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Very High Prevalence (very + high_prevalence)
Selected AbstractsSubclinical vascular alterations in young adults with type 1 diabetes detected by arterial tonometryDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 8 2009I. Barchetta Abstract Background Diabetes mellitus is characterized by a very high prevalence of atherosclerotic disease. Aims of this study were to determine arterial compliance parameters in type 1 diabetes (T1D) patients as an expression of early pre-clinical endothelial dysfunction and to evaluate the impact of glucose exposure parameters such as the duration of diabetes and glycosylated haemoglobin (HbA1c) on the risk of developing alterations in vascular compliance. Methods 23 patients with uncomplicated type 1 diabetes (mean age: 32.78 ± 9.06 years, mean disease duration: 10.78 ± 7.51 years, mean HbA1c levels: 7.7 ± 1.9) and 26 age- and sex-matched healthy subjects (mean age: 32.3 ± 8.51 years) were recruited. In these subjects, we evaluated arterial compliance by calibrated tonometry (HDI/PulsewaveÔ CR-2000). Parameters included the following: large artery elasticity (C1), small artery elasticity (C2), systemic vascular resistance (SVR) and total vascular impedance (TVI). Results Patients with longer duration of T1D (>10 years) showed significant alterations in C2 (4.97 ± 2.7 mL/mmHg × 100) and in SVR (1464.67 ± 169.16 dina × s × cm,5) when compared with both healthy individuals (C2: 8.28 ± 2.67 mL/mmHg × 100, p = 0.001; SVR: 1180.58 ± 151.55 dina × s × cm,5, p = 0.01) and patients with recent-onset disease (,10 years) (C2: 10.02 ± 3.6 mL/mmHg × 100, p < 0.001; SVR: 1124.18 ± 178.5 dina × s × cm,5, p < 0.000). Both disease duration and HbA1c independently predicted impaired arterial compliance. Conclusions Young adult T1D patients with no signs of disease complication have detectable vessel wall abnormalities, particularly of small arteries, suggestive of hyperglycaemia-related early endothelial dysfunction. Copyright © 2009 John Wiley & Sons, Ltd. [source] Possible involvement of epidermodysplasia verruciformis human papillomaviruses in the immunopathogenesis of psoriasis: a proposed hypothesisEXPERIMENTAL DERMATOLOGY, Issue 6 2003Slawomir Majewski Abstract:, We have shown previously in psoriasis a very high prevalence of epidermodysplasia verruciformis-associated human papillomavirus 5 (EVHPV5) DNA and antibodies to human papillomavirus 5 (HPV5) virus-like particle (VLP)L1, and we suggested that this benign hyperproliferative disorder could be a reservoir for EVHPVs. Here we provide new data confirming the expression of EVHPVs in psoriasis and present our hypothesis on their possible involvement in the immunopathogenesis of the disorder. The new important finding was detection by a radioimmunoprecipitation assay of a very high prevalence of antibodies to E6/E7 HPV5 oncoproteins, known to enhance keratinocyte proliferation. More recently, EV genes were identified, EVER1 and EVER2, whose mutations are responsible for epidermodysplasia verruciformis. Epidermodysplasia verruciformis-associated human papillomaviruses are harmless to the general population as a result of genetic restriction, which in psoriasis appears to be partly alleviated, and this may allow the viral gene expression. We hypothesize that induction of keratinocyte proliferation in psoriasis by various stimuli initiates the EVHPV life cycle with expression of early (E6/E7) and late (L1) viral proteins. The early proteins may, in turn, enhance the keratinocyte proliferation, and the late proteins could serve as a target for specific B- and T-cell-mediated responses. Immune responses against the viral antigens in the epidermis may result in chemoattraction of leukocytes and Munro abscess formation, as well as in production of proinflammatory cytokines, leading to self perpetuation of the psoriatic process. The novel immunomodulatory therapies could also inhibit immune responses against EVHPV proteins, leading to decreased cytokine production, keratinocyte proliferation and EVHPV expression. Thus the beneficial effect of these therapies is not discordant with the proposed hypothesis of possible involvement of EVHPVs in the immunopathogenesis of psoriasis. [source] Mutations and polymorphisms in the human methyl CpG-binding protein MECP2,,HUMAN MUTATION, Issue 2 2003Gabriel Miltenberger-Miltenyi Abstract Rett syndrome (RTT or RS) is a neurodevelopmental disorder and one of the most frequent genetic diseases in girls. Mutations of the MECP2 gene have been found in a variety of different RTT phenotypes. The MECP2 gene (Xq28) has been described in 1992. Up to now, 218 different mutations have been reported in a total group, of more than 2,100 patients. Mutations in the MECP2 gene are responsible for up to 75% of the classical RTT cases. The mutations, are distributed along the whole gene and are comprised of all types of mutations. Several polymorphisms and benign genetic variants have also been described. Apart from spared reported familial cases, almost all cases are sporadic. RTT syndrome has been considered to be a lethal trait in males. Studying the parental origin of the mutations, however, we and others have found a very high