Diurnal variations in proliferation and crypt survival suggest a small target cell population in mouse colon.
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Aging↗
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Results for “Target Population”
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Targets of population in Singapore.
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Adult↗
Use of scaled outcome criteria for a target patient population.
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California↗
Developing scaled outcome criteria for a target patient population.
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California↗
Early stages of simian immunodeficiency virus infection in lymph nodes. Evidence for high viral load and successive populations of target cells.
Lymph nodes obtained from 14 macaques sacrificed at early time points following experimental inoculation with simian immunodeficiency virus were analyzed by in situ hybridization for virus load and virus cellular tropism. The lymph nodes presented a remarkably high viral load during the early phase of infection, as viral RNA was detected in as many as 2% of lymph node cells 1 week after inoculation. At this stage, macrophages and T4 lymphocytes were identified by combined immunohistochemistry and in situ hybridization as the target cells of the virus. Simian immunodeficiency virus-positive macrophages concentrated in the subcapsular sinuses, suggesting an entry of infected cells via the afferent lymphatics. A shift in the pattern of viral infection was observed at 2 weeks after inoculation, with a concentration of viral RNA in the germinal centers of the developing lymphoid follicles. Follicular dendritic cells were found to be the major target of the virus at this stage. Follicular dendritic cells were associated with high levels of viral RNA but little or no detectable viral DNA, suggesting that the virus was present mostly in the form of viral particles trapped at the cell surface. Follicular dendritic cell-associated virus persisted at high levels for 2 months before subsiding, indicating that follicular dendritic cells constituted a major reservoir of the virus during the early stages of simian immunodeficiency virus infection.
Animals↗
DNA vaccines: what can we expect?
Direct injection of plasmid DNA in vivo was recently shown to induce both prolonged expression of encoded proteins and strong specific immune responses with particular features. Induction of specific antibodies, of CD8+ T lymphocytes, and of CD4+ T lymphocytes differentiated toward the TH1-like phenotype have been achieved in animal models of diseases for which either no vaccines currently exist, or for which vaccine optimization is yet needed. These promising initial results, along with the specific biological characteristics of DNA vaccines that render them particularly interesting in terms of vaccine production, open new perspectives in terms of immunization at a global level. The potential capacities of DNA vaccines to meet the challenge of inducing protection against specific target diseases or for population target groups currently identified as health priorities are reviewed here together with their possible drawbacks.
Animals↗
[What is the prevalence of elderly persons at high risk in primary care?].
OBJECTIVES: To find the prevalence in a Health District of elderly people at high risk and the reasons for their inclusion in this category. To evaluate the percentage of patients requiring home care. DESIGN: A crossover descriptive study. SETTING: Urban health centre. PATIENTS STUDY POPULATION: patients over 65, TARGET POPULATION: elderly people with their medical notes at our centre. SAMPLE: 329 individuals chosen by systematic sampling of everyone over 65. MEASUREMENTS AND MAIN RESULTS: The elderly person is defined as at high risk or fragile when he/she fulfils one of the following criteria: a recent hospital release, physical incapacity, mental deterioration, over 80, in an institution, confinement to the home, living alone or being widowed, and recent change of home. There was 38.07% prevalence of elderly people at high risk. The main reasons for classification as elderly people at high risk were: age over 80, living alone and physical incapacity. There is a significant link between being an elderly person at high risk and female. 31.7% of elderly people at high risk have a physical incapacity which prevents their attendance at the health centre. CONCLUSIONS: It needs to be bome in mind that almost 40% of the over-65s are included in the groups of elderly people at high risk and therefore need special attention from Primary Care professionals. Our organisation needs to be adapted to the growing demand for home visits, which should cover at least 12% of those over 65 and 31% of the fragile elderly.
Age Distribution↗
[Racial mix of the panamanian population].
