Advances on associations of exposure to air pollutants during pregnancy with congenital heart disease in offspring / 环境与职业医学

Congenital heart disease (CHD) is the most common birth defect and one of the major causes of neonatal death, with an average prevalence of 9.4‰ worldwide. We reviewed recent epidemiological studies and found that exposure to air pollutants is associated with increased CHD risks, but the associations are inconsistent between exposure to air pollutants and different subtypes of CHD due to developmental and etiological heterogeneity among different subtypes of CHD. It has been reported that air pollutants are associated with increased risks of ventricular septal defect, patent ductus arteriosus, pulmonary stenosis, tetralogy of Fallot, and transposition of the great arteries. However, associations between maternal exposure to air pollutants and atrial septal defect (ASD) are contradictory, with significantly positive associations of inhalable particulate matter and nitrogen dioxide exposure, negative associations of fine particulate matter and carbon monoxide, and mixed associations of sulfur dioxide. Adverse effects of air pollutant on cardiac development cover a wide time window beyond 3-8 weeks during gestation; particulate matter and nitrogen oxide are more likely to affect fetal heart in early pregnancy, while the association strength of carbon monoxide shows a trough in early pregnancy, and sulfur dioxide and ozone affect cardiac health throughout pregnancy. In addition, we discussed the limitations of previous studies on the associations between maternal air pollutant exposure and CHD, and highlighted the application of precise assessment on exposure to air pollutants, the performance of prospective cohort studies and longitudinal studies, and the necessity of studies on CHD subtypes, in order to provide scientific evidence to control exposure to environmental pollutants and CHD occurrence.

Mortalidad de pacientes hospitalizados por infección por SARS-CoV-2 en México. Análisis de una base de datos nacional a dos años de pandemia / Mortality of patients hospitalized for SARS-CoV-2 infection in Mexico. Analysis of a national database after two years of pandemic

Resumen Introducción: La infección por SARS-CoV-2 en la mayoría de los casos tiene un curso leve, aunque la insuficiencia respiratoria aguda se asocia a mayor mortalidad. Objetivo: Determinar la mortalidad global en pacientes con COVID-19 hospitalizados o en una unidad de cuidados intensivos (UCI). Métodos: Análisis inferencial a partir de una base de datos del periodo enero de 2020-diciembre de 2021, de la Dirección General de Epidemiología de México. Se incluyeron pacientes hospitalizados positivos a SARS-CoV-2. Se describieron las características generales y se realizó un modelo de regresión binaria para determinar las asociaciones con la mortalidad. Resultados: Se identificaron 116 446 pacientes que requirieron ingreso hospitalario. La mortalidad global fue de 44 %, la intrahospitalaria de 33 % y en la UCI de 33 %. La mortalidad de pacientes con ventilación mecánica e ingreso hospitalario fue de 87 % y en la UCI de 75 %. En el sector público predominaron los ingresos al Instituto Mexicano del Seguro Social y a la Secretaría de Salud, cada uno con RM = 2.24 (p = 0.004) y RM = 2.55 (p = 0.001) para mortalidad. Conclusión: La mortalidad fue mayor en el sector público y pudo deberse a la saturación de los servicios, lo que condicionó escasez de recursos.

Abstract Introduction: SARS-CoV-2 infection has in, most cases, a mild course, although acute respiratory distress syndrome is associated with higher mortality. Objective: To determine overall mortality in hospitalized or intensive care unit (ICU)-admitted COVID-19 patients. Methods: Inferential analysis from a database of the General Directorate of Epidemiology of Mexico. SARS-CoV-2-positive patients, hospitalized within the January 2020-December 2021 period, were included. General characteristics were described and a binary regression model was created to determine associations with mortality. Results: 116,446 patients who required hospital admission were identified. Overall mortality was 44%; in-hospital mortality, 33%; and ICU mortality, 33%. Mortality of patients with mechanical ventilation and hospital admission was 87%, and with ICU admission, 75%. In the public sector, hospital admissions at the Mexican Institute of Social Security and the Ministry of Health predominated, with OR = 2.24 (p = 0.004) and OR = 2.55 (p = 0.001), respectively, for mortality. Conclusion: Mortality was higher in the public sector, and this could be due to the overcrowding of services, which determined a scarcity of resources.

