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Sample records for diagnostic prevalence rates

  1. Facet joint pain in chronic spinal pain: an evaluation of prevalence and false-positive rate of diagnostic blocks.

    PubMed

    Manchukonda, Rajeev; Manchikanti, Kavita N; Cash, Kimberly A; Pampati, Vidyasagar; Manchikanti, Laxmaiah

    2007-10-01

    A retrospective review. Evaluation of the prevalence of facet or zygapophysial joint pain in chronic spinal pain of cervical, thoracic, and lumbar origin by using controlled, comparative local anesthetic blocks and evaluation of false-positive rates of single blocks in the diagnosis of chronic spinal pain of facet joint origin. Facet or zygapophysial joints are clinically important sources of chronic cervical, thoracic, and lumbar spine pain. The previous studies have demonstrated the value and validity of controlled, comparative local anesthetic blocks in the diagnosis of facet joint pain, with a prevalence of 15% to 67% variable in lumbar, thoracic, and cervical regions. False-positive rates of single diagnostic blocks also varied from 17% to 63%. Five hundred consecutive patients receiving controlled, comparative local anesthetic blocks of medial branches for the diagnosis of facet or zygapophysial joint pain were included. Patients were investigated with diagnostic blocks using 0.5 mL of 1% lidocaine per nerve. Patients with lidocaine-positive results were further studied using 0.5 mL of 0.25% bupivacaine per nerve on a separate occasion. Medial branch blocks were performed with intermittent fluoroscopic visualization, at 2 levels to block a single joint. A positive response was considered as one with at least 80% pain relief from a block of at least 2 hours duration when lidocaine was used, and at least 3 hours or longer than the duration of relief with lidocaine when bupivacaine was used, and also the ability to perform prior painful movements. A total of 438 patients met inclusion criteria. The prevalence of facet joint pain was 39% in the cervical spine [95% confidence interval (CI), 32%-45%]; 34% (95% CI, 22%-47%) in the thoracic pain; and 27% (95% CI, 22%-33%) in the lumbar spine. The false-positive rate with a single block in the cervical region was 45%, in the thoracic region was 42%, and in the lumbar region 45%. This retrospective review once again

  2. [Pedophilia. Prevalence, etiology, and diagnostics].

    PubMed

    Mokros, A; Osterheider, M; Nitschke, J

    2012-03-01

    Pedophilia is a disorder of sexual preference that increases the risk for committing sexual offenses against children. Consequently, pedophilia is not only relevant in psychiatric therapy and prognostics, but also greatly influences the public attitude towards criminality. Public opinion seems to equate pedophilia with child sexual abuse and vice versa which leads to stigmatization of patients and may impede treatment. The present paper provides information on recent studies on the potential origins of the disorder and introduces new diagnostic methods. Moreover, the article presents estimates on the prevalence of pedophilic sexual interest.

  3. Diagnostic Prevalence Rates from Early to Mid-Adolescence among Indigenous Adolescents: First Results from a Longitudinal Study

    ERIC Educational Resources Information Center

    Whitbeck, Les B.; Yu, Mansoo; Johnson, Kurt D.; Hoyt, Dan R.; Walls, Melissa L.

    2008-01-01

    The study investigates change in occurrences for mental and substance abuse children between early and mid-adolescence among a group of indigenous adolescents. Findings show a dramatic increase in occurrence rates for substance abuse disorder and conduct disorder, and a mental health crisis on indigenous reservations and reserves indicating a need…

  4. Trends in autism prevalence: diagnostic substitution revisited.

    PubMed

    Coo, Helen; Ouellette-Kuntz, Hélène; Lloyd, Jennifer E V; Kasmara, Liza; Holden, Jeanette J A; Lewis, M E Suzanne

    2008-07-01

    There has been little evidence to support the hypothesis that diagnostic substitution may contribute to increases in the administrative prevalence of autism. We examined trends in assignment of special education codes to British Columbia (BC) school children who had an autism code in at least 1 year between 1996 and 2004, inclusive. The proportion of children with an autism code increased from 12.3/10,000 in 1996 to 43.1/10,000 in 2004; 51.9% of this increase was attributable to children switching from another special education classification to autism (16.0/10,000). Taking into account the reverse situation (children with an autism code switching to another special education category (5.9/10.000)), diagnostic substitution accounted for at least one-third of the increase in autism prevalence over the study period.

  5. Prevalence Rates of Mental Disorders in Chilean Prisons

    PubMed Central

    Mundt, Adrian P.; Alvarado, Rubén; Fritsch, Rosemarie; Poblete, Catalina; Villagra, Carolina; Kastner, Sinja; Priebe, Stefan

    2013-01-01

    Objective High rates of mental disorders have been reported for prison populations worldwide, particularly in low- and middle-income countries (LMICs). The present study aimed to establish prevalence rates of mental disorders in Chilean prisoners. Method A nationwide random sample of 1008 prisoners was assessed in 7 penal institutions throughout Chile. Twelve-month prevalence rates were established using the Composite International Diagnostic Interview (CIDI) and compared to the prevalence rates previously published for the general population. Results Prevalence rates were 12.2% (95% CI, 10.2-14.1) for any substance use disorder, 8.3% (6.6-10.0) for anxiety disorders, 8.1% (6.5-9.8) for affective disorders, 5.7% (4.4-7.1) for intermittent explosive disorders, 2.2% (1.4-3.2) for ADHD of the adult, and 0.8% (0.3-1.3) for non-affective psychoses. Significantly higher prevalence rates among prisoners as compared to the general population in Chile were seen for major depression (6.1% vs. 3.7% males, Z=2.58, p<0.05) and illicit drug use (3.3% vs. 0.6% males with drug abuse, Z=2.04, p<0.05; 2.6% vs. 0.1% females with drug abuse, Z=5.36, p<0.001; 3.4% vs. 1.1% males with drug dependence, Z=3.70; p<0.001). Dysthymia (6.5% vs. 15.6%, Z=-2.39, p<0.05), simple (3.3% vs. 11.5%, Z=-3.13, p<0.001) and social phobias (3.9% vs. 9.7%, Z=2.38, p<0.05) were significantly less frequent in the female prison population than in the general population. One-year prevalence rates of alcohol abuse (2.3% vs. 3.9%; Z=-2.04; p<0.05) and dependence (2.7% vs. 8.2%; Z=-5.24; p<0.001) were less prevalent in the male prison population than in the general population. Conclusions Service provision for prison populations in Chile should acknowledge high rates of depression and illicit drug use. Overall prevalence rates are lower than reported in other LMICs. Previous research in prison populations in LMICs might have overestimated prevalence rates of mental disorders. PMID:23894415

  6. The Broad Autism Phenotype Questionnaire: Prevalence and Diagnostic Classification

    PubMed Central

    Sasson, Noah J.; Lam, Kristen S. L.; Childress, Debra; Parlier, Morgan; Daniels, Julie L.; Piven, Joseph

    2013-01-01

    The Broad Autism Phenotype Questionnaire (BAPQ; Hurley et al, 2007) was administered to a large community-based sample of biological parents of children with autism (PCAs) and comparison parents (CPs) (n = 1692). Exploratory factor analysis and internal consistency parameters confirmed a robust three factor structure of the BAPQ, corresponding to the proposed aloof, pragmatic language and rigidity subscales. Based upon the distribution of BAP features in the general population, new normative cutoff values for BAPQ subscales were established that provide increased specificity relative to those previously reported (Hurley et al, 2007), and thus enhance the utility of the BAPQ for diagnostically classifying the BAP. These cutoffs were also used to estimate prevalence of the BAP and its three components, with rates ranging between 14 – 23% for PCAs and between 5 – 9% for CPs. Analysis of patterns of BAP characteristics within family members revealed that BAP features were more likely to co-occur in PCAs relative to CPs. Collectively, these findings extend the utility of the BAPQ and provide additional evidence that it is an efficient and reliable tool for disaggregating the heterogeneity of autism through the identification of meaningful subgroups of parents. PMID:23427091

  7. Prevalence Rates of Attention Deficit/Hyperactivity Disorder in a School Sample of Venezuelan Children

    ERIC Educational Resources Information Center

    Montiel, Cecilia; Pena, Joaquin A.; Montiel-Barbero, Isabel; Polanczyk, Guilherme

    2008-01-01

    A total of 1,535 4-12 year-old children were screened with the Conners' rating scales, followed by diagnostic confirmation by the diagnostic interview schedule for children-IV-parent version. The prevalence of ADHD was estimated to be 10.03%, and only 3.9% of children had received medication for the treatment of ADHD symptoms. Prevalence rates and…

  8. [Orthorectic eating behaviour - nosology and prevalence rates].

    PubMed

    Barthels, Friederike; Pietrowsky, Reinhard

    2012-12-01

    Orthorectic eating behaviour is characterised by a fixation on a healthy diet and rigidity regarding self-imposed nutrition standards. Besides malnutrition, subjective distress and social isolation might be consequences of clinical relevance. So far there are few reliable data about nosology and prevalence rates, so that it is not yet possible to evaluate the clinical significance of orthorectic eating behaviour. This article discusses nosological classifications of orthorexia and presents prevalence rates of extremely healthy eating behaviour in general population as well as in several specific subgroups. To summarise, orthorectic eating behaviour seems to be most likely an eating disorder with healthy dieting as an overvalued idea. Data on prevelance of orthorectic eating behaviour, assessed with the recently developed Düsseldorfer Orthorexie Skala, suggest a rate of 1 to 2% in general population. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Increasing Prevalence Rate of Nontuberculous Mycobacteria ...

    EPA Pesticide Factsheets

    Rationale: Many nontuberculous mycobacteria (NTM) are clinically significant pathogens that cause disease in a variety of different human organs and tissues. Objectives: A population-based study was undertaken to investigate the prevalence of patients with a positive specimen for NTM within five states of the United States. Methods: We determined the case and age distribution of patients with at least one specimen positive for NTM, using data submitted to the disease surveillance systems of five states (Maryland, Mississippi, Missouri, Ohio, and Wisconsin) between 2008 and 2013. Crude, age-specific, and age-adjusted prevalence rates per 100,000 persons were calculated for each state. Measurements and Main Results: From 2008 to 2013, a total of 24,226 NTM cases were reported to the disease surveillance systems of the five states. The overall average annual age-adjusted prevalence rate rose from 8.7 to 13.9 per 100,000 persons between the beginning and end of the surveillance period. The number of cases and case rate in the 50–80+-year age group was higher than in the 0–49-year age group. Prevalence by age category differed among the five states. The highest number of NTM cases was observed in Mississippi for the 80+-year age group, whereas Wisconsin observed the highest number of NTM cases in the 60- to 69-year age group. Conclusions: From 2008 to 2013, the number of patients with positive specimens for NTM rose. This trend is likely to continue in the co

  10. Fetal alcohol spectrum disorders: Prevalence rates in South Africa.

    PubMed

    Olivier, L; Curfs, L M G; Viljoen, D L

    2016-05-25

    Fetal alcohol spectrum disorder (FASD) is an under-diagnosed condition in South Africa (SA). Fetal alcohol syndrome and FASD community prevalence studies were undertaken in 17 towns in three of the nine provinces in SA. The objective for all the studies was to determine the FASD prevalence rates by assessing the grade 1 learners in all the studies, using international FASD diagnostic criteria. The same methodology was used for all the studies in Gauteng, Western and Northern Cape provinces. Consenting grade 1 learners received anthropometric screening, clinical examinations and neurodevelopmental assessments. Structured interviews were used to assess maternal alcohol consumption during pregnancy. Reported prevalence rates ranged from 29 to 290 per 1 000 live births. FASD rates from studies conducted in SA are among the highest worldwide. FASD affects all communities in SA and is therefore a major public health concern in SA. Multidisciplinary and intersectoral interventions are urgently required to raise awareness about the dangers of prenatal alcohol exposure and the devastating effect of FASD on the lives of children, families and communities.

  11. [Anemia and iron deficiency in the elderly. Prevalence, diagnostics and new therapeutic options].

    PubMed

    Röhrig, G; Doehner, W; Schaefer, R M; Schulz, R J

    2012-04-01

    The prevalence of anemia in geriatric patients is high. With some variation in different patient cohorts, prevalence of anemia can reach 40%. Anemia is not an age-related disease on its own, but is a symptom with multifactorial genesis and high risk potential. It directly influences mortality, morbidity, and the rate of hospitalization, particularly in older patients suffering from chronic heart failure or chronic kidney disease. The high prevalence of anemia in chronic kidney disease is explained by a combination of erythropoietin and iron deficiency. This review summarizes the recommendations of the iron symposium at the 2010 German Geriatric Society Meeting in Potsdam, Germany. It intends to provide current information on prevalence, diagnostic work-up, and therapeutic options for anemia in the rapidly growing group of elderly patients.

  12. [Prevalence of dissocial conduct disorder in adolescents using an epidemiological diagnostic questionnaire].

    PubMed

    Pineda, D A; Puerta, I C

    Prevalence of Conduct Disorder has been calculated between 4 to 10%. To estimate the prevalence CD in Colombian adolescents, using a rating scale by self report. 190 male adolescents from secondary school population, 12 to 16 year-old, were stratified and selected in a randomizing procedure, from Medellín, Colombia. A checklist including 14 diagnostic symptoms taken from the DSM-IV Criterion A for CD was constructed, with a scale of 0 = never to 3 = almost always (Reliability alpha coefficient: 0.86). Prevalences were calculated as follow: (1) codifying as 'Probable TDC' a T score over 60; (2) codifying as Adolescent Antisocial Behavior (AAB) having three or more answers qualified with 1 or more points, and (3) codifying as CD obtaining three or more answers qualified with 2 or 3 points. The most prevalent CD symptoms were 'staying out at night before 13 year-old' (10.5%), 'having been cruel to animals' (8.4%), 'having been cruel to people' (7.4%), 'having broken into someone else's house or car' (7.3%), and 'using weapon or other objects that can cause serious physical harm to others' (6.9%). The prevalence of 'Probable CD' was 13.7%; prevalence of AAB was 56.8% and prevalence of CD was 8.4%. It was not found significant differences between socioeconomic strata. The prevalence of CD in the studied sample was 8.4%, independent of the socioeconomic strata.

  13. Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study

    PubMed Central

    Forni Ogna, Valentina; Ogna, Adam; Pruijm, Menno; Bassi, Isabelle; Zuercher, Emilie; Halabi, Georges; Phan, Olivier; Bullani, Roberto; Teta, Daniel; Gauthier, Thierry; Cherpillod, Anne; Mathieu, Claudine; Mihalache, Alexandra; Cornette, Francoise; Haba-Rubio, José; Burnier, Michel; Heinzer, Raphaël

    2015-01-01

    Background. Previous observations found a high prevalence of obstructive sleep apnea (OSA) in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. Methods. 104 patients from 6 Swiss hemodialysis centers underwent polygraphy and completed 3 OSA screening scores: STOP-BANG, Berlin's Questionnaire, and Adjusted Neck Circumference. The OSA predictors were identified on a derivation population and used to develop the diagnostic algorithm, which was validated on an independent population. Results. We found 56% OSA prevalence (AHI ≥ 15/h), which was largely underdiagnosed. Screening scores showed poor performance for OSA screening (ROC areas 0.538 [SE 0.093] to 0.655 [SE 0.083]). Age, neck circumference, and time on renal replacement therapy were the best predictors of OSA and were used to develop a screening algorithm, with higher discriminatory performance than classical screening tools (ROC area 0.831 [0.066]). Conclusions. Our study confirms the high OSA prevalence and highlights the low diagnosis rate of this treatable cardiovascular risk factor in the hemodialysis population. Considering the poor performance of OSA screening tools, we propose and validate a specific algorithm to identify hemodialysis patients at risk for OSA for whom further sleep investigations should be considered. PMID:26229952

  14. Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study.

    PubMed

    Forni Ogna, Valentina; Ogna, Adam; Pruijm, Menno; Bassi, Isabelle; Zuercher, Emilie; Halabi, Georges; Phan, Olivier; Bullani, Roberto; Teta, Daniel; Gauthier, Thierry; Cherpillod, Anne; Mathieu, Claudine; Mihalache, Alexandra; Cornette, Francoise; Haba-Rubio, José; Burnier, Michel; Heinzer, Raphaël

    2015-01-01

    Previous observations found a high prevalence of obstructive sleep apnea (OSA) in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. 104 patients from 6 Swiss hemodialysis centers underwent polygraphy and completed 3 OSA screening scores: STOP-BANG, Berlin's Questionnaire, and Adjusted Neck Circumference. The OSA predictors were identified on a derivation population and used to develop the diagnostic algorithm, which was validated on an independent population. We found 56% OSA prevalence (AHI ≥ 15/h), which was largely underdiagnosed. Screening scores showed poor performance for OSA screening (ROC areas 0.538 [SE 0.093] to 0.655 [SE 0.083]). Age, neck circumference, and time on renal replacement therapy were the best predictors of OSA and were used to develop a screening algorithm, with higher discriminatory performance than classical screening tools (ROC area 0.831 [0.066]). Our study confirms the high OSA prevalence and highlights the low diagnosis rate of this treatable cardiovascular risk factor in the hemodialysis population. Considering the poor performance of OSA screening tools, we propose and validate a specific algorithm to identify hemodialysis patients at risk for OSA for whom further sleep investigations should be considered.

  15. Gambling disorder: estimated prevalence rates and risk factors in Macao.

    PubMed

    Wu, Anise M S; Lai, Mark H C; Tong, Kwok-Kit

    2014-12-01

    An excessive, problematic gambling pattern has been regarded as a mental disorder in the Diagnostic and Statistical Manual for Mental Disorders (DSM) for more than 3 decades (American Psychiatric Association [APA], 1980). In this study, its latest prevalence in Macao (one of very few cities with legalized gambling in China and the Far East) was estimated with 2 major changes in the diagnostic criteria, suggested by the 5th edition of DSM (APA, 2013): (a) removing the "Illegal Act" criterion, and (b) lowering the threshold for diagnosis. A random, representative sample of 1,018 Macao residents was surveyed with a phone poll design in January 2013. After the 2 changes were adopted, the present study showed that the estimated prevalence rate of gambling disorder was 2.1% of the Macao adult population. Moreover, the present findings also provided empirical support to the application of these 2 recommended changes when assessing symptoms of gambling disorder among Chinese community adults. Personal risk factors of gambling disorder, namely being male, having low education, a preference for casino gambling, as well as high materialism, were identified.

  16. Prevalence rates for diabetes mellitus in Puerto Rico.

    PubMed

    Haddock, L; de Conty, I T

    1991-07-01

    The aim of this study was to analyze prevalence data for diabetes mellitus obtained from a household interview of a random sample of the general population by the Department of Health of the Commonwealth of Puerto Rico for the years 1975-1986. Details of the prevalence rate by sex and age were analyzed for the years 1981, 1984, 1985, and 1986 and for the urban and rural population in 1985. The mean prevalence rate of known cases of diabetes showed a tendency to increase from 3.1% in 1975 to 5.1% in 1986. Prevalence rates adjusted for age and sex showed an increase in the mean prevalence for 1986 compared with that of 1981. The prevalence rate was significantly higher for the rural population for the age-group 45-64 yr old and for the urban population for the age-group greater than or equal to 65 yr. The prevalence rate compares with that of Mexican Americans and Puerto Ricans in the New York City area. On the basis of the prevalence data, approximately 90% of the diabetic population is non-insulin dependent and 10% are insulin dependent. Major risk factors thought to explain the increased prevalence of non-insulin-dependent diabetes are increasing longevity of the Puerto Rican population, genetic predisposition, obesity, and changes in life-styles. In conclusion, Puerto Ricans, as other Hispanic Americans, have a higher prevalence of diabetes than the white American population.

  17. Plasma erosion rate diagnostics using laser-induced fluorescence

    NASA Technical Reports Server (NTRS)

    Gaeta, C. J.; Turley, R. S.; Matossian, J. N.; Beattie, J. R.; Williamson, W. S.

    1992-01-01

    An optical technique for measuring the sputtering rate of a molybdenum surface immersed in a xenon plasma has been developed and demonstrated. This approach, which may be useful in real-time wear diagnostics for ion thrusters, relies on laser-induced fluorescence to determine the density of sputtered molybdenum atoms.

  18. Depression With Atypical Features: Diagnostic Validity, Prevalence, and Treatment.

    PubMed

    Quitkin, Frederic M.

    2002-06-01

    Depression with atypical features is a treatable and relatively common disorder among depressed outpatients. A growing body of evidence suggests this is a biologically distinct subtype of depression. This assertion is supported by genetic epidemiologic studies and by a preferential response of the subtype to monoamine oxidase inhibitors compared with tricyclic antidepressants. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) includes atypical features as a parenthetical modifier for depressive illness. According to DSM-IV diagnostic criteria ("atypical features" specifier), the disorder is primarily characterized by 2 or more of the following symptoms as predominant features in patients with major depression or dysthymic disorder: overeating, oversleeping, "leaden paralysis," and interpersonal rejection sensitivity. Patients also show mood reactivity in response to actual or potential positive events. Despite aspects of the disorder resembling a maladaptive, persistent mode of behavior, patients diagnosed with depression with atypical features demonstrate a good response to antidepressant treatment.

  19. College students' perceived disease risk versus actual prevalence rates.

    PubMed

    Smith, Matthew Lee; Dickerson, Justin B; Sosa, Erica T; J McKyer, E Lisako; Ory, Marcia G

    2012-01-01

    To compare college students' perceived disease risk with disease prevalence rates. Data were analyzed from 625 college students collected with an Internet-based survey. Paired t-tests were used to separately compare participants' perceived 10-year and lifetime disease risk for 4 diseases: heart disease, cancer, diabetes, and overweight/obesity. Respondents estimated their risk of developing heart disease as lower than cancer, yet rated their risk of developing heart disease as higher than diabetes and being overweight/obese. Incongruence between college students' perceived disease risk and disease prevalence rates calls for improved public health education.

  20. Prevalence of Giardia spp. in young dogs using a combination of two diagnostic methods.

    PubMed

    Alves, João; Santos, Ana

    2016-03-01

    In this study, prevalence of the protozoan parasites from the genus Giardia spp, with zoonotic potential and worldwide dissemination, was accessed in young dogs, which are reported as having higher prevalence rates. With that purpose, 49 animals from the Grupo de Intervenção Cinotécnico of the Guarda Nacional Republicana (Portuguese Gendarmerie Canine Unit) were chosen. They were housed individually in areas with a high number of kennels (up to 100), with ages ragging from newborns to 10 years old. Dogs were divided in four groups, according their age: under 6 months (n = 16), 6-12 months (n = 6), 12-18 months (n = 13) and 18-24 months (n = 14), comprising 22 females and 27 males. Fecal samples were collected from every animal and all were submitted to two different diagnostic tests, a passive flotation technique with a ZnSO4 solution and a detection of fecal antigen using a commercially available ELISA test (Witness® Giardia - Zoetis). From the 49 samples, 5 (10.2%) were considered positive with ZnSO4 flotation technique and 6 (12.24%) with the Witness® Giardia test. When considering the combination of both tests, 5 animals (10.2%) were considered positive. Of these, 3 (60%) were from the group under 6 months old, 1 (20%) from the 6-12 months and 1 from the 18-24 (20%) months. Within each group, in the under 6 months group 18.75% (n = 16) were considered positive, 16.67% in the 6-12 month group (n = 6), 0% in the 12-18 month group (n=13) and 7.14% in 18-24 month group (n = 14). None of the animals had clinical signs and no significant differences were found when comparing prevalence according to age, breed or gender. A combination of fecal flotation and antigen ELISA tests have good sensitivity and are easy to perform in practice and, therefore, could be a good choice to perform a diagnostic and small animal veterinarians should have this possible diagnostic in mind when in the present of clinical signs, particularly in young dogs.

  1. College Students' Perceived Disease Risk versus Actual Prevalence Rates

    ERIC Educational Resources Information Center

    Smith, Matthew Lee; Dickerson, Justin B.; Sosa, Erica T.; McKyer, E. Lisako J.; Ory, Marcia G.

    2012-01-01

    Objective: To compare college students' perceived disease risk with disease prevalence rates. Methods: Data were analyzed from 625 college students collected with an Internet-based survey. Paired t-tests were used to separately compare participants' perceived 10-year and lifetime disease risk for 4 diseases: heart disease, cancer, diabetes, and…

  2. College Students' Perceived Disease Risk versus Actual Prevalence Rates

    ERIC Educational Resources Information Center

    Smith, Matthew Lee; Dickerson, Justin B.; Sosa, Erica T.; McKyer, E. Lisako J.; Ory, Marcia G.

    2012-01-01

    Objective: To compare college students' perceived disease risk with disease prevalence rates. Methods: Data were analyzed from 625 college students collected with an Internet-based survey. Paired t-tests were used to separately compare participants' perceived 10-year and lifetime disease risk for 4 diseases: heart disease, cancer, diabetes, and…

  3. Implementing personalized medicine with asymmetric information on prevalence rates.

    PubMed

    Antoñanzas, Fernando; Juárez-Castelló, Carmelo A; Rodríguez-Ibeas, Roberto

    2016-12-01

    Although personalized medicine is becoming the new paradigm to manage some diseases, the economics of personalized medicine have only focused on assessing the efficiency of specific treatments, lacking a theoretical framework analyzing the interactions between pharmaceutical firms and healthcare systems leading to the implementation of personalized treatments. We model the interaction between the hospitals and the manufacturer of a new treatment as an adverse selection problem where the firm does not have perfect information on the prevalence across hospitals of the genetic characteristics of the patients making them eligible to receive a new treatment. As a result of the model, hospitals with high prevalence rates benefit from the information asymmetry only when the standard treatment is inefficient when applied to the patients eligible to receive the new treatment. Otherwise, information asymmetry has no value. Personalized medicine may be fully or partially implemented depending on the proportion of high prevalence hospitals.

  4. Diagnostic interview study of the prevalence of depression among public employees engaged in long-term relief work in Fukushima.

    PubMed

    Maeda, Masaharu; Ueda, Yukiko; Nagai, Masato; Fujii, Senta; Oe, Misari

    2016-09-01

    The Great East Japan Earthquake and in particular, the Fukushima Daiichi Nuclear Power Plant accident, have had a serious psychological impact on not only residents, but also relief workers in Fukushima. Although public employees work in highly stressful situations and play a very important role in long-term relief, their psychiatric features have yet to be clarified. The two aims of this study were to identify the current prevalence rate of depression and post-traumatic stress disorder among public employees working in the disaster area using diagnostic interviews, and to speculate on the psychosocial factors affecting their mental condition. We conducted diagnostic interviews and self-administered questionnaires with 168 public employees working in two coastal towns in Fukushima. Results showed that the current prevalence of depression among public employees is as high as 17.9%, in contrast to the relatively low prevalence of post-traumatic stress disorder (4.8%). Based on the results of self-administered questionnaires and interview contents, frequent exposure to strong complaints or anger from residents and role conflicts were considered the cause of the high prevalence of depression. The present study reveals the serious mental status of public employees working in Fukushima and sheds light on the urgent need to establish an efficient care network to provide adequate psychiatric intervention. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  5. Prevalence of Autism Spectrum Disorder in Children Referred for Diagnostic Autism Evaluation.

    PubMed

    Monteiro, Sonia A; Spinks-Franklin, Adiaha; Treadwell-Deering, Diane; Berry, Leandra; Sellers-Vinson, Sherry; Smith, Eboni; Proud, Monica; Voigt, Robert G

    2015-12-01

    Increased public awareness of autism spectrum disorders (ASD) and routine screening in primary care have contributed to increased requests for diagnostic ASD evaluations. However, given the scarcity of subspecialty autism diagnostic resources, overreferral of children suspected of having ASD may be contributing to long waiting lists at tertiary care autism centers and delaying diagnosis for those children who truly have ASD. To determine whether children are being excessively referred to ASD-specific diagnostic clinics, our objective was to determine the prevalence of true ASD diagnoses in children referred for diagnostic ASD evaluation. Charts of all patients referred to a regional autism center between April 2011 and August 2012 for suspicion of a possible ASD were retrospectively reviewed and demographic and clinical diagnoses abstracted. Only 214 of 348 patients evaluated (61%) received an ASD diagnosis. Thus, concerns about autism are not confirmed by an ASD diagnosis in a significant number of children. © The Author(s) 2015.

  6. Diagnostic errors in older patients: a systematic review of incidence and potential causes in seven prevalent diseases

    PubMed Central

    Skinner, Thomas R; Scott, Ian A; Martin, Jennifer H

    2016-01-01

    Background Misdiagnosis, either over- or underdiagnosis, exposes older patients to increased risk of inappropriate or omitted investigations and treatments, psychological distress, and financial burden. Objective To evaluate the frequency and nature of diagnostic errors in 16 conditions prevalent in older patients by undertaking a systematic literature review. Data sources and study selection Cohort studies, cross-sectional studies, or systematic reviews of such studies published in Medline between September 1993 and May 2014 were searched using key search terms of “diagnostic error”, “misdiagnosis”, “accuracy”, “validity”, or “diagnosis” and terms relating to each disease. Data synthesis A total of 938 articles were retrieved. Diagnostic error rates of >10% for both over- and underdiagnosis were seen in chronic obstructive pulmonary disease, dementia, Parkinson’s disease, heart failure, stroke/transient ischemic attack, and acute myocardial infarction. Diabetes was overdiagnosed in <5% of cases. Conclusion Over- and underdiagnosis are common in older patients. Explanations for over-diagnosis include subjective diagnostic criteria and the use of criteria not validated in older patients. Underdiagnosis was associated with long preclinical phases of disease or lack of sensitive diagnostic criteria. Factors that predispose to misdiagnosis in older patients must be emphasized in education and clinical guidelines. PMID:27284262

  7. Lifetime Prevalence Rates of Sleep Paralysis: A Systematic Review

    PubMed Central

    Barber, Jacques P.

    2011-01-01

    Objective To determine lifetime prevalence rates of sleep paralysis. Data Sources Keyword term searches using “sleep paralysis”, “isolated sleep paralysis”, or “parasomnia not otherwise specified” were conducted using MEDLINE (1950-present) and PsychINFO (1872-present). English and Spanish language abstracts were reviewed, as were reference lists of identified articles. Study Selection Thirty five studies that reported lifetime sleep paralysis rates and described both the assessment procedures and sample utilized were selected. Data Extraction Weighted percentages were calculated for each study and, when possible, for each reported subsample. Data Synthesis Aggregating across studies (total N = 36533), 7.6% of the general population, 28.3% of students, and 31.9% of psychiatric patients experienced at least one episode of sleep paralysis. Of the psychiatric patients with panic disorder, 34.6% reported lifetime sleep paralysis. Results also suggested that minorities experience lifetime sleep paralysis at higher rates than Caucasians. Conclusions Sleep paralysis is relatively common in the general population and more frequent in students and psychiatric patients. Given these prevalence rates, sleep paralysis should be assessed more regularly and uniformly in order to determine its impact on individual functioning and better articulate its relation to psychiatric and other medical conditions. PMID:21571556

  8. Lifetime prevalence rates of sleep paralysis: a systematic review.

    PubMed

    Sharpless, Brian A; Barber, Jacques P

    2011-10-01

    To determine lifetime prevalence rates of sleep paralysis. Keyword term searches using "sleep paralysis", "isolated sleep paralysis", or "parasomnia not otherwise specified" were conducted using MEDLINE (1950-present) and PsychINFO (1872-present). English and Spanish language abstracts were reviewed, as were reference lists of identified articles. Thirty five studies that reported lifetime sleep paralysis rates and described both the assessment procedures and sample utilized were selected. Weighted percentages were calculated for each study and, when possible, for each reported subsample. Aggregating across studies (total N=36,533), 7.6% of the general population, 28.3% of students, and 31.9% of psychiatric patients experienced at least one episode of sleep paralysis. Of the psychiatric patients with panic disorder, 34.6% reported lifetime sleep paralysis. Results also suggested that minorities experience lifetime sleep paralysis at higher rates than Caucasians. Sleep paralysis is relatively common in the general population and more frequent in students and psychiatric patients. Given these prevalence rates, sleep paralysis should be assessed more regularly and uniformly in order to determine its impact on individual functioning and better articulate its relation to psychiatric and other medical conditions. Copyright © 2011. Published by Elsevier Ltd.

  9. Prevalence of canine methicillin resistant Staphylococcus pseudintermedius in a veterinary diagnostic laboratory in Italy.

    PubMed

    De Lucia, M; Moodley, A; Latronico, F; Giordano, A; Caldin, M; Fondati, A; Guardabassi, L

    2011-12-01

    The overall prevalence of methicillin-resistant Staphylococcus pseudintermedius (MRSP) was 2% (10/590) among 590 canine specimens submitted to an Italian veterinary diagnostic laboratory during a two-month period, and 21% (10/48) among Staphylococcus intermedius group (SIG) isolates. All methicillin-resistant strains exhibited additional resistance to fluoroquinolones, gentamicin, lincosamides, tetracyclines, and potentiated sulfonamides, belonged predominantly to spa type t02 and harboured SCCmec type II-III cassette.

  10. Rate of new findings in diagnostic office bronchoscopy.

    PubMed

    Soldatova, Liuba; DeSilva, Brad W; Matrka, Laura A

    2017-06-01

    Awake Flexible Tracheobronchoscopy (FTB) is an alternative to rigid bronchoscopy or sedated flexible bronchoscopy and allows an awake examination of the tracheobronchial tree. We hypothesized that the ability to perform office bronchoscopy as the need arises during a clinic visit would lead to a high rate of previously undiagnosed and clinically relevant findings. This study reports the rate and nature of such findings for this procedure at our institution. Retrospective chart review. The records of 127 adult patients evaluated at the voice and swallowing disorders clinic between June of 2012 and January of 2015 were reviewed. New findings were defined as new pathology visualized during FTB exam that was not previously diagnosed by means of other diagnostic modalities. A total of 233 scope procedures (84 transnasal bronchoscopies and 149 tracheoscopies) were reviewed, 232 of which were completed and one of which was incomplete due to severe subglottic stenosis. New, clinically relevant findings were seen in 57% of transnasal bronchoscopies (48 of 84) and 21% of tracheoscopies (32 of 149). All of these findings provided additional information directing workup or resulted in a change in patient management. Office-based evaluation of the tracheobronchial tree yields a high rate of new findings. In our study, office bronchoscopy had a 57% rate of new findings and was performed without complications. The utility of tracheoscopy was also apparent in its ability to quickly and safely examine the trachea, with a 21% rate of new findings. 4. Laryngoscope, 127:1376-1380, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Prevalence of restless legs syndrome in Ankara, Turkey: an analysis of diagnostic criteria and awareness.

    PubMed

    Yilmaz, Nesrin Helvaci; Akbostanci, Muhittin Cenk; Oto, Aycan; Aykac, Ozlem

    2013-09-01

    The aim of this study was threefold: (1) to investigate the prevalence of restless legs syndrome (RLS), in Ankara, Turkey; (2) to determine the predictive values of diagnostic criteria; and (3) to determine the frequency of physician referrals and the frequency of getting the correct diagnosis. A total of 815 individuals, from randomly selected addresses, above the age of 15, were reached using the questionnaire composed of the four diagnostic criteria. Individuals who responded by answering 'yes' for at least one question were interviewed by neurologists for the diagnosis of RLS. Frequency of physician referrals and frequency of getting the correct diagnosis of RLS were also determined for patients getting the final diagnoses of RLS. Prevalence of RLS in Ankara was 5.52 %; 41.0 % of the individuals diagnosed with RLS had replied 'yes' to either one, two or three questions asked by interviewers. However, only 21.3 % of individuals who replied 'yes' to all four questions received the diagnosis of RLS. Among the patients who had the final diagnosis of RLS, 25.7 % had referred to a physician for the symptoms and 22.2 % got the correct diagnosis. The RLS prevalence in Ankara was somewhere between Western and Far East countries compatible with the geographical location. Diagnostic criteria may not be fully predictive when applied by non-physician pollsters. Physician's probability of correctly diagnosing RLS is still low.

  12. Prevalence of Metabolic Syndrome in Elderly and Agreement among Four Diagnostic Criteria

    PubMed Central

    Saad, Maria Auxiliadora Nogueira; Cardoso, Gilberto Perez; Martins, Wolney de Andrade; Velarde, Luis Guillermo Coca; da Cruz, Rubens Antunes

    2014-01-01

    Background Metabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. Objective To determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. Methods Cross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. Results Prevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. Conclusion Prevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others. PMID:24676226

  13. [The influence of different diagnostic criteria and the culture on the prevalence of attention deficit hyperactivity disorder].

    PubMed

    Cardo, Esther; Servera, Mateu; Vidal, Carmen; de Azua, Begoña; Redondo, Marta; Riutort, Laura

    2011-03-01

    To compare the prevalence of attention deficit disorder and hyperactivity disorder (ADHD) using different diagnostic criteria (DSM-IV-TR versus ICD-10) and two specific scales based on DSM IV (ADHD-IV Rating Scales and SNAP-IV p90) in school-age children (6-12 years). . A population-based study applying stratified multistage sample design (by courses), proportional to the type of school (public, private and enterd) and demographic areas (rural, city). From a target population of approximately 30 000 subjects a sample of 1509 children. The prevalence rates of ADHD were within the expected range: 3.6% (95% CI = 2.6-4.6%) using DSM-IV criteria, 1.2% (95% CI = 0.6-1.8%) using the ICD-10, 4.6% (95% CI = 3.5-5.7%) using ADHD Rating Scales-IV with a cut-off of 90 percentile 4.11% (95% CI = 3.2-5.1%) using the scale SNAP-IV. However, we found some differences in reference to gender and subtype according to the criteria and instrument used. We propose to use standard scales, scale by age, sex and evaluator that includes maturation and sociocultural factors help us draw conclusions about the true prevalence of ADHD.

  14. Prevalence rates for depression by industry: a claims database analysis

    PubMed Central

    Alterman, Toni; Bushnell, P. Timothy; Li, Jia; Shen, Rui

    2015-01-01

    Purpose To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database. Methods Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002–2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources. Results Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity. Conclusions Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work. Clinical significance Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace. PMID:24907896

  15. [Tick-borne diseases in Poland: Prevalence and difficulties in diagnostics].

    PubMed

    Kmieciak, Wioletta; Ciszewski, Marcin; Szewczyk, Eligia M

    2016-01-01

    The article presents an overview of diagnostics of tick-borne diseases in Poland, which form one of the most prevalent group of occupational illnesses in the Polish area. This is a current issue due to a constantly growing number of tick-borne infections, i.e., Lyme borreliosis, tick-borne encephalitis, tularemia, Q fever, human granulocytic anaplasmosis and babesiosis. The scale of the problem is well illustrated by the latest reports of the Polish National Institute of Public Health - National Institute of Hygiene (NIPH - NIH). The article also covers the taxonomy of vectors of etiological factors, as well as their reservoirs and possible transmission to humans. The highest risk of tick-borne infection is particularly connected with people either resting or working in the forest or meadow surroundings (i.e., foresters, farmers, hunters). The article contains up-to-date data on epidemiology, etiopathogenesis, symptomatology, laboratory medicine and factors affecting the credibility of results according to current recommendations of the Polish Society of Epidemiology and Physicians of Infectious Diseases and the Polish National Chamber of Laboratory Diagnosticians. The presented review focuses on modern laboratory techniques used in difficult diagnostics of tick-borne diseases, mainly diagnostics algorithms, pre-analytical phase (type of biological material) and analytical phase of diagnostics (reference methods, efficacy of different techniques, interfering factors, proper diagnostic procedures).

  16. The DSM-5 diagnostic criteria for anorexia nervosa may change its population prevalence and prognostic value.

    PubMed

    Mustelin, Linda; Silén, Yasmina; Raevuori, Anu; Hoek, Hans W; Kaprio, Jaakko; Keski-Rahkonen, Anna

    2016-06-01

    The definition of anorexia nervosa was revised for the Fifth Edition of the Diagnostic and Statistical Manual (DSM-5). We examined the impact of these changes on the prevalence and prognosis of anorexia nervosa. In a nationwide longitudinal study of Finnish twins born 1975-1979, the women (N = 2825) underwent a 2-stage screening for eating disorders at mean age 24. Fifty-five women fulfilled DSM-IV criteria for lifetime anorexia nervosa. When we recoded the interviews using DSM-5 criteria, we detected 37 new cases. We contrasted new DSM-5 vs. DSM-IV cases to assess their clinical characteristics and prognosis. We also estimated lifetime prevalences and incidences and tested the association of minimum BMI with prognosis. We observed a 60% increase in the lifetime prevalence of anorexia nervosa using the new diagnostic boundaries, from 2.2% to 3.6%. The new cases had a later age of onset (18.8 y vs. 16.5, p = 0.002), higher minimum BMI (16.9 vs. 15.5 kg/m(2), p = 0.0004), a shorter duration of illness (one year vs. three years, p = 0.002), and a higher 5-year probability or recovery (81% vs. 67%, p = 0.002). Minimum BMI was not associated with prognosis. It therefore appears that the substantial increase in prevalence of anorexia nervosa is offset by a more benign course of illness in new cases. Increased diagnostic heterogeneity underscores the need for reliable indicators of disease severity. Our findings indicate that BMI may not be an ideal severity marker, but should be complemented by prognostically informative criteria. Future studies should focus on identifying such factors in prospective settings.

  17. Prevalence of neuropathic features of back pain in clinical populations: implications for the diagnostic triage paradigm.

    PubMed

    Hush, Julia M; Marcuzzi, Anna

    2012-07-01

    SUMMARY Contemporary clinical assessment of back pain is based on the diagnostic triage paradigm. The most common diagnostic classification is nonspecific back pain, considered to be of nociceptive etiology. A small proportion are diagnosed with radicular pain, of neuropathic origin. In this study we review the body of literature on the prevalence of neuropathic features of back pain, revealing that the point prevalence is 17% in primary care, 34% in mixed clinical settings and 53% in tertiary care. There is evidence that neuropathic features of back pain are not restricted to typical clinical radicular pain phenotypes and may be under-recognized, particularly in primary care. The consequence of this is that in the clinic, diagnostic triage may erroneously classify patients with nonspecific back pain or radicular pain. A promising alternative is the development of mechanism-based pain phenotyping in patients with back pain. Timely identification of contributory pain mechanisms may enable greater opportunity to select appropriate therapeutic targets and improve patient outcomes.

  18. Cardiovascular risk factors in primary care: methods and baseline prevalence rates--the DETECT program.

    PubMed

    Wittchen, H-U; Glaesmer, H; März, W; Stalla, G; Lehnert, H; Zeiher, A M; Silber, S; Koch, U; Böhler, S; Pittrow, D; Ruf, G

    2005-04-01

    DETECT is an epidemiological study in primary care to examine (a) the prevalence rates and comorbidity of diabetes mellitus, hypertension, hyperlipidaemia and coronary heart disease (CHD), and associated conditions; (b) the frequency of behavioural and clinical risk factors for onset and progression; (c) the 12-month course and outcome; and (d) the met and unmet needs for these patients. Three-stage, cross-sectional clinical-epidemiological study with a prospective-longitudinal component in a nationally representative sample of N = 3795 primary care settings [response rate (RR): 60.2%] and N = 55518 patients (RR: 95.5%). Patients completed a standardized assessment, including questionnaires for patients and the physician and diagnostic screening measures (i.e. blood pressure, heart rate, body mass index and waist circumference assessments). A subsample of patients (N = 7519) also completed a standardized laboratory screening program and was followed-up after 12 months. Data were weighted to adjust for non-response, regional distribution and attrition. (1) Doctors and patients sample can be regarded as representative for primary care settings in Germany. (2) The clinician-rated point prevalence of hypertension is highest (35.5%), followed by hyperlipidaemia (29.1%), diabetes (14.1%) and CHD (12.1%); prevalence rates of each disorder as well as their co-incidence rates increase markedly with age. (3) The vast majority (78%) of all patients revealed multiple (3+) behavioural and clinical risk factors. The findings of DETECT underline the considerable burden for primary care doctors in managing a highly morbid patient population, with predominantly complex risk factor constellations, in routine care. Our data provide, in unprecedented detail, a basis for calculating age-, gender- and risk-group-adjusted risk-factor profiles in routine care.

  19. Diagnostic methodology is critical for accurately determining the prevalence of ichthyophonus infections in wild fish populations

    USGS Publications Warehouse

    Kocan, R.; Dolan, H.; Hershberger, P.

    2011-01-01

    Several different techniques have been employed to detect and identify Ichthyophonus spp. in infected fish hosts; these include macroscopic observation, microscopic examination of tissue squashes, histological evaluation, in vitro culture, and molecular techniques. Examination of the peer-reviewed literature revealed that when more than 1 diagnostic method is used, they often result in significantly different results; for example, when in vitro culture was used to identify infected trout in an experimentally exposed population, 98.7% of infected trout were detected, but when standard histology was used to confirm known infected tissues from wild salmon, it detected ~50% of low-intensity infections and ~85% of high-intensity infections. Other studies on different species reported similar differences. When we examined a possible mechanism to explain the disparity between different diagnostic techniques, we observed non-random distribution of the parasite in 3-dimensionally visualized tissue sections from infected hosts, thus providing a possible explanation for the different sensitivities of commonly used diagnostic techniques. Based on experimental evidence and a review of the peer-reviewed literature, we have concluded that in vitro culture is currently the most accurate diagnostic technique for determining infection prevalence of Ichthyophonus, particularly when the exposure history of the population is not known.

  20. The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA

    USDA-ARS?s Scientific Manuscript database

    Summary: We evaluated the prevalence of osteoporosis using the osteoporosis diagnostic criteria developed by the National Bone Health Alliance (NBHA), which includes qualified fractures, FRAX score in addition to bone mineral density (BMD). The expanded definition increases the prevalence compared t...

  1. Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) normative elevation rates: comparisons with epidemiological prevalence rates.

    PubMed

    Tarescavage, Anthony M; Marek, Ryan J; Finn, Jacob A; Hicks, Adam; Rapier, Jessica L; Ben-Porath, Yossef S

    2013-01-01

    Odland, Berthelson, Sharma, Martin, and Mittenberg ( 2013 ) caution that clinically elevated scale scores produced by members of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 /2011) normative sample raise concerns about the potential for false positive findings of psychopathology. However, the MMPI-2-RF normative sample is intended to represent the general population of the United States, 26.2% of which met criteria for a Diagnostic and Statistical Manual-IV (APA, 1994 ) disorder in a 12-month period (Kessler, Chiu, Demler, & Walters, 2005 ). In the current study we compare scale elevation rates in the MMPI-2-RF normative sample to prevalence rates of mental disorders primarily drawn from the National Comorbidity Study Replication (Kessler et al., 2005 ). Our objective was to evaluate MMPI-2-RF elevation rates in an epidemiological context. Results indicate that MMPI-2-RF scale elevation rates were generally consistent with epidemiological data when examined in the context of standard interpretation guidelines for the inventory. We also reiterate Ben-Porath and Tellegen's (2008/2011) caution that MMPI-2-RF scale elevations alone are not sufficient to indicate the presence of psychiatric disorder. Rather they are best viewed as indications of the need to evaluate the individual for possible disorder(s). Implications of these results, limitations of this study, and future directions in research are discussed.

  2. How do different diagnostic criteria, age and gender affect the prevalence of attention deficit hyperactivity disorder in adults? An epidemiological study in a Hungarian community sample.

    PubMed

    Bitter, István; Simon, Viktoria; Bálint, Sára; Mészáros, Agnes; Czobor, Pál

    2010-06-01

    The goal of the study was twofold: (1) to investigate the effect of different diagnostic criteria on prevalence estimates of adult attention deficit hyperactivity disorder (ADHD), and (2) to provide prevalence estimates of adult ADHD for the first time in a Hungarian sample. Subjects between 18 and 60 years were included in the screening phase of the study (N = 3,529), conducted in 17 GP practices in Budapest. Adult self-report scale 6-item version was used for screening. Out of 279 positively screened subjects 161 subjects participated in a clinical interview and filled out a self-report questionnaire to confirm the diagnosis. Beside DSM-IV diagnostic criteria, we applied four alternative diagnostic criteria: 'No-onset' (DSM-IV criteria without the specific requirement for onset); full/Sx (DSM-IV "symptoms only" criteria); and reduced/Sx (DSM-IV "symptoms only" criteria with a reduced threshold for symptom count). Crude prevalence estimates adjusted for the specificity and sensitivity data of the screener were 1.35% in the 'DSM-IV' group, 1.64% in the 'No-onset' group, 3.65% in the 'Sx/full' group and 4.16% in the 'Sx/reduced' group. Logistic regression analysis showed that ADHD was significantly more prevalent with younger age and male gender [chi(2) = 14.46; P = 0.0007]. Prevalence estimates corrected for the 'not-interviewed' subsample and adjusted for specificity and sensitivity data of the screener was 2.3% in males, 0.91% in females; 2.02% in the < or =40 years age group and 0.70% in the >40 years age group, based on DSM-IV diagnostic criteria. Prevalence rates found in this study are somewhat lower, but still are in line with those reported in the literature.

  3. Detection of Onchocerca volvulus infection in low prevalence areas: a comparison of three diagnostic methods.

    PubMed

    Boatin, B A; Toé, L; Alley, E S; Nagelkerke, N J D; Borsboom, G; Habbema, J D F

    2002-12-01

    The standard assay for onchocerciasis diagnosis is microscopical detection of microfilariae in skin snips. Skin snipping is painful, requires appropriate sterilization of equipment, and may fail to diagnose light infections. Two alternatives are a polymerase chain reaction (PCR) test which detects parasite DNA in pieces or scrapings of skin and a test based on allergic reactions to topical application of diethylcarbamazine (DEC). We compared these 2 diagnostics with standard skin snip microscopy in 313 individuals from 2 villages in Guinea, with low prevalence after over 10 years of control by the Onchocerciasis Control Programme. Lower and upper bounds on sensitivities and specificities of these 3 tests were estimated. In addition, these parameters were estimated using 5 different statistical models. Where prevalence was low, PCR and the DEC patch test appeared to be more sensitive than skin snipping which has low sensitivity. As the DEC test is non-invasive, simple and cheap, it may provide a good alternative to skin snipping alone for surveillance in low prevalence areas.

  4. The Prevalence and Diagnostic Utility of Endoscopic Features of Eosinophilic Esophagitis: A Meta-Analysis

    PubMed Central

    Kim, Hannah P.; Vance, R. Brooks; Shaheen, Nicholas J.; Dellon, Evan S.

    2012-01-01

    Background & Aims Endoscopic findings such as esophageal rings, strictures, narrow-caliber esophagus, linear furrows, white plaques, and pallor or decreased vasculature might indicate the presence of eosinophilic esophagitis (EoE). We aimed to determine the prevalence and diagnostic utility of endoscopic features of EoE. Methods We conducted a systematic review and meta-analysis. PubMed, EMBASE, and GI meeting abstracts were searched to identify studies that included ≥ 10 patients with EoE and reported endoscopic findings. Pooled prevalence, sensitivity, specificity, and predictive values were calculated using random- and mixed-effects models. Results The search yielded 100 articles and abstracts on 4678 patients with EoE and 2742 without (controls). In subjects with EoE, the overall pooled prevalence of esophageal rings was 44%, strictures 21%, narrow-caliber esophagus 9%, linear furrows 48%, white plaques 27%, and pallor/decreased vasculature 41%. Substantial heterogeneity existed among studies. Results from endoscopy examinations were normal in 17% of patients, but this number decreased to 7% when the analysis was limited to prospective studies (P<.05). Overall levels of sensitivity were modest, ranging from 15% to 48%, whereas levels of specificity were greater, ranging from 90% to 95%. Positive predictive values ranged from 51% to 73% and negative predictive values ranged from 74% to 84%. Conclusions There is heterogeneity among studies in the reported prevalence of endoscopic findings in patients with EoE, but in prospective studies, at least 1 abnormality was detected by endoscopy in 93% of patients. The operating characteristics of endoscopic findings alone are inadequate for diagnosis of EoE. Esophageal biopsies should be obtained from all patients with clinical features of EoE, regardless of the endoscopic appearance of the esophagus. PMID:22610003

  5. Component-resolved diagnostics for the evaluation of peanut allergy in a low-prevalence area.

    PubMed

    Suratannon, Narissara; Ngamphaiboon, Jarungchit; Wongpiyabovorn, Jongkonnee; Puripokai, Panitchaya; Chatchatee, Pantipa

    2013-11-01

    Major allergenic components of peanut from distinct geographical regions are widely dispersed. Most of the diagnostic studies are from countries with a high prevalence. There have been only few reports of allergen component sensitizations from countries with a low prevalence of peanut allergy. We aimed to investigate roles of component-resolved diagnostic (CRD) to differentiate peanut allergy and peanut tolerance in the Asian population from a country with low prevalence of peanut allergy. Participants with peanut sensitization were enrolled. Clinical reactions were determined. Skin prick test (SPT) and specific IgE (sIgE) to peanut and related allergen components were performed. Forty subjects with peanut sensitization were included. The mean wheal sizes of SPT and peanut sIgE were not good predictors for differentiating peanut reactions. SIgE to rAra h 2 was more often found in patients with peanut allergy and anaphylaxis. sIgE to rAra h 9 was also more frequent in the peanut-allergic group but not related to severe reactions. In the peanut-tolerant group, despite positive SPT and/or sIgE to peanut, 90% had negative sIgE to rAha h 2 and rAra h 9. Combining rAra h 2 and rAra h 9 resulted in high performance of the test with sensitivity, specificity, positive predictive value, and negative predictive value of 84%, 90%, 0.89, and 0.86, respectively. The ratio between rAra h 2 sIgE to peanut sIgE of 0.6 can be helpful in predicting patients who will develop severe reaction. SIgE to cross-reactive carbohydrate determinants (CCD) was exclusively found in the peanut-tolerant group (33.3% vs. 0%, p = 0.012). Our study identifies three allergen components: rAra h 2, rAra h 9, and CCD as important components in the diagnosis of peanut allergy in an Asian country with low prevalence. The ratio between rArah h 2 sIgE to peanut sIgE can be used for predicting patients who will develop anaphylaxis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students

    PubMed Central

    2016-01-01

    Background and Aims Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future. Methods Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis. Results The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06–2.06) and age group (odds ratio: 1.34, 95% CI: 1.01–1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08–2.17, P < 0.05). Conclusions Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among

  7. The prevalence of clinical diagnostic groups in patients with temporomandibular disorders.

    PubMed

    Machado, Luciana Pimenta e Silva; Nery, Cláudio de Góis; Leles, Cláudio Rodrigues; Nery, Marianita Batista de Macedo; Okeson, Jeffrey P

    2009-07-01

    The aim of this study was to observe the prevalence of diagnostic groups of temporomandibular disorders (TMD) in patients who were referred or sought treatment for TMD and/or orofacial pain in a private clinic. The clinical records of 357 patients were evaluated and selected based on inclusion/exclusion criteria; the mean age was 32 years. A clinical examination was performed and the diagnosis was based on the American Academy of Orofacial Pain criteria. Results showed that 86.8% of patients were women and 93.3% of the patients presented more than one diagnosis. The most frequent chief complaint (n = 216, chi2 = 30.68, p = 0.001) and total diagnosis realized (n = 748, chi2 = 14.14, p = 0.001) were muscle related. We concluded that women seek treatment for dysfunction/disorders of orofacial structures more than men do; patients seeking specialized treatment have more than one diagnosis and muscle dysfunction is more prevalent than intra-articular disorders.

  8. Impact of Different Diagnostic Criteria on the Reported Prevalence of Junctional Ectopic Tachycardia After Pediatric Cardiac Surgery.

    PubMed

    Entenmann, Andreas; Michel, Miriam; Egender, Friedemann; Hessling, Vera; Kramer, Hans-Heiner

    2016-09-01

    Junctional ectopic tachycardia is a frequent complication after pediatric cardiac surgery. A uniform definition of postoperative junctional ectopic tachycardia has yet to be established in the literature. The objective of this study is to analyze differences in the general and age-related prevalence of postoperative junctional ectopic tachycardia according to different diagnostic definitions. Data files and electrocardiograms of 743 patients (age, 1 d to 17.6 yr) who underwent surgery for congenital heart disease during a 3-year period were reviewed. The prevalence of postoperative junctional ectopic tachycardia in this cohort was determined according to six different definitions identified in the literature and one definition introduced for analytical purposes. Agreement between the definitions was analyzed according to Cohen κ coefficients. A receiver operating characteristic analysis was performed to determine the ability of different definitions to discriminate between patients with increased postoperative morbidity and without. A university-affiliated tertiary pediatric cardiac PICU. Infants and children who underwent heart surgery. None. The prevalence of postoperative junctional ectopic tachycardia ranged from 2.0% to 8.3% according to the seven different definitions. Even among definitions for which the general prevalence was almost equal, the distribution according to age varied. Most definitions used a frequency criterion to define postoperative junctional ectopic tachycardia. Definitions based on a fixed frequency criterion did not identify cases of postoperative junctional ectopic tachycardia in patients older than 12 months. The grade of agreement was moderate or poor between definitions using a fixed or dynamic frequency criterion and those not based on a critical heart rate (κ = 0.37-0.66). In the receiver operating characteristic analysis, the definition with a fixed frequency criterion of 180 beats/min or an age-related frequency criterion

  9. Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments

    PubMed Central

    Krebber, A M H; Buffart, L M; Kleijn, G; Riepma, I C; de Bree, R; Leemans, C R; Becker, A; Brug, J; van Straten, A; Cuijpers, P; Verdonck-de Leeuw, I M

    2014-01-01

    Objective We aimed to investigate the prevalence of depression in cancer patients assessed by diagnostic interviews and self-report instruments, and to study differences in prevalence between type of instrument, type of cancer and treatment phase. Methods A literature search was conducted in four databases to select studies on the prevalence of depression among adult cancer patients during or after treatment. A total of 211 studies met the inclusion criteria. Pooled mean prevalence of depression was calculated using Comprehensive Meta-Analysis. Results Hospital Anxiety and Depression Scale—depression subscale (HADS-D) ≥ 8, HADS-D ≥11, Center for Epidemiologic Studies ≥ 16, and (semi-)structured diagnostic interviews were used to define depression in 66, 53, 35 and 49 studies, respectively. Respective mean prevalence of depression was 17% (95% CI = 16–19%), 8% (95% CI = 7–9%), 24% (95% CI = 21–26%), and 13% (95% CI = 11–15%) (p < 0.001). Prevalence of depression ranged from 3% in patients with lung cancer to 31% in patients with cancer of the digestive tract, on the basis of diagnostic interviews. Prevalence of depression was highest during treatment 14% (95% CI = 11–17%), measured by diagnostic interviews, and 27% (95% CI = 25–30%), measured by self-report instruments. In the first year after diagnosis, prevalence of depression measured with diagnostic interviews and self-report instruments were 9% (95% CI = 7–11%) and 21% (95% CI = 19–24%), respectively, and they were 8% (95% CI = 5–12%) and 15% (95% CI = 13–17%) ≥ 1 year after diagnosis. Conclusions Pooled mean prevalence of depression in cancer patients ranged from 8% to 24% and differed by the type of instrument, type of cancer and treatment phase. Future prospective studies should disentangle whether differences in prevalence of depression are caused by differences in the type of instrument, type of cancer or treatment

  10. Flame Chemiluminescence Rate Constants for Quantitative Microgravity Combustion Diagnostics

    NASA Technical Reports Server (NTRS)

    Luque, Jorge; Smith, Gregory P.; Jeffries, Jay B.; Crosley, David R.; Weiland, Karen (Technical Monitor)

    2001-01-01

    Absolute excited state concentrations of OH(A), CH(A), and C2(d) were determined in three low pressure premixed methane-air flames. Two dimensional images of chemiluminescence from these states were recorded by a filtered CCD camera, processed by Abel inversion, and calibrated against Rayleigh scattering, Using a previously validated 1-D flame model with known chemistry and excited state quenching rate constants, rate constants are extracted for the reactions CH + O2 (goes to) OH(A) + CO and C2H + O (goes to) CH(A) + CO at flame temperatures. Variations of flame emission intensities with stoichiometry agree well with model predictions.

  11. Comparing Sexual Assult Survey Prevalence Rates at Military Service Academies and U.S. Colleges

    DTIC Science & Technology

    2015-12-15

    December 15, 2015 SURVEY NOTE Note No. 2015-17 1 Comparing Sexual Assault Survey Prevalence Rates at Military Service Academies and U.S...Relations Survey (2014 SAGR) was designed to assess the prevalence of sexual assault and misconduct at Department of Defense Military Service Academies...rewards; or failure to obtain affirmative consent. 3 Table 3-21, AAU Report Comparing Sexual Assault Prevalence Rates at Military Service Academies

  12. Prevalence Rates and Demographic Characteristics Associated with Depression in Pregnancy and the Postpartum.

    ERIC Educational Resources Information Center

    Gotlib, Ian H.; And Others

    1989-01-01

    Examined prevalence of depression in 360 women during pregnancy and after delivery. At both assessments, approximately 25 percent reported elevated levels of depressive symptomatology. Ten percent met diagnostic criteria for depression during pregnancy; 6.8 percent were depressed postpartum. One-half of postpartum depression cases were new onset.…

  13. Prevalence Rates and Demographic Characteristics Associated with Depression in Pregnancy and the Postpartum.

    ERIC Educational Resources Information Center

    Gotlib, Ian H.; And Others

    1989-01-01

    Examined prevalence of depression in 360 women during pregnancy and after delivery. At both assessments, approximately 25 percent reported elevated levels of depressive symptomatology. Ten percent met diagnostic criteria for depression during pregnancy; 6.8 percent were depressed postpartum. One-half of postpartum depression cases were new onset.…

  14. Clinical and electromyographic deep tendon reflexes in polyneuropathy: diagnostic value and prevalence*.

    PubMed

    Sharma, K R; Saadia, D; Facca, A G; Resnick, S; Ayyar, D R

    2009-04-01

    Evidence is accumulating that patients with polyneuropathy may present with normal clinical deep tendon reflexes (C-DTR). There are few studies that assessed the diagnostic utility of electromyographically recorded DTR (Er-DTR) in patients with polyneuropathy. The objectives of this study were twofold: (i) to evaluate the prevalence of preserved C-DTR in polyneuropathy; (ii) diagnostic value of Er-DTR latency measurement in patients with polyneuropathy. We prospectively studied 38 controls and 185 patients with polyneuropathy. All subjects had evaluation of C-DTR, Er-DTR obtained from right biceps brachii (BR), right patellar (PR) and bilateral ankle reflexes (AR). Of these 185 patients, 118 (63.8%) had chronic axonal neuropathy (CAN), 49 (26.5%) demyelinating polyradiculoneuropathy (DPN) and 18 (9.7%) small fiber neuropathy (SFN). The C-DTR were normal in 65 patients whereas 39 of these 65 (60%) patients had abnormalities of Er-DTR at one or more sites. Er-DTR latencies in patients with polyneuropathies were prolonged at all sites compared with controls (P < 0.01). Among patients with various types of polyneuropathies the Er-DTR, mean latencies at all the sites and latency indicative of demyelination (>150% of the normal mean) were higher in patients with DPN than that of CAN or SFN (P < 0.01). We conclude that C-DTR are preserved in 35.1% of the patients with polyneuropathies and Er-DTR should be performed in such patients in order to provide electrophysiological evidence of a polyneuropathy. Er-DTR are useful in distinguishing axonal from demyelinating disorders of peripheral nerve, and detection of subclinical involvement of large fibers in SFN.

  15. Prevalence and heritability of clusters for diagnostic components of metabolic syndrome: the Oman family study.

    PubMed

    Lopez-Alvarenga, Juan C; Solís-Herrera, Carolina; Kent, Jack W; Jaju, Deepali; Albarwani, Sulayma; Al Yahyahee, Saheed; Hassan, M Osman; Bayoumi, Riad; Comuzzie, Anthony G

    2008-06-01

    Prevalence and heritability of metabolic syndrome (MetS) vary between populations according to the currently used criteria. We examined combinations for joint probabilities and heritabilities of MetS criteria from the National Cholesterol Education Program Adult Treatment Panel III (NCEP), World Health Organization (WHO), and International Diabetes Federation (IDF) in a sample of Omani families. We included 1277 subjects from 5 pedigrees. The likelihood ratio of diagnostic cluster dependence over clustering by chance was LDep = P(dependent)/P(independent). Heritabilities were adjusted by sex and age. The highest LDep were central obesity (CO) + high glucose level (HGl) + triglycerides (IDF, 3.08; NCEP, 4.38; WHO, 3.17; P < 0.001). Triglycerides combined with any other component were the most common cluster. The lowest LDep for IDF were high blood pressure (HBP) + CO + low HDL-C (1.21, P < 0.025); for NCEP were HBP + HGl + low HDL-C (1.21, P < 0.07). These components were gathered almost by chance alone. In contrast, the lowest LDep for WHO were HGl + CO + low HDL-C (2.01, P < 0.001). The WHO criteria yielded the highest heritability for a MetS diagnosis (h(2) = 0.9), followed by NCEP (0.48) and IDF (0.38). The rationale of the MetS diagnostics is based on insulin resistance. This base would be lost if we continue lowering cut-off points for diagnosis for increasing the sensitivity. The WHO showed the highest values for LDep for all components because they used the highest cut-off points.

  16. Explanatory Model to Describe School District Prevalence Rates for Mental Retardation and Learning Disabilities.

    ERIC Educational Resources Information Center

    McDermott, Suzanne

    1994-01-01

    Data reports from South Carolina's 92 independent school districts during 1980-81 were used to calculate prevalence rates of mental retardation and learning disabilities. These prevalence rates were 41.66/1,000 children enrolled for mental retardation and 33.21/1,000 children enrolled for learning disabilities. Additional analysis showed that…

  17. National Prevalence Rates of Bully Victimization among Students with Disabilities in the United States

    ERIC Educational Resources Information Center

    Blake, Jamilia J.; Lund, Emily M.; Zhou, Qiong; Kwok, Oi-man; Benz, Michael R.

    2012-01-01

    This study examined the prevalence rates of bully victimization and risk for repeated victimization among students with disabilities using the Special Education Elementary Longitudinal Study and the National Longitudinal Transition Study-2 longitudinal datasets. Results revealed that a prevalence rate ranging from 24.5% in elementary school to…

  18. National Prevalence Rates of Bully Victimization among Students with Disabilities in the United States

    ERIC Educational Resources Information Center

    Blake, Jamilia J.; Lund, Emily M.; Zhou, Qiong; Kwok, Oi-man; Benz, Michael R.

    2012-01-01

    This study examined the prevalence rates of bully victimization and risk for repeated victimization among students with disabilities using the Special Education Elementary Longitudinal Study and the National Longitudinal Transition Study-2 longitudinal datasets. Results revealed that a prevalence rate ranging from 24.5% in elementary school to…

  19. Prevalence of diminished ovarian reserve in Chinese women with polycystic ovary syndrome and sensitive diagnostic parameters.

    PubMed

    Jin, Jing; Ruan, Xiangyan; Hua, Lin; Tian, Xuanxuan; Li, Yanglu; Wang, Lijuan; Mueck, Alfred O

    2017-09-01

    To assess the prevalence of diminished ovarian reserve (DOR) in patients with polycystic ovary syndrome (PCOS) in China, and to search for sensitive diagnostic parameters. Three hundred and thirty eight PCOS women aged 20-39 years were recruited. Basic characteristics, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone and anti-Müllerian hormone (AMH) were measured. The best indices to diagnose PCOS with DOR were assessed. The prevalence of DOR in our Chinese PCOS patients was 16.9%. The level of E2 and FSH and the FSH/LH ratio had a positive correlation with PCOS and DOR (OR > 1, p < 0.05) independent of age and testosterone, while AMH and baseline antral follicle count had a negative correlation (OR < 1, p < 0.05). AMH was a good parameter to diagnose PCOS with DOR, the cutoff was 2.53 ng/ml, with sensitivity 92.5%, specificity 73.7% and area under curve 0.932. AMH had a significant positive correlation with LH (r = 0.016, p < 0.05) and testosterone (r = 0.209, p < 0.01), while had significant negative correlation with age (r=-0.140, p < 0.05), FSH (r=-0.229, p < 0.01) and FSH/LH ratio (r=-0.240, p < 0.01). In our study, AMH was a sensitive parameter to diagnose PCOS with DOR, but to improve the accuracy it will still need further studies.

  20. Headache in pediatric patients with celiac disease and its prevalence as a diagnostic clue.

    PubMed

    Lionetti, Elena; Francavilla, Ruggiero; Maiuri, Luigi; Ruggieri, Martino; Spina, Massimo; Pavone, Piero; Francavilla, Teresa; Magistà, Anna Maria; Pavone, Lorenzo

    2009-08-01

    To establish the prevalence of headache in children with celiac disease (CD), the response to a gluten-free diet, and the prevalence of CD in children affected by headache. This hospital-based study included 2 steps. In the retrospective part, 354 children with CD answered a questionnaire investigating the presence of headache before and after the gluten-free diet. The same questionnaire was administered to 200 healthy children matched for sex and age. In the prospective part, 79 children affected by headache were screened for CD by antitransglutaminase IgA. Diagnosis of CD was confirmed by duodenal biopsy; before starting a gluten-free diet patients underwent a brain positron emission tomography study. After 6 months of follow-up children were reevaluated for the presence of headache. Overall, 88 patients with CD complained of headaches before the diagnosis of CD as compared with 16 in the control group (24.8% vs 8%, P < 0.001). After the institution of a gluten-free diet, the headaches significantly improved in 68 children (77.3%), of whom 24 (27.3%) were headache-free during the study period. Four of 79 (5%) headache patients were found to have CD compared with 0.6% of the general population (P = 0.005). The brain positron emission tomography studies did not show any anomalies. During the follow-up, headaches improved in all 4 children with CD. We recorded -- in our geographical area -- a high frequency of headaches in patients with CD and vice versa with a beneficial effect of a gluten-free diet. Screening for CD could be advised in the diagnostic work-up of patients with headache.

  1. Sampling studies to estimate the HIV prevalence rate in female commercial sex workers.

    PubMed

    Pascom, Ana Roberta Pati; Szwarcwald, Célia Landmann; Barbosa Júnior, Aristides

    2010-01-01

    We investigated sampling methods being used to estimate the HIV prevalence rate among female commercial sex workers. The studies were classified according to the adequacy or not of the sample size to estimate HIV prevalence rate and according to the sampling method (probabilistic or convenience). We identified 75 studies that estimated the HIV prevalence rate among female sex workers. Most of the studies employed convenience samples. The sample size was not adequate to estimate HIV prevalence rate in 35 studies. The use of convenience sample limits statistical inference for the whole group. It was observed that there was an increase in the number of published studies since 2005, as well as in the number of studies that used probabilistic samples. This represents a large advance in the monitoring of risk behavior practices and HIV prevalence rate in this group.

  2. Allergy or tolerance in children sensitized to peanut: prevalence and differentiation using component-resolved diagnostics.

    PubMed

    Nicolaou, Nicolaos; Poorafshar, Maryam; Murray, Clare; Simpson, Angela; Winell, Henric; Kerry, Gina; Härlin, Annika; Woodcock, Ashley; Ahlstedt, Staffan; Custovic, Adnan

    2010-01-01

    Not all peanut-sensitized children develop allergic reactions on exposure. To establish by oral food challenge the proportion of children with clinical peanut allergy among those considered peanut-sensitized by using skin prick tests and/or IgE measurement, and to investigate whether component-resolved diagnostics using microarray could differentiate peanut allergy from tolerance. Within a population-based birth cohort, we ascertained peanut sensitization by skin tests and IgE measurement at age 8 years. Among sensitized children, we determined peanut allergy versus tolerance by oral food challenges. We used open challenge among children consuming peanuts (n = 45); others underwent double-blind placebo-controlled challenge (n = 34). We compared sensitization profiles between children with peanut allergy and peanut-tolerant children by using a microarray with 12 pure components (major peanut and potentially cross-reactive components, including grass allergens). Of 933 children, 110 (11.8%) were peanut-sensitized. Nineteen were not challenged (17 no consent). Twelve with a convincing history of reactions on exposure, IgE > or =15 kUa/L and/or skin test > or =8mm were considered allergic without challenge. Of the remaining 79 children who underwent challenge, 7 had > or =2 objective signs and were designated as having peanut allergy. We estimated the prevalence of clinical peanut allergy among sensitized subjects as 22.4% (95% CI, 14.8% to 32.3%). By using component-resolved diagnostics, we detected marked differences in the pattern of component recognition between children with peanut allergy (n = 29; group enriched with 12 children with allergy) and peanut-tolerant children (n = 52). The peanut component Ara h 2 was the most important predictor of clinical allergy. The majority of children considered peanut-sensitized on the basis of standard tests do not have peanut allergy. Component-resolved diagnostics may facilitate the diagnosis of peanut allergy. Copyright

  3. Prevalence and diagnostic accuracy of heart disease in children with asymptomatic murmurs.

    PubMed

    Sackey, Adziri H

    2016-03-01

    This study was performed to determine the prevalence of CHD among children referred with asymptomatic murmurs and to determine the diagnostic accuracy of the assessment of asymptomatic heart murmurs by general paediatricians. We reviewed the records of children who had been referred by general paediatricians to a cardiology clinic for further evaluation of a heart murmur. The referring paediatricians' clinical assessment of the murmur was compared with the cardiologist's echocardiographic diagnosis. A total of 150 children were referred by paediatricians to a paediatric cardiologist for further assessment of a heart murmur. Out of 150 children, 72 had a paediatrician's diagnosis of innocent murmur; of these 72 patients, two (3%) had heart disease on echocardiography. In all, after echocardiography, a range of congenital heart lesions was found in 28 (19%) of the 150 children. CHD is not rare among children with asymptomatic heart murmurs. In this series of children with asymptomatic murmurs, 19% had heart lesions on echocardiography. Most, but not all, of the children with heart lesions were identified on clinical examination by general paediatricians.

  4. PCR diagnostics underestimate the prevalence of avian malaria (Plasmodium relictum) in experimentally-infected passerines.

    PubMed

    Jarvi, Susan I; Schultz, Jeffrey J; Atkinson, Carter T

    2002-02-01

    Several polymerase chain reaction (PCR)-based methods have recently been developed for diagnosing malarial infections in both birds and reptiles, but a critical evaluation of their sensitivity in experimentally-infected hosts has not been done. This study compares the sensitivity of several PCR-based methods for diagnosing avian malaria (Plasmodium relictum) in captive Hawaiian honeycreepers using microscopy and a recently developed immunoblotting technique. Sequential blood samples were collected over periods of up to 4.4 yr after experimental infection and rechallenge to determine both the duration and detectability of chronic infections. Two new nested PCR approaches for detecting circulating parasites based on P. relictum 18S rRNA genes and the thrombospondin-related anonymous protein (TRAP) gene are described. The blood smear and the PCR tests were less sensitive than serological methods for detecting chronic malarial infections. Individually, none of the diagnostic methods was 100% accurate in detecting subpatent infections, although serological methods were significantly more sensitive (97%) than either nested PCR (61-84%) or microscopy (27%). Circulating parasites in chronically infected birds either disappear completely from circulation or to drop to intensities below detectability by nested PCR. Thus, the use of PCR as a sole means of detection of circulating parasites may significantly underestimate true prevalence.

  5. PCR diagnostics underestimate the prevalence of avian malaria (Plasmodium relictum) in experimentally-infected passerines

    USGS Publications Warehouse

    Jarvi, Susan I.; Schultz, Jeffrey J.; Atkinson, Carter T.

