EVOLUTION, Issue 7 2007
Wade E. Winterhalter
Phenotypic plasticity describes an organism's ability to produce multiple phenotypes in direct response to its environmental conditions. Over the past 15 years empiricists have found that this plasticity frequently exhibits geographic variation and often possesses a significant heritable genetic basis. However, few studies have examined both of these aspects of plasticity simultaneously. Here, we examined both the geographic and genetic variations of the plasticity for diapause incidence (the proportion of eggs that enter an arrested state of development capable of surviving over the winter) relative to temperatures and photoperiods associated with long and short season environments across six populations of the striped ground cricket, Allonemobius socius, using a half-sibling split brood quantitative genetic design. We found that plasticity, as measured by the slope of the reaction norm, was greater in the southern-low altitude region (where populations are bivoltine) relative to the southern-high and northern-low altitude regions (where populations are univoltine). However, the heritability of plasticity was only significantly different from zero in univoltine populations that experienced "intermediate" natal season lengths. These patterns suggest that selection may favor the plasticity of diapause incidence in bivoltine regions, but act against plasticity in regions in which populations are univoltine. Furthermore, our data suggest that under "intermediate" natal season length conditions, the interplay between local adaptation and gene flow may keep the plasticity of diapause incidence low (but still significant) while maintaining its genetic variation. As such, this study not only provides a novel observation into the geographic variation of phenotypic plasticity, but also provides much needed groundwork for tests of its adaptive significance. [source]

INCIDENCE OF LISTERIA SPECIES IN SEAFOOD PRODUCTS OF MYSORE, INDIA

JOURNAL OF FOOD SAFETY, Issue 4 2007
AHMED SAIF MOHAREM
ABSTRACT Listeria monocytogenes is one of the most important foodborne pathogens causing illness in humans and animals. Thus, a study was undertaken to investigate the incidence of Listeria species in fresh and dry fish samples marketed in Mysore, India. A total of 164 fresh and dry fish samples collected from retail outlet shops of Mysore, South India, during the period August 2005 through August 2006 were examined for the presence of Listeria species by using ISO 11290 protocol. The incidence of Listeria species was positive in 62 samples (37.8%), and L. monocytogenes was isolated from only three (1.83%) fresh fish samples. Listeria species in seafood were predominant in the order of Listeria innocua (50) (30.49%), Listeria grayi (eight) (4.9%), L. monocytogenes (three) (1.83%) and Listeria seeligeri (one) (0.6%). All isolates of Listeria species were subjected to polymerase chain reaction (PCR) and confirmed with the genus-specific set of primers, and special emphasis was given for detection of L. monocytogenes using a species-specific set of primers. The specificity and sensitivity of PCR were in good correlation with the cultural methods. The results indicated a high incidence of Listeria species and L. monocytogenes in fresh fish samples. This warrants the need for appropriate control measures as this would pose a serious threat to human health. [source]

INCIDENCE AND CHARACTERIZATION OF BACILLUS CEREUS IN MEAT AND MEAT PRODUCTS CONSUMED IN TURKEY

JOURNAL OF FOOD SAFETY, Issue 1 2006
KIYMET GÜVEN
ABSTRACT A total of 100 retail samples of meat and meat products were examined for Bacillus cereus using mannitol egg yolk polymyxin (MYP) agar as a selective isolation medium. Only 22.4% of the samples contained detectable levels of B. cereus, with counts ranging from log10 0.69 to 4.80 cfu/g, but a large number of other organisms up to log10 9.06 cfu/g were sometimes observed on the plates and may have masked the presence of B. cereus or inhibited growth. Two samples of soudjouck contained significant levels of B. cereus, sufficient enough to create a public health hazard. Selected isolates were tested for diarrheal enterotoxin production by a reversed passive latex agglutination (RPLA) test kit. Results showed no difference in the toxin production of B. cereus between beef, ground meat, soudjouck and pastrami samples. Plasmid-profile analysis and susceptibility to the six commonly used antimicrobial agents were done on selected B. cereus isolates. About 96.4% of the isolates contained plasmids. Plasmid sizes ranged between 2.5 and 3.5 kb. The isolates showed a high rate of resistance to oxacillin (OXA) and amoxicillin (AMC) and a low frequency of resistance to the other antimicrobial agents, with all of them being susceptible to vancomycin (VAN). Approximately 54% of the isolates showed multiple resistance. There was no apparent relationship between drug resistance and carriage of plasmids. [source]

SEASONALITY IN THE INCIDENCE OF CONGENITAL HYPOTHYROIDISM IN JAPAN

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7 2005
Dr Makiko Nakamizo PhD
No abstract is available for this article. [source]

