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Worldwide Problem (worldwide + problem)
Selected AbstractsUnderdiagnosis of Vertebral Fractures Is a Worldwide Problem: The IMPACT StudyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2005Pierre D Delmas MD Abstract Accurate radiographic diagnosis of vertebral fractures is important. This multicenter, multinational study assessed radiographic diagnoses of vertebral fracture in 2451 postmenopausal women with osteoporosis. Comparison between local and central readings yielded a false-negative rate of 34%. Underdiagnosis of vertebral fracture is a worldwide problem. Introduction: Vertebral fractures are the most common complication of osteoporosis. Although they are associated with significant morbidity, they frequently do not come to clinical attention. Accurate radiographic diagnosis is important. Materials and Methods: In a multicenter, multinational prospective study (the IMPACT trial), the accuracy of radiographic diagnosis of vertebral fracture was evaluated in postmenopausal women 65,80 years of age newly diagnosed with osteoporosis (based on BMD measurement). Lateral radiographs of the thoracolumbar spine were evaluated for identification of vertebral fractures, first locally and subsequently at a central reading center, using a validated semiquantitative method. False-positive and false-negative rates were calculated based on adjudicated discrepancies between the initial interpretation at the local site and the subsequent central reading, considered the "reference standard." Results: Of 2451 women with an evaluable radiograph both centrally and locally, 789 (32%) had at least one vertebral fracture. Adjudicated discrepancies (n = 350 patients) between local and central readings because of undetected vertebral fracture (68%) or equivocal terminology in the local radiology report (32%) yielded a false-negative rate of 34%. Conclusions: Underdiagnosis of vertebral fractures was observed in all geographic regions (false-negative rates: North America, 45.2%; Latin America, 46.5%; Europe/South Africa/Australia, 29.5%). The false-positive rate was 5% globally. Underdiagnosis of vertebral fracture is a worldwide problem attributable in part to a lack of radiographic detection, use of ambiguous terminology in the radiology report, or both. Efforts to improve accuracy and reduce variability in terminology and interpretation may increase the effectiveness of spinal radiography for detecting vertebral fractures in patients with osteoporosis. [source] Gastric cancer: Worldwide burden and prevention opportunitiesJOURNAL OF DIGESTIVE DISEASES, Issue 3 2005Sidney J WINAWER Gastric cancer is a major worldwide problem in developing and developed countries. It contributes substantially to the economic medical resource burden and population mortality in many countries. The absolute numbers of new cases of death are expected to increase significantly over the next decades because of the enlarging and aging of the world population. The putative factors are better understood today, and control of these factors, together with screening can help prevent this cancer from becoming an increasing burden to society. [source] Development of an Antibody Hapten-Chip System for Detecting the Residues of Multiple Antibiotic Drugs,JOURNAL OF FORENSIC SCIENCES, Issue 4 2009Ailiang Chen M.Sc. Abstract:, The abuse of antibiotic drugs during animal production remains a worldwide problem and the subsequent detection of the residues of various drugs present at low concentrations in complex biological matrices poses significant analytical challenges. The present study outlines a practical biochip assay system to identify antibiotic residues in different animal tissue extracts. The system uses a simple but efficient multiresidue sample extraction procedure to isolate the antibiotic residues which were then identified directly using high-affinity monoclonal antibodies presented in a competitive immunoassay with conjugated antibiotic hapten-chips. The hapten-chip can analyze six samples each for eight antibiotics on a single chip within 3 h. The analytical results with both artificial positive standard samples and the incurred samples show that the antibody hapten-chip system has a comparable accuracy and a similar sensitivity to a standard ultra performance liquid chromatography,mass spectrometry (MS)/MS assay. In conclusion, an effective analytical screening system based on antibody hapten-chip was developed for detecting multiple antibiotic residues from multiple samples. [source] Financial Costs of Alcoholism Treatment Programs: A Longitudinal and Comparative Evaluation Among Four Specialized CentersALCOHOLISM, Issue 1 2003B. Nalpas Background: Alcoholism is a worldwide problem. Many strategies for alcohol detoxification and relapse prevention exist, but each alcohol treatment center has its own program. The objective of this study was to analyze and compare the financial cost and effectiveness of alcohol treatment programs from inpatient stay to follow-up 1 year later. This was a prospective, open, nonrandomized study of 4 specialized alcohol treatment centers and 267 patients admitted for alcohol detoxification. Methods: We recorded all medical and nonmedical interventions related to the program during patient stay in the hospital and every 3 months after discharge for 1 year and recorded the occurrence of alcohol relapse. Financial evaluation was based on the prices of refund from the French national health insurance service. Results: The mean cost of hospitalization ranged from ,1326 to ,1917 (p= 0.001), a variation mainly due to the difference in the length of hospital stay but also to the cost of the inpatient program, routine medical checkups, and drugs administered. The mean cost of 1 year of follow-up per patient ranged from ,419 to ,1704 (p= 0.001). The efficiency, corresponding to the money spent to prevent the relapse of one patient during 1 month, was approximately ,500/month in three centers and ,658 in the fourth. However, for a similar efficiency, the effectiveness, assessed