Epidemiology Commons^™

Adiposity And The Development Of Premenstrual Syndrome, Elizabeth Bertone-Johnson, Susan Hankinson, Walter Willett, Susan Johnson, Joann Manson

Elizabeth R. Bertone-Johnson

Background Moderate to severe premenstrual syndrome (PMS) affects 8%–20% of premenopausal women and causes substantial levels of impairment, but few modifiable risk factors for PMS have been identified. Adiposity may impact risk through the complex interaction of hormonal and neurochemical factors, but it is not known if adiposity increases a woman's risk of developing PMS. We have addressed these issues in a prospective study nested within the Nurses' Health Study 2. Methods Participants were a subset of women aged 27–44 and free from PMS at baseline, including 1057 women who developed PMS over 10 years of follow-up and 1968 controls. …

Pufa And Vitamin D And Type 2 Diabetes Inflammatory Markers, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Similarities And Differences In Health Care Use And Hiv-Related Concerns Based On Immigration Profile: Findings From The Blacch Study Interviews, Shamara M. Baidoobonso, Harina Mokanan, Monica Abdelkader, Greta Bauer

Shamara M Baidoobonso, PhD

Background and Objectives: Most HIV and health studies in African, Caribbean and Black (ACB) communities occur in large urban centres and rarely examine how the interactions between race, migration, gender, HIV-related stigma, service use and multiple dimensions of social position interact and act individually to affect health and HIV vulnerability. This lack of information negatively impacts HIV prevention efforts for ACB communities. This analysis explores the HIV-related experiences of people from different immigration classes. Methods: Using a community-based approach, a purposive sample of 22 ACB community members were interviewed to collect information about health-related experiences in London, Ontario. Respondents represented …

Introducing The Black, African And Caribbean Canadian Health (Blacch) Study, Shamara M. Baidoobonso, Harina Mokanan, Mercy Nleya-Ncube, Greta Bauer

Shamara M Baidoobonso, PhD

Background and Objectives: African, Caribbean and other Black (ACB) persons account for an increasing proportion of new HIV cases in Canada, and are 12.6 times more likely to acquire HIV than the rest of Canada’s population. Few studies have fully acknowledged the ethnic, religious and socioeconomic diversity in ACB communities. Also, studies have rarely considered the social determinants of health and broader context in which ACB persons live and access health services, and how these may potentially impact HIV vulnerability. This lack of information negatively impacts HIV prevention and care efforts. The Black, African and Caribbean Canadian Health (BLACCH) Study …

Highlighting The Social Determinants Of Health As They Pertain To Africans In London, Ontario, Shamara M. Baidoobonso

Shamara M Baidoobonso, PhD

No abstract provided.

What Are The Factors That Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, P. Tai, R. Malthaner, L. Stitt, G. Rodrigues, R. Dar, B. Yaremko, J. Younus, M. Sanatani, M. Vincent, B. Dingle, D. Fortin, R. Inculet

Edward Yu

OBJECTIVES: The present study investigated factors affecting outcome at relapse after previous surgery and adjuvant chemoradiation (crt) in high-risk esophageal cancer patients. PATIENTS AND METHODS: From 1989 to 1999, we followed high-risk resected esophageal cancer patients who had completed postoperative crt therapy. Patients who relapsed with a disease-free interval of less than 3 months were treated with palliative crt when appropriate. Patients with a disease-free interval of 3 months or more were treated with best supportive care. Post-recurrence survival was estimated using the Kaplan-Meier technique, and statistical comparisons were made using log-rank chi-square tests and Cox regression. RESULTS: Of the …

Update On The Management Of Chronic Obstructive Pulmonary Disease, Andrea K. Maas, David M. Mannino

David M. Mannino

Chronic obstructive pulmonary disease is a highly prevalent, underdiagnosed, and undertreated chronic lung disease. Early and appropriate treatment may help modify the course of the disease with respect to exacerbation timing and frequency, quality of life, and mortality. Steady progress continues to be made in understanding the disease pathogenesis and treatment modalities, and there is some evidence that outcomes are improving.

