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  • Epidemiology  (56)
  • Springer  (56)
  • 1990-1994  (56)
  • 1985-1989
  • 1970-1974
  • 1992  (56)
  • 1
    ISSN: 1432-1076
    Keywords: HIV infections ; HIV seroprevalence ; Child ; Transmission ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A nationwide study involving 286 children of human immunodeficiency virus (HIV)-infected mothers living in Switzerland has been performed with the participation of all paediatricians interested in HIV infection in the country. Of these children 201 could be followed up prospectively from birth up to a median age of 22 months. Prevalence of HIV infection in Swiss parturients was estimated at 0.1% and apparently remained stable from 1986 to 1989. Vertical transmission rate was estimated at 14%–20%. Variables of maternal or perinatal history were not associated with transmission rate. Transmission to pairs of siblings of the same mothers was discordant in 33% (6 of 18), with always the elder sibling being infected. Postneonatal mortality in infants of HIV-infected mothers followed up from birth was increased 15-fold over the general population with a very high incidence (2 in 100) of sudden infant death apparently unrelated to HIV infection.
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  • 2
    ISSN: 1432-1246
    Keywords: Noise exposure ; Occupational medicine ; Arterial hypertension ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A cross-sectional study was performed in the Paris area, with a total of 7901 subjects; 432 of them were exposed to occupational noise ≥ 85 dBA. Noise was measured by the worksite physicians, and length of exposure was collected through interview. The subjects exposed to noise were mainly workers, their body mass index was higher and their job characteristics different from the other subjects, assembly line, shift-work and job under time pressure being more frequent. Blood pressure (BP) was higher among the exposed subjects; this was no longer the case after adjustment for age, body mass index and alcohol intake. Taking length of exposure into account, BP and the prevalence of hypertension increased for durations ≥ 25 years. This relationship was still significant after adjustment for age, body mass index and alcohol intake. These results suggest that a long occupational noise exposure is a risk factor for high blood pressure.
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  • 3
    ISSN: 1432-1246
    Keywords: Epidemiology ; Biological monitoring ; Aromatic amines ; Skin absorption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The biaromatic amine 4,4'-methylene dianiline (MDA) is an animal carcinogen, possibly also carcinogenic to humans. In a cohort of 595 power generator workers potentially exposed to MDA in a curing agent of an epoxy system, the overall standardised cancer incidence ratio (SIR) among males (n = 550), however, was only 0.52 [95% confidence interval (CI) 0.16–1.21] based on five observed cases. One male urinary bladder cancer case was found in comparison to 0.6 expected (SIR 1.67; 95% CI 0.04–9.31). This case was identified in an unexposed subcohort. High levels of MDA metabolites were ascertained in the urine of currently exposed workers, probably following percutaneous absorption. Although no evidence of an increased overall or bladder cancer risk was detected, the limitations of the study in regard to the size of the cohort, age and cancer latency preclude a definite risk assessment. The dermal absorption of MDA has been highlighted.
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  • 4
    ISSN: 1432-1246
    Keywords: Carbon disulfide ; Epidemiology ; Gastrointestinal tract ; Liver
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the framework of an extensive health survey, 119 viscose rayon workers exposed to carbon disulfide (CS2) and 79 workers from other plants not exposed to any toxic agent in the working environment underwent a gastrointestinal examination including a self-administered questionnaire, abdominal palpation, percussion and a number of liver function tests. In the viscose rayon factory the working conditions have not changed since 1932. Personal monitoring performed in 17 jobs showed CS2 exposures varying from 4 to 112 mg · m−3. For each individual a cumulative CS2 exposure index (CS2 index) was calculated. Univariate analysis of the questionnaire findings showed significantly higher prevalences of anorexia (37.0% vs 11.4%, P〈0.0001), vomiting (12.6% vs 3.8%, P = 0.04), and recent weight loss (10.9% vs 1.3%, P = 0.009) in the exposed than in the non-exposed workers. The exposed workers had a larger total number of gastrointestinal complaints and a larger proportion reported at least one complaint at least once a month than the non-exposed ones. Abdominal tenderness was very rare in both groups. In multiple logistic regression analysis, adjusting for alcohol intake, smoking, body mass index (BMI), coffee consumption, commuting time, stress at work, shift work, educational level, family history of ulcer disease and intake of medication, significant associations with exposure were found for anorexia (P = 0.0001), nausea (P = 0.009), vomiting (P = 0.002) and flatulence (P = 0.03). Stress at work was a determinant for quite a few digestive complaints, but shift work was not significantly associated with any of them. The exposed workers had significantly lower median values for aspartate aminotransferase (AST) and alanine aminotransferase (ALT) than the non-exposed (11.0 vs 13.5 mU/ml, P = 0.0008; 12.0 vs 13.0 mU/mL, P = 0.01, respectively. The values for liver size and γ-glutamyltransferase (GGT) were significantly higher in the exposed than in the non-exposed workers (72 vs 67 mm, P = 0.002; 13 vs 11 U/1, P = 0.0003, respectively). The alkaline phosphatase (AP) activity did not differ significantly between the two groups. In multiple linear regression, adjusting for alcohol, pharmaceuticals consumption and BMI, there was a slightly significant negative association between exposure and AST (P = 0.04) and positive association with liver size (P = 0.002) and GGT (P = 0.0001). Alcohol was positively associated with GGT, and BMI with ALT and GGT.
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  • 5
    ISSN: 1432-1246
    Keywords: Arsenic ; Cancer ; Copper ; Epidemiology ; Nickel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A total of 1388 workers employed for at least 3 months at a copper/nickel smelter and nickel refinery were followed up for cancer from 1953 to 1987 through the Finnish Cancer Registry. There were 1339 male and 49 female workers, making a total of 27130 and 706 person-years, respectively. All of the women worked in the refinery, which opened in 1960, the same year the smelting of nickel began. A total of 67 cancers were diagnosed among the men, the standardized incidence ratio for all cancers being 1.0. No cancer was found among the women (1.8 expected). The risk of cancer among men was analysed according to primary site, exposure to nickel, type of work, years since first exposure and age at diagnosis. In the subcohort of nickel refinery workers, one case of sinonasal cancer was observed, against 0.02 expected, but otherwise no significantly increased risks of cancer were found. In addition to the small size of the cohort, the non-positive finding concerning lung cancer might be related to the relatively low arsenic exposure and, perhaps, to the late commencement of nickel production.
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  • 6
    ISSN: 1432-1246
    Keywords: Pharmaceuticals ; Epidemiology ; CS2
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A total of 129 workers exposed to carbon disulphide (CS2) and 81 non-exposed controls were asked about their current use of pharmaceuticals, using a self-administered questionnaire. In all, 31% of the exposed and 19.8% of the non-exposed used some medicine (P = 0.08). The average number of pharmaceuticals per subject amounted to 0.71 in the exposed vs. 0.36 in the non-exposed (P = 0.049). Predominant types of medicines used were analgesics (12.4% in the exposed vs. 8.6% in the non-exposed,P = 0.50) and sedatives/hypnotics (10.1% in the exposed vs. 4.9% in the non-exposed,P = 0.21). The pharmaceuticals consumed can cause numerous (side) effects that are similar to the toxic effects of CS2. To take into account these possibly confounding agents, a classification system for possible (side) effects of pharmaceuticals was developed, taking the dose into account. According to this method, many (side) effects of pharmaceuticals that could occur were recorded with higher frequency and intensity in the exposed subjects. Potential (side) effects that occurred significantly more frequently in the exposed than in the non-exposed were: tiredness, sedation, dizziness (20.9% vs. 4.9%,P = 0.001), excitation, anxiety (10.9% vs. 2.5%,P = 0.03), vision disturbances (7.0% vs. 0%,P = 0.01), and erection decrease (5.4% vs. 0%,P = 0.045). The implications of these findings for epidemiological studies are discussed.
