WHO Criteria (who + criterion)

Distribution by Scientific Domains

Selected Abstracts

Quality of evidence for the present Swedish child health surveillance programme

S Bremberg
The present Swedish health surveillance programme includes 15 examinations by a nurse, 5 examinations by a physician, 7 assessments of development, 2 assessments of hearing and 1 assessment of visual acuity. The WHO criteria for evaluation of screening programmes can be applied to the Swedish health surveillance programme. These criteria state that the health problem must be important, that there should be an early phase during which the condition is only detectable by medical professionals and that treatment at an early phase should favourably affect the prognosis. The quality of evidence for fulfilment of these criteria has been graded I-III. Grade II-2 refers to evidence obtained from well-designed cohort or case-control analytical studies. The following disorders might be affected by health surveillance at child health centres: amblyopia, ADHD/DAMP, failure to thrive, cerebral palsy, congenital heart failure, congenital luxation of hip, hearing impairment (severe or moderate), mental retardation, retentio testis and hydrocephalus. None of these conditions fulfils the WHO criteria with quality of evidence grade II-2 or better. Thus, the evidence for the present Swedish health surveillance programme is problematic. [source]

Prediction of cardiovascular and total mortality in Chinese type 2 diabetic patients by the WHO definition for the metabolic syndrome

G. T.-C.
Aim:, The aim of this study is to investigate the prevalence of metabolic syndrome (MES) in type 2 diabetic patients and the predictive values of the World Health Organization (WHO) and National Cholesterol Education Programme (NCEP) definitions and the individual components of the MES on total and cardiovascular mortality. Methods:, A prospective analysis of a consecutive cohort of 5202 Chinese type 2 diabetic patients recruited between July 1994 and April 2001. Results:, The prevalence of the MES was 49.2,58.1% depending on the use of various criteria. There were 189 deaths (men: 100 and women: 89) in these 5205 patients during a median (interquartile range) follow-up period of 2.1 (0.3,3.6 years). Of these, 164 (87%) were classified as cardiovascular deaths. Using the NCEP criterion, patients with MES had a death rate similar to those without (3.51 vs. 3.85%). By contrast, based on the WHO criteria, patients with MES had a higher mortality rate than those without (4.3 vs. 2.4%, p = 0.002). Compared to patients with neither NCEP- nor WHO-defined MES, only the group with MES defined by the WHO, but not NCEP, criterion had significantly higher mortality rate (2.6 vs. 6.8%, p < 0.001). Using Cox regression analysis, only age, duration of diabetes and smoking were identified as independent factors for cardiovascular or total death. Among the various components of MES, hypertension, low BMI and albuminuria were the key predictors for these adverse events. Conclusions:, In Chinese type 2 diabetic patients, the WHO criterion has a better discriminative power over the NCEP criterion for predicting death. Among the various components of the MES defined either by WHO or NCEP, hypertension, albuminuria and low BMI were the main predictors of cardiovascular and total mortality. [source]

The metabolic syndrome and changing relationship between blood pressure and insulin with age, as observed in Aboriginal and Torres Strait Islander peoples

A. E. Schutte
Abstract Aims To determine the prevalence of the metabolic syndrome (MS) among Aboriginal and Torres Strait Islander peoples. A further objective was to investigate the relationships between fasting insulin and blood pressure (BP) within these groups with increasing age. Methods A cross-sectional population-based study included 369 Torres Strait Islanders (residing in Torres Strait and Far North Queensland), and 675 Aborigines from central Australia. Data necessary for classification of MS was collected, including fasting and 2-h glucose and insulin, urinary albumin and creatinine, anthropometric measurements, BP, serum lipids. Results The ATPIII criteria classified 43% of Torres Strait Islanders and 44% of Aborigines with MS, whereas 32 and 28%, respectively, had the MS according to WHO criteria. Agreement between the two criteria was only modest (kappa coefficient from 0.28 to 0.57). Factor analyses indicated no cluster including both insulin and BP in either population. Significant correlations (P < 0.05) [adjusted for gender, body mass index (BMI) and waist circumference] were observed between BP and fasting insulin: a positive correlation for Torres Strait Islanders aged 15,29 years, and an inverse correlation for Aborigines aged 40 years and older. Conclusion Torres Strait Islanders and Aborigines had very high prevalences of the MS. Specific population characteristics (high prevalences of central obesity, dyslipidaemia, renal disease) may make the WHO definition preferable to the ATPIII definition in these population groups. The poor agreement between criteria suggests a more precise definition of the metabolic syndrome that is applicable across populations is required. This study showed an inverse relationship with age for the correlation of BP and fasting insulin. [source]