Smoking During Pregnancy And Risk Of Abnormal Glucose Tolerance: A Prospective Hohort Study, Lisa Chasan-Taber, Amy E. Haskins, Elizabeth R. Bertone-Johnson, Penelope Pekow, Elena Carbone, Renée T. Fortner

Lisa Chasan-Taber

Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 …

Smoking During Pregnancy And Risk Of Abnormal Glucose Tolerance: A Prospective Hohort Study, Amy E. Haskins, Elizabeth R. Bertone-Johnson, Penelope Pekow, Elena Carbone, Renée T. Fortner, Lisa Chasan-Taber

Elizabeth R. Bertone-Johnson

Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 …

Exposure To Indoor Biomass Fuel Pollutants And Asthma Prevalence In Southeastern Kentucky: Results From The Burden Of Lung Disease (Bold) Study, Anna C. Barry, David M. Mannino, Claudia Hopenhayn, Heather Bush

David M. Mannino

BACKGROUND:

Asthma is a chronic inflammatory respiratory disease, characterized by episodic and reversible airflow obstruction and airway hyperresponsiveness and is influenced by both genetic and environmental factors.

METHODS:

The Burden of Obstructive Lung Disease (BOLD) survey was used to determine the prevalence of self-reported asthma in a target population of 325,000 adults aged > or =40 in Southeastern Kentucky. Postbronchodilator spirometry was used to classify subjects based on lung function. Risk factors for asthma in this population, in particular indoor usage of biomass fuels, were evaluated.

RESULTS:

The overall study population was comprised of 508 individuals, with 15.5% reporting current asthma …

Perfil Dos Acidentes De Trabalho No Brasil, 2004-2007 / Analysis Of Labor Accidents In Brazil, 2004 - 2007, Everton Fernando Alves

Everton Fernando Alves

Neste estudo sintetizam-se achados epidemiológicos de morbi- mortalidade decorrentes de acidentes de trabalho napopulação brasileira. O objetivo do estudo é descrever o perfil dos acidentes de trabalho no Brasil entre 2004 e 2007. Trata-se de um estudo descritivoexploratório utilizando como fonte de dados a estatística anual de acidentes do trabalho da Previdên- cia Social. Foram notificados 465.700 mil acidentesem 2004 e 653.090 em 2007, mostrando uma tendência ascendente nos acidentes com trabalhado- res formais no Brasil. Evidenciou-se que o estado de residência com maior acidentabilidade foi Santa Catarina com uma média de 577,3 acidentes para cada 100.000 trabalhadores. O aumento …

Using Multiple Sources Of Data To Assess The Prevalence Of Diabetes At The Subcounty Level, Duval County, Florida, 2007, William C. Livingood, Luminita Razaila, Elena Reuter, Rebecca Filipowicz, Ryan C. Butterfield, Katryne Lukens-Bull, Linda Edwards, Carlos Palacio, David L. Wood

David L. Wood

Distribution Of Health Care Expenditures For Hiv-Infected Patients, Ray Y. Chen, Neil A. Accortt, Andrew O. Westfall, Michael J. Mugavero, James L. Raper, Gretchen A. Cloud, Beth K. Stone, Jerome Carter, Stephanie Call, Maria Pisu, Jeroan J. Allison, Michael S. Saag

Jeroan J. Allison

BACKGROUND: Health care expenditures for persons infected with human immunodeficiency virus (HIV) in the United State determined on the basis of actual health care use have not been reported in the era of highly active antiretroviral therapy.

METHODS: Patients receiving primary care at the University of Alabama at Birmingham HIV clinic were included in the study. All encounters (except emergency room visits) that occurred within the University of Alabama at Birmingham Hospital System from 1 March 2000 to 1 March 2001 were analyzed. Medication expenditures were determined on the basis of 2001 average wholesale price. Hospitalization expenditures were determined on …

Trends In Aids-Defining And Non-Aids-Defining Malignancies Among Hiv-Infected Patients: 1989-2002, Roger Bedimo, Ray Y. Chen, Neil A. Accortt, James L. Raper, Carol Linn, Jeroan J. Allison, John Dubay, Michael S. Saag, Craig J. Hoesley

Jeroan J. Allison

In a comparison of rates of acquired immunodeficiency syndrome (AIDS)-defining malignancies (ADMs) for 1989-1996 versus 1997-2002, we found a decrease in ADMs (rate ratio, 0.31; P<.0001) and a significant increase in non-AIDS-defining malignancies (non-ADMs; rate ratio, 10.87; P<.0002). The mean CD4 cell count was lower among patients with ADMs than among those with non-ADMs. A longer duration of survival during highly active antiretroviral therapy might explain the increasing incidence of non-ADMs.