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  • 7
    ISSN: 1433-2965
    Keywords: Epidemiology ; Hip fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to examine the apparent incidence of hip fracture from discharge rates in European countries. A request was sent to the Ministries of Health in all European countries, asking for the number of hip fracture patients by age and sex, between the years 1983 and 1985. Seventeen countries responded. As expected, hip fracture was most frequently found amongst the elderly, particularly women. The incidence of hip fracture rose exponentially with age in both sexes. It was higher in women than men and there was a three-fold range between countries in the female to male sex ratio. There was an eleven-fold range in apparent incidence amongst women and a seven-fold range amongst men between the various countries. The highest incidence was found in the northern part of Europe and the lowest in the Mediterranean area. There was a significant positive correlation between the age-standardized incidence rates reported in men from each country and that in women. There was a larger difference in incidence between countries than between sexes, which suggests important genetic or environmental factors in the causation of hip fracture. The extent to which this reflects imperfect capture of data is uncertain but will be important to determine in order to identify reasons for differences and to enable confident projections of the future magnitude of this disorder.
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  • 8
    ISSN: 1433-3023
    Keywords: Age ; Epidemiology ; Female ; Urinary incontinence ; Urogynecology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A randomized study of the prevalence of urinary incontinence was performed among adult Finnish females. In 1986, 5247 women (aged 25–55 years) who participated voluntarily in a gynecological health study, anonymously completed a questionnaire concerning subjective symptoms and experiences with urinary incontinence. One-fifth of the studied population (20.1%) reported that they were handicapped by incontinence. The number of incontinent women increased significantly with increasing age up to 45 years. Stress urinary incontinence alone was reported by 73% of the women experiencing incontinence. Surprisingly, only one-third of the women stated that they needed treatment, and less than one-fifth of all had sought help for this disorder.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 420 (1992), S. 171-177 
    ISSN: 1432-2307
    Keywords: Hirschsprung's disease ; Neuronal dysplasia ; Hypoganglionosis ; Colorectal innervation defects ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Congenital colorectal innervation defects were evaluated by studying 3699 colonic mucosal biopsy specimens obtained from 773 patients over a 5-year period (1986–1991). In 358 cases (46.3%) a classifiable defect was present, with aganglionosis in 187 of these patients (52.2%) and hypoganglionosis of the colon in 18 (5.0%). Hypoplastic or aplastic sympathetic innervation (type-A neuronal intestinal dysplasia was found in 2.2% (n=8) and dysplasia of the parasympathetic submucous plexus (type-B neuronal intestinal dysplasia) in 40.6% (n=145) of the patients with classifiable defects. Identification of a specific innervation defect was not possible in 229 of the 773 patients (29.6%), 28% of whom exhibited slight dysplasia and 30% immaturity or hypogenesis of the submucous plexus. In 40% of the unclassifiable cases heterotopic nerve cells were found in the muscularis mucosae and/or lamina propria mucosae, while 2% had severe heterotopia with the cells of the myenteric plexus completely displaced into the circular and/or longitudinal muscle layers. These patients generally suffered from severe chronic constipation requiring surgical intervention. Four congenital innervation defects of the colorectum can thus be clearly differentiated at present: aganglionosis (in its various forms), hypoganglionosis, type-A neuronal intestinal dysplasia, and type-B neuronal intestinal dysplasia.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Osteoporosis international 2 (1992), S. 285-289 
    ISSN: 1433-2965
    Keywords: Epidemiology ; Hip fracture ; Incidence ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hip fractures are recognized to be a major public health problem in many Western nations, most notably those in North America, Europe and Oceania. Incidence rates for hip fracture in other parts of the world are generally lower than those reported for these predominantly Caucasian populations, and this has led to the belief that osteoporosis represents less of a problem to the nations of Asia, South American and Africa. Demographic changes in the next 60 years, however, will lead to huge increases in the elderly populations of those countries. We have applied available incidence rates for hip fracture from various parts of the world to projected populations in 1990, 2025 and 2050 in order to estimate the numbers of hip fractures which might occur in each of the major continental regions. The projections indicate that the number of hip fractures occurring in the world each year will rise from 1.66 million in 1990 to 6.26 million by 2050. While Europe and North America account for about half of all hip fractures among elderly people today, this proportion will fall to around one quarter in 2050, by which time steep increases will be observed throughout Asia and Latin America. The results suggest that osteoporosis will truly become a global problem over the next half century, and that preventive strategies will be required in parts of the world where they are not currently felt to be necessary.
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  • 11
    ISSN: 1433-8491
    Keywords: Depressive symptoms ; Cognitive impairment ; Co-occurrence ; Epidemiology ; Gender
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The cross-sectional data are reported for co-occurrence of depressive symptomatology and cognitive impairment from the first wave of a longitudinal study of normal and pathological aging in a representative sample of 2792 older adults (≥65) residing in the Aquitaine Region (Bordeaux) of Southwest France. The prevalence rate for co-occurrence was 4.2% for men and 6.2% for women. Co-occurrence was associated with age, no or little education, functional impairment and dissatisfaction with social support for both men and women, though men were at higher risk than women for the latter two factors, and women were at higher risk than men for no or little education. Women over the age of 85 years were at increased risk whereas men were not, and marital status was associated with co-occurrence for men but had no effect for women. These findings indicate that the risk of co-occurrence differs for men and women, and that, with the exception of social support, the correlates we examined play different roles according to gender.
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  • 12
    ISSN: 1432-0428
    Keywords: Epidemiology ; prevalence of diabetes mellitus ; population survey ; Italy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aims of this survey were (1) to estimate the prevalence of known diabetes mellitus in 1988 in Casale Monferrato (Northern Italy); (2) to validate different data sources available in Italy; (3) to identify a population-based cohort of diabetic patients. Multiple independent data sources were used and the capture-recapture method was applied to estimate the completeness of ascertainment of the survey. The primary data source was the list of all patients attending the diabetic clinic or those referred by family physicians and paediatricians of the area. The secondary data sources were the list of hospital discharges, the prescriptions data source and the list of all people using reagent strips and insulin syringes. On 1 October 1988 (the cut-off date) 2,069 cases of known diabetes were identified. The estimated completeness of ascertainment of the survey was 91%. Prevalence of known diabetes, Type 1 (insulin-dependent), Type 2 (non-insulin-dependent) and insulin-treated diabetes were, respectively, 2.21% (95% CI 2.13–2.29), 0.80/1,000 (0.62–0.98) and 2.10% (2.01–2.19), 2.92/1,000 (2.57–3.27). A higher prevalence of Type 2 diabetes was observed in women (2.30%, 2.18–2.42) than in men (1.88%, 1.76–2.00). Age-specific prevalence of Type 2 diabetes increased with age. Computerized data sources routinely available in the Piedmont Region (hospital discharges and prescriptions data sources) showed a low completeness of ascertainment when considered together (65%, 1,338 of 2,069), indicating the need to involve the diabetic clinic and family physicians in the ascertainment of known diabetes. In conclusion, the prevalence of known diabetes in Italy was lower than in Northern Europe and the United States.
