Varicella in Europe—A review of the epidemiology and experience with vaccination

There is no consensus as regards the European varicella immunisation policy; some countries have introduced varicella vaccination in their routine childhood immunisation programs whereas others have decided against or are debating. With the aim of providing an overview of the epidemiology of varicella in Europe and addressing the different strategies and the experiences so far, we performed a review of epidemiological studies done in Europe from 2004 to 2014. Varicella is mainly a disease of childhood, but sero-epidemiological studies show regional differences in the proportion of susceptible adults. Hospitalisation due to varicella is not common, but complications and hospitalisation mainly affect previously healthy children, which underlines the importance of not dismissing varicella as a disease of little importance. The experience with universal vaccination in Europe shows that vaccination leads to a rapid reduction of disease incidence. Vaccine effectiveness is high and a protective herd effect is obtained. Experience with vaccination in Europe has not been long enough, though, to draw conclusions on benefits and drawbacks with vaccination as well as the capacity for national programs in Europe to maintain a sufficiently high coverage to prevent a change in age group distribution to older children and young adults or on the impact that varicella immunisation may have on the epidemiology of shingles.     

Analysis of pattern of occurrence of thyroid carcinoma between 2001 and 2010

IntroductionAn ongoing discussion is found in medical literature about the reasons for changes in thyroid carcinoma incidence patterns over the last decades.ObjectiveTo analyze the clinical and pathological characteristics of thyroid carcinoma cases over a decade.MethodsCross-sectional study over an historical cohort. Medical records of 628 thyroid cancer cases in a single center were reviewed. 597 patients were included. Microcarcinoma cases were selected for a qualitative analysis phase, in which medical records were reviewed for better understanding of thyroid nodule and thyroid cancer diagnosis process.ResultsAn increase in the proportion of cases with thyroid cancer diagnosis was observed throughout the decade; new cases were predominantly tumors of less than 2 cm, with histopathological signs of low aggressiveness. There was an increase in proportion of cases with malignant cytological results among microcarcinomas.ConclusionThere is a trend for increase in thyroidectomies due to cancer in this institution, with proportional increment of cases with histopathological characteristics indicative of early disease. Among microcarcinomas, there is an increasing group represented by cancer cases that were not incidentally diagnosed, related to an enhancement in preoperative diagnostic methods.     

青光眼患者构成特点的统计学研究

目的：探讨门诊青光眼的疾病构成与年龄、性别分布及其变化特点，并与住院青光眼患者调查资料对比，分析其差异原因，为青光眼的防治研究提供新的流行病学资料。方法调查535例门诊青光眼患者的年龄、性别分布及不同类型青光眼的构成比等特点，并与本院近5年住院患者的调查结果进行比较。结果原发性闭角型青光眼274例、开角型青光眼108例、继发性青光眼93例、先天性青光眼60例，分别占门诊青光眼患者总数的51.21%、20.19%、17.39%和11.21%；其男女比例分别为1∶1.88、3.5∶1、2.44∶1和1∶1.07；原发性青光眼的构成比例中，PACG与POAG之比为2.54∶1。结论原发性闭角型青光眼和继发性青光眼仍为主要类型，且随着年龄增长，发病率有逐渐增高的趋势，是今后防盲致盲工作的两个重点。     

Portuguese children's exposure to second-hand tobacco smoke in the family car

ObjectivesTo assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents.MethodsIn 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N = 3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed.ResultsOf the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed.ConclusionsChildren's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.     