    2002-01-01

    Several polymerase chain reaction (PCR)-based methods have recently been developed for diagnosing malarial infections in both birds and reptiles, but a critical evaluation of their sensitivity in experimentally-infected hosts has not been done. This study compares the sensitivity of several PCR-based methods for diagnosing avian malaria (Plasmodium relictum) in captive Hawaiian honeycreepers using microscopy and a recently developed immunoblotting technique. Sequential blood samples were collected over periods of up to 4.4 yr after experimental infection and rechallenge to determine both the duration and detectability of chronic infections. Two new nested PCR approaches for detecting circulating parasites based on P. relictum 18S rRNA genes and the thrombospondin-related anonymous protein (TRAP) gene are described. The blood smear and the PCR tests were less sensitive than serological methods for detecting chronic malarial infections. Individually, none of the diagnostic methods was 100% accurate in detecting subpatent infections, although serological methods were significantly more sensitive (97%) than either nested PCR (61–84%) or microscopy (27%). Circulating parasites in chronically infected birds either disappear completely from circulation or to drop to intensities below detectability by nested PCR. Thus, the use of PCR as a sole means of detection of circulating parasites may significantly underestimate true prevalence.

  6. The Relationship Between Child Mortality Rates and Prevalence of Celiac Disease.

    PubMed

    Biagi, Federico; Raiteri, Alberto; Schiepatti, Annalisa; Klersy, Catherine; Corazza, Gino R

    2017-07-27

    Some evidence suggests that prevalence of celiac disease in the general population is increasing over time. Since the prognosis of celiac disease was a dismal one before discovering the role of gluten, our aim was to investigate a possible relationship between children under five-mortality rates and prevalence rates of celiac disease. Thanks to a literature review, we found 27 studies performed in 17 different countries describing the prevalence of celiac disease in schoolchildren; between 1995 and 2011, 4 studies were performed in Italy. A meta-analysis of prevalence rates was performed. Prevalence was compared between specific-country under-five mortality groups, publication year and age. In the last decades, under-five mortality rates have been decreasing all over the world. This reduction is paralleled by an increase of the prevalence of celiac disease. The Spearman correlation coefficient was -63%, 95%CI -82% to -33% (p < 0.001). So, the higher the mortality rate, the lower the prevalence of CD. This finding is confirmed by the meta-analysis of the 4 studies conducted in Italy over time. The under five-mortality rate seems to influence the prevalence of celiac disease in the general population. In the near future, the number of celiac disease patients will increase, thanks to the better environmental conditions that nowadays allow a better survival of celiac children.

  7. Associations between national gambling policies and disordered gambling prevalence rates within Europe.

    PubMed

    Planzer, Simon; Gray, Heather M; Shaffer, Howard J

    2014-01-01

    Policymakers and other interested stakeholders currently are seeking information about the comparative effectiveness of different regulatory approaches to minimising gambling-related harm. This study responds to this research gap by exploring associations between gambling policies and disordered gambling prevalence rates. We gathered information about gambling policies for thirty European jurisdictions and past-year prevalence rates for disordered gambling for twelve of these jurisdictions. We present policy trends and prevalence rates and then describe the level of association between policy and prevalence. We observe one statistically significant association between policy and prevalence: rates of sub-clinical (i.e., Level 2) disordered gambling were higher within environments that mandated less strict regulation of advertising for online gambling. Finally, we discuss the implications of our research in the context of the current process regarding the pan-European regulation of gambling. Our findings do not offer evidence for certain assumptions made in the past by the European judiciary.

  8. Migration background and juvenile mental health: a descriptive retrospective analysis of diagnostic rates of psychiatric disorders in young people

    PubMed Central

    Gaber, Tilman Jakob; Bouyrakhen, Samira; Herpertz-Dahlmann, Beate; Hagenah, Ulrich; Holtmann, Martin; Freitag, Christine Margarete; Wöckel, Lars; Poustka, Fritz; Zepf, Florian Daniel

    2013-01-01

    Introduction This article presents diagnostic rates for specific mental disorders in a German pediatric inpatient population over a period of 20 years with respect to migration background and socioeconomic status (SES). Methods Diagnostic data were obtained over a period of 20 years from 8,904 patients who visited a child and adolescent psychiatry mental health service in Germany. Data from 5,985 diagnosed patients (ICD-9 and ICD-10 criteria) were included with respect to gender, migration background, and SES. Results Migration- and gender-specific effects were found for both periods of assessment. The group of boys with a migration background showed significantly higher rates of reactions to severe stress, adjustment disorders, and posttraumatic stress disorder compared to their male, non-migrant counterparts. Conversely, boys without a migration background showed a significantly higher percentage rate of hyperkinetic disorders than male migrants. Similar results were found for female migrants in the latter assessment period (ICD-10). In addition, female migrants showed lower rates of emotional disorders whose onset occurs in childhood compared to their non-migrant counterparts. Conclusions Data from this investigation provide preliminary evidence that the prevalence of various psychiatric disorders in children and adolescents is influenced by migration background and SES. PMID:23787053

  9. A vine copula mixed effect model for trivariate meta-analysis of diagnostic test accuracy studies accounting for disease prevalence.

    PubMed

    Nikoloulopoulos, Aristidis K

    2015-08-11

    A bivariate copula mixed model has been recently proposed to synthesize diagnostic test accuracy studies and it has been shown that it is superior to the standard generalized linear mixed model in this context. Here, we call trivariate vine copulas to extend the bivariate meta-analysis of diagnostic test accuracy studies by accounting for disease prevalence. Our vine copula mixed model includes the trivariate generalized linear mixed model as a special case and can also operate on the original scale of sensitivity, specificity, and disease prevalence. Our general methodology is illustrated by re-analyzing the data of two published meta-analyses. Our study suggests that there can be an improvement on trivariate generalized linear mixed model in fit to data and makes the argument for moving to vine copula random effects models especially because of their richness, including reflection asymmetric tail dependence, and computational feasibility despite their three dimensionality.

  10. [Correlative factors on prevalence rate of dislipidemia among 1 337 coal miners in Shanxi province].

    PubMed

    Fu, Z D; Wen, D D; Wang, B; Xue, S L; Liu, G S; Li, X H; Zhao, Z H; Wang, J; Wei, B G; Wang, S P

    2017-02-10

    Objective: To understand the prevalence rate and correlative factors of dislipidemia among Shanxi coal miners and to provide evidence for the development of programs on dislipidemia prevention. Methods: We investigated 1 337 mine workers from a Coal Group in April 2016 and collected data related to their blood biochemistry. We then classified the types in accordance with the diagnostic criteria of " Guidelines for prevention and treatment of dyslipidemia in Chinese adults (2007)" , using χ(2) test and unconditional logistic regression model for analysis. Results: The overall prevalence rate of Dislipidemia was 59.1% (790/1 337), with males as 60.4% (708/1 173) and females as 50.0%(82/164) while males appeared higher (χ(2)=6.386, P<0.05). Among the 20-34, 35-49, 50 and above year-old groups, the rates were 68.8%, 58.7%, 49.5%, respectively. Results from the χ(2) test showed that gender, age and body mass index were the influencing factors on dislipidemia (χ(2)=7.117, P<0.01; χ(2)=37.135, P<0.01; χ(2)=7.009, P<0.05), while logistic regression analysis showed that sex, age, body mass index level, systolic blood pressure were significantly associated with dislipidemia (P<0.05). Male miners appeared 1.501 times (OR=1.501, 95%CI: 1.895-2.516) higher than female miners in suffering from the risk of dyslipidemia. In different age groups, risks of dyslipidemia in the 35-49, 20-34 year-old groups were 1.672 (OR=1.672, 95%CI: 1.501-2.392) and 2.369 times (OR= 2.369, 95% CI: 1.275-3.469) higher than the 50 year-old. Group that with high BMI, the risk of dyslipidemia was 1.443 times (OR=1.443, 95%CI: 1.139-1.828) higher than the normal BMI group. Group with abnormal systolic pressure was 1.829 times (OR=1.829, 95%CI: 1.152-2.906) higher than normal systolic pressure group. However, diastolic blood pressure, blood sugar, uric acid, and electrocardiogram findings did not seem to show statistically significant meanings on dislipidemia. Conclusion: Among the coal mine workers

  11. Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women.

    PubMed

    Feitosa, Alina Coutinho Rodrigues; Barreto, Luciana Tedgue; Silva, Isabela Matos da; Silva, Felipe Freire da; Feitosa, Gilson Soares

    2017-07-01

    There is a physiologic elevation of total cholesterol (TC) and triglycerides (TG) during pregnancy. Some authors define dyslipidemia (DLP) in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95%) and HDL concentration is below the 5th percentile (P5%) for gestational age (GA). To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6%) had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities. Durante a gestação ocorrem, fisiologicamente, elevações do colesterol total (CT) e triglicerídios (TG). Alguns autores definem dislipidemia (DLP) gestacional quando as concentrações de CT, LDL e TG são superiores ao percentil 95 (P95%) e de HDL, inferiores ao percentil 5 (P5%) para a idade gestacional. Comparar a prevalência da DLP em gestantes conforme critério por percentis com o da V

  12. A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks

    PubMed Central

    2011-01-01

    Background The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB), acromioclavicular joint (ACJ) and glenohumeral joint (GHJ). Methods Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance arthrogram (MRA) and GHJ diagnostic block. Differences in proportions of positive and negative imaging findings in the anaesthetic response groups were assessed using Fishers test and odds ratios were calculated a for positive anaesthetic response (PAR) to diagnostic blocks. Results In the 208 subjects recruited, the rotator cuff and SAB displayed the highest prevalence of pathology on both ultrasound (50% and 31% respectively) and MRA (65% and 76% respectively). The prevalence of PAR following SAB injection was 34% and ACJ injection 14%. Of the 59% reporting a negative anaesthetic response (NAR) for both of these injections, 16% demonstrated a PAR to GHJ injection. A full thickness tear of supraspinatus on ultrasound was associated with PAR to SAB injection (OR 5.02; p < 0.05). Ultrasound evidence of a biceps tendon sheath effusion (OR 8.0; p < 0.01) and an intact rotator cuff (OR 1.3; p < 0.05) were associated with PAR to GHJ injection. No imaging findings were strongly associated with PAR to ACJ injection (p ≤ 0.05). Conclusions Rotator cuff and SAB pathology were the most common findings on ultrasound and MRA. Evidence of a full thickness supraspinatus tear was associated with symptoms arising from the subacromial region, and a biceps tendon sheath effusion

  13. Prevalence of diabetes in Malaysia and usefulness of HbA1c as a diagnostic criterion.

    PubMed

    Wan Nazaimoon, W M; Md Isa, S H; Wan Mohamad, W B; Khir, A S; Kamaruddin, N A; Kamarul, I M; Mustafa, N; Ismail, I S; Ali, O; Khalid, B A K

    2013-07-01

    The prevalence of diabetes mellitus among Malaysians aged ≥ 30 years of age has increased by more than twofold over a 20-year period. This study aimed to determine the current status and to evaluate the diagnostic usefulness of the HbA(1c) cut-off point of 48 mmol/mol (6.5%). Using a two-stage stratified sampling design, participants aged ≥ 18 years were recruited from five zones selected to represent Malaysia. An oral glucose tolerance test was performed on all those not known to have diabetes. A total of 4341 subjects were recruited. By World Health Organization criteria, the prevalence of diabetes mellitus was 22.9%; of that percentage, 10.8% was known diabetes and 12.1% was newly diagnosed diabetes. Diabetes was most prevalent amongst Indians (37.9%) and Malays (23.8%). Prevalence of new diabetes mellitus was only 5.5% (95% CI 4.9-6.3) when based on the HbA(1c) diagnostic criteria of 48 mmol/mol (6.5%) and, although the cut-off point was highly specific (98.1%), it was less sensitive (36.7%) compared with 45 mmol/mol (6.3%), which showed the optimal sum of sensitivity (42.5%) and specificity (97.4%) in identifying new diabetes mellitus. This study recorded an overall diabetes prevalence of 22.6%, almost a twofold increase from 11.6% reported in 2006. This was likely attributable to the higher prevalence of new diabetes (12.1%) diagnosed following an oral glucose tolerance test. An HbA(1c) of 45 mmol/mol (6.3%) was found to be a better predictive cut-off point for detecting new diabetes in our multi-ethnic population. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  14. Neighborhood Incarceration Rate and Asthma Prevalence in New York City: A Multilevel Approach

    PubMed Central

    Hong, Clemens S.; Subramanian, S. V.; Wang, Emily A.

    2013-01-01

    Objectives. We examined the association between neighborhood incarceration rate and asthma prevalence and morbidity among New York City adults. Methods. We used multilevel modeling techniques and data from the New York City Community Health Survey (2004) to analyze the association between neighborhood incarceration rate and asthma prevalence, adjusting for individual-level sociodemographic, behavioral, and environmental characteristics. We examined interactions between neighborhood incarceration rate, respondent incarceration history, and race/ethnicity. Results. The mean neighborhood rate of incarceration was 5.4% (range = 2.1%–12.8%). Neighborhood incarceration rate was associated with individual-level asthma prevalence (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.03, 1.10) in unadjusted models but not after adjustment for sociodemographic characteristics (OR = 1.01; 95% CI = 0.98, 1.04). This association did not differ according to respondent race/ethnicity. Conclusions. Among New York City adults, the association between neighborhood incarceration rate and asthma prevalence is explained by the sociodemographic composition of neighborhoods and disparities in asthma prevalence at the individual level. Public health practitioners should further engage with criminal justice professionals and correctional health care providers to target asthma outreach efforts toward both correctional facilities and neighborhoods with high rates of incarceration. PMID:23488496

  15. Slowed articulation rate is a sensitive diagnostic marker for identifying non-fluent primary progressive aphasia.

    PubMed

    Cordella, Claire; Dickerson, Bradford C; Quimby, Megan; Yunusova, Yana; Green, Jordan R

    2017-01-01

    Primary progressive aphasia (PPA) is a neurodegenerative aphasic syndrome with three distinct clinical variants: non-fluent (nfvPPA), logopenic (lvPPA), and semantic (svPPA). Speech (non-) fluency is a key diagnostic marker used to aid identification of the clinical variants, and researchers have been actively developing diagnostic tools to assess speech fluency. Current approaches reveal coarse differences in fluency between subgroups, but often fail to clearly differentiate nfvPPA from the variably fluent lvPPA. More robust subtype differentiation may be possible with finer-grained measures of fluency. We sought to identify the quantitative measures of speech rate-including articulation rate and pausing measures-that best differentiated PPA subtypes, specifically the non-fluent group (nfvPPA) from the more fluent groups (lvPPA, svPPA). The diagnostic accuracy of the quantitative speech rate variables was compared to that of a speech fluency impairment rating made by clinicians. Automatic estimates of pause and speech segment durations and rate measures were derived from connected speech samples of participants with PPA (N=38; 11 nfvPPA, 14 lvPPA, 13 svPPA) and healthy age-matched controls (N=8). Clinician ratings of fluency impairment were made using a previously validated clinician rating scale developed specifically for use in PPA. Receiver operating characteristic (ROC) analyses enabled a quantification of diagnostic accuracy. Among the quantitative measures, articulation rate was the most effective for differentiating between nfvPPA and the more fluent lvPPA and svPPA groups. The diagnostic accuracy of both speech and articulation rate measures was markedly better than that of the clinician rating scale, and articulation rate was the best classifier overall. Area under the curve (AUC) values for articulation rate were good to excellent for identifying nfvPPA from both svPPA (AUC=.96) and lvPPA (AUC=.86). Cross-validation of accuracy results for articulation

  16. Metabolic Syndrome in People Living with Human Immunodeficiency Virus: An Assessment of the Prevalence and the Agreement between Diagnostic Criteria

    PubMed Central

    de Villiers, Anniza; Mukasa, Barbara; Mills, Edward J.

    2017-01-01

    Objectives. We determined metabolic syndrome (MetS) prevalence and assessed the agreement between different diagnostic criteria in HIV-infected South Africans. Method. A random sample included 748 HIV-infected adult patients (79% women) across 17 HIV healthcare facilities in the Western Cape Province. MetS was defined using the Joint Interim Statement (JIS 2009), International Diabetes Federation (IDF 2005), and Adult Treatment Panel III (ATPIII 2005) criteria. Results. Median values were 38 years (age), 5 years (diagnosed HIV duration), and 392 cells/mm3 (CD4 count), and 93% of the participants were on antiretroviral therapy (ART). MetS prevalence was 28.2% (95%CI: 25–31.4), 26.5% (23.3–29.6), and 24.1% (21–27.1) by the JIS, IDF, and ATPIII 2005 criteria, respectively. Prevalence was always higher in women than in men (all p < 0.001), in participants with longer duration of diagnosed HIV (all p ≤ 0.003), and in ART users not receiving 1st-line regimens (all p ≤ 0.039). The agreement among the three criteria was very good overall and in most subgroups (all kappa ≥ 0.81). Conclusions. The three most popular diagnostic criteria yielded similarly high MetS prevalence in this relatively young population receiving care for HIV infection. Very good levels of agreement between criteria are unaffected by some HIV-specific features highlighting the likely comparable diagnostic utility of those criteria in routine HIV care settings. PMID:28392801

  17. Immunophoretic rapid diagnostic tests as a source of immunoglobulins for estimating malaria sero-prevalence and transmission intensity.

    PubMed

    Williams, Geoffrey S; Mweya, Clement; Stewart, Laveta; Mtove, George; Reyburn, Hugh; Cook, Jackie; Corran, Patrick H; Riley, Eleanor M; Drakeley, Chris J

    2009-07-22

    Sero-epidemiological methods are being developed as a tool for rapid assessment of malaria transmission intensity. Simple blood collection methods for use in field settings will make this more feasible. This paper describes validation of such a method, by analysing immunoglobulins from blood retained within immunophoretic rapid diagnostic tests (RDTs) for Plasmodium falciparum. RDTs are now widely used for the diagnosis of malaria and estimation of parasite rates, and this method represents a further use for these devices in malaria control. Immunoglobulins eluted from RDTs, designed to detect parasite histidine rich protein-2 (HRP-2), were analysed by indirect ELISA for IgG recognizing the P. falciparum blood stage antigens merozoite surface protein-1(19) (MSP-1(19)) and apical membrane antigen-1 (AMA-1). Optimal storage conditions for RDTs were evaluated by comparing antibody responses from RDTs stored in dry or humid conditions at 4 degrees C or at ambient temperature (with or without air-conditioning) for 7, 31 or 70 days. Antibody levels estimated using 3,700 RDT samples from attendees at health facilities in North-eastern Tanzania were compared with contemporaneously collected filter paper blood spots (FPBS) and used to estimate seroconversion rates. Storage of RDTs at 4 degrees C was optimal for immunoglobulin recovery but short-term storage at ambient temperatures did not substantially affect anti-malarial IgG levels. Results from RDTs were comparable with those from FPBSs, for both antigens. RDT-generated titres tended to be slightly higher than those generated from FPBSs, possibly due to greater recovery of immunoglobulins from RDTs compared to filter paper. Importantly, however, RDT-based seroconversion rates, and hence serological estimates of malaria transmission intensity, agreed closely with those from FPBSs. RDTs represent a practical option for collecting blood for sero-epidemiological surveys, with potential cost and logistical advantages over

  18. Immunophoretic rapid diagnostic tests as a source of immunoglobulins for estimating malaria sero-prevalence and transmission intensity

    PubMed Central

    Williams, Geoffrey S; Mweya, Clement; Stewart, Laveta; Mtove, George; Reyburn, Hugh; Cook, Jackie; Corran, Patrick H; Riley, Eleanor M; Drakeley, Chris J

    2009-01-01

    Background Sero-epidemiological methods are being developed as a tool for rapid assessment of malaria transmission intensity. Simple blood collection methods for use in field settings will make this more feasible. This paper describes validation of such a method, by analysing immunoglobulins from blood retained within immunophoretic rapid diagnostic tests (RDTs) for Plasmodium falciparum. RDTs are now widely used for the diagnosis of malaria and estimation of parasite rates, and this method represents a further use for these devices in malaria control. Methods Immunoglobulins eluted from RDTs, designed to detect parasite histidine rich protein-2 (HRP-2), were analysed by indirect ELISA for IgG recognizing the P. falciparum blood stage antigens merozoite surface protein-119 (MSP-119) and apical membrane antigen-1 (AMA-1). Optimal storage conditions for RDTs were evaluated by comparing antibody responses from RDTs stored in dry or humid conditions at 4°C or at ambient temperature (with or without air-conditioning) for 7, 31 or 70 days. Antibody levels estimated using 3,700 RDT samples from attendees at health facilities in North-eastern Tanzania were compared with contemporaneously collected filter paper blood spots (FPBS) and used to estimate seroconversion rates. Results Storage of RDTs at 4°C was optimal for immunoglobulin recovery but short-term storage at ambient temperatures did not substantially affect anti-malarial IgG levels. Results from RDTs were comparable with those from FPBSs, for both antigens. RDT-generated titres tended to be slightly higher than those generated from FPBSs, possibly due to greater recovery of immunoglobulins from RDTs compared to filter paper. Importantly, however, RDT-based seroconversion rates, and hence serological estimates of malaria transmission intensity, agreed closely with those from FPBSs. Conclusion RDTs represent a practical option for collecting blood for sero-epidemiological surveys, with potential cost and logistical

  19. An evaluation of the prevalence of Bovine herpesvirus 1 abortions based on diagnostic submissions to five U.S.-based veterinary diagnostic laboratories.

    PubMed

    Gould, Stacie; Cooper, Vicky L; Reichardt, Niles; O'Connor, Annette M

    2013-03-01

    Bovine herpesvirus 1 (BoHV-1) is 1 of several viruses considered to be causal agents of bovine abortion. The current retrospective study examined data on bovine abortion submissions from 5 veterinary diagnostic laboratories from 2000 to 2011. The objective of the study was to describe prevalence of BoHV-1-associated abortion in submissions at veterinary diagnostic laboratories. There were 3 specific aims: 1) to examine the proportion of BoHV-1-related abortions with the introduction of new diagnostic assays such as polymerase chain reaction (PCR), 2) to evaluate the agreement of the histopathology report of the abortion submissions and the result of the assay used, and 3) to evaluate if there was an association between farm history of vaccination against BoHV-1 and BoHV-1-positive abortion submissions. An extended Mantel-Haenszel χ(2) for linear trend was used to analyze the prevalence of BoHV-1 over the study period and showed that collectively there is evidence of an increase of positive BoHV-1 abortions (P < 0.001). The comparison of the proportion of BoHV-1-positive submissions pre- and postadoption of PCR was not significant (P = 0.25). Using Cohen kappa coefficient test of agreement, a kappa value of 0.81 (P < 0.001) was found, suggesting high agreement of lesions reported and assay result. It was found that using a χ(2) test, a P value of 0.068 for nonmatched data (i.e., a history of vaccination against BoHV-1 in the herd) was associated with reduced detection of BoHV-1-positive abortion submissions.

  20. The impact of high-flux dialysis on mortality rates in incident and prevalent hemodialysis patients

    PubMed Central

    Kim, Hyung Wook; Kim, Su-Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong-Lim; Kim, Yon-Su; Kang, Shin-Wook; Kim, Nam-Ho; Yang, Chul Woo

    2014-01-01

    Background/Aims The effect of high-flux (HF) dialysis on mortality rates could vary with the duration of dialysis. We evaluated the effects of HF dialysis on mortality rates in incident and prevalent hemodialysis (HD) patients. Methods Incident and prevalent HD patients were selected from the Clinical Research Center registry for end-stage renal disease (ESRD), a Korean prospective observational cohort study. Incident HD patients were defined as newly diagnosed ESRD patients initiating HD. Prevalent HD patients were defined as patients who had been receiving HD for > 3 months. The primary outcome measure was all-cause mortality. Results This study included 1,165 incident and 1,641 prevalent HD patients. Following a median 24 months of follow-up, the mortality rates of the HF and low-flux (LF) groups did not significantly differ in the incident patients (hazard ratio [HR], 1.046; 95% confidence interval [CI], 0.592 to 1.847; p = 0.878). In the prevalent patients, HF dialysis was associated with decreased mortality compared with LF dialysis (HR, 0.606; 95% CI, 0.416 to 0.885; p = 0.009). Conclusions HF dialysis was associated with a decreased mortality rate in prevalent HD patients, but not in incident HD patients. PMID:25378976

  1. The impact of high-flux dialysis on mortality rates in incident and prevalent hemodialysis patients.

    PubMed

    Kim, Hyung Wook; Kim, Su-Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong-Lim; Kim, Yon-Su; Kang, Shin-Wook; Kim, Nam-Ho; Yang, Chul Woo; Kim, Yong Kyun

    2014-11-01

    The effect of high-flux (HF) dialysis on mortality rates could vary with the duration of dialysis. We evaluated the effects of HF dialysis on mortality rates in incident and prevalent hemodialysis (HD) patients. Incident and prevalent HD patients were selected from the Clinical Research Center registry for end-stage renal disease (ESRD), a Korean prospective observational cohort study. Incident HD patients were defined as newly diagnosed ESRD patients initiating HD. Prevalent HD patients were defined as patients who had been receiving HD for > 3 months. The primary outcome measure was all-cause mortality. This study included 1,165 incident and 1,641 prevalent HD patients. Following a median 24 months of follow-up, the mortality rates of the HF and low-flux (LF) groups did not significantly differ in the incident patients (hazard ratio [HR], 1.046; 95% confidence interval [CI], 0.592 to 1.847; p = 0.878). In the prevalent patients, HF dialysis was associated with decreased mortality compared with LF dialysis (HR, 0.606; 95% CI, 0.416 to 0.885; p = 0.009). HF dialysis was associated with a decreased mortality rate in prevalent HD patients, but not in incident HD patients.

  2. Luteinizing hormone--releasing hormone agonists: a quick reference for prevalence rates of potential adverse effects.

    PubMed

    Walker, Lauren M; Tran, Susan; Robinson, John W

    2013-12-01

    Men with prostate cancer (PCa) frequently undergo androgen deprivation therapy (ADT), typically in the form of a depot injection of luteinizing hormone-releasing hormone agonists (LHRHa). LHRHa are associated with many adverse effects (eg, hot flashes, sexual dysfunction, loss of muscle mass, osteopenia, metabolic syndrome), which drastically impact patient quality of life. This literature review, which includes a comprehensive table documenting prevalence rates, provides a quick reference for health care professionals involved in the care of men undergoing ADT with LHRHa. Primary sources were acquired from PubMed using the search terms "androgen deprivation therapy" and each potentially adverse effect (eg, "androgen deprivation therapy and hot flashes"). Commonly cited review articles were also examined for citations of original studies containing prevalence rates. More than 270 articles were reviewed. In contrast to many existing reviews, rates are cited exclusively from original sources. The prevalence rates, obtained from original sources, suggest that more than half of documented adverse effects are experienced by as many as 40% or more of patients. A critique of the literature is also provided. Although there is a vast literature of both original and review articles on specific adverse effects of LHRHa, the quality of research on prevalence rates for some adverse effects is subpar. Many review articles contain inaccuracies and do not cite original sources. The table of prevalence rates will serve as a quick reference for health care providers when counseling patients and will aid in the development of evidence-based patient education materials.

  3. Capture-recapture-adjusted prevalence rates of type 2 diabetes are related to social deprivation.

    PubMed

    Ismail, A A; Beeching, N J; Gill, G V; Bellis, M A

    1999-12-01

    We examined the prevalence of type 2 diabetes and social deprivation in one urban district in Liverpool from October 1995 to September 1996 inclusive. This area has a stable Caucasian population of 176, 682. Lists were made of all known diabetics attending six different medical points of contact during the year, and were condensed and aggregated to eliminate duplicates. From postcode data, each patient was assigned to residence in one of the 14 electoral wards in the district, for which demographic structure and standardized measures of social deprivation were known (Townsend index). The crude period prevalences of type 1 and type 2 diabetes were estimated for each ward. Crude prevalence data were then corrected by applying capture-recapture (CR) techniques to the different patient datasets to allow for undercount. The crude period prevalence (95%CI) of diabetes was 1.5% (1.4-1.5%), or 2585/176, 682. The mean age of people with diabetes was not significantly different between electoral wards. The crude period prevalence of type 2 diabetes within individual wards ranged from 0.4% (0.3-0.6%) in the least deprived area to 4.1% (3.6-4.6%) in the most deprived area. The corresponding range of CR-adjusted period prevalence rates of type 2 diabetes was from 3.2% (2.8-3.6%) to 6.7% (6.1-7.4%), and there was strong correlation between both crude and CR-adjusted prevalence and social deprivation in each ward (r=0.76, p<0.001 for crude; and r=0. 49, p<0.005 for CR-adjusted prevalence). There was no correlation between the crude or CR-adjusted period prevalence rates of type 1 diabetes and Townsend index (r=0.14, p=NS). This strong correlation between the prevalence of type 2 diabetes and social deprivation has important implications for the planning of health-care delivery.

  4. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples.

    PubMed

    Stammel, Nadine; Abbing, Eva M; Heeke, Carina; Knaevelsrud, Christine

    2015-01-01

    The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11). The present study investigated the impact of these changes in two different post-conflict samples. Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample) compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample). Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety) compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.

  5. How does relaxing the algorithm for autism affect DSM-V prevalence rates?

    PubMed

    Matson, Johnny L; Hattier, Megan A; Williams, Lindsey W

    2012-08-01

    Although it is still unclear what causes autism spectrum disorders (ASDs), over time researchers and clinicians have become more precise with detecting and diagnosing ASD. Many diagnoses, however, are based on the criteria established within the Diagnostic and Statistical Manual of Mental Disorders (DSM); thus, any change in these diagnostic criteria can have a great effect upon children with ASD and their families. It is predicted that the prevalence of ASD diagnoses will dramatically decrease with the adoption of the proposed DSM-5 criteria in 2013. The aim of this current study was to inspect the changes in prevalence first using a diagnostic criteria set which was modified slightly from the DSM-5 criteria (Modified-1 criteria) and again using a set of criteria which was relaxed even a bit more (Modified-2 criteria). Modified-1 resulted in 33.77 % fewer toddlers being diagnosed with ASD compared to the DSM-IV, while Modified-2 resulted in only a 17.98 % decrease in ASD diagnoses. Children diagnosed with the DSM-5 criteria exhibited the greatest levels of autism symptomatology, but the Mod-1, Mod-2, and DSM-IV groups still demonstrated significant impairments. Implications of these findings are discussed.

  6. Estimating malaria parasite prevalence from community surveys in Uganda: a comparison of microscopy, rapid diagnostic tests and polymerase chain reaction.

    PubMed

    Nankabirwa, Joaniter I; Yeka, Adoke; Arinaitwe, Emmanuel; Kigozi, Ruth; Drakeley, Chris; Kamya, Moses R; Greenhouse, Bryan; Rosenthal, Philip J; Dorsey, Grant; Staedke, Sarah G

    2015-12-30

    Household surveys are important tools for monitoring the malaria disease burden and measuring impact of malaria control interventions with parasite prevalence as the primary metric. However, estimates of parasite prevalence are dependent on a number of factors including the method used to detect parasites, age of the population sampled, and level of immunity. To better understand the influence of diagnostics, age, and endemicity on estimates of parasite prevalence and how these change over time, community-based surveys were performed for two consecutive years in three settings and the sensitivities of microscopy and immunochromatographic rapid diagnostic tests (RDTs) were assessed, considering polymerase chain reaction (PCR) as the gold standard. Surveys were conducted over the same two-month period in 2012 and 2013 in each of three sub-counties in Uganda: Nagongera in Tororo District (January-February), Walukuba in Jinja District (March-April), and Kihihi in Kanungu District (May-June). In each sub-county, 200 households were randomly enrolled and a household questionnaire capturing information on demographics, use of malaria prevention methods, and proxy indicators of wealth was administered to the head of the household. Finger-prick blood samples were obtained for RDTs, measurement of hemoglobin, thick and thin blood smears, and to store samples on filter paper. A total of 1200 households were surveyed and 4433 participants were included in the analysis. Compared to PCR, the sensitivity of microscopy was low (65.3% in Nagongera, 49.6% in Walukuba and 40.9% in Kihihi) and decreased with increasing age. The specificity of microscopy was over 98% at all sites and did not vary with age or year. Relative differences in parasite prevalence across different age groups, study sites, and years were similar for microscopy and PCR. The sensitivity of RDTs was similar across the three sites (range 77.2-82.8%), was consistently higher than microscopy (p < 0.001 for all

  7. The Prevalence of Toxocariasis and Diagnostic Value of Serologic Tests in Asymptomatic Korean Adults

    PubMed Central

    Lee, Jin-Young; Yang, Moon Hee; Hwang, Jung-Hae; Kang, Mira; Paeng, Jae-Won; Yune, Sehyo; Lee, Byung-Jae

    2015-01-01

    Purpose Toxocariasis is the most common cause of peripheral blood eosinophilia in Korea and produces eosinophilic infiltration in various organs, including the lung. However, the prevalence of toxocariasis in the general population is rarely reported. Methods We investigated the seroprevalence of Toxocara larval antibody among asymptomatic people who attended Samsung Medical Center for a health checkup, including low-dose chest computed tomography (CT) between March 2012 and December 2013. A total of 633 people (400 men and 233 women) were prospectively recruited. Results The Toxocara-seropositive rate was 51.2% using the current cutoff value based on Toxocara enzyme-linked immunosorbent assay (ELISA) (67.0% for men and 24.0% for women). In the multivariate-adjusted model, age (odds ratio [OR], 1.08; 95% confidence intervals [CI], 1.04-1.11), male sex (OR, 3.47; 95% CI, 2.26-5.33), rural residence (OR, 1.55; 95% CI, 1.05-2.30), and history of raw liver intake (OR, 8.52; 95% CI, 3.61-20.11) were significantly associated with Toxocara seropositivity. When subjects were divided into 3 groups using cutoff values base on weak positive and strong positive control optical densities (ODs), the ORs for peripheral blood eosinophilia and serum hyperIgEaemia were 0.31 (95% CI, 0.02-2.89) in the weakpositive group and 36.64 (95% CI, 11.73-111.42) in the strong positive group compared to the seronegative group. Similarly, ORs for the solid nodule with surrounding halo were 2.54 (95% CI, 0.60-10.84) in the weak positive group and 15.08 (95 CI 4.09-55.56) in the strong positive group compared to the seronegative group. Conclusions The study indicated that the Toxocara-seropositive rate obtained by using the current cutoff value based on ELISA was high in the asymptomatic population in Korea. The results of this study suggest that active toxocariasis may be more frequently seen in the Toxocara-strong positive group than in the Toxocara-weak positive group. PMID:26122506

  8. Prevalence rates of borderline symptoms reported by adolescent inpatients with BPD, psychiatrically healthy adolescents and adult inpatients with BPD.

    PubMed

    Zanarini, Mary C; Temes, Christina M; Magni, Laura R; Fitzmaurice, Garrett M; Aguirre, Blaise A; Goodman, Marianne

    2017-08-01

    The validity of borderline personality disorder (BPD) in children and adolescents has not been studied in a rigorous manner reflecting the criteria of Robins and Guze first detailed in 1970. This paper and the others in this series address some aspects of this multifaceted validation paradigm, which requires that a disorder has a known clinical presentation, can be delimited from other disorders, 'runs' in families, and something of its aetiology, treatment response and course is known. Three groups of subjects were studied: 104 adolescent inpatients meeting the Revised Diagnostic Interview for Borderlines and DSM-IV criteria for BPD, 60 psychiatrically healthy adolescents and 290 adult inpatients meeting the Revised Diagnostic Interview for Borderlines and DSM-III-R criteria for BPD. Adolescents with BPD had significantly higher prevalence rates of 22 of the 24 symptoms studied than psychiatrically healthy adolescents. Only rates of serious treatment regressions and countertransference problems failed to reach the Bonferroni-corrected level of 0.002. Adolescents and adults with BPD had only four symptomatic differences that reached this level of significance, with adolescents with BPD reporting significantly lower levels of quasi-psychotic thought, dependency/masochism, devaluation/manipulation/sadism and countertransference problems than adults with BPD. Taken together, the results of this study suggest that adolescents report BPD as severe as that reported by adults. They also suggest that BPD in adolescents is not a tumultuous phase of normal adolescence. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Statistics of hematologic malignancies in Korea: incidence, prevalence and survival rates from 1999 to 2008

    PubMed Central

    Park, Hyeon Jin; Park, Eun-Hye; Jung, Kyu-Won; Kong, Hyun-Joo; Won, Young-Joo; Lee, Joo Young; Yoon, Jong Hyung; Park, Byung-Kiu; Lee, Hyewon; Eom, Hyeon-Seok

    2012-01-01

    Background The nationwide statistical analysis of hematologic malignancies in Korea has not been reported yet. Methods The Korea Central Cancer Registry and the Korean Society of Hematology jointly investigated domestic incidence rates and prevalence of hematologic malignancies occurred between 1999 and 2008, and analyzed survival rates of patients who were diagnosed between 1993 and 2008. Data of hematologic malignancies from 1993 to 2008 were obtained from the Korean National Cancer Incidence Data base. The crude incidence rates, age-specific incidence rates, age-standardized incidence rates, annual percentage change of incidence, and prevalence from 1999-2008 were calculated. Survival rates for patients diagnosed in 1993-2008 were estimated. Results In 2008, a total of 8,006 cases of hematologic malignancies were occurred, which comprised 4.5% of all malignancies. In all genders, non-Hodgkin lymphoma, myeloid leukemia, and multiple myeloma were most frequent diseases. In terms of age, ages between 60 and 69 were most prevalent. From 1999 to 2008, the age-standardized incidence rates increased from 10.2 to 13.7, and the annual percentage change was 3.9%. The 5-year survival rate increased from 38.2% during 1993-1995 to 55.2% during 2004-2008. As of January 2009, number of patients with 10-year prevalence was 33,130, and with 5- to 10-year prevalence was 10,515. Conclusion This is the first nationwide statistical report of hematologic malignancies in Korea. It could be used as the basic information to help investigate epidemiologic characteristics, evaluate progress during the past years, and establish future strategies for hematologic malignancies. Periodic statistical analysis of hematologic malignancies in Korea should be continued. PMID:22479275

  10. Relationship between entomological inoculation rate, Plasmodium falciparum prevalence rate, and incidence of malaria attack in rural Gabon.

    PubMed

    Elissa, N; Migot-Nabias, F; Luty, A; Renaut, A; Touré, F; Vaillant, M; Lawoko, M; Yangari, P; Mayombo, J; Lekoulou, F; Tshipamba, P; Moukagni, R; Millet, P; Deloron, P

    2003-03-01

    To assess the relationships between variations of Plasmodium falciparum transmission and those of peripheral parasitaemia prevalence or malaria attack incidence rates in regions with limited fluctuations of transmission, we conducted a follow-up in two Gabonese populations. Entomological surveys were carried out from May 1995 to April 1996 in Dienga, and from May 1998 to April 1999 in Benguia. In Dienga, malaria transmission was seasonal, being not detected during two 3-month periods. Mean entomological inoculation rate (EIR) was 0.28 infective bite/person/night. In Benguia, malaria transmission was perennial with seasonal fluctuations, mean EIR being 0.76 infective bite/person/night. In Dienga, 301 schoolchildren were followed from October 1995 to March 1996. Clinical malaria attack was defined as fever associated with >5000 parasites/microl of blood. P. falciparum prevalence varied from 28 to 42%, and monthly malaria attack incidence from 30 to 169 per thousand. In Benguia, the entire population (122 persons) was followed from November 1998 to April 1999. Prevalence varied from 22 to 50%, and monthly malaria attack incidence from 52 to 179 per thousand. In each area, entomological variations were not related to parasite prevalence, but preceded malaria attack incidence with 1- or 2-month time lag, corresponding to the pre-patency period that differs in the two populations, possibly according to differences in immunity related to parasite transmission.

  11. European map of prevalence rates of elder abuse and its impact for future research.

    PubMed

    De Donder, Liesbeth; Luoma, Minna-Liisa; Penhale, Bridget; Lang, Gert; Santos, Ana J; Tamutiene, Ilona; Koivusilta, Mira; Schopf, Anna; Ferreira Alves, José; Reingarde, Jolanta; Perttu, Sirkka; Savola, Tiina; Verté, Dominique

    2011-06-01

    This article aims to map existing prevalence research on abuse and neglect of older people and to provide a critical overview of existing methodologies, which have been adopted to survey the prevalence rates of abuse against elders. This article is part of the prevalence study of Abuse and Violence against Older Women (AVOW) study, which was conducted in five European countries (Austria, Belgium, Finland, Lithuania, and Portugal). The article provides an overview of the state of the art of prevalence data, survey designs and methods, instruments and results in Europe. Therefore, this draws on an extensive literature search and qualitative content analysis, which was conducted as an early part of the AVOW study. Results indicate that some EU countries have a rich history of prevalence research, whereas other countries have just begun to tackle this aspect of research on of elder abuse. One of the lacunae concerns reliable numbers on the prevalence rates of elder abuse. Research about where, when and how often elder abuse occurs, is inadequate and inconsistent. Data in some cases are based on professionals' reports rather than on information from older people themselves. Surveying elders about such a sensitive topic, however, implies the need for an adequate research instrument (questionnaire) and research design, and an adapted data collection method. In conclusion, substantial attention is paid to outlining possible guidelines for future research.

  12. ITER Generic Diagnostic Upper Port Plug Nuclear Heating and Personnel Dose Rate Assesment

    SciTech Connect

    Russell E. Feder and Mahmoud Z. Youssef

    2009-01-28

    Neutronics analysis to find nuclear heating rates and personnel dose rates were conducted in support of the integration of diagnostics in to the ITER Upper Port Plugs. Simplified shielding models of the Visible-Infrared diagnostic and of a large aperture diagnostic were incorporated in to the ITER global CAD model. Results for these systems are representative of typical designs with maximum shielding and a small aperture (Vis-IR) and minimal shielding with a large aperture. The neutronics discrete-ordinates code ATTILA® and SEVERIAN® (the ATTILA parallel processing version) was used. Material properties and the 500 MW D-T volume source were taken from the ITER “Brand Model” MCNP benchmark model. A biased quadrature set equivelant to Sn=32 and a scattering degree of Pn=3 were used along with a 46-neutron and 21-gamma FENDL energy subgrouping. Total nuclear heating (neutron plug gamma heating) in the upper port plugs ranged between 380 and 350 kW for the Vis-IR and Large Aperture cases. The Large Aperture model exhibited lower total heating but much higher peak volumetric heating on the upper port plug structure. Personnel dose rates are calculated in a three step process involving a neutron-only transport calculation, the generation of activation volume sources at pre-defined time steps and finally gamma transport analyses are run for selected time steps. ANSI-ANS 6.1.1 1977 Flux-to-Dose conversion factors were used. Dose rates were evaluated for 1 full year of 500 MW DT operation which is comprised of 3000 1800-second pulses. After one year the machine is shut down for maintenance and personnel are permitted to access the diagnostic interspace after 2-weeks if dose rates are below 100 μSv/hr. Dose rates in the Visible-IR diagnostic model after one day of shutdown were 130 μSv/hr but fell below the limit to 90 μSv/hr 2-weeks later. The Large Aperture style shielding model exhibited higher and more persistent dose rates. After 1-day the dose rate was 230

  13. Consequences of high incarceration rate and high obesity prevalence on the prison system.

    PubMed

    Leddy, Meaghan A; Schulkin, Jay; Power, Michael L

    2009-10-01

    Incarceration and obesity rates have both increased in the United States. An implication is that there will be more obese inmates, which likely will raise the prevalence of obesity-related diseases, affecting the cost and performance of correctional health care. Other issues include increased costs of transport, restraint, and housing. There is surprisingly little published information on inmate obesity prevalence. The few published research studies suggest obesity prevalence in prisons reflects that of their region. Cardiovascular-related prisoner deaths appear to be associated with state-level obesity, though other risk factors are likely involved. Weight gain while incarcerated is common, and the prevalence of diabetes is increasing. The data suggest that preventive care is not a priority in prisons. Evidence from Japan suggests restricted diets and enforced activity can improve inmate health.

  14. Psychopathological rating scales for diagnostic use in adults with attention-deficit/hyperactivity disorder (ADHD).

    PubMed

    Rösler, M; Retz, W; Thome, J; Schneider, M; Stieglitz, R-D; Falkai, P

    2006-09-01

    The diagnosis of attention-deficit hyperactivity disorder (ADHD) in adults is a complex procedure which should include retrospective assessment of childhood ADHD symptoms either by patient recall or third party information, diagnostic criteria according to DSM-IV, current adult ADHD psychopathology including symptom severity and pervasiveness, functional impairment, quality of life and comorbidity. In order to obtain a systematic database for the diagnosis and evaluation of the course ADHD rating scales can be very useful. This article reviews rating instruments that have found general acceptance. The Wender-Utah Rating Scale (WURS) and the Childhood Symptoms Scale by Barkley and Murphy try to make a retrospective assessment of childhood ADHD symptoms. The Connors Adult ADHD Rating Scales (CAARS), the Current Symptoms Scales by Barkley and Murphy (CSS), the Adult Self Report Scale (ASRS) by Adler et al. and Kessler et al. or the Attention Deficit Hyperactivity Disorder--Self Report Scale (ADHD-SR by Rösler et al.) are self report rating scales focusing mainly on the DSM-IV criteria. The CAARS and the CSS have other report forms too. The Brown ADD Rating Scale (Brown ADD-RS) and the Attention Deficit Hyperactivity Disorder--Other Report Scale (ADHD-OR by Rösler et al.) are instruments for use by clinicians or significant others. Both self rating scales and observer report scales quantify the ADHD symptoms by use of a Likert scale mostly ranging from 0 to 3. This makes the instruments useful to follow the course of the disease quantitatively. Comprehensive diagnostic interviews not only evaluate diagnostic criteria, but also assess different psychopathological syndrome scores, functional disability measures, indices of pervasiveness and information about comorbid disorders. The most comprehensive procedures are the Brown ADD Diagnostic Form and the Adult Interview (AI) by Barkley and Murphy. An instrument of particular interest is the Wender Reimherr Interview (WRI

  15. State-level Uterine Corpus Cancer Incidence Rates Corrected for Hysterectomy Prevalence, 2004-2008

    PubMed Central

    Siegel, Rebecca L.; Devesa, Susan S.; Cokkinides, Vilma; Ma, Jiemin; Jemal, Ahmedin

    2012-01-01

    Background The interpretation of uterine cancer rates is hindered by the inclusion of women whose uterus has been surgically removed in the population at risk. Hysterectomy prevalence varies widely by state and race/ethnicity, exacerbating this issue. Methods We estimated hysterectomy-corrected, age-adjusted uterine corpus cancer incidence rates by race/ethnicity for 49 states and the District of Columbia during 2004-2008 using case counts obtained from population-based cancer registries; population data from the U.S. Census Bureau; and hysterectomy prevalence data from the Behavioral Risk Factor Surveillance System. Corrected and uncorrected incidence rates were compared with regard to geographic and racial/ethnic disparity patterns and the association with obesity. Results Among non-Hispanic whites, uterine cancer incidence rates (per 100,000 woman-years) uncorrected for hysterectomy prevalence ranged from 17.1 in Louisiana to 32.1 in New Jersey, mirrored regional hysterectomy patterns, and were not correlated with obesity prevalence (Pearson’s correlation coefficient, r = 0.06, two-sided p = 0.68). In comparison, hysterectomy-corrected rates were higher by 30% (District of Columbia) to more than 100% (Mississippi, Louisiana, Alabama, and Oklahoma), displayed no discernible geographic pattern, and were moderately associated with obesity (r = 0.37, two-sided p = 0.009). For most states, hysterectomy correction diminished or reversed the black/white deficit and accentuated the Hispanic/white deficit. Conclusion Failure to adjust uterine cancer incidence rates for hysterectomy prevalence distorts true geographic and racial patterns and substantially underestimates the disease burden, particularly for Southern states. Impact Correction for hysterectomy is necessary for the accurate evaluation of uterine cancer rates. PMID:23125334

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

    PubMed

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

    2015-12-01

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

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

    PubMed Central

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

    2015-01-01

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

  18. Prevalence rates for dementia and Alzheimer's disease in African Americans: 1992 versus 2001.

    PubMed

    Hall, Kathleen S; Gao, Sujuan; Baiyewu, Olusegun; Lane, Kathleen A; Gureje, Oye; Shen, Jianzhao; Ogunniyi, Adesola; Murrell, Jill R; Unverzagt, Frederick W; Dickens, Jeanne; Smith-Gamble, Valerie; Hendrie, Hugh C

    2009-05-01

    This study compares age-specific and overall prevalence rates for dementia and Alzheimer's disease (AD) in two nonoverlapping, population-based cohorts of elderly African Americans in Indianapolis in 2001 and 1992. We used a two-stage design. The first stage involves the Community Screening Interview for Dementia (CSI-D). The CSI-D scores are grouped into good, intermediate, and poor performance before selection for clinical assessment. Diagnoses were performed using standard criteria in a consensus diagnosis conference; clinicians were blind to performance groups. In 1992, interviewers visited randomly sampled addresses to enroll self-identified African Americans aged > or =65 years. Of 2582 eligible, 2212 enrolled (9.6% refused, and 4.7% were too sick). In 2001, Medicare rolls were used for African Americans aged >70 years. Of 4260 eligible, 1892 (44%) enrolled, 1999 (47%) refused, and the remainder did not participate for other reasons. The overall age-adjusted prevalence rate for dementia at age > or =70 years in 2001 was 7.45% (95 confidence interval [CI], 4.27-10.64), and in the 1992 cohort, this prevalence rate was 6.75% (95% CI, 5.77-7.74). The overall age-adjusted prevalence rate at age > or =70 years for AD in the 2001 cohort was 6.77% (95% CI, 3.65-9.90), and for the 1992 cohort, it was 5.47% (95% CI, 4.51-6.42). Rates for dementia and AD were not significantly different in the two cohorts (dementia, P = .3534; AD, P = .2649). We found no differences in the prevalence rates of dementia and AD between 1992 and 2001, despite significant differences in medical history and medical treatment within these population-based cohorts of African American elderly.

  19. Diagnostic Prevalence of Ankylosing Spondylitis Using Computerized Health Care Data, 1996 to 2009: Underrecognition in a US Health Care Setting

    PubMed Central

    Curtis, Jeffrey R; Harrold, Leslie R; Asgari, Maryam M; Deodhar, Atul; Salman, Craig; Gelfand, Joel M; Wu, Jashin J; Herrinton, Lisa J

    2016-01-01

    Introduction Few studies have assessed the prevalence and features of axial spondyloarthritis (axSpA) and ankylosing spondylitis in diverse, population-based, community settings. Objectives We used computerized diagnoses to estimate the prevalence of axSpA and ankylosing spondylitis in Kaiser Permanente Northern California (KPNC). Methods We identified persons aged 18 years or older with 1 or more International Classification of Diseases, Ninth Revision (ICD-9) diagnosis Code 720.X (ankylosing spondylitis and other inflammatory spondylopathies) in clinical encounter data from 1996 through 2009 to estimate the prevalence of axSpA and ankylosing spondylitis. We reviewed medical records to confirm the diagnosis in a random sample and estimated the positive predictive value of computerized data to identify confirmed cases using various case definitions. Results In the computerized data, 5568 adults had diagnostic codes indicating axSpA. On the basis of our case-finding approach using a single physician diagnosis code for ICD-9 720.X, the point prevalence of these conditions, standardized to the 2000 US Census, was 2.26 per 1000 persons for axSpA and 1.07 per 1000 for ankylosing spondylitis. Less than half of suspected cases saw a rheumatologist. The most specific algorithm for confirmed ankylosing spondylitis required 2 or more computerized diagnoses assigned by a rheumatologist, with 67% sensitivity (95% confidence interval, 64%–69%) and 81% positive predictive value (95% confidence interval, 79%–83%). Conclusions Observed prevalence in the KPNC population, compared with national estimates for axSpA and ankylosing spondylitis, suggests there is substantial underrecognition of these conditions in routine clinical practice. However, use of computerized data is able to identify true cases of ankylosing spondylitis, facilitating population-based research. PMID:27479952

  20. Diagnostic Prevalence of Ankylosing Spondylitis Using Computerized Health Care Data, 1996 to 2009: Underrecognition in a US Health Care Setting.

    PubMed

    Curtis, Jeffrey R; Harrold, Leslie R; Asgari, Maryam M; Deodhar, Atul; Salman, Craig; Gelfand, Joel M; Wu, Jashin J; Herrinton, Lisa J

    2016-01-01

    Few studies have assessed the prevalence and features of axial spondyloarthritis (axSpA) and ankylosing spondylitis in diverse, population-based, community settings. We used computerized diagnoses to estimate the prevalence of axSpA and ankylosing spondylitis in Kaiser Permanente Northern California (KPNC). We identified persons aged 18 years or older with 1 or more International Classification of Diseases, Ninth Revision (ICD-9) diagnosis Code 720.X (ankylosing spondylitis and other inflammatory spondylopathies) in clinical encounter data from 1996 through 2009 to estimate the prevalence of axSpA and ankylosing spondylitis. We reviewed medical records to confirm the diagnosis in a random sample and estimated the positive predictive value of computerized data to identify confirmed cases using various case definitions. In the computerized data, 5568 adults had diagnostic codes indicating axSpA. On the basis of our case-finding approach using a single physician diagnosis code for ICD-9 720.X, the point prevalence of these conditions, standardized to the 2000 US Census, was 2.26 per 1000 persons for axSpA and 1.07 per 1000 for ankylosing spondylitis. Less than half of suspected cases saw a rheumatologist. The most specific algorithm for confirmed ankylosing spondylitis required 2 or more computerized diagnoses assigned by a rheumatologist, with 67% sensitivity (95% confidence interval, 64%-69%) and 81% positive predictive value (95% confidence interval, 79%-83%). Observed prevalence in the KPNC population, compared with national estimates for axSpA and ankylosing spondylitis, suggests there is substantial underrecognition of these conditions in routine clinical practice. However, use of computerized data is able to identify true cases of ankylosing spondylitis, facilitating population-based research.

  1. The Influence of Survey Methodology in Estimating Prevalence Rates of Childhood Sexual Abuse Among Navy Recruits

    DTIC Science & Technology

    2000-08-15

    NAVAL HEALTH RESEARCH CENTER THE INFLUENCE OF SURVEY METHODOLOGY IN ESTIMATING PREVALENCE RATES OF CHILDHOOD SEXUAL ABUSE AMONG...different results than studies that ask about specific childhood sexual experiences (CSEs) or about experiences with specific types of parental physical... sexually abused. Data from all three sources independently accounted for variability in participants’ symptoms of depression, anxiety, and sexual

  2. Perceived Prevalence of Teasing and Bullying Predicts High School Dropout Rates

    ERIC Educational Resources Information Center

    Cornell, Dewey; Gregory, Anne; Huang, Francis; Fan, Xitao

    2013-01-01

    This prospective study of 276 Virginia public high schools found that the prevalence of teasing and bullying (PTB) as perceived by both 9th-grade students and teachers was predictive of dropout rates for this cohort 4 years later. Negative binomial regression indicated that one standard deviation increases in student- and teacher-reported PTB were…

  3. One-Year Prevalence Rates of Major Depressive Disorder in First-Year University Students

    ERIC Educational Resources Information Center

    Price, E. Lisa; McLeod, Peter J.; Gleich, Stephen S.; Hand, Denise

    2006-01-01

    First-year university students may be more at risk for experiencing Major Depressive Disorder (MDD) than the general population given associated risk factors of this age range. A two-phase procedure was used to estimate the one-year prevalence rate of MDD and comorbid Major Anxiety Disorders among first-year university students at a small Canadian…

  4. Perceived Prevalence of Teasing and Bullying Predicts High School Dropout Rates

    ERIC Educational Resources Information Center

    Cornell, Dewey; Gregory, Anne; Huang, Francis; Fan, Xitao

    2013-01-01

    This prospective study of 276 Virginia public high schools found that the prevalence of teasing and bullying (PTB) as perceived by both 9th-grade students and teachers was predictive of dropout rates for this cohort 4 years later. Negative binomial regression indicated that one standard deviation increases in student- and teacher-reported PTB were…

  5. Prevalence Rates of Depression, Anxiety, and Somatization among Rural Southwestern Native American Children.

    ERIC Educational Resources Information Center

    Morris, Carolyn T.; Morris, Christopher; Crowley, Susan L.

    Internalizing symptoms, which include anxiety and depression, may be the most common pattern of psychopathology found in children. However, the knowledge base targeting internalizing symptomology in Native American children of the Southwest is surprisingly limited. This paper reports on a study of prevalence rates of internalizing disorders among…

  6. Depression and anxiety in ovarian cancer: a systematic review and meta-analysis of prevalence rates

    PubMed Central

    Watts, Sam; Prescott, Philip; Mason, Jessica; McLeod, Natalie; Lewith, George

    2015-01-01

    Objectives To systematically review the literature pertaining to the prevalence of depression and anxiety in patients with ovarian cancer as a function of treatment stage. Design Systematic review and meta-analysis. Participants 3623 patients with ovarian cancer from primary research investigations. Primary outcome measure The prevalence of depression and anxiety in patients with ovarian cancer as a function of treatment stage. Results We identified 24 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 3623 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 25.34% (CI 22.79% to 28.07%), 22.99% (CI 19.85% to 26.46%) and 12.71% (CI 10.14% to 15.79%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 19.12% (CI 17.11% to 21.30%), 26.23% (CI 22.30% to 30.56%) and 27.09% (CI 23.10% to 31.49%). Conclusions Our findings suggest that the prevalence of depression and anxiety in women with ovarian cancer, across the treatment spectrum, is significantly greater than in the healthy female population. With the growing emphasis on improving the management of survivorship and quality of life, we conclude that further research is warranted to ensure psychological distress in ovarian cancer is not underdiagnosed and undertreated. PMID:26621509

  7. Diagnostic rate of primary aldosteronism in Emilia-Romagna, Northern Italy, during 16 years (2000-2015).

    PubMed

    Rossi, Ermanno; Perazzoli, Franco; Negro, Aurelio; Magnani, Antonia

    2017-08-01

    Although primary aldosteronism is considered the most common form of endocrine hypertension, the diagnostic rate of primary aldosteronism in the territory is unknown. The aims of the current study were to compare the number of patients discharged with International Classification of Diseases 9 Clinical Modification codes compatible with primary aldosteronism from all the hospitals in Emilia-Romagna during 16 years (from 2000 to 2015) with the number of expected cases of primary aldosteronism, and to compare the number of patients with primary aldosteronism who underwent adrenalectomy in the period 2000-2015 with the number of expected cases of unilateral primary aldosteronism. We accessed the Database of the Emilia-Romagna Health Service to select all patients from the age of 20 years discharged with International Classification of Diseases 9 Clinical Modification codes compatible with primary aldosteronism and, among them, those who underwent adrenalectomy in the same period. The prevalence of hypertension in Emilia-Romagna from the age of 20 years was drawn from the Health Search Database. The population from the age of 20 years in Emilia-Romagna has been drawn from the Italian National Statistical Institute. We hypothesized a prevalence of primary aldosteronism of 5% among hypertensive patients and a prevalence of unilateral subtypes of 30% among the primary aldosteronism patients. A total of 992 patients have been discharged with codes consistent with primary aldosteronism during 16 years in Emilia-Romagna, that is 1.9% of the expected cases of primary aldosteronism. A total of 160 of them underwent adrenalectomy in the same period, which corresponds to 1% of the expected cases of unilateral primary aldosteronism in Emilia-Romagna. Our results clearly indicate that primary aldosteronism is dramatically underdiagnosed and undertreated.

  8. Prevalence of PCR detectable malaria infection among febrile patients with a negative Plasmodium falciparum specific rapid diagnostic test in Zanzibar.

    PubMed

    Baltzell, Kimberly A; Shakely, Deler; Hsiang, Michelle; Kemere, Jordan; Ali, Abdullah Suleiman; Björkman, Anders; Mårtensson, Andreas; Omar, Rahila; Elfving, Kristina; Msellem, Mwinyi; Aydin-Schmidt, Berit; Rosenthal, Philip J; Greenhouse, Bryan

    2013-02-01

    We screened for malaria in 594 blood samples from febrile patients who tested negative by a Plasmodium falciparum-specific histidine-rich protein-2-based rapid diagnostic test at 12 health facilities in Zanzibar districts North A and Micheweni, from May to August 2010. Screening was with microscopy, polymerase chain reaction (PCR) targeting the cytochrome b gene (cytbPCR) of the four major human malaria species, and quantitative PCR (qPCR). The prevalence of cytbPCR-detectable malaria infection was 2% (12 of 594), including 8 P. falciparum, 3 Plasmodium malariae, and 1 Plasmodium vivax infections. Microscopy identified 4 of 8 P. falciparum infections. Parasite density as estimated by microscopy or qPCR was > 4,000 parasites/μL in 5 of 8 cytbPCR-detectable P. falciparum infections. The infections that were missed by the rapid diagnostic test represent a particular challenge in malaria elimination settings and highlight the need for more sensitive point-of-care diagnostic tools to improve case detection of all human malaria species in febrile patients.

  9. The prevalence, awareness and control rate of hypertension among elderly in northwest of Iran

    PubMed Central

    Ghaffari, Samad; Pourafkari, Leili; Tajlil, Arezou; Sahebihagh, Mohammad Hassan; Mohammadpoorasl, Asghar; Tabrizi, Jafar Sadegh; Nader, Nader D; Azizi Zeinalhajlou, Akbar

    2016-01-01

    Introduction: Adequate treatment of hypertension is infrequent in older patients. Determining the prevalence of hypertension in older patients, identifying the pattern of the treatment in this age group and evaluating their awareness of the disease may help healthcare systems to devise appropriate programs for controlling the disease. Methods: This descriptive cross sectional study included a sample from population of Tabriz, a large city in North-West of Iran, who were 60 years or older. Data collection and blood pressure measurements were conducted in the households of the participants from 1st June 2015 through 1st August 2015. Hypertension was defined as systolic and/or diastolic blood pressure (DBP) ≥150/90 mm Hg or receiving anti-hypertensive medications. Prevalence and determinants of hypertension, awareness of patients about their diagnosis and prevalence of treatment and adequately controlled blood pressure were determined. Results: The prevalence of hypertension was 68.0%. Among hypertensive patients 81.8% were aware of their diagnosis, 78.0% were receiving antihypertensive medications. Among treated patients, 46.2% were adequately controlled. In univariate analysis, prevalence of hypertension was significantly higher in women (74.0% vs. 60.7%, P < 0.001). Women were more likely to be aware of diagnosis and to receive antihypertensive medications; however, the prevalence of adequately controlled blood pressure was similar in treated men and women. Among included variables in logistic regression analysis, older age, lower number of family members in household, cardiac diseases, being on low salt low fat diet, higher Body mass index (BMI) and not being educated were independently associated with having hypertension. Conclusion: Hypertension is highly prevalent among older population of Tabriz. Despite high rate of treatment, the rates of control are relatively low, indicating a demand for prevention and better management of hypertension in older

  10. Prevalence of metabolic syndrome and insulin resistance in overweight and obese women according to the different diagnostic criteria.

    PubMed

    Kocełak, P; Chudek, J; Olszanecka-Glinianowicz, M

    2012-09-01

    Metabolic syndrome (MS) is a cluster of risk factors favoring the development of type 2 diabetes and cardiovascular diseases. The prevalence of MS diagnosis is dependent of used diagnostic criteria. The aim of the study is to compare the prevalence of MS in overweight and obese women without concomitant diseases according to the different diagnostic criteria and their sensitivity to identify subjects with insulin resistance. The study involved 126 overweight and obese women without concomitant diseases. In all subjects body mass, height, waist circumference and blood pressure were measured and plasma glucose, insulin and lipids levels were determined. MS was diagnosed using WHO, NCEP ATP III, IDF 2005 and IDF 2009 modified criteria. The insulin resistance was assessed based on the homeostatic model assessment insulin resistance (HOMA-IR≥2.5). The prevalence of MS was 43.8%, 43.8%, 38.1% and 18.1% according to IDF 2005, IDF 2009 modified, NCEP ATP III and WHO criteria, respectively. Insulin resistance was diagnosed in 89 women (70.6%). None of MS definitions allowed for proper discrimination of insulin resistant subjects. The highest sensitivity, but lowest specificity of insulin resistant discrimination had both IDF criteria (44.9% and 72.9%, respectively), while the highest specificity WHO criteria was missing sensitivity (91.8% and 17.9%, respectively). On the basis of both IDF criteria MS is diagnosed in significantly larger subset of overweight and obese women. However, NCEP ATPIII and both IDF criteria identify only less than half insulin resistant overweight and obese women as those with MS.

  11. Mortality rates, prevalence of malnutrition, and prevalence of lost pregnancies among the drought-ravaged population of Tete Province, Mozambique.

    PubMed

    Renzaho, Andre M N

    2007-01-01

    Tete Province, Mozambique has experienced chronic food insecurity and a dramatic fall in livestock numbers due to the cyclic problems characterized by the floods in 2000 and severe droughts in 2002 and 2003. The Province has been a beneficiary of emergency relief programs, which have assisted > 22% of the population. However, these programs were not based on sound epidemiological data, and they have not established baseline data against which to assess the impact of the programs. The objective of this study was to document mortality rates, causes of death, the prevalence of malnutrition, and the prevalence of lost pregnancies after 2.5 years of humanitarian response to the crisis. A two-stage, 30-cluster household survey was conducted in the Cahora Bassa and Changara districts from 22 October to 08 November 2004. A total of 838 households were surveyed, with a population size of 4,688 people. Anthropometric data were collected among children 6-59 months of age. In addition, crude mortality rates (CMRs), under five mortality rates (U5MRs), causes of deaths, and prevalence of lost pregnancies were determined among the sample population. The prevalence of malnutrition was 8.0% (95% confidence interval (CI) = 6.2-9.8%) for acute malnutrition, 26.9% (95% CI = 24.0-29.9%) for being underweight, and 37.0% (95% CI = 33.8-40.2%) for chronic malnutrition. Boys were more likely to be underweight than were girls (odds ratio (OR) = 1.34; 95% CI = 1.00, 1.82; p < 0.05) after controlling for age, household size, and food aid beneficiary status. Similarly, children 30-59 months of age were significantly less likely to suffer from acute malnutrition (OR = 0.45; 95% CI = 0.26, 0.79; p < 0.01) and less likely to be underweight (OR = 0.37; 95% CI = 0.27, 0.51; p < 0.01) than children 6-29 months of age, after adjusting for the other, aforementioned factors. The proportion of lost pregnancies was estimated at 7.7% (95% CI = 4.5-11.0%). A total of 215 deaths were reported during the

  12. County-level correlation between adult obesity rates and prevalence of dentists.

    PubMed

    Holzer, Jessica; Canavan, Maureen; Bradley, Elizabeth

    2014-09-01

    Investigators of previous studies regarding the correlation between area-level health care resources and obesity have not examined the association between the prevalence of dentists and rates of adult obesity. The authors conducted a study to address that knowledge gap. Using data compiled in the Robert Wood Johnson County Health Rankings and Roadmaps database, the authors conducted multivariable analyses of the relationship between the prevalence of dentists (from the 2011 Health Resources and Services Administration Area Resource File) and rates of obesity within counties. The authors controlled for prevalence of primary care providers, measures of the built environment (for example, number of recreational facilities per 10,000 population, the percentage of restaurants serving fast food) and county-level sociodemographic and economic factors. When the authors conducted a multivariable analysis adjusted for state-level fixed effects, they found that having one additional dentist per 10,000 population was associated significantly with a 1-percentage point reduction in the rate of obesity (P < .001). This effect was significantly larger in counties in which 25 percent of children or more (versus less than 25 percent of children) lived in poverty and in counties that had more primary care physicians per 10,000 population (P ≤ .009). The association between the prevalence of dentists and obesity, even after adjusting for primary care resources and sociodemographic factors, was evident. Although these data could not be used to assess causality, given the strength of the ecological, cross-sectional association, additional research involving person-level, longitudinal data is warranted. The correlation between the prevalence of dentists and obesity rates highlights the potential for dental professionals, as well as other primary care providers, to provide meaningful health education and support for improved nutritional behaviors, although the increased obesity rates in

  13. Imaging Characteristics and Prevalence of Pancreatic Carcinoma in Kosovo During 2011-2015 - Diagnostic Method as Choice.

    PubMed

    Dedushi, Kreshnike; Kabashi, Serbeze; Mucaj, Sefedin; Hasbahta, Gazmed; Ramadani, Naser; Hoxhaj, Astrit

    2016-06-01

    Pancreatic cancer is the 10(th)most common malignancy and the 4(th)largest cancer killer in adults. The purpose of this paper is to evaluate the number of cases presented with pancreatic carcinoma during the years 2011-2015, our experience of the imaging characteristics of pancreatic carcinoma. We evaluated prevalence of the pancreatic cancers, distant metastases and other local infiltration signs among the total cases of the pancreatic cancers diagnosed in the University Clinical Center of Kosovo, with the aim to compare these research findings to similar studies made in the developed countries. This is a retrospective research study done during the period of 2011-2015. This retrospective research study includes 362 patients recently diagnosed with pancreatic cancer, examined in the period of 2011-2015 at the University Clinical Center of Kosovo. The imaging diagnostics are performed with MSCT Sensation 64 Siemens, MSCT Emotion 6 Siemens, and 1.5T MRI Symphony Siemens, biopsy guide with MSCT Sensation 64 Siemens in the Radiologic Clinic of UCCK; while the histopathology diagnostics has been performed in Clinic of Pathology at UCCK and prevalence is taken from the number of cases Reported at the Institute of Oncology Institute of Statistics and NIPH (National Institute of Public Health of Kosovo). Out of a total of the 362 patients diagnosed with pancreas cancer, results is female 39.5% (n=143) and male 61.5% (n=219), report M: F (1: 1.6), 286 cases resulted in head and neck 79 % (n=286), 76 cases resulted in body and tail cancers (21%), distant metastases in first imaging modality were found in(n=155) patients 43 %, local infiltration was found in patients: gastric infiltration 15 % (n=54), duodenal and papilla infiltration 26% (n=94), local infiltration spleen 16% (n=57), local infiltration mesentery 43 % (n= 155), dilated biliary tree 34 % (n=123), regional lymph node infiltration 83 % (n= 300). Out of a total of the 362 patients diagnosed with pancreas cancer

  14. McDonald Criteria 2010 and 2005 Compared: Persistence of High Oligoclonal Band Prevalence Despite Almost Doubled Diagnostic Sensitivity

    PubMed Central

    Schwenkenbecher, Philipp; Sarikidi, Anastasia; Wurster, Ulrich; Bronzlik, Paul; Sühs, Kurt-Wolfram; Raab, Peter; Stangel, Martin; Pul, Refik; Skripuletz, Thomas

    2016-01-01

    The 2010 McDonald criteria were developed to allow a more rapid diagnosis of relapsing-remitting multiple sclerosis (MS) by only one MRI of the brain. Although cerebrospinal fluid (CSF) is not a mandatory part of the latest criteria, the evidence of an intrathecal humoral immunoreaction in the form of oligoclonal bands (OCB) is crucial in the diagnostic workup. To date, the impact of the 2010 McDonald criteria on the prevalence of OCB has not been investigated. We retrospectively evaluated data of 325 patients with a clinical relapse suggestive of demyelination that were treated in a German university hospital between 2010 and 2015. One hundred thirty-six patients (42%) were diagnosed with MS and 189 patients with CIS when the criteria of 2010 were applied. The criteria of 2005 allowed only 70 patients (22%) to be designated as MS. In contrast, the prevalence of OCB was marginal affected in MS patients with 96% for the criteria of 2010 and 98.5% for the criteria of 2005. In conclusion, OCB are prevalent in most MS patients and reflect the chronic inflammatory nature of the disease. We recommend CSF examination to exclude alternative diagnoses and reevaluation of the diagnosis MS in patients with negative OCB. PMID:27657060

  15. Estimating the Prevalence and Awareness Rates of Hypertension in Africa: A Systematic Analysis

    PubMed Central

    Adeloye, Davies; Basquill, Catriona

    2014-01-01

    Background The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off “≥140/90 mm Hg”. Methods We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years. Results Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively. Conclusion Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa. PMID:25090232

  16. Estimating the prevalence and awareness rates of hypertension in Africa: a systematic analysis.

    PubMed

    Adeloye, Davies; Basquill, Catriona

    2014-01-01

    The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off "≥140/90 mm Hg". We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years. Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively. Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa.

  17. Prevalence and Comparison of Diagnostic Methods for Trichomonas vaginalis Infection in Pregnant Women in Argentina

    PubMed Central

    Menghi, Claudia I.; Coppolillo, Enrique F.; Gatta, Claudia; Eliseth, Martha Cora; de Torres, Ramón A.; Vay, Carlos A.; Famiglietti, Angela M. R.

    2010-01-01

    The objectives of this study were to conduct a prevalence survey of trichomoniasis in pregnant women and to evaluate the utility of different methods for its diagnosis. A total of 597 vaginal exudates from pregnant women who were examined at the Hospital de Clinicas in Buenos Aires, Argentina from 1 August 2005 to 31 January 2007, were prospectively and consecutively evaluated. The investigation of Trichomonas vaginalis was made by different microscopic examinations, and culture on liquid medium. The sensitivity and specificity of the microscopic examinations were assessed considering culture on liquid medium as the "gold standard". The prevalence of T. vaginalis obtained by culture on liquid medium was 4.0% (24/597). The prevalence of T. vaginalis obtained by direct wet smear, prolonged May-Grunwald Giemsa staining, and sodium acetate-formalin (SAF)/methylene blue staining-fixing technique was 1.8%, 2.3% and 2.5%, respectively. The sensitivity of the direct wet smear was 45.8%, that of the prolonged May-Grunwald Giemsa staining was 58.3%, and that of the SAF/methylene blue method was 62.5%. Considering the 3 microscopic examinations altogether, the sensitivity rose to 66.7% and the specificity was 100% for all of them. This is the first time that the prevalence data of T. vaginalis by culture in pregnant women are published in Argentina. Due to the low sensitivity obtained by microscopy in asymptomatic pregnant women, the use of the liquid medium is recommended during pregnancy, in order to provide an early diagnosis and treatment. PMID:20333287

  18. Tomosynthesis in the Diagnostic Setting: Changing Rates of BI-RADS Final Assessment over Time.

    PubMed

    Raghu, Madhavi; Durand, Melissa A; Andrejeva, Liva; Goehler, Alexander; Michalski, Mark H; Geisel, Jaime L; Hooley, Regina J; Horvath, Laura J; Butler, Reni; Forman, Howard P; Philpotts, Liane E

    2016-10-01

    Purpose To evaluate the effect of tomosynthesis in diagnostic mammography on the Breast Imaging Reporting and Data System (BI-RADS) final assessment categories over time. Materials and Methods This retrospective study was approved by the institutional review board. The authors reviewed all diagnostic mammograms obtained during a 12-month interval before (two-dimensional [2D] mammography [June 2, 2010, to June 1, 2011]) and for 3 consecutive years after (tomosynthesis year 1 [2012], tomosynthesis year 2 [2013], and tomosynthesis year 3 [2014]) the implementation of tomosynthesis. The requirement to obtain informed consent was waived. The rates of BI-RADS final assessment categories 1-5 were compared between the 2D and tomosynthesis groups. The positive predictive values after biopsy (PPV3) for BI-RADS category 4 and 5 cases were compared. The mammographic features (masses, architectural distortions, calcifications, focal asymmetries) of lesions categorized as probably benign (BI-RADS category 3) and those for which biopsy was recommended (BI-RADS category 4 or 5) were reviewed. The χ(2) test was used to compare the rates of BI-RADS final assessment categories 1-5 between the two groups, and multivariate logistic regression analysis was performed to compare all diagnostic studies categorized as BI-RADS 3-5. Results There was an increase in the percentage of cases reported as negative or benign (BI-RADS category 1 or 2) with tomosynthesis (58.7% with 2D mammography vs 75.8% with tomosynthesis at year 3, P < .0001). A reduction in the percentage of probably benign (BI-RADS category 3) final assessments also occurred (33.3% with 2D mammography vs 16.4% with tomosynthesis at year 3, P < .0001). Although the rates of BI-RADS 4 or 5 assessments did not change significantly with tomosynthesis (8.0% with 2D mammography vs 7.8% with tomosynthesis at year 3, P = .2), there was a significant increase in the PPV3 (29.6% vs 50%, respectively; P < .0001). These trends increased

  19. Effect of diagnostic criteria on prevalence of frontotemporal dementia in the elderly.

    PubMed

    Gislason, Thorsteinn B; Östling, Svante; Börjesson-Hanson, Anne; Sjögren, Magnus; Simoni, Michela; Pantoni, Leonardo; Skoog, Ingmar

    2015-04-01

    Frontotemporal dementia (FTD) is believed to be rare in the elderly, and the influence of different criteria on the prevalence of FTD is unclear. Population-based samples of 70- to 95-year-olds (n = 2462) in Gothenburg, Sweden, underwent neuropsychiatric examinations. Behavioral variant FTD (bvFTD) was diagnosed according to the International Behavioural Variant FTD Criteria Consortium (FTDC), the Frontotemporal Lobe Degeneration Consensus criteria, and the Lund-Manchester Research Criteria. A subset (n = 1074) underwent computerized tomography (CT) of the brain. The prevalence of bvFTD varied between 0.2% and 0.5% at age 70 to 79 years, between 2.5% and 3.6% at age 80 to 89 years, and between 1.7% and 2.2% at age 90 to 95 years. The agreement between different criteria was low to moderate (κ = 0.20-0.42). Among those with bvFTD according to FTDC, 93.3% had frontal and/or temporal lobar atrophy on CT, compared with 12.6% of those without bvFTD (P < .001). The prevalence of bvFTD was higher than expected in this population. To a large extent, different criteria captured different individuals. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  20. PIN-diode diagnostics of pulsed electron beam for high repetition rate mode

    NASA Astrophysics Data System (ADS)

    Egorov, Ivan; Xiao, Yu; Poloskov, Artem

    2017-05-01

    This work describes the operating principle and test results of the diagnostics for measuring the pulsed electron beam parameters under repetitive operation mode. The diagnostics is based on a PIN-diode, which is used as a bremsstrahlung detector. The signal from a PIN-diode was converted to a pseudo constant voltage signal which can be measured by a conventional voltmeter. Then the signal acquired by the voltmeter was compared with a reference signal indicating the normal operating regime of the accelerator, thus information about the shot-to-shot reproducibility of the electron beam parameters was given. The system was developed and tested for the ASTRA-M accelerator with the following operating parameters: 470 kV accelerating voltage, 120 ns beam duration and up to 50 pulses per second repetition rate.

