Tuberculin reactivity in Bacillus Calmette-Guérin vaccinated subjects

Setting: The Centre for Prevention and Control of Tuberculosis in Barcelona, Spain, where the staff appointed to Training Centers are examined.Aims: To check for tuberculin sensitivity due to Bacillus Calmette-Guérin (BCG) vaccine and ascertain its duration.Method: We compared the results of a tuberculin test (TT) on vaccinated and non-vaccinated subjects. The induration diameter and the time elapsed between BCG vaccination and the TT were determined.Results: Of the 2424 vaccinated subjects, 1489 (61.4%) reacted to TT (≥ 5 mm) and of the 3135 non-vaccinated, 905 (28.9%) reacted, a significant difference. Of 1978 subjects vaccinated between 6 and 14 years of age, 63.3% were TT reactors, compared to 23.9% of the 1948 non-vaccinated. Induration diameters ≥ 15 mm amounted to 11% for vaccinated subjects and 8% for those not vaccinated, a significant difference. The time from vaccination to TT was 13–25 years. Of the 446 subjects vaccinated at birth, 237 were reactors (53.1%); of the 887 non-vaccinated subjects of the same age, 154 (17.4%) reacted. Reactors ≥ 15 mm amounted to 40 (9%) for vaccinated subjects and 46 for non-vaccinated (5.2%), a significant difference. The time elapsed between vaccination and TT was 20–25 years. For 124 vaccinated subjects with a previous negative TT, a second test was positive for 87 (70.2%), and for 257 non-vaccinated it was positive for 64 (24.9%). The difference is due to a booster effect.Conclusions: BCG vaccination at birth and for school age children causes a reactivity to tuberculin which persists for 20 to 25 years. An induration diameter of ≥ 15 mm does not exclude a vaccinal origin. For vaccinated subjects with a previous negative TT, it is necessary to exclude the booster effect.     

Concentration of allergic fungi spores in the air of flats in Lódź

The real contribution of moulds to the pathogenesis of allergic diseases remains unknown, although positive skin prick tests and/or specific serum IgE to moki allergens can be detected in 1-5% of atopic patients. A significant problem in assesment of exposure to mould allergens, resulting with difficulty in standarization of methods. The aim of this work was to assess the concentration of spores of 8 mould species in flats inhabited by peoples who Bont show any symptoms of allergy. The Open Petri Dish (OPD) method involving sedimentation of participles contained in the column of air over the dish was used to assess the number of spores in 1 m3 of indoor atmospheres. All colonies were counted, but only 8 mould species implicated in inhaled allergy were identified, ie.: Alternaria tenuis, Cladosporium herbarum, Helminthosporum halodes, Pullularia pullulans, Penicillium notatam, Rhizopus nigricans, Mucor mucedo, Aspergillus fumigatus. The tests were carried out in 10 flats located in various quarters of the cify of Lod? during three consecutive days of September 1995 between 5:00 pm and 6:04 pm. In analyzing the percentage of spores of each of the eight mould species tested we determined that, independent of fiat and test day, C. herbarum predominated. It is good agreement with the observations of other authors who report that among large quantities of fungi that are detected in late summer, usually C. herbarum spores dominate. This is the season when the incidence of the Cladosporium spores in the atmospheric air increases. Spores of H. halodes were detected least frequently. Our study demonstrated the presence of substantial amounts of mould spores in indoor air of houses in Lód?. The spores belong to species with documented allergenicity, suggesting that they may play a role in development of allergic sensitization in susceptible subjects.     

Waldenström's macroglobulinemia in young African-American adults

We have identified five African-American patients with Waldenstr?m's macroglobulinemia (WM) diagnosed at a young age (ages 35, 38, 38, 40, 51; 4 males, 1 female). All had a history of intravenous heroin abuse and four also used cocaine. Their manner of presentation and clinical course were typical. Three of three patients tested for the hepatitis C virus (HCV) were positive and three of three patients tested were HIV negative. The potential relationship between intravenous drug abuse and/or HCV to development of WM in this group of young patients is provocative, especially since a polyclonal increase in serum IgM is commonly seen in chronic intravenous heroin addicts. More recently, the contribution of HCV is being evaluated in lymphoproliferative disorders. Although WM is typically a disease of older people, it should also be considered in the differential in a young patient with a suggestive clinical picture.     

