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At least 595 records · Page 33Linked to original sources
PubMed1999

Factor analysis of digestive cancer mortality and food consumption in 65 Chinese counties.

Dietary factors were analyzed for the regional difference of GI tract cancer mortality rates in China. Sixty-five rural counties were selected among a total of 2,392 counties to represent a range of rates for seven most prevalent cancers. The dietary data in the selected 65 counties were obtained by three-day dietary record of households in 1983. The four digestive cancer mortality rates (annual cases per 100,000 standardized truncated rates for ages 35-64) and per capita food consumption were analyzed by the principal components factor analysis. Esophageal cancer associated with poor area, dietary pattern rich in starchy tubers, and salt, lack of consumption of meat, eggs, vegetables and rice. Stomach cancer seemed to be less associated with diet in this study because of its small model Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy, suggesting some other carcinogenic factors would play more important role in the development of this cancer in China. The colon and rectal cancer showed close relation to diet; rich in sea vegetables, eggs, soy sauce, meat and fish, while lack in consumption of milk and dairy products. Rapeseed oil was more important risk factor for colon cancer than that of rectum. Rice, processed starch and sugar were closely associated with colon cancer, supporting the insulin/colon cancer hypothesis.

Adult↗
PubMed1975

Path analysis of socioeconomic correlates of county infant mortality rates.

Relationships between selected socioeconomic characteristics of counties and infant mortality rates are examined. There are two research objectives: to determine the extent to which low family income, low education, sound housing, and the percentage of blacks "directly" and "jointly" relate to neonatal and postneonatal mortality rates; and to determine the degree to which a zero-order correlation between a given socioeconomic measure and general infant mortality is transmitted by neonatal and postneonatal mortality rates, respectively. Data corresponding to 2237 counties in the United States are analyzed by path analysis. Results show that the percentage of blacks and low education are two variables which have appreciable direct effects on both components of infant mortality. These two factors are also responsible in large measure for gross associations between low family income, sound housing, and rates of infant loss. On the basis of this study it is estimated that approximately two-thirds of the zero-order correlation between a given county measure of socioeconomic status and infant mortality occurs through the postneonatal component. Implications of these findings are discussed.

Black People↗
PubMed2005

Plasmodium-infected Anopheles mosquitoes collected in Virginia and Maryland following local transmission of Plasmodium vivax malaria in Loudoun County, Virginia.

Two recent outbreaks of locally acquired, mosquito-transmitted malaria in Virginia in 1998 and 2002 demonstrate the continued risk of endemic mosquito-transmitted malaria in heavily populated areas of the eastern United States. Increasing immigration, growth in global travel, and the presence of competent anopheline vectors throughout the eastern United States contribute to the increasing risk of malaria importation and transmission. On August 23 and 25, 2002, Plasmodium vivax malaria was diagnosed in 2 teenagers in Loudoun County, Virginia. The Centers for Disease Control and Prevention (CDC) deemed these cases to be locally acquired because of the lack of risk factors for malaria, such as international travel, blood transfusion, organ transplantation, or needle sharing. The patients lived approximately 0.5 mi apart; however, 1 patient reported numerous visits to friends who lived directly across the street from the other patient. Two Anopheles quadrimaculatus s.l. female pools collected in Loudoun County, Virginia, and 1 An. punctipennis female pool collected in Fairfax County, Virginia, tested positive for P. vivax 210 with the VecTest panel assay and enzyme-linked immunosorbent assay (ELISA). In addition, 2 An. quadrimaculatus s.l. female pools collected in Montgomery, Maryland, tested positive for P. vivax 210. The CDC confirmed these initial results with the circumsporozoite ELISA. The authors believe that this is the 1st demonstration of Plasmodium-infected mosquitoes collected in association with locally acquired human malaria in the United States since the current national malaria surveillance system began in 1957.

Adolescent↗
PubMed1983

Health profile of Skaraborg County 1977. A Swedish rural cross-sectional study.

