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At least 451 records · Page 25Linked to original sources
PubMed1994

Clostridium difficile-associated diarrhoea: epidemiological data from Western Australia.

The incidence of Clostridium difficile-associated diarrhoea (CDAD) was investigated retrospectively at a 690-bed teaching hospital for the period 1983-92. Our aims were to determine: (i) the distribution by age and sex of patients with CDAD, (ii) the possibility of a seasonal trend and, (iii) the influence of infection control procedures, contamination of the hospital environment and the use of third-generation cephalosporins. The laboratory diagnosis of CDAD was based on demonstration of the organism by stool culture and/or detection of specific cytotoxin in stool filtrates. C. difficile was detected in 917 patients who were being investigated for diarrhoeal illness. Yearly isolations varied from a low of 49 in 1983 to a high of 120 in 1990 (Chi square for linear trend 128.8; P < 0.005). Most patients were elderly, with 63% aged 60 years or more; the majority (59%) were female. The relationship between culture of C. difficile and detection of cytotoxin in faecal extracts was also examined. Sixty percent of a sample of 132 isolates from patients in whom faecal cytotoxin was not detected produced cytotoxin in vitro, suggesting that culture is a more sensitive indicator of infection with C. difficile than cytotoxin detection. When the total number of faecal specimens received in the laboratory was used as a denominator there was an increase in the number of incident cases of CDAD between 1983 and 1990, apart from 1986. When occupied bed days was used as the denominator a similar trend was observed with a peak in 1990.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

Viral meningitis due to echovirus types 6 and 9: epidemiological data from Western Australia.

During the autumn of 1992, Western Australia experienced a large viral meningitis outbreak of dual aetiology. Of the 161 cases, 64% were children under 15 years of age, with the highest notification rate being in children less than 5 years of age. Echovirus 9 caused 41% of cases and occurred mainly in the metropolitan areas of Western Australia whereas echovirus 6, which caused 37% of cases, was more widespread. An enterovirus was cultured from 70% of CSF specimens, 88% of faecal specimens and 68% of upper respiratory tract specimens. High CSF white cell counts and neutrophil predominance were common. Seven cases had normal CSF white cell counts even though an enterovirus was isolated from the CSF. Therefore, the CSF findings were of restricted value in excluding viral meningitis, and did not reliably distinguish between bacterial and viral meningitis.

Adolescent↗
PubMed1987

Respiratory tract infections due to Branhamella catarrhalis: epidemiological data from Western Australia.

During a 3-year period Branhamella catarrhalis was isolated in significant numbers from 239 (1.3%) of 19,488 specimens of sputum sent for routine microbiological examination at a 700-bed general hospital. The majority of patients (83%) were over 60 years of age and 65% were male. There was a distinct seasonal variation in isolations with a peak incidence during the winter and early spring, a pattern not found with other pathogens. Susceptibility to amoxycillin decreased by approximately 50% over the 3 years, corresponding to an increased incidence of beta-lactamase-producing strains. There were minimal changes in susceptibility to other antimicrobial agents. Underlying pulmonary disease was the major factor predisposing to B. catarrhalis infection, and 71% of patients were smokers or ex-smokers.

Adult↗
PubMed2001

Carriage of intestinal spirochaetes by humans: epidemiological data from Western Australia.

The purpose of this study was to investigate carriage of intestinal spirochaetes by selected population groups in Western Australia. Stool specimens from 293 rural patients with gastrointestinal disorders, and from 227 healthy migrants from developing countries were cultured. Spirochaete isolates were identified using PCR, and typed by pulsed field gel electrophoresis (PFGE). Brachyspira aalborgi was not isolated. Brachyspira pilosicoli was recovered from 15 rural patients, all Aboriginal. Prevalence was 9.9% in 151 Aboriginals and 0% in 142 non-Aboriginals. Carriage of B. pilosicoli amongst migrants was 10.6% (24/227). Carriage was significantly increased in Aboriginal children aged 2-5 years (P = 0.0027) and in migrant individuals from the Middle East and Africa (P = 0.0034). Carriage was significantly associated with detection of faecal protozoa in both Aboriginals (P = 0.0021) and migrants (P = 0.012). PFGE results indicated that the B. pilosicoli strains were genetically diverse.

