Drug-induced uveitis. Incidence, prevention and treatment

A study was made of all homicide deaths among black Americans during the period 1979-1991 in order to test two competing hypotheses about region of birth and region of death. One hypothesis was that Southern-born blacks had the highest homicide rates in every region of the US. The competing hypothesis was that blacks who did not migrate out of their region of birth had the highest homicide rates. We found that Southern-born blacks had the highest homicide rates among the population 35+ years old in the Northeast, Midwest, South and West. Yet non-migrants (region-born population) had higher rates than their Southern-born counterparts among the population 15-34 years old. Long distance migrants who were born in the Northeast, West or were foreign-born had the lowest homicide rates, by far. The distressing implications of these findings for public health efforts to prevent violent death are discussed.     

Incidence and prevalence of eye cancer

A three and one half-year-old female with Melnick-Needles osteodysplasia is presented. In addition to the characteristic bone roengenograms and obstructive uropathy, the patient had inadequate formation of bone marrow elements and pulmonary arter hypertension.     

Incidence and prevalence of lameness in dairy cattle

A survey was made of 37 dairy farms in Wirral, mid-Cheshire, mid-Somerset and Dyfed, Wales, to assess the incidence and prevalence of lameness in the cows between May 1989 and September 1991. The incidence was obtained from records made whenever a cow was examined for lameness or received preventive foot-trimming. The mean annual incidence was 54.6 new cases per 100 cows with a range from 10.7 to 170.1 and the mean values during summer and winter were 22.9 and 31.7, respectively. The prevalence of lameness was measured by regular visits at which locomotion was scored on a scale of 1 to 5, and the prevalence of lameness was calculated for each visit as the proportion of cows with scores of 3 or more. The mean annual prevalence over the whole period was 20.6 per cent with a range from 2.0 to 53.9 per cent for the 37 farms. The mean prevalences during summer and winter were 18.6 and 25.0 per cent, respectively. The prevalence measured at a single visit in midsummer or midwinter was significantly correlated with the mean prevalence over the whole corresponding period and may be useful as an assessment of the extent of lameness in a herd and the efficacy of control measures. There was evidence that training farmers to recognise early cases of lameness and request veterinary treatment resulted in a marked reduction in the duration of cases of lameness.     

Incidence and prevalence of autoimmune liver diseases

We studied prevalence and incidence of autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis in a Norwegian population. A search in patient databases was performed and medical records from the period 1985-94 were reviewed. Commonly accepted diagnostic criteria were used for inclusion. All three diseases were found to be rare, with a marked female preponderance in primary biliary cirrhosis (female 21/male 0) and to a lesser extent in autoimmune hepatitis (female 20/male 9). The age distribution shows that autoimmune hepatitis and primary sclerosing cholangitis are diagnosed in patients who are on an average 12 years younger than patients with primary biliary cirrhosis. The mean annual incidence was 1.6/100,000 for autoimmune hepatitis, 1.2/100,000 for primary biliary cirrhosis and 0.7/100,000 for primary sclerosing cholangitis. The end of study point prevalence was 14/100,000, 12/100,000 and 5.6/100,000, respectively.     

Incidence of rheumatoid arthritis in Finland during 1980-1990

OBJECTIVE: To obtain information on the incidence of rheumatoid arthritis and on its recent trends in Finland. METHODS: The study covered those subjects entitled to receive specially reimbursed medication for rheumatoid arthritis under the nationwide sickness insurance scheme in five out of 21 central hospital districts in Finland (population basis about one million adults) during three years: 1980, 1985, and 1990. RESULTS: The annual incidence of rheumatoid arthritis in 1980 and 1985, satisfying the American Rheumatism Association 1987 classification criteria, was 39/100,000 of the population > or = 16 years of age. The combined incidence of rheumatoid factor (RF) positive arthritis and RF negative polyarthritis was 46/100,000. A decline of approximately 40% occurred in the number of RF negative rheumatoid arthritis cases in 1990 compared with the earlier years. The declining trend was statistically significant (P = 0.008). CONCLUSION: The decline in incidence of RF negative rheumatoid arthritis in Finland may reflect changes in the environment specifically affecting the risk of RF negative disease.     