Prevalence of undiagnosed Type 2 diabetes and impaired fasting glucose in older B ritish men and women

M. C. Thomas
Abstract Aim To estimate the prevalence of undiagnosed diabetes and impaired fasting glucose in older British men and women, using the 1999 World Health Organization (WHO) thresholds based on fasting glucose measurements. Methods Participants in the British Regional Heart Study and the British Women's Heart and Health Study were selected from one socially representative general practice in 24 British towns. Included in this analysis were 3736 men and 3642 women aged 60,79 years (predominantly white), who provided a single fasting blood sample at a clinical examination between 1998 and 2001, and who had no previous diagnosis of diabetes. Results Two hundred and eleven men (5.7%) and 190 women (5.2%) had a fasting blood glucose level consistent with the WHO threshold for a diagnosis of diabetes (, 7.0 mmol/l), whilst a further 667 men (17.9%) and 642 women (17.6%) had impaired fasting glucose levels (6.1 , 7 mmol/l). When analyses were restricted to subjects who had fasted for at least 8 h, and whose blood sample was taken before 12.00 h, the predicted prevalence of undiagnosed diabetes (based on two separate measurements) was 6.7% in men and 6.0% in women. The predicted prevalence of impaired fasting glucose (based on two separate measurements) was approximately 20% in both sexes. Conclusions More than one-fifth of older white British men and women have either undiagnosed diabetes or impaired fasting glucose according to new WHO criteria. Strategies for the primary and secondary prevention of Type 2 diabetes among older individuals are urgently needed. [source]

Prevalence of the metabolic syndrome among the Inuit in Greenland.

A comparison between two proposed definitions
Abstract Aims To estimate the prevalence of the metabolic syndrome among Greenland Inuit according to the World Health Organization (WHO) definition and the definition suggested by the National Cholesterol Education Program (NCEP). Methods From 1999 to 2001, 917 adult Inuit participated in a health survey in Greenland. The examination included a 75-g oral glucose tolerance test (OGTT). Body mass index (BMI), waist circumference, waist-to-hip ratio and blood pressure were measured. Plasma glucose, serum insulin, lipids and urine albumin/creatinine ratio were measured. The metabolic syndrome was diagnosed according to the WHO criteria 1999 and to the working definition suggested by the NCEP 2001. Results Using the WHO and the NCEP criteria, 20.7% and 17.9% of the participants had the metabolic syndrome, respectively. There was a moderate agreement between the two definitions, , = 0.56 (95% CI 0.51,0.61). Of those with the WHO metabolic syndrome, 37.9% did not have the NCEP syndrome, and 28.5% of those with the NCEP syndrome were not classified with the metabolic syndrome under the WHO criteria. Compared with the WHO syndrome, men with the NCEP syndrome had higher mean values of waist circumference, BMI and triglycerides, and lower mean values of high-density lipoprotein (HDL) cholesterol; among women, triglycerides were higher with the NCEP syndrome. Conclusion The metabolic syndrome is common among Inuit using either the WHO definition or the proposed NCEP definition. The classification disagreement is considerable and a universally accepted definition is needed. [source]

Comparison of ADA and WHO criteria for the diagnosis of diabetes in elderly Koreans

K. M. Choi
Abstract Aims This study was conducted to compare the prevalence and cardiovascular risk factors of different categories of glucose tolerance in the elderly Korean population using World Health Organization (WHO) and American Diabetes Association (ADA) criteria. Methods This study included 1456 non-diabetic subjects over the age of 60 years, selected from a cross-sectional study, which was conducted in 1999 in Seoul, Korea. Fasting and post-challenge 2-h plasma glucose, insulin levels, body mass index (BMI), waist,hip ratio (WHR), blood pressure, and lipid profiles were examined. Prevalence of glucose tolerance categories and the level of agreement (, statistics) were obtained using WHO 2-h criteria and ADA fasting criteria. Comparison of cardiovascular risk factors among several concordant and discordant glucose intolerance groups was done. Results The prevalence rates of newly diagnosed diabetes of elderly men defined by WHO 2-h criteria and ADA fasting criteria were 11.8% and 4.8%, respectively. That of elderly women was 8.1% by WHO 2-h criteria and 3.1% by ADA fasting criteria. The prevalence of impaired glucose tolerance (IGT) by WHO criteria was also higher than that of impaired fasting glucose (IFG) by ADA criteria (23.5% vs. 10.0% men, 23.7% vs. 7.5% women). The level of agreement between ADA fasting criteria and WHO 2-h criteria was low (weighted , = 0.228 men, weighted , = 0.301 women). The concordant diabetic women by both ADA fasting criteria and WHO 2-h criteria showed higher BMI, WHR, diastolic blood pressure, total cholesterol and triglyceride levels than concordant normal subjects. However, the isolated post-challenge hyperglycaemia (IPH) women group was not different significantly from the concordant normal women group except in BMI. Conclusions Our results clearly show that the 1997 ADA fasting criteria are less sensitive for diagnosing diabetes than oral glucose tolerance test (OGTT)-based WHO criteria in elderly Koreans. Also, there is a poor agreement of different categories of glucose tolerance between ADA and WHO criteria; therefore, the OGTT remains a valuable test in diagnosing diabetes and classifying various categories of glucose intolerance, especially in elderly Koreans. [source]

