subset of incidents involving patients with physiological derangements. The majority of trauma incidents in Scotland occur in urban and deprived areas. A regionalized system of trauma care appears plausible, although the precise configuration of such a system requires further study. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system.

PubMed

Novak, Avrey; Nyflot, Matthew J; Ermoian, Ralph P; Jordan, Loucille E; Sponseller, Patricia A; Kane, Gabrielle M; Ford, Eric C; Zeng, Jing

2016-05-01

Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically during the documentation of patient positioning and localization of the patient. Incidents were most frequently detected during treatment delivery (30%), and incidents identified at this point also had higher severity scores than other workflow areas (NMRI = 1.6). Incidents identified during on-treatment quality management were also more severe (NMRI = 1.7), and the specific process steps of reviewing portal and CBCT images tended to catch highest-severity incidents. On average, safety barriers caught 46% of all incidents, most frequently at physics chart review, therapist's chart check, and the review of portal images; however, most of the incidents that pass through a particular safety barrier are not designed to be capable of being captured at that barrier. Incident learning systems can be used to assess the most common points of error origination and detection in radiation oncology. This can help tailor safety improvement efforts and target the highest impact portions of the workflow. The most severe near-miss events tend to originate during simulation, with the most severe near-miss events detected at the time of patient treatment. Safety barriers can be improved to allow earlier detection of near-miss events.

Inconsistency in the analysis of morphological deformities in chironomidae (Insecta: Diptera) larvae.

PubMed

Salmelin, Johanna; Vuori, Kari-Matti; Hämäläinen, Heikki

2015-08-01

The incidence of morphological deformities of chironomid larvae as an indicator of sediment toxicity has been studied for decades. However, standards for deformity analysis are lacking. The authors evaluated whether 25 experts diagnosed larval deformities in a similar manner. Based on high-quality digital images, the experts rated 211 menta of Chironomus spp. larvae as normal or deformed. The larvae were from a site with polluted sediments or from a reference site. The authors revealed this to a random half of the experts, and the rest conducted the assessment blind. The authors quantified the interrater agreement by kappa coefficient, tested whether open and blind assessments differed in deformity incidence and in differentiation between the sites, and identified those deformity types rated most consistently or inconsistently. The total deformity incidence varied greatly, from 10.9% to 66.4% among experts. Kappa coefficient across rater pairs averaged 0.52, indicating insufficient agreement. The deformity types rated most consistently were those missing teeth or with extra teeth. The open and blind assessments did not differ, but differentiation between sites was clearest for raters who counted primarily absolute deformities such as missing and extra teeth and excluded apparent mechanical aberrations or deviations in tooth size or symmetry. The highly differing criteria in deformity assignment have likely led to inconsistent results in midge larval deformity studies and indicate an urgent need for standardization of the analysis. © 2015 SETAC.

Rabies in the Americas: 1998-2014

PubMed Central

Vigilato, Marco A. N.; Pompei, Julio A.; Rocha, Felipe; Vokaty, Alexandra; Molina-Flores, Baldomero; Cosivi, Ottorino; Del Rio Vilas, Victor J.

2018-01-01

Through national efforts and regional cooperation under the umbrella of the Regional Program for the Elimination of Rabies, dog and human rabies have decreased significantly in Latin America and Caribbean (LAC) countries over the last three decades. To achieve this decline, LAC countries had to develop national plans, and consolidate capabilities such as regular mass dog vaccination, opportune post-exposure prophylaxis and sensitive surveillance. This paper presents longitudinal data for 21 LAC countries on dog vaccination, PEP and rabies surveillance collected from the biannual regional meeting for rabies directors from 1998–2014 and from the Regional Epidemiologic Surveillance System for Rabies (SIRVERA). Differences in human and dog rabies incidence rates and dog vaccination rates were shown between low, middle and high-income countries. At the peak, over 50 million dogs were vaccinated annually in national campaigns in the countries represented. The reported number of animal exposures remained fairly stable during the study period with an incidence rate ranging from 123 to 191 reported exposures per 100,000 people. On average, over 2 million doses of human vaccine were applied annually. In the most recent survey, only 37% of countries reported that they had sufficient financial resources to meet the program objectives. The data show a sufficient and sustained effort of the LAC countries in the area of dog vaccination and provide understanding of the baseline effort required to reduce dog-mediated rabies incidence. PMID:29558465

Rabies in the Americas: 1998-2014.

PubMed

Freire de Carvalho, Mary; Vigilato, Marco A N; Pompei, Julio A; Rocha, Felipe; Vokaty, Alexandra; Molina-Flores, Baldomero; Cosivi, Ottorino; Del Rio Vilas, Victor J

2018-03-01

Through national efforts and regional cooperation under the umbrella of the Regional Program for the Elimination of Rabies, dog and human rabies have decreased significantly in Latin America and Caribbean (LAC) countries over the last three decades. To achieve this decline, LAC countries had to develop national plans, and consolidate capabilities such as regular mass dog vaccination, opportune post-exposure prophylaxis and sensitive surveillance. This paper presents longitudinal data for 21 LAC countries on dog vaccination, PEP and rabies surveillance collected from the biannual regional meeting for rabies directors from 1998-2014 and from the Regional Epidemiologic Surveillance System for Rabies (SIRVERA). Differences in human and dog rabies incidence rates and dog vaccination rates were shown between low, middle and high-income countries. At the peak, over 50 million dogs were vaccinated annually in national campaigns in the countries represented. The reported number of animal exposures remained fairly stable during the study period with an incidence rate ranging from 123 to 191 reported exposures per 100,000 people. On average, over 2 million doses of human vaccine were applied annually. In the most recent survey, only 37% of countries reported that they had sufficient financial resources to meet the program objectives. The data show a sufficient and sustained effort of the LAC countries in the area of dog vaccination and provide understanding of the baseline effort required to reduce dog-mediated rabies incidence.

Association of Increased Urinary Albumin With Risk of Incident Clinical Fracture and Rate of Hip Bone Loss: the Osteoporotic Fractures in Men Study.

PubMed

Fink, Howard A; Vo, Tien N; Langsetmo, Lisa; Barzilay, Joshua I; Cauley, Jane A; Schousboe, John T; Orwoll, Eric S; Canales, Muna T; Ishani, Areef; Lane, Nancy E; Ensrud, Kristine E

2017-05-01

Prior studies suggest that increased urine albumin is associated with a heightened fracture risk in women, but results in men are unclear. We used data from Osteoporotic Fractures in Men (MrOS), a prospective cohort study of community-dwelling men aged ≥65 years, to evaluate the association of increased urine albumin with subsequent fractures and annualized rate of hip bone loss. We calculated albumin/creatinine ratio (ACR) from urine collected at the 2003-2005 visit. Subsequent clinical fractures were ascertained from triannual questionnaires and centrally adjudicated by review of radiographic reports. Total hip BMD was measured by DXA at the 2003-2005 visit and again an average of 3.5 years later. We estimated risk of incident clinical fracture using Cox proportional hazards models, and annualized BMD change using ANCOVA. Of 2982 men with calculable ACR, 9.4% had ACR ≥30 mg/g (albuminuria) and 1.0% had ACR ≥300 mg/g (macroalbuminuria). During a mean of 8.7 years of follow-up, 20.0% of men had an incident clinical fracture. In multivariate-adjusted models, neither higher ACR quintile (p for trend 0.75) nor albuminuria (HR versus no albuminuria, 0.89; 95% CI, 0.65 to 1.20) was associated with increased risk of incident clinical fracture. Increased urine albumin had a borderline significant, multivariate-adjusted, positive association with rate of total hip bone loss when modeled in ACR quintiles (p = 0.06), but not when modeled as albuminuria versus no albuminuria. Macroalbuminuria was associated with a higher rate of annualized hip bone loss compared to no albuminuria (-1.8% more annualized loss than in men with ACR <30 mg/g; p < 0.001), but the limited prevalence of macroalbuminuria precluded reliable estimates of its fracture associations. In these community-dwelling older men, we found no association between urine albumin levels and risk of incident clinical fracture, but found a borderline significant, positive association with rate of hip bone loss. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

Interlocking intramedullary nailing in distal tibial fractures.

PubMed

Tyllianakis, M; Megas, P; Giannikas, D; Lambiris, E

2000-08-01

This retrospective study examined the results of non-pilon fractures of the distal part of the tibia treated with interlocking intramedullary nailing. Seventy-three patients with equal numbers of fractures treated surgically between 1990 and 1998 were reviewed. Mean patient age was 39.8 years, and follow-up averaged 34.2 months. The AO fracture classification system was used. Concomitant fractures of the lateral malleolus were fixed. All but three fractures achieved union within 4.2 months on average. Satisfactory or excellent results were obtained in 86.3% of patients. These results indicate interlocking intramedullary nailing is a reliable method of treatment for these fractures and is characterized by high rates of union and a low incidence of complications.

Time Trend Analysis of Cancer‏ Incidence in Caspian Sea, 2004 - 2009: A Population-based Cancer Registries Study (northern Iran).

PubMed

Salehiniya, Hamid; Ghobadi Dashdebi, Sakineh; Rafiemanesh, Hosein; Mohammadian-Hafshejani, Abdollah; Enayatrad, Mostafa

2016-01-01

Cancer is a major public health problem in the world. In Iran especially after a transition to a dynamic and urban community, the pattern of cancer has changed significantly. An important change occurred regarding the incidence of cancer at the southern shores of the Caspian Sea, including Gilan, Mazandaran and Golestan province. This study was designed it investigate the epidemiology and changes in trend of cancer incidence in the geographic region of the Caspian Sea (North of Iran). Data were collected from Cancer Registry Center report of Iran health deputy. Trends of incidence were analyzed by joinpoint regression analysis. During the study period year (2004-2009), 33,807 cases of cancer had been recorded in three provinces of Gilan, Mazandran and Golstan. Joinpoint analysis indicated a significant increase in age-standardized incidence rates (ASR) with an average annual percentage change (AAPC) 10.3, 8.5 and 5.2 in Gilan, Mazandaran and Golestan, respectively. The most common cancer in these provinces were correspondingly cancer of stomach, breast, skin, colorectal and bladder, respectively. The incidence of cancer tends to be increasing in North of Iran. These findings warrant the epidemiologic studies are helpful in planning preventive programs and recognition of risk factors.

The Estonian study of Chernobyl cleanup workers: II. Incidence of cancer and mortality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rahu, M.; Tekkel, M.; Veidebaum, T.

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 oftenmore » 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.« less

Retrospective study of human cystic echinococcosis over the past decade in France, using a nationwide hospital medical information database.

PubMed

van Cauteren, Dieter; Millon, Laurence; de Valk, Henriette; Grenouillet, Frederic

2016-11-01

No specific surveillance system of cystic echinococcosis infections in humans exists in France. The incidence and trends over time have not been documented since the last decade of the twentieth century. We performed the current analysis to assess human cystic echinococcosis epidemiology over a 10-year period in France (including the island of Corsica but excluding the overseas territories) using a nationwide hospital medical information database. A total number of 2629 patients were identified in this database between 2005 and 2014. The average annual incidence rate was 0.42 hospitalized cases/100,000 inhabitants. It was highest in the Island of Corsica (1.76 cases/100,000) and in the region Provence-Alpes-Côte d'Azur (0.85 cases/100,000). This retrospective analysis of hospital records provides a population-based estimate of cystic echinococcosis incidence and trends over a 10-year period at a national level. It indicates a significant decrease of the incidence between 2005 and 2014 at the national level and in the area that reported the highest incidence. It stresses the fact that in France, cystic echinococcosis is not re-emerging and that the incidence remains low in comparison with similar studies in other Mediterranean countries.

THE EFFECT OF ENDOCRINE CHANGES, OF IRRADIATION AND OF ADDITIONAL TREATMENT OF THE SKIN ON THE INDUCTION OF TUMOURS IN THE FEMALE GENITAL TRACT OF RATS BY CHEMICAL CARCINOGENS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cherry, C.P.; Glucksmann, A.

1960-09-01

Ovariectomy reduced the incidence of vaginal tumors after intravaginal application of 9,10-dimethyl-1,2benzanthracene (DMBA), and administration of oestrogen or of progesterone raised the incidence of tumors only slightly. Repeated whole-body exposures to x rays also lowered the rate of tumor incidence after painting and so to a lesser extent did repeated pelvic irradiation of virgin rats and the application of DMBA to an additional dorsal skin region. In surgical castrates adrenalectomy or repeated pelvic irradiation restored the level of tumor incidence to that of intact and pregnant rats. Three levels of vaginal tumor incidence were found, and the distribution of tumormore » types and the length of the average induction time varied with the level: at the lowest level there were only sarcomas, at the intermediate level fibromas and presarcomatous lesions were found in addition to the sarcomas; and at the highest level the incidence of sarcomas is increased and epithelial tumors appear. Tumor induction in the vulva is not affected by castration, radiation, or hormone treatment but varies at certain dose levels with the dose of the carcinogen. (auth)« less

Epidemiologic and clinical characteristics of acute diarrhea with emphasis on Entamoeba histolytica infections in preschool children in an urban slum of Dhaka, Bangladesh.

PubMed

Haque, Rashidul; Mondal, Dinesh; Kirkpatrick, Beth D; Akther, Selim; Farr, Barry M; Sack, R Bradley; Petri, William A

2003-10-01

The epidemiology, clinical features, nutritional status, and causative agents of diarrhea were studied in 289 Bangladeshi children (147 boys and 142 girls) 2-5 years old. The use of improved diagnostic tests for amebiasis enabled for the first time analysis of the contribution of Entamoeba histolytica to total diarrheal illness in this community setting. The average incidence rate of diarrhea was 1.8/child-year, and the average number of diarrheal days was 3.7 days/child-year over an average observation period of 2.8 years/child. Seventy-five percent of the diarrheal episodes were < or = 2 days in duration. Persistent diarrhea was relatively uncommon (0.2% of the children) and chronic diarrhea was observed in only one episode. Compared with malnourished and/or stunted children, better-nourished children experienced significantly fewer diarrheal episodes. The diarrheal incidence rate for children with blood group A was significantly less that that of the children with blood groups O and AB. The most frequent bacterial enteropathogens isolated from diarrheal stool specimens were enterotoxigenic Escherichia coli (9%) and Aeromonas species (9%), followed by Plesimonas shigelloides (4%) and Shigella flexneri (3.8%). Rotavirus was the most common viral agent isolated from diarrheal stool samples (5%). Giardia lamblia, Cryptosporidium parvum, and E. histolytica were identified in 11%, 8.4%, and 8%, respectively, of the diarrheal stool specimens. Dysentery was observed in 7.7% of all diarrheal episodes. The most common pathogens isolated from dysenteric stool were S. flexneri (11.6%), Aeromonas sp. (10%), E. histolytica (8.7%), Campylobacter jejunii (5.8%), P. shigelloides (4.3%), and A. caviae (4.3%). The overall incidence rate of E. histolytica-associated diarrhea was 0.08/child-year. Visible blood and hemoccult test-detected blood loss was found in 7% and 25%, respectively, of cases of E. histolytica-associated diarrhea. Children who had recovered from a diarrheal episode with E. histolytica, but not E. dispar, had half the chance of developing subsequent E. histolytica-associated diarrhea, consistent with the development of species-specific acquired immunity. In conclusion, the use of modern diagnostic tests demonstrated that E. histolytica contributed to overall morbidity from diarrheal illness. Understanding the etiology, frequency, and consequences of acute diarrhea in children from a developing country should aid in the design of interventions to improve child health.

Changes to injury profile (and recommended cricket injury definitions) based on the increased frequency of Twenty20 cricket matches

PubMed Central

Orchard, John; James, Trefor; Kountouris, Alex; Portus, Marc

2010-01-01

This study analyzes injuries occurring prospectively in Australian men’s cricket at the state and national levels over 11 seasons (concluding in season 2008–09). In the last four of these seasons, there was more cricket played, with most of the growth being a new form of the game – Twenty20 cricket. Since the introduction of a regular Twenty20 program, injury incidence rates in each form of cricket have been fairly steady. Because of the short match duration, Twenty20 cricket exhibits a high match injury incidence, expressed as injuries per 10,000 hours of play. Expressed as injuries per days of play, Twenty20 cricket injury rates compare more favorably to other forms of cricket. Domestic level Twenty20 cricket resulted in 145 injuries per 1000 days of play (compared to 219 injuries per 1000 days of domestic one day cricket, and 112 injuries per 1000 days of play in first class domestic cricket). It is therefore recommended that match injury incidence measures be expressed in units of injuries per 1000 days of play. Given the high numbers of injuries which are of gradual onset, seasonal injury incidence rates (which typically range from 15–20 injuries per team per defined ‘season’) are probably a superior incidence measure. Thigh and hamstring strains have become clearly the most common injury in the past two years (greater than four injuries per team per season), perhaps associated with the increased amount of Twenty20 cricket. Injury prevalence rates have risen in conjunction with an increase in the density of the cricket calendar. Annual injury prevalence rates (average proportion of players missing through injury) have exceeded 10% in the last three years, with the injury prevalence rates for fast bowlers exceeding 18%. As the amount of scheduled cricket is unlikely to be reduced in future years, teams may need to develop a squad rotation for fast bowlers, similar to pitching staff in baseball, to reduce the injury rates for fast bowlers. Consideration should be given to rule changes which may reduce the impact of injury. In particular, allowing the 12th man to play as a full substitute in first class cricket (and therefore take some of the bowling workload in the second innings) would probably reduce bowling injury prevalence in cricket. PMID:24198544

Trends in hip fracture epidemiology in Australia: possible impact of bisphosphonates and hormone replacement therapy.

PubMed

Fisher, A A; O'Brien, E D; Davis, M W

2009-08-01

The purposes of this study were to analyse trends in hip fracture (HF) epidemiology over a 13-year period (1994-2007) in the Australian Capital Territory (ACT), to assess the potential impact of concurrent changes in hormone replacement therapy (HRT) and bisphosphonate use and to present a new prediction of HFs in Australia up to 2021. Annual sex- and age-specific incidence rates (per 100,000 population) were determined and standardized using the Australian 2006 population. The projected number of HFs was estimated by two models applying age- and sex-specific HF rates averaged for 2002-2006 (model 1) or continuously changing as observed in this period (model 2, Poisson regression) to the projected population. In 2006 compared to 2001, the population > or = 60 years in the ACT increased by 19.7%. Over the last 5 years the average annual incidence HF rate compared to the previous 3-year period decreased in females > or = 60 years of age by 28.3%. Between 2001 and 2006 the number of prescriptions for HRT dispensed in the ACT declined by 54.6, while the number of prescriptions for bisphosphonate increased by 245%, accompanied by a decline in standardized incidence of HF rates of 36.4%, mainly in women (42.1%). This represents an annual cost for bisphosphonates per one prevented HF, of $A45,250 or $A576 person/year. Compared to 2006 the total number of HFs in Australia according to model 1 will increase in 2011 by 20.1% and in 2021 by 58.8%, but according to model 2 will decrease by 15.5% in 2011 and 27.5% in 2021. Our data suggest that the previously predicted rising trend in HFs in elderly women reversed, but did not so for men. This was coincident with a significant fall in HRT use and increased prescribing of bisphosphonates, which is cost-effective. However caution should be used in attributing causation as this is an ecological study. If trends in HF observed in 2002-2006 continue, the absolute number of HFs in Australia in 2011-2021 will stabilise or decline (which is more likely), despite the rapid ageing of the population.

Effectiveness of suicide prevention programs for emergency and protective services employees: A systematic review and meta-analysis.

