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PubMed2005

[Associations of genetic polymorphisms in the EPHX1 gene and the GSTT1 gene with low birth weight in neonates].

OBJECTIVE: To investigate whether genetic polymorphisms in the microsomal epoxide hydrolase gene (EPHX1) and the glutathione S-transferase theta1 gene (GSTT1) are associated with low birth weight in neonates. METHODS: Using standard questionnaires, 246 singleton live born mother-neonates pairs (73 cases were mother-low birth weight neonate pairs and 173 controls were mother-non low birth weight neonate pairs) were investigated by the trained field workers with case-control study at the hospital in Anqing, Anhui Province, China between 1998 and 1999. A total of 246 neonates were genotyped for genetic polymorphisms in the EPHX1 gene and the GSTT1 gene by a polymerase chain reaction-restriction fragment length polymorphism assay. Multiple linear regression models were used to estimate the association of the genetic polymorphisms in the EPHX1 gene and the GSTT1 gene with neonatal low birth weight, adjusting for maternal age, education, parity, neonatal sex and gestational age. RESULTS: EPHX1 His139His homozygote was not associated with low birth weight among neonates, compared with EPHX1 His139Arg heterozygote/Arg139Arg homozygote before and after adjustment confounders. GSTT1 absent genotype group also was not associated with low birth weight among neonates, compared with GSTT1 present genotype group before and after adjustment confounders. When both EPHX1 139 polymorphism and GSTT1 polymorphism were considered, a significant reduction in birth weight was found among neonates with EPHX1 His139His homozygote and GSTT1 absent genotype (OR=3.46, P=0.035). CONCLUSION: The combination between genetic polymorphisms in the EPHX1 gene and the GSTT1 gene in neonates is significantly associated with neonatal low birth weight.

Birth Weight↗

PubMed2005

Baseline plasma viral load and CD4 cell percentage predict survival in HIV-1- and HIV-2-infected women in a community-based cohort in The Gambia.

OBJECTIVES: To estimate and compare the all-cause mortality rates among HIV-1-infected, HIV-2-infected, and uninfected women and to assess the predictive value of baseline plasma viral load (PVL) and CD4 cell percentage (CD4%) for mortality. DESIGN: Cohort study. METHODS: At presentation to antenatal clinics in The Gambia in 1993-1995, pregnant women were screened for antibodies to HIV-1 and HIV-2. Seropositive subjects and a similar number of seronegative controls were enrolled, and baseline PVL and CD4% were measured. Participants were visited regularly by field-workers until 18 months after delivery and again 4-7 years later. RESULTS: Thirty-two of 101 women infected with HIV-1, 23 of 243 infected with HIV-2, and 9 of 468 seronegative women died during a median follow-up of 6.9 years. The mortality rate was 56 deaths per 1000 person years of observation (pyo) for HIV-1-infected, 16 deaths per 1000 pyo for HIV-2-infected, and 3.1 deaths per 1000 pyo for HIV-uninfected women. After 8 years of follow-up, >50% of HIV-1-infected women were still alive. In multivariate analysis, a 1-log increase of HIV-1 PVL was associated with a 1.8-fold higher rate of mortality (95% confidence interval [CI], 0.9-3.4). In HIV-2 infection, women with a high PVL (>10,000 copies/mL) had an 8.7-fold (95% CI, 2.8-28) higher rate of mortality than did those with a low PVL (<1000 copies/mL). A 10% decrease in CD4% was associated with higher mortality rates among HIV-1-infected (1.6-fold; 95% CI, 1.1-2.3) and HIV-2-infected (1.5-fold; 95% CI, 1.0-2.3) subjects. DISCUSSION: Survival of HIV-1-infected women in The Gambia is similar to that in industrialized countries before the introduction of antiretroviral treatment. Survival of HIV-2-infected women is much better. However, women with high PVLs die as quickly as their HIV-1-infected counterparts.

Adolescent↗

PubMed2002

[Association of PON2 gene polymorphisms in neonates with preterm].

