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At least 577 records · Page 32Linked to original sources
PubMed1995

A study on prevention of hospital infection control caused by tooth preparation dust in the dental clinic. Part 1. Preventive measures against environmental pollution in the dental clinic caused by microbial particles.

Tooth preparation dust, an indispensable part of dental treatment, contains bacteria and viruses. In order to examine environmental pollution in the dental clinic during tooth preparation, we monitored microorganism spread by counting colony forming units (CFU) with the "Andersen Microbe Sampler." This test was conducted in a "Clean Booth." Mitis-salivarius medium was used to count the oral-streptococcus species. The ability of the "Extra-Oral Vacuum Aspirator (EOVA)" to effectively eliminate contamination was also tested, and the EOVA was found to reduce the spread of oral-streptococci, significantly. The EOVA was therefore viewed as an effective method for reducing air pollution in the dental clinic, and should be used when treating patients with certain infectious diseases.

Air Microbiology↗
PubMed1996

[Diabetes mellitus is currently one of the most frequent causes or associated causes of uremia. Data from the Piedmont registry of dialysis and transplantation (update, December 1993)].

A regular dialytic treatment of diabetic patients is until accepted from about twenty years in many areas. Aim of this work was a retrospective analysis of main clinical and survival data of diabetic patients (diabetic nephropathy or diabetes as comorbidous factor = 659 cases) admitted for dialysis in Piedmont (Northern Italy Region about 4,400,000 inhabitants) in the period 1981-1993 (functional recovery and follow-up < 1 month excluded). A progressive increment in incidence of diabetic patients was seen mostly in the aged. At 12/31/1993, 263 of 2404 patients admitted for dialysis were diabetics (10.9%); the majority of them was treated in Hospital Centers with bicarbonate haemodialysis (54.4%), while a small group was treated with CAPD (12.9%). During the years ¿80 was seen a progressive leaving of CAPD as first choice method in this population and in the last period the orienteering is the utilization of mixed methods (diffusive-convective as first choice). As regards the survival are not prominent significant differences between this cohort and the cohort affected by vasculopathy as comorbidous factor (86.2 and 54.2% in diabetics vs 78.6 and 55.2% in patients affected by vasculopathy at 1 and 3 years--p = 0.3481; patients aged 45-64 years). In conclusion the cohort of diabetic patients represent a good marker of the clinical problems of the elder population with high clinic risk, in progressive increasing in our Region.

Adult↗
PubMed1998

Steroid sulphatase deficiency is the major cause of extremely low oestriol production at mid-pregnancy: a urinary steroid assay for the discrimination of steroid sulphatase deficiency from other causes.

A method for determining whether a pregnant woman with an extremely low serum oestriol (ELSE) measurement of mid-trimester is carrying a fetus with steroid sulphatase deficiency or another more serious disorder is described. We undertook GC/MS analysis of steroids in random maternal urine samples and quantified oestriol, oestriol precursors (dehydroepiandrosterone (DHEA), 5-androstene-3 beta, 17 beta-diol, 16 alpha-hydroxy-dehydroepiandrosterone and 5-androstene-3 beta, 16 alpha, 17 beta-triol), pregnanediol, and five other steroids largely unaffected by pregnancy (androsterone, etiocholanolone, tetrahydrocortisol, 5 alpha-tetrahydrocortisol and tetrahydrocortisone). Thirty-two samples collected from seven normal pregnant women between the 7th and 27th week of pregnancy and 22 from individuals with ELSE were analysed. Diagnostic ratios of excreted products were developed. These included ratios of oestriol and oestriol precursors to the cumulative value for the five non-pregnancy-related steroids and ratios of oestriol and oestriol precursors to pregnanediol and to each other. Our data demonstrated high 3 beta-hydroxy-5-ene steroid excretion in all ELSE patients together with low urinary oestriol excretion, a situation only consistent with deficiency of steroid sulphatase. The normal individuals had high oestriol and low excretion of oestriol precursors. No patient in our series showed the low oestriol levels and low oestriol precursor values that would indicate a fetal adrenal abnormality as the underlying defect.

Androstenediol↗
PubMed1998

[National and international guidelines ignore significant cause of heart failure. Diastolic dysfunction is often the cause of heart failure in the elderly and in women].

Comparison of patients treated for chronic heart failure at a large hospital with patients included in major treatment studies published during the past ten years yielded important information. The former series was characterised by greater proportions of the elderly and of women than were the series recruited to the often cited ACE (angiotensin-converting enzyme) inhibitor studies. Although only patients with systolic dysfunction were recruited to the latter studies, a substantial body of evidence suggests the prevalence of severe heart failure among patients with normal systolic function to increase with increasing age. Thus, as many as 50 per cent of all elderly patients with chronic heart failure may have normal systolic function. In most cases, the heart failure is probably due to diastolic dysfunction, a condition that still lacks both a simple diagnostic procedure and a well-documented treatment.

