Increasing Prevalence (increasing + prevalence)

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Increasing prevalence of Type 2 diabetes mellitus in all ethnic groups in Mauritius

S. Söderberg
Abstract Aims To describe the prevalence of different stages of glucose intolerance in a population from Mauritius followed over 11 years. Methods Population-based surveys were undertaken in the multiethnic nation of Mauritius in 1987, 1992 and 1998, with 5083, 6616, and 6291 participants, respectively. Questionnaires, anthropometric measurements, and a 2-h 75-g oral glucose tolerance test were included. Subjects aged between 25 and 75 years with classifiable data were identified; 4991, 6463 and 5392 from 1987, 1992 and 1998, respectively. Glucose tolerance was classified according to WHO 1999 criteria. Results The prevalence of Type 2 diabetes increased significantly during the period studied, from 12.8% in 1987, to 15.2% in 1992, and 17.9% in 1998. The increasing prevalence was seen in both men and women, and in all age groups. The prevalence of known diabetes (KDM) increased progressively, and more markedly than the increase in newly diagnosed diabetes (NDM). A diagnosis of impaired glucose tolerance (IGT) was more prevalent amongst women whereas impaired fasting glucose (IFG) was more common amongst men. The prevalences of IGT and IFG did not change markedly during the period. The prevalence of diabetes and IGT was similar for participants of Indian, Creole and Chinese background in each survey, and the increasing prevalence of diabetes was seen in all ethnic groups. Conclusion In this study, we report an increasing prevalence of diabetes over an 11-year period in Mauritius. This increase was seen in both sexes, and in all age and ethnic groups, and was mainly due to an increase in the numbers of those with known diabetes. [source]

Increasing prevalence of diabetes mellitus in Oman

J. A. Al-Lawati
Abstract Aims To determine the prevalence of diabetes mellitus and impairedfasting glucose by age, gender, and by region and compare resultswith the 1991 survey; and estimate previously undiagnosed diabetesmellitus in the Omani population. Methods Cross-sectional survey containing a probability random sample of5838 Omani adults aged , 20 years. Diabetesand impaired fasting glucose (IFG) were assessed by fasting venous plasmaglucose using 1999 World Health Organization's diagnosticcriteria (normoglycaemia < 6.1 mmol/l, IFG , 6.1 but < 7 mmol/l,and diabetes , 7 mmol/l). The 1991 surveywas reanalysed using the same diagnostic criteria, and results werecompared. Results In 2000, the age-adjusted prevalence of diabetes among Omanis aged30,64 years reached 16.1% (95% confidenceinterval (CI) 14.7,17.4) compared with 12.2% (95% CI11.0,13.4) in 1991. IFG was found among 7.1% (95% CI6.2,8.1) of males and 5.1% (95% CI 4.4,6.0)of females. Generally, diabetes was more common in urban then ruralregions. Only one-third of diabetic subjects knew that they haddiabetes. Nearly half of the study population had a body mass index > 25 kg/m2. Conclusions The prevalence of diabetes is high in Oman and has increasedover the past decade. The high rate of abnormal fasting glucosetogether with high rates of overweight and obesity in the population makeit likely that diabetes will continue to be a major health problem inOman. Primary prevention programmes are urgently needed to counteract majorrisk factors that promote the development of diabetes. Diabet. Med. 19, 954,957 (2002) [source]

Increasing prevalence of allergic rhinitis but not asthma among children in Hong Kong from 1995 to 2001 (Phase 3 International Study of Asthma and Allergies in Childhood)

So-Lun Lee
There is a worldwide belief that the prevalence of asthma and other allergic diseases is increasing but the measures used in many studies are susceptible to systematic errors. We examined the trend of asthma, allergic rhinitis and eczema prevalence in school children aged 6,7 years in Hong Kong from 1995 to 2001 using standardized ISAAC methodology. There were 4448 and 3618 children participating in 2001 and 1995, respectively. The prevalence of life-time rhinitis (42.4% vs. 38.9%, p < 0.01), current rhinitis (37.4% vs. 35.1%, p < 0.03), current rhinoconjunctivitis (17.2 vs. 13.6%, p < 0.01) and life-time eczema (30.7% vs. 28.1%, p = 0.01) increased significantly. There was no significant change in prevalence of life-time asthma, life-time wheeze and current wheeze albeit a significant increase in severe asthma symptoms. We investigated a number of potential risk factors including sex, family history of atopy, sibship size, birth weight, respiratory tract infections, pet ownership and exposure to tobacco smoke. However, the increases in prevalence of rhinitis and eczema could not be entirely explained by the change of prevalence of these risk factors. The odds ratio OR for the study period remained significantly associated with current rhinitis (OR 1.31, 95% confidence intervals CI 1.17,1.46), current rhinoconjunctivitis (OR 1.63, 95% CI 1.41,1.87) and life-time eczema (OR 1.30, 95% CI 1.16,1.45) after adjustment for these confounding variables using logistic regression model. Further study is warranted to elucidate the factors contributing to the observable change in the prevalence of rhinitis in our population. [source]