PubMed

Witt, Katrina; Milner, Allison; Allisey, Amanda; Davenport, Lauren; LaMontagne, Anthony D

2017-04-01

This brief report summarizes the international literature on the effectiveness of suicide prevention programs for protective and emergency services employees. A systematic search of 11 electronic databases was undertaken until June 30, 2015. Quantitative meta-analysis was undertaken to investigate the effectiveness of these programs on suicide rates at post-intervention. Qualitative analyses were also used to identify program components that may be associated with reductions in suicide rates. A total of 13 studies were included. Only six reported sufficient information on suicide rates to enable inclusion in quantitative analyses, however. On average, these programs were associated with an approximate halving in suicide rates over an average follow-up period of 5.25 years (SD = 4.2; range: 1-11) (Incidence Rate Ratio 0.45, 95%CI 0.31-0.65; five studies; I 2 14.8%). Few programs integrated activities at the primary prevention level. A greater focus on the relatively neglected area of workplace primary prevention could further improve suicide prevention effectiveness. Am. J. Ind. Med. 60:394-407, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Reduction in Neisseria meningitidis infection in Italy after Meningococcal C conjugate vaccine introduction: A time trend analysis of 1994–2012 series

PubMed Central

de Waure, Chiara; Miglietta, Alessandro; Nedovic, Darko; Mereu, Giovanna; Ricciardi, Walter

2016-01-01

The incidence of invasive meningococcal disease (IMD) in Italy is among the lowest in Europe. Meningococcal C conjugate vaccine (MCC) was introduced in 2005 for 12 months old infants. The aim of this study was to describe the epidemiology of IMD in Italy from 1994 to 2012 and to evaluate the impact of MCC introduction. Data about Neisseria meningitidis (N. meningitidis) cases were drawn from the National Surveillance of Invasive Bacterial Diseases. The average incidence of IMD during 1994–2012 in Italy was 0.36 per 100,000 (95%CI 0.30; 0.40). N. meningitidis B was the most frequent serogroup and infants less than 12 months old were the most affected. Joinpoint analysis showed a statistically significant reduction in the incidence of N. meningitidis C related IMD after MCC introduction: the Annual Percentage Change declined from 21.8 (95%CI 15.1; 28.9) in 1994–2005 to −19.9 (95%CI −28.2; −10.7) afterwards. No changes were observed with respect to N. meningitidis B related IMD. Poisson regression showed a statistically significant reduction in the incidence of IMD both associated to N. meningitidis C (Incidence Rate Ratio 0.33; 95%CI 0.29; 0.37) and due to all serogroups (Incidence Rate Ratio 0.70; 95%CI 0.65; 0.75) in the post-vaccination period compared to the pre-vaccination one. On the other hand, the incidence of N. meningitidis B related IMD did not decrease. Our results suggest that MCC had an impact in decreasing the incidence of N. meningitidis C related IMD. However, data on typing are incomplete and efforts are needed to make them available for studying the need and the impact of other meningococcal vaccines. PMID:26308192

The epidemiology of polypharmacy in older adults: register-based prospective cohort study

PubMed Central

Morin, Lucas; Johnell, Kristina; Laroche, Marie-Laure; Fastbom, Johan; Wastesson, Jonas W

2018-01-01

Objective Polypharmacy is the concomitant use of several drugs by a single person, and it increases the risk of adverse drug-related events in older adults. Little is known about the epidemiology of polypharmacy at the population level. We aimed to measure the prevalence and incidence of polypharmacy and to investigate the associated factors. Methods A prospective cohort study was conducted using register data with national coverage in Sweden. A total of 1,742,336 individuals aged ≥65 years at baseline (November 1, 2010) were included and followed until death or the end of the study (December 20, 2013). Results On average, individuals were exposed to 4.6 (SD =4.0) drugs at baseline. The prevalence of polypharmacy (5+ drugs) was 44.0%, and the prevalence of excessive polypharmacy (10+ drugs) was 11.7%. The incidence rate of polypharmacy among individuals without polypharmacy at baseline was 19.9 per 100 person-years, ranging from 16.8% in individuals aged 65–74 years to 33.2% in those aged ≥95 years (adjusted hazard ratio [HR] =1.49, 95% confidence interval [CI] 1.42–1.56). The incidence rate of excessive polypharmacy was 8.0 per 100 person-years. Older adults using multi-dose dispensing were at significantly higher risk of developing incident polypharmacy compared with those receiving ordinary prescriptions (HR =1.51, 95% CI 1.47–1.55). When adjusting for confounders, living in nursing home was found to be associated with lower risks of incident polypharmacy and incident excessive polypharmacy (HR =0.79 and HR =0.86, p<0.001, respectively). Conclusion The prevalence and incidence of polypharmacy are high among older adults in Sweden. Interventions aimed at reducing the prevalence of polypharmacy should also target potential incident polypharmacy users as they are the ones who fuel future polypharmacy. PMID:29559811

Association between air pollution and acute childhood wheezy episodes: prospective observational study.

PubMed Central

Buchdahl, R.; Parker, A.; Stebbings, T.; Babiker, A.

1996-01-01

OBJECTIVE--To examine the association between the air pollutants ozone, sulphur dioxide, and nitrogen dioxide and the incidence of acute childhood wheezy episodes. DESIGN--Prospective observational study over one year. SETTING--District general hospital. SUBJECTS--1025 children attending the accident and emergency department with acute wheezy episodes; 4285 children with other conditions as the control group. MAIN OUTCOME MEASURES--Daily incidence of acute wheezy episodes. RESULTS--After seasonal adjustment, day to day variations in daily average concentrations of ozone and sulphur dioxide were found to have significant associations with the incidence of acute wheezy episodes. The strongest association was with ozone, for which a non-linear U shaped relation was seen. In terms of the incidence rate ratio (1 at a mean 24 hour ozone concentration of 40 microg/m3 (SD=19.1)), children were more likely to attend when the concentration was two standard deviations below the mean (incidence rate ratio=3.01; 95% confidence interval 2.17 to 4.18) or two standard deviations above the mean (1.34; 1.09 to 1.66). Sulphur dioxide had a weaker log-linear relation with incidence (1.12; 1.05 to 1.19 for each standard deviation (14.1) increase in sulphur dioxide concentration). Further adjustment for temperature and wind speed did not significantly alter these associations. CONCLUSIONS--Independent of season, temperature, and wind speed, fluctuations in concentrations of atmospheric ozone and sulphur dioxide are strongly associated with patterns of attendance at accident and emergency departments for acute childhood wheezy episodes. A critical ozone concentration seems to exist in the atmosphere above or below which children are more likely to develop symptoms. PMID:8597731

Spatiotemporal epidemiology of scarlet fever in Jiangsu Province, China, 2005-2015.

PubMed

Zhang, Qi; Liu, Wendong; Ma, Wang; Shi, Yingying; Wu, Ying; Li, Yuan; Liang, Shuyi; Zhu, Yefei; Zhou, Minghao

2017-08-30

A marked increase in the incidence rate of scarlet fever imposed a considerable burden on the health of children aged 5 to 15 years. The main purpose of this study was to depict the spatiotemporal epidemiological characteristics of scarlet fever in Jiangsu Province, China in order to develop and implement effective scientific prevention and control strategies. Smoothed map was used to demonstrate the spatial distribution of scarlet fever in Jiangsu Province. In addition, a retrospective space-time analysis based on a discrete Poisson model was utilized to detect clusters of scarlet fever from 2005 to 2015. During the years 2005-2015, a total of 15,873 scarlet fever cases occurred in Jiangsu Province, with an average annual incidence rate of 1.87 per 100,000. A majority of the cases (83.67%) occurred in children aged 3 to 9 years. Each year, two seasonal incidence peaks were observed, the higher occurring between March and July, the lower between November and the following January. The incidence in the southern regions of the province was generally higher than that in the northern regions. Seven clusters, all of which occurred during incidence peaks, were detected via space-time scan statistical analysis. The most likely cluster and one of the secondary clusters were detected in the southern and northern high endemic regions, respectively. The prevalence of scarlet fever in Jiangsu Province had a marked seasonality variation and was relatively endemic in some regions. Children aged 3 to 9 years were the major victims of this disease, and kindergartens and primary schools were the focus of surveillance and control. Targeted strategies and measures should be taken to reduce the incidence.

Prevalence of traumatic brain injury among children, adolescents and young adults: prospective evidence from a birth cohort.

PubMed

McKinlay, A; Grace, R C; Horwood, L J; Fergusson, D M; Ridder, E M; MacFarlane, M R

2008-02-01

Little is known about the incidence and prevalence of traumatic brain injury (TBI), particularly for infants, children and young adults. The purpose of this study was to provide an accurate estimate of the incidence and prevalence of TBIs for individuals between 0-25 years of age. A birth cohort of 1265 individuals was used, for which information regarding TBI events, both hospitalized and non-hospitalized, had been recorded. The average incidence for this age group ranged from 1.10-2.36 per 100 per year, with an overall prevalence of approximately 30%. The most common source of injury was falls for individuals 0-14 years of age and contact sports and motor vehicle accidents for 15-25 year olds. Approximately one third of the individuals who experienced a TBI went on to have one or more additional injuries. The incidence rates reported here are much higher than those previously found. It is clear that TBIs constitute a major health issue and therefore it is important to have accurate information to enable planning for primary healthcare services and to inform prevention programmes.

Age and gender patterns of thyroid cancer incidence in Ukraine depending on thyroid radiation doses from radioactive iodine exposure after the Chornobyl NPP accident.

PubMed

Fuzik, M M; Prysyazhnyuk, A Y; Shibata, Y; Romanenko, A Y; Fedorenko, Z P; Gudzenko, N A; Gulak, L O; Trotsyuk, N K; Goroh, Y L; Khukhrianska, O M; Sumkina, O V; Saenko, V A; Yamashita, S

2013-01-01

The objective of this study was to investigate the thyroid cancer incidence in a whole territory of Ukraine and to clear up its age and gender patterns depending on average regional (oblast) thyroid doses from radioactive iodine due to the Chornobyl accident. MATERIALS AND METHODS. On the basis of average accumulated thyroid doses from radioactive iodine the geographical regions of Ukraine with low and high average thyroid doses were identified for a comparative analysis performance. Methods of descriptive epidemiology were used. The level and dynamics of thyroid cancer incidence were analyzed in different gender and age groups (both for attained age and age at the moment of the Chornobyl accident). Results of this study confirmed the radiation excess of thyroid cancer in individuals who were children and adolescents in 1986. Some excess was observed in elder age groups too. Especial situation was observed in female age group 40-49 at the moment of the Chornobyl accident i.e. the age-specific thyroid cancer incidence rates were significantly higher in "high exposure" regions comparing with "low exposure" ones during all years of observation within 1989-2009. A probable radiation excess of thyroid cancer was suggested not only in children and adolescents but also in adult age groups. In elder age groups this excess was less expressed and manifested after a longer period of time. The origin of the phenomenon in female age group of 40-49 is unclear now. Hypothesis of combined effect of radiation and natural changing of hormonal status in this age should be checked in the future studies. Fuzik M. M, Prysyazhnyuk A. Ye, Shibata Y., Romanenko A. Yu., Fedorenko Z. P., Gudzenko N. A., Gulak L. O., Trotsyuk N. K., Goroh Ye. L., Khukhrianska O. M., Sumkina O. V., Saenko V. A., Yamashita Sh., 2013.

Radiation pasteurization of mink feed: Effect of irradiated feed on reproductive performance, growth and fur quality of mink

NASA Astrophysics Data System (ADS)

Passey, C. A.; Roy, D.; Savoie, L.; Malo, R.; Wilson, J.

No significant differences were observed in the net birth rate of kits/female between the 7 breeding groups. However, there was reduced incidence (P = 0.05) of kit deaths among the females receiving irradiated feed, and larger kit size (P < 0.0001) at birth particularly for the litter size of 5-8 kits. The second generation minks born to parents receiving feed irradiated to a planned dose of 1 kGy weighed on average about 2.5 % more, and their fur was on average about 1 ± 0.26 cm longer (12 % more males making the top length grade). Moreover, there was no effect of irradiated feed on fur quality. Irradiation of mink feed with subsequent frozen storage of the meat component improved the microbiological quality by decreasing the incidence of Pseudomonas sp. and Salmonella sp. Radiation pasteurization of mink feed (frozen meat to 1 kGy, and dry feed to 2 kGy or more) should therefore help improve feed utilization, keep the animals healthier, and reproducing better without affecting fur quality.

Epidemiology and Natural History of Primary Biliary Cholangitis in the Chinese: A Territory-Based Study in Hong Kong between 2000 and 2015.

PubMed

Cheung, Ka-Shing; Seto, Wai-Kay; Fung, James; Lai, Ching-Lung; Yuen, Man-Fung

2017-08-31

Studies on the epidemiology of primary biliary cholangitis (PBC) in the Chinese population are lacking. We aimed to determine the epidemiology of PBC in Hong Kong (HK) with a population of 7.3 million. We retrieved data from the electronic database of the HK Hospital Authority, the only public healthcare provider in Hong Kong. PBC cases between 2000 and 2015 were identified by International Classification of Diseases (ICD)-9 code. We estimated the age-/sex-adjusted incidence rate and prevalence of PBC, and analyzed the adverse outcomes (hepatocellular carcinoma (HCC), liver transplantation, and death). One thousand and sixteen PBC patients aged ≥20 years were identified (female-to-male ratio 4:1; median age 60.6 years, interquartile range (IQR) 51.8-72.6 years; median follow-up 5.6 years, IQR 1.6-8.7 years). The average age/sex-adjusted annual incidence rate and prevalence were 8.4 per million person-years and 56.4 per million, respectively. Between 2000 and 2015, the age/sex-adjusted annual incidence rate increased from 6.7 to 8.1 per million person-years (Poisson P=0.002), while age/sex-adjusted prevalence increased from 31.1 to 82.3 per million (Poisson P<0.001). Fifty patients developed HCC, and 49 underwent liver transplantation. Case fatality risk decreased from 10.8 to 6.4% (Poisson P=0.003). The 5- and 10-year overall survival rates were 81.5 and 78.3%, whereas the transplant-free survival rates were 78.0% and 74.3%, respectively. Increasing age, cirrhosis and being treatment-naïve were associated with lower transplant-free survival. There is a considerable increase in the incidence and prevalence of PBC in the Chinese population over the past 16 years, with significant morbidity and mortality.

A Prospective Analysis of the Injury Incidence of Young Male Professional Football Players on Artificial Turf

PubMed Central

Bianco, Antonino; Spedicato, Mirco; Petrucci, Marco; Messina, Giuseppe; Thomas, Ewan; Nese Sahin, Fatma; Paoli, Antonio; Palma, Antonio

2016-01-01

Background: The effects of synthetic surfaces on the risk of injuries is still debated in literature and the majority of published data seems to be contradictory. For such reasons the understanding of injury incidence on such surfaces, especially in youth sport, is fundamental for injury prevention. Objectives: The aim of this study was to prospectively report the epidemiology of injuries in young football players, playing on artificial turfs, during a one sports season. Patients and Methods: 80 young male football players (age 16.1 ± 3.7 years; height 174 ± 6.6 cm; weight 64.2 ± 6.3 kg) were enrolled in a prospective cohort study. The participants were then divided in two groups; the first included players age ranging from 17 to 19 (OP) whereas the second included players age ranging from 13 to 16 (YP). Injury incidence was recorded prospectively, according to the consensus statement for soccer. Results: A total of 107 injuries (35 from the OP and 72 from the YP) were recorded during an exposure time of 83.760 hours (incidence 1.28/1000 per player hours); 22 during matches (incidence 2.84/1000 per player hours, 20.5%) and 85 during training (incidence 1.15/1000 per player hours, 79.5%). Thigh and groin were the most common injury locations (33.6% and 21.5%, respectively) while muscle injuries such as contractures and strains were the most common injury typologies (68.23%). No statistical differences between groups were displayed, except for the rate of severe injuries during matches, with the OP displaying slightly higher rates compared to the YP. Severe injuries accounted for 10.28% of the total injuries reported. The average time lost due to injuries was 14 days. Re-injuries accounted for 4.67% of all injuries sustained during the season. Conclusions: In professional youth soccer injury rates are reasonably low. Muscle injuries are the most common type of injuries while groin and thigh the most common locations. Artificial turf pitches don’t seem to contribute to injury incidence in young football players. PMID:27217929

Climatic factors associated with amyotrophic lateral sclerosis: a spatial analysis from Taiwan.

PubMed

Tsai, Ching-Piao; Tzu-Chi Lee, Charles

2013-11-01

Few studies have assessed the spatial association of amyotrophic lateral sclerosis (ALS) incidence in the world. The aim of this study was to identify the association of climatic factors and ALS incidence in Taiwan. A total of 1,434 subjects with the primary diagnosis of ALS between years 1997 and 2008 were identified in the national health insurance research database. The diagnosis was also verified by the national health insurance programme, which had issued and providing them with "serious disabling disease (SDD) certificates". Local indicators of spatial association were employed to investigate spatial clustering of age-standardised incidence ratios in the townships of the study area. Spatial regression was utilised to reveal any association of annual average climatic factors and ALS incidence for the 12-year study period. The climatic factors included the annual average time of sunlight exposure, average temperature, maximum temperature, minimum temperature, atmospheric pressure, rainfall, relative humidity and wind speed with spatial autocorrelation controlled. Significant correlations were only found for exposure to sunlight and rainfall and it was similar in both genders. The annual average of the former was found to be negatively correlated with ALS, while the latter was positively correlated with ALS incidence. While accepting that ALS is most probably multifactorial, it was concluded that sunlight deprivation and/or rainfall are associated to some degree with ALS incidence in Taiwan.

[Risk factors for absenteeism due to sick leave in the petroleum industry].

PubMed

Oenning, Nágila Soares Xavier; Carvalho, Fernando Martins; Lima, Veronica Maria Cadena

2014-02-01

To identify risk factors for absenteeism among workers with sick leave in an oil company. A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave. To identify risk factors for absenteeism among workers with sick leave in an oil company. A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave.

[Spatio-temporal distribution of scrub typhus and related influencing factors in coastal beach area of Yancheng, China].

PubMed

Chen, Y Z; Li, F; Xu, H; Huang, L C; Gu, Z G; Sun, Z Y; Yan, G J; Zhu, Y J; Tang, C

2016-02-01

In order to provide better programs on monitoring, early warning and prevention of Scrub Typhus in the coastal beach area, temporal-spatial distribution characteristics of scrub typhus were summarized. Relationships between temporal-spatial clustering of Scrub Typhus, meteorological factors, rodent distribution and the biological characteristics in coastal beach area of Yancheng city, were studied. Reports on network-based Scrub Typhus epidemics and information on population, weather situation through monitoring those stations, from 2005 to 2014 were collected and processed, in the coastal beach area of Yancheng city. Distribution, density of the population concerned and seasonal fluctuation on rodents were monitored in coastal beach area, from April 2011 to December, 2013. METHODS as descriptive statistics, space-time permutation scantistics, autocorrelation and Cross-correlation analysis etc, were used to analyze the temporal-spatial distribution of Scrub Typhus and correlation with rodent distribution, density fluctuation and meteorological indexes. Zero-inflated Pearson (ZIP) regression model was contributed according to the distribution of related data. All methods were calculated under Excel 2003, SPSS 16.0, Mapinfo 11.0, Satscan 9.0 and Stata/SE 10.0 softwares. (1) The incidence of Scrub Typhus was gradually increasing and the highest incidence of the year was seen in 2014, as 5.81/10 million. There was an autumn peak of Scrub typhus, with the highest incidence rate as 12.02/10 million in November. The incidence rate of Scrub typhus appeared high in Binhai, Dafeng and Xiangshui, with the average incidence rates appeared as 3.30/10 million, 3.21/10 million and 2.79/10 million, respectively. There were 12 towns with high incidence rates in the coastal beach area, with incidence rate showed between 4.41/10 and 10.03/10 million. (2) There were three incidence clusters of Scrub typhus seen in 25 towns, between October 2012 and November 2012 in Dongtai, Dafeng, Sheyang areas and 5 towns between October and November, 2014 in Xiangshui area, together with another 6 towns in November of 2006, in Binhai area. (3) Apodemus agrarius appeared the dominant species in the coastal area, with the constituent ratio as 89.19%. The rodent density appeared two peaks in winter and summer in 2011 and 2013. The winter peak was seen in January and the summer peak lasting for 5-8 months. Scrub Typhus was seen 10-11 months in a year and the incidence was increasing, parallel with the peak of the rodent density. The peak incidence of Scrub Typhus showed a temperature/rainfall-related peak. Rodent density, temperature, rainfalls were correlated with the incidence of Scrub Typhus, under the Cross correlation analysis. Rains, Mean minimum temperature of a 3-month lagging were directly correlated but the duration of sunshine and relative humidity were negatively correlated with the incidence of Scrub Typhus, under the Zero-inflated Pearson (ZIP) regression model. Temporal-spatial clustering and factors as media creature and weather condition of Scrub Typhu were discovered, which provided evidence for effective measures on prevention and control of the disease.

Screening employees of services for homeless individuals in Montréal for tuberculosis infection.

PubMed

Isler, M A; Rivest, P; Mason, J; Brassard, P

2013-06-01

The results of a tuberculin skin test (TST) screening program offered to employees of services for homeless people in Montréal from 1998 to 2005 were analyzed to assess the occupational risk of tuberculosis (TB) infection. Employees with no known contact with TB were selected among volunteer participants. They were followed in two dynamic cohorts: individuals with a negative two-step baseline TST (cohort A) and individuals with a negative single baseline TST (cohort B). We estimated the prevalences of initial positive TST, boosting effect, and conversion rate. The average age of the workers was 38.9 years. The prevalence of an initial positive TST was 12.9%. A booster effect was observed in 5.1% of workers who completed a two-step TST. The incidence of conversion was 2.3/100 person-years for cohort A (n=93) and 3.5/100 person-years for cohort B (n=221). The incidence of conversion was not significantly associated with any of the demographics or workplace factors investigated. Our findings are comparable to the rates reported among community workers, whose risk is higher than the average health worker. This suggests that there are occasional unidentified contagious cases among the homeless individuals of participating institutions. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

The impact of out-of-pocket payments on health care inequity: the case of national health insurance in South Korea.

PubMed

Lee, Weon-Young; Shaw, Ian

2014-07-18

The global financial crisis of 2008 has led to the reinforcement of patient cost sharing in health care policy. This study aimed to explore the impact of direct out-of pocket payments (OOPs) on health care utilization and the resulting financial burden across income groups under the South Korean National Health Insurance (NHI) program with universal population coverage. We used the fourth Korean National Health and Nutrition Examination Survey (KNHNES-IV) and the Korean Household Income and Expenditure Survey (KHIES) of 2007, 2008 and 2009. The Horizontal Inequity Index (HIwv) and the average unit OOPs were used to measure income-related inequity in the quantitative and qualitative aspects of health care utilization, respectively. For financial burden, the incidence rates of catastrophic health expenditure (CHE) were compared across income groups. For outpatient and hospital visits, there was neither pro-poor or pro-rich inequality. The average unit OOPs of the poorest quintile was approximately 75% and 60% of each counterpart in the richest quintile in the outpatient and inpatient services. For the CHE threshold of 40%, the incidence rates were 5.7%, 1.67%, 0.72%, 0.33% and 0.27% in quintiles I (the poorest quintile), II, III, IV and V, respectively. Substantial OOPs under the NHI are disadvantageous, particularly for the lowest income group in terms of health care quality and financial burden.

