Detection of diabetes mellitus under population survey conditions (Forfar Community Survey, 1962).
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Data Collection↗
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[Cost-benefit analysis of the early detection program for metabolic diseases in the Autonomous Basque Community].
The efficiency of an early screening and treatment Programme for two Metabolic disorders, phenylketonuria and congenital hypothyroidism running since November 1982 in the Basque Country, is analysed. The cost-benefit analysis technique is used. The social costs of screening and treatment are compared with the social benefits for the prevention of mental handicap (1984-1985). Benefit-cost ratios and the net present value shows the social efficiency of the programme except when high discount rates have been used for discounting future costs and benefits. That conclusion is consistent with the results of other cost-benefit studies. In terms of cost-effectiveness the cost per child with mental handicap prevented was estimated on 3,300.000 ptas. That could be seen as the lowest social value for the prevention of a child with mental handicap.
Congenital Hypothyroidism↗
Plasma brain natriuretic peptide to detect preclinical ventricular systolic or diastolic dysfunction: a community-based study.
BACKGROUND: Preclinical systolic or diastolic dysfunction is associated with increased morbidity and mortality. We postulated that plasma brain natriuretic peptide (BNP) might serve as a biomarker for preclinical ventricular dysfunction (PCVD) but that the discriminatory values for BNP may vary with age and sex. METHODS AND RESULTS: We measured BNP, systolic and diastolic ventricular function, and clinical parameters in 2042 randomly selected residents of Olmsted County, Minn, aged 45 years or older. For preclinical systolic dysfunction, the areas under the receiver operating characteristics curve were higher for those with more severe (0.82 to 0.92) than any (0.51 to 0.74) systolic dysfunction and were similar in men and women and in younger and older persons. For preclinical diastolic dysfunction, the areas under the receiver operating characteristics curve were higher for those with moderate-to-severe (0.74 to 0.79) than any (0.52 to 0.68) diastolic dysfunction and were similar regardless of age or sex. Optimal discriminatory values of BNP varied with age and sex. Considering the prevalence of preclinical systolic or diastolic dysfunction and the predictive characteristics observed, using BNP to screen for PCVD would necessitate echo in 10% to 40% of those screened, with most confirmatory echocardiograms being negative, and would miss 10% to 60% of those affected. CONCLUSIONS: BNP is a suboptimal screening test for PCVD in the population.
Age Factors↗
Detecting and managing undernutrition of older people in the community.
Undernutrition is an important public health issue which is frequently undetected and untreated. Disease and illness are the major causes of undernutrition in this country, and older people are a particularly vulnerable group. Effective screening is needed to reduce the prevalence of malnutrition in older people and when this is established, action can then be taken to address the problem. Community nurses and the primary care team have a key role to play in making this happen. The recently developed Malnutrition Advisory Group (MAG) nutrition screening tool, for adults will help community staff and primary care staff to identify those older patients most at risk of malnutrition in the community. Routine nutrition screening of vulnerable individuals is the first stage in raising standards of nutrition care. Further improvements can be made through the development of appropriate nutritional guidelines, clinical risk management strategies provides opportunities to highlight the importance of nutrition care of older people.
Aged↗
Early detection of type 2 diabetes: the role of the community nurse.
Recent changes to the diagnostic criteria for type 2 diabetes have raised concerns that if steps are not taken to address relevant issues, the number of diagnosed sufferers will escalate in future years, with a similar increase in the prevalence of associated complications. Research suggests that for many patients, complications are evident at the time of diagnosis, and may have been present for several years before a diagnosis was made. Late presentation is the cause of considerable morbidity and mortality among these patients, largely because undiagnosed complications are often irreversible by the time the underlying diabetes is discovered. The current emphasis on public health augments the need for community nurses to recognize warning signs, particularly in patients who are at an increased risk of developing diabetes. This article aims to raise awareness of early signs and symptoms, and gives a brief insight into some of the associated health problems. If community nurses are to play a significant role in reducing the potentially devastating effects of this disease, they will need to be involved tin educating patients and implementing screening and intervention programmes.
Community Health Nursing↗
Detection of the early warning signs of cancer by community pharmacists: an evaluation of training on professional behavior.
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Arkansas↗
The Oregon Breast Cancer Detection Awareness Project: follow-up of a community-based breast cancer screening campaign.