prevalence of de novo mutations on the paternal chromosome. In this work we summarize the mutational reports published until now. One of our aims was to check the mutations' descriptions for consistency and particularly to rename them according to the recommended mutation nomenclature. The increasing number of investigations on the functions of the MeCP2 can help to gain more information about the neuropathogenetic mechanisms causing RTT. Hum Mutat 22:107,115, 2003. © 2003 Wiley-Liss, Inc. [source] Psychosocial treatments of suicidal behaviors: A practice-friendly reviewJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2006Katherine Anne Comtois Worldwide, almost a million people die by suicide each year. Intentional, nonfatal, self-inflicted injury, including both suicide attempts and acts without suicide intent, also has very high prevalence. This article provides a practice-friendly review of controlled studies of psychosocial treatments aiming to prevent suicide, attempted suicide, and nonsuicidal self-inflicted injuries. Despite relatively small sample sizes for a low-base-rate outcome such as self-inflicted injury, several psychotherapies have been found effective, including cognitive therapy, dialectical behavior therapy, problem-solving therapy, and interpersonal psychotherapy, as well as outreach interventions, such as sending caring letters. The clinical implications of the review are discussed with the goal of translating the science to service,particularly the importance of outreach and treatment of non-compliance, the assessment and management of suicide risk, and competency in effective psychotherapies. These are critical steps for clinical psychology and psychotherapists to take in their role in suicide prevention. © 2005 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 161,170, 2006. [source] Identification of ,hot spots' of obesity and being underweight in early pregnancy in LiverpoolJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2009J. C. Abayomi Abstract Background: Obesity and being underweight in pregnancy are related to an increased risk of maternal and foetal morbidity, yet their prevalence is often unknown. The present study aimed to identify neighbourhoods with a higher than average prevalence or ,hot spots' of obesity and/or being underweight among first trimester pregnant women. Methods: A database was compiled consisting of postcode, height and weight for 7981 women who had booked-in for antenatal care between July 2004 and June 2005 at Liverpool Women's Hospital. Body mass index (BMI) was calculated and women were categorised accordingly. Postcodes for 6865 cases across Merseyside were converted to geolocations (pin-points on a map) using conversion software (http://www.census.ac.uk/cdu/). Results: There was a very high prevalence of being overweight (27%) and obesity (17%); 3.8% of women were underweight and probably malnourished (BMI < 18.5 kg m,2); and a further 10.7% of women were possibly malnourished (BMI < 20.0 kg m,2. Deriving case density from the geolocations allowed visualisation and identification of six neighbourhoods with above average levels of obesity and three neighbourhoods had marked concentrations of both being underweight and obesity. Conclusions: These neighbourhoods, particularly those identified as ,hot spots' for both being underweight and obesity, include some of the most deprived wards in the UK. As dietetic intervention may help to promote optimal weight gain during pregnancy and improve dietary intake for pregnant women and their families, primary health care providers should target these localities with a high prevalence of low and high BMI as a priority. [source] Prevalence of gastrointestinal tract lesions in 73 brachycephalic dogs with upper respiratory syndromeJOURNAL OF SMALL ANIMAL PRACTICE, Issue 6 2005C. M. Poncet Objectives: To determine the prevalence of gastrointestinal tract lesions in brachycephalic dogs with upper respiratory tract disease. Methods: The gastrointestinal tract and respiratory disorders of 73 brachycephalic dogs presented with upper respiratory signs were evaluated. Clinical signs and endoscopic and histological anomalies of the upper digestive tract were analysed. Results: A very high prevalence of gastrointestinal tract problems brachycephalic dogs presented with upper respiratory problems was observed clinically, endoscopically and histologically. Endoscopic anomalies of the upper digestive tract were present even in dogs without digestive clinical signs. Furthermore, histological evaluation of the digestive tract sometimes showed inflammatory lesions not macroscopically visible at endoscopy. Statistical analysis showed a relationship between the severity of the respiratory and digestive signs. This was significant in French bulldogs, males and heavy brachycephalic dogs. Clinical Significance: These observations show a correlation between upper respiratory and gastrointestinal tract problems in brachycephalic breeds with upper respiratory disease. Surgical treatment of respiratory disease could improve the digestive clinical signs, and/or gastro-oesophageal medical treatment could improve the outcome for surgically treated brachycephalic dogs. [source] Drug related