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At least 1,189 records · Page 66Linked to original sources
PubMed2001

The prevalence of multiple sclerosis in the world: an update.

The systematic study of multiple sclerosis (MS) in populations, started in 1929 by Sydney Allison, now consists of over 400 publications dealing with the prevalence of MS throughout the world. However, any attempt to redefine the pattern of geographical differences in MS frequency remains as difficult as ever. The comparison of prevalence studies carried out in different areas and times is made difficult by the variability in surveyed population sizes, age structures, ethnic origins and composition, and the difficult quantification of numerators, especially regarding the recognition of benign and very early cases. Additionally, complete case ascertainment depends on access to medical care, local medical expertise, number of neurologists, accessibility and availability of new diagnostic procedures, the degree of public awareness about MS, and the investigators' zeal and resources. Critical examination of the more recent data on MS prevalence leads to some revisions of previously held concepts, the most interesting of which is the appreciation of the greater influence of genetic factors on disease acquisition. The rarity of MS among Samis, Turkmen, Uzbeks, Kazakhs, Kyrgyzis, native Siberians, North and South Amerindians, Chinese, Japanese, African blacks and New Zealand Maoris, as well as the high risk among Sardinians, Parsis and Palestinians, clearly indicate that the different susceptibilities of distinct racial and ethnic groups are an important determinant of the uneven geographic distribution of the disease. The updated distribution of MS in Europe, showing many exceptions to the previously described north-south gradient, requires more explanation than simply a prevalence-latitude relationship. Prevalence data imply that racial and ethnic differences are important in influencing the worldwide distribution of MS and that its geography must be interpreted in terms of the probable discontinuous distribution of genetic susceptibility alleles, which can however be modified by environment. Because the environmental and genetic determinants of geographic gradients are by no means mutually exclusive, the race versus place controversy is, to some extent, a useless and sterile debate.

Genetic Predisposition to Disease↗
PubMed2004

An appraisal of gastric cancer research in cancer journals.

We assessed the trends in the proportion of articles on gastric cancer published in major cancer journals, the research fields of interest, and the first author's affiliation. Articles in PubMed, addressing cancer in general and stomach cancer in particular, were quantified. Abstracts of gastric cancer articles were hand-searched. The British Journal of Cancer, Cancer, Cancer Research, the International Journal of Cancer, and the Journal of the National Cancer Institute were included in the journal survey. Stomach cancer was addressed in 2.9% of the articles in 1982-1984 and 3.3% in 2000-2002. The proportion of articles from Asia increased (32.2% vs 50.2%) and that for the United States decreased (34.4% vs 15.1%) in 2000-2002. Articles addressing etiologic genetic factors were more frequent in 2000-2002 (11.5% vs 61.6%). The proportion of stomach cancer articles was largely below the expected share considering the frequency of malignancies, and did not reflect the geography of biomedical publications. A trend was observed favoring the evaluation of genetic factors.

Biomedical Research↗
PubMed2006

The making of an interdisciplinary partnership: the case of the Chicago Food System Collaborative.

Interdisciplinary partnerships foster innovation to address pressing social problems. This paper describes an interdisciplinary partnership called the Chicago Food System Collaborative (CFSC) composed of a team of partners from four academic institutions and three community-based organizations representing a total of eight disciplines that included: community development and community organizing, community psychology, geography, nursing, nutrition, public health, sociology, and urban planning and policy. Partners came together to address the issue of access to healthy foods and nutrition in a working class African American neighborhood. We analyze and discuss the core principles that guided the partnership and its impact across three dimensions: understanding through interdisciplinary action research, building capacity, and facilitating innovations in practices and policies. Despite the challenges of interdisciplinary partnerships, the potential benefits and impact of such efforts reflect their value as a comprehensive approach to addressing complex social problems.

Black or African American↗
PubMed2005

Social inequities along the cervical cancer continuum: a structured review.

OBJECTIVE: To reveal areas of research/knowledge related to social inequities and cervical cancer. METHODS: A Medline search was performed looking for US based research on cervical cancer and social inequities since 1990. The papers found were organized into cells defined by a "cancer disparities grid." RESULTS: The majority of research published about cervical cancer and social inequities in the US, lies within the social domains of: race/ethnicity and socioeconomic position. Conflicting information exists as to whether race/ethnicity is a good predictor of screening and survival. Some research implied that differentials based on race/ethnicity are likely secondary to differentials in socioeconomic position. Some research about age, insurance status, and immigrant status and cervical cancer was found. Scarce information was found relating to sexuality, language, disability and geography and cervical cancer. DISCUSSION: The "cancer disparities grid" facilitated a systematic and visual review of existing literature on social inequities and cervical cancer. The grid helped to elucidate uncontested existing social inequities, conflicting social inequities, and areas where social inequity data does not exist. The cancer disparities grid can be used as a research tool to help identify areas for future research, clinical programs, and political action related to cervical cancer and social inequities.