Seroprevalence of SARS Cov 2 Immunoglobulin among First Year Medical Students in a Tertiary Care Hospital of Odisha: A Cross-Sectional Study

Introduction: COVID-19 caused by SARS coronavirus two has halted life across the globe since its emergence in December 2019. Most of the infected persons are asymptomatic or have mild symptoms. Serosurvey is vital for the estimation of the burden of infection. In this context, our study objective is to estimate the Seroprevalence of SARS CoV 2 IgG among the first-year medical students after the first wave in February 2021. Method: A cross-sectional study was conducted among the first-year medical students of Veer Surendra Sai Institute of Medical Sciences and Research. All the students were enrolled, and their data & serum sample was collected. Serum samples were tested for the presence of Anti-Spike IgG. Data were analyzed by using appropriate statistical tests. Results: The Seroprevalence of anti-SARS CoV 2 IgG was estimated to be 38.8 %. Most (82 %) of the students used the mask per recommendation. Use of mask, BMI, Contact history with COVID-19 patient, attending social gathering & previous COVID-19 were associated with Seropositivity. Regular mask use, BMI, and Previous COVID-19 were significant predictors for Seropositivity. Conclusion: The Seroprevalence of SARS Cov 2 after the first wave of the pandemic is less than 40 %. It calls for the proper implementation of a vaccination program with strict vigilance and surveillance to stop subsequent waves

Association between asthma and sleep hours in Brazilian adolescents: ERICA

Abstract Objective To investigate the association between asthma and sleep duration in participants of the Study of Cardiovascular Risks in Adolescents. Materials and methods Cross-sectional, national, school-based study, involving adolescents aged 12-17 years. In the period between 2013−14, data from 59,442 participants were analyzed. Bivariate analysis between current asthma and short sleep duration, defined as < 7 h/night, was performed separately with the other variables analyzed: sex, age group, type of school, weight categories, and common mental disorders. Then, different generalized linear models with Poisson family and logarithmic link functions were used to assess the independence of potential confounding covariates associated with both asthma and short sleep duration in the previous analysis. Crude and adjusted prevalence ratios and respective 95% confidence intervals were calculated, and a value of p < 0.05 was considered significant for all analyses performed. Results Prevalence of current asthma was 13.4%, being significantly higher among students with short sleep duration (PR: 1.17; 95% CI: 1.01-1.35; p = 0.034). This remained significant even after adjusting for the other study covariates. Conclusion There was a positive association between the prevalence of current asthma and short sleep duration among Brazilian adolescents. Considering the high prevalence and morbidity of the disease in this age group, the promotion of sleep hygiene should be considered as a possible health strategy aimed at contributing to better control of asthma in this population.

Types of randomized clinical trials published in PubMed over 40 years / Tipos de ensayos clínicos con asignación aleatoria publicados en PubMed durante 40 años

Abstract Introduction: there are several variations of randomized clinical trials. Trials can be classi fied by design as parallel, cross-over, factorial, assignment by group, n-of-1, paired, withdrawal, adaptive and pragmatic; and by purpose as superiority, non-inferiority and equivalence. Given this heterogeneity, the Consolidated Standards of Reporting Trials (CONSORT) were introduced in 1996 to provide a guideline for reporting randomized clinical trials. Objective: to describe the publication tendency of the various types of randomized clinical trials over 40 years, with reference to the publication of CONSORT and its extensions. Methods: the PubMed tool was used to search for randomized clinical trials published between 1979 and 2018, classifying them according to the varieties described. Results: a total of 472,114 published articles were found; 90.2% did not report the type of design and 98.2% did not report the purpose. Among the articles that reported the variety of randomized clinical trial, the predominant design was cross-over (5.9%), followed by parallel groups (2.34%); while the most common purpose was superiority (0.84%). After the launch of CONSORT, there was an increased proportion of articles published with the following designs: parallel groups; difference in proportions 1.89 95% CI (1.1-2.7); paired 1.07 95% CI (0.2-1.9); and pragmatic 4.73 95% CI (4.4-5.1); and for the purpose of non-inferiority 5.97 95% CI (5.6-6.3). Discussion: most articles on randomized clinical trials do not mention their type in the title and abstract. The proportion of articles that did, increased slightly after CONSORT was published. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.1884).

Resumen Introducción: existen múltiples variantes del ensayo clínico aleatorizado; según diseño: grupos paralelos, cruzado, factorial, asignación por grupos, N de 1, pareado, retiro, adaptativo y pragmático; y por propósito: superioridad, no inferioridad y equivalencia. Debido a esta heterogeneidad, en 1996 se introdujo el CONSORT (Consolidated Standards of Reporting Trials) para suministrar una guía para el reporte de los ensayos clínicos aleatorizados. Objetivo: describir la tendencia de publicación de los tipos de ensayos clínicos aleatorizados durante 40 años, en relación con la publicación del CONSORT y sus extensiones. Métodos: se utilizó la herramienta PubMed para realizar una búsqueda de ensayos clínicos aleatorizados publicados entre 1979 y 2018, discriminándolos según las variantes descritas. Resultados: se encontraron 472 114 artículos publicados, el 90.2% no reportó tipo de diseño y 98.2% no reportó propósito. Entre los artículos que reportaron la variante de ensayos clínicos aleatorizados, el diseño predominante fue el cruzado (5.9%), seguido por grupos paralelos (2.34%); mientras que el propósito más frecuente fue el de superioridad (0.84%). Hubo un aumento en la proporción de artículos por variante publicados después del lanzamiento del CONSORT para los diseños de: grupos paralelos; diferencia de proporciones 1.89 IC 95% (1.1-2.7); pareado 1.07 IC 95% (0.2-1.9); pragmático 4.73 IC 95% (4.4-5.1); y para el propósito de no inferioridad 5.97 IC 95% (5.6-6.3). Discusión: la mayoría de los artículos sobre ensayos clínicos aleatorizados no mencionan en su título y resumen la variante de estos. La proporción de artículos que sí lo hicieron, aumentó discre tamente después de la publicación del CONSORT. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.1884).