A Stepwise Approach To Stroke Surveillance In Brazil: The Emma (Estudo De Mortalidade E Morbidade Do Acidente Vascular Cerebral) Study, Paulo A. Lotufo

Paulo A Lotufo

Background: Stroke mortality rates in Brazil are the highest in the Americas. Deaths from cerebrovascular disease surpass coronary heart disease. Aim: To verify stroke mortality rates and morbidity in an area of Sa˜o Paulo, Brazil, using the World Health Organization Stepwise Approach to Stroke Surveillance. Methods: We used the World Health Organization Stepwise Approach to Stroke Surveillance structure of stroke surveillance. The hospital-based data comprised fatal and nonfatal stroke (Step 1). We gathered stroke-related mortality data in the community using World Health Organization questionnaires (Step 2). The questionnaire determining stroke prevalence was activated door to door in a family-healthprogramme neighbourhood …

Controle De Infecção Em Clínicas De Cirurgia Plástica / Infection's Control In Plastic Surgery Clinics, Everton Fernando Alves

Everton Fernando Alves

A infecção é a mais frequente e grave complicação que acomete pacientes que procuram serviços estéticos e/ou funcionais em clínicas de cirurgia plástica. Uma infecção hospitalar eleva os custos do processo, tanto para o paciente quanto para a empresa. Diante disso, torna-se importante a instalação de uma comissão de controle de infecção hospitalar, tendo como responsável um enfermeiro. A importância deste profissional se dá por meio da organização da Central de Material Estarilizado (CME), bem como do estabelecimento de outras medidas efetivas para a prevenção e controle de infecções nas clínicas apresentadas ao longo desse artigo.

Pilot Study Of The Characteristics Of Acute Stroke Events In Patients Discharged From The Carolina University Hospital, Puerto Rico In 2007, Juan Carlos Zevallos, Juan Gonzalez, Fernando Santiago, Rafael Rodriguez, Ada Rivera, Ana Michelle Garcia, Felixa Flecha, Marielys Colon, Jorge L. Yarzebski

Jorge L. Yarzebski

BACKGROUND: Stroke is the third leading cause of death in Puerto Rico. We examined the pre-hospital phase, management and case-fatality-rates (CFR) of patients discharged with acute stroke from the Carolina University of Puerto Rico Hospital during 2007.

METHODS: Trained personnel collected information on demographics, delay-time, mode-of-transportation, management, and mortality from all medical records. STATAa was utilized to conduct univariate comparison of demographics, mode-of-transportation, therapeutics and diagnostic characteristics. Logistic regression analysis assessed cohort effect and controlled for confounders.

RESULTS: The average age was 69.1 years, and 53% were males. The average delay between onset of symptoms suggestive of stroke and arrival …

Overview Of The Essential Tremor, Theresa A. Zesiewicz, Abinaya Chari, Israt Jahan, Amber M. Miller, Kelly L. Sullivan

Kelly L. Sullivan

Essential tremor (ET) is one of the most common movement disorders in the world. Despite this, only one medication (propranolol) is approved by the Food and Drug Administration (FDA) to treat it. Fortunately, recent studies have identified some additional medications as treatment of ET. Surgical procedures, such as deep brain stimulation of the ventral intermediate nucleus of the thalamus, offer treatment for refractory tremor. The epidemiology, pathogenesis, and medical and surgical treatment of ET will be discussed in this paper.

Qualidade De Vida De Estudantes De Enfermagem De Uma Faculdade Privada / Quality Of Life Of Undergraduate Nursing Students From A Private University, Everton Fernando Alves

Everton Fernando Alves

O presente estudo teve como objetivo avaliar a qualidade de vida dos estudantes no curso de Enfermagem de uma faculdade privada. Realizou-se um estudo descritivo, com abordagem quantitativa, utilizando a Escala de Qualidade de Vida de Flanagan e um instrumento de coleta de dados complementares, contendo questões estruturadas. Resultou numa amostra de 192 (cento e noventa e dois) estudantes. O diagnóstico evidenciou que a maioria dos estudantes está „Satisfeitos‟ e „Pouco satisfeitos‟ com a sua qualidade de vida, entretanto identificou a presença de vários problemas que necessitam de atenção dos educadores. Concluiu-se que se faz necessária a formação de um …

Validation Of A Stroke Symptom Questionnaire For Epidemiological Surveys., Paulo A. Lotufo