The racial admixture of a target population can be ascertained by quantifying the contribution to the genetic pool of each of its components (ancestral populations), which could be two, three or more. The racial admixture is of importance for the understanding of results derived from biomedical and anthropological studies. The main objective of this investigation is to determine the population frequencies of genetic systems ABO and Rh and to use these data to calculate the racial admixture of the country and of each sample province, fitting a trihybrid model. To achieve this, the Krieger method, implemented by the computer program Mistura 3, was applied to phenotypic data of systems ABO and Rh in a sample of 4,202 subjects born in seven provinces. In the general population of Panama, 38.72% of genes from the genetic pool have an African origin, 35.87%, an Amerindian origin and 25.40%, a Caucasian origin. In the province of Cocle we found a contribution of 16.47% of African genes, 55.25% of Amerindian genes and 28.28% of Caucasian genes. The province of Colon presents 69.34% of African genes, 25.00% of Amerindian genes and 5.65% of Caucasian genes. In contrast, Chiriquí presents 5.56% of African genes, 50.63% of Amerindian genes and 43.80% of Caucasian genes. The province of Herrera is characterized by the following proportions: 58.45% African genes, 28.44% Amerindian genes and 13.11% Caucasian genes. In the province of Los Santos there is a 62.29% African contribution, a 14.35% Amerindian contribution and a 22.72% Caucasian one. In the province of Panama there is a 57.01%, 26.25% and 16.74% contribution of African, Amerindian and Caucasian genes, respectively. Finally, in Veraguas a contribution of 18.59% of African genes, 44.29% of Amerindian genes and 37.12% of Caucasian genes was found.
Adolescent↗
Treatment of epilepsy in 3 specialized populations.
When discussing the treatment of epilepsy, targeted populations need to be defined. Three patient groups, children, the elderly, and women, are considered "special" because of metabolic and physical differences that require particular care during treatment of this disease. Treatment options vary significantly among these populations. Metabolic differences in very young and elderly patients require close attention by the prescribing physician. Rates of metabolism in children may be much faster than in nonelderly adults, requiring dosing adjustments to ensure enough medication is used to control seizures. Additional concerns with treating children include their increased sensitivity to toxic effects. Elderly patients may have slower metabolic rates because of decreased renal or hepatic function, and thus these patients can easily be overdosed as toxic drug levels build when clearance is reduced. Many elderly patients also may have concomitant illnesses that require other chronic medications. The potential for drug interactions is very high among this population. Women are considered a special population because of issues related to contraception, childbirth, and breast-feeding. Some antiepileptic medications are known to reduce the efficacy of oral contraceptives, and no medication has been proven safe for pregnant women. The pharmacokinetic profiles of many new generation antiepileptic medications may be advantageous to these specialized populations by creating fewer adverse effects, cleaner metabolism, and the reduced risk for drug interactions and teratogenicity.
Age Factors↗
Population pharmacokinetic modelling and estimation of dosing strategy for NXY-059, a nitrone being developed for stroke.
BACKGROUND AND OBJECTIVES: NXY-059 (disufenton sodium, Cerovive, a nitrone with neuroprotective and free radical trapping properties (in experimental stroke) is under development for the treatment of acute stroke. The objectives of this study were to develop a population pharmacokinetic model for NXY-059 in acute stroke patients and to estimate individualised dosing strategies for NXY-059 using preclinical pharmacological and clinical pharmacokinetic information and knowledge of characteristics of the patient population. METHODS: NXY-059 was given as a continuous intravenous infusion for 72 hours, including a 1-hour loading infusion. Maintenance infusion rates were individualised based on creatinine clearance (CL(CR)). Population pharmacokinetic models were derived using NONMEM software. Optimal dosing strategies, individualised based on CL(CR) or bodyweight, were estimated using the population pharmacokinetic models, empirical covariate distributions relevant for the target population, and a target definition. Dosing strategies were selected based on target fulfillment criteria and parsimony. PATIENTS: Pharmacokinetic data from 179 patients with acute ischaemic or haemorrhagic stroke, included in two clinical studies, were used for the analyses. Patients were aged 34-92 years with varying degrees of renal impairment (estimated CL(CR) 20-143 mL/min). MAIN OUTCOME MEASURES AND RESULTS: The final population model based on data from both studies comprised a two-compartment model with unexplained interpatient variability for clearance (23% coefficient of variation [CV]) and central volume of distribution (40% CV). Part of the variability in clearance and volume of distribution was explained by CL(CR) and bodyweight, respectively. Typical clearance was estimated to 4.54 L/h in a patient with CL(CR) of 70 mL/min. The preferred dosing strategy for NXY-059 comprised an initial loading infusion (the same for all patients) followed by an individualised maintenance infusion on the basis of CL(CR) (three dosing categories) with cut-off values (at which infusion rates are incremented or decremented) of 50 and 80 mL/min. CONCLUSION: The results illustrate how an individualised dosing strategy, given a pharmacokinetic target, for NXY-059 was successfully optimised through estimation using the increasing pharmacokinetic and pharmacodynamic knowledge during a clinical drug development programme. The chosen dosing strategy of NXY-059 provides an easily adapted treatment regimen for acute stroke, resulting in early achievement of target plasma concentrations.
