Fibers in the Mediterranean diet. An epidemiological study of the Campania Region

BACKGROUND: The authors have evaluated: a) the survival of the "mediterranean diet" as way of life; b) the comparison between fiber content in the diet of adult or school children of the Campania Region. METHODS: To study nutritional epidemiology of adults, a new method consisting of publishing a 24-hour recall dietary chart in a new paper with big regional circulation, Il Mattino, and analyzing all the charts from the different towns of Campania was used. For that, the ZIP code of the subject was used as an informatics button. Data were housed in a computer using Food Meter (an informatics program by Bayer-Medimatica). RESULTS: Differences statistically significant were found between adults or children residing in various district of the Campania Region and Naples town. CONCLUSIONS: Finally, it is important to underline that the amount of fibers of children's diets was higher than adult diets.     

Automobile accidents in patients with sleep apnea syndrome. An epidemiological and mechanistic study

AIM: To compare the pregnancy outcome, in particular gestational age and birth weight in women with systemic lupus erythematosus (SLE) diagnosed before and after pregnancy, and to review data on presence or absence of the antiphospholipid (aPL) antibody and flares of disease activity. METHOD: Case histories were reviewed of women with a diagnosis of SLE and an obstetric event attending Monash Medical Centre (MMC) over an eight year period (1988-96). Fifty-four pregnancies in 28 women were studied, with 44 occurring after the diagnosis of SLE (Group 1) and ten prior to the diagnosis of SLE (Group 2). RESULTS: In Group 1 there were 25 live births (63%) with 16 full term and nine premature deliveries, 12 spontaneous abortions, three foetal deaths in utero and four elective terminations. In Group 2 there were seven live births (70%), two spontaneous abortions and one foetal death in utero. The mean gestational age of live births was 35.8 weeks and 39.2 weeks respectively (p < 0.001). The mean birth weight of live births was 2448 g and 3030 g respectively (p < 0.023). a PL antibodies were positive in eight of 26 women tested with three live births and were negative in 18 of 26 women with 12 live births. Flares of disease activity occurred in 17 of 28 pregnancies. CONCLUSION: Pregnancy in women with a predisposition to SLE have a high risk of an adverse outcome. Clinical disease confers an additional risk. The mean gestational age and birth weight were significantly less in women with established disease. Mild flares in disease activity resulted in a favourable outcome while renal flares had a worse outcome.     

Prospective epidemiological study of rheumatism in the Irkutsk Region

The changes in the prevalence and primary incidence of rheumatism in the region were analyzed by the epidemiological surveys and notifications made in 1961 to 1994. During this period, the primary incidence rates showed a 70-fold decrease, mainly due to those among females and children. The paper presents changes in the pattern of risk factors of rheumatism and defines the prevalence decrease rate of rheumatism in three follow-up periods. A comprehensive rehabilitation programme for rheumatic patients has been worked out.     

An epidemiological study of the adolescent nonfatal unintentional injuries in Taiwan

Despite the observation of TBE cases after consumption of raw milk from cows or goats, so far the proof of the alimentary route of human infection has not been possible. In the regions of southwestern Germany, where TBE is known to be endemic, milk-borne TBE infections have not yet been observed. To assess the significance of raw milk consumption for viral transmission, a cross-sectional study (114 forestry workers, 177 individuals exposed during their leisure-time activities, 170 non-exposed individuals) and a case-control study (50 TBE patients, 150 controls) were carried out. The results of the study show that both the time spent in the endemic region and also the professional exposure to ticks do influence TBE seroprevalence, whereas the consumption of raw milk (milk directly from the farmer) is no major risk factor for TBE infection or disease. Among leisure-time activities, only hunting has an effect comparable to the one of the professional exposure to ticks. Besides epidemiological data obtained in humans, serological investigations of cows were performed. Here it is shown that milk-producing animals are involved in the natural transmission of TBE virus. Since former studies had shown that TBE-viremic animals excrete the virus with the milk--although over a short period and in low concentrations--the occurrence of milk-borne TBE infections cannot be excluded in the endemic regions of south-western Germany. However, from the epidemiological point of view, their significance may be neglected. Vaccination has proven the most reliable means of TBE prevention, irrespective of the route of infection.     