Incidence and prevalence of symptomatic celiac disease among adults in Denmark

The purpose was: 1) to determine annual incidence rates of adult coeliac disease, 2) to calculate the risk of having developed coeliac disease in adult life, and 3) to calculate the life time prevalence by five-year birth cohorts. All patients fulfilling defined criteria for adult coeliac disease living in the county of Copenhagen and diagnosed during the years 1976-1991 were included. The reference population consisted of 503,283 subjects. The overall incidence had been stable during the period, and was 1.27/10(5). The figures for females and males were 1.55/10(5) and 0.96/10(5), respectively (p = 0.04). The median (range) age at the time of diagnosis was 40.1 (16-81). Age specific incidence rates varied considerably, with the peak rate located in the middle-aged population. The incidence rates were influenced by age at diagnosis (p = 0.01) and sex (p = 0.04), but not by the year when diagnosed. For a subject aged 89 years, the risk was 0.88/1000. The overall prevalence was 45.9/10(5). In conclusion, this incidence/prevalence is one of the lowest reported, and is definitely lower than prevalences reported from our neighbouring Scandinavian countries. Nothing points to higher incidence rates being present in Danish adults to compensate for the previously demonstrated very low rates in Danish children.     

Drug-induced pseudolymphoma and hypersensitivity syndrome. Two different clinical entities

OBJECTIVE: To test the hypothesis that drug-induced pseudolymphoma and hypersensitivity syndrome are 2 distinct clinical entities. DESIGN: Retrospective study from 1980 to 1993. SETTING: Departments of dermatology and medicine of 5 referral universitary hospitals. PATIENTS: Twenty-four patients who met arbitrary criteria selected as being suggestive of lymphoma, with probable drug cause. Patients with other definite cutaneous drug-induced eruptions were excluded. INTERVENTION: None. MAIN OUTCOME MEASURES: Suspect drugs; clinical, biological, and pathological findings; and evolution of each case and of 110 published case reports. RESULTS: Two groups were separated according to their mode of onset and clinical aspect. Three patients (and 15 cases in the literature) had subacute papulonodular or infiltrated plaques, without visceral involvement. Skin biopsy specimens showed a dense lymphocytic infiltrate mimicking lymphoma. Healing was constant when the drug was stopped. The 21 remaining patients (and 95 published cases) had an acute widespread eruption, with fever, enlarged lymph nodes, and multivisceral involvement. Lymphocytosis, atypical lymphocytes, eosinophilia, hepatitis, and high levels of lactate dehydrogenase were frequent. Skin biopsy findings were usually not specific (lymphocytic infiltrate and keratinocyte necrosis) but sometimes mimicked lymphoma. Severe forms and relapses occurred, even after the drug was stopped. The inducing drugs were the same in the 2 groups. CONCLUSIONS: These 2 groups correspond to drug-induced pseudolymphoma and hypersensitivity syndrome. We think that they are 2 distinct entities with different clinical and biological features and outcome, even if the pathological findings are sometimes similar. Prospective studies are needed to confirm these facts, to evaluate the therapy, and to follow up patients.     

Incidence and prevalence of juvenile chronic arthritis in East Berlin 1980-88

OBJECTIVE: To estimate the incidence and prevalence rates of juvenile chronic arthritis (JCA). METHODS: The study population was children under 16 years of age living in the East Berlin area (part of the former German Democratic Republic). By admission order that was effective up to 1990, all children with symptoms of a rheumatic disease living in the East Berlin area had to be referred to the 2nd Children's Hospital at Berlin-Buch. This specific condition allowed us to ascertain cases from the clinical records and to calculate population rates. Based upon this data, the results of surveys with different methods of case ascertainment are compared. RESULTS: An incidence rate of 3.5 per 100,000 and a prevalence rate of 2.0 per 10,000 children were calculated. The frequency of JCA is higher for girls, with an incidence of 4.3 per 100,000 and a prevalence of 2.3 per 10,000. The figures for boys are 2.7 per 100,000 and 1.7 per 10,000, respectively. CONCLUSION: Because of the specific prerequisites, the population rates of prevalence and incidence that were based on clinical records can be regarded as valid in this study. Deviant results of other surveys can be explained by differences in the study design or in the diagnostic procedures used.     

