Secular trends in adiposity in Norwegian 9-year-olds from 1999-2000 to 2005

Background  

Due to the negative health consequences of childhood obesity monitoring trends in body mass and adiposity is essential. The purpose of this study was to describe secular trends in the prevalence of overweight and obesity among 9-year-old children, and to study changes in adiposity and fat distribution by investigating changes in waist circumference (WC) and skinfold thicknesses.     

Increasing trend of antimicrobial drug-resistance in organisms causing bacteremia at a tertiary-care hospital: 1995 to 2000

We described the trends of drug-resistant organisms isolated in blood cultures from patients detected in a teaching hospital from 1995 to 2000. We found an increase in the number of clinical isolates of Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter spp, Serratia spp, Staphylococcus aureus, S. epidermidis and Enterococcus spp, resistant to antibiotics commonly used to treat infections caused by these organisms. The frequency of gram-negative bacilli resistant to third-generation cephalosporins and quinolones increased during the period of study, and in 2000 more than 20% of the isolates were resistant. In contrast, the frequency of resistance to aminoglycosides and carbapenems was less than 20%. The frequency of resistant staphylococci increased exuberantly fifty fold to quinolones and five fold to oxacillin during the study period, therefore in 2000, 26.1% of S. aureus isolates and 61% of S. epidermidis were resistant to oxacillin. The frequency of resistant enterococci also increased, and in 2000, 50% were resistant to ampicillin, and 37.5% to gentamicin. The increase of drug resistant organisms isolated in blood had a direct impact in the empirical treatment of severely infected patients in our hospital. It is important to continuously supervise antibiotic use, and to adopt more strict control measures to decrease the frequency of infections caused by drug resistant organisms.     

Two-year trends of peripherally inserted central catheter-line complications at a tertiary-care hospital: role of nursing expertise.

We found reductions in peripherally inserted central catheter (PICC) complication rates over 2 years of observation (20.4 vs 13.8/1,000 line-days; relative risk, 0.5-0.9). This difference represents a cost saving due to reduced line reinsertions and reduced use of thrombolytic agents. The presence of a dedicated PICC insertion nursing team and education of ward nurses in PICC maintenance is a plausible explanation for the observed differences.     

Excess mortality, hospital stay, and cost due to candidemia: a case-control study using data from population-based candidemia surveillance.

OBJECTIVE: To determine the mortality, hospital stay, and total hospital charges and cost of hospitalization attributable to candidemia by comparing patients with candidemia with control-patients who have otherwise similar illnesses. Prior studies lack broad patient and hospital representation or cost-related information that accurately reflects current medical practices. DESIGN: Our case-control study included case-patients with candidemia and their cost-related data, ascertained from laboratory-based candidemia surveillance conducted among all residents of Connecticut and Baltimore and Baltimore County, Maryland, during 1998 to 2000. Control-patients were matched on age, hospital type, admission year, discharge diagnoses, and duration of hospitalization prior to candidemia onset. RESULTS: We identified 214 and 529 sets of matched case-patients and control-patients from the two locations, respectively. Mortality attributable to candidemia ranged between 19% and 24%. On multivariable analysis, candidemia was associated with mortality (OR, 5.3 for Connecticut and 8.5 for Baltimore and Baltimore County; P < .05), whereas receiving adequate treatment was protective (OR, 0.5 and 0.4 for the two locations, respectively; P < .05). Candidemia itself did not increase the total hospital charges and cost of hospitalization; when treatment status was accounted for, having received adequate treatment for candidemia significantly increased the total hospital charges and cost of hospitalization ($6,000 to $29,000 and $3,000 to $22,000, respectively) and the length of stay (3 to 13 days). CONCLUSION: Our findings underscore the burden of candidemia, particularly regarding the risk of death, length of hospitalization, and cost associated with treatment.     

Outbreak of methicillin-resistant Staphylococcus aureus in a German tertiary-care hospital.

A biphasic outbreak of methicillin-resistant Staphylococcus aureus in intensive-care units of a German tertiary-care hospital afflicted 89 patients within 4 years. The spread of the outbreak most likely was facilitated by the contamination of mobile radiograph equipment. The outbreak was controlled by measures of hospital hygiene.     