An epidemiological study of patterns of condylar fractures in children

OBJECTIVE: To find out how the site and type of condylar fracture are affected by its aetiology and the age and sex of the patient. DESIGN: Retrospective study. SETTING: Tertiary referral centre, Finland. MATERIAL: Radiographs of 101 children (aged 15 years or less) with 119 condylar fractures. MAIN OUTCOME MEASURES: Site of fracture and degree of displacement. RESULTS: A total of 26 of the 119 fractures were intracapsular (22%) and 93 (78%) extracapsular. Only among patients less than 6 years of age was there a preponderance of intracapsular fractures (7/12 fractures in 10 patients, 58%). In the older children 78% (83/107) were in the condylar neck. There were few subcondylar fractures (5/119, 4%). Only 6 fractures were displaced (5%). Dislocation of the condyle from the glenoid fossa was common in all age groups. CONCLUSION: The site of condylar fracture is age related, but not associated with sex or aetiology.     

An epidemiological study of acute carbon monoxide poisoning in the West Midlands

OBJECTIVES: To describe the epidemiology of carbon monoxide (CO) poisoning in a defined population, identifying those at greatest risk from acute poisoning resulting in admission to hospital or death. METHODS: A retrospective study with routinely collected information, set in the former West Midlands Regional Health Authority; population of 5.2 million. The data comprised 939 deaths and 701 hospital admissions due to CO poisoning between January 1988 to December 1994. The main outcome measures were age and sex standardised incidence rates (SIRs) for non-intentional, suicidal, and undetermined poisonings for health authorities and the linear relation with socioeconomic deprivation. RESULTS: Overall rate of non-intentional poisonings over the 7 year period was 7.6/100,000, an annual rate of 1.1/100,000. The 7 year rates were highest in people > or = 85; men 24.0/100,000 and women 19.7/100,000. For suicides the 7 year rate was 19.6/100,000, an annual rate of 2.8/100,000. The 7 year rates were highest for men of 35-39, 64.1/100,000, and for women aged 45-49, 15.3/100,000. None of the causes of poisoning were related to deprivation. Non-intentional poisonings showed a strong seasonal variation with the highest rates being recorded in the months October to March. Increased rates of poisoning were found in the rural districts of the West Midlands. There seems to have been a decline in suicides coinciding with the introduction of three way catalytic converters on cars. CONCLUSIONS: Elderly people and the very young are at the greatest risk from non-intentional CO poisoning and rates are highest in the winter months. Although deaths from non-intentional CO poisoning are declining nationally, in the West Midlands they have remained stable and hospital admissions are increasing. It is not solely an urban phenomenon with rates for non-intentional CO poisoning and suicides higher in the rural districts. Health authorities need to consider all populations in any prevention programme. Further work is needed to establish the extent of the burden of chronic CO poisoning and the impact of catalytic converters on suicides.     

Handball injuries. An epidemiological and socioeconomic study

A total of 570 injuries in handball players were prospectively registered in a well-defined geographical area of 124,321 inhabitants. The incidence of handball injuries was 46/10,000 inhabitants/year and in females (61/10,000/year) double that for males (31/10,000/year). Sixty-two percent of the injuries were distortions and sprains and 12% were fractures. A total of 7% were hospitalised and the loss of income because of sick leave was in total $3870. Sixty-eight percent of the injured handball players did not play for more than one week. Surprisingly, 8% of the minor injuries resulted in a risk leave of more than six days. Five percent of these injured quit a tournament of training after sustaining a handball injury.     

An epidemiological investigation for gram-positive coccus, especially PRSP, in Kinki area

An epidemiological investigation for penicillin-resistant Streptococcus pneumonia (PRSP) was performed at 18 medical institutes in Kinki area by the questionnaire from Kinki Infection Working Group 1995. This investigation was the first report that was performed for a long term (one year) and a large area. The most frequent specimen was sputum from out-patients (50.3%) and inpatients (48.8%), and especially from spinal fluid of 3 cases were detected. Polymicrobial infection with more than 3 pathogens was 15.7%, and it was more frequent than MRSA previously investigated. Simultaneous pathogens detected with PRSP were Candida species, Haemophilus influenzae and Staphylococcus aureus. In terms of chemosusceptibility, VCM (100%), FMOX (97.9%), IPM/CS (85.9%), CEZ (93.4%) and CDTR-PI were determined to be high by sensitive. However, the sensitivity of CCL, which was one of the most common antibiotics, was only 37.7%.     