Adult↗
PubMed2005

HLA and disease.

Association of HLA and diseases is well known. Several population studies are available suggesting evidence of association of HLAs in more than 40 diseases. HLA found across various populations vary widely. Some of the reasons attributed for such variation are occurrence of social stratification based on geography, language and religion, consequences of founder effect, racial admixture or selection pressure due to environmental factors. Hence certain HLA alleles that are predominantly associated with disease susceptibility or resistance in one population may or may not show any association in other populations for the same disease. Despite of these limitations, HLA associations are widely studied across the populations worldwide and are found to be important in prediction of disease susceptibility, resistance and of evolutionary maintenance of genetic diversity. This review consolidates the HLA data on some prominent autoimmune and infectious diseases among various ethnic groups and attempts to pinpoint differences in Indian and other population.

Alleles↗
PubMed2006

Distribution, infections, treatments and molecular analysis in a large cohort of patients with primary immunodeficiency diseases (PIDs) in Taiwan.

One hundred and twenty-four patients (from 120 families) diagnosed as primary immunodeficiency diseases were enrolled from five tertiary medical centers. The distribution by an update eight categories showed 45 patients (13 females/32 males; 36.3%) with "predominant antibody deficiencies," 27 patients (6/21; 21.8%) with "T- and B-cell immunodeficiency," 25 patients (9/16; 20.2%) with "congenital defects of phagocyte," 25 patients (4/21; 20.2%) with "other well-defined immunodeficiency syndromes," one boy (0.8%) with "disease in immune deregulation" (Chediak-Higashi syndrome) and another with "complement 3 deficiency." None had "defects in innate immunity" or "auto inflammatory disorders." Pseudomonas and Salmonella spp. were the two most identified microorganisms in septicemia (39.7%; 27/68 episodes). Twenty-three patients (18.5%) had mortality. Stem cell transplantation succeeded in 7 of 12 patients. In addition to nine patients with DiGerge syndrome recognized by FISH, direct sequencing identified 12 unique mutations from 20 families, reflecting distinct Taiwan geography, although a selection bias may exist.

Child↗
PubMed2006

Child care health consultation programs: barriers and recommendations.

OBJECTIVES: While many studies describe the need for health services in early care and education (ECE) settings and the role of child care health consultants (CCHCs), little information exists about the challenges to developing health consultation programs. The goal of this paper is to provide insight for the development of current and future child care health consultation programs by describing the barriers identified by CCHCs related to program implementation in 20 California counties. METHODS: Forty-four child care health consultants participated in nine focus groups during their health consultation training at the California Training Institute. Participants were asked to discuss the barriers they encountered while establishing new county-wide child care health consultation programs. Themes were assigned to each response, and frequency and percentage of each theme were documented and trends were identified. RESULTS: The four general themes describing barriers to program implementation were: Program Management, Child Care Culture, Geography and Community Services. Twenty additional sub-themes, including Multi-agency involvement, Chaos, Travel time, and Fragmentation, were assigned to each response. The most frequent general theme was Program Management. The most frequent sub-theme was Professional Support. CONCLUSIONS: The barriers identified by the child care health consultants can be valuable for administrators and clinicians establishing or developing child care health consultation programs. Program managers should be prepared for the unique challenges of child care health consultation and provide flexibility and support for child care health consultants.

California↗
PubMed2006

The development of a standardized neighborhood deprivation index.

Census data are widely used for assessing neighborhood socioeconomic context. Research using census data has been inconsistent in variable choice and usually limited to single geographic areas. This paper seeks to a) outline a process for developing a neighborhood deprivation index using principal components analysis and b) demonstrate an example of its utility for identifying contextual variables that are associated with perinatal health outcomes across diverse geographic areas. Year 2000 U.S. Census and vital records birth data (1998-2001) were merged at the census tract level for 19 cities (located in three states) and five suburban counties (located in three states), which were used to create eight study areas within four states. Census variables representing five socio-demographic domains previously associated with health outcomes, including income/poverty, education, employment, housing, and occupation, were empirically summarized using principal components analysis. The resulting first principal component, hereafter referred to as neighborhood deprivation, accounted for 51 to 73% of the total variability across eight study areas. Component loadings were consistent both within and across study areas (0.2-0.4), suggesting that each variable contributes approximately equally to "deprivation" across diverse geographies. The deprivation index was associated with the unadjusted prevalence of preterm birth and low birth weight for white non-Hispanic and to a lesser extent for black non-Hispanic women across the eight sites. The high correlations between census variables, the inherent multidimensionality of constructs like neighborhood deprivation, and the observed associations with birth outcomes suggest the utility of using a deprivation, index for research into neighborhood effects on adverse birth outcomes.