INCIDENCE AND OUTCOMES OF KNEE AND HIP JOINT REPLACEMENT IN VETERANS AND CIVILIANS

ANZ JOURNAL OF SURGERY, Issue 5 2006
Vanessa Wells
Background: This article describes the incidence of total knee and hip replacement, and compares post-surgery health status outcomes in veterans and civilians. Methods: The numbers of male veterans and civilians who had a knee and/or a hip replacement in South Australia (1994,2002) were obtained. Standardized morbidity ratios, and odds ratios for age group by veteran/civilian interactions, were calculated. Presurgery and 1-year post-surgery Medical Outcomes Short Form (36) Health Survey, Knee Society and Harris hip scores were completed. Independent samples t -tests were used to compare presurgery scores. ancova models were used to determine any differences between veterans and civilians post-surgery. Results: For veterans, standardized morbidity ratios were 0.987 and 0.715 for knee and hip replacements, respectively (P < 0.0001). Veterans' odds ratios for knee and hip replacements were significantly lower in the 65- to 74-year age group (P < 0.001), similar in the 75- to 84-year and above 85-year age groups for hip replacement, but significantly higher in the above 85-year age group for knee replacement (P < 0.001). Presurgery, veterans reported significantly lower scores (P < 0.003) for knee function. After knee replacement, veterans reported significantly lower Medical Outcomes Short Form (36) Health Survey scores for bodily pain, physical functioning, role , physical, role , emotional, social functioning and physical component summary (P < 0.033). Significantly lower physical functioning, role , physical and physical component summary scores (P < 0.02) were reported by veterans post-surgery for hip replacement. Conclusion: Veterans are delaying joint replacement. Presurgical knee function is worse in veterans. Post-surgery, the veterans are worse off in a number of health status outcomes. [source]

CALCIUM ANTAGONIST PROPERTY OF CPU228, A DOFETILIDE DERIVATIVE, CONTRIBUTES TO ITS LOW INCIDENCE OF TORSADES DE POINTES IN RABBITS

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 4 2007
Zhi-Jiang Huang
SUMMARY 1Torsades de pointes (TDP) is a severe adverse effect during the clinical use of dofetilide, a selective blocker of the rapid component of the delayed rectifier potassium channel (IKr). The present study was designed to test whether CPU228, a derivative of dofetilide with calcium (Ca2+) antagonist properties, could reduce TDP without reducing the blockade of IKr. 2The incidence of TDP in a rabbit model and the effective refractory period (ERP) were measured and compared for dofetilide and CPU228. Suppression of IKr and the L-type Ca2+ current (ICa,L) and the Ca2+ transients of isolated cardiomyocytes were investigated by whole-cell patch-clamp and Fluo-3 dye spectrophotometry. 3The incidence of TDP was greatly reduced by CPU228 relative to dofetilide, occurring in only one of six rabbits compared with five of six rabbits following dofetilide (P < 0.05). In isolated atria, prolongation of ERP by CPU228 was less than that of dofetilide and no reverse frequency dependence was observed. Negative inotropism by CPU228 was significant against positive inotropism by dofetilide. CPU228 inhibited both IKr and ICa,L currents and the IC50 for ICa,L inhibition was 0.909 µmol/L. At 3 µmol/L, CPU228 significantly suppressed the Ca2+ transients. 4CPU228 is able to block ICa,L, contributing to decreased TDP, while also blocking IKr activity. By combined blockade of IKr and ICa,L, CPU228 shares the property of complex Class III anti-arrhythmic agents. [source]

Treatment of Anemia With Darbepoetin Alfa in Heart Failure

CONGESTIVE HEART FAILURE, Issue 3 2010
William T. Abraham MD
Anemia is common in heart failure (HF) patients. A prespecified pooled analysis of 2 randomized, double-blind, placebo-controlled studies evaluated darbepoetin alfa (DA) in 475 anemic patients with HF (hemoglobin [Hb], 9.0,12.5 g/dL). DA was administered subcutaneously every 2 weeks and titrated to achieve and maintain a target Hb level of 14.0±1.0 g/dL. By week 27, mean (SD) Hb concentrations did not increase with placebo but increased with DA from 11.5 (0.7) to 13.3 (1.3) g/dL. Hazard ratios (HRs) for DA compared with placebo for all-cause death or first HF hospitalization (composite end point), all-cause death, and HF hospitalization by month 12 were 0.67 (95% confidence interval [CI], 0.44,1.03; P=.067), 0.76 (95% CI, 0.39,1.48; P=.419), and 0.66 (95% CI, 0.40,1.07; P=.093), respectively. Incidence of adverse events was similar in both groups. In post hoc analyses, improvement in the composite end point was significantly associated with the mean Hb change from baseline (adjusted HR, 0.40; P=.017) with DA treatment. There was no increased risk of all-cause mortality or first HF hospitalization with DA in patients with reduced renal function or elevated baseline B-type natriuretic peptide, a biomarker of worse HF. These results suggest that DA is well tolerated, corrects HF-associated anemia, and may have favorable effects on clinical outcomes., Congest Heart Fail. 2010;16:87,95. © 2010 Wiley Periodicals, Inc. [source]

Tolerability, Safety, and Efficacy of ,-Blockade in Black Patients With Heart Failure in the Community Setting: Insights From a Large Prospective ,-Blocker Registry

CONGESTIVE HEART FAILURE, Issue 1 2007
William T. Abraham MD
Heart failure (HF) clinical trials suggest different responses of blacks and whites to ,-blockers. Differences between clinical trial and community settings may also have an impact. The Carvedilol Heart Failure Registry (COHERE) observed experience with carvedilol in 4280 patients with HF in a community setting. This analysis compares characteristics, outcomes, and carvedilol dosing of blacks and whites in COHERE. Compared with whites (n=3433), blacks (n=523) had more severe HF symptoms despite similar systolic function. At similar carvedilol maintenance doses, symptoms improved in 33% of blacks vs 28% of whites, while worsening in 10% and 11%, respectively (both nonsignificant), and HF hospitalization rates were reduced comparably in both groups (,58% vs ,56%, respectively; both P<.001). Incidence and hazard ratios of death were similar in blacks and whites (6.9% vs 7.5%, hazard ratio 1.2 vs 1.0, P=.276). Thus carvedilol was similarly effective in blacks and whites with HF in the community setting, consistent with carvedilol clinical trials. [source]

