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At least 379 records · Page 21Linked to original sources
PubMed2005

Impact of periodontal preventive programmes on the data from epidemiologic studies.

This report provides only circumstantial evidence for the impact of programmes on periodontal epidemiology. The prerequisites for programmes and campaigns are described, and epidemiologic data on periodontal disease are compared with known changes in factors that may be affected by such activities. Unfortunately, parameters for periodontal disease as a process are not available. Only variables indicating irreversible effects on the periodontal status can be obtained. A lack of appropriate studies creates additional problems. This review indicates that preventive programmes and campaigns to improve oral hygiene have affected periodontal epidemiologic data concerning gingivitis and mild/moderate periodontitis favourably. Severe periodontitis seems not to have been influenced by such activities. Smoking is strongly associated with the severity of periodontitis. Therefore, a positive effect may be anticipated following the smoking cessation campaigns currently introduced worldwide. However, because of the irreversible nature of our epidemiologic parameters, it will take decades before any effect may be evident. It is recommended that periodontal epidemiology should be revitalized by introducing a nominalistic categorization instead of the changing essentialistic approaches used so far in order to facilitate the interpretation of data.

Gingivitis↗
PubMed1995

The application of multidimensional scaling methods to epidemiological data.

This paper illustrates the use of multidimensional scaling methods (MDS) to examine space-time patterns in epidemic data. The paper begins by outlining the principles of MDS. The model is then formally specified and illustrated by application to two data sets. The first is partly a tutorial example. It uses monthly reported measles morbidity data for the 31-year period from January 1960 to December 1990, collected for the 50 states of the USA, plus New York City and the District of Columbia. These data are used to explore the various ways in which MDS may be used to identify changing spatial patterns in geographically-coded data. In addition to their tutorial use, the data are also employed to search for any substantive changes in the geographical structure of measles epidemics in the USA that may have followed the introduction of mass vaccination in 1965. New England appears to have developed an epidemic profile distinct from the rest of the USA, and there is tentative evidence of an urban-rural split in epidemic characteristics. The second data set takes annual reported measles mortality data for New Zealand and the states of Australia from 1860 to 1949. MDS is used to show how the spatial relationships among these geographical units have changed over time in response to changes in the sizes of local susceptible populations.

Australia↗
PubMed1998

[Epilepsy and psychiatric disorders: epidemiological data].

Data about psychiatric disorders associated with epilepsy as well as their risk factors are heterogeneous. The overall prevalence of psychiatric disturbances in epileptic patients can be estimated between 20 and 30 per cent. It is the highest in pharmocoresistant cases seen in specialized centers. Psychotic disorders, depression, and suicide are the three most common among interictal disturbances. Psychoses affect 2 to 9 per cent of patients and are more frequent in cases with aura or altered consciousness, such as in complex partial seizures and absences. They correlate positively with the multiplicity of seizures but often inversely with their frequency. Temporal lobe epilepsy is associated with schizo phrenic-like and paranoid types of psychosis, but frontal lobe epilepsy is also common. A putative association with predominant left or bilateral EEG abnormalities in cases with partial epilepsy remains to be confirmed, as well as the frequency of underlying structural lesions. Depressive disorders affect 20 to 60 per cent of patients. While their occurrence with partial complex seizures and left hemisphere foci is common, the role of temporal lobe involvement still appears controversial. Depression prevails in cases with seizures that occasionally, albeit rarely, secondarily generalize and correlates with the duration of the disease, intractable seizures, and polypharmacy. A genetic factor is likely to play a role. Suicides rates are increased, encountered in 0.2-0.5 per cent of patients and causing deaths in 3-7 per cent of them. The overall risk might be the highest during the first years after diagnosis of epilepsy, as well as in patients with temporal lobe foci, depression, or psychosis. Great variability and discordance in results show the major difficulties encountered in epidemiologic studies. Most of these problems relate to the classification of epileptic disorders as well as that of psychiatric disorders, the variability in the methods and measures which are used, and frequent bias in the selection of patients. We review here data about the frequency of major psychiatric disorders in epileptic patients or the frequency of epileptic disorders in psychiatric patients, and also possible risk factors related to the epileptic disease and its evolution.