[Preliminary investigation on acute flaccid paralysis (AFP) cases in Jinan area].

PubMed

Xu, A; Li, L; Zhao, S

1994-06-01

Eighty AFP cases under 12 years old from 6 hospitals in Jinan were investigated. Among them, there were 17 (21.25%) cases with poliomyelitis (POLIO), 40 (50.00%) cases with Guillian-Barre syndrome (GBS) and 23 (28.75%) cases with other AFP diseases. Most AFP cases occurred from May to October and no significant seasonal difference was found for each kind of AFP cases (P > 0.05), but the average age for POLIO cases (1.55 +/- 1.24) was significantly lower than that for non-POLIO AFP cases (3.76 +/- 2.58) (P < 0.01). The reporting rate from hospitals to each level of epidemic prevention station (EPS) for POLIO, GBS and other AFP cases were 100%, 12.50% and 43.75%, respectively (P < 0.01). Sixty-five AFP cases occurred in 6 prefectures around Jinan city. The average incidence rate (per 100,000) for total AFP, non-POLIO AFP and GBS cases among children under 12 years old were 1.11, 0.89 and 0.53, respectively. The results are helpful to estimate the incidence of AFP cases among children in north provinces of China and also indicate that the POLIO surveillance system in Shandong Province at the present is not sensitive enough, so the AFP cases reporting work of hospitals and the surveillance at each level of EPS should be enhanced.

Prospective Surveillance of Invasive Group A Streptococcal Disease, Fiji, 2005–2007

PubMed Central

Jenney, Adam; Kado, Joseph; Good, Michael F.; Batzloff, Michael; Waqatakirewa, Lepani; Mullholland, E. Kim; Carapetis, Jonathan R.

2009-01-01

We undertook a prospective active surveillance study of invasive group A streptococcal (GAS) disease in Fiji over a 23-month period, 2005–2007. We identified 64 cases of invasive GAS disease, which represents an average annualized all-ages incidence of 9.9 cases/100,000 population per year (95% confidence interval [CI] 7.6–12.6). Rates were highest in those >65 years of age and in those <5 years, particularly in infants, for whom the incidence was 44.9/100,000 (95% CI 18.1–92.5). The case-fatality rate was 32% and was associated with increasing age and underlying coexisting disease, including diabetes and renal disease. Fifty-five of the GAS isolates underwent emm sequence typing; the types were highly diverse, with 38 different emm subtypes and no particular dominant type. Our data support the view that invasive GAS disease is common in developing countries and deserves increased public health attention. PMID:19193265

On the averaging area for incident power density for human exposure limits at frequencies over 6 GHz

NASA Astrophysics Data System (ADS)

Hashimoto, Yota; Hirata, Akimasa; Morimoto, Ryota; Aonuma, Shinta; Laakso, Ilkka; Jokela, Kari; Foster, Kenneth R.

2017-04-01

Incident power density is used as the dosimetric quantity to specify the restrictions on human exposure to electromagnetic fields at frequencies above 3 or 10 GHz in order to prevent excessive temperature elevation at the body surface. However, international standards and guidelines have different definitions for the size of the area over which the power density should be averaged. This study reports computational evaluation of the relationship between the size of the area over which incident power density is averaged and the local peak temperature elevation in a multi-layer model simulating a human body. Three wave sources are considered in the frequency range from 3 to 300 GHz: an ideal beam, a half-wave dipole antenna, and an antenna array. 1D analysis shows that averaging area of 20 mm  ×  20 mm is a good measure to correlate with the local peak temperature elevation when the field distribution is nearly uniform in that area. The averaging area is different from recommendations in the current international standards/guidelines, and not dependent on the frequency. For a non-uniform field distribution, such as a beam with small diameter, the incident power density should be compensated by multiplying a factor that can be derived from the ratio of the effective beam area to the averaging area. The findings in the present study suggest that the relationship obtained using the 1D approximation is applicable for deriving the relationship between the incident power density and the local temperature elevation.

Comparison of renal pelvic pressure and postoperative fever incidence between standard- and mini-tract percutaneous nephrolithotomy.

PubMed

Wu, Cheng; Hua, Li-Xin; Zhang, Jian-Zhong; Zhou, Xun-Rong; Zhong, Wei; Ni, Hao-Dong

2017-01-01

This study was proposed to compare the clinical effectiveness of mini-tract percutaneous nephrolithotomy (MPCNL) with standard-tract percutaneous nephrolithotomy (SPCNL) and verify whether MPCNL is associated with both higher renal pelvic pressure (RPP) and incidence of postoperative fever. A total of 228 patients with kidney stone were randomly allocated to the MPCNL group (n=114) and SPCNL group (n=114). Both intraoperative and postoperative indexes along with the incidence of complications were compared between the two treatment groups. RPP was measured using a baroreceptor which was connected to an open-ended ureteric catheter during the operation of percutaneous nephrolithotomy. The MPCNL group exhibited significantly longer average operation time, more average amount of flush water, and lesser average amount of bleeding during the operation than the SPCNL group (p<0.05). Moreover, significantly lesser average amount of postoperative serum creatinine, shorter average hospital stay, and more average amount of postoperative hemoglobin were observed in the MPCNL group than in the SPCNL group (p<0.05). MPCNL were more applicable to clear caliceal stones (p<0.05), whereas SPCNL were more effective for the removal of simple pelvic stones. The difference in the incidence of postoperative fever between the two treatment groups also appeared to be significant (p<0.05). Logistic regression provided solid evidence that both RPP and its accumulation time at which RPP≥30 mmHg significantly affected the incidence of postoperative fever. MPCNL was correlated with both higher RPP and increased likelihood of postoperative fever compared with SPCNL. Copyright © 2016 The Authors. Published by Elsevier Taiwan.. All rights reserved.

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

PubMed

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

2014-01-01

Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain. Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains.

Epidemiology of HCC in Brazil: incidence and risk factors in a ten-year cohort.

PubMed

Paranaguá-Vezozzo, Denise C; Ono, Suzane K; Alvarado-Mora, Mónica V; Farias, Alberto Q; Cunha-Silva, Marlone; França, João I D; Alves, Venancio A F; Sherman, Morris; Carrilho, Flair José

2014-01-01

The lack of information about hepatocellular carcinoma (HCC) in Brazil weakens health policy in preventing deaths from the illness. The aim of this study was to establish the cumulative incidence and the risk factors for hepatocellular carcinoma development in patients under a surveillance program. 884 patients with compensated cirrhosis were prospectively followed up for at least five years, from August 1998 until August 2008, with at least one annual ultrasonography liver examination and serum alpha fetoprotein (AFP) measurement. Among 884 patients, 72 (8.1%) developed a tumor with a median follow up of 21.4 months. In the hepatocellular carcinoma group, hepatitis C virus infection was the major etiological factor (65.3%), 56.9% (41/72) were male and the mean average age was 57 ± 10 years. The annual incidence of hepatocellular carcinoma was 2.9%. 79.2% (57/72) of HCCs were detected within Milan Criteria, and the mean survival time was 52.3 months, significantly higher than for those outside Milan, with a mean time of 40.6 months (p = 0.0003). The annual incidence of HCC among this large series of Brazilian cirrhotic patients was around 2.9% with a detection rate of 8.1%, or a cumulative incidence rate over five years of 14.3%. The three variables related to HCC risk were low serum albumin [HR: 0.518 (0.46-0.78)], high AFP > 20 ng/mL [HR: 3.16 (1.86-5.38)], and ethnicity (Brazilian-East Asian descendants vs. other mixed Brazilian ethnicities) [HR: 2.86 (1.48-5.53)].

Disease invasion risk in a growing population.

PubMed

Yuan, Sanling; van den Driessche, P; Willeboordse, Frederick H; Shuai, Zhisheng; Ma, Junling

2016-09-01

The spread of an infectious disease may depend on the population size. For simplicity, classic epidemic models assume homogeneous mixing, usually standard incidence or mass action. For standard incidence, the contact rate between any pair of individuals is inversely proportional to the population size, and so the basic reproduction number (and thus the initial exponential growth rate of the disease) is independent of the population size. For mass action, this contact rate remains constant, predicting that the basic reproduction number increases linearly with the population size, meaning that disease invasion is easiest when the population is largest. In this paper, we show that neither of these may be true on a slowly evolving contact network: the basic reproduction number of a short epidemic can reach its maximum while the population is still growing. The basic reproduction number is proportional to the spectral radius of a contact matrix, which is shown numerically to be well approximated by the average excess degree of the contact network. We base our analysis on modeling the dynamics of the average excess degree of a random contact network with constant population input, proportional deaths, and preferential attachment for contacts brought in by incoming individuals (i.e., individuals with more contacts attract more incoming contacts). In addition, we show that our result also holds for uniform attachment of incoming contacts (i.e., every individual has the same chance of attracting incoming contacts), and much more general population dynamics. Our results show that a disease spreading in a growing population may evade control if disease control planning is based on the basic reproduction number at maximum population size.

Methodological challenges in evaluating health care financing equity in data-poor contexts: lessons from Ghana, South Africa and Tanzania.

PubMed

Borghi, Josephine; Ataguba, John; Mtei, Gemini; Akazili, James; Meheus, Filip; Rehnberg, Clas; Di, McIntyre

2009-01-01

Measurement of the incidence of health financing contributions across socio-economic groups has proven valuable in informing health care financing reforms. However, there is little evidence as to how to carry out financing incidence analysis (FIA) in lower income settings. We outline some of the challenges faced when carrying out a FIA in Ghana, Tanzania and South Africa and illustrate how innovative techniques were used to overcome data weaknesses in these settings. FIA was carried out for tax, insurance and out-of-pocket (OOP) payments. The primary data sources were Living Standards Measurement Surveys (LSMS) and household surveys conducted in each of the countries; tax authorities and insurance funds also provided information. Consumption expenditure and a composite index of socioeconomic status (SES) were used to assess financing equity. Where possible conventional methods of FIA were applied. Numerous challenges were documented and solution strategies devised. LSMS are likely to underestimate financial contributions to health care by individuals. For tax incidence analysis, reported income tax payments from secondary sources were severely under-reported. Income tax payers and shareholders could not be reliably identified. The use of income or consumption expenditure to estimate income tax contributions was found to be a more reliable method of estimating income tax incidence. Assumptions regarding corporate tax incidence had a huge effect on the progressivity of corporate tax and on overall tax progressivity. LSMS consumption categories did not always coincide with tax categories for goods subject to excise tax (e.g., wine and spirits were combined, despite differing tax rates). Tobacco companies, alcohol distributors and advertising agencies were used to provide more detailed information on consumption patterns for goods subject to excise tax by income category. There was little guidance on how to allocate fuel levies associated with 'public transport' use. Hence, calculations of fuel tax on public transport were based on individual expenditure on public transport, the average cost per kilometre and average rates of fuel consumption for each form of transport. For insurance contributions, employees will not report on employer contributions unless specifically requested to and are frequently unsure of their contributions. Therefore, we collected information on total health insurance contributions from individual schemes and regulatory authorities. OOP payments are likely to be under-reported due to long recall periods; linking OOP expenditure and illness incidence questions--omitting preventive care; and focusing on the last service used when people may have used multiple services during an illness episode. To derive more robust estimates of financing incidence, we collected additional primary data on OOP expenditures together with insurance enrolment rates and associated payments. To link primary data to the LSMS, a composite index of SES was used in Ghana and Tanzania and non-durable expenditure was used in South Africa. We show how data constraints can be overcome for FIA in lower income countries and provide recommendations for future studies.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflectingmore » potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically during the documentation of patient positioning and localization of the patient. Incidents were most frequently detected during treatment delivery (30%), and incidents identified at this point also had higher severity scores than other workflow areas (NMRI = 1.6). Incidents identified during on-treatment quality management were also more severe (NMRI = 1.7), and the specific process steps of reviewing portal and CBCT images tended to catch highest-severity incidents. On average, safety barriers caught 46% of all incidents, most frequently at physics chart review, therapist’s chart check, and the review of portal images; however, most of the incidents that pass through a particular safety barrier are not designed to be capable of being captured at that barrier. Conclusions: Incident learning systems can be used to assess the most common points of error origination and detection in radiation oncology. This can help tailor safety improvement efforts and target the highest impact portions of the workflow. The most severe near-miss events tend to originate during simulation, with the most severe near-miss events detected at the time of patient treatment. Safety barriers can be improved to allow earlier detection of near-miss events.« less

Increasing hip fracture rates among older adults in Ecuador: analysis of the National Hospital Discharge System, 1999-2016.

PubMed

Orces, Carlos H; Gavilanez, Enrique Lopez

2017-12-07

The Ecuadorian hospital discharge system examined trends in hip fracture hospitalization rates among older adults. A significant upward trend in hip fracture rates occurred in both genders over the study period. Previous research has reported increasing hip fracture rates in Ecuador. Thus, this study aimed to extend previous findings by examining the nationwide incidence of hip fractures among adults aged 65 years and older between 1999 and 2016. A secondary objective was to compare hip fracture trends among older Ecuadorians with their counterparts in the United States (U.S.). The National Hospital Discharge System and the Healthcare Cost and Utilization Project net were assessed to identify older adults hospitalized with a principal diagnosis of hip fractures in Ecuador and the U.S., respectively. The Joinpoint regression analysis software was used to examine the average annual percent change in hip fracture rates. A total of 20,091 adults with a mean age of 82.3 (SD 8.1) years were hospitalized with a principal diagnosis of hip fractures during the study period. After an adjustment for age, hip fracture rates increased annually on average by 4.6% (95% CI 3.8%, 5.4%) from 96.4/100,000 in 1999 to 173.1/100,000 persons in 2016. Between 1999 and 2014, hip fracture age-adjusted rates decreased on average by - 2.5% (95% CI - 2.7%, - 2.3%) among older adults in the U.S. while hip fracture rates steadily increased by 4.6% (95% CI, 3.6%, 5.7%) per year in their Ecuadorian counterparts. Hip fracture rates markedly increased among older adults in Ecuador. The present findings should alert public health authorities to implement policies of osteoporosis awareness and prevention in Ecuador.

The lifetime cost of hepatocellular carcinoma : a claims data analysis from a medical centre in Taiwan.

PubMed

Lang, Hui-Chu; Wu, Jaw-Ching; Yen, Sang-Hue; Lan, Chung-Fu; Wu, Shi-Liang

2008-01-01

Hepatocellular carcinoma (HCC) is the second most common cancer in Taiwan. For males in Taiwan, it is the most dangerous cancer, with both the highest incidence and mortality rate. To determine cancer-related medical care costs for long-term survivors of HCC. The estimation of the lifetime cost was based on the insurer perspective and adopted an incidence-based approach. Data was sourced from the 1999-2002 cancer registry statistics of patients with HCC and the claims data of Taipei Veterans General Hospital (TVGH). In total there were 2873 HCC patients at TVGH. In addition to this data, the research used population National Health Insurance claims data from the National Health Research Institutes (1996-2002) as the comparison group. The probabilities of survival, dying of cancer or dying of other causes were estimated using cancer registry statistics. To estimate lifetime (10-year) cost, we divided the disease process into three phases: initial, continuing and terminal. The cost of HCC was calculated as the sum of the average cost of each phase. The expected lifetime cost for treatment of an HCC patient was estimated by incorporating the phase-specific costs with the survival and mortality rates. The results showed that 895 patients survived <1 year, and treatment for each of these patients cost on average New Taiwan dollars ($NT) 206 573 ($US 1 = $NT 33, year 2002 value) over this period. For those who survived > or =1 year, the terminal phase of treatment resulted in the highest costs, $NT 237 032. On average, for each patient, the initial phase cost was $NT 140 403 and the monthly cost for the continuing phase was $NT 8687. For the average HCC patient, the 10-year lifetime cost was $NT 418 554 (in nominal $NT). Our study showed that the terminal phase cost the most out of the three treatment phases. The aggregate lifetime cost of HCC is useful for health policy making and clinical decision making.

Randomized trial of betahistine mesilate tablets as augmentation for oxcarbazepine and carbamazepine in treating vestibular paroxysmia.

PubMed

Xue, Hui; Xiang, Wenping; Yu, Yichuan; Liu, Guorong; Chong, Yi; Zhou, Jiying

2018-01-01

Vestibular paroxysmia (VP) is a rare episodic peripheral vestibular disorder. This study was conducted to compare the efficacy and acceptability of carbamazepine (CBZ) plus betahistine mesilate tablets (BMT) (CBZ+BMT) and oxcarbazepine (OXC) plus BMT (OXC+BMT) in treating VP, and investigated whether the synergistic effect could be increased along with the increased dose of BMT. VP patients were recruited and randomly assigned to receive CBZ+BMT or OXC+BMT. The doses of CBZ and OXC were set to 200 and 300 mg/time, twice daily, respectively. The doses of BMT were set to 12 and 18 mg/time, twice daily. Half of the patients in each group received BMT 12 mg/time and the other half received BMT 18 mg/time. The treatment was continued for 12 weeks. The vertigo frequency, vertigo score, vertigo duration, response rate, and drug-related side effects were analyzed. In total, 92 patients in the CBZ+BMT group and 93 patients in the OXC+BMT group completed this trial. After 12 weeks of treatment, the two groups had similar average vertigo frequency, average vertigo score, average vertigo duration, and response rate. But the incidence of side effects was significantly higher in the CBZ+BMT group than in the OXC+BMT group ( p =0.04). Subgroup analysis found that patients receiving BMT (18 mg) had greater reductions in average vertigo frequency, average vertigo duration, and average vertigo score, and higher response rates than patients receiving BMT (12 mg). These results demonstrated that OXC+BMT may be suitable as an alternative method in VP patients with CBZ hypersensitivity, and the synergistic effect could be increased along with the increased dose of BMT.

The relationship between peripheral intravenous catheter indwell time and the incidence of phlebitis.

PubMed

Powell, Jessica; Tarnow, Karen Gahan; Perucca, Roxanne

2008-01-01

The purpose of this study was to determine any relationship between peripheral IV catheter indwell time and phlebitis in hospitalized adults. A retrospective review of quarterly quality assurance data-monitoring indwell time, phlebitis rating, and site and tubing labels-was performed. Of 1,161 sites, only 679 had documented indwell time to use. Average indwell time was 1.9 days, and overall phlebitis rate was 3.7%. Analysis of variance revealed a significant association between phlebitis and indwell time. However, asymptomatic peripheral IVs may not need to be removed at regular intervals because there were healthy, asymptomatic sites with indwell time up to 10 days.

Fat embolism syndrome in long bone fracture--clinical experience in a tertiary referral center in Taiwan.

PubMed

Tsai, I-Tzun; Hsu, Chin-Jung; Chen, Ying-Hao; Fong, Yi-Chin; Hsu, Horng-Chaung; Tsai, Chun-Hao

2010-08-01

Fat embolism syndrome (FES) is a potentially fatal complication of long bone fractures. There have been no reports of FES in long bone fractures in this decade in Taiwan. The purpose of this study was to review the FES experiences in a tertiary referral center between January 1997 and February 2008. Between January 1997 and February 2008, 13 patients with long bone fractures with documented FES in our institution were reviewed. FES was diagnosed clinically by at least 2 major criteria or 1 major with at least 4 minor signs of Gurd's criteria. The incidences of FES, less than those reported in the literature, were 0.15% in fracture of the tibia, 0.78% in fracture of the femur and 2.4% in multiple fractures. The mortality rate of FES, similar to other available results, was about 7.7%. All cases were less than 35 years old, except for 1 70-year-old male. Fat embolism occurred within an average of 48.5 hours after long bone fracture. Eleven presented with sudden drop in hemoglobin level, dropping 4.2 g/dL on average. Nine presented with thrombocytopenia, and 10 presented with sudden drop in platelet count, dropping 140,000/dL on average. Two had cerebral sequelae without recovery at the last 48-month follow-up. This 12-year interval retrospective study revealed modern epidemiologic results for FES in long bone fracture. Compared with the available literature in the recent decade, the incidence of FES in long bone fracture in our institution is less and the mortality rate is similar. Copyright 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

Animal reservoir, natural and socioeconomic variations and the transmission of hemorrhagic fever with renal syndrome in Chenzhou, China, 2006-2010.

PubMed

Xiao, Hong; Tian, Huai-Yu; Gao, Li-Dong; Liu, Hai-Ning; Duan, Liang-Song; Basta, Nicole; Cazelles, Bernard; Li, Xiu-Jun; Lin, Xiao-Ling; Wu, Hong-Wei; Chen, Bi-Yun; Yang, Hui-Suo; Xu, Bing; Grenfell, Bryan

2014-01-01

China has the highest incidence of hemorrhagic fever with renal syndrome (HFRS) worldwide. Reported cases account for 90% of the total number of global cases. By 2010, approximately 1.4 million HFRS cases had been reported in China. This study aimed to explore the effect of the rodent reservoir, and natural and socioeconomic variables, on the transmission pattern of HFRS. Data on monthly HFRS cases were collected from 2006 to 2010. Dynamic rodent monitoring data, normalized difference vegetation index (NDVI) data, climate data, and socioeconomic data were also obtained. Principal component analysis was performed, and the time-lag relationships between the extracted principal components and HFRS cases were analyzed. Polynomial distributed lag (PDL) models were used to fit and forecast HFRS transmission. Four principal components were extracted. Component 1 (F1) represented rodent density, the NDVI, and monthly average temperature. Component 2 (F2) represented monthly average rainfall and monthly average relative humidity. Component 3 (F3) represented rodent density and monthly average relative humidity. The last component (F4) represented gross domestic product and the urbanization rate. F2, F3, and F4 were significantly correlated, with the monthly HFRS incidence with lags of 4 months (r = -0.289, P<0.05), 5 months (r = -0.523, P<0.001), and 0 months (r = -0.376, P<0.01), respectively. F1 was correlated with the monthly HFRS incidence, with a lag of 4 months (r = 0.179, P = 0.192). Multivariate PDL modeling revealed that the four principal components were significantly associated with the transmission of HFRS. The monthly trend in HFRS cases was significantly associated with the local rodent reservoir, climatic factors, the NDVI, and socioeconomic conditions present during the previous months. The findings of this study may facilitate the development of early warning systems for the control and prevention of HFRS and similar diseases.