Censuses↗
PubMed2001

Preparation of the HIV-infected Traveler to the Tropics.

Pre-travel advice and planning can help the HIV-infected traveler minimize the unavoidable risks of tropical travel. Issues to cover: the diagnosis, staging, and stabilization of HIV infection and its sequelae; adequacy of the supply of medications currently used; optimal sources of medical care in planned destinations; potential HIV-related legal restrictions on travel; special risks associated with the medical geography of the traveler's route and planned activities; the need to avoid food-, water-, and vector-borne diseases; any appropriate vaccination, chemoprophylaxis, and antimicrobial agents; and arrangement for adequate medical follow-up upon the traveler's return.

Journal Article↗
PubMed2006

Ehrlichia infection of the central nervous system.

Ehrlichiosis in the United States is caused by three closely related bacterial species (Ehrlichia chaffeensis, Ehrlichia ewingii, and Anaplasma phagocytophilum), all transmitted through tick bite. Although there is variation with respect to geography and tick vector, the clinical manifestations are similar, and treatment of these infections is identical. Ehrlichiosis can present with a spectrum of neurologic manifestations, ranging in severity from headache to meningoencephalitis. Treatment is straightforward if the diagnosis is suspected, but antibiotic therapy should not be delayed pending laboratory confirmation. Doxycycline, the treatment of choice for adults and children with suspected ehrlichiosis, has high bioavailability and can be administered orally in most cases. Therapy is typically continued at least 3 days after the last documented fever. Although there have been no studies specifically evaluating duration or dosing of doxycycline for Ehrlichia meningoencephalitis, anecdotal reports suggest 100 mg doxycycline administered twice daily is effective, despite limited penetration into the cerebrospinal fluid. Because doxycycline interacts with CYP3A4 enzymes, there is potential for drug interactions with a number of medications. In endemic areas, documentation of coinfection with Borrelia burgdorferi, the etiologic agent of Lyme disease, may require prolonging the duration of doxycycline therapy.

Journal Article↗
PubMed1985

Epidemiology of congestive heart failure.

The incidence of congestive heart failure (CHF) is influenced by a variety of factors, including availability of medical care, socioeconomic status, geography, nutrition and race. The etiology of CHF in China, England, Botswana and Sweden will be examined and compared with prospective findings from Boston and Detroit. Because the therapy used in the treatment of CHF varies with the underlying causes, which may be as diverse as rheumatic fever, systemic hypertension and viral infection, the importance of fully determining its pathogenesis is emphasized.

Cardiomyopathy, Dilated↗
PubMed1983

Bacterial meningitis--1982.

The etiologic agents in bacterial meningitis vary with time, geography, and patient age. Predominant pathogens are Escherichia coli, group B streptococci, Listeria monocytogenes, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae. Approximately 70 percent of all cases occur in children under the age of five. The case-fatality rate in the United States in 1978 was 13.6 percent, but it is known that underreporting of cases, and therefore of case-fatalities, occurs. Prevention by vaccine appears to be the ultimate solution, but until a vaccine is developed emphasis should be on rapid diagnosis, improved management, and proper choice of antibiotic.

Age Factors↗
PubMed1975

The effect of availability and utilization of prenatal care and hospital services on infant mortality rates. Summary of the findings of the Louisiana Infant Mortality Study. Part II.

A total of 69,556 birth and 1,541 death certificates from Louisiana, 1972, were reviewed. Infant, neonatal, and postneonatal mortality rates were computed for number of prenatal visits, type of hospital of delivery, hospital vs. nonhospital delivery, and geographical access to health care. The mortality rates were twice as great for infants born outside of hospitals. With no prenatal care, the infant mortality rates were between four- and tenfold greater than the rates of women receiving more than nine visits even when race, poverty, geography, and birth weight were considered. Infant mortality rates were twice as high in the neonatal period and three times greater in the postneonatal period among the poor who utilized charity hospitals. This study illustrates a method which could be incorporated into state vital statistics reports which would detect populations at risk of excess infant deaths and would provide a more refined analysis of birth and infant death data to monitor improvements in care of high-risk groups.

Black or African American↗
PubMed1978

Manpower for obstetrics-gynecology. I. Demographic considerations and practice work load.