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  • 13
    ISSN: 1432-0827
    Keywords: Osteoporosis ; Hip fracture ; Acid-base equilibrium ; Vegetarianism ; Dietary proteins ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary Age-adjusted female hip fracture incidence has been noted to be higher in industrialized countries than in nonindustrialized countries. A possible explanation that has received little attention is that elevated metabolic acid production associated with a high animal protein diet might lead to chronic bone buffering and bone dissolution. In an attempt to examine this hypothesis, cross-cultural variations in animal protein consumption and hip fracture incidence were examined. When female fracture rates derived from 34 published studies in 16 countries were regressed against estimates of dietary animal protein, a strong, positive association was found. This association could not plausibly be explained by either dietary calcium or total caloric intake. Recent studies suggest that the animal protein-hip fracture association could have a biologically tenable basis. We conclude that further study of the metabolic acid-osteoporosis hypothesis is warranted.
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  • 14
    ISSN: 1432-0827
    Keywords: Epidemiology ; Vertebral fracture ; Hip fracture ; Osteoporosis ; Time trend
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary Several studies suggest secular increases in hip fracture incidence through this century, but little is known about such trends for vertebral fracture. We have examined changes in the incidence of clinically ascertained vertebral fractures among Rochester, Minnesota residents aged 35–69 years, that were first diagnosed between 1950 and 1989. Our results indicate no overall increase in incidence over the 40-year period. Categorization of fractures according to the level of preceding trauma, however, revealed a significant increase in the incidence of fractures following moderate trauma among women aged 60–69 years. This increase occurred between 1950 and 1964, and leveled off thereafter. Rates for severe trauma fractures among postmenopausal women, and for vertebral fractures from any cause among younger men and women, remained stable. The rise in moderate trauma fractures in postmenopausal women paralleled that for hip fractures in Rochester and began to plateau at around the same time. It might have resulted from increased diagnosis of vertebral fractures, but the increase in hip fracture incidence is inconsistent with this explanation. An increase in the prevalence of osteoporosis, however, might account for the trend in both types of fractures.
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  • 15
    ISSN: 1432-0428
    Keywords: Epidemiology ; Paris Prospective Study ; coronary heart disease ; diabetes mellitus ; impaired glucose tolerance ; body fat distribution ; plasma triglyceride level ; blood pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The Paris Prospective Study is a long-term, large-scale study of the factors predicting coronary heart disease in healthy middle-aged men. Subjects with impaired glucose tolerance or diabetes (not treated by insulin) at the first follow-up examination (n = 973) were selected from the total cohort for a separate analysis of the predictors of death from coronary heart disease. An index of body fat distribution, the iliac to thigh ratio, was entered into the list of potentially predictive variables, despite the fact that it had been measured one year before the first follow-up examination. After 15 years of mean follow-up, 41 of the selected subjects had died from coronary heart disease. Univariate analysis showed that these subjects differed from the subjects who died of another cause or who were alive at 15 years on the following variables: iliac to thigh ratio (p 〈 0.0005), plasma tri glyeride level (p 〈 0.006), systolic blood pressure (p 〈 0.01), and body mass index (p 〈 0.04). In multivariate regression analysis using the Cox model, only iliac to thigh ratio and triglyceride plasma level achieved statistical significance as independent predictors. This result supports the current hypothesis that upper-body fat distribution, a characteristic trait of subjects with diabetes of glucose intolerance, plays an important role towards their high cardiovascular risk. However, it is unlikely that this role would be mediated through the lipid abnormalities that have been described as associated with upper-body fat deposition.
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  • 16
    ISSN: 1433-8491
    Keywords: Seasonal depression ; Epidemiology ; Specific symptoms ; Course ; Retrospective reliability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a longitudinal cohort study of young adults from the Canton of Zurich in Switzerland (Zurich Study), seasonal patterns of several psychiatric and psychosomatic syndromes were investigated in two interviews over a period of three years. At an age of 27–28 years, 23% of the depressives, 15% of the neurasthenic subjects, and 14% of the subjects with backache reported an increased susceptibility in autumn and/or winter. With respect to the course we found that 10.4% of the subjects of the longitudinal sample (n=417) suffered from seasonal depression (including individuals with subsyndromal seasonal difficulties) overtwo consecutive years. Specific symptoms, such as hypersomnia, increase of appetite or weight gain, were not found to be consistently associated with seasonal depression. A comparison of actual and retrospective reports on seasonal depression resulted in a very low reliability. In view of these results the seasonal subtype of depression should be diagnosed with caution, except when the diagnosis is based on longitudinal observations and/or external sources of information (e.g. family members, partner).
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  • 17
    ISSN: 1434-4726
    Keywords: Otitis media with effusion ; Acute otitis media ; Upper respiratory tract infection ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The etiology of middle ear disease in Nijmegen, The Netherlands was studied on the basis of a data set collected in a prospective epidemiological study on otitis media with effusion (OME) in a cohort of 1439 preschool children. A factor analysis was used to evaluate two hypotheses: (1) that OME, acute otitis media (AOM), common cold and tonsillitis are manifestations of the same pathological entity, and (2) that a group of children can be distinguished who develop these conditions more frequently than average. The results only partly supported these hypotheses. The correlation between OME, AOM, common cold and tonsillitis was lower than expected from a review of the literature. Common cold appeared to be the ubiquitous ENT disease in childhood and, depending on the child's predisposition, could be accompanied by OME, AOM or tonsillitis. The course of middle ear and upper airway disease showed a gradual scale from “healthy” to “ill” with most of the children suffering from these conditions at an average frequency.
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  • 18
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1434-4726
    Keywords: Ear disease ; Otitis media and cholesteatoma ; Children ; Clinical management ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary There is a long-lasting debate concerning cholesteatoma in children. This retrospective epidemiological study includes 81 ears harboring cholesteatoma and treated surgically. All patients were Egyptian and were treated at Alazhar University Hospital, Cairo. Among this group 37 ears belonged to patients younger than 18 years old. To clarify comparison with adult patients, a system of classification based on certain anatomical criteria is proposed. Statistical analysis proved that cholesteatoma in children treated at Alazhar University Hospital differs significantly in two main aspects: it is associated with more pathological changes and is associated with higher morbidity. Additionally, patients younger than 12 years are at high risk for complications. A subgroup of adolescents with cholesteatoma is marginal and has disease representing the characteristics of both adults and younger children.
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  • 19
    ISSN: 1434-9949
    Keywords: Osteoarthritis ; Radiographic ; Elderly ; Epidemiology ; Population
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prevalence of radiographic osteoarthritis in hand and knee joints was studied in representative subsamples of the 75 and 79 year old population of Göteborg, Sweden. A comparison between two cohorts of 79-year-olds, revealed no significant difference between them. A longitudinal study within one of these cohorts including those aged between 75 and 79 showed a modest but not statistically significant progression of osteoarthritis in hand and knee joints. The results suggest a reduced progression of osteoarthritis after 75 years of age.