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Adult↗
Phylogenetic characterization of microbial mats and streamers from a Japanese alkaline hot spring with a thermal gradient.
Dense microbial mats and streamers of various colors developed in an alkaline-hot spring water at 48-76 degrees C and ~0.077 mm sulfide in Nakabusa, Japan. The microbial community structures with a thermal gradient were compared by denaturing gradient gel electrophoresis (DGGE) analysis of the PCR-amplified 16S ribosomal RNA gene fragments. The sequence analysis revealed that a predominant cyanobacterial DGGE band phylogenetically related to Synechococcus elongatus was detected only from green mats at 48 degrees C. Four DGGE bands were detected commonly from green mats at 48 degrees C, orange mats at 58 degrees C and brown mats at 60 degrees C. The sequence analysis revealed that these were phylogenetically related to Chloroflexaceae group, Rhodothermus group, a candidate division OP10, and an unclassified bacterium. On the other hand, Aquificae-, Thermodesulfobacteria-, Thermus group-, and Crenarchaeota-like sequences were detected as a predominant component of DGGE profiling from the streamers only at temperatures over 66 degrees C, but no phototrophic bacterial bands were detected. Thus, the microbial community structure above 60 degrees C was drastically different from that at the lower temperatures. After the addition of hydrogen into in vitro gray streamers with in situ spring water, sulfide production markedly occurred in the presence of ambient sulfate at 66 degrees C. This result suggests that in situ sulfide is partly produced by Thermodesulfobacteria-like sulfate-reducing bacteria in the streamers.
Bacteria↗
[Taeniasis and detection of antibodies against cysticercus among inhabitants of a rural community in Guerrero State, Mexico].
OBJECTIVE: To assess the frequency of Taenia solium carriers and its relationship with human cysticercosis in a Mexican locality. MATERIAL AND METHODS: A cross-sectional study was conducted in 1998, in a locality of Guerrero State, Mexico. Four hundred and three fecal samples were analyzed by enzyme-linked immunosorbent assay (ELISA) to detect Taenia sp coproantigen. Ninety two serum samples were also analyzed for antibodies against cisticerci using the immunoelectrotransfer blot assay (IET). Data were analyzed using descriptive statistics and odds ratios. RESULTS: Five of the 403 fecal samples were positive (1.2%). The adult cestode was recovered in only two people. Three (3.26%) out of the 92 serum samples that were analyzed for anticysticercus antibodies were positive. Seventeen serum samples corresponded to people living with a person positive to the coproantigen test (first group), the remaining 75 were obtained from people without a history of releasing taenia proglottids (second group). In the first group, 2 positive sera were detected (11.8%), while in the second only I was positive (1.3%) (odds ratio = 9.87, 95% confidence interval 0.64 to 295.56, p = 0.08). CONCLUSIONS: The difficulty to obtain the adult parasite in persons positive to coproantigens, may be due to difficult expulsion, a shorter permanence of the parasite in the host, insufficient dosage of treatment, or to lack of specificity of the diagnostic test. Further studies are needed to evaluate these possibilities; a better knowledge of parasite transmission dynamics will allow the implementation of prevention and control measures and a better assessment of diagnostic tests under field conditions. The English version of this paper is available at: http://www.insp.mx/salud/index.html.
Adolescent↗
Application of postexposure feeding depression bioassays with Daphnia magna for assessment of toxic effluents in rivers.
A bioassay that used postexposure feeding depression in Daphnia magna Straus as an endpoint previously had been developed under laboratory conditions. Laboratory studies revealed that this was a sensitive, robust endpoint, which could potentially be used in an in situ bioassay. This study adapted the laboratory bioassay for use in the field and deployed D. magna in situ at four known or suspected contaminated and reference sites. The bioassay was demonstrated to be reliable for use in the field because more than 90% of test organisms were recovered live from the test chambers after exposure allowing feeding rates to be measured after exposure. At each of the contaminated sites, significant depressions in postexposure feeding rates were recorded. Although depressions in postexposure feeding rates were apparent at all contaminated sites, with the exception of Langholm, no impacts were detected on the benthic macroinvertebrate community, when using the Biological Monitoring Working Party scoring system. This demonstrated that during this study, post-exposure feeding depression was a more reliable and sensitive endpoint to use to detect toxicity than were changes in community structure. Therefore, the postexposure feeding depression bioassay can offer a sensitive, robust, ecologically relevant diagnostic endpoint for use in water-quality assessment schemes.