Adult↗
Mass media interventions for promoting HIV testing.
BACKGROUND: Use of the mass media is one of the important strategies in communicating behavioral change in relation to HIV/AIDS prevention. Mass media are used to promote voluntary HIV counseling and testing and to sustain test-seeking behavior. OBJECTIVES: To assess the effect of mass media interventions and the most effective form of mass media intervention at a general population level or in specific target populations, in relation to changes in HIV testing, compared with a control group or with pre-intervention levels. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2004), MEDLINE (1966 to April 2004), EMBASE (1980 to April 2004), NLM Gateway, CINAHL (1982 to April 2004), AIDSearch (1980 to April 2004), and PsycINFO (1974 to April 2004), Sociological abstracts (1982 to April 2004), and Communication studies (1982 to April 2003). The reference lists of related reviews were searched and experts in the field were contacted to identify ongoing research. Relevant web sites of international agencies (UNAIDS, WHO, UNFPA, World Bank, and Centers for Disease Control and Prevention) were also searched. All these searches were done without language restriction. All databases were searched up to April 2004. SELECTION CRITERIA: Randomized controlled trials, including cluster-randomized trials and controlled clinical trials, that compared either multimedia interventions or one type of media strategy with a control in relation to promotion of HIV testing were included. Interrupted time series analyses that assessed the effect of mass media against no media or an alternative intervention to promote HIV testing were also included. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Types of mass media interventions, participants, and outcomes were extracted in every possible instance. MAIN RESULTS: Of the 35 references that were identified, two randomized controlled trials, three non-randomized controlled studies, and nine interrupted time series were included in the final analysis. All individual studies concluded that mass media were effective, and this was confirmed by reanalysis of the interrupted time series studies which all had initial impact. Mass media interventions for promotion of HIV testing showed significant immediate (Random effect: Estimated mean = 5.487, 95%CI = 2.370 to 8.605) and overall (Random effect: Estimated mean = 6.095, 95%CI = 1.812 to 10.378) effect. No long-term effects were seen on mass media interventions for promotion of HIV testing (Random effect: Estimated mean = 4.447, 95%CI = -0.188 to 9.082). AUTHORS' CONCLUSIONS: Mass media interventions have immediate and overall effects in promotion of HIV testing. No long-term effects were seen. There was no significant impact of detecting seropositive status after mass media intervention for promoting HIV testing, and this finding was limited to a small number of studies. Further research is required to identify possible effects on seropositivity status after mass media intervention for promotion of HIV testing among high-risk groups in epidemic countries. Additional research is needed to identify the effectiveness of different types of mass media interventions, the cost effectiveness of the interventions, and characteristics of messages.
Controlled Clinical Trials as Topic↗
Characteristics of participants in a televised smoking cessation intervention.
Participants in various components of a televised self-help smoking cessation program, based on the American Lung Association's Freedom From Smoking in 20 Days, are compared with a sample of the population of smokers to whom the intervention was addressed. Over 325,000 smokers in the target population were exposed to the program at some level. Most watched televised segments. Approximately 75,000 manuals were distributed and about 55,000 were used. Comparisons between participants and the targeted smoking population indicate that the intervention attracted those in the smoking population who are expected to be the majority of smokers by the Year 2000-blacks, females, and those with incomes under $13,000 per year. Participants with these characteristics were most likely to view the televised segments. Heavy smokers, females, and those with the most education were most likely to refer to the manual at least twice a week during the intervention. Older, nonblack participants and those with incomes of $13,000 or more per year were most likely to attend group support sessions outside the home. Overall, the patterns of association indicate that although a televised smoking cessation program can attract individuals similar to those projected to be smokers in 2000, participation in various components of the intervention will vary by demographic characteristics.
Adolescent↗
[Epidemiological monitoring of psychological, neurological and sensory handicaps in the 0-24-year-old Abruzzo population (Italy). Preliminary results].
