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PubMedDate not supplied

[Shared surveillance: meningococcal disease vs influenza].

OBJECTIVE: To analyse the association between the behavior of meningococcal disease and influenza, using for this purpose population statistics for Spain for the period of 1964 to 1997. METHODS: Ecological study of the incidence of meningococcal disease and influenza in Spain from 1964 to 1997, inclusive. The study used weekly statistical data for these diseases supplied by the Compulsory Disease Reporting System (Enfermedades de Declaración Obligatoria, EDO). The deterministic component of the meningococcal disease and influenza series was studied by means of spectral analysis based on the Fast Fourier Transformation, and the non-deterministic component was studied using the ARIMA model. The Box-Jenkins method was used for pre-bleaching the series, and a cross-correlation was subsequently established between the residuals in order to detect the presence of any significant correlations between the meningococcal disease and influenza series. RESULTS: During the period from 1964 to 1997, the week that showed, on average, the greatest number of cases for the season was week 7 in the case of meningococcal disease and week 6 in the case of influenza. Spectral analysis of the meningococcal disease and influenza series clearly demonstrated the annual periodicity of both series, and periodicity of nearly 11 years for meningococcal disease and slightly over 10 years for influenza. When cross-correlation is established after prebleaching the series, positive correlations are obtained in the results of lags 0, 1, 2, and 3. Introducing influenza as an exogenous variable in the multivariate model of meningococcal disease corroborates these results. There was a statistically significant relationship between the two processes during the same week and with a three-week lapse. CONCLUSIONS: By means of a methodology not previously applied to this subject, and by the use of prolonged time-span, country-comprehensive population statistics (which includes several epidemics waves), an association was shown to exist between meningococcal disease and influenza. This suggests the need for the surveillance of the two processes in an interrelated manner.

Disease Outbreaks↗
PubMed1999

Forecasting patient outcomes in the management of hyperlipidemia.

BACKGROUND: To forecast adult patient outcomes in the management of hyperlipidemia using adult National Health and Examination Survey III (NHANES III) population statistics and National Cholesterol Education Program (NCEP) guidelines for goals of therapy. METHODS: Review of the hyperlipidemia drug therapy English-language medical literature with emphasis on randomized controlled trials of more than 6 weeks' duration published in the last 7 years, product package inserts, US Food and Drug Administration submission information, and NHANES III population statistics. Data were extracted from studies of lipid-lowering therapy to modify low-density lipoprotein (LDL) levels for primary and secondary prevention of coronary heart disease. The data that were evaluated included sample size, study design, therapeutic intervention, length of study, percentage change in LDL levels, and patient demographics. RESULTS: Cumulative frequency curves of the LDL distribution among the US adult population were constructed. The mean efficacy of drug therapy from qualified studies was used to extrapolate the percentage of the population expected to respond to the intervention and to forecast the patient outcome. CONCLUSIONS: A useful tool for clinicians was constructed to approximate the percentage of patients, based on risk stratification, who would reach NCEP target goal after a given pharmacotherapeutic intervention to decrease LDL levels.

Adult↗
PubMed1997

Characteristics of information resources preferred by primary care physicians.

Primary care physicians use patient data, medical knowledge, logistic information, and population statistics. They rely on their personal knowledge to care for their patients, their top priority. When they seek information beyond this personal knowledge base, they frequently want information in the context of the care of a specific patient. They also continually add to their personal knowledge base. Less frequently, they seek logistic information and population statistics. For patient-specific questions, physicians most often seek medical facts or medical opinions. A physician may be persistent in seeking information if the patient's problem is perceived to be urgent and the doctor believes a definitive answer exists. Information resources for answering clinical questions should be readily available, familiar, and quick to use. Lifelong learning activities should also be readily available, and they should require a minimum of time, effort, and expense. Minimal cost in time and effort is particularly important when knowledge is sought as a part of ongoing medical learning, since there is less immediate benefit to balance the time and effort invested in information seeking.

Humans↗
PubMed1986

Heuristic informational analysis of sequences.

Nucleotide or amino-acid sequences are interpreted as successions of words of length k (k-tuples) the frequencies of which are highly variable in different statistical populations of genes or proteins. After building k-tuple reference tables from coherent subsets or entire data banks, the local information content profile of individual sequences is drawn. Anomalous regions (peaks or depressions) of such a profile can lead to the discovery and identification of specific sequence patterns. Along the same principle, the simultaneous use of two reference statistical populations and the computation of an index combining the two information profiles lead to a general and powerful discriminant analysis methods. The identification of a "signal" associated with gene conversion, the introns/exons discrimination and the location of function specific patterns in proteins are given as examples of successful applications of this heuristic informational approach.

Amino Acid Sequence↗
PubMed1992

Epidemiology of pediatric trauma: importance of population-based statistics.