Metabolic effects of metformin in patients with impaired glucose tolerance

M. Lehtovirta
Abstract Aims To assess the effect of metformin on insulin sensitivity, glucose tolerance and components of the metabolic syndrome in patients with impaired glucose tolerance (IGT). Methods Forty first-degree relatives of patients with Type 2 diabetes fulfilling WHO criteria for IGT and participating in the Botnia study in Finland were randomized to treatment with either metformin 500 mg b.i.d. or placebo for 6 months. An oral glucose tolerance test (OGTT) and a euglycaemic hyperinsulinaemic clamp in combination with indirect calorimetry was performed at 0 and 6 months. The patients were followed after stopping treatment for another 6 months in an open trial and a repeat OGTT was performed at 12 months. Results Metformin treatment resulted in a 20% improvement in insulin-stimulated glucose metabolism (from 28.7 ± 13 to 34.4 ± 10.7 µmol/kg fat-free mass (FFM)/min) compared with placebo (P = 0.01), which was primarily due to an increase in glucose oxidation (from 16.6 ± 3.6 to 19.1 ± 4.4 µmol/kg FFM; P = 0.03) These changes were associated with a minimal improvement in glucose tolerance, which was maintained after 12 months. Conclusions Metformin improves insulin sensitivity in subjects with IGT primarily by reversal of the glucose fatty acid cycle. Obviously large multicentre studies are needed to establish whether these effects are sufficient to prevent progression to manifest Type 2 diabetes and associated cardiovascular morbidity and mortality. Diabet. Med. 18, 578,583 (2001) [source]

Prevalence and determinants of diabetes mellitus and glucose intolerance in a Canarian Caucasian population , comparison of the 1997 ADA and the 1985 WHO criteria.

The Guía Study.
Summary Aims To estimate the prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance in a Canarian population according to the 1997 ADA and the 1985 WHO criteria; and to study the cardiovascular risk factors associated with these categories. Methods A total of 691 subjects over 30 years old were chosen in a random sampling of the population (stratified by age and sex). An oral glucose tolerance test was performed (excluding known diabetic patients) and lipids were determined in the fasting state. Anthropometric and blood pressure measurements were performed, and history of smoking habits and medications was recorded. Results The prevalence of diabetes was 15.9% (1997 ADA) and 18.7% (1985 WHO); the prevalence of impaired fasting glucose and impaired glucose tolerance was 8.8 and 17.1%, respectively. The age-adjusted prevalence of diabetes (Segi's standard world population) for the population aged 30,64 years was 12.4% (1985 WHO). The risk factors significantly associated with diabetes (1997 ADA and 1985 WHO) were age, body mass index; waist-to-hip ratio, systolic and mean blood pressure, triglycerides, total cholesterol and low HDL-cholesterol. Age, body mass index and systolic blood pressure were associated with impaired fasting glucose and impaired glucose tolerance; triglycerides were also associated with impaired fasting glucose. Conclusions The prevalence of diabetes mellitus and glucose intolerance in Guía is one of the highest among studied Caucasian populations. The new 1997 ADA criteria estimate a lower prevalence of diabetes. Impaired fasting glucose also had a lower prevalence than impaired glucose intolerance and the overlap of these categories was modest. [source]

