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At least 865 records · Page 48Linked to original sources
PubMed2003

Detection of renal dysfunction based on serum creatinine levels in a Brazilian community: the Bambuí Health and Ageing Study.

There are few population-based studies of renal dysfunction and none conducted in developing countries. In the present study the prevalence and predictors of elevated serum creatinine levels (SCr > or = 1.3 mg/dl for men and 1.1 mg/dl for women) were determined among Brazilian adults (18-59 years) and older adults (>60 years). Participants included all older adults (N = 1742) and a probabilistic sample of adults (N = 818) from Bambu town, MG, Southeast Brazil. Predictors were investigated using multiple logistic regression. Mean SCr levels were 0.77 +/- 0.15 mg/dl for adults, 1.02 +/- 0.39 mg/dl for older men, and 0.81 +/- 0.17 mg/dl for older women. Because there were only 4 cases (0.48%) with elevated SCr levels among adults, the analysis of elevated SCr levels was restricted to older adults. The overall prevalence of elevated SCr levels among the elderly was 5.09% (76/1494). The prevalence of hypercreatinemia increased significantly with age (chi = 26.17, P = 0.000), being higher for older men (8.19%) than for older women (5.29%, chi = 5.00, P = 0.02). Elevated SCr levels were associated with age 70-79 years (odds ratio [OR] = 2.25, 95% confidence interval [CI]: 1.15-4.42), hypertension (OR = 3.04, 95% CI: 1.34-6.92), use of antihypertensive drugs (OR = 2.46, 95% CI: 1.26-4.82), chest pain (OR = 3.37, 95% CI: 1.31-8.74), and claudication (OR = 3.43, 95% CI: 1.30-9.09) among men, and with age >80 years (OR = 4.88, 95% CI: 2.24-10.65), use of antihypertensive drugs (OR = 4.06, 95% CI: 1.67-9.86), physical inactivity (OR = 2.11, 95% CI: 1.11-4.02) and myocardial infarction (OR = 3.89, 95% CI: 1.58-9.62) among women. The prevalence of renal dysfunction observed was much lower than that reported in other population-based studies, but predictors were similar. New investigations are needed to confirm the variability in prevalence and associated factors of renal dysfunction among populations.

Adolescent↗
PubMed1990

The detection of rotavirus antigen in faeces of asymptomatic children from two different communities in Zimbabwe.

A study of the existence in Zimbabwe of Rotavirus asymptomatic infection was conducted. Rectal swabs were collected from children aged between one month and two years, who were attending health clinics at Chiweshe Hospital (rural area) and Rujeko (a Harare high density suburb) in Zimbabwe. These infants were tested for the presence of Rotavirus antigen, using the ELISA test. Out of 292 specimens collected during a period of one year, 6.9 pc were found positive for Rotavirus antigen although none of the infants had symptoms of Rotavirus infection. Our results show no significant difference (x2 = .357, P = .55) between the prevalence of Rotavirus in children, 1-12 months old from Rujeko and Chiweshe. Likewise, there was no significant difference (x2 = 1.52, P = .281) in the 13-14 months children. It was however shown that a significant difference (x2 = 9.28, P = 0.0096) appeared between winter months versus dry or wet months. We, therefore, conclude that Rotavirus antigen is prevalent in asymptomatic children, and that it is more frequent during winter months.

Antigens, Viral↗
PubMed2006

Effect of introduced phthalate-degrading bacteria on the diversity of indigenous bacterial communities during di-(2-ethylhexyl) phthalate (DEHP) degradation in a soil microcosm.