OBJECTIVE: To describe the setting up of the Abruzzo Region (Italy) Service for Prevention and Epidemiological Register of Handicaps, to show prevalence data of occurring diseases and fit regression models aimed at explicating disease occurrence in terms of risk factors; to discuss services access data in terms of their efficacy in fitting social and health needs. SETTING AND DESIGN: We managed data obtained from a regional information system, based upon primary information sources operating in the Local Health Agencies (i.e. school medicine services, general practitioners, paediatricians, familiar counseling services, rehabilitation centers) and specialistic structures for diagnostic detection (multidisciplinary school équipes, hospital division of infant neuropsychiatry, outpatient infant neuropsychiatry services). The data managing model is a population-based epidemiological register. The target population is the 0-24 years population of the Abruzzo Region. MAIN OUTCOME MEASURES: Occurrence data are expressed as prevalence rates, using standardisation according to the global population of the area of interest. Diagnoses have been defined according to the standard ICD-9 and ICD-10 criteria; definition of handicaps has been made according to the WHO classification (1981). Association between indicator (socio-demographic and anamnestic) variables and occurrence of disease has been fitted by logistic regression models. RESULTS: Prevalence estimates obtained for the main infant neuropsychiatric diseases, as well as for the main handicap-determining genetic and/or congenital diseases, are consistent with the findings of literature in similar settings. An exception is the high occurrence of hyperkinetic disorders in both sexes. Rehabilitation is the main health need for all diagnostic axes. With respect to social needs, school and home personal care seem to be scarcely relevant if related to disease prevalence. Logistic regression analysis indicates socio-economic status and presence of handicapped relatives in the family as factors associated with the occurrence of disease. Respectively, the two factors are negatively associated with the occurrence of hyperkinetic disorders and positively associated with occurrence of mental retardation. Moreover, living in a natural family is negatively associated with evolutive disorders. CONCLUSIONS: This is a report about the preliminary results obtained by a specialised register for infant psychological and neurological handicaps. The findings suggest, as operating indications, the standardisation of diagnostic procedures and the definition of common managing guidelines in different areas. Anyhow, the findings of this report highlight the importance of an epidemiological knowledge of handicap in order to design correct prevention strategies and health services planning.
Adolescent↗
Mental health services for homeless mentally ill persons. Federal initiatives and current service trends.
Recent research suggests that approximately one third of the population of homeless single adults suffer from severe mental illnesses. Despite multiple health, mental health, and social welfare needs, this population is often unable to obtain necessary housing and community-based services. For this reason, since 1982, the National Institute of Mental Health (NIMH) has undertaken a number of federal initiatives to encourage research and assist states and localities in improving services focused on this vulnerable subgroup of the homeless population. This article describes the target population, NIMH research findings, and current mental health service trends--with particular emphasis on two mental health programs established under the Stewart B. McKinney Homeless Assistance Act. Proposed future directions for federal research and evaluation efforts in this area are also discussed.
Community Mental Health Services↗
Prevalence of primary open-angle glaucoma in a Spanish population: the Segovia study.
PURPOSE: To determine the prevalence of primary open-angle glaucoma (POAG) in Segovia, Spain. METHODS: We conducted a cross-sectional, population-based epidemiologic study, the target population of which was residents of Segovia, Spain, aged 40 to 79 years. A sample of 569 subjects was randomly selected in a stratified manner according to gender and age groups. All participants underwent a complete ophthalmic examination that included measurement of visual acuity and refraction, tonometry, anterior segment biomicroscopy, funduscopy, stereoscopic photographs of the optic nerve head, and automated white-on-white visual field testing. Two independent observers evaluated the optic nerve photographs and visual fields. The diagnosis of POAG was established when any eye had an open angle and a glaucomatous optic nerve and glaucomatous visual field. The prevalence of POAG in the population was estimated from the prevalence in the complete sample and the patients already diagnosed at the only glaucoma service in the city. RESULTS: The estimated prevalences (99% confidence interval) in the population were, respectively, 2.1% (1.9-2.3%), and 1.7% (1.6-1.8%) for POAG and ocular hypertension. The prevalence of POAG increased with age (P < 0.005) and tended to be greater (P = 0.054) in men (2.4%) than women (1.7%). CONCLUSION: The prevalence of POAG in this Segovia population is 2.1%, similar to that estimated in previous studies performed in predominantly Caucasian populations.
Adult↗
Occurrence and risk indicators of increased probing depth in an adult Brazilian population.