Adult↗
PubMedDate not supplied

Respiratory effects of environmental pollution: epidemiological data.

A recent document of the American Thoracic Society and two previous reports of the International Union Against Tuberculosis and Lung Disease have summarized the negative health effects due to air pollution in a list ranging from the increase of mortality to the perception of bad odors. A significant attempt to estimate, on an annual basis, the negative effects of air pollution from particulate matter less than 10 microns in aerodynamic diameter (PM10) has been carried out on data from Austria, France, and Switzerland: e.g. in France, air pollution from PM10 is responsible annually for 31,700 deaths, 36,700 new cases of chronic bronchitis and 577,000 attacks of asthma in adults, 450,000 cases of acute bronchitis and 243,000 attacks of asthma in children. Recently, a study on the long-term effects of air pollution on about 500,000 residents in metropolitan US areas evidenced that each 10 micrograms/m3 elevation in fine particulate air pollution is associated with approximately a 4%, 6% and 8% increased risk of all-cause, cardiopulmonary and lung cancer mortality, respectively. Some Italian experiences have also confirmed respiratory health damages from air pollution, namely the prospective epidemiologic studies on general population samples of the Po Delta and Pisa areas; the cross-sectional study on schoolchildren of the 'Italian study on respiratory disorders in childhood and environment' (SIDRIA); and a meta-analysis of the Italian studies on short-term effects of air pollution. In conclusion, epidemiologic studies suggest that air pollution plays an important role in the exacerbation and in the pathogenesis of chronic respiratory diseases. Thus, respiratory physicians, as well as public health professionals, should advocate for a cleaner environment.

Adult↗
PubMed2003

[NSAIDs digestive risk: epidemiologic data].

A HIGH RISK: Conventional non-steroidal anti-inflammatory drugs (NSAIDs) produce, by a factor of about 4, a major increase of the secondary GI adverse effect risk (ulcer and bleeding). According to published data, the number of patients to be treated with an NSAID for a duration of more than 2 months, a duration which can result in death, is 1220 (909 to 2500). A LONG TERM RISK: The GI risk induced by an NSAID appears constant over time. Upon discontinuation of treatment with an NSAID, an elevated risk is observed during the first 3 months following the end of treatment.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

[Malaria in Vietnam in 1996: brief synthesis of epidemiological data].

Vietnam is in a tropical region where malaria is considered as a public health problem. Plasmodium falciparum is responsible for 72% of cases of malaria and Plasmodium vivax for 28%. Analysis of available data shows that the situation is complex. The overall incidence of malaria is low, i.e. approximately 8.5: 1000 in 1995 but the disease is unevenly distributed over the country which has a variety of terrain and climates. Hilly and mountainous areas are the most affected especially in the center of the country where the annual incidence can exceed 10%. In most provinces, the majority of people are not immunized and malaria is unstable. Emergence of chemoresistant parasites is a major problem. Resistance rates of Plasmodium falciparum ranges from 40.78% to 61.67% for chloroquine and from 25.80% to 47.40% for sulfamides. Locally produced artemisinin derivatives are being more and more widely used in order to cope with this problem local. Given the great epidemiological variability of malaria in Vietnam, careful analysis needed before attempting any type of group and individual prophylaxis.

Cause of Death↗
PubMed1983

The use of epidemiologic data for personal risk assessment in health hazard/health risk appraisal programs.

Health Hazard/Health Risk Appraisal (HHA/HRA) programs employ personal risk assessment as an educational and motivational technique to encourage the adoption of healthier lifestyles by health education clients. We have reviewed the scientific basis of of the risk assessments provided in HHA/HRA. There are severe limitations in both the data and the risk estimation procedures. Various undocumented assumptions enter into the projections; several key aspects are arbitrary. Proposals for improvement of the procedure generally require data that are not available. Attention has largely focused on increasing mathematical sophistication (e.g. adjustment for competing risks) while ignoring problems in accuracy of the client data from which projections are calculated and serious questions about the health education messages implicit in the appraisal results. Health Hazard/Health Risk Appraisal programs should be candid about the limitations of the technique. Use of appraisal results for evaluation purposes is questionable. The health education messages produced by such programs deserve attention, since their appropriateness, especially for clients who are not white, middle class and middle-aged, has not been established.