  1. Can early breastfeeding support increase the 6-8 week breastfeeding prevalence rate?

    PubMed

    Price, Linda

    2014-05-01

    Breastfeeding has significant health benefits for mothers and babies and is an important strategy to reduce health inequalities (UNICEF, 2010). The Baby Friendly Initiative, a strategy to increase breastfeeding rates, has been adopted by the trust. In line with the trust's priorities, the health visiting team initiated a project to increase the 6-8 breastfeeding prevalence rates. Breastfeeding mothers in a defined project area were offered breastfeeding support in their homes within the first postnatal week. Although the results after six months did demonstrate an overall increase in the 6-8 week prevalence rate of 5%, the monthly figures where disappointingly inconsistent and it was difficult to attribute the rise to the increased support offered. Nevertheless, the feedback from mothers who received support demonstrated that it was valued and had a positive impact on their confidence to continue to breastfeed.

  2. Emesis as a Screening Diagnostic for Low Dose Rate (LDR) Total Body Radiation Exposure

    PubMed Central

    Camarata, A. S.; Switchenko, J. M.; Demidenko, E.; Flood, A. B.; Swartz, H. M.; Ali, A. N.

    2015-01-01

    Current radiation disaster manuals list the time-to-emesis (TE) as the key triage indicator of radiation dose. The data used to support TE recommendations were derived primarily from nearly instantaneous, high dose rate exposures as part of variable condition accident databases. To date, there has not been a systematic differentiation between triage dose estimates associated with high and low dose rate (LDR) exposures, even though it is likely that after a nuclear detonation or radiologic disaster, many surviving casualties would have received a significant portion of their total exposure from fallout (LDR exposure) rather than from the initial nuclear detonation or criticality event (high dose rate exposure). This commentary discusses the issues surrounding the use of emesis as a screening diagnostic for radiation dose after LDR exposure. As part of this discussion, previously published clinical data on emesis after LDR total body irradiation (TBI) is statistically re-analyzed as an illustration of the complexity of the issue and confounding factors. This previously published data includes 107 patients who underwent TBI up to 10.5 Gy in a single fraction delivered over several hours at 0.02 to 0.04 Gy/min. Estimates based on these data for the sensitivity of emesis as a screening diagnostic for low dose rate radiation exposure range from 57.1% to 76.6%, and the estimates for specificity range from 87.5% to 99.4%. Though the original data contain multiple confounding factors, the evidence regarding sensitivity suggests that emesis appears to be quite poor as a medical screening diagnostic for LDR exposures. PMID:26910032

  3. Survey on the use of health services by adult men: prevalence rates and associated factors1

    PubMed Central

    de Arruda, Guilherme Oliveira; Marcon, Sonia Silva

    2016-01-01

    Objective estimate the prevalence and identify factors associated with the use of health services by men between 20 and 59 years of age. Method population-based, cross-sectional domestic survey undertaken with 421 adult men, selected through systematic random sampling. The data were collected through a structured instrument and analyzed using descriptive and inferential statistics with multiple logistic regression. Results the prevalence rate of health service use during the three months before the interviews was 42.8%, being higher among unemployed men with a religious creed who used private hospitals more frequently, had been hospitalized in the previous 12 months and referred some disease. Conclusion the prevalence of health service use by adult men does not differ from other studies and was considered high. It shows to be related with the need for curative care, based on the associated factors found. PMID:27027680

  4. Prevalence of Premorbid Metabolic Syndrome in Spanish Adult Workers Using IDF and ATPIII Diagnostic Criteria: Relationship with Cardiovascular Risk Factors

    PubMed Central

    Tauler, Pedro; Bennasar-Veny, Miquel; Morales-Asencio, Jose M.; Lopez-Gonzalez, Angel A.; Vicente-Herrero, Teofila; De Pedro-Gomez, Joan; Royo, Vanessa; Pericas-Beltran, Jordi; Aguilo, Antoni

    2014-01-01

    Background Metabolic Syndrome (MetS) is a complex disorder defined as a cluster of interconnected risk factors such as hypertension, dyslipidemia, obesity and high blood glucose levels. Premorbid metabolic syndrome (PMetS) is defined by excluding patients with previously diagnosed cardiovascular disease or diabetes mellitus from those suffering MetS. We aimed to determine the prevalence of PMetS in a working population, and to analyse the relationship between the diagnostic criteria of the International Diabetes Federation (IDF) and of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII). The relationship between the presence of PMetS and cardiovascular risk factors was also analysed. Research Methodology/Findings A cross-sectional study was conducted in 24,529 male and 18,736 female Spanish (white western European) adult workers (20–65 years) randomly selected during their work health periodic examinations. Anthropometrics, blood pressure and serum parameters were measured. The presence of MetS and PMetS was ascertained using ATPIII and IDF criteria. Cardiovascular risk was determined using the Framingham-REGICOR equation. The results showed MetS had an adjusted global prevalence of 12.39% using ATPIII criteria and 16.46% using IDF criteria. The prevalence of PMetS was slightly lower (11.21% using ATPIII criteria and 14.72% using IDF criteria). Prevalence in males was always higher than in females. Participants with PMetS displayed higher values of BMI, waist circumference, blood pressure, glucose and triglycerides, and lower HDL-cholesterol levels. Logistic regression models reported lower PMetS risk for females, non-obese subjects, non-smokers and younger participants. Cardiovascular risk determined with Framingham-REGICOR was higher in participants with PMetS. Conclusions PMetS could be a reliable tool for the early identification of apparently healthy individuals who have a significant risk for developing cardiovascular events and

  5. Influence of patient and diagnostic parameters on reported retear rates after arthroscopic rotator cuff repair.

    PubMed

    Müller, Andreas M; Flury, Matthias; Alsayed, Hasan N; Audigé, Laurent

    2017-07-01

    The purpose of this meta-analysis was to investigate patient and diagnostic parameters influencing the reported rates of recurrent rotator cuff defects after ARCR. PubMed, EMBASE, Cochrane Library and Scopus databases were searched for clinical studies on tendon defects after ARCR. Imaging modalities, definitions, detection time points, and other known patient risk factors (patient age, tear severity, grade of fatty infiltration, repair technique) as well as reported defect rates were extracted. A meta-analysis of proportion and meta-regression analysis were used to investigate independent variables influencing reported defect rates. Of 109 articles reviewed, the diagnostic studies used magnetic resonance imaging (MRI) only (n = 56), ultrasound (US) only (n = 28), MRI or computed tomography (CT) arthrography (CTA, n = 14) or a combination of US, MRI and CTA (n = 11) up to 57 months after ARCR. Definitions of tendon defects were highly variable, including those of partial tendon healing with insufficient thickness defined as either an acceptable outcome (n = 72) or a recurrent defect (n = 22). Reported defect rates demonstrated highly significant heterogeneity between studies and groups. Follow-up time and the evaluation of partial tendon healing were independent factors of the defect rate alongside age, tear severity and repair technique. The type of imaging did not significantly alter defect rates. A number of specific factors significantly alter the rates of rotator cuff defects reported after ARCR. Standardized protocols in clinical practice are required for consistent diagnosis of recurrent defects after ARCR. IV.

  6. Molecular and serologic diagnostic approaches; the prevalence of herpes simplex in idiopathic men infertile.

    PubMed

    Amirjannati, Nasser; Yaghmaei, Farhad; Akhondi, Mohammad Mehdi; Nasiri, Mahboubeh; Heidari-Vala, Hamed; Sehhat, Zahra

    2014-05-01

    Human pathogens that can cause infertility may also affect sperm count and quality. Viral infections can be considered as direct and/or indirect cause of male factor infertility. Our goal was to investigate the prevalence of herpes simplex virus in the semen of infertile men attending the Avicenna Infertility Clinic, and to compare it with the herpes virus serology results. This cross sectional study was conducted during 2009-2010. Infertile men participating without any clinical signs of infection with herpes simplex virus, and no obvious cause for their infertility were included. Semen and blood samples were used for Polymerase Chain Reaction (PCR) and serologic testing for these people. Two samples were collected: one ml semen sample to verify the existence of genital herpes simplex virus in infertile men, and blood samples of 217 individuals tested for antibodies to herpes simplex virus. Data were analyzed by SPSS 16. According to the PCR results of semen samples the prevalence of herpes simplex in semen was 12% and serologic test showed 3.2% prevalence within blood. Nine to 10% of IgM negative were PCR positive and only 2-3% of IgM positive were PCR positive. Between herpes serologic studies with positive controls and negative controls by using both tests, there was a significant positive relationship (r=0.718 and p<0.001). The relationship between semen PCR test results and serological survey of herpes patients with a negative control in both Pearson and Spearman tests was positive and significant (r=0.229 and p=0.001). Correlation between the PCR results of semen samples with two positive control subjects and a positive IgM test was statistically confirmed (r=0.235 and p<0.001). We recommend that if there is suspicion to herpes simplex as a microorganism that theoretically could impact semen parameters and cause infertility it is prudent to use PCR technique on semen sample rather than ELISA on serum.

  7. Avian bornavirus and proventricular dilatation disease: diagnostics, pathology, prevalence, and control.

    PubMed

    Hoppes, Sharman M; Tizard, Ian; Shivaprasad, H L

    2013-05-01

    Avian bornavirus (ABV) has been shown the cause of proventricular dilatation disease (PDD) in psittacines. Many healthy birds are infected with ABV, and the development of PDD in such cases is unpredictable. As a result, the detection of ABV in a sick bird is not confirmation that it is suffering from PDD. Treatment studies are in their infancy. ABV is not restricted to psittacines. It has been found to cause PDD-like disease in canaries. It is also present at a high prevalence in North American geese, swans, and ducks. It is not believed that these waterfowl genotypes can cause disease in psittacines. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Prevalence, Treatment, and Control Rates of Conventional and Ambulatory Hypertension Across 10 Populations in 3 Continents.

    PubMed

    Melgarejo, Jesus D; Maestre, Gladys E; Thijs, Lutgarde; Asayama, Kei; Boggia, José; Casiglia, Edoardo; Hansen, Tine W; Imai, Yutaka; Jacobs, Lotte; Jeppesen, Jørgen; Kawecka-Jaszcz, Kalina; Kuznetsova, Tatiana; Li, Yan; Malyutina, Sofia; Nikitin, Yuri; Ohkubo, Takayoshi; Stolarz-Skrzypek, Katarzyna; Wang, Ji-Guang; Staessen, Jan A

    2017-07-01

    Hypertension is a major global health problem, but prevalence rates vary widely among regions. To determine prevalence, treatment, and control rates of hypertension, we measured conventional blood pressure (BP) and 24-hour ambulatory BP in 6546 subjects, aged 40 to 79 years, recruited from 10 community-dwelling cohorts on 3 continents. We determined how between-cohort differences in risk factors and socioeconomic factors influence hypertension rates. The overall prevalence was 49.3% (range between cohorts, 40.0%-86.8%) for conventional hypertension (conventional BP ≥140/90 mm Hg) and 48.7% (35.2%-66.5%) for ambulatory hypertension (ambulatory BP ≥130/80 mm Hg). Treatment and control rates for conventional hypertension were 48.0% (33.5%-74.1%) and 38.6% (10.1%-55.3%) respectively. The corresponding rates for ambulatory hypertension were 48.6% (30.5%-71.9%) and 45.6% (18.6%-64.2%). Among 1677 untreated subjects with conventional hypertension, 35.7% had white coat hypertension (23.5%-56.2%). Masked hypertension (conventional BP <140/90 mm Hg and ambulatory BP ≥130/80 mm Hg) occurred in 16.9% (8.8%-30.5%) of 3320 untreated subjects who were normotensive on conventional measurement. Exclusion of participants with diabetes mellitus, obesity, hypercholesterolemia, or history of cardiovascular complications resulted in a <9% reduction in the conventional and 24-hour ambulatory hypertension rates. Higher social and economic development, measured by the Human Development Index, was associated with lower rates of conventional and ambulatory hypertension. In conclusion, high rates of hypertension in all cohorts examined demonstrate the need for improvements in prevention, treatment, and control. Strategies for the management of hypertension should continue to not only focus on preventable and modifiable risk factors but also consider societal issues. © 2017 American Heart Association, Inc.

  9. Prevalence and Incidence Rates of Dementia and Cognitive Impairment No Dementia in the Mexican Population

    PubMed Central

    Mejia-Arango, Silvia; Gutierrez, Luis Miguel

    2012-01-01

    Objective To estimate the prevalence and incidence of dementia and cognitive impairment without dementia (CIND) in the Mexican population. Methods The MHAS study is a prospective panel study of health and aging in Mexico with 7,000 elders that represent 8 million subjects nationally. Using measurements of cognition and activities of daily living of dementia cases and CIND were identified at baseline and follow up. Overall incidence rates and specific rates for sex, age and education were calculated. Results Prevalence was 6.1% and 28.7% for dementia and CIND, respectively. Incidence rates were 27.3 per 1,000 person-years for dementia and 223 per 1,000 persons-year for CIND. Rates of dementia and CIND increased with advancing age and decreased with higher educational level; sex had a differential effect depending on the age strata. Hypertension, diabetes and depression were risk factors for dementia but not for CIND. Discussion These data provide estimates of prevalence and incidence of dementia and cognitive impairment in the Mexican population for projection of future burden. PMID:21948770

  10. Prevalence rate of chronic overuse pain among sport-poomsae-Taekwondo athletes.

    PubMed

    Koh, Jae O

    2016-07-07

    BACKGROUNDː To estimate the prevalence of chronic overuse pain (COP) and to identify possible risk factors of COP in sport-poomsae-Taekwondo. METHODSː This is a cross-sectional survey. A total of 263 sport-poomsae competitors (112 females; 151 males; aged between 12-44 years), who competed at the 2014 sport-poomsae- Taekwondo competition, participated in this study. The prevalence rate of COP and possible risk factors associated with COP were analyzed by using Chi-square tests and independent t-tests. RESULTSː A total of 173 athletes reported that they experienced COP (65.8%; 95% Confidence Interval [CI]: 60.5-71.5). Female athletes showed a higher prevalence rate than their male counterparts (75.9% vs. 58.3%). Lower body (61.5%) and knee joints (26.4%) were the two primarily injured body part. A total of 101 athletes reported that they injured in the previous year. Among those, 81.2% were suffered from COP. The technique that caused pain most frequently was side-kick among females and front-kick among males. Prevalence rates of COP were significantly different by sex, education level, training hour, and a history of injury. CONCLUSIONː The prevalence of COP is high among sport-poomsae-Taekwondo athletes. Competitors who are female, have a history of injury, and train for extended hours were more likely to experience COP. To identify other potential risk factors of COP in sport- poomsae-Taekwondo, more research is needed to build upon the findings.

  11. High-Throughput Diagnostic Assay for a Highly Prevalent Cardiomyopathy-Associated MYBPC3 Variant.

    PubMed

    Barefield, David Y; Lynch, Thomas L; Jagadeesan, Aravindakshan; Sanagala, Thriveni; Sadayappan, Sakthivel

    2016-11-01

    A 25-basepair deletion variant of MYBPC3 occurs at high frequency in individuals of South Asian descent and is estimated to affect 55 million people worldwide, carrying an increased likelihood of cardiomyopathy. Since this variant is prevalent and severe in this subpopulation, quick and affordable screening to provide risk-assessment to guide treatment for these patients is critical. An RNaseH qPCR assay was developed to quickly and specifically diagnose the presence of the 25-basepair deletion variant in MYBPC3. RNAseH-blocked nucleotide primers were designed to identify the presence or absence of the wild type MYBPC3 allele or the genomic sequence containing the 25-basepair deletion. Using this assay, three blinded operators were able to accurately determine the genotype from human genomic DNA samples from blood and saliva using a qPCR thermocycler. Furthermore, positive variant subjects were examined by both electrocardiography and echocardiography for the presence of cardiomyopathy. A simple, robust assay was established, verified and validated that can be automated to detect the presence of the highly prevalent 25-basepair deletion MYBPC3 variant using both blood and saliva samples. The assay will provide quick and accurate prescreening of individuals at high risk for cardiomyopathies and allow for better clinical identification of 25-basepair deletion MYBPC3 carriers in large cohort epidemiological studies.

  12. High-Throughput Diagnostic Assay for a Highly Prevalent Cardiomyopathy-Associated MYBPC3 Variant

    PubMed Central

    Barefield, David Y; Lynch, Thomas L; Jagadeesan, Aravindakshan; Sanagala, Thriveni; Sadayappan, Sakthivel

    2016-01-01

    A 25-basepair deletion variant of MYBPC3 occurs at high frequency in individuals of South Asian descent and is estimated to affect 55 million people worldwide, carrying an increased likelihood of cardiomyopathy. Since this variant is prevalent and severe in this subpopulation, quick and affordable screening to provide risk-assessment to guide treatment for these patients is critical. An RNaseH qPCR assay was developed to quickly and specifically diagnose the presence of the 25-basepair deletion variant in MYBPC3. RNAseH-blocked nucleotide primers were designed to identify the presence or absence of the wild type MYBPC3 allele or the genomic sequence containing the 25-basepair deletion. Using this assay, three blinded operators were able to accurately determine the genotype from human genomic DNA samples from blood and saliva using a qPCR thermocycler. Furthermore, positive variant subjects were examined by both electrocardiography and echocardiography for the presence of cardiomyopathy. A simple, robust assay was established, verified and validated that can be automated to detect the presence of the highly prevalent 25-basepair deletion MYBPC3 variant using both blood and saliva samples. The assay will provide quick and accurate prescreening of individuals at high risk for cardiomyopathies and allow for better clinical identification of 25-basepair deletion MYBPC3 carriers in large cohort epidemiological studies. PMID:27990320

  13. Increasing Prevalence, Changes in Diagnostic Criteria, and Nutritional Risk Factors for Autism Spectrum Disorders

    PubMed Central

    Neggers, Yasmin H.

    2014-01-01

    The frequency of autism spectrum disorders (ASD) diagnoses has been increasing for decades, but researchers cannot agree on whether the trend is a result of increased awareness, improved detection, expanding definition, or an actual increase in incidence or a combination of these factors. Though both genetic and multiple environmental risk factors have been studied extensively, many potentially modifiable risk factors including nutritional and immune function related risk factors such as vitamin D, folic acid, and metabolic syndrome have not received sufficient attention. Several recent studies have put forward hypotheses to explain the mechanism of association between both folic acid and vitamin D and autism. A continuous rise in the prevalence of autism in the USA has coincided with a significant enhancement of maternal folate status with FDA mandated folic acid fortification of certain foods starting in 1998. There is also a growing body of research that suggests that vitamin D status either in utero or early in life may be a risk for autism. In this communication, controversies regarding increase in estimate of prevalence, implications of changes in definition, and possible association between some modifiable nutritional risk factors such as folic acid and vitamin D and ASD will be discussed. PMID:24967269

  14. A two-photon laser induced fluorescence diagnostic with improved sensitivity, localization, and measurement rate

    NASA Astrophysics Data System (ADS)

    Elliott, Drew; Scime, Earl; Short, Zachary

    2016-10-01

    A two-photon absorption laser induced fluorescence diagnostic has been developed for measuring neutrals in fusion plasmas. Implementation of this diagnostic on the HIT-SI3 spheromak has demonstrated the sensitivity of the diagnostic and shown that measurements taken over several plasma pulses are possible. These measurements yielded an unexpected loss of signal when complex collection optics were utilized. Simulations show that this loss of signal can be explained by chromatic aberrations caused by the disparate Kr and D emission. This loss of signal has been addressed with the development of a new calibration scheme involving xenon gas. The Xe calibration scheme emission occurs at 656.00 nm while the deuterium emission is 656.09 nm. This nearly identical emission allows for advanced optical techniques such as confocal collection/injection and spatial filtering to be employed without loss of signal. Spatial filtering has been demonstrated to decrease noise while improving measurement localization, while confocal collection/injection allows for probing and measuring to occur through one viewport. The Xe scheme also allows for a Doppler-free hydrogen measurement. Doppler-free measurements eliminate the need to scan the laser spectrally thus greatly increasing the rate of measurement.

  15. New malaria parasites of the subgenus Novyella in African rainforest birds, with remarks on their high prevalence, classification and diagnostics.

    PubMed

    Valkiūnas, Gediminas; Iezhova, Tatjana A; Loiseau, Claire; Smith, Thomas B; Sehgal, Ravinder N M

    2009-04-01

    Blood samples from 655 passerine birds were collected in rainforests of Ghana and Cameroon and examined both by microscopy and polymerase chain reaction (PCR)-based techniques. The overall prevalence of Plasmodium spp. was 46.6%, as determined by combining the results of both these diagnostic methods. In comparison to PCR-based diagnostics, microscopic examination of blood films was more sensitive in determining simultaneous infection of Plasmodium spp., but both detection methods showed similar trends of prevalence of malaria parasites in the same study sites. Plasmodium (Novyella) lucens n. sp., Plasmodium (Novyella) multivacuolaris n. sp. and Plasmodium (Novyella) parahexamerium n. sp. were found in the olive sunbird Cyanomitra olivacea (Nectariniidae), yellow-whiskered greenbul Andropadus latirostris (Picnonotidae), and white-tailed alethe Alethe diademata (Turdidae), respectively. These parasites are described based on the morphology of their blood stages and a segment of the mitochondrial cytochrome b (cyt b) gene, which can be used for molecular identification and diagnosis of these species. Illustrations of blood stages of new species are given, and phylogenetic analysis identifies DNA lineages closely related to these parasites. Malaria parasites of the subgenus Novyella with small erythrocytic meronts clearly predominate in African passerines. It is probable that the development of such meronts is a characteristic feature of evolution of Plasmodium spp. in African rainforest birds. Subgeneric taxonomy of avian Plasmodium spp. is discussed based on the recent molecular phylogenies of these parasites. It is concluded that a multi-genome phylogeny is needed before revising the current subgeneric classification of Plasmodium. We supported a hypothesis by Hellgren, Krizanauskiene, Valkiūnas, Bensch (J Parasitol 93:889-896, 2007), according to which, haemosporidian species with a genetic differentiation of over 5% in mitochondrial cyt b gene are expected to be

  16. Are complement deficiencies really rare? Overview on prevalence, clinical importance and modern diagnostic approach.

    PubMed

    Grumach, Anete Sevciovic; Kirschfink, Michael

    2014-10-01

    Complement deficiencies comprise between 1 and 10% of all primary immunodeficiencies (PIDs) according to national and supranational registries. They are still considered rare and even of less clinical importance. This not only reflects (as in all PIDs) a great lack of awareness among clinicians and general practitioners but is also due to the fact that only few centers worldwide provide a comprehensive laboratory complement analysis. To enable early identification, our aim is to present warning signs for complement deficiencies and recommendations for diagnostic approach. The genetic deficiency of any early component of the classical pathway (C1q, C1r/s, C2, C4) is often associated with autoimmune diseases whereas individuals, deficient of properdin or of the terminal pathway components (C5 to C9), are highly susceptible to meningococcal disease. Deficiency of C1 Inhibitor (hereditary angioedema, HAE) results in episodic angioedema, which in a considerable number of patients with identical symptoms also occurs in factor XII mutations. New clinical entities are now reported indicating disease association with partial complement defects or even certain polymorphisms (factor H, MBL, MASPs). Mutations affecting the regulators factor H, factor I, or CD46 and of C3 and factor B leading to severe dysregulation of the alternative pathway have been associated with renal disorders, such as atypical hemolytic uremic syndrome (aHUS) and - less frequent - with membranoproliferative glomerulonephritis (MPGN). We suggest a multi-stage diagnostic protocol starting based on the recognition of so called warning signs which should aid pediatricians and adult physicians in a timely identification followed by a step-wise complement analysis to characterize the defect at functional, protein and molecular level. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: Convergence and Discrepancy in Diagnosing Autism.

    ERIC Educational Resources Information Center

    Saemundsen, Evald; Magnusson, Pall; Smari, Jakob; Sigurdaedottir, Solveig

    2003-01-01

    The agreement between the Autism Diagnostic Interview-Revised (ADI- R) and the Childhood Autism Rating Scale (CARS) was investigated in the diagnostic assessment of 54 children (ages 22-114 months) referred for possible autism. The observed agreement between the two systems was 66.7%. The CARS identified more cases of autism than the ADI-R.…

  18. A novel serogenetic approach determines the community prevalence of celiac disease and informs improved diagnostic pathways

    PubMed Central

    2013-01-01

    Background Changing perspectives on the natural history of celiac disease (CD), new serology and genetic tests, and amended histological criteria for diagnosis cast doubt on past prevalence estimates for CD. We set out to establish a more accurate prevalence estimate for CD using a novel serogenetic approach. Methods The human leukocyte antigen (HLA)-DQ genotype was determined in 356 patients with ‘biopsy-confirmed’ CD, and in two age-stratified, randomly selected community cohorts of 1,390 women and 1,158 men. Sera were screened for CD-specific serology. Results Only five ‘biopsy-confirmed’ patients with CD did not possess the susceptibility alleles HLA-DQ2.5, DQ8, or DQ2.2, and four of these were misdiagnoses. HLA-DQ2.5, DQ8, or DQ2.2 was present in 56% of all women and men in the community cohorts. Transglutaminase (TG)-2 IgA and composite TG2/deamidated gliadin peptide (DGP) IgA/IgG were abnormal in 4.6% and 5.6%, respectively, of the community women and 6.9% and 6.9%, respectively, of the community men, but in the screen-positive group, only 71% and 75%, respectively, of women and 65% and 63%, respectively, of men possessed HLA-DQ2.5, DQ8, or DQ2.2. Medical review was possible for 41% of seropositive women and 50% of seropositive men, and led to biopsy-confirmed CD in 10 women (0.7%) and 6 men (0.5%), but based on relative risk for HLA-DQ2.5, DQ8, or DQ2.2 in all TG2 IgA or TG2/DGP IgA/IgG screen-positive subjects, CD affected 1.3% or 1.9%, respectively, of females and 1.3% or 1.2%, respectively, of men. Serogenetic data from these community cohorts indicated that testing screen positives for HLA-DQ, or carrying out HLA-DQ and further serology, could have reduced unnecessary gastroscopies due to false-positive serology by at least 40% and by over 70%, respectively. Conclusions Screening with TG2 IgA serology and requiring biopsy confirmation caused the community prevalence of CD to be substantially underestimated. Testing for HLA-DQ genes and

  19. Molecular and serologic diagnostic approaches; the prevalence of herpes simplex in idiopathic men infertile

    PubMed Central

    Amirjannati, Nasser; Yaghmaei, Farhad; Akhondi, Mohammad Mehdi; Nasiri, Mahboubeh; Heidari-Vala, Hamed; Sehhat, Zahra

    2014-01-01

    Background: Human pathogens that can cause infertility may also affect sperm count and quality. Viral infections can be considered as direct and/or indirect cause of male factor infertility. Objective: Our goal was to investigate the prevalence of herpes simplex virus in the semen of infertile men attending the Avicenna Infertility Clinic, and to compare it with the herpes virus serology results. Materials and Methods: This cross sectional study was conducted during 2009-2010. Infertile men participating without any clinical signs of infection with herpes simplex virus, and no obvious cause for their infertility were included. Semen and blood samples were used for Polymerase Chain Reaction (PCR) and serologic testing for these people. Two samples were collected: one ml semen sample to verify the existence of genital herpes simplex virus in infertile men, and blood samples of 217 individuals tested for antibodies to herpes simplex virus. Data were analyzed by SPSS 16. Results: According to the PCR results of semen samples the prevalence of herpes simplex in semen was 12% and serologic test showed 3.2% prevalence within blood. Nine to 10% of IgM negative were PCR positive and only 2-3% of IgM positive were PCR positive. Between herpes serologic studies with positive controls and negative controls by using both tests, there was a significant positive relationship (r=0.718 and p<0.001). The relationship between semen PCR test results and serological survey of herpes patients with a negative control in both Pearson and Spearman tests was positive and significant (r=0.229 and p=0.001). Correlation between the PCR results of semen samples with two positive control subjects and a positive IgM test was statistically confirmed (r=0.235 and p<0.001). Conclusion: We recommend that if there is suspicion to herpes simplex as a microorganism that theoretically could impact semen parameters and cause infertility it is prudent to use PCR technique on semen sample rather than ELISA

  20. Translating Research to Practice for Children With Autism Spectrum Disorder: Part I: Definition, Associated Behaviors, Prevalence, Diagnostic Process, and Interventions.

    PubMed

    Johnson, Norah L; Burkett, Karen; Reinhold, Judy; Bultas, Margaret W

    2016-01-01

    The number of children with autism spectrum disorder (ASD) is rising, along with the potential for challenging behaviors during health care encounters. We present an overview of the emerging science related to ASD diagnosis and interventions for children with ASD. Emerging science on ASD reveals common associated challenging behaviors, increasing prevalence, emphasis on early diagnosis at 18 to 24 months of age, changes in the diagnostic process with criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, and interventions with medication, education, and behavior management. Family and health care provider preparation strategies facilitate care of children with ASD and their families. Early diagnosis at 18 to 24 months of age and evidence-based interventions contribute to best outcomes for children and families. Health care providers must be aware of the state of the science for diagnosis and best practices to provide family-centered care for this growing population. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  1. Effects of Age and Sex on Estimated Diabetes Prevalence Using Different Diagnostic Criteria: The Tromsø OGTT Study

    PubMed Central

    Hutchinson, Moira Strand; Joakimsen, Ragnar Martin; Njølstad, Inger; Schirmer, Henrik; Figenschau, Yngve; Svartberg, Johan; Jorde, Rolf

    2013-01-01

    HbA1c 6.5% has recently been recommended as an alternative diagnostic criterion for diabetes. The aims of the study were to evaluate the effects of age, sex, and other factors on prevalence of diabetes and to compare risk profiles of subjects with diabetes when defined by HbA1c and glucose criteria. Subjects were recruited among participants in the longitudinal population-based Tromsø Study. HbA1c, fasting plasma glucose, and 2-hour plasma glucose were measured in 3,476 subjects. In total, 294 subjects met one or more of the diagnostic criteria for diabetes; 95 met the HbA1c criterion only, 130 met the glucose criteria only, and 69 met both. Among subjects with diabetes detected by glucose criteria (regardless of HbA1c), isolated raised 2-hour plasma glucose was more common in subjects aged ≥ 60 years as compared to younger subjects and in elderly women as compared to elderly men. Subjects with diabetes detected by glucose criteria only had worse cardiometabolic risk profiles than those detected by HbA1c only. In conclusion, the current HbA1c and glucose criteria defined different subjects with diabetes with only modest overlap. Among a substantial proportion of elderly subjects, and especially elderly women, the 2-hour plasma glucose was the only abnormal value. PMID:23365572

  2. Prevalence rates of respiratory symptoms and diseases in general population samples of North and Central Italy.

    PubMed

    Viegi, G; Pedreschi, M; Baldacci, S; Chiaffi, L; Pistelli, F; Modena, P; Vellutini, M; Di Pede, F; Carrozzi, L

    1999-11-01

    Four cross-sectional general population surveys in Italy: northern rural Po Delta area (1980-1982, n = 3284; 1988-1991, n = 2841), and central urban Pisa area (1985-1988, n = 3865; 1991-1993, n = 2841). To analyse changes in prevalence rates of respiratory symptoms and diseases. Prospective epidemiological studies by standardised interviewer-administered questionnaire. Prevalence rates of respiratory symptoms and diseases tended to be higher in males (except for dyspnea and pleuritis), in the urban area (more polluted), and in the second surveys; moreover, they increased with age. Asthma peaked in those aged under 25 years and over 64 years. The highest prevalence rates were shown by current smokers of both sexes for all respiratory symptoms and by ex-smoker males for all respiratory diseases, while female current smokers reported chronic bronchitis, emphysema and asthma more frequently. The most clear-cut trend towards increase between the two surveys within each area was exhibited by wheeze and asthma. These findings highlight the relevance of sex, age and smoking habit, as well as the possible effects of air pollution, in relation to respiratory symptoms. They also indicate a trend towards an increase in asthma symptoms in Italian general population samples in the 1990s, and an under-estimate of medically diagnosed chronic respiratory diseases.

  3. Hair cell alteration prevalence rates in students of a school in Distrito Federal.

    PubMed

    Silva, Valéria Gomes da; Sampaio, André Luiz Lopes; Oliveira, Carlos Augusto Costa Pires de; Tauil, Pedro Luiz; Jansen, Glaucia Magalhães Brito

    2012-01-01

    Exposure to loud music is increasing among young people, and so could be the number of hearing impairment cases in this population. Otoacoustic emission tests are sensitive in capturing the effects of exposure to noise, and allow the detection of early cochlear disorders. This study aims to look into the prevalence rates of injuries to outer hair cells in a population of students through otoacoustic emission testing. One-hundred and thirty-four subjects were submitted to transient evoked and distortion product otoacoustic emission tests. Subjects were assessed on a "pass/fail" scale. This is a cross-sectional descriptive study on prevalence rates. More than four fifths (80.6%) of the 134 subjects had altered transient otoacoustic emissions, most of whom were males; 97.8% had altered distortion product otoacoustic emissions and 79.9% had altered test results in both transient evoked and distortion product OAEs; most were males; 94.0% reported they used earphones; and 82.8% stated they frequented places where loud music was played. The high prevalence rates of altered test results seem to indicate the presence of early cochlear disorders in the studied subjects. A significant number of subjects reported exposure to loud music, a habit that may be conducive to the onset of cochlear disorders.

  4. Comparative evaluation of molecular diagnostic tests for Nucleospora salmonis and prevalence in migrating juvenile salmonids from the Snake River, USA

    USGS Publications Warehouse

    Badil, Samantha; Elliott, Diane G.; Kurobe, Tomofumi; Hedrick, Ronald P.; Clemens, Kathy; Blair, Marilyn; Purcell, Maureen K.

    2011-01-01

    Nucleospora salmonis is an intranuclear microsporidian that primarily infects lymphoblast cells and contributes to chronic lymphoblastosis and a leukemia-like condition in a range of salmonid species. The primary goal of this study was to evaluate the prevalence of N. salmonis in out-migrating juvenile hatchery and wild Chinook salmon Oncorhynchus tshawytscha and steelhead O. mykiss from the Snake River in the U.S. Pacific Northwest. To achieve this goal, we first addressed the following concerns about current molecular diagnostic tests for N. salmonis: (1) nonspecific amplification patterns by the published nested polymerase chain reaction (nPCR) test, (2) incomplete validation of the published quantitative PCR (qPCR) test, and (3) whether N. salmonis can be detected reliably from nonlethal samples. Here, we present an optimized nPCR protocol that eliminates nonspecific amplification. During validation of the published qPCR test, our laboratory developed a second qPCR test that targeted a different gene sequence and used different probe chemistry for comparison purposes. We simultaneously evaluated the two different qPCR tests for N. salmonis and found that both assays were highly specific, sensitive, and repeatable. The nPCR and qPCR tests had good overall concordance when DNA samples derived from both apparently healthy and clinically diseased hatchery rainbow trout were tested. Finally, we demonstrated that gill snips were a suitable tissue for nonlethal detection of N. salmonis DNA in juvenile salmonids. Monitoring of juvenile salmonid fish in the Snake River over a 3-year period revealed low prevalence of N. salmonis in hatchery and wild Chinook salmon and wild steelhead but significantly higher prevalence in hatchery-derived steelhead. Routine monitoring of N. salmonis is not performed for all hatchery steelhead populations. At present, the possible contribution of this pathogen to delayed mortality of steelhead has not been determined.

  5. Creativity and mental illness: prevalence rates in writers and their first-degree relatives.

    PubMed

    Andreasen, N C

    1987-10-01

    Rates of mental illness were examined in 30 creative writers, 30 matched control subjects, and the first-degree relatives of both groups. The writers had a substantially higher rate of mental illness, predominantly affective disorder, with a tendency toward the bipolar subtype. There was also a higher prevalence of affective disorder and creativity in the writers' first-degree relatives, suggesting that these traits run together in families and could be genetically mediated. Both writers and control subjects had IQs in the superior range; the writers excelled only on the WAIS vocabulary subtest, confirming previous observations that intelligence and creativity are independent mental abilities.

  6. A Continuation of the Paradigm Wars? Prevalence Rates of Methodological Approaches across the Social/Behavioral Sciences

    ERIC Educational Resources Information Center

    Alise, Mark A.; Teddlie, Charles

    2010-01-01

    A new line of research has emerged that examines the prevalence rates of mixed methods within disciplines in the social/behavioral sciences. Research presented in this article is unique in that it examines prevalence rates across multiple disciplines using an established cross-disciplinary classification scheme. Results indicate that there are…

  7. A Continuation of the Paradigm Wars? Prevalence Rates of Methodological Approaches across the Social/Behavioral Sciences

    ERIC Educational Resources Information Center

    Alise, Mark A.; Teddlie, Charles

    2010-01-01

    A new line of research has emerged that examines the prevalence rates of mixed methods within disciplines in the social/behavioral sciences. Research presented in this article is unique in that it examines prevalence rates across multiple disciplines using an established cross-disciplinary classification scheme. Results indicate that there are…

  8. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples

    PubMed Central

    Stammel, Nadine; Abbing, Eva M.; Heeke, Carina; Knaevelsrud, Christine

    2015-01-01

    Background The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11). Objective The present study investigated the impact of these changes in two different post-conflict samples. Method Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Results Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample) compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample). Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety) compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. Conclusions The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data. PMID:25989951

  9. Prevalence of Body Dysmorphic Disorder and Surgeon Diagnostic Accuracy in Facial Plastic and Oculoplastic Surgery Clinics.

    PubMed

    Joseph, Andrew W; Ishii, Lisa; Joseph, Shannon S; Smith, Jane I; Su, Peiyi; Bater, Kristin; Byrne, Patrick; Boahene, Kofi; Papel, Ira; Kontis, Theda; Douglas, Raymond; Nelson, Christine C; Ishii, Masaru

    2017-07-01

    Body dysmorphic disorder (BDD) is a relative contraindication for facial plastic surgery, but formal screening is not common in practice. The prevalence of BDD in patients seeking facial plastic surgery is not well documented. To establish the prevalence of BDD across facial plastic and oculoplastic surgery practice settings, and estimate the ability of surgeons to screen for BDD. This multicenter prospective study recruited a cohort of 597 patients who presented to academic and private facial plastic and oculoplastic surgery practices from March 2015 to February 2016. All patients were screened for BDD using the Body Dysmorphic Disorder Questionnaire (BDDQ). After each clinical encounter, surgeons independently evaluated the likelihood that a participating patient had BDD. Validated instruments were used to assess satisfaction with facial appearance including the FACE-Q, Blepharoplasty Outcomes Evaluation (BOE), Facelift Outcomes Evaluation (FOE), Rhinoplasty Outcomes Evaluation (ROE), and Skin Rejuvenation Outcomes Evaluation (SROE). Across participating practices (9 surgeons, 3 sites), a total of 597 patients were screened for BDD: 342 patients from site 1 (mean [SD] age, 44.2 [16.5] years); 158 patients, site 2 (mean [SD] age, 46.0 [16.2] years), site 3, 97 patients (mean [SD] age, 56.3 [15.5] years). Overall, 58 patients [9.7%] screened positive for BDD by the BDDQ instrument, while only 16 of 402 patients [4.0%] were clinically suspected of BDD by surgeons. A higher percentage of patients presenting for cosmetic surgery (37 of 283 patients [13.1%]) compared with those presenting for reconstructive surgery (21 of 314 patients [6.7%]) screened positive on the BDDQ (odds ratio, 2.10; 95% CI, 1.20-3.68; P = .01). Surgeons were only able to correctly identify 2 of 43 patients (4.7%) who screened positive for BDD on the BDDQ, and the positive likelihood ratio was only 1.19 (95% CI, 0.28-5.07). Patients screening positive for BDD by the BDDQ had lower

  10. Prevalence rates and psychosocial characteristics associated with depression in pregnancy and postpartum in Maltese women.

    PubMed

    Felice, Ethel; Saliba, Joseph; Grech, Victor; Cox, John

    2004-10-15

    Investigators have commented on the apparent high prevalence of psychiatric symptoms in pregnancy. In Malta there is lack of epidemiological data and therefore, the prevalence of depression during pregnancy and at 8 weeks postpartum among a community sample of Maltese women was carried out. A random sample of 239 pregnant women were interviewed at booking using a detailed sociodemographic history, the revised version of the clinical interview schedule (CIS-R) and Maltese translation of the Edinburgh postnatal depression scale (EPDS). The CIS-R was again administered over the phone at 36 weeks and the EPDS sent by post. At 8 weeks postpartum, the CIS-R, modified version of the social maladjustment schedule and the EPDS were again administered to 95.8% of women. The point prevalence of depression meeting ICD-10 research criteria was 15.5% at booking, 11.1% in the third trimester and 8.7% postpartum of which only 3.9% had an onset since delivery. The low rate of new onset postpartum depression compared with other studies in our sample may be attributable to the social support available to women living in a cohesive Catholic island community. The follow-up was limited to 8 weeks postpartum. No control group was used to compare the prevalence of depression in women who did not recently have a baby.

  11. Current prevalence rate of latex allergy: Why it remains a problem?

    PubMed Central

    Wu, Miaozong; McIntosh, James; Liu, Jian

    2016-01-01

    Objectives: This article aims to review the current prevalence rate of latex allergy among healthcare workers, susceptible patients, and the general public, and to investigate why latex is still a ubiquitous occupational health hazard. Methods: Scientific publications on PubMed, particularly those published within the last five years, and current regulations from agencies such as Food and Drug Administration (FDA) were reviewed. Consumer and commercial products that may contain latex were also surveyed. Results: Approximately 12 million tons of natural rubber latex is produced annually and is widely used to manufacture millions of consumer and commercial products. Only limited number of latex-derived products have been approved and regulated by government agencies, such as FDA, whereas the majority of finished products do not label whether they contain latex. Owing to millions of unidentifiable products containing latex and many routes for exposure to latex, preventing contact with latex allergens and reducing the prevalence of latex allergy are more difficult than expected. Reported data suggest that the average prevalence of latex allergy worldwide remains 9.7%, 7.2%, and 4.3% among healthcare workers, susceptible patients, and general population, respectively. Conclusions: Latex-derived products are ubiquitous, and latex allergy remains a highly prevalent health risk in many occupations and to the general population. Developing alternative materials and increasing the ability to identify and label latex-derived products will be practicable approaches to effectively control the health risks associated with latex. PMID:27010091

  12. Current prevalence rate of latex allergy: Why it remains a problem?

    PubMed

    Wu, Miaozong; McIntosh, James; Liu, Jian

    2016-05-25

    This article aims to review the current prevalence rate of latex allergy among healthcare workers, susceptible patients, and the general public, and to investigate why latex is still a ubiquitous occupational health hazard. Scientific publications on PubMed, particularly those published within the last five years, and current regulations from agencies such as Food and Drug Administration (FDA) were reviewed. Consumer and commercial products that may contain latex were also surveyed. Approximately 12 million tons of natural rubber latex is produced annually and is widely used to manufacture millions of consumer and commercial products. Only limited number of latex-derived products have been approved and regulated by government agencies, such as FDA, whereas the majority of finished products do not label whether they contain latex. Owing to millions of unidentifiable products containing latex and many routes for exposure to latex, preventing contact with latex allergens and reducing the prevalence of latex allergy are more difficult than expected. Reported data suggest that the average prevalence of latex allergy worldwide remains 9.7%, 7.2%, and 4.3% among healthcare workers, susceptible patients, and general population, respectively. Latex-derived products are ubiquitous, and latex allergy remains a highly prevalent health risk in many occupations and to the general population. Developing alternative materials and increasing the ability to identify and label latex-derived products will be practicable approaches to effectively control the health risks associated with latex.

  13. High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China.

    PubMed

    Maimaiti, Rena; Zhang, Yuexin; Pan, Kejun; Mijiti, Peierdun; Wubili, Maimaitiali; Musa, Maimaitijiang; Andersson, Rune

    2017-01-05

    Tuberculosis and HIV co-epidemics are problems in many parts of the world. Xinjiang is a high tuberculosis and HIV prevalence area in China. We aimed to investigate the prevalence and cure rate of tuberculosis among HIV positive patients in Xinjiang. In a retrospective study between 2006 and 2011, clinical and laboratory data on 333 patients with HIV and tuberculosis were compared to 2668 patients with HIV only. There were 31 HIV positive patients with no data on tuberculosis. The prevalence of tuberculosis co-infection among the HIV positive patients was 11% (95% CI 10-12%), significantly higher than the national figure in China of 2%. In most cases HIV was diagnosed late, with advanced immunodeficiency. The use of isoniazid preventive therapy was only 57.9% in patients without tuberculosis who fulfilled the criteria for receiving this prevention. The cure rate one year after diagnosis was 69.2%, which was lower than the officially reported 91.4% in all tuberculosis cases in Xinjiang in 2011. The hazard of not surviving over the five years was significantly higher in patients with HIV + tuberculosis compared to HIV only after adjusting for sex and Intravenous drug use with HR = 1.84 (95% CI 1.43-2.35; p < 0.0001). The prevalence of tuberculosis among HIV positive patients in Xinjiang was higher than in China taken as a whole, and HIV was diagnosed late, with underuse of isoniazid preventive therapy. The low cure rate and reduced survival can be due to late diagnosis of HIV and no testing for antibiotic resistance, together with insufficient control of adherence to the treatment regimens for tuberculosis and HIV.

  14. Risk factors associated with high prevalence rates of hepatitis C infection in Egypt.

    PubMed

    Reker, Celeste; Islam, K M

    2014-08-01

    Egypt has the highest reported prevalence of hepatitis C virus (HCV) globally. Until now, no systematic review has been conducted to understand risk factors associated with these high prevalence rates of HCV. This study attempted to identify the various HCV risk factors in Egypt responsible for the high incidence and prevalence rates. Using systematic literature review methods, we searched databases for eligible manuscripts, selecting cohort and case-control studies published in English. Peer-reviewed papers published between 2008 and February 2013 were included. A total of 11 articles met the study selection criteria. The most examined risk factors found during our review analysis were surgery, transfusion, and age (64-82% of total articles; n = 11). Multiple risk factors held significant association with HCV infection in the included research. Based on this review, the main HCV risk factor categories are unsafe medical practices and familial risk factors. Improving medical safety and encouraging familial education on HCV may help reduce the incidence of the disease. Most risk factors for HCV transmission in Egypt are healthcare-associated. Primary prevention of HCV infection remains important to reduce HCV transmission. Further research should also focus on risk factor dynamics of HCV in Egypt to reduce transmission and HCV disease burden. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Disturbances of motor unit rate modulation are prevalent in muscles of spastic-paretic stroke survivors.

    PubMed

    Mottram, C J; Heckman, C J; Powers, R K; Rymer, W Z; Suresh, N L

    2014-05-01

    Stroke survivors often exhibit abnormally low motor unit firing rates during voluntary muscle activation. Our purpose was to assess the prevalence of saturation in motor unit firing rates in the spastic-paretic biceps brachii muscle of stroke survivors. To achieve this objective, we recorded the incidence and duration of impaired lower- and higher-threshold motor unit firing rate modulation in spastic-paretic, contralateral, and healthy control muscle during increases in isometric force generated by the elbow flexor muscles. Impaired firing was considered to have occurred when firing rate became constant (i.e., saturated), despite increasing force. The duration of impaired firing rate modulation in the lower-threshold unit was longer for spastic-paretic (3.9 ± 2.2 s) than for contralateral (1.4 ± 0.9 s; P < 0.001) and control (1.1 ± 1.0 s; P = 0.005) muscles. The duration of impaired firing rate modulation in the higher-threshold unit was also longer for the spastic-paretic (1.7 ± 1.6 s) than contralateral (0.3 ± 0.3 s; P = 0.007) and control (0.1 ± 0.2 s; P = 0.009) muscles. This impaired firing rate of the lower-threshold unit arose, despite an increase in the overall descending command, as shown by the recruitment of the higher-threshold unit during the time that the lower-threshold unit was saturating, and by the continuous increase in averages of the rectified EMG of the biceps brachii muscle throughout the rising phase of the contraction. These results suggest that impairments in firing rate modulation are prevalent in motor units of spastic-paretic muscle, even when the overall descending command to the muscle is increasing.

  16. Disturbances of motor unit rate modulation are prevalent in muscles of spastic-paretic stroke survivors

    PubMed Central

    Heckman, C. J.; Powers, R. K.; Rymer, W. Z.; Suresh, N. L.

    2014-01-01

    Stroke survivors often exhibit abnormally low motor unit firing rates during voluntary muscle activation. Our purpose was to assess the prevalence of saturation in motor unit firing rates in the spastic-paretic biceps brachii muscle of stroke survivors. To achieve this objective, we recorded the incidence and duration of impaired lower- and higher-threshold motor unit firing rate modulation in spastic-paretic, contralateral, and healthy control muscle during increases in isometric force generated by the elbow flexor muscles. Impaired firing was considered to have occurred when firing rate became constant (i.e., saturated), despite increasing force. The duration of impaired firing rate modulation in the lower-threshold unit was longer for spastic-paretic (3.9 ± 2.2 s) than for contralateral (1.4 ± 0.9 s; P < 0.001) and control (1.1 ± 1.0 s; P = 0.005) muscles. The duration of impaired firing rate modulation in the higher-threshold unit was also longer for the spastic-paretic (1.7 ± 1.6 s) than contralateral (0.3 ± 0.3 s; P = 0.007) and control (0.1 ± 0.2 s; P = 0.009) muscles. This impaired firing rate of the lower-threshold unit arose, despite an increase in the overall descending command, as shown by the recruitment of the higher-threshold unit during the time that the lower-threshold unit was saturating, and by the continuous increase in averages of the rectified EMG of the biceps brachii muscle throughout the rising phase of the contraction. These results suggest that impairments in firing rate modulation are prevalent in motor units of spastic-paretic muscle, even when the overall descending command to the muscle is increasing. PMID:24572092

  17. Diagnosis of allergy against beta-lactams in primary care: prevalence and diagnostic criteria.

    PubMed

    Salden, Odette A E; Rockmann, Heike; Verheij, Theo J M; Broekhuizen, Berna D L

    2015-06-01

    Secondary care studies showed that a recorded allergy to beta-lactams could not be confirmed by valid allergy testing in >85% of cases. In daily practice, recorded beta-lactam allergies probably cause prescription of secondary choice antibiotics. This overrating of beta-lactam allergy hampers appropriate use of narrow spectrum antibiotic and generates unnecessary cost and bacterial resistance. To assess registration and over diagnosis of allergies against beta-lactams in Dutch primary care. A retrospective cohort study in 8288 primary care subjects was performed. Patients with recorded allergy were identified through International Classification for Primary Care coding. Signs and symptoms of the recorded allergic reaction and patient's characteristics were extracted from patient's files and patients were sent a questionnaire. The probability of allergy was based on a composite reference standard that was scored by two authors independently. One hundred sixty-three subjects had a recorded allergy (2.0%). In 51.5% of cases, no characteristics of the recorded allergic reaction were reported in patients' medical files. Based on our composite reference standard, allergy was excluded in 19 subjects (11.7%). Risk factors for allergy registration were female gender, age <4 years, and the comorbidities-asthma, allergies and skin disorders. The prevalence of recorded allergy against beta-lactam antibiotics in a large Dutch primary care centre was 2%. Due to lack of registration of accompanying signs and symptoms of the recorded allergy, this diagnosis is uncertain in most patients. Better documentation and classification by a screening algorithm of future possible allergic reactions to beta-lactams are needed in primary care. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Pituitary Antibodies in Women with Hashimoto's Thyroiditis: Prevalence in Diagnostic and Prediagnostic Sera

    PubMed Central

    Guaraldi, Federica; Landek-Salgado, Melissa A.; Hutfless, Susan; Samoni, Francesca; Talor, Monica V.; Matos, Peter G.; Salvatori, Roberto; Rose, Noel R.

    2012-01-01

    Background Pituitary antibodies have been reported with greater frequency in patients with Hashimoto's thyroiditis than in healthy controls, although there is significant variability in the strength of the association and the methodologies used. Methods We designed a nested case–control study to characterize the prevalence of pituitary antibodies at the time of the clinical diagnosis of Hashimoto's thyroiditis, as well as at 2, 5, and 7 years before diagnosis. Active component female service member cases (n=87) and matched female controls (n=107) were selected using the Defense Medical Surveillance System database (DMSSD) between January 1998 and December 2007. Pituitary antibodies were measured by immunofluorescence using human pituitary glands collected at autopsy as the substrate. Results At diagnosis, pituitary antibodies were present in 9% of cases with Hashimoto's (8 of 87) and 3% of controls (3 of 107). When the data were analyzed using a conditional logistic regression model, which takes into account the matching on age and work status, pituitary antibodies increased the odds of having Hashimoto's thyroiditis by sevenfold (95% confidence interval from 1.3 to 40.1, p=0.028), after adjusting for components of the DMSSD-category-termed race and for thyroperoxidase antibodies. Before diagnosis, pituitary antibodies were positive in 3 of the 11 subjects (2 cases and 1 control) at the −2-year time point, and negative in all 11 subjects at the −5- and −7-year time points. Conclusions In summary, using a nested case–control design, we confirm that pituitary antibodies are more common in Hashimoto's thyroiditis and suggest that they appear late during its natural history. PMID:22468943

  19. Impact of heart rate on diagnostic accuracy of second generation 320-detector computed tomography coronary angiography.

    PubMed

    Nerlekar, Nitesh; Ko, Brian S; Nasis, Arthur; Cameron, James D; Leung, Michael; Brown, Adam J; Wong, Dennis T L; Ngu, Philip J; Troupis, John M; Seneviratne, Sujith K

    2017-06-01

    To assess the impact of elevated heart rate (HR) on the diagnostic accuracy and image quality of second-generation 320-detector computed tomography coronary angiography (320-CTCA). Consecutive patients with suspected coronary disease referred for invasive coronary angiography (ICA) were prospectively recruited and underwent 320-CTCA. Pre-scan beta-blockers were administered if native HR>80 bpm and post-scan cohorts stratified by traditional (HR ≤60 bpm) and elevated HR (61-80 bpm). A wider phase window was used for the elevated HR group (30-80%). 320-CTCA and ICA were analyzed by independent readers blinded to other data. Significant disease was defined as ≥50% visual stenosis on ICA. Uninterpretable segments by 320-CTCA were considered to be significant on an intention-to-diagnose principle. Image quality was assessed by 5-point Likert score. Of 107 patients studied (1,662 segments), there was no significant difference in sensitivity, specificity, positive and negative predictive value between patients with HR ≤60 bpm (n=55) vs. HR 61-80 bpm (n=52): 97%, 88%, 95%, 94% vs. 100%, 88%, 95%, 100%; Receiver operator characteristic-area under the curve 0.93 vs. 0.94, P=0.82). Overall per-patient diagnostic accuracy was 96% in both groups with no significant difference in interpretable segments (Likert ≥2) or median radiation dose (2.4 mSv vs. 2.7 mSv, P=0.35). Only 4/1,662 (0.2%) segments were uninterpretable by motion artefact in the whole cohort. In patients with HR >60 and up to 80bpm, second generation 320-CTCA provides comparably adequate diagnostic accuracy to HR ≤60 without significantly impacting upon overall segmental evaluability.

  20. Crime and violence in Brazil: Systematic review of time trends, prevalence rates and risk factors☆

    PubMed Central

    Murray, Joseph; Cerqueira, Daniel Ricardo de Castro; Kahn, Tulio

    2013-01-01

    Between 1980 and 2010 there were 1 million homicides in Brazil. Dramatic increases in homicide rates followed rises in inequality, more young men in the population, greater availability of firearms, and increased drug use. Nevertheless, disarmament legislation may have helped reduce homicide rates in recent years. Despite its very high rate of lethal violence, Brazil appears to have similar levels of general criminal victimization as several other Latin American and North American countries. Brazil has lower rates of drug use compared to other countries such as the United States, but the prevalence of youth drug use in Brazil has increased substantially in recent years. Since 1990, the growth of the Brazilian prison population has been enormous, resulting in the fourth largest prison population in the world. Through a systematic review of the literature, we identified 10 studies assessing the prevalence of self-reported offending in Brazil and 9 studies examining risk factors. Levels of self-reported offending seem quite high among school students in Brazil. Individual and family-level risk factors identified in Brazil are very similar to those found in high-income countries. PMID:24027422

  1. Crime and violence in Brazil: Systematic review of time trends, prevalence rates and risk factors.

    PubMed

    Murray, Joseph; Cerqueira, Daniel Ricardo de Castro; Kahn, Tulio

    2013-09-01

    Between 1980 and 2010 there were 1 million homicides in Brazil. Dramatic increases in homicide rates followed rises in inequality, more young men in the population, greater availability of firearms, and increased drug use. Nevertheless, disarmament legislation may have helped reduce homicide rates in recent years. Despite its very high rate of lethal violence, Brazil appears to have similar levels of general criminal victimization as several other Latin American and North American countries. Brazil has lower rates of drug use compared to other countries such as the United States, but the prevalence of youth drug use in Brazil has increased substantially in recent years. Since 1990, the growth of the Brazilian prison population has been enormous, resulting in the fourth largest prison population in the world. Through a systematic review of the literature, we identified 10 studies assessing the prevalence of self-reported offending in Brazil and 9 studies examining risk factors. Levels of self-reported offending seem quite high among school students in Brazil. Individual and family-level risk factors identified in Brazil are very similar to those found in high-income countries.

  2. A high repetition rate transverse beam profile diagnostic for laser-plasma proton sources

    NASA Astrophysics Data System (ADS)

    Dover, Nicholas; Nishiuchi, Mamiko; Sakaki, Hironao; Kando, Masaki; Nishitani, Keita

    2016-10-01

    The recently upgraded J-KAREN-P laser can provide PW peak power and intensities approaching 1022 Wcm-2 at 0.1 Hz. Scaling of sheath acceleration to such high intensities predicts generation of protons to near 100 MeV, but changes in electron heating mechanisms may affect the emitted proton beam properties, such as divergence and pointing. High repetition rate simultaneous measurement of the transverse proton distribution and energy spectrum are therefore key to understanding and optimising the source. Recently plastic scintillators have been used to measure online proton beam transverse profiles, removing the need for time consuming post-processing. We are therefore developing a scintillator based transverse proton beam profile diagnostic for use in ion acceleration experiments using the J-KAREN-P laser. Differential filtering provides a coarse energy spectrum measurement, and time-gating allows differentiation of protons from other radiation. We will discuss the design and implementation of the diagnostic, as well as proof-of-principle results from initial experiments on the J-KAREN-P system demonstrating the measurement of sheath accelerated proton beams up to 20 MeV.

  3. High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up.

    PubMed

    Amor, Aranzazu; Rodriguez, Esperanza; Saugar, José M; Arroyo, Ana; López-Quintana, Beatriz; Abera, Bayeh; Yimer, Mulat; Yizengaw, Endalew; Zewdie, Derejew; Ayehubizu, Zimman; Hailu, Tadesse; Mulu, Wondemagegn; Echazú, Adriana; Krolewieki, Alejandro J; Aparicio, Pilar; Herrador, Zaida; Anegagrie, Melaku; Benito, Agustín

    2016-12-01

    Soil-transmitted helminthiases (hookworms, Ascaris lumbricoides and Trichuris trichiura) are extremely prevalent in school-aged children living in poor sanitary conditions. Recent epidemiological data suggest that Strongyloides stercoralis is highly unreported. However, accurate data are essential for conducting interventions aimed at introducing control and elimination programmes. We conducted a cross-sectional survey of 396 randomly selected school-aged children in Amhara region in rural area in north-western Ethiopia, to assess the prevalence of S. stercoralis and other intestinal helminths. We examined stools using three techniques: conventional stool concentration; and two S. stercoralis-specific methods, i.e. the Baermann technique and polymerase chain reaction. The diagnostic accuracy of these three methods was then compared. There was an overall prevalence of helminths of 77.5%, with distribution differing according to school setting. Soil-transmitted helminths were recorded in 69.2%. Prevalence of S. stercoralis and hookworm infection was 20.7 and 54.5%, respectively, and co-infection was detected in 16.3% of cases. Schistosoma mansoni had a prevalence of 15.7%. Prevalence of S. stercoralis was shown 3.5% by the conventional method, 12.1% by the Baermann method, and 13.4% by PCR, which thus proved to be the most sensitive. Our results suggest that S. stercoralis could be overlooked and neglected in Ethiopia, if studies of soil-transmitted helminths rely on conventional diagnostic techniques alone. A combination of molecular and stool microscopy techniques yields a significantly higher prevalence. In view of the fact that current control policies for triggering drug administration are based on parasite prevalence levels, a comprehensive diagnostic approach should instead be applied to ensure comprehensive control of helminth infections.

  4. Prevalence Rate and Risk Factors of Depression in Outpatients with Premature Ejaculation

    PubMed Central

    Zhang, Xiansheng; Liu, Jishuang; Xia, Lei; Yang, Jiajia; Hao, Zongyao; Zhou, Jun; Liang, Chaozhao

    2013-01-01

    The purpose of this study is to investigate the prevalence rate and risk factors of depression in outpatients who were diagnosed with PE. Therefore, between September 2009 and September 2011, 1801 outpatients at andrology clinics were enrolled and consented to participate in our survey by completed a verbal questionnaire. It included the following: (1) demographic data (e.g., age, body mass index), (2) PE duration, medical history, and sexual history, (3) self-estimated intravaginal ejaculatory latency times, (4) the Zung Self-rating Depression Scale (SDS), and (5) the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and (6) the International Index of Erectile Function (IIEF-5). The results showed that a total of 1,206 patients were diagnosed with PE. The prevalence rate of depression in these PE patients was 26.78%. Depression was associated with PE duration, NIH-CPSI score, and IIEF-5 score. Risk factors for depression specifically included PE durations for 13–24, 25–60, or ≥61 months, CPSI scores of 15–30 or ≥31, and IIEF-5 scores <22. These findings suggested that several associated factors (PE duration, CPSI scores, and IIEF-5 scores) were the risk factors of depression in men with PE. PMID:23844361

  5. Prevalence rates and clinical implications of bipolar disorder "with mixed features" as defined by DSM-5.

    PubMed

    Shim, In Hee; Woo, Young Sup; Bahk, Won-Myong

    2015-03-01

    We investigated the increase in the prevalence of bipolar disorder with mixed features following the replacement of DSM-IV-TR criteria with DSM-5 criteria. Additionally, we examined the clinical implications of the use of "with mixed features" as a specifier with bipolar disorder. We retrospectively reviewed medical charts from 2003 to 2013. A total of 331 patients diagnosed with bipolar disorder using the DSM-IV TR were enrolled and categorized into four groups: manic/hypomanic with mixed features, manic/hypomanic without mixed features, depressed with mixed features, and depressed without mixed features. These classifications were made in accordance with the DSM-5 definition of bipolar disorder "with mixed features." Changes in the prevalence, demographic and clinical characteristics were compared among the groups. The prevalence rates of mixed features were significantly different when using the DSM-5 criteria vs. the DSM-IV-TR criteria. Patients with mixed features had a younger age of onset, younger age at hospitalization, more frequent hospitalizations for mixed episodes, and greater suicide risk compared with patients without mixed features. Retrospective study may have resulted in under diagnosis of mixed states. An approximately three-fold greater risk for mixed features was observed in patients with bipolar disorder when using the DSM-5 criteria than when using the DSM-IV-TR criteria. The additional patients may represent patients with sub-syndromal mixed features and could indicate that patients with mixed features are underdiagnosed. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Prevalence rate of supernumerary teeth among non-syndromic South Indian population: An analysis.

    PubMed

    Mahabob, M Nazargi; Anbuselvan, G J; Kumar, B Senthil; Raja, S; Kothari, Sucitha

    2012-08-01

    Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stage. The main objective of the study was to determine the prevalence rate of supernumerary teeth in the patients who reported to the Department of Oral Medicine and Radiology and to study the associated clinical complications. A longitudinal observational study was conducted of 2216 patients for a period of 4 months with the documentation of demographic data, the presence of supernumerary teeth, their location, and associated complications such as mechanical trauma, dental caries, and associated pathology. The study recorded 27 supernumerary teeth from the examined 2216 patients. This yields a prevalence of 1.2%, with greater frequency in males which was 1.49% and in females the frequency was 0.85%. The greatest proportion of supernumerary teeth was found in the maxillary anterior region (77.8%). Out of this, 85.7% were classified as mesiodens based on their location. The displacement of adjacent teeth was the most common finding, followed by dental caries. The prevalence of supernumerary teeth in this study was 1.2% which is in agreement with that reported in similar studies and the maxillary mesiodens was the most common location. Displacement of adjacent teeth was the most common finding.

  7. Prevalence of Pre-Analytical Errors in Clinical Chemistry Diagnostic Labs in Sulaimani City of Iraqi Kurdistan.

    PubMed

    Najat, Dereen

    2017-01-01

    Laboratory testing is roughly divided into three phases: a pre-analytical phase, an analytical phase and a post-analytical phase. Most analytical errors have been attributed to the analytical phase. However, recent studies have shown that up to 70% of analytical errors reflect the pre-analytical phase. The pre-analytical phase comprises all processes from the time a laboratory request is made by a physician until the specimen is analyzed at the lab. Generally, the pre-analytical phase includes patient preparation, specimen transportation, specimen collection and storage. In the present study, we report the first comprehensive assessment of the frequency and types of pre-analytical errors at the Sulaimani diagnostic labs in Iraqi Kurdistan. Over 2 months, 5500 venous blood samples were observed in 10 public diagnostic labs of Sulaimani City. The percentages of rejected samples and types of sample inappropriateness were evaluated. The percentage of each of the following pre-analytical errors were recorded: delay in sample transportation, clotted samples, expired reagents, hemolyzed samples, samples not on ice, incorrect sample identification, insufficient sample, tube broken in centrifuge, request procedure errors, sample mix-ups, communication conflicts, misinterpreted orders, lipemic samples, contaminated samples and missed physician's request orders. The difference between the relative frequencies of errors observed in the hospitals considered was tested using a proportional Z test. In particular, the survey aimed to discover whether analytical errors were recorded and examine the types of platforms used in the selected diagnostic labs. The analysis showed a high prevalence of improper sample handling during the pre-analytical phase. In appropriate samples, the percentage error was as high as 39%. The major reasons for rejection were hemolyzed samples (9%), incorrect sample identification (8%) and clotted samples (6%). Most quality control schemes at Sulaimani

  8. Prevalence of Pre-Analytical Errors in Clinical Chemistry Diagnostic Labs in Sulaimani City of Iraqi Kurdistan

    PubMed Central

    2017-01-01

    Background Laboratory testing is roughly divided into three phases: a pre-analytical phase, an analytical phase and a post-analytical phase. Most analytical errors have been attributed to the analytical phase. However, recent studies have shown that up to 70% of analytical errors reflect the pre-analytical phase. The pre-analytical phase comprises all processes from the time a laboratory request is made by a physician until the specimen is analyzed at the lab. Generally, the pre-analytical phase includes patient preparation, specimen transportation, specimen collection and storage. In the present study, we report the first comprehensive assessment of the frequency and types of pre-analytical errors at the Sulaimani diagnostic labs in Iraqi Kurdistan. Materials and Methods Over 2 months, 5500 venous blood samples were observed in 10 public diagnostic labs of Sulaimani City. The percentages of rejected samples and types of sample inappropriateness were evaluated. The percentage of each of the following pre-analytical errors were recorded: delay in sample transportation, clotted samples, expired reagents, hemolyzed samples, samples not on ice, incorrect sample identification, insufficient sample, tube broken in centrifuge, request procedure errors, sample mix-ups, communication conflicts, misinterpreted orders, lipemic samples, contaminated samples and missed physician’s request orders. The difference between the relative frequencies of errors observed in the hospitals considered was tested using a proportional Z test. In particular, the survey aimed to discover whether analytical errors were recorded and examine the types of platforms used in the selected diagnostic labs. Results The analysis showed a high prevalence of improper sample handling during the pre-analytical phase. In appropriate samples, the percentage error was as high as 39%. The major reasons for rejection were hemolyzed samples (9%), incorrect sample identification (8%) and clotted samples (6

  9. Shock Tube Measurement for the Dissociation Rate Constant of Acetaldehyde Using Sensitive CO Diagnostics.

    PubMed

    Wang, Shengkai; Davidson, David F; Hanson, Ronald K

    2016-09-08

    The rate constant of acetaldehyde thermal dissociation, CH3CHO = CH3 + HCO, was measured behind reflected shock waves at temperatures of 1273-1618 K and pressures near 1.6 and 0.34 atm. The current measurement utilized sensitive CO diagnostics to track the dissociation of CH3CHO via oxygen atom balance and inferred the title rate constant (k1) from CO time histories obtained in pyrolysis experiments of 1000 and 50 ppm of CH3CHO/Ar mixtures. By using dilute test mixtures, the current study successfully suppressed the interferences from secondary reactions and directly determined the title rate constant as k1(1.6 atm) = 1.1 × 10(14) exp(-36 700 K/T) s(-1) over 1273-1618 K and k1(0.34 atm) = 5.5 × 10(12) exp(-32 900 K/T) s(-1) over 1377-1571 K, with 2σ uncertainties of approximately ±30% for both expressions. Example simulations of existing reaction mechanisms updated with the current values of k1 demonstrated substantial improvements with regards to the acetaldehyde pyrolysis chemistry.

  10. Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012-2013

    PubMed Central

    Sanchez, Travis Howard; Sullivan, Patrick Sean

    2016-01-01

    Background In the United States, men who have sex with men (MSM) increasingly represent the majority of people living with and acquiring human immunodeficiency virus (HIV) infection. Local and federal surveillance programs estimate the number of persons living with an HIV diagnosis, persons living with HIV infection, and new diagnoses. Given the absence of population-based estimates of the number of MSM for US states, metropolitan statistical areas (MSAs), or counties, it is not possible to accurately estimate rates using these indicators at these levels, inhibiting the ability to understand HIV burden and to direct prevention efforts. Objective To synthesize recently published estimates of MSM population size with publicly available HIV surveillance data, in order to estimate the prevalence of HIV diagnosis and infection and the rate of new diagnoses, at the national, state, MSA, and county levels. Methods The number of MSM living with HIV infection in 2012 (prevalence), living with an HIV diagnosis in 2012 (diagnosed prevalence), and newly diagnosed with HIV infection in 2013 (new diagnosis), at state, MSA, and county levels, were obtained from publicly available data from AIDSVu.org and the US Centers for Disease Control and Prevention. The estimated number of MSM living in every US county was calculated using recently published methodology that utilized data from the National Health and Nutrition Examination Survey and American Community Survey. Estimated county-level MSM counts were aggregated to form MSA- and state-level totals. From this, we estimated HIV prevalence, diagnosed prevalence, and new diagnosis rates. Results The estimated HIV prevalence among MSM in the United States in 2012 was 15.0% (666,900/4,452,772), the diagnosed HIV prevalence in 2012 was 11.1% (493,453/4,452,772), and the new diagnosis rate for 2013 was 0.7 per 100 MSM. For diagnosed prevalence at the state level, 6 states had both <15,000 cases and diagnosed prevalence rates of ≥15

  11. Bayesian Estimation of the True Prevalence and of the Diagnostic Test Sensitivity and Specificity of Enteropathogenic Yersinia in Finnish Pig Serum Samples.

    PubMed

    Vilar, M J; Ranta, J; Virtanen, S; Korkeala, H

    2015-01-01

    Bayesian analysis was used to estimate the pig's and herd's true prevalence of enteropathogenic Yersinia in serum samples collected from Finnish pig farms. The sensitivity and specificity of the diagnostic test were also estimated for the commercially available ELISA which is used for antibody detection against enteropathogenic Yersinia. The Bayesian analysis was performed in two steps; the first step estimated the prior true prevalence of enteropathogenic Yersinia with data obtained from a systematic review of the literature. In the second step, data of the apparent prevalence (cross-sectional study data), prior true prevalence (first step), and estimated sensitivity and specificity of the diagnostic methods were used for building the Bayesian model. The true prevalence of Yersinia in slaughter-age pigs was 67.5% (95% PI 63.2-70.9). The true prevalence of Yersinia in sows was 74.0% (95% PI 57.3-82.4). The estimates of sensitivity and specificity values of the ELISA were 79.5% and 96.9%.

  12. Bayesian Estimation of the True Prevalence and of the Diagnostic Test Sensitivity and Specificity of Enteropathogenic Yersinia in Finnish Pig Serum Samples

    PubMed Central

    Vilar, M. J.; Ranta, J.; Virtanen, S.; Korkeala, H.

    2015-01-01

    Bayesian analysis was used to estimate the pig's and herd's true prevalence of enteropathogenic Yersinia in serum samples collected from Finnish pig farms. The sensitivity and specificity of the diagnostic test were also estimated for the commercially available ELISA which is used for antibody detection against enteropathogenic Yersinia. The Bayesian analysis was performed in two steps; the first step estimated the prior true prevalence of enteropathogenic Yersinia with data obtained from a systematic review of the literature. In the second step, data of the apparent prevalence (cross-sectional study data), prior true prevalence (first step), and estimated sensitivity and specificity of the diagnostic methods were used for building the Bayesian model. The true prevalence of Yersinia in slaughter-age pigs was 67.5% (95% PI 63.2–70.9). The true prevalence of Yersinia in sows was 74.0% (95% PI 57.3–82.4). The estimates of sensitivity and specificity values of the ELISA were 79.5% and 96.9%. PMID:26539540

  13. Changes in Yearly Birth Prevalence Rates of Children with Down Syndrome in the Period 1986-2007 in the Netherlands

    ERIC Educational Resources Information Center

    de Graaf, G.; Haveman, M.; Hochstenbach, R.; Engelen, J.; Gerssen-Schoorl, K.; Poddighe, P.; Smeets, D.; van Hove, G.

