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PubMed1982

The pathology of small airways in chronic airflow limitation.

Small airways' disease is an ambiguous term that has been used in three ways: 1. to describe the lesions in the peripheral airways in patients with severe chronic airflow limitation; 2. to describe patients with isolated severe bronchiolitis and 3. to describe patients with mild chronic airflow limitation or the lesions in the small airways of such objects. Emphysema is probably the most important variable in causing chronic airflow limitation. The lesions in the peripheral airways in patients with severe chronic airflow limitation include narrowing and loss of small airways, inflammation, goblet cell metaplasia and intraluminal mucus. The first two lesions are best related to the development of cor pulmonale. In emphysema the peripheral airways are greatly distorted and lack alveolar support, and stenotic areas decrease more in dimension than the rest of the airways. Isolated severe bronchiolitis is best defined in patients with rheumatoid arthritis and causes a characteristic clinical syndrome of rapidly progressive airflow limitation. The most important cause of mild chronic airflow limitation is inflammation of the peripheral airways. This may act by displacing the surface active layer of the airway or, more likely, by inducing muscular hyperactivity. This may result from a direct action on muscle by mediators or may act through a vagally mediated reflex.

Arthritis, Rheumatoid↗

PubMed1981

Response monitoring and action limits: use of ADC numbers in understanding the operational characteristics of the Beckman ASTRA chemistry system.

The Beckman ASTRA is a microprocessor-controlled multichannel chemistry analyzer. The output of each module is available to the operator as analog-to-digital conversion (ADC) numbers, which we record during each calibration (Response Monitoring). After so studying three instruments for a total of 33 months, we have established limits for Calibrator ADC numbers that indicate possible operator action (Action Limits). These Action Limits are tighter than the microprocessor's programmed limits, and alert the operator to short- and long-term drift. These tighter limits warn of (a) impending failure of the instrument to calibrate or (b) possible inaccuracies in results for patients. We have instituted changes in preventive maintenance based on our studies of each module's operational characteristics, and have replaced electrodes that failed to meet our Response Monitoring specifications. Response Monitoring and Action Limits based upon ADC numbers have significantly enhanced our understanding of the ASTRA system and thus improved its operational efficiency and analytical reliability. Estimates of precision and accuracy (true value) were satisfactory in comparison to our prior single-channel continuous-flow and flame photometry analytical measurement systems.

Autoanalysis↗

PubMed1995

Novel use of limited primer extension in detecting mutations in human iduronate 2-sulfatase gene.

Hunter syndrome is characterized by a deficiency of iduronate 2-sulfatase. A large number of mutations in the gene have been reported. We describe here the development of a limited primer method for the identification of mutations. In the reaction mixture designed for the limited primer extension, one or two deoxynucleotides from the four necessary deoxynucleotides are added as "selected nucleotides" and another deoxynucleotide which is radiolabeled is added as the "limited nucleotide". The absence of one or two of the deoxynucleotides limits the length of primer elongation, and the low concentration of the "limited nucleotide" causes an "extension-delay" effect and results in a banding pattern upon electrophoresis of the products thus making it possible to distinguish mutant and normal alleles. We have studied three novel mutations in exon IX, 407delTT (TTT to T), 423insCC (CCC to CCCCC), and W502X (TGG to TAG) of the iduronate 2-sulfatase gene by the limited primer extension method.

Base Sequence↗

PubMed1993

Estimation of upper limits on human radiation absorbed doses from carbon-11-labeled compounds.

Radiation absorbed dose estimates for short-lived PET tracers are commonly based on biodistributions in rodents which (because of more rapid distribution and other species differences) may have limited relevance to humans. The initial purpose of this study was to estimate an intravenously injectable quantity of 11C which could not, on a priori grounds, exceed regulatory limits on radiation absorbed doses for individual organs. Upper limits on organ cumulative activities were estimated by assuming that 11C-labeled compounds are instantaneously distributed in the blood plasma, and then transferred solely and irreversibly to a single organ. The rate-constant (min-1) for each organ was taken to be its fractional cardiac output, since the plasma volume of 3 liters is recirculated each minute. The method was extended by using measured time courses of radioactivity in human arterial plasma available from previous PET studies with several 11C compounds in place of the assumption that the injected radioactivity was initially instantaneously distributed throughout the plasma. Calculations for 11C L-deprenyl, cogentin, cocaine, N-methylspiperone, putrescine and 2-deoxy-D-glucose, assuming transfer limited to a single organ, gave the kidneys rather than the thyroid as critical organ in each case. The upper-limit self-doses were 140, 210, 320, 360, 450 and 750 mrad/mCi, respectively, indicating that 34, 24, 15, 14 and 6.5 mCi, respectively, could be administered in a single PET study. These results suggest a strategy for human studies with 11C-labeled compounds: a preliminary study at the 3.5-mCi level would yield 11C arterial plasma data which could in turn be used to give a refined upper limit on radiation absorbed doses. For many 11C compounds, this strategy would demonstrate that sufficient radioactivity could be injected to give acceptable human PET images and would avoid the death of animals for biodistribution studies.

