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Selected AbstractsUnder-report and underdiagnosis of chronic respiratory diseases in an African countryALLERGY, Issue 7 2009P. Martins Background:, Chronic respiratory diseases (CRD) are greatly underestimated. The aim of this study was to assess the burden associated with reported CRD and chronic obstructive pulmonary disease, as defined on the basis of various standardized criteria, by estimating their point prevalence in a sample of individuals attending the Primary Health Care (PHC) level and Emergency Room (ER) Departments in Cape Verde (CV) archipelago. The second aim of the study was to identify factors related to airways obstruction and reported CRD in this population. Methods:, A cross-sectional study was carried out in CV during 2 weeks. Outpatients aged more than 20 years seeking care at PHC level and ER answered a standardized questionnaire and were subjected to spirometry, independently of their complaint. Two criteria for airways obstruction were taken into account: forced expiratory volume (FEV1) <80% of the predicted value and FEV1/forced vital capacity (FVC) ratio <0.70. Results:, A total of 274 individuals with a satisfactory spirometry were included. 22% of the individuals had a FEV1 < 80%. Individuals older than 46 years had a higher risk of having airways obstruction. Asthma diagnosis (11%) had a clear association with airways obstruction. Smoking was a risk factor for a lower FEV1. Working in a dust place and cooking using an open fire were both related to chronic bronchitis and asthma diagnosis. Conclusion:, Under-report and underdiagnosis of chronic respiratory conditions seem to be a reality in CV just as in other parts of the world. To improve diagnosis, our results reinforce the need of performing a spirometry. [source] A population-based description of glioblastoma multiforme in Los Angeles County, 1974,1999CANCER, Issue 12 2005Indro Chakrabarti M.D., M.P.H. Abstract BACKGROUND There have been reports that the incidence rates of brain tumors have increased over the past few decades, but most have considered all brain tumors together. The authors analyzed the pattern of glioblastoma multiforme (GBM) occurrence in Los Angeles County, California to shed light on the incidence and descriptive epidemiology of this type of brain tumor. METHODS Data were obtained from the Los Angeles County Cancer Surveillance Program. Incidence rates were analyzed by gender, race, age at diagnosis, period of diagnosis (1974,1981, 1982,1988, or 1989,1999), and socioeconomic status (SES). In addition, data were stratified according to anatomic subsite. A multivariate model describing changes in rates by each of these variables was constructed. RESULTS Age-specific incidence rates (ASIR) rose sharply after age 30 years. The peak ASIR was at age 70,74 years in males and at age 75,79 years in females. The age-adjusted incidence rate (AAIR) of GBM increased from 1974 to 1999 by an estimated 2.4% per year among males and 2.8% per year among females. Overall, males had a 60% increased risk of brain tumors compared with females. Males had a higher incidence of GBM compared with females at each anatomic subsite except the posterior fossa. The largest male:female ratio occurred in the occipital lobes. Non-Latino whites had the highest incidence rates (2.5 per 100,000) followed by Latino whites (1.8 per 100,000), and blacks (1.5 per 100,000). After 1989, compared with the period before magnetic resonance imaging (MRI) was available, there was an increase in GBM incidence rates among those with of higher SES that was most pronounced in females. The incidence of GBM was highest for frontal lobe tumors and for tumors that involved two or more lobes (overlapping tumors), followed by tumors in the temporal and parietal lobes. In the multivariate analysis, year of diagnosis, SES, gender, race (Latino but not black), site, and age at diagnosis all were important predictors of incidence rate. CONCLUSIONS GBM incidence increased in Los Angeles County over the last 30 years and especially after 1989, suggesting that the introduction of MRI may have contributed to the increase. Individuals older than age 65 years experienced the greatest increase in incidence over time. Older age, male gender, higher SES, and non-Latino white race increased the risk of GBM. Previously unreported incidence rates for GBM among Latino whites were significantly lower than among non-Latino whites but were intermediate between non-Latino whites and blacks. Cancer 2005. © 2005 American Cancer Society. [source] Research Submission: Chronic Headache and Comorbibities: A Two-Phase, Population-Based, Cross-Sectional StudyHEADACHE, Issue 8 2010Ariovaldo Da Silva Jr MD Background., Studies using resources of a public family health program to estimate the prevalence of chronic daily headaches (CDH) are lacking. Objectives., To estimate the 1-year prevalence of CDH, as well as the presence of associated psychiatric and temporomandibular disorders (TMD) comorbidities, on the entire population of a city representative of the rural area of Brazil. Methods., This was a cross-sectional, population-based, 2-phase study. In the first phase, health agents interviewed all individuals older than 10 years, in a rural area of Brazil. In the second stage, all individuals who reported headaches on 4 or more days per week were then evaluated by a multidisciplinary team. CDH were classified according to the second edition of the International Classification of Headache Disorders (ICHD-2). Medication overuse headache was diagnosed, as per the ICHD-2, after detoxification trials. Psychiatric comorbidities and TMD were diagnosed based on the DSM-IV and on the Research Diagnostic Criteria for Temporomandibular Disorders