A cooperative study between the University of Southern California Division of Research in Medical Education and the American College of Obstetricians and Gynecologists represents one subset of a large-scale study of manpower supply in obstetrics-gynecology. A stratified random sample of all obstetrician-gynecologists was obtained from the AMerican Medical Association's "Master File of Physicians." A total of 879 respondents (56 per cent of the sample) completed a detailed, one-week log of practice activities and self-descriptive questionnaire. This initial report describes these physicians by practice arrangement as related to age and geography. Practice work load is identified by encounter time per patient, work hours per day and week, and variations related to geographic location and population served. The descriptive findings may have important implications for manpower planning.

Adult↗
PubMed1981

Retinotopic analysis of fiber pathways in the regenerating retinotectal system of the adult newt cynops Pyrrhogaster.

Retinotopic analysis of the pathways of regenerating retinal fibers within the optic tract and in the tectum of an adult newt was performed by selective labeling of the retinal fibers with horseradish peroxidase. At the tenth week of regeneration, all the regenerating retinal fibers from different retinal quadrants had terminal arbors nearly at the parts of the tectum innervated normally by those quadrants. The pathways for individual retinal fibers, however, were greatly disorganized within the optic tract and did not show any retinotopic ordered geography. The most rostral segregation of pathways of regenerating fibers was observed at the diencephalo-tectal junction. THe temporal retinal fibers invaded the tectum directly, while the dorsal, ventral and nasal retinal fibers generally shifted toward the dorsomedial or the lateral direction, as if they traced the dorsomedial or the lateral tracts formed in normal newt. The direction of the shifting of fiber pathways, however, did not depend on the origins of retinal fibers within retinal circumference, but depended on the location of fibers with in the optic tract. As a result, a large number of regenerating fibers reached their normal sites of innervation within the tectum via anomalous routes. These mis-routed fibers did not form branches or terminal arbors at ectopic parts within the tectum.

Afferent Pathways↗
PubMed1994

Heightened free radical activity in blacks with chronic pancreatitis at Johannesburg, South Africa.

Four indices of free radical activity were measured in fasting serum/plasma samples from 14 consecutive blacks with clinically quiescent chronic pancreatitis and 15 outwardly healthy hospital personnel at Soweto, the township near Johannesburg in South Africa. The patients had higher serum levels than did controls of lipid isomerisation (P < 0.002) and peroxidation (P < 0.05) markers, with lower plasma levels of glutathione (P < 0.0001) and bioactive fraction of vitamin C (P < 0.002). Lipid peroxide and non-bioavailable vitamin C concentrations in Sowetan patients were significantly higher than in their counterparts from Manchester, UK (P < 0.0001, P < 0.0005, respectively). These differences mirrored those in controls in that outwardly healthy Sowetans had much higher serum lipid peroxide levels than Manchester controls (P < 0.001) and much lower plasma concentration of vitamin C (P < 0.001) and hence of the bioavailable fraction ascorbate (P < 0.0002). Heightened free radical activity is thus a common denominator in chronic pancreatitis irrespective of geography, or putative aetiological factors whether alcoholism or idiopathic, since that ratio was approximately 95:5 at Johannesburg and 50:50 at Manchester. The further finding of subclinical oxidative stress in Sowetan controls and the endemic nature of chronic pancreatitis in that area supports the hypothesis that oxidative stress may be involved in its pathogenesis.

Adult↗
PubMed1990

Nepal: integrating traditional and modern health services in the remote area of Bashkharka.

Within a framework of Primary Health Care (PHC) and Health Promotion (HP), the focus of this paper is on integrating traditional and modern health care in the remote area of Bashkharka, Nepal. The relevance to integrated health care of factors such as geography, ethnicity, religion, national infrastructure and international development agencies are discussed. Issues concerning the relationship between the theory and practice of PHC and HP are raised.

Health Policy↗
PubMedDate not supplied

The epidemiology of myelopathy associated with human T-lymphotropic virus 1.

A progressive spastic myelopathy is one of the principal manifestations of the human T cell lymphotropic virus type 1. Recent research is reviewed on the geography and epidemiology of this specific form of tropical spastic paraparesis. First recognized in the Caribbean, Colombia and Japan, it is now also confirmed as a major neurological problem in areas of eastern Brazil, western equatorial Africa, Natal and Seychelles, with other scattered foci world-wide. Accurate surveys call for sophisticated techniques including polymerase chain reaction amplification. The only defined modes of spread are by breast feeding, sexual contact and blood cell infusion. The onset of neurological disease is associated with high antibody titres and a high rate of spontaneous T lymphocyte proliferation. Molecular analysis has revealed no nucleotide sequence variation in cases with or without myelopathy. In non-transfusion cases the clinical attack rate is low with a very long latent period, but there are unexplained regional differences and familial cases are an important exception. Current research is focused on possible local, ethnic, or genetic co-factors.

Africa↗