Historical epidemiology and grid analysis of epidemiologic data.
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The authors describe the epidemiological situation with regard to late syphilis in the period of 25 years with particular reference to the last decade (1965--1974). The activities of consultation services for late syphilis and their role in prevention of late organ involvement are discussed.
BACKGROUND: Chronic fatigue syndrome (CFS) has no diagnostic clinical signs or diagnostic laboratory abnormalities and it is unclear if it represents a single illness. The CFS research case definition recommends stratifying subjects by co-morbid conditions, fatigue level and duration, or functional impairment. But to date, this analysis approach has not yielded any further insight into CFS pathogenesis. This study used the integration of peripheral blood gene expression results with epidemiologic and clinical data to determine whether CFS is a single or heterogeneous illness. RESULTS: CFS subjects were grouped by several clinical and epidemiological variables thought to be important in defining the illness. Statistical tests and cluster analysis were used to distinguish CFS subjects and identify differentially expressed genes. These genes were identified only when CFS subjects were grouped according to illness onset and the majority of genes were involved in pathways of purine and pyrimidine metabolism, glycolysis, oxidative phosphorylation, and glucose metabolism. CONCLUSION: These results provide a physiologic basis that suggests CFS is a heterogeneous illness. The differentially expressed genes imply fundamental metabolic perturbations that will be further investigated and illustrates the power of microarray technology for furthering our understanding CFS.
The prevalence of urinary incontinence (UI) in women has been the subject of many epidemiologic studies. Since 1968 the field has accumulated sufficient data that we now know how stress UI and urge UI appear in populations categorized by race, age, parity, body mass index and other demographic factors. The first comprehensive study in the U.S., the MESA study, was done in 1983. For community-dwelling women 60 years or older, it came up with the now familiar figure of 38% in this age-group. Very similar figures have been found in other national populations, but there are great differences in sub-populations and also by type--stress, urge, or mixed UI. However, with all differences in prevalence acknowledged, no type of UI is unusual in a population of older women. This article delineates, with detailed discussion of individual studies, prevalence by type, age, race, obstetric and gynecologic-surgery history, and anatomic dysfunction, plus consideration of the effects of obesity and menopause on UI. The conclusion is that a problem so widespread is a candidate for prevention, and that the few trials in this direction should be augmented.
The author compares the epidemiological, cytological and colposcopical data found in IUD users, with a control population of estro-progestogens and condom users. The age, parity and clinical symptomatology, mainly leukorrhea, was higher in IUD users. At the colposcopic examination a normal pattern was found in condom users more frequently, but the suspect colposcopic signs were frequently associated with the use of the IUD. The oncologic evaluation of smears showed a slight dysplasia in 17.65% and 10.53% in IUD users and estro-progestogen users respectively. The only case of carcinoma in situ was found in the IUD users group. The bacteriological diagnosis on the smears did not reveal a quantitative difference in the three groups, while a qualitative difference was found, particularly with a high frequency of Trichomonas vaginalis and Corynebacterium vaginalis, and one case of Actinomyces in IUD users. The cytological study of the endometrium obtained by mono-use devices, revealed an aspect of aspecific non plasmacellular endometritis in 75% of the cases; a dysfunctional hormonal cytological aspect in 32.50%, and the oncological evaluation in 60% of the cases revealed atypical endometrial cells IUD related. No neoplastic lesion was found. The author concludes that the use of IUD must be prudent and accurate follow up must be carried out.
In April 1996, an outbreak of toxic polyneuropathy in cats occurred in the Netherlands. All cats had been fed one of two brands of dry cat food from one manufacturer. Chemical analyses of these foods, stomach contents, and liver and kidney of affected cats revealed contamination with the ionophor salinomycin. Epidemiologic and clinical data were collected from 823 cats, or about 1% of the cats at risk. In 21 affected cats, postmortem examination was performed. The affected cats had acute onset of lameness and paralysis of the hindlimbs followed by the forelimbs. Clinical and pathologic examination indicated a distal polyneuropathy involving both the sensory and motor nerves.
OBJECTIVES: The present large scale epidemiological study was designed to assess the prevalence of mental disorders in adolescents. METHODS: Two cross-sectional studies have been performed in adolescents in Dresden and the results of the examination of 627 high school and 485 secondary school students (mean age 15.5 years) are presented. Self rating procedures like the Beck Depression inventory (BDI) and clinical interviews have been used to enhance validity. RESULTS: The results underline the high prevalence rates of anxiety and depression in adolescents. Up to 30% of the 9th and 10th grades students suffer from mental disorders or are at risk for the development of mental disorders. CONCLUSIONS: Therefore primary prevention of mental disorders is desirable.