    2011-01-01

    Background: The Netherlands are lacking reliable national empirical data in relation to the development of birth prevalence of Down syndrome. Our study aims at assessing valid national live birth prevalence rates for the period 1986-2007. Method: On the basis of the annual child/adult ratio of Down syndrome diagnoses in five out of the eight Dutch…

  14. Changes in Yearly Birth Prevalence Rates of Children with Down Syndrome in the Period 1986-2007 in the Netherlands

    ERIC Educational Resources Information Center

    de Graaf, G.; Haveman, M.; Hochstenbach, R.; Engelen, J.; Gerssen-Schoorl, K.; Poddighe, P.; Smeets, D.; van Hove, G.

    2011-01-01

    Background: The Netherlands are lacking reliable national empirical data in relation to the development of birth prevalence of Down syndrome. Our study aims at assessing valid national live birth prevalence rates for the period 1986-2007. Method: On the basis of the annual child/adult ratio of Down syndrome diagnoses in five out of the eight Dutch…

  15. Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates

    PubMed Central

    2012-01-01

    Although much is known today about the prevalence of food allergy in the developed world, there are serious knowledge gaps about the prevalence rates of food allergy in developing countries. Food allergy affects up to 6% of children and 4% of adults. Symptoms include urticaria, gastrointestinal distress, failure to thrive, anaphylaxis and even death. There are over 170 foods known to provoke allergic reactions. Of these, the most common foods responsible for inducing 90% of reported allergic reactions are peanuts, milk, eggs, wheat, nuts (e.g., hazelnuts, walnuts, almonds, cashews, pecans, etc.), soybeans, fish, crustaceans and shellfish. Current assumptions are that prevalence rates are lower in developing countries and emerging economies such as China, Brazil and India which raises questions about potential health impacts should the assumptions not be supported by evidence. As the health and social burden of food allergy can be significant, national and international efforts focusing on food security, food safety, food quality and dietary diversity need to pay special attention to the role of food allergy in order to avoid marginalization of sub-populations in the community. More importantly, as the major food sources used in international food aid programs are frequently priority allergens (e.g., peanut, milk, eggs, soybean, fish, wheat), and due to the similarities between food allergy and some malnutrition symptoms, it will be increasingly important to understand and assess the interplay between food allergy and nutrition in order to protect and identify appropriate sources of foods for sensitized sub-populations especially in economically disadvantaged countries and communities. PMID:23256652

  16. Obtaining a male circumcision prevalence rate of 80% among adults in a short time

    PubMed Central

    Marshall, Esaie; Rain-Taljaard, Reathe; Tsepe, Motlalepule; Monkwe, Cornelius; Taljaard, Dirk; Hlatswayo, Florence; Xaba, Dumazile; Molomo, Tebogo; Lissouba, Pascale; Puren, Adrian; Auvert, Bertran

    2017-01-01

    Abstract World Health Organization recommends a target for the male circumcision prevalence rate of 80%. This rate will have a substantial impact on the human immunodeficiency virus-acquired immunodeficiency syndrome epidemic in Eastern and Southern Africa. The objective of the study was to assess whether an innovative intervention can lead to an increased voluntary male medical circumcision (VMMC) uptake among adults in a short time. This prospective observational study of a demand generation intervention was conducted in the township of Orange Farm (South Africa) in August to November 2015. In this community male circumcision prevalence rate among adults was stable between 2010 and 2015 at 55% and 57%, despite regular VMMC campaigns at community level and the presence of a VMMC clinic that offered free VMMC. The intervention took place in a random sample of 981 households where 522 men aged 18 to 49 years accepted to participate in the study. Among the 226 uncircumcised men, 212 accepted to be enrolled in the intervention study. A personal male circumcision adviser trained in interpersonal communication skills was assigned to each uncircumcised participant. The male circumcision advisers were trained to explain the risks and benefits of VMMC, and to discuss 24 possible reasons given by men for not being circumcised. Participants were then followed for 9 weeks. Each participant had a maximum of 3 motivational interviews at home. Participants who decided to be circumcised received financial compensation for their time equivalent to 2.5 days of work at the minimum South African salary rate. Among the 212 uncircumcised men enrolled in the intervention, 69.8% (148/212; 95% confidence interval [CI]; 63.4%–75.7%) agreed to be circumcised, which defines the uptake of the intervention. The male circumcision prevalence rate of the sample increased from 56.7% (296/522) to 81.4% (425/522; 77.9%–84.6%), P < 0.001, corresponding to a relative increase of 43.6% (95% CI

  17. A Visual Rating Scale for the Hummingbird Sign with Adjustable Diagnostic Validity.

    PubMed

    Kim, Young Eun; Kang, Suk Yun; Ma, Hyeo-Il; Ju, Young-Su; Kim, Yun Joong

    2015-01-01

    Although the hummingbird sign (HBS) is a distinctive feature of progressive supranuclear palsy (PSP) VS. idiopathic Parkinson's disease (IPD) and other parkinsonian disorders, there are no consensus criteria for its identification. To develop consensus criteria for the HBS to enable accurate communication between researchers and physicians, we developed a new radiologic rating scale for the HBS (the HBS-RS), and the inter-rater reliability (IRR) and diagnostic validity of the HBS-RS were evaluated. Two raters blinded to the clinical diagnoses reviewed T1 midsagittal magnetic resonance images of 133 patients with IPD (n = 93) or PSP (n = 40). The existence of the HBS was assessed in two steps that were separated by two weeks; the first was based on their own experience and the second was according to the HBS-RS. The HBS-RS comprises 4 items (contour of the third ventricle floor, shape of the beak, shape of the hummingbird head, and midbrain atrophy), with weighted scores from 0 to 2. The IRR of individual items in the HBS-RS and of the composite scores showed moderate-to-good agreement (Cohen's kappa [κ], 0.479-0.766) and were observed to be highest for the contour of the third ventricle floor. The sensitivities and specificities varied depending on the cut-off for each item or for the composite scores. The sensitivities for each item were high (85.0-92.5) at a low cut-off (0 VS. 1 or 2). The specificities reached more than 80% when the composite scores of the HBS-RS were used. Receiver operating characteristic curves for the total HBS-RS scores showed fair diagnostic accuracy for PSP (AUC, 0.76 and 0.73). The HBS-RS is a simple and measurable visual assessment tool to identify the HBS, with adjustable diagnostic validity for PSP. The results suggest that the HBS-RS may be used for objective measurements of the HBS in research and in the clinic.

  18. Diagnostic for a high-repetition rate electron photo-gun and first measurements

    NASA Astrophysics Data System (ADS)

    Filippetto, D.; Doolittle, L.; Huang, G.; Norum, E.; Portmann, G.; Qian, H.; Sannibale, F.

    2015-05-01

    The APEX electron source at LBNL combines the high-repetition-rate with the high beam brightness typical of photoguns, delivering low emittance electron pulses at MHz frequency. Proving the high beam quality of the beam is an essential step for the success of the experiment, opening the doors of the high average power to brightness-hungry applications as X-Ray FELs, MHz ultrafast electron diffraction etc.. As first step, a complete characterization of the beam parameters is foreseen at the Gun beam energy of 750 keV. Diagnostics for low and high current measurements have been installed and tested, and measurements of cathode lifetime and thermal emittance in a RF environment with mA current performed. The recent installation of a double slit system, a deflecting cavity and a high precision spectrometer, allow the exploration of the full 6D phase space. Here we discuss the present layout of the machine and future upgrades, showing the latest results at low and high repetition rate, together with the tools and techniques used.

  19. [Diagnostic accuracy of language tests and parent rating for identifying language disorders].

    PubMed

    Tippelt, S; Kühn, P; Grossheinrich, N; von Suchodoletz, W

    2011-07-01

    Until now German language tests have been rarely evaluated for their diagnostic accuracy. The goal of the study was to determine whether frequently used German language instruments are valid measures for identifying developmental language disorders in 3-year-old children. The language test SETK 3-5 (including the short version SSV) and the parent questionnaire SBE-3-KT were administered to 88 children with and without language impairment. The procedure of the selection of children enabled an extrapolation to general population. A language sample rating was used as a gold standard. Depending on case definition 6-22% of children were classified as language impaired by SETK 3-5, 9% by SSV and 15% by SBE-3-KT. Sensitivity, specificity and positive predictive values of SETK 3-5 for specified cut-offs were 35-93%, 86-97% and 41-58%, respectively. The corresponding values of SSV were 49%, 96%, 56% and of SBE-3-KT 92%, 93%, 59%. 3-year-old children with developmental language disorders can been identified with sufficient accuracy by means of SETK 3-5, an individual language test, as well as by SBE-3-KT, a parent questionnaire. However, the number of false positive classifications is relatively high. The hit rate of SSV, an individual short test, was too low for clinical use. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012

    PubMed Central

    Sengul, Sule; Akpolat, Tekin; Erdem, Yunus; Derici, Ulver; Arici, Mustafa; Sindel, Sukru; Karatan, Oktay; Turgan, Cetin; Hasanoglu, Enver; Caglar, Sali; Erturk, Sehsuvar

    2016-01-01

    Objectives: The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. Methods: The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Results: Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Conclusion: Although some progress has been made in

  1. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012.

    PubMed

    Sengul, Sule; Akpolat, Tekin; Erdem, Yunus; Derici, Ulver; Arici, Mustafa; Sindel, Sukru; Karatan, Oktay; Turgan, Cetin; Hasanoglu, Enver; Caglar, Sali; Erturk, Sehsuvar

    2016-06-01

    The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Although some progress has been made in recognizing hypertension from 2003 to 2012

  2. Do antimicrobials increase the carriage rate of penicillin resistant pneumococci in children? Cross sectional prevalence study.

    PubMed Central

    Arason, V. A.; Kristinsson, K. G.; Sigurdsson, J. A.; Stefánsdóttir, G.; Mölstad, S.; Gudmundsson, S.

    1996-01-01

    OBJECTIVE: To study the correlation of antimicrobial consumption with the carriage rate of penicillin resistant and multiresistant pneumococci in children. DESIGN: Cross sectional and analytical prevalence study. SETTING: Five different communities in Iceland. MAIN OUTCOME MEASURE: Prevalence of nasopharyngeal carriage of penicillin resistant pneumococci in children aged under 7 years in relation to antibiotic use as determined by information from parents, patient's records, and total sales of antimicrobials from local pharmacies in four study areas. RESULTS: Total antimicrobial sales for children (6223 prescriptions) among the four areas for which data were available ranged from 9.6 to 23.2 defined daily doses per 1000 children daily (1.1 to 2.6 courses yearly per child). Children under 2 consumed twice as much as 2-6 year olds (20.5 v 10.9 defined daily doses per 1000 children daily). Nasopharyngeal specimens were obtained from 919 children, representing 15-38% of the peer population groups in the different areas. Pneumococci were carried by 484 (52.7%) of the children, 47 (9.7%) of the isolates being resistant to penicillin or multiresistant. By multivariate analysis age (< 2 years), area (highest antimicrobial consumption), and individual use of antimicrobials significantly influenced the odds of carrying penicillin resistant pneumococci. By univariate analysis, recent antimicrobial use (two to seven weeks) and use of co-trimoxazole were also significantly associated with carriage of penicillin resistant pneumococci. CONCLUSIONS: Antimicrobial use, with regard to both individual use and total antimicrobial consumption in the community, is strongly associated with nasopharyngeal carriage of penicillin resistant pneumococci in children. Control measures to reduce the prevalence of penicillin resistant pneumococci should include reducing the use of antimicrobials in community health care. PMID:8761224

  3. The Impact of Height during Childhood on the National Prevalence Rates of Overweight

    PubMed Central

    van Dommelen, Paula; de Kroon, Marlou L. A.; Cameron, Noël; Schönbeck, Yvonne; van Buuren, Stef

    2014-01-01

    Background It is known that height and body mass index (BMI) are correlated in childhood. However, its impact on the (trend of) national prevalence rates of overweight and obesity has never been investigated. The aim of our study is to investigate the relation between height and national prevalence rates of overweight and obesity in childhood between 1980, 1997, and 2009, and to calculate which fixed value of p (2.0,2.1, …,3.0) in kg/mp during childhood is most accurate in predicting adult overweight. Methods and findings Cross-sectional growth data of children from three Dutch nationwide surveys in 1980, 1997, and 2009, and longitudinal data from the Terneuzen Birth Cohort and the Harpenden Growth Study were used. Relative risks (RR) and 95% confidence intervals (CI) were calculated. Our study showed that tall (>1 standard deviation (SD)) girls aged 5.0–13.9 y were more often overweight (RR = 3.5,95%CI:2.8–4.4) and obese (RR = 3.9,95%CI:2.1–7.4) than short girls (<−1 SD). Similar results were found in boys aged 5.0–14.9 y (RR = 4.4,95%CI:3.4–5.7 and RR = 5.3,95%CI:2.6–11.0). No large differences were found in the other age groups and in comparison with children with an average stature. Tall boys aged 2.0–4.9 y had a significantly higher positive trend in overweight between 1980 and 1997 compared to short boys (RR = 4.0,95%CI:1.38–11.9). For other age groups and in girls, no significant trends were found. The optimal Area Under the Curve (AUC) to predict adult overweight was found for p = 2.0. Conclusions and significance Tall girls aged 5.0–13.9y and tall boys aged 5.0–14.9y have much higher prevalence rates of overweight and obesity than their shorter peers. We suggest taking into account the impact of height when evaluating trends and variations of BMI distributions in childhood, and to use BMI to predict adult overweight. PMID:24465694

  4. Substances used and prevalence rates of pharmacological cognitive enhancement among healthy subjects.

    PubMed

    Franke, Andreas G; Bagusat, Christiana; Rust, Sebastian; Engel, Alice; Lieb, Klaus

    2014-11-01

    Pharmacological "cognitive enhancement" (CE) is defined as the use of any psychoactive drug with the purpose of enhancing cognition, e.g. regarding attention, concentration or memory by healthy subjects. Substances commonly used as CE drugs can be categorized into three groups of drugs: (1) over-the-counter (OTC) drugs such as coffee, caffeinated drinks/energy drinks, caffeine tablets or Ginkgo biloba; (2) drugs being approved for the treatment of certain disorders and being misused for CE: drugs to treat attention-deficit/hyperactivity disorder (ADHD) such as the stimulants methylphenidate (MPH, e.g. Ritalin(®)) or amphetamines (AMPH, e.g. Attentin(®) or Adderall(®)), to treat sleep disorders such as modafinil or to treat Alzheimer's disease such as acetylcholinesterase inhibitors; (3) illicit drugs such as illicit AMPH, e.g. "speed", ecstasy, methamphetamine (crystal meth) or others. Evidence from randomized placebo-controlled trials shows that the abovementioned substances have limited pro-cognitive effects as demonstrated, e.g. regarding increased attention, increased cognitive speed or shortening of reaction times, but on the same time poses considerable safety risks on the consumers. Prevalence rates for the use of CE drugs among healthy subjects show a broad range from less than 1 % up to more than 20 %. The range in prevalence rates estimates results from several factors which are chosen differently in the available survey studies: type of subjects (students, pupils, special professions, etc.), degree of anonymity in the survey (online, face-to-face, etc.), definition of CE and substances used/misused for CE, which are assessed (OTC drugs, prescription, illicit drugs) as well as time periods of use (e.g. ever, during the past year/month/week, etc.). A clear and comprehensive picture of the drugs used for CE by healthy subjects and their adverse events and safety risks as well as comprehensive and comparable international data on the prevalence rates of

  5. Estimation of infection prevalence and sensitivity in a stratified two-stage sampling design employing highly specific diagnostic tests when there is no gold standard.

    PubMed

    Miller, Ezer; Huppert, Amit; Novikov, Ilya; Warburg, Alon; Hailu, Asrat; Abbasi, Ibrahim; Freedman, Laurence S

    2015-11-10

    In this work, we describe a two-stage sampling design to estimate the infection prevalence in a population. In the first stage, an imperfect diagnostic test was performed on a random sample of the population. In the second stage, a different imperfect test was performed in a stratified random sample of the first sample. To estimate infection prevalence, we assumed conditional independence between the diagnostic tests and develop method of moments estimators based on expectations of the proportions of people with positive and negative results on both tests that are functions of the tests' sensitivity, specificity, and the infection prevalence. A closed-form solution of the estimating equations was obtained assuming a specificity of 100% for both tests. We applied our method to estimate the infection prevalence of visceral leishmaniasis according to two quantitative polymerase chain reaction tests performed on blood samples taken from 4756 patients in northern Ethiopia. The sensitivities of the tests were also estimated, as well as the standard errors of all estimates, using a parametric bootstrap. We also examined the impact of departures from our assumptions of 100% specificity and conditional independence on the estimated prevalence. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Effect of rice cultivation on the prevalence and infection rates of Schistosoma intermediate host.

    PubMed

    el-Hawy, A M; Negm, I A; el-Alamy, M A; Agina, A A

    1993-12-01

    In this study, it was aimed to explore the effect of rice cultivation on the prevalence, density and infection rates on the snail intermediate hosts of human schistosomiasis. A village was chosen and examine for the main water canal supplying the rice field by making three successive scoops at 10.20, 30, 40 and 50 meters up stream the site of the pump supplying the rice field. The same was done in the large irrigation canal supplying 50 feddans of rice up to 100 meters (i.e. 10 sampling sites). Also the drains in between the rice fields were examined at 10 meters distance throughout the drain. The hunted snails were sorted, the Biomphalaria alexanderina and Bulinus truncatus were separated, their age was determined then crushed to look for immature stages under the microscope. Also the vegetations coming in the scoops were examined. The results showed that rice cultivation and irrigation is a suitable site for the prevalence and intensity of snails. Both species of snails were found in the main canal, irrigation canal and drains. All Bulinus truncatus snails were free from infections. The number of infected Biomphalaria alexanderina snails was significantly higher in the irrigation canal and drains than main canal which may be attributed to pollution of the drain water and irrigation canal by micturition and defecation or to the use of water in ablution.

  7. Cross method for analysis of the erythrocyte sedimentation rate and aggregation coefficient in medical diagnostics

    NASA Astrophysics Data System (ADS)

    Yamaikina, Irene V.; Furmanchuk, Dmitryi A.

    1998-06-01

    Method of erythrocyte sedimentation rate (ESR) measurement is non-specific one. The ESR are tightly correlated to increase or decrease of aggregation coefficient (N). The variations of N could happen due to two main reasons: either changes in concentration of plasma proteins (first of all of fibrinogen) or changes of erythrocyte membrane characteristics (surface charge, transmembrane potential). The cross-method of ESR analysis has been proposed, using blood samples from patient and healthy donor of the same ABO blood groups and Rh-factors. The hematocrit (Ho)-ESR dependencies were measured in four variants: (1) patient's erythrocytes in patient's plasma; (2) patient's erythrocytes in donor's plasma; (3) donor's erythrocytes in donor's plasma; (4) donor's erythrocytes in patient's plasma. On presenting the ESR data for more than 100 patients with different bone marrow disorders after chemotherapy in the coordinates Ho-ESR three conventional zones could be marked out: high-ESR zone, medium zone and zone of low level of Ho. Proposed cross-method allows to estimate which of the two aforementioned reasons results in ESR variation. Some patients revealed not only changed fibrinogen level but additional changes in membrane affinity to fibrinogen. The modificated ESR cross-method opens us some new capacities in medical diagnostics.

  8. Rates and Correlates of Unemployment Across Four Common Chronic Pain Diagnostic Categories.

    PubMed

    Giladi, Hili; Scott, Whitney; Shir, Yoram; Sullivan, Michael J L

    2015-09-01

    To examine rates and correlates of unemployment across distinct common chronic pain diagnoses. Data were analyzed from a sample of 2,382 patients with chronic pain in the Quebec Pain Registry (QPR). Patients were grouped into the following diagnostic categories based on their primary pain diagnosis recorded in the QPR: musculoskeletal pain; myofascial pain; neuropathic pain, and visceral pain. Analyses were performed to examine the associations between pain diagnosis, patient demographics, pain intensity, depressive symptoms, and unemployment status. Pain diagnosis, age, marital status, education, pain intensity, and depressive symptoms were each significant unique predictors of unemployment status in a hierarchical logistic regression analysis; the addition of depressive symptoms in this model contributed to the greatest increment of model fit. Depressive symptoms are associated with unemployment across a number of common chronic pain conditions, even when controlling for other factors that are associated with unemployment in these patients. Depressive symptoms, as a modifiable factor, may thus be an important target of intervention for unemployed patients with chronic pain.

  9. Information-Gathering Patterns Associated with Higher Rates of Diagnostic Error

    ERIC Educational Resources Information Center

    Delzell, John E., Jr.; Chumley, Heidi; Webb, Russell; Chakrabarti, Swapan; Relan, Anju

    2009-01-01

    Diagnostic errors are an important source of medical errors. Problematic information-gathering is a common cause of diagnostic errors among physicians and medical students. The objectives of this study were to (1) determine if medical students' information-gathering patterns formed clusters of similar strategies, and if so (2) to calculate the…

  10. Information-Gathering Patterns Associated with Higher Rates of Diagnostic Error

    ERIC Educational Resources Information Center

    Delzell, John E., Jr.; Chumley, Heidi; Webb, Russell; Chakrabarti, Swapan; Relan, Anju

    2009-01-01

    Diagnostic errors are an important source of medical errors. Problematic information-gathering is a common cause of diagnostic errors among physicians and medical students. The objectives of this study were to (1) determine if medical students' information-gathering patterns formed clusters of similar strategies, and if so (2) to calculate the…

  11. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    SciTech Connect

    Shah, Chirag; Vicini, Frank A.

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  12. Prevalence of muscle weakness based on different diagnostic criteria in community-dwelling older adults: A comparison of grip strength dynamometers.

    PubMed

    Kim, Miji; Shinkai, Shoji

    2017-05-18

    The present study compared the performance of the Jamar and Smedley dynamometers for the measurement of grip strength, and the two dynamometers were used to determine the prevalence rate of weakness in a large, community-dwelling, older adult population, based on different diagnostic criteria. A total of 467 community-dwelling older adults aged 69-89 years were recruited into the study. Grip strength was measured with two dynamometers; the Jamar hydraulic hand dynamometer was used as the reference device. To assess agreement between grip strength measurements by the two dynamometers, linear regression and Bland-Altman analyses were carried out. In a comparison of the dynamometers, high coefficients of determination (R(2) ) were obtained for grip strength (R(2)  = 0.80, standard error of the estimate 2.68 kg in male participants, and R(2)  = 0.75, standard error of the estimate = 1.95 kg in female participants). There was systematic bias with underestimation of grip strength (bias 3.09 kg, 95% confidence interval 2.77 to 3.41 for men; bias 2.60 kg, 95% confidence interval 2.31 to 2.89 for women) by the Smedley dynamometer. In both sexes, no proportional bias was noted between the two dynamometers for measurement of grip strength (r = 0.030, P = 0.611 for male participants; r = -0.033, P = 0.653 for female participants). The prevalence of weakness ranged from 1.8 to 19.9% in male participants, and 0.5 to 27.4% in female participants. The present study shows that despite the excellent correlation between the two dynamometers, there is a statistically significant difference in grip strength measurements. The Smedley dynamometer showed a higher prevalence of weakness than did the Jamar dynamometer. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  13. Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women.

    PubMed

    Kahn, Jessica A; Rosenthal, Susan L; Jin, Yan; Huang, Bin; Namakydoust, Azadeh; Zimet, Gregory D

    2008-05-01

    To estimate rates of human papillomavirus (HPV) vaccination, factors associated with intention and belief in one's ability (self-efficacy) to receive the vaccine, and prevalence of vaccine-type HPV during the first year after an HPV-6, HPV-11, HPV-16, HPV-18 vaccine was licensed. Sexually experienced females 13-26 years of age (N=409) were recruited from three primary care clinics, completed a questionnaire, and underwent cervicovaginal HPV DNA testing. Outcome measures were HPV vaccination, intention and belief in one's ability to receive the HPV vaccine in the next year, and prevalence of vaccine-type HPV. Factors independently associated with intention and belief in one's ability to receive the HPV vaccine were determined by logistic regression. Five percent of participants had received at least one HPV vaccine dose, 66% intended to receive the vaccine, 65% were confident they could find the time to get vaccinated, 54% believed that they could receive all three shots, and 42% believed that they could afford vaccination. Sixty-eight percent of women were HPV-positive: 9% for HPV-6, 3% for HPV-11, 17% for HPV-16, and 12% for HPV-18. Factors independently associated with intention included believing that influential people would approve of vaccination, higher perceived severity of cervical cancer or genital warts, fewer safety barriers, and pregnancy history. Factors associated with a high belief in one's ability to receive the vaccine included perceived severity of HPV, sexually transmitted disease history, insurance coverage, and fewer practical barriers to vaccination. Interventions that aim to increase intention and belief in one's ability to receive HPV vaccines, which may lead to higher vaccination rates, should address personal beliefs about vaccination as well as systemic barriers to vaccination. III.

  14. Estimation of the prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia

    PubMed Central

    Meza, Benjamin P.L.; Lohrke, Britta; Wilkinson, Robert; Pitman, John P.; Shiraishi, Ray W.; Bock, Naomi; Lowrance, David W.; Kuehnert, Matthew J.; Mataranyika, Mary; Basavaraju, Sridhar V.

    2014-01-01

    Background Acute transfusion reactions are probably common in sub-Saharan Africa, but transfusion reaction surveillance systems have not been widely established. In 2008, the Blood Transfusion Service of Namibia implemented a national acute transfusion reaction surveillance system, but substantial under-reporting was suspected. We estimated the actual prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia. Methods The percentage of transfusion events resulting in a reported acute transfusion reaction was calculated. Actual percentage and rates of acute transfusion reactions per 1,000 transfused units were estimated by reviewing patients’ records from six hospitals, which transfuse >99% of all blood in Windhoek. Patients’ records for 1,162 transfusion events occurring between 1st January – 31st December 2011 were randomly selected. Clinical and demographic information were abstracted and Centers for Disease Control and Prevention National Healthcare Safety Network criteria were applied to categorize acute transfusion reactions1. Results From January 1 – December 31, 2011, there were 3,697 transfusion events (involving 10,338 blood units) in the selected hospitals. Eight (0.2%) acute transfusion reactions were reported to the surveillance system. Of the 1,162 transfusion events selected, medical records for 785 transfusion events were analysed, and 28 acute transfusion reactions were detected, of which only one had also been reported to the surveillance system. An estimated 3.4% (95% confidence interval [CI]: 2.3–4.4) of transfusion events in Windhoek resulted in an acute transfusion reaction, with an estimated rate of 11.5 (95% CI: 7.6–14.5) acute transfusion reactions per 1,000 transfused units. Conclusion The estimated actual rate of acute transfusion reactions is higher than the rate reported to the national haemovigilance system. Improved surveillance and interventions to reduce transfusion-related morbidity and mortality

  15. Estimation of the prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia.

    PubMed

    Meza, Benjamin P L; Lohrke, Britta; Wilkinson, Robert; Pitman, John P; Shiraishi, Ray W; Bock, Naomi; Lowrance, David W; Kuehnert, Matthew J; Mataranyika, Mary; Basavaraju, Sridhar V

    2014-07-01

    Acute transfusion reactions are probably common in sub-Saharan Africa, but transfusion reaction surveillance systems have not been widely established. In 2008, the Blood Transfusion Service of Namibia implemented a national acute transfusion reaction surveillance system, but substantial under-reporting was suspected. We estimated the actual prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia. The percentage of transfusion events resulting in a reported acute transfusion reaction was calculated. Actual percentage and rates of acute transfusion reactions per 1,000 transfused units were estimated by reviewing patients' records from six hospitals, which transfuse >99% of all blood in Windhoek. Patients' records for 1,162 transfusion events occurring between 1(st) January - 31(st) December 2011 were randomly selected. Clinical and demographic information were abstracted and Centers for Disease Control and Prevention National Healthcare Safety Network criteria were applied to categorize acute transfusion reactions. From January 1 - December 31, 2011, there were 3,697 transfusion events (involving 10,338 blood units) in the selected hospitals. Eight (0.2%) acute transfusion reactions were reported to the surveillance system. Of the 1,162 transfusion events selected, medical records for 785 transfusion events were analysed, and 28 acute transfusion reactions were detected, of which only one had also been reported to the surveillance system. An estimated 3.4% (95% confidence interval [CI]: 2.3-4.4) of transfusion events in Windhoek resulted in an acute transfusion reaction, with an estimated rate of 11.5 (95% CI: 7.6-14.5) acute transfusion reactions per 1,000 transfused units. The estimated actual rate of acute transfusion reactions is higher than the rate reported to the national haemovigilance system. Improved surveillance and interventions to reduce transfusion-related morbidity and mortality are required in Namibia.

  16. Period Prevalence and Reporting Rate of Needlestick Injuries to Nurses in Iran: A Systematic Review and Meta-Analysis.

    PubMed

    Rezaei, Satar; Hajizadeh, Mohammad; Zandian, Hamed; Fathi, Afshin; Nouri, Bijan

    2017-08-01

    The purpose of this systematic review and meta-analysis was to provide a precise estimate of the period prevalence of needlestick injuries (NSI) among nurses working in hospitals in Iran and the reporting rate of NSI to nurse managers. We searched both international (PubMed, Scopus and the Institute for Scientific Information) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases to find studies published from 2000 to 2016 of NSI among Iranian nurses. The following keywords in Persian and English were used: "needle-stick" or "needle stick" or "needlestick," with and without "injury" or "injuries," "prevalence" or "frequency," "nurses" or "nursing staff," and "Iran." In a sample of 21 articles with 6,480 participants, we estimated that the overall 1-year period prevalence of NSI was 44% (95% confidence interval [CI], 35-53%) among Iranian nurses. The overall 1-year period prevalence of reporting NSI to nurse managers was 42% (95% CI, 33-52%). In meta-regression analysis, sample size, mean age, years of experience, and gender ratio were not associated with prevalence of NSI or reporting rate. The year of data collection was positively associated with period prevalence of NSI (p < .05), but not with the period prevalence of reporting NSI to nurse managers. Results indicated a high NSI period prevalence and low NSI reporting rate among nurses in Iran. Thus, effective interventions are required in hospitals in Iran to reduce the prevalence and increase the reporting rate of NSI. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  17. Malignancy rates and diagnostic performance of the Bosniak classification for the diagnosis of cystic renal lesions in computed tomography - a systematic review and meta-analysis.

    PubMed

    Sevcenco, Sabina; Spick, Claudio; Helbich, Thomas H; Heinz, Gertraud; Shariat, Shahrokh F; Klingler, Hans C; Rauchenwald, Michael; Baltzer, Pascal A

    2017-06-01

    To systematically review the literature on the Bosniak classification system in CT to determine its diagnostic performance to diagnose malignant cystic lesions and the prevalence of malignancy in Bosniak categories. A predefined database search was performed from 1 January 1986 to 18 January 2016. Two independent reviewers extracted data on malignancy rates in Bosniak categories and several covariates using predefined criteria. Study quality was assessed using QUADAS-2. Meta-analysis included data pooling, subgroup analyses, meta-regression and investigation of publication bias. A total of 35 studies, which included 2,578 lesions, were investigated. Data on observer experience, inter-observer variation and technical CT standards were insufficiently reported. The pooled rate of malignancy increased from Bosniak I (3.2 %, 95 % CI 0-6.8, I(2) = 5 %) to Bosniak II (6 %, 95 % CI 2.7-9.3, I(2) = 32 %), IIF (6.7 %, 95 % CI 5-8.4, I(2) = 0 %), III (55.1 %, 95 % CI 45.7-64.5, I(2) = 89 %) and IV (91 %, 95 % CI 87.7-94.2, I(2) = 36). Several study design-related influences on malignancy rates and subsequent diagnostic performance indices were identified. The Bosniak classification is an accurate tool with which to stratify the risk of malignancy in renal cystic lesions. • The Bosniak classification can accurately rule out malignancy. • Specificity remains moderate at 74 % (95 % CI 64-82). • Follow-up examinations should be considered in Bosniak IIF and Bosniak II cysts. • Data on the influence of reader experience and inter-reader variability are insufficient. • Technical CT standards and publication year did not influence diagnostic performance.

  18. Mapping the serological prevalence rate of West Nile fever in equids, Tunisia.

    PubMed

    Bargaoui, R; Lecollinet, S; Lancelot, R

    2015-02-01

    West Nile fever (WNF) is a viral disease of wild birds transmitted by mosquitoes. Humans and equids can also be affected and suffer from meningoencephalitis. In Tunisia, two outbreaks of WNF occurred in humans in 1997 and 2003; sporadic cases were reported on several other years. Small-scale serological surveys revealed the presence of antibodies against WN virus (WNV) in equid sera. However, clinical cases were never reported in equids, although their population is abundant in Tunisia. This study was achieved to characterize the nationwide serological status of WNV in Tunisian equids. In total, 1189 sera were collected in 2009 during a cross-sectional survey. Sera were tested for IgG antibodies, using ELISA and microneutralization tests. The estimated overall seroprevalence rate was 28%, 95% confidence interval [22; 34]. The highest rates were observed (i) in the north-eastern governorates (Jendouba, 74%), (ii) on the eastern coast (Monastir, 64%) and (iii) in the lowlands of Chott El Jerid and Chott el Gharsa (Kebili, 58%; Tozeur, 52%). Environmental risk factors were assessed, including various indicators of wetlands, wild avifauna, night temperature and chlorophyllous activity (normalized difference vegetation index: NDVI). Multimodel inference showed that lower distance to ornithological sites and wetlands, lower night-time temperature, and higher NDVI in late spring and late fall were associated with higher serological prevalence rate. The model-predicted nationwide map of WNF seroprevalence rate in Tunisian equids highlighted different areas with high seroprevalence probability. These findings are discussed in the perspective of implementing a better WNF surveillance system in Tunisia. This system might rely on (i) a longitudinal survey of sentinel birds in high-risk areas and time periods for WNV transmission, (ii) investigations of bird die-offs and (iii) syndromic surveillance of equine meningoencephalitis.

  19. Using prevalence indices to aid interpretation and comparison of agreement ratings between two or more observers.

    PubMed

    Burn, Charlotte C; Weir, Alex A S

    2011-05-01

    Veterinary clinical and epidemiological investigations demand observer reliability. Kappa (κ) statistics are often used to adjust the observed percentage agreement according to that expected by chance. In highly homogenous populations, κ ratings can be poor, despite percentage agreements being high, because the probability of chance agreement is also high. Veterinary researchers are often unsure how to interpret these ambiguous results. It is suggested that prevalence indices (PIs), reflecting the homogeneity of the sample, should be reported alongside percentage agreements and κ values. Here, a published PI calculation is extended, permitting extrapolation to situations involving three or more observers. A process is proposed for classifying results into those that do and do not attain clinically useful ratings, and those tested on excessively homogenous populations and which are therefore inconclusive. Pre-selection of balanced populations, or adjustment of scoring thresholds, can help reduce population homogeneity. Reporting PIs in observer reliability studies in veterinary science and other disciplines enables reliability to be interpreted usefully and allows results to be compared between studies.

  20. Population prevalence of edentulism and its association with depression and self-rated health

    PubMed Central

    Tyrovolas, Stefanos; Koyanagi, Ai; Panagiotakos, Demosthenes B.; Haro, Josep Maria; Kassebaum, Nicholas J.; Chrepa, Vanessa; Kotsakis, Georgios A.

    2016-01-01

    Edentulism is associated with various adverse health outcomes but treatment options in low- and middle-income countries (LMICs) are limited. Data on its prevalence and its effect on mental health and overall-health is lacking, especially from LMICs. Self-reported data on complete edentulism obtained by standardized questionnaires on 201,953 adults aged ≥18 years from 50 countries which participated in the World Health Survey (WHS) 2002–2004 were analyzed. Age and sex-standarized edentulism prevalence ranged from 0.1% (95% CI = 0.0–0.3) (Myanmar) to 14.5% (95% CI = 13.1–15.9) (Zimbabwe), and 2.1% (95% CI = 1.5–3.0) (Ghana) to 32.3% (95% CI = 29.0–35.8) (Brazil) in the younger and older age groups respectively. Edentulism was significantly associated with depression (OR 1.57, 95% CI = 1.23–2.00) and poor self-rated health (OR 1.38, 95% CI = 1.03–1.83) in the younger group with no significant associations in the older age group. Our findings highlight the edentulism-related health loss in younger persons from LMICs. The relative burden of edentulism is likely to grow as populations age and live longer. Given its life-long nature and common risk factors with other NCDs, edentulism surveillance and prevention should be an integral part of the global agenda of NCD control. PMID:27853193

  1. Call for early prevention: prevalence rates of overweight among Turkish and Moroccan children in The Netherlands.

    PubMed

    van Dommelen, Paula; Schönbeck, Yvonne; HiraSing, Remy A; van Buuren, Stef

    2015-10-01

    Monitoring overweight in risk groups is necessary. Our aim is to assess the trend in overweight and obesity in Turkish and Moroccan children in the Netherlands since 1997 and to monitor the levels of lifestyle-related behaviours in 2009. We selected cross-sectional data of Turkish and Moroccan children aged 2-18 years from two national Growth Studies performed in 1997 and 2009 in the Netherlands. Lifestyle-related behaviours were obtained in the 2009 study by questionnaire. In 2009, 31.9% of Turkish and 26.6% of Moroccan children had overweight, whereas this was, respectively, 26.7% and 19.6% in 1997. Already at 2 years, 21.1% in Turkish and 22.7% in Moroccan children had overweight in 2009. The prevalence of obesity was above 4% from 3 years onwards. High (i.e. ≥ 25%) prevalence rates of unhealthy lifestyle-related behaviours were found for not having breakfast (26-49%) among Turkish and Moroccan adolescent (i.e. 15-18 years) girls, consuming no fruit (29-45%) and watching TV/PC ≥ 2 h (35-72%) among all Turkish and Moroccan adolescents, no walking/cycling to school/day care among preschool children (2-4 years) (28-56%) and adolescents (34-94%), drinking ≥ 2 glasses of sweet beverages (44-74%) and being <1 h physically active (29-65%) among all children. An upward trend of overweight and obesity occurred in Turkish and Moroccan children. Already at 2 years of age, one out of five Turkish and Moroccan children had overweight, which calls for early prevention with attention to specific lifestyle-related behaviours. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. Population prevalence of edentulism and its association with depression and self-rated health.

    PubMed

    Tyrovolas, Stefanos; Koyanagi, Ai; Panagiotakos, Demosthenes B; Haro, Josep Maria; Kassebaum, Nicholas J; Chrepa, Vanessa; Kotsakis, Georgios A

    2016-11-17

    Edentulism is associated with various adverse health outcomes but treatment options in low- and middle-income countries (LMICs) are limited. Data on its prevalence and its effect on mental health and overall-health is lacking, especially from LMICs. Self-reported data on complete edentulism obtained by standardized questionnaires on 201,953 adults aged ≥18 years from 50 countries which participated in the World Health Survey (WHS) 2002-2004 were analyzed. Age and sex-standarized edentulism prevalence ranged from 0.1% (95% CI = 0.0-0.3) (Myanmar) to 14.5% (95% CI = 13.1-15.9) (Zimbabwe), and 2.1% (95% CI = 1.5-3.0) (Ghana) to 32.3% (95% CI = 29.0-35.8) (Brazil) in the younger and older age groups respectively. Edentulism was significantly associated with depression (OR 1.57, 95% CI = 1.23-2.00) and poor self-rated health (OR 1.38, 95% CI = 1.03-1.83) in the younger group with no significant associations in the older age group. Our findings highlight the edentulism-related health loss in younger persons from LMICs. The relative burden of edentulism is likely to grow as populations age and live longer. Given its life-long nature and common risk factors with other NCDs, edentulism surveillance and prevention should be an integral part of the global agenda of NCD control.

  3. Incidental vestibular schwannomas: a review of prevalence, growth rate, and management challenges.

    PubMed

    Schmidt, Richard F; Boghani, Zain; Choudhry, Osamah J; Eloy, Jean Anderson; Jyung, Robert W; Liu, James K

    2012-09-01

    With the relatively recent increase in the use of MRI techniques, there has been a concurrent rise in the number of vestibular schwannomas (VSs) detected as incidental findings. These incidental VSs may be prevalent in up to 0.02%-0.07% of individuals undergoing MRI and represent a significant portion of all diagnosed VSs. The management of these lesions poses a significant challenge for practitioners. Most incidental VSs tend to be small and associated with minimal symptoms, permitting them to be managed conservatively at the time of diagnosis. However, relatively few indicators consistently predict tumor growth and patient outcomes. Furthermore, growth rates have been shown to vary significantly over time with a large variety of long-term growth patterns. Thus, early MRI screening for continued tumor growth followed by repeated MRI studies and clinical assessments throughout the patient's life is an essential component in a conservative management strategy. Note that tumor growth is typically associated with a worsening of symptoms in patients who undergo conservative management, and many of these symptoms have been shown to significantly impact the patient's quality of life. Specific indications for the termination of conservative management vary across studies, but secondary intervention has been shown to be a relatively safe option in most patients with progressive disease. Patients with incidental VSs will probably qualify for a course of conservative management at diagnosis, and regular imaging combined with the expectation that the tumor and symptoms may change at any interval is crucial to ensuring positive long-term outcomes in these patients. In this report, the authors discuss the current literature pertaining to the prevalence of incidental VSs and various considerations in the management of these lesions. It is hoped that by incorporating an understanding of tumor growth, patient outcomes, and management strategies, practitioners will be able to

  4. Combination of five diagnostic tests to estimate the prevalence of hookworm infection among school-aged children from a rural area of colombia.

    PubMed

    Barreto, Rafael E; Narváez, Javier; Sepúlveda, Natalia A; Velásquez, Fabián C; Díaz, Sandra C; López, Myriam Consuelo; Reyes, Patricia; Moncada, Ligia I

    2017-09-01

    Public health programs for the control of soil-transmitted helminthiases require valid diagnostic tests for surveillance and parasitic control evaluation. However, there is currently no agreement about what test should be used as a gold standard for the diagnosis of hookworm infection. Still, in presence of concurrent data for multiple tests it is possible to use statistical models to estimate measures of test performance and prevalence. The aim of this study was to estimate the diagnostic accuracy of five parallel tests (direct microscopic examination, Kato-Katz, Harada-Mori, modified Ritchie-Frick, and culture in agar plate) to detect hookworm infections in a sample of school-aged children from a rural area in Colombia. We used both, a frequentist approach, and Bayesian latent class models to estimate the sensitivity and specificity of five tests for hookworm detection, and to estimate the prevalence of hookworm infection in absence of a Gold Standard. The Kato-Katz and agar plate methods had an overall agreement of 95% and kappa coefficient of 0.76. Different models estimated a sensitivity between 76% and 92% for the agar plate technique, and 52% to 87% for the Kato-Katz technique. The other tests had lower sensitivity. All tests had specificity between 95% and 98%. The prevalence estimated by the Kato-Katz and Agar plate methods for different subpopulations varied between 10% and 14%, and was consistent with the prevalence estimated from the combination of all tests. The Harada-Mori, Ritchie-Frick and direct examination techniques resulted in lower and disparate prevalence estimates. Bayesian approaches assuming imperfect specificity resulted in lower prevalence estimates than the frequentist approach. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Asymptomatic bacteriuria: prevalence rates of causal microorganisms, etiology of infection in different patient populations, and recent advances in molecular detection.

    PubMed

    Ipe, Deepak S; Sundac, Lana; Benjamin, William H; Moore, Kate H; Ulett, Glen C

    2013-09-01

    Bacteriuria, or the presence of bacteria in urine, is associated with both asymptomatic and symptomatic urinary tract infection and underpins much of the dynamic of microbial colonization of the urinary tract. The prevalence of bacteriuria in dissimilar patient groups such as healthy adults, institutionalized elderly, pregnant women, and immune-compromised patients varies widely. In addition, assessing the importance of 'significant bacteriuria' in infected individuals represents a diagnostic challenge, partly due to various causal microorganisms, and requires careful consideration of the distinct etiologies of bacteriuria in different populations and circumstances. Recent molecular discoveries have revealed how some bacterial traits can enable organisms to grow in human urine, which, as a fitness adaptation, is likely to influence the progression of bacteriuria in some individuals. In this review, we comprehensively analyze currently available data on the prevalence of causal organisms with a focus on asymptomatic bacteriuria in dissimilar populations. We evaluate recent advances in the molecular detection of bacteriuria from a diagnostic viewpoint and briefly discuss the potential benefits and some of the challenges of these approaches. Overall, this review provides an update on the comparative prevalence and etiology of bacteriuria from both microbiological and clinical perspectives. © 2013 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

  6. Early Pregnancy Diabetes Screening and Diagnosis: Prevalence, Rates of Abnormal Test Results, and Associated Factors.

    PubMed

    Mission, John F; Catov, Janet; Deihl, Tiffany E; Feghali, Maisa; Scifres, Christina

    2017-10-06

    To evaluate the prevalence of early diabetes screening in pregnancy, rates of abnormal diabetes test results before 24 weeks of gestation, and factors associated with early diabetes screening. This was a retrospective cohort study of all singleton deliveries from 2012 to 2014 among diverse clinical practices at a large academic medical center. We assessed rates of early (less than 24 weeks of gestation) and routine (at or beyond 24 weeks of gestation) diabetes screening, with abnormal test results defined using the Carpenter-Coustan criteria, a 50-g glucose challenge test result greater than 200 mg/dL, or a hemoglobin A1C level greater than 6.5%. Univariate and multivariate analyses were used to evaluate clinical and demographic determinants of screening and diagnosis. Overall, 1,420 of 11,331 (12.5%) women underwent early screening. Increasing body mass index (BMI) category, race, public insurance, history of gestational diabetes mellitus, a family history of diabetes, and chronic hypertension were associated with early screening. Early screening rates rose with increasing BMI category, but only 268 of 551 (48.6%) of women with class III obesity underwent early screening. Among those screened early, 2.0% of normal-weight women, 4.0% of overweight women, 4.2% of class I obese women, 3.8% of class II obese women, and 9.0% of class III obese women had abnormal early test results (P<.001). Early diabetes screening is used inconsistently, and many women with risk factors do not undergo early screening. A significant proportion of women with class III obesity will test positive for gestational diabetes mellitus before 24 weeks of gestation, and studies are urgently needed to assess the effect of early diabetes screening and diagnosis on perinatal outcomes in high-risk women.

  7. Rare chromosome abnormalities, prevalence and prenatal diagnosis rates from population-based congenital anomaly registers in Europe

    PubMed Central

    Wellesley, Diana; Dolk, Helen; Boyd, Patricia A; Greenlees, Ruth; Haeusler, Martin; Nelen, Vera; Garne, Ester; Khoshnood, Babak; Doray, Berenice; Rissmann, Anke; Mullaney, Carmel; Calzolari, Elisa; Bakker, Marian; Salvador, Joaquin; Addor, Marie-Claude; Draper, Elizabeth; Rankin, Judith; Tucker, David

    2012-01-01

    The aim of this study is to quantify the prevalence and types of rare chromosome abnormalities (RCAs) in Europe for 2000–2006 inclusive, and to describe prenatal diagnosis rates and pregnancy outcome. Data held by the European Surveillance of Congenital Anomalies database were analysed on all the cases from 16 population-based registries in 11 European countries diagnosed prenatally or before 1 year of age, and delivered between 2000 and 2006. Cases were all unbalanced chromosome abnormalities and included live births, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly. There were 10 323 cases with a chromosome abnormality, giving a total birth prevalence rate of 43.8/10 000 births. Of these, 7335 cases had trisomy 21,18 or 13, giving individual prevalence rates of 23.0, 5.9 and 2.3/10 000 births, respectively (53, 13 and 5% of all reported chromosome errors, respectively). In all, 473 cases (5%) had a sex chromosome trisomy, and 778 (8%) had 45,X, giving prevalence rates of 2.0 and 3.3/10 000 births, respectively. There were 1 737 RCA cases (17%), giving a prevalence of 7.4/10 000 births. These included triploidy, other trisomies, marker chromosomes, unbalanced translocations, deletions and duplications. There was a wide variation between the registers in both the overall prenatal diagnosis rate of RCA, an average of 65% (range 5–92%) and the prevalence of RCA (range 2.4–12.9/10 000 births). In all, 49% were liveborn. The data provide the prevalence of families currently requiring specialised genetic counselling services in the perinatal period for these conditions and, for some, long-term care. PMID:22234154

  8. Rare chromosome abnormalities, prevalence and prenatal diagnosis rates from population-based congenital anomaly registers in Europe.

    PubMed

    Wellesley, Diana; Dolk, Helen; Boyd, Patricia A; Greenlees, Ruth; Haeusler, Martin; Nelen, Vera; Garne, Ester; Khoshnood, Babak; Doray, Berenice; Rissmann, Anke; Mullaney, Carmel; Calzolari, Elisa; Bakker, Marian; Salvador, Joaquin; Addor, Marie-Claude; Draper, Elizabeth; Rankin, Judith; Tucker, David

    2012-05-01

    The aim of this study is to quantify the prevalence and types of rare chromosome abnormalities (RCAs) in Europe for 2000-2006 inclusive, and to describe prenatal diagnosis rates and pregnancy outcome. Data held by the European Surveillance of Congenital Anomalies database were analysed on all the cases from 16 population-based registries in 11 European countries diagnosed prenatally or before 1 year of age, and delivered between 2000 and 2006. Cases were all unbalanced chromosome abnormalities and included live births, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly. There were 10,323 cases with a chromosome abnormality, giving a total birth prevalence rate of 43.8/10,000 births. Of these, 7335 cases had trisomy 21,18 or 13, giving individual prevalence rates of 23.0, 5.9 and 2.3/10,000 births, respectively (53, 13 and 5% of all reported chromosome errors, respectively). In all, 473 cases (5%) had a sex chromosome trisomy, and 778 (8%) had 45,X, giving prevalence rates of 2.0 and 3.3/10,000 births, respectively. There were 1,737 RCA cases (17%), giving a prevalence of 7.4/10,000 births. These included triploidy, other trisomies, marker chromosomes, unbalanced translocations, deletions and duplications. There was a wide variation between the registers in both the overall prenatal diagnosis rate of RCA, an average of 65% (range 5-92%) and the prevalence of RCA (range 2.4-12.9/10,000 births). In all, 49% were liveborn. The data provide the prevalence of families currently requiring specialised genetic counselling services in the perinatal period for these conditions and, for some, long-term care.

  9. Prevalence of domestic violence in community practice and rate of physician inquiry.

    PubMed

    Hamberger, L K; Saunders, D G; Hovey, M

    1992-01-01

    National surveys show that each year in the United States approximately 2 million women are battered by their husbands. Only a small percentage of these women are identified by physicians. The objective of this research was to determine the incidence and prevalence of spouse abuse among women seeking health care in a family practice clinic (or setting). During a two-month period, all adult women seeking health care from a family practice clinic in a medium-sized Midwestern community were asked to complete an anonymous questionnaire about whether they had ever been physically assaulted by their partners. Of 476 consecutive women seen in practice, 394 (82.7%) agreed to participate. Of these, 22.7% had been physically assaulted by their partners within the last year. The lifetime rate of physical abuse was 38.8%. Only six women in the sample had ever been asked about abuse by their physician in a recent visit [corrected]. Although spouse abuse is common, physicians rarely ask about it. Physicians should be trained to detect and assess abuse among female patients.

  10. Extraspinal Incidental Findings on Routine MRI of Lumbar Spine: Prevalence and Reporting Rates in 1278 Patients.

    PubMed

    Tuncel, Sedat Alpaslan; Çaglı, Bekir; Tekataş, Aslan; Kırıcı, Mehmet Yadigar; Ünlü, Ercüment; Gençhellaç, Hakan

    2015-01-01

    The aim of the present study was to determine the prevalence and reporting rate of incidental findings (IF) in adult outpatients undergoing lumbar magnetic resonance imaging (MRI). Re-evaluation of a total of 1278 lumbar MRI images (collected from patients with a mean age of 50.5 years, range 16-91 years) captured between August 2010-August 2011 was done by a neuroradiologist and a musculoskeletal radiologist. IFs were classified according to organ or system (liver, gallbladder, kidney, bladder, uterus, ovary, lymph node, intestine and aorta). The rate of reporting of a range of IF was examined. The outcome of each patient's treatment was evaluated based on review of hospital records and by telephone interviews. A total of 253 IFs were found in 241 patients (18.8% of 1278). Among these, clinically significant IFs (n = 34) included: 2 renal masses (0.15%), 2 aortic aneurysms (0.15%), 2 cases of hydronephrosis (0.15%), 11 adrenal masses (0.86%), 7 lymphadenopathies (0.55%), 6 cases of endometrial or cervical thickening (0.47%), 1 liver hemangioma (0.08%), 1 pelvic fluid (0.08%) and 2 ovarian dermoid cysts (0.15%). Overall, 28% (71/253) of IFs were included in the clinical reports, while clinically significant findings were reported in 41% (14/34) of cases. Extraspinal IFs are commonly detected during a routine lumbar MRI, and many of these findings are not clinically significant. However, IFs including clinically important findings are occasionally omitted from formal radiological reports.

  11. Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation.

    PubMed

    Burri, Andrea; Maercker, Andreas

    2014-06-28

    Guided by previous explorations of historical and cultural influences on the occurrence of PTSD, the aim of the present study was to investigate the contributions of war victimisation (in particular, World War II) and other civil trauma on the prevalence of PTSD, as mediated by cultural value orientation. Secondary data analysis was performed for 12 European countries using data, including PTSD prevalence and number of war victims, crime victims, and natural disaster victims, from different sources. Ten single value orientations, as well as value aggregates for traditional and modern factors, were investigated. Whilst differences in PTSD prevalence were strongly associated with war victim rates, associations, albeit weaker, were also found between crime victims and PTSD. When cultural value orientations, such as stimulation and conformity as representatives of modern and traditional values, were included in the multivariate predictions of PTSD prevalence, an average of approximately 80% of PTSD variance could be explained by the model, independent of the type of trauma exposure. The results suggest that the aftermath of war contributes to current PTSD prevalence, which may be explained by the high proportion of the older population who directly or indirectly experienced traumatic war experiences. Additional findings for other types of civil trauma point towards an interaction between value orientation and country-specific trauma rates. Particularly, being personally oriented towards stimulation appears to interact with differences in trauma prevalence. Thus, cultural value orientation might be viewed not only as an individual intrinsic process but also as a compensatory strategy after trauma exposure.

  12. Next-generation sequencing (NGS) as a diagnostic tool for retinal degeneration reveals a much higher detection rate in early-onset disease

    PubMed Central

    Shanks, Morag E; Downes, Susan M; Copley, Richard R; Lise, Stefano; Broxholme, John; Hudspith, Karl AZ; Kwasniewska, Alexandra; Davies, Wayne IL; Hankins, Mark W; Packham, Emily R; Clouston, Penny; Seller, Anneke; Wilkie, Andrew OM; Taylor, Jenny C; Ragoussis, Jiannis; Németh, Andrea H

    2013-01-01

    Inherited retinal degeneration (IRD) is a common cause of visual impairment (prevalence ∼1/3500). There is considerable phenotype and genotype heterogeneity, making a specific diagnosis very difficult without molecular testing. We investigated targeted capture combined with next-generation sequencing using Nimblegen 12plex arrays and the Roche 454 sequencing platform to explore its potential for clinical diagnostics in two common types of IRD, retinitis pigmentosa and cone-rod dystrophy. 50 patients (36 unknowns and 14 positive controls) were screened, and pathogenic mutations were identified in 25% of patients in the unknown, with 53% in the early-onset cases. All patients with new mutations detected had an age of onset <21 years and 44% had a family history. Thirty-one percent of mutations detected were novel. A de novo mutation in rhodopsin was identified in one early-onset case without a family history. Bioinformatic pipelines were developed to identify likely pathogenic mutations and stringent criteria were used for assignment of pathogenicity. Analysis of sequencing metrics revealed significant variability in capture efficiency and depth of coverage. We conclude that targeted capture and next-generation sequencing are likely to be very useful in a diagnostic setting, but patients with earlier onset of disease are more likely to benefit from using this strategy. The mutation-detection rate suggests that many patients are likely to have mutations in novel genes. PMID:22968130

  13. Efficiency of diagnostic methods for correlation between prevalence of enteric protozoan parasites and HIV/AIDS status--an experience of a tertiary care hospital in East Delhi.

    PubMed

    Kashyap, Bineeta; Sinha, Sanchaita; Das, Shukla; Rustagi, Nitesh; Jhamb, Rajat

    2010-10-01

    Since the beginning of the AIDS pandemic, opportunistic infections have been recognized as common complications of HIV infection. Enteric protozoan parasitic infections are one of the leading causes of morbidity and mortality in HIV infected patients. The present study is, therefore, aimed to determine the prevalence of these parasites and study their association with immune status in HIV patients with emphasis on the correlation between various diagnostic techniques to give an accurate diagnosis to avoid empirical treatment. This prospective study, carried out between November 2009 and May 2010 included all HIV seropositive patients presenting with diarrhea to the ART center. A total of 64 stool samples were analyzed by wet mount examination, three different staining techniques, and antigen detection by ELISA for various enteric protozoan infections. Total prevalence of enteric protozoan parasites was 30%. Among the total cases, Cryptosporidium was seen in 12% cases followed by Giardia, E. histolytica and Isospora belli. The maximum diagnostic yield for coccidian parasites was with safranin-methylene blue staining technique. Parasitic burden contributes towards early morbidity in HIV infection. This study provides important information about prevalence of intestinal protozoan parasites in HIV infection. A combination of procedures should be carried out for the screening of stool specimens of HIV patients for better diagnosis and management.

  14. The influence of subclinical hyperthyroidism on blood pressure, heart rate variability, and prevalence of arrhythmias.

    PubMed

    Kaminski, Grzegorz; Makowski, Karol; Michałkiewicz, Dariusz; Kowal, Jarosław; Ruchala, Marek; Szczepanek, Ewelina; Gielerak, Grzegorz

    2012-05-01

    The impact of subclinical hyperthyroidism (sHT) on the cardiovascular system still needs to be elucidated. The aim of the study was to prospectively assess blood pressure (BP), variability in heart rate, and the prevalence of arrhythmias in patients with sHT, both before and after they are restored to the euthyroid state. The study group consisted of 44 normotensive patients (37 women, 7 men), aged 22-65 years (mean±SD: 45.9±11.0) with sHT. Enrolled patients were drawn from 1080 patients referred to our department for treatment of hyperthyroidism. Study patients were treated with radioiodine treatment to restore the euthyroid state. Ambulatory BP monitoring and Holter electrocardiography were performed (i) when sHT was diagnosed and (ii) at least 6 months after they became euthyroid. sHT in comparison to the euthyroid state was associated with higher (109.3±7.1 vs. 107.1±7.7 mmHg) nocturnal systolic mean BP (p=0.035) and BP load (14.8 vs. 10.2%, p=0.033), mean diastolic BP (66.4±6.6 vs. 64.8±6.6 mmHg, p=0.047), and mean arterial pressure (80.8±43.1 vs. 79.3±43.6 mmHg, p=0.049). Moreover, significant changes in both the time and frequency domain measures of heart rate variability (HRV) were observed: decrease of the square root of the mean squared differences of successive NN intervals (rMSSD) (45.68±34.1 vs. 65.09±50.6 ms, p=0.03) and the low frequency power (LF) (5.71±0.99 vs. 6.0±1.01 ms(2), p=0.049) as well as increase of QT interval dispersion (58.25±28.5 vs. 46.90±12.1 ms, p=0.020). This was accompanied by a clinically insignificant increase in the frequency of ventricular extrasystoles (VES) (3.1±7.4 vs. 0.6±1.2 per hour, p=0.048) and increased mean heart rate (78.4±6.8 vs. 76.0±8.0 beats/min, p=0.004). Some of the parameters correlated positively with thyroid hormones: nocturnal diastolic BP with free triiodothyronine (FT(3)) (r=0.397, p=0.008), rMSSD with free thyroxine (FT(4)) (r=0.389, p=0.013), and QT interval dispersion with FT(4

  15. Prevalence rates of Giardia and Cryptosporidium among diarrheic patients in the Philippines.

    PubMed

    Natividad, Filipinas F; Buerano, Corazon C; Lago, Catherine B; Mapua, Cynthia A; de Guzman, Blanquita B; Seraspe, Ebonia B; Samentar, Lorena P; Endo, Takuro

    2008-11-01

    The prevalence of Giardia and Cryptosporidium among 3,456 diarrheic patients corrected from May 2004 to May 2005 in the Philippines was determined. Of 133 (3.8%) positive samples, 69 (2.0%) were positive for Giardia and 67 (1.9%) for Cryptosporidium. Three samples had co-infection with Giardia and Cryptosporidium. Luzon had the highest positive samples (5.0%) followed by Mindanao (4.9%), then Visayas (2.2%). Giardia was most prevalent in Mindanao (3.6%) while Cryptosporidium was most prevalent in Luzon (3.1%). The prevalence of Giardia (2.0%) among pediatric patients (0-18 years) did not significantly differ from that (1.9%) among adults (> 18 years old). However, for Cryptosporidium, the prevalence (2.9%) among pediatric patients was significantly higher compared to that (0.2%) among adult patients. In the pediatric population, the highest percentage of patients with Giardia was the 5-9 year old age group, while that of Cryptosporidium was in the 0-4 year old group. The prevalence of Giardia, but not Cryptosporidium, was significantly higher in male than female adults. Seasonality had a distinct peak in September with Cryptosporidium more prevalent in the rainy (2.6%) than dry season (0.9%).

  16. Temporal changes in liver cancer incidence rates in Japan: accounting for death certificate inaccuracies and improving diagnostic techniques.

    PubMed

    Sharp, G B; Cologne, J B; Fukuhara, T; Itakura, H; Yamamoto, M; Tokuoka, S

    2001-09-01

    Primary liver cancer (PLC) rates have risen dramatically during the past few decades in some regions, particularly in Japan, where PLC is now the third major cause of cancer death. PLC is one of the most difficult tumors to diagnose correctly, because (i) the liver is a frequent site of cancer metastasis and (ii) death from PLC is often attributed to cirrhosis or chronic hepatitis. Also, because the disease is often rapidly fatal, a large proportion of liver cancer cases are identified based on death certificates alone without confirmation by clinical records. Thus, worldwide differences in published incidence rates for this disease reflect regional or national differences in both the accuracy of death certificates and the sensitivity of diagnostic methods. By comparing death certificate causes of death with those based on pathology review, we were able to adjust 1958--1994 incidence rates for a large Japanese cohort for these errors. Although the death certificate false-positive error rate declined, the false-negative error rate remained high throughout the study. The introduction of improved liver cancer diagnostic methods in Japan in the early 1980s was associated with a sharp increase in PLC incidence. We conclude that errors in death certificate causes of death and changes in liver cancer diagnostic techniques have had an important impact on the reported incidence of this disease. Taking these factors into account, rates of hepatocellular carcinoma rose between 2.4- and 4.3-fold in our Japanese cohort from 1960 to 1985, peaked about 1993 and declined thereafter. Incidence rates of cholangiocarcinoma remained stable through 1987.

  17. The prevalence and diagnostic utility of systemic inflammatory response syndrome vital signs in a pediatric emergency department.

    PubMed

    Scott, Halden F; Deakyne, Sara J; Woods, Jason M; Bajaj, Lalit

    2015-04-01

    This study sought to determine the prevalence, test characteristics, and severity of illness of pediatric patients with systemic inflammatory response syndrome (SIRS) vital signs among pediatric emergency department (ED) visits. This was a retrospective descriptive cohort study of all visits to the ED of a tertiary academic free-standing pediatric hospital over 1 year. Visits were included if the patient was <18 years of age and did not leave before full evaluation or against medical advice. Exclusion criteria were trauma diagnoses or missing documentation of vital signs. Data were electronically extracted from the medical record. The primary predictor was presence of vital signs meeting pediatric SIRS definitions. Specific vital sign pairs comprising SIRS were evaluated as predictors (temperature-heart rate, temperature-respiratory rate, and temperature-corrected heart rate, in which a formula was used to correct heart rate for degree of temperature elevation). The primary outcome measure was requirement for critical care (receipt of a vasoactive agent or intubation) within 24 hours of ED arrival. There were 56,210 visits during the study period; 40,356 met inclusion criteria. Of these, 6,596 (16.3%) visits had fever >38.5°C, and 6,122 (15.2% of included visits) met SIRS vital sign criteria. Among included visits, those with SIRS vital signs accounted for 92.8% of all visits with fever >38.5°C. Among patients with SIRS vital signs, 4993 (81.6%) were discharged from the ED without intravenous (IV) therapy and without 72-hour readmission. Critical care within the first 24 hours was present in 99 (0.25%) patients: 23 patients with and 76 without SIRS vital signs. Intensive care unit (ICU) admission was present in 126 (2.06%) with SIRS vital signs and 487 (1.42%) without SIRS vital signs. SIRS vital signs were associated with increased risk of critical care within 24 hours (relative risk [RR] = 1.69, 95% confidence interval [CI] = 1.06 to 2.70), ICU admission (RR

  18. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions.

    PubMed

    Verallo-Rowell, Vermén M

    2011-01-01

    The validated hypoallergenic (vh) rating system was initiated in 1988 to try to objectively validate the "hypoallergenic" claim in cosmetics. To show how the system rates cosmetic hypoallergenicity and to compare the prevalence of cosmetic contact dermatitis (CCD) among users of regular cosmetics versus cosmetics with high VH numbers. (1) Made a VH list based on top allergens from patch-test results published by the North American Contact Dermatitis Group (NACDG) and the European Surveillance System on Contact Allergies (ESSCA); (2) reviewed global regulatory, cosmetic, drug, packaging, and manufacturing practices to show how allergens may contaminate products; (3) compared cosmetic ingredients lists against the VH list to obtain the VH rating (the more allergens absent, the higher the VH rating); and (4) obtained CCD prevalence among users of regular cosmetics versus users of cosmetics with high VH ratings. (1) Two VH lists (1988, 2003) included only cosmetic allergens in the NACDG surveys, the third (2007) included cosmetic and potential contaminant noncosmetic allergens, and the fourth (2010) adds ESSCA patch-test surveys. (2) CCD prevalence is 0.05 to 0.12% (average, 0.08%) among users of cosmetics with high VH ratings versus 2.4 to 36.3% among users of regular cosmetics. The VH rating system is shown to objectively validate the hypoallergenic cosmetics claim.

  19. Value of the "Test & Treat" Strategy for Uninvestigated Dyspepsia at Low Prevalence Rates of Helicobacter pylori in the Population.

    PubMed

    Agréus, Lars; Talley, Nicholas J; Jones, Michael

    2016-06-01

    In populations with a low prevalence rate of Helicobacter pylori (H. pylori) infection from Western countries, guidelines for the management of uninvestigated dyspepsia generally recommend that the "test and treat" strategy should be avoided in favor of empiric proton-pump inhibitor therapy in younger patients (on average < 50 years of age) without alarm symptoms and signs. The prevalence of H. pylori infection has fallen from about 30% to about 10% in Sweden and other countries. We aimed to explore whether the rationale for test and treat is relevant in contemporary clinical practice. In settings with an infection rate in the adult population of 30% and 10%, we modeled the positive and negative predictive values for indirect (nonendoscopy) tests on current H. pylori infection with a presumed sensitivity and specificity of 95%. We then calculated the difference in false-negative and false-positive test outcome, and eradication prescription rates in the two scenarios. While the positive predictive value for the test decreased from 0.89 to 0.68 when the prevalence of H. pylori fell from 30% to 10%, there were only 1% more false-negative tests and 1% less false-positive tests. The eradication prescription rate would decrease by 18% with a 10% prevalence rate. The recommendation to stop applying "test and treat" at lower prevalence rates of H. pylori should be reconsidered. The test and treat strategy is the preferred approach for most patients who present with dyspepsia. © 2015 John Wiley & Sons Ltd.

  20. Diagnostic accuracy of heart-rate recovery after exercise in the assessment of diabetic cardiac autonomic neuropathy.

    PubMed

    Sacre, J W; Jellis, C L; Coombes, J S; Marwick, T H

    2012-09-01

    Poor prognosis associated with blunted post-exercise heart-rate recovery may reflect autonomic dysfunction. This study sought the accuracy of post-exercise heart-rate recovery in the diagnosis of cardiac autonomic neuropathy, which represents a serious, but often unrecognized complication of Type 2 diabetes. Clinical assessment of cardiac autonomic neuropathy and maximal treadmill exercise testing for heart-rate recovery were performed in 135 patients with Type 2 diabetes and negative exercise echocardiograms. Cardiac autonomic neuropathy was defined by abnormalities in ≥ 2 of 7 autonomic function markers, including four cardiac reflex tests and three indices of short-term (5-min) heart-rate variability. Heart-rate recovery was defined at 1-, 2- and 3-min post-exercise. Patients with cardiac autonomic neuropathy (n = 27; 20%) had lower heart-rate recovery at 1-, 2- and 3-min post-exercise (P < 0.01). Heart-rate recovery demonstrated univariate associations with autonomic function markers (r-values 0.20-0.46, P < 0.05). Area under the receiver-operating characteristic curve revealed good diagnostic performance of all heart-rate recovery parameters (range 0.80-0.83, P < 0.001). Optimal cut-offs for heart-rate recovery at 1-, 2- and 3-min post-exercise were ≤ 28 beats/min (sensitivity 93%, specificity 69%), ≤ 50 beats/min (sensitivity 96%, specificity 63%) and ≤ 52 beats/min (sensitivity 70%, specificity 84%), respectively. These criteria predicted cardiac autonomic neuropathy independently of relevant clinical and exercise test information (adjusted odds ratios 7-28, P < 0.05). Post-exercise heart-rate recovery provides an accurate diagnostic test for cardiac autonomic neuropathy in Type 2 diabetes. The high sensitivity and modest specificity suggests heart-rate recovery may be useful to screen for patients requiring clinical autonomic evaluation. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  1. Confidence interval for rate ratio in a 2 x 2 table with structural zero: an application in assessing false-negative rate ratio when combining two diagnostic tests.

    PubMed

    Tang, Man-Lai; Tang, Nian-Sheng; Carey, Vincent J

    2004-06-01

    In this article, we consider problems with correlated data that can be summarized in a 2 x 2 table with structural zero in one of the off-diagonal cells. Data of this kind sometimes appear in infectious disease studies and two-step procedure studies. Lui (1998, Biometrics54, 706-711) considered confidence interval estimation of rate ratio based on Fieller-type, Wald-type, and logarithmic transformation statistics. We reexamine the same problem under the context of confidence interval construction on false-negative rate ratio in diagnostic performance when combining two diagnostic tests. We propose a score statistic for testing the null hypothesis of nonunity false-negative rate ratio. Score test-based confidence interval construction for false-negative rate ratio will also be discussed. Simulation studies are conducted to compare the performance of the new derived score test statistic and existing statistics for small to moderate sample sizes. In terms of confidence interval construction, our asymptotic score test-based confidence interval estimator possesses significantly shorter expected width with coverage probability being close to the anticipated confidence level. In terms of hypothesis testing, our asymptotic score test procedure has actual type I error rate close to the pre-assigned nominal level. We illustrate our methodologies with real examples from a clinical laboratory study and a cancer study.

  2. Diagnostic efficiency of several methods of identifying socially rejected children and effect of participation rate on classification accuracy.

    PubMed

    McKown, Clark; Gumbiner, Laura M; Johnson, Jason

    2011-10-01

    Social rejection is associated with a wide variety of negative outcomes. Early identification of social rejection and intervention to minimize its negative impact is thus important. However, sociometric methods, which are considered high in validity for identifying socially rejected children, are frequently not used because of (a) procedural challenges, (b) community apprehension, and (c) sensitivity to missing data. In a sample of 316 students in grades K through 8, we used receiver operating characteristics (ROC) analyses to compare the diagnostic efficiency of several methods for identifying socially rejected children. When not using least-liked nominations, (a) most-liked nominations yielded the greatest diagnostic efficiency (AUC=.96), (b) peer ratings were more efficient (AUC=.84 to .99) than teacher ratings (AUC=.74 to .81), and (c) teacher report of social status was more efficient (AUC=.81) than scores from teacher behavior rating scales (AUC=.74 to .75). We also examined the effects of nominator non-participation on diagnostic efficiency. At participation as low as 50%, classification of sociometric rejection (i.e., being rejected or not rejected) was quite accurate (κ=.63 to .77). In contrast, at participation as high as 70%, classification of sociometric status (i.e., popular, average, unclassified, neglected, controversial, or rejected) was significantly less accurate (κ=.50 to .59).

  3. Prevalence rate for inherited thrombophilia in patients with chronic and recurrent venous leg ulceration.

    PubMed

    Wiszniewski, Adam; Bykowska, Ksenia; Bilski, Radoslaw; Jaśkowiak, Wojciech; Proniewski, Jacek

    2011-01-01

    The aim of the study was to determine the prevalence rate for inherited thrombophilia (IT) in patients with chronic (CVU) and recurrent venous leg ulceration. We also investigated and evaluated the severity of the clinical pattern of CVU in patients with and without IT. We examined 110 patients with CVU (the study group) and 110 healthy subjects (the control group). We prepared a questionnaire to be completed by each study participant. Ultrasound Doppler color imaging or/and duplex ultrasonography was performed to evaluate the efficiency of the venous system. The ankle-brachial index was calculated to determine the efficiency of the arterial system. We examined both groups for the presence of IT. IT was diagnosed in 30% of study group and in 1.8% of control group. Our diagnoses of deep vein thrombosis (DVT) were based on medical interviews, physical examinations, and an ultrasonography of the venous system and concerned 64 study group patients (58.2%), 35 of whom (31.8%) experienced recurrent DVT. Proximal and/or distal DVT was determined in an interview and/or by an ultrasonography performed for all patients with CVU and IT. In 94% of these patients, DVT was recurrent, and in 88% of patients with CVU and IT, we observed recurrent DVT and CVU. It recurred more often and persisted longer when compared to patients with CVU and no IT, despite similar management. No differences were observed in ulcer size, localization, or pain level related to ulceration between patients with CVU and IT and those with CVU and no IT.

  4. Construction Industry Apprentices' Substance Use: A Survey of Prevalence Rates, Reasons for Use, and Regional and Age Differences

    ERIC Educational Resources Information Center

    du Plessis, Karin; Corney, Tim

    2011-01-01

    Prevalence rates and reasons for substance use were studied in a sample of 172 male construction industry apprentices who had a mean age of 20 years. Results were compared with those of men in similar age groups in Victoria, and regional and age differences were explored. Findings indicate that more metropolitan apprentices had experimented with…

  5. How Variable Are Interstate Prevalence Rates of Learning Disabilities and Other Special Education Categories? A Longitudinal Comparison

    ERIC Educational Resources Information Center

    Hallahan, Daniel P.; Keller, Clayton E.; Martinez, Elizabeth A.; Byrd, E. Stephen; Gelman, Jennifer A.; Fan, Xitao

    2007-01-01

    This study compared interstate variability of prevalence rates for special education categories from 1984 to 1985 through 2001 to 2002, using the coefficient of variation (CV), which is designed to compare variances when the means of the groups compared are radically different. The category of learning disabilities, presumed by many to be the most…

  6. Effect of personal risk factors on the prevalence rate of musculoskeletal disorders among workers of an Iranian rubber factory.