Four previously isolated di-butyl-phthalate (DBP) degraders were tested for their abilities to degrade di-(2-ethylhexyl) phthalate (DEHP). In aqueous medium supplemented with 100mg/l of DEHP, both isolate G1 and Rhodococcus rhodochrous G2 showed excellent degradative activity; in three days they were able to degrade more than 97% of the added DEHP. Rhodococcus rhodochrous G7 degraded 32.5% of the added DEHP and Corynebacterium nitrilophilus G11 showed the least amount of DEHP degradation. The addition of surfactant Brij 30 at 0.1x critical micelle concentration (2mg/l) significantly improved DEHP degradation by Rhodococcus rhodochrous G2 (more than 90% of the added DEHP was degraded within 24 hours), but slightly inhibited the degradation of DEHP by the isolate G1 and Rhodococcus rhodochrous G7. Based on the 16S rDNA sequence data, isolate G1 was identified as Gordonia polyisoprenivorans. Soil inhibited DEHP degradation by G. polyisoprenivorans G1; fourteen days after a second addition of DEHP, 11.5% of the total added DEHP (i.e., 243.4 microg/g soil) remained detectable. Changes in the bacterial community were monitored using denaturing gradient gel electrophoresis (DGGE) and respective dendrogram analysis. It is clear that DEHP and DEHP plus G. polyisoprenivorans G1 substantially affected the bacterial community structure in the soils. However, as the population of indigenous DEHP degraders increased in the DEPH-treated soil, its bacterial communities resembled those in the DEHP plus G. polyisoprenivorans G1-inoculated soil by Day 17.

Biodegradation, Environmental↗
PubMed1997

Evaluation of environmental deterioration by analysing fish parasite biodiversity and community structure.

The degree of biological diversity is often used as an indicator of the well-being of ecological systems. This approach can also be applied to analyse biodiversity in parasite communities. In particular, studies on parasite communities can be employed to detect a decline in biodiversity which characterizes habitats affected by pollution. Beside the most widely used diversity indices, such as the Shannon, Brillouin and inverse Simpson, that have been widely applied in different host-parasite systems, new approaches have been recently developed in order to overcome problems related to high dominance. Walther et al. (1995) proposed an asymptotic equation suitable for evaluating parasite species richness as a function of sampling effort. Such an equation was earlier proposed by Miller and Weigert (1989) to describe plant species diversity and to calculate true species richness as the ratio between the increase in species richness (a) and the parameter that set the species richness asymptote (b). True species richness has been shown to decline in parasite communities of mugilids collected in polluted areas. Biodiversity calculations can also be run in parallel with other biological studies for the description of environmental conditions. The completion of parasite life cycles requires complex biocoenotic interactions and is restricted by environmental constraints. Therefore another approach for monitoring the health of an ecosystem was by analysing the ratio between monoxenous and heteroxenous parasite species infecting model hosts. By this methodology it was possible to confirm pollution effect highlighted by other quantitative methods.

Animals↗
PubMed1990

Detection by immune electron microscopy of 27-nm viral particles associated with community-acquired diarrhea in children.

The proportion of diarrheal illnesses of unknown origin that were associated with small round virus (SRV, 23-38 nm) particles among children less than 2 years old attending an outpatient clinic in Baltimore was determined. During a 9-month period, stool specimens from 188 patients with acute diarrhea and 108 healthy age-matched control children were examined for enteric bacterial pathogens, protozoa, enteric adenovirus, and rotavirus. An enteropathogen was identified in 75 patients (40%) and in 21 controls (20%). A random sample of specimens without an identifiable pathogen was then examined for SRV particles by immune electron microscopy (IEM) using commercial human gamma globulin. Viruses of 26-30 nm diameter that were not enteroviruses were detected in specimens from 9 (12.5%) of the 72 patients and 1 (1.8%) of the 53 control subjects (P less than .04). Of 6 patients with available acute and convalescent sera, 4 demonstrated a significant immune response when tested by IEM. All patients experienced a mild, self-limited (1-3 days) illness. These findings suggest that SRV may be endemic in the Baltimore community and may result in clinically significant diarrheal illnesses.

Case-Control Studies↗
PubMed1998

Parasite extinction and colonisation and the evolution of parasite communities: a simulation study.