Haemoglobin and anaemia in a gender perspective: The Tromsø Study,

Tove Skjelbakken
Abstract:,Objectives:,To examine the gender-specific distribution of haemoglobin (Hb) and the World Health Organization (WHO) criteria for anaemia compared with the 2.5 percentile for Hb. Methods:,A population-based study from Tromsø, Northern Norway. All inhabitants above 24 yr were invited. In total, 26 530 (75%) had their Hb analysed. Results:,The 2.5,97.5 percentile of Hb was 129,166 and 114,152 g/L for all men and women, respectively. In men, mean Hb decreased from 148 to 137 g/L between 55,64 and 85+ yr. In women, mean Hb increased from 132 to 137 g/L between 35,44 and 65,74 yr and then decreased to 131 g/L among the oldest. Using the WHO criteria for anaemia (Hb: <130 and <120 g/L, men and women respectively), the prevalence of anaemia in men increased with age from 0.6% aged 25,34 to 29.6% aged 85+. For women, the prevalence of anaemia varied from 9.1%, 2.2% and 16.5% in the age groups of 35,44, 55,64 and 85+ yr, respectively. The WHO criteria gave a two to three times higher prevalence of anaemia compared with the 2.5 percentile of Hb in women, but the difference was small in men. Poor self-rated health was not associated with low values of Hb in women. In men, there was an association in some age groups. Conclusion:,The WHO criteria for anaemia and the 2.5 percentile for Hb corresponded well for men, but not for women. The WHO criteria of anaemia may result in medicalization of healthy women. [source]

Anemia and cognitive performance in hospitalized older patients: results from the GIFA study

Valentina Zamboni
Abstract Background Anemia represents a major risk factor for adverse health-related events in older persons. The aim of this study was to evaluate the association between hemoglobin levels/anemia and cognitive function in hospitalized older persons. Method Data are from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study. Hemoglobin levels (in g/dL) were measured upon admission to hospital; anemia was defined according to the WHO criteria. Cognitive performance was assessed by the Abbreviated Mental Test (AMT) on admission; an AMT score <7 defined cognitive impairment. Logistic regressions and analyses of covariance were performed to evaluate the relationship between cognitive status and hemoglobin levels/anemia. Results Mean age of the sample (n,=,13,301) was 72.0 years. Participants with cognitive impairment presented a higher prevalence of anemia (47%) compared to those without cognitive impairment (35%, p,<,0.001). Adjusted logistic regressions showed that hemoglobin levels/anemia were significantly associated with cognitive impairment (OR,=,0.96, 95%CI,=,0.94,0.99, p,=,0.004, and OR,=,1.32, 95%CI,=,1.18,1.48, p,<,0.001, respectively). Patients with anemia and cognitive impairment at the hospital admission presented a higher number of impaired Activities of Daily Living compared to those with only one or none of the studied conditions (p for trend,<,0.001). Conclusion Low hemoglobin levels and anemia are independently associated with cognitive performance in older persons admitted to acute care units. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Prevalence of osteoporosis among postmenopausal women in Sri Lanka: a cross-sectional community study

Abstract Objective:, This study was designed to estimate the prevalence of osteoporosis among postmenopausal women selected from seven provinces in Sri Lanka. Method:, The study was a community-based cross-sectional survey of a group of 1642 community-dwelling postmenopausal women in seven provinces, except the North and East, in Sri Lanka. Phalangeal bone mineral density (BMD) was measured in all subjects using an AccuDEXA. In a subgroup of 150 women BMDs in the spine from L2,L4 and proximal femur were measured using a Norland Eclipse central DXA machine. In this subgroup, the diagnosis of osteoporosis was made according to the WHO criteria based on T-scores of the spine or femoral neck. The sensitivity, specificity, positive predictive value and negative predictive value of different phalangeal BMD levels were examined and the prevalence of osteoporosis was calculated using the most acceptable cut-off value. Results:, A sharp decline in phalangeal BMD (0.006 g/cm2/year) was seen during the postmenopausal period. Phalangeal T-score of ,2.00, which had sensitivity, specificity, positive predictive value and negative predictive value of 78%, 85%, 91% and 68% respectively, was selected as the most suitable value to predict osteoporosis: 357 women had phalangeal T-scores either equal to or lower than ,2.00. When the positive predictive value and negative predictive value of this cut-off value were applied, 736 women (44.9%) in our sample were likely to have osteoporosis. Conclusions:, Osteoporosis is a prevalent disease among postmenopausal women in Sri Lanka. Similar prevalence figures have been reported from other Asian countries. [source]

Novel point mutation in exon 12 of the glucose-6- Phosphate Dehydrogenase Gene: G6PD Flores

