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PubMed2000

Different diagnostic methods for detection of influenza epidemics.

Linking continuous community-based morbidity recording of influenza-like illness (ILI) with virological sampling has consistently proved its value as one of the earliest indicators of circulating influenza activity. The clinical morbidity recording in the Portuguese national surveillance network, during a 7-year period, and the contribution of different diagnostic techniques, including virus isolation, multiplex RT-PCR, immunocapture enzyme linked immunoassay (EIA) and complement fixation tests (CFTs) for the detection of influenza in such a community-based setting is described and evaluated in this study. There was good correlation between the increase of morbidity, total samples taken and the detection of influenza virus by all the methods although this was less evident for virus isolation and EIA than for RT-PCR or serology. From a total of 1685 throat swabs collected from cases of ILI, 43.6% were RT-PCR positive, 17.5% were positive by capture EIA and in 5% virus isolates were made. The detection of influenza by RT-PCR occurred earlier than by any other method and showed the best correlation with epidemic patterns of morbidity registration. We conclude that in surveillance systems where virus culture is sub-optimal, RT-PCR provides a rapid, sensitive, specific method for detecting influenza viruses from community-based sampling.

Complement Fixation Tests↗
PubMed2001

[Etiology of community-acquired pneumonia in ambulatory patients. Usefulness of a diagnostic investigation protocol using detection of Streptococcus pneumoniae and Legionella pneumophila antigens in urine samples].

BACKGROUND: To determine the etiology of community-acquired pneumonia (CAP) in ambulatory patients and to assess the efficiency of a diagnostic protocol by using tests to detect bacterial antigens in urine samples. PATIENTS AND METHOD: One-year prospective study that included blood and sputum cultures, serologic studies, and detection of Legionella pneumophila and Streptococcus pneumoniae urinary antigens. RESULTS: 49 patients were recruited and an etiological diagnosis was attained in 34 (69%). Microorganisms most frequently isolated were S. pneumoniae (12 cases), Mycoplasma pneumoniae (7), Haemophilus influenzae (4), respiratory viruses (4) and Coxiella burnetii (3 cases). CONCLUSIONS: By means of a non-invasive protocol with urinary antigen tests, a microbial etiology can be established in two thirds of patients with mild CAP. S. pneumoniae is the main cause of mild CAP.

Adolescent↗
PubMedDate not supplied

Intestinal parasites in Zambian patients with AIDS.

Previous studies have found a high prevalence of Isospora belli and Cryptosporidium parvum infections in African acquired immune deficiency syndrome (AIDS) patients with chronic diarrhoea. We aimed to determine the prevalence of gastrointestinal parasite in AIDS patients in hospital, not only those with diarrhoea, and to compare them with the general community. Clinically diagnosed AIDS patients in a Zambian teaching hospital were interviewed and examined, and stool specimens were studied for parasite infection. A control group was recruited from adults in a township near Lusaka. Of 90 AIDS patients (58% male), 50 (56%) had chronic diarrhoea and 9 (10%) had diarrhoea of shorter duration. In the control group (105 adults; 85% female), only one complained of diarrhoea. A variety of intestinal protozoa and helminths was found in 57% of AIDS patients and 88% of the community members. Isosporiasis was detected in 7, and cryptosporidiosis in 2, AIDS patients, all with diarrhoea, but not in any control. Strongyloides was found in 2 AIDS patients with diarrhoea and one community resident. Hospital patients with AIDS had fewer Entamoeba coli and E. histolytica infections, probably because of previous chemotherapy. We conclude that AIDS predisposes to isosporiasis and cryptosporidiosis, but not to infection with extracellular intestinal parasites, such as Entamoeba species, Blastocystis, Chilomastix, Endolimax, Ascaris and Necator.

Acquired Immunodeficiency Syndrome↗
PubMed2003

[Risk factors related with eating disorders in a community of adolescents].