We determined what evolutionary processes influence the likelihood of detecting an effect of host ecological characteristics on the richness of parasite communities in comparative analyses among related host species. We used a mathematical model to generate phylogenies of hosts in which parasite communities varied over evolutionary time as parasite species were either gained or lost during host speciation events. Gain or loss of parasites were stochastic and could either be strongly, moderately, weakly, or not, affected by host ecological characteristics. The model was evaluated over this range of effects of host ecology, and for various mean probabilities of parasite gain and loss and various rates of change in host ecological characteristics at speciation events. Our results suggest that phylogenetic effects (the passing of parasite species from mother to daughter host species) are likely to obscure ecological effects (the effect of host body size, diet, habitat, lifespan, etc.) except when the effects of host ecology are strong, and the probabilities of gain or loss of parasites are high, or host ecological characteristics change markedly at speciation events. This outcome was not influenced by the shape of the phylogenetic tree used in the simulations. Sensitivity analysis of our model also shows this result to be robust to a wide range of assumptions and parameter values. Thus, because the composition of parasite communities tends to reflect their ancestry, the effect of host ecology will often be very difficult to detect.

Animals↗
PubMed2005

Nested PCR-denaturing gradient gel electrophoresis approach to determine the diversity of sulfate-reducing bacteria in complex microbial communities.

Here, we describe a three-step nested-PCR-denaturing gradient gel electrophoresis (DGGE) strategy to detect sulfate-reducing bacteria (SRB) in complex microbial communities from industrial bioreactors. In the first step, the nearly complete 16S rRNA gene was amplified using bacterial primers. Subsequently, this product was used as a template in a second PCR with group-specific SRB primers. A third round of amplification was conducted to obtain fragments suitable for DGGE. The largest number of bands was observed in DGGE patterns of products obtained with primers specific for the Desulfovibrio-Desulfomicrobium group, indicating a large diversity of these SRBs. In addition, members of other phylogenetic SRB groups, i.e., Desulfotomaculum, Desulfobulbus, and Desulfococcus-Desulfonema-Desulfosarcina, were detected. Bands corresponding to Desulfobacterium and Desulfobacter were not detected in the bioreactor samples. Comparative sequence analysis of excised DGGE bands revealed the identity of the community members. The developed three-step PCR-DGGE strategy is a welcome tool for studying the diversity of sulfate-reducing bacteria.

Base Sequence↗
PubMed1977

The hypertension detection and follow-up program: a progress report.

The NHLBI-supported Hypertension Detection and Follow-Up Program (HDFP) is a community-based program designed to assess the value of early detection and vigorous treatment of persons with high blood pressure of varied severity. HDFP staff members have measured the blood pressures of 158,906 persons in their homes or work places in 14 communities across the United States. Of those persons, 10,940 were found to be hypertensive in a two-state screening process and were enrolled in the Program. Half were referred on a random basis to sources of care in the community, and half were invited to the special Stepped-Care clinics sponsored by the HDFP. These clinics, in a vigorous attempt to normalize blood pressure for all these hypertensive participants, stress intensive follow-up and special attention to achieve compliance with treatment. More than 80% under Stepped Care are continuing on therapy after 2 years, and three-fourths of these have achieved desired normal levels of pressure. The majority of hypertensives found in this Program have less severe elevations of blood pressure, and even among them reductions in blood pressure were substantial because of the vigorous follow-up and special attention to compliance. The HDFP is continuing its efforts to find to what extent sustained treatment of those with elevated blood pressure can reduce mortality or complications due to hypertension.

Adult↗
PubMed1994

Relational themes in the inpatient community meeting.

The authors present a model of psychiatric inpatient community meetings run as large group interpretive psychotherapy. They developed this model in part from Gill's notion that patients attach plausible meanings to therapist behavior based on the patient's characteristic and stereotypical ways of experiencing relationships. The model provides a framework for the description of 11 clinically derived "unconscious relational configurations" that can frequently be detected as organizing "relational themes" of community meetings. The authors present two clinical vignettes in which staff detect these themes and interpret them together with the defenses against them. They then discuss the prominent negative affective valence that characterizes the "unconscious relational configurations."