The cross-sectional study entitled Health Profile of Skaraborg County, 1977 (HPS 77), forms part of an evaluation of a care programme for persons suffering from high blood pressure. Concurrently with the implementation of the study, epidemiological data were collected concerning the health profile of an entire county, with the aim of facilitating comparisons between the municipalities in the county. This paper describes how the study was implemented and gives an analysis of non-participation and validity. A comparison is made between participants and non-participants with regard to record data obtained from the National Health Insurance Fund, hospital records and the register of the Temperance Board. The non-participants differ in most respects from the participants, who have a more marked pattern of disorders in their case histories. In a longitudinal non-participants analysis, participants are compared with non-participants with respect to mortality during the following four-year period. In this study the non-participants differed, in having a higher mortality rate. The validity of the questionnaire is discussed on the basis of three different analyses. The validity varied considerably, depending on the questions studied. For example, 53% of those with myocardial infarction in the questionnaire were confirmed in hospital records. This was also true for 62% of those with stroke and 49% of those with angina pectoris in a follow-up interview. Medication for hypertension was confirmed in 94%. Ten of twelve participants who reported three or more symptoms of mental disorders were confirmed at interview with a physician. Studies like HPS 77 could be useful when planning preventive as well as curative measures. Thus it is important to describe not only the implementation of the study, but also its validity and the importance of non-participation for the results presented.

Adolescent↗
PubMed1997

Do general practitioners want guidelines? Attitudes toward a county-based and a national college-based approach.

OBJECTIVE: We carried out two studies (a and b) to assess general practitioners' attitudes towards a) regionally developed guidelines and b) guidelines developed by the Danish College of General Practitioners. DESIGN: a) A randomized study among all GPs in Aarhus county comparing their attitudes towards guidelines in general and towards regional multidisciplinary developed guidelines on Pap-testing for cervical cancer, and b) a survey among all Danish GPs on attitudes towards earlier submitted guidelines for diabetes Type 2. SETTING: GPs in Aarhus county and in all Denmark. SUBJECTS: a) Questionnaires sent to 370 doctors in Aarhus county, and b) to 3471 GPs in all Denmark. MAIN OUTCOME MEASURES: a) Attitudes to the known Pap guidelines compared with general attitudes. Themes in question were acceptance of guidelines, acceptance of multidisciplinary involvement, especially from the administrative staff, perceived effect on the consultation and the quality of care. In study b) remembrance of receiving, having read and used previous guidelines. Wishes with respect to future updates. RESULTS: a) GPs were very positive towards the Pap guidelines they knew, and only few resisted. The number of positive answers was significantly fewer when doctors were asked about guidelines in general. b) There was an overwhelmingly positive attitude towards guidelines from the College on diabetes care and other topics relevant to GP work. CONCLUSION: Danish GPs reported a very positive attitude towards the presented well-known guidelines on Pap testing and diabetes Type 2, and a fairly positive attitude towards hypothetical questions on guidelines in general.

Attitude of Health Personnel↗
PubMed1997

Regional differences in hospital admission rates for suspected and verified myocardial infarction in Nord-Trøndelag county, Norway.

OBJECTIVE: To investigate differences in the occurrences of hospitalized suspected and verified acute myocardial infarction (AMI) between the two hospital regions, Namdal and Innherred, within a single county in Norway. DESIGN: A descriptive epidemiological study. SETTING: The county of Nord-Trøndelag in the central part of Norway (131,000 inhabitants). SUBJECTS: Patients admitted for suspected AMI 13 March-11 June 1995. MAIN OUTCOME MEASURES: Proportion of verified AMI among patients admitted. Regional incidence rates for AMI. RESULTS: Among 347 patients admitted to hospitals with suspected AMI, AMI was verified in 120 (35%), corresponding to an annual incidence rate of 509 and 294 per 100,000 (p < 0.001). CONCLUSIONS: Among patients admitted with suspicion of AMI, approximately one third had AMI. The study revealed substantial differences for AMI between two neighbouring hospital regions within one county in Norway. This difference may have implications for the planning and cost of hospital care.

