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PubMed2002

[Lung cancer: survival rate differences in Danish counties. Survival analysis of 33.838 patients during the period 1984-1998].

INTRODUCTION: The quality of care for Nordic cancer patients has been considered to be low in Denmark. Our quality problem was believed to be caused by the structure of our secondary health care. But there may be other explanations for the poor survival in Denmark, and the comparison with the other Nordic countries may be flawed by confounding factors, such as smoking habits and spread of cancer at the time of diagnosis. We therefore, analysed differences in regional survival after diagnosis of carcinoma of the lung in Denmark to look for signs of similar flaws. MATERIALS AND METHODS: A sample from the National Cancer Registry of all cases of carcinoma of the lung, diagnosed in 1984-1995. Persons older than 80 were excluded. Age and spread of cancer were included in a Cox analysis. RESULTS: Survival was dependent on residence. Within the first five months of diagnosis, survival was significantly poorer in Copenhagen City and better in the counties of Aarhus, Aalborg, and Viborg. At five months, the differences had diminished and only the counties of Fyn and Sønderjylland differed from the nationel average in a negative way. DISCUSSION: Better results were achieved than previously expected in some Danish counties. Interpretation of the Nordic results should be more critical and include possible confounders, such as smoking and spread of cancer at diagnosis. The Danish problem with cancer may be because of the delay of patient and doctor in the primary health care, together with an extreme life-style, including too much urban life and tobacco smoking.

Adult↗
PubMed2001

[The predomination of rotavirus G3 serotype among children with diarrhea in Lulong County in 1998].

OBJECTIVE: To investigate the epidemiology of rotavirus diarrhea among children in rural population. METHODS: 120 stool specimens collected from children with diarrhea during the winter of 1998 in Lulong County, Hebei Province were examined for rotavirus by PAGE and ELISA and for serotype by ELISA and PCR. RESULTS: Rotavirus was detected in children aged between 2-24 months. The positive rate of rotavirus was 39.2% and the ratio of male to female was 1-1.47. All rotavirus RNA profiles were long pattern. The distribution of rotavirus serotypes was type 3(61.7%), followed by type 1(36.2%), and type 4(6.4%). CONCLUSIONS: The epidemiology of rotavirus diarrhea during 1998 rotavirus season in Lulong County was similar to that of other regions in China, but rotavirus serotype G3 was a prevalent strain in Lulong County, which was uncommon and different from the predominant G1 in other places throughout China.

Child, Preschool↗
PubMedDate not supplied

[Prevalence and severity of dental caries and treatment needs in small Brazilian counties].

The aim of this study was to assess the prevalence and severity of dental caries and the need for dental treatment among schoolchildren in two small Brazilian counties. WHO criteria (1986) for the diagnosis of dental caries and treatment needs were adopted. All 6 to 12-year-old schoolchildren in both São João do Sul (n = 803) and Treviso (n = 382), both in the State of Santa Catarina, were invited to participate in the study. The response rate was 96% and 91% respectively. All kappa values for inter- and intra-examiner agreement were greater than 0.62. Prevalence of caries among 6 to 12-year-old children was 62.1% in São João do Sul and 63.6% in Treviso. Mean DMF-T for the same age group was 1.91 and 1.84 respectively. Need for treatment was high in both counties, however it was mainly related to simple clinical procedures. In conclusion, prevalence of dental caries among 6 to 12-year-old schoolchildren was lower in the two small counties studied than in other small communities in Brazil. The need for treatment was great, but it was related to simple clinical procedures. In addition, there is a need to collect further data from small towns to develop an oral health strategy appropriate to such areas.

Brazil↗
PubMed1993

[Marital status of the population in Bekes county, 1980-1990].

An analysis of marriage patterns in Bekes County, Hungary, is presented for the period 1980-1990. The author notes "that the number of married couples decreased, while that of unmarried, widowed and divorced increased, both on [the] national level and in [the] county.... The study shows the marital status of the county's population by age and sex, and refers to the main reasons behind the changes [taking] place in this field." (SUMMARY IN ENG AND RUS)

Age Factors↗
PubMed2002

[Child neglect in the county of Copenhagen. Changing incidence?].