Secular trends in fruit intake among Danish schoolchildren, 1988 to 2006: Changing habits or methodological artefacts?

Background  

Intermittent monitoring of fruit and vegetable intake at the population level is essential for the evaluation and planning of national dietary interventions. Yet, only a limited number of studies on time trends in fruit and vegetable intake among children and adolescents have been published internationally. In Denmark, national comprehensive campaigns to enhance fruit and vegetable consumption were initiated in 2001. This paper describes secular trends in fruit intake among Danish adolescents by six comparable school surveys from 1988 to 2006. The paper demonstrates and discusses the consequences of measurement changes introduced in long-term trend analyses.     

1985-2014年云南省傈僳族儿童青少年生长长期趋势分析

目的 分析1985-2014年云南省傈僳族儿童青少年的生长长期变化,为促进其体质与健康提供科学依据。方法 收集1985、1995、2005年和2014年四次云南省7~18岁傈僳族学生的身高、体重、体质指数(BMI)、身高最大增长年龄(MIA)、月经初潮(MMA)和首次遗精中位数年龄(MSA)等进行动态分析。结果 近30年来,7~18岁傈僳族男、女生身高平均增加4.5 cm和6.0 cm,体重平均增加3.1 kg和4.3 kg,MIA提前1.13岁和3.17岁,MMA提前了1.52岁,18岁男、女生成年身高平均增加3.6 cm和-0.4 cm。2005-2014年,傈僳族男、女生BMI平均增加0.3 kg/m²和0.3 kg/m²,MSA提前了0.40岁。结论 云南省傈僳族儿童青少年处于不完全性长期趋势,应加强重视,采取各种有效措施促进其健康成长。     

Secular trends in maternal mortality in Sweden from 1750 to 1980

Mortality statistics have been kept continuously in Sweden since 1750 and reveal that the maternal mortality rate declined from 900 to 6 per 100 000 live births over the period 1750 to 1980. Two-thirds of this decrease occurred during the 19th century and the remainder in the 20th century. In the 18th century, 10% of deaths among women aged between 15 and 49 years were due to complications at parturition, but today this accounts for only 0.2% of deaths in women of this age group. Life-table analysis indicates that 1 out of 29 women in Sweden lost her life in parturition during the 18th century, while today only 1 out of 1000 women dies as a result of complications during pregnancy and parturition.     

Parasitic infections in a New York City hospital: trends from 1971 to 1984.

We report the frequency of parasitic infections 1971-84 in a major New York City Medical Center whose catchment area includes many immigrants from Dominican Republic. Infection with 7,803 parasites was documented in 41,958 laboratory specimens. Trends were toward fewer total specimens being sent and fewer still being positive, although a rise in G. lamblia, E. histolytica, and Cryptosporidium is apparent in recent years. Parasitology laboratories should provide similar data to alert clinicians to the parasites prevalent locally.     

Breakthrough candidemia in patients with cancer differs from de novo candidemia in host factors and Candida species but not intensity.

OBJECTIVES: To evaluate the risk factors associated with breakthrough candidemia in patients with cancer and to compare them with those of de novo candidemia in this patient population. DESIGN: Retrospective case series of 120 episodes of candidemia, 90 de novo and 30 breakthrough candidemias. SETTING: University-affiliated, tertiary-care cancer center in Houston, Texas. PATIENTS: All patients with cancer who acquired candidemia between January 1993 and December 1998 were included if they had non-catheter-related candidemia and information about quantitative blood cultures. RESULTS: Although less frequent, breakthrough candidemia was seen more often in neutropenic patients with leukemia. The intensity of breakthrough candidemia was comparable to that of de novo candidemia. Most (70%) of the breakthrough candidemias were due to Candida glabrata or C. krusei. CONCLUSIONS: In breakthrough candidemia, the same risk factors seen in de novo candidemia were encountered, although more frequently. C. glabrata and C. krusei are the leading causes of breakthrough candidemia in patients with cancer.     