Aged↗
PubMed1999

Short-term outcome of perinatal care in a Swedish county. Mortality, neonatal intensive care and overall evaluation of neuromotor function at 0-10 months of corrected age in preterm and term infants.

Improvements in obstetrical and neonatal care during the last decades have led to a marked increase in survival rate of preterm and term infants. In order to study the short- and long-term outcome in infants who survived neonatal intensive care (NIC) and were born in the county of Uppsala between January 1st 1986 and April 30th 1989, a prospective long-term follow-up study was conducted. Epidemiological data on all infants born in the county during the study period and the short-term outcome, measured as overall neuromotor function at term and at 2, 4, 6 and 10 months of corrected age in 245 infants surviving NIC and 72 healthy control infants are presented. The infants' neuromotor function was evaluated with different clinical neurological methods. In the study population of NIC infants 85.9% survived the neonatal period. The early infant mortality was high in this group 11.6% compared to that of all infants born in the county of Uppsala (0.30%). Only a minority of the infants showed abnormal neuromotor function. A comparison of the results of the overall evaluation of neuromotor function at 10 months of age with those of the examinations made at an earlier age showed poor correspondence in individual infants, especially in preterm and very preterm infants.

Bronchopulmonary Dysplasia↗
PubMed1997

The prevalence and severity of rheumatoid arthritis in Oslo. Results from a county register and a population survey.

The objective was (1) to examine the prevalence of rheumatoid arthritis (RA) by a county patient register, (2) to cross-validate the register findings by a postal population survey, and (3) to estimate prevalences of disease subsets according to age, sex, and levels of physical disability. The study was performed within a county setting in the city of Oslo with 356,486 inhabitants between 20 and 79 years of age. Prevalence estimates were calculated from a county patient register comprising 1333 patients with RA and a population survey of 10,000 inhabitants. The overall prevalence of RA between 20 and 79 years was 0.437 (95% CI 0.413, 0.461) after adjusting for the incompleteness of the register by a factor of 1.17. Prevalences exceeding 1.0% was only found among females over 60 years. The prevalence of RA with MHAQ scores > or = 1.5 and > or = 2.0 (range 1-4) was 0.225 (95% CI 0.209, 0.243) and 0.099 (0.088, 0.111) respectively. We conclude that RA is less frequent in the city of Oslo than stated in most of the literature. The prevalence of RA with physical disability levels assumed to be associated with increased mortality is less than half of the overall prevalence of 0.4-0.5%.

Adult↗
PubMedDate not supplied

Prevalence of tick-borne pathogens in Ixodes scapularis in a rural New Jersey County.

To assess the potential risk for other tick-borne diseases, we collected 100 adult Ixodes scapularis in Hunterdon County, a rapidly developing rural county in Lyme disease endemic western New Jersey. We tested the ticks by polymerase chain reaction for Borrelia burgdorferi, Babesia microti, and the rickettsial agent of human granulocytic ehrlichiosis (HGE). Fifty-five ticks were infected with at least one of the three pathogens: 43 with B. burgdorferi, five with B. microti, and 17 with the HGE agent. Ten ticks were coinfected with two of the pathogens. The results suggest that county residents are at considerable risk for infection by a tick-borne pathogen after an I. scapularis bite.

Animals↗
PubMed1985

Epidemiological survey of Paragonimus westermani in Ulchin County, Kyungpook Province, Korea.