Changing Incidence and Survival for Heart Failure

CONGESTIVE HEART FAILURE, Issue 3 2006
Imran S. Virk MD
[source]

Patch Occupancy and Potential Metapopulation Dynamics of Three Forest Mammals in Fragmented Afromontane Forest in South Africa

CONSERVATION BIOLOGY, Issue 4 2000
Michael J. Lawes
We recorded patch occupancy of blue duiker ( Philantomba monticola), tree hyrax ( Dendrohyrax arboreus), and samango monkey (Cercopithecus mitis labiatus) in 199 forest patches. Their rarity is ascribed to the fragmentation and destruction of their forest habitat. Incidence functions, derived from presence and absence data, were formulated as generalized linear models, and environmental effects were included in the fitted logistic models. The small and mostly solitary hyrax and duiker persisted in smaller patches than the large and social monkey. Although this result follows expectations based on relative home-range sizes of each species, the incidence probability of the samango monkey was invariant with increasing isolation, whereas a gradual decrease with increasing isolation was observed for the hyrax and duiker. Group dynamics may inhibit dispersal and increase the isolation effect in social species such as samango monkeys. A mainland-island metapopulation model adequately describes patterns of patch occupancy by the hyrax and duiker, but the monkeys' poor dispersal ability and obvious area-dependent extirpation suggest that they exist in transient, nonequilibrium (declining) metapopulations. Through identification of large forest patches for careful protection and management, the survival of all three species,especially the monkey,could be prolonged. Because no functional metapopulation may exist for the monkey, however, this is an emergency measure. For the duiker and hyrax, larger patches should form part of a network of smaller and closer patches in a natural matrix. Resumen: Investigamos la persistencia de tres mamíferos forestales raros de tamaño mediano (2,9 kg) en los bosques fragmentados de cinturón de niebla Podocarpus en la región central de la provincia KwaZulu-Natal, Sudáfrica. Registramos la ocupación del duiker azul ( Philantomba monticola), el hyrax arborícola ( Dendrohyrax arboreus) y el mono samango (Cercopithecus mitis labiatus) en 199 parches forestales. Su rareza se atribuye a la fragmentación y destrucción de su hábitat forestal. Las funciones de incidencia, derivadas de datos de presencia y ausencia, fueron formuladas como modelos lineales generalizados, y los efectos ambientales fueron incluidos en los modelos logísticos ajustados. Los pequeños y mayormente solitarios hyrax y duiker persistieron en parches más pequeños que los monos, que son más grandes y más sociables. A pesar de que este resultado obedece a expectativas basadas en tamaños de rango de hogar relativos de cada especie, la probabilidad de incidencia del mono samango no cambió con un incremento en el aislamiento, mientras que una disminución gradual al crecer el aislamiento se observó en hyrax y duiker. Las dinámicas de grupos podrían inhibir la dispersión e incrementar el efecto de aislamiento en especies sociables como lo es el mono samango. Un modelo de metapoblación continente-isla describe adecuadamente los patrones de la ocupación de parches por hyrax y duiker; sin embargo, la pobre capacidad de dispersión de los monos y la obvia extirpación área-dependente sugiere que estos existen en metapoblaciones transitorias, desequilibradas (en disminución). Mediante la identificación de parches forestales grandes para la protección y manejo cuidadosos, la supervivencia de las tres especies ( pero especialmente la de los monos) podría ser prolongada. Sin embargo, debido a que no existen metapoblaciones funcionales de monos, esta es una medida de emergencia. Para el duiker y el hyrax, los parches grandes deberán formar parte de una red de parches más pequeños y más cercanos en una matriz natural. [source]

Incidence and cytological features of pulmonary hamartomas indeterminate on CT scan

CYTOPATHOLOGY, Issue 3 2008
A. Saqi
Objective:, Pulmonary hamartomas have a characteristic heterogeneous radiological appearance. However, when composed predominantly of undifferentiated mesenchymal fibromyxoid component, their homogeneous appearance on computed tomography is indeterminate for malignancy. Rendering an accurate preoperative diagnosis in these cases can alter management. The aim of this study was to determine the incidence and accuracy of cytodiagnosis for hamartomas ,indeterminate' by imaging. Methods:, We retrospectively reviewed records for hamartomas diagnosed by transthoracic fine needle aspiration (FNA) including immediate impressions and final diagnoses. Cytological features evaluated included the presence of fibromyxoid stroma, bronchioloalveolar cell hyperplasia, fibroadipose tissue, cartilage and smooth muscle. Results:, Eighteen (1.3%) hamartomas were identified from 1355 transthoracic FNAs. The immediate impression was hamartoma in 13 (72%), carcinoid in one (6%), mucinous bronchioloalveolar carcinoma in two (11%) and non-diagnostic in two (11%). The final diagnosis of hamartoma in cases diagnosed as carcinoid, mucinous bronchioloalaveolar carcinoma and non-diagnostic on immediate impression was rendered following assessment of all cytological material. Conclusion:, Overall, FNAs are highly reliable for diagnosing hamartomas even when composed principally of undifferentiated mesenchymal fibromyxoid stroma, especially with the aid of all available preparations including Diff-Quik smears, Papanicolaou smears, ThinPreps and cell block material. [source]