A retrospective epidemiological investigation has been conducted on nipple cancer cases observed over the past 10 years in the hospital of Castellamonte and Cuorgné. The high percentage of advanced cases of breast cancer encountered indicates the need for facilities (accurate, wide-ranging information, a tracer unit etc.) to provide early and therefore useful treatment of breast cancer in the area in question.
Despite recent large scale trials, the management of atrial fibrillation remains very variable. The authors report the results of a prospective study of the management of atrial fibrillation in their department. One hundred consecutive patients admitted for atrial fibrillation were included in the study. The epidemiological and clinical data and the results of the therapeutic strategy were recorded prospectively. Three embolic complications occurred before hospital admission. The hospital stay was marked by spontaneous reduction of atrial fibrillation in 14 cases in the 6 hours following admission. The therapeutic strategy was the following: 40 arrhythmias were respected (well tolerated, > 1 year or with a left atrium 60 mm). Oral amiodarone (30 mg/Kg and 15 mg/Kg the next day) was given to 22 patients. Only 9 patients (41%) were converted (average delay of 12 hours). Four patients received intravenous amiodarone, reducing two arrhythmias. Twenty patients were treated by external electrical cardioversion of first intent and 14 after failure of pharmacological reduction. All of these procedures, early (after 48 hours anticoagulation and transoesophageal echocardiography), or late (after 1 month of anticoagulation), restored sinus rhythm without complications, especially embolic. This register showed a relatively low efficacy of oral amiodarone in the reduction of atrial fibrillation and underlines the efficacy and safety of external electrical cardioversion, even when performed early.
The cartographic representation of continuous quantitative data is often required in studies of the spatial distribution of health indicators. It imposes a succession of choices which directly affect the result obtained. The conversion of continuous data to discrete data is one of the most important steps in the development of epidemiological maps. This article presents the methods currently used to make data discrete, discusses the advantages and disadvantages of each method and assesses their appropriateness for various situations. As an example, and for comparison purposes, we mapped the same series of statistics (relative rates of avoidable male deaths, "associated with the health care system", for "employment zones" in France from 1988 to 1992), using each of the methods discussed.
OBJECTIVE: To evaluate the epidemiological characteristic and risk factors of chronic obstructive pulmonary disease (COPD) in the rural area of Beijing. METHODS: The data of 1,624 people aged more than 40 in 5 villages in Yanqing County in Beijing were collected. The habitation condition, life and cooking habit, smoking history, personal history and family history were asked, and their physical examinations and lung function tests were conducted. RESULTS: The prevalence of COPD was 9.11% in this area, 15.05% in males and 3.76% in females. There were significant differences in sex, age, smoking history, family history, frequent cough before age 14 and body index between the COPD and non-COPD groups. The prevalence of corpulmonale was 1.66% in this area. CONCLUSION: The prevalence of COPD was high in this area and related with sex, age, smoking history, family history, frequent cough before age 14 and low body index. Other factors such as environment, working exposure need to be studied in the future. COPD is a major public health problem, which should claim more attention.
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Analysis of a major multi-site epidemiologic study of heart disease has required estimation of the pairwise correlation of several measurements across subpopulations. Because the measurements from each subpopulation were subject to sampling variability, the Pearson product moment estimator of these correlations produces biased estimates. This paper proposes a model that takes into account within and between sub-population variation, provides algorithms for obtaining maximum likelihood estimates of these correlations and discusses several approaches for obtaining interval estimates.
The trend toward a decline in the percentage of women with infertility in the United States appears real. While the factors associated with this trend are likely many, complex, and interrelated, we cannot overlook the positive impact of those individuals who practice in the field of reproductive medicine.
Since April 1995 increased number of type 7 were isolated in Japan and also in Kawasaki city. From May 1996 to March 1999, Adenovirus type 7 (Ad7) were isolated from 49 patients with high body temperature, and longer febrile period were observed in infants and younger children. Lower respiratory tract infection occurred and a young child developed fatal pneumonia. Ad7 were isolated not only in summer but in winter. They were prevalent all season. We analyzed 27 strains of Ad7 genetically using restriction enzyme and compared the results with epidemiological and clinical data. Consequently we can not found any difference in genetic pattern between these Ad7 regardless of age or symptom. The pattern was all the same as Ad7d that of already issued in Japan.