Animals↗

PubMed1996

[Lowering the promille limit?].

The Legislator's decision not to lower the 0.8 per mile alcohol level limit of the section 240 StVG runs counter to the tendency of fighting dring driving altogether. This decision was made despite the fact, that according to current medical science the risk limit lies at 0.4 per mile. It can't be justified by the "ultima ratio" principle which was introduced by the legislator for decision making. Much on the contrary, it suggests a development where considerations will no longer be applied only for the protection of the citizen. Here we can observe a continuation of the interpretation of the alcohol level limits which seem to simply serve as a means of ensuring a conviction. The economical analysis of the law is the theoretical background to this consideration which dominated by this process. This analysis does not take any further limitations of legislative powers into consideration with the exception of effectiveness, efficiency and its maximum use under the political and economic aspects. Therefore it allows the protection of the individual to be obscured by these maxims. However, lowering of the alcohol level risk limit to 0.4 per mile should not be insisted on, but instead there should be a call for the introduction of an alcohol ban altogether. This request could be justified with the lack of the legal basis of the alcohol level limits.

Accidents, Traffic↗

PubMed1996

Three cases of enduring memory impairment after bilateral damage limited to the hippocampal formation.

Patient RB (Human amnesia and the medial temporal region: enduring memory impairment following a bilateral lesion limited to field CA1 of the hippocampus, S. Zola-Morgan, L. R. Squire, and D. G. Amaral, 1986, J Neurosci 6:2950-2967) was the first reported case of human amnesia in which detailed neuropsychological analyses and detailed postmortem neuropathological analyses demonstrated that damage limited to the hippocampal formation was sufficient to produce anterograde memory impairment. Neuropsychological and postmortem neuropathological findings are described here for three additional amnesic patients with bilateral damage limited to the hippocampal formation. Findings from these patients, taken together with the findings from patient RB and other amnesic patients, make three important points about memory. (1) Bilateral damage limited primarily to the CA1 region of the hippocampal formation is sufficient to produce moderately severe anterograde memory impairment. (2) Bilateral damage beyond, the CA1 region, but still limited to the hippocampal formation, can produce more severe anterograde memory impairment. (3) Extensive, temporally graded retrograde amnesia covering 15 years or more can occur after damage limited to the hippocampal formation. Findings from studies with experimental animals are consistent with the findings from amnesic patients. The present results substantiate the idea that severity of memory impairment is dependent on locus and extent of damage within the hippocampal formation and that damage to the hippocampal formation can cause temporally graded retrograde amnesia.

Aged↗

PubMed1996

Evaluation of a laboratory critical limit (alert value) policy for hypercalcemia.

OBJECTIVE: To evaluate a laboratory critical limit policy for hypercalcemia requiring the laboratory to notify the physician for any serum calcium level higher than 2.99 mmol/L (12.0 mg/dL). DESIGN: The protocol was assessed using the following criteria: recognition, treatment (fluids or drugs) or no treatment of hypercalcemia, and the effect of adopting lower (2.64 mmol/L) or higher (3.22 mmol/L) calcium critical limits. RESULTS: Patients were divided into four groups: group 1, 2.64 to 2.74 mmol/L (n = 131); group 2, 2.77 to 2.87 mmol/L (n = 33); group 3, 2.89 to 2.99 mmol/L (n = 16); and group 4, higher than 2.99 mmol/L (n = 11). Hypercalcemia was recognized in 48%, 55%, 56%, and 100%; treated with fluids in 0%, 0%, 6%, and 9%; treated with drugs in 0%, 0%, 0%, and 73%; and not treated in 100%, 100%, 94%, and 18% of patients in groups 1 through 4, respectively. Lower calcium critical limits of 2.64, 2.77, and 2.89 mmol/L would lead to an increase of 1371%, 442%, and 142% in telephone calls. A higher calcium critical limit of 3.22 mmol/L would have resulted in not notifying the physician of six patients (60%) who were treated for hypercalcemia. CONCLUSIONS: The present hypercalcemia policy is effective because patients with calcium levels below 2.99 mmol/L (< 1%) are rarely treated for hypercalcemia and because lowering the calcium critical limit alert value would not increase physician awareness of hypercalcemic patients. It would, however, result in a significant increase in telephone calls. A higher calcium critical limit (3.22 mmol/L) would potentially result in missing a significant number of hypercalcemic patients in need of therapy.

