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PubMed1996

[Phenotypic differences of nosocomial bacterial strains isolated in the obstetric-gynecology service of the University Hospital Center of Dakar].

A study on nosocomial infections was conducted in the Laboratory of Bacteriology-Virology of Aristide Le Dantec's Hospital, in collaboration with the Gynecology Obstetrics clinic located both in the same Dakar's hospital, during May 1995. The aim of the study was to define the phenotypical characteristics of various bacterial strains isolated from the atmosphere health care staff's hands, medical equipment (material, antiseptics) and patients (hospitalized pregnant and newborns in day Nursery). A total of 133 strains were collected and the most frequent isolates were Staphylococcus aureus (27 strains) and Klebsiella pneumoniae (10 strains) encountered mainly in the atmosphere. Otherwise, Escherichia coli (11 strains) and Enterococcus faecalis (11 strains) were more present in hospitalized patients. Results obtained after antimicrobial agents susceptibility (Antibiotics and Heavy metal salts) by Antibiogramm and Minimal inhibitory concentrations (MIC) and also data from biotyping of Klebsiella strains have allowed us to say there's a probable contamination of hospitalized patients by the bacteria from the atmosphere but manuportage too.

Bacterial Infections↗
PubMed1997

The prevalence of hypertension in seven populations of west African origin.

OBJECTIVES: This study was undertaken to describe the distribution of blood pressures, hypertension prevalence, and associated risk factors among seven populations of West African origin. METHODS: The rates of hypertension in West Africa (Nigeria and Cameroon), the Caribbean (Jamaica, St. Lucia, Barbados), and the United States (metropolitan Chicago, Illinois) were compared on the basis of a highly standardized collaborative protocol. After researchers were given central training in survey methods, population-based samples of 800 to 2500 adults over the age of 25 were examined in seven sites, yielding a total sample of 10014. RESULTS: A consistent gradient of hypertension prevalence was observed, rising from 16% in West Africa to 26% in the Caribbean and 33% in the United States. Mean blood pressures were similar among persons aged 25 to 34, while the increase in hypertension prevalence with age was twice as steep in the United States as in Africa. Environmental factors, most notably obesity and the intake of sodium and potassium, varied consistently with disease prevalence across regions. CONCLUSION: The findings demonstrate the determining role of social conditions in the evolution of hypertension risk in these populations.

Adult↗
PubMed1988

Stroke rehabilitation outcome studies: comparison of a Japanese facility with 17 U.S. facilities.

A Japanese university hospital collaborated with a mixed group of 17 American hospitals in using common measures of functional status and outcomes for patients undergoing rehabilitation after stroke. Management protocols were similar for all facilities. Philosophies and operational factors concerning length of stay and discharge destinations varied among facilities. In Japan there was little pressure for discharge of rehabilitation patients. Japanese patients were kept in the hospital as long as they improved in their functional scores. The Japanese sample had fewer patients with bilateral involvement, patients were younger, were admitted after a longer period of time following the onset of the stroke, had less severe disability on admission, and had longer lengths of stay, and this may have accounted for higher Barthel score gains for the Japanese sample. These factors may have worked together with the family support system in Japan to account for higher discharge rate to the community for the Japanese sample.

Activities of Daily Living↗
PubMed2003

Oxatomide for stable asthma in adults and children.