To determine the validity of using hospital-based pediatric trauma registry data to draw specific inferences with regard to regional pediatric trauma system design, we compared statistical data on the incidence and mortality of pediatric and adult injuries and burns calculated by the New York State Department of Health, based on legally mandated reports of injury deaths and hospital discharges for 1989. During this year, some 488 children, aged 0 to 14 years, died as a result of injuries, a rate of 13.8 per 100,000 annually, of whom 408 (11.6/100,000) died as a result of traumatic injuries or burns, a population-based rate 20% of that observed in adults. During the same period, 16,402 children were hospitalized for treatment of traumatic injuries and burns, a rate of 465 per 100,000 annually, a population-based rate 56% of that observed in adults; and of this number, some 90 children died, yielding an in-hospital mortality "rate" (ie, case fatality ratio) of 0.55%, and a population-based rate of 2.6 per 100,000 annually. Thus, 9.0 of the 11.6 per 100,000 children who died in New York State in 1989 as a result of traumatic injuries and burns were not admitted to the hospital and, therefore, were unknown to the statewide hospital reporting system.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Traffic↗
PubMed2003

Molecular investigation on strain genetic relatedness and population structure of Beauveria bassiana.

Triplicate molecular methods, i.e. polymerase chain reaction-restriction fragment length polymorphism of the pr1 gene, microsatellite markers and 28S rDNA haplotyping by detecting the presence or absence of group I introns, were used for population study of the entomopathogenic fungus, Beauveria bassiana. The findings showed that the average genetic diversity index of geographical populations was significantly smaller than that of populations derived from insect host orders, indicating that the genetic relatedness of B. bassiana strains was highly associated with geographical locality rather than insect host species. The reproductive style of all the B. bassiana populations was found to be non-clonal. Population structure analysis revealed that the average divergent coefficient among populations of B. bassiana was far below 1 (0.1112), which indicated that there was no significant genetic differentiation between populations, and that the overall genetic diversity mainly resulted from the genetic variations within geographical populations. Statistically, genetic distances between populations were positively correlated with geographical distances, suggesting that geographical separation poses an obstacle to the possibility and frequency of genetic exchanges between populations. On the other hand, gene flow was indirectly established to occur between B. bassiana populations.

Animals↗
PubMed2003

Estimating the efficacy of interventions to prevent mother-to-child transmission of human immunodeficiency virus in breastfeeding populations: comparing statistical methods.

Postnatal transmission of human immunodeficiency virus infection through breastfeeding complicates evaluating the efficacy of interventions aimed to reduce mother-to-child transmission risk. Results from trials in Africa evaluating either peripartum antiretroviral therapy or refraining from breastfeeding show an estimated long-term efficacy at 15-24 months of age between 25 and 50 percent. Differences in statistical methods, duration of follow-up, and age at weaning hinder direct comparison between trials. The authors recently outlined theoretically preferred statistical methods for evaluating interventions aimed to reduce risk of mother-to-child transmission of human immunodeficiency virus. When multiple test results and/or supplementary information is available, the more sophisticated methods account for the fact that exact age at infection is unknown, that risk for infection ends at weaning, or that censoring due to death may be informative. The authors apply these methods to four scenarios, using data from four randomized trials carried out in Africa between 1995 and 2000. The authors' findings suggest that, to estimate the cumulative proportion infected at age 6 weeks, a standard Kaplan-Meier approach is likely to give valid results. For estimation of this proportion at age 18 months, more sophisticated methods, such as the extension of the Kaplan-Meier procedure to interval-censored data and competing risks, would be preferred.

Adult↗
PubMed2006

Relation between single neuron and population spiking statistics and effects on network activity.

To simplify theoretical analyses of neural networks, individual neurons are often modeled as Poisson processes. An implicit assumption is that even if the spiking activity of each neuron is non-Poissonian, the composite activity obtained by summing many spike trains limits to a Poisson process. Here, we show analytically and through simulations that this assumption is invalid. Moreover, we show with Fokker-Planck equations that the behavior of feedforward networks is reproduced accurately only if the tendency of neurons to fire periodically is incorporated by using colored noise whose autocorrelation has a negative component.

Action Potentials↗
PubMed2001

Declining trend in major gynaecological surgery in The Netherlands during 1991-1998. Is there an impact on surgical skills and innovative ability?

