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PubMedDate not supplied

[Initial epidemiological data on the clinical effects in health workers employed in the manual lifting of patients in wards].

An investigation was carried out by teams from various centres coordinated by the EPM (Ergonomics of Posture and Movement) Research Unit on 54 different hospitals in various regions of northern and central Italy. The teams examined a total of 3341 health workers whose job involved manual handling of patients (553 male and 2788 females, 1568 working in hospitals and 1773 in geriatric residences). Numerous meetings were held to ensure that the methods of assessing the exposure indexes and spinal impairment were identical in the various teams. The final data were processed centrally at the EPM Research Unit. The sample analyzed may be considered as representative of the situation in hospitals in Italy, at least for northern and central Italy. The mean age was 36 years, mean length of service in the department 6 years and mean length of job duration not exceeding 10 years; staff turnover was high. Physical examination revealed that 8.4% of the workers had had at least one episode of acute low back pain in the previous 12 months: i.e., 4 times the values of the reference groups. Also in the case of clinical-functional spondyloarthropathies of the lumbosacral spine, in the females there was a significantly higher prevalence than in the reference groups. All disorders were more severe in sectors more at risk, i.e., old peoples homes, rehabilitation centres, orthopaedic and surgical departments, and in any case higher in old peoples homes and geriatric residences. The initial data concerning the ratio between presence of spinal disease and risk index were also positive.

Adult↗
PubMed1999

[The vascular risk in the diabetic: the lipid factor, from epidemiologic data to intervention trials].

It might seem likely that the lipid abnormalities observed in diabetes could be treated more efficiently by fibrates than by statins, whereas subgroup analysis in three intervention trials has shown that statins prevent cardiovascular diseases in diabetic patients. The magnitude of relative risk reduction in these trials was similar to that observed in non-diabetic populations, but the greater absolute risk for diabetic patients led to increased absolute benefit. These data concerned only secondary prevention in well-controlled diabetic patients with combined hyperlipidaemia. Subgroup analysis based on LDL-cholesterol concentration in cardiovascular prevention trials with statin and the results of fibrate trials performed in the general population suggest that fibrates could still be recommended for hypertriglyceridaemic diabetic patients whose LDLc is lower than 1.4 g/l. This hypothesis needs to be tested in the light of results of ongoing fibrate trials specifically conducted in diabetic patients.

Cardiovascular Diseases↗
PubMedDate not supplied

[Biology of papillomavirus infections. IV. Sero-epidemiological data].

Serological assays using synthetic peptides or recombinant proteins to identify specific HPV infection either fail to correlate with the type of infection or are only able to identify a small percentage of infected individuals. But genetically engineered Virus Like Particles (VLP) seem useful to develop Elisas for serological diagnosis of HPV infection and antibodies to VLP appear to correlate well with HPV DNA presence. The levels of secretory immunoglobulins in genital secretions would provide a better indicator of HPV infection, but reproducibility and standardization of the detection methods are unresolved. The clinical relevance of serologic responses is still questionable, since frequency and titer of several types of antibodies generated against HPV show a great variability which is dependent on the HPV type specificity, on the recognized epitopes and on the type of samples. However the detection of neutralizing antibodies associated with disease recurrence and antibodies raised against HPV16 E6 and E7 peptides found to react with sera of cancer patients, needs to pay attention.

DNA, Viral↗
PubMed1999

[Clinical and epidemiological data of patients with malignant melanoma from the Munich Tumor Center 1977-1997].

Since 1997, data of patients with malignant melanomas have been systematically documented in the tumor registry of the Tumor Center Munich. Analysis of data of 8071 patients revealed that tumor thickness has steadily declined over the years. While in 1977 the median tumor thickness was 1.45 mm, it is now 0.75 mm. This has been followed by a significant improvement in overall survival. Males and older patients tend to have thicker melanomas than females and younger patients. There has been a relative increase of melanomas of the trunk. At diagnosis, 95% of patients had local disease. Of these patients, 18.3% developed metastastes. At least two-thirds of these patients had progression at the primary tumor site or the regional lymph nodes, both of which can be assessed by clinical or ultrasound examinations. Overall survival of patients with thin melanomas is excellent and does not differ substantially from the overall survival of the general population comparable in sex and age.

Adult↗
PubMedDate not supplied

[Analysis of premature termination in inpatient psychosomatic rehabilitation based on epidemiologic data from two hospital companies].

Premature termination of inpatient psychotherapy can have multiple, mostly negative, effects for patients, therapists, clinics, insurance companies, and employers, but research regarding inpatient settings is still deficient. The analysis of two sets of data of four different rehabilitation clinics from two different hospital companies (2699 and 2215 patients, respectively), aimed at possible predictors and outcomes of premature termination. We found ratios of premature termination of 8.3% and 14.7%, respectively. Especially young patients under 30 years of age and patients with eating and personality disorders were more likely to terminate inpatient treatment prematurely. Treatment outcome as rated by therapists was in significantly fewer cases among premature terminators than among successful terminators improved. The results seem to indicate, that assignment to inpatient psychotherapy can be optimized. For a better understanding of the process of premature termination more theory guided prospective and followup studies are necessary.

Adult↗
PubMed1999

[Epidemiologic data for tetanus prophylaxis. Assessment of the need for vaccination].