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  • 20
    ISSN: 1590-3478
    Keywords: Epidemiology ; province of Pavia ; familial ALS-sporadic ALS ; inheritance ; variable penetrance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Abbiamo esaminato otto casi di SLA familiare (Sclerosi Laterale Amiotrofica) appartenenti a tre diverse famiglie isolate nella nostra provincia e ricoverati nel nostro Istituto tra il 1970 ed il 1989. I criteri clinici di diagnosi sono stati soddisfatti in tutti i casi e l'EMG è stato eseguito in 6 casi su 8. Quattro casi mostravano un esordio di tipo classico e quattro un esordio di tipo bulbare. L'età media di insorgenza della malattia nelle tre famiglie era di 65.7+10.6 anni. La sopravvivenza media era di 19.1+9.2 mesi. La modalità di trasmissione era autosomica dominante con penetranza variabile. In due famiglie erano affetta due diverse generazioni, nella terza famiglia una sola. Fattori ambientali non sembrano essere coinvolti nello sviluppo della malattia. Ulteriori studi genetici potranno far luce sulla patogenesi della SLA familiare.
    Notes: Abstract We examined 8 cases of familial ALS (amyotrophic lateral sclerosis) in three different families from our province, admitted to our hospital between 1970 and 1989. Clinical criteria for diagnosis were satisfied in all cases; EMG was performed in 6 out of 8 patients. 4 cases showed classical onset and 4 cases bulbar onset. The average age at onset was 65.7+10.6 years. The average survival was 19.1+9.2 months. In two families two generations were affected, in the other only one. The mode of transmission was found to be autosomal dominant with variable penetrance. Neither environmental nor toxic factors seemed to be involved in the development of the illness. Genetic investigations may help to elucidate the pathogenesis of familial ALS.
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  • 21
    ISSN: 1573-7284
    Keywords: Alcoholism ; Epidemiology ; Alcoholics anonymous
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A study on the characteristics of alcoholics attending the “Alcoholics in treatment” clubs, a community and family-oriented programme against alcoholism, has been conducted in the Friuli-Venezia Giulia region, Northeastern Italy. A total of 598 individuals (93% of those contacted) completed the questionnaire, 431 (72%) were males and 167 (28%) were females. With respect to marital status, never married men and widows seemed to be at high_ risk of alcoholism. Total alcohol consumption in males significantly exceeded that in females (X12 2 trend 18.86 p 〈 0.001) and this excess mainly seemed to be primarily associated with wine (X1 2 trend 32.81 p 〈 0.001). Younger individuals (〈 50 yrs) tended to begin drinking earlier and to report higher intake from alcoholic beverages other than wine as compared to older individuals (〈- 50 yrs) (X1 2 trend = 25.25 p 〈 0.001). A high percentage of males (30%) reported heavier alcohol intake in their father as compared to themselves while only 12 of females reported heavier intake in their mother as compared to themselves. Health complaints seemed to be the chief reason which prompted individuals, particularly above age 50, to attend “Alcoholics in treatment” clubs but awareness of alcohol-related health problems played a substantial role, as shown by the very common overestimation of alcohol as the primary cause of death in Italy by the individuals attending the club.
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  • 22
    ISSN: 1573-7284
    Keywords: Epidemiology ; Seroepidemiology ; Agricultural workers ; Abattoir workers ; Yersinosis ; Work-related diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Increased risk of high Yersinia enterocolitica 0:3 and 0:9 antibody content has been previously reported in occupations with swine contact. In this study several possible confounders of this elevated risk among pig farmers and abattoir workers were considered. Only in three instances the standardized risk ratio was decreased close to unity, namely after the standardization of Y. enterocolitica 0:3 IgG antibody positivity for age among abattoir workers, after the standardization of Y. enterocolitica 0:9 IgG antibody positivity for farm butchering among pig farmers and for smoking among abattoir workers. As the decrease did not apply for both pig farmers and abattoir workers and for both 0:3 and 0:9 serotypes considered, it seems reasonable to assume that the three decreases represent products of multiple testing inherent in this kind of search of confounders rather than any true effects. In view of the present knowledge on the determinants of yersinia antibodies in populations, the crude risk ratios for elevated yersinia antibodies can be held to be reasonably unconfounded.
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  • 23
    ISSN: 1573-7284
    Keywords: Typhoid fever ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Typhoid fever is endemic in the Neapolitan area, where its yearly incidence rate largely exceeds the corresponding national figure. During the period from January to June, 1990, a matched case-control study was carried out in order to identify risk factors of the disease in this area; 51 subjects (mean age 27.2 years) with typhoid fever were compared with 102 controls matched with respect to age, sex and educational level. Consumption of raw shellfish was reported by 76.5% of the cases, as opposed to 19.6% of the controls (P 〈 0.01). Subjects who had eaten this food item had a 13.3-fold risk (C.I. 95% = 5.5 - 32.8) of contracting typhoid fever. In contrast, no risk was found to be associated with consumption of cooked shellfish, raw vegetables, ice-cream, non-potable water, or unpasteurized milk. The risk factor identified in this study shows that hazardous dietary habits and inadequate sewage treatment facilities, combined with lack of sanitation in the harvesting and marketing of shellfish, play a major role in the endemicity of typhoid fever in the Neapolitan area.
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  • 24
    ISSN: 1573-7284
    Keywords: Blastocystis hominis ; Epidemiology ; Day care centres and primary schools ; Patients attending the hospital ; Clinical significance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A prospective study was carried out to investigate the epidemiology and clinical significance of Blastocystis hominis in the following groups of the population of the city of Salamanca (Spain): in children attending 11 day car centres and 7 primary schools, two fecal samples were obtained from each child, and in 1231 patients attending the Clinical Hospital. A B. hominis incidence of 5.3–10.3% was found in the day care centres and an incidence rate of 13.4–19.4% was found in the primary schools. All the cases were observed in asymptomatic children. The incidence of B. hominis was greater in children older than 3 years in the day care centres and in the 10–14 year-old group in the primary schools. A heavier parasitization was observed in the boys than in the girls and in the students of schoold in areas of low socio-economic level. B. hominis was identified in 40 patients attending the Clinical Hospital (3.25% of all those studied). The maximum peak of incidence was found in subjects with ages between 10 and 14 years. A follow up study was performed on 18 patients parasitized exclusively by B. hominis; 7 of these were considered to have acute gastroenteritis and one chronic gastroenteritis associated with the protozoan. No statistically significant association was observed between the number of B. hominis cells and the presence of diarrhoea. Our results show that despite the high number of asymptomatic carriers of B. hominis in the juvenile population, this protozoan may be, on other occasions, responsible for gastrointestinal symptoms.
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  • 25
    ISSN: 1573-7284
    Keywords: Coronary risk ; Hyperlipidemia ; Hypertension ; Hyperglycemia ; Overweight ; WHO-CINDI ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated mean levels and prevalences of total cholesterol, HDL cholesterol, triglycerides, fasting blood glucose, systolic blood pressure and body mass index in adults aged 25 to 64 years participating in the WHO Country-wide Integrated Noncommunicable. Diseases Intervention (CINDI) Programme in Vorarlberg, western Austria. According to the Austrian expert panel and based upon the above age standardized risk factors 50.9% of the male and 29.3% of the female population were at high risk for developing coronary heart disease. Risk factor levels were further compared between euglycemic and hyperglycemic participants. After adjusting for age hyperglycemia was associated with higher body mass index in men (p=0.026) and women (p〈0.001), higher systolic blood pressure in men (p〈0.001) and women (p=0.003), and higher levels of triglycerides in women (p=0.008). No significant differences were observed in total and HDL cholesterol in either sex. When controlling for age and body mass index, fasting blood glucose levels had significant associations only with systolic blood pressure in men (p=0.001). But, with respect to all risk factors, hyperglycemic participants had an age-adjusted adverse coronary risk profile both in men (p=0.002) and in women (p〈0.001).