In order to determine the epidemiological pattern of the Paragonimus westermani, the infestation rates of the cercarial and metacercarial larvae of digenetic trematodes in the snail and crayfish host, and the prevalence of Paragonimus westermani among the residents in the vicinity of the stream Namdae, Wyangpi, and Kwang, in the Ulchin county, Kyungpook province were studied from March to October in 1984. The population density of the snails per square meter of the habitats ranged form 5 to 25, with average of 15. Among the seven habitats, one, Ducheon, had snails infested with the cercariae of Paragonimus westermani, and the proportion of infested snails was very low, the average being 0.152 per thousand. Of six hundred and four crayfish examined, 113 or 18.7 per cent harboured the encysted larvae of Paragonimus westermani. A high infestation rate for the metacercariae in the crayfish was found in two habitats; 39.0 per cent in the Ducheon and 21.6 per cent in the Sokwang. The prevalence of Paragonimus westermani among the residents in Ulchin county was relatively high, 25.8 per cent by the Paragonimus intradermal tests and the difference in the rate of infection between males and females was found to be significant(t>2). The results obtained in this study indicate that endemic foci of Paragonimus westermani exist in Ulchin county and the prevalence of this lung fluke among the residents is relatviely high.

Journal Article↗
PubMed2001

Incidence patterns of vivax malaria in civilians residing in a high-risk county of Kyonggi-do (province), Republic of Korea.

The characteristics of vivax malaria epidemics along the demilitarized zone (DMZ) in the Republic of Korea has been established by the early surveillance data. To further characterize the epidemic, data of civilian patients microscopically diagnosed with malaria from 1995 through 2000 were analyzed in Yonchon-gun (county). Malaria incidence was greater in male civilians > 30 years of age (p < 0.05). The annual parasite index was significantly higher in those living in the administrative areas (Myeon) traversed by DMZ than those living in Myons not traversed by DMZ (p < 0.05). Analysis according to the distance (4 to 14 km) from DMZ showed that people living in villages close to DMZ had higher annual parasite indices than those living in villages remote from DMZ (p for trend < 0.05). Civilians living in Myeons with plains and located in northwestern part of the county had higher annual parasite indices than those living in hilly Myeons located in southeastern part of the county (p for trend < 0.05). These findings suggest that the contraction of vivax malaria is related with night-time outdoor activities, and that the distance from DMZ is a risk factor. In this area, the flying distance of infected vector mosquitos can explain the annually repeating occurrence of civilian cases.

Adolescent↗
PubMed2000

Helicobacter pylori infection and risk of gastric cancer in Changle County,Fujian Province,China.

AIM:To evaluate the effects of Helicobacter pylor infection and other environmental factors on the development of gastric cancer.METHODS:A population-based case control study was conducted in Changle County, Fujian Province. The primary gastric cancer cases were histologically confirmed or diagnosed by surgery between January 1996 and March 1998. Healthy controls were randomly selected and matched by age, sex, and neighborhood of residence.A total of 101 pairs were included in the study. Specially trained interviewers conducted face-to-face interviews with the subjects according to a standardized questionnaire. Helicobacter pylori infections were measured by serum IgG antibody to Helicobacter pylori. Conditional Logistic Regression analysis was used.RESULTS:The presence of IgG antibody to Helicobacter pylori was 63.7% in study subjects, 56.0% in patients with cardiac cancer, and 60.5% in patients with non-cardiac gastric cancer. The risk factors of gastric cancer in Changle County were identified such as low educational level (OR = 3.864; 95% confidence interval (95%CI) 1.604-9.311), low consumption of fresh vegetables (OR = 4.925; 95%CI 1.356-17.885), high intake of fish sauce (OR = 10.587; 95%CI 2.821-39.738), unscheduled meals (OR = 4.254; 95%CI 1.445-12.552), and Helicobacter pylori infection (OR = 3.453; 95%CI 0.901-13.224).CONCLUSION:Helicobacter pylori infection may be important in the etiology of gastric cancer, but major risk factors other than Helicobacter pylori are responsible for the high gastric morbidity in Changle County.

Journal Article↗
PubMed2002

Reduction of the incidence and mortality of rectal cancer by polypectomy: a prospective cohort study in Haining County.