Diverticulitis in the young patient-Is it different ？

AIM: To prospectively study the incidence and the natural history of acute diverticulitis in young patients. METHODS: A total of 207 patients hospitalized at our hospital between January 2000 to February 2005 with the diagnosis of acute diverticulitis were included. Their demographic characteristics, medical history, physical, radiographic and endoscopic findings as well as therapy were recorded. Patients were followed every 6 mo for the first year and later annually. RESULTS: The mean patients' age was 61 (range 27-92) years. Twenty- five patients (12%) were younger than 45 years. Acute diverticulitis was significantly more prevalent among male in the young age group as compared to the older age group (19/25, 76% vs 61/182, 33%, respectively, P = 0.0001). Complications occurred more often in the young age group; 32% vs 13%, (P = 0.002). During follow-up, 6 patients (28%) remained asymptomatic in the young age group as compared to 87 patients (55%) in the older age group (P = 0.024). As a result, sigmoidectomies were performed twice as often in the young age group (38% vs 13%, P = 0.002). CONCLUSION: Diverticulitis in young patients has a male predominance, a more aggressive course with a higher rate of complications and a higher recurrence rate. An earlier surgical approach might be considered in young patients with acute diverticulitis.     

Cancer mortality in young adults in Switzerland, 1951–1989

Summary Trends in mortality from all neoplasms and major cancer sites in Switzerland among populations aged between 20 and 44 years are presented. In men total cancer mortality was approximately constant around 270/10⁶ between 1951 and 1965, but declined appreciably thereafter to 217 per million in 1980–1989. The overall fall was 20%. The pattern of trends was similar for women, although a modest decline was already apparent in the earlier calendar period, and the overall fall was 29% (from 303 to 215/10⁶). These favourable trends reflect therapeutic advancements for Hodgkin's disease, leukaemias, testis and (chiefly non-epithelial) ovarian cancer, better control of cervical cancer, the long-term decline in gastric cancer, but also the downward trends in cancer of the intestines and a few less common sites, such as gallbladder and thyroid neoplasms for reasons that are not yet clear. Appreciable rises were observed for lung and other tobacco-related sites in women, for the oral cavity in men and (in earlier calendar periods) cutaneous melanoma in both sexes. Although restricted to a selected number of sites, these rises are discouraging, since the causes of these neoplasms have long been recognized. Somewhat discouraging also is the absence of decline in male lung cancer. These problems notwithstanding, the overall pattern of trends in cancer mortality in young Swiss adults over the last few decades is still reassuring, particularly in comparison with those observed in other European countries, and in the more general frame-work of the debate on the perspectives of progress in cancer control. Although restricted to a small proportion of all cancer deaths, in fact, trends in young adults offer useful indications on the likely future trends in the same generations in the near future, since they reflect more recent changes in the pattern of exposure. The size of the changes, however, will probably differ, since the prevalent cancers in middle age are different from those in the young.     

Preliminary analysis of the incidence rate of scabies in Lódź population

We have analysed all the reported and diagnosed cases of scabies in the years 1999-2000 per 100 000 inhabitants in the Lód? voivodeship. The data was obtained from the Regional Administration Unit for the Control of Epidemics and Hygiene Promotion in Lód?. The incidence in Lód? voivodeship was found to be twice as high (89,0) as that in Poland (44,0). The highest incidence in Lód? voivodeship was found in Radomsko (268,0), Pabianice (149,0) and Kutno (148.5) districts. The number of new cases registered in 1999-2000 did not increase in the districts: Leczyca, Radomsko, Lowicz and Be?chatów.     

Toxocarosis in the Lódź region over the years 1996-2000

In the paper epidemiologic analysis of toxocarosis with socio-medical background in humans in the Lód? macroregion over the years 1996-2000 was carried out. It was found that 58.2% of toxocarosis cases represent asymptomatic invasions occurring more often in town residents. The clinical form "minor" pertained the country residents, patients of elementary education and the group "pupil-student". The "major" form of toxocarosis was found in the country residents, young people, and patients over 60 years old.     

Does a routinely measured blood pressure in young adolescence accurately predict hypertension and total cardiovascular risk in young adulthood?

BACKGROUND: It is insufficiently known if routine blood pressure (BP) measurement by school doctors has added predictive value for later hypertension and cardiovascular risk. OBJECTIVE: To assess whether screening of BP in adolescence has additional predictive value to already routinely collected indicators of later hypertension and cardiovascular risk. METHODS: In the Dutch city of Utrecht, routine BPs and anthropometry were collected from school health records of 750 adolescents. In The Hague, standardized repeated BP measurements and anthropometry were available for 262 adolescents. Of both cohorts, 998 now young adults were recently re-examined. Predictors of adult hypertension, systolic blood pressure (SBP) > or = 140 mmHg and/or diastolic blood pressure (DBP) > or = 90 mmHg) and 10-year cardiovascular risk were analysed by logistic regression and area under receiver operator characteristics curve (AUC). RESULTS: A total of 167 young adults had hypertension. Single adolescent SBP and DBP predicted hypertension: odds ratio (OR) 1.04 per mmHg [95% confidence interval (CI): 1.03-1.06], OR 1.02 (1.00-1.04), respectively, but with little discriminative power. Gender, adolescent body mass index (BMI) and age combined predicted hypertension: AUC 0.71 (0.67-0.75), which slightly improved by adding SBP: AUC 0.74 (0.70-0.77); difference in AUC 0.03 (0.002-0.06). SBP exclusively predicted hypertension within men: OR 1.03 (1.01-1.04), AUC: 0.59 (0.53-0.65), and within women: OR 1.08 (1.05-1.11), AUC 0.74 (0.67-0.82). However, an adolescent BP of > or = 120 mmHg did not efficiently detect hypertensive men, while it detected 57.9% of hypertensive women. Only young adult men had meaningful 10-year cardiovascular risks, which only SBP predicted: OR risk score > 95th percentile 1.04 (1.02-1.07), AUC 0.67 (0.60-0.75). CONCLUSION: A single routine BP measurement in adolescent girls efficiently predicts young adult hypertension. In adolescent boys, BP predicts young adult 10-year cardiovascular risk.     