Meteorological conditions associated with increased incidence of West Nile virus disease in the United States, 2004-2012.

PubMed

Hahn, Micah B; Monaghan, Andrew J; Hayden, Mary H; Eisen, Rebecca J; Delorey, Mark J; Lindsey, Nicole P; Nasci, Roger S; Fischer, Marc

2015-05-01

West Nile virus (WNV) is a leading cause of mosquito-borne disease in the United States. Annual seasonal outbreaks vary in size and location. Predicting where and when higher than normal WNV transmission will occur can help direct limited public health resources. We developed models for the contiguous United States to identify meteorological anomalies associated with above average incidence of WNV neuroinvasive disease from 2004 to 2012. We used county-level WNV data reported to ArboNET and meteorological data from the North American Land Data Assimilation System. As a result of geographic differences in WNV transmission, we divided the United States into East and West, and 10 climate regions. Above average annual temperature was associated with increased likelihood of higher than normal WNV disease incidence, nationally and in most regions. Lower than average annual total precipitation was associated with higher disease incidence in the eastern United States, but the opposite was true in most western regions. Although multiple factors influence WNV transmission, these findings show that anomalies in temperature and precipitation are associated with above average WNV disease incidence. Readily accessible meteorological data may be used to develop predictive models to forecast geographic areas with elevated WNV disease risk before the coming season. © The American Society of Tropical Medicine and Hygiene.

Changes in malaria burden and transmission in sentinel sites after the roll-out of long-lasting insecticidal nets in Papua New Guinea.

PubMed

Hetzel, Manuel W; Reimer, Lisa J; Gideon, Gibson; Koimbu, Gussy; Barnadas, Céline; Makita, Leo; Siba, Peter M; Mueller, Ivo

2016-06-14

Papua New Guinea exhibits a complex malaria epidemiology due to diversity in malaria parasites, mosquito vectors, human hosts, and their natural environment. Heterogeneities in transmission and burden of malaria at various scales are likely to affect the success of malaria control interventions, and vice-versa. This manuscript assesses changes in malaria prevalence, incidence and transmission in sentinel sites following the first national distribution of long-lasting insecticidal nets (LLINs). Before and after the distribution of LLINs, data collection in six purposively selected sentinel sites included clinical surveillance in the local health facility, household surveys and entomological surveys. Not all activities were carried out in all sites. Mosquitoes were collected by human landing catches. Diagnosis of malaria infection in humans was done by rapid diagnostic test, light microscopy and PCR for species confirmation. Following the roll-out of LLINs, the average monthly malaria incidence rate dropped from 13/1,000 population to 2/1,000 (incidence rate ratio = 0.12; 95 % CI: 0.09-0.17; P < 0.001). The average population prevalence of malaria decreased from 15.7 % pre-LLIN to 4.8 % post-LLIN (adjusted odds ratio = 0.26; 95 % CI: 0.20-0.33; P < 0.001). In general, reductions in incidence and prevalence were more pronounced in infections with P. falciparum than with P. vivax. Additional morbidity indicators (anaemia, splenomegaly, self-reported fever) showed a decreasing trend in most sites. Mean Anopheles man biting rates decreased from 83 bites/person/night pre-LLIN to 31 post-LLIN (P = 0.008). Anopheles species composition differed between sites but everywhere diversity was lower post-LLIN. In two sites, post-LLIN P. vivax infections in anophelines had decreased but P. falciparum infections had increased despite the opposite observation in humans. LLIN distribution had distinct effects on P. falciparum and P. vivax. Higher resilience of P. vivax may be attributed to relapses from hypnozoites and other biological characteristics favouring the transmission of P. vivax. The effect on vector species composition varied by location which is likely to impact on the effectiveness of LLINs. In-depth and longer-term epidemiological and entomological investigations are required to understand when and where residual transmission occurs and whether observed changes are sustained.

The Incidence Rate and Economic Burden of Community-Acquired Pneumonia in a Working-Age Population

PubMed Central

Broulette, Jonah; Yu, Holly; Pyenson, Bruce; Iwasaki, Kosuke; Sato, Reiko

2013-01-01

Background Community-acquired pneumonia (CAP) is frequently associated with the very young and the elderly but is a largely underrecognized burden among working-age adults. Although the burden of CAP among the elderly has been established, there are limited data on the economic burden of CAP in the employed population. Objective To assess the economic impact of CAP in US working-age adults from an employer perspective by estimating the incidence rate and costs of healthcare, sick time, and short-term disability for this patient population. Methods This retrospective cohort study is based on data from 2 Truven Health Analytics databases. The study population consisted of commercially insured active employees aged 18 to 64 years, early retirees aged <65 years, and adult dependents of both cohorts. CAP was identified using medical claims with pneumonia diagnosis codes during the 2009 calendar year. Incidence rate, episode level, and annual costs were stratified by age and by risk based on the presence of comorbidities. Descriptive statistics were used to compare healthcare (ie, medical and pharmacy) costs, sick time, and short-term disability costs between the cohorts with and without CAP. Linear regression was used to estimate the average annual incremental healthcare cost in employed patients with inpatient or outpatient CAP versus individuals without CAP. Results Study eligibility was met by 12,502,017 employed individuals, including 123,920 with CAP and 12,378,097 without CAP; the overall incidence rate of CAP was 10.6 per 1000 person-years. Among individuals with and without CAP, the costs of healthcare, sick time, and short-term disability increased with advancing age and with higher risk status. The mean annual healthcare costs were $20,961 for patients with CAP and $3783 for individuals without CAP. Overall, the mean costs of sick time and short-term disability were $1129 and $1016, respectively, in active employees with CAP, and $853 and $322, respectively, in their counterparts without CAP. Compared with individuals without CAP, the average annual incremental healthcare cost ranged from $39,889 to $113,837 for inpatient management of patients with CAP and from $4170 to $31,524 for outpatient management of patients with CAP, depending on the risk level. Conclusions CAP is a common and costly infection among working-age individuals, especially in patients with comorbidities. Prevention strategies, such as influenza and pneumococcal vaccination, that target working-age adults with underlying medical conditions may be the most valuable in reducing the morbidity and costs associated with CAP. PMID:24991378

The incidence rate and economic burden of community-acquired pneumonia in a working-age population.

PubMed

Broulette, Jonah; Yu, Holly; Pyenson, Bruce; Iwasaki, Kosuke; Sato, Reiko

2013-09-01

Community-acquired pneumonia (CAP) is frequently associated with the very young and the elderly but is a largely underrecognized burden among working-age adults. Although the burden of CAP among the elderly has been established, there are limited data on the economic burden of CAP in the employed population. To assess the economic impact of CAP in US working-age adults from an employer perspective by estimating the incidence rate and costs of healthcare, sick time, and short-term disability for this patient population. This retrospective cohort study is based on data from 2 Truven Health Analytics databases. The study population consisted of commercially insured active employees aged 18 to 64 years, early retirees aged <65 years, and adult dependents of both cohorts. CAP was identified using medical claims with pneumonia diagnosis codes during the 2009 calendar year. Incidence rate, episode level, and annual costs were stratified by age and by risk based on the presence of comorbidities. Descriptive statistics were used to compare healthcare (ie, medical and pharmacy) costs, sick time, and short-term disability costs between the cohorts with and without CAP. Linear regression was used to estimate the average annual incremental healthcare cost in employed patients with inpatient or outpatient CAP versus individuals without CAP. Study eligibility was met by 12,502,017 employed individuals, including 123,920 with CAP and 12,378,097 without CAP; the overall incidence rate of CAP was 10.6 per 1000 person-years. Among individuals with and without CAP, the costs of healthcare, sick time, and short-term disability increased with advancing age and with higher risk status. The mean annual healthcare costs were $20,961 for patients with CAP and $3783 for individuals without CAP. Overall, the mean costs of sick time and short-term disability were $1129 and $1016, respectively, in active employees with CAP, and $853 and $322, respectively, in their counterparts without CAP. Compared with individuals without CAP, the average annual incremental healthcare cost ranged from $39,889 to $113,837 for inpatient management of patients with CAP and from $4170 to $31,524 for outpatient management of patients with CAP, depending on the risk level. CAP is a common and costly infection among working-age individuals, especially in patients with comorbidities. Prevention strategies, such as influenza and pneumococcal vaccination, that target working-age adults with underlying medical conditions may be the most valuable in reducing the morbidity and costs associated with CAP.

Incidence of Hospitalized Stroke in the Czech Republic: The National Registry of Hospitalized Patients.

PubMed

Sedova, Petra; Brown, Robert D; Zvolsky, Miroslav; Kadlecova, Pavla; Bryndziar, Tomas; Kubelka, Tomáš; Weiss, Viktor; Volný, Ondřej; Bednarik, Josef; Mikulik, Robert

2017-05-01

Contemporary stroke incidence data are not available in some countries and regions, including in Eastern Europe. Based on previous validation of the accuracy of the National Registry of Hospitalized Patients (NRHOSP), we report the incidence of hospitalized stroke in the Czech Republic (CR) using the NRHOSP. The results of the prior validation study assessing the accuracy of coding of stroke diagnoses in the NRHOSP were applied, and we calculated (1) the overall incidence of hospitalized stroke and (2) the incidence rates of hospitalized stroke for the three main stroke types: cerebral infarction (International Classification of Diseases Tenth Revision, CI I63), subarachnoid hemorrhage (SAH I60), and intracerebral hemorrhage (ICH I61). We calculated the average annual age- and sex-standardized incidence. The overall incidence of hospitalized stroke was 241 out of 100,000 individuals. The incidence of hospitalized stroke for the main stroke types was 8.2 cases in SAH, 29.5 in ICH, and 211 in CI per 100,000 individuals. The standardized annual stroke incidence adjusted to the 2000 World Health Organization population for overall stroke incidence of hospitalized stroke was 131 per 100,000 individuals. Standardized stroke incidence for stroke subtypes was 5.7 cases in SAH, 16.7 in ICH, and 113 in CI per 100,000 individuals. These studies provide an initial assessment of the burden of stroke in this part of the world. The estimates of hospitalized stroke in the CR and Eastern Europe suggest that ICH is about three times more common than SAH, and hemorrhagic stroke makes up about 18% of strokes. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Fatal Occupational Injuries among Non-governmental Employees in Malaysia

PubMed Central

Abas, Adinegara bin Lutfi; Mohd Said, Datuk Abd. Razzak B.; Aziz Mohammed, Mohammed Azman B.; Sathiakumar, Nalini

2012-01-01

Background In Malaysia, surveillance of fatal occupational injuries is fragmented. We therefore analyzed an alternative data source from Malaysia’s Social Security organization, the PERKESO. Methods We conducted a secondary data analysis of the PERKESO database comprised of 7 million employees from 2002 to 2006. Results Overall, the average annual incidence was 9.2 fatal occupational injuries per 100,000 workers. During the five-year period, there was a decrease in the absolute number of fatal injuries by 16% and the incidence by 34%. The transportation sector reported the highest incidence of fatal injuries (35.1/100,000), followed by agriculture (30.5/100,000) and construction (19.3/100,000) sectors. Persons of Indian ethnicity were more likely to sustain fatal injuries compared to other ethnic groups. Conclusions Government and industry should develop rigorous strategies to detect hazards in the workplace, especially in sectors that continuously record high injury rates. Targeted interventions emphasizing worker empowerment coupled with systematic monitoring and evaluation is critical to ensure success in prevention and control measures. PMID:22544443

Forecasting malaria incidence based on monthly case reports and environmental factors in Karuzi, Burundi, 1997–2003

PubMed Central

Gomez-Elipe, Alberto; Otero, Angel; van Herp, Michel; Aguirre-Jaime, Armando

2007-01-01

Background The objective of this work was to develop a model to predict malaria incidence in an area of unstable transmission by studying the association between environmental variables and disease dynamics. Methods The study was carried out in Karuzi, a province in the Burundi highlands, using time series of monthly notifications of malaria cases from local health facilities, data from rain and temperature records, and the normalized difference vegetation index (NDVI). Using autoregressive integrated moving average (ARIMA) methodology, a model showing the relation between monthly notifications of malaria cases and the environmental variables was developed. Results The best forecasting model (R2adj = 82%, p < 0.0001 and 93% forecasting accuracy in the range ± 4 cases per 100 inhabitants) included the NDVI, mean maximum temperature, rainfall and number of malaria cases in the preceding month. Conclusion This model is a simple and useful tool for producing reasonably reliable forecasts of the malaria incidence rate in the study area. PMID:17892540

Incidence, in-hospital case-fatality rates, and management practices in Puerto Ricans hospitalized with acute myocardial infarction.

PubMed

Zevallos, Juan C; Yarzebski, Jorge; González, Juan A; Banchs, Héctor L; García-Palmieri, Mario; Mattei, Hernando; Ayala, José; González, Marijesmar; Torres, Vanessa; Ramos, Iris N; Pericchi, Luis R; Torres, David A; González, María C; Goldberg, Robert J

2013-09-01

There are extremely limited data on minority populations, especially Hispanics, describing the clinical epidemiology of acute coronary disease. The aim of this study is to examine the incidence rate of acute myocardial infarction (AMI), in-hospital case-fatality rate (CFR), and management practices among residents of greater San Juan (Puerto Rico) who were hospitalized with an initial AMI. Our trained study staff reviewed and independently validated the medical records of patients who had been hospitalized with possible AMI at any of the twelve hospitals located in greater San Juan during calendar year 2007. The incidence rate (# per 100,000 population) of 1,415 patients hospitalized with AMI increased with advancing age and were significantly higher for older patients for men (198) than they were for women (134). The average age of the study population was 64 years, and women comprised 45% of the study sample. Evidence-based cardiac therapies, e.g., aspirin, beta blockers, ACE inhibitors/angiotensin receptor blockers, and statins, were used with 60% of the hospitalized patients, and women were less likely than men to have received these therapies (59% vs. 65%) or to have undergone interventional cardiac procedures (47% vs. 59%) (p<0.05). The in-hospital CFR increased with advancing age and were higher for women (8.6%) than they were for men (6.0%) (p<0.05). Efforts are needed to reduce the magnitude of AMI, enhance the use of evidence-based cardiac therapies, reduce possible gender disparities, and improve the short-term prognoses of Puerto Rican patients hospitalized with an initial AMI.

Fit for the fight? Illnesses in the Norwegian team in the Vancouver Olympic Games.

PubMed

Hanstad, Dag Vidar; Rønsen, Ola; Andersen, Svein S; Steffen, Kathrin; Engebretsen, Lars

2011-06-01

The development of strategies to prevent illnesses before and during Olympic Games provides a basis for improved health and Olympic results. (1) To document the efficacy of a prevention programme on illness in a national Olympic team before and during the 2010 Vancouver Olympic Winter Games (OWG), (2) to compare the illness incidence in the Norwegian team with Norwegian incidence data during the Turin 2006 OWG and (3) to compare the illness incidence in the Norwegian team with illness rates of other nations in the Vancouver OWG. Information on prevention measures of illnesses in the Norwegian Olympic team was based on interviews with the Chief Medical Officer (CMO) and the Chief Nutrition and Sport Psychology Officers, and on a review of CMO reports before and after the 2010 OWG. The prevalence data on illness were obtained from the daily reports on injuries and illness to the International Olympic Committee. The illness rate was 5.1% (five of 99 athletes) compared with 17.3% (13 out of 75 athletes) in Turin (p=0.008). A total of four athletes missed one competition during the Vancouver Games owing to illness, compared with eight in Turin. The average illness rate for all nations in the Vancouver OWG was 7.2%. Conclusions Although no definite cause-and-effect link between the implementation of preventive measures and the prevalence of illness in the 2010 OWG could be established, the reduced illness rate compared with the 2006 OWG, and the low prevalence of illnesses compared with other nations in the Vancouver OWG suggest that the preparations were effective.

Characteristics and outcome of unplanned out-of-institution births in Norway from 1999 to 2013: a cross-sectional study.

PubMed

Gunnarsson, Björn; Smárason, Alexander K; Skogvoll, Eirik; Fasting, Sigurd

2014-10-01

To study the incidence, maternal characteristics and outcome of unplanned out-of-institution births (= unplanned births) in Norway. Register-based cross-sectional study. All births in Norway (n = 892 137) from 1999 to 2013 with gestational age ≥22 weeks. Analysis of data from the Medical Birth Registry of Norway from 1999 to 2013. Unplanned births (n = 6062) were compared with all other births (reference group). The annual incidence rate of unplanned births was 6.8/1000 births and remained stable during the period of study. Young multiparous women residing in remote municipalities were at the highest risk of experiencing unplanned births. The unplanned birth group had higher perinatal mortality rate for the period, 11.4/1000 compared with 4.9/1000 for the reference group (incidence rate ratio 2.31, 95% confidence interval 1.82-2.93, p < 0.001). Annual perinatal mortality rate for unplanned births did not change significantly (p = 0.80) but declined on average by 3% per year in the reference group (p < 0.001). The unplanned birth group had a lower proportion of live births in all birthweight categories. Live born neonates with a birthweight of 750-999 g in the unplanned birth group had a more than five times higher mortality rate during the first week of life, compared with reference births in the same birthweight category. Unplanned births are associated with adverse outcome. Excessive mortality is possibly caused by reduced availability of necessary medical interventions for vulnerable newborns out-of-hospital. © 2014 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

The current status of syphilis prevention and control in Jiangsu province, China: A cross-sectional study

PubMed Central

Chen, Yuan-Fang; Ding, Jian-Ping; Yan, Hong-Jing; Lu, Jing; Ding, Ping; Chen, Guo-Hong; Li, Jian-Jun; Huan, Xi-Ping; Yang, Hai-Tao; Tang, Wei-Ming; Fu, Geng-Feng

2017-01-01

Objective To analyze the midterm evaluation data from the National Syphilis Prevention and Control Plan (2010–2020) and evaluate the current status of syphilis prevention and control in Jiangsu province, China. Methods We collected data via (1) field surveys conducted in 2015 and (2) data recorded in existing syphilis surveillance systems. We conducted descriptive statistical analysis to evaluate the current landscape of syphilis control initiatives and their potential effect in syphilis control. Results The incidence of all cases of syphilis decreased from 2010 (32.3 per 100,000) to 2015 (30.1 per 100,000), with an annual growth of -1.17% (x2trend = -7.52, P<0.001) in Jiangsu province. The incidence of primary and secondary syphilis and congenital syphilis both decreased significantly from 2010 to 2015. The average awareness rate of syphilis knowledge among professional personnel was 95.4% (3781/3963). Rural residents had the lowest awareness rate (83.5%, 1875/2245) and commercial sex workers had the highest awareness rate (92.1%, 7804/8474) in 2015. Only 47.8% (33908/70894) of patients received provider-initiated syphilis counseling and testing (PISTC) services in sexually transmitted disease (STD) clinics, but 94.5% (87927/93020) of all syphilis patients received free testing for syphilis. Overall, 97.2% (9378/9648) of syphilis reported cases of syphilis at medical institutions were confirmed to be accurate, and 92.2% (5850/6345) of patients diagnosed with syphilis at medical institutions received treatment with penicillin. Conclusion The syphilis incidence rate in Jiangsu has decreased in recent years, but remains at a high level. It is essential to promote PISTC services to improve knowledge of syphilis and rates of testing and treatment in Jiangsu province. PMID:28837587

The current status of syphilis prevention and control in Jiangsu province, China: A cross-sectional study.

PubMed

Chen, Yuan-Fang; Ding, Jian-Ping; Yan, Hong-Jing; Lu, Jing; Ding, Ping; Chen, Guo-Hong; Li, Jian-Jun; Huan, Xi-Ping; Yang, Hai-Tao; Tang, Wei-Ming; Fu, Geng-Feng

2017-01-01

To analyze the midterm evaluation data from the National Syphilis Prevention and Control Plan (2010-2020) and evaluate the current status of syphilis prevention and control in Jiangsu province, China. We collected data via (1) field surveys conducted in 2015 and (2) data recorded in existing syphilis surveillance systems. We conducted descriptive statistical analysis to evaluate the current landscape of syphilis control initiatives and their potential effect in syphilis control. The incidence of all cases of syphilis decreased from 2010 (32.3 per 100,000) to 2015 (30.1 per 100,000), with an annual growth of -1.17% (x2trend = -7.52, P<0.001) in Jiangsu province. The incidence of primary and secondary syphilis and congenital syphilis both decreased significantly from 2010 to 2015. The average awareness rate of syphilis knowledge among professional personnel was 95.4% (3781/3963). Rural residents had the lowest awareness rate (83.5%, 1875/2245) and commercial sex workers had the highest awareness rate (92.1%, 7804/8474) in 2015. Only 47.8% (33908/70894) of patients received provider-initiated syphilis counseling and testing (PISTC) services in sexually transmitted disease (STD) clinics, but 94.5% (87927/93020) of all syphilis patients received free testing for syphilis. Overall, 97.2% (9378/9648) of syphilis reported cases of syphilis at medical institutions were confirmed to be accurate, and 92.2% (5850/6345) of patients diagnosed with syphilis at medical institutions received treatment with penicillin. The syphilis incidence rate in Jiangsu has decreased in recent years, but remains at a high level. It is essential to promote PISTC services to improve knowledge of syphilis and rates of testing and treatment in Jiangsu province.