Paulo A Lotufo

CONTEXT AND OBJECTIVE:Stroke is a relevant issue within public health and requires epidemiological surveillance tools. The aim here was to validate a questionnaire for evaluating individuals with stroke symptoms in the Stroke Morbidity and Mortality Study (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral, EMMA), São Paulo, Brazil.DESIGN AND SETTING:This was a cross-sectional study performed among a sample of the inhabitants of Butantã, an area in the western zone of the city of São Paulo.METHODS:For all households in the coverage area of a primary healthcare unit, household members over the age of 35 years answered a stroke symptom questionnaire …

Plasma Prekallikrein Levels Are Positively Associated With Circulating Lipid Levels And The Metabolic Syndrome In Children., James A. Mackenzie, Kristen A. Roosa, Brooks B. Gump, Amy K. Dumas, Kestutis G. Bendinskas

Brooks B. Gump

Plasma prekallikrein (PK) has been shown to be associated with cardiovascular disease (CVD) and its risk factors, but these associations have not been investigated in children. The present study examined PK activity in relation to well-established cardiovascular risk factors in a cohort of children aged 9–11 years (N = 97). We found a significant and positive association between PK and fasting levels of total cholesterol (p < 0.01), non-high-density lipoprotein cholesterol (p < 0.01), and triglycerides (p < 0.001). In addition, there was a significant association between PK activity and the metabolic syndrome, a clustering of risk factors considered to have an impact on atherosclerosis and CVD mortality. Finally, we found that children with a family history of CVD had significantly elevated PK activity. These novel findings warrant further investigations into the relationship between circulating PK levels and CVD risk factors because PK may be involved in the progression of the disease state. Il est bien connu que la pre´kallicre´ine (PK) est associe´e a` la maladie cardiovasculaire (CVD) et a` ses facteurs de risque, mais ces associations n’ont pas e´te´ ve´rifie´es chez les enfants. Cette e´tude se propose de ve´rifier l’association entre l’activite´ de la PK et les facteurs de risque de CVD aupre`s d’une cohorte d’enfants aˆge´s de 9 a` 11 ans (N = 97). On observe une corre´lation positive significative entre la PK et les variables suivantes : la concentration totale de choleste´rol a` jeun (p < 0,01), les concentrations des lipoprote´ines non a` haute densite´ (p < 0,01) et la concentration des triglyce´rides (p < 0,001). De plus, on observe une corre´lation significative entre l’activite´ de la PK et le syndrome me´tabolique constitue par un ensemble de facteurs ayant un effet sur l’athe´roscle´rose et la mortalite´ due a` la CVD. En dernier lieu, les enfants avec des ante´ce´dents familiaux de CVD pre´sentent une plus importante activite´ de la PK, et ce, de fac¸on significative. Ces premie`res observations sugge`rent d’autres e´tudes sur la relation entre la concentration sanguine de PK et les facteurs de risque de CVD, car la PK pourrait eˆtre implique´e dans la progression de la maladi

Recent Trends In Exposure To Secondhand Smoke In The United States Population, Chieh-I Chen, Tanya Burton, Christine L. Baker, Vera Mastey, David M. Mannino

David M. Mannino

Background Previous research using the National Health and Nutrition Examination Surveys (NHANES) data documented a significant downward trend in secondhand smoke (SHS) exposure between 1988 and 2002. The objective of this study was to assess whether the downward trend in exposure continued from 2001 through 2006.

Methods We analyzed data from the 2001-2006 NHANES to estimate exposure of nonsmokers to SHS. Geometric means of serum cotinine levels for all nonsmokers were computed.

Results Overall serum cotinine levels (95% Confidence Intervals) in 2001-2002, 2003-2004, and 2005-2006 were 0.06 ng/mL (0.05-0.07), 0.07 ng/mL (0.06-0.09), and 0.05 ng/mL (0.05-0.06), respectively. Subgroup analysis by …

Interventions To Improve Excreta Disposal For Preventing Diarrhoea, Thomas F. Clasen, Kristof Bostoen, Wolf-Peter Schmidt, Sophie Boisson, Isaac Chun-Hai Fung, Marion W. Jenkins, Beth Scott, Steven Sugden, Sandy Cairncross

Isaac Chun-Hai Fung

Background: Diarrhoeal diseases are a leading cause of mortality and morbidity, especially among young children in low-income countries, and are associated with exposure to human excreta.
Objectives: To assess the effectiveness of interventions to improve the disposal of human excreta for preventing diarrhoeal diseases.
Search Strategy: We searched the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in The Cochrane Library; MEDLINE; EMBASE; LILACS; the metaRegister of Controlled Trials (mRCT); and Chinese-language databases available under the Wan Fang portal, and the China National Knowledge Infrastructure (CNKI-CAJ). We also handsearched relevant conference proceedings, and …

Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Reduction Of Circulating Endothelial Cells In Peripheral Blood Of Als Patients, Svitlana Garbuzova-Davis, Robert L. Woods Iii, Michael K. Louis, Theresa A. Zesiewicz, Nicole Kuzmin-Nichols, Kelly L. Sullivan, Amber M. Miller, Diana G. Hernandez-Ontiveros, Paul R. Sanberg

Kelly L. Sullivan

Background: Amyotrophic Lateral Sclerosis (ALS) treatment is complicated by the various mechanisms underlying motor neuron degeneration. Recent studies showed that the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB) are compromised in an animal model of ALS due to endothelial cell degeneration. A later study demonstrated a loss of endothelium integrity in the spinal cords of ALS patients. Since circulating endothelial cells (CECs) in the peripheral blood are associated with endothelium damage, being detached dysfunctional endothelial cells, we hypothesized that CEC levels may reflect endothelium condition in ALS patients.
Methodology/Principal Findings: CEC levels were estimated in whole blood smears from …

Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo

Paulo A Lotufo

Cancer are not surpassing Cardiovascular Diseases. Here you have an evaluation of mortality in Brazil. The debate was ignited by paper from IARC (International Agency for Research on Cancer) that forecasts cancer deaths surpassing heart diseases rates during de 2020’s. There is no dispute about the fact that - at least in the US and other countries - the decline of mortality deaths for heart diseases presenting a faster pace compared to cancer death rates. It is an epidemiological evidence that must be analyzed and some headline fueling hype as “heart diseases as an old agenda of public health and …

Effects Of Duration Of Untreated Psychosis On Long-Term Outcome Of People Hospitalized With First Episode Schizophrenia, Amresh Shrivastava, Nilesh Shah, Megan Johnston, Larry Stitt, Meghana Thakar, Gurusamy Chinnasamy

Amresh Srivastava

Duration of untreated psychosis (DUP) has emerged as a reliable predictor of outcome but continues to remain under scientific scrutiny. The present study examines the effect of differential periods of DUP on long-term outcome of first episode schizophrenia at Mumbai, India. This research was a prospective, 10-year follow-up naturalistic study. Hospitalized patients of first episode schizophrenia were selected and followed up. Results showed that the mean DUP was higher for a group which showed clinical recovery on Clinical Global Impression Scale [14.0 months (SD=8.0) in recovered and 10.8 months (SD=5.7) in non-recovered group (P=0.091)]. DUP was not found to be …

The Black, African And Caribbean Canadian Health (Blacch) Study: Laying The Foundation For Conducting Hiv Epidemiologic Studies With Ethno-Racial Minority Communities In Understudied Urban-Rural Locales, Shamara M. Baidoobonso, Greta Bauer

Shamara M Baidoobonso, PhD

Challenge: London reportedly has Ontario’s third-highest HIV infection rate, and a small (2.2%) but growing African, Caribbean and other Black (ACB) population. These diverse communities historically faced racism, exploitation and social exclusion, which have lasting impacts. Although a target population for HIV prevention, they are difficult to reach for research and programming, especially in London and similar urban-rural locales with few ACB-specific resources. In ACB communities, HIV is most commonly spread through heterosexual contact, yet cultural and religious norms often discourage discussions about sex and sexuality, whether normative or non-normative. Homophobia, racism and HIV-related stigma discourage ACB persons from seeking …

Water, Sanitation And Hygiene For The Prevention Of Diarrhoea, Sandy Cairncross, Caroline Hunt, Sophie Boisson, Kristof Bostoen, Val Curtis, Isaac Chun-Hai Fung, Wolf-Peter Schmidt

Isaac Chun-Hai Fung

Background: Ever since John Snow's intervention on the Broad St pump, the effect of water quality, hygiene and sanitation in preventing diarrhoea deaths has always been debated. The evidence identified in previous reviews is of variable quality, and mostly relates to morbidity rather than mortality.
Methods: We drew on three systematic reviews, two of them for the Cochrane Collaboration, focussed on the effect of handwashing with soap on diarrhoea, of water quality improvement and of excreta disposal, respectively. The estimated effect on diarrhoea mortality was determined by applying the rules adopted for this supplement, where appropriate.
Results: The striking effect …