Incidence of dental trauma associated with facial trauma in Brazil: a 1-year evaluation

DENTAL TRAUMATOLOGY, Issue 1 2004
Alessandro Costa Da Silva
Abstract,,, Dental trauma occurs frequently in young people, and mostly occurs in conjunction with facial trauma. In the literature, there are still few reports relating dental trauma, facial trauma, and soft-tissue injuries. This research aimed to evaluate: (i) the overall incidence of dental trauma in 340 patients who presented with facial trauma over a 1-year-period, (ii) the epidemiology of these related diseases, and (iii) the most common dental trauma when a facial trauma was present. Of all facial trauma, 15.29% presented dental trauma, of which luxations and avulsions were the most frequent injuries (40.30% each), occurring mainly on weekends (38.46%) and in October (15.38%), followed by March and June (13.46% each). The sex ratio presented the proportion of 3.3:1 (M:F). Trauma occurred mainly in the second decade (44.23%). These results highlight the high incidence of dental and facial trauma, and suggest the importance of the adoption of appropriate prevention protocols and effective therapeutic methods. [source]

Reduction in the Incidence of Squamous Cell Carcinoma in Solid Organ Transplant Recipients Treated with Cyclic Photodynamic Therapy

DERMATOLOGIC SURGERY, Issue 5 2010
ANDREA WILLEY MD
BACKGROUND AND OBJECTIVES Squamous cell carcinomas (SCCs) produce significant morbidity in solid organ transplant recipients (SOTRs), particularly in patients who develop multiple tumors. Topical photodynamic therapy (PDT) has been shown to decrease the number of keratotic lesions in SOTRs, but the duration of the beneficial effect is limited. The aim of this study was to evaluate the potential benefit of cyclic PDT in the prevention of new SCCs in SOTRs. METHODS Twelve high-risk SOTRs received cyclic PDT treatments at 4- to 8-week intervals for 2 years. The development of new SCCs (invasive and in situ) performed 12 and 24 months after the start of cyclic PDT were compared with the number of SCCs developed during the year before initiation of cyclic PDT. RESULTS The median reduction in the 12- and 24-month post-treatment counts from the 1-month pretreatment counts was 79.0% (73.3,81.8%) and 95.0% (87.5,100.0%), respectively. Treatments were well tolerated. CONCLUSION Cyclic PDT with 5-aminolevulinic acid may reduce the incidence of SCC in SOTRs. Additional studies with larger numbers of patients and optimized protocols are necessary to further explore the potential benefits of cyclic PDT in the prevention of skin cancer in this high-risk patient population. Dr. Lee is member of the Medical Advisory Board of Dusa Pharmaceuticals, Inc. [source]

Assessment of Incidence, Cause, and Consequences of Pressure Ulcers to Evaluate Quality of Provided Care

DERMATOLOGIC SURGERY, Issue 11 2009
JAN WILLEM H. P. LARDENOYE MD
BACKGROUND Pressure ulcers are one of the most frequently registered complications in general surgery. OBJECTIVE To obtain insight into the incidence, cause, and consequences of pressure ulcers and to evaluate the value of pressure ulcer registration to assess quality of care. RESULTS During the 9-year study period, 275 pressure ulcers were registered (5.8% of total registered complications). Age and female sex were independent risk factors for pressure ulcer development. Pressure ulcer classification was as follows: mild (53.3%), moderate (35.6%), severe (9.5%), and irreversible damage (1.5%). Patients undergoing hip surgery and major limb amputation were at risk for pressure ulcer development (10.4% and 8.8%, respectively). In most patients (89.5%), pressure ulcers had no consequences other than local wound therapy; in 12 patients (4.4%), pressure ulceration led to alteration in medication; in 15 patients (5.5%), length of hospital stay was prolonged; and four patients (0.4%) suffered from irreversible damage. CONCLUSION The incidence of pressure ulcers is strongly correlated to sex, age, and indication of admittance. Most ulcers were classified as mild and had no consequences. The insight obtained into incidence, cause, and consequences of pressure ulcers can be used as an indicator of quality of provided care if adjusted for case mix and indication of operation. [source]

Incidence of and Risk Factors for Medical Malpractice Lawsuits among Mohs Surgeons

DERMATOLOGIC SURGERY, Issue 1 2006
CLIFFORD S. PERLIS MD
BACKGROUND Despite rising medical malpractice costs, little is known about the factors associated with claims filed against Mohs surgeons. OBJECTIVE We sought to define the scope of medical malpractice claims filed against Mohs surgeons and to identify salient factors associated with the filing and disposition of those claims. METHODS A comprehensive survey was mailed to 599 physicians with US addresses listed in the 2003 directory of the American College of Mohs Micrographic Surgery and Cutaneous Oncology. RESULTS Of the 300 completed surveys returned, 33 (11%) reported ever having been sued. Physicians who practiced Mohs surgery for a longer period of time were more likely to have been sued for malpractice. Physicians reported the wrong site and functional outcome as the most frequent causes of malpractice lawsuits. [source]

Risk factors for incident mild cognitive impairment , results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe)

ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010
T. Luck
Luck T, Riedel-Heller SG, Luppa M, Wiese B, Wollny A, Wagner M, Bickel H, Weyerer S, Pentzek M, Haller F, Moesch E, Werle J, Eisele M, Maier W, van den Bussche H, Kaduszkiewicz H for the AgeCoDe Study Group. Risk factors for incident mild cognitive impairment , results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Objectives:, To provide age- and gender-specific incidence rates of MCI among elderly general practitioner (GP) patients (75+ years) and to identify risk factors for incident MCI. Method:, Data were derived from the longitudinal German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Incidence was calculated according to the ,person-years-at-risk' method. Risk factors were analysed using multivariate logistic regression models. Results:, During the 3-year follow-up period, 350 (15.0%) of the 2331 patients whose data were included in the calculation of incidence developed MCI [person-years (PY) = 6198.20]. The overall incidence of MCI was 56.5 (95% confidence interval = 50.7,62.7) per 1000 PY. Older age, vascular diseases, the apoE ,4 allele and subjective memory complaints were identified as significant risk factors for future MCI. Conclusion:, Mild cognitive impairment is frequent in older GP patients. Subjective memory complaints predict incident MCI. Especially vascular risk factors provide the opportunity of preventive approaches. [source]

Incidence and diagnostic diversity in first-episode psychosis

ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010
R. Reay
Reay R, Mitford E, McCabe K, Paxton R, Turkington D. Incidence and diagnostic diversity in first-episode psychosis. Objective:, To investigate the incidence and range of diagnostic groups in patients with first-episode psychosis (FEP) in a defined geographical area. Method:, An observational database was set up on all patients aged 16 years and over presenting with FEP living in a county in Northern England between 1998 and 2005. Results:, The incidence of all FEP was 30.95/100 000. The largest diagnostic groups were psychotic depression (19%) and acute and transient psychotic disorder (19%). Fifty-four per cent of patients were aged 36 years and over. Patients with schizophrenia spectrum disorder only accounted for 55% of cases. Conclusion:, This clinical database revealed marked diversity in age and diagnostic groups in FEP with implications for services and guidelines. These common presentations of psychoses are grossly under researched, and no treatment guidelines currently exist for them. [source]

Incidence of social phobia and identification of its risk indicators: a model for prevention

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009
C. Acarturk
Objective:, This study seeks to examine the incidence of social phobia in the general population and to establish a number of risk indicators. Method:, Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population based prospective study (n = 7076). A sample of adults aged 18,64 years (n = 5618) were re-interviewed 1 year later using Composite International Diagnostic Interview (CIDI). Results:, The 12-month incidence of DSM-III-R social phobia was 1.0%. Low education, low mastery, low self-esteem, emotional neglect in childhood and ongoing difficulties were found to be risk indicators. After including other mental disorders as risk indicators in the model, the incidence was found to be more common among those with low mastery, major depression, subthreshold social phobia, emotional neglect, negative life events, and low education. Conclusion:, The incidence of social phobia can be predicted relatively well with psychosocial variables and comorbidity. [source]

Incidence of insulin resistance in obese subjects in a rural Japanese population: The Tanno and Sobetsu study

DIABETES OBESITY & METABOLISM, Issue 1 2005
H. Ohnishi
Objectives:, Although it is well known that obesity is closely related to insulin resistance, the incidence of the development of insulin resistance in people with obesity is not known. In this study, we investigated the incidence of insulin resistance in citizens of two rural communities in Japan. Subjects and methods:, The subjects were 102 men and 126 women over the age of 30 years selected from 1035 citizens who had undergone medical examinations in the towns of Tanno and Sobetsu, Hokkaido, in 1991 and 1998. Those who were on medication for hypertension, diabetes, hyperlipidaemia, coronary heart disease and cerebral vessel disease were excluded. The simple index to determine insulin resistance [i.e. homeostasis model assessment (HOMA-R) , 1.73] was used, and subjects who were determined to be positive for insulin resistance according to this index in 1991 were also excluded in order to determine the incidence of insulin resistance in subjects who had no abnormalities other than obesity. The systolic blood pressure (SBP), diastolic blood pressure, body mass index (BMI), triglyceride level, high-density lipoprotein level, blood sugar level, serum insulin value and HOMA-R were measured in all subjects in 1991 and in 1998. Moreover, the subjects were divided into two groups according to BMI, a normal group consisting of subjects with BMI < 25 and an obesity group consisting of subjects with BMI , 25. We also compared the incidences of insulin resistance in normal and obesity groups of subjects who were newly determined to be positive for insulin resistance on the basis of data obtained from medical examinations conducted in 1998. Results:, The incidence of insulin resistance was significantly higher in the obesity group than in the normal group (25.0 vs. 4.5%). The results of logistic regression analysis showed that obesity was closely related to insulin resistance and that the relative risk of development of insulin resistance adjusted for age, sex, SBP, FPG and HDL was 3.193 (95% CI 1.085,9.401). Conclusions:, The incidence of insulin resistance was significantly higher in the obesity group than in the normal group in this study, suggesting that improvement in obesity is important for prevention of the occurrence of type 2 diabetes or atherosclerotic disease based on insulin resistance. [source]