OBJECTIVE: To detect risk factors related with eating disorders. DESIGN: Descriptive, cross-sectional study. SETTING: 5 secondary schools in the Virgen de Rocío health area in Seville, Spain. PARTICIPANTS: 789 students enrolled in the first and second years of compulsory secondary school, and their families. MAIN MEASURES. Body mass index, risk behaviors related with food and exercise, influence of the mass media on models of desirable body types, and family climate. Data were obtained with three validated questionnaires: the Eating Attitudes Test (EAT-40), the CIMEC-26, and the Family Environment Scale (FES). RESULTS: In 6.9% of the participants, BMI was between 15 and 17, reflecting slight malnutrition. On the EAT scale, 68 participants (8.8%) had scores that were indicative of illness or risk of illness, and 25 (3.3%) could be diagnosed as having eating behavior disorder according to DSM-IV criteria. According to the CIMEC questionnaire, 104 participants (13.5%) were found to be significantly vulnerable to media pressures, and 85 (11.1%) were considered highly vulnerable. Parents' comments on eating behavior were related with the results on the EAT-40 CIMEC questionnaires (P=.01). No statistically significant relationship was found between family climate scores and the scores on the EAT-40 or CIMEC questionnaires. Students in rural or suburban area schools scored higher on the EAT-40 (P=.04) and CIMEC (P=.01) than students in urban or city center schools. CONCLUSION: The identification of persons considered at risk will allow us to use primary prevention programs more efficiently.

Adolescent↗
PubMed2003

[PSA and anthropometric measurements among Amazon Indians: an evaluation of the Parkatejê community].

OBJECTIVE: PSA (prostate-specific antigen) screening for early detection of prostate cancer in a native community is of great epidemiological importance. The study was conducted with the objective of verifying the occurrence of prostate cancer among members of an Amazon community, as well as its possible relationship to acculturation and overweight (body mass index). METHODS: Lifestyle and anthropometric information was collected from a group of 22 men, presumedly over age 50, members of an isolated community of 363 Amazonian Indians--self-denominated Parkatejê and Kykatêjê--from Pará state, in Northern Brazil. In addition to physical and hematological exams, total and free PSA dosages were performed. RESULTS: Total PSA serum levels ranged from 0.35 to 25.8 ng/ml. Three subjects had PSA levels greater than 4.0 ng/ml, and another two had levels between 2.5 and 4.0 ng/ml. Prostate biopsies performed on two subjects indicated the presence of prostate adenocarcinoma in one of them and of intraepithelial neoplasia on the other. Overweight (BMI> or =25 Kg/m2) and waist-to-hip ratio > or =0.9 were observed in 68.1% and 72% of subjects, respectively. CONCLUSIONS: Changes in nutritional habits caused by contact with civilization, such as the substitution of more caloric foods for the traditional game and vegetable fiber are increasing the prevalence of overweight among the community. In view of the association between prostate cancer incidence, high-fat diet, and less physical activity, it can be assumed that further cases of prostate neoplasia will occur in the future, since several community members already have high PSA serum levels.

Adenocarcinoma↗
PubMed1990

Schistosomiasis mansoni in the Dominican Republic; prevalence and intensity in various urban and rural communities, 1982-1987.

Surveys to detect foci of schistosomiasis mansoni endemicity in the Dominican Republic were carried out from 1982 to 1987 and showed that the disease is far more widely distributed in the country than previously thought. New foci (San Rafael del Yuma, Batey Palo Bonito, Maicillo, Nisibon and additional barrios in the city of Higuey) were found in the eastern provinces, and other completely new foci (Bayaguana, Sabana Rey (Cotui) and Jarabacoa) in the center of the country and in the National District (Guerra) were also detected. Prevalence rates in the various barrios (sections) of the city of Higuey varied between 7.4% and 24.6%, whereas they were 10.2% in Maicillo, 7.8% in El Valle and 9.9% in El Seibo. The intensity of infection was very low as judged by eggs per gram of feces. Serodiagnosis using the circumoval precipitin test raised the infection rate from that indicated by stool examination, as in Maicillo, or both results were equal, as in Las Palmillas.

Adolescent↗
PubMed1988

Evaluation and synthesis of health effects studies of communities surrounding arsenic producing industries.

Epidemiological studies designed to detect lung cancer risk and other health effects in communities surrounding arsenic-producing copper smelters were reviewed. The studies were about evenly divided in finding deleterious and 'beneficial' effects of arsenic. All of the studies had insufficient statistical power to detect the small increases in risk that may occur. Even the most powerful studies were not designed to detect relative risks less than about 1.2 and the majority of the studies had little power to detect risks under 2.0. Confidence intervals for the relative risks from these studies were not very useful in putting an upper bound on adverse effects of arsenic. Sources of bias and other difficulties with community health studies are also discussed. We argue that these studies may be a good and economical first investigation but, due to a lack of power, null findings do not rule out the possibility of excess risks that may be significant from a public health viewpoint.

Air Pollutants↗
PubMed1988

Occurrence of rotaviruses in Guangzhou and Hong Kong.