AIM: To reduce the incidence and mortality of rectal cancer and address the hypothesis that colorectal cancer often arise from precursor lesion(s), either adenomas or non-adenomatous polyps, by conducting a population-based mass screening for colorectal cancer in Haining County, Zhejiang, PRC. METHODS: From 1977 to 1980, physicians screened the population of Haining County using 15 cm rigid endoscopy. Of over 240000 participants, 4076 of them were diagnosed with precursor lesions, either adenomas or non-adenomatous polyps, which were then removed surgically. All individuals with precursor lesions were followed up and reexamined by endoscopy every two to five years up to 1998. RESULTS: After the initial screening, 953 metachronous adenomas and 417 non-adenomatous polyps were detected and removed from the members of this cohort. Further, 27 cases of colorectal cancer were detected and treated. Log-rank tests showed that the survival time among those cancer patients who under went mass screening increased significantly compared to that of other colorectal cancer patients (P<0.0001). According to the population-based cancer registry in Haining County, age-adjusted incidence and mortality of rectal cancer decreased by 41% and 29% from 1977-1981 to 1992-1996, respectively. Observed cumulative 20-year rectal cancer incidence was 31% lower than the expected in the screened group; the mortality due to rectal cancer was 18% lower than the expected in the screened group. CONCLUSION: Mass screening for rectal cancer and precursor lesions with protocoscopy in the general population and periodical following-up with routine endoscopy for high-risk patients may decrease both the incidence and mortality of rectal cancer.

Adenoma↗
PubMed1996

Epiglottitis in adults and children in Olmsted County, Minnesota, 1976 through 1990.

OBJECTIVE: To compare the initial clinical manifestations and sequelae of epiglottitis among children and adult residents of Olmsted County, Minnesota. MATERIAL AND METHODS: We conducted a population-based retrospective cohort study of all Olmsted County residents with the diagnosis of epiglottitis during the 15-year period from Jan. 1, 1976, through Dec. 31, 1990. RESULTS: From 1976 through 1990, 41 residents (20 children and 21 adults) of Olmsted County were diagnosed with epiglottitis. (One case in an adult was first diagnosed at autopsy and was included only in the incidence rates and analysis of seasonal and secular trends.) Children had a mean annual incidence rate of 4.25 per 100,000, whereas the rate in adults was 2.18 per 100,000. The age- and sex-adjusted incidence of epiglottitis decreased during the study period from 4.94 per 100,000 during 1976 through 1980 to 2.08 per 100,000 during 1986 through 1990. No seasonal effect was detected in adults or children. At initial assessment, adults tended to have pharyngeal symptoms (sore throat and odynophagia), cervical adenopathy, and ear pain, whereas children most often had respiratory (stridor, dyspnea, and retractions) and laryngeal symptoms. Proportionately, more children than adults received artificial airway support and had associated pneumonia. One death occurred in an adult, in whom the diagnosis was made at autopsy. CONCLUSION: The incidence of epiglottitis has decreased significantly in recent years. Children and adults have considerably different initial manifestations of epiglottitis.

Adolescent↗
PubMed2001

Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota.

OBJECTIVES: To estimate the incidence of physician-diagnosed primary Sjögren syndrome (SS) among residents of Olmsted County, Minnesota, in the setting of usual medical care and to determine how often objective criteria are available in the medical records of such patients. PATIENTS AND METHODS: We reviewed all medical records of residents in Olmsted County with physician-diagnosed SS from 1976 to 1992 to determine whether they had undergone objective tests for keratoconjunctivitis sicca, salivary dysfunction, or serologic abnormality. Confounding illnesses were excluded. To identify misclassified cases, all records from patients with xerostomia or keratoconjunctivitis sicca were also reviewed. The average annual SS incidence rates were calculated by considering the entire population to be at risk. RESULTS: Of 75 patients with onset of SS during the study period, 53 had primary SS. All patients were white, 51 (96.2%) were women, and the mean +/- SD age was 59+/-15.8 years. The age- and sex-adjusted annual incidence was 3.9 per 100,000 population (95% confidence interval, 2.8-4.9) for patients with primary SS. Eleven patients (20.8%) with physician-diagnosed SS had no documentation of objective eye, mouth, or laboratory abnormalities. Objective evaluations performed most frequently were laboratory and ocular tests and least often were investigations of xerostomia. CONCLUSIONS: The average annual incidence rate for physician-diagnosed primary SS in Olmsted County is about 4 cases per 100,000 population. These data probably underestimate the true incidence because they are based on usual medical care of patients with SS in a community setting, rather than on a case-detection survey. In the future, a true incidence may be possible with a higher index of suspicion, greater attention to objective tests, and increased awareness of new classification criteria for SS. For epidemiological studies based on existing data, application of current criteria may not be feasible, and consensus on criteria for such studies would be useful.