Poorer prognosis in young patients with gastric cancer?

BACKGROUND/AIMS: Although the relationship between prognosis and age of patients with gastric cancer is controversial, a poorer prognosis in young patients has been suggested by most investigators. To further examine the hypothesis, a retrospective study was undertaken to analyze a large series of patients with gastric cancer in Taiwan. METHODOLOGY: A total of 1,642 consecutive patients diagnosed with gastric cancer and receiving further management at one medical center from 1988 to 1993 were reviewed. The gender, TNM tumor stage, rate of curative resection and survival of the patients were compared in the young age group (< or = 39 years) and the old age group (> 39 years). Survival was estimated with the product-limit method and difference in survival was tested by the log-rank test. Multivariate analysis was done by the Cox proportional hazard model. RESULTS: Among the 1,642 patients, 61 patients were in the young age group and 1,581 patients were in the old age group. There was no significant difference for the 2 groups of patients in the distribution of TNM stage (stage I: 20%; II: 8%; III: 13%; IV: 59% vs. 19%, 11%, 25% and 45% respectively, in the old age group, p = 0.098) and rate of curative resection (38% vs 51% in the old age group, p = 0.059). The overall 5-year survival showed no significant difference between the 2 groups (25% vs. 29% in the old). Subgroup analyses showed that survival after curative resection and survival without curative treatment (including palliative resection and no resection) also had no difference in the 2 groups. Multivariate analysis also showed that age was not an independent factor. CONCLUSIONS: Although most reports suggested a dismal prognosis in young patients with gastric cancer, based on our findings, young patients (< or = 39 years) do not have a worse prognosis than older patients.     

Prevalence of Trichomonas vaginalis Donné in women of Lódź population in 1955-1999 years

Search for Trichomonas vaginalis was carried out in direct (in 0.85% NaCl and 0.1% safranine) and fixed stained microscopical preparations ( Wright or Giemsa methods, after fixation with 70% methyl alcohol) and cultures ( Pavlova, Johanson-Trussel-John, Roiron-Ratner, Simic media), from materials of the vagina, urethra and cervix uteri. In the years 1955-1999 a total of about 12000 women were examined. The prevalence of T. vaginalis in women population of Lód? region was high (from 26.6% still 78.0%); on the last ten years in about half of the sample examined women were infected of T. vaginalis.     

Sex workers in Vietnam: how many, how risky?

Because of concerns for HIV risks and need to plan effective programs, we assessed the number and risks of sex workers in Nha Trang City, Vietnam. Sex workers were contacted in streets, beaches, bars, and restaurants, and a capture-recapture method was used to estimate their number. An estimated 444 women worked on the streets and beach ("direct" sex workers) and 486 worked in bars and restaurants or other facilities ("indirect" sex workers). Direct and indirect sex workers engaged in sex work primarily to support their families. Direct sex workers were older and were more at risk for HIV risk than were indirect sex workers. Direct sex workers had more clients, were less likely to report always using condoms (67% vs. 81%), more likely to report a prior sexually transmitted infection (19% vs. 16%), and more likely to have clients who inject drugs (16% vs. 13%). This assessment has implications for planning programs to reduce sex work and its risks in Vietnam and potentially other countries.     

Does work contribute to successful aging outcomes in older workers?

Older workers are the fastest growing segment of the labor force, yet little is known about designing jobs for older workers that optimize their experiences relative to aging successfully. This study examined the contribution of workplace job design (opportunities for decision-making, skill variety, coworker support, supervisor support) to dimensions of successful aging (social network, emotional support, personal control, generativity) in a sample of 109 older workers in the retail homebuilding industry. Older workers completed four standardized tests reflecting the job design and successful aging variables. Results indicated that job design contributed to 23% of the variance in generativity and 15.5% of the variance in personal sense of control scores. Skill variety and coworker support were the most important job design variables for successful aging outcomes. The potential for workplaces to become social institutions that contribute to dimensions of successful aging is discussed.