Animals↗
Immunocapture UPPCR combined with DGGE for rapid detection of Shigella species.
AIMS: To develop an immunocapture universal primer PCR (iUPPCR) combined with denaturing gradient gel electrophoresis (DGGE) and evaluate it as a method permitting rapid detection of Shigella species and their serotypes. METHODS AND RESULTS: This method amplifying the conserved regions of bacterial 16S rRNA genes of different species or serotypes of Shigella dysentery bacilli captured and enriched by polyvalent antibodies can detect and distinguish causative pathogens rapidly. Four serotypes from three Shigella species including Shigella dysenteriae serotype 1, Shigella boydii serotype 1, Shigella flexneri serotypes 1a and 3a were examined. CONCLUSION: Our approach could be adopted for not only axenic bacterial population but also mixed communities and achieve rapid detection of various bacteria from the same genus or species in one sample. SIGNIFICANCE AND IMPACT OF THE STUDY: The iUPPCR-DGGE method was shown to be more convenient than serotype-specific-antibody-based method of iUPPCR for Shigella species detection and it could be also applied to the quick detection for other kinds of pathogens with many serotypes.
Electrophoresis, Polyacrylamide Gel↗
Active transmission of human chagas disease in Colima Mexico.
Despite efforts to eradicate American trypanosomiasis (AT) and Chagas disease from the Americas, there are still areas of active transmission that can eventually become a source of reinfection in previously controlled regions. Mexico could be one of those areas, where there are no formal preventive control programs despite the presence of communities infested by Triatominae bugs infected with Trypanosoma cruzi. This study explored the prevalence of T. cruzi infection in 405 habitants of 17 communities in the state of Colima, on the Pacific Mexican coast, through a seroepidemiological probabilistic survey. The results revealed a point seroprevalence of 2.4% positive for anti-T. cruzi. In addition, 2 clinical cases of chronic and 2 of acute Chagas disease were detected in the explored communities. These findings confirm the risk of active transmission of AT in Western Mexico, especially in rural and suburban communities infested with intra-domestic triatominae, where control programs should be implemented.
Adolescent↗
Microbial populations identified by fluorescence in situ hybridization in a constructed wetland treating acid coal mine drainage.
Microorganisms are an integral part of the biogeochemical processes in wetlands, yet microbial communities in sediments within constructed wetlands receiving acid mine drainage (AMD) are only poorly understood. The purpose of this study was to characterize the microbial diversity and abundance in a wetland receiving AMD using fluorescence in situ hybridization (FISH) analysis. Seasonal samples of oxic surface sediments, comprised of Fe(III) precipitates, were collected from two treatment cells of the constructed wetland system. The pH of the bulk samples ranged between pH 2.1 and 3.9. Viable counts of acidophilic Fe and S oxidizers and heterotrophs were determined with a most probable number (MPN) method. The MPN counts were only a fraction of the corresponding FISH counts. The sediment samples contained microorganisms in the Bacteria (including the subgroups of acidophilic Fe- and S-oxidizing bacteria and Acidiphilium spp.) and Eukarya domains. Archaea were present in the sediment surface samples at < 0.01% of the total microbial community. The most numerous bacterial species in this wetland system was Acidithiobacillus ferrooxidans, comprising up to 37% of the bacterial population. Acidithiobacillus thiooxidans was also abundant. Heterotrophs in the Acidiphilium genus totaled 20% of the bacterial population. Leptospirillum ferrooxidans was below the level of detection in the bacterial community. The results from the FISH technique from this field study are consistent with results from other experiments involving enumeration by most probable number, dot-blot hybridization, and denaturing gradient gel electrophoresis analyses and with the geochemistry of the site.
Acidithiobacillus↗
Toxic Microcystis is widespread in Lake Erie: PCR detection of toxin genes and molecular characterization of associated cyanobacterial communities.