criteria, respectively. Results., A total of 1631 subjects participated in the direct interviews. Of them, 57 (3.6%) had CDH. Chronic migraine was the most common of the CDH (21, 36.8%). Chronic tension-type headache (10, 17.5%), medication overuse headache (13, 22.8%) and probable medication overuse headache (10, 17.5%) were also common. Psychiatric disorders were observed in 38 (67.3%) of the CDH subjects. TMD were seen in 33 (58.1)% of them. Conclusions., The prevalence of CDH in the rural area of Brazil is similar to what has been reported in previous studies. A significant proportion of them have psychiatric comorbidities and/or TMD. In this sample, comorbidities were as frequent as reported in convenience samples from tertiary headache centers. (Headache 2010;50:1306-1312) [source] Prevalence of oral mucosal lesions in elderly people in Santiago, ChileJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 10 2003I. Espinoza Abstract Background:, Oral prevalence studies are important to know the state of health and the needs of treatment. Our aim was to determine the prevalence of oral mucosal lesions and associated factors among aging Chileans. Methods:, A random sample by age, gender, and socioeconomic status was obtained, comprising 889 individuals older than 65 years. Individuals were interviewed and examined in Santiago, the capital of Chile, according to the World Health Organization guidelines. Results:, The prevalence of one or more oral mucosal lesions in the sample was 53%. Logistic regression model revealed that denture use increased the probability of one or more oral mucosal lesions by threefold, while age, gender, smoking, medication use, xerostomia, and social or cultural factors had no effect. The most common lesion was denture stomatitis (22.3%), followed by irritative hyperplasia (9.4%), oral mucosal varicosities (9%), solitary pigmented lesions (4%), traumatic ulcer (3.5%), angular cheilitis (2.9%), multiple pigmented lesions (2.8%), hemangioma (2.3%), lichen planus (2.1%), leukoplakia (1.7%), recurrent aphthous stomatitis (1.4%), nicotine stomatitis (1.3%), median rhomboid glossitis (0.9%), actinic cheilitis (0.9%), pyogenic granuloma (0.7%), oral squamous papiloma (0.6%), and mucocele (0.2%). One case of oral cancer was observed. Different factors increased the probability of specific oral mucosal pathologies. Conclusions:, We can conclude that oral mucosal lesions are common in elderly people in Santiago, suggesting the necessity for improved standards of prevention, and diagnostic and opportune treatment of these lesions. [source] Gleaning signals about the past from cemetery dataAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 1 2010Lisa Sattenspiel Abstract Cemetery headstones provide an easily accessible source of demographic data in human populations. In common with other sources of demographic data, such as skeletal samples, cemetery data may not be representative of the populations from which they were derived. In some circumstances they can be reasonably representative, however, and in such cases they may provide signals about demographic changes in the population that contributed to the cemetery. We present here analyses of burials occurring between 1900 and 1990 at the Columbia Cemetery in Columbia, Missouri. Our analyses, in combination with archival materials relating to infrastructure improvements in Columbia and data on infectious disease mortality in the state of Missouri, show that patterns of death observed in the cemetery data provide evidence for the timing of changes in the health of Columbia's residents. At the time that major improvements in sanitation and hygiene were implemented, burials of individuals dying under age 45 decreased significantly while burials of individuals older than 45 remained relatively high. Furthermore, data on infectious disease mortality indicate significant declines in deaths from water- and milk-borne infections, but no change in mortality from respiratory illnesses. These data also indicate that observed changes occurred about a decade later in Columbia than in large cities and more densely populated states elsewhere in the United States. Thus, this study illustrates the value of cemetery data in helping to fill gaps about how and when different events known to affect patterns of birth and death may have played out across time and space. Am J Phys Anthropol, 2010. © 2009 Wiley-Liss, Inc. [source] Prevalence of exfoliation syndrome in Pella-GreeceACTA OPHTHALMOLOGICA, Issue 2007S TSIRONI Purpose: To determine the prevalence of exfoliation syndrome (XFS) in the area of Pella, Greece. Methods: We studied a cluster, stratified sample of 700 individuals >45 years old (350 women and 350 men), representative of the population of Pella County. A comprehensive protocol recorded exfoliation findings before and after pupillary dilatation, as well as signs commensurate with possible XFS. The intraocular pressure (IOP) was recorded in all cases. Results: Typical XFS was detected in 10% of the examined persons. The percentage of clinically evident XFS rose from 0% in the 45-54 age group, to 2% for the 55-64 age group, 21.3% for the 66-74 age group and 34% for the >75 group of patients. There was no significant difference between the two sexes concerning the prevalence of XFS. Mean IOP was higher (20.04 mmHg) for the individuals with XFS versus those without (15.37 mmHg). Twelve patients with XFS (17.14%) had previously undiagnosed exfoliative glaucoma (XFG). Among the 70 persons with XFS, 60 (94.2%) had lens opacities, while 224 (35.5%) among the 630 persons without XFS had cataract. Conclusions: The prevalence of XFS in the area of Pella was determined to be 10% for individuals older than 45. There is strong correlation between XFS, glaucoma and cataract. [source] |