Research progress on the relationship between ultra-processed foods intake and metabolic syndrome / 公共卫生与预防医学

Objective To analyze the epidemiological evidence on the relationship between ultra-processed foods intake and metabolic syndrome. Methods CNKI, Wanfang database, PubMed and Web of Science Core Collection database were searched to obtain literature, as of June 10, 2020, about ultra-processed foods intake and metabolic syndrome. The relevant literature was reviewed and analyzed. Results A total of 4 epidemiological studies about the relationship between ultra-processed foods intake and metabolic syndrome were found, of which three studies suggested a positive correlation, and one study suggested no correlation. Conclusion There may be a positive correlation between ultra-processed foods intake and metabolic syndrome, but the research results available are still controversial. Further research is needed to explore the relationship between ultra-processed foods intake and metabolic syndrome.

The Effects of Corona Virus (COVID-19) Outbreak on the Individuals’ Mental Health and on the Decision Makers: A Comparative Epidemiological Study

Background: The results of epidemiological studies help in developing protective and treatment plans for community members, and identifying the psychological support services that individuals need to reduce the negative effects of these stressful conditions. Therefore, this study aimed to detect the effect of the outbreak of the deadly COVID-19 on the mental health of individuals. A survey descriptive design was used in this study to detect the level of psychological problems and to determine the differences in psychological problems due to nationality, age, sex, social status, learning level, and income. Method: A random sample consists of 5611(3423 Egyptians and 2188 Saudis) participants was chosen, their ages ranged between (16 to more than 50) year. The study sample was divided into sub-groups according to nationality, age, sex, social status, learning level, income level. The researchers in this study prepared psychological problems symptoms inventory that has been applied online to the sample. Results: The findings indicated that the increased prevalence of COVID -19 has a negative effect on the mental health of individuals, as the level of psychological problems were increased, and the results also found differences in the prevalence of psychological problems symptoms due to demographic variables. Conclusion: The study results emphasized the importance of prevention and treatment of psychological problems symptoms caused by the outbreak of the deadly COVID-19. As well as, these findings stressed on the role of counseling and therapy via the internet as well as, cross-cultural counseling and treatment.

Epidemiological Study of Road Traffic Accident Cases Attending Tertiary Care Hospital of Kashmir: A Cross Sectional Study

Background:Road Traffic Accidents (RTAs) are an important cause of mortality and morbidity worldwideand are highly on rise. Its socioeconomic repercussions are a matter of great concern. In order to control the losses created due to RTA, it is important to study its causative factors.Aim and Objectives:To study the various epidemiological factors related to road traffic accident cases.Methodology:It was a Cross-sectional study that was conducted in two tertiary care hospitals of Kashmir (Government Hospital for Bone and Joint surgery, Barzulla and SMHS Hospital, Srinagar) from Oct 2018 to Nov 2018. Study participants were RTA patients coming to the Emergency of these two hospitals. A pretested semi-structured interview schedule was used to collect necessary information regarding the accident.Results:RTAs affected mainly the people of productive age group (20-40 years) which were predominantly male. Approximately 1/6thof the victims were illiterate and 2/5th of the victims were unemployed. Most of the accidents occurred on Saturdays (26%) and Sundays (22.5%) while less number of accidents wasreported on Tuesdays (5.0%) and Wednesdays (5.0%). Most of the accidents (39%) occurred between 16:01 to 20:00 hours. Use of Safety measures (helmet/seatbelt) was reported by only 24% of the cases. Two wheeler drivers were more (61.5%) involved in accidents (61.5%). Weather condition at the time of accident in majority of the cases (53.5%) was found to be sunny.Conclusion:Most of the factors that are responsible for RTA and its multiple consequences are preventable. A comprehensive programme can reduce the prevalence of RTA to a great degree

A six years prospective epidemiological study of acute encephalitis syndrome among children admitted in a rural tertiary care center

Background: Acute Encephalitis Syndrome (AES) is a major public health issue in India. The common etiologies of AES in India are various infectious agents. There are seasonal and regional variations in etiologies making diagnosis and effective intervention often difficult. Our study represents the epidemiological data that will help in planning management in larger perspective.Methods: This is a six years prospective observational study conducted in the Department of Pediatrics, North Bengal Medical College Hospital, Darjeeling from January 1st, 2013 to December 31st, 2018. In this study all clinically diagnosed AES cases were included fulfilling inclusion and exclusion criterion.Results: 585 out of 39420 patients (1.48%) were diagnosed clinically as AES over six years. Male patients (372) contributing to 63.6% and female patients (213) 36.4% of the study. Majority cases (271) were seen in the age group of 1-5 years amounting to 46.3% with mean age 5.1'3.6 years. In July 2014 number of cases were maximum 59 (10%) followed by May 2013 20 (3.4%). Among the 585 AES cases, 263 (45%) were suspected for viral etiology (JE= 84, 14.3%). Total 457 cases (78.1%) were alive with insignificant to age and gender variance. Vaccination status revealed 11 among 15 JE deaths were unimmunized which is statistically significant (p < 0.05) by Chi-square test.Conclusions: The magnitude and etiologies of AES need to be explored and understood in various geographic regions and in different seasons to have a better insight for development of future policies to reduce the burden.