Secular trends in blood pressure among Japanese schoolchildren: a population-based annual survey from 1994 to 2010

Background: Monitoring secular trends in blood pressure (BP) among children is important in predicting subsequent hypertension and cardiovascular disease. We investigated secular trends in BP using data from population-based annual screenings of Japanese schoolchildren.Methods: The participants were 10 894 children (all fourth graders between 1994 and 2010 and all seventh graders between 1997 and 2010) living in the town of Ina in Saitama Prefecture, Japan. Body height, weight, and BP were measured, after which children were classified as non-overweight, overweight, or obese. Trends in variables relative to calendar year were analyzed using regression models.Results: Systolic BP was significantly associated with calendar year among fourth- and seventh-grade boys (-0.350 and -0.434 mm Hg/year, respectively) and fourth- and seventh-grade girls (-0.513 and -0.473 mm Hg/year, respectively) (all P < 0.001), respectively, over time. Systolic BP and calendar year were significantly negatively correlated regardless of physique or sex among all fourth graders, but not among obese seventh-grade girls. In addition, diastolic BP and calendar year did not significantly correlate among seventh-grade overweight or obese boys or obese seventh-grade girls.Conclusions: BP decreased among fourth-grade schoolchildren in Ina during the past 17 years, regardless of sex or physique. However, BP and calendar year did not significantly correlate among obese seventh graders.     

Smoking trends in Italy from 1950 to 2000

STUDY OBJECTIVE: To assess how the prevalence of smokers in Italy from 1950 to 2000 has changed, in parallel with law development and the growing attention towards smoking prevention. DESIGN, SETTING, AND PARTICIPANTS: Historical data on smoking trends have been obtained using data collected in 2000 by the National Institute of Statistics. A correction coefficient is proposed to overcome the bias of differential mortality reported in other papers. The sample is made up of 102 261 people aged 15-69 years. MAIN RESULTS: A general downward trend is seen; there is a more pronounced decrease starting from 1975 to 1980. In both sexes the peak prevalence tends to decrease according to the birth cohort because of the earlier age in which they gave up. A partial exception to the decline of tobacco use in recent years may be made for the 15-19 year-old age group, which has remained stable since 1990. CONCLUSIONS: Although a comprehensive community programme against tobacco was not developed, the different prevention actions implemented in Italy have contributed to a change in attitude and behaviour. The effect of tobacco control strategies implemented in Italy until now is more evident in relation to the breaking of the smoking habit, which happens at an increasingly younger age, although it is not clear how much it is able to prevent people from starting smoking.     

Secular trends of sudden infant death syndrome in Norway 1967–1988: application of a method of case identification to Norwegian registry data

Summary. In Norway, towards the end of the 1980s, sudden infant death syndrome (SIDS) was the most frequent cause of infant death. Both SIDS and the total post-perinatal mortality rates had increased. This paper presents a procedure for identifying SIDS from death certificates. Supplemented with additional information, a database was established to evaluate secular trends of SIDS and for further analytical research. The Medical Birth Registry of Norway comprises 1.3 million births from 1967 to 1988. Of these, 5447 infants died in the post-perinatal period. The cause of death was reviewed by an expert panel and 1984 cases of SIDS were retrieved.
Low maternal age, higher birth order, male gender, and lower birthweight were confirmed as risk factors for SIDS. In 1988, the rate for SIDS and for total post-perinatal deaths reached 2.69 and 5.02 per 1000 infants at risk. The incidence of SIDS increased 2.2 times from the period 1967–1971 to the period 1987–1988. Adjusted for maternal age, birth order, and birthweight, the odds ratio was 3.1. The increase is due to factors not yet accounted for. Adjusted mortality rates for the other post-perinatal deaths were not different from the crude rates.     

Molecular epidemiology of Candida parapsilosis sepsis from outbreak investigations in neonatal intensive care units.