Psychiatric epidemiology of old age: the H70 study , the NAPE Lecture 2003

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2004
I. Skoog
Objective: To describe methodological issues and possibilities in the epidemiology of old age psychiatry using data from the H70 study in Göteborg, Sweden. Method: A representative sample born during 1901,02 was examined at 70, 75, 79, 81, 83, 85, 87, 90, 92, 95, 97, 99 and 100 years of age, another during 1906,07 was examined at 70 and 79 years of age, and samples born between 1922 and 1930 were examined at 70 years of age. The study includes psychiatric examinations and key informant interviews performed by psychiatrists, physical examinations performed by geriatricians, psychometric testings, blood sampling, computerized tomographies of the brain, cerebrospinal fluid analyses, anthropometric measurements, and psychosocial background factors. Results: Mental disorders are found in approximately 30% of the elderly, but is seldom detected or properly treated. Incidence of depression and dementia increases with age. The relationship between blood pressure and Alzheimer's disease is an example of how cross-sectional and longitudinal studies yield completely different results. Brain imaging is an important tool in epidemiologic studies of the elderly to detect silent cerebrovascular disease and other structural brain changes. The high prevalence of psychotic symptoms is an example of the importance to use several sources of information to detect these symptoms. Dementia should be diagnosed in all types of studies in the elderly, as it influences several outcomes such as mortality, blood pressure, and rates of depression. Suicidal feelings are rare in the elderly and are strongly related to mental disorders. Conclusion: Modern epidemiologic studies in population samples should be longitudinal and include assessments of psychosocial risk factors as well as comprehensive sets of biologic markers, such as brain imaging, neurochemical analyses, and genetic information to maximize the contribution that epidemiology can provide to increase our knowledge about the etiology of mental disorders. [source]

Incidence and characteristics of lower limb amputations in people with diabetes

DIABETIC MEDICINE, Issue 4 2009
S. Fosse
Abstract Aims To estimate the incidence, characteristics and potential causes of lower limb amputations in France. Methods Admissions with lower limb amputations were extracted from the 2003 French national hospital discharge database, which includes major diagnoses and procedures performed during hospital admissions. For each patient, diabetes was defined by its record in at least one admission with or without lower limb amputation in the 2002,2003 databases. Results In 2003, 17 551 admissions with lower limb amputation were recorded, involving 15 353 persons, which included 7955 people with diabetes. The crude incidence of lower limb amputation in people with diabetes was 378/100 000 (349/100 000 when excluding traumatic lower limb amputation). The sex and age standardized incidence was 12 times higher in people with than without diabetes (158 vs. 13/100 000). Renal complications and peripheral arterial disease and/or neuropathy were reported in, respectively, 30% and 95% of people with diabetes with lower limb amputation. Traumatic causes (excluding foot contusion) and bone diseases (excluding foot osteomyelitis) were reported in, respectively, 3% and 6% of people with diabetes and lower limb amputation, and were 5 and 13 times more frequent than in people without diabetes. Conclusions We provide a first national estimate of lower limb amputation in France. We highlight its major impact on people with diabetes and its close relationship with peripheral arterial disease/neuropathy and renal complications in the national hospital discharge database. We do not suggest the exclusion of traumatic causes when studying the epidemiology of lower limb amputation related to diabetes, as diabetes may contribute to amputation even when the first cause appears to be traumatic. [source]

Incidence and outcome of asymptomatic bacteriuria in females with Type 2 diabetes mellitus over a 1-year follow-up period and association with risk factors

DIABETIC MEDICINE, Issue 11 2005
A. Sotiropoulos
No abstract is available for this article. [source]

Results of longterm hospital based cytological screening in asymptomatic women

DIAGNOSTIC CYTOPATHOLOGY, Issue 3 2006
Jata S. Misra Ph.D., M.I.A.C.
Abstract Routine cytological screening has been carried out in 27,062 asymptomatic women attending Gynaec and Family Planning O.P.D. of Queen Mary's Hospital, Lucknow, India (April 1971,December 2004). Incidence of squamous intraepithelial lesion (SIL) was found to be 5.9% in the series, while cervical malignancy was seen in 0.6% of cases. The study highlighted the immense utility of cytological screening in minimizing the incidence of carcinoma cervix in the segment of the urban population screened, as the incidence dropped down to 0.5% in the second half from 1.1% noticed in the first half of the screening period. The study also emphasized the utility of clinically downstaging the cervical cancer as 7,316 women showing clinical lesions of cervix were found to harbor SIL in 15.3% and carcinoma cervix in 1.3% of cases as against the incidence of 2.5% for SIL and 0.6% for frank cancer in women with normal cervix. The investigation into different risk factors involved in cervical carcinogenesis revealed that the incidence of SIL and cancer cervix showed a rise with increasing age and parity and prolonged sexual period. The incidences of both cervical cytopathologies were also higher in women of low socio-economic status while religion was found to have no bearing on the occurrence of the disease. Among the four sexually transmitted diseases (STDs) diagnosed in the cervical smears, Trichomonas vaginalis was found to be more prevalent (2.6%), while human papillomavirus (HPV) and Herpes simplex was seen in 0.4 and 0.2% of cases, respectively Herpes simplex was found to have strong affinity with both SIL and carcinoma cervix, while only SIL incidence was high with HPV infection. The study emphasizes need of proper education to women of low socio-economic class for creating awareness regarding hazards and risk factors of cervical cancer as well as management and cure of the disease. Diagn. Cytopathol. 2006;34: 184,187. © 2006 Wiley-Liss, Inc. [source]