BACKGROUND/AIMS: There is little information about the occurrence and risk indicators for periodontal diseases in Latin America. The present study describes the prevalence, extent and severity of periodontal probing depth (PPD) and assesses the association between demographic, behavioural and environmental risk indicators and the extent and severity of PPD in this population. MATERIALS AND METHODS: The target population was urban adults aged > or =30 years in Rio Grande do Sul state in South Brazil. A representative sample was selected using a multi-stage, probability, cluster sampling strategy and included 853 dentate subjects 30-103 years of age. A full-mouth clinical examination was carried out at six sites per tooth on all permanent teeth, excluding third molars, and was conducted in a mobile examination centre. RESULTS: Approximately 65% and 25% of the subjects and 19% and 5% teeth per subject had PPD > or =5 and > or =7 mm, respectively. 31.6%, 33.7% and 34.7% subjects had generalized, localized or no PPD > or =5 mm, respectively. Probing depth increased in prevalence with increasing age, and leveled off at around 50 years of age and beyond. PPD > or =5 mm was significantly higher in males than in females, and in non-Whites than in Whites. Cigarette smokers had a significantly higher occurrence of PPD > or =5 mm than non-smokers, and this relationship was dose dependent. A multivariate model showed that generalized PPD > or =5 mm was associated with subjects aged > or =40 years, males, non-Whites and moderate or heavy cigarette smokers (relative risk ratios: 2.0, 2.0, 2.2, 2.4 and 6.8, respectively). CONCLUSION: Moderate and deep probing depth was a common finding in this urban adult Brazilian population. Older age, male gender, non-White race and moderate and heavy cigarette smoking were significant risk indicators of increased PPD, and these may be useful indicators of periodontal disease high-risk groups.
Adult↗
Luminal narrowing after percutaneous transluminal coronary angioplasty. A study of clinical, procedural, and lesional factors related to long-term angiographic outcome. Coronary Artery Restenosis Prevention on Repeated Thromboxane Antagonism (CARPORT) Study Group.
BACKGROUND: The renarrowing process after successful percutaneous transluminal coronary angioplasty (PTCA) is now believed to be caused by a response-to-injury vessel wall reaction. The magnitude of this process can be assessed by the change in minimal lumen diameter (MLD) at follow-up angiography. The aim of the present study was to find independent patient-related, lesion-related, and procedure-related risk factors for this luminal narrowing process. A model that accurately predicts the amount of luminal narrowing could be an aid in patient or lesion selection for the procedure, and it could improve assessment of medium-term (6 months) prognosis. Modification or control of the identified risk factors could reduce overall restenosis rates, and it could assist in the selection of patients at risk for a large loss in lumen diameter. This population could then constitute the target population for pharmacological intervention studies. METHODS AND RESULTS: Quantitative angiography was performed on 666 successfully dilated lesions at angioplasty and at 6-month follow-up. Multivariate linear regression analysis was performed to obtain variables with an independent contribution to the prediction of the absolute change in minimal lumen diameter. Diabetes mellitus, duration of angina < 2.3 months, gain in MLD at angioplasty, pre-PTCA MLD, lesion length > or = 6.8 mm, and thrombus after PTCA were independently predictive of change in MLD. Overall prediction of the model was poor, however, percentage-correct classification for a predicted change between -0.1 to -0.4 mm was approximately 10%. Lesions showing no change or regression (change > -0.1 mm) and lesions showing large progression (< or = -0.4 mm) were more predictable (correct classification, 59.5% and 49.7%, respectively). CONCLUSIONS: Renarrowing after successful PTCA as determined with contrast angiography is a process that cannot be accurately predicted by simple clinical, morphological, and lesion characteristics.
Angioplasty, Balloon, Coronary↗
Prevalence of stroke in Kinmen.
BACKGROUND AND PURPOSE: Stroke is the second most common cause of death in Taiwan. We studied its prevalence, risk factors, and mortality in a rural Chinese population. METHODS: A door-to-door survey of stroke was conducted in two Kinmen Island townships with a total population of 26105 people. Our target population (n = 5061) consisted of all the registered residents in these townships who were aged > or = 50 years on August 1, 1993. All participants were given a standardized neurological examination and a questionnaire. RESULTS: The participation rate was 77.4% (n = 3915). Ninety-six cases of completed stroke were identified. Eighty-nine patients had one, 6 patients had two, and 1 patient had three episodes of stroke. The prevalence of stroke in persons aged > or = 50 years was 24.5 per 1000 (95% confidence interval, 19.7 to 29.3 per 1000). Prevalence increased with age. Statistically significant risk factors associated with stroke included hypertension, diabetes mellitus, and irregular heartbeats. Of the stroke survivors, 59% were independent in activities of daily living and 71% could walk independently. CONCLUSIONS: Compared with other countries, Taiwan has a moderately high prevalence of stroke. The risk factors for stroke in this rural region of a developing country are similar to those in developed countries. Most stroke survivors here perform their daily activities independently without outside assistance.
Activities of Daily Living↗