Suicide in patients with Parkinson''s disease. An epidemiological study

The purpose of this study was to estimate the risk of suicide for patients with Parkinson's disease (PD) in Denmark compared with that in the background population. The study involved 458 patients with a PD diagnosis, 226 men and 232 women. The follow-up period to either death or end of follow-up on December 31, 1990 was 0 to 17 years, mean 5.7 years. Deaths in the follow-up period amounted to 254, 135 men and 119 women. Two women committed suicide. The number of expected suicides was 1.06 for men and 0.55 for women, a total of 1.62. Neither for men nor for women was the difference between expected and observed suicides statistically significant.     

An epidemiological study of the haemostatic and other effects of oral contraceptives

Factors V, VII and VIII (each determined by biological assay), fibrinogen, platelet count and adhesiveness, and fibrinolytic activity were measured in 234 white pre-menopausal women, of whom 57 (24%) were on oral contraceptives and 177 (76%) were not. Cholesterol, triglyceride and blood pressure levels were also recorded. In 20 of the women on oral contraceptives, and in an age-matched group of 20 who were not, prothrombin, factor X, antithrombin III and alpha 2-macroglobulin levels were determined, and factors VII and VIII were also measured immunologically. For the majority of the variables studied, the differences between those using and not using oral contraceptives were greater in younger than older women; in the case of factor VII (biological assay) and fibrinogen, the differences between the regression slopes on age were statistically significant, and mean values were substantially higher in those on oral contraceptives. There was also a significant difference between regression slopes on age for cholesterol. Mean levels of prothrombin, factors VII (immunological assay) and X, triglycerides and blood pressure were significantly higher, and mean levels of antithrombin III significantly lower, in those on oral contraceptives compared with those not. Overall, fibrinolytic activity was significantly higher in the women on oral contraceptives; this difference was, however, almost entirely due to the greatly increased fibrinolytic activity of the non-smokers on oral contraceptives, activity in the smokers on oral contraceptives being similar to that of the women not on these preparations. There were no significant differences in mean platelet count or adhesiveness, or in haemoglobin, packed cell volume, uric acid and blood sugar levels. Among the women on oral contraceptives, there was a significant negative correlation between factor VIII and fibrinolytic activity; this was largely due to five women all of blood groups A and B, in whom, besides high factor-VIII levels and poor fibrinolytic activity, other variables (e.g. fibrinogen) were raised in a direction that might be expected to favour thrombogenesis. It is possible that it is those women whose fibrinolytic activity does not increase in order to compensate for the effects of oral contraceptives on clotting factors, lipids and blood pressure, who are at special risk of thromboembolic episodes. The differential effects of oral contraceptives by age must be borne in mind in evaluating the effects of these preparations on the haemostatic and lipid systems.     

An epidemiological test of the hyperinsulinemia-hypertension hypothesis

The association between hyperinsulinemia and hypertension was tested in a population of 421 men and 228 women from the Baltimore Longitudinal Study of Aging. Subjects are white, middle-class, generally healthy, community-dwelling volunteers who ranged in age from 17-95 yr. Those with disease or medications known to influence any of the studied variables were excluded from the analysis. Twenty-five percent of the subjects were borderline or hypertensive [systolic blood pressure (BP) > or = 140 or diastolic BP > or = 90 mm Hg]. Standard oral glucose tolerance tests were performed; the logarithms of the fasting insulin level and insulin area were used in the analyses. In addition, body mass index and percent body fat (from age and skinfold thickness equations) and waist hip ratio were computed. In simple correlations, systolic BP and diastolic BP were statistically significantly related to insulin levels (only 1-4% of the variance was explained). Since age, body fat, fat distribution, insulin levels, and BP were highly intercorrelated, insulin and blood pressure correlations were examined after controlling for the confounding variables. Correlations of BP and insulin levels adjusted for age, body fat, and fat distribution were entirely nonsignificant. In this large noninterventive population study, the hyperinsulinemia-hypertension hypothesis is not confirmed.     

