The occupational burden of chronic obstructive pulmonary disease.

Although chronic obstructive pulmonary disease (COPD) is attributed predominantly to tobacco smoke, occupational exposures are also suspected risk factors for COPD. Estimating the proportion of COPD attributable to occupation is thus an important public health need. A randomly selected sample of 2,061 US residents aged 55-75 yrs completed telephone interviews covering respiratory health, general health status and occupational history. Occupational exposure during the longest-held job was determined by self-reported exposure to vapours, gas, dust or fumes and through a job exposure matrix. COPD was defined by self-reported physician's diagnosis. After adjusting for smoking status and demography, the odds ratio for COPD related to self-reported occupational exposure was 2.0 (95% confidence interval (CI) 1.6-2.5), resulting in an adjusted population attributable risk (PAR) of 20% (95% CI 13-27%). The adjusted odds ratio based on the job exposure matrix was 1.6 (95% CI 1.1-2.5) for high and 1.4 (95% CI 1.1-1.9) for intermediate probability of occupational dust exposure; the associated PAR was 9% (95% CI 3-15%). A narrower definition of COPD, excluding chronic bronchitis, was associated with a PAR based on reported occupational exposure of 31% (95% CI 19-41%). Past occupational exposures significantly increased the likelihood of chronic obstructive pulmonary disease, independent of the effects of smoking. Given that one in five cases of chronic obstructive pulmonary disease may be attributable to occupational exposures, clinicians and health policy-makers should address this potential avenue of chronic obstructive pulmonary disease causation and its prevention.

[Standard of birth weight for gestational age in 55706 healthy newborns in a public maternity of Buenos Aires]. / Estándar de peso para la edad gestacional en 55706 recién nacidos sanos de una maternidad pública de Buenos Aires.

UNLABELLED: Birth-weight-for-gestational-age patterns in Argentina are scarce and outdated. The same study has been performed within our institution for 8 years already. Our hypothesis is that there could have been population changes with repercussions on fetal growth. The objectives were: 1) to determine new normal values of birth weight (BW)-for-gestational-age; 2) to study growth speed and acceleration, and 3) to compare these new results between trienniums. POPULATION: All liveborn babies between 1988-1998 (n = 67,857) were included. Those with BW lower than 500 g, gestational age (GA) lower than 25 weeks or mistakes in the appraisal of GA and outliers (birth-weight-for gestational-age > 2.5 DS of the median) were excluded. Those without maternal or obstetric history that could have influenced the BW were defined as "healthy newborns" (n = 55,706). The software Persi, that employs 34 of the 93 variables included in the Perinatal Clinical Record (SIP/OPS/OMS, Agustina v 5.1), was used. Birth weight median, standard deviation and error, coefficient of variation, skewness and kurtosis's coefficients, real and polynomial percentiles, standard distribution (Z), and the corresponding charts were generated in an automatic way for each gestational week and through the use of the method of least squares (polynomial models up to 4th grade). Results were as follows: maximum variability 15% as from the 30th week, maximum absolute speed in the 36th week (263 g/week) and a positive acceleration, up to the 36th week, and then a negative one (maximum -127 g/week2 in the 42nd week) was observed. Skewness varied between -0.247 (31st week) and 0.129 (38th week), and kurtosis was around 3, from which it can be inferred that the population has a normal distribution. Compared to the score z, the new curves showed a maximum error of 1.53% for the 10 percentile and 1.50% for the 50 percentile. By analyzing the data by trienniums (88-91, 91-93, 94-96 and 97-98) a growing mean BW (3243 +/- 539 g to 3286 +/- 508 g; p < 0.001) and 10 percentile (2600 to 2690 g, p < 0.001) trend was appreciated. IN CONCLUSION: new values of birth weight-for-gestational-age were determined, and a secular increase trend of the mean birth weight (+43 g) was observed.

Estándar de peso para la edad gestacional en 55706 recién nacidos sanos de una maternidad pública de Buenos Aires. / [Standard of birth weight for gestational age in 55706 healthy newborns in a public maternity of Buenos Aires]

Birth-weight-for-gestational-age patterns in Argentina are scarce and outdated. The same study has been performed within our institution for 8 years already. Our hypothesis is that there could have been population changes with repercussions on fetal growth. The objectives were: 1) to determine new normal values of birth weight (BW)-for-gestational-age; 2) to study growth speed and acceleration, and 3) to compare these new results between trienniums. Population: All liveborn babies between 1988-1998 (n = 67,857) were included. Those with BW lower than 500 g, gestational age (GA) lower than 25 weeks or mistakes in the appraisal of GA and outliers (birth-weight-for gestational-age > 2.5 DS of the median) were excluded. Those without maternal or obstetric history that could have influenced the BW were defined as [quot ]healthy newborns[quot ] (n = 55,706). The software Persi, that employs 34 of the 93 variables included in the Perinatal Clinical Record (SIP/OPS/OMS, Agustina v 5.1), was used. Birth weight median, standard deviation and error, coefficient of variation, skewness and kurtosiss coefficients, real and polynomial percentiles, standard distribution (Z), and the corresponding charts were generated in an automatic way for each gestational week and through the use of the method of least squares (polynomial models up to 4th grade). Results were as follows: maximum variability 15

as from the 30th week, maximum absolute speed in the 36th week (263 g/week) and a positive acceleration, up to the 36th week, and then a negative one (maximum -127 g/week2 in the 42nd week) was observed. Skewness varied between -0.247 (31st week) and 0.129 (38th week), and kurtosis was around 3, from which it can be inferred that the population has a normal distribution. Compared to the score z, the new curves showed a maximum error of 1.53

for the 10 percentile and 1.50

for the 50 percentile. By analyzing the data by trienniums (88-91, 91-93, 94-96 and 97-98) a growing mean BW (3243 +/- 539 g to 3286 +/- 508 g; p < 0.001) and 10 percentile (2600 to 2690 g, p < 0.001) trend was appreciated. In conclusion: new values of birth weight-for-gestational-age were determined, and a secular increase trend of the mean birth weight (+43 g) was observed.

A comprehensive survey of pediatric diarrhea at a private hospital in Metro Manila.

The epidemiology of diarrhea among Filipino pediatric patients, representing a cross-section of socioeconomic strata, was investigated over a one year period. Rotavirus was detected in 33.9% of the diarrhea stools examined and was the leading cause of diarrhea in the study population. Although proportionately more rotavirus was found during the cold season, most children became infected with rotavirus during the rainy season, when diarrheal disease was at its peak in Metropolitan Manila. Enteric adenovirus types 40 or 41 were associated with only 5.4% of the diarrhea cases. Overall, one or more etiologic agents of diarrhea were detected in 67.2% of the stools examined. Many of these positive stools (21.6%) contained multiple diarrheogenic agents. Bacterial enteric pathogens were isolated from 32.3% of the cases. Nearly 70% of these patients with bacterial gastroenteritis became ill during the rainy season. Etiology specific and general risk factors associated with diarrheal illness in the study population are discussed.