Adult↗

PubMed1997

Trans-2-en-valproic acid limits action potential firing frequency in mouse central neurons in cell culture.

Effects of the trans-isomer of 2-en-valproate (trans-2-en-NaVP; E-delta2-en-valproate or 2-en-valproate), an unsaturated metabolite of valproic acid (VPA), on intracellularly recorded sodium-dependent action potentials of cultured mouse spinal cord and cortical neurons were compared with those of the anticonvulsant sodium valproate (NaVP). The maximal rate of rise of action potentials triggered by trains of 1-msec or 400-msec pulses declined progressively until failure to fire in both cell types during exposure to trans-2-en-NaVP or NaVP was observed. The limitation of firing by both drugs was concentration, voltage, rate and time dependent. The IC50 of trans-2-en-NaVP was 1.2 x 10(-3) at < or =1 hr and 4.8 x 10(-5) M at 24 to 48 hr. Trans-2-en-NaVP did not limit sustained repetitive firing in all cortical neurons. This may reflect slower rates of firing during 400-msec depolarizations in neurons of this type. In paired-pulse experiments, the absolute refractory period was 7 msec in control solution and 15 msec (P < .01 vs. control; n = 9) in solution containing 6 x 10(-4) M trans-2-en-NaVP. Firing was limited in all spinal cord neurons after exposure to 0.5 mM NaVP for 24 to 48 hr; 80% were limited by 1 mM NaVP at < or =1 hr. Coincubation of the spinal cord neurons with trans-2-en-NaVP and NaVP for 24 hr showed no hyperadditive effect of these two drugs in vitro. Limitation of sustained repetitive firing was reversed by hyperpolarization in the continuing presence of either drug and incubation in drug-free medium. Limitation of sodium-dependent action potential firing rates could contribute, at least in part, to the anticonvulsant effect of trans-2-en-NaVP.

Action Potentials↗

PubMed1996

Chronic conditions, physical limitations and dependency among seniors living in the community.

The majority (75%) of people aged 55 and over who live in the community, as opposed to living in long-term health care institutions, report having at least one chronic condition. However, only about one in six has some physical limitation. As well, one in six men and one in four women who live in the community need help with everyday activities such as housework or meal preparation. With advancing age, the prevalence of most chronic conditions increases, as does the prevalence of physical problems and dependency. The contribution of particular conditions to physical limitations and dependency varies. According to Statistics Canada's 1994-95 National Population Health Survey, the conditions most strongly related to physical limitations and to the need for help with activities of daily living were epilepsy and the effects of stroke, neither of which affected a large percentage of the household population aged 55 and over. By contrast, arthritis/rheumatism, non-arthritic back problems and cataracts, which were also associated with physical limitations and dependency, affected a relatively large percentage of community-dwelling seniors. This article shows the prevalence of specific chronic conditions, physical limitations and dependency among people aged 55 and over living in the community, by sex and age. Logistic regression is used to examine relationships between each chronic condition and the existence of physical limitations and dependency.

Activities of Daily Living↗

PubMedDate not supplied

Should the transfusion trigger and hemoglobin low critical limit be identical?

At this medical center, the transfusion trigger and the hemoglobin low critical limit are identical (< 8.0 g/dL), but should they be the same? To answer this question, over one year all hemoglobin results < 8.0 g/dL (n = 421) were reviewed, physician awareness of and response to various hemoglobin levels were evaluated, and the effect of adopting a lower hemoglobin critical limit assessed. Patients were divided into three groups: (1) 7.5-7.9 g/dL (n = 81); (2) 7.0-7.4 g/dL (n = 53); and (3) < 7.0 g/dL (n = 59). Seventy (86 percent), 47 (89 percent), and 52 (88 percent) patients were transfused in Groups 1, 2, and 3; transfused units, mean (sd), were 2.0 (0.8), 2.3 (1.1), and 2.8 (1.7), respectively. Post transfusion hemoglobin increase, mean (sd) was 2.1 (1.0), 2.4 (1.0), and 3.1 (1.5) g/dL for Groups 1, 2, and 3, indicating an inverse correlation between severity of anemia and number of transfused units and post-transfusion hemoglobin increase. Physicians were aware of anemia for all patients in Groups 1 and 2, but three patients in Group 3, not clinically anemic, had erroneous results (improperly collected specimens). Physicians randomly surveyed (n = 20) indicated that the hemoglobin critical limit could be lowered without adverse clinical consequence. A lower hemoglobin critical limit of 7.5 and < 7.0 g/dL would lead to a 52 percent and 77 percent decrease in phone calls for physician notification. The medical center has now lowered the critical limit for hemoglobin to < 7.0 g/dL. The transfusion trigger and the low critical limit for hemoglobin are distinct entities, need not be identical, and represent a balance between the need for transfusion response and the need to be aware of a highly abnormal lab result.