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  • 26
    ISSN: 1573-7284
    Keywords: All causes mortality ; Multivariate analysis ; Risk functions ; Prediction ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nine population samples of mean aged 40–59, for a total of 1777 individuals drawn from nine health units, were examined in 1978–79 for the measurement of some risk factors possibly related to total mortality. The analysis evaluated the possible relationship between blood pressure levels and smoking habits measured in the population samples and the official death rates covering the period 1980–82 in the health units from which the samples were drawn. The analysis was conducted in a direct way but also by the help of a risk function linking blood pressure and smoking habits as obtained from another Italian population sample. The cograduation test between mean blood pressure in the nine areas and total mortality was 0.58 (linear correlation 0.57); the cograduation test was-0.70 for non-smokers, 0.62 for ex-smokers, 0.50 for present smokers (linear correlation of-0.27, 0.29, and 0.14 respectively). The death rates estimated by the risk function (Cox model) tended to overestimate the death rates from 5 to 64% (average 36.3%). The cograduation test between expected and observed death rates was 0.56 (linear correlation coefficient 0.66). Some limitations of this pilot study are largely explained by the small size of the sample and by the need to use a risk function provided by another population sample.
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  • 27
    ISSN: 1573-7284
    Keywords: Hystoplasma capsulatum var. capsulatum ; Histoplasmin sensitivity ; Epidemiology ; Northwestern Argentina
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The present work was undertaken to obtain epidemiological data on the extent and distribution of Histoplasma capsulatum infections in the Chuscha and La Higuera areas. Skin test surveys of the human population with histoplasmin and paracoccidioidin were carried out in 40% of the permanent population of both localities, between 3 and 88 years old. It was found that 53.57% of the population were histoplasmin reactors and 1.86% of the population were paracoccidioidin reactors.
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  • 28
    ISSN: 1573-7284
    Keywords: Rickettsia conorii ; Mediterranean spotted fever ; Epidemiology ; Climatic factors ; France
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors report the general epidemiologic features of Mediterranean spotted fever (MSF) in the Marseille area (South France). Age was a risk factor, increasing after 50 years, and annual incidence seemed positively correlated with the average temperature of the preceding year and negatively correlated with the number of days with frost of the preceding year. However, correlations were not significant.
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  • 29
    ISSN: 1573-7284
    Keywords: Epidemiology ; Head injury ; Incidence ; Mortality ; Socio-demographic and temporal correlates ; Alcohol consumption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The epidemiology of head injury was studied in Cantabria, Spain, using a methodological design consisting of a cross-selectional analysis of one year of duration and an additional one year follow-up of all the patients included in the initial sample. The 477 cases identified represent a rate of 91/100,000, with males showing a head injury rate 2.7 times higher that than for females. Sixty per cent of all cases involved traffic accidents, falls accounted for 24% and industrial accidents were the cause in 8%. The annual age-adjusted mortality rate was 19.7/100,000. Over 92% of all deaths occurred prior to hospital admission. The presence of alcohol intoxication was evaluated in 211 cases by determining the osmolar gap. It was found that 51% of all the cases examined presented clear evidence of acute alcohol intoxication.
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  • 30
    ISSN: 1573-7284
    Keywords: Skin cancer ; Ultraviolet Radiation ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A retrospective study of 143 patients histologically diagnosed with non-melanoma skin cancer (NMSC) was carried out in order to evaluate the influence of ultraviolet (UV) radiation on the appearance of more than one NMSC in the same person. Descriptive statistical and logistic regression analyses were carried out for each variable and its possible interaction, in order to determine the potential appearance of multiple NMSC. The results obtained were in agreement with those of earlier studies. A significant relationship was observed between occupational UV exposure and individuals with more than one NMSC. Those patients tended to be blue-eyed and were chronically exposed to UV radiation as a result of occupational activities (although not always in leisure activities); most did not take protective measures such as the use of hats or creams.
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  • 31
    ISSN: 1573-7284
    Keywords: Campylobacter ; Portugal ; Epidemiology ; Biotyping ; Plasmids ; Antimicrobial resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract From 1984 to 1989, stool samples from 2811 gastroenteritis cases were examined for the presence ofCampylobacter jejuni andC. Coli, Salmonella, Shigella andYersinia species. Isolation rates were:Campylobacter jejuni andC. Coli, 5.3%,Salmonella spp., 14.8%,Shigella spp., 4.6% andYersinia enterocolitica, 1.1%. Age group distribution analysis shows a higherCampylobacter isolation rate in children under one year of age. Seasonal distribution revealed a peak incidence in winter as in other Meditteranean countries. Predominant biotypes wereC. jejuni I (51%),C. jejuni II (21.5%) andC. coli I (18.8%). Antimicrobial susceptibility testing did not reveal resistance to erythromycin. Thirty of the strains harboured plasmids with 7 different profiles.
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  • 32
    ISSN: 1573-7284
    Keywords: Diet ; Gastric cancer ; Epidemiology ; Case-control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the relationship between diet and gastric cancer in a case-control study. One hundred and nine (109) cases were taken from pathology reports of the regional hospitals, and the 123 controls were obtained from the municipal census of the municipalities of the study. The data were analysed using the Mantel-Haenszel chi-square test. The non-consumption of fresh fruits appeared as a statistically significant risk factor, as well as the consumption of home-made sausages and home-cured meats in general, the risk of which was enhanced when they were eaten smoked. It appears that the less frequent the consumption of fresh fruit and the more frequent the consumption of sausages were the higher the risk was. The non-consumption of fresh vegetables also appeared to be a risk factor, but it was not statistically significant.
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  • 33
    ISSN: 1573-7284
    Keywords: Epidemiology ; HIV ; HTLV-I/II ; Intravenous Drug Users ; RIPA ; Western Blot
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The seroprevalence of HTLV-I/II was evaluated in 1247 Italian individuals at high risk for HIV infection. The population studied consisted of 985 intravenous drug users (IVDUs), 474 of whom on methadone maintenance and 511 in a therapeutic community, 110 HIV-infected patients in various stages of HIV-related disease and 152 hemophiliacs. Sera were screened for antibody to HTLV-I/II by enzyme immunoassay (EIA) and confirmed by Western blot and radioinununoprecipitation assay. Confirmed positive samples were further differentiated by EIA using HTLV-I and HTLV-II specific peptides. The overall prevalence of anti-HTLV-I/II was 4.0% in IVDUs, with the highest prevalence (8.2%) among HIV-infected symptomatic patients. None of the hemophiliacs was antiHTLV-I/II positive, even though 63.1% tested positive for HIV antibodies. The trend of seroprevalence in drug users and the evaluation of possible risk factors demonstrated that HTLV-I/II infection has been present in Italy before the onset of HIV epidemic. The overall seroprevalence showed no significant changes during the 10 year period covered by this survey but correlated with HIV seropositivity, age and duration of drug use. Peptide testing showed that HTLV infection was mainly due to HTLV-II.