Maria-Odete Rodrigues
Abstract In Portugal there are a wide variety of G6PD deficiency associated mutations. In an individual from the island of Flores of the Azorean archipelago, we report a new mutation in the G6PD gene that gives rise to a "moderate rate of G6PD deficiency" (12.6% of the normal activity) according to WHO criteria. Direct sequencing revealed a C,A point mutation at position 1387 with the consequent substitution of an Argine by Serine. We designated this new mutation as G6PD FLORES. The mutation is associated with haplotype I ( , , + + , , ), using six intragenic RFLPs. This information may also be seen as contributing to the clarification of the genetic makeup of the Azorean population, founder mutations, and/or gene flow. J. Clin. Lab. Anal. 18:129,131, 2004. © 2004 Wiley-Liss, Inc. [source]

Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord-Trøndelag Diabetes Study, Norway

T. Claudi
Abstract. Claudi T, Midthjell K, Holmen J, Fougner K, Krüger Ø, Wiseth R (University of Tromsø/Rønvik Health Center, Bodø; National Institute of Public Health, Community Medicine Research Unit, Verdal; University Hospital of Trondheim; and Norwegian University of Science and Technology, Trondheim, Norway). Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord-Trøndelag Diabetes Study, Norway. J Intern Med 2000; 248: 493,501. Objective. To study cardiovascular status and risk factors in persons with newly diagnosed type 2 diabetes and controls in a large population. Design. Case,control study. Setting. Population screening Subjects. The screening of 74 499 individuals (88.1%), aged 20 years and older, in Nord-Trøndelag County, Norway, during 1984,86 detected 428 persons with undiagnosed diabetes according to the 1980 WHO criteria, of whom 205 attended a clinical follow-up examination assessing cardiovascular status and risk factors. Methods. For each of 205 cases, one control person matched by age and sex underwent the same clinical examination. Lipids, body mass index, waist/hip ratio, blood pressure, pulse rate, blood pressure medication, kidney function, cardiovascular disease, family history and lifestyle were recorded. Results. At the screening prior to the diagnosis of diabetes, those with diabetes reported poorer general health, less physical activity, more siblings with diabetes and more frequent use of antihypertensive medication. They had higher body mass index, systolic and diastolic blood pressure and pulse rate compared with controls. At the clinical evaluation, diabetics had higher urine albumin levels, increased waist/hip ratio, and higher total cholesterol/HDL cholesterol ratios than the controls. They also reported a greater incidence of angina pectoris and had more ECG changes. Conclusions. Diabetics presented with more cardiovascular risk factors, angina pectoris and ECG changes than the controls, and they had an established metabolic syndrome more often than controls. These results suggest that prevention of cardiovascular disease in diabetics requires earlier diagnosis of the diabetes. [source]

Tooth loss and prosthodontic rehabilitation among 35- to 44-year-old Iranians

Summary, This study aimed to investigate the frequency of tooth loss and the magnitude of prosthodontic rehabilitation based on socio-demographic information among 35- to 44-year-old Iranians. Data (n = 8240) were collected by 33 examiners as part of a national survey using WHO criteria for sampling and clinical diagnosis. Gender, age, place of residence and level of education served as socio-demographic information. The number of teeth, functional dentition (subjects with 20 or more teeth) and prosthodontic rehabilitation were used as clinical variables. The chi-square test and logistic regression analysis were the methods of statistical evaluation. Of all subjects, 3% were edentulous. Of dentate subjects, 3% had 1,9 teeth, 21% had 10,19 teeth, 37% had 20,24 teeth and 39% had 25,28 teeth. In total, 76% of dentate subjects enjoyed a functional dentition. Among dentate subjects, 11% of the men and 16% of the women had prosthodontic rehabilitation with higher figures (P < 0·001) among women, older subjects and urban residents. Having a functional dentition was more likely among those with higher levels of education [odds ratios (OR) = 1·8, 95% confidence intervals (CI) = 1·6,2·1]. Women (OR = 2·4, 95% CI = 1·8,3·0) and urban residents (OR = 2·4, 95% CI = 1·8,3·3) were the most likely groups to have prosthodontic rehabilitation. Having prosthodontic rehabilitation was more likely among those lacking a functional dentition (OR = 6·0, 95% CI = 4·8,7·6). The greatest unmet treatment needs were found among those without a functional dentition. Functional dentition should be set as a primary oral health goal among working-age adults. [source]

CASA-based sperm kinematics of environmental risk factor-exposed human semen samples designated as normozoospermic in conventional analysis