Diabetic nephropathy in Africa:A systematic review

AIM:To determine the prevalence and incidence of diabetic nephropathy in Africa.METHODS:We performed a systematic narrative review of published literature following the MOOSE Guidelines for Meta-Analysis and Systematic Reviewsof Observational Studies.We searched Pub MedMEDLINE for all articles published in English and French languages between January 1994 and July 2014 using a predefined strategy based on the combination of relevant terms and the names of each of the 54 African countries and African sub-regions to capture the largest number of studies,and hand-searched the reference lists of retrieved articles.Included studies reported on the prevalence,incidence or determinants of chronic kidney disease(CKD) in people with diabetes within African countries.RESULTS:Overall,we included 32 studies from 16 countries;two being population-based studies and the remaining being clinic-based surveys.Most of the studies(90.6%) were conducted in urban settings.Methods for assessing and classifying CKD varied widely.Measurement of urine protein was the most common method of assessing kidney damage(62.5% of studies).The overall prevalence of CKD varied from 11% to 83.7%.Incident event rates were 94.9% for proteinuria at 10 years of follow-up,34.7% for endstage renal disease at 5 years of follow-up and 18.4% for mortality from nephropathy at 20 years of followup.Duration of diabetes,blood pressure,advancing age,obesity and glucose control were the common determinants of kidney disease.CONCLUSION:The burden of CKD is important among people with diabetes in Africa.High quality data from large population-based studies with validated measures of kidney function are still needed to better capture the magnitude and characteristics of diabetic nephropathy in Africa.     

2010-2015年腾冲市疟疾疫情流行病学分析

目的分析2010-2015年腾冲市疟疾疫情特征，为进一步推进消除疟疾进程，适时调整和制定防控措施提供依 据。方法收集2010-2015年腾冲市疟疾疫情资料，采用Microsoft Excel 2010软件对数据进行整理分析。结果2010- 2015年，腾冲市共报告疟疾病例1 408例，以间日疟为主，共1 091例，占77.49%，且比例逐年增加；恶性疟256例，占 18.18%，比例逐年降低；三日疟5例，卵形疟1例，混合感染1例，未分型54例。共有1 390例输入性病例，其中98.06%的 病例为缅甸输入。年龄主要集中在21 ~ 40岁（908例），男女性别比例为11.03∶1。职业以农民和民工为主。2010-2015 年全年各月均有发病，以4-6月最多，发病高峰与流动人口回归有关。结论腾冲市输入性疟疾疫情仍比较严重，消除 疟疾工作面临很多的挑战。     

Epidemiology of gout and hyperuricemia in New Caledonia

ObjectivesNew Caledonia is a Pacific island of 270,000 inhabitants with mixed ethnicities, including Polynesians (10.2%), people from European ancestry (27.2%), and Melanesians (39.1%),. This study aimed at determining the prevalence of gout and hyperuricemia in the general population and the various ethnicities of New Caledonia.MethodsA 3-degree random sample of the population aged 18 to 60 years was adjusted according to the 2014 New Caledonia census. Face-to-face planned interviews and physical measurements were performed by trained nurses. All consenting participants underwent capillary measurement of creatinine; all consenting men and only women older than 40 years underwent point-of-care uricemia testing. Gout was defined by a validated algorithm. Two definitions of hyperuricemia were used: capillary level equivalent to plasma uric acid level > 360 μmol/l (6 mg/dl) and > 420 μmol/l (7 mg/dl) and/or urate-lowering drug treatment for both thresholds.ResultsWe included 1144 participants (adjusted mean age 37.7 ± 12.0 years; adjusted sex ratio 50.4% men). The adjusted prevalence of gout was 3.3% (95% confidence interval 2.2–4.9). Prevalence was 6.7% (2.5–16.8), 4.1% (1.8–8.9), and 2.6% (1.4–4.7) for Polynesians, Europeans and Melanesians, respectively, and 1.9% (0.5–6.6) for other ethnicities. Prevalence of hyperuricemia, determined in 658 participants, was 67.0% (61.9–71.6) and 37.0% (32.3–42.0) for the 360- and 420-μmol/l thresholds, respectively, and was significantly greater for Polynesians and Melanesians than Europeans for both thresholds.ConclusionsThe prevalence of gout and hyperuricemia in New Caledonia was high, including in patients of European descent.