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  • 34
    ISSN: 1573-7284
    Keywords: Epidemiology ; Hepatitis C virus antibody ; Homosexual men ; HCV transmission
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors report on an anti-hepatitis C virus antibody (HCV Ab) prevalence (6.9%) in 622 homo-bisexual males from Northern Italy, voluntarily attending an HIV and STDs screening program in the period 1984–89. The anti-HCV antibody prevalence shows a significant correlation with: i) presence of serological markers for HBV (O.R. = 3.12; 95% C.I. =1.53–6.52) and HIV (O.R. = 12.09; C.I. = 6.52–22.52) infection; ii) a stable relationship with an anti-HCV antibody positive partner (O.R. = 7.79; 95% C.I. = 2.50–23.90); iii) more than twenty different male partners per year (O.R. = 2.55; 95% C.I. =1.17–5.66). These data demonstrate the existence of a sexual transmission of HCV among homosexuals. This route might contribute in maintaining endemic levels of HCV infection in the homo-bisexual population and it might represent an important way of spreading the virus in the general population too.
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  • 35
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    European journal of epidemiology 8 (1992), S. 346-349 
    ISSN: 1573-7284
    Keywords: Epidemiology ; Dermatophytosis ; Genetic susceptibility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clustering of cases of dermatophytosis suggests that inherited susceptibility may play a part in determining the epidemiology of some forms of this infection, notably tinea imbricata. Some studies of T. concentricum infection show that autosomal recessive susceptibility may provide an answer although this is not the case in all endemic areas. Further support comes from the association between dermatophytosis in man and inherited conditions such as atopy, chronic mucocutaneous candidosis and tylosis as well as experimental data showing that susceptibility to dermatophytosis in mice varies in different inbred strains. Possible mechanisms are discussed.
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  • 36
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    European journal of epidemiology 8 (1992), S. 625-626 
    ISSN: 1573-7284
    Keywords: Epidemiology ; Advances ; Studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 37
    ISSN: 1573-7284
    Keywords: Epidemiology ; Cardiovascular diseases ; Cancer ; Women ; Biological bank ; Epidemiological projects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In spite of their important impact on populations, a number of diseases - all types of cancer and coronary heart disease in women - are “rare” events for statistical analysis and often analyzed in designs affected by selection and information biases, such as case-control studies. Large cohort studies based on the storage of biological specimens appear to be the most suitable solution for identifying risks for those diseases. Progetto ATENA, a study on the etiology of major chronic diseases in women is based on this design. Ten thousand women, aged 30–69 years, living in the area of the city of Naples, free of cancer and cardiovascular disease, are being recruited over a four-year period. Ten per cent of the cohort is being randomly selected from the electoral roles, the rest will be volunteers. Information on dietary habits, reproductive history, familiarity for chronic disease, active smoking habits and passive smoking exposure, physical activity, and socio-demographic data are being collected. Clinical data such as blood pressure, anthropometry, and electrocardiogram are also taken. All the participants provide biological samples of blood (fasting drawing) and urine (timed morning spot). The biological samples are processed in order to explore the main areas under study (nutritional markers, metabolism, endocrinology, genetics, environmental exposure markers, thrombogenesis). The samples are stored in liquid nitrogen (−196° C) as soon as the blood and urine processing have been finished. An appropriate follow-up information system on the health status of the participants is being set up to estimate incidence and mortality rates.
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  • 38
    ISSN: 1573-7284
    Keywords: Chlamydia trachomatis ; Infection ; Epidemiology ; Risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A study of Chlamydia trachomatis was conducted in 5270 subjects seen at clinics of the Faculty of Medicine and Surgery at La Sapienza University in Rome, the S. Anna Hospital in Turin, and the Provincial Maternity Hospital Institute in Milan. In these areas, C. trachomatis was present in 5.8% of the cases examined; in addition it was present with statistically significant frequencies in cases of salpingitis (49.1) and epididymitis (21.7). It may also be found in cases of extrauterine pregnancy, sterility and abortion. Those most affected were women who had begun their sexual activity at an early age, were under 25, had several sexual partners and who used the coil and/or spermicides. A routine check for C. trachomatis should be considered for those women with those risk factors.
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  • 39
    ISSN: 1573-7284
    Keywords: Gallstones ; Epidemiology ; Dietary and socio-economic habits ; Pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Five hundred and twelve women attending the antenatal clinic of the Rotunda Hospital of Dublin were studied by means of abdominal real time ultrasound (US) scanning to establish some of the characteristics of those subjects found to be gallstone-positive, compared to the gallstone-negative control population. Coffee, tea and sucrose consumption, dietary fats, attendance at fast-food restaurants, education, cigarette smoking, alcohol, and physical activity did not show any substantial differences between the two groups, while there was a significantly higher prevalence of cholelithiasis in women who had been dieting and in overweight subjects.
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  • 40
    ISSN: 1573-7284
    Keywords: ELISA ; Leptospirosis ; Australis ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An enzyme-linked immunosorbent assay (ELISA) was assessed to detect in humans IgM and IgG against the main serogroups/serovars of Leptospira present in Italy. Sonicated antigens from strain Wijnberg, serogroups Icterohaemorrhagiae and Riccio 2, serogroup Australis, were used in ELISA and the results were compared to microagglutination test (MAT). IgM were confirmed to be the predominant class of antibodies; the total sensitivity obtained by Wijnberg/ELISA with the sera of patients infected by different serogroups was 81.5% in relation to MAT, better sensitivity was achieved by the use of Riccio 2/ELISA; no reaction occurred with the control sera. Cross-reactivity was noted with some sera of patients with Lyme disease (IgM) and with few sera of patients with autoimmune disease (IgM and IgG). To improve the sensitivity of the ELISA both antigens Wijnberg and Riccio 2 must be employed in the immunoenzimatic assay, since serogroup Australis must be considered as a new emerging serogroup causing human leptospirosis in our country.
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  • 41
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    European journal of epidemiology 8 (1992), S. 252-255 
    ISSN: 1573-7284
    Keywords: Gonorrhoea ; Epidemiology ; Seasonal variation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Seasonal variations in the incidence of gonorrhoea were observed in the 1970's with a peak in the third quarter of the year and a trough in the first and fourth quarters. The aim of this study was to determine what, if any, seasonal trends were present in Scotland and Lothian between 1984 and 1989 and postulate mechanisms to explain our observations. We observed a change in the previously reported pattern with regular peaks of infection in the first and third quarters of the year for Scotland but no regular trend in the Lothian region. The most likely explanation for the observed trends are changes in sexual behaviour related to summer vacations and seasonal work patterns but other unidentified factors probably also contribute.
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  • 42
    ISSN: 1573-7284
    Keywords: Murine typhus ; Greece ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cases of murine typhus were described in Chalkis, capital town of the island Evia in Greece. In the present work a prospective study on murine typhus was carried out in Chalkis General Hospital in 1985, is presented. During this year 49 cases, serologicaly confirmed using indirect fluorescence assay, were diagnosed. Signs and symptoms of the patients as well as preliminary epidemiological data are reported in this paper.
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  • 43
    ISSN: 1573-7284
    Keywords: Leishmania ; Leishmaniasis ; Dog ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined 444 dogs by visiting farms and peripheral districts on the Gargano promontory (Province of Foggia, Apulia, South Italy). Clinical examination and immunofluorescence antibody test for leishmaniasis were performed. Bone marrow and lymph node samples obtained from 25 dogs with positive serological test were cultured on Tobie-Evans medium. The results obtained show both a higher seropositivity rate for canine leishmaniasis (14.4%) and a higher percentage of asymptomatic dogs with positive serological test (53.1%) compared to previous research in the same area. Seven strains isolated from infected dogs belonged to Leishmania infantum species zymodeme Montpellier 1. None of 82 sera of humans living in close contact with infected dogs were positive for leishmaniasis.