The prevalence, structure and clinical problems of multiple sclerosis in the Transcarpathian area based on epidemiological study data

As many as 230 patients with disseminated sclerosis were examined in the Transcarpathian region. Sick male- and female populations were found out to be almost similar. There were more sick persons in the medium-range areas of the Carpathian Mountains, with a mean age being 35 +/- 5 years. It has been established that intake of spirulina makes for lengthening of remission in those patients with disseminated sclerosis.     

An epidemiological and social study of 127 patients with AIDS IN Aragon

BACKGROUND: There have been several studies on survival patterns in Indian patients with systemic lupus erythematosus but it is still not clear as to which factors at diagnosis predict survival outcome. The impact of specific organ involvement, and of disease activity itself, needs to be studied further. METHODS: We conducted a non-concurrent prospective study of 98 lupus patients between 1981 and 1993. The clinical symptoms, signs and investigation results at onset, and at subsequent visits, were abstracted from the case notes. A systemic lupus erythematosus disease activity index (SLEDAI) was constructed at the initial presentation and for each subsequent visit. Patients not attending for at least 6 months were traced by post. The quantitative data from the SLEDAI was used to construct a Markov chain mathematical expression designed to predict life expectancy. RESULTS: The cumulative percentage survival at 1, 5 and 10 years was found to be 89%, 77% and 60%, respectively. The Markov chain predicted a life expectancy of 13.9 years. Central nervous system and renal involvement were poor prognostic factors. Proteinuria (> 0.5 g/day) caused a 50% reduction in life expectancy but increased disease activity at onset did not predispose to a poor outcome. CONCLUSION: The survival of patients with systemic lupus erythematosus continues to be poor. Central nervous system and renal disease indicate a poor outcome. Hence, new treatment strategies must be evolved to improve the survival of such patients.     

An epidemiological study of Serratia marcescens isolates from nosocomial infections by enzyme electrophoresis

Serratia marcescens isolates from 164 patients with suspected nosocomial infection in several hospitals in the greater Paris region were investigated by analysis of the electrophoretically demonstrable allelic variations of gene loci coding for five esterases and five other enzymes. All the loci were polymorphic and the mean number of alleles per locus was 6.1. A total of 72 distinctive electrophoretic types (ETs) representing multilocus genotypes was distinguished. The isolates were divided into two groups according to their resistance to antibiotics: 82 multiresistant isolates (MRI) and 82 relatively susceptible isolates (RSI). Seventy-two MRI (88%) were in four genetically related ETs: ET1, ET2, ET8 and ET9; ET1 was found in 48 isolates, whereas the remaining MRI were in 10 ETs, and all RSI in 61 ETs. Three ETs contained both MRI and RSI. The mean coefficients of genetic diversity for the 10 enzyme loci among ETs and isolates were smaller for MRI than for RSI, while the modal ET of MRI resembled that of RSI. The epidemiological significance of isolates varied according to their ET. Thus, isolates belonging to ET1, ET2 and ET8 were responsible for outbreaks or for sporadic infections, whereas isolates of other ETs were responsible for only sporadic infections. The temporal distribution of ET1 isolates among hospitals identified seven outbreaks in seven clinical departments.     

Gender differences in the sensitivity to posttraumatic stress disorder: An epidemiological study of urban young adults.

The authors examine the relationship between 2 separate but interrelated findings in the epidemiology of posttraumatic stress disorder (PTSD): women's greater PTSD risk following traumatic events and the sensitizing effects of a prior trauma on the PTSD response to a subsequent trauma. Data come from a representative sample of 1,698 young adults from a large U.S. city. Analysis was conducted on the subset exposed to traumatic events. Women's risk for PTSD following assaultive violence was higher than men's. When assaultive violence preceded a later nonassaultive trauma in women, there was an increased risk (relative risk = 4.9) for PTSD, which was not observed in men. The relative risk estimate in women was significantly higher than in men. These findings suggest that assaultive violence elicits women's PTSD response directly and by sensitizing them to the effects of subsequent traumatic events of lesser magnitude. (PsycINFO Database Record (c) 2010 APA, all rights reserved)