During the past decade, algae blooms, which include the toxic cyanobacterium Microcystis, have reoccurred in the Laurentian Great Lakes, most commonly in the western basin of Lake Erie. Whereas the western basin is the most impacted by toxic Microcystis in Lake Erie, there has historically been little effort focused on identifying the spatial distribution of Microcystis throughout this lake. To address this lack of knowledge, we have employed a polymerase-chain-reaction-based detection of genes required for synthesis of the toxin microcystin (mcyD and mcyB), as well as 16S rDNA fragments specific to either all Microcystis or all cyanobacteria. Using a multiplex approach, we tested 21 samples from 13 field stations and found that toxigenic Microcystis were present in the western and eastern basins in the summers of 1999, 2000, and 2002 and the central basin in 1999 and 2002. This is the most extensive distribution of Microcystis reported in Lake Erie. Clone libraries (16S rDNA) of these cyanobacterial communities were generated from 7 of the 13 field stations (representing all three basins) to partially characterize this microbial community. These libraries were shown to be dominated by sequences assigned to the Synechococcus and Cyanobium phylogenetic cluster, indicating the importance of picoplankton in this large lake system.
Bacterial Toxins↗
Relationship between self-reported prevalence of diabetes mellitus using the Cornell Medical Index (CMI) and prevalence determined by glycosylated hemoglobin (HbA(1c)) in an elderly community-dwelling population.
Reports of diabetes mellitus samples in community-dwelling unselected populations suggest a prevalence of 6%. A further 3% of unknown diabetes mellitus subjects are suggested when using formal biochemical methods of diagnosis. In this study, we present the prevalence of diabetes mellitus by self-reports using the CMI and concomitant biochemical detection in 436 community-dwelling older adults who have participated in a 20-year-study of age and cognitive performance in Manchester, UK. Twenty-three of the group reported that they had diagnosed diabetes mellitus, three individuals had a raised HbA(1c) of greater than 7.0% on random testing, but no knowledge of having diabetes mellitus. These individuals were re-contacted and three said they subsequently had a diagnosis of diabetes mellitus made within the two years following the questionnaire. We conclude that in an older population of community-dwelling subjects the numbers of undiagnosed cases of diabetes mellitus is lower than anticipated, based on large unselected population samples. The greater opportunity to interact with health care professionals who may consider screening for diabetes mellitus may explain these findings.
Age Factors↗
Preparation of a DNA gene probe for detection of mercury resistance genes in gram-negative bacterial communities.
A DNA gene probe was prepared to study genetic change mechanisms responsible for adaptation to mercury in natural bacterial communities. The probe was constructed from a 2.6-kilobase NcoI-EcoRI DNA restriction fragment which spans the majority of the mercury resistance operon (mer) in the R-factor R100. The range of specificity of this gene probe was defined by hybridization to the DNA of a wide variety of mercury-resistant bacteria previously shown to possess the mercuric reductase enzyme. All of the tested gram-negative bacteria had DNA sequences homologous to the mer probe, whereas no such homologies were detected in DNA of the gram-positive strains. Thus, the mer probe can be utilized to study gene flow processes in gram-negative bacterial communities.
Base Sequence↗
The East York Health Needs Study. I: Prevalence of DSM-III-R psychiatric disorder in a sample of Canadian women.
BACKGROUND: This study reports the prevalence of psychiatric disorder in women from a Canadian community. The GHQ and the CES-D were compared for their utility. METHOD: A thousand women over the age of 18 were mailed the GHQ and the CES-D. Our return rate was 44.4%; 24% were personally interviewed by interviews blind to screening information. The CIDI was used to establish DSM-III-R diagnoses. Four versions of the GHQ and one version of the CES-D were calibrated against the CIDI. RESULTS: The prevalence of general psychiatric disorder was estimated as between 15% and 19%, anxiety disorders between 10% and 13%, and depression occurring with anxiety between 3% and 4%. The calibrated GHQ was the most reliable instrument. CONCLUSIONS: Prevalence of DSM-III-R psychiatric disorder can be reliably determined with the calibrated GHQ. Anxiety disorders are most prevalent in this community, and were best detected using calibrated versions of the longer form GHQ.
Adolescent↗
Patient education in the community hospital.
Recent events have led to a favorable climate for the development of hospital-based patient education. A pilot model program in a community hospital is utilized to illustrate the variety of settings in which patient education is conducted, and includes: group classes, patient clubs, volunteer visits, individual instruction, community outreach, screening and detection programs, and behavior modification workshops. The use of television for inpatient education is highlighted in a discussion of media approaches and needs.
Audiovisual Aids↗