falls: a study in the French Pharmacovigilance database,,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 1 2005Emmanuelle Souchet Abstract Objective To investigate the risk of falls associated with drugs among the French population using data reported to the French spontaneous reporting system and recorded in the French Pharmacovigilance database. Methods All cases including a fall were searched in the French Pharmacovigilance database between 1995 and 1999. Drugs involved and characteristics of patients were investigated. In a second step, we estimated the risk associated with psychotropic and cardiovascular drugs in a case/non case comparison, where cases were reports including a fall and non cases all other reports. This risk was estimated by calculation of crude and age and gender adjusted reporting odds ratios (ROR). Results During this period, 328 reports including a fall were reported (0.4% of the database). Patients were female in 70%. Mean age was 76,±,18 years. Comparisons between cases and non cases showed that cases were more likely to be women (OR: 1.9; 95% confidence interval (CI) [1.5,2.4]) and older. After adjustment on age and gender, falls remained significantly associated with exposure to benzodiazepines (4.7,[3.7,5.9]), imipraminic antidepressants (3.6 [2.5,5.1]), serotonin reuptake inhibitor (SRI) antidepressants (2.2 [1.5,3.1]) or nitrates (1.9 [1.2,2.8]). Conclusion This study confirms that taking psychotropic drugs strongly increases the risk of falls. The role of cardiovascular drugs (except nitrates) remains not significant when confounding factors are taken into account. According to the very high prevalence of psychotropic drug use in the French elderly, further study are needed to investigate the relative effect of some drugs on falls, like for example SRIs or short acting benzodiazepines. Copyright © 2004 John Wiley & Sons, Ltd. [source] High prevalence of HFE gene mutations in patients with porphyria cutanea tarda in the Czech RepublicBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2008K. Kratka Summary Background, Iron overload and hepatitis C virus (HCV) infection are independent factors which are thought to play a role in the pathogenesis of porphyria cutanea tarda (PCT). Objectives, To determine the prevalence of the HFE gene mutations p.Cys282Tyr (C282Y), p.His63Asp (H63D) and p.Ser65Cys (S65C), the p.Tyr250X (Y250X) mutation of the TFR2 gene, and HCV infection in patients with PCT in the Czech population, and to make comparison of the iron status among the respective genotypes. Methods, Iron metabolism indices, results of mutational analysis and serological markers of HCV infection were examined in 63 patients with PCT. Results, The HFE gene mutations were detected in 70% of patients with PCT compared with 35% in the control group (P < 0·001). Mean serum ferritin levels were increased in all genotypes, the highest being in homozygotes for the p.Cys282Tyr mutation. HCV infection was detected in only 8% of patients with PCT. Conclusions, There was a very high prevalence of the p.Cys282Tyr and p.His63Asp mutations observed in patients with PCT accompanied by mild degrees of iron overload, which was genotype dependent. [source] The metabolic syndrome and changing relationship between blood pressure and insulin with age, as observed in Aboriginal and Torres Strait Islander peoplesDIABETIC MEDICINE, Issue 11 2005A. E. Schutte Abstract Aims To determine the prevalence of the metabolic syndrome (MS) among Aboriginal and Torres Strait Islander peoples. A further objective was to investigate the relationships between fasting insulin and blood pressure (BP) within these groups with increasing age. Methods A cross-sectional population-based study included 369 Torres Strait Islanders (residing in Torres Strait and Far North Queensland), and 675 Aborigines from central Australia. Data necessary for classification of MS was collected, including fasting and 2-h glucose and insulin, urinary albumin and creatinine, anthropometric measurements, BP, serum lipids. Results The ATPIII criteria classified 43% of Torres Strait Islanders and 44% of Aborigines with MS, whereas 32 and 28%, respectively, had the MS according to WHO criteria. Agreement between the two criteria was only modest (kappa coefficient from 0.28 to 0.57). Factor analyses indicated no cluster including both insulin and BP in either population. Significant correlations (P < 0.05) [adjusted for gender, body mass index (BMI) and waist circumference] were observed between BP and fasting insulin: a positive correlation for Torres Strait Islanders aged 15,29 years, and an inverse correlation for Aborigines aged 40 years and older. Conclusion Torres Strait Islanders and Aborigines had very high prevalences of the MS. Specific population characteristics (high prevalences of central obesity, dyslipidaemia, renal disease) may make the WHO definition preferable to the ATPIII definition in these population groups. The poor agreement between criteria suggests a more precise definition of the metabolic syndrome that is applicable across populations is required. This study showed an inverse relationship with age for the correlation of BP and fasting insulin. [source] | |||||||||||||||||||