Anemia↗

PubMed1998

A prospective comparison of the costs of reusable and limited-reuse laparoscopic instruments.

OBJECTIVE: To compare the cost and performance of 2 types of laparoscopic instrumentation: reusable laparoscopic hook cautery instruments and curved scissors, or limited-reuse laparoscopic hook cautery instruments and curved scissors. DESIGN: A randomized trial. SETTING: The operating room of a tertiary care hospital. METHOD: All general surgeons performing laparoscopic procedures at the hospital were randomized to be supplied with either reusable or limited-reuse hook cautery and curved scissors. Instrument use was recorded, together with principal outcome measures. OUTCOME MEASURES: Life expectancy of the instruments, the number of cases for which they were used, the number, nature and cost of repairs, their purchase cost and surgeon satisfaction. RESULTS: Reusable hook cautery instruments were less expensive than their limited-reuse counterparts. Excellent surgeon satisfaction was reported with the use of this type of instrument. The limited-reuse curved scissors arm of the study was terminated early because of a breach in study protocol. CONCLUSIONS: Reusable hook cautery instruments were better than their limited-reuse counterparts. Rigorous attempts to compare the cost of laparoscopic instruments may be limited by their rapid evolution in design and the availability of many types of instruments on the market.

Attitude of Health Personnel↗

PubMed1998

Limited-access coronary artery bypass grafting. The Texas Heart Institute experience.

Limited-access coronary artery bypass grafting, without the aid of cardiopulmonary bypass, is being performed with increased frequency, but its indications are not well defined. To determine the outcome of, and indications for, this procedure, we analyzed our experience with limited-access coronary artery bypass grafting. Between February 1996 and June 1998, 84 patients underwent limited-access coronary artery bypass grafting at our institution. We retrospectively divided these patients into 2 groups: a high-risk group with complex disease and multiple comorbidities (n = 56), and a low-risk group with uncomplicated disease (n = 28). There were 2 perioperative deaths (2%), and both of them occurred in high-risk cases. Early and late complications included myocardial infarction (2 cases), recurrent angina necessitating revascularization (2 cases), and multisystem dysfunction (1 case). Compared with conventional bypass grafting, limited-access coronary artery bypass grafting offered a smaller skin incision, fewer arrhythmias, less blood loss, less need for inotropic drugs, shorter hospitalization, lower cost, and quicker recovery time. Limited-access coronary artery bypass grafting might have a role in treating high-risk patients who have complex disease and require single-vessel bypass. Anastomosis can be challenging, however, if the target coronary artery is small, calcific, or intramyocardial. Moreover, the long-term results are unknown. Therefore, nonselective use of limited-access coronary artery bypass grafting is unjustified.

Aged↗

PubMed2006

Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability.