Psammoma bodies in cervicovaginal smears: Incidence and significance

DIAGNOSTIC CYTOPATHOLOGY, Issue 2 2002
Vinita Parkash M.D.
Abstract Psammoma bodies (PB) are seen in a wide variety of gynecologic conditions. However, only a few reports address the incidence or significance of PB in cervicovaginal smears (CVS). Twenty patients with PBs in CVS were identified over a 5-yr period during which time 82,840 CVS were screened. Nine cases were associated with malignancy: six uterine serous/clear cell carcinoma, two serous ovarian carcinoma, and one fallopian tube carcinoma. The remaining 11 were benign: one had an ovarian cystadenofibroma and one had PB associated with benign endometrium and endosalpingiosis. In the remaining nine cases, PB were not found on additional studies, although four gave a history of oral contraception and one each had chronic endometritis and IUD in place. The presence of atypical glandular cells diagnostic of carcinoma was the only single feature that predicted carcinoma (7/7). A combination of clinicopathologic features were helpful predictors of malignancy: postmenopausal bleeding (8/9 cases), age over 45 (9/9 cases), and abnormal clinical examination (5/9 cases). Conversely, benignancy was associated with postmenopausal bleeding in 1/11 cases, age over 45 in 3/11 cases and abnormal clinical examination in 2/11 cases. The incidence of PB in our series consecutively screened smears is 8 per 82,840 smears (0.009%). Unlike prior reports, we found that the presence of PB on CVS is not as ominous a finding as previously indicated, as only 12.5% (1/8) of patients with PB on their CVS harbor carcinoma. PB in a CVS in a young patient merits a thorough examination, but not surgical exploration in the absence of additional clinical findings or atypical cells on the CVS. Older patients (>45 yr) have a higher incidence of malignancy, even in the absence of clinical findings or atypical cells on CVS, and may warrant a surgical exploration. Diagn. Cytopathol. 2002;26:81,86; DOI 10.1002/dc.10058 © 2002 Wiley-Liss, Inc. [source]

Preventing heavy alcohol use in adolescents (PAS): cluster randomized trial of a parent and student intervention offered separately and simultaneously

ADDICTION, Issue 10 2009
Ina M. Koning
ABSTRACT Aims To evaluate the effectiveness of two preventive interventions to reduce heavy drinking in first- and second-year high school students. Design and setting Cluster randomized controlled trial using four conditions for comparing two active interventions with a control group from 152 classes of 19 high schools in the Netherlands. Participants A total of 3490 first-year high school students (mean 12.68 years, SD = 0.51) and their parents. Intervention conditions (i) Parent intervention (modelled on the Swedish Örebro Prevention Program) aimed at encouraging parental rule-setting concerning their children's alcohol consumption; (ii) student intervention consisting of four digital lessons based on the principles of the theory of planned behaviour and social cognitive theory; (iii) interventions 1 and 2 combined; and (iv) the regular curriculum as control condition. Main outcome measures Incidence of (heavy) weekly alcohol use and frequency of monthly drinking at 10 and 22 months after baseline measurement. Findings A total of 2937 students were eligible for analyses in this study. At first follow-up, only the combined student,parent intervention showed substantial and statistically significant effects on heavy weekly drinking, weekly drinking and frequency of drinking. At second follow-up these results were replicated, except for the effects of the combined intervention on heavy weekly drinking. These findings were consistent across intention-to-treat and completers-only analyses. Conclusions Results suggest that adolescents as well as their parents should be targeted in order to delay the onset of drinking, preferably prior to onset of weekly drinking. [source]

Incidence and impact of axial malformations in larval bullfrogs (Rana catesbeiana) developing in sites polluted by a coal-burning power plant

ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 4 2000
William A. Hopkins
Abstract Amphibian malformations have recently received much attention from the scientific community, but few studies have provided evidence linking environmental pollution to larval amphibian malformations in the field. We document an increased incidence of axial malformations in bullfrog larvae (Rana catesbeiana) inhabiting two sites contaminated with coal combustion wastes. In the polluted sites, 18 and 37% of larvae exhibited lateral curvatures of the spine, whereas zero and 4% of larvae from two reference sites had similar malformations. Larvae from the most heavily polluted site had significantly higher tissue concentrations of potentially toxic trace elements, including As, Cd, Se, Cu, Cr, and V, compared with conspecifics from the reference sites. In addition, malformed larvae from the most contaminated site had decreased swimming speeds compared with those of normal larvae from the same site. We hypothesize that the complex mixture of contaminants produced by coal combustion is responsible for the high incidence of malformations and associated effects on swimming performance. [source]

Investigating the Incidence of type i errors for chronic whole effluent toxicity testing using Ceriodaphnia dubia

ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 1 2000
Timothy F. Moore
Abstract The risk of Type I error (false positives) is thought to be controlled directly by the selection of a critical p value for conducting statistical analyses. The critical value for whole effluent toxicity (WET) tests is routinely set to 0.05, thereby establishing a 95% confidence level about the statistical inferences. In order to estimate the incidence of Type I errors in chronic WET testing, a method blank-type study was performed. A number of municipal wastewater dischargers contracted 16 laboratories to conduct chronic WET tests using the standard test organism Ceriodaphnia dubia. Unbeknownst to the laboratories, the samples they received from the wastewater dischargers were comprised only of moderately hard water, using the U.S. Environmental Protection Agency's standard dilution water formula. Because there was functionally no difference between the sample water and the laboratory control/dilution water, the test results were expected to be less than or equal to 1 TUc (toxic unit). Of the 16 tests completed by the biomonitoring laboratories, two did not meet control performance criteria. Six of the remaining 14 valid tests (43%) indicated toxicity (TUc > 1) in the sample (i.e., no-observed-effect concentration or IC25 < 100%). This incidence of false positives was six times higher than expected when the critical value was set to 0.05. No plausible causes for this discrepancy were found. Various alternatives for reducing the rate of Type I errors are recommended, including greater reliance on survival endpoints and use of additional test acceptance criteria. [source]