Temporal patterns and forecast of dengue infection in Northeastern Thailand.

PubMed

Silawan, Tassanee; Singhasivanon, Pratap; Kaewkungwal, Jaranit; Nimmanitya, Suchitra; Suwonkerd, Wanapa

2008-01-01

This study aimed to determine temporal patterns and develop a forecasting model for dengue incidence in northeastern Thailand. Reported cases were obtained from the Thailand national surveillance system. The temporal patterns were displayed by plotting monthly rates, the seasonal-trend decomposition procedure based on loess (STL) was performed using R 2.2.1 software, and the trend was assessed using Poisson regression. The forecasting model for dengue incidence was performed in R 2.2.1 and Intercooled Stata 9.2 using the seasonal Autoregressive Integrated Moving Average (ARIMA) model. The model was evaluated by comparing predicted versus actual rates of dengue for 1996 to 2005 and used to forecast monthly rates during January to December 2006. The results reveal that epidemics occurred every two years, with approximately three years per epidemic, and that the next epidemic will take place in 2006 to 2008. It was found that if a month increased, the rate ratio for dengue infection decreased by a factor 0.9919 for overall region and 0.9776 to 0.9984 for individual provinces. The amplitude of the peak, which was evident in June or July, was 11.32 to 88.08 times greater than the rest of the year. The seasonal ARIMA (2, 1, 0) (0, 1, 1)12 model was model with the best fit for regionwide data of total dengue incidence whereas the models with the best fit varied by province. The forecasted regional monthly rates during January to December 2006 should range from 0.27 to 17.89 per 100,000 population. The peak for 2006 should be much higher than the peak for 2005. The highest peaks in 2006 should be in Loei, Buri Ram, Surin, Nakhon Phanom, and Ubon Ratchathani Provinces.

[Upper limb work-related musculoskeletal disorders (UL-WMSDs) in a large factory of the upholstered furniture industry: risk management].

PubMed

Nicoletti, S; Castoro, V; Iacobellis, M; Loizzo, N; Monopoli, L

2008-01-01

The industrial production of upholstered furniture exposes workers to significant risk of occupational disorders due to ergonomics-related problems, such as repetitive strain and movements of the upper limb, manual load lifting, prolonged static postures. This paper describes the main measures taken by the biggest company in the "sofa sector" in southern Italy in order to solve such problems in the years 1996-2004. the classic instruments of ergonomics were used such as risk assessment, medical surveillance, training and information programmes, technological reorganization of the manufacturing process and of single working tasks. The accident rate (number of accidents per million working hours) which showed an increasing trend in the previous years, rose from a value of 31 in 1996 to 51 in the years 1999-2000 (with a percentage of accidents related to load lifting in the range 25-35%). At the same time the incidence rate of work-related upper limb musculoskeletal disorders (UL-WMSDs) in the population of workers (which had increased in the meantime from 2500 to 3500 employees) reached nearly 5% in 2001, with peaks of 8-9% in the work tasks with higher exposure. Accident rates progressively fell in the following three years until a value of 20 was reached in 2004 and 2005, while the mean incidence rate of WMSDs reached a value of nearly 1%. The data need to be compared with the trends in the other companies of the sector in the same period, with an average incidence rate of WMSDs around 2% and a generally increasing trend. Ergonomic interventions not only concur in the management and control of negative events for workers health but also in achieving advantages in terms of lower costs and greater productivity.

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

PubMed

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

2010-01-01

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

Formation of Gaps at the Specimen-Bar Interfaces in Numerical Simulations of Compression Hopkinson Bar Tests on Soft, Nearly Incompressible Materials

DTIC Science & Technology

2010-09-01

history of the axial stress at the S-TB interface is qualitatively and quantitatively similar, with the times delayed by about 1 s (see figure 12). In...average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed...the specimen and sufficiently short rise times to the final strain rate, small gaps formed at both the specimen-incident bar and the specimen

Epidemiology of uveitis among the Chinese population in Taiwan: a population-based study.

PubMed

Hwang, De-Kuang; Chou, Yiing-Jeng; Pu, Cheng-Yun; Chou, Pesus

2012-11-01

This study aimed to investigate the incidence and prevalence of uveitis in Taiwan, and then analyzed the risk factors related to uveitis using multivariate regression. Population-based cohort study using medical claims data. We randomly selected 1 000 000 residents from the Taiwan National Health Insurance Research Database. All participants with correct registry data (96%) were included in the study. The study period was from 2000 to 2008. All types of uveitis were identified using the International Classification of Diseases, 9th revision, Clinical Modification diagnostic codes. The annual incidence and cumulative prevalence of uveitis were calculated. A univariate and a multivariate Poisson regression were used to determine the risk factors associated with uveitis. The first diagnosis of uveitis noted during the study period. The annual cumulative incidence rate of uveitis ranged from 102.2 to 122.0 cases per 100 000 persons over the study period, and the average incidence density was 111.3 cases per 100 000 person-years (95% confidence interval, 108.4-114.1). The cumulative prevalence was found to have increased from 318.8 cases per 100 000 persons in 2003 to 622.7 cases per 100 000 persons in 2008. Anterior uveitis was the most common location and accounted for 77.7% of all incident cases, which was followed by panuveitis, posterior uveitis, and intermediate uveitis. Multivariate regression analysis showed that males, the elderly, and individuals who lived in an urban area had higher incidence rates for uveitis. The epidemiology of uveitis in Taiwan differs from most previous studies in other countries. The incidence of uveitis in Taiwan has increased significantly recently. The elderly and individuals living in urban areas are the populations that are most commonly affected by uveitis. These findings are consistent with suggestions found in several recent studies. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Trends in incidence, mortality and survival of penile squamous cell carcinoma in Norway 1956-2015.

PubMed

Hansen, Bo T; Orumaa, Madleen; Lie, A Kathrine; Brennhovd, Bjørn; Nygård, Mari

2018-04-15

We examine trends in incidence, mortality and survival of penile squamous cell carcinoma (SCC) in Norway over 60 years. Data on all cases of penile cancer diagnosed in Norway during 1956-2015 were obtained from the Cancer Registry of Norway. Trends in age-standardized rates of penile SCC incidence, mortality and 5-year relative survival were assessed by the annual percentage change statistic and joinpoint regression. A total of 1,596 penile cancer cases were diagnosed during 1956-2015, among which 1,474 (92.4%) were SCC. During 2011-2015, the age-standardized incidence and mortality of penile SCC were 0.91 (95% confidence interval (CI): 0.78; 1.05) and 0.50 (0.42; 0.60) per 100,000, respectively, and the 5-year relative survival was 61.6% (41.9; 76.4). The incidence of SCC increased during 1956-2015, with an average annual percentage change (AAPC) of 0.80% (0.46; 1.15). The increase was strongest among men diagnosed at a relatively early age (age<=64 years; AAPC: 1.47% (0.90; 2.05)). Mortality also increased over the study period (AAPC: 0.47% (0.10; 0.85)), whereas 5-year relative survival did not change (AAPC: 0.08% (-0.19; 0.36)). We conclude that the incidence of penile SCC has increased at a moderate and constant rate during 1956-2015, and that the most consistent increase occurred among younger men. Mortality also increased during the study period. However, survival did not change, thus changes in diagnostics and treatment had little impact on survival from penile SCC. Since a substantial proportion of penile SCC is caused by human papillomavirus (HPV), the incidence increase may in part be attributed to increased exposure to HPV in the population. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

Trends in incidence, mortality and survival of penile squamous cell carcinoma in Norway 1956–2015

PubMed Central

Orumaa, Madleen; Lie, A. Kathrine; Brennhovd, Bjørn; Nygård, Mari

2017-01-01

We examine trends in incidence, mortality and survival of penile squamous cell carcinoma (SCC) in Norway over 60 years. Data on all cases of penile cancer diagnosed in Norway during 1956–2015 were obtained from the Cancer Registry of Norway. Trends in age‐standardized rates of penile SCC incidence, mortality and 5‐year relative survival were assessed by the annual percentage change statistic and joinpoint regression. A total of 1,596 penile cancer cases were diagnosed during 1956–2015, among which 1,474 (92.4%) were SCC. During 2011–2015, the age‐standardized incidence and mortality of penile SCC were 0.91 (95% confidence interval (CI): 0.78; 1.05) and 0.50 (0.42; 0.60) per 100,000, respectively, and the 5‐year relative survival was 61.6% (41.9; 76.4). The incidence of SCC increased during 1956–2015, with an average annual percentage change (AAPC) of 0.80% (0.46; 1.15). The increase was strongest among men diagnosed at a relatively early age (age<=64 years; AAPC: 1.47% (0.90; 2.05)). Mortality also increased over the study period (AAPC: 0.47% (0.10; 0.85)), whereas 5‐year relative survival did not change (AAPC: 0.08% (−0.19; 0.36)). We conclude that the incidence of penile SCC has increased at a moderate and constant rate during 1956–2015, and that the most consistent increase occurred among younger men. Mortality also increased during the study period. However, survival did not change, thus changes in diagnostics and treatment had little impact on survival from penile SCC. Since a substantial proportion of penile SCC is caused by human papillomavirus (HPV), the incidence increase may in part be attributed to increased exposure to HPV in the population. PMID:29205336

Global temporal patterns of pancreatic cancer and association with socioeconomic development.

PubMed

Wong, Martin C S; Jiang, Johnny Y; Liang, Miaoyin; Fang, Yuan; Yeung, Ming Sze; Sung, Joseph J Y

2017-06-09

Pancreatic cancer induces a substantial global burden. We examined its global incidence/mortality rates and their correlation with socioeconomic development (Human Development Index [HDI] and Gross Domestic Product [GDP] in 2000 as proxy measures). Data on age-standardized incidence/mortality rates in 2012 were retrieved from the GLOBOCAN database. Temporal patterns in 1998-2007 were assessed for 39 countries according to gender. The Average Annual Percent Change (AAPC) of the incidence/mortality trends was evaluated using joinpoint regression analysis. The age-standardized incidence ranged between 0.8-8.9/100,000. When compared among countries, Brazil (AAPC = 10.4, 95%C.I. = 0.8,21) and France (AAPC = 4.7, 95%C.I. = 3.6,5.9) reported the highest incidence rise in men. The greatest increase in women was reported in Thailand (AAPC = 7, 95%C.I. = 2.1,12.1) and Ecuador (AAPC = 4.3, 95%C.I. = 1.3,7.3). For mortality, the Philippines (APCC = 4.3, 95%C.I. = 2,6.6) and Croatia (AAPC = 2, 95% C.I. = 0,3.9) reported the biggest increase among men. The Philippines (AAPC = 5.8, 95% C.I. 4.5,7.2) and Slovakia (AAPC = 3.1, 95% C.I. 0.9,5.3) showed the most prominent rise among women. Its incidence was positively correlated with HDI (men: r = 0.66; women: r = 0.70) and GDP (men: r = 0.29; women: r = 0.28, all p < 0.05), and similarly for mortality (men: r = 0.67; women: r = 0.72 [HDI]; men: r = 0.23; women: r = 0.28 [GDP]). In summary, the incidence and mortality of pancreatic cancer were rising in many countries, requiring regular surveillance.

Epidemiology of Tuberculosis in Immigrants in a Large City with Large-Scale Immigration (1991-2013)

PubMed Central

Orcau, Àngels; Millet, Joan-Pau; Ros, Miriam; Gil, Sonia; Caylà, Joan A.

2016-01-01

Background The increase in immigration in Barcelona between 2000 and 2008 forced a reorganization of the control of tuberculosis (TB). TB clinical units (TBCU) were created and community health workers (CHW) were gradually included. Objective To understand trends in the incidence of TB among immigrants, their main characteristics and treatment compliance during the period 1991–2013. Design We conducted a cross-sectional population-based study of cases detected among immigrants by the Tuberculosis Program in Barcelona, Spain. Sociodemographic, clinical characteristics and risk factors were described. The annual incidence was calculated for various periods and geographical areas of origin. In the linear trend analysis, a p-value of <0.05 was considered statistically significant. Results We detected 3,284 cases. Incidence decreased from 144.8/100,000 inhabitants in 1991 to 53.4/100,000 in 2013. Individuals born in Pakistan-India-Bangladesh had the highest average annual incidence (675/100,000). In all, 2,156 cases (65.7%) were male. 2,272 (69.2%) had pulmonary TB, of which 48.2% were smear-positive. 33% of the cases (1,093) lived in the inner city. Contact tracing (CT) coverage in smear-positive individuals rose from 56.8% in 1991–1999 to 81.4% in 2000–2013 (p<0.01); this value was less than 50% in people from Africa and Eastern European countries. The case fatality rate was 3.6% overall and 9.8% among those born in high-income countries (p<0.01). The highest rate of treatment default (12.8%) was observed among cases from the Maghreb. The rate of successful treatment increased from 69.9% in 1991–1999 to 87.5% in 2000–2013 (p<0.01). Conclusion The incidence of TB in immigrants is decreasing in Barcelona. Organizational actions, such as incorporating CHWs and TBCUs, have been decisive for the observed improvements. PMID:27749904

Epidemiology of Tuberculosis in Immigrants in a Large City with Large-Scale Immigration (1991-2013).

PubMed

Ospina, Jesús E; Orcau, Àngels; Millet, Joan-Pau; Ros, Miriam; Gil, Sonia; Caylà, Joan A

2016-01-01

The increase in immigration in Barcelona between 2000 and 2008 forced a reorganization of the control of tuberculosis (TB). TB clinical units (TBCU) were created and community health workers (CHW) were gradually included. To understand trends in the incidence of TB among immigrants, their main characteristics and treatment compliance during the period 1991-2013. We conducted a cross-sectional population-based study of cases detected among immigrants by the Tuberculosis Program in Barcelona, Spain. Sociodemographic, clinical characteristics and risk factors were described. The annual incidence was calculated for various periods and geographical areas of origin. In the linear trend analysis, a p-value of <0.05 was considered statistically significant. We detected 3,284 cases. Incidence decreased from 144.8/100,000 inhabitants in 1991 to 53.4/100,000 in 2013. Individuals born in Pakistan-India-Bangladesh had the highest average annual incidence (675/100,000). In all, 2,156 cases (65.7%) were male. 2,272 (69.2%) had pulmonary TB, of which 48.2% were smear-positive. 33% of the cases (1,093) lived in the inner city. Contact tracing (CT) coverage in smear-positive individuals rose from 56.8% in 1991-1999 to 81.4% in 2000-2013 (p<0.01); this value was less than 50% in people from Africa and Eastern European countries. The case fatality rate was 3.6% overall and 9.8% among those born in high-income countries (p<0.01). The highest rate of treatment default (12.8%) was observed among cases from the Maghreb. The rate of successful treatment increased from 69.9% in 1991-1999 to 87.5% in 2000-2013 (p<0.01). The incidence of TB in immigrants is decreasing in Barcelona. Organizational actions, such as incorporating CHWs and TBCUs, have been decisive for the observed improvements.

Safety leadership: application in construction site.

PubMed

Cooper, Dominic

2010-01-01

The extant safety literature suggests that managerial Safety Leadership is vital to the success and maintenance of a behavioral safety process. The current paper explores the role of Managerial Safety Leadership behaviors in the success of a behavioral safety intervention in the Middle-East with 47,000 workers from multiple nationalities employed by fourteen sub-contractors and one main contractor. A quasi-experimental repeating ABABAB, within groups design was used. Measurement focused on managerial Safety Leadership and employee safety behaviors as well as Corrective Actions. Data was collected over 104 weeks. During this time, results show safety behavior improved by 30 percentage points from an average of 65% during baseline to an average of 95%. The site achieved 121 million man-hours free of lost-time injuries on the longest run. Stepwise multiple regression analyses indicated 86% of the variation in employee safety behavior was associated with senior, middle and front-line manager's Safety Leadership behaviors and the Corrective Action Rate. Approximately 38% of the variation in the Total Recordable Incident Rate (TRIR) was associated with the Observation rate, Corrective Action Rate and Observers Records of managerial safety leaders (Visible Ongoing Support). The results strongly suggest manager's Safety Leadership influences the success of Behavioral Safety processes.

Prostate Cancer in South Africa: Pathology Based National Cancer Registry Data (1986–2006) and Mortality Rates (1997–2009)

PubMed Central

Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

2014-01-01

Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986–2006) and data on mortality (1997–2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA. PMID:24955252

Injury risks for on-road farm equipment and horse and buggy crashes in Pennsylvania: 2010-2013.

PubMed

Gorucu, Serap; Murphy, Dennis J; Kassab, Cathy

2017-04-03

The purpose of this study was to investigate characteristics associated with farm equipment and horse and buggy roadway crashes in relation to person, incident, and injury characteristics to identify appropriate points for injury incident prevention. Information on crashes occurring on public roads during the years 2010-2013 was obtained from the Pennsylvania Department of Transportation (PennDOT) and analyzed. There were 344 farm equipment and 246 horse and buggy crashes during the 4-year study period. These crashes involved 666 and 504 vehicles and 780 and 838 people, respectively. In incidents with farm equipment, the non-farm equipment drivers had an almost 2 times greater injury risk than farm equipment operators. Horse and buggy crashes were almost 3 times more injurious to the horse and buggy drivers than the drivers of the other vehicles. The average crash rate for farm equipment was 198.4 crashes per 100,000 farm population and for horse and buggy the crash rate was calculated as 89.4 crashes per 100,000 Amish population per year. This study suggests that road safety and public health programs should focus not only on farm equipment operators and horse and buggy drivers but on other motorists sharing the roadway with them.

Prostate cancer in South Africa: pathology based national cancer registry data (1986-2006) and mortality rates (1997-2009).

PubMed

Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

2014-01-01

Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986-2006) and data on mortality (1997-2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA.

Prognostic impact of intestinal wall thickening in hospitalized patients with heart failure.

PubMed

Ikeda, Yuki; Ishii, Shunsuke; Fujita, Teppei; Iida, Yuichiro; Kaida, Toyoji; Nabeta, Takeru; Maekawa, Emi; Yanagisawa, Tomoyoshi; Koitabashi, Toshimi; Takeuchi, Ichiro; Inomata, Takayuki; Ako, Junya

2017-03-01

Intestine-cardiovascular relationship has been increasingly recognized as a key factor in patients with heart disease. We aimed to identify the relationships among intestinal wall edema, cardiac function, and adverse clinical events in hospitalized heart failure (HF) patients. Abdominal computed tomographic images of 168 hospitalized HF patients were retrospectively investigated for identification of average colon wall thickness (CWT) from the ascending to sigmoid colon. Relationships between average CWT and echocardiographic parameters, blood sampling data, and primary outcomes including readmission for deteriorated HF and all-cause mortality were evaluated. Among the echocardiographic parameters, lower left ventricular diastolic function was correlated with higher average CWT. In multivariate analysis, higher logarithmic C-reactive protein level, lower estimated glomerular filtration rate, lower peripheral blood lymphocyte count, higher E/E' ratio, and extremely higher/lower defecation frequency were independently correlated with higher average CWT. Multivariate Cox-hazard analysis demonstrated that higher average CWT was independently related to higher incidence of primary outcomes. In hospitalized HF patients, increased CWT was associated with lower cardiac performance, and predicted poorer long-term clinical outcomes. Copyright © 2016. Published by Elsevier B.V.

[An investigation on acute flaccid paralysis (AFP) cases in some provinces with high risk of poliomyelitis of China].

PubMed

Wang, Z; Yang, B P; Li, H F

1995-04-01

In the mid Jun, 1994, a study team organized by MOPH investigated AFP cases in 10 provinces with high prevalence of poliomyelitis (polio). Twenty prefectures and ten counties were selected randomly from each of 10 provinces and relevant prefectures. The team identified 681 AFP cases under 15 years old from 45 hospitals at prefecture level and 13 hospitals at country level based on hospital records from cases occurred during 1991-1994. AFP, Polio, Non-polio AFP and GBS (Guillian-Barre Syndrome) cases aged from 0-14 years scattered around 101 counties (cities) among target population and their average incidences by year were 1.04, 0.48, 0.57 and 0.31 (per 10(5) respectively. Noticingly, the incidence of polio had reduced significantly since 1991, and its proportion among AFP was also reducing from first place yearly since 1991. In addition, over 95% of the polio cases were concentrated in the 4 year olds which indicated that the target population for surveillance and prevention should mainly be focusing on 0-4 year olds. As the incidence of non-polio AFP has been used as a current sensitive index of surveillance system, we noticed that the incidence rates had been significantly different from various regions. According to the analytic data, we recommend that "Rate of non-polio AFP in children 0-14 years of age greater than 1/10(5)" might be a better and more sensitive index for surveillance program in China.

Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study

PubMed Central

Crowson, Cynthia S.; Makol, Ashima; Ytterberg, Steven R.; Saitta, Antonino; Salvarani, Carlo; Matteson, Eric L.; Warrington, Kenneth J.

2016-01-01

Objective To investigate the incidence of venous thromboembolism (VTE) and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA) compared to the general population. Methods A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review. Results The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women) and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (%) of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014) but similar rates of stroke, transient ischemic attack (TIA), and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events. Conclusion In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects. PMID:26901431

The incidence of public sector hospitalisations due to dog bites in Australia 2001-2013.