Factores pronósticos de recidiva en mujeres con cáncer de mama. Hospital "José Ramón López Tabranes". Matanzas. 2010-2015 / Recurrence prognostic factors in women with breast cancer. Hospital "Jose Ramon Lopez Tabrane". Province of Matanzas. 2010-2015

RESUMEN Introducción: la neoplasia de mama, constituye la segunda causa de mortalidad por cáncer en la mujer cubana. El conocimiento de los factores pronósticos de recaída es determinante para la toma de decisiones en el tratamiento. Objetivo: identificar los factores pronósticos de recidiva por cáncer de mama. Materiales y métodos: Se realizó un estudio observacional, analítico, retrospectivo. Participaron 264 mujeres diagnosticadas con cáncer de mama en la consulta de mastología del Hospital "José Ramón López Tabranes", de la provincia Matanzas, desde el 1 de enero del 2010 hasta el 31 de diciembre del 2015. Se utilizó el método de Kaplan Meier para determinar el tiempo libre de enfermedad, estratificado por las variables seleccionadas y un análisis bivariado para estimar la relación entre la recaída y cada una de las variables. Los datos fueron cruzados en tablas de contingencia y se calculó el riesgo relativo y los intervalos de confianza del 95 %. Se utilizó el test Chi cuadrado. El efecto independiente de las variables seleccionadas en la recaída se verificó mediante el análisis multivariado de regresión de Cox. Resultados: durante el seguimiento, 64 pacientes presentaron recaída, para una incidencia acumulada de 24,2 %. El análisis multivariado demostró peor pronóstico en aquellas mujeres con infiltración de ganglios linfáticos axilares (RR=5.65; IC: 2.21-14.44) y grado histológico III (RR=3.44; IC 1.98-5.97). Conclusiones: se identificaron como factores pronósticos de recaída: el estatus ganglionar positivo y el grado histológico III. El conocimiento de estos factores repercute directamente en la supervivencia, y es decisivo para individualizar el tratamiento.

ABSTRACT Introduction: breast neoplasm is the second cause of mortality in Cuban women. The knowledge of the recurrence prognostic factors is crucial for the treatment decision taking. Objective: to determine the recurrence prognostic factors due to breast cancer in this series. Material and methods: a retrospective, analytic, observational, cohort study was carried out; participated 264 women diagnosed with breast cancer in the mastology consultation of the hospital "Jose Ramon Lopez Tabrane", province of Matanzas, from January 1st 2010 to December 31st 2015. The Kaplan-Meier method was used to determine disease-free time, stratified according to the chosen variables, and a bi-variate analysis to estimate the relation between recurrence and each of these variables. Data were crossed in contingency tables and the relative risk (RR) and their confidence intervals (CI) of 95 % were calculated for each of them. The Chi squared test was used to find the significant statistic association. The independent effect of the chosen variables in the recurrence was verified by means of the Cox regression multivariate analysis. Results: during the follow up, 64 patients had recurrence for an accumulated incidence of 24.2 %. The multivariate analysis by means of the Cox proportional risk model showed the worst prognosis in women with infiltration of the axillary lymph nodes (RR=5.65; CI: 2.21-14.44) and histological grade III (RR=3.44; CI 1.98-5.97). Conclusions: the positive gangliar status and histological grade III were identified as recurrence risk factors. Knowing these factors directly affects survival and is decisive to individualize the treatment.

Estudo epidemiológico de biópsias realizadas em uma clínica odontológica universitária no período entre 2011 e 2018 / Epidemiological survey of biopsies performed in a dental school clinic in the period from 2011 to 2018

A grande quantidade de patologias com características clínicas semelhantes possibilita a coexistência de vários diagnósticos diferenciais frente a uma única lesão na mucosa bucal. Muitas vezes a realização de exames complementares, como a biópsia, torna-se mandatória para confirmação do diagnóstico sugestivo. Realizar levantamento dos laudos histopatológicos provenientes de biópsias executadas em uma clínica-escola odontológica no período entre 2011 e 2018. A partir dos prontuários odontológicos, as informações foram coletadas e tabuladas. Foram determinadas a frequência de cada lesão em relação ao total e ao seu próprio grupo de doenças e as características dos indivíduos. Um total de 106 diagnósticos de 105 pacientes (idade média 47,5 anos), sendo a maioria do sexo feminino (68 indivíduos - 64,8%) e leucoderma (67 indivíduos - 63,8%), foram avaliados. Em relação aos grupos de doenças, o mais representativo foi o das neoplasias benignas epiteliais ou mesenquimais (35 casos - 33%), seguido pelo dos processos proliferativos não neoplásicos (30 casos - 28,3%). Quanto aos diagnósticos, foram observados 25 diferentes, nos quais se destacaram o fibroma (30 casos - 28,3%) e a hiperplasia fibrosa inflamatória (22 casos - 20,8%). Não foi constatada nenhuma patologia maligna. Traçar o perfil epidemiológico de certo grupo de indivíduos pode muitas vezes facilitar os diagnósticos, além de auxiliar na implementação de medidas de prevenção e na orientação dos assuntos a serem abordados nos cursos das instituições de ensino superior(AU)