Increasing prevalence of multiple sclerosis in Finland

M-L. Sumelahti
Objectives , To follow-up the prevalence trends of MS from 1983 to 1993 in western and southern Finland. MS epidemiology has been previously followed from 1964 to 1978 in these regions. The updated prevalences were correlated with incidence trends in the same period. Methods, Age-adjusted and age-specific MS prevalence rates were calculated for cases classified by Poser's criteria. Results, In the western health-care districts, Seinäjoki and Vaasa, prevalences in 1993 were 202/105 and 111/105. In the southern district Uusimaa the respective figure was 108/105. In Seinäjoki a significant 1.7-fold increase was found in 1993 as compared to 1983, mainly due to increased incidence. In Uusimaa a significant 1.2-fold increase in prevalence was found in the presence of stable incidence. In Vaasa prevalence was stable, although incidence was declining. Conclusion, The prevalence of MS is increasing in Seinäjoki and Uusimaa but not in Vaasa. Both the prevalence and incidence in Seinäjoki are now among the highest reported. [source]

Increasing prevalence of obesity in primary school children: cohort study

Richard Reading
First page of article [source]

Increasing prevalence of atopic eczema in Taiwanese adolescents from 1995 to 2001

Y.-L. Lee
Summary Background The prevalence of atopic eczema in adolescents has recently been reported as increasing in many countries, a phenomenon yet to be fully explained. This study compared the prevalence of atopic eczema among Taiwanese adolescents with individual-level risk factors and community-level data of temperature, relative humidity, and air pollutants to determine whether changes in these factors could explain the observed change in prevalence. Methods We conducted two nationwide, cross-sectional surveys of atopic illness and symptoms among Taiwanese 12,15-year-old schoolchildren in 1995,1996 and 2001. The effects of personal and environmental factors were assessed and temporal changes of outdoor monitoring data were also compared with the prevalence difference of atopic eczema. Results A total of 42 919 adolescents from the 1995 to 1996 survey and 10 215 adolescents from the 2001 survey attended schools located within 1 km of 22 monitoring stations. The 12-month prevalence of atopic eczema increased significantly during this period [adjusted prevalence ratio (PR)=1.43, 95% confidence interval (CI) 1.21,1.70 in boys; PR=1.77, 95% CI 1.49,2.10 in girls]. After adjustment for potential risk factors, the prevalence differences were statistically unchanged. Although parental education level contributed the most, changes in personal and environmental factors might not explain the observed prevalence increases of atopic eczema. Temporal change in the relative humidity was significantly associated with prevalence increase among boys but its contribution was also small. Conclusion Correlates of the investigated risk factors that have changed over time still underlie the prevalence increases of atopic eczema in Taiwanese adolescents. The exact reasons for the rising trends remain to be elucidated. [source]

Delayed Wound Healing After Three Different Treatments for Widespread Actinic Keratosis on the Atrophic Bald Scalp

Patricia J. F. Quaedvlieg MD
Background. Actinic keratosis is an exceedingly common premalignant lesion that can develop into squamous cell carcinoma. There is an increasing prevalence of actinic keratosis with increasing age. Numerous treatment options are available for the treatment of actinic keratosis on the scalp. Although we know that atrophic skin heals slowly, one should be careful but should not hesitate to treat. Objective. We present three patients with widespread actinic keratotic lesions on the atrophic bald scalp who received different treatments. Methods. Patient 1 was treated with medium-depth chemical peel, patient 2 with cryopeel, and patient 3 with CO2 laser resurfacing. In all patients, the entire surface area was treated. Results. Despite the different treatment methods used, all three patients had severly delayed wound healing as a complication. Remarkably, all patients had a prolonged period of re-epithelialization. Conclusion. Care has to be taken in patients with widespread actinic keratosis on the atrophic bald scalp when treating the entire surface area regardless the treatment modality. [source]