    PubMed

    Samaei, S E; Tirgar, A; Khanjani, N; Mostafaee, M; Bagheri Hosseinabadi, M

    2017-01-01

    Musculoskeletal Disorders (MSDs) are among the most common occupational disorders in many countries and have an increasing trend. The present study was conducted in order to determine the prevalence rate of MSDs in different body regions and the effect of personal factors on the prevalence rate of MSDs among rubber industry workers. This analytical and cross-sectional study was performed on 206 workers of an Iranian rubber factory in 2014. The samples were randomly selected. Data were gathered by means of personal information form, the Nordic Musculoskeletal Questionnaire (NMQ) and the Rapid Entire Body Assessment (REBA). The results were analyzed using SPSS16; by descriptive and analytical statistics. The mean age and work history of subjects were 34.54±6.36 and 12.34±6.28 years, respectively. The highest prevalence rate of MSDs in the last twelve-months was related to the lower back region with a prevalence rate of 62.1%. Based on logistic regression, a significant correlation was found between MSDs and the final REBA score so that for a one-unit increase in score, the risk or complaint of neck and low back pain increased by 48.5% and 37.1%, respectively. Many rubber factory workers experience MSDs especially in the lower back region as a consequence of occupational risk factors. Therefore, detecting the occupational risk factors, work position standards and following ergonomic interventions are highly recommended.

  7. How Variable Are Interstate Prevalence Rates of Learning Disabilities and Other Special Education Categories? A Longitudinal Comparison

    ERIC Educational Resources Information Center

    Hallahan, Daniel P.; Keller, Clayton E.; Martinez, Elizabeth A.; Byrd, E. Stephen; Gelman, Jennifer A.; Fan, Xitao

    2007-01-01

    This study compared interstate variability of prevalence rates for special education categories from 1984 to 1985 through 2001 to 2002, using the coefficient of variation (CV), which is designed to compare variances when the means of the groups compared are radically different. The category of learning disabilities, presumed by many to be the most…

  8. Construction Industry Apprentices' Substance Use: A Survey of Prevalence Rates, Reasons for Use, and Regional and Age Differences

    ERIC Educational Resources Information Center

    du Plessis, Karin; Corney, Tim

    2011-01-01

    Prevalence rates and reasons for substance use were studied in a sample of 172 male construction industry apprentices who had a mean age of 20 years. Results were compared with those of men in similar age groups in Victoria, and regional and age differences were explored. Findings indicate that more metropolitan apprentices had experimented with…

  9. High prevalence of CCDC103 p.His154Pro mutation causing primary ciliary dyskinesia disrupts protein oligomerisation and is associated with normal diagnostic investigations.

    PubMed

    Shoemark, Amelia; Moya, Eduardo; Hirst, Robert A; Patel, Mitali P; Robson, Evelyn A; Hayward, Jane; Scully, Juliet; Fassad, Mahmoud R; Lamb, William; Schmidts, Miriam; Dixon, Mellisa; Patel-King, Ramila S; Rogers, Andrew V; Rutman, Andrew; Jackson, Claire L; Goggin, Patricia; Rubbo, Bruna; Ollosson, Sarah; Carr, Siobhán; Walker, Woolf; Adler, Beryl; Loebinger, Michael R; Wilson, Robert; Bush, Andrew; Williams, Hywel; Boustred, Christopher; Jenkins, Lucy; Sheridan, Eamonn; Chung, Eddie M K; Watson, Christopher M; Cullup, Thomas; Lucas, Jane S; Kenia, Priti; O'Callaghan, Christopher; King, Stephen M; Hogg, Claire; Mitchison, Hannah M

    2017-08-08

    Primary ciliary dyskinesia is a genetically heterogeneous inherited condition characterised by progressive lung disease arising from abnormal cilia function. Approximately half of patients have situs inversus. The estimated prevalence of primary ciliary dyskinesia in the UK South Asian population is 1:2265. Early, accurate diagnosis is key to implementing appropriate management but clinical diagnostic tests can be equivocal. To determine the importance of genetic screening for primary ciliary dyskinesia in a UK South Asian population with a typical clinical phenotype, where standard testing is inconclusive. Next-generation sequencing was used to screen 86 South Asian patients who had a clinical history consistent with primary ciliary dyskinesia. The effect of a CCDC103 p.His154Pro missense variant compared with other dynein arm-associated gene mutations on diagnostic/phenotypic variability was tested. CCDC103 p.His154Pro variant pathogenicity was assessed by oligomerisation assay. Sixteen of 86 (19%) patients carried a homozygous CCDC103 p.His154Pro mutation which was found to disrupt protein oligomerisation. Variable diagnostic test results were obtained including normal nasal nitric oxide levels, normal ciliary beat pattern and frequency and a spectrum of partial and normal dynein arm retention. Fifteen (94%) patients or their sibling(s) had situs inversus suggesting CCDC103 p.His154Pro patients without situs inversus are missed. The CCDC103 p.His154Pro mutation is more prevalent than previously thought in the South Asian community and causes primary ciliary dyskinesia that can be difficult to diagnose using pathology-based clinical tests. Genetic testing is critical when there is a strong clinical phenotype with inconclusive standard diagnostic tests. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Increasing Prevalence Rate of Nontuberculous Mycobacteria Infections in Five States, 2008–2013

    EPA Science Inventory

    Rationale: Many nontuberculous mycobacteria (NTM) are clinically significant pathogens that cause disease in a variety of different human organs and tissues. Objectives: A population-based study was undertaken to investigate the prevalence of patients with a positive specimen fo...

  11. Adoption of Diagnostic Technology and Variation in Caesarean Section Rates: A Test of the Practice Style Hypothesis in Norway

    PubMed Central

    Grytten, Jostein; Monkerud, Lars; Sørensen, Rune

    2012-01-01

    Objective To examine whether the introduction of advanced diagnostic technology in maternity care has led to less variation in type of delivery between hospitals in Norway. Data Sources The Medical Birth Registry of Norway provided detailed medical information for 1.7 million deliveries from 1967 to 2005. Information about diagnostic technology was collected directly from the maternity units. Study Design The data were analyzed using a two-level binary logistic model with Caesarean section as the outcome measure. Level one contained variables that characterized the health status of the mother and child. Hospitals are level two. A heterogeneous variance structure was specified for the hospital level, where the error variance was allowed to vary according to the following types of diagnostic technology: two-dimensional ultrasound, cardiotocography, ST waveform analysis, and fetal blood analyses. Principal Finding There was a marked variation in Caesarean section rates between hospitals up to 1973. After this the variation diminished markedly. This was due to the introduction of ultrasound and cardiotocography. Conclusion Diagnostic technology reduced clinical uncertainty about the diagnosis of risk factors of the mother and child during delivery, and variation in type of delivery between hospitals was reduced accordingly. The results support the practice style hypothesis. PMID:22594486

  12. Validity of Diagnostic Codes and Prevalence of Physician-Diagnosed Psoriasis and Psoriatic Arthritis in Southern Sweden – A Population-Based Register Study

    PubMed Central

    Löfvendahl, Sofia; Theander, Elke; Svensson, Åke; Carlsson, Katarina Steen; Englund, Martin; Petersson, Ingemar F.

    2014-01-01

    Objective To validate diagnostic codes for psoriasis and psoriatic arthritis (PsA) and estimate physician-diagnosed prevalence of psoriasis and PsA in the Skåne region, Sweden. Methods In the Skåne Healthcare Register (SHR), all healthcare consultations are continuously collected for all inhabitants in the Skåne region (population 1.2 million). During 2005–2010 we identified individuals with ≥1 physician-consultations consistent with psoriasis (ICD-10). Within this group we also identified those diagnosed with PsA. We performed a validation by reviewing medical records in 100 randomly selected cases for psoriasis and psoriasis with PsA, respectively. Further, we estimated the pre- and post-validation point prevalence by December 31, 2010. Results We identified 16 171 individuals (psoriasis alone: n = 13 185, psoriasis with PsA n = 2 986). The proportion of ICD-10 codes that could be confirmed by review of medical records was 81% for psoriasis and 63% for psoriasis with PsA with highest percentage of confirmed codes for cases diagnosed ≥2 occasions in specialized care. For 19% and 29% of the cases respectively it was not possible to determine diagnosis due to insufficient information. Thus, the positive predicted value (PPV) of one ICD-10 code for psoriasis and psoriasis with PsA ranged between 81–100% and 63–92%, respectively. Assuming the most conservative PPV, the post-validation prevalence was 1.23% (95% CI: 1.21–1.25) for psoriasis (with or without PsA), 1.02% (95% CI: 1.00–1.03) for psoriasis alone and 0.21% (95% CI: 0.20–0.22) for psoriasis with PsA. The post-validation prevalence of PsA in the psoriasis cohort was 17.3% (95% CI: 16.65–17.96). Conclusions The proportion of diagnostic codes in SHR that could be verified varied with frequency of diagnostic codes and level of care highlighting the importance of sensitivity analyses using different case ascertainment criteria. The prevalence of physician-diagnosed psoriasis and Ps

  13. Statewide prevalence of school children at risk of anaphylaxis and rate of adrenaline autoinjector activation in Victorian government schools, Australia.

    PubMed

    Loke, Paxton; Koplin, Jennifer; Beck, Cara; Field, Michael; Dharmage, Shyamali C; Tang, Mimi L K; Allen, Katrina J

    2016-08-01

    The prevalence of school students at risk of anaphylaxis in Victoria is unknown and has not been previously studied. Similarly, rates of adrenaline autoinjector usage in the school environment have yet to be determined given increasing prescription rates. We sought to determine time trends in prevalence of school children at risk of anaphylaxis across all year levels and the annual usage rate of adrenaline autoinjectors in the school setting relative to the number of students at risk of anaphylaxis. Statewide surveys from more than 1,500 government schools including more than 550,000 students were used and prevalence rates (%) with 95% CIs were calculated. The overall prevalence of students at risk of anaphylaxis has increased 41% from 0.98% (95% CI, 0.95-1.01) in 2009 to 1.38% (95% CI, 1.35-1.41) in 2014. There was a significant drop in reporting of anaphylaxis risk with transition from the final year of primary school to the first year of secondary school, suggesting a change in parental reporting of anaphylaxis risk among secondary school students. The number of adrenaline autoinjectors activated per 1000 students at risk of anaphylaxis ranged from 6 to 8 per year, with consistently higher activation use in secondary school students than in primary school students. Statewide prevalence of anaphylaxis risk has increased in children attending Victorian government schools. However, adrenaline autoinjector activation has remained fairly stable despite known increase in the rates of prescription. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. Adjusting the HIV prevalence for non-respondents using mortality rates in an open cohort in northwest Tanzania.

    PubMed

    Tenu, Filemon; Isingo, Raphael; Zaba, Basia; Urassa, Mark; Todd, Jim

    2014-06-01

    To estimate HIV prevalence in adults who have not tested for HIV using age-specific mortality rates and to adjust the overall population HIV prevalence to include both tested and untested adults. An open cohort study was established since 1994 with demographic surveillance system (DSS) and five serological surveys conducted. Deaths from Kisesa DSS were used to estimate mortality rates and 95% confidence intervals by HIV status for 3- 5-year periods (1995-1999, 2000-2004, and 2005-2009). Assuming that mortality rates in individuals who did not test for HIV are similar to those in tested individuals, and dependent on age, sex and HIV status and HIV, prevalence was estimated. In 1995-1999, mortality rates (per 1000 person years) were 43.7 (95% CI 35.7-53.4) for HIV positive, 2.6 (95% CI 2.1-3.2) in HIV negative and 16.4 (95% CI 14.4-18.7) in untested. In 2000-2004, mortality rates were 43.3 (95% CI 36.2-51.9) in HIV positive, 3.3 (95% CI 2.8-4.0) in HIV negative and 11.9 (95% CI 10.5-13.6) in untested. In 2005-2009, mortality rates were 30.7 (95% CI 24.8-38.0) in HIV positive, 4.1 (95% CI 3.5-4.9) in HIV negative and 5.7 (95% CI 5.0-6.6) in untested residents. In the three survey periods (1995-1999, 2000-2004, 2005-2009), the adjusted period prevalences of HIV, including the untested, were 13.5%, 11.6% and 7.1%, compared with the observed prevalence in the tested of 6.0%, 6.8 and 8.0%. The estimated prevalence in the untested was 33.4%, 21.6% and 6.1% in the three survey periods. The simple model was able to estimate HIV prevalence where a DSS provided mortality data for untested residents. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  15. Definition of insulin resistance affects prevalence rate in pediatric patients: a systematic review and call for consensus.

    PubMed

    van der Aa, Marloes P; Knibbe, Catherijne A J; Boer, Anthonius de; van der Vorst, Marja M J

    2017-02-01

    As a result of the rising prevalence of childhood obesity, there is an increasing interest in the type 2 diabetes mellitus precursor insulin resistance (IR). The aim of this study is to review definitions (methods and cutoff values) to define IR in children and to apply these definitions to a previously described obese pediatric population. A systematic literature review on prevalence and/or incidence rates in children was performed. The extracted definitions were applied to an obese pediatric population. In the 103 identified articles, 146 IR definitions were reported based on 14 different methods. Fasted definitions were used 137 times, whereas oral/intravenous glucose tolerance test-derived methods were used nine times. The homeostasis model for the assessment of insulin resistance (HOMA-IR) and fasted plasma insulin (FPI) were the most frequently used fasted methods (83 and 37 times, respectively). A wide range in cutoff values to define IR was observed, resulting in prevalence rates in the predefined obese pediatric population between 5.5% (FPI>30 mU/L) and 72.3% (insulin sensitivity indexMatsuda≤7.2). To compare IR incidence and prevalence rates in pediatric populations, a uniform definition of IR should be defined.

  16. Prevalence rates of childhood protective factors in adolescents with BPD, psychiatrically healthy adolescents and adults with BPD.

    PubMed

    Borkum, Dana B; Temes, Christina M; Magni, Laura R; Fitzmaurice, Garrett M; Aguirre, Blaise A; Goodman, Marianne; Zanarini, Mary C

    2017-08-01

    Existing literature on the aetiology of borderline personality disorder (BPD) has primarily focused on pathological childhood experiences, while little to no research has been conducted on protective factors that may serve to ameliorate these symptoms. The current study attempts to fill this gap in the literature by comparing the rates of childhood protective factors among adolescents with BPD, psychiatrically healthy adolescents and adults with BPD. One hundred and four subjects were adolescent inpatients between the ages of 13 and 17 who met Revised Diagnostic Interview for Borderlines and Diagnostic and Statistical Manual of Mental Disorders Fourth Edition criteria for BPD. Sixty were age-matched psychiatrically healthy comparison subjects. Two hundred and ninety subjects were adult inpatients between the ages of 18 and 35 who met Revised Diagnostic Interview for Borderlines and Revised Diagnostic and Statistical Manual of Mental Disorders Third Edition criteria for BPD. All three groups were interviewed by using the Revised Childhood Experiences Questionnaire, a semi-structured interview that assesses pathological and protective childhood experiences. Psychiatrically healthy adolescents reported significantly higher rates of 4 out of 18 protective factors than adolescents with BPD. Adolescents with BPD reported significantly higher rates of 5 of these 18 protective factors than adults with BPD. Adults with BPD were significantly more likely to endorse having a steady after school or weekend work record than adolescents with BPD. Taken together, the results of this study suggest that adolescents meeting criteria for BPD report lower rates of some protective factors than psychiatrically healthy adolescents. They also suggest that they have higher rates of some protective factors than adults with BPD. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  17. Neuropsychological Criteria for Mild Cognitive Impairment Improves Diagnostic Precision, Biomarker Associations, and Progression Rates

    PubMed Central

    Bondi, Mark W.; Edmonds, Emily C.; Jak, Amy J.; Clark, Lindsay R.; Delano-Wood, Lisa; McDonald, Carrie R.; Nation, Daniel A.; Libon, David J.; Au, Rhoda; Galasko, Douglas; Salmon, David P.

    2014-01-01

    We compared two methods of diagnosing mild cognitive impairment (MCI): conventional Petersen/Winblad criteria as operationalized by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and an actuarial neuropsychological method put forward by Jak and Bondi designed to balance sensitivity and reliability. 1,150 ADNI participants were diagnosed at baseline as cognitively normal (CN) or MCI via ADNI criteria (MCI: n = 846; CN: n = 304) or Jak/Bondi criteria (MCI: n = 401; CN: n = 749), and the two MCI samples were submitted to cluster and discriminant function analyses. Resulting cluster groups were then compared and further examined for APOE allelic frequencies, cerebrospinal fluid (CSF) Alzheimer’s disease (AD) biomarker levels, and clinical outcomes. Results revealed that both criteria produced a mildly impaired Amnestic subtype and a more severely impaired Dysexecutive/Mixed subtype. The neuropsychological Jak/Bondi criteria uniquely yielded a third Impaired Language subtype, whereas conventional Petersen/Winblad ADNI criteria produced a third subtype comprising nearly one-third of the sample that performed within normal limits across the cognitive measures, suggesting this method’s susceptibility to false positive diagnoses. MCI participants diagnosed via neuropsychological criteria yielded dissociable cognitive phenotypes, significant CSF AD biomarker associations, more stable diagnoses, and identified greater percentages of participants who progressed to dementia than conventional MCI diagnostic criteria. Importantly, the actuarial neuropsychological method did not produce a subtype that performed within normal limits on the cognitive testing, unlike the conventional diagnostic method. Findings support the need for refinement of MCI diagnoses to incorporate more comprehensive neuropsychological methods, with resulting gains in empirical characterization of specific cognitive phenotypes, biomarker associations, stability of diagnoses, and prediction of

  18. Bombay blood group: Is prevalence decreasing with urbanization and the decreasing rate of consanguineous marriage.

    PubMed

    Mallick, Sujata; Kotasthane, Dhananjay S; Chowdhury, Puskar S; Sarkar, Sonali

    2015-01-01

    Bombay blood group although rare is found to be more prevalent in the Western and Southern states of India, believed to be associated with consanguineous marriage. To estimate the prevalence of the Bombay blood group (Oh) in the urban population of Puducherry. To find the effect of urbanization on consanguineous marriage and to establish whether consanguinity plays a part in the prevalence of Oh group. To compare Oh group prevalence with that of other neighboring states, where population is not predominantly urban. This is a descriptive study in a tertiary care hospital in Puducherry, over a period of 6 years. All blood samples showing 'O' group were tested with anti-H lectin. Specialized tests like Adsorption Elution Technique, inhibition assay for determination of secretor status were performed on Oh positive cases. Any history of consanguineous marriage was recorded. All variables were categorical variable and percentage and proportions were calculated manually. Analysis of the results of 35,497 study subjects showed that the most common group was 'O' group constituting 14,164 (39.90%) of subjects. Only three "Oh" that is, Bombay phenotype (0.008%) were detected. Consanguinity was observed in two cases (66.66%). This study shows the prevalence of Bombay blood group representing the urban population of Puducherry, to be high (0.008%) and associated with consanguineous marriage (66.66%). Thus, consanguinity is still an important risk factor present, even in an urban population in Southern India.

  19. How Does Relaxing the Algorithm for Autism Affect DSM-V Prevalence Rates?

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Hattier, Megan A.; Williams, Lindsey W.

    2012-01-01

    Although it is still unclear what causes autism spectrum disorders (ASDs), over time researchers and clinicians have become more precise with detecting and diagnosing ASD. Many diagnoses, however, are based on the criteria established within the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM"); thus, any change in these diagnostic…

  20. How Does Relaxing the Algorithm for Autism Affect DSM-V Prevalence Rates?

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Hattier, Megan A.; Williams, Lindsey W.

    2012-01-01

    Although it is still unclear what causes autism spectrum disorders (ASDs), over time researchers and clinicians have become more precise with detecting and diagnosing ASD. Many diagnoses, however, are based on the criteria established within the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM"); thus, any change in these diagnostic…

  1. Prevalence and monthly distribution of head lice using two diagnostic procedures in several age groups in Uberlândia, State of Minas Gerais, Southeastern Brazil.

    PubMed

    Borges, Raquel; Silva, Juliana J; Rodrigues, Rosângela M; Mendes, Júlio

    2007-01-01

    Some epidemiological characteristics of head lice, Pediculus capitis, were studied using two procedures: cut hair analysis and head inspection. Higher prevalence rates were observed in the middle and at the end of the school terms. Both procedures indicated that children were the main reservoir for this type of pediculosis in Uberlândia.

  2. Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation

    PubMed Central

    2014-01-01

    Background Guided by previous explorations of historical and cultural influences on the occurrence of PTSD, the aim of the present study was to investigate the contributions of war victimisation (in particular, World War II) and other civil trauma on the prevalence of PTSD, as mediated by cultural value orientation. Secondary data analysis was performed for 12 European countries using data, including PTSD prevalence and number of war victims, crime victims, and natural disaster victims, from different sources. Ten single value orientations, as well as value aggregates for traditional and modern factors, were investigated. Results Whilst differences in PTSD prevalence were strongly associated with war victim rates, associations, albeit weaker, were also found between crime victims and PTSD. When cultural value orientations, such as stimulation and conformity as representatives of modern and traditional values, were included in the multivariate predictions of PTSD prevalence, an average of approximately 80% of PTSD variance could be explained by the model, independent of the type of trauma exposure. Conclusion The results suggest that the aftermath of war contributes to current PTSD prevalence, which may be explained by the high proportion of the older population who directly or indirectly experienced traumatic war experiences. Additional findings for other types of civil trauma point towards an interaction between value orientation and country-specific trauma rates. Particularly, being personally oriented towards stimulation appears to interact with differences in trauma prevalence. Thus, cultural value orientation might be viewed not only as an individual intrinsic process but also as a compensatory strategy after trauma exposure. PMID:24972489

  3. Prevalence and Clinical Correlates of Sarcopenia, Identified According to the EWGSOP Definition and Diagnostic Algorithm, in Hospitalized Older People: The GLISTEN Study.

    PubMed

    Bianchi, Lara; Abete, Pasquale; Bellelli, Giuseppe; Bo, Mario; Cherubini, Antonio; Corica, Francesco; Di Bari, Mauro; Maggio, Marcello; Manca, Giovanna Maria; Rizzo, Maria Rosaria; Rossi, Andrea P; Landi, Francesco; Volpato, Stefano

    2017-01-21

    Prevalence of sarcopenia is substantial in most geriatrics settings, but estimates vary greatly across studies because of difference in population characteristics, diagnostic criteria, and methods used to assess muscle mass, muscle strength, and physical performance. We investigated the feasibility of the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm assessment in hospitalized older adults and analyzed prevalence and clinical correlates of sarcopenia. Cross-sectional analysis of 655 participants enrolled in a multicenter observational study of older adults admitted to 12 acute hospital wards in Italy. Sarcopenia was assessed as low skeletal mass index (kg/m2) plus either low handgrip strength or low walking speed (EWGSOP criteria). Skeletal muscle mass was estimated using bioimpedance analysis. Of the 655 patients (age 81.0 ± 6.8 years; women 51.9%) enrolled in the study, 275 (40.2%) were not able to perform the 4-m walking test because of medical problems. The overall prevalence of sarcopenia on hospital admission was 34.7% (95% confidence interval 28-37) and it steeply increased with aging (p < .001). In multivariable analysis, patients with sarcopenia on hospital admission were older and were more likely to be male and to have congestive heart failure, cerebrovascular disease, and severe basic activities of daily living disability. The prevalence of sarcopenia was inversely correlated with body mass index. Based on EWGSOP criteria, prevalence of sarcopenia is extremely high among older adults on admission to acute hospital wards. Older age, male gender, congestive heart failure, cerebrovascular disease, severe activities of daily living disability, and body mass index were the clinical variables significantly associated with the presence of sarcopenia.

  4. [Psychotic disorders among immigrants from Turkey in Western Europe: An overview of incidences, prevalence estimates, and admission rates].

    PubMed

    Binbay, Tolga; Ulaş, Halis; Alptekin, Köksal; Elbi, Hayriye

    2012-01-01

    To provide an overview of incidence and prevalence estimates, admission rates, and related features of psychotic disorders among immigrants from Turkey in Western Europe. Articles published in all languages between 1990 and 2010 were included. In order to detect relevant studies, a string ([schizo* OR psych*] AND [Turk*] AND [migra* OR immigra*]) was used in MEDLINE and PsychINFO. Turkish indexes and abstracts books of national congresses were also screened to locate additional papers. We included 21 studies which yielded 25 rates on psychotic disorders among immigrants from Turkey. Fifteen papers reported rates for the immigrants from Turkey in The Netherlands, four for Germany, one for Denmark and one for Switzerland. The incidence estimates of non-affective and affective psychosis among immigrants from Turkey were between 38.5 and 44.9 per 100,000 while incidence estimates of schizophrenia were between 12.4 and 63.8 per 100,000. The prevalence estimates of schizophrenia and other psychotic disorders were between 1.1 and 6.2 per 1,000. Rates and relative risks of psychotic disorders in immigrants from Turkey tended to be higher than the natives and lower than other immigrant groups with similar sociocultural background. In addition to other risk factors, social contextual factors including discrimination and neighbourhood characteristics were the key environmental factors that modulate rates of psychotic disorders among immigrants from Turkey. Males were under a higher risk of incidence, prevalence estimates, and admission rates. Variations in rates and relative risks indicate a possible etiological role of social experiences in immigrants. Studies with a focus on comparing the rates and the social factors of psychotic disorders between immigrants from Turkey in Western Europe and their family members residing in Turkey may provide additional insight into the epidemiology of psychotic disorders.

  5. Estimating HIV prevalence from surveys with low individual consent rates: annealing individual and pooled samples

    PubMed Central

    2013-01-01

    Many HIV prevalence surveys are plagued by the problem that a sizeable number of surveyed individuals do not consent to contribute blood samples for testing. One can ignore this problem, as is often done, but the resultant bias can be of sufficient magnitude to invalidate the results of the survey, especially if the number of non-responders is high and the reason for refusing to participate is related to the individual’s HIV status. One reason for refusing to participate may be for reasons of privacy. For those individuals, we suggest offering the option of being tested in a pool. This form of testing is less certain than individual testing, but, if it convinces more people to submit to testing, it should reduce the potential for bias and give a cleaner answer to the question of prevalence. This paper explores the logistics of implementing a combined individual and pooled testing approach and evaluates the analytical advantages to such a combined testing strategy. We quantify improvements in a prevalence estimator based on this combined testing strategy, relative to an individual testing only approach and a pooled testing only approach. Minimizing non-response is key for reducing bias, and, if pooled testing assuages privacy concerns, offering a pooled testing strategy has the potential to substantially improve HIV prevalence estimates. PMID:23446064

  6. Bombay blood group: Is prevalence decreasing with urbanization and the decreasing rate of consanguineous marriage

    PubMed Central

    Mallick, Sujata; Kotasthane, Dhananjay S.; Chowdhury, Puskar S.; Sarkar, Sonali

    2015-01-01

    Context: Bombay blood group although rare is found to be more prevalent in the Western and Southern states of India, believed to be associated with consanguineous marriage. Aims: To estimate the prevalence of the Bombay blood group (Oh) in the urban population of Puducherry. To find the effect of urbanization on consanguineous marriage and to establish whether consanguinity plays a part in the prevalence of Oh group. To compare Oh group prevalence with that of other neighboring states, where population is not predominantly urban. Settings and Design: This is a descriptive study in a tertiary care hospital in Puducherry, over a period of 6 years. Materials and Methods: All blood samples showing ‘O’ group were tested with anti-H lectin. Specialized tests like Adsorption Elution Technique, inhibition assay for determination of secretor status were performed on Oh positive cases. Any history of consanguineous marriage was recorded. Statistical Analysis Used: All variables were categorical variable and percentage and proportions were calculated manually. Results: Analysis of the results of 35,497 study subjects showed that the most common group was ‘O’ group constituting 14,164 (39.90%) of subjects. Only three “Oh” that is, Bombay phenotype (0.008%) were detected. Consanguinity was observed in two cases (66.66%). Conclusions: This study shows the prevalence of Bombay blood group representing the urban population of Puducherry, to be high (0.008%) and associated with consanguineous marriage (66.66%). Thus, consanguinity is still an important risk factor present, even in an urban population in Southern India. PMID:26420929

  7. Diagnostic ultrasound is unable to enhance the rate of neoplastic transformation in cultured mammalian cells.

    PubMed

    Tolsma, S S; Madsen, E L; Chmiel, J; Martin, A O; Bouck, N P

    1991-11-01

    The ability of diagnostic pulsed ultrasound to induce heritable genetic damage of the type that could result in neoplasia was assayed using BHK21/cl 13 hamster cells or normal human fibroblasts as targets. Using an exposure apparatus carefully designed to minimize beam attenuation and reflection, cavitation, and heating, cells were exposed from 20 seconds to 40 minutes either to clinical machines operating at maximum power, or to a highly focused nonclinical transducer at 2900 W/cm2, or to 200 shocks from a lithotripter. No evidence of an increase in the frequency of neoplastically transformed BHK cells or in the frequency of mutant human cells was seen over those found in matched sham-exposed controls.

  8. [Clinical and diagnostic value of heart rate variabilities in workers exposed to noise and vibration].

    PubMed

    Serebriakov, P V; Melent'ev, A V; Demina, I D

    2010-01-01

    Noise and vibration cause disorders of vegetative regulation of cardiovascular system. Daily ECG monitoring with heart rate variabilities analysis enables quanitative evaluation of disordered vegetative control over heart rate and diagnosis of cardioneuropathy caused by long occupational exposure to noise and vibration.

  9. Prevalence, diagnostics and management of musculoskeletal disorders in primary health care in Sweden – an investigation of 2000 randomly selected patient records

    PubMed Central

    Fahlström, Martin; Djupsjöbacka, Mats

    2016-01-01

    Abstract Rationale, aims and objectives The aims of this study is to investigate the prevalence of patients seeking care due to different musculoskeletal disorders (MSDs) at primary health care centres (PHCs), to chart different factors such as symptoms, diagnosis and actions prescribed for patients that visited the PHCs due to MSD and to make comparisons regarding differences due to gender, age and rural or urban PHC. Methods Patient records (2000) for patients in working age were randomly selected equally distributed on one rural and one urban PHC. A 3‐year period was reviewed retrospectively. For all patient records' background data, cause to the visit and diagnosis were registered. For visits due to MSD, type and location of symptoms and actions to resolve the patients problems were registered. Data was analysed using cross tabulation, multidimensional chi‐squared. Results The prevalence of MSD was high; almost 60% of all patients were seeking care due to MSD. Upper and lower limb problems were most common. Symptoms were most prevalent in the young and middle age groups. The patients got a variety of different diagnoses, and between 13 and 35% of the patients did not receive a MSD diagnose despite having MSD symptoms. There was a great variation in how the cases were handled. Conclusions The present study points out some weaknesses regarding diagnostics and management of MSD in primary care. PMID:27538347

  10. Prevalence of signs and symptoms of temporomandibular disorders in children in the State of Puebla, Mexico, evaluated with the research diagnostic criteria for temporomandibular disorders (RDC/TMD).

    PubMed

    Moyaho-Bernal, Angeles; Lara-Muñoz, Ma Del Carmen; Espinosa-De Santillana, Irene; Etchegoyen, Graciela

    2010-01-01

    The aim of this work was to describe the prevalence of signs and symptoms of temporomandibular disorders (TMD) in children of the State of Puebla, Mexico. A descriptive observational study was performed. After calculating sample size, children who met the following selection criteria were included: registered at an official elementary school, either sex, ages between 8 and 12 years, who accept to participate in the study and whose parents have signed the informed consent forms. The Research Diagnostic Criteria for Temporomandibular Disorders were used by calibrated researchers (Kappa 90) under the same conditions. Descriptive statistics were applied by using SPSSv15 software. The study included 235 children, 129 (54.9%) female and 106 (45.1%) male, of average age 9.31 + 1.2 years. Prevalence of signs and symptoms was 33.2%, and predominately muscular (82%), 48.1% showed signs of muscular pain and 19.1% joint pain. 63.4% showed signs of alteration in the mouth opening pattern, 39.1% presented joint sounds on opening or closing the mouth and 20.4% on mandibular excursions. The high prevalence of signs and symptoms related to temporomandibular disorders, in particular in children with mixed dentition, shows the importance of TMD evaluation during this period, when morphological changes associated to growth and craniofacial development prevail.

  11. Differences in the prevalence of diagnosis of overweight-obesity in Spanish children according to the diagnostic criteria set used.

    PubMed

    Ajejas Bazán, María Julia; Jiménez Trujillo, María Isab; Wärnberg, Julia; Domínguez Fernández, Silvia; López de Andrés, Ana; Pérez Farinós, Napoleón

    2017-09-28

    To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain. Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used. The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables. The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Prevalence of glucose-6-phosphate dehydrogenase deficiency and diagnostic challenges in 1500 immigrants in Denmark examined for haemoglobinopathies.

    PubMed

    Warny, Marie; Klausen, Tobias Wirenfeldt; Petersen, Jesper; Birgens, Henrik

    2015-09-01

    Similar to the thalassaemia syndromes, glucose-6-phosphate dehydrogenase (G6PD) deficiency is highly prevalent in areas historically exposed to malaria. In the present study, we used quantitative and molecular methods to determine the prevalence of G6PD deficiency in a population of 1508 immigrants in Denmark. We found the allele frequency to be between 2.4 and 2.9% in the female immigrants. Furthermore, the mutation pattern in the studied population showed a high prevalence of the G6PD A-(202A) variant in African and African-American immigrants, a high prevalence of the G6PD Mediterranean variant in Mediterranean European and Western Asian immigrants, and substantial heterogeneity in the variants found in the Eastern Asian/Pacific immigrants. Inasmuch as many of the patients included in this investigation had various thalassaemic syndromes, we were able to evaluate the effects of the interaction between a low mean corpuscular haemoglobin (MCH) value and G6PD activity, particularly in heterozygous females. The activity level was markedly influenced by the MCH value in females with normal G6PD activity, but not in heterozygous and homozygous females. Comparison of patients with normal G6PD activity and heterozygous females indicated considerable overlap in activity levels. To help separating heterozygous females from females with wild-type genes, a DNA analysis is necessary when the female activity level is between 4.0 and 4.9 U/g hgb corresponding to 50-60% of the median activity of unaffected males.

  13. Mouse heart rate in a human: diagnostic mystery of an extreme tachyarrhythmia.

    PubMed

    Chhabra, Lovely; Goel, Narender; Prajapat, Laxman; Spodick, David H; Goyal, Sanjeev

    2012-01-01

    We report telemetry recording of an extreme non-fatal tachyarrhythmia noted in a hospitalized quadriplegic male with history of atrial fibrillation where the average ventricular conduction rate was found to be about 600 beats per minute and was associated with transient syncope. A medical literature review suggests that the fastest human ventricular conduction rate reported to date in a tachyarrhythmia is 480 beats per minute. We therefore report the fastest human heart rate noted in a tachyarrhythmia and the most probable mechanism of this arrhythmia being a rapid atrial fibrillation with 1:1 conduction in the setting of probable co-existing multiple bypass tracts.

  14. Trans-nasal flexible bronchoscopy in wheezing children: Diagnostic yield, impact on therapy, and prevalence of laryngeal cleft.

    PubMed

    Boesch, Richard P; Baughn, Julie M; Cofer, Shelagh A; Balakrishnan, Karthik

    2017-09-14

    Persistent or recurrent wheezing is a common indication for flexible bronchoscopy, as anatomic and infectious or inflammatory changes are highly prevalent. We sought to evaluate the prevalence of anatomic, infectious, and inflammatory disease in a cohort of children undergoing flexible bronchoscopy for wheezing or poorly controlled asthma. We retrospectively reviewed all children <18 years old who underwent flexible bronchoscopy at our center from October 29, 2012-December 31, 2016 for the primary or secondary indication of wheezing (persistent, frequently recurring, or atypical) or poorly controlled asthma. A total of 101 procedures were identified in 94 patients, aged 3 months to 18 years. Potential anatomic causes for wheezing identified in 45.7% of patients and inflammatory changes in 49.5% of procedures. This included the identification of a laryngeal cleft in 17% for which half required medical or surgical management. Tracheobronchomalacia was the most commonly identified anatomic lesion. Thirty children from this cohort had poorly controlled asthma. Among this subgroup, 54% had increased neutrophils on BAL and 30% had an anatomic contributor to wheezing, including one with a laryngeal cleft. Based on findings from flexible bronchoscopy, management changes made in 63.8% of patients. This included medication changes in 54 and surgical intervention in 9. We conclude that transnasal flexible bronchoscopy has high yield in children with recurrent, persistent, or atypical wheezing and those with poorly controlled asthma. Laryngeal cleft has a reasonably high prevalence that warrants specific evaluation in this population. © 2017 Wiley Periodicals, Inc.

  15. [Detection of an intrapulmonary shunt in patients with liver cirrhosis through contrast-enhanced transcranial Doppler. A study of prevalence, pattern characterization, and diagnostic validity].

    PubMed

    Ramírez Moreno, José María; Millán Núñez, María Victoria; Rodríguez Carrasco, Marta; Ceberino, David; Romaskevych-Kryvulya, Olena; Constantino Silva, Ana Belén; Muñoz-Vega, Pedro; García-Corrales, Carmen; Guiberteau-Sánchez, Ana; Roa Montero, Ana; Márquez-Lozano, Patricia; Narváez Rodríguez, Isidoro

    2015-10-01

    Intrapulmonary vascular dilatations (IPVD) are considered a complication of cirrhosis. The technique of choice for their diagnosis is contrast-enhanced echocardiography (CEE). The aim of this study was to determine the usefulness of contrast-enhanced transcranial Doppler (CETD) in the diagnosis of IPVD. We consecutively included patients evaluated for liver transplantation. A cross-sectional study was conducted. The investigator interpreting CETD was blind to the results of the gold standard (CEE). The accuracy of the diagnostic test was evaluated through sensitivity, specificity, positive and negative predictive values, and likelihood ratio. CETD (n=43) showed a right-to-left shunt in 23 patients (62.2%): 4 early, 2 indeterminate and 17 late. Nineteen (51,4%) cases were classified as IPVD. With CEE (n=37), 10 procedures (27%) were negative for shunt, 27 (73%) were positive, and 21 (56.8%) were compatible with IPVD. Patients with and without IPVD showed no differences in age, sex, etiology, severity, or MELD score, independently of the diagnostic test. In the diagnostic validity study (n=37) of CETD versus CEE, the AUC for diagnostic yield was 0.813% (95%CI: 0.666-0.959; P=.001), sensitivity was 76.2% (95%CI: 54.9-89.4) and specificity was 90% (95%CI: 63.9-96.5). The positive likelihood ratio was 6.095. We found a high prevalence of IPVD in candidates for liver transplantation. When a late right-to-left shunt with recirculation is observed, CETD has a high probability of detecting IPVD, with few false-positive results. Because this technique has not previously been described in this indication, similar studies are needed for comparison. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  16. The Swedish Version of the Ritvo Autism and Asperger Diagnostic Scale: Revised (RAADS-R). A Validation Study of a Rating Scale for Adults

    ERIC Educational Resources Information Center

    Andersen, Lisa M. J.; Naswall, Katharina; Manouilenko, Irina; Nylander, Lena; Edgar, Johan; Ritvo, Riva Ariella; Ritvo, Edward; Bejerot, Susanne

    2011-01-01

    There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75…

  17. High prevalence of substance use among heterosexuals living in communities with high rates of AIDS and poverty in Washington, DC.

    PubMed

    Kuo, Irene; Greenberg, Alan E; Magnus, Manya; Phillips, Gregory; Rawls, Anthony; Peterson, James; Hamilton, Flora; West-Ojo, Tiffany; Hader, Shannon

    2011-09-01

    To assess the prevalence and patterns of substance use, HIV prevalence, and sexual risk behaviors in a community-based sample of heterosexuals recruited from areas at high risk for HIV/AIDS and poverty in Washington, DC. Community-recruited heterosexuals aged 18-50 from areas of high AIDS and poverty rates in DC were analyzed. Based on past 12 months use, participants were hierarchically classified into five groups: (1) ever injection drug use (IDU); (2) non-injection crack; (3) non-injection heroin and cocaine; (4) marijuana; and (5) no drug use. Sexual behaviors and HIV serology were also assessed. Of 862 participants, 40% were men, most were Black and unemployed, and more than half had ever been incarcerated. Prevalence of past year substance use was high: binge drinking (59%); marijuana (50%); non-injection crack (28%); heroin and/or cocaine injection (28%), non-injection cocaine (13%); and ecstasy (13%). In the hierarchical classification, 25% were ever IDU, 15% non-injection crack users, 2% non-injection heroin and/or cocaine users, 31% marijuana users, and 27% reported no drug use. Overall HIV seroprevalence was 5.7% and differed by drug use group-9.5%, 11.1%, 1.8%, 1.6%, and 3.2%, respectively. Nearly half reported having ≥3 sex partners in the past year; 20% reported exchange partners, and 69% had concurrent sex partners. Estimated prevalence of substance use in this heterosexual population was high. HIV prevalence among IDUs and non-injection crack users was higher than the estimated population prevalence in Washington, DC. Sexual behaviors above and beyond drug use are likely to be driving HIV transmission. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Excitation rates for plasma impurity measurements by x-ray diagnostics

    SciTech Connect

    Hill, K.W.; Bitter, M.; von Goeler, S.; Hsuan, H.; Hulse, R.; Johnson, L.C.; Lasalle, P.; McGuire, K.S.; Murphy, A.; Stevens, J.E.; and others

    1988-08-01

    Measurement of intrinsic and injected impurity concentrations and transport in tokamak plasmas by x-ray pulse-height analysis (PHA) and x-ray imaging (XI) diode arrays requires reliable excitation rates for a number of charge states of a range of elements (Al, Se, Ti, Cr, Fe, Ni, Ge, etc.). Previous PHA measurements at Princeton have relied on a coronal-equilibrium average of excitation rates for iron, and a prescription for scaling the average rate to nearby elements. For improved accuracy in PHA measurements (using the MIST impurity equilibrium and transport code) and for interpretation of XI data (using an x-ray simulation code), rates for excitation of dominant charge states by electron impact, dielectronic recombination, and radiative recombination have been calculated from available atomic data and parametrized as a function of atomic number (Z = 10--42) and electron temperature (T/sub e/ = 0.1--10.0 keV).

  19. Methods for estimating comparable prevalence rates of food insecurity experienced by adults in 147 countries and areas

    NASA Astrophysics Data System (ADS)

    Nord, Mark; Cafiero, Carlo; Viviani, Sara

    2016-11-01

    Statistical methods based on item response theory are applied to experiential food insecurity survey data from 147 countries, areas, and territories to assess data quality and develop methods to estimate national prevalence rates of moderate and severe food insecurity at equal levels of severity across countries. Data were collected from nationally representative samples of 1,000 adults in each country. A Rasch-model-based scale was estimated for each country, and data were assessed for consistency with model assumptions. A global reference scale was calculated based on item parameters from all countries. Each country's scale was adjusted to the global standard, allowing for up to 3 of the 8 scale items to be considered unique in that country if their deviance from the global standard exceeded a set tolerance. With very few exceptions, data from all countries were sufficiently consistent with model assumptions to constitute reasonably reliable measures of food insecurity and were adjustable to the global standard with fair confidence. National prevalence rates of moderate-or-severe food insecurity assessed over a 12-month recall period ranged from 3 percent to 92 percent. The correlations of national prevalence rates with national income, health, and well-being indicators provide external validation of the food security measure.

  20. Prevalence rates of health and welfare conditions in broiler chickens change with weather in a temperate climate

    PubMed Central

    Edwards, Phil; Hajat, Shakoor

    2016-01-01

    Climate change impact assessment and adaptation research in agriculture has focused primarily on crop production, with less known about the potential impacts on livestock. We investigated how the prevalence of health and welfare conditions in broiler (meat) chickens changes with weather (temperature, rainfall, air frost) in a temperate climate. Cases of 16 conditions were recorded at approved slaughterhouses in Great Britain. National prevalence rates and distribution mapping were based on data from more than 2.4 billion individuals, collected between January 2011 and December 2013. Analysis of temporal distribution and associations with national weather were based on monthly data from more than 6.8 billion individuals, collected between January 2003 and December 2013. Ascites, bruising/fractures, hepatitis and abnormal colour/fever were most common, at annual average rates of 29.95, 28.00, 23.76 and 22.29 per 10 000, respectively. Ascites and abnormal colour/fever demonstrated clear annual cycles, with higher rates in winter than in summer. Ascites prevalence correlated strongly with maximum temperature at 0 and −1 month lags. Abnormal colour/fever correlated strongly with temperature at 0 lag. Maximum temperatures of approximately 8°C and approximately 19°C marked the turning points of curve in a U-shaped relationship with mortality during transportation and lairage. Future climate change research on broilers should focus on preslaughter mortality. PMID:27703686

  1. "Delirium Day": a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool.

    PubMed

    Bellelli, Giuseppe; Morandi, Alessandro; Di Santo, Simona G; Mazzone, Andrea; Cherubini, Antonio; Mossello, Enrico; Bo, Mario; Bianchetti, Angelo; Rozzini, Renzo; Zanetti, Ermellina; Musicco, Massimo; Ferrari, Alberto; Ferrara, Nicola; Trabucchi, Marco

    2016-07-18

    To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission

  2. A pulse-burst laser system for a high-repetition-rate Thomson scattering diagnostic.

    PubMed

    Den Hartog, D J; Jiang, N; Lempert, W R

    2008-10-01

    A "pulse-burst" laser system is being constructed for addition to the Thomson scattering diagnostic on the Madison Symmetric Torus (MST) reversed-field pinch. This laser is designed to produce a burst of up to 200 approximately 1 J Q-switched pulses at repetition frequencies 5-250 kHz. This laser system will operate at 1064 nm and is a master oscillator, power amplifier. The master oscillator is a compact diode-pumped Nd:YVO(4) laser, intermediate amplifier stages are flashlamp-pumped Nd:YAG, and final stages will be flashlamp-pumped Nd:glass (silicate). Variable pulse width drive (0.3-20 ms) of the flashlamps is accomplished by insulated-gate bipolar transistor switching of large electrolytic capacitor banks. The burst train of laser pulses will enable the study of electron temperature (T(e)) and electron density (n(e)) dynamics in a single MST shot, and with ensembling, will enable correlation of T(e) and n(e) fluctuations with other fluctuating quantities.

  3. A pulse-burst laser system for a high-repetition-rate Thomson scattering diagnostic

    SciTech Connect

    Den Hartog, D. J.; Jiang, N.; Lempert, W. R.

    2008-10-15

    A ''pulse-burst'' laser system is being constructed for addition to the Thomson scattering diagnostic on the Madison Symmetric Torus (MST) reversed-field pinch. This laser is designed to produce a burst of up to 200 approximately 1 J Q-switched pulses at repetition frequencies 5-250 kHz. This laser system will operate at 1064 nm and is a master oscillator, power amplifier. The master oscillator is a compact diode-pumped Nd:YVO{sub 4} laser, intermediate amplifier stages are flashlamp-pumped Nd:YAG, and final stages will be flashlamp-pumped Nd:glass (silicate). Variable pulse width drive (0.3-20 ms) of the flashlamps is accomplished by insulated-gate bipolar transistor switching of large electrolytic capacitor banks. The burst train of laser pulses will enable the study of electron temperature (T{sub e}) and electron density (n{sub e}) dynamics in a single MST shot, and with ensembling, will enable correlation of T{sub e} and n{sub e} fluctuations with other fluctuating quantities.

  4. [Calcaneous ultrasonography as measurement of osteoporosis prevalence in the general population in relation to the diagnostic criterion utilized. Data of the study GIUMO].

    PubMed

    Sosa Henríquez, M; Saavedra Santana, P; Alegre López, J; Gómez Alonso, C; González Macías, J; Guañabens Gay, N; Hawkins Carranza, F; Lozano Tonkin, C; Martínez Izquierdo, M T; Mosquera Martínez, J; Muñoz Torres, M; Pérez Cano, R; Quesada Gómez, J M; Salas Heredia, E

    2003-07-01

    In recent years, a large number of techniques have been developed to estimate the bone mineral density for the diagnosis of osteoporosis. However, diagnostic criteria established by WHO are invariably applied for the interpretation of dual radiological densitometry (DEXA), which could not be correct in the case of the interpretation of ultrasound. We studied 2,589 randomly chosen people of both sexes, 1,138 males and 1,451 women from 10 to 99 years, in 11 spanish provinces. We carried out a measurement of the following calcaneous ultrasound parameters with the Sahara and Hologic devices: speed of the sound (SOS), coefficient of attenuation of wide band (BUA), index of consistency (QUI) and estimated bone mineral density (est. BMD). The prevalence of osteopenia and osteoporosis was calculated by applying the WHO criteria (osteopenia Tscore < or = 1 and osteoporosis Tscore < or = 2.5) and the prevalence of osteoporosis by applying a Tscore 1.8 as threshold. According to the WHO criteria, osteoporosis (Tscore < or = 2.5) is seen in 1.5 % males and 5.9 % females from 51 to 70 years, and in 2.6% males and 22.1% females over 70 years. Using a Tscore 1.8 as threshold, osteoporosis prevalence increases to 8.2% males and 21.9% females from 51 to 70 years, and to 8.4% males and 40.9% females over 70 years. Osteoporosis prevalence in spanish people of both sexes differs notably when applying the cut off point in a Tscore of 2.5, as WHO recommends, or in a Tscore of 1.8 as is suggested by other authors. Consensus is necessary to establish the appropriate cut off point or threshold for the diagnosis of osteoporosis with quantitative ultrasonography of calcaneum.

  5. Taenia solium porcine cysticercosis in Madagascar: Comparison of immuno-diagnostic techniques and estimation of the prevalence in pork carcasses traded in Antananarivo city.

    PubMed

    Porphyre, V; Betson, M; Rabezanahary, H; Mboussou, Y; Zafindraibe, N J; Rasamoelina-Andriamanivo, H; Costard, S; Pfeiffer, D U; Michault, A

    2016-03-30

    Taenia solium cysticercosis was reported in official veterinary and medical statistics to be highly prevalent in pigs and humans in Madagascar, but few estimates are available for pigs. This study aimed to estimate the seroprevalence of porcine cysticercosis among pigs slaughtered in Antananarivo abattoirs. Firstly, the diagnostic performance of two antigen-ELISA techniques (B158B60 Ag-ELISA and HP10 Ag-ELISA) and an immunoblotting method were compared with meat inspection procedures on a sample of pigs suspected to be infected with (group 1; n=250) or free of (group 2; n=250) T. solium based on direct veterinary inspection in Madagascar. Sensitivity and specificity of the antigen ELISAs were then estimated using a Bayesian approach for detection of porcine cysticercosis in the absence of a gold standard. Then, a third set of pig sera (group 3, n=250) was randomly collected in Antananarivo slaughterhouses and tested to estimate the overall prevalence of T. solium contamination in pork meat traded in Antananarivo. The antigen ELISAs showed a high sensitivity (>84%), but the B158B60 Ag-ELISA appeared to be more specific than the HP10 Ag-ELISA (model 1: 95% vs 74%; model 2: 87% vs 71%). The overall prevalence of porcine cysticercosis in Antananarivo slaughterhouses was estimated at 2.3% (95% credibility interval [95%CrI]: 0.09-9.1%) to 2.6% (95%CrI: 0.1-10.3%) depending on the model and priors used. Since the sample used in this study is not representative of the national pig population, village-based surveys and longitudinal monitoring at slaughter are needed to better estimate the overall prevalence, geographical patterns and main risk factors for T. solium contamination, in order to improve control policies.

  6. HIV testing rates, prevalence, and knowledge among outpatients in Durban, South Africa: Time trends over four years.

    PubMed

    Ramirez-Avila, Lynn; Regan, Susan; Chetty, Senica; Giddy, Janet; Ross, Douglas; Katz, Jeffrey N; Freedberg, Kenneth A; Losina, Elena; Walensky, Rochelle P; Bassett, Ingrid V

    2015-09-01

    The HIV public health messages in South Africa have increased. Our objective was to evaluate changes over time in HIV testing behaviour, prevalence and knowledge. We prospectively enrolled adults (≥18 years) prior to HIV testing at one urban and one peri-urban outpatient department in Durban, South Africa. A baseline questionnaire administered before testing included the number of prior HIV tests and four knowledge items. We used test results to estimate previously undiagnosed HIV prevalence among those tested. We assessed linear trends over enrollment. From November 2006 to August 2010, 5229 subjects enrolled and 4877 (93%) were HIV tested and had results available. Subjects reporting prior testing over time increased, from 13% in study year 1 to 42% in year 4 (linear trend p < 0.001). The HIV prevalence among those tested declined steadily and significantly over time, from 64% of enrollees in study year 1 to 39% in the final year (linear trend p < 0.001). The percentage of subjects who recognised that medicine can help people with HIV live longer increased from 80% in study year 1 to 96% in study year 4. Rates of HIV testing have increased and prevalence among those tested has decreased in outpatients in Durban, South Africa.

  7. Conscious and nonconscious African American stereotypes: impact on first impression and diagnostic ratings by therapists.

    PubMed

    Abreu, J M

    1999-06-01

    Sixty therapists randomly assigned to 1 of 2 priming conditions were primed with African American stereotypes or neutral words using 80-ms flash words on a computer screen. This procedure may activate information processing outside of conscious awareness. After this task, participants were exposed to a brief vignette introducing Mr. X, a patient referred for treatment, and then were asked to rate Mr. X on various dimensions. Results indicate that participants primed with stereotype words rated Mr. X significantly less favorably on hostility-related attributes and significantly more favorably on hostility-unrelated attributes than did participants primed with neutral words. The findings suggest that therapists can be affected by African American stereotypes in ways that produce negative or positive first impressions depending on the nature of the attribute that is rated.

  8. Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans

    PubMed Central

    2012-01-01

    Background Available definition criteria for metabolic syndrome (MS) have similarities and inconsistencies. The aim of this study was to determine the prevalence of MS in a group of Cameroonians with type 2 diabetes, according to the International Diabetes Federation (IDF) and the National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III) criteria, and to assess the concordance between both criteria, and the implications of combining them. Methods We collected clinical and biochemical data for 308 patients with type 2 diabetes (men 157) at the National Obesity Center of the Yaounde Central Hospital, Cameroon. Concordance was assessed with the use of the Kappa statistic. Results Mean age (standard deviation) was 55.8 (10.5) years and the median duration of diagnosed diabetes (25th–75th percentiles) was 3 years (0.5–5.0), similarly among men and women. The prevalence of MS was 71.7% according to the IDF criteria and 60.4% according to NCEP-ATP III criteria. The prevalence was significantly higher in women than in men independently of the criteria used (both p < 0.001). Overall concordance between both definitions was low to average 0.51 (95% confidence interval: 0.41–0.61). Combining the two sets of criteria marginally improved the yield beyond that provided by the IDF criteria alone in men, but not in the overall population and in women. Conclusions The IDF and NCEP-ATP III criteria do not always diagnose the same group of diabetic individuals with MS and combining them merely increases the yield beyond that provided by the IDF definition alone. This study highlights the importance of having a single unifying definition for MS in our setting. PMID:22650602

  9. Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa

    PubMed Central

    May, Philip A.; De Vries, Marlene M.; Marais, Anna-Susan; Kalberg, Wendy O.; Buckley, David; Adnams, Colleen M.; Hasken, Julie M.; Tabachnick, Barbara; Robinson, Luther K.; Manning, Melanie A.; Bezuidenhout, Heidre; Adam, Margaret P.; Jones, Kenneth L.; Seedat, Soraya; Parry, Charles D.H.; Hoyme, H. Eugene

    2017-01-01

    Background: Prevalence and characteristics of fetal alcohol syndrome (FAS) and total fetal alcohol spectrum disorders (FASD) were studied in a second sample of three South African rural communities to assess change. Methods: Active case ascertainment focused on children with height, weight and/or head circumference ≤25th centile and randomly-selected children. Final diagnoses were based on dysmorphology, neurobehavioral scores, and maternal risk interviews. Results: Cardinal facial features, head circumference, and total dysmorphology scores differentiated specific FASD diagnostic categories in a somewhat linear fashion but all FASD traits were significantly worse than those of randomly-selected controls. Neurodevelopmental delays were significantly worse for children with FASD than controls. Binge alcohol use was clearly documented as the proximal maternal risk factor for FASD, and significant distal risk factors were: low body mass, education, and income; high gravidity, parity, and age at birth of the index child. FAS rates continue to extremely high in these communities at 89–129 per 1000 children. Total FASD affect 196–276 per 1000 or 20–28% of the children in these communities. Conclusions: Very high rates of FASD persist in these general populations where regular, heavy drinking, often in a binge fashion, co-occurs with low socioeconomic conditions. PMID:28498341

  10. Replication of High Fetal Alcohol Spectrum Disorders Prevalence Rates, Child Characteristics, and Maternal Risk Factors in a Second Sample of Rural Communities in South Africa.

    PubMed

    May, Philip A; De Vries, Marlene M; Marais, Anna-Susan; Kalberg, Wendy O; Buckley, David; Adnams, Colleen M; Hasken, Julie M; Tabachnick, Barbara; Robinson, Luther K; Manning, Melanie A; Bezuidenhout, Heidre; Adam, Margaret P; Jones, Kenneth L; Seedat, Soraya; Parry, Charles D H; Hoyme, H Eugene

    2017-05-12

    Background: Prevalence and characteristics of fetal alcohol syndrome (FAS) and total fetal alcohol spectrum disorders (FASD) were studied in a second sample of three South African rural communities to assess change. Methods: Active case ascertainment focused on children with height, weight and/or head circumference ≤25th centile and randomly-selected children. Final diagnoses were based on dysmorphology, neurobehavioral scores, and maternal risk interviews. Results: Cardinal facial features, head circumference, and total dysmorphology scores differentiated specific FASD diagnostic categories in a somewhat linear fashion but all FASD traits were significantly worse than those of randomly-selected controls. Neurodevelopmental delays were significantly worse for children with FASD than controls. Binge alcohol use was clearly documented as the proximal maternal risk factor for FASD, and significant distal risk factors were: low body mass, education, and income; high gravidity, parity, and age at birth of the index child. FAS rates continue to extremely high in these communities at 9-129 per 1000 children. Total FASD affect 196-276 per 1000 or 20-28% of the children in these communities. Conclusions: Very high rates of FASD persist in these general populations where regular, heavy drinking, often in a binge fashion, co-occurs with low socioeconomic conditions.

  11. Screening for colorectal cancer and advanced colorectal neoplasia in kidney transplant recipients: cross sectional prevalence and diagnostic accuracy study of faecal immunochemical testing for haemoglobin and colonoscopy.

    PubMed

    Collins, Michael G; Teo, Edward; Cole, Stephen R; Chan, Choy-Yoke; McDonald, Stephen P; Russ, Graeme R; Young, Graeme P; Bampton, Peter A; Coates, P Toby

    2012-07-25

    To investigate whether screening kidney transplant recipients aged over 50 years for colorectal cancer with a faecal immunochemical test for haemoglobin might be justified, by determining the prevalence of advanced colorectal neoplasia and evaluating the diagnostic accuracy of faecal haemoglobin testing compared with colonoscopy in a population of kidney transplant recipients at otherwise average risk. Cross sectional prevalence and diagnostic accuracy study with index test of faecal haemoglobin and reference standard of colonoscopy. Outpatient clinics in metropolitan and regional hospitals in South Australia. 229 kidney transplant recipients aged 50 years and over, who were at least 6 months (mean 9.0 (SD 8.4) years) post-transplant and otherwise at average risk of colorectal cancer, completed the study between June 2008 and October 2011. Faecal immunochemical testing (Enterix Insure) for human haemoglobin, followed by colonoscopy with histological evaluation of retrieved samples. Prevalence of advanced colorectal neoplasia, defined as an adenoma at least 10 mm in diameter, villous features, high grade dysplasia, or colorectal cancer; sensitivity, specificity, and predictive values of faecal haemoglobin testing for advanced neoplasia compared with colonoscopy. Advanced colorectal neoplasia was found in 29 (13%, 95% confidence interval 9% to 18%) participants, including 2% (n=4) with high grade dysplasia and 2% (n=5) with colorectal cancer. Faecal testing for haemoglobin was positive in 12% (n=28); sensitivity, specificity, and positive and negative predictive values for advanced neoplasia were 31.0% (15.3% to 50.8%), 90.5% (85.6% to 94.2%), 32.1% (15.9% to 52.4%), and 90.1% (85.1% to 93.8%). Colonoscopy was well tolerated, with no significant adverse outcomes. To identify one case of advanced neoplasia, 8 (6 to 12) colonoscopies were needed. Kidney transplant recipients aged over 50 years have a high prevalence of advanced colorectal neoplasia. Faecal haemoglobin

  12. Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates.

    PubMed

    Boscarino, Joseph A; Hoffman, Stuart N; Han, John J

    2015-01-01

    Previously, we estimated the prevalence and risk factors for prescription opioid-use disorder among outpatients on opioid therapy using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and DSM-4 criteria. However, at the time, the DSM-5 criteria were not finalized. In the current study, we analyzed these data using the final DSM-5 criteria and compared these results. Using electronic records from a large US health care system, we identified outpatients receiving five or more prescription orders for opioid therapy in the past 12 months for noncancer pain (mean prescription orders =10.72; standard deviation =4.96). In 2008, we completed diagnostic interviews with 705 of these patients using the DSM-4 criteria. In the current study, we reassessed these results using the final DSM-5 criteria. The lifetime prevalence of DSM-5 opioid-use disorders using the final DSM-5 criteria was 58.7% for no or few symptoms (<2), 28.1% for mild symptoms (2-3), 9.7% for moderate symptoms (4-5), and 3.5% for severe symptoms (six or more). Thus, the lifetime prevalence of "any" prescription opioid-use disorder in this cohort was 41.3% (95% confidence interval [CI] =37.6-45.0). A comparison to the DSM-4 criteria indicated that the majority of patients with lifetime DSM-4 opioid dependence were now classified as having mild opioid-use disorder, based on the DSM-5 criteria (53.6%; 95% CI =44.1-62.8). In ordinal logistic regression predicting no/few, mild, moderate, and severe opioid-use disorder, the best predictors were age <65 years, current pain impairment, trouble sleeping, suicidal thoughts, anxiety disorders, illicit drug use, and history of substance abuse treatment. Given the final DSM-5 criteria, including the elimination of tolerance and withdrawal, inclusion of craving and abuse symptoms, and introduction of a new graded severity classification, the prevalence of opioid-use disorders has changed, while many of the DSM-4 risk factors for opioid dependence were

  13. Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates

    PubMed Central

    Boscarino, Joseph A; Hoffman, Stuart N; Han, John J

    2015-01-01

    Aims Previously, we estimated the prevalence and risk factors for prescription opioid-use disorder among outpatients on opioid therapy using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and DSM-4 criteria. However, at the time, the DSM-5 criteria were not finalized. In the current study, we analyzed these data using the final DSM-5 criteria and compared these results. Methods Using electronic records from a large US health care system, we identified outpatients receiving five or more prescription orders for opioid therapy in the past 12 months for noncancer pain (mean prescription orders =10.72; standard deviation =4.96). In 2008, we completed diagnostic interviews with 705 of these patients using the DSM-4 criteria. In the current study, we reassessed these results using the final DSM-5 criteria. Results The lifetime prevalence of DSM-5 opioid-use disorders using the final DSM-5 criteria was 58.7% for no or few symptoms (<2), 28.1% for mild symptoms (2–3), 9.7% for moderate symptoms (4–5), and 3.5% for severe symptoms (six or more). Thus, the lifetime prevalence of “any” prescription opioid-use disorder in this cohort was 41.3% (95% confidence interval [CI] =37.6–45.0). A comparison to the DSM-4 criteria indicated that the majority of patients with lifetime DSM-4 opioid dependence were now classified as having mild opioid-use disorder, based on the DSM-5 criteria (53.6%; 95% CI =44.1–62.8). In ordinal logistic regression predicting no/few, mild, moderate, and severe opioid-use disorder, the best predictors were age <65 years, current pain impairment, trouble sleeping, suicidal thoughts, anxiety disorders, illicit drug use, and history of substance abuse treatment. Conclusion Given the final DSM-5 criteria, including the elimination of tolerance and withdrawal, inclusion of craving and abuse symptoms, and introduction of a new graded severity classification, the prevalence of opioid-use disorders has changed, while many of the DSM-4

  14. The Wender Utah Rating Scale: Adult ADHD Diagnostic Tool or Personality Index?

    ERIC Educational Resources Information Center

    Hill, B.D.; Pella, Russell D.; Singh, Ashvind N.; Jones, Glenn N.; Gouvier, Wm. Drew

    2009-01-01

    Objective: The Wender Utah Rating Scale (WURS) is used to retroactively assess ADHD symptoms. This study sought to determine whether the WURS actually functions as an index of dysfunctional personality traits. Method: Five hundred twenty-two adult participants completed the WURS and at least one of the following measures: Wechsler Adult…

  15. The Wender Utah Rating Scale: Adult ADHD Diagnostic Tool or Personality Index?

    ERIC Educational Resources Information Center

    Hill, B.D.; Pella, Russell D.; Singh, Ashvind N.; Jones, Glenn N.; Gouvier, Wm. Drew

    2009-01-01

    Objective: The Wender Utah Rating Scale (WURS) is used to retroactively assess ADHD symptoms. This study sought to determine whether the WURS actually functions as an index of dysfunctional personality traits. Method: Five hundred twenty-two adult participants completed the WURS and at least one of the following measures: Wechsler Adult…

  16. Health facility-based malaria surveillance: the effects of age, area of residence and diagnostics on test positivity rates.

    PubMed

    Francis, Damon; Gasasira, Anne; Kigozi, Ruth; Kigozi, Simon; Nasr, Sussann; Kamya, Moses R; Dorsey, Grant

    2012-07-07

    The malaria test positivity rate (TPR) is increasingly used as an indicator of malaria morbidity because TPR is based on laboratory-confirmed cases and is simple to incorporate into existing surveillance systems. However, temporal trends in TPR may reflect changes in factors associated with malaria rather than true changes in malaria morbidity. This study examines the effects of age, area of residence and diagnostic test on TPR at two health facilities in regions of Uganda with differing malaria endemicity. The analysis included data from diagnostic blood smears performed at health facilities in Walukuba and Aduku between January 2009 and December 2010. The associations between age and time and between age and TPR were evaluated independently to determine the potential for age to confound temporal trends in TPR. Subsequently, differences between observed TPR and TPR adjusted for age were compared to determine if confounding was present. A similar analysis was performed for area of residence. Temporal trends in observed TPR were compared to trends in TPR expected using rapid diagnostic tests, which were modelled based upon sensitivity and specificity in prior studies. Age was independently associated with both TPR and time at both sites. At Aduku, age-adjusted TPR increased relative to observed TPR due to the association between younger age and TPR and the gradual increase in age distribution. At Walukuba, there were no clear differences between observed and age-adjusted TPR. Area of residence was independently associated with both TPR and time at both sites, though there were no clear differences in temporal trends in area of residence-adjusted TPR and observed TPR at either site. Expected TPR with pLDH- and HRP-2-based rapid diagnostic tests (RDTs) was higher than observed TPR at all time points at both sites. Adjusting for potential confounders such as age and area of residence can ensure that temporal trends in TPR due to confounding are not mistakenly ascribed

  17. Health facility-based malaria surveillance: The effects of age, area of residence and diagnostics on test positivity rates

    PubMed Central

    2012-01-01

    Background The malaria test positivity rate (TPR) is increasingly used as an indicator of malaria morbidity because TPR is based on laboratory-confirmed cases and is simple to incorporate into existing surveillance systems. However, temporal trends in TPR may reflect changes in factors associated with malaria rather than true changes in malaria morbidity. This study examines the effects of age, area of residence and diagnostic test on TPR at two health facilities in regions of Uganda with differing malaria endemicity. Methods The analysis included data from diagnostic blood smears performed at health facilities in Walukuba and Aduku between January 2009 and December 2010. The associations between age and time and between age and TPR were evaluated independently to determine the potential for age to confound temporal trends in TPR. Subsequently, differences between observed TPR and TPR adjusted for age were compared to determine if confounding was present. A similar analysis was performed for area of residence. Temporal trends in observed TPR were compared to trends in TPR expected using rapid diagnostic tests, which were modelled based upon sensitivity and specificity in prior studies. Results Age was independently associated with both TPR and time at both sites. At Aduku, age-adjusted TPR increased relative to observed TPR due to the association between younger age and TPR and the gradual increase in age distribution. At Walukuba, there were no clear differences between observed and age-adjusted TPR. Area of residence was independently associated with both TPR and time at both sites, though there were no clear differences in temporal trends in area of residence-adjusted TPR and observed TPR at either site. Expected TPR with pLDH- and HRP-2-based rapid diagnostic tests (RDTs) was higher than observed TPR at all time points at both sites. Conclusions Adjusting for potential confounders such as age and area of residence can ensure that temporal trends in TPR due to

  18. Measuring Interobserver Disagreement in Rating Diagnostic Characteristics of Pulmonary Nodule Using the Lung Imaging Database Consortium and Image Database Resource Initiative.

    PubMed

    Lin, Hongli; Huang, Changxing; Wang, Weisheng; Luo, Jiawei; Yang, Xuedong; Liu, Yuling

    2017-04-01

    The purpose of this study was to measure and analyze interobserver disagreement in rating diagnostic characteristics of pulmonary nodules on computed tomography scans using the Lung Imaging Database Consortium and Image Database Resource Initiative (LIDC/IDRI) database, and then to provide investigators with understanding the variability in rating diagnostic characteristics among radiologists. A histogram-based accumulated nodule-level approach is proposed to measure interobserver disagreement in rating diagnostic characteristics of pulmonary nodules among radiologists. The mean rating differences of radiologists on nodule level are calculated; next, a histogram of the accumulated nodule-level disagreements is constructed; and finally, mean, variance, skewness, and kurtosis statistics based on the histogram are extracted to analyze and summary interobserver disagreement in terms of the assessment of diagnostic characteristics of radiologists. Using the developed computer scheme, the disagreement of radiologists in rating all of 1880 distinct nodules from 1018 computed tomography scans are analyzed using original ratings as well as combined ratings according to the LIDC/IDRI instruction. The interobserver disagreement in rating diagnostic characteristics according to the defined categories of the LIDC/IDRI is substantial. The mean values of disagreement range from 0.0052 to 0.2341. The highest disagreement lies in rating subtlety characteristics, whereas internal structure receives the lowest disagreement of 0.0052. The calcification, texture, spiculation, lobulation, malignancy, sphericity, and margin receive disagreements of 0.0393, 0.1351, 0.1616, 0.1943, 0.2144, 0.2174, and 0.2228, respectively. Disagreements exist across radiologists in rating diagnostic characteristics of pulmonary nodules, and the disagreement levels vary from each other. Agreement among radiologists is improved by combining ratings according to the LIDC/IDRI instruction. For investigators

  19. The use of existing denture-satisfaction ratings for a diagnostic test to indicate prognosis with newly delivered complete dentures.

    PubMed

    Kawai, Yasuhiko; Matsumaru, Yuichi; Kanno, Kyoko; Kawase, Mitsuaki; Kawase, Mitsuo; Shu, Kazuyoshi; Izawa, Takeshi; Gunji, Atsuko; Kobayashi, Kihei

    2009-10-01

    The study investigated the relation between subjective satisfaction ratings of existing dentures and outcomes of newly delivered dentures, and the ability of the diagnostic test, using existing ratings, to indicate prognosis with newly delivered dentures. Consecutive 165 edentulous patients were recruited from November 2001 to August 2006 at a university-affiliated hospital. Dentures were fabricated with an acrylic base with full-balanced occlusion using hard resin artificial teeth by multiple prosthodontists. At the baseline and 3-month after delivery, patients rate their overall, maxillary, and mandibular satisfaction for existing and replaced dentures on a 100-mm visual analogue scale (VAS). The association between baseline ratings and newly delivered dentures was analyzed by regression analysis. The test's performance was measured by constructing a two-by-two table; patients with the following cutoff values on the VAS (overall: diagnostic tests was assessed by means of sensitivity, specificity, and likelihood ratios. Mandibular dentures showed a significant association between baseline and new dentures (coefficient=0.27, p=0.01). Results of test measures for overall, maxillary, and mandibular existing dentures were 71%, 38%, and 87% (sensitivity); 62%, 66%, and 49% (specificity); and 1.1, 1.9, and 1.7 (positive likelihood), and 0.5, 1.0, and 0.2 (negative likelihood). Test performance indicates that the negative (satisfied) result for mandibular existing dentures may be useful to rule out the unsatisfied patients with new mandibular dentures.

  20. Chapter 5: Actual and counterfactual smoking prevalence rates in the U.S. population via microsimulation.

    PubMed

    Jeon, Jihyoun; Meza, Rafael; Krapcho, Martin; Clarke, Lauren D; Byrne, Jeff; Levy, David T

    2012-07-01

    The smoking history generator (SHG) developed by the National Cancer Institute simulates individual life/smoking histories that serve as inputs for the Cancer Intervention and Surveillance Modeling Network (CISNET) lung cancer models. In this chapter, we review the SHG inputs, describe its outputs, and outline the methodology behind it. As an example, we use the SHG to simulate individual life histories for individuals born between 1890 and 1984 for each of the CISNET smoking scenarios and use those simulated histories to compute the corresponding smoking prevalence over the period 1975-2000.

  1. Lynxacarus radovskyi mites in feral cats: a study of diagnostic methods, preferential body locations, co-infestations and prevalence.

    PubMed

    Ketzis, Jennifer K; Dundas, James; Shell, Linda G

    2016-10-01

    Lynxacarus radovskyi (fur mites) are ectoparasites found on the hair shafts of cats living in tropical environments. Diagnosis is via microscopic examination of hairs. Various anatomical areas have been reported to harbour these mites. To assess adhesive tape impressions and trichograms for detecting L. radovskyi and co-infestations; to determine host body predilection sites and affected gender; to determine prevalence of L. radovskyi in a feral cat population. 121 feral cats in a trap, neuter and release programme. After cats were premedicated for surgical sterilization, hairs from seven to nine body sites were removed from each cat using adhesive tape impression and trichogram techniques. Samples were examined at 10-100× magnification using compound or stereo microscopes. The prevalence of L. radovskyi was 71% (86 of 121) within the feral cat population. Tape impressions identified 75 cats; trichograms identified 56 cats. There were fewer false negative results with tape impressions. Caudal body sites were more likely to be positive, with the perianal area being the most commonly affected. Males and females were infested equally. Tape impressions identified more Cheyletiella blakei infestations and both methods identified some Felicola felis infestations. Tape impressions were easier to perform and identified more L. radovskyi positive cats and more co-infestations. Hairs from the perianal area and other caudal body sites are most likely to harbour L. radovskyi. Within this feral cat population, L. radovskyi was a common infestation. © 2016 ESVD and ACVD.

  2. Prevalence, rates and correlates of intimate partner violence among South African women during pregnancy and the postpartum period.

    PubMed

    Groves, Allison K; Moodley, Dhayendre; McNaughton-Reyes, Luz; Martin, Sandra L; Foshee, Vangie; Maman, Suzanne

    2015-03-01

    Intimate partner violence (IPV) is a significant public health problem in South Africa. However, limited research exists on IPV during pregnancy and the postpartum period in South Africa. The purpose of this study is to describe the prevalence, rates and correlates of IPV among South African women during pregnancy and the first 9 months postpartum. Data are from a longitudinal study with women recruited during pregnancy between 2008 and 2010 at a public clinic in Durban. We used a modified version of the World Health Organization's IPV scale to estimate prevalence and rates of IPV during pregnancy, at 4 months postpartum and 9 months postpartum and we used logistic regression to assess the correlates of IPV during this time. More than 20 % of all women experienced at least one act of physical, psychological or sexual IPV during pregnancy. Nearly one-quarter of all women experienced at least one act of physical, psychological or sexual IPV during the first 9 months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first 4 months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. The high levels of IPV during pregnancy and the postpartum period highlight the need to develop screening and intervention strategies specifically for this time. Further, women should be screened not only for physical violence but also psychological violence given that psychological violence may result in distinct negative consequences.