Adolescent↗
PubMed2005

An evaluation and comparison of three commonly used statistical models for automatic detection of outbreaks in epidemiological data of communicable diseases.

We evaluated three established statistical models for automated 'early warnings' of disease outbreaks; counted data Poisson CuSums (used in New Zealand), the England and Wales model (used in England and Wales) and SPOTv2 (used in Australia). In the evaluation we used national Swedish notification data from 1992 to 2003 on campylobacteriosis, hepatitis A and tularemia. The average sensitivity and positive predictive value for CuSums were 71 and 53%, for the England and Wales model 87 and 82% and for SPOTv2 95 and 49% respectively. The England and Wales model and the SPOTv2 model were superior to CuSums in our setting. Although, it was more difficult to rank the former two, we recommend the SPOTv2 model over the England and Wales model, mainly because of a better sensitivity. However, the impact of previous outbreaks on baseline levels was less in the England and Wales model. The CuSums model did not adjust for previous outbreaks.

Australia↗
PubMed1997

First epidemiological data on pathogenic leptospires isolated on the Azorean islands.

Insectivores (Erinaceus europaeus) and rodents (Rattus rattus, R. norvegicus and Mus musculus) from different islands of the Azores Archipelago were found to carry three distinct Leptospira interrogans s.l. serovars (copenhageni, icterohaemorrhagiae and ballum) which have never been previously investigated there. The house mouse and the black rat were the major Leptospira reservoirs showing isolation rates ranging from 0% for both species (in Graciosa) to 88% and 33%, respectively (in Sãao Miguel). This study also showed that the majority of the animals with positive kidney cultures exhibited specific agglutinins against the isolated strains of Leptospira. The observed isolation rates in the different islands, with a very interesting island variation in prevalence, suggest that small mammals, serving as sylvatic reservoirs of pathogenic leptospires, may represent an important risk to the health of humans and livestock, particularly in the islands of Terceira and Sãao Miguel.

Animals↗
PubMed1997

Successful coping, adaptation and resilience in the elderly: an interpretation of epidemiologic data.

The elderly are often thought to suffer inevitable declines in functional abilities due to normal aging and concomitant diseases (acute and chronic). This view may be true for many aspects of physical health. However, an abundance of evidence suggests that mental health diverges from physical health in that Coping, Adaptation and Resilience (CAR) functions are surprisingly well-preserved throughout most of the life span. The normal "anatomy" and "physiology" of the CAR construct is described. It's robust relationship with the abnormalities of DSM-IV geriatric mental disorders is illustrated. Opportunities for new approaches to treatment are noted. These insights from the elderly are applicable to all age groups.

Adaptation, Psychological↗
PubMed2003

Acquired melanocytic nevi as risk factor for melanoma development. A comprehensive review of epidemiological data.

Acquired melanocytic nevi (MN) in Caucasian populations are important markers for the risk of melanoma development. The total number of MN on the whole body is the most important independent risk factor for melanoma and the risk of melanoma development increases almost linearly with rising numbers of MN. Additionally, the presence of atypical MN and of actinic lentigines are likewise independent risk factors for melanoma. Atypical mole syndrome should be defined by the presence of many acquired MN and a threshold number of atypical MN. Acquired MN develops mainly during childhood and adolescence in the first two decades of life. The number of acquired nevi seems to be related to hereditary factors and nevus-prone families exist. The amount of sun exposure is the most important environmental risk factor for nevus development, particularly in early childhood. Interestingly, sunburns may play a role in nevus development, but seem not to be required, and even moderate sun exposure promotes the process. Therefore, preventive measures for nevus and melanoma development should target young children and adolescents.

Dysplastic Nevus Syndrome↗
PubMed2003

Abuse and dependence potential for the non-benzodiazepine hypnotics zolpidem and zopiclone: a review of case reports and epidemiological data.