A large number of pathologies with similar clinical features may allow coexistence of several differential diagnoses in a single lesion on the buccal mucosa. According to the clinical picture, complementary exams such as biopsy are often mandatory to confirm the suggestive diagnosis. To carry out a survey of histopathological diagnoses from biopsies performed in a dental school clinic in the period from 2011 to 2018. Information from dental records was gathered and tabulated. The frequency of each lesion was determined in relation to the total and its own group of diseases as well as the epidemiological characteristics of the individuals. A total of 106 diagnoses from 105 patients (mean age 47.5 years) were evaluated, being the majority of them female (68 individuals - 64.8%) and white (67 individuals - 63.8%). In relation to the groups of diseases, epithelial or mesenchymal benign neoplasms (35 cases - 33%) were the most representative, followed by nonneoplastic proliferative processes (30 cases - 28.3%). Regarding the diagnoses, 25 different ones were observed, in which fibroma (30 cases - 28.3%) and inflammatory fibrous hyperplasia (22 cases - 20.8%) were more prevalent. No malignant pathology was found. To describe the epidemiological profile of a population can often facilitate diagnoses, besides assisting in the implementation of preventive measures and in the definition of graduate and post-graduate courses' scope(AU)

Clinicoepidemiological Study of Childhood Vitiligo

Introduction: Vitiligo is a cosmetically disfiguring,psychologically devastating disease and is resistant to therapy.Vitiligo in childhood can be associated with significantemotional trauma that may have long‑lasting effects on thepsychosocial development of these children and self esteem.Childhood vitiligo has different epidemiological, clinical,therapeutic, and prognostic profile. This study was carried outto assess the clinical and epidemiological characteristics ofvitiligo in pediatric patients.Material and methods: It was a prospective, observationalstudy carried out over a period of 1 year. All patients youngerthan 18 years of age with vitiligo attending the Dermatologyop of Osmania General hospital, hyderabad between April2017 and March 2018 were included in the study.Results: The most common pattern of vitiligo wasvulgaris (48%) followed by focal (34%), mucosal (8%)acro‑facial(6%), segmental (4%). Lower limb was the mostcommon site for vitiligo seen in 56 patients (56%), followedby face (21%), upper limbs (10%), mucosal (8%) and scalp(5%). No patients had universal presentation. 27 patients(27%) had Leukotrichia whereas Koebner’s phenomenon waspositive in 24 patients (24%).Conclusion: Childhood vitiligo is common depigmentingdisorder encountered frequently in females probably dueto higher concern about the disfiguring nature of disease infemales, with a mean age of onset being around 6.3 years.Vitiligo vulgaris was the most common pattern of presentation,followed by the focal type of vitiligo while the universalpattern was rare in childhood. Lower limbs were the mostcommon site of involvement followed by face. Patients withfamily history tend to present at an early age

Factores epidemiológicos relacionados con el cáncer de mama. Hospital "José Ramón López Tabrane". Provincia Matanzas. 2010-2015 / Epidemiological factors related to breast cancer. Hospital ¨José Ramón López Tabrane¨. Province of Matanzas. 2010-2015

RESUMEN Introducción: el cáncer de mama constituye la segunda causa de mortalidad por cáncer en la mujer cubana, solo superado en el último trienio por las neoplasias de tráquea, bronquios y pulmones. Objetivo: describir algunas características epidemiológicas relacionadas con esta enfermedad. Materiales y métodos: se realizó un estudio epidemiológico observacional descriptivo y retrospectivo, en mujeres diagnosticadas con neoplasia de mama, en la consulta de mastología del hospital provincial "José Ramón López Tabranes" de la provincia de Matanzas, en el período comprendido entre el 1 de Enero del 2010 y el 31 de Diciembre del 2015. La muestra estuvo constituida por 288 mujeres y para el análisis de los datos se utilizaron frecuencias absolutas y porcientos. Resultados: predominaron las pacientes entre los 40 y 69 años (71.2 %), de color de piel blanca (65.6%) y sin antecedentes patológicos familiares de cáncer mamario (86.1%). Las variables clínico-patológicas estuvieron caracterizadas por un predominio de pacientes en estadio II (62.2 %), con estatus postmenopáusico al momento del diagnóstico (56.9 %) y con un tamaño del tumor entre 2 y 5 cm (77.4 %). El tipo histológico más frecuente fue el carcinoma ductal infiltrante, presentándose en el 85.7 % de la serie y en el 43.6 % de las enfermas se diagnosticó el tumor con grado histológico II. Es de señalar que el 61.1 % de las mujeres del estudio tenían afectación ganglionar al momento del diagnóstico. Conclusiones: se describen los principales factores sociodemográficos y clínico-patológicos, relacionados con esta enfermedad en el territorio, permitiendo realizar un cierre de campo para la ejecución de futuras investigaciones causales.