Aged↗
PubMed1999

Cause of death as a contemporary problem.

Four characteristics have been identified that affect the contemporary analysis of cause of death: (1) the increasing use of cause-of-death data for public policy; (2) the growing disjuncture between cause of death and cause of poor health; (3) the problem of specifying cause of death for the elderly, who constitute a growing proportion of the population and, accordingly, of mortality; and (4) the impact of technology and medical science on the temporal comparability of mortality statistics. With regard to the first issue, statistical data in general are being used with increasing sophistication throughout society. The public is exposed to all types of data by the media,and is increasingly educated in how to interpret statistics. Government at all levels increasingly uses data to help to help identify priorities, to choose among policy options, and to evaluate outcomes of decision making. Cause-of-death data are but a specific subset of information that are being used to understand social, economic, and health issues and to make more informed private and public choices regarding these issues. Increasing use of any data set is likely to result in better data simply because greater use results in closer scrutiny of data quality with resultant emphasis on evaluation and systematic efforts to improve quality. This is happening to cause-of-death data in the United States. The National Center for Health Statistics (NCHS) initiated major efforts through two national workshops in 1989 and 1991 to improve the quality of medical certification of death through better training of physicians, medical examiners, and coroners. While there is no clear evidence that the initiatives resulting from these workshops alone resulted in data quality improvement, the indicators used by NCHS to measure quality of medical certification point to continued gradual improvement in completeness and specificity in cause-of-death data. The gap between causes of morbidity and causes of mortality is growing because advances in medical science has essentially eliminated many infectious and communicable diseases that previously caused premature death and have considerably reduced the lethality of chronic conditions that previously caused death at earlier ages. As acute conditions have moved into the background, so to speak, a variety of disabilities and impairments have moved forward as sources of illness,pain, and diminished quality of life. As a consequence, the previously clear etching in mortality statistics of a society's health has become blurred by advances in medicine, healthcare, and prevention. Mortality data continue to have value per set and are important to social and medical knowledge because of their availability as a uniquely continuous data set. However, increasingly, a complete and contemporary profile of the health of a society requires data on both morbidity and mortality as complimentary indicators of health and social development. Not only do we need to know of what causes people to die, but also what health conditions aggravate and diminish their lives and, at an aggregate level, that conditions impose the greatest health costs on the community. Increasingly, these are debilitating conditions of the elderly that may diminish life but may not cause death. Medical description of the cause of death of an elderly person has probably never been easy; however, the contemporary extension of life has made the problem more visible and substantial than in earlier times. It is likely that the relatively few octogenarians of centuries past were also afflicted by concurrent medical conditions, and that even younger persons were prematurely afflicted by conditions that are now identified with advanced age. For these population groups, the description of cause of death, as a single and singular initiating event, is problematic.

Brain Neoplasms↗
PubMedDate not supplied

Cause of death reporting systems in India: a performance analysis.

BACKGROUND: Reliable statistics on the causes of death in the population are essential for setting priorities in the health sector. Most cause of death reporting systems in developed countries rely on medical certification of the cause of death according to the International Classification of Death (ICD-10), and have achieved near-total coverage. Developing countries such as India, where adequate medical facilities are not available, depend on lay reporting of the cause of death in rural areas, using a sample registration system. The use of the cause of death statistics in India is questioned in view of the poor coverage, and poor compliance with guidelines for cause of death reporting, coding and classification. METHODS: A brief description of the reporting system in India is followed by the characteristics of a usable cause of death reporting system. We identified 9 criteria based on a review of the literature and our own assessment of the problem. The performance of the cause of death reporting system for rural and urban areas of India was examined against each of the 9 criteria. We offer a subjective rating on a three-category rating scale consisting of (i) satisfactory, (ii) tolerable, and (iii) poor. RESULTS: The major factors affecting the use of the cause of death statistics in India are: (i) poor coverage; (ii) high incidence of unclassifiable deaths; (iii) long delay and irregular publication of statistics; and (iv) lack of systematic screening. CONCLUSIONS: We recommend the following steps to improve the usability of cause of death statistics in India. Introducing periodical reviews jointly by the Departments of Health and Municipal Administration to identify non-reporting municipalities, sample units, and further identification of non-reporting health care institutions sustained over a period of, say, five years will raise coverage substantially. The other measures include: (i) training programmes to build up cause of death report writing skills among physicians; (ii) compilation and publication of cause of death statistics at the state level; (iii) sponsored research on the cause of death reporting structure and its implications for policy-making; and (iv) computerization of filling, tabulation and flow of cause of death statistics at the municipality and the state levels. To reduce the unusually high level of unclassifiable deaths, the Registration of Births and Deaths Act should be amended to ensure that hospitals and health care institutions maintain medical records. For accurate cause of death data from rural areas, we recommend that the performance of the sample registration survey-cause of death (SRS-COD) component be evaluated according to the above criteria.

Adolescent↗