AIMS: The non-benzodiazepine hypnotics zolpidem and zopiclone, which are indicated for short-term treatment of insomnia, were considered originally by physicians as almost devoid of abuse and dependence potential. Several recent publications, however, have suggested that both agents carry a significant risk of abuse. To substantiate and re-evaluate this situation, the world literature was reviewed for cases of dependence of both agents; these cases were analysed in order to identify certain underlying patterns, if evident. METHODS: A systematic review based on a Medline literature search was conducted including the years 1966-2002 to assemble all available clinical case reports that were analysed for typical features of abuse and dependence according to prespecified criteria. Only case reports were of interest, and clinical studies were excluded. No limitations as to language or publication year were applied. The terms 'zolpidem', 'zopiclone' and 'abuse', 'dependence', 'addiction', 'withdrawal' and 'intoxication' were used to identify relevant publications. Potentially relevant citations were retrieved and assessed for inclusion independently by two authors. RESULTS: A total of 36 cases for zolpidem were identified, most of them reported in recent years, and 22 cases for zopiclone. Both sexes were involved to a similar extent; and cases were reported in all age groups. In extreme cases, dose increases reached a factor of 30-120 above the recommended doses. The majority of patients had a history of former drug or alcohol abuse and/or other psychiatric conditions. CONCLUSION: On the basis of world-wide prescription numbers, which are approximately twofold higher for zolpidem (1,338,774,000 tablets from June 2001 to June 2002 in Europe, Japan and United States) than for zopiclone (664,897,000 tablets during the same period in Europe and Japan), the relative incidence of reported dependence similar for both drugs and remarkably lower than that of benzodiazepines used for the treatment of disturbed sleep. The findings offer the conclusion that zolpidem and zopiclone are relatively safe drugs. However, as both drugs are psychotropic drugs, patients with a history of abuse or dependence and those with psychiatric diseases seem to be at increased risk of abuse of these agents.

Adult↗
PubMed2003

Disease progression in patients with thin cutaneous melanomas (tumour thickness < or = 0.75 mm): clinical and epidemiological data from the Tumour Center Munich 1977-98.

BACKGROUND: Although survival in patients with thin melanomas (tumour thickness < or = 0.75 mm) is usually excellent, thin melanomas have the potential to metastasize. OBJECTIVES: To determine risk factors for the development of disease progression in patients with thin cutaneous melanomas. METHODS: A retrospective study was performed between 1977 and 1998 to identify risk factors for the development of disease progression in 2302 patients with cutaneous melanoma with tumour thickness < or = 0.75 mm, diagnosed and treated at the Department of Dermatology and Allergology, Ludwig-Maximilians University, Munich, Germany. The Kaplan-Meier method was used to estimate the influence of different clinical characteristics for the occurrence of first progression during 10 years of follow-up. RESULTS: An analysis of the data from 6298 patients with cutaneous melanoma identified 2302 patients (37%) who presented with cutaneous melanoma with a tumour thickness < or = 0.75 mm, without clinical signs of metastasis at initial diagnosis (clinical stage Ia). A small subgroup of our patients (77 of 2302) developed metastatic disease during the follow-up period. The estimated rate of occurrence of metastasis after 10 years of follow-up was 4.7%. The mean follow-up time was 62 months (median 46). Of these 77 patients, 16 experienced progression at the primary tumour site and 32 presented with regional lymph node metastases. Twenty-eight patients primarily developed systemic metastases (seven patients with and 20 without regional lymph node metastases, one patient with regional lymph node metastases and local recurrence). In one patient the primary site of metastatic disease was not reported. Clinical characteristics included age, sex of the patient and different subtypes of cutaneous melanoma: superficial spreading melanoma, nodular melanoma, acrolentiginous melanoma (ALM) and lentigo maligna melanoma (LMM). Male patients and patients with LMM or ALM were significantly over-represented (P = 0.02 and P = 0.002). In the group of 77 patients with thin melanomas (< or = 0.75 mm), local recurrence was over-represented as compared with those with melanomas > 0.75 mm. No difference in group was found for overall survival after the occurrence of lymph node metastasis as the first manifestation of disease progression. CONCLUSIONS: Thorough follow-up and skin examination is recommended for a subgroup of patients with thin tumours, which consists of male patients with LMM or ALM located in the head and neck region.