ABSTRACT Introduction: breast cancer is the second cause of mortality in Cuban women, exceeded in the last three years only by tracheal, bronchial and lung neoplasms. Objective: to describe several epidemiological characteristics related to this disease. Material and method: a retrospective, observational-descriptive epidemiological study was carried out in women diagnosed with breast neoplasm in the Mastology consultation of the provincial hospital ¨Jose Ramon Lopez Tabrane¨, of Matanzas, in the period from January 1st 2010 to December 31st 2015. The sample was formed by 288 women, and for data analyses were used absolute frequencies and percents. Results: there was a predominance of white patients (65.6 %), aged 40-69 years (71.2 %), and without familiar antecedents of breast cancer (86.1 %). The clinical-pathological variables were characterized by the predominance of stage II patients (62.2 %), with menopausal status at the moment they were diagnosed (56.9 %), and with a tumor sized 2-5 cm (77.4 %). The most frequent histological kind was the duct infiltrative carcinoma that was present in 85.7 % of the series; histological grade II tumor was diagnosed in 43.6 % of the patients. it is important to say that 61.1 % of the studied women showed gangliar affectation at the moment of the diagnosis. Conclusions: the main socio-demographic and clinic-pathological factors related to this disease are described, allowing a closing to carry out future causal research.

An Epidemiological Study Of 104 Cases Of Papulosquamous Disorders In South India

BACKGROUND: Papulosquamous disorder is heterogeneous group of diseases characterised by scaly papules and plaques. AIM OFTHE STUDY:To observe the recent trends in age and sex distribution ,co-morbidities and associated nail changes in a sample of patients with Papulosquamous disorders. MATERIALS AND METHODS:In a Tertiary care centre in Tamilnadu , 104 patients with Papulosquamous disorders were selected over a period of one year and studied clinically with special attention to nail changes. RESULTS: The male: female ratio was 1.2:1. Age group commonly affected was 31-45 years. Psoriasis was most common followed by Lichen planus and Pityriasis rubra pilaris. Pityriasis Lichenoides chronica and parapsoriasis were least common. 61.5% of the total patients had nail changes with nail pitting being the most common change. The common co-morbidities observed were diabetes mellitus, hypertension and atopy. . CONCLUSION: More detailed studies are required for effective management of this subset of skin disorders.

Relationship between dentition, anthropometric measurements, and metabolic syndrome in the elderly / Relação entre dentição, medidas antropométricas e síndrome metabólica em idosos

Abstract Introduction Tooth loss is a health disorder of the elderly population that may lead to masticatory deficiency and nutritional risks, inducing the biochemical changes of metabolic syndrome (MS). Objective To verify the relationship among number of teeth, anthropometric measurements, and MS in a group of elderly people. Material and method The study was developed in Porto Alegre, RS, Brazil, and it was divided into three phases. The first phase collected information from the database of all project participants and the second one collected sociodemographic, anthropometric, and biochemical data. The third phase was divided into two other phases: first, oral health interviews were applied to the elderly (281 patients evaluated by telephone and 23 visited at home) and second, 45 patients were randomly selected and invited to validate the data obtained by telephone with oral clinical examinations performed by a trained dental surgeon. The sample consisted of 304 individuals. The data collected were tabulated and analyzed using statistical tests. Result Elderly women with severe tooth loss present a significantly higher risk of developing MS. Thus, the maintenance of natural teeth in the elderly is a protective factor for the syndrome. Conclusion The findings support the hypothesis that the oral health of individuals, expressed by the number of teeth, may compromise and increase the risk of MS in the elderly.

Resumo Introdução A perda dentária é um distúrbio de saúde dos idosos que pode levar à deficiência mastigatória e riscos nutricionais, induzindo alterações bioquímicas da síndrome metabólica (SM). Objetivo Verificar a relação entre número de dentes, medidas antropométricas e SM em um grupo de idosos. Material e método O estudo foi desenvolvido na cidade de Porto Alegre, RS, Brasil, e foi dividido em três fases. A primeira fase coletou informações do banco de dados de todos os participantes do projeto e a segunda coletou dados sociodemográficos, antropométricos e bioquímicos. A terceira fase foi dividida em duas outras fases: primeiro foram aplicadas entrevistas de saúde bucal aos idosos (281 pacientes avaliados por ligações telefônicas e 23 atendidos em domicílio) e, segundo, 45 pacientes foram selecionados aleatoriamente e convidados a validar os dados obtidos por telefone com exames clínicos orais. A amostra foi composta por 304 indivíduos. Os dados coletados foram tabulados e analisados ​​por meio de testes estatísticos. Resultado Mulheres idosas com perda dentária severa apresentam um risco significativamente maior de desenvolver SM. Assim, a manutenção dos dentes naturais nos idosos é um fator protetor para a síndrome. Conclusão Os achados reforçam a hipótese de que a saúde bucal dos indivíduos, expressa pelo número de dentes, pode comprometer e aumentar o risco de SM em idosos.