OBJECTIVES: To assess the number of major surgical procedures in gynaecology over a period of eight years in The Netherlands and to detect possible trends. Relevance of the trends and the possible impact on surgical skills and on innovative ability are discussed. DESIGN: Observational study. SETTING: Hospital care in The Netherlands. SAMPLE: Data from a national hospital discharge database, from all 119 hospitals in The Netherlands. METHODS: When a patient is discharged from the hospital. data on the diagnosis and treatment are registered by local medical officers and administrators. Registration of surgical procedures is based on the International Classification of Procedures in Medicine (ICPM, WHO 1978), the so-called WCC-standard. All hospitals but one (a cancer centre) in The Netherlands participate in this registration, resulting in 99.3% of all admissions. Data on gynaccological manpower were obtained from the Dutch College of Obstetricians and Gynaecologists. In order to standardise the frequency numbers per 1,000 women, yearly data of the female population according to age were obtained from the Central Office for Population Statistics. RESULTS: The female population aged 20 years of age and older increased 3% between 1991 and 1998, from 5.8 million to 6.0 million. In the same period the number of gynaecologists grew from 604 to 625, also an increase of 3%. The total number of hysterectomies dropped from 21,433 in 1991 to 16,320 (-24 %) in 1998 (chi2 for trend 1,245.1. P < 0.001) Surgery of the uterine cavity, either performed hysteroscopically or blind, increased from 311 to 1,958 (+ 625%) cases per year (chi2 for trend 2,459.2, P < 0.001). No trend has been detected in the numbers of adnexal operations, including surgical treatment of tubal pregnancy (tubotomy or tubectomy). In 1998, 12% of all ovarian surgery and 28% of all surgery for ectopic pregnancies was performed laparoscopically. Surgery for female urinary incontinence experienced a strong decline of 46% in the studied period. The frequency of vaginal repair decreased with 1354 (-16%) cases. The abdominal prolapse surgery (abdominal sacral colpopexy, obliteration of the Douglas pouch) is steadily increasing, although the absolute numbers are small. In 1998 seven hundred and forty-three women underwent an abdominal approach of their prolapse repair, compared with 7239 that had the vaginal repair. CONCLUSIONS: The declining trend of major gynaecological surgery in combination with the increasing number of gynaecologists will result in more difficulty for gynaecologists to acquire and maintain surgical skills and may therefore affect their ability to innovate within the surgical profession.

Adult↗
PubMed1999

Case detection, gender and disability in leprosy in Bangladesh: a trend analysis.

A trend analysis is presented of all newly detected leprosy cases over an 18-year period (1979-1996) in a highly leprosy endemic area of Bangladesh. A total of 23,678 new cases were registered, with an average of 860 new cases per year in the first 12 years, and increasing to around 3000 in 1996. The male:female (M:F) ratio decreased from 2.3 to 1.4. The proportions of newly detected cases with MB leprosy and of newly detected cases with any disability decreased over time. These reductions were more marked in the higher age groups of both sexes. The reduction in disability was primarily attributable to a decline in grade 2 disability. New case detection rates (NCDR) of all leprosy patients per 10,000 general population increased for males from 3 to 6; and for females from 1 to 4, while the NCDR of MB leprosy decreased in males from 1.4 to 0.6, and in females fluctuated around 0.45. The NCDRs of leprosy patients with disabilities showed an initial decrease in the first period, especially in males, but later showed an increase. The NCDR of males with disability was about twice as high as that of females. Finally, female NCDRs in the ages between 15 and 30 were low by comparison with the male NCDRs at the same time. This may be due to the sociocultural characteristics of the Bangladeshi society, with gender differences in exposure, health seeking behaviour and opportunities for case detection. Operational changes in the control programme have contributed to the changed profile of newly detected cases. This study shows that the application of general population statistics is essential for understanding the dynamics in leprosy control programmes under changing operational conditions. Combining case detection figures with such statistics helps to identify population groups that are possibly not benefiting sufficiently from the services provided, and to clarify the dynamics in control programmes and the future trends and programme requirements.

Adolescent↗
PubMed1976

Longevity syndromes: familial hypobeta and familial hyperalpha lipoproteinemia.

Longevity and morbidity and death from myocardial infarction were examined in eight kindreds with familial hypobeta lipoproteinemia and in 18 kindreds with familial hyperalpha lipoproteinemia. Expectation of life for males and females from kindreds with hypobeta lipoproteinemia was 9 and 12 years longer (p less than or equal to 0.002) than that indicated by population statistics for U.S. white populations, whereas expectation of life for males and females from kindreds with hyperalpha lipoproteinemia was 5 and 7 years longer (p less than 0.02). Morbidity from myocardial infarction in 115 living first-degree adult relatives of probands with hypobeta and hyperalpha lipoproteinemia and in 364 living first-degree adult relatives of normolipemic spouse controls were compared. Nonfatal myocardial infarction (MI) was reported for 18 of 364 (5 per cent) relatives of normal spouse controls and in 0 of 115 relatives of hypobeta and hyperalpha subjects (p less than 0.05). The ratios (mean+/-S.E.) of C-LDL to C-HDL in familial hypobeta and hyperalpha lipoproteinemia were 0.79+/-0.06 and 1.21+/-0.06, as compared to 2.41+/-0.12 in a control population (p less than 0.001). If high-density lipoproteins confer protection against development of atherosclerosis, whereas low-density lipoproteins have opposite effects, then we speculate that the low ratio of C-LDL:C-HDL may be related to prolonged longevity and decreased morbidity from myocardial infarction in familial hypobeta and hyperalpha lipoproteinemia.

Adolescent↗