Electropherotypes of human rotavirus (HRV) isolated from Hong Kong and Guangzhou were compared to study the transmission of HRV between the cities. Forty-one electropherotypes were identified from 418 hospitalized patients with HRV infection at the Queen Mary Hospital, and 22 were detected from 66 outpatients in community clinics at a separate area in Hong Kong. Nineteen electropherotypes were detected in 370 hospitalized cases of HRV infection from seven hospitals in Guangzhou. Results showed that HRV electropherotypes appeared to circulate freely within each area, yet the HRV population between the two cities remained different. Six electropherotypes were common to both cities. Three of these were predominant types found in Guangzhou and later detected in Hong Kong. One of these was found to cause an outbreak in Hong Kong. Of the remaining three electropherotypes, two were detected in both cities simultaneously, whereas one was first detected in Hong Kong.

Child, Preschool↗
PubMed1995

Comparison of free-living and particle-associated bacterial communities in the chesapeake bay by stable low-molecular-weight RNA analysis.

Free-living and particle-associated bacterial communities in the Chesapeake Bay estuary were analyzed and compared by using acridine orange direct counts and low-molecular-weight (LMW) RNA analysis. Samples were taken from top and bottom waters at upper- and mid-bay sites in December 1992. Free-living bacteria dominated the bacterial numbers at all sampling sites, although particle-associated bacteria increased in areas with greater particle loads. LMW RNAs (5S rRNA and tRNA) obtained directly from free-living, particle-associated, and total bacterioplankton communities were analyzed by high-resolution electrophoresis. There were distinct differences in the migration distances between LMW RNAs of free-living and particle-associated communities taken from the same site, indicating that the two communities differ in composition. In addition, LMW RNA profiles differed minimally with depth for all of the communities examined, presumably because of vertical mixing. 5S rRNAs of free-living communities from the upper- and mid-bay regions differed considerably. Particle-associated RNAs, on the other hand, were very similar, suggesting consistent environmental conditions on particles that select for similar community members. Lastly, several isolated bacteria had 5S rRNAs that were not detected in their respective extracted community 5S rRNAs, indicating that these isolated organisms were not representative of dominant members.

Journal Article↗
PubMed2000

Clinical pharmacy in primary care and community pharmacy.

The role of the community pharmacist involved in primary care has been undergoing change. In the late 1970s and early 1980s, developments in computerized medication surveillance within the Netherlands enabled pharmacists to react to prescriptions and detect inappropriate pharmacotherapy in community pharmacy sites. This activity became more clinically or patient-oriented in the late 1980s. In the early 1990s, pharmaceutical care was introduced in community pharmacy practice, and emphasis was given to providing patient-centered care and documenting cognitive services. The key features of pharmaceutical care provided in the primary care setting are described based on a review of the literature and on experiences in the Netherlands. Patient outcomes have yet to be shown to be improved by community pharmacy practice; methods for measuring performance are still lacking. Methods to evaluate the extent of integration of community pharmacy services into the clinical team are also lacking but are needed in order to define the future role of community pharmacists in the primary care setting. Integrated care needs to be developed in the Netherlands in order to present the next phase in the process of the "pharmaceutical evolution."

Community Pharmacy Services↗
PubMed2004

[Immunity to flavivirus in Amerindian population of the Sierra de Perijá, Zulia state, Venezuela].

Little information is available about Flavivirus infection in amerindian populations in western Venezuela. On this account the activity and seroprevalence of these viruses were determined and the hypothesis concerning the existence of a sylvatic cycle, conditioning the infection transmission of these viruses in indigenous populations, was studied. For this, blood samples from Yukpas (n=144) and Barí (n=110) communities were collected, 35 (Yukpas=25 and Barí=10) of which were processed for viral isolation followed by RT-PCR. The anti-Flavivirus IgG antibodies were determined by ELISA. The results did not show active Dengue cases and the seroprevalence of anti-Flavivirus IgG in the Yukpa population was significantly higher (p < 0.0001) than in the Barí population (43.1% vs. 6.4%). The present study has determined the presence of Flavivirus immunity in Yukpa and Barí populations. These results show a higher prevalence at the former than in the Barí population, which suggests circulation of Flavivirus, mainly in the Yukpa communities, being scarce and sporadic in Barí villages. However, in the indigenous populations studied, the causes or factors that determine the off set of Flavivirus infections in these zones could vary. The detected prevalence between both communities may be due to differences in the structure settlements and social habits. No evidences were found to support the presence of a sylvatic cycle in the Flavivirus transmission, specially of Dengue, in this population.

Adolescent↗
PubMedDate not supplied

[Epidemic outbreak of hepatitis B from the tattoo in gypsy families].