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  • 44
    ISSN: 1573-7284
    Keywords: Epidemiology ; Tumour mortality ; Cluster analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper attempts to demonstrate the utility of cluster analysis as a descriptive method of studying mortality in epidemiology. In order to verify which algorithms of clustering best fit the data structure, the method of cophenetic correlation was implemented. Furthermore the probabilistic algorithm proposed by Beale was used to assess the partition. The results show the presence of some striking clusters between Local Sanitary Units of the Emilia Romagna Region for four types of tumour in men.
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  • 45
    ISSN: 1573-7284
    Keywords: Epidemiology ; Pneumocystosis ; Pneumocystis carinii pneumonia ; Taxonomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pneumocystis carinii is a widespread eukaryotic microorganism found in the lungs of healthy mammals, including humans. It is able to proliferate extensively in the alveoli, becoming an important agent of severe pneumonitis in immunosuppressed hosts, especially in persons suffering from AIDS. The taxonomic position of P. carinii is uncertain. Typical cytoplasmic organelles of eukaryotic cells have been found and described in the parasite. Biochemical research is hindered by the lack of an efficient in vitro culture system. Results of comparative study of nucleic acid sequences suggest that Pneumocystis is a fungus. However, ultrastructural, biochemical and nucleic acid homology insights appear as clearly insufficient to class Pneumocystis. Pneumocystis infection might be acquired, as deep mycoses, from environmental sources through the respiratory tract. Thus, the hypothesis of an environmental stage of the parasite must be considered. Pneumocystis might be seen as a widespread pathogenic dimorphous fungus. As fungal agents, P. carinii is able to disseminate from the infected lung to other organs. However, deep mycoses and pneumocystosis induce different histopathological changes in the host. Furthermore, deep fungal infections, unlike pneumocystosis, cannot be transmitted from one infested host to another one. Beside these two aspects, pneumocystosis shares many features with deep mycoses. Research on the epidemiology of pneumocystosis is needed.
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  • 46
    ISSN: 1432-0827
    Keywords: Epidemiology ; Vertebral fractures ; Morphology ; Prospective studies ; Fracture prevalence, incidence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary It has been proposed that vertebral dimensions be used to objectively identify vertebral fractures, permitting standardization of methodology for comparisons between studies. In this report, we evaluate the ability of various vertebral dimensions and ratios to identify “abnormal” vertebrae. As no “gold standard” exists for prevalent vertebral fractures, we examined the ability of cross-sectional dimensions (at a single point in time) to detect fractured vertebrae that had been identified from changes in dimensions compared with previous radiographs. Theoretically, a cutoff of 3 SD below the mean will rarely misclassify normal vertebrae as fractured (specificity=99.9%). However, we found that this cutoff correctly identified only about 70% of the incident fractures. A less stringent criterion (2 SD below the mean; theoretical specificity=97.7%) identified about 85–90% of true fractures. Dividing by stature or other vertebral heights sometimes yielded marginal improvements in the ability of the anterior or posterior height dimensions to diagnose fractures. The results suggest that the true fracture prevalence may sometimes be substantially higher than suggested by cross-sectional vertebral measurements.
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  • 47
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    Journal of mathematical biology 30 (1992), S. 473-491 
    ISSN: 1432-1416
    Keywords: Chaos ; Nonlinear coupled oscillators ; Epidemiology ; Dynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Mathematics
    Notes: Abstract It is now documented that childhood diseases such as measles, mumps, and chickenpox exhibit a wide range of recurrent behavior (periodic as well as chaotic) in large population centers in the first world. Mathematical models used in the past (such as the SEIR model with seasonal forcing) have been able to predict the onset of both periodic and chaotic sustained epidemics using parameters of childhood diseases. Although these models possess stable solutions which appear to have the correct frequency content, the corresponding outbreaks require extremely large populations to support the epidemic. This paper shows that by relaxing the assumption of uniformity in the supply of susceptibles, simple models predict stable long period oscillatory epidemics having small amplitude. Both coupled and single population models are considered.
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  • 48
    ISSN: 1432-1459
    Keywords: Epidemiology ; Hereditary ataxias ; Hereditary spastic paraplegias
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An epidemiological survey of hereditary ataxias and paraplegias was conducted in Molise, a region of Italy (335, 211 inhabitants on 1 January 1989). Total prevalence was 7.5 x 10−5 inhabitants (95% confidence limits 4.8–11.1). There were 7 patients with Friedreich's disease, 5 with early onset cerebellar ataxia with retained tendon reflexes, 4 with ataxia-telangiectasia, 9 with hereditary spastic paraplegias (2 autosomal dominant and 7 autosomal recessive cases). There was no patient with autosomal dominant cerebellar ataxia.
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  • 49
    ISSN: 1432-1335
    Keywords: Cancer ; Epidemiology ; Liver cirrhosis ; Alcohol ; Tobacco
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Eastern Austrian regional mortality patterns of oral cancer (oral cavity, pharynx and larynx) and oesophageal, lung and urinary bladder cancer were compared to smoker rates and to liver cirrhosis mortality by type of residence: Vienna (1.7×106 inhabitants), middle towns (50 000–100 000 and 10 000–50 000 inhabitants), small towns (2000–10 000 inhabitants) and rural areas categorized by agrarian quota ≦10%, 10%–20% and 〉20%. The study area (Vienna, Lower Austria and Burgenland) covers 23 600 km2 with 3.23×106 inhabitants. In men, liver cirrhosis correlated negatively with smoker rates (r=−0.74, P=0.1). Deaths from oral cancer and oesophageal cancer correlated significantly with deaths from liver cirrhosis (r=0.81, P=0.03; r=0.78, P=0.04, respectively) but not with smoker rates; lung cancer and bladder cancer correlated significantly with smoker rates (r=0.91, P=0.01; r0.83, P=0.04, respectively), but not with liver cirrhosis. In women, similar urban-rural gradients for all parameters resulted in a positive correlation between liver cirrhosis and smoker rates (r=0.59, P=0.22) and a significant correlation of lung cancer with liver cirrhosis (r=0.75, P=0.05). Oral cancer correlated significantly with liver cirrhosis (r=0.83, P=0.02), but not with smoker rates; lung cancer correlated more significantly with smoker rates (r=0.92, P=0.01) than with liver cirrhosis; bladder cancer correlated positively with smoker rates (r=0.70, P=0.12). Geographical distribution of oral and oesophageal cancer in Eastern Austria seems thus to be highly subject to the prevalence of heavy drinking. Sociocultural influences upon the occurrence of these cancers seem to be mediated through drinking habits rather than through smoking habits alone.
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  • 50
    ISSN: 1432-1440
    Keywords: Pulmonary blastoma ; Malignant lung tumours ; Epidemiology ; Histogenesis ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A 57-year-old man was found to have a tumour in the right lower lobe of the lungs, which was not classifiable by biopsy. The tumour could only be partially removed by surgical resection. The diagnosis of a pulmonary blastoma was made from the resected tissue. Clinically, rapid progress occured with invasion in the mediastinal space and the epigastrium. In spite of radiation therapy, the patient died about 21/2 months after surgery of respiratory insufficiency. Autopsy confirmed a pulmonary blastoma with extensive infiltration of the mediastinal space and upper abdomen as well as metastases in the regional lymph nodes, pleura, peritoneum, thyroid gland, heart and central nervous system. The present report of a pulmonary blastoma should draw attention to this extremely rare tumour. It should be included in the differential diagnosis, because the survival time can be increased if the correct diagnosis is made very early.
