Therapeutic management in ambulatory elderly patients with atrial fibrillation: the S.AGES cohort.

UNLABELLED: Few epidemiologic studies have specifically focused on very old community dwelling population with atrial fibrillation (AF). The objectives of the AF-S.AGES cohort were to describe real-life therapeutic management of non-institutionalized elderly patients with AF according to age groups, i.e., 65-79 and ≥ 80 and to determine the main factors associated with anticoagulant treatment in both groups. METHODS: Observational study (N=1072) aged ≥ 65 years old, recruited by general practitioners. Characteristics of the sample were first evaluated in the overall sample and according to age (< 80 or ≥ 80 years) and to use of anticoagulant treatment at inclusion. Logistic models were used to analyze the determinants of anticoagulant prescription among age groups. RESULTS: Mean age was 78.0 (SD=6.5) years and 42% were ≥ 80 years. Nineteen percent had paroxysmal AF, 15% persistent, 56% permanent and 10% unknown type, 77% were treated with vitamin K antagonists (VKA), 17% with antiplatelet therapy with no differences between age groups. Rate-control drugs were more frequently used than rhythm-control drugs (55% vs. 37%, p < 0.001). VKA use was associated with permanent AF, younger age and cancer in patients ≥ 80 years old and with permanent AF and preserved functional autonomy in patients < 80 years old. Hemorrhagic scores were independently associated with non-use of VKA whereas thromboembolic scores were not associated with VKA use. CONCLUSIONS: In this elderly AF outpatient population, use of anticoagulant therapy was higher even after 80 years than in previous studies suggesting that recent international guidelines are better implemented in the elderly population.

[Viral hepatitis A as an occupational disease in the city of Iasi]. / Hepatita virala A, ca boala profesionala în municipiul Iasi.

OBJECTIVES: Few studies have been carried out to evaluate the role of hepatitis A virus (HAV) as an occupational hazard. Our analysis of data on occupational diseases in Romania showed that hepatitis ranks as one of the first among infectious occupational diseases. MATERIALS AND METHODS: Data on the role of hepatitis A, as occupational disease, were obtained by testing sera obtained from different occupational groups and compared results with the degree of immunity found among the normal population. An ELISA technique was used to determine the presence of each hepatitis marker (Murex kits for anti-HAV IgG). RESULTS: The ratio of prevalence in each subset compared to the general population was used to express relative risk. The results of our study show that hepatitis A is an important hazard to sewerage workers. In view of these results, it should be considered whether the occupational differences alone account for the divergence in immunity between the groups or whether socioeconomic aspects and differences in the standard of hygiene are also responsible for HAV infections.

[An epidemiological assessment of acute diarrheal diseases in Iasi city and County (1985-1994)]. / Evaluari epidemiologice asupra bolii diareice acute în municipiul si judetul Iasi (1985-1994).

Acute diarrhoea, with a remarkable etiologic, clinic and epidemiologic polymorphism represents, for various reasons, an important concern for health preservation both in industrialised countries and, mainly, in the developing ones. It is that, at world level, 1.2-1.5 milliards of diarrhoea episodes, of which 750-950 millions in children, causing death in over 4 millions aged 0-5 years, are recorded. In Romania, although the real data of morbidity by acute diarrhoea are not known, the reports show a significant decrease in the past 10 years. In 1993, 420.2 cases at 100,000 inhabitants were reported, the most commonly affected being the children age 0-4 years. In Moldavia (Romania), numerous extensive studies on the epidemiology of acute diarrhoea have been carried out. This paper present and aims rendering evident some epidemiological aspects of acute diarrhoea cases reported in the interval 1985-1994 in Iasi County and town.