INTRODUCTION: The aim of the study was to evaluate the incidence of physical violence, neglect, and sexual abuse of children as reported to the local authorities in the County of Copenhagen during the year 1998, and compare it with a similar study conducted in 1993. MATERIAL AND METHODS: A questionnaire was posted to the local authorities of the 18 districts in the county. They were asked how many new, verified, and suspected cases of physical, emotional, and sexual abuse had come to their attention in 1998. RESULTS: A total number of 182 cases were identified, corresponding to a total incidence of 2.1 cases per 1000 children aged 0-17 years (2.1@1000), with 0.6@1000 for physical abuse, 0.8@1000 for emotional neglect, and 0.7@1000 for sexual abuse. More than one-third of the cases were considered verified. We found a slight fall in the incidence of abuse of children, as compared to our study from 1993 (2.1@1000 as compared to 2.7@1000 in 1993). The incidence of physical neglect, which the authors' assess to be the most reliable parameter, was found to be unchanged (0.8@1000). DISCUSSION: The authors recommend a common, uniform, centralised registration of cases of child abuse in the counties. We suggest that such registration should contain information about the age of the child, initials, type of abuse, verified or suspected, and who reported the case.

Adolescent↗
PubMed2002

[Diabetes specialist care at the turn of the Millennium in Békés County of Hungary (experience with 5935 new patients between 1996 and 2000)].

INTRODUCTION: Authors collect systematically the main demographic data of the registered new diabetic patients, who are presented in the specialist diabetes care station of county Békés. AIM(S): These data are compared with the similar data of the previous five years periods. PATIENTS: According to the present sixth registration, the number of the new diabetic patients increased rather (5935 patients), while the inhabitants of county Békés decreased. RESULTS: The proportions as per age and gender did not change in comparison with the earlier periods, but in some age-decade male predominance could be observed. Recently most of the patients are those over 50 years (type 2) with the striking increase over 70 years, too. The number of obese patients is constantly high. The ratios of employments are considerably changed vs the first examined period (before 25 years), the number of retired patients is increased and that of household women is decreased. Proportion of the different therapeutic regimens is near to what is required (reaching of normoglycaemia), but the number of patients treated with the oral antidiabetics is somewhat higher as desired. Number of those needing insulin is increasing. CONCLUSION: Recently (31. Dec. 2000) altogether 30.446 new diabetic patients are registered in county Békés, the incidence in the last period is 30,44/10.000 subjects/year.

Adult↗
PubMed2003

Descriptive study of sexually transmitted diseases in Tarrant County, Texas, from 1998 through 2000.

Incidence rates of sexually transmitted diseases in Tarrant County, Texas, from 1998 through 2000 were assessed and compared with the rates in Texas and the United States, with the focus on similarities and differences in gender, age, and race/ethnicity. Data were obtained from the Tarrant County Public Health Department, the Texas Department of Health, and the Centers for Disease Control and Prevention. The rates for gonorrhea and syphilis in Tarrant County were significantly higher than rates in Texas and the United States. The largest disparity was found among blacks, followed by Hispanics and then whites, with those aged 15 to 24 years at greatest risk. To increase awareness and reduce the burden of sexually transmitted diseases, prevention programs need to be developed.

Adolescent↗
PubMed2003

[The epidemiological survey of prevalence rate of hypertension in the countryside of Zhangwu county, Liaoning province].

OBJECTIVE: To investigate the prevalence state of essential hypertension in the countryside of Zhangwu county, Liaoning province to confirm whether this county is the high prevalence region of essential hypertension. METHODS: Five thousand, two hundred and eight 15-year olds or older were sampled by means of whole population random sampling. Blood pressure was measured and the related risk factors were investigated with the uniform questionnaire. SPSS 10.0 of statistical software was used for data analysis. RESULTS: The standardized prevalence rate of hypertension was 35.0% at this region, 40.0% in male, 32.0% in female. The prevalence rates of hypertension were increased with the increasing of the age in both males and females. There were significant statistically differences in the prevalence rates of hypertension between the different age groups, different countrysides and different villages. The standardized prevalence rate of hypertension were 43.0% the highest and 29.0% lowest respectively in the countryside, with prevalence rates, were 59.4% highest and 26.9% lowest respectively in the village. In all the patients with hypertension, 72.0% having hypertension II, III. CONCLUSION: The countryside of Zhangwu county was a high prevalence region of essential hypertension which was unusual in our country. The reason of this status was still unknown which called for further study.