BACKGROUND: To document an outbreak of Hepatitis B in a gypsy community in the Upper Aragón region, as well as the control measures adopted. METHODS: Documented study of Hepatitis B cases and families, including an epidemiological survey and the determining of hepatitis B viral indicators (MVHB) using immunoenzymatic methods. RESULTS: 84.8% participation (39/45). During the months of February and March 1988, 5 cases of Hepatitis B were detected in a gypsy community in the Upper Aragon region (12.8% attack rate, 5/39), with an average age of 13.0 + 7.3, (4 women and one man). Four of the cases detected had previously undergone tatooing. The fifth case was due to direct transmission from mother to a recently born child. The MVHB study of families showed a further two cases. MVHB rate being 17.9% (7/39). Vaccinations were given to all persons susceptible to the disease. CONCLUSIONS: It is suggested that tatooing could be a significant factor to be considered in relation to the transmission of Hepatitis B in gypsy communities. Due to the high rate of incidence of the disease in this ethnic group, general vaccination is prescribed.

Disease Outbreaks↗
PubMed2003

Small-scale vertical distribution of bacterial biomass and diversity in biological soil crusts from arid lands in the Colorado plateau.

We characterized, at millimeter resolution, bacterial biomass, diversity, and vertical stratification of biological soil crusts in arid lands from the Colorado Plateau. Microscopic counts, extractable DNA, and plate counts of viable aerobic copiotrophs (VAC) revealed that the top centimeter of crusted soils contained atypically large bacterial populations, tenfold larger than those in uncrusted, deeper soils. The plate counts were not always consistent with more direct estimates of microbial biomass. Bacterial populations peaked at the immediate subsurface (1-2 mm) in light-appearing, young crusts, and at the surface (0-1 mm) in well-developed, dark crusts, which corresponds to the location of cyanobacterial populations. Bacterial abundance decreased with depth below these horizons. Spatially resolved DGGE fingerprints of Bacterial 16S rRNA genes demonstrated the presence of highly diverse natural communities, but we could detect neither trends with depth in bacterial richness or diversity, nor a difference in diversity indices between crust types. Fingerprints, however, revealed the presence of marked stratification in the structure of the microbial communities, probably a result of vertical gradients in physicochemical parameters. Sequencing and phylogenetic analyses indicated that most of the naturally occurring bacteria are novel types, with low sequence similarity (83-93%) to those available in public databases. DGGE analyses of the VAC populations indicated communities of lower diversity, with most types having sequences more than 94% similar to those in public databases. Our study indicates that soil crusts represent small-scale mantles of fertility in arid ecosystems, harboring vertically structured, little-known bacterial populations that are not well represented by standard cultivation methods.

Biomass↗
PubMed2005

Effect of humic material on the bacterioplankton community composition in boreal lakes and mesocosms.

The bacterioplankton community composition in two Finnish forest lakes with different content of humic substances was studied by denaturing gradient gel electrophoresis (DGGE) and sequencing of the major bands. The same dominant bacterial phylotypes were detected in the bacterioplankton communities of clear-water Lake Ahvenlammi and humic Lake Sammalisto. For 4 years, in every water layer, Actinobacteria was the dominant and Verrucomicrobia the second most common phylum. In the hypolimnion, other dominant phyla were also found. We set up a mesocosm experiment to assess the effect of a sudden load of allochthonous humus extract to the bacterioplankton community composition. Changes in the bacterial communities were followed in four control and four humus extract-added mesocosms for 50 days. In the humic mesocosms the phylotypes of allochthonous Proteobacteria arriving with the humus extract were initially prevalent but disappeared during the first weeks. After this the Actinobacteria-dominated communities resembled the bacterioplankton communities of the control mesocosms and Lake Ahvenlammi. Towards the end of the experiment the community patterns in all the mesocosms started to change slightly because of erratic occurrence of new proteobacterial phylotypes. Thus the effects of a sudden load of allochthonous humic material and bacteria to the bacterioplankton community composition were transient.

Actinobacteria↗
PubMed2005

Impact of Bt corn on rhizospheric and soil eubacterial communities and on beneficial mycorrhizal symbiosis in experimental microcosms.