Analysis of distribution characteristics and related risk factors of patients with hyperglycemia in non-endocrine departments / 中华内分泌外科杂志

Objective@#To retrospectively analyze the detection rate, distribution characteristics of hyperglycemia patients in non-endocrinological departments of first-class hospitals and the related risk factors of hyperglycemia in ICU patients.@*Methods@#4364 patients with hyperglycemia in non-endocrinology Department of Shanxi People’s Hospital admitted from Feb 1, 2017 to Jan 31, 2018 were selected. The detection rate of hyperglycemia was counted and the distribution characteristics of hyperglycemia were analyzed. The risk factors of hyperglycemia in ICU patients were analyzed by logistic regression.@*Results@#① General situation: The detection rate of hyperglycemia in non-endocrinological inpatients was 7.57%, with an average age of (60.2±16.14) years and a male-to-female ratio of 1.28:1. ② The detection rate and distribution characteristics of hyperglycemia in the internal medicine department and surgical department: the detection rate of hyperglycemia in internal medicine department was 8.46%; male-to-female ratio was 1.54:1, and the average age was (61.01±13.96) years. The detection rate of surgical department was 6.56%,male-to-female ratio was 1.03:1, and the average age was (59.03±14.14) years. The detection rate of geriatrics in internal medicine department was higher, The detection rate of Neurosurgery in surgical department was higher. ③ Types of hyperglycemia: 2424 cases (55.54%) of diabetes were diagnosed; 757 cases (17.35%) of diabetes were newly diagnosed; 319 cases (7.31%) of stress hyperglycemia. ④ The detection rate of OGTT or HbAlC respectively and both indicators in internal medicine were higher than in surgery (χ2=79.68, 197.29, 67.48, all P=0.00) . ⑤ Logistic analysis revealed that perioperative period, diabetes and the history of glucocorticoid use were independent factors for the prevalence of hyperglycemia in ICU patients[OR (95%CI) respectively, 1.015 (1.169~4.265) , 2.999 (1.487~6.049) , 5.456 (2.067-~14.398) , all P<0.05].@*Conclusions@#The detection rate of hyperglycemia in tertiary is higher. Perioperative period, diabetes and history of glucocorticoid use are closely related to the prevalence of hyperglycemia in ICU patients. Non-endocrine physicians should strengthen the standardized management of hyperglycemia among inpatients.

Analysis of occupational pneumoconiosis in Jiangsu province from 2006 to 2017 / 中华劳动卫生职业病杂志

Objective@#To analyze the characteristics and patterns of occupational pneumoconiosis in Jiangsu Province, China, from 2006 to 2017, and to provide a scientific basis for government departments to develop effective interventions and preventive strategies against occupational pneumoconiosis.@*Methods@#The data of 9327 patients with occupational pneumoconiosis were retrieved from the online report of occupational pneumoconiosis in Jiangsu Province from 2006 to 2017. Excel worksheet and SPSS 20.0 software were used to organize and analyze the data, respectively. An epidemiological statistical analysis was performed on age of onset, length of dust exposure, type of work, industry category, type of pneumoconiosis, annual incidence of pneumoconiosis, regional distribution, enterprise scale, and economic category in those patients.@*Results@#A total of 9 327 patients with occupational pneumoconiosis were reported in Jiangsu Province from 2006 to 2017. In those patients, 8 559 were newly diagnosed and 768 had advanced disease. The male-female ratio was 16.34:1.Patients with stage I pneumoconiosis(6 994, 74.99%) were dominant in all the patients. The mean age of onset and length of dust exposure were 58.5±10.7 and 15.3±10.9 years, respectively. Most of the patients (6 012, 64.46%) had an age of onset between 50 and 69 years. For the length of dust exposure, the highest percentage was observed in patients exposed for no more than 5 years (2 231, 23.92%).The largest number of patients diagnosed with pneumoconiosis(1 200, 12.87%) was reported in 2010. Most of the patients(7 012, 75.18%) were from four cities, i.e, Wuxi (2 090, 22.41%), Yancheng (1 987, 21.30%), Suzhou (1 552, 16.64%), and Xuzhou (1 383, 14.83%). In all the patients, the incidence of silicosis (6791, 72.81%) was highest, followed by coal worker pneumoconiosis (1 364, 14.62%) and electric welder pneumoconiosis (563, 6.04%).Pneumoconiosis complicated by tuberculosis was found in 28 (0.3%) patients.A total of 1616 (17.33%) patients were reported in health, social security, and social welfare industries, while 1474 (15.80%) patients worked for coal mining and washing. Rock drillers (2 818, 30.21%) were dominant in those patients.State-owned economic enterprises reported the largest number of patients(5 441, 58.34%).Patients from small enterprises (4 323, 46.35%) had the highest percentage.@*Conclusion@#Pneumoconiosis is an occupational disease with a high incidence in Jiangsu Province. Pneumoconiosis patients show an industry- and job-centered distribution. The length of dust exposure is decreasing.