Preemptive Low-frequency Stimulation Decreases the Incidence of Amygdala-kindled Seizures

EPILEPSIA, Issue 1 2005
Jeffrey H. Goodman
Summary:,Purpose: The use of electrical stimulation as a therapy for epilepsy is currently being studied in experimental animals and in patients with epilepsy. This study examined the effect of preemptive, low-frequency, 1-Hz sine wave stimulation (LFS) on the incidence of amygdala-kindled seizures in the rat. Methods: Electrodes were implanted into the basolateral amygdalae of adult male rats. All animals received a kindling stimulus of 60-Hz, 400-,A, sine wave for 1 s twice a day. Experimental animals received an additional LFS consisting of 1 Hz, 50 ,A for 30 s immediately before the kindling stimulus. Afterdischarge (AD) duration, behavioral seizure score, the number of stimulations required to elicit the first stage five seizure and to become fully kindled were measured. After 20 stimulations, a crossover procedure was performed. Fully kindled rats from each group were switched, so that the original controls received LFS plus the kindling stimulus, and the original experimental rats received only the kindling stimulus. Results: During kindling acquisition, LFS induced a significant decrease in AD duration. A significant increase in the number of times the kindling stimulus failed to elicit an AD was noted. Control rats exhibited an AD 99% of the time compared with 70% in experimental rats (p < 0.0001; Fisher's Exact test). In fully kindled animals, the incidence of stage five seizures in the original controls significantly decreased from 98% to 42% (p < 0.0001) when the LFS was added to the kindling paradigm. Conclusions: The dramatic decrease in the incidence of stage 5 seizures in fully kindled animals after preemptive LFS strongly suggests that LFS may be an effective therapy for the prevention of seizures in patients with epilepsy. [source]

Time Trends in Incidence, Mortality, and Case-Fatality after First Episode of Status Epilepticus

EPILEPSIA, Issue 8 2001
Giancarlo Logroscino
Summary: ,Purpose: Status epilepticus (SE) is a medical emergency associated with a high mortality. Clinical series have suggested that mortality after SE has decreased. No studies have systematically examined trends in incidence, mortality, and case fatality after SE in a well-defined population. Methods: All first episodes of SE receiving medical attention between January 1, 1935, and December 31, 1984, were ascertained through the Rochester Epidemiology Project Records-Linkage System and followed up until death or study termination (February 1, 1996). We calculated incidence rates in the 50-year period (1935,1984), while we considered mortality and case-fatality in the last 30-year period (1955,1984). Results: Incidence of SE increased over time to 18.1/100,000 (1975 through 1984). The increase was related to an increased incidence in the elderly and to the advent of myoclonic SE after cardiac arrest, a condition not seen in the early decades. In the last decade, ,16% of the incidence was due to myoclonic SE. The mortality rates increased from 3.6 per year in the decade 1955,1965 to 4.0/100,000 per year between 1975 and 1984. The 30-day case-fatality (CF) was unchanged, although a trend toward improvement was shown after excluding myoclonic SE. Conclusions: Incidence and mortality rates of SE have increased in the last 30 years. Case fatality remained the same. The increased incidence and mortality are due to the occurrence in the last decade of myoclonic SE after cardiac arrest. The mortality in the elderly was twice that of the youngest age group, across all study periods. Changes in the age and cause distribution of SE over time are responsible for the stable survivorship. There is improvement in survivorship in the last decade when myoclonic SE is excluded. [source]

Incidence of Status Epilepticus in Adults in Germany: A Prospective, Population-Based Study

EPILEPSIA, Issue 6 2001
Susanne Knake
Summary: ,Purpose: To determine the incidence and case-fatality rate of status epilepticus (SE) in adults in Hessen, Germany, we performed a prospective, population-based study from July 1997 through June 1999. Methods: All adult patients residing within the zip-code area 35 (area-35) with SE were included. Area-35 had 743.285 adult inhabitants, including 123.353 adult inhabitants of the primary service area of the University Hospital Marburg (PS-area). Patients were reported by 16 hospitals in the area and were prospectively identified and carefully reviewed within 5 days by one of the authors. Based on the crude annual incidence of SE and a rate of underascertainment of 10% determined for the PS-area, the corrected, age-adjusted incidence of SE in area 35, more representative of the population of Germany, was calculated. Results: The crude annual incidence in the PS-area was 15.8/100,000 [95% confidence interval (CI), 11.2,21.6]. The calculated, corrected, age-adjusted incidence of SE in area 35 was 17.1/100,000. It was higher for men compared with women (26.1 vs. 13.7) and for those aged 60 years and older (54.5 vs. 4.2/100,000, p < 0.0001). The etiology was mainly remote symptomatic due to cerebrovascular disease. Epilepsy was previously diagnosed in only 50% of the patients. The case-fatality rate was 9.3%. Conclusions: Based on our data, at least 14,000 patients would be affected by SE in Germany, associated with ,1,300 deaths annually. The incidence of SE in Germany is similar to that found in the white United States population. Furthermore, this study confirms the higher incidence of SE in male patients and in the elderly population. This may be due to a higher incidence of cerebrovascular disease in these subpopulations. [source]