Adolescent↗
PubMed1992

Sales of alcohol to underage purchasers in three New York counties and Washington, D.C.

A study was conducted in which young males, under the legal alcohol purchase age of 21, attempted to purchase beer at grocery stores and other retail outlets. Underage purchases were attempted at a sample of stores in Washington, D.C.; Westchester County, New York: and Albany and Schenectady counties, New York. Beer was sold to the underage purchasers at 97 percent of the Washington, D.C. stores, 80 percent of the Westchester County stores, and 44 percent of the Albany and Schenectady stores, despite the fact that such sales are illegal. Beer was more likely to be sold to the underage purchasers at smaller neighborhood stores in urban areas. Sales were least likely in Albany, which experienced recent police enforcement of the alcohol purchase age laws. Vigorous enforcement of the minimum purchase age laws is needed to reverse the current national trend toward more alcohol-related highway fatalities among youth.

Adolescent↗
PubMed1992

Racial misclassification of American Indians with AIDS in Los Angeles County.

American Indian/Alaska Natives (AI/ANs) appear to be underrepresented in AIDS surveillance statistics. We estimated the accuracy of racial classification and reporting completeness of AIDS among AI/ANs in Los Angeles County by surveying community-based organizations (CBOs) that provide services to persons with AIDS and then comparing the survey to AIDS surveillance data. The surveyed CBOs reviewed 6,500 records and found 60 Native American (the classification used by CBOs for AI/ANs) clients with AIDS compared with six AI/AN AIDS cases reported to the Los Angeles County AIDS surveillance registry. Racial classification was evaluated for 37 (62%) of the 60 Native American CBO clients. Only 11 (30%) of the 37 were verified as AI/ANs. The remaining 26 (70%) misunderstood the racial nomenclature and were reclassified by the CBOs as other races. Of 10 verified AI/AN clients for whom names were available, eight (80%) had been reported to the AIDS registry. However, seven (88%) of these eight were erroneously reported as other races. Racial misclassification accounts for much of the underrepresentation of AI/ANs in the Los Angeles County AIDS surveillance registry.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Centralization of obstetric care and perinatal mortality in Norwegian counties 1986-90. Analysis based on public statistics from the medical birth registry].

The relationship between centralization of obstetric care and perinatal mortality was studied in 19 Norwegian counties for the period 1986-90. No significant trend was found. However, during the period 1988-1990 prenatal mortality was significantly higher, with a relative risk of 1.21 (95% confidence interval 1.00-1.45), in the three counties with only one obstetric department than it was in all other counties. The analysis did not support the notion that greater centralization of obstetric care would decrease perinatal mortality.

Centralized Hospital Services↗
PubMed2003

Local transmission of Plasmodium vivax malaria--Palm Beach County, Florida, 2003.

The majority of malaria cases diagnosed in the United States are imported, usually by persons who travel to countries where malaria is endemic. However, small outbreaks of locally acquired mosquito-transmitted malaria continue to occur. Despite certification of malaria eradication in the United States in 1970, 11 outbreaks involving 20 cases of probable locally acquired mosquito-transmitted malaria have been reported to CDC since 1992, including two reported in July 1996 from Palm Beach County, Florida (Palm Beach County Health Department, unpublished data, 1998). This report describes the investigation of seven cases of locally acquired Plasmodium vivax malaria that occurred in Palm Beach County during July-August 2003. In addition to considering malaria in the differential diagnosis for febrile patients with a history of travel to malarious areas, health-care providers also should consider malaria as a possible cause of fever among patients who have not traveled but are experiencing alternating fevers, rigors, and sweats with no obvious cause.

Adolescent↗
PubMed2003

[Epidemiology of inflammatory bowel diseases in Veszprém county of Western Hungary between 1977 and 2001].