Serum uric acid level and its correlation among adolescents in Hangjiang district of Yangzhou city / 中华风湿病学杂志

Objective@#To investigate the prevalence of hyperuricemia and its correlation among adolescents aged 13-16 in Hanjiang district of Yangzhou city.@*Methods@#Five hundred and nine adolescents aged 13-16 years in Hangjiang district of Yangzhou city were recruited. Their fasting serum uric acid level were measured by Benecheck premium UA monitoring system. The demographic imformation, family history, eating and living habits of the respondents were collected by questionnaires.@*Results@#The average serum uric acid level of 509 adolescents in Hangjiang district of Yangzhou city was (374±98) μmol/L, and (420±103) μmol/L in males, higher than that of females [(329±70) μmol/L](t=11.69, P<0.05). The overall prevalence of HUA was 36.9%(188/509), and 43.2%(108/250) in males, higher than in females 30.8%(80/259)(χ2=4.16, P<0.05). Multivariate Logistic regression analysis showed that male [OR=1.70, 95%CI(1.18, 2.45)], obese [OR=8.99, 95%CI(4.58, 17.63)], high-salt oily diet [OR=1.67, 95%CI(1.05, 2.61)], soy products [OR=2.66, 95%CI(1.45, 4.88)], animal offal [OR=7.81, 95%CI(3.42, 17.83)], seafood [OR=4.80, 95%CI(2.83, 8.12)], sugary drinks [OR=6.49, 95%CI(3.08, 13.64)] and time spent on electronic products [OR=1.98, 95%CI(1.07, 3.65)] might be risk factors for hyperuricemia (P<0.05), while fruit [OR=0.52, 95%CI(0.32, 0.85)] and outdoor activities [OR=0.55, 95%CI(0.33, 0.92)] might be protective factors for HUA (P<0.05).@*Conclusion@#There is a high prevalence of hyperuricemia among adolescents aged 13-16 in Hangjiang district of Yangzhou city. The level of serum uric acid in adolescents significantly increased. Male, obesity, high salt and oily diets, soy products, animal offal, seafood, and sugary drinks may be risk factors for HUA. Fruits and outdoor activities may be protective factors for HUA. Relevant disciplines can take corresponding measures to prevent adolescent HUA.

Discussion on the status quo and norms of epidemiology research of osteoarthritis in China / 中国实用内科杂志

Osteoarthritis(OA) is the most common joint disease. With the aging of the world population and the increase of obesity, the prevalence of OA is increasing year by year. Although China's OA epidemiological research has carried out many regional investigations and studies, the data differs a lot, which may be related to the inconsistency of the diagnostic criteria used in the survey and the non-standard test methods. Analyze the root causes of these problems, start with the epidemiological diagnostic criteria of OA, standardize the imaging examination methods of OA, and not only carry out cross-sectional research but also conduct cohort research, as well as multi-joint, multi-regional and multiethnic investigations. Improving the epidemiological data of China's OA is conducive to clarifying the prevalence and risk factors of OA in China,providing a strong basis for early diagnosis and early prevention and treatment and reducing the occurrence and development of OA.

Epidemiology of nosocomial infection in recipients after renal transplantation: a single-center analysis / 器官移植

Objective To investigate the epidemiological characteristics of renal transplantation recipients, effective prevention and control measures. Methods A total of 456 renal transplant recipients were monitored from January 2014 to December 2017. Postoperative infection including baseline data, infection site and infectious pathogen type was analyzed. Results Among 456 renal transplant recipients, 78 cases (17.1%) developed nosocomial infection. Postoperative infection time was 9(3-21) d. Infection sites mainly included the lower respiratory tract, urinary system and blood infection. Infection pathogens consisted of Staphylococci (n=13), Enterococcus faecium (n=6), fungi (n=6), Stenotrophomonas maltophilia (n=4), Acinetobacter baumannii (n=4), Pseudomonas aeruginosa (n=4), Staphylococcus epidermidis (n=4), Klebsiella pneumoniae (n=1), Escherichia coli (n=1) and other negative bacteria (n=9). Among them, 11 cases (14%) were infected with multi-drug resistant bacteria, and 4 cases died. Conclusions In renal transplant recipients, the incidence of nosocomial infection is relatively high, with early postoperative onset, common multiple drug-resistant bacterial infection and high mortality. Preoperative preparations should be fully implemented, postoperative lower respiratory tract infection should be actively prevented and prevention and treatment measures for multidrug-resistant bacteria should be standardized.