Branch of Institute for Biomedicine,Anhui Medical University,Anqing 246000,China Abstract:The objective is to investigate whether gene polymorphisms in the PON2 gene (PON2148 and PON2311) of neonates are associated with preterm. Using standard questionnaires,194 singleton live born mother-neonate pairs (include preterm cases and term controls) were investigated by the trained field workers with cross-sectional survey at the hospitals in Anqing,Anhui Province,China. Epidemiological and clinical data and blood samples were obtained from 194 mother-neonate pairs. Among neonates,PON2 Ala148Ala homozygote is significantly associated with preterm,compared with Gly148Gly homozygote / Ala148Gly heterozygote before and after adjustment confounders and the same was true for PON2 Ser311Ser homozygote. However,when PON2148 polymorphism and PON2311 polymorphism were considered jointly,no significant gene interaction between PON2148 polymorphism and PON2311 polymorphism in relation to preterm was observed. We draw a conclusion from this research that both PON2148 polymorphism and PON2311 polymorphism in neonates are significantly associated with preterm respectively. But the gene interactions between PON2148 polymorphism and PON2311 polymorphism in neonates are not significantly associated with preterm.

English Abstract↗

PubMed2005

The distribution of mental disorders among an isolated island community in southern Ethiopia.

BACKGROUND: It is now recognized that surveys of unique communities are important to better understand the epidemiology of mental disorders. The Zeway islanders are completely different from the surrounding cultural groups, in the midst of whom they have been living in isolation for over three centuries. OBJECTIVES: To describe the prevalence and sociodemographic correlates of major mental disorders in this community. METHODS: Trained and supervised field workers were employed to conduct a door-to-door survey of the entire adult population of the islands using the Amharic CIDI (Composite International Diagnostic Interview). RESULTS: A total of 18.3% of the study subjects were classified as having ICD-10 diagnoses, excluding substance use disorders. The most prevalent CIDI/ICD-10 disorder in the study were neurotic and somatoform disorders (17%). Affective disorders were present in 2.2% while no cases of psychoses were found. The prevalence of tobacco use and alcohol dependence was 0.4% and 1.5%, respectively, with all cases being males. CONCLUSION: The pattern of occurrence of mental disorders in this isolated community is different from other populations in Ethiopia and elsewhere with no reported case of psychoses.

Adult↗

PubMed2005

[Care and problems in intractable neurological diseases--home care of intractable diseases from the view of a practicing physician].

Taking into account how to care patients at home with intractable neurological disease and their family, I have introduced the achievement of the medical caring technique by an aged family member, the risks of the PEG and acute respiratory failures under BiPAP, the problems in home rehabilitation, and the experiences of home terminal care, from the view point of a practicing physician. Home caring pursues to support patients and their family to live peacefully with disease with highest quality of life. Hospice caring is also an important issue. From now on, I would like to try to give even better home care by early recognition of problems and by cooperating with hospitals, clinics and other field workers.

Aged↗

PubMed2006

Determination of definitive and intermediate hosts of cercarial dermatitis-producing agents in northern Iran.

BACKGROUND: The study concerns the prevalence of avian schistosomes in intermediate and definite hosts in Mazandaran Province, northern Iran. METHODS: A total of 14190 fresh-water snails belonging to various genera were sampled and tested for cercarial emission by lighting and then crushing. During the same period, the nasal blood vessels and mesenteric veins of aquatic birds, mainly belonging to the Anatidae family, were examined under dissecting microscope for detecting adult worms. RESULTS: Forty-seven (0.33%) of examined snails mainly Lymnaea gedrosiana, L.palustris, L.stagnalis, and Planorbis planorbis were found to be infected with larval stages of Trichobilharzia spp. Adult schistosomes were observed in 25 (18.1%) wild waterfowls. The most infected birds were Anas platyrhynchos, A.clypeata, and Aythya ferina, respectively. CONCLUSION: Annually migration of various species of aquatic birds toward the northern parts of Iran and the simultaneous presence of intermediate snails in the water resources of this area, combined with long hours of sunshine in the summer months, suggest that cercarial dermatitis could be a prominent health problem, especially among paddy field workers in this area.

Animals↗

PubMed2006

[Home care in intractable neurological diseases].