Ego↗
PubMedDate not supplied

Assessing the effectiveness of community screening programs.

Community screening programs seek to detect disorders or risk factors in seemingly healthy persons. The following seven guidelines for determining whether a screening program is likely to be effective are proposed and discussed: (1) Has the effectiveness of the program been demonstrated in a randomized trial? (2) Are efficacious treatments available? (3) Does the burden of suffering warrant screening? (4) Is there a good screening test? (5) Does the program reach those who could benefit? (6) Can the health system cope with the program? (7) Do persons with positive screenings comply with advice and interventions?

Community Health Services↗
PubMedDate not supplied

Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample.

Child psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated. To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community, SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 7984 5-15 year olds from the 1999 British Child Mental Health Survey. Multi-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 94.6% (95% Cl, 94.1-95.1%) and a sensitivity of 63.3% (59.7-66.9%). The questionnaires identified over 70% of individuals with conduct, hyperactivity, depressive, and some anxiety disorders, but fewer than 50% of individuals with specific phobias, separation anxiety and eating disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs. Community screening programmes based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments.

Adolescent↗
PubMed2000

A cost analysis of community screening for diabetes in the central Wisconsin Medicare population (results from the MetaStar pilot project in Wausau).

CONTEXT: Type 2 diabetes mellitus is often undiagnosed and untreated. OBJECTIVE: To estimate the costs and possible savings of screening for Type 2 diabetes mellitus in the Wisconsin Medicare population from a population health perspective. DESIGN: The costs and benefits of community screening were analyzed using various primary and secondary data sources. Data on the community screening were obtained by MetaStar, collaborators at the screening site, and published material. Results from a Monte Carlo simulation model, developed by the CDC Diabetes Cost-Effectiveness Study Group, and recent developments in diabetes research were used to estimate the incidence levels of major complications for Type 2 diabetes. SETTING AND PARTICIPANTS: Medicare beneficiaries in central Wisconsin residing in the Wausau Hospital Service Area, which is composed of 14 zip codes. RESULTS: Of 826 Medicare patients screened, 32 were diagnosed as having diabetes. If we use the same assumptions offered by the CDC Study Group, we find that the excess lifetime costs from screening and early treatment ($4850) exceed costs saved from preventing complications ($378), costing an average of $4471 per diabetic. However, if we alter assumptions on cardiovascular disease reduction risk and routine care costs, we find that screening could save an average of $619 per diabetic detected. CONCLUSIONS: The costs of community screening, using the CDC Study Group's assumptions, are greater than the costs of diabetes without screening in this population. However, recent evidence on cardiovascular disease risk and routine care costs could alter the results, leading to lower costs and greater benefits in the future. More research is necessary, particularly in the area of quality of life measures, to more accurately reflect the benefits of screening.

Aged↗
PubMed1998

Early detection of diabetic retinopathy by a mobile retinal photography service working in partnership with primary health care teams.

Community-wide fundus photography was organized for early detection of diabetic retinopathy (DR) by mobile teams. High-quality three-field Kodachrome fundus photography, performed according to the London Protocol through dilated pupils was offered free of charge to primary care; images were taken in the community and assessed centrally. Data are presented from the first 80 primary health care centres (PHCCs) participating, serving 990,000 (about 60%) of inhabitants in Stockholm County. Beginning in 1990, 6863 diabetes patients were invited by PHCCs; 5490 (80%) attended. We reached 77% of persons with known diabetes; only 37% had had their eyes examined during the preceding 2 years. For 97% of patients, images were assessable. DR was present in 34% of patients (non-proliferative DR not requiring further assessment 29%, non-proliferative DR requiring further assessment 1.1%, proliferative DR 0.5% and macular involvement 3.6%). Re-examination after 2 years was offered to 64%; follow-up photography after 1 year to 24%. Fluorescein angiography and/or photocoagulation treatment was performed in 3.6%. This method of early diagnosis is feasible, acceptable, and reached twice as many patients as did the usual referral-based system of care. We now plan to extend this service to cover the whole county.