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  • 51
    ISSN: 1432-1939
    Keywords: Fecundity ; Survival ; Demography ; Rust fungus ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Summary The epidemiology of rust caused by the fungus Melampsora lini and the effects of infection by this pathogen on its host, the herbaceous perennial Linum marginale, were determined in the field and in garden experiments. There was considerable natural variability in disease levels over the four years (1986–1989) of the study. In two years (1986, 1989) major rust epidemics occurred. In the field, the main effect of disease was to reduce survivorship during the winter following infection. Plants which were heavily infected during the 1986 or 1989 growing seasons had reduced survivorship relative to more lightly infected plants. Melampsora lini infections did not appear to affect survivorship in either 1987 or 1988. Flowering was correlated with environmental factors and the number of stems a plant possessed. A severe drought in 1987 completely inhibited flowering. In the other three years the number of flowers produced by a plant was strongly positively correlated with the number of stems it possessed. Disease levels had no consistent effect on flowering. Controlled garden experiments were also used to examine the response of seedlings and adult plants to infection. These showed that both the timing and severity of disease appears to determine the effect of M. lini infections on L. marginale. Early, severe infection reduced growing season and overwintering survivorship as well as capsule production. However, plants in the field were most often infected only after flowering had begun, and the predominant effect of infection was a reduction in overwintering survivorship. The high variability in disease levels from year to year and the deferred nature of the effect of the rust on its host have significant implications for the design of experiments aimed at assessing the role of diseases in plant communities.
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  • 52
    ISSN: 1432-1971
    Keywords: Cardiomyopathy ; Syndromes ; Metabolic disorders ; Epidemiology ; Congenital heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cardiomyopathy (Cm), a rare form of cardiac disease in infancy, is receiving increasing attention stimulated by the availability of endocardial biopsy and new forms of therapy. Population-based information on frequency of occurrence, types, and maternal and infant characteristics of this diverse group of heart muscle disorders has been obtained in the course of an etiologic study on cardiovascular disease in infancy. The Baltimore-Washington Infant Study (BWIS) enrolled 2659 infants with heart disease and 2801 control infants between January 1, 1981 and March 31, 1987, a 6-year prevalence of 4.46/1000 live births. Fifty-six infants had cardiomyopathy, in the absence of a structural defect (prevalence 1/10,000). The cases were classified clinicopathologically as follows: dilated Cm (n=17), hypertrophic Cm (n=26), tumor (n=5), endocardial fibroelastosis (n=5), glycogen storage (n=1), mucocutaneous lymph node syndrome (n=1), and infarction (n=1). Eleven syndromic associations and six metabolic disturbances indicate genetic risk factors. Some of the same syndromes occurred in other infants who had structural cardiac abnormalities. This overlap suggests that embryonic myocardial disease might sometimes be responsible for altered cardiac structures, possibly secondary to hemodynamic changes. Familial myocardial disease occurred in two infants with hypertrophic Cm. The Cm group did not differ by race and sex from controls, but the mothers were of lower educational and occupational status with less private care and with later registration for pregnancy care. The descriptive epidemiology of this population-based case group provides evidence of greater etiologic heterogeneity than has been shown in clinical reports.
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  • 53
    Electronic Resource
    Electronic Resource
    Springer
    Psychopharmacology 106 (1992), S. S71 
    ISSN: 1432-2072
    Keywords: Epidemiology ; Major depression ; Dysthymia ; Recurrent brief depression ; Bipolar disorder ; Hypomania
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Review of the published literature produces 1-year prevalence rates for major depressive disorder DSM-III between 2.6 and 6.2%, for dysthymia between 2.3 and 3.7%, bipolar disorder 1.0–1.7%. Data from the prospective Zurich Study with four interviews over 10 years give relatively high 10-year prevalence rates for subjects from age 20 to 30 (14.4% major depression, 10.5% recurrent brief depression, 0.9% dysthymia, 3.3% bipolar disorder, 1.3% hypomania). On average, 49% of all these cases received treatment for affective disorder, resulting in a weighted treatment prevalence rate of the population of 11.6% (18% for females and 5% for males). It has to be assumed that lifetime prevalence rates based on recall may greatly underestimate true morbidity.
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  • 54
    ISSN: 1432-198X
    Keywords: Haemorrhagic fever ; Renal syndrome ; Epidemiology ; Hantaviruses ; Bunyaviridae ; Acute renal dysfunction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Haemorrhagic fever with renal syndrome (HFRS) is characterized by fever, headache, abdominal pain, renal dysfunction and various haemorrhagic manifestations. The viruses causing HFRS all belong to theHantavirus genus in theBunyaviridae family. At least three of the different hantaviruses are associated with human disease: Hantaan, Seoul, and Puumala viruses. HFRS is endemic in a belt from Norway in the west, through Sweden, Finland, the Soviet Union, China, Korea to Japan in the east. The clinical severity of HFRS varies throughout this belt. A severe form with haemorrhagic manifestations and significant lethality (Korean haemorrhagic fever — caused by Hantaan and Seoul virus) occurs in Asia, while a milder form (nephropathia epidemica caused by Puumala virus) with less haemorrhagic manifestations and no or low lethality is found in Europe. All hantaviruses are spread by rodents where the major route of transmission to man is via aerosol from rodent urine, saliva and faeces. Although HFRS occurs with the same clinical picture in children as in adults both incidence rates and antibody prevalence rates are very low in children under 10 years. Men of working age make up the bulk of clinical cases.
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  • 55
    ISSN: 1530-0358
    Keywords: Colorectal cancer ; Gallstones ; Cholecystectomy ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The prevalence of gallstone disease in 145 consecutive patients with colorectal cancer was compared with gallstone prevalence in 4,159 subjects randomly selected from a population. The group of patients had a significantly higher prevalence of gallstone disease than the population (odds ratio=1.59,95 percent confidence limits 1.04–2.45), whereas cholecystectomies occurred with equal frequency in the two groups. There was a nonsignificant trend toward more right-sided cancers in patients with gallstones than in patients without. These results, together with available literature, give substantial evidence for an association between gallstones and colorectal cancer, an association which is not due to cholecystectomy being a predisposing factor to colorectal cancer. Sporadic findings of an association between cholecystectomy and colorectal cancer can be explained by the above relationship.
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  • 56
    ISSN: 1437-160X
    Keywords: Epidemiology ; Rheumatic disease ; Shoulder nodules
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary During a community survery of rheumatic complaints in a Javanese rural population, fibrous shoulder girdle nodules having a consistent form and position were observed in seven men. This was 2.3% of 303 men with complaints examined from a total population of 2184 men surveyed by house-to-house interviews (response rate 95.2%). Nodules were not seen in any of the 640 women examined with complaints from a total population of 2499, nor were they seen in 130 men and 159 women with complaints from an urban population of 481 men and 590 women over the age of 15 years. It was considered most likely that these shoulder nodules were the result of longstanding repetitive mechanical irritation due to carrying heavy loads by a resiliant wooden pole balanced across the shoulder.
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