BACKGROUND: Oxatomide is a histamine H1-receptor antagonist. As an oral agent, oxatomide may be useful in managing asthma. Some guidelines recommend oxatomide for long-term prophylaxis of asthma in children. There is no clear evidence whether children or adults with asthma benefit from oxatomide. OBJECTIVES: To determine whether oxatomide alone, or in combination with other interventions, results in better disease control in people with asthma. SEARCH STRATEGY: The Collaborative Airway Group register and Collaborations trial register CENTRAL were searched using terms: oxatomide* OR Celtect OR Pinset OR KW-4354 OR Tincet. Reference lists of all relevant trials or review articles were checked. Enquiries were made of authors of included studies and relevant pharmaceutical companies. A search of 'Igaku Chuo Zasshi' and 'J-Medicine' were made using the following terms: oxatomide (also in Japanese) or Celtect (also in Japanese) or KW-4354. SELECTION CRITERIA: Studies were randomised, placebo-controlled trials and the interventions were oxatomide or matched placebo given alone or in combination with other asthma-medication for at least 4 weeks. DATA COLLECTION AND ANALYSIS: Four independent reviewers performed assessments of methodological quality and extracted relevant data. MAIN RESULTS: Six studies are included in this review. Three studies were mainly conducted in adults, two were conducted in older children (5-16 years) and one in infants (18-25 months). Trial duration was 4 to 52 weeks. Doses of oxatomide varied between studies, ranging from 1 mg/kg/day for infants to 180 mg/day for adults. Only data on adverse events was suitable for meta-analysis. Although PEF did not change significantly in any of the studies, the FVC and FEV1 improved significantly in two. There was no uniform change in symptom scores. There was no significant difference between oxatomide and placebo treatment in use of inhaled corticosteroid or bronchodilator. Two studies showed significant improvement with oxatomide as judged subjectively by physicians. Adverse events, analysed using data from 4 parallel and one cross over study, showed oxatomide to be associated with a significantly higher risk of any adverse event (OR: 2.97, 95%CI: 1.69 to 5.22) and drowsiness (OR: 5.22,95%CI: 2.53 to 10.74). REVIEWER'S CONCLUSIONS: There is no evidence to show that oxatomide has a significant effect on the control of stable asthma. Some studies reported significant benefits in subjective parameters. There was improvement in some lung function outcomes reported, but this were not consistent across measures or studies and may represent reporting bias. Adverse events, including drowsiness, were significantly greater with oxatomide than placebo.

Adult↗
PubMed2002

Behavioral problems and tobacco use among adolescents in Central America and the Dominican Republic.

OBJECTIVES: The purpose of this study was to examine the association between behavioral problems and tobacco use among adolescent students in six countries of Central America and in the Dominican Republic. METHODS: Data were drawn from a multinational collaborative study that included questionnaire surveys of between 451 and 1,170 school-attending adolescents in each of the seven countries studied. Assessments were based on an adapted, Spanish-language version of the Drug Use Screening Inventory (DUSI). The conditional form of logistic regression was employed for analysis, matching students on type of school and area, with further statistical adjustments for sex, age, and selected risk factors. RESULTS: Occurrence of tobacco use was observed to vary dramatically from country to country. Nonetheless, for the combined group of countries, the estimated odds of tobacco use in youths at the highest levels of behavioral problems was more than five times that for youths at the lowest levels, after controlling for sex, age, lack of participation in recreational activities, level of irritability, and levels of problems with school, family, and mental health. Country-specific analyses show that youths at the highest levels of behavioral problems have a consistently greater occurrence of tobacco use as compared to youths at the lowest levels of behavioral problems. CONCLUSIONS: These findings are concordant with prior studies on tobacco use among adolescents with behavioral problems. Although the magnitude of observed associations varied according to the country of residence, the strength of these associations and their significance by conventional standards were observed in nearly all the countries sampled. This is the first study in these seven countries on potentially causal relationships such as these. More research is needed to augment our knowledge regarding the observed cross-country differences and ultimately to develop, implement, and evaluate effective tobacco preventive intervention programs.

Adolescent↗
PubMed2001

XAFS at the Pacific Northwest Consortium-Collaborative Access Team undulator beamline.

The Pacific Northwest Consortium-Collaborative Access Team (PNC-CAT) has begun operating an insertion device beamline at the Advanced Photon Source. The beamline has been extensively used for XAFS studies. This paper summarizes its capabilities, and our initial operational experience. The beamline is based on APS undulator A, and incorporates full undulator scanning. The monochromator is liquid nitrogen cooled and has both Si(111) and Si(311) crystals in a side-by-side configuration. Crystal changes only take a few minutes. The crystals cover the energy range from 3-50 keV with fluxes as high as 2x10(13) ph/sec. Microbeams can be produced using Kirkpatrick-Baez mirrors (spot size 1-3 microm) or tapered capillaries (sub-microm spots). When these optics are combined with a 13-element Ge detector, the beamline provides powerful microbeam imaging and spectroscopy capabilities. Experimental examples from the environmental field and in-situ UHV film growth will be discussed.

Journal Article↗
PubMed2005

Activation of the interferon-alpha pathway identifies a subgroup of systemic lupus erythematosus patients with distinct serologic features and active disease.