CONTEXT: Aerobic fitness, an important predictor of cardiovascular disease and mortality, is difficult to assess by maximal exercise testing in older adults. Extended walking tests have been examined as outcome predictors in medically ill populations but not in community-dwelling older adults. OBJECTIVE: To determine whether an extended walking test predicts poor outcomes in older adults. DESIGN, SETTING, AND PARTICIPANTS: Observational cohort study enrolling 3075 community-dwelling adults aged 70 to 79 years living in Pittsburgh, Pa, or Memphis, Tenn. Of those participating in the Health, Aging, and Body Composition Study, 1584 (52%) were women and 1281 (42%) were black. Participants enrolled from March 1997 to April 1998. Ability to complete the long-distance corridor walk and total performance time was assessed at the baseline examination. MAIN OUTCOME MEASURES: Total mortality, incident cardiovascular disease, incident mobility limitation, and mobility disability were ascertained after a mean (SD) of 4.9 (0.9) years. RESULTS: Among patients eligible to exercise, 351 died, 308 had episodes of incident cardiovascular disease, 1116 had occurrences of mobility limitation, and 509 had occurrences of mobility disability. Inability to complete walking 400 m tended to be associated with a higher risk of mortality and incident cardiovascular disease and, after accounting for potential confounders, was associated with incident mobility limitation (212.6 vs 79.1 events/1000 person-years; adjusted hazard ratio [HR], 1.86; 95% confidence interval [CI], 1.58-2.18; P<.001) and mobility disability (85.2 vs 28.8 events/1000 person-years; adjusted HR, 1.95; 95% CI, 1.56-2.44; P<.001). Of those who completed 400 m, each additional minute of performance time was associated with an adjusted HR of 1.29 (95% CI, 1.12-1.48) for mortality, 1.20 (95% CI, 1.01-1.42) for incident cardiovascular disease, 1.52 (95% CI, 1.41-1.63) for mobility limitation, and 1.52 (95% CI, 1.37-1.70) for disability after adjustment for demographics, health behaviors, clinical and subclinical disease, and cardiovascular disease risk factors. Findings were consistent in both men and women and blacks and whites. Among participants who completed the test and after adjusting for potential confounders, those in the poorest quartile of functional capacity (walk time >362 seconds) had a higher risk of death than those in the best quartile (walk time <290 seconds; adjusted HR, 3.23; 95% CI, 2.11-4.94; P<.001). CONCLUSIONS: Older adults in the community who reported no difficulty walking had a wide range of performance on this extended walking test. Ability to do the test and performance were important prognostic factors for total mortality, cardiovascular disease, mobility limitation, and mobility disability in persons in their eighth decade.

Aged↗

PubMed2001

Misinterpretation and misuse of exposure limits.

Users of occupational exposure limits (OELs) often fail to distinguish between the complementary processes of risk assessment and exposure (risk) management. The former refers to those activities that lead to the selection of a reasonably protective exposure limit and often includes an analysis of exposure databases and an evaluation of group-based risk. The latter focuses on individual risk, and refers to those actions required of employers to ensure that each employee is unlikely to incur harm to health. This presentation focuses on how this failure to distinguish leads to misinterpretation and misuse of OELs. A typical OEL definition consists of at least three components: a concentration, an averaging time, and a target (usually the individual worker). OELs are occasionally improperly applied, resulting in a reduction of the expected level of protection. For example, sampling strategies proposed by the American Industrial Hygiene Association (AIHA) and Comité Européen de Normalisation (CEN) permit workers to be aggregated into exposure groups. Under certain circumstances this practice can leave some workers unevaluated and unprotected. Protection is also reduced when the averaging time is extended from a single shift to multiple shifts. Frequently, OELs are misinterpreted as upper limits to exposures averaged over weeks, months, or even years, rather than a single shift. Much of this confusion can be traced to the desire of some to reconcile research (epidemiology) sampling strategies with compliance sampling strategies. But the two have fundamentally different goals and objectives. Others are simply attracted to alternative OEL interpretations that permit frequent overexposures (i.e., measurements that exceed the OEL), thus making compliance easier. Given the current limitations of industrial hygiene and occupational epidemiology, and the general unwillingness of employers to routinely collect exposure data, OELs should continue to be defined as upper limits for single shift exposures. The current OEL model, which permits the use of proximate risk management goals to realize long-range objectives, should be retained. There are, however, valid reasons for augmenting this model to include criteria for evaluating compliance with long-range objectives. The augmented OEL model would be applicable to future new and revised OELs. The author suggests that OEL setting organizations consider harmonizing definitions and statistical interpretations for both existing and new OELs, thus minimizing future misinterpretation and misuse.

Europe↗

PubMed2007

Risk factors for adverse drug events in older adults with mobility limitations in the community setting.

OBJECTIVES: To investigate risk factors for self-reported adverse drug events (ADEs) in a cohort of annually surveyed Iowa Medicare beneficiaries with mobility limitations. DESIGN: Prospective cohort study with baseline and two annual follow-up questionnaires. SETTING: Population-based sample of Iowa Medicare beneficiaries with mobility limitations. PARTICIPANTS: Members of the cohort with complete follow-up questionnaires and prescription dispensing data (N=689). MEASUREMENTS: The questionnaires asked about self-reported ADEs in the previous 12 months, sociodemographic data, smoking, alcohol use, number of mobility limitations, and history of chronic disease. Pharmacy dispensing records were the source of number and classes of prescription drug use. Linked Medicare claims provided additional comorbidity data. RESULTS: Of the 689 subjects, 151 (21.9%) reported an ADE, 83% of which resulted in physician contact and 56% of which resulted in discontinuing the medication. Number of different medications dispensed during the prior year was an independent predictor of a self-reported ADE. Neither age, extent of mobility limitation, nor number of chronic conditions was independently associated with reporting an ADE. CONCLUSION: Excess ADE risk observed with increasing mobility limitations is mediated through greater medication use.