Adolescent↗
PubMed1992

The early detection of nonpalpable breast carcinoma with needle localization. Experience with 500 patients in a community hospital.

During a 5-year interval, 500 women underwent 530 needle localizations (NL) for nonpalpable, mammographically suspicious breast lesions. These lesions were localized using the Homer Mammalok Breast Needle/Wire Localizer (Namic; Glens Falls, NY). Almost one half the NL (260/530) were performed for suspicious calcifications; 19 per cent (49/260) proved to be cancerous. Cancer (CA) was identified 90 times in 88 patients (17%); 64 per cent (58/90) were invasive and 36 per cent (32/90) were noninvasive carcinomas. Eighty per cent of the lesions were 1 cm or smaller. Eighty-four axillary dissections were done and only 7 patients (8%) had axillary metastasis. During the same time interval, 277 women underwent axillary dissection, with or without mastectomy, for palpable breast cancer. Ninety-one per cent (252/277) had invasive carcinomas and 38 per cent (104/277) had axillary metastasis. Estrogen receptor assays (ERA) and progesterone receptor assays (PRA) were similar for both patient populations. The authors conclude that NL is an effective, safe method of detecting highly curable, occult breast cancer. It can be done effectively at a community hospital with results very similar to large university studies.

Adult↗
PubMed2000

Interferon-gamma responses to candidate leprosy skin-test reagents detect exposure to leprosy in an endemic population.

New tools for the detection of leprosy exposure in a community will be necessary for the eradication of leprosy. Candidate leprosy skin-test antigens derived from the fractionation of the leprosy bacillus into cytoplasmic and cell-wall proteins free of immuno-inhibitory mycobacterial lipoglycans and carbohydrates were used in an overnight blood test to determine whether exposure to leprosy can be detected by the production of the cytokine interferon gamma (IFN-gamma). Strong IFN-gamma responses were detected in leprosy contacts to both skin-test antigens compared with control subjects from the same endemic communities. There was little response in patients with tuberculosis. Responses were greatest in contacts with recent leprosy exposure. The implications of these findings for the application of these reagents in a field trial as skin tests to detect exposure to leprosy are discussed in light of the strong association between overnight IFN-gamma to PPD and the tuberculin skin-test responses previously reported.

Adolescent↗
PubMed2001

The validity of the 12-item General Health Questionnaire in Australia: a comparison between three scoring methods.

OBJECTIVE: To investigate the specificity and sensitivity of three different scoring methods of the 12-item General Health Questionnaire (GHQ-12) and hence to determine the best GHQ-12 threshold score for the detection of mental illness in community settings in Australia. METHOD: Secondary data analysis of the 1997 Australian National Survey of Health and Wellbeing (n = 10 641), using the Composite International Diagnostic Interview as the gold standard for diagnosis of mental illness. RESULTS: The area under the Receiver Operating Characteristic (ROC) curve for the C-GHQ scoring method was 0.84 (95% CI = 0.83-0.86) compared with the area for the standard scoring method of 0.78 (95% CI = 0.76-0.80). The best threshold with C-GHQ was 3/4, with sensitivity 82.9% (95% CI = 80.2-85.5%) and specificity 69.0% (95% CI = 68.6-69.4%). The best threshold score with the standard scoring method was 0/1, with sensitivity 75.4% (95% CI = 72.5-78.4%) and specificity 69.9% (95% CI = 69.5-70.3%). These were also the best thresholds for a subsample of the population who had consulted a health practitioner in the previous 4 weeks. CONCLUSION: In the Australian setting, the C-GHQ scoring method is preferable to the standard method of scoring the GHQ-12. In Australia the GHQ-12 appears to be a less useful instrument for detecting mental illness than in many other countries.

Adolescent↗