Actuarial Analysis↗
PubMed1986

[Reflections on optimizing the detection, diagnosis and therapy of bronchial cancer using epidemiologic data].

The disproportions of incidence rates, the portions of early stages and the cumulated resection rates as well as the per cents of first detection by autopsy of lung cancer patients between adjoining regions lead to recommendations for getting over subjective faults in early detection, diagnostics and therapy. A determining factor on this way is the collective discussion of those physicians who are directly responsible for the lung cancer patients (oncologist, pulmologist, thorax surgeon, radiologist, district physician). Goal is the qualification of physicians in the special matter and the mobilisation of existing material resources. The mortality as the only criterion of effectivity of medical efforts is questionable and may lead to errors in judgement and decision.

Carcinoma, Bronchogenic↗
PubMed1997

[Intoxication by marine animal venoms in Madagascar (ichthyosarcotoxism and chelonitoxism): recent epidemiological data].

If seafood poisonings are well documented in the Pacific region, they are not often reported in the Indian Ocean. In Madagascar, fishermen and people living in coastal areas are traditionally aware of seafood poisonings. Mass intoxications were described in the sixties, including lethal cases following sardine ingestion. From 1989 to 1993, 28 ichtyosarcotoxism cases, mainly ciguatera occurring in children, were reported in Tulear hospital. From July 1993 to May 1996, nine seafood poisoning outbreaks occurred in coastal villages after turtle, shark and sardine meals. Clinical symptoms were related to marine toxins. For turtle intoxications, gastro-intestinal symptoms are the most frequently seen (acute stomatitis, dysphagia, vomiting and diarrhea), with case fatality rates around 7%. For shark intoxications, the most frequent symptoms were neurologic (paresthesia specially peribuccal and extremities), and gastro-intestinal (diarrhea and vomiting), with specific case fatality rates varying from 0% to 30%. For sardine intoxication, symptoms were gastro-intestinal (vomiting) and neurologic (paresthesia), and from the two intoxicated people one died. Two previously unknown biotoxins were isolated from the liver of a shark responsible for a mass poisoning, namely carchatoxins. For the turtles, the search of chelonitoxin is under way. For the sardines, clupeotoxin was isolated. Because of the frequency and the gravity of collective seafood poisonings occurring in recent years, the Ministry of Health has implemented a Seafood Poisoning National Control Programme. This programme is based on three major strategies: the setting of an epidemiological surveillance network, the prevention of the communities through educational programmes, and the development of research on marine eco-environment.

Animals↗
PubMed1982

Progestogens in cardiovascular diseases: an introduction to the epidemiologic data.

Earlier publications on the cardiovascular risks associated with oral contraceptive use emphasized the role of estrogens. Today most oral contraceptives contain less tha 50 microgram of estrogen. Furthermore, prescribing practices have improved so that most women with risk factors are not taking oral contraceptives. No differences in risk of fatal myocardial infarctions could be demonstrated by women taking 50 microgram estrogen products versus those taking products with lower estrogen dosages. Perhaps this result reflects small numbers of patients in the study, or perhaps it reflects an effect of progestogen. Since the lower estrogen doses are associated with levonorgestrel, the possibility exists that the advantages of reduced estrogen dosage are masked by the progestogen effect. A larger study is required to examine the relative importance of the estrogen and progestogen components in combined oral contraceptives.

Adult↗
PubMed2003

[Hyperhomocysteinemia: an independent risk factor or a simple marker of vascular disease? 2. Epidemiological data].

Elevated plasma total homocysteine (tHcy) is considered as a risk factor for occlusive cardiovascular disease (CVD). This concept is based on the observations of premature vascular disease in patients with homocystinuria and on the association between tHcy and increased risk of CVD in prospective studies. However, some observations have raised questions about tHcy as a risk factor. First, low risk population based prospective studies tend to indicate a weak association or no association between tHcy and CVD. Second, several traditional risk factors for CVD are associated with tHcy and may confound the relation between tHcy and CVD. Third, the C667T transition of the methylenetetrahydrofolate reductase causes a moderate increase in tHcy but no or only minor increased CVD risk. Thus, only placebo-controlled intervention studies with tHcy-lowering B-vitamins and clinical endpoints can provide additional valid arguments for the debate over whether tHcy is a causal CVD risk factor.