PubMed

Rajshekar, Mithun; Blizzard, Leigh; Julian, Roberta; Williams, Anne-Marie; Tennant, Marc; Forrest, Alex; Walsh, Laurence J; Wilson, Gary

2017-08-01

To estimate the incidence of dog bite-related injuries requiring public sector hospitalisation in Australia during the period 2001-13. Summary data on public sector hospitalisations due to dog bite-related injuries with an ICD 10-AM W54.0 coding were sourced from the Australian Institute of Health and Welfare for the study period 2001-2013. In Australia, on average, 2,061 persons were hospitalised each year for treatment for dog bite injuries at an annual rate of 12.39 (95%CI 12.25-12.53) per 100,000 during 2001-13. The highest annual rates of 25.95 (95%CI 25.16-26.72) and 18.42 (95%CI 17.75-19.07) per 100,000 were for age groups 0-4 and 5-9 years respectively. Rates of recorded events increased over the study period and reached 16.15 (95%CI 15.78-16.52) per 100,000 during 2011-13. Dog bites are a largely unrecognised and growing public health problem in Australia. Implications for public health: There is an increasing public sector burden of hospitalisations for injuries from dog bites in Australia. © 2017 Menzies Institute for Medical Research.

[Epidemiology of ophidism in Venezuela (1996-2004)].

PubMed

De Sousa, Leonardo; Bastouri-Carrasco, Jessica; Matos, Mercedes; Borges, Adolfo; Bónoli, Stefano; Vásquez-Suárez, Aleikar; Guerrero, Belsy; Rodríguez-Acosta, Alexis

2013-06-01

The data of accidents caused by snakebites in Venezuela, registered at the morbidity statistics of the Direction of Epidemiology and Strategic Analysis of the Ministry of Health and Social Development were analyzed. During the years of 1996-2004, 53,792 snakebites were registered in Venezuela (5,976 cases average per year), with a higher incidence during the year 2004 (7,486 incidents). Zulia reported the highest frequency of all the states (5,975 cases); meanwhile the Midwestern region, constituted by Lara, Portuguesa, Falc6n and Yaracuy states, had a higher morbidity for snake bites. The highest incidence, distributed per states was registered in Cojedes, during the year 2001, with 228.72 cases per 100,000 inhabitants. When it was determined by regions, the highest incidence occurred during the year 2004 at los Llanos with 63.81 per 100,000 inhabitants. The median of the incidence rate for Venezuela during the period was of 21.46 accidents per 100,000 inhabitants. The classification of the endemic areas for ophidism, according to the percentiles 23, 50, 75 and 90, organized the country in: (a) states and regions of very high endemicity, (b) high endemicity, (c) middle, (d) low and (e) very low endemicity. These epidemiological data indicated that the accidents caused by snakes constitute a collective health problem in Venezuela.

Green-diode-pumped femtosecond Ti:Sapphire laser with up to 450 mW average power.

PubMed

Gürel, K; Wittwer, V J; Hoffmann, M; Saraceno, C J; Hakobyan, S; Resan, B; Rohrbacher, A; Weingarten, K; Schilt, S; Südmeyer, T

2015-11-16

We investigate power-scaling of green-diode-pumped Ti:Sapphire lasers in continuous-wave (CW) and mode-locked operation. In a first configuration with a total pump power of up to 2 W incident onto the crystal, we achieved a CW power of up to 440 mW and self-starting mode-locking with up to 200 mW average power in 68-fs pulses using semiconductor saturable absorber mirror (SESAM) as saturable absorber. In a second configuration with up to 3 W of pump power incident onto the crystal, we achieved up to 650 mW in CW operation and up to 450 mW in 58-fs pulses using Kerr-lens mode-locking (KLM). The shortest pulse duration was 39 fs, which was achieved at 350 mW average power using KLM. The mode-locked laser generates a pulse train at repetition rates around 400 MHz. No complex cooling system is required: neither the SESAM nor the Ti:Sapphire crystal is actively cooled, only air cooling is applied to the pump diodes using a small fan. Because of mass production for laser displays, we expect that prices for green laser diodes will become very favorable in the near future, opening the door for low-cost Ti:Sapphire lasers. This will be highly attractive for potential mass applications such as biomedical imaging and sensing.

A Prospective, Multicenter Study to Compare a Disposable, High-fluid Capacity Underpad to Nonpermeable, Disposable, Reusable Containment Products on Incontinence-associated Dermatitis Rates Among Skilled Nursing Facility Residents.

PubMed

Motta, Glenda; Milne, Catherine T

2017-12-01

Due to the high prevalence of incontinence among skilled nursing facility (SNF) residents, incontinence-associated derma- titis (IAD) is a common occurrence. In addition, facility staff may mistakenly identify IAD as a pressure injury. A prospective, descriptive, multicenter study was conducted in 3 Connecticut facilities to evaluate the effect of substituting a disposable, high- uid capacity underpad for nonpermeable disposable and reusable containment products on the rate of IADs. Residents with and without IAD but with high IAD risk scores who were bed- or chairbound or ambulatory and used disposable nonpermeable briefs and underpads or reusable, laundered containment products when in bed longer than 2 hours were randomly enrolled and observed for a 4-week period. Facility staff were trained on the importance of differentiating between IAD and pressure injury; they substituted the study product (a disposable, high- uid capacity underpad) for all previously used containment products. Patient risk for IAD and skin condition were assessed using the Perineal Assessment Tool (PAT) and the Skin Condition Assessment Tool (SAT), respectively, at 5 time points: baseline, week 1, week 2, week 3, and week 4. The PAT is a 4-item instrument based conceptually on the 4 determinants in perineal skin breakdown; subscales are rated from 1 (least risk) to 3 (most risk), with a total score range of 4 to 12. The SAT is used to evaluate IAD speci cally, generating a cumulative severity score ranging from 0 to 3 on area of skin affected, degree of redness, and depth of ero- sion. Final data analysis was conducted on 40 residents: 25 had IAD present at enrollment and 15 were deemed high risk for developing IAD. Mean SAT scores in the 25 participants with IAD decreased with signi cance at week 1 (P = .0016), week 2 (P = .0023), week 3 (P = .0005), and week 4 (P <.0001). Baseline IAD severity scores averaged 3.3 ± 1.7. Overall IAD average severity scores in this group decreased from baseline mean of 3.3 ± 1.7 to 0.7 ± 1.4 at week 4 (P <.001). The 15 participants with intact, nondamaged skin at enrollment did not develop IAD from baseline to week 4, and PAT score risk levels decreased from high (7 or greater) to low (6 or less) as a result of a speci c reduction in the duration of irritant exposure category for 11 (73%) of this group of participants by week 4. PAT risk level scores for both IAD and non-IAD participants at baseline averaged 8.1 ± 1.4; after 4 weeks, they averaged 7.0 ± 1.5). Although change was not significant, results suggest the use of a disposable, high- uid capacity underpad improved SAT scores over time. IAD rates increased in each facility, but pressure injury incidence rates decreased for the study duration. Replacing a nonpermeable, reusable containment product with a disposable, high- uid capacity underpad when SNF residents are in bed longer than 2 hours may impact the severity of IAD and reduce its incidence. The inverse impact reported on IAD and pressure injury incidence rates 1 month after training suggest study educational efforts had a short-lasting effect. Future research is indicated to determine the most effective method to improve nurses' ability to identify and distinguish IAD from pressure injury in the SNF setting.

[Ecological Trendofthe Incidence of Tuberculosis in Mianyang City During 2004-2013].

PubMed

Zhang, Wen-Hao; Xiao, Chuan; Ren, Tao; Wang, Li-Ping; Wang, Lan; Yuan, Ping

2016-09-01

To determine the trend of the incidence of tuberculosis (TB) in Mianyang City during 2004-2013 and its ecological determinants. Linear correlations between TB incidence and ecological factors were analyzed using the data collected in Mianyang City from 2004 to 2013. A multivariate linear regression model was established to determine the ecological predictors of TB incidence. The incidence of TB in Mianyang City decreased over the period of 2004-2013. Economic development and increased health resources were negatively correlated with TB incidence. Population density was positively correlated with TB incidence. A multivariate linear regression equationon TB incidence ( y ) was established with the independent variables ( x₁ to x ₁₀) forming a component (using principal component analysis) to eliminate multicollinearity: y =117.692-1.467 x ₁-1.145 x ₂-1.961 x ₃-4.777 x ₄-2.690 x ₅-6.181 x ₆+82.234 x ₇-2.721 x ₈-0.351 x ₉-0.382 x ₁₀. The incidence of TB decreased with the increases of real GDP per capita ( x ₁), average wage of workers( x ₂), per capita disposable income of urban residents ( x ₃), rural per capita net income ( x ₄), per capita consumption expenditure of urban residents ( x ₅), per capita living consumption expenditure of rural residents ( x ₆), number of licensed (assistant) physicians per thousand population ( x ₈), urbanization rate ( x ₉),and per capita housing construction area of urban ( x ₁₀),while it increased with the increase of density of population ( x ₇). Socio-economic development, health resources and population density are predictors of TB incidence.

Forecasting the incidence of tuberculosis in China using the seasonal auto-regressive integrated moving average (SARIMA) model.

PubMed

Mao, Qiang; Zhang, Kai; Yan, Wu; Cheng, Chaonan

2018-05-02

The aims of this study were to develop a forecasting model for the incidence of tuberculosis (TB) and analyze the seasonality of infections in China; and to provide a useful tool for formulating intervention programs and allocating medical resources. Data for the monthly incidence of TB from January 2004 to December 2015 were obtained from the National Scientific Data Sharing Platform for Population and Health (China). The Box-Jenkins method was applied to fit a seasonal auto-regressive integrated moving average (SARIMA) model to forecast the incidence of TB over the subsequent six months. During the study period of 144 months, 12,321,559 TB cases were reported in China, with an average monthly incidence of 6.4426 per 100,000 of the population. The monthly incidence of TB showed a clear 12-month cycle, and a seasonality with two peaks occurring in January and March and a trough in December. The best-fit model was SARIMA (1,0,0)(0,1,1) 12 , which demonstrated adequate information extraction (white noise test, p>0.05). Based on the analysis, the incidence of TB from January to June 2016 were 6.6335, 4.7208, 5.8193, 5.5474, 5.2202 and 4.9156 per 100,000 of the population, respectively. According to the seasonal pattern of TB incidence in China, the SARIMA model was proposed as a useful tool for monitoring epidemics. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Low Serum Bicarbonate and Kidney Function Decline: The Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Driver, Todd H.; Shlipak, Michael G.; Katz, Ronit; Goldenstein, Leonard; Sarnak, Mark J.; Hoofnagle, Andrew N.; Siscovick, David S.; Kestenbaum, Bryan; de Boer, Ian H.; Ix, Joachim H.

2014-01-01

Background Among populations with established chronic kidney disease (CKD), metabolic acidosis is associated with more rapid progression of kidney disease. The association of serum bicarbonate concentrations with early declines in kidney function is less clear. Study Design Retrospective cohort study. Setting & Participants 6380 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with a baseline estimated glomerular filtration rate (eGFR) >60 mL/min/1.73m2 using the CKD-EPI (CKD Epidemiology Collaboration) creatinine–cystatin C equation. Predictors Serum bicarbonate concentrations. Outcomes Rapid kidney function decline (eGFR decline >5% per year) and incident reduced eGFR (eGFR<60 mL/min/1.73 m2 with minimum rate of eGFR loss of 1 mL/min/1.73 m2 per year). Results The average bicarbonate concentration was 23.2 ± 1.8 mEq/L. 1730 (33%) participants had rapid kidney function decline, and 487 had incident reduced eGFR during follow-up. Each 1-SD lower baseline bicarbonate concentration was associated with 12% higher adjusted odds of rapid kidney function decline (95% CI, 6%–20%) and higher risk of incident reduced eGFR (adjusted incidence rate ratio, 1.11; 95% CI, 1.03–1.20) in models adjusting for demographics, baseline eGFR, albuminuria, and CKD risk factors. The OR for the associations of bicarbonate <21mEq/L relative to 23–24 mEq/L was 1.35 (95% CI, 1.05–1.73) for rapid kidney function decline, and the incidence rate ratio was 1.16 (95% CI, 0.83–1.62) for incident reduced eGFR. Limitations Etiology of metabolic acidosis cannot be determined in this study. Conclusions Lower serum bicarbonate concentrations are independently associated with rapid kidney function decline independent of eGFR or albuminuria in community-living persons with a baseline eGFR >60 mL/min/1.73 m2. If confirmed, our findings suggest that metabolic acidosis may indicate either early kidney disease that is not captured by eGFR or albuminuria, or may have a causal role in the development of an eGFR <60 mL/min/1.73 m2. PMID:24953891

Low serum bicarbonate and kidney function decline: the Multi-Ethnic Study of Atherosclerosis (MESA).

PubMed

Driver, Todd H; Shlipak, Michael G; Katz, Ronit; Goldenstein, Leonard; Sarnak, Mark J; Hoofnagle, Andrew N; Siscovick, David S; Kestenbaum, Bryan; de Boer, Ian H; Ix, Joachim H

2014-10-01

Among populations with established chronic kidney disease (CKD), metabolic acidosis is associated with more rapid progression of kidney disease. The association of serum bicarbonate concentrations with early declines in kidney function is less clear. Retrospective cohort study. 5,810 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with a baseline estimated glomerular filtration rate (eGFR) > 60mL/min/1.73 m(2) using the CKD-EPI (CKD Epidemiology Collaboration) creatinine-cystatin C equation. Serum bicarbonate concentrations. Rapid kidney function decline (eGFR decline > 5% per year) and incident reduced eGFR (eGFR < 60mL/min/1.73 m(2) with minimum rate of eGFR loss of 1 mL/min/1.73 m(2) per year). Average bicarbonate concentration was 23.2 ± 1.8mEq/L. 1,730 (33%) participants had rapid kidney function decline, and 487 had incident reduced eGFR during follow-up. Each 1-SD lower baseline bicarbonate concentration was associated with 12% higher adjusted odds of rapid kidney function decline (95% CI, 6%-20%) and higher risk of incident reduced eGFR (adjusted incidence rate ratio, 1.11; 95% CI, 1.03-1.20) in models adjusting for demographics, baseline eGFR, albuminuria, and CKD risk factors. The OR for the associations of bicarbonate level < 21 mEq/L relative to 23-24 mEq/L was 1.35 (95% CI, 1.05-1.73) for rapid kidney function decline, and the incidence rate ratio was 1.16 (95% CI, 0.83-1.62) for incident reduced eGFR. Cause of metabolic acidosis cannot be determined in this study. Lower serum bicarbonate concentrations are associated independently with rapid kidney function decline independent of eGFR or albuminuria in community-living persons with baseline eGFR > 60 mL/min/1.73 m(2). If confirmed, our findings suggest that metabolic acidosis may indicate either early kidney disease that is not captured by eGFR or albuminuria or may have a causal role in the development of eGFR < 60 mL/min/1.73 m(2). Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Mobile phones, cordless phones and rates of brain tumors in different age groups in the Swedish National Inpatient Register and the Swedish Cancer Register during 1998-2015

PubMed Central

Carlberg, Michael

2017-01-01

We used the Swedish Inpatient Register (IPR) to analyze rates of brain tumors of unknown type (D43) during 1998–2015. Average Annual Percentage Change (AAPC) per 100,000 increased with +2.06%, 95% confidence interval (CI) +1.27, +2.86% in both genders combined. A joinpoint was found in 2007 with Annual Percentage Change (APC) 1998–2007 of +0.16%, 95% CI -0.94, +1.28%, and 2007–2015 of +4.24%, 95% CI +2.87, +5.63%. Highest AAPC was found in the age group 20–39 years. In the Swedish Cancer Register the age-standardized incidence rate per 100,000 increased for brain tumors, ICD-code 193.0, during 1998–2015 with AAPC in men +0.49%, 95% CI +0.05, +0.94%, and in women +0.33%, 95% CI -0.29, +0.45%. The cases with brain tumor of unknown type lack morphological examination. Brain tumor diagnosis was based on cytology/histopathology in 83% for men and in 87% for women in 1980. This frequency increased to 90% in men and 88% in women in 2015. During the same time period CT and MRI imaging techniques were introduced and morphology is not always necessary for diagnosis. If all brain tumors based on clinical diagnosis with CT or MRI had been reported to the Cancer Register the frequency of diagnoses based on cytology/histology would have decreased in the register. The results indicate underreporting of brain tumor cases to the Cancer Register. The real incidence would be higher. Thus, incidence trends based on the Cancer Register should be used with caution. Use of wireless phones should be considered in relation to the change of incidence rates. PMID:28976991

Acute diarrhea during army field exercise in southern China

PubMed Central

Bai, Yang; Dai, Ying-Chun; Li, Jian-Dong; Nie, Jun; Chen, Qing; Wang, Hong; Rui, Yong-Yu; Zhang, Ya-Li; Yu, Shou-Yi

2004-01-01

AIM: During emergency period, infectious diseases can be a major threat to military forces. During field training in southern China, diarrhea is the main cause of nonbattle injury. To evaluate the causes of and risk factors for diarrhea in emergency period, we collected clinical and epidemiological data from the People’s Liberation Army (PLA) during field training in southern China. METHODS: From September 25 to October 2 1997, 2636 military personnel were investigated. Fecal sample cultures for lapactic pathogens were obtained from 103 military personnel with diarrhea. In addition, a questionnaire was administered to 103 cases and 206 controls to evaluate the association between illness and potential risk factors. At the same time, another questionnaire of 1:4 case-case control was administered to 22 severe cases (each severe case paired 4 mild cases). RESULTS: The training troop’s diarrhea incidence rate was significantly higher than that of garrison. The diarrhea incidence rate of officers was significantly lower than that of soldiers. A lapactic pathogen was identified in 63.1% (65/103) of the troops with diarrhea. Enterotoxigenic Escherichia coli (35.0%) and plesiomona shigelloides (16.5%) were the most common bacterial pathogens. All bacterial isolates were sensitive to norfloxacin and ceftazidine. However, almost all of them were resistant to sulfamethoxazole, trimethoprim-sulfamethoxazole, oxytetracycline, doxycycline, furazolidone, ampicillin and cloromycetin to a different degree. Risk factors associated with diarrhea included drinking raw water, eating outside, contacting diarrhea patients, lacking sanitation, depression, lacking sleep, which were established by multiple-factor logistic regression analysis. In addition, the unit incidence rate was associated with the density of flies and the average daily boiled water available by regression and discriminate analysis. CONCLUSION: A series of risk factors are associated with the incidence rate of diarrhea. Our results may provide a useful basis for prevention and cure of diarrhea in emergency period of PLA. PMID:14695783

Cardiovascular Risks Associated with Incident and Prevalent Periodontal Disease

PubMed Central

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

2014-01-01

Aim While prevalent periodontal disease associates with cardiovascular risk, little is known about how incident periodontal disease influences future vascular risk. We compared effects of incident versus prevalent periodontal disease in developing major cardiovascular diseases (CVD), myocardial infarction (MI), ischemic stroke and total CVD. Material and Methods In a prospective cohort of 39863 predominantly white women, age ≥ 45 years and free of cardiovascular disease at baseline were followed for an average of 15.7 years. Cox proportional hazard models with time-varying periodontal status (prevalent [18%], incident [7.3%] vs. never [74.7%]) were used to assess future cardiovascular risks. Results Incidence rates of all CVD outcomes were higher in women with prevalent or incident periodontal disease. For women with incident periodontal disease, risk factor adjusted hazard ratios (HRs) were 1.42 (95% CI, 1.14–1.77) for major CVD, 1.72 (1.25–2.38) for MI, 1.41(1.02–1.95) for ischemic stroke, and 1.27(1.06–1.52) for total CVD. For women with prevalent periodontal disease, adjusted HRs were 1.14 (1.00–1.31) for major CVD, 1.27 (1.04–1.56) for MI, 1.12(0.91–1.37) for ischemic stroke, and 1.15(1.03–1.28) for total CVD. Conclusion New cases of periodontal disease, not just those that are pre-existing, place women at significantly elevated risks for future cardiovascular events. PMID:25385537

Population-based incidence and comparative demographics of community-associated and healthcare-associated Escherichia coli bloodstream infection in Auckland, New Zealand, 2005-2011.

PubMed

Williamson, Deborah A; Lim, Alwin; Wiles, Siouxsie; Roberts, Sally A; Freeman, Joshua T

2013-08-21

Escherichia coli is a major human pathogen, both in community and healthcare settings. To date however, relatively few studies have defined the population burden of E. coli bloodstream infections. Such information is important in informing strategies around treatment and prevention of these serious infections. Against this background, we performed a retrospective, population-based observational study of all cases of E. coli bacteremia in patients presenting to our hospital between January 2005 and December 2011. Auckland District Health Board is a tertiary-level, university-affiliated institution serving a population of approximately 500,000, within a larger metropolitan population of 1.4 million. We identified all patients with an episode of bloodstream infection due to E. coli over the study period. A unique episode was defined as the first positive E. coli blood culture taken from the same patient within a thirty-day period. Standard definitions were used to classify episodes into community- or healthcare-associated E. coli bacteremia. Demographic information was obtained for all patients, including: age; gender; ethnicity; length of stay (days); requirement for intensive care admission and all-cause, in-patient mortality. A total of 1507 patients had a unique episode of E. coli bacteremia over the study period. The overall average annual incidence of E. coli bacteremia was 52 per 100,000 population, and was highest in the under one year and over 65-year age groups. When stratified by ethnicity, rates were highest in Pacific Peoples and Māori (83 and 62 per 100,000 population respectively). The incidence of community-onset E. coli bacteremia increased significantly over the study period. The overall in-hospital mortality rate was 9% (135/1507), and was significantly higher in patients who had a hospital-onset E. coli bacteremia. Our work provides valuable baseline data on the incidence of E. coli bacteremia in our locale. The incidence was higher that that described from other developed countries, with significant demographic variation, most notably in ethnic-specific incidence rates. Future work should assess the possible reasons for this disparity.