Type 2 diabetes mellitus and obesity in sub-Saharan Africa

Vivian C. Tuei
Abstract While communicable diseases such as human immunodeficiency virus/acquired immune deficiency syndrome, malaria, and tuberculosis have continued to pose greater threats to the public health system in sub-Saharan Africa (SSA), it is now apparent that non-communicable diseases such as diabetes mellitus are undoubtedly adding to the multiple burdens the peoples in this region suffer. Type 2 diabetes mellitus (T2DM) is the most common form of diabetes (90,95%), exhibiting an alarming prevalence among peoples of this region. Its main risk factors include obesity, rapid urbanization, physical inactivity, ageing, nutrition transitions, and socioeconomic changes. Patients in sub-Saharan Africa also show manifestations of ,-cell dysfunction and insulin resistance. However, because of strained economic resources and a poor health care system, most of the patients are diagnosed only after they have overt symptoms and complications. Microvascular complications are the most prevalent, but metabolic disorders and acute infections cause significant mortality. The high cost of treatment of T2DM and its comorbidities, the increasing prevalence of its risk factors, and the gaps in health care system necessitate that solutions be planned and implemented urgently. Aggressive actions and positive responses from well-informed governments appear to be needed for the conducive interplay of all forces required to curb the threat of T2DM in sub-Saharan Africa. Despite the varied ethnic and transitional factors and the limited population data on T2DM in sub-Saharan Africa, this review provides an extensive discussion of the literature on the epidemiology, risk factors, pathogenesis, complications, treatment, and care challenges of T2DM in this region. Copyright © 2010 John Wiley & Sons, Ltd. [source]

CB1 receptors: emerging evidence for central and peripheral mechanisms that regulate energy balance, metabolism, and cardiovascular health

Daniela Cota
Abstract Insulin resistance, dyslipidaemia and obesity are the major cardiometabolic risk factors contributing to the development of type 2 diabetes and cardiovascular disease (CVD). Owing to the increasing prevalence of obesity, type 2 diabetes, and CVD, new and effective pharmacologic therapies are urgently needed. In this regard, the endogenous cannabinoid system (ECS), a neuromodulatory system involved in the regulation of various aspects of energy balance and eating behaviour through central and peripheral mechanisms, may present the potential to meet this need. In the central nervous system (CNS), cannabinoid type 1 (CB1) receptors and their respective ligands, the endocannabinoids, have a significant role in the modulation of food intake and motivation to consume palatable food. CB1 receptors have also been found in organs involved in the regulation of metabolic homeostasis, such as liver, white adipose tissue, muscle and pancreas. Dysregulation of the ECS has been associated with the development of dyslipidaemia, glucose intolerance, and obesity, and CB1 receptor blockade may have a role in ameliorating these metabolic abnormalities. Thus, pharmacologic options targeting the ECS may provide a novel, effective approach to the prevention and management of CVD, type 2 diabetes and obesity. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Is insulin resistance caused by defects in insulin's target cells or by a stressed mind?

Jonas Burén
Abstract The importance of understanding insulin action is emphasized by the increasing prevalence of insulin resistance in various populations and by the fact that it plays an important pathophysiological role in many common disorders, for example, diabetes, obesity, hypertension and dyslipidemia. The primary factors responsible for the development of insulin resistance are so far unknown, although both genetic and environmental factors are involved. The genetic defects responsible for the common forms of insulin resistance, for example, in type 2 diabetes, are largely unidentified. Some studies from our group as well as by other investigators suggest that cellular insulin resistance is reversible and that it may be secondary to factors in the in vivo environment. These may include insulin-antagonistic action of hormones like catecholamines, glucocorticoids, sex steroids and adipokines as well as dysregulation of autonomic nervous activity and they could contribute to the early development of insulin resistance. Some of these factors can directly impair glucose uptake capacity and this might be due to alterations in key proteins involved in insulin's intracellular signaling pathways. This article briefly summarizes proposed mechanisms behind cellular and whole-body insulin resistance. In particular, we question the role of intrinsic defects in insulin's target cells as primary mechanisms in the development of insulin resistance in type 2 diabetes and we suggest that metabolic and neurohormonal factors instead are the main culprits. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Increasing prevalence of Type 2 diabetes mellitus in all ethnic groups in Mauritius

S. Söderberg
Abstract Aims To describe the prevalence of different stages of glucose intolerance in a population from Mauritius followed over 11 years. Methods Population-based surveys were undertaken in the multiethnic nation of Mauritius in 1987, 1992 and 1998, with 5083, 6616, and 6291 participants, respectively. Questionnaires, anthropometric measurements, and a 2-h 75-g oral glucose tolerance test were included. Subjects aged between 25 and 75 years with classifiable data were identified; 4991, 6463 and 5392 from 1987, 1992 and 1998, respectively. Glucose tolerance was classified according to WHO 1999 criteria. Results The prevalence of Type 2 diabetes increased significantly during the period studied, from 12.8% in 1987, to 15.2% in 1992, and 17.9% in 1998. The increasing prevalence was seen in both men and women, and in all age groups. The prevalence of known diabetes (KDM) increased progressively, and more markedly than the increase in newly diagnosed diabetes (NDM). A diagnosis of impaired glucose tolerance (IGT) was more prevalent amongst women whereas impaired fasting glucose (IFG) was more common amongst men. The prevalences of IGT and IFG did not change markedly during the period. The prevalence of diabetes and IGT was similar for participants of Indian, Creole and Chinese background in each survey, and the increasing prevalence of diabetes was seen in all ethnic groups. Conclusion In this study, we report an increasing prevalence of diabetes over an 11-year period in Mauritius. This increase was seen in both sexes, and in all age and ethnic groups, and was mainly due to an increase in the numbers of those with known diabetes. [source]