Amino Acid Substitution↗
PubMed1996

Typing multidrug-resistant Staphylococcus aureus: conflicting epidemiological data produced by genotypic and phenotypic methods clarified by phylogenetic analysis.

An outbreak of an unusual tetracycline-sensitive, rifampicin- and ciprofloxacin-resistant, methicillin-resistant Staphylococcus aureus (MRSA) strain at a large teaching hospital was investigated. Two typing methods, phage typing and restriction fragment length polymorphism (RFLP) by pulsed-field gel electrophoresis (RFLP-PFGE), gave conflicting results which were clarified by phylogenetic analysis. Phage typing identified all the "epidemic-associated" strains as identical, while RFLP-PFGE further divided these strains into four pulsotypes. Phylogenetic analysis showed these four pulsotypes were related genetically and also recognized a second strain of MRSA causing a continuing cross-infection problem. Variation in the RFLP-PFGE pattern was shown to occur following lysogenization of phage-sensitive MRSA. These results indicate that in analyzing outbreaks caused by subgroups of clonal organisms like MRSA, it is necessary to use at least two typing methods and that conflicts between these could be resolved by phylogenetic analysis.

Bacterial Typing Techniques↗
PubMed2000

Evidence for transmission of pertussis in schools, Massachusetts, 1996: epidemiologic data supported by pulsed-field gel electrophoresis studies.

In 1996, 18 of 20 pertussis outbreaks reported in Massachusetts occurred in schools. Pertussis surveillance data were reviewed and a retrospective cohort study was conducted in a high school that experienced an outbreak. Bordetella pertussis isolates from 9 school cases and from 58 cases statewide were examined by use of pulsed-field gel electrophoresis (PFGE). Statewide incidence rates were highest among children aged <1 year, 10-14 years, and 15-19 years (106, 117, and 104 cases per 100,000, respectively). Among 34 confirmed and 20 probable cases at the school, 61% had cough onset within 8 weeks of school opening. Five different PFGE types were identified among the 58 B. pertussis isolates from throughout the state. All 9 isolates from the affected high school were the same PFGE type. School-aged children may play an important role in pertussis epidemics. Consideration should be given to use of acellular pertussis vaccines among school-aged children.

Adolescent↗
PubMed1993

Restriction endonuclease analysis of clinical Pseudomonas aeruginosa strains: useful epidemiologic data from a simple and rapid method.

Newer genetic techniques have replaced phenotypic methods of subtyping Pseudomonas aeruginosa strains. Widespread application of newer methodologies, however, may be limited by technologic complexity and the cost of equipment. We conducted restriction endonuclease analysis (REA) of sheared genomic DNAs from 48 clinical P. aeruginosa strains using the enzyme SalI and electrophoresis in horizontal, low-concentration (0.3 to 0.6%) agarose gels. Each REA profile consisted of a smear of lower-molecular-mass bands as well as a countable number of well-resolved bands in the 8.3- to 48.5-kbp range which could easily be compared when isolates were run side-by-side on the same gel. In general, the REA patterns of strains recovered from different patients differed by at least seven bands, and those of serial isolates from individual patients were identical or differed by, at most, two bands over this 8.3- to 48.5-kbp range. REA of strains already subtyped by field inversion gel electrophoresis revealed that the two techniques generally paralleled each other. Overall, some unrelated strains had similar REA profiles, but the relative simplicity and low cost of the approach coupled with the ability to demonstrate differences between most unrelated strains should make this type of REA an attractive first step in the investigation of institutional P. aeruginosa problems.

Adult↗
PubMed1964

EPIDEMIOLOGICAL DATA CONCERNING ONE YEAR OF A MALARIA SURVEILLANCE PILOT PROJECT IN SOUTHERN RHODESIA.