INTRODUCTION: An epidemiological study of inflammatory bowel disease (IBD) in Veszprém county (located in western part of Hungary) was carried out from 1977 to 2001. METHODS: Both hospital and outpatient records of IBD patients were collected reviewed carefully. Most patients have been followed up regularly. RESULTS: The number of population has decreased during the observed period from 386,000 to 376,000. The county has both industrial and agrarian parts. 560 new ulcerative colitis (UC) cases, 212 Crohn's disease (CD), and 40 indeterminate colitides (IC) were diagnosed in the investigated period. Incidence rate increased from 1.66 (1977-1981) to 11.01 (1997-2001) in UC, and from 0.41 to 4.68 in CD, respectively. The incidence rate in IC rose from 0.26 to 0.74. The M/F ratio in UC was 1.06, in CD: 1.03, respectively, 41 UD patients and 13 CD patients died, the cause of death was disease related in 6 UC and in 6 CD patients. The average age at death in UC was not different from that observed in general population (66.4 years) but in CD (50.1 years) it was much earlier. The disease related mortality was low, 0.06/100,000 both in UC and CD. The prevalence rate at the end of 2001 was 142.6 for UC and 52.9/100,000 inhabitants for CD. Mean age at onset in UC was 38.9 +/- 15.5 years, in CD 31.7 +/- 12.8 years. We observed only one peak onset of the diseases, in UC it was between 30 and 40 years, in CD between 20 and 30 years. People living in towns were more liable to acquire the disease (ORUC = 1.27, ORCD = 1.13). The rate of smokers at the onset was 14.3% (OR = 0.25) in UC and 50.5% (OR = 1.98) in CD. Ex-smokers were 18.4% and 6.4%. Family history of IBD was present in 3.4% in UC and 9.9% in CD. The location of UC (according to the known largest extent) was proctitis in 112 cases, proctosigmoiditis in 162 cases, left sided colitis in 117 and subtotal or pancolitis in 169 cases. The location of CD was only ileal in 68 cases, ileocolonic in 87 cases, colonic in 57 cases. The behaviour of CD was non-stricturing-non-penetrating in 63 cases, stricturing in 54 cases, penetrating in 95 cases. 59.4% of the CD patients had at least one operation, 6.1% had more than 3 operations. CONCLUSION: The incidence and prevalence rates have increased steadily in Veszprém County, now it reaches that of most western European countries. There were no gender differences either in UC or CD. Smoking seemed to be a risk factor for CD, but it was preventive for UC. The rapid increase in incidence supports a role for environmental (e.g. diet, lifestyle changes) risk factors.

Adolescent↗
PubMed2003

[Irrational drug use in Siauliai, Panevezys and Utena counties of Lithuania].

UNLABELLED: In our study, we aimed to investigate the irrational use of the reimbursed drugs in some counties of Lithuania in 2001 by investigating the viewpoints of the physicians to the problems of the irrational pharmacotherapy, possible causes and solutions of them. This investigation was designed as a qualitative structured questionnaire. The study was composed of two stages. The personal health records of 2001 of Siauliai, Panevezys and Utena counties residents were analyzed and the cases of irrational drug use were selected, examined and verified during the first stage. There were 318 personal health records analyzed and 111 cases of irrational drug use verified. The 23 problems of irrational pharmacotherapy were distinguished and classified according to the responsibilities. The viewpoints of the physicians to the problems of the irrational pharmacotherapy were confirmed and analyzed during the second stage of the study. Thirty-one physicians were interviewed and responses summarized. CONCLUSIONS: 1. The irrational drug use took place in Siauliai, Panevezys and Utena counties of Lithuania in 2001. 2. Twenty-three types of problems of irrational pharmacotherapy can be distinguished. They can be classified into the 3 main levels according to the responsibility: the level of the administration (institution), the physician and the patient; other problems can be distinguished separately. 3. The most frequently specified by physicians possible reasons of the irrational drug use were the lack of information, the overcharge of the physician and the lack of the qualification. 4. The most frequently specified possible solutions of the irrational drug use by physicians were the growth of qualification, the establishment of the algorithms and the increase of the time spent per patient. 5. There was noticed particular tendency at the level of the physicians: physicians eliminated their responsibility at this level and related the problems with other levels--the levels of the administration (institution) and the patient.

Attitude of Health Personnel↗
PubMed1992

[Treatment of injuries in the county of Ringkøbing. 1. Incidence of injuries during a period of 4 weeks].