Aged↗

PubMed2006

A random sample survey for prevalence of major neurological disorders in Kolkata.

BACKGROUND & OBJECTIVES: Large scale epidemiological studies on neurological disorders are very few in India. We therefore planned to conduct a cross-sectional population-based epidemiological study on a stratified randomly selected sample from the city of Kolkata to study the prevalence of major neurological disorders such as epilepsy, stroke, dementia and Parkinsonism. METHODS: The method of case ascertainment was two- stage house-to-house survey; the first stage was undertaken by a field team consisting of four field workers and a neuropsychologist. Screening questionnaire based on National Institute of Mental Health and Neuro Sciences (NIMHANS) protocol was used. In the second stage a neurologist examined all the screened positive cases. RESULTS: A total of 52,377 subjects participated in the study. The crude prevalence rates (per 100,000 population) of major neurological disorders with 95 per cent confidence intervals (95% CI) and age adjusted rates (AAR) based on US 2000 population were 557.5 (95% CI 496.17-624.40 and AAR - 516.77) in epilepsy, 486.85 (95% CI 377.0 to 551.11 and AAR-765.68) in stroke, 87.82 (95% CI 64.02-117.50 and AAR-168.4) in dementia and 45.82 (95% CI 29.64-67.63 and AAR-71.64) in Parkinsonism. The weighted prevalence rates (per 100,000) of the whole population based on re-screening of 10 per cent of negative samples were 763.89 (95% CI 690.55- 842.57) in epilepsy, 624.32 (95% CI 555.64-699.24) in stroke and 139.37 (95% CI 108.71-176.06) in dementia. INTERPRETATION & CONCLUSION: A high rate of stroke and overall lower prevalence of Parkinsonism and dementia was recorded as compared to western studies. High prevalence rate of stroke emphasizes the need to study incidence, morbidity and mortality profile of stroke including its socio-economic impact and also case-control analysis to determine the underlying risk factors.

Adolescent↗

PubMedDate not supplied

Validity of verbal autopsy in determining causes of adult deaths.

A verbal autopsy (VA) questionnaire, which had an open-ended description of the deceased's illness followed by a series of close-ended questions on specific symptoms and signs, was used by three trained field workers to interview relatives of the deceased who had died in a Chandigarh hospital in previous year. The sensitivity and specificity of the cause of death assigned by physician from the verbal autopsy was calculated against the cause of death derived from the hospital records. Of the 262 verbal autopsies, 60% were males and 23% belonged to rural area. Specificity of VA cause of death was high (>95%) for all broad cause groups except cardiovascular (79%) diseases. Sensitivity was highest for injuries (85%) and it was in the range of 60% to 65% for circulatory diseases, neoplasms, and infectious diseases. Sensitivity was low (20% to 40%) for respiratory, digestive and endocrine diseases. Cause specific proportionate mortality for major cause groups by the VA were statistically similar to the causes of deaths derived from the hospital records (p>0.05). Therefore, VA can be used for determining causes of adult deaths.

Adult↗

PubMed1991

Multibacillary leprosy presenting as a solitary skin lesion; report of three cases and its significance in control programs.

Three patients with solitary skin lesions showing the cardinal signs of leprosy were seen and clinically classified among the paucibacillary cases. Initially, they were treated with two drugs (rifampin and dapsone) as recommended by the WHO Expert Committee. On the first visit of their follow-up, they were seen to be histopathologically either in the borderline (BB) or borderline lepromatous (BL) group, and acid-fast bacilli were demonstrated in the sections. Later they were put on three drugs (rifampin, dapsone and clofazimine) as given for multibacillary cases, and therapeutically they also behaved like bacilliferous leprosy. Such cases are rare and the reasons for the occurrence are not clear. Further studies on the subtle relationship between the local host factors and the virulence of the organisms grown from these lesions may offer an explanation. In light of these cases and previous reports of even lepromatous leprosy presenting as a single skin lesion, field workers--including both medical and paramedical workers--should carefully perform and interpret slit-skin smears from clinically diagnosed paucibacillary cases so that such unusual presentations of the disease are treated appropriately and not missed.