Age Factors↗

PubMed2026

Characterisation of metabolic burden in Pseudomonas putida reveals precursor limitation in heterologous lycopene production.

BACKGROUND: The introduction of heterologous pathways into microbial hosts often imposes a metabolic burden on the cell, arising from three major physiological constraint layers: competition for gene expression resources, limited precursor availability and flux distribution, and insufficient energy and redox supply. Although Pseudomonas putida KT2440 is considered a robust and metabolically versatile production host, it remains unclear which of these constraint layers primarily limits heterologous terpenoid production in this organism. Here, lycopene biosynthesis was used as a model system to systematically dissect these three potential sources of metabolic burden. RESULTS: A capacity-monitoring system revealed no clear reduction in transcriptional or translational capacity across the tested strains and cultivation conditions, indicating that general gene expression capacity was not the primary limiting factor. Instead, lycopene production depended strongly on promoter architecture and plasmid backbone, showing that regulatory design shaped pathway performance. Enhancing precursor supply by introducing a heterologous mevalonate (MVA) pathway substantially increased product titres, identifying precursor availability from the native MEP pathway as the dominant bottleneck. This conclusion was independently supported by exogenous mevalonate supplementation, which further increased lycopene accumulation but also revealed saturation at higher concentrations, suggesting that downstream pathway balance or enzyme capacity became limiting once precursor supply was relieved. Under controlled bioreactor conditions, lycopene titres increased from approximately 1 mg/L to nearly 25 mg/L, indicating that process conditions further modulate production performance, suggesting an additional contribution of process-dependent energy and redox constraints. CONCLUSION: Metabolic burden during heterologous lycopene production in P. putida is governed primarily by precursor availability rather than by limitations in general gene expression capacity. Regulatory properties of the vector system strongly influence pathway performance, while controlled cultivation conditions can further improve production by alleviating additional process-dependent constraints. Together, these findings provide a systematic framework for distinguishing constraint layers and guiding the optimisation of heterologous terpenoid production systems.

Lycopene↗

PubMed2004

New EMF safety limits for occupational and public exposure in Poland.

On July 23, 2001, new safety limits for occupational exposure to electromagnetic fields (EMF) were introduced in Poland. The limits have been based on the analysis of international recommendations, e.g., ICNIRP (1998), WHO (1998), IEEE standard (1999), drafts of European standards (ENV 1995), and a critical review of the world literature on the biological effects of EMF and health effects of exposure to EMF. Derived from safety limits for occupational exposure, new safety exposure limits for general population were introduced on November 28, 2003. In this paper mandatory procedures for setting limits of exposure to agents harmful to health in the workplace and natural environment are presented. The most essential provisions of two regulations, one issued by the Minister of Labour and Social Policy and the other by the Minister of the Environment, forming the basis of the modern system of EMF exposure control in Poland, are also discussed.

Electromagnetic Fields↗

PubMed2006

State prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation--United States, 2003.

Arthritis is costly (86 billion dollars annually), highly prevalent (affecting 43 million U.S. adults), the leading cause of disability, and associated with substantial disparities in pain, activity limitations, and compromised quality of life. State-based estimates of arthritis prevalence and impact help define the burden of arthritis and provide state arthritis programs with data for program planning. This report summarizes results from the 2003 Behavioral Risk Factor Surveillance System (BRFSS) survey on state-specific prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation in 50 states, the District of Columbia (DC), and three territories. The findings indicated that the prevalence of adults with self-reported doctor-diagnosed arthritis ranged from 17.9% to 37.2% (state median: 27.0%) and with arthritis-attributable activity limitation ranged from 6.3% to 16.7% (state median: 9.9%); the proportion of adults with arthritis-attributable activity limitation among those with self-reported doctor-diagnosed arthritis ranged from 30.1% to 49.8% (state median: 37.4%). These high rates of arthritis prevalence and activity limitation are projected to increase with the aging of the population, requiring increased intervention measures to reduce this impact.

Activities of Daily Living↗