During a period of four weeks (17 September-14 October 1990) all treatments of injured persons in the five hospitals in the County of Ringkøbing were registered. In addition, the refund accounts for all additional services connected with injuries submitted by the 166 general practitioners to the Danish National Health Insurance were also registered. A total incidence rate (calculated on an annual basis) of injuries requiring treatment was found to be 229/1000 og the population per annum. As compared with a similar investigation carried out in 1969, increases in incidence rates of 2.1 for admissions, 3.8 for outpatient hospital treatments and 4.4 for treatment of injuries in general practice were found. An increase in the number of minor injuries is thus concerned, probably partly conditioned by an altered threshold for seeking treatment and partly a slighter increase in the number of more serious injuries. In addition, a significant difference in the frequency of injuries requiring treatment with more numerous treatments was found in the regions of Lemvig and Ringkøbing as compared with the remainder of the county. It is recommended that registration from casualty departments with collection of data for analysis of accidents be undertaken with the object of elucidating the background for the increase in the injuries and the differences between the individual regions in the county.

Accidents↗
PubMed1992

[Treatment of injuries in the county of Ringkøbing. 3. Attitude and behavior of the population and general practitioners in relation to treatment of injuries].

This investigation describes the attitudes and behaviour of the population and the general practitioners in the County of Ringkøbing concerning treatment of injuries and the closed casualty department. The investigation consists of three parts. 1. In order to describe the general practitioners in the County of Ringkøbing as those who treat injuries, a questionnaire was sent to these and 88.0% replied. In general, the general practitioners had relatively great experience of work in casualty departments from their hospital appointments. Only eight (5.6%) had experience for less than six months. Practically all (93.2%) had assistance during the day but, during on-call periods, only 16.4% had assistance from doctors. Only 2.1% had access to radiographic examination in their practices. The general practitioners stated that they were able to complete treatment in 82.5% (95-50) of the patients without referral to hospital. Lack of facilities and expertise were the commonest reasons for referral to hospital. 70% considered treatment of injuries as interesting or very interesting. Only 1.4% found it boring. 2. In order to describe self referral to hospital in cases of slight injury by the population of the County of Ringkøbing a questionnaire was sent to 600 of the population aged over 17 years chosen at random. 71.6% replied. 70% stated that they would contact their general practitioner or doctor-on-call in cases of wounds and suspected fracture. The individuals who would contact the casualty department, particularly in the case of wounds, were persons who lived close to the casualty department and who did not have any advantage in contacting their own general practitioner where distance was concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1992

Epidemiology of Lyme disease in Olmsted County, MN, 1975-1990.

Lyme disease has been reported in Minnesota since 1980. Until now, it has not been regarded as endemic in Olmsted County. We reviewed the medical records of all 68 cases of Lyme disease diagnosed in residents of Olmsted County for 1980-1990. Only 17 of the 68 cases met Centers for Disease Control surveillance criteria for definite Lyme disease (13 men, 4 women). Of these 17 cases, 3 were likely acquired in Olmsted County. The age and sex adjusted incidence rate was 2.3/100,000 (95% CI 1.1-3.4). Although reporting of Lyme disease is mandatory in Minnesota, only 7 suspected or definite cases were actually reported to public health officials. Of these, 4 met the case definition. In this population Lyme disease was both over-diagnosed and underreported. This observation questions current data and could have important health policy implications if confirmed nationally.

Adolescent↗
PubMed2004

School-associated pertussis outbreak--Yavapai County, Arizona, September 2002-February 2003.

On September 21, 2002, a pertussis case (confirmed by isolation of Bordetella pertussis) was reported to the Yavapai County Health Department (YCHD). The patient was a child aged 13 years in the 8th grade at a middle school in Yavapai County; the child had attended school during the illness. A case consistent with the clinical definition of pertussis had been reported in another student in the same classroom 2 weeks earlier. On September 22, a second culture-confirmed case was reported from the same classroom. Subsequent investigation identified five additional persons (two students in the same classroom, two 8th-grade teachers, and one parent of an ill student) with prolonged cough illnesses. In comparison, during the previous 10 years, an average of four pertussis cases were reported annually from this county. On September 26, YCHD, in conjunction with the Arizona Department of Health Services (ADHS) and school officials, notified the community of the pertussis outbreak in the middle school and initiated control measures. This report summarizes the epidemiology of the outbreak and the control measures used to contain it. Health-care providers should consider pertussis in persons of any age with acute cough illnesses and consider obtaining nasopharyngeal (NP) specimens for B. pertussis culture.

Adolescent↗