Determinants of social inequalities in stroke incidence across Europe: a collaborative analysis of 126 635 individuals from 48 cohort studies.

PubMed

Ferrario, Marco M; Veronesi, Giovanni; Kee, Frank; Chambless, Lloyd E; Kuulasmaa, Kari; Jørgensen, Torben; Amouyel, Philippe; Arveiler, Dominique; Bobak, Martin; Cesana, Giancarlo; Drygas, Wojciech; Ferrieres, Jean; Giampaoli, Simona; Iacoviello, Licia; Nikitin, Yuri; Pajak, Andrzej; Peters, Annette; Salomaa, Veikko; Soderberg, Stefan; Tamosiunas, Abdonas; Wilsgaard, Tom; Tunstall-Pedoe, Hugh

2017-12-01

Knowledge on the origins of the social gradient in stroke incidence in different populations is limited. This study aims to estimate the burden of educational class inequalities in stroke incidence and to assess the contribution of risk factors in determining these inequalities across Europe. The MORGAM (MOnica Risk, Genetics, Archiving and Monograph) Study comprises 48 cohorts recruited mostly in the 1980s and 1990s in four European regions using standardised procedures for baseline risk factor assessment and fatal and non-fatal stroke ascertainment and adjudication during follow-up. Among the 126 635 middle-aged participants, initially free of cardiovascular diseases, generating 3788 first stroke events during a median follow-up of 10 years, we estimated differences in stroke rates and HRs for the least versus the most educated individuals. Compared with their most educated counterparts, the overall age-adjusted excess hazard for stroke was 1.54 (95% CI 1.25 to 1.91) and 1.41 (95% CI 1.16 to 1.71) in least educated men and women, respectively, with little heterogeneity across populations. Educational class inequalities accounted for 86-413 and 78-156 additional stroke events per 100 000 person-years in the least compared with most educated men and women, respectively. The additional events were equivalent to 47%-130% and 40%-89% of the average incidence rates. Inequalities in risk factors accounted for 45%-70% of the social gap in incidence in the Nordic countries, the UK and Lithuania-Kaunas (men), but for no more than 17% in Central and South Europe. The major contributors were cigarette smoking, alcohol intake and body mass index. Social inequalities in stroke incidence contribute substantially to the disease rates in Europe. Healthier lifestyles in the most disadvantaged individuals should have a prominent impact in reducing both inequalities and the stroke burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Trends in colorectal cancer incidence: a period and birth-cohort analysis in a well-defined French population.

PubMed

Chauvenet, Marion; Cottet, Vanessa; Lepage, Côme; Jooste, Valérie; Faivre, Jean; Bouvier, Anne-Marie

2011-06-30

France stands among high-risk areas for colorectal cancer. Different trends in CRC incidence are reported around the world. The aim of this study was to provide temporal trends in CRC incidence over a 30-year period in a French well-defined population. Between 1976 and 2005, 17,028 new cases were registered by the Burgundy digestive cancer registry. The mean variations in age-standardized incidence rates were estimated using a Poisson regression adjusted for age for each gender and location. The cumulative risk by birth cohort of developing a cancer over the age range 0-74 years was estimated using an age-cohort model. Incidence rates for right and left colon cancers increased more rapidly in males (respectively +11.7% and +10.3% on average by 5-year period) than in females (respectively +5.9% and +6.1%). It remained stable for sigmoid cancers in males (-0.1%) and decreased in females (-5.2%). It also decreased for rectal cancers both in males (-2.7%) and in females (-2.0%). The cumulative risk increased from 3.9% for males born around 1900 to 4.9% for those born around 1930 and then slightly decreased (4.5% among those born around 1950). It remained at the same level for females born around 1900 (2.7%) as for those born around 1930 (2.7%) and then slightly increased (2.9%) for those born around 1950. For right colon cancers, the cumulative risk increased strikingly in successive birth cohorts from 0.53% to 1.2% in males and 0.55% to 0.77% in females. The corresponding cumulative risks for the left colon were 0.24% and 0.42% in males and 0.14% and 0.29% in females. For sigmoid cancer, they decreased from 1.59% to 1.08% in males, and 0.88% to 0.80% in females. Temporal variations in incidence rates of colorectal cancers differed according to subsite, suggesting different aetiological factors and implications for diagnosis and screening strategies. Total colonoscopy must be the preferred strategy in high-risk groups or after a positive faecal occult blood test.

Population-based incidence and comparative demographics of community-associated and healthcare-associated Escherichia coli bloodstream infection in Auckland, New Zealand, 2005 – 2011

PubMed Central

2013-01-01

Background Escherichia coli is a major human pathogen, both in community and healthcare settings. To date however, relatively few studies have defined the population burden of E. coli bloodstream infections. Such information is important in informing strategies around treatment and prevention of these serious infections. Against this background, we performed a retrospective, population-based observational study of all cases of E. coli bacteremia in patients presenting to our hospital between January 2005 and December 2011. Methods Auckland District Health Board is a tertiary-level, university-affiliated institution serving a population of approximately 500,000, within a larger metropolitan population of 1.4 million. We identified all patients with an episode of bloodstream infection due to E. coli over the study period. A unique episode was defined as the first positive E. coli blood culture taken from the same patient within a thirty-day period. Standard definitions were used to classify episodes into community- or healthcare-associated E. coli bacteremia. Demographic information was obtained for all patients, including: age; gender; ethnicity; length of stay (days); requirement for intensive care admission and all-cause, in-patient mortality. Results A total of 1507 patients had a unique episode of E. coli bacteremia over the study period. The overall average annual incidence of E. coli bacteremia was 52 per 100,000 population, and was highest in the under one year and over 65-year age groups. When stratified by ethnicity, rates were highest in Pacific Peoples and Māori (83 and 62 per 100,000 population respectively). The incidence of community-onset E. coli bacteremia increased significantly over the study period. The overall in-hospital mortality rate was 9% (135/1507), and was significantly higher in patients who had a hospital-onset E. coli bacteremia. Conclusions Our work provides valuable baseline data on the incidence of E. coli bacteremia in our locale. The incidence was higher that that described from other developed countries, with significant demographic variation, most notably in ethnic-specific incidence rates. Future work should assess the possible reasons for this disparity. PMID:23964864

Modeling climate effects on hip fracture rate by the multivariate GARCH model in Montreal region, Canada.

PubMed

Modarres, Reza; Ouarda, Taha B M J; Vanasse, Alain; Orzanco, Maria Gabriela; Gosselin, Pierre

2014-07-01

Changes in extreme meteorological variables and the demographic shift towards an older population have made it important to investigate the association of climate variables and hip fracture by advanced methods in order to determine the climate variables that most affect hip fracture incidence. The nonlinear autoregressive moving average with exogenous variable-generalized autoregressive conditional heteroscedasticity (ARMAX-GARCH) and multivariate GARCH (MGARCH) time series approaches were applied to investigate the nonlinear association between hip fracture rate in female and male patients aged 40-74 and 75+ years and climate variables in the period of 1993-2004, in Montreal, Canada. The models describe 50-56% of daily variation in hip fracture rate and identify snow depth, air temperature, day length and air pressure as the influencing variables on the time-varying mean and variance of the hip fracture rate. The conditional covariance between climate variables and hip fracture rate is increasing exponentially, showing that the effect of climate variables on hip fracture rate is most acute when rates are high and climate conditions are at their worst. In Montreal, climate variables, particularly snow depth and air temperature, appear to be important predictors of hip fracture incidence. The association of climate variables and hip fracture does not seem to change linearly with time, but increases exponentially under harsh climate conditions. The results of this study can be used to provide an adaptive climate-related public health program and ti guide allocation of services for avoiding hip fracture risk.

Modeling climate effects on hip fracture rate by the multivariate GARCH model in Montreal region, Canada

NASA Astrophysics Data System (ADS)

Modarres, Reza; Ouarda, Taha B. M. J.; Vanasse, Alain; Orzanco, Maria Gabriela; Gosselin, Pierre

2014-07-01

Changes in extreme meteorological variables and the demographic shift towards an older population have made it important to investigate the association of climate variables and hip fracture by advanced methods in order to determine the climate variables that most affect hip fracture incidence. The nonlinear autoregressive moving average with exogenous variable-generalized autoregressive conditional heteroscedasticity (ARMA X-GARCH) and multivariate GARCH (MGARCH) time series approaches were applied to investigate the nonlinear association between hip fracture rate in female and male patients aged 40-74 and 75+ years and climate variables in the period of 1993-2004, in Montreal, Canada. The models describe 50-56 % of daily variation in hip fracture rate and identify snow depth, air temperature, day length and air pressure as the influencing variables on the time-varying mean and variance of the hip fracture rate. The conditional covariance between climate variables and hip fracture rate is increasing exponentially, showing that the effect of climate variables on hip fracture rate is most acute when rates are high and climate conditions are at their worst. In Montreal, climate variables, particularly snow depth and air temperature, appear to be important predictors of hip fracture incidence. The association of climate variables and hip fracture does not seem to change linearly with time, but increases exponentially under harsh climate conditions. The results of this study can be used to provide an adaptive climate-related public health program and ti guide allocation of services for avoiding hip fracture risk.

Prospective, nonrandomized controlled trials to compare the effect of a silk-like fabric to standard hospital linens on the rate of hospital-acquired pressure ulcers.

PubMed

Coladonato, Joseph; Smith, Annette; Watson, Nancy; Brown, Anne T; McNichol, Laurie L; Clegg, Amy; Griffin, Tracy; McPhail, Lora; Montgomery, Terry G

2012-10-01

Hospital bedding and gowns influence skin moisture, temperature, friction, and shear, which in turn may affect the development of pressure ulcers. To evaluate the effect of a new silk-like synthetic fabric on the incidence of pressure ulcers in an acute care setting, two consecutive 6-month clinical trials were conducted among 307 consecutively admitted patients in a Medical Renal Unit (August 2008 and March 2010) and in 275 patients admitted to a Surgical Intensive Care Unit (ICU) (September 2009 to March 2010). During the first 8 weeks, all patients used standard hospital bed linens, reusable underpads, and gowns. During the second 8 weeks, all admitted patients used the intervention linens (a silk-like fabric) followed by another 8 weeks of control (standard linen) use. Demographic variables and the prevalence of pressure ulcers on admission were statistically similar for control and intervention groups in both study populations with the exception of gender in the Renal Unit study (13% higher proportion of men in intervention group). Average Braden Scores were also similar and low (<18) in all study patients. Upon admission to the Medical Renal Unit, 21 of 154 patients (13.6%) in the control and 26 of 153 patients (17.0%) in the intervention group had a pressure ulcer. The incidence of new ulcers was 12.3% in the control and 4.6% in the intervention group (P = 0.01); average length of stay was 5.97 days (σ = 4.0) for control and 5.31 days (σ = 3.8) for intervention patients (P = 0.07). In the Surgical ICU group, 18 of 199 patients in the control (9.1%) and four of 76 patients in the intervention group (5.3%) were admitted with a pressure ulcer; the incidence of new pressure ulcers was 7.5 % in the control and 0% in the intervention group (P = 0.01). Average length of stay was 4.5 days and 4.33 days in the control and intervention groups, respectively (P = 0.33). The significant differences between the control and intervention group in the rate of pressure ulcer development suggests that the type of linens used affect pressure ulcer risk and that this silk-like synthetic fabric technology may help reduce the incidence of pressure ulcers in high-risk patients. Controlled clinical studies in other patient populations are warranted.

Investigation of the thermal and optical performance of a spatial light modulator with high average power picosecond laser exposure for materials processing applications

NASA Astrophysics Data System (ADS)

Zhu, G.; Whitehead, D.; Perrie, W.; Allegre, O. J.; Olle, V.; Li, Q.; Tang, Y.; Dawson, K.; Jin, Y.; Edwardson, S. P.; Li, L.; Dearden, G.

2018-03-01

Spatial light modulators (SLMs) addressed with computer generated holograms (CGHs) can create structured light fields on demand when an incident laser beam is diffracted by a phase CGH. The power handling limitations of these devices based on a liquid crystal layer has always been of some concern. With careful engineering of chip thermal management, we report the detailed optical phase and temperature response of a liquid cooled SLM exposed to picosecond laser powers up to 〈P〉  =  220 W at 1064 nm. This information is critical for determining device performance at high laser powers. SLM chip temperature rose linearly with incident laser exposure, increasing by only 5 °C at 〈P〉  =  220 W incident power, measured with a thermal imaging camera. Thermal response time with continuous exposure was 1-2 s. The optical phase response with incident power approaches 2π radians with average power up to 〈P〉  =  130 W, hence the operational limit, while above this power, liquid crystal thickness variations limit phase response to just over π radians. Modelling of the thermal and phase response with exposure is also presented, supporting experimental observations well. These remarkable performance characteristics show that liquid crystal based SLM technology is highly robust when efficiently cooled. High speed, multi-beam plasmonic surface micro-structuring at a rate R  =  8 cm2 s-1 is achieved on polished metal surfaces at 〈P〉  =  25 W exposure while diffractive, multi-beam surface ablation with average power 〈P〉  =100 W on stainless steel is demonstrated with ablation rate of ~4 mm3 min-1. However, above 130 W, first order diffraction efficiency drops significantly in accord with the observed operational limit. Continuous exposure for a period of 45 min at a laser power of 〈P〉  =  160 W did not result in any detectable drop in diffraction efficiency, confirmed afterwards by the efficient parallel beam processing at 〈P〉  =  100 W. Hence, no permanent changes in SLM phase response characteristics have been detected. This research work will help to accelerate the use of liquid crystal spatial light modulators for both scientific and ultra high throughput laser-materials micro-structuring applications.

A nationwide epidemiological study of newly diagnosed spine metastasis in the adult Korean population.

PubMed

Sohn, Seil; Kim, Jinhee; Chung, Chun Kee; Lee, Na Rae; Park, Eunjung; Chang, Ung-Kyu; Sohn, Moon Jun; Kim, Sung Hwan

2016-08-01

Metastatic spine tumor has become clinically important because of the availability of improved diagnostic tools and increases in survival periods in cancer patients. In spite of this interest, the burden of metastatic spine tumor on the general population has not been extensively reported. The aim of this 2009-2011 nationwide study of adult Koreans was to describe characteristics, medical use, and survival rate of patients with newly diagnosed metastatic spine tumors according to the primary tumor. This is a retrospective cohort study. A national health insurance database was used to identify a cohort of patients with newly diagnosed metastatic spine tumors. This study aimed to analyze characteristics, medical use, and survival rate of patients with newly diagnosed metastatic spine tumors according to the primary tumor. Data for patients with metastatic spine tumors were extracted from the Korean Health Insurance Review and Assessment Service database. Data included patient age, sex, health insurance type, comorbidities, medical cost, and hospital stay duration. Hospital stay duration and medical costs per person during 1 calendar year were evaluated. In addition, survival rates of patients with metastatic spine tumor according to primary tumor sites were evaluated. The incidence rate of spine metastasis increased with age, year of diagnosis, and the number of comorbidities (p≤.0001). The 6 most prevalent primary tumor sites were lung, liver and biliary tract, breast, colon, stomach, and prostate. Of patients with the 6 most prevalent primary tumors, total average annual medical costs, including inpatient and outpatient services, ranged from 12,734USD (prostate origin) to 15,556 USD (lung origin). Of patients with the 6 most prevalent primary tumors, total average annual hospital stay duration, including inpatient and outpatient services, ranged from 70.8 days (stomach origin) to 78.7 days (colon origin). Median overall survival duration in patients with metastatic spine tumor was 191 days. In addition to age, sex, and comorbidities, primary tumor sites (lung, liver and biliary tract, breast, stomach, and prostate) significantly affected survival rate. This nationwide study was able to depict the burden of metastatic spine tumor in Korea. The metastatic spine tumor incidence rate is highest in the group of 70- to 79-year-old men. Average annual medical costs ranged from 12,734 USD to 15,556 USD. The mean annual hospital stay duration was from 70.8 days to 78.7 days. In addition to age, sex, and comorbidities, primary tumor sites significantly affected the survival rate in patients with metastatic spine tumor. Copyright © 2016 Elsevier Inc. All rights reserved.

Biomechanical risk factors for carpal tunnel syndrome: a pooled study of 2474 workers

PubMed Central

Harris-Adamson, Carisa; Eisen, Ellen A; Kapellusch, Jay; Garg, Arun; Hegmann, Kurt T; Thiese, Matthew S; Dale, Ann Marie; Evanoff, Bradley; Burt, Susan; Bao, Stephen; Silverstein, Barbara; Merlino, Linda; Gerr, Fred; Rempel, David

2015-01-01

Background Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes. Objective This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors. Methods 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models. Results After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS. Conclusions In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS. PMID:25324489

Penile fracture epidemiology, diagnosis and management in Iran: a narrative review

PubMed Central

Mirzazadeh, Majid; Fallahkarkan, Morteza

2017-01-01

Penile fracture (PF) is considered an emergency in urology. In the literature there are some case series reporting considerable incidence of PF in some parts of Iran. There are no accurate data about the incidence of PF all around Iran. Although it may be uncommon in other parts of the country and in the other countries, it can also be underreported. There are some challenges in diagnosis, management, and also reporting of these cases. In this review of Iranian medical literature, we searched for penile fracture and penile injury keywords in Medline, Scopus, SID, Google and Persian medical journals. We reviewed the status of epidemiology, etiology, diagnosis, management and complications of PF in different parts of Iran in the published literature. To collect more accurate data, we also performed a questionnaire-based study with sending questionnaires by emails to 700 urologists throughout the country with 14% response rate. Incidence of PF varies significantly in different parts of Iran. Western province of Kermanshah has a significantly higher rate of PF. Adding data from different regions of Iran, we calculated that incidence of PF in Iran can be estimated between 1.14 to 10.48 per 100,000 of male populations, most probably closer to lower end. Although the incidence of PF varies significantly in different geographical areas, urologists practicing in Iran on average may encounter a PF patient every 3.5 months. To diagnose PF, majority of reviewed studies relied on history and clinical examination and did not recommend imaging except in patients with possible urethral injuries. Immediate surgical intervention can make good functional results with low morbidity and short hospital stay. Delayed surgical intervention and observational management approaches need large population studies with long term follow up. PMID:28540222

Penile fracture epidemiology, diagnosis and management in Iran: a narrative review.

PubMed

Mirzazadeh, Majid; Fallahkarkan, Morteza; Hosseini, Jalil

2017-04-01

Penile fracture (PF) is considered an emergency in urology. In the literature there are some case series reporting considerable incidence of PF in some parts of Iran. There are no accurate data about the incidence of PF all around Iran. Although it may be uncommon in other parts of the country and in the other countries, it can also be underreported. There are some challenges in diagnosis, management, and also reporting of these cases. In this review of Iranian medical literature, we searched for penile fracture and penile injury keywords in Medline, Scopus, SID, Google and Persian medical journals. We reviewed the status of epidemiology, etiology, diagnosis, management and complications of PF in different parts of Iran in the published literature. To collect more accurate data, we also performed a questionnaire-based study with sending questionnaires by emails to 700 urologists throughout the country with 14% response rate. Incidence of PF varies significantly in different parts of Iran. Western province of Kermanshah has a significantly higher rate of PF. Adding data from different regions of Iran, we calculated that incidence of PF in Iran can be estimated between 1.14 to 10.48 per 100,000 of male populations, most probably closer to lower end. Although the incidence of PF varies significantly in different geographical areas, urologists practicing in Iran on average may encounter a PF patient every 3.5 months. To diagnose PF, majority of reviewed studies relied on history and clinical examination and did not recommend imaging except in patients with possible urethral injuries. Immediate surgical intervention can make good functional results with low morbidity and short hospital stay. Delayed surgical intervention and observational management approaches need large population studies with long term follow up.

The effects of changes in cadmium and lead air pollution on cancer incidence in children.

PubMed

Absalon, Damian; Slesak, Barbara

2010-09-15

This article presents the results of research on the effects of air pollution on cancer incidence in children in the region of Silesia (Poland), which has undergone one of the most profound anthropogenic transformations in Europe. The main objective of the research was to specify the impact of changes in cadmium and lead pollution in the years 1990-2005 on the incidence of cancers reported in children. Lead concentration ranged from 0 to 1490 x 10(-9) G m(-2)/year, and cadmium concentration ranged from 0 to 33.7 x 10(-9) G m(-2)/year. There was no strong significant correlation (max 0.3) between air pollution and incidence rate (IR) in the general population of children in any particular year. Alongside the cartographic presentation of dependences, correlation coefficients between the variables in question were calculated. This made it possible to determine the relationship between the pollution levels and incidence rates in the area. There was a significant reduction in the level of pollution during the investigated period. The study of the relationship between the number of cancers reported and the condition of the natural environment revealed increased sensitivity to toxins in boys (correlation coefficient 0.3). In addition, the spatial distribution of the number of cases reported in boys suggests a correlation with the spatial distribution of the coefficients for the entire group of children included in the study. The yearly average IR of childhood cancer in specific districts ranged from 0 to 61.48/100,000 children under 18 years of age during the 1995-2004 period. Copyright 2010 Elsevier B.V. All rights reserved.