  3. High rates of incident and prevalent anal human papillomavirus infection among young men who have sex with men.

    PubMed

    Glick, Sara Nelson; Feng, Qinghua; Popov, Viorica; Koutsky, Laura A; Golden, Matthew R

    2014-02-01

    There are few published estimates of anal human papillomavirus (HPV) infection rates among young men who have sex with men (YMSM). We estimated incidence and prevalence of type-specific anal HPV infection using clinician-collected anal swabs for HPV DNA testing obtained during a 1-year prospective study of 94 YMSM (mean age, 21 years) in Seattle. Seventy percent of YMSM had any HPV infection detected during the study, and HPV-16 and/or -18 were detected in 37%. The incidence rate for any new HPV infection was 38.5 per 1000 person-months and 15.3 per 1000 person-months for HPV-16/18; 19% had persistent HPV-16/18 infection. No participant tested positive for all 4 HPV types in the quadrivalent vaccine. The number of lifetime male receptive anal sex partners was significantly associated with HPV infection. The prevalence of HPV-16/18 was 6% among YMSM with a history of 1 receptive anal sex partner and 31% among YMSM with ≥ 2 partners. Although the high prevalence of HPV among YMSM highlights the desirability of vaccinating all boys as a strategy to avert the morbidity of HPV infection, most YMSM appear to remain naive to either HPV-16 or -18 well into their sexual lives and would benefit from HPV immunization.

  4. The Dynamics of Type 2 Diabetes Mellitus Prevalence and Management Rates among Rural Population in Henan Province, China

    PubMed Central

    Liu, Xiaotian; Wang, Ling; Wang, Panpan; Liu, Ruihua; Yang, Kaili; Qian, Xinling; Fan, Jingjing; Yu, Songcheng

    2017-01-01

    The aim of this study was to estimate the dynamics of type 2 diabetes mellitus (T2DM) prevalence and management rates based on a rural cohort study in Henan Province of China. The rural prospective study was conducted for 20194 Chinese population ≥18 years in 2007-2008 and followed during 2013-2014. A total of 14009 individuals were recruited for the prospective analysis ultimately. Over 5.74 years of follow-up, the age-standardized prevalence, awareness, treatment, and control of T2DM increased from 6.18%, 44.41%, 34.39%, and 19.08% at baseline to 7.87%, 59.64%, 52.17%, and 26.52% at follow-up in total population, respectively. Similar changes were found in men and women except the age-standardized control in men. The four parameters of T2DM were higher among various factors at follow-up than those at baseline. There was no statistical difference in awareness (P = 0.089) and treatment (P = 0.257) in the newly diagnosed T2DM compared with the rates at baseline. The current study indicated that the prevalence, awareness, treatment, and control of T2DM displayed chronological increasing trends while the awareness, treatment, and control of T2DM were still disproportionally low in central China. More works are needed urgently to popularize public health education and improve the quality of medical care in T2DM. PMID:28326333

  5. Prevalence and rates of intimate partner violence among South African women during pregnancy and the postpartum period

    PubMed Central

    Groves, Allison K.; Moodley, Dhayendre; McNaughton-Reyes, Luz; Martin, Sandra L.; Foshee, Vangie; Maman, Suzanne

    2014-01-01

    Objectives Intimate partner violence (IPV) is a significant public health problem in South Africa. However, limited research exists on IPV during pregnancy and the postpartum period in South Africa. The purpose of this study is to describe the prevalence, rates and correlates of IPV among South African women during pregnancy and the first nine months postpartum. Methods Data are from a longitudinal study with women recruited during pregnancy between 2008 and 2010 at a public clinic in Durban. We used a modified version of the World Health Organization’s IPV scale to estimate prevalence and rates of IPV during pregnancy, at four months postpartum and nine months postpartum and we used logistic regression to assess the correlates of IPV during this time. Results More than 20% of all women experienced at least one act of physical, psychological or sexual IPV during pregnancy. Nearly one-quarter of all women experienced at least one act of physical, psychological or sexual IPV during the first nine months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first four months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. Conclusions The high levels of IPV during pregnancy and the postpartum period highlight the need to develop screening and intervention strategies specifically for this time. Further, women should be screened not only for physical violence but also psychological violence given that psychological violence may result in distinct negative consequences. PMID:24889116

  6. The outcome of the primary vascular access and its translation into prevalent access use rates in chronic haemodialysis patients.

    PubMed

    Praehauser, Claudia; Breidthardt, Tobias; Moser-Bucher, Cora Nina; Wolff, Thomas; Baechler, Katrin; Eugster, Thomas; Dickenmann, Michael; Gurke, Lorenz; Mayr, Michael

    2012-08-01

    The American Fistula First Breakthrough Initiative currently aims for a 66% arterio-venous fistula (AVF) rate, while in the UK, best practice tariffs target AVF and arterio-venous graft (AVG) rates of 85%. The present study aims to assess whether these goals can be achieved. We conducted a retrospective cohort study on patients who initiated haemodialysis from 1995 to 2006. Outcomes were the final failure-free survival of the first permanent access and the type of second access created. Prevalent use rates for the access types were calculated on the 1st January of each year for the second half of the study period. Two hundred and eleven out of 246 patients (86%) received an AVF, 16 (6%) an AVG and 19 (8%) a permanent catheter (PC) as the first permanent access. Eighty-six (35%) patients had final failure of the primary access. One- and 3-year final failure-free survival rates were 73 and 65% for AVF compared with 40 and 20% for AVG and 62 and 0% for PC, respectively. In patients with primary AVF, female sex {hazard ratio (HR) 2.20 [confidence interval (CI) 1.29-3.73]} and vascular disease [HR 2.24 (CI 1.26-3.97)] were associated with a poorer outcome. A similar trend was observed for autoimmune disease [HR 2.14 (CI 0.99-4.65)]. As second accesses AVF, AVG and PC were created in 47% (n = 40), 38% (n = 33) and 15% (n = 13). The median prevalent use rate was 80.5% for AVF, 14% for AVG and 5.5% for PC. The vascular access targets set by initiatives from the USA and UK are feasible in unselected haemodialysis patients. High primary AVF rates, the superior survival rates of AVFs even in patient groups at higher risk of access failure and the high rate of creation of secondary AVFs contributed to these promising results.

  7. Diagnostic Accuracy of the Small Membrane Filtration Method for Diagnosis of Pulmonary Tuberculosis in a High-HIV-Prevalence Setting

    PubMed Central

    Boum, Yap; Kim, Soyeon; Orikiriza, Patrick; Acuña-Villaorduña, Carlos; Vinhas, Solange; Bonnet, Maryline; Nyehangane, Dan; Mwanga-Amumpaire, Juliet; Fennelly, Kevin P.

    2016-01-01

    Sputum acid-fast bacilli (AFB) smear microscopy has suboptimal sensitivity but remains the most commonly used laboratory test to diagnose pulmonary tuberculosis (TB). We prospectively evaluated the small membrane filtration (SMF) method that concentrates AFB in a smaller area to facilitate detection to improve the diagnostic performance of microscopy. We enrolled adults with suspicion of pulmonary TB from health facilities in southwestern Uganda. Clinical history, physical examination, and 3 sputum samples were obtained for direct fluorescent AFB smear, SMF, Xpert MTB/RIF, and MGIT culture media. Sensitivity and specificity were estimated for SMF, AFB smear, and Xpert MTB/RIF, using MGIT as the reference standard. The analysis was stratified according to HIV status. From September 2012 to April 2014, 737 participants were included in the HIV-infected stratum (146 [20.5%] were culture positive) and 313 were in the HIV-uninfected stratum (85 [28%] were culture positive). In HIV-infected patients, the sensitivity of a single SMF was 67.4% (95% confidence interval [CI], 59.9% to 74.1%); for AFB, 68.0% (95% CI, 60.6% to 74.6%); and for Xpert MTB/RIF, 91.0% (95% CI, 85.0% to 94.8%). In HIV-uninfected patients, the corresponding sensitivities were 72.5% (95% CI, 62.1% to 80.9%), 80.3% (95% CI, 70.8% to 87.2%), and 93.5% (95% CI, 85.7% to 97.2%). The specificity for all 3 tests in both HIV groups was ≥96%. In this setting, the SMF method did not improve the diagnostic accuracy of sputum AFB. The Xpert MTB/RIF assay performed well in both HIV-infected and -uninfected groups. PMID:27030493

  8. Rethinking Mandatory HIV Testing During Pregnancy in Areas With High HIV Prevalence Rates: Ethical and Policy Issues

    PubMed Central

    Schuklenk, Udo; Kleinsmidt, Anita

    2007-01-01

    We analyzed the ethical and policy issues surrounding mandatory HIV testing of pregnant women in areas with high HIV prevalence rates. Through this analysis, we seek to demonstrate that a mandatory approach to testing and treatment has the potential to significantly reduce perinatal transmission of HIV and defend the view that mandatory testing is morally required if a number of conditions can be met. If such programs are to be introduced, continuing medical care, including highly active antiretroviral therapy, must be provided and pregnant women must have reasonable alternatives to compulsory testing and treatment. We propose that a liberal regime entailing abortion rights up to the point of fetal viability would satisfy these requirements. Pilot studies in the high-prevalence region of southern African countries should investigate the feasibility of this approach. PMID:17538051

  9. Rethinking mandatory HIV testing during pregnancy in areas with high HIV prevalence rates: ethical and policy issues.

    PubMed

    Schuklenk, Udo; Kleinsmidt, Anita

    2007-07-01

    We analyzed the ethical and policy issues surrounding mandatory HIV testing of pregnant women in areas with high HIV prevalence rates. Through this analysis, we seek to demonstrate that a mandatory approach to testing and treatment has the potential to significantly reduce perinatal transmission of HIV and defend the view that mandatory testing is morally required if a number of conditions can be met. If such programs are to be introduced, continuing medical care, including highly active antiretroviral therapy, must be provided and pregnant women must have reasonable alternatives to compulsory testing and treatment. We propose that a liberal regime entailing abortion rights up to the point of fetal viability would satisfy these requirements. Pilot studies in the high-prevalence region of southern African countries should investigate the feasibility of this approach.

  10. Transmission rates, screening methods and costs of MRSA--a systematic literature review related to the prevalence in Germany.

    PubMed

    Tübbicke, A; Hübner, C; Kramer, A; Hübner, N-O; Fleßa, S

    2012-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) infections represent a serious challenge for health care institutions, which is inherent in the combination of prevalence, transmission rates and costs. Furthermore, performing an MRSA screening requires information on the complex system of effectiveness, accuracy and costs of different screening methods. The purpose of this study was to give an overview of parameters with decisive significance for the burden of MRSA and the selection of a specific MRSA screening strategy. A systematic literature search for peer-reviewed health economic studies associated with MRSA was performed (from 1995 to the present). Eighty-seven different studies met all inclusion and exclusion criteria. Primary outcomes included the prevalence of MRSA, MRSA transmission rates, performance characteristics of MRSA screening methods, costs for pre-emptive isolation precautions and costs per MRSA case. The prevalence rates reported for all inpatients (1.2-5.3 %) as well as for inpatients with risk factors or patients in risk areas (3.85-20.6 %) vary greatly. The range of cross-transmission rates per day reported for patients with MRSA in isolation is 0.00081-0.009 and for carriers not in isolation is 0.00137-0.140, respectively. For polymerase chain reaction (PCR) methods, the mean sensitivity and specificity were 91.09 and 95.79 %, respectively. Culture methods show an average sensitivity of 89.01 % and an average specificity of 93.21 %. The turn-around time for PCR methods averages 15 h, while for the culture method, it can only be estimated as 48-72 h. This review filtered important parameters and cost drivers, and covered them with literature-based averages. These findings serve as an ideal evidence base for further health economic considerations of the cost-effectiveness of different MRSA screening methods.

  11. Prevalence and Clinical Correlates of Sarcopenia in Community-Dwelling Older People: Application of the EWGSOP Definition and Diagnostic Algorithm

    PubMed Central

    2014-01-01

    Background. Muscle impairment is a common condition in older people and a powerful risk factor for disability and mortality. The aim of this study was to apply the European Working Group on Sarcopenia in Older People criteria to estimate the prevalence and investigate the clinical correlates of sarcopenia, in a sample of Italian community-dwelling older people. Methods. Cross-sectional analysis of 730 participants (74% aged 65 years and older) enrolled in the InCHIANTI study. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria using bioimpedance analysis for muscle mass assessment. Logistic regression analysis was used to identify the factors independently associated with sarcopenia. Results. Sarcopenia defined by the European Working Group on Sarcopenia in Older People criteria increased steeply with age (p < .001), with 31.6% of women and 17.4% of men aged 80 years or older being affected by this condition. Higher education (odds ratio: 0.85; 95% CI: 0.74–0.98), lower insulin-like growth factor I (lowest vs highest tertile, odds ratio: 3.89; 95% CI: 1.03–14.1), and low bioavailable testosterone (odds ratio: 2.67; 95% CI: 1.31–5.44) were independently associated with the likelihood of being sarcopenic. Nutritional intake, physical activity, and level of comorbidity were not associated with sarcopenia. Conclusions. Sarcopenia identified by the European Working Group on Sarcopenia in Older People criteria is a relatively common condition in Italian octogenarians, and its prevalence increases with aging. Correlates of sarcopenia identified in this study might suggest new approaches for prevention and treatment of sarcopenia. PMID:24085400

  12. Prevalence and clinical correlates of sarcopenia in community-dwelling older people: application of the EWGSOP definition and diagnostic algorithm.

    PubMed

    Volpato, Stefano; Bianchi, Lara; Cherubini, Antonio; Landi, Francesco; Maggio, Marcello; Savino, Elisabetta; Bandinelli, Stefania; Ceda, Gian Paolo; Guralnik, Jack M; Zuliani, Giovanni; Ferrucci, Luigi

    2014-04-01

    Muscle impairment is a common condition in older people and a powerful risk factor for disability and mortality. The aim of this study was to apply the European Working Group on Sarcopenia in Older People criteria to estimate the prevalence and investigate the clinical correlates of sarcopenia, in a sample of Italian community-dwelling older people. Cross-sectional analysis of 730 participants (74% aged 65 years and older) enrolled in the InCHIANTI study. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria using bioimpedance analysis for muscle mass assessment. Logistic regression analysis was used to identify the factors independently associated with sarcopenia. Sarcopenia defined by the European Working Group on Sarcopenia in Older People criteria increased steeply with age (p < .001), with 31.6% of women and 17.4% of men aged 80 years or older being affected by this condition. Higher education (odds ratio: 0.85; 95% CI: 0.74-0.98), lower insulin-like growth factor I (lowest vs highest tertile, odds ratio: 3.89; 95% CI: 1.03-14.1), and low bioavailable testosterone (odds ratio: 2.67; 95% CI: 1.31-5.44) were independently associated with the likelihood of being sarcopenic. Nutritional intake, physical activity, and level of comorbidity were not associated with sarcopenia. Sarcopenia identified by the European Working Group on Sarcopenia in Older People criteria is a relatively common condition in Italian octogenarians, and its prevalence increases with aging. Correlates of sarcopenia identified in this study might suggest new approaches for prevention and treatment of sarcopenia.

  13. Flea species infesting dogs in Florida and Bartonella spp. prevalence rates.

    PubMed

    Yore, K; DiGangi, B; Brewer, M; Balakrishnan, N; Breitschwerdt, E B; Lappin, M

    2014-01-31

    Several Bartonella spp. associated with fleas can induce a variety of clinical syndromes in both dogs and humans. However, few studies have investigated the prevalence of Bartonella in the blood of dogs and their fleas. The objectives of this study were to determine the genera of fleas infesting shelter dogs in Florida, the prevalence of Bartonella spp. within the fleas, and the prevalence of Bartonella spp. within the blood of healthy dogs from which the fleas were collected. Fleas, serum, and EDTA-anti-coagulated whole blood were collected from 80 healthy dogs, and total DNA was extracted for PCR amplification of Bartonella spp. The genera of fleas infesting 43 of the dogs were determined phenotypically. PCR amplicons from blood and flea pools were sequenced to confirm the Bartonella species. Amplicons for which sequencing revealed homology to Bartonella vinsonii subsp. berkhoffii (Bvb) underwent specific genotyping by targeting the 16S-23S intergenic spacer region. A total of 220 fleas were collected from 80 dogs and pooled by genus (43 dogs) and flea species. Bartonella spp. DNA was amplified from 14 of 80 dog blood samples (17.5%) and from 9 of 80 pooled fleas (11.3%). B. vinsonii subsp. berkhoffii DNA was amplified from nine dogs and five of the flea pools. Bartonella rochalimae (Br) DNA was amplified from six dogs and two flea pools. One of 14 dogs was co-infected with Bvb and Br. The dog was infested with Pulex spp. fleas containing Br DNA and a single Ctenocephalides felis flea. Of the Bvb bacteremic dogs, five and four were infected with genotypes II and I, respectively. Of the Bvb PCR positive flea pools, three were Bvb genotype II and two were Bvb genotype I. Amplification of Bvb DNA from Pulex spp. collected from domestic dogs, suggests that Pulex fleas may be a vector for dogs and a source for zoonotic transfer of this pathogen from dogs to people. The findings of this study provide evidence to support the hypothesis that flea-infested dogs may be a

  14. Surveys of Health Professions Trainees: Prevalence, Response Rates, and Predictive Factors to Guide Researchers.

    PubMed

    Phillips, Andrew W; Friedman, Benjamin T; Utrankar, Amol; Ta, Andrew Q; Reddy, Shalini T; Durning, Steven J

    2017-02-01

    To establish a baseline overall response rate for surveys of health professions trainees, determine strategies associated with improved response rates, and evaluate for the presence of nonresponse bias. The authors performed a comprehensive analysis of all articles published in Academic Medicine, Medical Education, and Advances in Health Sciences Education in 2013, recording response rates. Additionally, they reviewed nonresponse bias analyses and factors suggested in other fields to affect response rate including survey delivery method, prenotification, and incentives. The search yielded 732 total articles; of these, 356 were research articles, and of these, 185 (52.0%) used at least one survey. Of these, 66 articles (35.6%) met inclusion criteria and yielded 73 unique surveys. Of the 73 surveys used, investigators reported a response rate for 63.0% of them; response rates ranged from 26.6% to 100%, mean (standard deviation) 71.3% (19.5%). Investigators reported using incentives for only 16.4% of the 73 surveys. The only survey methodology factor significantly associated with response rate was single- vs. multi-institutional surveys (respectively, 74.6% [21.2%] vs. 62.0% [12.8%], P = .022). Notably, statistical power for all analyses was limited. No articles evaluated for nonresponse bias. Approximately half of the articles evaluated used a survey as part of their methods. Limited data are available to establish a baseline response rate among health professions trainees and inform researchers which strategies are associated with higher response rates. Journals publishing survey-based health professions education research should improve reporting of response rate, nonresponse bias, and other survey factors.

  15. Impact of the Implementation of New WHO Diagnostic Criteria for Gestational Diabetes Mellitus on Prevalence and Perinatal Outcomes: A Population-Based Study.

    PubMed

    Erjavec, Katja; Poljičanin, Tamara; Matijević, Ratko

    2016-01-01

    Objectives. To determine the impact of the implementation of new WHO diagnostic criteria for gestational diabetes mellitus (GDM) on prevalence, predictors, and perinatal outcomes in Croatian population. Methods. A cross-sectional study was performed using data from medical birth certificates collected in 2010 and 2014. Data collected include age, height, and weight before and at the end of pregnancy, while perinatal outcome was assessed by onset of labor, mode of delivery, and Apgar score. Results. A total of 81.748 deliveries and 83.198 newborns were analysed. Prevalence of GDM increased from 2.2% in 2010 to 4.7% in 2014. GDM was a significant predictor of low Apgar score (OR 1.656), labor induction (OR 2.068), and caesarean section (OR 1.567) in 2010, while in 2014 GD was predictive for labor induction (OR 1.715) and caesarean section (OR 1.458) only. Age was predictive for labor induction only in 2014 and for caesarean section in both years, while BMI before pregnancy was predictive for all observed perinatal outcomes in both years. Conclusions. Despite implementation of new guidelines, GDM remains burdened with increased risk of labor induction and caesarean section, but no longer with low Apgar score, while BMI remains an important predictor for all three perinatal outcomes.

  16. Impact of the Implementation of New WHO Diagnostic Criteria for Gestational Diabetes Mellitus on Prevalence and Perinatal Outcomes: A Population-Based Study

    PubMed Central

    Poljičanin, Tamara; Matijević, Ratko

    2016-01-01

    Objectives. To determine the impact of the implementation of new WHO diagnostic criteria for gestational diabetes mellitus (GDM) on prevalence, predictors, and perinatal outcomes in Croatian population. Methods. A cross-sectional study was performed using data from medical birth certificates collected in 2010 and 2014. Data collected include age, height, and weight before and at the end of pregnancy, while perinatal outcome was assessed by onset of labor, mode of delivery, and Apgar score. Results. A total of 81.748 deliveries and 83.198 newborns were analysed. Prevalence of GDM increased from 2.2% in 2010 to 4.7% in 2014. GDM was a significant predictor of low Apgar score (OR 1.656), labor induction (OR 2.068), and caesarean section (OR 1.567) in 2010, while in 2014 GD was predictive for labor induction (OR 1.715) and caesarean section (OR 1.458) only. Age was predictive for labor induction only in 2014 and for caesarean section in both years, while BMI before pregnancy was predictive for all observed perinatal outcomes in both years. Conclusions. Despite implementation of new guidelines, GDM remains burdened with increased risk of labor induction and caesarean section, but no longer with low Apgar score, while BMI remains an important predictor for all three perinatal outcomes. PMID:28097023

  17. [Estimates and trends of obesity prevalence through mortality rates associated of chronic diseases in Mexico].

    PubMed

    Villa, Antonio R; Escobedo, Michelle H; Méndez-Sánchez, Nahum

    2004-01-01

    The pandemy of obesity is affecting more than 300 millions of adults in the world. The trend is increasing. Diabetes, coronary hearth disease, hypertension, cerebrovascular disease and dyslipidemia are chronic diseases associated with obesity. The methodology of this paper is proposed as an alternative resource based in mortality data to quantify the magnitude of chronic diseases in developing countries. Deaths for Mexico registered in 2000, according to selected causes, were taken to derive indirectly the prevalence of obesity in years 2000, 2005, and 2010, both males and females > or = 35 years-old. In 2010, an estimation of 8 million of Mexican with obesity is made. This methodology is referred to be probed in the quantification and projection of chronic diseases. According with our estimation, we hope in Mexico at 2010 to have between 8 and 14 millions of people > or = 35 years-old with obesity.

  18. The theoretical reliability of PCR-based fish viral diagnostic methods is critically affected when they are applied to fish populations with low prevalence and virus loads.

    PubMed

    Dopazo, C P; Moreno, P; Olveira, J G; Borrego, J J

    2017-09-15

    The reliability of PCR techniques is an important issue in viral diagnosis, and it is even crucial when they must be applied for detection of viruses in asymptomatic carriers. The problems will arise when the aim is to study fish wild populations, where the viral loads and prevalence values are extremely low. We have evaluated several PCR procedures employed by two laboratories for monitoring fish captured in several oceanographic campaigns performed in the Gulf of Cádiz. To evaluate the reliability of different diagnostics test used, we have re-analyzed fish samples that had been previously subjected to diagnosis for a surveillance of viruses performed in 2010-2011 in wild fish populations. The following parameters were employed: the clinical sensitivity (Ss), the clinical specificity (Sp), the predictive positive value (PPV), the predictive negative value (PNV), and the positive and negative likelihood ratio (LR(+) and LR(-) ). For viral nervious necrosis virus (VNNV), a RT-PCR procedure supplemented by nested PCR showed the highest values (100%) for all the parameters. For viral hemorrhagic septicemia virus (VHSV), the highest values were provided by RT-PCR supplemented by dot blot hybridization. In the case of Infectious pancreatic necrosis virus (IPNV), none of the procedures yielded 100% for any parameter. The results obtained for viral prevalence indicate: (i) that the conservation of the samples at -80 °C did not affect to the capacity of detection of the virus in the tissues, and (ii) that the reproducibility of the diagnosis can be affected by factors including the staff experience and/or the materials employed. Finally, the use of a combination of procedures in advised to ensure the maximum reliability of the diagnosis when it is applied to asymptomatic fish populations. This paper describes a strategy of combining diagnostic tests for the surveillance and monitoring of wild fish populations to reduce underestimation of the prevalence of viruses this

  19. Prevalence of Group A b-Hemolytic Streptococcus Among Children with Tonsillopharyngitis in Kyrgyzstan: The Difficulty of Diagnostics and Therapy.

    PubMed

    Omurzakova, Nazgul A; Yamano, Yoshihisa; Saatova, Guli M; Alybaeva, Mayramkan S; Nishioka, Kusuki; Nakajima, Toshihiro

    2010-10-13

    Rheumatic fever (RF) is well known disease as a result of frequent complication of the group A b-hemolytic streptococcal (GABHS) tonsillopharyngitis, have noticeably grown for the last 15 years among young generation in the Kyrgyz Republic. It is important to hold a study about the prevalence of RF and GABHS and their susceptibility to antibiotics in the Kyrgyz Republic. We have studied 200 children with chronic tonsillopharyngitis at the National Center of Pediatrics and Child Surgery in Bishkek (the Kyrgyz Republic) from August till September 2008. 188 (48 out of them are with RF) out of total 200 children are Kyrgyz and 12 are Russian (2 out of them are with RF). 111 out of total are female (34 out of them are with RF) and 89 are male (17 out of them are with RF). The average age of the subjects is 10.9±6.0 (from 3 to 17 years old). The presence of GABHS was assessed using two ways: by the rapid antigen detection test (RADT) for outcrop of streptococcus antigen in smear from mucosal surface of tonsils, and by bacterial culture analysis (BA). RADT was used to determine its specificity and sensitivity in order to recommend practitioners its further wide use. Furthermore, the discovered culture of GABHS have been investigated on susceptibility to antibiotics by disc-diffusion method. RESEARCH RESULTS: GABHS antigen was positive in 72 (36.0 %) subjects from RADT and in 80 (40.0%) subjects from BA out of 200 total subjects. In the patients with RF (n=51), GABHS was positive in 18 (35.2%) subjects by RADT and in 24 (47.0%) subjects by BA. In the subjects without RF (n=149), GABHS was positive in 54 (36.2%) subjects by RADT and in 56 (37.5%) by BA. Among 80 GABHS positive results sensitive to antibiotics were: to penicillin only 10 (12.5%), to ampicillin-29 (36.2%), to amoxicillin-36 (45.0%), to ceftriaxon - 31 (38.7%), to roxithromycin - 21 (26.2%), to erythromycin- 19 (23.7%). It is noted that 21 (26.2%) GABHS positive results were absolutely resistant for all these

  20. Psychiatric symptoms among prospective bariatric surgery patients: rates of prevalence and their relation to social desirability, pursuit of surgery, and follow-up attendance.

    PubMed

    Rosik, Christopher H

    2005-05-01

    There is a very limited empirical literature regarding the psychiatric status of prospective bariatric patients and no studies that examine potential social desirability effects on self-presentation for this patient population. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) was utilized to assess the prevalence of 13 DSM-IV Axis I disorders in a sample of 294 bariatric patients attending a presurgical psychological consultation. Marlowe-Crowne Social Desirability Scale (MCSD) was also included for 256 of these patients. Six-month follow-up data for a sub-sample of 64 patients was obtained to compare the extent of presurgical psychiatric symptoms between individuals who did versus did not pursue the surgery and those who attended versus failed to attend post-operative follow-up appointments. The results suggested the presence of an Axis I disorder among half of these patients, with comorbidity present in 29.9% of the sample. Highest prevalence rates were suggested for somatization (29.3%), social phobia (18%), hypochondriasis (15%), and obsessive-compulsive disorder (13.6%). Univariate analyses revealed that only MSCD scores were significantly and negatively related to total symptom levels. Analyses of the follow-up data indicated that patients who pursued the surgery had fewer total symptoms. Patients who attended all of their follow-up appointments tended to be older and weighed more at their presurgical evaluation. These findings suggest that significant psychopathology can be found among bariatric patients, and highlight the importance of attending to impression management issues and anxiety spectrum disorders in presurgical psychological evaluations.

  1. The Prevalence, Rate of Progression, and Treatment of Elbow Flexion Contracture in Children with Brachial Plexus Birth Palsy

    PubMed Central

    Sheffler, Lindsey C.; Lattanza, Lisa; Hagar, Yolanda; Bagley, Anita; James, Michelle A.

    2012-01-01

    Background: Elbow flexion contracture is a well-known complication of brachial plexus birth palsy that adversely affects upper-extremity function. The prevalence, risk factors, and rate of progression of elbow flexion contracture associated with brachial plexus birth palsy have not been established, and the effectiveness of nonoperative treatment involving nighttime splinting or serial casting has not been well studied. Methods: The medical records of 319 patients with brachial plexus birth palsy who had been seen at our institution between 1992 and 2009 were retrospectively reviewed to identify patients with an elbow flexion contracture (≥10°). The chi-square test for trend and the Kaplan-Meier estimator were used to evaluate risk factors for contracture, including age, sex, and the extent of brachial plexus involvement. Longitudinal models were used to estimate the rate of contracture progression and the effectiveness of nonoperative treatment. Results: An elbow flexion contracture was present in 48% (152) of the patients with brachial plexus birth palsy. The median age of onset was 5.1 years (range, 0.25 to 14.8 years). The contracture was ≥30° in 36% (fifty-four) of these 152 patients and was accompanied by a documented radial head dislocation in 6% (nine). The prevalence of contracture increased with increasing age (p < 0.001) but was not significantly associated with sex or with the extent of brachial plexus involvement. The magnitude of the contracture increased by 4.4% per year before treatment (p < 0.01). The magnitude of the contracture decreased by 31% when casting was performed (p < 0.01) but thereafter increased again at the same rate of 4.4% per year. The magnitude of the contracture did not improve when splinting was performed but the rate of increase thereafter decreased to <0.1% per year (p = 0.04). Conclusions: The prevalence of elbow flexion contracture in children with brachial plexus birth palsy may be greater than clinicians perceive

  2. The prevalence, rate of progression, and treatment of elbow flexion contracture in children with brachial plexus birth palsy.

    PubMed

    Sheffler, Lindsey C; Lattanza, Lisa; Hagar, Yolanda; Bagley, Anita; James, Michelle A

    2012-03-07

    Elbow flexion contracture is a well-known complication of brachial plexus birth palsy that adversely affects upper-extremity function. The prevalence, risk factors, and rate of progression of elbow flexion contracture associated with brachial plexus birth palsy have not been established, and the effectiveness of nonoperative treatment involving nighttime splinting or serial casting has not been well studied. The medical records of 319 patients with brachial plexus birth palsy who had been seen at our institution between 1992 and 2009 were retrospectively reviewed to identify patients with an elbow flexion contracture (≥10°). The chi-square test for trend and the Kaplan-Meier estimator were used to evaluate risk factors for contracture, including age, sex, and the extent of brachial plexus involvement. Longitudinal models were used to estimate the rate of contracture progression and the effectiveness of nonoperative treatment. An elbow flexion contracture was present in 48% (152) of the patients with brachial plexus birth palsy. The median age of onset was 5.1 years (range, 0.25 to 14.8 years). The contracture was ≥30° in 36% (fifty-four) of these 152 patients and was accompanied by a documented radial head dislocation in 6% (nine). The prevalence of contracture increased with increasing age (p < 0.001) but was not significantly associated with sex or with the extent of brachial plexus involvement. The magnitude of the contracture increased by 4.4% per year before treatment (p < 0.01). The magnitude of the contracture decreased by 31% when casting was performed (p < 0.01) but thereafter increased again at the same rate of 4.4% per year. The magnitude of the contracture did not improve when splinting was performed but the rate of increase thereafter decreased to <0.1% per year (p = 0.04). The prevalence of elbow flexion contracture in children with brachial plexus birth palsy may be greater than clinicians perceive. The prevalence increased with patient age but

  3. Left ventricular diastolic dysfunction in dialysis patients assessed by novel speckle tracking strain rate analysis: prevalence and determinants.

    PubMed

    de Bie, Mihály K; Ajmone Marsan, Nina; Gaasbeek, André; Bax, Jeroen J; Groeneveld, Marc; Gabreels, Bas A; Delgado, Victoria; Rabelink, Ton J; Schalij, Martin J; Jukema, J Wouter

    2012-01-01

    Background. Diastolic dysfunction is common among dialysis patients and is associated with increased morbidity and mortality. Novel echocardiographic speckle tracking strain analysis permits accurate assessment of left ventricular diastolic function, independent of loading conditions and taking all myocardial segments into account. The aim of the study was to evaluate the prevalence of diastolic dysfunction in chronic dialysis patients using this novel technique, and to identify its determinants among clinical and echocardiographic variables. Methods. Patients currently enrolled in the ICD2 study protocol were included for this analysis. Next to conventional echo measurements diastolic function was also assessed by global diastolic strain rate during isovolumic relaxation (SRIVR). Results. A total of 77 patients were included (age 67 ± 8 years, 74% male). When defined as E/SRIVR ≥236, the prevalence of diastolic dysfunction was higher compared to more conventional measurements (48% versus 39%). Left ventricular mass (OR 1.02, 95% CI 1.00-1.04, P = 0.014) and pulse wave velocity (OR 1.34, 95% CI 1.07-1.68, P = 0.01) were independent determinants of diastolic dysfunction. Conclusion. Diastolic dysfunction is highly prevalent among dialysis patients and might be underestimated using conventional measurements. Left ventricular mass and pulse wave velocity were the only determinants of diastolic dysfunction in these patients.

  4. Prevalence of hypothyroidism in diabetic kidney disease and effect of thyroid hormone replacement on estimate glomerular filtration rate

    PubMed Central

    Bajaj, Sarita; Purwar, Naincy; Gupta, Arvind; Gupta, Poonam; Srivastava, Anubha

    2016-01-01

    Aims: To determine the prevalence of subclinical and overt hypothyroidism in diabetic kidney disease (DKD) and effect of thyroid hormone replacement on progression of DKD. Materials and Methods: A prospective cohort study on 41 adult DKD patients who were screened for hypothyroidism. Hypothyroid DKD patients were started on levothyroxine replacement and were reviewed after 3 and 6 months. Results: Of the total population, 14 (34.1%) cases were hypothyroid, among whom 12 (29.3%) cases were subclinical, and 2 (4.8%) were overt hypothyroidism. Prevalence of hypothyroidism and mean thyroid stimulating hormone levels increased with increasing severity of DKD. There were 2 (14.3%) hypothyroid cases in stage 3b, 4 (28.5%) cases in stage 4, and 8 (57.2%) in stage 5 DKD. The mean estimate glomerular filtration rate (ml/min/1.73 m2) at baseline was 13.6 ± 13.3 which increased to 16.4 ± 14.5 and 21.2 ± 15.3 after 3 and 6 months of thyroid hormone replacement therapy (THRT), respectively (P < 0.001). Conclusions: Hypothyroidism is commonly associated with DKD. Prevalence of hypothyroidism increased with declining renal function. THRT significantly improved renal function in DKD patients with hypothyroidism after 3 and 6 months of therapy. PMID:27867882

  5. Erosion rate diagnostics in ion thrusters using laser-induced fluorescence

    NASA Technical Reports Server (NTRS)

    Gaeta, C. J.; Matossian, J. N.; Turley, R. S.; Beattie, J. R.; Williams, J. D.; Williamson, W. S.

    1993-01-01

    We have used laser-induced fluorescence (LIF) to monitor the charge-exchange ion erosion of the molybdenum accelerator electrode in ion thrusters. This real-time, nonintrusive method was implemented by operating a 30cm-diam ring-cusp thruster using xenon propellant. With the thruster operating at a total power of 5 kW, laser radiation at a wavelength of 390 nm (corresponding to a ground state atomic transition of molybdenum) was directed through the extracted ion beam adjacent to the downstream surface of the molybdenum accelerator electrode. Molybdenum atoms, sputtered from this surface as a result of charge-exchange ion erosion, were excited by the laser radiation. The intensity of the laser-induced fluorescence radiation, which is proportional to the sputter rate of the molybdenum atoms, was measured and correlated with variations in thruster operating conditions such as accelerator electrode voltage, accelerator electrode current, and test facility background pressure. We also demonstrated that the LIF technique has sufficient sensitivity and spatial resolution to evaluate accelerator electrode lifetime in ground-based test facilities.

  6. Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2.

    PubMed

    Ten Have, Margreet; Verheul, Roel; Kaasenbrood, Ad; van Dorsselaer, Saskia; Tuithof, Marlous; Kleinjan, Marloes; de Graaf, Ron

    2016-07-19

    Despite increasing knowledge of the prevalence of borderline personality disorder (BPD) in the general population, and rising awareness of mental disorders both as a categorical and a dimensional construct, research is still lacking on the prevalence of the number of BPD symptoms and their associated consequences, such as comorbidity, disability, and the use of mental health services) in the general population. Data were obtained from the second wave of the Netherlands Mental Health Survey and Incidence Study-2 (N = 5303), a nationally representative face-to-face survey of the general population. BPD symptoms were measured by means of questions from the International Personality Disorder Examination. Comorbidity of common mental disorders was assessed with the Composite International Diagnostic Interview version 3.0. Of the total population studied, 69.9 % reported no BPD symptoms, while 25.2 % had 1-2 symptoms, 3.8 % had 3-4 symptoms, and 1.1 % had ≥ 5 BPD symptoms. The number of BPD symptoms reported was found to be positively associated with not living with a partner, having no paid job, and/or having a comorbid mood, anxiety or substance use disorder. Even after adjustment for sociodemographic characteristics and comorbidity, the number of BPD symptoms turned out to be uniquely associated with disability. It also showed a positive relationship with using services for dealing with mental health problems, although this relationship was strongly affected by the presence of comorbid disorders. Because even a relatively low number of BPD symptoms appears to be associated with psychiatric comorbidity and functional disability, not only full-blown BPD but also subthreshold levels of BPD symptoms need to be identified in clinical practice and research.

  7. Recorded gonorrhoea rates in Denmark, 1900–2010: the impact of clinical testing activity and laboratory diagnostic procedures

    PubMed Central

    Lind, Inga; Hoffmann, Steen

    2015-01-01

    Objectives Assessment of the relations between recorded gonorrhoea rates and clinical testing activity and disposable diagnostic tests. Methods In Denmark, two sources of information on the epidemiology of gonorrhoea are available: (1) a mandatory clinical notification system (since 1867) comprising summary information about geographic distribution, season, age group and gender; in 1994, more detailed anonymous individualised epidemiological information was included; (2) a voluntary countrywide laboratory surveillance system for culture-confirmed cases (since 1957) comprising information about patient's age and gender, infected anatomical sites and medical setting attended. Results Both surveillance systems showed marked simultaneous changes in gonorrhoea rates, although periodically considerable under-reporting or under-diagnosing was demonstrated. The annual incidence of notified cases peaked in 1919 (474/100 000), in 1944 (583/100 000) and in 1972 (344/100 000). Since 1995, the incidence has been at a low endemic level (1.5–10/100 000) and the total male/female incidence ratios were from 3 to 7 times higher than previously recorded. Among approximately 2 million persons tested during 1974–1988 78 213 men and 63 143 women with culture-confirmed gonorrhoea were identified. During this period, pharyngeal sampling was performed in 36% of men and 25% of women with gonorrhoea; pharyngeal gonorrhoea was found in 10% and 16%, respectively; 40% and 30% of these patients had no concomitant urogenital gonorrhoea. Among men with gonorrhoea, 34% were sampled from the rectum; 9% had rectal gonorrhoea, among whom the rectum was the only infected site in 67%. Conclusions Crucial factors for case finding are clinical sampling tradition and appropriate laboratory diagnostic facilities. When case finding is insufficient, a reservoir of asymptomatic rectal or pharyngeal gonorrhoea remains unrecognised. PMID:26621510

  8. Assessment of the construct validity of the Australian Health Star Rating: a nutrient profiling diagnostic accuracy study.

    PubMed

    Cooper, S L; Pelly, F E; Lowe, J B

    2017-03-15

    Nutrient profiling models classify the healthiness of foods based on their nutritional composition and provide the science that underlies nutrition signposting schemes. The two objectives were to examine the construct validity of the Health Star Rating (HSR) system by determining its diagnostic accuracy and to detect the optimal HSR cutoff points to define healthiness in packaged dairy foods. We hypothesised that ultra-processed dairy, defined by NOVA, would have less stars (less healthy) and non-ultra-processed dairy would have more stars (more healthy). The diagnostic accuracy of the HSR system used for 621 dairy foods for sale in an Australian regional supermarket was investigated. The healthiness of packaged dairy was measured using the NOVA food classification system. The dairy beverages model was found to discriminate between healthy and less healthy dairy beverages as classified by NOVA (AUC: 0.653; 95% CI: 0.556-0.750; P=0.005). A receiver operating characteristic curve analysis for dairy beverages demonstrated that the optimal cutoff point corresponded to a rating of four stars. There was no discrimination power when using the HSR for predicting the health value of yoghurt and other dairy, or cheeses. At the optimal cutoff point of four stars the HSR has a high sensitivity but a low specificity to correctly classify healthy packaged dairy beverages, as defined by NOVA. We provide evidence to support the construct validity of the HSR model for dairy beverages, but not for the models used for yoghurts and other dairy products, or cheeses.European Journal of Clinical Nutrition advance online publication, 15 March 2017; doi:10.1038/ejcn.2017.23.

  9. Diagnostic imaging rates for head injury in the ED and states' medical malpractice tort reforms.

    PubMed

    Smith-Bindman, Rebecca; McCulloch, Charles E; Ding, Alexander; Ding, Alex; Quale, Christopher; Chu, Philip W

    2011-07-01

    Physicians' fears of being sued may lead to defensive medical practices, such as ordering nonindicated medical imaging. We investigated the association between states' medical malpractice tort reforms and neurologic imaging rates for patients seen in the emergency department with mild head trauma. We assessed neurologic imaging among a national sample of 8588 women residing in 10 US states evaluated in an emergency setting for head injury between January 1, 1992, and December 31, 2001. We assessed the odds of imaging as it varied by the enactment of medical liability reform laws. The medical liability reform laws were significantly associated with the likelihood of imaging. States with laws that limited monetary damages (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.40-0.99), mandated periodic award payments (OR, 0.64; 95% CI, 0.43-0.97), or specified collateral source offset rules (OR, 0.62; 95% CI, 0.40-0.96) had an approximately 40% lower odds of imaging, whereas states that had laws that limited attorney's contingency fees had significantly higher odds of imaging (OR, 1.5; 95% CI, 0.99-2.4), compared to states without these laws. When we used a summation of the number of laws in place, the greater the number of laws, the lower the odds of imaging. In the multivariate analysis, after adjusting for individual and community factors, the total number of laws remained significantly associated with the odds of imaging, and the effect of the individual laws was attenuated, but not eliminated. The tort reforms we examined were associated with the propensity to obtain neurologic imaging. If these results are confirmed in larger studies, tort reform might mitigate defensive medical practices. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Sialendoscopy – a diagnostic and therapeutic approach subjectively rated by patients

    PubMed Central

    Wierzbicka, Małgorzata; Piskadło, Karolina; Bednarek, Mateusz; Szyfter, Witold

    2014-01-01

    Introduction Sialendoscopy is a miniinvasive procedure which shows the excretory ducts of the salivary glands. Aim To evaluate patient satisfaction with sialendoscopy in submandibular and parotid gland sialolithiasis. Material and methods The study group included 100 consecutive patients with sialolithiasis, treated by means of sialendoscopy. The analysis was designed prospectively. The patients answered closed questions of our own, in-house made questionnaire. Results The number of sialendoscopic procedures necessary for symptom resolution ranged from 1 to 3. The mean value was 1.2 and the median was 1. In 64 patients (64%) one procedure was sufficient for symptom resolution, while 10 (10%) and 8 (8%) patients required 2 and even 3 procedures, respectively. Sixty-three patients (63%) did not report any postoperative complications; 33 patients (33%) reported transient swelling of the submandibular region and 4 patients (4%) reported inflammation of the salivary gland. The level of treatment efficacy was 82%. Among 53 patients treated using sialendoscopy for the first time 92.3% rated this approach subjectively as a very good or good technique, whereas among 47 patients who had previously undergone non-endoscopic treatment, this percentage increased to 96.4%. The general level of satisfaction with the applied method did not depend on the age, gender, duration of ailments, the number of previously performed procedures or the number of sialendoscopic procedures necessary to obtain improvement and postoperative complications. Conclusions Sialendoscopy may be performed practically in any case without risking the patient's discomfort or unpleasant experience. Assessment of sialendoscopy by the patients confirmed the minimally invasive character of this technique. PMID:25561986

  11. Prevalence rates of hypertension self-care activities among African Americans.

    PubMed

    Warren-Findlow, Jan; Seymour, Rachel B

    2011-06-01

    A comprehensive understanding of the self-care activities that contribute to blood pressure control may explain health disparities experienced by African Americans with hypertension. This study assessed the prevalence of self-care activities among African Americans with high blood pressure and examined differences between adherers and nonadherers to self-care activities. Interviews were conducted with 186 African Americans. Self-care activities were measured using the H-SCALE (Hypertension Self-Care Activity Level Effects), which was developed to assess the behavioral activities recommended for optimal management of high blood pressure. More than half of participants reported adhering to medication recommendations and prescribed physical activity levels (58.6% and 52.2%, respectively). Following practices related to weight management was less frequent, (30.1%) and adherence to low-salt diet recommendations was also low (22.0%). Three-fourths were nonsmokers and 65% abstained from alcohol. Across the self-care activities, adherers were more likely to be older and female. Nonadherers were more likely to be uninsured. Many African Americans still face challenges related to hypertension self-care, particularly with weight management and salt reduction. The H-SCALE was a valid and reliable measure of hypertension self-care activities. In addition to monitoring blood pressure, health care providers should assess patients' hypertension self-care activities using the H-SCALE.

  12. Case-mix adjustment approach to benchmarking prevalence rates of nosocomial infection in hospitals in Cyprus and Greece.

    PubMed

    Kritsotakis, Evangelos I; Dimitriadis, Ioannis; Roumbelaki, Maria; Vounou, Emelia; Kontou, Maria; Papakyriakou, Panikos; Koliou-Mazeri, Maria; Varthalitis, Ioannis; Vrouchos, George; Troulakis, George; Gikas, Achilleas

    2008-08-01

    To examine the effect of heterogeneous case mix for a benchmarking analysis and interhospital comparison of the prevalence rates of nosocomial infection. Cross-sectional survey. Eleven hospitals located in Cyprus and in the region of Crete in Greece. The survey included all inpatients in the medical, surgical, pediatric, and gynecology-obstetrics wards, as well as those in intensive care units. Centers for Disease Control and Prevention criteria were used to define nosocomial infection. The information collected for all patients included demographic characteristics, primary admission diagnosis, Karnofsky functional status index, Charlson comorbidity index, McCabe-Jackson severity of illness classification, use of antibiotics, and prior exposures to medical and surgical risk factors. Outcome data were also recorded for all patients. Case mix-adjusted rates were calculated by using a multivariate logistic regression model for nosocomial infection risk and an indirect standardization method.Results. The overall prevalence rate of nosocomial infection was 7.0% (95% confidence interval, 5.9%-8.3%) among 1,832 screened patients. Significant variation in nosocomial infection rates was observed across hospitals (range, 2.2%-9.6%). Logistic regression analysis indicated that the mean predicted risk of nosocomial infection across hospitals ranged from 3.7% to 10.3%, suggesting considerable variation in patient risk. Case mix-adjusted rates ranged from 2.6% to 12.4%, and the relative ranking of hospitals was affected by case-mix adjustment in 8 cases (72.8%). Nosocomial infection was significantly and independently associated with mortality (adjusted odds ratio, 3.6 [95% confidence interval, 2.1-6.1]). The first attempt to rank the risk of nosocomial infection in these regions demonstrated the importance of accounting for heterogeneous case mix before attempting interhospital comparisons.

  13. Trends in the Prevalence Rates and Numbers of Blind and Visually Impaired Schoolchildren.

    ERIC Educational Resources Information Center

    Kirchner, C.

    1990-01-01

    This paper draws on primary and secondary data sources to document an increasing number of visually handicapped children. The paper discusses socioeconomic trends, increased rates of handicapping conditions in general, increased number of legally blind schoolchildren, and evidence of an increase in retinopathy of prematurity. (JDD)

  14. The Prevalent Rate of Problem-Solving Approach in Teaching Mathematics in Ghanaian Basic Schools

    ERIC Educational Resources Information Center

    Nyala, Joseph; Assuah, Charles; Ayebo, Abraham; Tse, Newel

    2016-01-01

    Stakeholders of mathematics education decry the rate at which students' performance are falling below expectation; they call for a shift to practical methods of teaching the subject in Ghanaian basic schools. The study explores the extent to which Ghanaian basic school mathematics teachers use problem-solving approach in their lessons. The…

  15. Prevalence and rates of recognition of anxiety disorders in internal medicine outpatient departments of 23 general hospitals in Shenyang, China.

    PubMed

    Qin, Xiaoxia; Phillips, Michael R; Wang, Wei; Li, Yueling; Jin, Qiu; Ai, Li; Wei, Shengnan; Dong, Guanghui; Liu, Li

    2010-01-01

    Assess the prevalence, risk factors and treating clinicians' rates of recognition of anxiety disorders in internal medicine departments of different types of general hospitals in Shenyang, China. A two-stage screening process using an expanded Chinese version of the 12-item General Health Questionnaire (GHQ) and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID) identified 457 persons 15 years of age or older with current anxiety disorders from among 5312 consecutive attendees at the outpatient internal medicine departments of 23 randomly selected general hospitals. Clinical charts were reviewed to determine whether or not the treating internist had made a diagnosis of anxiety or prescribed anxiolytic medications. The 1-month prevalence of any type of anxiety disorder was 9.8% (95% CI=9.0-10.8%). The prevalences of the three most common disorders: anxiety disorder not otherwise specified, generalized anxiety disorder and anxiety disorder due to a general medical condition, were 6.3% (5.6-7.1%), 2.4% (2.0-2.9%), and 0.6% (0.4-0.8%), respectively. Multivariate logistic regression analysis identified the following independent predictors of having a current anxiety disorder: every being married (OR=3.5, 95% CI=2.3-5.4), prior treatment for psychological problems (3.3, 1.8-6.0), having religious beliefs (1.9, 1.3-2.9), low family income (1.5, 1.2-1.9) and never having attended college (1.3, 1.02-1.8). Among the 402 patients with anxiety disorders for whom the clinical chart was reviewed only 16 (4.0%, CI=2.3-6.3%) were diagnosed with an anxiety condition or treated with anxiolytic medications. The prevalence of anxiety in internal medicine outpatients in urban China is lower than that reported in most western countries and the profile of risk factors is somewhat different. The very low rate of recognition of these disorders by internists is related both to the low rates of care-seeking for psychological problems in the general population and to the

  16. Prevalence of gestational diabetes mellitus based on various screening strategies in western Kenya: a prospective comparison of point of care diagnostic methods.

    PubMed

    Pastakia, Sonak D; Njuguna, Benson; Onyango, Beryl Ajwang'; Washington, Sierra; Christoffersen-Deb, Astrid; Kosgei, Wycliffe K; Saravanan, Ponnusamy

    2017-07-14

    Early diagnosis of gestational diabetes mellitus (GDM) is crucial to prevent short term delivery risks and long term effects such as cardiovascular and metabolic diseases in the mother and infant. Diagnosing GDM in Sub-Saharan Africa (SSA) however, remains sub-optimal due to associated logistical and cost barriers for resource-constrained populations. A cost-effective strategy to screen for GDM in such settings are therefore urgently required. We conducted this study to determine the prevalence of gestational diabetes mellitus (GDM) and assess utility of various GDM point of care (POC) screening strategies in a resource-constrained setting. Eligible women aged ≥18 years, and between 24 and 32 weeks of a singleton pregnancy, prospectively underwent testing over two days. On day 1, a POC 1-h 50 g glucose challenge test (GCT) and a POC glycated hemoglobin (HbA1c) was assessed. On day 2, fasting blood glucose, 1-h and 2-h 75 g oral glucose tolerance test (OGTT) were determined using both venous and POC tests, along with a venous HbA1c. The International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria was used to diagnose GDM. GDM prevalence was reported with 95% confidence interval (CI). Specificity, sensitivity, positive predictive value, and negative predictive value of the various POC testing strategies were determined using IADPSG testing as the standard reference. Six hundred-sixteen eligible women completed testing procedures. GDM was diagnosed in 18 women, a prevalence of 2.9% (95% CI, 1.57% - 4.23%). Compared to IADPSG testing, POC IADPSG had a sensitivity and specificity of 55.6% and 90.6% respectively while that of POC 1-h 50 g GCT (using a diagnostic cut-off of ≥7.2 mmol/L [129.6 mg/dL]) was 55.6% and 63.9%. All other POC tests assessed showed poor sensitivity. POC screening strategies though feasible, showed poor sensitivity for GDM detection in our resource-constrained population of low GDM prevalence. Studies to identify

  17. The impact of urbanization and population density on childhood Plasmodium falciparum parasite prevalence rates in Africa.

    PubMed

    Kabaria, Caroline W; Gilbert, Marius; Noor, Abdisalan M; Snow, Robert W; Linard, Catherine

    2017-01-26

    Although malaria has been traditionally regarded as less of a problem in urban areas compared to neighbouring rural areas, the risk of malaria infection continues to exist in densely populated, urban areas of Africa. Despite the recognition that urbanization influences the epidemiology of malaria, there is little consensus on urbanization relevant for malaria parasite mapping. Previous studies examining the relationship between urbanization and malaria transmission have used products defining urbanization at global/continental scales developed in the early 2000s, that overestimate actual urban extents while the population estimates are over 15 years old and estimated at administrative unit level. This study sought to discriminate an urbanization definition that is most relevant for malaria parasite mapping using individual level malaria infection data obtained from nationally representative household-based surveys. Boosted regression tree (BRT) modelling was used to determine the effect of urbanization on malaria transmission and if this effect varied with urbanization definition. In addition, the most recent high resolution population distribution data was used to determine whether population density had significant effect on malaria parasite prevalence and if so, could population density replace urban classifications in modelling malaria transmission patterns. The risk of malaria infection was shown to decline from rural areas through peri-urban settlements to urban central areas. Population density was found to be an important predictor of malaria risk. The final boosted regression trees (BRT) model with urbanization and population density gave the best model fit (Tukey test p value <0.05) compared to the models with urbanization only. Given the challenges in uniformly classifying urban areas across different countries, population density provides a reliable metric to adjust for the patterns of malaria risk in densely populated urban areas. Future malaria risk

  18. Changing trends in sex specific prevalence rates for childhood asthma, eczema, and hay fever.

    PubMed

    Osman, Mustafa; Tagiyeva, Nara; Wassall, Heather J; Ninan, Titus K; Devenny, Anne M; McNeill, Geraldine; Helms, Peter J; Russell, George

    2007-01-01

    Numerous surveys of school-aged children have shown increasing asthma prevalence with a less publicized but noticeable change in the male to female ratio. We sought to confirm this change in the sex ratio in four questionnaire-based surveys and investigate possible explanations. Identical questionnaire surveys were performed in 1989 (n=3,390), 1994 (n=4,047), 1999 (n=3,540) and 2004 (n=1,920) in school-children aged 9-11 years. Over these 15 years the male to female ratio (M:F) significantly narrowed for wheeze (1.34 to 0.98:1 P < 0.0002), for asthma (1.74 to 1.02:1 P < 0.0001), for eczema (1.42:1 to 0.81:1 P < 0.0001) and for hay fever (1.46 to 0.93:1 P < 0.0001). The diagnosis of asthma in children with wheeze was more commonly made in boys in 1989 relative risk RR 1.32 (1.12, 1.56), even in those with accompanying eczema and/or hay fever RR 1.20 (0.99, 1.45). By 2004 this sex bias in diagnosis was no longer present, RR 1.01 (0.91, 1.12) for wheeze and 1.02 (0.85, 1.21) for those with wheeze and eczema and/or hay fever. From 1989 to 2004 no significant difference in sex distribution changes between older and younger children occurred, making secular trends in the onset of puberty in females an unlikely contributory factor. The disappearance of the bias to diagnose asthma in symptomatic males but not in females may be partly responsible for the narrowing of the sex ratio, but other factors such as those enhancing the expression of asthma and atopy in females may also be implicated.

  19. Comparative analysis of diagnostic adequacy rate between aspiration and nonaspiration techniques of fine-needle cytology in patients with thyroid cancer and ultrasonographically suspicious cervical lymph nodes.

    PubMed

    Aydin, Cevdet; Dellal, Fatma Dilek; Tam, Abbas Ali; Ogmen, Berna; Kilicarslan, Aydan; Topaloglu, Oya; Ersoy, Reyhan; Cakir, Bekir

    2017-10-01

    We aimed to compare nonaspiration (NAS) and aspiration (AS) techniques in the evaluation of fine-needle cytology of lymph node (FNC-LN) in terms of diagnostic adequacy of cytologic material. One hundred and twenty-three superficial cervical LNs in 75 patients who underwent NAS and AS-FNC-LN in the same visit were evaluated. Cytological results were categorized as diagnostic and nondiagnostic. The rates of malignancy were 13.8% in AS versus 16.3% in NAS technique, whereas nondiagnostic cytology was detected in 43.1% and 25.2%, respectively (P = .549 and P < .01). The diagnostic adequacy rate in NAS-FNC-LN was significantly higher than AS-FNC-LN. However, NAS technique seems to be more simple and comfortable. We suggest both NAS and AS-FNC-LN in cytologic evaluation of suspicious cervical LNs until the diagnostic accuracy is determined with prospective studies. © 2017 Wiley Periodicals, Inc.

  20. Impact of using DSM-5 criteria for diagnosing binge eating disorder in bariatric surgery candidates: change in prevalence rate, demographic characteristics, and scores on the Minnesota Multiphasic Personality Inventory--2 restructured form (MMPI-2-RF).

    PubMed

    Marek, Ryan J; Ben-Porath, Yossef S; Ashton, Kathleen; Heinberg, Leslie J

    2014-07-01

    Binge eating disorder (BED) was recently included in the DSM-5. The prevalence rate for BED using the DSM-IV-TR research criteria tends to be higher in bariatric surgery candidates than the normative population; however, no studies have examined how many more bariatric surgery candidates will meet the new, less conservative criteria of DSM-5. We explore the current BED prevalence rate change in a sample of bariatric surgery candidates. Data were obtained for 1,283 bariatric surgery candidates. 84 men and 213 women were diagnosed with current BED using DSM-IV-TR research criteria. A semi-structured interview, the binge eating scale (BES), and a Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) were given to every patient as part of standard procedures mandated by the facility. An additional 3.43% (p < .001) of bariatric surgery candidates met the diagnostic threshold for BED when using DSM-5 criteria. These individuals were demographical similar and produced similar MMPI-2-RF and BES scores when compared with patients who met DSM-IV-TR criteria for BED. Thus, the current investigation indicates that individuals meeting BED criteria based on DSM-5 are similar to those meeting the more conservative diagnostic threshold outlined in DSM-IV-TR in a sample of bariatric surgery candidates. © 2014 Wiley Periodicals, Inc.

  1. Examining the prevalence rate of Pediculus capitis infestation according to sex and social factors in primary school children

    PubMed Central

    Doroodgar, Abbas; Sadr, Fakhraddin; Doroodgar, Masoud; Doroodgar, Moein; Sayyah, Mansour

    2014-01-01

    Objective To determine the prevalence rate of head louse infestation among elementary students, and examine the associated factors with infection in the city of Aran and Bidgol. Methods A total of 19 boys' and girls' primary schools were selected by multistage, systematic random sampling. Overall, 3 590 students were examined for head lice infestation in urban areas of Aran and Bidgol during 2008. The diagnosis was based on live louse or nit on the scalp of students. The students were screened by standard questionnaire and demographic data in addition to related information were obtained by interview and observation. The data were analyzed by SPSS software using chi-square and Fisher's exact tests. Results The mean age of students was (8.68±1.58) years ranging between 6-12 years. The total prevalence of head louse infestation was 0.47%. This rate was 0.42% and 0.05% in female and male, respectively. There was a significant association between pediculosis and sex, father's job, mother's education, access to bathroom in home, prior infection, drug use and nationality, respectively (P<0.05). Conclusions The results showed that pediculosis was not a major health priority among primary school in city of Aran and Bidgol. However, enhancing the knowledge of students about head lice infestation and the existence of health teachers in schools can play a significant role in disease control.

  2. CONTINUOUS MID-INFRARED STAR FORMATION RATE INDICATORS: DIAGNOSTICS FOR 0 < z < 3 STAR-FORMING GALAXIES

    SciTech Connect

    Battisti, A. J.; Calzetti, D.; Johnson, B. D.; Elbaz, D.

    2015-02-20

    We present continuous, monochromatic star formation rate (SFR) indicators over the mid-infrared wavelength range of 6–70 μm. We use a sample of 58 star-forming galaxies (SFGs) in the Spitzer–SDSS–GALEX Spectroscopic Survey at z < 0.2, for which there is a rich suite of multi-wavelength photometry and spectroscopy from the ultraviolet through to the infrared. The data from the Spitzer Infrared Spectrograph (IRS) of these galaxies, which spans 5–40 μm, is anchored to their photometric counterparts. The spectral region between 40–70 μm is interpolated using dust model fits to the IRS spectrum and Spitzer 70 and 160 μm photometry. Since there are no sharp spectral features in this region, we expect these interpolations to be robust. This spectral range is calibrated as a SFR diagnostic using several reference SFR indicators to mitigate potential bias. Our band-specific continuous SFR indicators are found to be consistent with monochromatic calibrations in the local universe, as derived from Spitzer, WISE, and Herschel photometry. Our local composite template and continuous SFR diagnostics are made available for public use through the NASA/IPAC Infrared Science Archive (IRSA) and have typical dispersions of 30% or less. We discuss the validity and range of applicability for our SFR indicators in the context of unveiling the formation and evolution of galaxies. Additionally, in the era of the James Webb Space Telescope this will become a flexible tool, applicable to any SFG up to z ∼ 3.

  3. Prevalence and rates of recognition of depressive disorders in internal medicine outpatient departments of 23 general hospitals in Shenyang, China.

    PubMed

    Qin, Xiaoxia; Wang, Wei; Jin, Qiu; Ai, Li; Li, Yueling; Dong, Guanghui; Liu, Li; Phillips, Michael R

    2008-09-01

    One important approach to increasing recognition and treatment rates for depression in urban China is to identify persons with depression who have contact with primary health care services, most of which are provided in the outpatient departments of general hospitals. We aim to assess the prevalence, risk factors and rates of recognition of depressive disorders in internal medicine outpatient departments of general hospitals. Outpatients with depression among 5312 consecutive attendees at outpatient internal medicine departments of 23 randomly selected general hospitals in Shenyang are identified by a two-stage screening process using the General Health Questionnaire and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Charts of subjects with DSM-IV depressive disorders are reviewed to determine if treating clinicians made a diagnosis of depression or prescribed anti-depressant medications. The current prevalence of any type of depressive disorder was 11.0% (95% CI: 10.1%-12.1%); and those of major depressive disorder, dysthymia, and depression not otherwise specified were 3.6% (3.1%-4.2%), 2.8% (2.4%-3.4%), and 4.1% (3.5%-4.8%) respectively. Only 4.0% (2.5%-6.1%) of the depressed patients were identified by the treating clinician and only 3.0% (1.6%-4.9%) were provided with antidepressant medication. Older age, female gender, reporting religious beliefs, low educational level, low income level and widowhood were independently associated with the occurrence of depression. The prevalence of depression in primary care settings in urban China is lower than that reported in most western countries but the risk factors for depression are similar. The very low rates of recognition and treatment are related both to the low rates of care seeking for psychological problems and to the high-volume collective model of hospital-based primary care delivery. Increasing the recognition and treatment of depression in Chinese general hospitals will require changing

  4. A Survey of Inhalant Use Disorders among Delinquent Youth: Prevalence, Clinical Features, and Latent Structure of DSM-IV Diagnostic Criteria

    PubMed Central

    Howard, Matthew O; Perron, Brian E

    2009-01-01

    Background Inhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth. Methods Cross-sectional survey conducted in 2003. Of 740 youth residing in Missouri State Division of Youth Services' (MDYS) residential treatment facilities at the time the study was conducted, 723 (97.7%) completed interviews. Eighty-seven percent were male, with a mean age of 15.5 (SD = 1.2). Nearly 4 in 10 youth (38.5%; n = 279) reported lifetime inhalant use. Youth ranged from very mildly to severely antisocial. Results Of 279 inhalant users, 52 (18.6%) met DSM-IV inhalant abuse criteria and 79 (28.3%) met inhalant dependence criteria. Five of 10 IUD criteria were met by > 10% of the total sample. Latent class analyses demonstrated a substantial concordance between DSM-IV-defined IUDs and an empirically-derived classification based on responses to DSM-IV IUD diagnostic criteria. Conclusion IUDs and constituent criteria were prevalent among youth in the juvenile justice system. Two groups of problem inhalant users were identified, symptomatic users-DSM-IV inhalant abuse and highly symptomatic users-DSM-IV inhalant dependence, which differed primarily in severity of inhalant-related problems. Inhalant screening, prevention and treatment efforts in juvenile justice settings are rarely delivered, but critically needed. PMID:19267939

  5. A survey of inhalant use disorders among delinquent youth: prevalence, clinical features, and latent structure of DSM-IV diagnostic criteria.

    PubMed

    Howard, Matthew O; Perron, Brian E

    2009-03-08

    Inhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth. Cross-sectional survey conducted in 2003. Of 740 youth residing in Missouri State Division of Youth Services' (MDYS) residential treatment facilities at the time the study was conducted, 723 (97.7%) completed interviews. Eighty-seven percent were male, with a mean age of 15.5 (SD = 1.2). Nearly 4 in 10 youth (38.5%; n = 279) reported lifetime inhalant use. Youth ranged from very mildly to severely antisocial. Of 279 inhalant users, 52 (18.6%) met DSM-IV inhalant abuse criteria and 79 (28.3%) met inhalant dependence criteria. Five of 10 IUD criteria were met by > 10% of the total sample. Latent class analyses demonstrated a substantial concordance between DSM-IV-defined IUDs and an empirically-derived classification based on responses to DSM-IV IUD diagnostic criteria. IUDs and constituent criteria were prevalent among youth in the juvenile justice system. Two groups of problem inhalant users were identified, symptomatic users-DSM-IV inhalant abuse and highly symptomatic users-DSM-IV inhalant dependence, which differed primarily in severity of inhalant-related problems. Inhalant screening, prevention and treatment efforts in juvenile justice settings are rarely delivered, but critically needed.

  6. Acute stress disorder and the transition to post-traumatic stress disorder in children and adolescents: prevalence, course, prognosis, diagnostic suitability and risk markers

    PubMed Central

    Meiser-Stedman, Richard; McKinnon, Anna; Dixon, Clare; Boyle, Adrian; Smith, Patrick; Dalgleish, Tim

    2017-01-01

    Background Early recovery from trauma exposure in youth is poorly understood. This prospective longitudinal study examined the early course of traumatic stress responses in recently trauma-exposed youth; evaluated the revised DSM-5 acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) diagnoses and alternative diagnoses; and identifed risk factors for persistent traumatic stress. Method Participants were 8-17 year old Emergency Departments attendees exposed to single incident traumas. Structured clinical interviews were undertaken at two (n=226) and nine weeks (n=208) post-trauma. Results Using the revised criteria in DSM-5, 14.2% met criteria for ASD at week 2 and 9.6% met criteria for PTSD at 9 weeks. These prevalences were similar to the corresponding DSM-IV diagnoses (18.6% ASD at week two; 8.7% PTSD at week nine). Using the same diagnostic criteria (DSM-IV or DSM-5) across assessments (i.e. ‘2 week PTSD’) suggested that caseness declined in prevalence by approximately half. Overlap between DSM-IV and DSM-5 ASD and DSM-5 preschool child PTSD diagnoses was considerable. Two diagnoses were strongly predictive of corresponding week nine diagnoses. Youth with ASD who subsequently had PTSD reported more negative alterations in cognition and mood at two-weeks than those youth who did not develop PTSD. Conclusions Youth exposed to single-event traumas experience considerable natural recovery in the first months post-trauma. Using DSM-5 criteria, ASD may not capture all clinically significant traumatic stress in the acute phase and is only moderately sensitive for later PTSD. Future research needs to address the role and etiology of negative alterations in cognition and mood symptoms. PMID:28135019

  7. Prevalence of Temporomandibular Disorders in an Adult Brazilian Community Population Using the Research Diagnostic Criteria (Axes I and II) for Temporomandibular Disorders (The Maringá Study).

    PubMed

    Progiante, Patrícia Saram; Pattussi, Marcos Pascoal; Lawrence, Herenia P; Goya, Suzana; Grossi, Patrícia Krieger; Grossi, Márcio Lima

    2015-01-01

    The primary objective of this study was to assess the prevalence of temporomandibular disorders (TMDs) and comorbid factors (sleep bruxism and headaches). This study was a cross-sectional population survey in the city of Maringá, state of Paraná, Brazil. Axes I and II of the Research Diagnostic Criteria for TMD (RDC/TMD) were used for assessment of TMD signs and symptoms. The population was users of the Brazilian public health system (SUS), of both sexes, between the ages of 20 and 65 years, and not seeking treatment for TMD. The selected population (N = 1,643) was composed mostly of (a) women (65.9%), (b) married or single individuals (90.6%), (c) Caucasians (70.1%), (d) individuals aged 32.7 ± 10.3 years, (e) individuals earning a medium income (75.1%), and (f) those who had completed a high school education or higher (79.9%). According to the chronic pain grade classification (CPG) in the RDC/TMD Axis II, 36.2% of the population had some degree of TMD pain (CPG I to IV); however, only 5.1% had severe limitation due to pain (CPG III or IV). In the RDC/TMD Axis I diagnoses, 29.5% presented with muscle disorders (group I), 7.9% with disk displacements (group II), and 39.1% with other joint disorders (group III). Headaches were present in 67.9% and awake and sleep bruxism in 30% and 33.4% of the population, respectively. The prevalence of signs and symptoms of TMD was high in this population, but with low disability; however, the proportion of patients in need of treatment was much lower.

  8. Very high childhood obesity prevalence and low adherence rates to the Mediterranean diet in Greek children: the GRECO study.

    PubMed

    Farajian, Paul; Risvas, Grigoris; Karasouli, Konstantina; Pounis, Georgios D; Kastorini, Christina M; Panagiotakos, Demosthenes B; Zampelas, Antonis

    2011-08-01

    In order to provide estimates of overweight and obesity among Greek schoolchildren, and the adherence rates to the Mediterranean diet (MD), a nationwide survey was performed among fifth and sixth grade students aged 10-12 years old. A stratified sampling in 10 regions of the country was applied to voluntarily enroll a representative sample of 4786 children. Children were weighed and measured and completed a semi-quantitative food frequency questionnaire with a supplementary section for the assessment of dietary aspects and physical activity levels. Additionally, the KIDMED index was used to evaluate the degree of adherence to the MD. According to the IOTF cut-offs, overweight (OW) and obesity (OB) prevalence among boys was 29.9% and 12.9%, while in girls 29.2% and 10.6%, respectively. Only 4.3% of the children had an optimal KIDMED score. KIDMED score did not differ between boys and girls and no differences were detected between normal weight and OW and OB children. However, children from semi-urban or rural regions had higher score. Furthermore, children with higher KIDMED score reported following a healthier diet and having higher physical activity levels. The prevalence of childhood obesity in Greece is the highest ever reported together with low adherence rates to the dietary patterns of the MD. Current findings suggest an increased risk for even higher rates of obesity in adolescence and adulthood in the near future. Taking into account that children are also abandoning the traditional cardio-protective MD, the increased risk for future adverse health consequences seems evident. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. Gender differences in drunk driving prevalence rates and trends: a 20-year assessment using multiple sources of evidence.

    PubMed

    Schwartz, Jennifer

    2008-09-01

    This research tracked women's and men's drunk driving rates and the DUI sex ratio in the United States from 1982-2004 using three diverse sources of evidence. Sex-specific prevalence estimates and the sex ratio are derived from official arrest statistics from the Federal Bureau of Investigation, self-reports from the Centers for Disease Control and Prevention, and traffic fatality data from the National Highway and Transportation Safety Administration. Drunk driving trends were analyzed using Augmented Dickey Fuller time series techniques. Female DUI arrest rates increased whereas male rates declined then stabilized, producing a significantly narrower sex ratio. According to self-report and traffic data, women's and men's drunk driving rates declined and the gender gap was unchanged. Women's overrepresentation in arrests relative to their share of offending began in the 1990s and accelerated in 2000. Women's arrest gains, contrasted with no systematic change in DUI behavior, and the timing of this shift suggest an increased vulnerability to arrest. More stringent laws and enforcement directed at less intoxicated offenders may inadvertently target female offending patterns.

  10. Self-rated chronic conditions and 2-week prevalence in adults in Zhongshan, China: an epidemiological survey

    PubMed Central

    Zhu, Chunyan; Sun, Xiaomin; Geng, Qingshan; Fu, Rong; Yang, Hongling; Jiang, Wei

    2015-01-01

    Objective To examine the association between behavioural factors and the risk of chronic conditions and 2-week prevalence. Design This was a cross-sectional survey. Setting The study was conducted in Zhongshan, China. Participants A multistage clustering sampling method was used to select a representative sample of residents from the household registration system between July and September 2011. The overall sample replacement rate was 9.4%, and the final sample included 43 028 individuals. Outcome measures Chronic conditions and 2-week prevalence. Results 4979 (11.6%) of the participants reported having at least one chronic condition, 1067 (2.5%) had two or more concurrent chronic conditions, and 6830 (15.9%) reported having at least one disease in a 2-week recall period. The most common chronic condition was primary hypertension, which was reported by 6.8% of participants. Logistic regression models demonstrated that the main factors for having a chronic condition and 2-week prevalence were older age (≥65 years of age; OR 44.91, 95% CI 33.05 to 61.03; and OR 12.71, 95% CI 10.44 to 15.46, respectively), obesity (OR 3.00, 95% CI 2.63 to 3.42; and OR 2.50, 95% CI 2.22 to 2.82, respectively) and being a former smoker (OR 3.02, 95% CI 2.54 to 3.58; and OR 3.24, 95% CI 2.74 to 3.82, respectively). Conclusions This study suggests that older age, obesity and unhealthy behaviours are high-risk factors for poorer health status among the residents of Zhongshan, China. The present findings highlight the importance of recognising and managing harmful behaviours in order to improve health. PMID:26560055

  11. The prevalent use of contraception among teenagers in Denmark and the corresponding low pregnancy rate.

    PubMed

    Wielandt, Hanne; Boldsen, Jesper; Knudsen, Lisbeth B

    2002-01-01

    In Denmark the number of births and induced abortions among teenagers has reduced and teenage parenthood is now rare. This paper evaluates the correlation between this observed fertility and reported sexual and contraceptive behaviour. In 1989 a sample of 16-20-year-olds in Denmark was selected at random and personally interviewed about sexual and contraceptive behaviour. Ninety-five per cent of the young women who had experienced sexual intercourse used contraception at the most recent sexual intercourse. In order to support the validity of this finding a model was developed to estimate an expected number of conceptions in the age groups concerned. The model included both the information on coital frequency and use of contraception from the questionnaire and available efficacy rates on contraception. The estimates derived by the model were compared with the registered number of births and induced abortions derived from public registers. The analysis revealed a high accordance between the estimated number of conceptions and the registered number of births and induced abortions for each age group. This underlines the validity of the data on sexual and contraceptive behaviour sampled among teenagers in Denmark. The findings indicate that contraceptive failure is a much greater problem than non-use of contraception for teenagers in Denmark.