ANDROLOGIA, Issue 4 2010
D. Mukhopadhyay
Summary This study was conducted after an initial epidemiological survey of patients in and around Calcutta, India, concerning their lifestyle history, degree of risk exposure and semen analysis based on conventional WHO criteria. It was found that a large group of exposed patients were showing normozoospermic semen parameters in conventional semen analysis. Hence, a selected group of subjects, designated as normozoospermic in routine analysis, but under risk factor exposure, were selected for a repeat computer aided semen analysis (CASA) and were compared with a control group. The parameters considered among CASA results were: curvilinear velocity (VCL), straight-line velocity, average path velocity (VAP), straightness index (STR), lateral head displacement (ALH) and beat cross frequency. The results depict a significant decline in the mean values of VCL (P = 0.029) and STR (P = 0.007) in the tobacco-exposed group when compared with the unexposed group. On the other hand, there was a significant decline in the mean values of VCL (P = 0.014) and ALH (P = 0.040) in the heavy metal-exposed group when compared with the unexposed group. The other parameters did not show significant change in either group. Semen samples that had been designated normozoospermic in conventional analysis were seen to be influenced by risk factors at the level of sperm motion kinetics. [source]

Integrity of mitochondrial membrane potential reflects human sperm quality

ANDROLOGIA, Issue 1 2009
J. A. Espinoza
Summary The aim of this work was to evaluate intracellular reactive oxygen species (ROS) levels, phosphatidylserine (PS) externalisation and mitochondrial membrane potential integrity in the spermatozoa of healthy donors and outpatients who consulted for infertility and to correlate the results with the classic sperm parameters. For the evaluation of intracellular ROS levels, PS externalisation and mitochondrial membrane potential integrity, the fluorescent compounds dihydroethidium, annexin V-FITC and JC-1, respectively, were used and analysed by using flow cytometry. Conventional seminal analysis, including motility, viability, morphology, sperm count and volume, was performed according to the WHO criteria. The mitochondrial membrane potential and ROS results showed significant differences between the spermatozoa of individuals with a normal semen analysis and those of the group presenting abnormality in at least one of the sperm parameters. Mitochondrial membrane potential showed a significant and direct correlation with all the sperm parameters analysed. ROS were inversely correlated with motility, viability and morphology. PS externalisation, however, did not show any differences between the two groups, nor was it correlated with the sperm parameters examined. The evaluation of mitochondrial membrane potential integrity is a test that reflects sperm quality, which makes it highly recommendable to be applied as a complement to routine sperm analyses. [source]

Persistent iodine deficiency in a cohort of Tasmanian school children: associations with socio-economic status, geographical location and dietary factors

Kristen L. Hynes
Objective: To determine the adequacy of iodine nutrition of Tasmanian primary school-aged children and to examine possible associations with socio-economic status (SES), location and dietary factors. Methods: Urinary iodine levels and measures of SES, geographical information and dietary habits were surveyed in a population-based sample of 170 children (4 to 12 years) at baseline (1998/99) and at follow-up (2000/01). Results: Median urinary iodine concentration in 1989-99 and 2000-01 were 75 ,g/L (range 15 ,g/L to 240 ,g/L) and 76 ,g/L (range 18 ,g/L to 480 ,g/L) respectively. No significant associations with SES or geographical location were found. More frequent or recent intake of foods that are likely to be dietary sources of iodine tended to be associated with greater prevalence of adequate urinary iodine, particularly consumption of yoghurt and ,fruche' (p=0.04). Conclusions: After several decades of iodine sufficiency, Tasmanian primary school-aged children are again mildly iodine-deficient by WHO criteria. Despite reduction in iodophor use by the dairy industry in the past decade, consumption of dairy products continues to be associated with higher levels of iodine nutrition. Implications: The lack of association of iodine levels with SES and geographical location within Tasmania found in our study, and the results of studies of iodine levels in Melbourne and Sydney, suggest that inadequate iodine nutrition is a widespread problem in south-eastern Australia. Our study suggests that milk-containing products continue to be an important source of iodine for children. [source]

Extremely low frequency-modulated static magnetic fields to treat cancer: A pilot study on patients with advanced neoplasm to assess safety and acute toxicity