A polyphasic approach has been developed to gain knowledge of suitable key indicators for the evaluation of environmental impact of genetically modified Bt 11 and Bt 176 corn lines on soil ecosystems. We assessed the effects of Bt corn (which constitutively expresses the insecticidal toxin from Bacillus thuringiensis, encoded by the truncated Cry1Ab gene) and non-Bt corn plants and their residues on rhizospheric and bulk soil eubacterial communities by means of denaturing gradient gel electrophoresis analyses of 16S rRNA genes, on the nontarget mycorrhizal symbiont Glomus mosseae, and on soil respiration. Microcosm experiments showed differences in rhizospheric eubacterial communities associated with the three corn lines and a significantly lower level of mycorrhizal colonization in Bt 176 corn roots. In greenhouse experiments, differences between Bt and non-Bt corn plants were detected in rhizospheric eubacterial communities (both total and active), in culturable rhizospheric heterotrophic bacteria, and in mycorrhizal colonization. Plant residues of transgenic plants, plowed under at harvest and kept mixed with soil for up to 4 months, affected soil respiration, bacterial communities, and mycorrhizal establishment by indigenous endophytes. The multimodal approach utilized in our work may be applied in long-term field studies aimed at monitoring the real hazard of genetically modified crops and their residues on nontarget soil microbial communities.

Bacillus thuringiensis↗
PubMed1995

Comparison of the genome ds RNA of human rotavirus strains shed in parts of Ibadan, Nigeria.

The incidence and genome electropherotypes of human rotavirus detected in a hospital and in a community within Ibadan, Nigeria were compared by polyacrylamide gel electrophoresis. On the whole, 13% (31/239) rotavirus was detected; 14.7% (15/102) from the community and 11.7% (16/137) from the hospital. The incidence was significantly higher (P < 0.01) in the community than in the hospital. There were 11 (80.0%) long and 3 (20.0%) short forms observed in the community, whereas 14 (87.5%) long and 2 (12.5%) short froms were detected in the hospital. On co-electrophoresis, however, only 4 and 6 distinct electropherotypes were demonstrated in the hospital and the community respectively. Three of these were common to both places with 1 and 3 electropherotypes being unique to the hospital and the community, respectively.

Child, Preschool↗
PubMed2006

Bringing prostate cancer education to deaf men.

INTRODUCTION: A review of the scientific literature yielded no examples of programs that were designed to give deaf men access to information about prostate cancer, early detection, and treatment. The community's diverse linguistic abilities, multiple preferences for receiving information, and the small size of the community, create additional challenges for health educators. MATERIALS AND METHODS: A prostate cancer education program was adapted for deaf men (N=121), with the goal of creating a single program that could meet the educational needs of this diverse community. The program was evaluated using baseline, post-test, and two-month follow-up surveys, plus focus group discussions. RESULTS: Overall, baseline knowledge about prostate cancer and awareness of the screening options for the early detection of prostate cancer increased significantly at post-test and this gain was maintained at the two-month follow-up. While prostate-specific antigen (PSA) screening and digital rectal exams also increased among men 50 and older, the increase was not statistically significant, possibly a consequence of the small sample size. Participants' reported their preferred methods of communication. Greater knowledge gains were demonstrated among those who preferred communications via American Sign Language (ASL) versus English-based communications. CONCLUSION: Cancer education programs offered in ASL can help address health knowledge disparities and that in turn can contribute to alleviating these disparities. Clinicians and health educators can help raise the deaf community's health awareness through programs such as this one, which ultimately evolved into the Internet accessible ASL video: Prostate Cancer: Know Your Options.

Adult↗
PubMed2006

Detection of enteroaggregative Escherichia coli in faecal samples from patients in the community with diarrhoea.

The aim of this study was to assess the usefulness of a multiplex PCR assay targeting the aat, aaiA and astA genes for the detection of typical and atypical enteroaggregative Escherichia coli (EAEC) in bacterial cultures from faecal samples from patients with community-acquired diarrhoea. The isolates harbouring these genes were also tested using the HEp-2 cell-adhesion assay to clarify their EAEC status. aat, aai or astA was found in E. coli faecal isolates from 39 (7.8 %) of 500 patients, and 20 of these strains adhered to HEp-2 cells in a pattern characteristic of EAEC. Eight isolates carrying the aai or astA gene but not the aat gene were shown to be HEp-2 cell test positive, although 12 strains with this genotype were HEp-2 cell test negative. Using the HEp-2 adhesion assay as the gold standard, the addition of primers detecting aaiA and astA to the aat PCR increased the number of EAEC isolates detected, but identified strains of E. coli that were not EAEC. The variety of genotypes exhibiting aggregative adherence highlights the problems associated with developing a molecular diagnostic test for EAEC. This PCR assay detects a variety of strains exhibiting characteristics of the EAEC group, making it a useful tool for identifying both typical and atypical EAEC.

Adhesins, Escherichia coli↗