Hospital in-patients with diabetes: increasing prevalence and management problems

M. E. Wallymahmed
Abstract Aims To re-assess the prevalence, management problems, clinical outcomes and discharge summaries of hospital in-patients with diabetes. Methods Case records of all patients occupying in-patient beds were audited on a single weekday in 2003 in a large urban hospital and repeated after 3 months. Data was compared with an identical audit 12 years previously. Results Over 12 years the number of beds available for admission (1191) had reduced by 25% with a bed occupancy of 97%. Diabetes prevalence had increased from 7.0% to 11.1% (P < 0.01) (97% Type 2). Diabetes management was considered inappropriate in 29%, more than in 1991 (20%). After 3 months, discharge summaries had been completed on 75% of patients but diabetes was mentioned in only 53%. Conclusion The prevalence of in-patient diabetes (11.1%) was over 50% greater and diabetes management was suboptimal in more patients than in 1991. In many length of stay was prolonged and almost half of the discharge summaries did not mention diabetes. These findings have major implications for service delivery and resource planning. [source]

Prevalence and socio-demographic correlates of drug use among adolescents: results from the Mexican Adolescent Mental Health Survey

ADDICTION, Issue 8 2007
Corina Benjet
ABSTRACT Aims To estimate the life-time and 12-month prevalence of illicit drug use among Mexican adolescents, the age of onset of first drug use and the socio-demographic correlates. Method A multi-stage probability survey of adolescents aged 12,17 years residing in the Mexico City Metropolitan Area was carried out in 2005. Adolescents were administered the computer-assisted adolescent version of the World Mental Health Composite International Diagnostic Interview by trained lay interviewers in their homes. The response rate was 71% (n = 3005). Descriptive and logistic regression analyses were performed considering the multi-stage and weighted sample design of the survey. Findings Of the adolescents, 5.2% have ever tried illicit drugs, 2.9% in the last 12 months. The most frequently used drugs are marijuana, followed by tranquilizers/stimulants. The median age of first use is 14 years. Correlates of life-time drug use are older age, having dropped out of school, parental drug problems, low religiosity and low parental monitoring. Conclusions While drug use among Mexican adolescents is lower than among adolescents from other developed countries, its increasing prevalence with age and the narrowing male/female ratio calls for firm public health actions, particularly prevention strategies. [source]

Sleep and the metabolic syndrome

Robert Wolk
The metabolic syndrome represents a clustering of several interrelated risk factors of metabolic origin that are thought to increase cardiovascular risk. It is still uncertain whether this clustering results from multiple underlying risk factors or whether it has a single cause. One metabolic abnormality that may underlie several clinical characteristics of the metabolic syndrome is insulin resistance. This review discusses the evidence that sleep disturbances (obstructive sleep apnoea, sleep deprivation and shift work) may independently lead to the development of both insulin resistance and individual clinical components of the metabolic syndrome. The converse may also be true, in that metabolic abnormalities associated with the metabolic syndrome and insulin resistance may potentially exacerbate sleep disorders. The notion that sleep disturbances exert detrimental metabolic effects may help explain the increasing prevalence of the metabolic syndrome and insulin resistance in the general population and may have important implications for population-based approaches to combat the increasing epidemic of metabolic and cardiovascular disease. [source]

Extensively drug-resistant tuberculosis: current challenges and threats

Amita Jain
Abstract Extensively drug-resistant tuberculosis (XDR-TB) is defined as tuberculosis caused by a Mycobacterium tuberculosis strain that is resistant to at least rifampicin and isoniazid among the first-line antitubercular drugs (multidrug-resistant tuberculosis; MDR-TB) in addition to resistance to any fluroquinolones and at least one of three injectable second-line drugs, namely amikacin, kanamycin and/or capreomycin. Recent studies have described XDR-TB strains from all continents. Worldwide prevalence of XDR-TB is estimated to be c. 6.6% in all the studied countries among multidrug-resistant M. tuberculosis strains. The emergence of XDR-TB strains is a reflection of poor tuberculosis management, and controlling its emergence constitutes an urgent global health reality and a challenge to tuberculosis control activities in all parts of the world, especially in developing countries and those lacking resources and as well as in countries with increasing prevalence of HIV/AIDS. [source]

Hypothesis: exposure to endocrine-disrupting chemicals may interfere with timing of puberty