Flavio Ronchetto
Abstract Results of a toxicity pilot human study approved by the competent ethical Committee are reported. Eleven patients with heavily pre-treated advanced cancer were enrolled in a pilot study with different schedules of time exposure to static magnetic fields (MF), amplitude modulated by ELF. An area including the neck, thoracic and abdomen was MF exposed daily, 5 days/week for 4 weeks according to two different schedules: 20 min daily (4 patients) and 70 min daily (7 patients). ECOG performance status was 1 (2 patients), 2 (8 patients), 3 (1 patient). Toxicity was assessed according to WHO criteria. ECG, Chest X-ray, physical examination, blood cell count and complete blood chemistry were performed before and at the end of the treatment. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) elevation (grade 2 toxicity) in 1 patient and microscopic urinary abnormalities in 5 patients were the only negative effects observed. We conclude that MF can be safely administrated according to the MF exposure schedules. Bioelectromagnetics 25:563,571, 2004. © 2004 Wiley-Liss, Inc. [source]

Five-year incidence of visual impairment and blindness in older Icelanders: the Reykjavik Eye Study

Elin Gunnlaugsdottir
Abstract. Purpose:, This study examined age, sex and cause-specific 5-year incidence of visual impairment and blindness in a middle-aged and elderly Icelandic population. Methods:, The study cohort consisted of a population-based, random sample of citizens aged , 50 years. Of 1379 eligible subjects, 1045 underwent a baseline examination in 1996; 846 of the 958 survivors (88.2%) underwent a 5-year follow-up examination in 2001. All participants underwent an extensive ophthalmological examination including best corrected visual acuity (BCVA) using a Snellen chart. We used World Health Organization (WHO) criteria, which define visual impairment as BCVA in the better eye of < 6/18 and , 3/60 and blindness as BCVA in the better eye of < 3/60. We also used US criteria, which consider BCVA of < 6/12 and > 6/60 in the better eye to represent visual impairment and BCVA of , 6/60 in the better eye to represent blindness. The causes of incident visual loss in either eye were determined. Deterioration or improvement in vision were defined as a loss or gain of , 2 Snellen lines. Results:, According to WHO criteria, 5-year incidence of bilateral visual impairment and blindness were 1.07% (95% confidence interval [CI] 0.37,1.76) and 0.35% (95% CI 0.00,0.76), respectively. Using US criteria, equivalent incidence of bilateral visual impairment and blindness were 3.49% (95% CI 2.24,4.74) and 0.95% (95% CI 0.29,1.60), respectively. Age-related macular degeneration and cataract were the major causes of incident visual impairment and blindness. Conclusions:, Incidences of visual impairment and blindness increased significantly with age. Age-related macular degeneration, present in 75% of affected persons, was the most common cause of 5-year incident legal blindness in this middle-aged and elderly Icelandic population. [source]

Feeding practices of infants through the first year of life in Italy

M Giovannini
Aim: To investigate infant feeding practices through the first year of life in Italy, and to identify factors associated with the duration of breastfeeding and early introduction of solid foods. Methods: Structured phone interviews on feeding practices were conducted with 2450 Italian-speaking mothers randomly selected among women who delivered a healthy-term singleton infant in November 1999 in Italy. Interviews were performed 30 d after delivery and when the infants were aged 3, 6, 9 and 12 mo. Type of breastfeeding was classified according to the WHO criteria. Results: Breastfeeding started in 91.1% of infants. At the age of 6 and 12mo, respectively, 46.8% and 11.8% of the infants was still breastfed, 68.4% and 27.7% received formula, and 18.3% and 65.2% were given cow's milk. Solids were introduced at the mean age of 4.3 mo (range 1.6,6.5 mo). Introduction of solids occurred before age 3 and 4 mo in 5.6% and 34.2% of infants, respectively. The first solids introduced were fruit (73.1%) and cereals (63.9%). The main factors (negatively) associated with the duration of breastfeeding were pacifier use (p > 0.0001), early introduction of formula (p > 0.0001), lower mother's age (p > 0.01) and early introduction of solids (p= 0.05). Factors (negatively) associated with the introduction of solids foods before the age of 3 mo were mother not having breastfed (p > 0.01), early introduction of formula (p > 0.01), lower infant bodyweight at the age of 1 mo (p= 0.05) and mother smoking (p= 0.05). Conclusion: The duration of breastfeeding in Italy is still inadequate, as well as compliance with international recommendations for timing of introduction of complementary foods. National guidelines, public messages and educational campaigns should be promoted in Italy. [source]

Breastfeeding promotion in non-UNICEF-certified hospitals and long-term breastfeeding success in Germany