  12. Prevalence of hypothyroidism in nondiabetic chronic kidney disease and effect of thyroxine replacement on estimated glomerular filtration rate

    PubMed Central

    Bajaj, S.; Purwar, N.; Gupta, A.; Gupta, P.; Srivastava, A.

    2017-01-01

    Reduced T3 and free T4, elevated thyroid stimulating hormone, and hyporesponsiveness to thyrotropin releasing hormone raise questions about the presence of hypothyroidism in chronic kidney disease (CKD) and raise the possibility of benefit from thyroxine supplementation. A prospective cohort study was conducted on 73 nondiabetic CKD cases. Hypothyroid patients were started on levothyroxine and were reviewed after 3 and 6 months. The mean age of study population was 42.3 ± 16.8 years. Of the total population, 32 (43.8%) cases had hypothyroidism, among whom 2 (2.7%) had overt hypothyroidism and 30 (41.1%) had subclinical hypothyroidism. Prevalence of hypothyroidism increased with increasing severity of CKD. There were 1 (3.1%) case with hypothyroidism in stage 3b, 8 (25%) cases in stage 4, and 23 (71.9%) cases in stage 5. The mean estimated glomerular filtration rate (ml/min/1.73 m2) at baseline was 13.7 ± 8.9 which increased to 17.5 ± 6.8 and 22.4 ± 9.3 after 3 and 6 months of thyroid hormone replacement therapy (THRT), respectively (P < 0.001). Hypothyroidism is commonly associated with nondiabetic CKD and its prevalence increases with declining renal function. THRT significantly improves renal function in nondiabetic CKD with hypothyroidism. PMID:28356660

  13. Long term observation of MRSA prevalence in a German rehabilitation center: risk factors and variability of colonization rate

    PubMed Central

    Gieffers, Jens; Ahuja, André; Giemulla, Ronald

    2016-01-01

    Background: Data on MRSA prevalence in rehabilitation centers are sparse. Methods: We screened more than 18,000 patients with neurological, cardiac/pulmonary or orthopedic diagnoses treated in three German rehabilitation centers and documented potential risk factors in almost 1,500 of them. Results: 2.1% were MRSA positive (CI 1.9%–2.4%). Prevalence was higher in neurologic patients (3.7%) and lower in orthopedic patients (0.9%). While the overall MRSA situation was stable over two years, the weekly MRSA rate fluctuated strongly (0.0% to 8.0%). We confirmed five risk factors in our study population. A risk adapted screening strategy derived from our data had a significance of 74% and a positive predictive value of only 2.2%. Conclusion: MRSA positivity is a rare and highly variable event, requiring a huge sample size to generate robust data. The benefit of a risk-adapted screening strategy over a general screening should be questioned in each individual setting. PMID:27777874

  14. Development and application of a fecal antigen diagnostic sandwich ELISA for estimating prevalence of Fasciola gigantica in cattle in central Java, Indonesia.

    PubMed

    Estuningsih, Endah; Spithill, Terry; Raadsma, Herman; Law, Ruby; Adiwinata, G; Meeusen, Els; Piedrafita, David

    2009-04-01

    The purpose of this study was to compare the sensitivity and specificity of an ELISA test to detect Fasciola gigantica antigens (coproantigens) in bovine feces, with fecal egg counting and an ELISA for detecting anti-F. gigantica antibodies in serum. Monoclonal antibodies to cathepsin L were generated and used to capture this antigen in feces of infected cattle. Blood, feces, and livers were collected from 150 cattle at an abattoir in Jakarta, Indonesia, for anti-Fasciola antibodies, coproantigen detection, and F. gigantica egg and worm counts. Fluke recovery varied from 1 to 426 per host, with a mean of 32 flukes. The results showed that the sensitivity and specificity of coproantigen detecting ELISA (95 and 91%, respectively) was better than the anti-F. gigantica antibody ELISA (91 and 88%, respectively) and to fecal egg counting (87 and 100%, respectively). The coproantigen ELISA was able to detect 100% of the cattle with >15 flukes. A survey of 305 cattle in central Java over a 10-mo period validated this test in the field, demonstrating a high prevalence of fascioliasis and establishing the test as a useful diagnostic method to determine patent F. gigantica infections in cattle.

  15. Clopidogrel use After Myocardial Revascularization: Prevalence, Predictors, and One-Year Survival Rate

    PubMed Central

    Prates, Paulo Roberto L.; Williams, Judson B.; Mehta, Rajendra H.; Stevens, Susanna R.; Thomas, Laine; Smith, Peter K.; Newby, L. Kristin; Kalil, Renato A. K.; Alexander, John H.; Lopes, Renato D.

    2016-01-01

    Introduction Antiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario. Objective Identify predictors of clopidogrel following CABG. Methods We evaluated 5404 patients who underwent CABG between 2000 and 2009 at Duke University Medical Center. We excluded patients undergoing concomitant valve surgery, those who had postoperative bleeding or death before discharge. Postoperative clopidogrel was left to the discretion of the attending physician. Adjusted risk for 1-year mortality was compared between patients receiving and not receiving clopidogrel during hospitalization after undergoing CABG. Results At hospital discharge, 931 (17.2%) patients were receiving clopidogrel. Comparing patients not receiving clopidogrel at discharge, users had more comorbidities, including hyperlipidemia, hypertension, heart failure, peripheral arterial disease and cerebrovascular disease. Patients who received aspirin during hospitalization were less likely to receive clopidogrel at discharge (P≤0.0001). Clopidogrel was associated with similar 1-year mortality compared with those who did not use clopidogrel (4.4% vs. 4.5%, P=0.72). There was, however, an interaction between the use of cardiopulmonary bypass and clopidogrel, with lower 1-year mortality in patients undergoing off-pump CABG who received clopidogrel, but not those undergoing conventional CABG (2.6% vs 5.6%, P Interaction = 0.032). Conclusion Clopidogrel was used in nearly one-fifth of patients after CABG. Its use was not associated with lower mortality after 1 year in general, but lower mortality rate in those undergoing off-pump CABG. Randomized clinical trials are needed to determine the benefit of routine use of clopidogrel in CABG. PMID:27556308

  16. Prevalence of rheumatic regional pain syndromes in Latin-American indigenous groups: a census study based on COPCORD methodology and syndrome-specific diagnostic criteria.

    PubMed

    Alvarez-Nemegyei, José; Peláez-Ballestas, Ingris; Goñi, Mario; Julián-Santiago, Flor; García-García, Conrado; Quintana, Rosana; Silvestre, Adriana M R; García-Olivera, Imelda; Mathern, Nora A; Loyola-Sanchez, Adalberto; Conti, Silvana; Sanabria, Alvaro J; Pons-Estel, Bernardo A

    2016-07-01

    This study assessed the overall and specific prevalence of the main rheumatic regional pain syndromes (RRPS) in four Latin-American indigenous groups. A Community Oriented Program for Control of Rheumatic Diseases (COPCORD) methodology-based census study was performed in 4240 adults (participation rate: 78.88 %) in four indigenous groups: Chontal (Oaxaca, Mexico, n = 124), Mixteco (Oaxaca, Mexico; n = 937), Maya-Yucateco (Yucatán, Mexico; n = 1523), and Qom (Rosario, Argentina; n = 1656). Subjects with musculoskeletal pain were identified using a cross-cultural, validated COPCORD questionnaire administered by bilingual personnel, and reviewed by general practitioners or rheumatologists using standardized case definitions for the 12 most frequent RRPS. The overall prevalence of RRPS was confirmed in 239 cases (5.64 %, 95 % CI: 4.98-6.37). The prevalence in each group was Chontal n = 19 (15.32 %, 95 % CI: 10.03-22.69); Maya-Yucateco n = 165 (10.83 %, 95 % CI: 9.37-12.49); Qom n = 48 (2.90 %, 95 % CI: 2.19-3.82); and Mixteco n = 7 (0.75 %, 95 % CI: 0.36-1.53). In the whole sample, the syndrome-specific prevalence was rotator cuff tendinopathy: 1.98 % (95 % CI: 1.60-2.45); lateral epicondylalgia: 0.83 % (95 % CI: 0.59-1.15); medial epicondylalgia: 0.73 % (95 % CI: 0.52-1.04); biceps tendinopathy: 0.71 % (95 % CI: 0.50-1.01); anserine syndrome: 0.64 % (95 % CI: 0.44-0.92); inferior heel pain: 0.61 % (95 % CI: 0.42-0.90); trochanteric syndrome: 0.49 % (95 % CI: 0.25-0.64); de Quervain's tendinopathy: 0.45 % (95 % CI: 0.29-0.70); trigger finger: 0.42 % (95 % CI: 0.27-0.67); carpal tunnel syndrome: 0.28 % (95 % CI: 0.16-0.49); Achilles tendinopathy (insertional): 0.12 % (95 % CI: 0.05-0.28); and Achilles tendinopathy (non-insertional): 0.07 % (95 % CI: 0.02-0.21). Leaving aside the comparison between Maya-Yucateco and Chontal groups (p = 0.18), we found significant differences (p < 0.001) in

  17. Validation of the Unified Parkinson's Disease Rating Scale (UPDRS) section I as a screening and diagnostic instrument for apathy in patients with Parkinson's disease.

    PubMed

    Pedersen, Kenn Freddy; Larsen, Jan Petter; Aarsland, Dag

    2008-01-01

    We examined the validity of the motivation/initiative item of the Unified Parkinson's Disease Rating Scale (UPDRS) section I as a screening and diagnostic measure for apathy in Parkinson's disease (PD). Fifty-eight patients with PD were evaluated with the UPDRS, the 14-item Apathy Scale (AS), and standardized rating scales of depression and cognitive impairment. Apathy was diagnosed using specific items of the AS together with proposed criteria for apathy. A score of 2 or more on the motivation/initiative item was adequate to screen for apathy, whereas a score of 4 had high diagnostic accuracy at the cost of unacceptable low sensitivity.

  18. Understanding Onychomycosis Resolving Diagnostic Dilemmas.

    PubMed

    Stein Gold, Linda F

    2016-03-01

    No scientifically rigorous, large, prospective studies have been done to document the true prevalence of onychomycosis; the reported rates vary mainly by climate and by population, but the overall prevalence in the United States is estimated to be at least 10%. Advanced age and diabetes are the most commonly reported risk factors for onychomycosis. The differential diagnosis of onychomycosis is lengthy, and visual inspection alone is not sufficient for a definitive diagnosis-direct microscopic examination of a wet-mount preparation with 10% to 20% potassium hydroxide is the first-line diagnostic test.

  19. Avoiding sedation in research MRI and spectroscopy in infants: our approach, success rate and prevalence of incidental findings.

    PubMed

    Gale, Christopher; Jeffries, Suzan; Logan, Karen Mary; Chappell, Karyn E; Uthaya, Sabita N; Modi, Neena

    2013-05-01

    Performing magnetic resonance investigations in a paediatric population can be difficult; image acquisition is commonly complicated by movement artefact and non-compliance. Sedation is widely used for clinically indicated investigations, but there is controversy when used for research imaging. Over a 10-year period we have performed whole body MRI on over 450 infants and hepatic magnetic resonance spectroscopy on over 270 infants. These investigations have been accomplished without the use of sedation in infants up to 3 months of age. Our overall success rate in achieving good quality images free of movement artefact is 94%. The prevalence of incidental findings on whole body (excluding brain) MRI in our cohort was 0.8%. We conclude that the use of sedation for research MRI in this group is not necessary. Our approach to MRI in infancy is also described.

  20. Preliminary data on changes in neural tube defect prevalence rates after folic acid fortification in South America.

    PubMed

    Castilla, Eduardo E; Orioli, Iêda M; Lopez-Camelo, Jorge S; Dutra, Maria da Graça; Nazer-Herrera, Julio

    2003-12-01

    Several South American countries are fortifying wheat flour with folic acid. However, only Chile started in 2000 to add 2.2 mg/kg, providing 360 microg daily per capita, an acceptable dosage for preventing the occurrence of some neural tube defect (NTD) cases. ECLAMC (Spanish acronym for the Latin American Collaborative Study of Congenital Malformations) routinely monitoring birth defects in South America since 1976, surveyed the impact of this fortification. Data from 361,374 births occurred in 43 South American hospitals, distributed in five different countries, active throughout the 1999-2001 triennium, were selected from the ECLAMC network. Birth prevalence rates for three different congenital anomalies with similar expected prevalence rates, were surveyed by the Cumulative Sum Method (CUSUM) method. They were NTD, oral clefts (OC), and Down syndrome (DS). Expected values were derived from observations made in 1999, and CUSUM was applied to the consecutive series of 24 months covering years 2000 and 2001. Only one of three congenital anomaly types, NTDs, in only one of five sampled out countries, Chile, showed a significant decrease, of 31%, during the 2000-2001 biennium, corresponding to the birth of the periconceptionally fortified infants. The level of significance (P < 0.001) was reached in the 20th month after fortification started, corresponding to August 2001. This is the first observation of a significant decrease in the occurrence of NTD after folic acid food fortification in a population little influenced by confounders common in the developed world as pre-existing secular decreasing trends, and partially unregistered induced abortions.

  1. Diagnostic significance of a mild decrease of baroreflex sensitivity with respect to heart rate in type 1 diabetes mellitus.

    PubMed

    Svačinová, J; Honzíková, N; Krtička, A; Tonhajzerová, I; Javorka, K; Javorka, M

    2013-01-01

    Decreased baroreflex sensitivity is an early sign of autonomic dysfunction in patients with type-1 diabetes mellitus. We evaluated the repeatability of a mild baroreflex sensitivity decrease in diabetics with respect to their heart rate. Finger blood pressure was continuously recorded in 14 young diabetics without clinical signs of autonomic dysfunction and in 14 age-matched controls for 42 min. The recordings were divided into 3-min segments, and the mean inter-beat interval (IBI), baroreflex sensitivity in ms/mm Hg (BRS) and mHz/mm Hg (BRSf) were determined in each segment. These values fluctuated in each subject within 42 min and therefore coefficients of repeatability were calculated for all subjects. Diabetics compared with controls had a decreased mean BRS (p=0.05), a tendency to a shortened IBI (p=0.08), and a decreased BRSf (p=0.17). IBI correlated with BRS in diabetics (p=0.03); this correlation was at p=0.12 in the controls. BRSf was IBI independent (controls: p=0.81, diabetics: p=0.29). We conclude that BRS is partially dependent on mean IBI. Thus, BRS reflects not only an impairment of the quick baroreflex responses of IBI to blood pressure changes, but also a change of the tonic sympathetic and parasympathetic heart rate control. This is of significance during mild changes of BRS. Therefore, an examination of the BRSf index is highly recommended, because this examination improves the diagnostic value of the measurement, particularly in cases of early signs of autonomic dysfunction.

  2. Non-invasive vascular radial/circumferential strain imaging and wall shear rate estimation using video images of diagnostic ultrasound.

    PubMed

    Wan, Jinjin; He, Fangli; Zhao, Yongfeng; Zhang, Hongmei; Zhou, Xiaodong; Wan, Mingxi

    2014-03-01

    The aim of this work was to develop a convenient method for radial/circumferential strain imaging and shear rate estimation that could be used as a supplement to the current routine screening for carotid atherosclerosis using video images of diagnostic ultrasound. A reflection model-based correction for gray-scale non-uniform distribution was applied to B-mode video images before strain estimation to improve the accuracy of radial/circumferential strain imaging when applied to vessel transverse cross sections. The incremental and cumulative radial/circumferential strain images can then be calculated based on the displacement field between consecutive B-mode images. Finally, the transverse Doppler spectra acquired at different depths along the vessel diameter were used to construct the spatially matched instantaneous wall shear values in a cardiac cycle. Vessel phantom simulation results revealed that the signal-to-noise ratio and contrast-to-noise ratio of the radial and circumferential strain images were increased by 2.8 and 5.9 dB and by 2.3 and 4.4 dB, respectively, after non-uniform correction. Preliminary results for 17 patients indicated that the accuracy of radial/circumferential strain images was improved in the lateral direction after non-uniform correction. The peak-to-peak value of incremental strain and the maximum cumulative strain for calcified plaques are evidently lower than those for other plaque types, and the echolucent plaques had higher values, on average, than the mixed plaques. Moreover, low oscillating wall shear rate values, found near the plaque and stenosis regions, are closely related to plaque formation. In conclusion, the method described can provide additional valuable results as a supplement to the current routine ultrasound examination for carotid atherosclerosis and, therefore, has significant potential as a feasible screening method for atherosclerosis diagnosis in the future. Copyright © 2014 World Federation for Ultrasound in

  3. Prevalence of hypertension and decreased glomerular filtration rate in obese children: results of a population-based field study.

    PubMed

    Duzova, Ali; Yalçinkaya, Fatos; Baskin, Esra; Bakkaloglu, Aysin; Soylemezoglu, Oguz

    2013-11-01

    Obesity has risen considerably in the Western world and the trend is increasing in non-Western, developing countries, as well. Several school screening studies showed the relation between body mass index and hypertension. In adults, obesity is associated with an increased risk of development and progression of kidney disease. However, data at the epidemiological level are limited, both for children and adults. The aim of this study was to determine the prevalence of obesity and evaluate its association with hypertension and glomerular filtration rate (GFR) among children in Turkey. A population-based field study in which individuals were accessed by house visits throughout Turkey has been conducted. The study sample (3622 children; 5-18 years; 49.6% female, mean age 11.88 ± 3.40 years) was selected to represent the Turkish population regarding geographical region, gender and age (5-18 years). Obesity was defined as the body mass index ≥95th percentile for age and gender. The Schwartz formula was used to estimate GFR. Blood pressure (BP) percentile was determined according to age, gender and length. The prevalence of overweight, obesity and hypertension were 9.3, 8.9 and 6.1%, respectively. Logistic regression analysis revealed urban area (OR 1.50; 95% CI 1.15-1.96; P = 0.003) as an independent risk for obesity and age decreased (OR 0.921; 95% CI 0.890-0.924; P < 0.001) risk for obesity. Obese children had the highest rate of hypertension (11.4 versus 5.6%; P < 0.001; OR 2.17, 95% CI 1.49-3.17; P < 0.001) and stage II hypertension (3.8 versus 0.7%; OR 6.01, 95% CI 2.93-12.33; P < 0.001). Systolic and diastolic BP z-scores were significantly higher in obese children. The mean estimated (eGFR) was lower in obese children (122.7 ± 21.6 versus 129.4 ± 23.1, P < 0.001). The rates of children with eGFR < 90 and <75 mL/min/1.73 m(2) were higher in obese patients, but did not reach statistical significance. Our nation-wide population-based field study among children

  4. The prevalence and clinical characteristics associated with Diagnostic and Statistical Manual Version-5-defined anxious distress specifier in adults with major depressive disorder: results from the International Mood Disorders Collaborative Project.

    PubMed

    McIntyre, Roger S; Woldeyohannes, Hanna O; Soczynska, Joanna K; Vinberg, Maj; Cha, Danielle S; Lee, Yena; Gallaugher, Laura A; Dale, Roman S; Alsuwaidan, Mohammad T; Mansur, Rodrigo B; Muzina, David J; Carvalho, Andre; Kennedy, Sidney

    2016-05-01

    The aim of the study was to evaluate the prevalence of and illness characteristics in adults with major depressive disorder (MDD) with anxious distress specifier (ADS) enrolled in the International Mood Disorders Collaborative Project, which is a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto, Canada and the Cleveland Clinic, Cleveland, Ohio, USA. Data from participants who met criteria for a current major depressive episode as part of MDD (n = 830) were included in this post hoc analysis. Diagnostic and Statistical Manual Version-5-defined ADS was operationalized as the presence of at least two out of three proxy items instead of two out of five specifiers. A total of 464 individuals (i.e. 56%) met criteria for ADS. There were no between-group differences in sociodemographic variables (e.g. gender, employment, marital status). Greater severity of illness was observed in adults with ADS as evidenced by a higher number of hospitalizations, higher rates of suicidal ideation, greater depressive symptom severity, greater workplace impairment, decreased quality of life, and greater self-reported cognitive impairment. Our findings underscore the importance of evaluating ADS in adults with MDD as its presence identifies a subpopulation with greater illness-associated burden and hazards.

  5. Prevalence and incidence rates of autism in the UK: time trend from 2004–2010 in children aged 8 years

    PubMed Central

    Taylor, Brent; Jick, Hershel; MacLaughlin, Dean

    2013-01-01

    Objectives To update UK studies begun in the early 1990s on the annual prevalence and incidence rates of autism in children; undertaken in response to a March 2012 press release, widely covered by the media, from the US Centre for Disease Control (CDC) reporting that the autism prevalence rate in 2008 in 8-year-old US children was 1 in 88, a 78% increase from a CDC estimate in 2004. This finding suggested a continuation of the dramatic increase in children diagnosed as autistic, which occurred in the 1990s. Design Population study using the UK General Practice Research Database (GPRD). Methods Annual autism prevalence rates were estimated for children aged 8 years in 2004–2010 by dividing the number diagnosed as autistic in each or any previous year by the number of children active in the study population that year. We also calculated annual incidence rates for children aged 2–8 years, by dividing the number newly diagnosed in 2004–2010 by the same denominators. Results Annual prevalence rates for each year were steady at approximately 3.8/1000 boys and 0.8/1000 girls. Annual incidence rates each year were also steady at about 1.2/1000 boys and 0.2/1000 girls. Conclusions Following a fivefold increase in the annual incidence rates of autism during the 1990s in the UK, the incidence and prevalence rates in 8-year-old children reached a plateau in the early 2000s and remained steady through 2010. Whether prevalence rates have increased from the early 2000s in the USA remains uncertain. PMID:24131525

  6. The Incremental Utility of Behavioral Rating Scales and a Structured Diagnostic Interview in the Assessment of Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Vaughn, Aaron J.; Hoza, Betsy

    2013-01-01

    The current study examined the incremental utility of rating scales, a structured diagnostic interview, and multiple informants in a comprehensive assessment of attention-deficit/hyperactivity disorder (ADHD). The sample included 185 children with ADHD (M[subscript age] = 9.22, SD = 0.95) and 82 children without ADHD (M[subscript age] = 9.24, SD =…

  7. Prevalence of poor self-rated health and associated risk factors among older adults in Cali, Colombia

    PubMed Central

    Zapata-Ossa, Helmer de J; Cubides-Munévar, Ángela M; Curcio, Carmen L; Villegas, Juan de D; Reyes-Ortiz, Carlos A

    2013-01-01

    Introduction: Self-rated health (SRH) has beeen considered an important marker of quality of life and an independent predictor of mortality in older adults. Objective: To determine the prevalence of poor SRH and identify risk factors associated with poor SRH among older adults residing in the Commune 18 of the city of Cali, Colombia, in 2009. Methods: A population-based cross-sectional study with a single-stage cluster sampling design. Sample included 314 persons aged 60 and older. The dependent variable, SRH was dichotomized into good (excellent, very good, good) and poor (fair, poor). Independent variables were sociodemographic, biological, mental, functional and geriatric syndromes. Logistic regression was used for multivariate statistical modeling. Results: Overall, 40.1% reported poor SRH (women 42.9%, men 35.0%). Factors independently associated with poor SRH were diabetes mellitus, depression, fear of falling and frailty syndrome (frail and pre-frail vs. non-frail). Widowed men reported poorer health than married men while other marital status (single/separated/divorced) was associated with better self-rated health in women. Conclusion: Potential modifiable factors such as depression and frailty syndrome are important determinants for poor SRH in Colombian older adults. PMID:24892239

  8. Prevalence of poor self-rated health and associated risk factors among older adults in Cali, Colombia.

    PubMed

    Ocampo-Chaparro, José M; Zapata-Ossa, Helmer de J; Cubides-Munévar, Angela M; Curcio, Carmen L; Villegas, Juan de D; Reyes-Ortiz, Carlos A

    2013-10-01

    Self-rated health (SRH) has beeen considered an important marker of quality of life and an independent predictor of mortality in older adults. To determine the prevalence of poor SRH and identify risk factors associated with poor SRH among older adults residing in the Commune 18 of the city of Cali, Colombia, in 2009. A population-based cross-sectional study with a single-stage cluster sampling design. Sample included 314 persons aged 60 and older. The dependent variable, SRH was dichotomized into good (excellent, very good, good) and poor (fair, poor). Independent variables were sociodemographic, biological, mental, functional and geriatric syndromes. Logistic regression was used for multivariate statistical modeling. Overall, 40.1% reported poor SRH (women 42.9%, men 35.0%). Factors independently associated with poor SRH were diabetes mellitus, depression, fear of falling and frailty syndrome (frail and pre-frail vs. non-frail). Widowed men reported poorer health than married men while other marital status (single/separated/divorced) was associated with better self-rated health in women. Potential modifiable factors such as depression and frailty syndrome are important determinants for poor SRH in Colombian older adults.

  9. Prevalence rates of respiratory symptoms in Italian general population samples exposed to different levels of air pollution

    SciTech Connect

    Viegi, G. Univ. of Arizona, Tucson ); Paoletti, P.; Carrozzi, L.; Vellutini, M.; Diviggiano, E.; Pistelli, G.; Giutini, G. ); Di Pede, C. Occupational Medicine Service, Toscana ); Lebowitz, M.D. )

    1991-08-01

    The authors surveyed two general population samples aged 8 to 64 living in the unpolluted, rural area of the Po Delta (northern Italy) and in the urban area of Pisa (central Italy). Each subject filled out a standardized interviewer-administered questionnaire. The Pisa sample was divided into three groups according to their residence in the urban-suburban areas and to outdoor air pollution exposure (automobile exhaust only or industrial fumes as well). Significantly higher prevalence rates of all the respiratory symptoms and diseases were found in Pisa compared with the Po Delta. Current smoking was more frequent in the rural area, but the urban smokers had a higher lifetime cigarette consumption. Childhood respiratory trouble and recurrent respiratory illnesses were evenly distributed. Exposure to parental smoking in childhood and lower educational level were more frequent in Po Delta, whereas familial history of respiratory/allergic disorders and work and indoor exposures were more often reported in the city. Multiple logistic regression models estimating independently the role of the various risk factors showed significant odds ratios associated with residence in Pisa for all the symptoms but chronic phlegm. The conclusion, these preliminary analyses indicate an urban factor related to the rates of respiratory symptoms and diseases in Italy in the 1980s.

  10. Sex differences in prevalence rates and predictors of cigarette smoking among in-school adolescents in Kilimanjaro, Tanzania.

    PubMed

    Siziya, S; Ntata, P R T; Rudatsikira, E; Makupe, C M; Umar, E; Muula, A S

    2007-09-01

    An analysis of the Global Youth Tobacco Survey for Kilimanjaro, Tanzania was carried out to assess sex differences in the prevalence rates and predictors of current cigarette smoking among in-school adolescents. A total of 2323 adolescents participated in the study of whom 53% were females and 47% males. The prevalence of current cigarette smoking was 3.0% and 1.4% among males and females, respectively. The common factors that were significantly positively associated with cigarette smoking between sexes were: having more pocket money, closest friend smoked cigarettes, seeing actors smoke on TV, videos or movies, and seeing advertisements for cigarettes at social gatherings. Seeing anti-smoking messages at social gatherings were negatively associated with smoking among both sexes. While having had something such as a t-shirt or pen with a cigarette brand logo on it was positively associated with cigarette smoking among males, it was negatively associated with cigarette smoking among females. Male adolescents older than 15 years, those in their 9th year of schooling, and those who had seen cigarette brand names on TV were more likely to smoke. Meanwhile, male respondents who were in their 8th year of schooling, had seen anti-smoking media messages, and advertisements for cigarettes in newspapers or magazines were less likely to smoke. Among female adolescents, those who had parents who smoked, and surprisingly those who perceived that cigarette smoking as harmful were more likely to smoke. Interestingly, seeing advertisement for cigarettes on billboards was negatively associated with smoking among female adolescents. Interventions aimed to reduce adolescent smoking need to be designed and implemented with due consideration of sex differences in these associated factors.

  11. [Prevalence of low glomerular filtration rate in the elderly population of Spain. The PREV-ICTUS study].

    PubMed

    Cea-Calvo, Luis; Redón, Josep; Martí-Canales, Juan C; Lozano, José V; Llisterri, José L; Fernández-Pérez, Cristina; Aznar, José; González-Esteban, Jorge

    2007-11-17

    To assess the prevalence of low glomerular filtration rate (GFR < 60 ml/min/1.73 m2) in general population of subjects aged 60 years or older of Spain, and the related factors. Analysis of PREV-ICTUS, a population-based study carried out in a sample of subjects aged 60 years or more, randomly selected and stratified by Autonomic Communities according to the census of inhabitants and the habitat in each Community. Demographic data, cardiovascular risk factors and diseases were collected. GFR was calculated using the MDRD (Modification of Diet in Renal Disease) equation. In 6,799 subjects (age 71.9 years-old; 53.6% women; 72.9% with arterial hypertension [HT]; 27.0% with diabetes mellitus [DM]; 24.3% with cardiovascular disease), 25.9% had low GFR (95% confidence interval, 24.8-26.9). The prevalence increased linearly, from 16.5% in subjects aged 60-64 years to 46.5% in those aged 85 or more (p < 0.001), and was higher in women (36.1% vs 14.1% in men, p < 0.001). In the multivariate analysis, low GFR was independently related to advanced age (odds ratio [OR] between 1.30 y 4.20), female gender (OR = 5.82), HT older than 7 years (OR = 1.23), uric acid (OR = 1.52 for each increment of 1 mg/dl) and cardiovascular disease (OR = 1.68). The association with DM did not reach statistical significance. In a model without cardiovascular disease, related factors remained the same, increasing the significance of HT older than 7 years (OR = 1.31) and of DM (OR = 1.19). One out or 4 subjects of this sample showed low GFR. The variables directly associated with low GFR were advanced age, female gender, HT of longer evolution, cardiovascular disease, increased uric acid, and, in one model, DM.

  12. Sexual victimization of youth with a physical disability: an examination of prevalence rates, and risk and protective factors.

    PubMed

    Mueller-Johnson, Katrin; Eisner, Manuel P; Obsuth, Ingrid

    2014-11-01

    Children with disabilities have been shown to be at greater risk of victimization than those without. Although much of the research combines disability of any type into a single disability category, recent evidence suggests that not all types of disabilities are equally associated with victimization. To date, little knowledge exists about the victimization of youth with physical disabilities. This study used data from a national school-based survey of adolescents (n = 6,749, mean age = 15.41, SD = .66) in Switzerland to investigate sexual victimization (SV) among physically disabled youth. Two subtypes of SV were differentiated: contact SV, including penetration or touching/kissing, and non-contact SV, such as exhibitionism, verbal harassment, exposure to sexual acts, or cyber SV. A total of 360 (5.1%) youth self-identified as having a physical disability. Lifetime prevalence rates for contact SV were 25.95% for girls with a physical disability (odds ratio [OR] = 1.29 compared with able-bodied girls), 18.50% for boys with physical disability (OR = 2.78 compared with able-bodied boys), and 22.35% for the total sample with physical disability (OR = 1.74 compared with able-bodied youth). For non-contact SV, the lifetime prevalence was 48.11% for girls with a physical disability (OR = 1.44 compared with able-bodied girls), 31.76% for boys with physical disability (OR = 1.95 compared with able-bodied boys), and 40.28% for the total sample with physical disability (OR = 1.67 compared with able-bodied youth). After controlling for other risk factors, physical disability was a significant predictor of contact and non-contact SV for boys, but not for girls. © The Author(s) 2014.

  13. Rapid diagnostic imaging and pathologic evaluation of surgical tissue using video rate structured illumination microscopy (VR-SIM) (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Wang, Mei; Tulman, David; Elfer, Kate; Sholl, Andrew; Brown, J. Quincy

    2016-03-01

    Currently available pathology techniques for obtaining a rapid tissue diagnosis, or for determining the adequacy of specimens intended for downstream analysis, are too slow, labor-intensive, and destructive for point-of-care (POC) applications. We previously demonstrated video-rate structured illumination microscopy (VR-SIM) for accurate, high-throughput, non-destructive diagnostic imaging of fluorescently-stained prostate biopsies in seconds per biopsy, with an area under the ROC curve of 0.82-0.88 after pathologist review. In addition, we have demonstrated that it is feasible to use VR-SIM to routinely image very large gross pathology specimens, such as entire prostate resection surfaces, in relatively short timeframes at subcellular resolution. However, our prior work has focused on applications in prostate cancer; the utility in other organ sites has not been explored. Here we extended our technology to varying size kidney, liver, and lung biopsies. We conducted a validation study of VR-SIM against histopathology on a variety of human tissues, including both small biopsies and large slices of tissue. We conducted a blinded study in which the study pathologist accurately identified the organs based on VR-SIM images alone. The results were then used to create a clinical atlas between VR-SIM and H and E images for the different tissues of interest. This clinical atlas will be used to aid in pathologist interpretation in future POC clinical applications of VR-SIM in kidney, liver, and lung. Such applications could include on-site identification of the presence of kidney glomeruli for to ensure successful downstream IHC analysis, or determination of the adequacy of lung cancer biopsies for genomic analysis.

  14. High-resolution rapid diagnostic imaging of whole prostate biopsies using video-rate fluorescence structured illumination microscopy

    PubMed Central

    Wang, Mei; Kimbrell, Hillary Z.; Sholl, Andrew B.; Tulman, David B.; Elfer, Katherine N.; Schlichenmeyer, Tyler C.; Lee, Benjamin R.; Lacey, Michelle; Brown, J. Quincy

    2015-01-01

    Rapid assessment of prostate core biopsy pathology at the point-of-procedure could provide benefit in a variety of clinical situations. Even with advanced trans-rectal ultrasound guidance and saturation biopsy protocols, prostate cancer can be missed in up to half of all initial biopsy procedures. In addition, collection of tumor specimens for downstream histological, molecular, and genetic analysis is hindered by low tumor yield due to inability to identify prostate cancer grossly. However, current point-of-procedure pathology protocols such as frozen section analysis (FSA) are destructive, and too time- and labor-intensive to be practical or economical. Ex vivo microscopy of the excised specimens, stained with fast-acting fluorescent histology dyes, could be an attractive non-destructive alternative to FSA. In this work, we report the first demonstration of video-rate structured illumination microscopy (VR-SIM) for rapid high-resolution diagnostic imaging of prostate biopsies in realistic point-of-procedure timeframes. Large mosaic images of prostate biopsies stained with acridine orange are rendered in seconds, and contain excellent contrast and detail, exhibiting close correlation with corresponding H&E histology. A clinically-relevant review of VR-SIM images of 34 unfixed and uncut prostate core biopsies by two independent pathologists resulted in an area under the ROC curve (AUC) of 0.82–0.88, with a sensitivity ranging from 63–88% and a specificity ranging from 78–89%. When biopsies contained more than 5% tumor content, the sensitivity improved to 75–92%. The image quality, speed, minimal complexity, and ease of use of VR-SIM could prove to be features in favor of adoption as an alternative to destructive pathology at the point-of-procedure. PMID:26282168

  15. Prevalence of pincer, cam, and combined deformities in Japanese hip joints evaluated with the Japanese Hip Society diagnostic guideline for femoroacetabular impingement: A CT-based study.

    PubMed

    Mimura, Tomohiro; Mori, Kanji; Itakura, Shin; Furuya, Yuki; Kawasaki, Taku; Imai, Shinji

    2017-01-01

    Femoroacetabular impingement (FAI) is thought to be associated with hip osteoarthritis. We investigated the prevalences of radiologic deformities of the pincer, cam, and their combinations in Japanese hip joints using computed tomography (CT) according to the Japanese Hip Society diagnostic guideline for FAI. Multi-slice CT images were evaluated. Pincer deformities were defined as: type 1: center-edge angle (CE) ≥40°; type 2: CE ≥ 30° and acetabular roof obliquity ≤0°; type 3: CE ≥ 25° and retroverted acetabulum. Cam deformities were defined as: type 1: CE ≥ 25°, α-angle ≥55°, and head-neck offset ratio <0.14; type 2: CE ≥ 25°, α-angle ≥55°, and herniation pit positive; type 3: CE ≥ 25°, α-angle ≥55°, and pistol grip deformity positive. We studied 128 hips. Pincer was detected in 35.9% (type 1, 12.5%; type 2, 18.0%; type 3, 13.3%). Cam was detected in 24.2% (type 1, 23.4%; type 2, 7.8%; type 3, 10.9%). Combined deformities were detected in 10.2%. Type 3 pincer/type 1 cam was the most frequent combined deformity compared with all combined deformities. All of the cam deformities, total combined deformities, and all radiological FAIs appeared significantly more often in men. When we used this guideline to diagnose FAI in a Japanese population, radiological FAI was common, and pincer deformities were more common than cam deformities. The most frequent seen pincer, cam, and combined deformities was type 2 pincer, type 1 cam, and the combination of type 3 pincer/type 1 cam, respectively. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  16. A 5-year epidemiological study on the prevalence rate of idiopathic scoliosis in Tokyo: school screening of more than 250,000 children.

    PubMed

    Ueno, Masaki; Takaso, Masashi; Nakazawa, Toshiyuki; Imura, Takayuki; Saito, Wataru; Shintani, Ryousuke; Uchida, Kentaro; Fukuda, Michinari; Takahashi, Kazuhisa; Ohtori, Seiji; Kotani, Toshiaki; Minami, Shohei

    2011-01-01

    School screening for scoliosis is a powerful tool that can be used to identify children who may have scoliosis. There have been no reports on the recent prevalence of idiopathic scoliosis in Japan since 1988. A 5-year epidemiologic study was performed to determined the prevalence of idiopathic scoliosis, the curve magnitude, the distribution of this magnitude, and the sex ratio in school children. Between 2003 and 2007, a total of 255,875 children aged 11-14 years were screened. A total of 3,424 children were found to be positive as a result of Moiré topography. With radiographic examination, 2,225 (65.0%) children with a Cobb angle of 10° or more were detected. The overall prevalence rate in schoolchildren 11-14 years of age with Cobb angles of 10° or more was 0.87%. The prevalence rate in girls increased from 0.78% at the age of 11-12 years to 2.51% at the age of 13-14 years. For boys, the prevalence rates were 0.04% at the age of 11-12 years and 0.25% at the age of 13-14 years. The overall ratio of girls to boys with scoliosis was 11:1. The ratio of girls to boys was 17:1 at the age of 11-12 years and 10:1 at the age of 13-14 years. The majority of the curves fell in the range of 10°-19°. There was a slight increase in the prevalence rates of children with a curve of high magnitude (≥20°) as compared to the prevalence rate in 1988. We suggest that school screening for scoliosis is effective for early detection; however, it is first necessary to review and optimize the target groups.

  17. An Epidemiological and Diagnostic Study of Asperger Syndrome according to Four Sets of Diagnostic Criteria

    ERIC Educational Resources Information Center

    Mattila, Marja-Leena; Kielinen, Marko; Jussila, Katja; Linna, Sirkka-Liisa; Bloigu, Risto; Ebeling, Hanna; Moilanen, Irma

    2007-01-01

    Objective: This study evaluated the diagnostic process and prevalence rates of Asperger syndrome (AS) according to the DSM-IV, ICD-10, and criteria developed by Gillberg and Gillberg and by Szatmari and colleagues and clarified confusion about AS. Method: An epidemiological study of 5,484 eight-year-old children in Finland, 4,422 (80.6%) of whom…

  18. Heart-Rate Dependent Improvement in Image Quality and Diagnostic Accuracy of Coronary Computed Tomographic Angiography by Novel Intra-cycle Motion Correction Algorithm

    PubMed Central

    Cho, Iksung; Elmore, Kimberly; Hartaigh, Bríain ó; Schulman-Marcus, Josh; Granser, Heidi; Valenti, Valentina; Xiong, Guanglei; Carrascosa, Patricia M; Min, James K

    2014-01-01

    Background To determine the effect of a novel intra-cycle motion correction algorithm (MCA) on diagnostic accuracy of coronary CT angiography (CCTA) Methods Coronary artery phantom models were scanned at static and heart rates (HR) simulation of 60–100 beat/min and reconstructed with a conventional algorithm (CA) and MCA. Results Among 144 coronary segments, improvements in image interpretability, quality and diagnostic accuracy by MCA were observed for HRs of 80 and 100 (P<0.05 for all), but not for HR of 60. Conclusion Novel intra-cycle motion correction algorithm demonstrates improved heart-rate dependent image interpretability, and quality and accuracy, particularly at higher heart rates. PMID:25649255

  19. Diagnostic accuracy and recall rates for digital mammography and digital mammography combined with one-view and two-view tomosynthesis: results of an enriched reader study.

    PubMed

    Rafferty, Elizabeth A; Park, Jeong Mi; Philpotts, Liane E; Poplack, Steven P; Sumkin, Jules H; Halpern, Elkan F; Niklason, Loren T

    2014-02-01

    The purpose of this study was to compare two methods of combining tomosynthesis with digital mammography by assessing diagnostic accuracy and recall rates for digital mammography alone and digital mammography combined with one-view tomosynthesis and two-view tomosynthesis. Three hundred ten cases including biopsy-proven malignancies (51), biopsy-proven benign findings (47), recalled screening cases (138), and negative screening cases (74) were reviewed by 15 radiologists sequentially using digital mammography, adding one-view tomosynthesis, and then two-view tomosynthesis. Cases were assessed for recall and assigned a BI-RADS score and probability of malignancy for each imaging method. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis. Screening recall rates were compared using pooled logistical regression analysis. A p value of < 0.0167 was considered significant. The area under the ROC curve (AUC) for digital mammography (DM), DM plus one-view tomosynthesis, and DM plus two-view tomosynthesis was 0.828, 0.864, and 0.895, respectively. Both one-view and two-view tomosynthesis plus DM were significantly better than DM alone (Δ AUCs 0.036 [p = 0.009] and 0.068 [p < 0.001]). Average noncancer recall rates for digital mammography, DM plus one-view tomosynthesis, and DM plus two-view tomosynthesis were 44.2%, 27.2%, and 24.0%, respectively. Combined with DM, one-view and two-view tomosynthesis both showed significantly lower noncancer recall rates than digital mammography alone (p < 0.001). Digital mammography with two-view tomosynthesis showed a significantly lower recall rate than digital mammography with one-view tomosynthesis (p < 0.001). Diagnostic accuracy for dense (Δ AUC, 0.091%; p < 0.001) and nondense (Δ AUC, 0.035%; p = 0.001) breasts improved with DM plus two-view tomosynthesis compared with digital mammography alone. Compared with digital mammography, diagnostic sensitivity for invasive cancers increased with the

  20. ST segment/heart rate hysteresis improves the diagnostic accuracy of ECG stress test for coronary artery disease in patients with left ventricular hypertrophy.

    PubMed

    Zimarino, Marco; Montebello, Elena; Radico, Francesco; Gallina, Sabina; Perfetti, Matteo; Iachini Bellisarii, Francesco; Severi, Silva; Limbruno, Ugo; Emdin, Michele; De Caterina, Raffaele

    2016-10-01

    The exercise electrocardiographic stress test (ExET) is the most widely used non-invasive diagnostic method to detect coronary artery disease. However, the sole ST depression criteria (ST-max) have poor specificity for coronary artery disease in patients with left ventricular hypertrophy. We hypothesised that ST-segment depression/heart rate hysteresis, depicting the relative behaviour of ST segment depression during the exercise and recovery phase of the test might increase the diagnostic accuracy of ExET for coronary artery disease detection in such patients. In three cardiology centres, we studied 113 consecutive patients (mean age 66 ± 2 years; 88% men) with hypertension-related left ventricular hypertrophy at echocardiography, referred to coronary angiography after an ExET. The following ExET criteria were analysed: ST-max, chronotropic index, heart rate recovery, Duke treadmill score, ST-segment depression/heart rate hysteresis. We detected significant coronary artery disease at coronary angiography in 61 patients (53%). At receiver-operating characteristic analysis, ST-segment depression/heart rate hysteresis had the highest area under the curve value (0.75, P < 0.001 when compared with the 'neutral' receiver-operating characteristic curve value of 0.5). Area under the curve values were 0.68 (P < 0.01) for the chronotropic index, 0.58 (P = NS) for heart rate recovery, 0.57 (P = NS) for ST-max and 0.52 (P = NS) for the Duke treadmill score. Among currently available ExET diagnostic variables, ST-segment depression/heart rate hysteresis offers a substantially better diagnostic accuracy for coronary artery disease than conventional criteria in patients with hypertension-related left ventricular hypertrophy. © The European Society of Cardiology 2016.

  1. High prevalence rate of pituitary incidentaloma: is it associated with the age-related decline of the sex hormones levels?

    PubMed

    Kastelan, Darko; Korsic, Mirko

    2007-01-01

    Incidental pituitary adenoma is the common finding during brain imaging. According to multistep model of pituitary tumourigenesis genetic alterations provide the initiating event that transforms cells while hormones play a role in promoting cell proliferation. Development of pituitary adenoma in a case of excessive hypophysiotrophic hormones production or reduced feedback suppression by target gland hormones emphasizes the importance of hormonal stimulation in pituitary tumourigenesis. Pituitary hyperplasia has been reported in pregnancy, hypothyroidism and conditions such as CRH or GHRH hypersecretion. Moreover, recent study reported one case of gonadotroph macroadenoma and two cases of gonadotroph cells hyperplasia in patients with Klinefelter syndrome probably due to protracted stimulation of gonadotroph cells because of lack of androgen feedback. Significant changes of the hypothalamic-pituitary-gonadal axis occurred with aging. In females, after menopause, estradiol level decreases by 35-fold and estrone level by 20-fold that results in increased gonadotropins levels. Similarly, FSH, but not LH, level is increased with advancing age in men, too, although the age-related difference in the level is less in comparison with women. Regarding these data, we hypothesised that high prevalence rate of pituitary incidentaloma in the elderly is associated with age-related decline in sex hormones levels and subsequent lack of feedback suppression leading to permanent gonadotrophs stimulation which is the crucial step in the pituitary tumour development. According to previously mentioned multistep model of pituitary tumourigenesis, incidentaloma will develop only in persons with already present intrinsic pituitary cell defects. However, further studies have to answer the questions of whether the incidence of pituitary tumours is more frequent in elderly, whether women with late onset menopause or those taking long-term hormone replacement therapy have lower rate of

  2. Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications.

    PubMed

    Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

    2016-06-01

    Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling method including stratified and simple random sampling. The Young's questionnaire of internet addiction and SRH question used for data collection. Chi-square, t-test, and logistic regression used in data analysis. More than 79.9% of students reported their general health good and very good. The student's mean score of general health was higher than the average. In addition, the prevalence of internet addiction was 28.7%. An inverse significant correlation observed between SRH and internet addiction score (r=-0.198, p=0.002). Using internet for Entertainment, using private Email and chat rooms were the most important predictors of affecting to internet addiction. Moreover, internet addiction is the most predictors of SRH and increased the odds of bad SRH. The good SRH of medical students was higher than general population but in health faculty' students were lower than others. Due to the effect of internet addiction on SRH and increasing trend of internet use in medical students, as well as low age of participants, attention to psychological aspects and the job expectancy in future, can effective on increasing the good SRH.

  3. [Study on the secular changes of BMI, prevalence rates of overweight, obesity and related factors in an urban elderly population, Beijing from 2001 to 2010].

    PubMed

    Wang, Yiyan; He, Yao; Jiang, Bin; Wang, Jianhua; Wu, Lei; Liu, Miao; Sun, Dongling; Li, Xiaoying; Yang, Shanshan

    2014-04-01

    The aim of this study was to assess the secular changes of BMI, prevalence rates of overweight and obesity as well as related factors in an elderly population of Beijing, during 2001 and 2010. A two-round population-based cross-sectional study was conducted in an elderly population, selected from a representative urban area in Beijing in 2001 (n = 2 277) and 2010 (n = 2 102) respectively. In this population, the age-adjusted means on BMI were 25.3 (95%CI, 25.1-25.5) for men and 25.8 (95%CI, 25.5-25.9) for women in 2001, and 25.0 (95%CI, 24.8-25.1) and 25.0 (95%CI, 24.7-25.1) in 2010, respectively, which all significantly declined. According to the WHO criteria, related data were shown as follows:the age standardized prevalence rates of overweight (BMI ≥ 25 kg/m²) were 48.3% among men and 46.3% among women in 2001, 44.5% and 39.9% for men and women in 2010 respectively; the age-standardized prevalence rates of obesity (BMI ≥ 30 kg/m²)were 5.4% on men and 11.6% on women in 2001, but declined to 4.9% and 7.3% in 2010 respectively; the prevalence rates of overweight and obesity were both significantly declined in women, but not in men. However, according to WGOC criteria, the age standardized prevalence rates on overweight (BMI ≥ 24 kg/m²) were 47.9% in men and 44.9% in women in 2001, and were 47.2% and 41.0% respectively for men and women in 2010; the age-standardized prevalence rates of obesity (BMI ≥ 28 kg/m²) were 19.2% in men and 24.2% in women in 2001, both significantly declined to 15.5% and 18.0% in 2010, respectively. Positive correlations were found between the levels of blood pressure, glucose and lipids and BMI. Results from multiple factors logistic regression analysis also indicated that healthy lifestyle including reducing cigarette smoking, alcohol drinking and increasing daily exercises in the last 10 years, also played roles in the decrease of prevalence rates on both overweight and obesity. The mean BMI and prevalence rates of overweight

  4. A Meta-Analysis of the Global Prevalence Rates of Staphylococcus aureus and Methicillin-Resistant S. aureus Contamination of Different Raw Meat Products.

    PubMed

    Ou, Qianting; Peng, Yang; Lin, Dongxin; Bai, Chan; Zhang, Ting; Lin, Jialing; Ye, Xiaohua; Yao, Zhenjiang

    2017-03-30

    Previous research has indicated that raw meats are frequently contaminated with Staphylococcus aureus , but data regarding the pooled prevalence rates of S. aureus and methicillin-resistant S. aureus (MRSA) contamination in different types of raw meat products (beef, chicken, and pork) and across different periods, regions, and purchase locations remain inconsistent. We systematically searched the PubMed, EMBASE, Ovid, Web of Science, and HighWire databases to identify studies published up to June 2016. The STROBE guidelines were used to assess the quality of the 39 studies included in this meta-analysis. We observed no significant differences in the pooled prevalence rates of S. aureus and MRSA contamination identified in various raw meat products, with overall pooled prevalence rates of 29.2% (95% confidence interval [CI], 22.8 to 35.9%) and 3.2% (95% CI, 1.8 to 4.9%) identified for the two contaminants, respectively. In the subgroup analyses, the prevalence of S. aureus contamination in chicken products was highest in Asian studies and significantly decreased over time worldwide. In European studies, the prevalence rates of S. aureus contamination in chicken and pork products were lower than those reported on other continents. The pooled prevalence rates of S. aureus contamination in chicken and pork products and MRSA contamination in beef and pork products were significantly higher in samples collected from retail sources than in samples collected from slaughterhouses and processing plants. These results highlight the need for good hygiene during transportation to and manipulation at retail outlets to reduce the risk of transmission of S. aureus and MRSA from meat products to humans.

  5. Reported Diabetes Mellitus Prevalence Rates in the Colombia Healthcare System from 2009 to 2012: Analysis by Regions Using Data of the Official Information Sources.

    PubMed

    Barengo, Noël C; Tamayo, Diana Carolina

    2015-01-01

    The objective of this study was to describe the reported diabetes mellitus (DM) prevalence rates of the 20-79-year-old population in Colombia from 2009 to 2012 reported by the healthcare system. Information on number of patients treated for DM was obtained by the Integral Information System of Social Protection (SISPRO), the registry of the Ministry of Health and Social Protection, and the High Cost Account (CAC), an organization to trace high expenditure diseases. From both sources age-standardized reported DM prevalence rates per 100.000 inhabitants from 2009 to 2012 were calculated. Whereas the reported DM prevalence rates of SISPRO revealed an increase from 964/100.000 inhabitants (2009) to 1398/100.000 inhabitants in 2012 (mean annual increase 141/100.000; p value: 0.001), the respective rates in the CAC register were 1082/100.000 (2009) and 1593/100.000 in 2012 (mean annual increase 165/100.000; p value: 0.026). The number of provinces reporting not less than 19% of the highest national reported DM prevalence rates (1593/100.000) increased from two in 2009 to ten in 2012. Apparently, the registries and the information retrieving system have been improved during 2009 and 2012, resulting in a greater capacity to identify and report DM cases by the healthcare system.

  6. Reported Diabetes Mellitus Prevalence Rates in the Colombia Healthcare System from 2009 to 2012: Analysis by Regions Using Data of the Official Information Sources

    PubMed Central

    Barengo, Noël C.; Tamayo, Diana Carolina

    2015-01-01

    The objective of this study was to describe the reported diabetes mellitus (DM) prevalence rates of the 20–79-year-old population in Colombia from 2009 to 2012 reported by the healthcare system. Information on number of patients treated for DM was obtained by the Integral Information System of Social Protection (SISPRO), the registry of the Ministry of Health and Social Protection, and the High Cost Account (CAC), an organization to trace high expenditure diseases. From both sources age-standardized reported DM prevalence rates per 100.000 inhabitants from 2009 to 2012 were calculated. Whereas the reported DM prevalence rates of SISPRO revealed an increase from 964/100.000 inhabitants (2009) to 1398/100.000 inhabitants in 2012 (mean annual increase 141/100.000; p value: 0.001), the respective rates in the CAC register were 1082/100.000 (2009) and 1593/100.000 in 2012 (mean annual increase 165/100.000; p value: 0.026). The number of provinces reporting not less than 19% of the highest national reported DM prevalence rates (1593/100.000) increased from two in 2009 to ten in 2012. Apparently, the registries and the information retrieving system have been improved during 2009 and 2012, resulting in a greater capacity to identify and report DM cases by the healthcare system. PMID:26494999

  7. Prevalence of sleep bruxism in children: A systematic review

    PubMed Central

    Machado, Eduardo; Dal-Fabbro, Cibele; Cunali, Paulo Afonso; Kaizer, Osvaldo Bazzan

    2014-01-01

    INTRODUCTION: Prevalence of sleep bruxism (SB) in children is subject to discussions in the literature. OBJECTIVE: This study is a systematic literature review aiming to critically assess the prevalence of SB in children. METHODS: Survey using the following research databases: MEDLINE, Cochrane, EMBASE, PubMed, Lilacs and BBO, from January 2000 to February 2013, focusing on studies specifically assessing the prevalence of SB in children. RESULTS: After applying the inclusion criteria, four studies were retrieved. Among the selected articles, the prevalence rates of SB ranged from 5.9% to 49.6%, and these variations showed possible associations with the diagnostic criteria used for SB. CONCLUSION: There is a small number of studies with the primary objective of assessing SB in children. Additionally, there was a wide variation in the prevalence of SB in children. Thus, further, evidence-based studies with standardized and validated diagnostic criteria are necessary to assess the prevalence of SB in children more accurately. PMID:25628080

  8. Adaptive prospective ECG-triggered sequence coronary angiography in dual-source CT without heart rate control: Image quality and diagnostic performance.

    PubMed

    Pan, Chang-Jie; Qian, Nong; Wang, Tao; Tang, Xiao-Qiang; Xue, Yue-Jun

    2013-02-01

    The aim of this study was to evaluate the accuracy of using second generation dual-source CT (DSCT) to obtain high quality images and diagnostic performance and to reduce the radiation dose in adaptive prospective electrocardiography (ECG)-triggered sequence (CorAdSeq) CT coronary angiography (CTCA) without heart rate control. No prescan β-blockers were administered. Un-enhanced CT and CTCA with adaptive prospective CorAdSeq scanning without heart rate control were performed in 683 consecutive patients divided into two body mass index (BMI) groups: BMI <25 kg/m(2) (group A, n=412) and BMI ≥25 kg/m(2) (group B, n=271). The image quality and quantitative stenosis of all coronary segments with a diameter ≥1 mm were assessed. The mean heart rate (MHR), heart rate variability (HRV) and radiation dose values were recorded. In 426 cases, the diagnostic performance was evaluated using quantitative conventional coronary angiography as the reference standard. Diagnostic image quality was obtained in 98.5% of segments in group A and in 98.8% of segments in group B, with no significant differences between the groups. No correlations were observed between the image quality score and MHR or HRV (P=0.492, P=0.564, respectively). The effective radiation doses in groups A and B were 2.57±1.01 mSv and 6.36±1.88 mSv, respectively. The sensitivities and specificities of diagnosing coronary heart disease per patient were 99.6% and 97.8% in group A and 99.5% and 97.5% in group B, respectively (P>0.05). Adaptive prospective CorAdSeq scanning, without heart rate control, by second generation DSCT had a high image quality and diagnostic performance for coronary artery stenosis with lower radiation doses.

  9. Convergent Validity of the Autism Spectrum Disorder-Diagnostic for Children (ASD-DC) and Childhood Autism Rating Scales (CARS)

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Mahan, Sara; Hess, Julie A.; Fodstad, Jill C.; Neal, Daniene

    2010-01-01

    Previous studies analyzed the reliability as well as sensitivity and specificity of the Autism Spectrum Disorder-Diagnostic for Children (ASD-DC). This study further examines the psychometric properties of the ASD-DC by assessing whether the ASD-DC has convergent validity against a psychometrically sound observational instrument for Autistic…

  10. Convergent Validity of the Autism Spectrum Disorder-Diagnostic for Children (ASD-DC) and Childhood Autism Rating Scales (CARS)

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Mahan, Sara; Hess, Julie A.; Fodstad, Jill C.; Neal, Daniene

    2010-01-01

    Previous studies analyzed the reliability as well as sensitivity and specificity of the Autism Spectrum Disorder-Diagnostic for Children (ASD-DC). This study further examines the psychometric properties of the ASD-DC by assessing whether the ASD-DC has convergent validity against a psychometrically sound observational instrument for Autistic…

  11. Effect of heart rate on the diagnostic accuracy of 256-slice computed tomography angiography in the detection of coronary artery stenosis: ROC curve analysis.

    PubMed

    Wang, Gang; Wu, Yifen; Zhang, Zhentao; Zheng, Xiaolin; Zhang, Yulan; Liang, Manqiu; Yuan, Huanchu; Shen, Haiping; Li, Dewei

    2016-05-01

    The aim of the present study was to investigate the effect of heart rate (HR) on the diagnostic accuracy of 256-slice computed tomography angiography (CTA) in the detection of coronary artery stenosis. Coronary imaging was performed using a Philips 256-slice spiral CT, and receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic value of 256-slice CTA in coronary artery stenosis. The HR of the research subjects in the study was within a certain range (39-107 bpm). One hundred patients suspected of coronary heart disease underwent 256-slice CTA examination. The cases were divided into three groups: Low HR (HR <75 bpm), moderate HR (75≤ HR <90 bpm) and high HR (HR ≥90 bpm). For the three groups, two observers independently assessed the image quality for all coronary segments on a four-point ordinal scale. An image quality of grades 1-3 was considered diagnostic, while grade 4 was non-diagnostic. A total of 97.76% of the images were diagnostic in the low-HR group, 96.86% in the moderate-HR group and 95.80% in the high-HR group. According to the ROC curve analysis, the specificity of CTA in diagnosing coronary artery stenosis was 98.40, 96.00 and 97.60% in the low-, moderate- and high-HR groups, respectively. In conclusion, 256-slice coronary CTA can be used to clearly show the main segments of the coronary artery and to effectively diagnose coronary artery stenosis. Within the range of HRs investigated, HR was found to have no significant effect on the diagnostic accuracy of 256-slice coronary CTA for coronary artery stenosis.

  12. Effect of heart rate on the diagnostic accuracy of 256-slice computed tomography angiography in the detection of coronary artery stenosis: ROC curve analysis

    PubMed Central

    WANG, GANG; WU, YIFEN; ZHANG, ZHENTAO; ZHENG, XIAOLIN; ZHANG, YULAN; LIANG, MANQIU; YUAN, HUANCHU; SHEN, HAIPING; LI, DEWEI

    2016-01-01

    The aim of the present study was to investigate the effect of heart rate (HR) on the diagnostic accuracy of 256-slice computed tomography angiography (CTA) in the detection of coronary artery stenosis. Coronary imaging was performed using a Philips 256-slice spiral CT, and receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic value of 256-slice CTA in coronary artery stenosis. The HR of the research subjects in the study was within a certain range (39–107 bpm). One hundred patients suspected of coronary heart disease underwent 256-slice CTA examination. The cases were divided into three groups: Low HR (HR <75 bpm), moderate HR (75≤ HR <90 bpm) and high HR (HR ≥90 bpm). For the three groups, two observers independently assessed the image quality for all coronary segments on a four-point ordinal scale. An image quality of grades 1–3 was considered diagnostic, while grade 4 was non-diagnostic. A total of 97.76% of the images were diagnostic in the low-HR group, 96.86% in the moderate-HR group and 95.80% in the high-HR group. According to the ROC curve analysis, the specificity of CTA in diagnosing coronary artery stenosis was 98.40, 96.00 and 97.60% in the low-, moderate- and high-HR groups, respectively. In conclusion, 256-slice coronary CTA can be used to clearly show the main segments of the coronary artery and to effectively diagnose coronary artery stenosis. Within the range of HRs investigated, HR was found to have no significant effect on the diagnostic accuracy of 256-slice coronary CTA for coronary artery stenosis. PMID:27168831

  13. Prevalence of bovine subclinical endometritis 4h after insemination and its effects on first service conception rate.

    PubMed

    Kaufmann, T B; Drillich, M; Tenhagen, B-A; Forderung, D; Heuwieser, W

    2009-01-15

    The objective of this study was to investigate the prevalence of subclinical endometritis 4h after AI and its effect on first service conception rate (FSCR) in dairy cows. A total of 201 Holstein-Friesian cows with no signs of clinical endometritis were examined 4h after first AI for signs of subclinical endometritis. Endometrial samples were collected from the uterus using the cytobrush technique. The proportion of polymorphonuclear cells (PMN) in the cytological sample was used to characterize an inflammation of the endometrium. Cows were categorized into three groups according to the proportion of PMN in the sample. Cows with 0% PMN (n=115) were assigned to group Zero, cows with >0-15% PMN (n=59) to group Medium, and cows with >15% PMN (n=27) to group High. Pregnancy diagnosis was performed between days 38-44 after AI by palpation of the uterus and its contents per rectum. The FSCR was significantly higher in group Medium than in groups Zero and High (57.6% vs. 39.1% and 29.6%). Statistical analysis revealed an interaction between parity and PMN group. Primiparous cows were at higher risk of being classified into group Medium than multiparous cows (OR=2.27, P=0.01). Primiparous cows in group Zero had lower odds of pregnancy after first AI than primiparous cows in group Medium (OR=0.3, P=0.02). A comparison with cows that were not examined for subclinical endometritis showed that the collection of endometrial samples itself had no effect on FSCR.

  14. Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study.

    PubMed

    Zhang, Lin; Zhang, Wei; Zhang, Lingling; Tian, Danping; Li, Li; Deng, Xin; Deng, Jing; Ning, Peishan; Hu, Guoqing

    2016-06-23

    Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Data came from the first health service household interview of Hunan province, China, in 2013. A Rao-Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR) was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45-64 years, 46%; 18-44 years, 37%). After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1-3.5) and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7-6.5) for young adults aged 18-44 years. The associations were not statistically significant for age groups 45-64 years and 65 years or older. The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey.

  15. Effect of agricultural activities on prevalence rates, and clinical and presumptive malaria episodes in central Côte d'Ivoire.

    PubMed

    Koudou, Benjamin G; Tano, Yao; Keiser, Jennifer; Vounatsou, Penelope; Girardin, Olivier; Klero, Kouassi; Koné, Mamadou; N'goran, Eliézer K; Cissé, Guéladio; Tanner, Marcel; Utzinger, Jürg

    2009-09-01

    Agricultural activities, among other factors, can influence the transmission of malaria. In two villages of central Côte d'Ivoire (Tiémélékro and Zatta) with distinctively different agro-ecological characteristics, we assessed Plasmodium prevalence rates, fever and clinically confirmed malaria episodes among children aged 15 years and below by means of repeated cross-sectional surveys. Additionally, presumptive malaria cases were monitored in dispensaries for a 4-year period. In Tiémélékro, we observed a decrease in malaria prevalence rates from 2002 to 2005, which might be partially explained by changes in agricultural activities from subsistence farming to cash crop production. In Zatta, where an irrigated rice perimeter is located in close proximity to human habitations, malaria prevalence rates in 2003 were significantly lower than in 2002 and 2005, which coincided with the interruption of irrigated rice farming in 2003/2004. Although malaria transmission differed by an order of magnitude in the two villages in 2003, there was no statistically significant difference between the proportions of severe malaria episodes (i.e. axillary temperature>37.5 degrees C plus parasitaemia>5000 parasites/microl blood). Our study underscores the complex relationship between malaria transmission, prevalence rate and the dynamics of malaria episodes. A better understanding of local contextual determinants, including the effect of agricultural activities, will help to improve the local epidemiology and control of malaria.

  16. Carbohydrate Malabsorption and Putative Carbohydrate-Specific Small Intestinal Bacterial Overgrowth: Prevalence and Diagnostic Overlap Observed in an Austrian Outpatient Center.

    PubMed

    Enko, Dietmar; Kriegshäuser, Gernot; Kimbacher, Christine; Stolba, Robert; Mangge, Harald; Halwachs-Baumann, Gabriele

    2015-01-01

    While lactose malabsorption is a well-investigated condition, few epidemiologic data are available for fructose and sorbitol malabsorption. The aim of this study was to assess the prevalence rates for primary lactose malabsorption, fructose and sorbitol malabsorption, and carbohydrate-specific small intestinal bacterial overgrowth (cs-SIBO) in an Austrian outpatient center. In total, 306 adult patients, who were primarily referred with suspected carbohydrate malabsorption by general practitioners to our outpatient clinic, underwent genetic testing (C/T-13910 polymorphism) for primary lactose malabsorption, and a combined hydrogen (H2)/methane (CH4) breath test for fructose (25 g) and sorbitol (12.5 g) malabsorption. Cohen's kappa (κ) was calculated for agreement between positive breath test results and self-reported symptoms during the test. Seventy-eight (25.49%) patients were C/C-13910 homozygotes, indicating primary lactose malabsorption. Thirty-four (11.11%) and 57 (18.63%) patients were classified as fructose and sorbitol malabsorbers. Cohen's κ measuring agreements between positive fructose and sorbitol breath test results and self-reported symptoms during the test were 0.33 and 0.49, respectively. Twenty-nine (9.50%) patients with an early H2/CH4 peak (i.e. within 60 minutes after fructose and/or sorbitol ingestion) were diagnosed with cs-SIBO. In Austria, carbohydrate malabsorption is a frequent condition in patients referred by general practitioners to carbohydrate malabsorption testing. © 2015 S. Karger AG, Basel.

  17. Diagnostic investigation rates and use of prescription and non-prescription medications amongst dyspeptics: a population-based study of 2300 Australians.

    PubMed

    Westbrook, J I; Talley, N J

    2003-05-01

    : There is limited knowledge of the diagnostic investigation rates and use of prescription and non-prescription drugs amongst dyspeptics. : To assess the investigation rates and use of prescription and non-prescription anti-ulcer medications amongst dyspeptics in the population. : A cross-sectional survey was performed of 2300 Australians. : Of 748 dyspeptics, 422 (56%) had consulted a doctor regarding dyspepsia at some time in their life. Of the consulters, 64% had undergone investigations at some time: 37% an endoscopy, 54% a barium meal and 27% both. A diagnosis of peptic ulcer was reported by 31% of those investigated. The symptom profile of gastroscopy patients differed significantly from that of uninvestigated dyspeptics. Of the consulters, 36% had taken anti-ulcer prescription drugs in the last 3 months: Histamine-2 receptor antagonists (73% of prescriptions), proton pump inhibitors (17%), cytoprotectants (5%) and prokinetic drugs (5%). Antacids were taken by 30% of non-consulting dyspeptics, 44% of consulters not on prescription drugs and 58% of dyspeptics taking prescription drugs. Advancing age, but not gender, was associated with diagnostic investigation and prescription and non-prescription drug usage. : There are high rates of diagnostic investigation amongst dyspeptics who consult doctors. Many individuals with dyspepsia decide to self-medicate with antacids regardless of consulting or prescriptions, suggesting that current management is suboptimal.

  18. Validation of multiple diagnostic techniques to detect Cryptosporidium sp. and Giardia sp. in free-ranging western lowland gorillas (Gorilla gorilla gorilla) and observations on the prevalence of these protozoan infections in two populations in Gabon.

    PubMed

    van Zijll Langhout, Martine; Reed, Patricia; Fox, Mark

    2010-06-01

    Anthropozoonotic diseases threaten the survival of western lowland gorillas (Gorilla gorilla gorilla). Use of accurate diagnostic techniques in gorilla health monitoring contributes to the conservation of gorillas by providing robust information for appropriate management decisions. To identify suitable protozoa diagnostic techniques for wild gorillas, 95 fecal specimens were collected in Lopé National Park and east of Moukalaba-Doudou National Park in Gabon, areas with high and low levels of human activity, respectively. The samples were examined for Cryptosporidium sp. and Giardia sp. by using the following diagnostic techniques: a commercially available immunofluorescent antibody test kit, Merifluor, and a rapid immune-assay, ImmunoCard STAT!, to detect Cryptosporidium sp. and Giardia sp., and a modified Ziehl-Neelsen stain to detect Cryptosporidium sp. oocysts. The results obtained from the Merifluor test, considered the "gold standard" in human studies, were used to estimate the prevalence of Cryptosporidium sp. and Giardia sp. infections in Lopé National Park (19.0% and 22.6%, respectively) and east of Moukalaba-Doudou National Park (0% and 9.1%, respectively). The difference in prevalence in both areas may be associated with differing levels of anthropogenic disturbance. The sensitivity and specificity of the latter two diagnostic techniques were calculated by using the Merifluor test as a control. The ImmunoCard STAT! was found suitable for Giardia sp. antigen detection (specific but not sensitive) and inappropriate for Cryptosporidium sp. antigen detection (not specific or sensitive). The modified Ziehl-Neelsen stain was found to be highly specific but not sensitive in the detection of Cryptosporidium sp. oocysts. These results underline the necessity of using ancillary tests and concentration methods to correctly identify positive samples. This is the first report of Cryptosporidium sp. and Giardia sp. infections in free-ranging western lowland gorillas

  19. Anterior disc displacement with reduction and symptomatic hypermobility in the human temporomandibular joint: prevalence rates and risk factors in children and teenagers.

    PubMed

    Huddleston Slater, James J R; Lobbezoo, Frank; Onland-Moret, N Charlotte; Naeije, Machiel

    2007-01-01

    To assess the prevalence rates and risk factors of anterior disc displacement with reduction (ADDR) and symptomatic hypermobility in a large sample of children and teenagers. Prevalence rates were also established in samples of young adults and adults. Children from 7 Dutch primary and secondary schools (n = 1,833) aged 4 to 18 years (mean age +/- SD 10.8 +/- 3.9 years), 220 dental students aged 19 to 30 years (mean age +/- SD 21.9 +/- 3.6 years), and 100 dental school employees more than 30 years old (mean age +/- SD 43.5 +/- 9.8 years) were examined. The presence of ADDR or symptomatic hypermobility was scored using well-defined clinical criteria. For the children only, an additional standardized oral history and clinical examination were performed to assess possible risk factors. Odds ratios (ORs) were calculated with the use of logistic multivariate regression analysis. The prevalence rate of ADDR in at least 1 of the 2 joints increased during childhood and adolescence and stabilized into adulthood at about 26.6%. In children and teenagers, besides age (OR = 1.06 for boys, OR = 1.23 for girls), risk factors for ADDR were a history of orthodontics (OR = 1.57), an increasing overbite (OR = 1.15), and protrusion (OR = 1.12). In children and teenagers, the prevalence rate of symptomatic hypermobility was higher for girls (13.8%) than for boys (8.2%). Besides gender (OR = 2.07), risk factors for symptomatic hypermobility were race (OR = 2.61 for non-Caucasians), masticatory muscle pain (OR = 1.95), and increasing maximum mouth opening (OR = 1.08). In children and teenagers, ADDR and symptomatic hypermobility have different prevalence rates and risk factors.

  20. Infectious diseases prevalence, vaccination coverage, and diagnostic challenges in a population of internationally adopted children referred to a Tertiary Care Children's Hospital from 2009 to 2015.

    PubMed

    Sollai, Sara; Ghetti, Francesca; Bianchi, Leila; de Martino, Maurizio; Galli, Luisa; Chiappini, Elena

    2017-03-01

    Infectious diseases are common in internationally adopted children (IAC).With the objective to evaluate infectious diseases prevalence in a large cohort of IAC and to explore possible risk factors for tuberculosis (TB) and parasitic infections, clinical and laboratory data at first screening visit of all IAC (<18 years) consecutively referred to our Center in 2009 to 2015 were collected and analyzed.In total, 1612 children (median age: 5.40 years; interquartile range: 3.00-7.90) were enrolled, 123/1612 (7.60%) having medical conditions included in the special needs definition. The most frequent cutaneous infections were Molluscum contagiosum (42/1612; 2.60%) and Tinea capitis (37/1612; 2.30%). Viral hepatitis prevalence was <1% (hepatitis B virus [HBV]: 13 children, 0.80%; hepatitis C virus: 1 child, 0.10%; hepatitis A virus: 6 children, 0.40%). A parasitic infection was diagnosed in 372/1612 (23.10%) children. No risk factors for parasitosis were evidenced. Active TB was diagnosed in 4/1355 (0.3%) children, latent TB in 222/1355 (16.40%). Only 3.7% (51/1355) children had concordant positive tuberculin skin test (TST) and QuantiFERON-TB-Gold In-Tube (QFT-G-IT) results. Risk factors for TST+/QFT-G-IT- results were previous Bacille de Calmette-Guérin vaccination (adjusted odds ratio [aOR]: 2.18; 96% confidence interval [CI]: 1.26-3.79; P = 0.006), and age ≥5 years (aOR: 1.49; 95% CI: 1.06-2.11; P = 0.02). The proportion of children with nonprotective titers for vaccine-preventable diseases (VPD) ranged from 15.70% (208/1323) for tetanus to 35.10% (469/1337) for HBV.Infectious diseases were commonly observed in our cohort. The high rate of discordant TST/QFT-G results brings up questions regarding the optimal management of these children, and suggests that, at least in children older than 5 years, only QFT-G-IT results may be reliable. The low proportion of children protected for VPD, confirms importance of a timely screening.