Few factual data have been published on the problem of disappearing malaria due to Plasmodium falciparum in Africa. In Southern Rhodesia a surveillance project has been under way since January 1961. The author describes malaria surveillance procedures, methods, organization and costs for the year 1962-63 and presents data relevant to a sparsely populated part of rural Africa where a surveillance visitor can cover a population of only some 3500 by monthly house-to-house visits. Through such visits, and through special surveys, an annual blood examination rate of 25% was achieved in the area at fairly low cost.It was found in the area studied, where 98% of infections are due to P. falciparum, that even Africans who have previously attained a high level of immunity will produce typical fever and associated malaria symptoms on reinfection after several years. Methods of case detection have proved adequately sensitive, despite the problem of asymptomatic carriers and despite the difficulty of obtaining true medical histories. Evidence is produced that much residual low-level transmission occurs indoors, although Anopheles gambiae are found in low density in human dwellings. Drug dosages and preventive treatment are described in detail; to reduce the number of asymptomatic carriers, single-dose presumptive treatment is advocated, at least in the last year of the attack phase. Many of the findings presented will be applicable to other African countries where malaria has been reduced to a low incidence.

Adolescent↗
PubMedDate not supplied

Cadmium, lung and prostate cancer: a systematic review of recent epidemiological data.

Cadmium (Cd) and its compounds were classified as "carcinogenic to humans (Group 1)" by IARC in 1993. The observation of an increased number of lung cancers in a U.S. cohort of cadmium-exposed workers and the finding of tumors in animals exposed to various cadmium compounds apparently played an important role in this assessment. Since this evaluation, several cohorts of cadmium exposed workers have been updated and some additional data regarding environmental exposure to cadmium and cancer risk have been published. The main purpose of this systematic review was to examine whether inclusion of the studies that were not available for the 1993 evaluation might change the overall assessment of the carcinogenic potential of cadmium compounds. A second objective was to examine whether the recent studies are qualitatively better than the older ones and whether they should receive more weight in this assessment. A third issue was to investigate whether a competing effect between nonmalignant respiratory disease (NMRD) and lung cancer may have affected the results for lung cancer in occupationally exposed cohorts. Overall, considering the results of the most recent studies does not suggest that the effect of cadmium on lung cancer increases with improvement of the study design but points to a lower relative risk in the groups exposed to cadmium in the absence of arsenic and nickel. No evidence was found to support the hypothesis that NMRD represents a competing cause of death reducing the mortality from lung cancer. The association between cadmium exposure and prostate cancer was not confirmed in the latest available updates. Studies in environmentally exposed populations do not indicate an increased relative risk of cancer.

Adult↗
PubMed2004

Follow-up of epidemiological data of cryptococcosis in Austria, Germany and Switzerland with special focus on the characterization of clinical isolates.

The present survey in Austria, Germany and Switzerland continued the survey of cryptococcosis set up by the European Confederation of Medical Mycology (ECMM) in 1997. From 2000 to 2003 77 cases have been reported. An HIV infection is still the most important risk factor (68%). Young HIV+ women from ASIA contributed to the increase of cryptococcosis in females. A total of 129 clinical isolates of both surveys were genotyped by PCR fingerprinting to study the prevalence of different genotypes. The prevalence of Cryptococcus neoformans var. grubii (serotype A) with the genotypes VNA1 and VNA2 was higher in Germany and Austria (74.5%) than in Switzerland (52%), while in Switzerland the Cr. neoformans hybrids AD (26%) and Cr. neoformans var. neoformans (serotype D) (22%) were more prevalent compared with Germany and Austria (8 and 17.5% respectively). Cryptococcus gattii isolates were studied by FT-IR spectroscopy. DNA in the ITS region was sequenced to get further information about Cr. neoformans serotype AD strains and about the geographical origin of the Cr. gattii isolates. The ITS sequence of the serotype AD isolates of the genotypes VNAD1, VNAD2 and VNAD4 is usually identical to serotype A or serotype D respectively. In the three isolates of the genotype VNAD3 a genotype-specific sequence pattern was detected. Two autochthonous infections due to Cr. gattii could indicate that the genotype VGIV with the ITS type 'Asia 2' might be endemic in Europe.

Adult↗