A. Mouritsen
Summary A recent decline in onset of puberty , especially among girls , has been observed, first in the US in the mid-1990s and now also in Europe. The development of breast tissue in girls occurs at a much younger age and the incidence of precocious puberty (PP) is increasing. Genetic factors and increasing prevalence of adiposity may contribute, but environmental factors are also likely to be involved. In particular, the widespread presence of endocrine-disrupting chemicals (EDCs) is suspected to contribute to the trend of earlier pubertal onset. The factors regulating the physiological onset of normal puberty are poorly understood. This hampers investigation of the possible role of environmental influences. There are many types of EDCs. One chemical may have more than one mode of action and the effects may depend on dose and duration of the exposure, as well as the developmental stage of the exposed individual. There may also be a wide range of genetic susceptibility to EDCs. Human exposure scenarios are complex and our knowledge about effects of mixtures of EDCs is limited. Importantly, the consequences of an exposure may not be apparent at the actual time of exposure, but may manifest later in life. Most known EDCs have oestrogenic and/or anti-androgenic actions and only few have androgenic or anti-oestrogenic effects. Thus, it appears plausible that they interfere with normal onset of puberty. The age at menarche has only declined by a few months whereas the age at breast development has declined by 1 year; thus, the time span from initiation of breast development to menarche has increased. This may indicate an oestrogen-like effect without concomitant central activation of the hypothalamic,pituitary axis. The effects may differ between boys and girls, as there are sex differences in age at onset of puberty, hormonal profiles and prevalence of precocius puberty. [source]

Management of heart failure in elderly people

M. Imazio
Summary Aims:, To review currently available knowledge on presentation, clinical features and management of heart failure (HF) in elderly people. Methods:, To review currently available evidence, we performed a thorough search of several evidence-based sources of information, including Cochrane Database of Systematic Reviews, Clinical Evidence, Evidence-based guidelines from National Guidelines Clearinghouse and a comprehensive MEDLINE search with the MeSH terms: ,heart failure', ,elderly' and ,management'. Results:, A number of features of ageing may predispose elderly people to HF, and may impair the ability to respond to injuries. Another hallmark of elderly patients is the increasing prevalence of multiple coexisting chronic conditions and geriatric syndromes that may complicate the clinical presentation and evolution of HF. Although diagnosis may be challenging, because atypical symptoms and presentations are common, and comorbid conditions may mimic or complicate the clinical picture, diagnostic criteria do not change in elderly people. Drug treatment is not significantly different from that recommended in younger patients, and largely remains empiric, because clinical trials have generally excluded elderly people and patients with comorbid conditions. Disease management programmes may have the potential to reduce morbidity and mortality for patients with HF. Conclusions:, Heart failure is the commonest reason for hospitalisation and readmission among older adults. HF shows peculiar features in elderly people, and is usually complicated by comorbidities, presenting a significant financial burden worldwide, nevertheless elderly people have been generally excluded from clinical trials, and thus management largely remains empiric and based on evidence from younger age groups. [source]

Management of advanced HIV disease with no other complications in women and in Africans

I. Williams
Summary The number of patients who present with advanced human immunodeficiency virus (HIV) disease [defined as a helper lymphocyte (CD4) count <50 cells/mm3 or the presence of an acquired immunodeficiency syndrome (AIDS)-defining illness] is increasing. In the USA during 1994,1999, a relatively stable proportion of 43% of people diagnosed with HIV infection were tested late in the infection (had AIDS diagnosed within 1 year of diagnosis). A recent review of newly diagnosed infections in 2003 found that 301/977 (31%) of patients in the UK and Ireland presented late (<200 CD4 cells/mm3). Before a diagnosis is made, patients with advanced disease do not benefit from antiretroviral therapy and may continue to transmit the infection to others. Furthermore, when antiretroviral therapy is initiated in patients with CD4 counts of 201,350 cells/mm3, the risk of death is lower than when treatment is started at lower CD4 cell counts. With the increasing prevalence of HIV in women and African immigrants, some doctors are concerned that different management approaches need to be used in these groups. This article reviews the evidence and some clinical scenarios for patients with advanced disease without complications and women and Africans who may present with advanced HIV disease. The aim is to offer practical advice on therapeutic options for treatment-naļve patients who present with advanced HIV disease on the basis of available clinical evidence. [source]

The Metabolic Syndrome: A Modern Plague Spread by Modern Technology

Aaron Spalding MD
Malnutrition and infectious disease represent the most common health threats facing the developing world. However, increasing technological developments and the expansion of western culture have contributed to the increasing prevalence of the metabolic syndrome. The epidemiologic significance and potential costs to governmental health care systems of an increasing incidence of metabolic syndrome could become high. The role of environmental influences that lead to the development of the metabolic syndrome needs to be explored. Because the metabolic syndrome becomes more common as nations develop, investigations into the ramifications of this disease often come too late. [source]