OBJECTIVE: Gene-expression studies have demonstrated increased expression of interferon (IFN)-inducible genes (IFIGs) in peripheral blood mononuclear cells (PBMCs) of many patients with systemic lupus erythematosus (SLE), with a predominant effect of type I IFN. This study examined the hypothesis that increased disease severity and activity, as well as distinct autoantibody specificities, characterize SLE patients with activation of the type I IFN pathway. METHODS: Freshly isolated PBMCs from 77 SLE patients, 22 disease controls, and 28 healthy donors were subjected to real-time polymerase chain reaction for 3 IFIGs that are preferentially induced by IFNalpha, and the data were used to derive IFNalpha scores for all individuals. Expression of IFIGs was significantly higher in SLE patients compared with disease controls or healthy donors. SLE patients with high and low IFNalpha scores were compared for clinical manifestations of disease, disease severity, disease activity, serologic features, and potential confounders, by bivariate and multivariate analyses. RESULTS: SLE patients with a high IFNalpha score had a significantly higher prevalence of renal disease, a greater number of American College of Rheumatology criteria for SLE, and a higher Systemic Lupus International Collaborating Clinics damage index (SDI) score than did SLE patients with low IFNalpha scores. Patients with high scores showed increased disease activity, as measured by lower C3 levels, hemoglobin levels, absolute lymphocyte counts, and albumin levels, and a higher anti-double-stranded DNA (dsDNA) titer, erythrocyte sedimentation rate, and SLE Disease Activity Index 2000 score. The presence of antibodies specific for Ro, U1 RNP, Sm, and dsDNA, but not phospholipids, was significantly associated with a high IFNalpha score. Logistic regression analysis confirmed that renal disease, higher SDI scores, low complement levels, and presence of anti-RNA binding protein (RBP) autoantibodies were associated with a high IFNalpha score. CONCLUSION: Activation of the IFNalpha pathway defines a subgroup of SLE patients whose condition is characterized by increased disease severity, including renal disease, increased disease activity, reflected in complement activation, and autoreactivity to RBP.

Adolescent↗
PubMed2002

Oral health status and its inequality among education groups: comparing seven international study sites.

This study compares oral health status and its inequality among education groups across seven study sites in five countries: Erfurt, Germany; Lodz, Poland; Yamanashi, Japan; New Zealand; and Baltimore and the Lakota and Navajo Indian Health Service sites in the United States. The data, from the International Collaborative Study of Oral Health Outcomes, were collected through personal interviews and clinical examinations. The research group measured the study sites' overall oral health, examining the percentage of the population with five or more missing and two or more decayed teeth. The group also assessed the magnitude of inequality among education groups by using indices of excess morbidity. Baltimore had the lowest percentage (10.8 percent) of decayed teeth and second lowest percentage (17.3 percent) of missing teeth, but the greatest indices of excess morbidity (79.2 percent for missing, 73.1 percent for decayed). Lodz, by contrast, had the worst overall dentition status (75.3 percent for missing, 70.3 percent for decayed) but the lowest inequality indices (10.6 percent for missing, 13.8 percent for decayed). This study demonstrates the need for policymakers in the study countries to consider not only overall levels but also the distribution of oral health, and it presents various challenges for oral health professionals in designing and implementing oral health programs.

Baltimore↗
PubMed2006

Epilepsy Care in the World: results of an ILAE/IBE/WHO Global Campaign Against Epilepsy survey.

PURPOSE: Information about existing resources available within the countries to tackle the huge medical, social, and economic burden caused by epilepsy is lacking. To fill this information gap, a survey of country resources available for epilepsy care was conducted within the framework of the ILAE/IBE/WHO Global Campaign Against Epilepsy. METHODS: The study represents a major collaborative effort involving the World Health Organization (WHO), the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). RESULTS: Data were collected from 160 countries representing 97.5% of the world population. The information included availability, role, and involvement of professional and patient associations for epilepsy, epilepsy treatment and services including antiepileptic drugs, human resources involved in epilepsy care, teaching in epileptology, disability benefits, and problems encountered by people with epilepsy and health professionals involved in epilepsy care. The data confirm that epilepsy care is grossly inadequate compared with the needs in most countries. In addition, large inequities exist across regions and income groups of countries, with low-income countries having extremely meager resources. Complete results of this survey can be found in the Atlas: Epilepsy Care in the World. CONCLUSIONS: The data reinforce the need for urgent, substantial, and systematic action to enhance resources for epilepsy care, especially in low-income countries.