Adolescent↗

PubMed1991

Evaluation of a computerized field data collection system for health surveys.

A customized field data collection system (FDCS) has been developed for a hand-held computer to collect and check questionnaire data. The data quality, preparation time, and user acceptability of the system were evaluated during a malaria morbidity survey in Bakau, the Gambia. Eight field-workers collected data with either the FDCS or on paper questionnaire forms in alternate weeks over a 6-week period. Significantly fewer item errors occurred with the FDCS, and by the end of the survey period interview times were significantly less with the FDCS than with the paper and pencil questionnaire. Advanced appropriate technology may have a useful role in providing accurate and rapid information, particularly in overcoming bottlenecks in data processing, and in obviating the need for costly expertise and equipment. In developing countries this could help to improve the quality of data on health care.

Data Collection↗

PubMed1990

[Serological survey of human leptospirosis in a high risk population in Chile].

Two hundred and sixty five subjects with high risk works for leptospirosis were submitted to microscopic agglutination test for leptospira. 122 worked at animal farms, 71 in rice growing fields and 72 in slaughter houses. 30 control subjects were also tested. A total of 66 samples (22%) were positive, most of them with low titers. Percentage of positive reactions were higher for persons working in rice fields, followed by those working in slaughter houses and animal farms. The 21-40 year age group was most affected in all working sites. Serovars found most commonly were ichterohemorrhagic in rice field workers, hardjo and ballum in slaughter houses and pomona and hardjo in animal farms.

Adolescent↗

PubMed1990

[Colostomy devices for the extracorporeal organ].

Colostomy devices are classified as follows: One-piece and two-piece by structure; Closed, open-end or straight, open-top, drainable, and mini by pouch function. The one-piece device is simple and convenient (disposable) but not cheap; The two-piece one has various exchangeable pouches but some skill is necessary for fitting a pouch to the flange. A closed pouch is disposal en bloc, while an open pouch allows a hand to be inserted several times. The drainable pouch is useful for draining faeces easily with water, while a mini-pouch is unobtrusive and attractive. The skin barrier has been used frequently as a part of the device. Its contents are hydrophilic colloid, hydrophobic colloid and agglutinant. The barrier functioning is dependent on content-ratio and on structure. The latter is classified as blend, laminate, swiss-roll, polka-dot, and froth in type. The apparatus must be used for individual colostomy, utilizing the characteristics based on its specificity; an open-type one-piece unit is used with skin barrier for a postoperative colostomy in the first week, a drainable-type, two-piece unit for another week following suture removal or for diarrhea, and a closed type for rehabilitation. This procedure is called a pouch total system. The irrigation method is good for a scheduled defecation and for peri-stomal dermatitis and for a deformed stoma, but takes more than a half hour and needs a special toilet for irrigation. Indication of the method is for a young ostomate, a sportsman, a field worker, a neurotic or myosophobic person and so on. Today a pouch-free natural defecation method is becoming popular; a kind of stopper is used for a colostomy. This is a foam plug which expands to block feces and eliminates noise and odor. The method is good for pouch-free living, but fecal leakage is encountered in diarrhea.

Colostomy↗

PubMed1988

[Diagnosis of aphasia in clinical practice--results of a written survey].

A mail survey of clinics in the Federal Republic of Germany revealed that aphasia assessment is performed primarily by speech & language pathologists, and medical specialists. Psychologists, linguists, and speech educators, on the other hand, are involved to a much lesser degree in the process of aphasia diagnosis. Diagnosticians primarily rely on psychometric aphasia testing. Utilization of these procedures appears to be motivated by their high degree of formalization, which facilitates diagnostic objectivity, and by the good selection, syndrome classification, and severity determination this entails. Criticism is directed at the structural complexity of the tests, insufficient economy, their restricted scope, and insufficient coverage of non-language defect syndromes. Psychometric aphasia testing in many cases is used in combination with other, clinical (i.e. non-standardized) aphasia testing procedures, the advantages of the latter appearing to make up for the disadvantages in the psychometric procedures. Despite their shortcomings of not permitting adequate checks on aphasia course, use of these other procedures is held to be justified in that they are economical to administer; have a broad range of application, i.e. are useable also in acute or very severe conditions; cover non-language disorders, and, finally, are therapy-oriented. Field workers in the survey sample insist on having available both the psychometric and clinical procedures. For those involved in constructing aphasia assessment procedures, this indicates a need for developments in both "directions", which obviously are complementary to each other. Action theoretical criteria may be useful in elaborating clinical procedures.