by the mean time without relapse, was significantly (p= 0.001) different; center 1, which had the highest total cost, had an effectiveness 1.56 times higher than center 3, which had the lowest cost. Conclusions: This work emphasizes the heterogeneity of the costs and effectiveness of alcoholism treatment programs and suggests that research should be conducted to determine which program is the most rational, cost-efficient, and beneficial for patients and the public health office economy. [source] The anti-allergenic properties of milk kefir and soymilk kefir and their beneficial effects on the intestinal microfloraJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 15 2006Je-Ruei Liu Abstract Food allergy is now recognized as a worldwide problem, and like other atopic disorders its incidence appears to be increasing. Kefir is reported to possess the ability to reduce intestinal permeation of food antigens; however, no experimental study has clearly evaluated the relationships between kefir consumption, allergen-specific IgE response, and intestinal microflora. The aim of this study was to evaluate the effect of oral consumption of milk kefir and soymilk kefir on in vivo IgE and IgG1 production induced by ovalbumin (OVA) in mice. The effects of kefir administration on the murine intestinal microflora were also examined. Oral administration of milk kefir and soymilk kefir for 28 days significantly increased the fecal populations of bifidobacteria and lactobacilli, while it significantly decreased those of Clostridium perfringens. Milk kefir and soymilk kefir also significantly decreased the serum OVA-specific IgE and IgG1 levels for both groups, but not those of the IgG2a analogues. Consumption of milk kefir and soymilk kefir suppressed the IgE and IgG1 responses and altered the intestinal microflora in our supplemented group, suggesting that milk kefir and soymilk kefir may be considered among the more promising food components in terms of preventing food allergy and enhancement of mucosal resistance to gastrointestinal pathogen infection. Copyright © 2006 Society of Chemical Industry [source] The Association Between Emergency Department Crowding and Adverse Cardiovascular Outcomes in Patients with Chest PainACADEMIC EMERGENCY MEDICINE, Issue 7 2009Jesse M. Pines MD Abstract Objectives:, While emergency department (ED) crowding is a worldwide problem, few studies have demonstrated associations between crowding and outcomes. The authors examined whether ED crowding was associated with adverse cardiovascular outcomes in patients with chest pain syndromes (chest pain or related complaints of possible cardiac origin). Methods:, A retrospective analysis was performed for patients ,30 years of age with chest pain syndrome admitted to a tertiary care academic hospital from 1999 through 2006. The authors compared rates of inpatient adverse outcomes from ED triage to hospital discharge, defined as delayed acute myocardial infarction (AMI), heart failure, hypotension, dysrhythmias, and cardiac arrest, which occurred after ED arrival using five separate crowding measures. Results:, Among 4,574 patients, 251 (4%) patients developed adverse outcomes after ED arrival; 803 (18%) had documented acute coronary syndrome (ACS), and of those, 273 (34%) had AMI. Compared to less crowded times, ACS patients experienced more adverse outcomes at the highest waiting room census (odds ratio [OR] = 3.7, 95% confidence interval [CI] = 1.3 to 11.0) and patient-hours (OR = 5.2, 95% CI = 2.0 to 13.6) and trended toward more adverse outcomes during time of high ED occupancy (OR = 3.1, 95% CI = 1.0 to 9.3). Adverse outcomes were not significantly more frequent during times with the highest number of admitted patients (OR = 1.6, 95% CI = 0.6 to 4.1) or the highest trailing mean length of stay (LOS) for admitted patients transferred to inpatient beds within 6 hours (OR = 1.5, 95% CI = 0.5 to 4.0). Patients with non-ACS chest pain experienced more adverse outcomes during the highest waiting room census (OR = 3.5, 95% CI = 1.4 to 8.4) and patient-hours (OR = 4.3, 95% CI = 2.6 to 7.3), but not occupancy (OR = 1.8, 95% CI = 0.9 to 3.3), number of admitted patients (OR = 0.6, 95% CI 0.4 to 1.1), or trailing LOS for admitted patients (OR = 1.2, 95% CI = 0.6 to 2.0). Conclusions:, There was an association between some measures of ED crowding and a higher risk of adverse cardiovascular outcomes in patients with both ACS-related and non,ACS-related chest pain syndrome. [source] Does stand structure influence susceptibility of eucalypt floodplain forests to dieback?AUSTRAL ECOLOGY, Issue 3 2010SHAUN C. CUNNINGHAM Abstract Forest dieback is a worldwide problem that is likely to increase with climate change and increasing human demands for resources. Eucalyptus camaldulensis forests are an acute example of forest dieback, with 70% of the Victorian Murray River floodplain in some state of dieback. If we are to halt dieback in these floodplain forests, we need to understand what makes stands susceptible to dieback. Forest diebacks are often related to stand structure, with dieback more severe in senescent or high-density stands. We determined whether certain stand structures make these forests more susceptible to dieback. We undertook an extensive survey of 176 stands across 100 000 ha of forest, covering the range of stand condition on this floodplain. Large and small trees (20-, 40-, 80- and 120-cm diameter) showed a similar reduction in the probability of being alive with decreasing stand condition. A slight improvement in stand condition was found at higher densities and basal areas, which may reflect the higher productivity or younger age of these stands. Stand condition was moderately, positively correlated with longitude, with stand condition being higher in the east of the Murray River floodplain where flooding frequencies are currently higher. This suggests that dieback of these floodplain forests would be more effectively mitigated by increased water availability through flooding than by altering stand structure. [source] | |||||||||||||