Cross-Cultural Comparison↗
PubMed2001

Measurement of the charged pion electromagnetic form factor.

Separated longitudinal and transverse structure functions for the reaction 1H(e,e(')pi(+))n were measured in the momentum transfer region Q2 = 0.6--1.6 (GeV/c)(2) at a value of the invariant mass W = 1.95 GeV. New values for the pion charge form factor were extracted from the longitudinal cross section by using a recently developed Regge model. The results indicate that the pion form factor in this region is larger than previously assumed and is consistent with a monopole parametrization fitted to very low Q2 elastic data.

Journal Article↗
PubMed2006

Depressive symptom deterioration in a large primary care-based elderly cohort.

OBJECTIVE: The purpose of this study is to examine the incidence and clinical predictors of symptom deterioration in depressed elderly patients who have responded to treatment in primary care. METHOD: A cohort study of 901 older adults from 18 primary care clinics in five states who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for major depression and/or dysthymia at baseline interview, had participated in a trial of collaborative care for depression compared to usual care, and had improved to the point of no longer meeting criteria for major depression at 12 months were observed for one year (18 and 24 months) after enrolling in the original study. RESULTS: A total of 40% of patients met criteria for significant depressive symptom deterioration over the 12- to 24-month observational period. Among usual-care patients, higher initial severity of depression and a higher number of residual DSM-IV depressive symptoms at 12 months were significant predictors of symptom deterioration. No variables predicted symptom deterioration in intervention patients. CONCLUSIONS: There is a high rate of symptom deterioration among elderly patients in primary care who are treated for depression. Efforts to improve long-term outcomes of older patients with major depression and/or dysthymia should focus on providing more intensive treatment and follow up for patients with residual depressive symptoms.

Antidepressive Agents↗
PubMed2005

Near-threshold diffractive psi-meson photoproduction from the proton.

Photoproduction of a phi meson on protons was studied by means of linearly polarized photons at forward angles in the low-energy region from threshold to Egamma = 2.37 GeV. The differential cross sections at t = -|t|min do not increase smoothly as Egamma increases but show a local maximum at around 2.0 GeV. The angular distributions demonstrate that phi mesons are photoproduced predominantly by helicity-conserving processes, and the local maximum is not likely due to unnatural-parity processes.

Journal Article↗
PubMed1996

International comparison of baccalaureate nursing degrees: collaboration in qualitative analysis.

This paper describes a study which investigated the perceived similarities and differences of a selection of baccalaureate nursing degrees from different continents. An international research team was formed, and by using a modified version of the Delphi process and nominal group techniques the group undertook a qualitative analysis of curriculum documents. The major areas analysis were: aims, content, methods and assessment. Under these headings the group produced a list of key issues supported by a number of indicative statements by collating the independent analyses undertaken by each of the team members. Examples of findings are that critical thinking and personal development are most obvious in aims but that the progression of curricula may not achieve this, there are differences in 'western' and 'asian' orientations to the concept of personal autonomy. Sciences are valued more than arts or humanities. The lecture method as well as practice placement dominate the teaching methods. Transcultural nursing is not significant except where there are two therapeutic ideologies in existence. Assessment methods are largely summative. The findings have application in the development of credit transfer and international exchange schemes. The conclusions highlight areas of special considerations when designing such schemes.

China↗
PubMed1992

Chronic illness in the community and the concept of 'social prevalence'.

General practice is an important source of information on the occurrence and distribution of chronic disease in the population. In this study, the burden of chronic illness was expressed as different indices of prevalence. Data were provided by 42 general practitioners in 15 computerized practices, collaborating in the Registration Network Family Practices of the University of Limburg in the Netherlands. Morbidity data concerning the actual health status of 25,357 subjects, as recorded by their GPs, were classified following the International Classification of Primary Care using the diagnostic criteria of the International Classification of Health Problems in Primary Care-2-Defined. The most frequent single disease was asthma (3.5%), while locomotor problems represented the most prevalent category (8.3%). The overall prevalence of chronic disease was 29.4%, with a clear positive correlation with age and, to a lesser extent, with a lower educational level. The 'social prevalence' of chronic illness (including individuals related to chronically diseased patients via their households) could be measured in a subset of the database (n = 4577), and amounted to 56%. It is concluded that the role of the GP as a family doctor involved with chronic disease concerns the majority of the general population.