Aphasia↗

PubMed1989

[Antibodies against Hantaan virus and Leptospira in subjects at risk in Rome].

A survey on the prevalence of Hantaan and leptospiral antibodies on mammalogists and rodent control personnel was performed. None of the 66 trappers studied (using IFI ) had detectable Hantaan antibody, while only 2 out of 20 mammalogists presented antibody at low titer (1:32). For leptospiral antibody the microagglutination test (MAT) using live leptospires as antigen was performed. 14 out of 66 trappers, or 21.2 per cent, had antibodies, at titer of 1:50 or more, to various leptospiral serovars: L.icterohaemorrhagiae in 12 cases, L.hardjo in 1 case, L.bratislava in 1 case. On the contrary, none of the mammalogists showed positivity for any of 16 serovars used. The environmental risk factors could justify the high prevalence of leptospiral antibodies in the field workers (trappers), while continuous laboratory contacts with rodents explain the presence of Hantaan virus antibodies in mammalogists .

Agglutination Tests↗

PubMed1989

[Estimation of the incidence of human trypanosomiasis due to Trypanosoma brucei gambiense using epidemiological parameters essentially linked to the vector: case of a focus in the Ivory Coast].

The entomo-epidemiological studies carried out from 1980 to 1985 in the human trypanosomiasis focus at Bouaflé (Ivory Coast) were designed to estimate the main epidemiological parameters related to G. palpalis palpalis, the sleeping sickness vector in the zone considered. This paper defines the mathematical relationships which can exist between these parameters leading to the production of a simple model enabling estimates to be made of the incidence of human trypanosomiasis caused by T.b. gambiense in this focus. The model predicted a mean annual incidence of 1.50% in the Bouaflé focus. In the zones with high pig densities which were characterised by high densities of tsetse flies with weak anthropophily, the model predicted an incidence of 1.22%. However, a disease incidence of 1.76% was estimated for zones where domestic pigs were absent or at low density and characterised by low densities of tsetse flies with strong anthropophily. The author also emphasizes the relationships between mathematical models and realities in the field and the usefulness of these models to the field worker in planning control campaigns.

Animals↗

PubMed1989

[Concepts of health personnel in relation to the management of acute diarrhea].

With the objective of gaining more knowledge on the concepts of management of acute diarrhea in children from health personnel, a study was designed and carried out in two Central American countries. The sample was composed of pediatric residents, general practitioners, registered nurses and assistant nurses. A special form was designed and field workers were trained for this purpose. A total of 389 health personnel was interviewed. The results showed that there is a good knowledge on morbidity and mortality from diarrheal disease in children, less knowledge on the etiology of the disease and very little knowledge on the composition of oral rehydration solutions. Also there is no standard criterion on the use of drugs, being the general practitioners and nurses who have more wrong concepts. The factors most mentioned for non-acceptance of oral rehydration therapy (ORT) are little promotion of ORT, that the rehydration salts are not available in every place, that mothers do not accept ORT and that ORT seems a non-scientific therapy.

Acute Disease↗

PubMed1989

A variant of mass (epidemic) psychogenic illness in the agricultural work setting.

California experiences episodes of suspected agricultural field worker poisonings annually. These episodes are not only disruptive to ongoing agricultural operations, but the prospect of such poisoning is a source of great concern to workers, employers, and government agencies alike. Three episodes of group illness are examined in which actual poisoning does not seem to be involved. Factors contributing to the generation of these episodes include fear, uncertainty, incomplete understanding of hazards, and social pressures. Physicians can minimize extended disability for workers by reassuring victims and waiting until circumstances are verified before issuing statements which may further alarm or add to already existing fears.

Agricultural Workers' Diseases↗