  1. Infectious diseases prevalence, vaccination coverage, and diagnostic challenges in a population of internationally adopted children referred to a Tertiary Care Children's Hospital from 2009 to 2015

    PubMed Central

    Sollai, Sara; Ghetti, Francesca; Bianchi, Leila; de Martino, Maurizio; Galli, Luisa; Chiappini, Elena

    2017-01-01

    Abstract Infectious diseases are common in internationally adopted children (IAC). With the objective to evaluate infectious diseases prevalence in a large cohort of IAC and to explore possible risk factors for tuberculosis (TB) and parasitic infections, clinical and laboratory data at first screening visit of all IAC (<18 years) consecutively referred to our Center in 2009 to 2015 were collected and analyzed. In total, 1612 children (median age: 5.40 years; interquartile range: 3.00–7.90) were enrolled, 123/1612 (7.60%) having medical conditions included in the special needs definition. The most frequent cutaneous infections were Molluscum contagiosum (42/1612; 2.60%) and Tinea capitis (37/1612; 2.30%). Viral hepatitis prevalence was <1% (hepatitis B virus [HBV]: 13 children, 0.80%; hepatitis C virus: 1 child, 0.10%; hepatitis A virus: 6 children, 0.40%). A parasitic infection was diagnosed in 372/1612 (23.10%) children. No risk factors for parasitosis were evidenced. Active TB was diagnosed in 4/1355 (0.3%) children, latent TB in 222/1355 (16.40%). Only 3.7% (51/1355) children had concordant positive tuberculin skin test (TST) and QuantiFERON-TB-Gold In-Tube (QFT-G-IT) results. Risk factors for TST+/QFT-G-IT− results were previous Bacille de Calmette-Guérin vaccination (adjusted odds ratio [aOR]: 2.18; 96% confidence interval [CI]: 1.26–3.79; P = 0.006), and age ≥5 years (aOR: 1.49; 95% CI: 1.06–2.11; P = 0.02). The proportion of children with nonprotective titers for vaccine-preventable diseases (VPD) ranged from 15.70% (208/1323) for tetanus to 35.10% (469/1337) for HBV. Infectious diseases were commonly observed in our cohort. The high rate of discordant TST/QFT-G results brings up questions regarding the optimal management of these children, and suggests that, at least in children older than 5 years, only QFT-G-IT results may be reliable. The low proportion of children protected for VPD, confirms importance of a timely screening. PMID

  2. ITER Generic Diagnostic Upper Port Plug Nuclear Heating and Personnel Dose Rate Assesment Neutronics Analysis using the ATTILA Discrete Ordinates Code

    SciTech Connect

    Russell Feder and Mahmoud Z. Yousef

    2009-05-29

    Neutronics analysis to find nuclear heating rates and personnel dose rates were conducted in support of the integration of diagnostics in to the ITER Upper Port Plugs. Simplified shielding models of the Visible-Infrared diagnostic and of the ECH heating system were incorporated in to the ITER global CAD model. Results for these systems are representative of typical designs with maximum shielding and a small aperture (Vis-IR) and minimal shielding with a large aperture (ECH). The neutronics discrete-ordinates code ATTILA® and SEVERIAN® (the ATTILA parallel processing version) was used. Material properties and the 500 MW D-T volume source were taken from the ITER “Brand Model” MCNP benchmark model. A biased quadrature set equivelant to Sn=32 and a scattering degree of Pn=3 were used along with a 46-neutron and 21-gamma FENDL energy subgrouping. Total nuclear heating (neutron plug gamma heating) in the upper port plugs ranged between 380 and 350 kW for the Vis-IR and ECH cases. The ECH or Large Aperture model exhibited lower total heating but much higher peak volumetric heating on the upper port plug structure. Personnel dose rates are calculated in a three step process involving a neutron-only transport calculation, the generation of activation volume sources at pre-defined time steps and finally gamma transport analyses are run for selected time steps. ANSI-ANS 6.1.1 1977 Flux-to-Dose conversion factors were used. Dose rates were evaluated for 1 full year of 500 MW DT operation which is comprised of 3000 1800-second pulses. After one year the machine is shut down for maintenance and personnel are permitted to access the diagnostic interspace after 2-weeks if dose rates are below 100 μSv/hr. Dose rates in the Visible-IR diagnostic model after one day of shutdown were 130 μSv/hr but fell below the limit to 90 μSv/hr 2-weeks later. The Large Aperture or ECH style shielding model exhibited higher and more persistent dose rates. After 1-day the dose rate was 230

  3. Substance Use and Other Mental Health Disorders Among Veterans Returning to the Inner City: Prevalence, Correlates, and Rates of Unmet Treatment Need

    PubMed Central

    Vazan, Peter; Golub, Andrew; Bennett, Alex S.

    2013-01-01

    Estimates of substance use and other mental health disorders of veterans (N = 269) who returned to predominantly low-income minority New York City neighborhoods between 2009 and 2012 are presented. Although prevalences of posttraumatic stress disorder, traumatic brain injury, and depression clustered around 20%, the estimated prevalence rates of alcohol use disorder, drug use disorder, and substance use disorder were 28%, 18%, and 32%, respectively. Only about 40% of veterans with any diagnosed disorder received some form of treatment. For alcohol use disorder, the estimate of unmet treatment need was 84%, which is particularly worrisome given that excessive alcohol use was the greatest substance use problem. PMID:23869460

  4. Prevalence of Internet gaming disorder in German adolescents: diagnostic contribution of the nine DSM-5 criteria in a state-wide representative sample.

    PubMed

    Rehbein, Florian; Kliem, Sören; Baier, Dirk; Mößle, Thomas; Petry, Nancy M

    2015-05-01

    Internet gaming disorder (IGD) is included as a condition for further study in Section 3 of the DSM-5. Nine criteria were proposed with a threshold of five or more criteria recommended for diagnosis. The aims of this study were to assess how the specific criteria contribute to diagnosis and to estimate prevalence rates of IGD based on DSM-5 recommendations. Large-scale, state-representative school survey using a standardized questionnaire. Germany (Lower Saxony). A total of 11 003 ninth-graders aged 13-18 years (mean = 14.88, 51.09% male). IGD was assessed with a DSM-5 adapted version of the Video Game Dependency Scale that covered all nine criteria of IGD. In total, 1.16% [95% confidence interval (CI) = 0.96, 1.36] of respondents were classified with IGD according to DSM-5 recommendations. IGD students played games for longer periods, skipped school more often, had lower grades in school, reported more sleep problems and more often endorsed feeling 'addicted to gaming' than their non-IGD counterparts. The most frequently reported DSM-5 criteria overall were 'escape adverse moods' (5.30%) and 'preoccupation' (3.91%), but endorsement of these criteria rarely related to IGD diagnosis. Conditional inference trees showed that the criteria 'give up other activities', 'tolerance' and 'withdrawal' were of key importance for identifying IGD as defined by DSM-5. Based on a state-wide representative school survey in Germany, endorsement of five or more criteria of DSM-5 internet gaming disorder (IGD) occurred in 1.16% of the students, and these students evidence greater impairment compared with non-IGD students. Symptoms related to 'give up other activities', 'tolerance' and 'withdrawal' are most relevant for IGD diagnosis in this age group. © 2015 Society for the Study of Addiction.

  5. Population Reference Values and Prevalence Rates following Universal Screening for Subclinical Hypothyroidism during Pregnancy of an Afro-Caribbean Cohort

    PubMed Central

    Johnson, Nadine; Chatrani, Vikash; Taylor-Christmas, Anna-Kay; Choo-Kang, Eric; Smikle, Monica; Wright-Pascoe, Rosemarie; Phillips, Karen; Reid, Marvin

    2014-01-01

    Background Subclinical hypothyroidism (SCH) has been reported to be associated with adverse pregnancy outcomes, however universal screening and treatment is controversial. Objectives Our objectives were to determine population-specific pregnancy reference values (R1) for serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) at 14 weeks' gestation, along with the prevalence of SCH and thyroid peroxidase antibody (TPOAb). Methods This was a prospective hospital-based cohort study. 1,402 subjects were recruited. Blood samples were obtained from 769 singleton pregnancies due to default between recruitment and scheduled blood draw. The prevalence of SCH was determined using R1, the laboratory non-pregnant reference values (R2) and previously recommended pregnancy reference values (R3). Results R1 for TSH and FT4 was 0.03-3.17 mU/l (mean ± SD, 1.1 ± 0.76) and 8.85-17.02 pmol/l (mean ± SD, 11.96 ± 2.06), respectively. The prevalence of SCH using reference values R1, R2 and R3 was 1.4% (11/769), 0.5% (4/769) and 1.9% (15/769). Prevalence was significantly greater using R3 when compared to R2 (p = 0.011). TPOAb prevalence was 2.6%. A significantly greater prevalence of TPOAb was found in subclinical hypothyroid subjects using all three reference values than in euthyroid subjects (∼25 vs. 2%, p < 0.05). Conclusions These reference values are the first to be reported for an Afro-Caribbean population. Our findings support the use of pregnancy-specific reference values in our population. PMID:25759799

  6. Rating Scales for Diagnostic Assessment of Writing: What Should They Look Like and Where Should the Criteria Come from?

    ERIC Educational Resources Information Center

    Knoch, Ute

    2011-01-01

    Rating scales act as the de facto test construct in a writing assessment, although inevitably as a simplification of the construct (North, 2003). However, it is often not reported how rating scales are constructed. Unless the underlying framework of a rating scale takes some account of linguistic theory and research in the definition of…

  7. Rating Scales for Diagnostic Assessment of Writing: What Should They Look Like and Where Should the Criteria Come from?

    ERIC Educational Resources Information Center

    Knoch, Ute

    2011-01-01

    Rating scales act as the de facto test construct in a writing assessment, although inevitably as a simplification of the construct (North, 2003). However, it is often not reported how rating scales are constructed. Unless the underlying framework of a rating scale takes some account of linguistic theory and research in the definition of…

  8. Reduced rates of hospital-acquired UTI in medical patients. Prevalence surveys indicate effect of active infection control programmes.

    PubMed

    Christensen, M; Jepsen, O B

    2001-01-01

    Prevalence surveys have been part of the Danish infection control programme since 1974. Nationwide surveys were carried out in 1978, 1979, 1980, 1991 and 1999. The results indicate a net reduction of approximately 25%, mainly due to a reduction of urinary tract infections (UTIs) in medical patients. Results from the nationwide surveys are validated by results of occasional independent surveys performed in regions or single hospitals. The reduction coincides with preventive programmes focused on catheter policy and UTI. We conclude that the prevalence survey is an important part of our strategic programme for infection control in hospitals.

  9. Prevalence of parent-rated attention deficit hyperactivity disorder and associated parent-related factors in primary school children of Navi Mumbai--a school based study.

    PubMed

    Ajinkya, Shaunak; Kaur, Darpan; Gursale, Akshay; Jadhav, Pradeep

    2013-03-01

    To study the prevalence of parent-rated attention deficit hyperactivity disorder and associated parent-related factors in primary school children of Navi Mumbai. One hundred twenty two children including both boys and girls aged between 6 y and 11 y were selected from a school at Navi Mumbai and their parents were given the National Innovative for Children's Healthcare Quality (NICHQ) Vanderbilt Assessment Scale to be filled and returned, which was subsequently analyzed using SPSS (version 16). The prevalence of attention deficit hyperactivity disorder was 12.3 % with boy to girl ratio of 3:2. It was more prevalent in nuclear type of family and in families where a single parent was working especially where the father was the sole breadwinner and doing semi-skilled or unskilled type of work. No significant relation was found between the numbers of work-related hours when parents were away from children and attention deficit hyperactivity disorder. Attention deficit hyperactivity disorder is prevalent in the primary school-going population of Navi Mumbai, especially in boys. The increased prevalence in nuclear families and families with single working parent should further be explored. Further studies with larger sample size and longer period of follow up may be recommended. The study also recommends screening of school children for symptoms of attention deficit hyperactivity disorder (ADHD) for early diagnosis and treatment.

  10. Open access echocardiography has diagnostic yield similar to outpatient echocardiography and is highly rated by general practitioners and patients.

    PubMed

    Mahadevan, V S; Earley, M; McClements, B

    2005-03-30

    Open access echocardiography is widely available to General Practitioners (GP). There is little data comparing the proportion of echocardiographic studies which are abnormal in open access series with that in hospital outpatient practice. This study compares the diagnostic yield from echocardiograms performed for similar indications by open access and hospital out patient requested groups and assesses the attitudes of GPs and patients to open access echocardiography. The reports of 151 consecutive patients who had open access echocardiograms were analysed using predefined criteria for an abnormal study. The reports of 100 consecutive patients who had a new outpatient requested echocardiograms for similar indications were used as the control group. The attitudes of GPs and patients to the open access service were also assessed. Fifty seven percent of patients in the open access group and 51% in the hospital requested group had abnormal studies (p>0.05). 92% of GPs who responded to the questionnaire thought the report was easy to understand while 69% thought it led to a change in patient management. 74% said a clinic referral would have been made without this service and 79% preferred a management strategy to be included in the report. 90% of patients had been informed of the result by their GP. Open access echocardiography has a diagnostic yield similar to echocardiograms requested on new hospital outpatients in a district general hospital setting. GPs and patients report high levels of satisfaction with this service.

  11. Clinical value of contrast-enhanced ultrasound in improving diagnostic accuracy rate of transthoracic biopsy of anterior-medial mediastinal lesions

    PubMed Central

    Fu, Jingjing; Yang, Wei; Wang, Song; Bai, Jing; Wu, Hao; Wang, Haiyue; Yan, Kun; Chen, Minhua

    2016-01-01

    Objective To evaluate the clinical value of contrast-enhanced ultrasound (CEUS) in transthoracic biopsy of anterior-medial mediastinal lesions. Methods A total of 123 patients with anterior or middle mediastinum lesions required ultrasound guided transthoracic biopsy for pathological diagnosis. Among them, 72 patients received CEUS examinations before biopsy. After CEUS, 8 patients were excluded from biopsy and the rest 64 patients underwent biopsy (CEUS group). During the same period, 51 patients received biopsy without CEUS examination (US group). The ultrasonography characteristics, the number of biopsy puncture attempts, diagnostic accuracy rate and the incidence of complications were recorded and compared between the two groups. Results A large portion of necrosis area or superficial large vessels was found in 8 patients, so the biopsy was cancelled. The internal necrosis was demonstrated in 43.8% of the lesions in CEUS group and in 11.8% of US group (P>0.001). For thymic carcinoma, CEUS increased the detection rate of internal necrosis and pericardial effusion than conventional ultrasound (62.5% vs. 18.8%, P=0.012; 56.3% vs. 12.5%, P=0.023). The average number of punctures in CEUS group and US group was 2.36±0.70 and 2.21±0.51 times, respectively (P>0.05). The diagnostic accuracy rate of biopsy in CEUS group (96.9%, 62/64) was significantly higher than that in US group (84.3%, 43/51) (P=0.022). In US group, 2 patients suffered from mediastinal bleeding (3.9%), while no major complications occurred in CEUS group. Conclusions CEUS examination provided important information before transthoracic mediastinum biopsy and improved diagnostic accuracy rate in biopsy of anterior and middle mediastinum lesions than conventional ultrasound. PMID:28174490

  12. Prevalence, Employment Rate, and Cost of Schizophrenia in a High-Income Welfare Society: A Population-Based Study Using Comprehensive Health and Welfare Registers.

    PubMed

    Evensen, Stig; Wisløff, Torbjørn; Lystad, June Ullevoldsæter; Bull, Helen; Ueland, Torill; Falkum, Erik

    2016-03-01

    Schizophrenia is associated with recurrent hospitalizations, need for long-term community support, poor social functioning, and low employment rates. Despite the wide- ranging financial and social burdens associated with the illness, there is great uncertainty regarding prevalence, employment rates, and the societal costs of schizophrenia. The current study investigates 12-month prevalence of patients treated for schizophrenia, employment rates, and cost of schizophrenia using a population-based top-down approach. Data were obtained from comprehensive and mandatory health and welfare registers in Norway. We identified a 12-month prevalence of 0.17% for the entire population. The employment rate among working-age individuals was 10.24%. The societal costs for the 12-month period were USD 890 million. The average cost per individual with schizophrenia was USD 106 thousand. Inpatient care and lost productivity due to high unemployment represented 33% and 29%, respectively, of the total costs. The use of mandatory health and welfare registers enabled a unique and informative analysis on true population-based datasets. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  13. A Higher Prevalence Rate of Campylobacter in Retail Beef Livers Compared to Other Beef and Pork Meat Cuts

    PubMed Central

    Noormohamed, Aneesa; Fakhr, Mohamed K.

    2013-01-01

    The objectives of this study were to determine the prevalence of Campylobacter jejuni and Campylobacter coli in retail beef, beef livers, and pork meats purchased from the Tulsa (OK, USA) area and to further characterize the isolates obtained through antimicrobial susceptibility testing. A total of 97 chilled retail beef (50 beef livers and 47 other cuts), and 100 pork samples were collected. The prevalence of Campylobacter in beef livers was 39/50 (78%), while no Campylobacter was isolated from the other beef cuts. The prevalence in pork samples was 2/100 (2%). A total of 108 Campylobacter isolates (102 beef livers isolates and six pork isolates) were subjected to antimicrobial resistance profiling against sixteen different antimicrobials that belong to eight different antibiotic classes. Of the six pork Campylobacter coli isolates, four showed resistance to all antimicrobials tested. Among the beef liver isolates, the highest antibiotic resistances were to tetracyclines and β-lactams, while the lowest resistances were to macrolides, aminoglycosides, lincosamides, and phenicols. Resistances to the fluoroquinolone, macrolide, aminoglycoside, tetracycline, β-lactam, lincosamide, and phenicol antibiotic classes were significantly higher in Campylobacter coli than Campylobacter jejuni isolates. Multidrug Resistance (MDR) among the 102 Campylobacter (33 Campylobacter jejuni and 69 Campylobacter coli) beef liver isolates was significantly higher in Campylobacter coli (62%) than Campylobacter jejuni (39%). The high prevalence of Campylobacter in retail beef livers and their antimicrobial resistance raise concern about the safety of these retail products. PMID:23698698

  14. Large-scale survey of rates of achieving targets for blood glucose, blood pressure, and lipids and prevalence of complications in type 2 diabetes (JDDM 40)

    PubMed Central

    Yokoyama, Hiroki; Oishi, Mariko; Takamura, Hiroshi; Yamasaki, Katsuya; Shirabe, Shin-ichiro; Uchida, Daigaku; Sugimoto, Hidekatsu; Kurihara, Yoshio; Araki, Shin-ichi; Maegawa, Hiroshi

    2016-01-01

    Objective The fact that population with type 2 diabetes mellitus and bodyweight of patients are increasing but diabetes care is improving makes it important to explore the up-to-date rates of achieving treatment targets and prevalence of complications. We investigated the prevalence of microvascular/macrovascular complications and rates of achieving treatment targets through a large-scale multicenter-based cohort. Research design and methods A cross-sectional nationwide survey was performed on 9956 subjects with type 2 diabetes mellitus who consecutively attended primary care clinics. The prevalence of nephropathy, retinopathy, neuropathy, and macrovascular complications and rates of achieving targets of glycated hemoglobin (HbA1c) <7.0%, blood pressure <130/80 mm Hg, and lipids of low-density/high-density lipoprotein cholesterol <3.1/≥1.0 mmol/L and non-high-density lipoprotein cholesterol <3.8 mmol/L were investigated. Results The rates of achieving targets for HbA1c, blood pressure, and lipids were 52.9%, 46.8% and 65.5%, respectively. The prevalence of microvascular complications was ∼28% each, 6.4% of which had all microvascular complications, while that of macrovascular complications was 12.6%. With an increasing duration of diabetes, the rate of achieving target HbA1c decreased and the prevalence of each complication increased despite increased use of diabetes medication. The prevalence of each complication decreased according to the number achieving the 3 treatment targets and was lower in subjects without macrovascular complications than those with. Adjustments for considerable covariates exhibited that each complication was closely inter-related, and the achievement of each target was significantly associated with being free of each complication. Conclusions Almost half of the subjects examined did not meet the recommended targets. The risk of each complication was significantly affected by 1 on-target treatment (inversely) and the

  15. Prevalence of Genital Human Papillomavirus Infection and Human Papillomavirus Vaccination Rates Among US Adult Men: National Health and Nutrition Examination Survey (NHANES) 2013-2014.

    PubMed

    Han, Jasmine J; Beltran, Thomas H; Song, John W; Klaric, John; Choi, Y Sammy

    2017-06-01

    Human papillomavirus (HPV) is a common sexually transmitted infection that is a major cause of noncervical anogenital and oropharyngeal cancers. Prophylactic HPV vaccine is available for primary prevention. However, the population prevalence data for male genital HPV infection is not well known, while the HPV vaccination coverage is low in the United States. To estimate the prevalence of genital HPV infection and the HPV vaccination rate in the United States among adult men and to examine potential risk factors for HPV infection. The National Health and Nutrition Examination Survey (NHANES) samples a representative cross-section of the US population. Men aged 18 to 59 years were examined in mobile examination centers during the NHANES 2013-2014. DNA was extracted from self-collected penile swab specimens, and HPV genotyping was performed by polymerase chain reaction amplification. Demographic and vaccination information was gathered via self-report during home-based standardized interviews. Binary multivariable logistic regression was used to estimate the odds of HPV infection. The prevalence of genital HPV infection and the HPV vaccination coverage rate among adult men. During the NHANES 2013-2014, a total of 1868 men aged 18 to 59 years were examined. The overall genital HPV infection prevalence was 45.2% (95% CI, 41.3%-49.3%). The infection prevalence with at least 1 high-risk HPV subtype defined by DNA testing was 25.1% (95% CI, 23.0%-27.3%). In vaccine-eligible men, the prevalence of infection with at least 1 HPV strain targeted by the HPV 4-valent vaccine and HPV 9-valent vaccine was 7.1% (95% CI, 5.1%-9.5%) and 15.4% (95% CI, 11.7%-19.6%), respectively. Among vaccine-eligible men, the HPV vaccination coverage was 10.7% (95% CI, 7.8%-14.6%). Among men aged 18 to 59 years in the United States, the overall prevalence of genital HPV infection was 45.2% (95% CI, 41.3%-49.3%). The overall genital HPV infection prevalence appears to be widespread among all age

  16. Structure and Dynamics of Fuel Jets Injected into a High-Temperature Subsonic Crossflow: High-Data-Rate Laser Diagnostic Investigation under Steady and Oscillatory Conditions

    SciTech Connect

    Lucht, Robert; Anderson, William

    2015-01-23

    An investigation of subsonic transverse jet injection into a subsonic vitiated crossflow is discussed. The reacting jet in crossflow (RJIC) system investigated as a means of secondary injection of fuel in a staged combustion system. The measurements were performed in test rigs featuring (a) a steady, swirling crossflow and (b) a crossflow with low swirl but significant oscillation in the pressure field and in the axial velocity. The rigs are referred to as the steady state rig and the instability rig. Rapid mixing and chemical reaction in the near field of the jet injection is desirable in this application. Temporally resolved velocity measurements within the wake of the reactive jets using 2D-PIV and OH-PLIF at a repetition rate of 5 kHz were performed on the RJIC flow field in a steady state water-cooled test rig. The reactive jets were injected through an extended nozzle into the crossflow which is located in the downstream of a low swirl burner (LSB) that produced the swirled, vitiated crossflow. Both H2/N2 and natural gas (NG)/air jets were investigated. OH-PLIF measurements along the jet trajectory show that the auto-ignition starts on the leeward side within the wake region of the jet flame. The measurements show that jet flame is stabilized in the wake of the jet and wake vortices play a significant role in this process. PIV and OH–PLIF measurements were performed at five measurement planes along the cross- section of the jet. The time resolved measurements provided significant information on the evolution of complex flow structures and highly transient features like, local extinction, re-ignition, vortex-flame interaction prevalent in a turbulent reacting flow. Nanosecond-laser-based, single-laser-shot coherent anti-Stokes Raman scattering (CARS) measurements of temperature and H2 concentraiton were also performed. The structure and dynamics of a reacting transverse jet injected into a vitiated oscillatory crossflow presents a unique opportunity for

  17. Prevalence of metabolic syndrome in non-diabetic, pregnant Angolan women according to four diagnostic criteria and its effects on adverse perinatal outcomes.

    PubMed

    Dos Prazeres Tavares, Hamilton; Dos Santos, Débora Cristina Damasceno Meirelles; Abbade, Joelcio Francisco; Negrato, Carlos Antonio; de Campos, Paulo Adão; Calderon, Iracema Mattos Paranhos; Rudge, Marilza Vieira Cunha

    2016-01-01

    Metabolic syndrome (MetS) is a cluster of risk factors for type 2 diabetes (Type2 DM) and cardiovascular diseases (CVD), and its prevalence varies based on region, population, and sex. Newborns of women with MetS have a greater risk of adverse perinatal outcomes. This study explores the prevalence of metabolic syndrome in non-diabetic, pregnant Angolan women and the adverse perinatal outcomes associated with it. This cross-sectional study collected the demographic, anthropometric and clinical data of 675 pregnant women in the maternity ward of General Hospital in Huambo, Angola. Metabolic syndrome was defined using four criteria: the third report of the National Cholesterol Education Program Adult Treatment Panel (ATPIII), the Joint Interim Statement (JIS), and definitions by both Bartha et al. and Chatzi et al. The crude prevalence of metabolic syndrome was 36.6 % based on the JIS definition, 29.2 % based on NCEP ATPIII, 12.6 % based on Chatzi et al. and 1.8 % based on Bartha et al. In general, the prevalence of adverse perinatal outcomes was 14.1 %. There was a high prevalence of metabolic syndrome, depending on the criteria used, and thus a great need to harmonize the criteria and cutoff points. Perinatal adverse outcomes were higher in pregnant women with metabolic syndrome.

  18. [Needs for dental prostheses and their use in elderly Brazilians according to the National Oral Health Survey (SBBrazil 2010): prevalence rates and associated factors].

    PubMed

    Azevedo, Juliana S; Azevedo, Marina Sousa; Oliveira, Luisa Jardim Correa de; Correa, Marcos Britto; Demarco, Flávio Fernando

    2017-08-21

    The objectives of this study were to evaluate the use of and need for dental prostheses among elderly Brazilians (65-74 years of age) and to verify associated factors. Data were analyzed from 7,496 elderly participants in the National Oral Health Survey in 2010 (SBBrazil 2010). Use of and need for dental prosthesis were the outcomes. The exposure variables included demographic and socioeconomic characteristics, dental services use, and self-rated oral health. Descriptive, bivariate, and multivariate analyses were performed. Prevalence rates for use of and need for dental prostheses were 78.2% and 68.7%, respectively. The Southeast Region had the highest prevalence of use (71.3%) and the greatest need for dental prostheses (82.9%). Multivariate Poisson regression analyses showed greater use of dental prostheses by women, individuals with 5 to 7 years of schooling, and users of private dental services, and lower use by black individuals and those with self-reported need for dental prostheses. Less need for dental prostheses was seen in women and in users of private services, and greater need in those with self-reported need for dental prostheses. Regional differences were seen in the distribution of use and need for dental prostheses. Still, the findings showed high prevalence rates for both outcomes in all regions of Brazil. Socioeconomic and demographic variables and use of dental services influenced the use of and need for dental prostheses.

  19. Effect of a novel vendor-specific motion-correction algorithm on image quality and diagnostic accuracy in persons undergoing coronary CT angiography without rate-control medications.

    PubMed

    Leipsic, Jonathon; Labounty, Troy M; Hague, Cameron J; Mancini, G B John; O'Brien, Julie M; Wood, David A; Taylor, Carolyn M; Cury, Ricardo C; Earls, James P; Heilbron, Brett G; Ajlan, Amr M; Feuchtner, Gudrun; Min, James K

    2012-01-01

    Although coronary CT angiography (CTA) shows high diagnostic performance for detection and exclusion of obstructive coronary artery disease, limited temporal resolution of current-generation CT scanners may allow for motion artifacts, which may result in nonevaluable coronary segments. We assessed a novel vendor-specific motion-correction algorithm for its effect on image quality and diagnostic accuracy. Thirty-six consecutive patients with severe aortic stenosis undergoing coronary CTA without rate control and invasive coronary angiography as part of an evaluation for transcatheter aortic valve replacement. We compared image quality and diagnostic accuracy between standard (STD) and motion-corrected (MC) reconstructions. Coronary CTAs were interpreted in an intent-to-diagnose fashion by 2 experienced readers; a third reader provided consensus for interpretability and obstructive coronary stenosis (≥50% stenosis). All studies were interpreted with and without motion correction using both 45% and 75% of the R-R interval for reconstructions. Quantitative coronary angiography was performed by a core laboratory. Mean age was 83.0 ± 6.4 years; 47% were men. Overall image quality (graded 1-4) was higher with the use of MC versus STD reconstructions (2.9 ± 0.9 vs 2.4 ± 1.0; P < 0.001). MC reconstructions showed higher interpretability on a per-segment [97% (392/406) vs 88% (357/406); P < 0.001] and per-artery [96% (128/134) vs 84% (112/134); P = 0.002] basis, with no difference on a per-patient level [92% (33/36) vs 89% (32/36); P = 1.0]. Diagnostic accuracy by MC reconstruction was higher than STD reconstruction on a per-segment [91% (370/406) vs 78% (317/406); P < 0.001] and per-artery level [86% (115/134) vs 72% (96/134); P = 0.007] basis, with no significant difference on a per-patient level [86% (31/36) vs 69% (25/36); P = 0.16]. The use of a novel MC algorithm improves image quality, interpretability, and diagnostic accuracy in persons undergoing coronary CTA

  20. Conduct Disorder in Girls: Diagnostic and Intervention Issues

    ERIC Educational Resources Information Center

    Delligatti, Nina; Akin-Little, Angeleque; Little, Steven G.

    2003-01-01

    Current prevalence rates of Conduct Disorder (CD) in girls may be an underestimate due to inappropriate diagnostic criteria, biased perceptions by those responsible for reporting problematic behavior, and differential social constraints for each gender. Relatively few published studies of CD and related behaviors in girls exist. Available evidence…

  1. Research Potential of a Heart Rate Variability Diagnostic System for the Study of Stress and Health Risk in Peacekeeping Operations

    DTIC Science & Technology

    2004-06-01

    physiological reactivity [ Blanchard & Buckley, 1999; Buckley & Kaloupek, 2001; Cohen et al, 1997; Liberzon et al, 1999; McFall et al, 1990]. Results of...sympathetic activity [ Blanchard et al, 1991; Bremner et al, 1999; Keane et al, 1985; Kolb, 1987; Kolb, 1984]; and increased sympathetic activity and...in increased heart rate, blood pressure, and increased low frequency component of heart rate variability [ Blanchard , 1990; Buckley & Kaloupek, 2001

  2. A Simple “Blood-Saving Bundle” Reduces Diagnostic Blood Loss and the Transfusion Rate in Mechanically Ventilated Patients

    PubMed Central

    Riessen, Reimer; Behmenburg, Melanie; Blumenstock, Gunnar; Guenon, Doris; Enkel, Sigrid; Schäfer, Richard; Haap, Michael

    2015-01-01

    Introduction Aim of this study was to reduce blood loss caused by diagnostic blood sampling and to minimize the development of anemia in a high-risk group of mechanically ventilated medical intensive care patients. We therefore implemented a “blood-saving bundle” (BSB) combining a closed-loop arterial blood sampling system, smaller sampling tubes, reduced frequency of blood drawings, and reduced sample numbers. Methods The study included all patients from our medical ICU who were ventilated for more than 72 hours. Exclusion criteria were: acute or chronic anemia on admission, bleeding episode(s) during the ICU stay, or end-of-life therapy. The BSB was introduced in 2009 with training and educational support. Patients treated in 2008, before the introduction of the BSB, served as a control group (n = 41, 617 observation days), and were compared with patients treated in 2010 after the introduction of the BSB (BSB group, n = 50, 559 observation days). Primary endpoints were blood loss per day, and development of anemia. Secondary endpoints were numbers of blood transfusions, number of days on mechanical ventilation, and length of the ICU stay. Results Mean blood loss per ICU day was decreased from 43.3 ml (95% CI: 41.2 to 45.3 ml) in the controls to 15.0 ml (14.3 to 15.7 ml) in the BSB group (P < 0.001). The introduction of a closed-loop arterial blood sampling system was the major contributor to this effect. Mean hemoglobin concentrations showed no significant differences in both groups during the ICU stay. Hemoglobin values <9 g/dl, however, were recorded in 21.2% of observation days in the controls versus 15.4% in the BSB group (P = 0.01). Units of transfused red blood cells per 100 observation days decreased from 7 to 2.3 (P < 0.001). The mean number of ventilation days was 7.1 days (6.1 to 8.3 days) in the controls and 7.5 days (6.6 to 8.5 days) in the BSB group (P = NS). In total, patients in the BSB group stayed in ICU for a mean of 9.9 days (8.6 to 11

  3. UK Renal Registry 11th Annual Report (December 2008): Chapter 4 ESRD prevalent rates in 2007 in the UK: national and centre-specific analyses.

    PubMed

    Farrington, Ken; Hodsman, Alex; Casula, Anna; Ansell, David; Feehally, John

    2009-01-01

    This chapter describes the demographics of UK RRT patients in 2007. Complete data were electronically collected from 71 UK centres with the remaining 1 centre submitting summary data. A series of cross-sectional and longitudinal analyses were performed to describe the demographics of prevalent UK RRT patients in 2007 at a centre and a national level. There were 45,484 adult patients receiving RRT on 31/12/2007. The population prevalence for adults was 746 per million population per year (pmp) with an annual increase in prevalence of approximately 5% per annum. There was substantial variation in standardised prevalence ratios between Primary Care Trust (PCT)/Health Authority (HA) areas which were associated with geographical factors and differences in ethnicity with mean standardised prevalence ratios (SPR) significantly higher in PCTs/HAs with a high proportion of ethnic minorities. The median age of prevalent RRT patients was 57 years (HD 65 years, PD 60 years, transplant 50 years). Median RRT vintage was 5.3 years (HD 2.8 years, PD 2.1 years, transplant 10.4 years). For all ages, crude prevalence rates in males exceeded those in females, peaking in the 75-79 year age band for males at 2,506 pmp and in females in the 70-74 year age band at 1,314 pmp. The most common identifiable diagnosis was glomerulonephritis (15.3%) but in those over 65 it was diabetes (15.1%). The most common treatment modality was transplantation (46.6%), closely followed by centre-based HD (42.1%) in either the primary centre (25.2%) or the satellite unit (16.9%). The HD population has continued to expand, and the PD population to contract. HD was increasingly prominent with increasing age at the expense of transplantation. There were national, area and dialysis centre level variation in the prevalent UK RRT population. This has implications for service planning and ensuring equity of care for RRT patients. Copyright 2009 S. Karger AG, Basel.

  4. RAD sequencing yields a high success rate for westslope cutthroat and rainbow trout species-diagnostic SNP assays

    USGS Publications Warehouse

    Stephen J. Amish,; Paul A. Hohenlohe,; Sally Painter,; Robb F. Leary,; Muhlfeld, Clint C.; Fred W. Allendorf,; Luikart, Gordon

    2012-01-01

    Hybridization with introduced rainbow trout threatens most native westslope cutthroat trout populations. Understanding the genetic effects of hybridization and introgression requires a large set of high-throughput, diagnostic genetic markers to inform conservation and management. Recently, we identified several thousand candidate single-nucleotide polymorphism (SNP) markers based on RAD sequencing of 11 westslope cutthroat trout and 13 rainbow trout individuals. Here, we used flanking sequence for 56 of these candidate SNP markers to design high-throughput genotyping assays. We validated the assays on a total of 92 individuals from 22 populations and seven hatchery strains. Forty-six assays (82%) amplified consistently and allowed easy identification of westslope cutthroat and rainbow trout alleles as well as heterozygote controls. The 46 SNPs will provide high power for early detection of population admixture and improved identification of hybrid and nonhybridized individuals. This technique shows promise as a very low-cost, reliable and relatively rapid method for developing and testing SNP markers for nonmodel organisms with limited genomic resources.

  5. Contrast venography of the leg: diagnostic efficacy, tolerance, and complication rates with ionic and nonionic contrast media

    SciTech Connect

    Bettmann, M.A.; Robbins, A.; Braun, S.D.; Wetzner, S.; Dunnick, N.R.; Finkelstein, J.

    1987-10-01

    A prospective, three-center study of two contrast agents for leg venography was performed to evaluate both the relative frequency of adverse effects and whether low-osmolality agents provided significant advantages for this procedure. Fifty-four patients were studied with the standard preparation (iothalamate meglumine) and 57 with a nonionic agent (iopamidol). Both were used at an iodine concentration of 200 mg/mL, and there were no differences in volume of contrast material, duration of infusion, percentage of positive studies, or overall diagnostic adequacy. Patient discomfort was less with iopamidol than with iothalamate (18% vs. 44%), although discomfort was generally mild in both groups. By objective follow-up studies, the frequency of postvenographic thrombosis was not significantly different in the two groups (8% vs. 9%). Contrast venography, then, had a low frequency of complications when either a dilute conventional or a low-osmolality agent was employed. Although the frequency of postvenographic thrombosis was low with both agents, patient discomfort was less with the low-osmolality formulation.

  6. RAD sequencing yields a high success rate for westslope cutthroat and rainbow trout species-diagnostic SNP assays.

    PubMed

    Amish, Stephen J; Hohenlohe, Paul A; Painter, Sally; Leary, Robb F; Muhlfeld, Clint; Allendorf, Fred W; Luikart, Gordon

    2012-07-01

    Hybridization with introduced rainbow trout threatens most native westslope cutthroat trout populations. Understanding the genetic effects of hybridization and introgression requires a large set of high-throughput, diagnostic genetic markers to inform conservation and management. Recently, we identified several thousand candidate single-nucleotide polymorphism (SNP) markers based on RAD sequencing of 11 westslope cutthroat trout and 13 rainbow trout individuals. Here, we used flanking sequence for 56 of these candidate SNP markers to design high-throughput genotyping assays. We validated the assays on a total of 92 individuals from 22 populations and seven hatchery strains. Forty-six assays (82%) amplified consistently and allowed easy identification of westslope cutthroat and rainbow trout alleles as well as heterozygote controls. The 46 SNPs will provide high power for early detection of population admixture and improved identification of hybrid and nonhybridized individuals. This technique shows promise as a very low-cost, reliable and relatively rapid method for developing and testing SNP markers for nonmodel organisms with limited genomic resources.

  7. Increasing prevalence of smoke-free homes and decreasing rates of sudden infant death syndrome in the United States: an ecological association study.

    PubMed

    Behm, Ilan; Kabir, Zubair; Connolly, Gregory N; Alpert, Hillel R

    2012-01-01

    This study utilises an ecological design to analyse the relation between concurrent temporal trends in sudden infant death syndrome (SIDS) rates and prevalence of smoke-free households with infants in the USA, controlling for an important risk factor, infant supine sleep position. Annual state-specific SIDS cases were computed using period linked birth/infant death files; the prevalence of 100% smoke-free homes with infants using Tobacco Use Supplement to the Current Population Survey data, and percentage of infants in supine sleep position from National Infant Sleep Position data, for years 1995-2006. Incidence rate ratios relating trends in SIDS cases and risk factors were determined using time-series negative binomial regression. Population-level health effects were assessed with secondhand smoke (SHS) exposure population attributable fractions and excess attributable SIDS deaths. For every 1% absolute increase in the prevalence of smoke-free homes with infants, SIDS rates decreased 0.4% from 1995 to 2006, controlling for supine sleep position. Nationally, it is possible that 20% of the 1326 total SIDS cases were attributable to childhood SHS exposure at home in 2006 with potentially 534 fewer infant deaths attributable to SHS exposure in 2006 than in 1995, owing to an increasing prevalence of 100% smoke-free homes with infants. Cumulatively, 4402 (lower 95% CI) to 6406 (upper 95% CI) excess SIDS cases may have been attributable to SHS exposure in the home over the 12-year study period. The uptake of voluntary restrictions on smoking inside the home may present a public health benefit for infants in their first year of life. In light of inherent ecological study design limitations, these results warrant further individual level research linking postnatal SHS exposure and SIDS.

  8. Prevalence, awareness, treatment, and control of hypertension in elderly adults with chronic kidney disease: results from the survey of Prevalence, Awareness, and Treatment Rates in Chronic Kidney Disease Patients with Hypertension in China.

    PubMed

    Cai, Guangyan; Zheng, Ying; Sun, Xuefeng; Chen, Xiangmei

    2013-12-01

    Data regarding hypertension in elderly adults with chronic kidney disease (CKD) remains limited. This study aimed to assess the epidemiological characteristics of hypertension in elderly adults with CKD using data from a nationwide survey. A nationwide, multicenter, cross-sectional study with a large sample. The Survey of Prevalence, Awareness, and Treatment Rates in Chronic Kidney Disease Patients with Hypertension in China (PATRIOTIC). Participants in PATRIOTIC (aged≥60; n=2,414). Trained physicians measured blood pressure (BP) using a standard protocol with a mercury sphygmomanometer at the time of admission. The prevalence, awareness, and treatment of hypertension in elderly adults with CKD were 82.0%, 90.7%, and 87.3%, respectively. The control of hypertension at BP less than 140/90 mmHg was 29.6% and at BP less than 130/80 mmHg it was 12.1%. No significant differences were noted in the prevalence, awareness, treatment, or control of hypertension in individuals with CKD divided into the age groups of 60 to 69, 70 to 79, and 80 and older (P>.05). With increasing age, the proportion of isolated systolic hypertension in elderly adults with CKD with uncontrolled hypertension increased (P=.02). Obesity (P=.01), CKD Stages 4 and 5 (P<.001), and concomitant diabetes mellitus (P=.002) were significantly associated with uncontrolled hypertension in elderly adults with CKD, using the goal of BP less than 140/90 mmHg. The prevalence of hypertension in elderly adults in China with CKD is high, and its control is poor. Most elderly adults with CKD with uncontrolled hypertension have systolic hypertension. Obesity, CKD Stages 4 and 5, and diabetes mellitus were adversely associated with greater uncontrolled hypertension in elderly adults with CKD. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  9. Evaluation of frequency and time-frequency spectral analysis of heart rate variability as a diagnostic marker of the sleep apnoea syndrome.

    PubMed

    Hilton, M F; Bates, R A; Godfrey, K R; Chappell, M J; Cayton, R M

    1999-11-01

    The sleep apnoea/hypopnoea syndrome (SAHS) elicits a unique heart rate rhythm that may provide the basis for an effective screening tool. The study uses the receiver operator characteristic (ROC) to assess the diagnostic potential of spectral analysis of heart rate variability (HRV) using two methods, the discrete Fourier transform (DFT) and the discrete harmonic wavelet transform (DHWT). These two methods are compared over different sleep stages and spectral frequency bands. The HRV results are subsequently compared with those of the current screening method of oximetry. For both the DFT and the DHWT, the most diagnostically accurate frequency range for HRV spectral power calculations is found to be 0.019-0.036 Hz (denoted by AB2). Using AB2, 15 min sections of non-REM sleep data in 40 subjects produce ROC areas, for the DFT, DHWT and oximetry, of 0.94, 0.97 and 0.67, respectively. In REM sleep, ROC areas are 0.78, 0.79 and 0.71, respectively. In non-REM sleep, spectral analysis of HRV appears to be a significantly better indicator of the SAHS than the current screening method of oximetry, and, in REM sleep, it is comparable with oximetry. The advantage of the DHWT over the DFT is that it produces a greater time resolution and is computationally more efficient. The DHWT does not require the precondition of stationarity or interpolation of raw HRV data.

  10. Prevalence rates of sexual difficulties and associated distress in heterosexual men and women: results from an Internet survey in Flanders.

    PubMed

    Hendrickx, Lies; Gijs, Luk; Enzlin, Paul

    2014-01-01

    As most epidemiological surveys on sexual problems have not included assessment of associated distress, the principal aim of this study was to provide prevalence estimates of both DSM-IV-TR-defined (American Psychiatric Association [APA], 2000 ) and less commonly assessed sexual difficulties and dysfunction (e.g., lack of responsive sexual desire, lack of subjective arousal). A secondary aim was to obtain information about comorbidity between sexual desire and sexual arousal difficulties/dysfunction. This study comprised an online survey completed by 35,132 heterosexual Flemish men and women (aged 16 to 74 years). Results indicated that sexual dysfunctions were far less common than sexual difficulties, and some uncommonly assessed sexual problems (e.g., "lack of responsive desire" in women; "hyperactive sexual desire" in men) were quite prevalent. In women, there was a high comorbidity between "lack of spontaneous sexual desire" and "lack of responsive sexual desire"; between "lack of genital arousal" and "lack of subjective sexual arousal"; and between sexual desire and sexual arousal difficulties/dysfunctions. The implications of these findings for epidemiological research on sexual dysfunction and for the newly defined DSM-5 Female Sexual Interest/Arousal Disorder (APA, 2013 ) are discussed.

  11. Estimating Plasmodium falciparum transmission rates in low-endemic settings using a combination of community prevalence and health facility data.

    PubMed

    Yukich, Joshua; Briët, Olivier; Bretscher, Michael T; Bennett, Adam; Lemma, Seblewengel; Berhane, Yemane; Eisele, Thomas P; Keating, Joseph; Smith, Thomas

    2012-01-01

    As some malaria control programs shift focus from disease control to transmission reduction, there is a need for transmission data to monitor progress. At lower levels of transmission, it becomes increasingly more difficult to measure precisely, for example through entomological studies. Many programs conduct regular cross sectional parasite prevalence surveys, and have access to malaria treatment data routinely collected by ministries of health, often in health management information systems. However, by themselves, these data are poor measures of transmission. In this paper, we propose an approach for combining annual parasite incidence and treatment data with cross-sectional parasite prevalence and treatment seeking survey data to estimate the incidence of new infections in the human population, also known as the force of infection. The approach is based on extension of a reversible catalytic model. The accuracy of the estimates from this model appears to be highly dependent on levels of detectability and treatment in the community, indicating the importance of information on private sector treatment seeking and access to effective and appropriate treatment.

  12. Prevalence of eating disorders in males: a review of rates reported in academic research and UK mass media.

    PubMed

    Sweeting, Helen; Walker, Laura; MacLean, Alice; Patterson, Chris; Räisänen, Ulla; Hunt, Kate

    Media presentations of health issues affect evaluations of personal susceptibility to particular illnesses and hence help-seeking behaviours. We examined data on prevalence of eating disorders (EDs - which are often characterised as 'female') among males in: scientific literature; readily-accessible web-based information; and UK newspaper articles (published 7/12/2002-7/12/2012). This revealed conflicting statistics. Academic papers suggest men comprise around 25% of community-based samples, but much lower proportions (10% or less) of clinic samples. Websites and newspapers present widely differing statistics both on prevalence overall (numbers with EDs in the UK ranged from 60,000 to 2.7 million), and in men (generally suggesting they constituted 10-25% of those with EDs), rarely distinguishing between diagnosed and non-diagnosed samples. By 2011, newspapers were more consistent on overall numbers with EDs in the UK (1.6 million) and the proportion who were men (20%), drawing on one website as the authoritative source. Conflicting statistics may confuse men searching for ED (or other) health-related information, lead to underestimations of male susceptibility to EDs and/or reinforce inappropriate stereotypes of EDs as confined to adolescent girls.

  13. Prevalence of eating disorders in males: a review of rates reported in academic research and UK mass media

    PubMed Central

    Sweeting, Helen; Walker, Laura; MacLean, Alice; Patterson, Chris; Räisänen, Ulla; Hunt, Kate

    2015-01-01

    Media presentations of health issues affect evaluations of personal susceptibility to particular illnesses and hence help-seeking behaviours. We examined data on prevalence of eating disorders (EDs – which are often characterised as ‘female’) among males in: scientific literature; readily-accessible web-based information; and UK newspaper articles (published 7/12/2002-7/12/2012). This revealed conflicting statistics. Academic papers suggest men comprise around 25% of community-based samples, but much lower proportions (10% or less) of clinic samples. Websites and newspapers present widely differing statistics both on prevalence overall (numbers with EDs in the UK ranged from 60,000 to 2.7 million), and in men (generally suggesting they constituted 10-25% of those with EDs), rarely distinguishing between diagnosed and non-diagnosed samples. By 2011, newspapers were more consistent on overall numbers with EDs in the UK (1.6 million) and the proportion who were men (20%), drawing on one website as the authoritative source. Conflicting statistics may confuse men searching for ED (or other) health-related information, lead to underestimations of male susceptibility to EDs and/or reinforce inappropriate stereotypes of EDs as confined to adolescent girls. PMID:26290657

  14. Flagellated algae protein evolution suggests the prevalence of lineage-specific rules governing evolutionary rates of eukaryotic proteins.

    PubMed

    Chang, Ting-Yan; Liao, Ben-Yang

    2013-01-01

    Understanding the general rules governing the rate of protein evolution is fundamental to evolutionary biology. However, attempts to address this issue in yeasts and mammals have revealed considerable differences in the relative importance of determinants for protein evolutionary rates. This phenomenon was previously explained by the fact that yeasts and mammals are different in many cellular and genomic properties. Flagellated algae species have several cellular and genomic characteristics that are intermediate between yeasts and mammals. Using partial correlation analyses on the evolution of 6,921 orthologous proteins from Chlamydomonas reinhardtii and Volvox carteri, we examined factors influencing evolutionary rates of proteins in flagellated algae. Previous studies have shown that mRNA abundance and gene compactness are strong determinants for protein evolutionary rates in yeasts and mammals, respectively. We show that both factors also influence algae protein evolution with mRNA abundance having a larger impact than gene compactness on the rates of algae protein evolution. More importantly, among all the factors examined, coding sequence (CDS) length has the strongest (positive) correlation with protein evolutionary rates. This correlation between CDS length and the rates of protein evolution is not due to alignment-related issues or domain density. These results suggest no simple and universal rules governing protein evolutionary rates across different eukaryotic lineages. Instead, gene properties influence the rate of protein evolution in a lineage-specific manner.

  15. Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999-2004.

    PubMed

    Wong, Charlene A; Jim, Melissa A; King, Jessica; Tom-Orme, Lillian; Henderson, Jeffrey A; Saraiya, Mona; Richardson, Lisa C; Layne, Larry; Suryaprasad, Anil; Espey, David K

    2011-12-01

    To present more accurate incidence rates of cervical, uterine, and ovarian cancer by geographic region in American Indian/Alaska Native (AI/AN) women. The authors used data from central cancer registries linked to Indian Health Service (IHS) patient registration database, the Behavioral Risk Factor Surveillance System, IHS National Data Warehouse, and the National Hospital Discharge Survey. Cancer incidence rates were adjusted for hysterectomy and oophorectomy prevalence and presented by region for non-Hispanic White (NHW) and AI/AN women. AI/AN women had a higher prevalence of hysterectomy (23.1%) compared with NHW women (20.9%). Correcting cancer rates for population-at-risk significantly increased the cancer incidence rates among AI/AN women: 43% for cervical cancer, 67% for uterine cancer, and 37% for ovarian cancer. Risk-correction led to increased differences in cervical cancer incidence between AI/AN and NHW women in certain regions. Current reporting of cervical, uterine, and ovarian cancer underestimates the incidence in women at risk and can affect the measure of cancer disparities. Improved cancer surveillance using methodology to correct for population-at-risk may better inform disease control priorities for AI/AN populations.

  16. Vector-borne disease surveillance in puerto rico: pathogen prevalence rates in canines ? Implications for public health and the u.s. Military ? Applying the one health concept.

    PubMed

    McCown, Michael E; Opel, Taylor; Grzeszak, Benjamin

    2013-01-01

    prevalence, complete risk assessments, and impleme t timely preventive medicine and other preventive measures. The lower VBD prevalence rate in the canine samples from Fort Buchanan demonstrates the value of responsible pet ownership and importance of preventive medicine and public health. 2013.

  17. Non-suicidal self-injury in Mexican young adults: Prevalence, associations with suicidal behavior and psychiatric disorders, and DSM-5 proposed diagnostic criteria.

    PubMed

    Benjet, Corina; González-Herrera, Irene; Castro-Silva, Everardo; Méndez, Enrique; Borges, Guilherme; Casanova, Leticia; Medina-Mora, Maria Elena

    2017-06-01

    Non-suicidal self-injury (NSSI) may lead to scarring, infection, accidental death and psychological distress. Little is known about NSSI in the general population of young adults in developing countries like Mexico. The current study examined the prevalence of any NSSI and each type of NSSI, the prevalence of meeting DSM-5 proposed criteria, and finally the association of NSSI with socio-demographic variables, suicidal behavior and psychiatric disorders. This study was conducted in a community sample of 1071 young adults between 19 and 26 years of age residents of Mexico City. The lifetime prevalence of NSSI was 18.56% with females having 87% greater odds. The 12-month prevalence was 3.19%. Only 0.22% of the total sample and 6.96% of those that self-injured in the past 12 months met full criteria proposed by DSM-5, in part due to the lack of reported impairment; 39.99% of those that self-injured reported impairment. Suicidal behavior commonly co-occurred with NSSI. All lifetime anxiety, mood, disruptive behavior and substance use disorders were associated with greater risk for lifetime NSSI whereas only 12-month depression and substance use disorder was associated with greater risk of 12-month NSSI. The cross-sectional nature of the study precludes conclusions of causality and directionality and the study excluded institutionalized and homeless young adults. NSSI is a concerning problem in young adults from Mexico City due to the important associations with all types of psychiatric disorders and suicidal behavior. Because many who self-injure do not perceive impairment, they are unlikely to seek treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. The Impact of Noninvasive Follicular Variant of Papillary Thyroid Carcinoma on Rates of Malignancy for Fine-Needle Aspiration Diagnostic Categories.

    PubMed

    Strickland, Kyle C; Howitt, Brooke E; Marqusee, Ellen; Alexander, Erik K; Cibas, Edmund S; Krane, Jeffrey F; Barletta, Justine A

    2015-09-01

    Increased recognition of the indolent nature of noninvasive follicular variant of papillary thyroid carcinoma (NFVPTC) along with greater insight into the molecular alterations of these tumors has prompted endocrine pathologists to question whether these tumors warrant a diagnosis of carcinoma. However, a change in terminology would affect the rates of malignancy of fine-needle aspiration (FNA) diagnostic categories. Therefore, the aim of this study was to determine the percentage decrease in associated risk of malignancy for each FNA diagnostic category if NFVPTCs were no longer termed carcinomas. We evaluated a cohort of 655 FNAs with subsequent resection specimens over a 22-month time period. The diagnoses of the preceding FNAs were recorded according to the Bethesda System for Reporting Thyroid Cytopathology. For cases with more than one preceding FNA, the FNA diagnosis associated with the highest risk of malignancy was identified. Slides for all resection specimens with a diagnosis of FVPTC were reviewed to identify noninvasive tumors. By definition, all of these tumors were encapsulated, partially encapsulated, or well circumscribed and lacked any indication of infiltrative growth, capsular penetration, or lymphovascular invasion. Our cohort of 655 FNAs with subsequent resection specimens included 53 (8.1%) nondiagnostic (ND), 167 (25.5%) benign, 97 (14.8%) atypia/follicular lesion of undetermined significance (AUS/FLUS), 88 (13.4%) suspicious for follicular neoplasm (SFN), 94 (14.4%) suspicious for malignancy (SUS), and 156 (23.8%) malignant cases (POS). Surgical resections demonstrated benign findings in 309 (47.2%) and malignant tumors in 346 (52.8%), including 85 NFVPTCs accounting for 24.6% of malignancies. Our rates of malignancy for ND, benign, AUS/FLUS, SFN, SUS, and POS were 18.9%, 13.2%, 39.2%, 45.5%, 87.2%, and 98.7%, respectively. If NFVPTC were no longer termed carcinoma, these rates would drop to 17.0% (10% decrease), 5.4% (59% decrease), 21

  19. Music close to one's heart: heart rate variability with music, diagnostic with e-bra and smartphone

    NASA Astrophysics Data System (ADS)

    Hegde, Shantala; Kumar, Prashanth S.; Rai, Pratyush; Mathur, Gyanesh N.; Varadan, Vijay K.

    2012-04-01

    Music is a powerful elicitor of emotions. Emotions evoked by music, through autonomic correlates have been shown to cause significant modulation of parameters like heart rate and blood pressure. Consequently, Heart Rate Variability (HRV) analysis can be a powerful tool to explore evidence based therapeutic functions of music and conduct empirical studies on effect of musical emotion on heart function. However, there are limitations with current studies. HRV analysis has produced variable results to different emotions evoked via music, owing to variability in the methodology and the nature of music chosen. Therefore, a pragmatic understanding of HRV correlates of musical emotion in individuals listening to specifically chosen music whilst carrying out day to day routine activities is needed. In the present study, we aim to study HRV as a single case study, using an e-bra with nano-sensors to record heart rate in real time. The e-bra developed previously, has several salient features that make it conducive for this study- fully integrated garment, dry electrodes for easy use and unrestricted mobility. The study considers two experimental conditions:- First, HRV will be recorded when there is no music in the background and second, when music chosen by the researcher and by the subject is playing in the background.

  20. The Strengths of Youth in a Public Behavioral Health System: Measurement Choices, Prevalence Rates, and Group Differences.

    PubMed

    Accomazzo, Sarah; Shapiro, Valerie B; Israel, Nathaniel; Kim, B K Elizabeth

    2017-04-01

    Youth with severe emotional and behavioral problems receiving services in public behavioral health systems have strengths that are understudied in research and underutilized in practice. This study explores four alternative strategies (individual item scores, the number of "actionable" strengths, subscales, and a total composite) for summarizing the strengths of youth assessed with the Child and Adolescent Needs and Strengths (CANS) in a large, urban, public behavioral health system. The paper examines whether these summarization strategies produce divergent understandings of the prevalence of strengths across gender, age, and racial groups. Analyses suggest that youth enter this system with high levels of strengths. There are few group differences in strengths across the diverse summarization strategies. Though the practice-preferred method of using individual strengths items provides the most interpretable information about strengths, the aggregation strategies may be useful for programs and systems. Implications for policy and practice are discussed.

  1. Variability of the human heart rate as a diagnostic instrument obtained by mean of a wireless monitor

    NASA Astrophysics Data System (ADS)

    Barajas Mauricio, Sánchez; Hernández González, Martha Alicia; Figueroa Vega, Nicte; Malacara Hernández, Juan Manuel; Fraga Teodoro, Córdova

    2014-11-01

    Introduction: Heart rate variability (HRV) is the cyclic measurement of RR intervals between normal beats. Aim: To determine the VFC via a wireless Polar monitor. Material and methods: 100 symptomatic menopausal women were studied for measurements of HRV were I post a Polar RS400 Watch four hrs. Results: Obtained through the fast Fourier transform, the frequency domain HRV low frequency (LF) 0.04-0.15 Hz, high frequency (HF) 0.15-0.4Hz and the ratio LF / HF. Conclusion: obtaining HRV is important for cardiovascular autonomic assessment in menopausal women.

  2. Rates and causes of disagreement in interpretation of full-field digital mammography and film-screen mammography in a diagnostic setting.

    PubMed

    Venta, L A; Hendrick, R E; Adler, Y T; DeLeon, P; Mengoni, P M; Scharl, A M; Comstock, C E; Hansen, L; Kay, N; Coveler, A; Cutter, G

    2001-05-01

    This study was performed to determine the rates and causes of disagreements in interpretation between full-field digital mammography and film-screen mammography in a diagnostic setting. Patients undergoing diagnostic mammography were invited to participate in the digital mammography study. Three views, selected by the radiologist interpreting the film-screen mammography, were obtained in both film-screen mammography and digital mammography. Radiologists independently assigned a Breast Imaging Reporting and Data System (BI-RADS) category to the film-screen mammography and the digital mammography images. The BI-RADS categories were grouped into the general categories of agreement, partial agreement, or disagreement. A third and different radiologist reviewed all cases of disagreement, reached a decision as to management, and determined the primary cause of disagreement. Six radiologists reviewed digital mammography and film-screen mammography diagnostic images in a total of 1147 breasts in 692 patients. Agreement between digital mammography and final film-screen mammography assessment was present in 937 breasts (82%), partial agreement in 159 (14%), and disagreement in 51 (4%), for a kappa value of 0.29. The primary causes of disagreement were differences in management approach of the radiologists (52%), information derived from sonography or additional film-screen mammograms (34%), and technical differences between the two mammographic techniques (10%). Significant disagreement between film-screen mammography and digital mammography affecting follow-up management was present in only 4% of breasts. The most frequent cause of disagreement in interpretation was a difference in management approach between radiologists (interobserver variability). This source of variability was larger than that due to differences in lesion visibility between film-screen mammography and digital mammography.

  3. Risk factors for the occurrence of spina bifida (a case-control study) and the prevalence rate of spina bifida in Japan.

    PubMed

    Kondo, Atsuo; Morota, Nobuhito; Ihara, Satoshi; Saisu, Takeshi; Inoue, Katsumi; Shimokawa, Shoko; Fujimaki, Hiroya; Matsuo, Keisuke; Shimosuka, Yoichi; Watanabe, Tomoyuki

    2013-09-01

    The Japanese government recommended in 2000 that women planning pregnancy should take 400 μg of folic acid daily to decrease the risk of having an infant with spina bifida. We aimed to identify risk factors for the occurrence of spina bifida and to evaluate how the prevalence rate has altered over the past 3 decades. Subjects comprised 360 women who gave birth to spina bifida-affected offspring and 2333 women who gave birth to offspring without spina bifida between 2001 and 2012. A self-administered questionnaire was used to collect data, which were analyzed by multiple logistic regression models. The prevalence rate of spina bifida was obtained through data provided by international and domestic organizations. Four variables were significantly associated with the increased risk of having newborns afflicted with spina bifida: not taking folic acid supplements (odds ratios [OR], 2.50; 95% confidence interval [CI], 1.72-3.64), presence of spina bifida patients within third-degree relatives (OR, 4.26; 95% CI, 1.12-16.19), taking anti-epileptic drugs without folic acid (OR, 20·20; 95% CI, 2.06-198.17), and low birth weight in the newborns ≤ 2500 g (OR, 4.21; 95% CI, 3.18-5.59). The prevalence rate of spina bifida has remained 5 to 6 per 10,000 total births and has not shown any decreasing trend over the past 11 years. Four risk factors were identified among Japanese women. Because recommendations and information have not decreased the occurrence of spina bifida, the Japanese government should implement mandatory food fortification. Copyright © 2013 Wiley Periodicals, Inc.

  4. Epidemiology of Salmonella sp. in California cull dairy cattle: prevalence of fecal shedding and diagnostic accuracy of pooled enriched broth culture of fecal samples

    PubMed Central

    Abu Aboud, Omran A.; Adaska, John M.; Williams, Deniece R.; Rossitto, Paul V.; Champagne, John D.; Lehenbauer, Terry W.; Atwill, Robert; Li, Xunde

    2016-01-01

    Background The primary objective of this cross-sectional study was to estimate the crude, seasonal and cull-reason stratified prevalence of Salmonella fecal shedding in cull dairy cattle on seven California dairies. A secondary objective was to estimate and compare the relative sensitivity (Se) and specificity (Sp) for pools of 5 and 10 enriched broth cultures of fecal samples for Salmonella sp. detection. Methods Seven dairy farms located in the San Joaquin Valley of California were identified and enrolled in the study as a convenience sample. Cull cows were identified for fecal sampling once during each season between 2014 and 2015, specifically during spring, summer, fall, and winter, and 10 cows were randomly selected for fecal sampling at the day of their sale. In addition, study personnel completed a survey based on responses of the herd manager to questions related to the previous four month’s herd management. Fecal samples were frozen until testing for Salmonella. After overnight enrichment in liquid broth, pools of enrichment broth (EBP) were created for 5 and 10 samples. All individual and pooled broths were cultured on selective media with putative Salmonella colonies confirmed by biochemical testing before being serogrouped and serotyped. Results A total of 249 cull cows were enrolled into the study and their fecal samples tested for Salmonella. The survey-weighted period prevalence of fecal shedding of all Salmonella sp. in the cull cow samples across all study herds and the entire study period was 3.42% (N = 249; SE 1.07). The within herd prevalence of Salmonella shed in feces did not differ over the four study seasons (P = 0.074). The Se of culture of EBP of five samples was 62.5% (SE = 17.12), which was not statistically different from the Se of culture of EBP of 10 (37.5%, SE = 17.12, P = 0.48). The Sp of culture of EBP of five samples was 95.24% (SE = 3.29) and for pools of 10 samples was 100.00% (SE = 0). There was no statistical difference

  5. Application of a high-repetition-rate laser diagnostic system for single-cycle-resolved imaging in internal combustion engines.

    PubMed

    Hult, Johan; Richter, Mattias; Nygren, Jenny; Aldén, Marcus; Hultqvist, Anders; Christensen, Magnus; Johansson, Bengt

    2002-08-20

    High-repetition-rate laser-induced fluorescence measurements of fuel and OH concentrations in internal combustion engines are demonstrated. Series of as many as eight fluorescence images, with a temporal resolution ranging from 10 micros to 1 ms, are acquired within one engine cycle. A multiple-laser system in combination with a multiple-CCD camera is used for cycle-resolved imaging in spark-ignition, direct-injection stratified-charge, and homogeneous-charge compression-ignition engines. The recorded data reveal unique information on cycle-to-cycle variations in fuel transport and combustion. Moreover, the imaging system in combination with a scanning mirror is used to perform instantaneous three-dimensional fuel-concentration measurements.

  6. Deriving estimates of contralateral footedness from prevalence rates in samples of Brazilian and non-Brazilian right- and left-handers.

    PubMed

    Martin, William Lee Berdel; Machado, Angélica Homobono

    2005-07-01

    Although footedness is closely associated with handedness, accurate prevalence rates of contralateral footedness in right- and left-handed populations were previously unavailable to researchers studying the relationship between phenotypic and hemispheric asymmetries. We collected preference data from 2081 Brazilian children and adolescents, and relate the prevalence of crossed hand/foot preferences to values reported elsewhere in the literature. In our samples, about 4% of the dextrals and 33% of the sinistrals exhibited a contralateral kicking preference. This is in close agreement with the weighted means from our analysis of 19 papers in the literature, which yields 4.0% left-footed kicking in dextrals and 33.5% right-footed kicking in sinistrals. These values are in marked contrast to the 50% figure for right-footed kicking in sinistrals as given by MacNeilage and colleagues (1988, 1991). Among Brazilians with mixed handedness, there was a substantial increase in incongruent footedness. Male consistent right- and left-handers showed a higher prevalence of cross-footed preferences in their kicking preference than females. The sex difference in dextrals was attributed to a training effect in soccer-related activities, and to a sampling bias in sinistrals.

  7. Rates of diagnosis and treatment of neurological disorders within a prevalent population of community-dwelling elderly people in sub-Saharan Africa.

    PubMed

    Dewhurst, Felicity; Dewhurst, Matthew J; Gray, William K; Chaote, Paul; Howlett, William; Orega, Golda; Walker, Richard W

    2012-12-01

    The prevalence of neurological disorders in those aged 70years and over in the Hai district of Tanzania has been previously reported. The following research reports rates of patient's: treatment seeking, diagnosis and treatment within this prevalent population. All people identified as having at least one neurological disorder in the prevalence study were questioned regarding whether they had sought treatment for their disorder, whether they had had a previous correct diagnosis and whether they were being currently treated. From a background population of 2232 people, 349 people had neurological disorders, of whom 225 (64.5%) had sought treatment for their symptoms. Of the 384 disorders identified in these 349 people, only 14.6% had been diagnosed and only 9.9% were receiving appropriate treatment. Males were significantly more likely to have been diagnosed and were more likely to have been treated appropriately. Levels of diagnosis and treatment were low, with some gender inequality. Reasons for this may include a lack of recognition of the condition within the local population and lack of access to appropriate services. In the absence of effective primary and secondary preventative measures, and effective treatment, the burden of neurological disorders is likely to increase with further demographic ageing. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  8. Occurrence and Prevalence of Insect Pathogens in Populations of the Codling Moth, Cydia pomonella L.: A Long-Term Diagnostic Survey

    PubMed Central

    Zimmermann, Gisbert; Huger, Alois M.; Kleespies, Regina G.

    2013-01-01

    About 20,550 larvae, pupae and adults of the codling moth, Cydia pomonella L., were diagnosed for pathogens during long-term investigations (1955–2012) at the Institute for Biological Control in Darmstadt, Germany. The prevailing entomopathogens diagnosed in these studies were insect pathogenic fungi, especially Beauveria bassiana and Isaria farinosa, the microsporidium, Nosema carpocapsae, the Cydia pomonella granulovirus (CpGV), as well as mostly undetermined bacteria. While the CpGV was observed exclusively in larvae and pupae from laboratory colonies or from field experiments with this virus, entomopathogenic fungi were most frequently diagnosed in last instars in autumn and in diapausing larvae and pupae in spring. B. bassiana was identified as the major fungal pathogen, causing larval prevalences of 0.9% to 100% (mean, about 32%). During prognostic long-term studies in larvae and adults of C. pomonella, N. carpocapsae was diagnosed in codling moth populations from various locations in Germany. The mean prevalence generally ranged between 20% and 50%. Experiments revealed that the fecundity and fertility of microsporidia-infected female adults were significantly reduced compared to healthy ones. The results underpin the importance of naturally occurring microbial antagonists and represent a base for further ecological studies on developing new or additional biological and integrated control strategies. PMID:26462428

  9. Occurrence and Prevalence of Insect Pathogens in Populations of the Codling Moth, Cydia pomonella L.: A Long-Term Diagnostic Survey.

    PubMed

    Zimmermann, Gisbert; Huger, Alois M; Kleespies, Regina G

    2013-08-02

    About 20,550 larvae, pupae and adults of the codling moth, Cydia pomonella L., were diagnosed for pathogens during long-term investigations (1955-2012) at the Institute for Biological Control in Darmstadt, Germany. The prevailing entomopathogens diagnosed in these studies were insect pathogenic fungi, especially Beauveria bassiana and Isaria farinosa, the microsporidium, Nosema carpocapsae, the Cydia pomonella granulovirus (CpGV), as well as mostly undetermined bacteria. While the CpGV was observed exclusively in larvae and pupae from laboratory colonies or from field experiments with this virus, entomopathogenic fungi were most frequently diagnosed in last instars in autumn and in diapausing larvae and pupae in spring. B. bassiana was identified as the major fungal pathogen, causing larval prevalences of 0.9% to 100% (mean, about 32%). During prognostic long-term studies in larvae and adults of C. pomonella, N. carpocapsae was diagnosed in codling moth populations from various locations in Germany. The mean prevalence generally ranged between 20% and 50%. Experiments revealed that the fecundity and fertility of microsporidia-infected female adults were significantly reduced compared to healthy ones. The results underpin the importance of naturally occurring microbial antagonists and represent a base for further ecological studies on developing new or additional biological and integrated control strategies.

  10. A history of breast cancer and older age allow risk stratification of mammographic BI-RADS 3 ratings in the diagnostic setting.

    PubMed

    Benndorf, Matthias; Wu, Yirong; Burnside, Elizabeth S

    2016-01-01

    The objective was to investigate whether risk stratification of mammographic Breast Imaging: Reporting and Data System (BI-RADS) 3 can be accomplished in the diagnostic setting. We analyzed 4941 BI-RADS-3-rated patients (23 malignant outcomes) and built logistic-regression models with age, personal and family history of breast cancer, fibroglandular density, and additional mammographic findings as predictive variables. A personal history of breast cancer (odds ratio: 5.53) and older age (odds ratio: 12.44/10.93 for age 50-64/>64) are independent risk factors. Patients with both risk factors have a risk >2%. Biopsy may be warranted in older patients with a history of breast cancer who would be otherwise assigned BI-RADS 3. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Investigations concerning the prevalence of Coxiella burnetii and Chlamydia abortus in sheep in correlation with management systems and abortion rate in Lower Saxony in 2004.

    PubMed

    Runge, Martin; Binder, Alfred; Schotte, Ulrich; Ganter, Martin

    2012-01-01

    The intracellular bacteria Coxiella (C) burnetii and Chlamydia (Chl) abortus induce abortion in sheep and also affect humans. While Chl. abortus only infrequently infects humans, C burnetii is the aetiological agent of numerous Q fever outbreaks during the last decades. There is only limited knowledge about the prevalence of both pathogens in sheep, although sheep are involved in almost all Q fever outbreaks in Germany. The aim of our study was to investigate the prevalence of both pathogens in flocks located in Lower Saxony, Germany, in correlation to the management form and abortion rate. Serum samples of 1714 sheep from 95 flocks located in Lower Saxony were investigated by ELISA. 2.7% of these samples were positive, 1.3% showed inconclusive results in the C. burnetii-ELISA. Elevated intra-flock seroprevalences were only detected in three migrating flocks. Chlamydia-specific antibodies could be detected in 15.1% serum samples of mainly shepherded and migrating flocks. In one of these flocks with a high intra-flock seroprevalence for C burnetii (27%) and Chlamydia (44.9%), C burnetii was detected in 21.6% of the placenta samples of normal births and in 12.5% of the colostrum samples by PCR. Aborted fetuses and the corresponding placentas were negative in C burnetii-PCR, but in most of them and also in many other placenta samples Chl. abortus could be detected by PCR and DNA microarray. This survey shows a low overall prevalence of C. burnetii in sheep in Lower Saxony in the year 2004. However, three migrating flocks with a high intra-flock prevalence are localized in the southern parts of Lower Saxony. Spreading of C burnetii could occur, because of the large radius of grazing of all three flocks.

  12. Improvements in cerebral blood flow and recanalization rates with transcranial diagnostic ultrasound and intravenous microbubbles after acute cerebral emboli.

    PubMed

    Gao, Shunji; Zhang, Yan; Wu, Juefei; Shi, William T; Lof, John; Vignon, Francois; Drvol, Lucas; Xie, Feng; Muirhead, David; Powers, Jeffry E; High, Robin; White, Matthew L; Porter, Thomas R

    2014-09-01

    Intravenous microbubbles (MBs) and transcutaneous ultrasound have been used to recanalize intra-arterial thrombi without the use of tissue plasminogen activator. In the setting of acute ischemic stroke, it was our objective to determine whether skull attenuation would limit the ability of ultrasound alone to induce the type and level of cavitation required to dissolve thrombi and improve cerebral blood flow (CBF) in acute ischemic stroke. In 40 pigs, bilateral internal carotid artery occlusions were created with 4-hour-old thrombi. Pigs were then randomized to high-mechanical index (MI = 2.4) short-pulse (5 microseconds) transcranial ultrasound (TUS) alone or a systemic MB infusion (3% Definity) with customized cavitation detection and imaging system transmitting either high-MI (2.4) short pulses (5 microseconds) or intermediate-MI (1.7) long pulses (20 microseconds). Angiographic recanalization rates of both internal carotids were compared in 24 of the pigs (8 per group), and quantitative analysis of CBF with perfusion magnetic resonance imaging was measured before, immediately after, and at 24 hours using T2* intensity versus time curves in 16 pigs. Complete angiographic recanalization was achieved in 100% (8/8) of pigs treated with image-guided high-MI TUS and MBs, but in only 4 of 8 treated with high-MI TUS alone or 3 of 8 pigs treated with image-guided intermediate-MI TUS and MBs (both P < 0.05). Ipsilateral and contralateral CBF improved at 24 hours only after 2.4-MI 5-microsecond pulse treatments in the presence of MB (P < 0.005). There was no evidence of microvascular or macrovascular hemorrhage with any treatment. Guided high-MI impulses from an ultrasound imaging system produce sustained improvements in ipsilateral and contralateral CBF after acute cerebral emboli.

  13. The prevalence of osteoporosis and the rate of bone loss in Korean adults: the Chungju metabolic disease cohort (CMC) study.

    PubMed

    Lim, Y; Jo, K; Ha, H-S; Yim, H-W; Yoon, K-H; Lee, W-C; Son, H-Y; Baek, K H; Kang, M-I

    2017-04-01

    Because the rate of bone loss is an important risk factor for fracture, we studied longitudinal changes in bone mineral density (BMD). Although the BMD of the hip decreased over time, spine BMD remained largely stable or increased. Therefore, spine BMD may not be appropriate for assessing BMD change.

  14. The Prevalence of Drug Abuse in the Army: A Comparison of Urinalysis and Survey Rates. Technical Report 75-17.

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