Adolescent↗
PubMed2006

Measurement of the Gerasimov-Drell-Hearn Integrand for 2H from 200 to 800 MeV.

A measurement of the helicity dependence of the total inclusive photoabsorption cross section on the deuteron was carried out at MAMI (Mainz) in the energy range 200<Egamma<800 MeV. The experiment used a 4pi detection system, a circularly polarized tagged photon beam and a frozen-spin target which provided longitudinally polarized deuterons. The contribution to the Gerasimov-Drell-Hearn sum rule for the deuteron determined from the data is 407+/-20(stat)+/-24(syst) mu b for 200<Egamma<800 MeV.

Journal Article↗
PubMed2000

Exclusion limits on the WIMP-nucleon cross section from the cryogenic dark matter search.

The Cryogenic Dark Matter Search (CDMS) employs Ge and Si detectors to search for weakly interacting massive particles (WIMPs) via their elastic-scattering interactions with nuclei while discriminating against interactions of background particles. CDMS data, accounting for the neutron background, give limits on the spin-independent WIMP-nucleon elastic-scattering cross section that exclude unexplored parameter space above 10 GeV/c2 WIMP mass and, at >75% C.L., the entire 3sigma allowed region for the WIMP signal reported by the DAMA experiment.

Journal Article↗
PubMed2001

Finding paradigms for the future of alcoholism research: an interdisciplinary perspective.

This is a review article and critique of current research strategies in the alcohol field. Although the alcohol field is proud of its multidisciplinary tradition and scientific findings within specific disciplines, there are very few models of cross-disciplinary research and communication. Currently, the favored model of risk is genetic; the favored model of pathophysiology is molecular neuroscience; and the favored model of clinical investigation is narrowly categorical. If there is a hierarchy within science that is based on explanatory power, then models of alcoholism emerging from neuroscience, molecular biology, and genetics should be able to accommodate (if not account for) the findings on clinical aspects of alcohol dependence, as well as data on differential risk, course, and recovery that come from the behavioral and social sciences. The first section of this article reviews the most popular models of alcohol dependence over the past 40 years. I argue that the currently fashionable categorical approach to diagnosis in DSM-IV (and ICD-10) has failed to serve as a framework for interdisciplinary research and has failed to meet the needs of human geneticists, population-based researchers, psychosocial researchers, basic scientists working in animal models, and patient-oriented researchers. I argue for a return to the dimensional approach to diagnosis in the alcohol dependence syndrome construct. In the second section of the article, I lay out an agenda for revitalized patient-oriented research in the alcohol field, as a bridge between basic biological research and innovations in clinical practice, as well as the key to a valid diagnostic system that can inform research strategies in genetics and population-based research. In the third section of the article, I highlight the interface between genetic and psychosocial models of risk and propose a possible structure for future collaboration. I conclude with a plea to funding agencies and investigators to translate discipline-based scientific findings into a science relevant to alcoholism by addressing the challenges and opportunities of an interdisciplinary research agenda on the pathophysiology of alcohol dependence and the multidimensional sources of risk.

Alcoholism↗
PubMed1989

[Prevalence of risk factors and indicators of mortality among males 40-59 years of age with various forms of ischemic heart disease (data of a 5-year prospective study)].

A collaborative study was undertaken to assess the efficacy of multifactor prevention of myocardial infarction and cerebral stroke. A representative group of 5951 males aged 40-50 years was examined in Kaunas. Coronary heart disease (CHD) was detected in 11.1%, including 2.7% who had a history of myocardial infarction, 2.5% had exertional angina, its painless type was found in 5.9%. In males with CHD, arterial hypertension, hypercholesterolemia, obesity were more common and smoking was more infrequent than in those without the disease. The results of the 5-year follow-up showed that CHD males had higher total and cardiovascular mortality and myocardial infarction morbidity rates than males without CHD. Males with prior MI and pain-free CHD significantly differed from those from the control group in total and cardiovascular mortality rates. No statistically significant difference was found in MI mortality and morbidity rates between male patients with exertional angina and controls.

Adult↗