Incidence and prevalence of digestive system tumors in Italy: estimates from mortality data

This work presents estimates and middle-term projections of incidence and prevalence levels in Italy for cancers of the oral cavity and pharynx, of the stomach, and of colon and rectum. The estimation procedure was previously validated using incidence data observed by Italian cancer registries operating in limited geographical areas. Projections up to the year 2000 of mortality, incidence, and prevalence rates and estimated cohort effects are reported for stomach and colorectal cancers only. For both cancer sites, cohort effects, rather than period effects, result to be responsible for mortality and incidence dynamics. Incidence levels show a general decreasing trend for stomach cancer and an increasing one for colorectal cancer. Cumulative risk trend tends, however, to level-off for the youngest cohorts. Moreover, the well known geographical differences between the North and the South of the country seem to be progressively reducing.     

Incidence and prevalence of recognised and unrecognised myocardial infarction in women. The Reykjavik Study

AIMS: The incidence and prevalence of recognised and unrecognised myocardial infarction were determined in the Icelandic cohort study of 13,000 women (the Reykjavik Study), followed for up to 29 years (mean 15 years). METHODS AND RESULTS: Women attending the Reykjavik Study, born between 1908 and 1935, were examined in five stages from 1968 to 1991. A health survey included history and ECG manifestations of coronary heart disease. Data retrieved from hospitals, autopsy records and death certificates identified 596 fatal and non-fatal myocardial infarctions to the end of 1992 (61 prior to examination, 320 non-fatal and 215 fatal). The incidence of recognised myocardial infarction ranged from 22 cases/100,000/year at 35-39 years to 1800 cases/100,000/year at 75-79 years. The incidence of unrecognised myocardial infarction ranged from 18 cases/100,000/year at 35 years to 219 cases/100,000/year at 75 years. Thirty-three percent of non-fatal myocardial infarctions were unrecognised. More occurred in the younger age groups (40%) than in the older (27%). The prevalence of recognised myocardial infarction was influenced by age and calendar year. In 1990, it was 1.3/1,000 at 35 years and 60/1000 at 75 years. Prevalence showed a time trend, tripling in all age groups from 1968-1992. Fore unrecognised myocardial infarction, prevalence rose from 0.9/1000 at 35 years to 19.2/1000 at 75 years, although there was no evident time trend. CONCLUSION: Myocardial infarction in women is very age-dependent with both incidence and prevalence increasing continuously and steeply with age. There was a significant trend for an increase in prevalence of recognised myocardial infarction from 1968 to 1992. The proportion of unrecognised non-fatal infarctions ranged from 27% in the oldest age group to 40% in the youngest. On average, this form of coronary heart disease is as common as in men.     

Incidence and prevalence of intracranial aneurysms and hemorrhage in Olmsted County, Minnesota, 1965 to 1995

OBJECTIVE: To determine the risk of acquiring ventilator-associated pneumonia (VAP) and the impact on costs when extending ventilator circuit change intervals beyond 2 days to 7 and 30 days. DESIGN: Prospective 4-year review of mechanically ventilated patients. SETTING: The respiratory and medical ICUs of an 800-bed tertiary teaching Veterans Affairs hospital. PATIENTS: All adult patients receiving mechanical ventilation from January 1991 through December 1994. INTERVENTIONS: Ventilator circuits with active heated water humidifiers were changed at 2-day intervals during a 2-year control period, followed by 7-day and 30-day intervals (for 1 year each). Heated wire circuits were adopted with the 30-day interval. The rate of VAP per 1,000 ventilator days was calculated for each circuit change interval group. Survival analysis was used to model VAP with ventilator circuit change to determine risk. RESULTS: During the study period, 637 patients received mechanical ventilation. During the 2 years with 2-day change intervals, the VAP per 1,000 ventilator days was 11.88 (n=343), compared with 3.34 (n=137) and 6.28 (n=157) for 7-day and 30-day change intervals, respectively. The risk of acquiring a VAP for those with a circuit change every 2 days was significantly greater (relative risk, 3.1; p=0.0004; 95% confidence interval, 1.662, 5.812) than those with the 7- and 30-day circuit changes. Extending circuit change intervals reduced supply and labor costs averaging $4,231/yr for each ventilator in use. CONCLUSIONS: Circuit change intervals of 7 and 30 days have lower risks for VAP than the 2-day intervals, yielding substantial reductions in morbidity as well labor and supply costs.     