M Dulon
Aim: To assess breastfeeding practices using the World Health Organization/United Nations Children's Fund (WHO/UNICEF) Ten Steps to Successful Breastfeeding for Baby-Friendly Hospitals in unselected non-UNICEF certified German hospitals and to examine the influences of breastfeeding promotion on long-term breastfeeding success as assessed by WHO criteria. Methods: Information on the fulfilment of the Ten Steps was collected in 177 randomly chosen maternity hospitals by a postal questionnaire. Breastfeeding duration was assessed in 1487 mothers delivering in these hospitals. Multiple logistic regression was used to estimate the association between a low breastfeeding promotion index, defined as fulfilment of fewer than five steps, and the risk of short-term breastfeeding, less than 4 mo. Results: A higher breastfeeding promotion index was not associated with early breastfeeding but was significantly associated with full breastfeeding at 4 and 6 mo. After adjusting for confounding factors, delivering in a hospital with a low breastfeeding promotion index was associated with an increased risk of short-term breastfeeding [odds ratio (OR) 1.24], although associations with maternal demographic variables (young age: OR 3.34), low educational level (OR 2.81) and upbringing in East Germany (OR 2.27) were stronger. Conclusion: In unselected German hospitals even moderate levels of breastfeeding promotion identified by WHO/UNICEF criteria were associated with long-term breastfeeding success. [source]

Discriminant validity of the International Caries Detection and Assessment System (ICDAS) and comparability with World Health Organization criteria in a cross-sectional study

Fausto Medeiros Mendes
Mendes FM, Braga MM, Oliveira LB, Antunes JLF, Ardenghi TM, Bönecker M. Discriminant validity of the International Caries Detection and Assessment System (ICDAS) and comparability with World Health Organization criteria in a cross-sectional study. Community Dent Oral Epidemiol 2010; 38: 398,407. © 2010 John Wiley & Sons A/S Abstract,,, Objectives:, The aim of this cross-sectional study in preschool children was to assess the ability of International Caries Detection and Assessment System (ICDAS) in discriminating socioeconomic factors associated with the presence of caries lesions at both noncavitated and cavitated thresholds and to compare with the standard World Health Organization (WHO) criteria. Methods:, The study was carried out in Amparo, Brazil, during the National Day of Children's Vaccination including 252 children aged 36,59 months. The same child was independently examined by two calibrated examiners, one using the ICDAS and the other using WHO criteria. Socioeconomic information was also recorded. Associations between socioeconomic factors and presence of caries assessed as binary (caries prevalence) and count outcome (actual dmfs values) obtained by WHO criteria and by ICDAS at noncavitated and cavitated thresholds were evaluated by Poisson regression analysis with robust variance. Results:, Some covariates were significantly associated with the presence of caries evaluated by the WHO criteria and by ICDAS (using score 3 as cut-off point). When noncavitated scores of ICDAS were used to calculate the presence of caries, the discriminant power decreased. When dmfs values were used as outcome, no differences in the associations were observed between two systems or using noncavitated caries lesions. Conclusion:, Cavitated scores of ICDAS present similar discriminant validity compared with WHO criteria when presence of caries is used as outcome; however, when actual dmfs values are used, no differences are observed in using noncavitated or cavitated caries lesions. [source]

Caries experience in the primary dentition among French 6-year-olds between 1991 and 2000

Colette Adam
Abstract , Background:, There are few national caries preventive policies for children in France. Various surveys suggest that in the late 1980s, oral health of the 6-year olds in France was poorer than in those of other European countries. In Val de Marne (a Department just east of Paris) a public dental service was established in 1991. A programme to inform preschool staff about dental diseases was commenced and volunteers brought oral health information to parents and health professionals. Periodical monitoring of primary tooth caries of 6-year olds was planned. Aim:, The aim of the study was to evaluate changes in primary tooth caries in 6-year olds over the 10 years of the programme. Methods:, Participating 6-year olds, randomly selected, were examined in schools by dentists. Clinical data were collected (WHO criteria). Sociodemographic data were collected through questionnaire. Statistical analysis involved comparison of mean values, variance analysis and chi-square test for categorical variables. Results:, The proportions of children with caries experience were, 38.9%, 30.6% and 22.2% in 1991, 1995 and 2000 respectively (P < 0.01). The dft index decreased from 1.74 to 1.39 and 1.05 respectively. About 75% of children with dental caries remained untreated. Children of non-European native parents or belonging to low socioeconomic families remained those most affected by dental caries in 2000. Conclusion:, Dental caries in 6-year olds improved between 1991 and 2000 in Val de Marne but caries remained a socially inequitable disease. Most children did not have access to dental care. The situation requires changes to the dental care provision system. [source]