Obesity: attitudes of undergraduate student nurses and registered nurses

Man-Yuk Poon
Aim., To investigate undergraduate student nurses' and registered nurses' attitudes towards obese persons and towards the management of obese patients. Background., Obesity is a global public health problem. Escalating rates of overweight and obesity are also taking a toll in Asian countries that have historically had much lower rates. Despite the growing prevalence of obesity worldwide, studies show that nurses and other health professionals hold negative attitudes towards obese people, which may affect the care of obese patients. Design., Cross-sectional study. Methods., A self-administered questionnaire was completed by 352 undergraduate student nurses and 198 registered nurses. The questionnaire consisted of the Fat Phobia Scale, the Attitudes Toward Obese Adult Patients Scale and a demographic profile. Data were analysed using descriptive statistics and student's t -tests. Results., Overall mean scores on the Fat Phobia Scale (3·53 SD 0·47) indicated average levels of fat phobia and mean scores on the Attitudes Toward Obese Adult Patients scale (2·64 SD 0·51) indicated neutral attitudes towards obese patients. Registered nurses had significantly higher levels of fat phobia and more negative attitudes than did student nurses. The majority of participants perceived that obese people liked food, overate and were shapeless, slow and unattractive. Additionally, over one-half of participants believed that obese adults should be put on a diet while in hospital. Conclusions., Results of this study show that both registered nurses and student nurses have negative perceptions of obesity and are unlikely to attribute positive characteristics to obese individuals. That registered nurses hold more negative attitudes towards obese person is cause for concern. Relevance to clinical practice., Given the increasing prevalence of obesity and the disproportionate number of obese persons affected by many health conditions, current and future nurses should have positive professional attitudes towards obese individuals. Obesity needs to more be adequately addressed, both in basic nursing education programs and in continuing professional education for practising nurses. [source]

Granulomatous tattoo reaction and erythema nodosum in a young woman: common cause or coincidence?

Uwe Wollina MD
Summary Tattooing has become quite popular in Western countries. With the increasing prevalence, there is also an increased risk of adverse effects. We describe a 17-year-old female patient with a black and red,colored tattoo, who developed immediately after red tattooing general malaise with fever, nausea, and vomiting. A bullous reaction was temporarily seen within the red part of her tattoo. The reaction later shifted to a subacute dermatitis with bacterial superinfection. Two months later, she felt ill again. She developed painful tender nodules on the anterior aspect of both lower legs identified as erythema nodosum without sarcoidosis. Is this is a unique case of adverse reaction to tattoo pigments with a type I and a type IV reaction, or is this a coincidence? The treatment was initiated with systemic and topical corticosteroids and topical antibiotics combined with compression bandages for the legs. After 3 weeks of treatment, the erythema nodosum completely resolved and did not reappear during a 1-year follow-up. The treatment of the local reactions, however, was unsatisfactory without complete response. There is an indispensable need for regulation of tattoo pigments and tattooing to improve consumer safety. [source]

Changing trends in gastrointestinal disease in the Asia,Pacific region

The new millennium has seen distinct changes in the pattern of gastrointestinal disease in the Asia,Pacific region. These changes are important as more than half of the world's population come from the region and therefore impact significantly on the global disease burden. The highest incidence of gastric cancer (GCA) has been reported from Asia and GCA remains a very important cancer. However time-trend studies have shown a decrease in GCA incidence in several countries in Asia. A rise in cardio-esophageal cancers as seen in the West has not been reported. On the other hand, colorectal cancer has been steadily increasing in Asia with age-standardized incidence rates of some countries approaching that of the West. The pattern of acid-related diseases has also changed. Gastroesophageal reflux disease is a fast emerging disease with an increasing prevalence of reflux esophagitis and reflux symptoms. The prevalence of peptic ulcer disease has at the same time declined in step with a decrease in H. pylori infection. Many of the changes taking place mirror the Western experience of several decades ago. Astute observation of the epidemiology of emerging diseases combined with good scientific work will allow a clearer understanding of the key processes underlying these changes. With rapid modernization, lifestyle changes have been blamed for an increase in several diseases including gastroesophageal reflux disease, nonalcoholic fatty liver disease and colorectal cancer. A worrying trend has been the increase in obesity among Asians, which has been associated with an increase in metabolic diseases and various gastrointestinal cancers. Conversely, an improvement in living conditions has been closely linked to the decrease in GCA and H. pylori prevalence. [source]