Mental representation of normal subjects about the sources of knowledge in different semantic categories and unique entities.

According to the “sensory-motor model of semantic knowledge,” different categories of knowledge differ for the weight that different “sources of knowledge” have in their representation. Our study aimed to evaluate this model, checking if subjective evaluations given by normal subjects confirm the different weight that various sources of knowledge have in the representation of different biological and artifact categories and of unique entities, such as famous people or monuments. Results showed that the visual properties are considered as the main source of knowledge for all the living and nonliving categories (as well as for unique entities), but that the clustering of these “sources of knowledge” is different for biological and artifacts categories. Visual data are, indeed, mainly associated with other perceptual (auditory, olfactory, gustatory, and tactual) attributes in the mental representation of living beings and unique entities, whereas they are associated with action-related properties and tactile information in the case of artifacts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caries and fluorosis prevalence in communities with different concentrations of fluoride in the water

The need to defluoridate and fluoridate the water supplies in areas with drinking water naturally containing above-optimal (>/=2.5 mg/l) and suboptimal (相似文献   

Anterior uveitis and leptospirosis

Seven patients with anterior uveitis due to leptospirosis are presented. The diagnosis was based upon serologic tests and exclusion of other etiologic possibilities. Six patients came from a well-known endemic area of leptospirosis during the time of epidemics and one case came from an area which was not known to be endemic at the time. In 5 patients the uveitis was bilateral. The disease was mild in all but 2 patents who needed systemic administration of steroids. The posterior part of the eye was not involved in any of the cases.     

Immunopathology of uveitis

Two major types of plaque-bearing adhering junctions are commonly distinguished: the actin microfilament-anchoring adhaerens junctions (AJs) and the desmosomes anchoring intermediate-sized filaments (IFs). Both types of junction usually possess the common plaque protein, plakoglobin, whereas the other plaque proteins and the transmembrane cadherins are mutually exclusive. For example, AJs contain E-, N-, or P-cadherin in combination with alpha- and beta-catenin, vinculin and alpha-actinin, whereas in desmosomes, desmogleins and desmocollins are associated with desmoplakin and one or several of the plakophilins (PP1-3). Here we describe a novel type of adhering junction comprising proteins of both AJs and desmosomes and the tight junction (TJ) plaque protein, ZO-1, in a newly established, liver-derived tumorigenic rat cell line (RMEC-1). By immunofluorescence microscopy, cell-cell contacts are characterized by mostly continuous-appearing lines which are usually resolved by electron microscopy as extended arrays of closely spaced small plaque subunits. These plaque-covered regions are positive for plakoglobin, alpha- and beta-catenin, the arm-repeat protein p120, vinculin, desmoplakin and protein ZO-1. They are positive for E-cadherin in cultures early on in passaging, but tend to turn negative for all known cadherins in densely grown cultures. On immunoblotting SDS-PAGE-separated proteins from dense-grown cell monolayers, "pan-cadherin" antibodies have reacted with a band at approximately 140 kDa, identified as N-cadherin by peptide fingerprinting of the immunoprecipitated protein, which for reasons not yet clear is modified or masked in immunolocalization experiments. The exact histological derivation of RMEC-1 cells is not known. However, the observations of several endothelial markers and the fact that all cells are rich in IFs containing vimentin and/or desmin, while only subpopulations also reveal IFs containing CKs 8 and 18, is suggestive of a mesenchymal, probably endothelial origin. We discuss the molecular relationship of this novel type of extended junction with other types of adhering junctions.