The DNA probe, Cp3-13, was used in a Southern blot assay for genotyping Candida parapsilosis (CP) from 3 fungemia outbreaks in neonatal intensive care units (NICUs) in the southeastern U.S. Genotyping, in 2 outbreaks, supplied evidence of horizontal transmission of CP. In the third outbreak, bloodstream isolates (BSIs) of 2 genotypes circulated in the NICU, one was shared by a BSI and a healthcare worker's hand culture. A fourth cluster of recurrent episodes of fungemia occurred in outpatients of a children's hospital receiving total parenteral nutrition (TPN) at home. Each child was infected with a different CP genotype which persisted during recurrences. These genotypes were included in a dendrogram from a CDC population-based surveillance for candidemia consisting of 73 clone-corrected Cp3-13 genotypes (overall SAB = 0.36). Analysis revealed a cluster of 11 genotypes (mean SAB = 0.66) including 3 pairs with identical hybridization profiles. A second cluster of 8 genotypes contained clones from 3 outbreaks (mean SAB = 0.76) but no clustering of genotypes specific for neonates was identified. No decreased susceptibility to azole and polyene antifungal agents was detected in this collection of CP. The frequent occurrence of transmission of CP in this vulnerable population underlines the relevance of Cp3-13 subtyping to investigate suspected transmission and persistence of CP strains in the NICU.     

中国2005-2014年中小学生身高体重变化趋势分析

分析中国2005-2014年7~18岁学生身高、体重变化趋势及其特点,为构建中国儿童青少年身高、体重百分位数参考值提供科学依据.方法 采用2005-2014年的全国学生体质与健康调研中的身高、体重测量数据,应用LMS方法对数据进行拟合,获得身高、体重的第5,50,95百分位数曲线,分析2005-2010年、2010-2014年的身高、体重变化趋势.结果 2005-2010年7~18岁城市男生、乡村男生、城市女生、乡村女生第50百分位身高增量分别为1.0,1.6,0.8,1.1 cm,2010-2014年身高增量分别为1.0,1.4,0.9,1.3 cm;2005-2010年7~18岁城市男生、乡村男生、城市女生、乡村女生第50百分位体重增量分别为1.3,1.9,0.9,1.1 kg,2010-2014年体重增量分别为1.7,2.1,1.3,1.5 kg.以18岁学生的身高、体重作为成年身高、体重的估计值,2005-2014年期间,我国学生成年身高、体重增加明显.乡村学生身高和体重的平均增长量普遍高于城市学生,男生高于女生;2010-2014年身高和体重的增长趋势均比2005-2010年更明显.结论 我国儿童青少年生长发育水平仍保持较快的增长趋势,尤其是体重增长较为迅速,且身高、体重的城乡差距在逐渐缩小.     

Prevalence of surgical-site infections and patterns of antimicrobial use in a large tertiary-care hospital in Ho Chi Minh City, Vietnam.

BACKGROUND: Few studies have been conducted in Vietnam on the epidemiology of healthcare-associated infections or antimicrobial use. Thus, we sought to determine the prevalence of and risk factors for surgical-site infections (SSIs) and to document antimicrobial use in surgical patients in a large healthcare facility in Vietnam. METHODS: We conducted a point-prevalence survey of SSIs and antimicrobial use at Cho Ray Hospital, Ho Chi Minh City, a 1,250-bed inpatient facility. All patients on the 11 surgical wards and 2 intensive care units who had surgery within 30 days before the survey date were included. RESULTS: Of 391 surgical patients, 56 (14.3%) had an SSI. When we compared patients with and without SSIs, factors associated with infection included trauma (relative risk [RR], 2.65; 95% confidence interval [CI95], 1.60 to 4.37; P < .001), emergency surgery (RR, 2.74; CI95, 1.65 to 4.55; P < .001), and dirty wounds (RR, 3.77; CI95, 2.39 to 5.96; P < .001). Overall, 198 (51%) of the patients received antimicrobials more than 8 hours before surgery and 390 (99.7%) received them after surgery. Commonly used antimicrobials included third-generation cephalosporins and aminoglycosides. Thirty isolates were identified from 26 SSI patient cultures; of the 25 isolates undergoing antimicrobial susceptibility testing, 22 (88%) were resistant to ceftriaxone and 24 (92%) to gentamicin. CONCLUSIONS: Our data show that (1) SSIs are prevalent at Cho Ray Hospital; (2) antimicrobial use among surgical patients is widespread and inconsistent with published guidelines; and (3) pathogens often are resistant to commonly used antimicrobials. SSI prevention interventions, including appropriate use of antimicrobials, are needed in this population.     