Adult↗
PubMed2003

[Epidemiological data of patients with sudden hearing loss -- a retrospective study over a period of three years].

In this retrospective study data of 257 patients (11- 6 years; 52 % male, 48 % female) admitted during the last three years for treatment of sudden unilateral hearing loss are statistically evaluated. No correlation with coexisting disease like hypertension, coronary heart disease, hypercholesteremia, arthropathy of the cervical spine, diabetes, thyroid disorders or nicotine abuse were evident. In 194 patients (75 %) total remission was achieved after rheological therapy. Patients additionally treated with steroids had a significant better outcome. Younger patients had higher remission rates. The best prognosis was found for patients with hearing loss in the lower frequency range. There were no differences in remission rates for patients with preexisting sensorineural hearing loss or chronic otitis media. Also patients suffering from recurrent episodes of sudden hearing loss had a similar outcome also.

Adolescent↗
PubMed1983

[Chlamydia trachomatis--epidemiologic data from the outpatient department of obstetrics/gynecology of the University of Tübingen/Germany].

The incidence of Chlamydia trachomatis in cervical und urethral specimens obtained from gynaecologically healthy women was evaluated by means of a tissue culture method. In 172 women seen in our outpatient department for cancer screening the rate was 4,1%, in a group of 98 female industrial workers as high as 15,3%. The incidence seen in 107 pregnant women was 10,3%, however, none of 246 amniotic fluid specimen obtained by amniocentesis was found to contain Chlamydia trachomatis.

Adult↗
PubMedDate not supplied

MDMA: a review of epidemiologic data.

This article reviews recent surveys and reports that provide insight regarding prevalence, frequency, trends, perceptions, and seizures of methylenedioxymethamphetamine (MDMA) or "Ecstasy." An estimated 6.4 million individuals have used MDMA. Among students in the eighth, 10th, and 12th grades, MDMA use has substantially increased from mid-1990 levels to 2001, with sharp increases noted in 2000 and a more gradual increase in 2001. Exposure to MDMA among high school seniors has increased progressively and nearly quadrupled over the past decade, and a substantial proportion of young adults report having friends who use MDMA. Perceived availability has increased dramatically during the 1990s, with sharp increases in 2000 and again in 2001 among high school seniors. MDMA is now one of the most available drugs for youth. Among college students and young adults, MDMA use has increased progressively and substantially throughout the 1990s, and sharply increased in 2000. MDMA-related emergency department visits increased progressively and dramatically during the 1990s, often or nearly doubling from year to year. Most visits were attributed to patients ages 25 years or younger. The motive for their MDMA use tended to be recreation, and their reasons for the emergency department visit tended to be overdose and unexpected reactions. MDMA-related deaths are rare, but the rate is increasing, as are the number of MDMA-related calls at selected poison control centers. The quantity of MDMA seized by U.S. law enforcement has increased dramatically recently, as have the number of MDMA-related arrests. MDMA use is worldwide, and in certain European countries it is the second most frequently used drug following marijuana.

Animals↗
PubMed1991

New epidemiological data on resistance to netilmicin and other aminoglycosides.

In previous investigations we considered the increasing resistance of Gram-negative organisms to aminoglycosides over time. We therefore performed further studies to evaluate eventual variations in the incidence of bacterial resistance to aminoglycosides over the last four years. We tested Gram-negative microorganisms recently isolated from pathological materials of various clinical origins with gentamicin, amikacin, tobramycin and netilmicin. Our data show evidence that there was no significant increasing resistance to aminoglycosides, and that netilmicin continues to be active as an anti-Gram-negative antibiotic.

Amikacin↗