ABSTRACT A water-soluble polysaccharide from Inonotus obliquus (IOPS) was isolated from the mushroom Inonotus obliquus (Fr.) Pilat. The chemical compositions, molecular weight and inhibitory activities on glycosidase and antioxidant properties of IOPS were investigated. The results indicated that IOPS was an acid protein-bound polysaccharide, with a molecular weight of 1.7 × 104 Da and the contents of neutral sugar, protein and uronic acids being 42.5, 18.5 and 6.1%, respectively. IOPS exhibited an inhibitory activity against ,-glucosidase with the IC50 value of 93.3 µg/mL, whereas it had no effective inhibition on ,-amylase. Results of antioxidant activity assays revealed that IOPS had inhibitory activity on the concentration-dependent quenching of 1,1-Diphenyl-2-picrylhydrazyl and hydroxyl radicals. Furthermore, IOPS inhibited the formation of thiobarbituric acid-reactive substances in Fe2+/ascorbate-induced lipid peroxidation in rat liver tissue. These results clearly demonstrated that IOPS was one of the main bioactive components of I. obliquus that contributed to hypoglycemic activity and antioxidant activity. PRACTICAL APPLICATIONS Diabetes mellitus is one of the primary threats to human health because of its increasing prevalence, chronic course and disabling complications. Postprandial hyperglycemia plays an important role in the development of type 2 diabetes mellitus and complications associated with the disease. One therapeutic approach to decrease postprandial hyperglycemia is to retard the absorption of glucose through inhibition of carbohydrate-hydrolyzing enzymes in the digestive organs. In this study, a polysaccharide isolated from the mushroom Inonotus obliquus (IOPS) was shown to have notable glycosidase inhibitory effects and antioxidant activities. This research will benefit for the investigation of effective and safe ,-glucosidase inhibitors from natural materials. IOPS could be a good candidate for application in food and medicinal fields. It might be developed for functional food or lead compounds for use in antidiabetes. [source]

Healing Following Cranial Trauma,

Lenore T. Barbian Ph.D.
Abstract:, This paper reports on the gross appearance of the initial osseous response following cranial gunshot wounds. A total of 127 adult crania and cranial sections were analyzed for four types of bone response: osteoblastic, osteoclastic, line of demarcation, and sequestration. In general, no osteoblastic or osteoclastic response was noted during the first week. This response was followed by an increasing prevalence of expression after this time. By the sixth week postfracture both osteoclastic and osteoblastic activity was scored for 100% of the sample. Further, our observations suggest that the line of demarcation may establish the boundary between the living bone and bone not surviving the fracture. Sequestration appears to be a long-term event and was scored as present well past the eighth week of healing. The osseous expression of infection following fracture was also considered. [source]

Gastroesophageal reflux disease in Asian countries: Disorder of nature or nurture?

Khek Yu Ho
Abstract Gastroesophageal reflux disease (GERD) is less prevalent in Asia than in the West, but there is now evidence to suggest that its frequency is rapidly rising in Asia. The different prevalence rates reported in various Asian studies may represent different points in the ,rising' phase of GERD. The cause for the lower but increasing prevalence of GERD in Asia is not known, but genetics and to some extent environmental factors, may have initially protected Asians against GERD. However, with the recent globalization of economies, the associated lifestyle changes in many developing Asian countries may have tipped the balance in favor of the development of GERD. [source]

The effect of including a conventional snack (cereal bar) and a nonconventional snack (almonds) on hunger, eating frequency, dietary intake and body weight

S. Zaveri
Abstract Background:, With the increasing prevalence of being overweight and obesity, dietary strategies to curb hunger levels and increase satiety at lower energy intakes are sought. The frequency of eating and type of snack may influence total energy intake. The present study aimed to assess the impact of providing either a conventional snack (cereal bar) or a nonconventional snack (almonds) on eating frequency, hunger rating, dietary intake, body weight and blood lipids. Methods:, Forty-five healthy men (aged 25,50 years, body mass index = 25,35 kg m,2) were recruited and allocated to a control, cereal bar or almond snack group. Two packets of cereal bars and almonds were introduced for 12 weeks to the cereal bar group and the almond snack group, respectively. Dietary intakes and eating frequency were assessed by 4-day unweighed diet diaries; visual analogue scales were used to assess hunger ratings; and fasting blood parameters (i.e. glucose, insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol) were measured at baseline, 6 and 12 weeks. In addition, anthropometric measures (height, weight, skinfold thickness, waist and hip circumference) were measured at baseline, 6 and 12 weeks. Results:, The present study found no significant change in the eating frequency within groups at 12 weeks. However, the almond snack group had a significantly higher eating frequency than the control group (P , 0.05) and cereal bar group (P , 0.01). This did not result in higher energy intake, body weight or percentage body fat in the almond snack group. Conclusion:, The present study demonstrated that snacking on almonds, in comparison to cereal bars, promoted a higher eating frequency, but not a higher energy intake. Advice to snack on either almonds or cereal bars did not result in weight gain, suggesting that energy compensation took place. [source]