Lightning fatalities and injuries in Turkey

NASA Astrophysics Data System (ADS)

Tilev-Tanriover, Ş.; Kahraman, A.; Kadioğlu, M.; Schultz, D. M.

2015-08-01

A database of lightning-related fatalities and injuries in Turkey was constructed by collecting data from the Turkish State Meteorological Service, newspaper archives, European Severe Weather Database, and the internet. The database covers January 1930 to June 2014. In total, 742 lightning incidents causing human fatalities and injuries were found. Within these 742 incidents, there were 895 fatalities, 149 serious injuries, and 535 other injuries. Most of the incidents (89 %) occurred during April through September, with a peak in May and June (26 and 28 %) followed by July (14 %). Lightning-related fatalities and injuries were most frequent in the afternoon. Most of the incidents (86 %) occurred in rural areas, with only 14 % in the urban areas. Approximately, two thirds of the victims with known gender were male. Because of the unrepresentativeness of the historical data, determining an average mortality rate over a long period is not possible. Nevertheless, there were 31 fatalities (0.42 per million) in 2012, 26 fatalities (0.35 per million) in 2013, and 25 fatalities (0.34 per million) in 2014 (as of June). There were 36 injuries (0.49 per million) in each of 2012 and 2013, and 62 injuries (0.84 per million) in 2014 (as of June).

Lightning fatalities and injuries in Turkey

NASA Astrophysics Data System (ADS)

Tilev-Tanriover, Ş.; Kahraman, A.; Kadioğlu, M.; Schultz, D. M.

2015-03-01

A database of lightning-related fatalities and injuries in Turkey was constructed by collecting data from the Turkish State Meteorological Service, newspaper archives, European Severe Weather Database, and the internet. The database covers January 1930 to June 2014. In total, 742 lightning incidents causing human fatalities and injuries were found. Within these 742 incidents, there were 895 fatalities, 149 serious injuries, and 535 other injuries. Most of the incidents (89%) occurred during April through September, with a peak in May and June (26 and 28 %) followed by July (14%). Lightning-related fatalities and injuries were most frequent in the afternoon. Most of the incidents (86%) occurred in the rural areas, with only 14% in the urban areas. Approximately, two thirds of the victims with known gender were male. Because of the unrepresentativeness of the historical data, determining an average mortality rate over a long period is not possible. Nevertheless, there were 31 fatalities (0.42 per million) in 2012, 26 fatalities (0.35 per million) in 2013, and 25 fatalities (0.34 per million) in 2014 (as of June). There were 36 injuries (0.49 per million) in each of 2012 and 2013, and 62 injuries (0.84 per million) in 2014 (as of June).

Incidence and mortality trends of aspiration pneumonia in Parkinson's disease in the United States, 1979-2010.

PubMed

Akbar, Umer; Dham, Bhavpreet; He, Ying; Hack, Nawaz; Wu, Samuel; Troche, Michelle; Tighe, Patrick; Nelson, Eugene; Friedman, Joseph H; Okun, Michael S

2015-09-01

Careful examination of long-term analyses and trends is essential in understanding the medico-economic burden of this common complication. We sought to describe the long-term (32-year) trends of incidence and mortality in PD patients hospitalized with aspiration pneumonia (AsPNA). Incidence and mortality of AsPNA in hospitalized PD versus non-PD patients was assessed by logistic regression analysis applied to a national database between the years 1979 and 2010. Covariates such as age-decennium, gender, year AsPNA occurred, and the interactions with PD diagnosis were investigated. Rate of AsPNA and mortality over the 32-years was trended and compared. AsPNA occurred in 3.6% of PD patients and 1.0% of non-PD patients. The average mortality for PD patients was less (17% vs. 22%). Long-term (32-year) trends revealed a nearly 10-fold increase in incidence of AsPNA in PD (0.4% in 1979, 4.9% in 2010), decreasing mortality overtime, higher likelihood in males, and increasing average age of AsPNA patients (steeper increase in PD). All p-values<0.05. In regression analysis, each successive year had a slight increase in odds of AsPNA (OR 1.03 in PD, OR1.06 in non-PD). Trends over 32 years revealed a 10-fold increase in AsPNA among PD and non-PD patients, and an associated decrease in mortality. Our data suggest that PD patients are living longer, have slightly more AsPNA, but a lower mortality than was seen in past decades. Further research should investigate the causes of AsPNA in PD, and also potential interventions to decrease its occurrence. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Breast cancer in Finistère, France: epidemiological description and tendencies over a 10-year period (2000-2009) according to pathology data].

PubMed

Lietard, Claire; Conan, Virginie; Le Fur, Jean-Marie; Minot, Jean-Pierre; Le Callonec, Marie; Brisseau, Cyrille; Saliou, Philippe; Lejeune, Benoist; Lagarde, Nicole; Garlantézec, Ronan

2013-02-01

The aim of this study was the description of breast carcinoma over a 10-year period according to pathology data. Descriptive epidemiological study based on data collection of pathological code ADICAP (injury, organ, and applied technical), histological, hormonal, node and administrative data. From January 1st 2000 to December 31st 2009, 6186 women living in Finistère have had a diagnosis of invasive breast carcinoma. The incidence rate involved from 125 per 100,000 women to 136 in 2009. Average age to the first diagnosis was 61.4 ± 13.6; class of age with the more important incidence rate was for the 50-74 years old. The different histological subtypes varied over the period (P<0.0001). Tumour's size was notified for more than 75% in the whole period of the study. The average size evolved significantly over the period (P<0.0001 from 23.5mm [± 18.4] in 2000 to 21.02 [± 16.2] in 2009, particularly after 2003 [P<0.0002]). The grade status (SBR, MSBR and Elston Ellis) showed a trend to the gravity decrease over the period (respectively P=0.03 [r(2)=-0,04]; P<0.0001 [r(2)=-0.10]; P<0.0001 [r(2)=-0.08]). Our results confirm the interest of pathology database for the description of invasive breast cancer. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Percutaneous Lead Extraction in Infection of Cardiac Implantable Electronic Devices: a Systematic Review

PubMed Central

Menezes Júnior, Antônio da Silva; Magalhães, Thaís Rodrigues; Morais, Alana de Oliveira Alarcão

2018-01-01

Introduction In the last two decades, the increased number of implants of cardiac implantable electronic devices has been accompanied by an increase in complications, especially infection. Current recommendations for the appropriate treatment of cardiac implantable electronic devices-related infections consist of prolonged antibiotic therapy associated with complete device extraction. The purpose of this study was to analyze the importance of percutaneous extraction in the treatment of these devices infections. Methods A systematic review search was performed in the PubMed, BVS, Cochrane CENTRAL, CAPES, SciELO and ScienceDirect databases. A total of 1,717 studies were identified and subsequently selected according to the eligibility criteria defined by relevance tests by two authors working independently. Results Sixteen studies, describing a total of 3,354 patients, were selected. Percutaneous extraction was performed in 3,081 patients. The average success rate for the complete percutaneous removal of infected devices was 92.4%. Regarding the procedure, the incidence of major complications was 2.9%, and the incidence of minor complications was 8.4%. The average in-hospital mortality of the patients was 5.4%, and the mortality related to the procedure ranged from 0.4 to 3.6%. The mean mortality was 20% after 6 months and 14% after a one-year follow-up. Conclusion Percutaneous extraction is the main technique for the removal of infected cardiac implantable electronic devices, and it presents low rates of complications and mortality related to the procedure.

Clinical experience with thymoglobulin and antithymocyte globulin-Fresenius as induction therapy in renal transplant patients: a retrospective study.

PubMed

Cicora, Federico; Mos, Fernando; Paz, Marta; Roberti, Javier

2013-10-01

We describe our experiences with, and compare the outcomes of, 2 groups of renal transplant patients treated with thymoglobulin or antithymocyte globulin-Fresenius as induction therapy at transplant to reduce the incidence of acute rejection and prevent delayed allograft function. Twenty-four recipients of deceased-donor or living-donor kidney transplants received thymoglobulin, and 23 patients received antithymocyte globulin-Fresenius. Patient and graft survival and efficacy and safety were assessed at 3 months. The demographic characteristics of both groups were comparable, but the predominant donor type was significantly different. Incidence of complications, delayed graft function, and creatinine concentrations were comparable in both groups. At 3 months after the transplant, patient survival rate was 92% in the thymoglobulin group and 96% in the antithymocyte globulin-Fresenius group (P > .05), and death-censored graft survival rate for both groups was not significantly different. Average hematocrit and lymphocyte, neutrophil, and platelet counts were comparable in both groups at 3 months' follow-up. Average white blood count at 1 month was significantly different between the groups: at 5.62 ± 2.45 × 103 cells/mm³ in the thymoglobulin group and 7.85 ± 4.10 × 103 cells/mm³ in the ATG-F group (P < .05). Considering the study design limitations, we observed that our group of treated patients, safety, and efficacy of thymoglobulin and antithymocyte globulin-Fresenius were generally comparable.

Olecranon Bursitis in a Military Population: Epidemiology and Evidence for Prolonged Morbidity in Combat Recruits.

PubMed

Schermann, Haggai; Karakis, Isabella; Dolkart, Oleg; Maman, Eran; Kadar, Assaf; Chechik, Ofir

2017-09-01

Olecranon bursitis (OB) is a benign but disturbing condition that may adversely affect a military recruit's combat preparedness. This study was designed to assess incidence, risk factors, and associated medical burden of OB in the Israel Defense Forces. This is a retrospective study drawing on medical records of all Israel Defense Forces soldiers diagnosed as having OB between 2005 and 2015. OB was classified as septic and noninfectious. Crude incidence rates and duty-specific incidence rates were calculated. Medical burden was defined by the number of physician visits, referrals to orthopedic specialist consultations, duration of symptoms, and duration of pharmaceutical treatment. Demographic and occupational information (age, sex, height, weight, socioeconomic status, country of origin, type of military service, time of presentation to medical services) was used to identify risk factors for septic bursitis and longer duration of symptoms. Statistical analysis was performed in R statistical software. Risk factors were evaluated using the Chi-square test for categorical variables and Pearson correlation coefficients were used for continuous variables. The study was approved by the Israeli Defense Force IRB. A total of 2,692 soldiers were diagnosed with OB during the study period. The crude annual incidence rate of OB was 29/100,000 person-years (PY). Combat duty had an incidence of 97/100,000 PY, and noncombat duties had an incidence of 12/10,000 PY (p < 0.001). Female incidence (8.4/100,000 PY) was similar to male incidence (11/100,000 PY) in administrative duties (p = 0.54). More cases were diagnosed during summer and autumn than in other seasons (p = 0.016). Septic bursitis constituted 24% of all cases, was more frequent in combat soldiers (32%), and on average presented earlier in service than noninfectious OB (13 vs. 17 weeks since recruitment). The mean duration of symptoms was estimated at 17.58 weeks, with a mean of 1.75 physician visits per soldier. About 19% received a specialist referral. Origin from the former USSR was associated with a higher duration of symptoms (p = 0.012). Type of military service was the principal risk factor for OB, as indicated by a higher incidence of the disorder among combat compared to noncombat units, possibly the result of field training without protective gear and repetitive trauma to elbows. The greater number of diagnoses of OB during summer and autumn, when training is more intensive, support that explanation. Sex did not affect incidence of OB in administrative units. The medical burden appears to be relatively low, since most of the soldiers had only one physician visit. OB is highly prevalent in military compared to civilian populations. Outdoor training involving crawling is a probable explanation for the much higher rates among combat units and increased number of diagnoses during warm summer and autumn months. Prevention by use of protective gear seems to be the most promising intervention. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Trends Analysis of rhBMP Utilization in Single-Level Posterior Lumbar Interbody Fusion in the United States

PubMed Central

Lao, Lifeng; Cohen, Jeremiah R.; Brodke, Darrel S.; Youssef, Jim A.; Park, Jong-Beom; Yoon, S. Tim; Wang, Jeffrey C.; Meisel, Hans-Joerg

2017-01-01

Study Design: Retrospective study. Objectives: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used in spinal fusion surgery, but there is little information on rhBMP-2 utilization in single-level posterior lumbar interbody fusion (PLIF). The purpose of our study was to evaluate the trends and demographics of rhBMP-2 utilization in single-level PLIF. Methods: Patients who underwent single-level PLIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database, a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were recorded for each patient. Results were reported for each variable as the incidence of procedures identified per 100 000 patients searched in the database. Results: A total of 2735 patients had single-level PLIF. The average rate of single-level PLIF with rhBMP-2 maintained at a relatively stable level (28% to 31%) from 2005 to 2009, but decreased in 2010 (9.9%) and 2011 (11.8%). The overall incidence of single-level PLIF without rhBMP-2 (0.68 cases per 100 000 patients) was statistically higher (P < .01) compared to single-level PLIF with rhBMP-2 (0.21 cases per 100 000 patients). The average rate of single-level PLIF with rhBMP-2 utilization was the highest in West (30.1%), followed by Midwest (26.9%), South (20.5%), and Northeast (17.8%). The highest incidence of single-level PLIF with rhBMP-2 was observed in the age group <65 years (0.3 per 100 000 patients). Conclusions: To our knowledge, this is the first study to report on the demographics associated with rhBMP-2 use in single-level PLIF. There was a 3-fold increase in the rate of PLIF without rhBMP-2 compared to PLIF with rhBMP-2, with both procedures being mainly done in patients less than 65 years of age. PMID:28989840

Trends Analysis of rhBMP Utilization in Single-Level Posterior Lumbar Interbody Fusion in the United States.

PubMed

Lao, Lifeng; Cohen, Jeremiah R; Buser, Zorica; Brodke, Darrel S; Youssef, Jim A; Park, Jong-Beom; Yoon, S Tim; Wang, Jeffrey C; Meisel, Hans-Joerg

2017-10-01

Retrospective study. Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used in spinal fusion surgery, but there is little information on rhBMP-2 utilization in single-level posterior lumbar interbody fusion (PLIF). The purpose of our study was to evaluate the trends and demographics of rhBMP-2 utilization in single-level PLIF. Patients who underwent single-level PLIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database, a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were recorded for each patient. Results were reported for each variable as the incidence of procedures identified per 100 000 patients searched in the database. A total of 2735 patients had single-level PLIF. The average rate of single-level PLIF with rhBMP-2 maintained at a relatively stable level (28% to 31%) from 2005 to 2009, but decreased in 2010 (9.9%) and 2011 (11.8%). The overall incidence of single-level PLIF without rhBMP-2 (0.68 cases per 100 000 patients) was statistically higher ( P < .01) compared to single-level PLIF with rhBMP-2 (0.21 cases per 100 000 patients). The average rate of single-level PLIF with rhBMP-2 utilization was the highest in West (30.1%), followed by Midwest (26.9%), South (20.5%), and Northeast (17.8%). The highest incidence of single-level PLIF with rhBMP-2 was observed in the age group <65 years (0.3 per 100 000 patients). To our knowledge, this is the first study to report on the demographics associated with rhBMP-2 use in single-level PLIF. There was a 3-fold increase in the rate of PLIF without rhBMP-2 compared to PLIF with rhBMP-2, with both procedures being mainly done in patients less than 65 years of age.

[Comparison study on locking compress plate external fixator and standard external fixator for treatment of tibial open fractures].

PubMed

Wu, Gang; Luo, Xiaozhong; Tan, Lun; Lin, Xu; Wu, Chao; Guo, Yong; Zhong, Zewei

2013-11-01

To compare the clinical results of locking compress plate (LCP) as an external fixator and standard external fixator for treatment of tibial open fractures. Between May 2009 and June 2012, 59 patients with tibial open fractures were treated with LCP as an external fixator in 36 patients (group A), and with standard external fixator in 23 patients (group B). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, location, and interval between injury and surgery between 2 groups (P > 0.05). The time of fracture healing and incision healing, the time of partial weight-bearing, the range of motion (ROM) of knee and ankle, and complications were compared between 2 groups. The incidence of pin-track infection in group A (0) was significantly lower than that in group B (21.7%) (P=0.007). No significant difference was found in the incidence of superficial infection and deep infection of incision, and the time of incision healing between 2 groups (P > 0.05). Deep vein thrombosis occurred in 5 cases of group A and 2 cases of group B, showing no significant difference (Chi(2)=0.036, P=0.085). All patients were followed up 15.2 months on average (range, 9-28 months) in group A, and 18.6 months on average (range, 9-47 months) in group B. The malunion rate and nonunion rate showed no significant difference between groups A and B (0 versus 13.0% and 0 versus 8.7%, P > 0.05); the delayed union rate of group A (2.8%) was significantly lower than that of group B (21.7%) (Chi(2)=5.573, P=0.018). Group A had shorter time of fracture healing, quicker partial weight-bearing, greater ROM of the knee and ankle than group B (P < 0.05). The LCP external fixator can obtain reliable fixation in treating tibial open fracture, and has good patients' compliance, so it is helpful to do functional exercise, improve fracture healing and function recovery, and reduce the complication incidence.

Patterns and Trends of Liver Cancer Incidence Rates in Eastern and Southeastern Asian Countries (1983-2007) and Predictions to 2030.

PubMed

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.

Short-Term Effects of Climatic Variables on Hand, Foot, and Mouth Disease in Mainland China, 2008–2013: A Multilevel Spatial Poisson Regression Model Accounting for Overdispersion

PubMed Central

Yang, Fang; Yang, Min; Hu, Yuehua; Zhang, Juying

2016-01-01

Background Hand, Foot, and Mouth Disease (HFMD) is a worldwide infectious disease. In China, many provinces have reported HFMD cases, especially the south and southwest provinces. Many studies have found a strong association between the incidence of HFMD and climatic factors such as temperature, rainfall, and relative humidity. However, few studies have analyzed cluster effects between various geographical units. Methods The nonlinear relationships and lag effects between weekly HFMD cases and climatic variables were estimated for the period of 2008–2013 using a polynomial distributed lag model. The extra-Poisson multilevel spatial polynomial model was used to model the exact relationship between weekly HFMD incidence and climatic variables after considering cluster effects, provincial correlated structure of HFMD incidence and overdispersion. The smoothing spline methods were used to detect threshold effects between climatic factors and HFMD incidence. Results The HFMD incidence spatial heterogeneity distributed among provinces, and the scale measurement of overdispersion was 548.077. After controlling for long-term trends, spatial heterogeneity and overdispersion, temperature was highly associated with HFMD incidence. Weekly average temperature and weekly temperature difference approximate inverse “V” shape and “V” shape relationships associated with HFMD incidence. The lag effects for weekly average temperature and weekly temperature difference were 3 weeks and 2 weeks. High spatial correlated HFMD incidence were detected in northern, central and southern province. Temperature can be used to explain most of variation of HFMD incidence in southern and northeastern provinces. After adjustment for temperature, eastern and Northern provinces still had high variation HFMD incidence. Conclusion We found a relatively strong association between weekly HFMD incidence and weekly average temperature. The association between the HFMD incidence and climatic variables spatial heterogeneity distributed across provinces. Future research should explore the risk factors that cause spatial correlated structure or high variation of HFMD incidence which can be explained by temperature. When analyzing association between HFMD incidence and climatic variables, spatial heterogeneity among provinces should be evaluated. Moreover, the extra-Poisson multilevel model was capable of modeling the association between overdispersion of HFMD incidence and climatic variables. PMID:26808311

Short-Term Effects of Climatic Variables on Hand, Foot, and Mouth Disease in Mainland China, 2008-2013: A Multilevel Spatial Poisson Regression Model Accounting for Overdispersion.

PubMed

Liao, Jiaqiang; Yu, Shicheng; Yang, Fang; Yang, Min; Hu, Yuehua; Zhang, Juying

2016-01-01

Hand, Foot, and Mouth Disease (HFMD) is a worldwide infectious disease. In China, many provinces have reported HFMD cases, especially the south and southwest provinces. Many studies have found a strong association between the incidence of HFMD and climatic factors such as temperature, rainfall, and relative humidity. However, few studies have analyzed cluster effects between various geographical units. The nonlinear relationships and lag effects between weekly HFMD cases and climatic variables were estimated for the period of 2008-2013 using a polynomial distributed lag model. The extra-Poisson multilevel spatial polynomial model was used to model the exact relationship between weekly HFMD incidence and climatic variables after considering cluster effects, provincial correlated structure of HFMD incidence and overdispersion. The smoothing spline methods were used to detect threshold effects between climatic factors and HFMD incidence. The HFMD incidence spatial heterogeneity distributed among provinces, and the scale measurement of overdispersion was 548.077. After controlling for long-term trends, spatial heterogeneity and overdispersion, temperature was highly associated with HFMD incidence. Weekly average temperature and weekly temperature difference approximate inverse "V" shape and "V" shape relationships associated with HFMD incidence. The lag effects for weekly average temperature and weekly temperature difference were 3 weeks and 2 weeks. High spatial correlated HFMD incidence were detected in northern, central and southern province. Temperature can be used to explain most of variation of HFMD incidence in southern and northeastern provinces. After adjustment for temperature, eastern and Northern provinces still had high variation HFMD incidence. We found a relatively strong association between weekly HFMD incidence and weekly average temperature. The association between the HFMD incidence and climatic variables spatial heterogeneity distributed across provinces. Future research should explore the risk factors that cause spatial correlated structure or high variation of HFMD incidence which can be explained by temperature. When analyzing association between HFMD incidence and climatic variables, spatial heterogeneity among provinces should be evaluated. Moreover, the extra-Poisson multilevel model was capable of modeling the association between overdispersion of HFMD incidence and climatic variables.