OBJECTIVE: In spite of the low morbidity secondary to tetanus, the high fatality rate (about 50%) requires effective and extensive protection of the population by vaccination. Since documentation is often lacking, booster tetanus vaccination is frequently applied in cases of minor injury. This leads to vaccination associated complications such as hyperergic reactions. The more intense the vaccination-associated side effects are, the less revaccination is possible. We investigated the tetanus immune status of a selected Austrian population. MATERIALS AND METHODS: Tetanus antitoxin antibodies were measured with ELISA (Immunozym Tetanus, Immuno AG) in serum samples from 218 subjects who were hospitalised in a dermatology unit. In addition, patient history and data concerning vaccination were collected. RESULTS: Based on the assumption that an antitoxin level of 0.1 IU/ml provides sufficient protection, 63% of the subjects were found to be adequately protected. 56% showed high antibody concentrations above 0.5 IU/ml. However, the data also revealed no protection by vaccination in 37% of the subjects. Data obtained by case history or vaccination certificates could not serve as a discrimination factor for applying revaccination or not. CONCLUSION: We strongly recommend better documentation of tetanus vaccination. In some cases, a search for tetanus antibodies before applying booster tetanus vaccination might be necessary.

Adult↗
PubMed1999

[International Stroke Trial Switzerland: some epidemiologic data].

Randomised trials provide the best evidence on the effects of treatment on a particular disease. They can also provide valuable data on outcome. In the present article, data from 1631 Swiss patients randomised in the International Stroke Trial (IST) are presented. Baseline characteristics and outcome in the Swiss patients were compared with the 17,804 patients randomised in other countries. On average, compared with other countries, Swiss patients were: 2.5 years older (CI: 1.9-3.1; p < 0.001); more likely to have presented with total anterior circulation infarcts (28 vs 23%); less likely to have lacunar strokes (16 vs 25%; p < 0.00001); more likely to be randomised and treated early (within 3 hours, 7 vs 4%, and within 6 hours, 25 vs 15%; p < 0.00001). However, Swiss patients were more likely to be dead or dependent 6 months after the stroke (66.9 vs 62.2%; p < 0.00001). The difference in death or dependency was almost entirely explained by the difference in age and baseline severity of strokes. These data highlight the difficulties inherent in between-country comparisons of outcome after stroke. They also emphasise the need for international multicentre trials to use methods of randomisation (either stratification or minimisation), as IST did, to ensure balance of prognostic factors within each participating country; to do otherwise might confound the assessment of the effect of treatment.

Aged↗
PubMed1979

[Estimation of coronary disease mortality and morbidity in France from epidemiological data].

The incidence of coronary heart diseases in France is estimated from three sources of information. Mortality statistics underestimate the number of deaths from coronary heart diseases. An evaluation of this number is proposed, but with a rather important lack of precision; for example, between 10 and 20% of male mortality between age 45 and 64. These French coronary death rates are inferior to those of numerous other European or Anglo-Saxon countries, but are comparable with those of some mediterranean countries. The incidence of coronary heart diseases measured in the Paris Prospective Study is inferior by half to that of the Framingham Study and is also inferior to those of several male populations from the 7 Countries Study, in the same age limits. Three French registers give similar results about the incidence of acute myocardial infarction. This incidence is equal to the lower limit of those measured in 21 foreign registers. These concording data suggest that the incidence of coronary heart diseases is relatively moderate in France. Etiological hypotheses are planned and the interest in a surveillance of French sanitary data is reminded.

Adult↗
PubMedDate not supplied

New epidemiological data on liver oncogenesis.

The purpose of this review is to address and discuss the following: a) the malignant transformation of hepatocytes may occur, irrespective of the etiologic agent, in the context of increased cellular turnover induced by chronic hepatic damage and regeneration, with genetic mutations being a frequent event prior to the development of this tumor; b) although it is clear that hepatitis B virus-induced chronic liver injury, regeneration and cirrhosis is a major risk factor for hepatocellular carcinoma development, there are also several reports of the direct carcinogenic effects of hepatitis B virus. For instance, integration of hepatitis B virus DNA can directly induce chromosomal rearrangements and viral gene product transactivating properties may influence cellular genes important in the control of the growth process; c) hepatitis C virus and other risk agents, including alcohol, environmental factors and metabolic diseases may operate, mainly through chronic liver damage that progress to liver cirrhosis, a major predisposing factor for the development of hepatocellular carcinoma, regardless of etiology; d) at the molecular level, the interaction between oncogenes, tumor suppressor genes (with or without aflatoxins and hepatitis B virus) and several growth factors may play an additional role in hepatocellular carcinoma development.

Animals↗
PubMed2000

[Migraine: epidemiological data, repercussions on daily life and socioeconomic cost].

Studies made on the basis of IHS criteria on the prevalence of migraine show relatively homogeneous results, that is to say about 12% of the adult population is prone to migraine attacks, with a marked female bias (female/male ratio, 3.7:1). Migraine-associated comorbidity has not been extensively researched due to significant methodological problems. Migraine as a risk factor in relation to cardiovascular disease remains a subject of discussion, and migraine with aura appears to present a cerebral infarct risk in young women taking oral contraception. There is an established and significant association between migraine, anxiety and depressive disorders. Certain studies have determined the important repercussions of migraine on the quality of life. Some subjects are reluctant to contact a doctor, and therefore voluntarily deny themselves access to medical treatment to relieve their condition. The socioeconomic cost of migraine attacks is high, and the direct cost in France is estimated at about 4 billion French francs. It is quite probable that the indirect costs (e.g., absenteeism, reduced efficiency at work) are even higher.

Activities of Daily Living↗