Charles Negy
Despite the increasing prevalence of interethnic marriages, remarkably little empirical literature exists for guiding clinical interventions offered to these couples. This study compared the marriages of 72 couples with one Mexican-American partner and one non-Hispanic White American partner, 75 Mexican-American couples, and 66 non-Hispanic White couples. Overall, the interethnic couples were more similar to non-Hispanic White couples than they were to Mexican-American couples across multiple domains, with the latter group indicating modestly higher levels of relationship distress. Among interethnic couples, Mexican-American wives' level of acculturation related significantly to both their own marital- and parental-role orientation and to distress in their relationships with children, as well as to their husbands' marital distress regarding child rearing and the couple's interactions regarding finances. Implications for clinical interventions with Mexican- and White-American interethnic couples are discussed. [source]

Vitamin D and Bone Physiology: Demonstration of Vitamin D Deficiency in an Implant Osseointegration Rat Model

James Kelly DDS
Abstract Purpose: The patient population varies in nutritional deficiencies, which may confound the host response to biomaterials. The objective of this study was to evaluate the effect of a common deficiency of vitamin D on implant osseointegration in the rat model. Materials and Methods: Male Sprague-Dawley rats were maintained under the cessation of vitamin D intake and UV exposure. The serum levels of 1,25(OH)2D3, 25 OHD3, Ca, and P were determined. Miniature cylindrical Ti6Al4V implants (2-mm long, 1-mm diameter) were fabricated with double acid-etched (DAE) surface or modified DAE with discrete crystalline deposition (DCD) of hydroxyapatite nanoparticles. DAE and DCD implants were placed in the femurs of vitamin D-insufficient and control rats. After 14 days of healing, the femur-implant samples were subjected to implant push-in test and nondecalcified histology. The surfaces of recovered implant specimens after the push-in test were further evaluated by scanning electron microscopy (SEM). Results: The decreased serum level of 25 OHD3 demonstrated the establishment of vitamin D insufficiency in this model. The implant push-in test revealed that DAE and DCD implants in the vitamin D-insufficient group (15.94 ± 8.20 N, n = 7; 15.63 ± 3.96 N, n = 7, respectively) were significantly lower than those of the control group (24.99 ± 7.92 N, n = 7, p < 0.05; 37.48 ± 17.58 N, n = 7, p < 0.01, respectively). The transcortical bone-to-implant contact ratio (BIC) was also significantly decreased in the vitamin D-insufficient group. SEM analyses further suggested that the calcified tissues remaining next to the implant surface after push-in test appeared unusually fragmented. Conclusions: The effect of vitamin D insufficiency significantly impairing the establishment of Ti6Al4V implant osseointegration in vivo was unexpectedly profound. The outcome of Ti-based endosseous implants may be confounded by the increasing prevalence of vitamin D insufficiency in our patient population. [source]

Sleep problems and daytime somnolence in a German population-based sample of snoring school-aged children

Summary Habitual snoring is associated with daytime symptoms like tiredness and behavioral problems. Its association with sleep problems is unclear. We aimed to assess associations between habitual snoring and sleep problems in primary school children. The design was a population-based cross-sectional study with a nested cohort study. The setting was twenty-seven primary schools in the city of Hannover, Germany. Habitual snoring and sleep problems were assessed in primary school children using an extended version of Gozal's sleep-disordered breathing questionnaire (n = 1144). Approximately 1 year later, parents of children reported to snore habitually (n = 114) and an equal number of children who snored never or occasionally were given the Sleep Disturbance Scale for Children, a validated questionnaire for the assessment of pediatric sleep problems. Snoring status was re-assessed using the initial questionnaire and children were then classified as long-term habitual snorers or ex-habitual snorers. An increasing prevalence of sleep problems was found with increasing snoring frequency for sleep-onset delay, night awakenings, and nightmares. Long-term habitual snorers were at significantly increased risk for sleep,wake transition disorders (e.g. rhythmic movements, hypnic jerks, sleeptalking, bruxism; odds ratio, 95% confidence interval: 12.0, 3.8,37.3), sleep hyperhidrosis (3.6, 1.2,10.8), disorders of arousal/nightmares (e.g. sleepwalking, sleep terrors, nightmares; 4.6, 1.3,15.6), and excessive somnolence (i.e. difficulty waking up, morning tiredness, daytime somnolence; 6.3, 2.2,17.8). Ex-habitual snorers were at increased risk for sleep,wake transition disorders (4.4, 1.4,14.2). Habitual snoring was associated with several sleep problems in our study. Long-term habitual snorers were more likely to have sleep problems than children who had stopped snoring spontaneously. [source]

Protecting Medical Privacy: Challenges in the Age of Genetic Information

Sheri A. Alpert
This article examines the privacy issues that arise from the convergence of two trends: the computerization of medical records, and the increasingly detailed level of personal genetic information that will potentially be placed within the electronic medical record. The article discusses the privacy and public policy implications for medical care, group identity, and familial relationships arising from the transition toward electronic medical records which will increasingly contain highly detailed genetic information. As such, the article focuses on the confidentiality of the electronic medical record, the increasing prevalence and sophistication of genetic testing and analysis, and the implications of electronic genetic information. [source]