Adult↗
PubMed1995

The incidence of giant cell arteritis in Olmsted County, Minnesota: apparent fluctuations in a cyclic pattern.

OBJECTIVE: To investigate trends in the incidence of giant cell arteritis over a 42-year period in Olmsted County, Minnesota. DESIGN: Population-based incidence study. SETTING: Olmsted County, Minnesota. METHODS: All incidence cases of giant cell arteritis first diagnosed between 1950 and 1991 were identified using the unified record system at Mayo Clinic. Age- and sex-specific incidence rates were calculated using the number of incidence cases as the numerator and population estimates as the denominator. Overall rates were age- and sex-adjusted to the 1980 United States white population. The annual incidence rates were graphically illustrated using a 3-year centered moving average. RESULTS: Between 1950 and 1991, 125 Olmsted County residents (103 women and 22 men) were diagnosed with giant cell arteritis. The age- and sex-adjusted incidence per 100,000 persons 50 years of age or older was 17.8 (95% CI, 14.7 to 21.0); incidence was significantly higher in women (24.2 [CI, 19.5 to 28.9]) than in men (8.2 [CI, 4.8 to 11.6]). Age-specific incidence rates increased with age (P < 0.0001). The annual incidence rates increased significantly over the study period (P = 0.002) and appear to have clustered in five peak periods, which occurred about every 7 years. A significant calendar-time effect was identified; it predicted an increase in incidence of 2.6% (CI, 0.9% to 4.3%) every 5 years. CONCLUSIONS: Our observation of a regular cyclic pattern in incidence rates over time supports the hypothesis of an infectious cause for giant cell arteritis. Similar studies in other populations are needed to confirm our findings.

Age Distribution↗
PubMed1999

The reform of the rural cooperative medical system in the People's Republic of China: interim experience in 14 pilot counties.

During the 1960's and 1970's the Chinese government encouraged the 'rural cooperative medical systems' (RCMS), in order to ensure access to basic health care among the rural population. There was a break in the development of the RCMS in the early 1980's, as a consequence of market economic reforms. These reforms involved a shift from a communal to a household production system. As a result the collective way of financing rural health care was more or less abandoned. However, the government of the People's Republic of China was aware of the need to provide social protection against health care expenses. In March 1994 the government initiated a project to reestablish the RCMS. This project was implemented on a pilot basis in 14 counties of seven provinces. The reestablishment of the RCMS would be guided by the basic principles of health insurance. In October 1995, a first mid-term evaluation of the RCMS Project was held. One of the major research questions concerned the extent to which the RCMS had reduced the risk of paying health care bills that would otherwise be a burden on families. This article addresses this question and assesses the results obtained after two years of RCMS experimental work. A general finding is that the population structure by occupation and income varies, and that the RCMS has adapted itself to this variety. It is also confirmed that the burden of health care costs on families was reduced, more so in some counties than in others, but this reduction has been modest. The research results indicate that there is ample room for improvement. The outlook is hopeful, however. At the national level, there is now systematic thinking about RCMS. The current RCMS work is also having a considerable influence on other counties that are keen to reestablish the RCMS.

China↗