Secular trends in adolescent never smoking from 1990 to 1999 in California: an age-period-cohort analysis

OBJECTIVES: We analyzed age, time period, and cohort effects on trends in adolescent cigarette smoking in California from 1990 to 1999. METHODS: Data from subjects aged 12 to 17 years (n = 26 536; 50.4% male) from the California Tobacco Survey and the California Youth Tobacco Survey were analyzed, and never smokers were used as the outcome measure. RESULTS: The proportion of never smokers increased from 60% for males and 66% for females in 1990 to around 70% for both sexes in 1999. Respondents were more likely to be never smokers if born in 1978 or later (i.e., aged 12 years or younger in 1990, when most tobacco control programs started in California). CONCLUSIONS: The statewide antitobacco programs prevented adolescents from starting to smoke, primarily through a cohort effect.     

云南省1985-2014年纳西族儿童青少年生长长期趋势

分析1985-2014年云南省纳西族儿童青少年的生长长期变化,为促进其体质与健康提供科学依据.方法 收集1985,1995,2005和2014年4次云南省7~18岁纳西族学生的身高、体重、体质量指数(BMI)和身高最大增长年龄(MIA)等资料进行动态分析.结果 近30年来,7~18岁纳西族男、女生身高平均增加5.7 cm和4.7 cm,体重平均增加6.4 kg和5.8 kg,MIA提前2.56岁和0.06岁,18岁男、女生成年身高平均增加3.4 cm和2.6 cm.2005-2014年纳西族男、女生BMI平均增加0.6 kg/m2和0.4 kg/m2.纳西族成年身高性差从1985年的12.8 cm增大至2014年的13.6 cm.结论 云南省纳西族儿童青少年出现生长长期趋势,应加强重视,采取各种有效措施促进其健康成长.     

云南省佤族儿童青少年生长长期趋势分析

分析1985-2014年云南省佤族儿童青少年的生长长期变化,为促进少数民族学生体质与健康提供科学依据.方法 收集1985,1995,2005和2014年4次云南省7~18岁佤族学生的身高、体重、胸围、体质量指数(BMI)、月经初潮(女)和首次遗精(男)年龄等资料进行动态分析.结果 近30 a来,7~18岁佤族男、女生身高平均增加5.7 cm和6.5 cm,体重平均增加4.7 kg和5.5 kg,胸围平均增加0.8 cm和3.7 cm,男、女生成年(18岁)身高平均增加2.7 cm和0.8cm,女生月经初潮年龄提前1.03岁.2005-2014年佤族男、女生BMI平均增加0.5 kg/m2和0.7 kg/m2,男生首次遗精年龄提前1.54岁.结论 云南省佤族儿童青少年处于不完全性生长长期趋势.应加强重视,采取各种有效措施促进儿童青少年的健康成长.     

Susceptibilities of Candida species to amphotericin B and fluconazole: the emergence of fluconazole resistance in Candida tropicalis.

OBJECTIVE: To determine the susceptibilities of Candida species isolated from Taiwan to amphotericin B and fluconazole. DESIGN: Prospective surveillance study. METHODS: Each hospital was asked to submit up to 10 C. albicans and 40 non-albicans Candida species during the collection period, from April 15 to June 15, 1999. One isolate was accepted from each episode of infection. The broth microdilution method was used to determine susceptibilities to amphotericin B and fluconazole. RESULTS: Only 3 of 632 isolates, one each of C. famata, C. krusei, and C. tropicalis, were resistant to amphotericin B. A total of 53 (8.4%) of 632 clinical yeast isolates, consisting of 4% C. albicans, 8% C. glabrata, 15% C. tropicalis, and 70% C. krusei, were resistant to fluconazole. In contrast, no C. parapsilosis isolate was resistant to fluconazole. Isolates from tertiary-care medical centers had higher rates of resistance to fluconazole than did those from regional and local hospitals (11.4% vs 6.6%). Isolates from different sources showed different levels of susceptibility to fluconazole. All of the isolates with the exception of C. tropicalis and C. krusei isolated from blood were susceptible to fluconazole. A pattern of co-resistance to both amphotericin B and fluconazole was observed. CONCLUSIONS: Non-albicans Candida species had higher rates of resistance to fluconazole than did C. albicans (44 of 395 [11.2%] vs 9 of 237 [3.8%]; P = .002). The increasing rate of fluconazole resistance in C. tropicalis (15%) is important because C. tropicalis is one of the most commonly isolated non-albicans Candida species.