Tuberculosis in Havana City, 1995-1999

OBJECTIVE: Tuberculosis is a worldwide health problem getting a prioritized attention by the Cuban National Health System. To describe the main indicators of the Cuban Tuberculosis Control Program. METHODS: Based on surveillance data from the Provincial Center of Hygiene and Epidemiology, the health care network and strategies of the tuberculosis control program were reviewed; incidence rates, case finding indicators, diagnosis and case management were described. RESULTS: Eight subjects with respiratory symptoms were found per 1,000 attending general medical care services. The incidence rates of all tuberculosis types declined from 16.4 in 1995 to 12.0 x 10(5) people in 1999. Pulmonary tuberculosis incidence rate was reduced from 15.1 in1995 to 10.4 x 10(5) in 1999, whereas extrapulmonary tuberculosis had an increment from 1.3 to 1.6 x 10(5) in the same period. Of all new cases, 40-50 % were diagnosed at multispecialty clinics, 67.6% were diagnosed by positive smears, 15.2 % by positive cultures, 13.8 % by clinical and X-rays evidences only; and 0.9 % and 1.5 % were respectively diagnosed by biopsy and necropsy. There was an increase in the incidence rate in the age group 15-64 years in 1996 and 1997 but it declined again in 1998 and 1999. The age group 64 years and over showed a rate reduction from 1995 to 1999. In general, incidence rates diminished in the overall period. The average delay between onset of symptoms and diagnosis improved from 42 days in 1995 to 28.6 days in 1999. CONCLUSIONS: There seems to be a halt in reporting trends of new cases in 1996. Tuberculosis indicators reveal satisfactory changes in the study period.     

Increase in bloodstream infections in Finland, 1995-2002

A national, population-based laboratory surveillance of bloodstream infections (BSI) in Finland was performed. Blood-culturing rates were determined from data from clinical microbiology laboratories and trends in rates were evaluated using Poisson regression. During 1995-2002, 51,510 cases of BSI were notified; the annual incidence increased from 104 to 145 cases/100,000 (40%). Rates increased in all age groups but persons aged >or= 75 years accounted for 28% of cases and showed the largest rate increase. Escherichia coli, coagulase-negative staphylococci, Staphylococcus aureus and Streptococcus pneumoniae accounted for 58% of isolates and their relative proportions were unchanged over time. The annual blood-culturing rate increased by one-third during the study period but the number of BSI detected per blood cultures remained unchanged. Regional BSI incidence was significantly associated with blood-culturing rates. We conclude that the increase in BSI rates may have been due to more frequent blood culturing but was not associated with changes in the reporting system or aetiology of BSI.     

Water traffic accidents, drowning and alcohol in Finland, 1969-1995

OBJECTIVE: To examine age- and sex-specific mortality rates and trends in water traffic accidents (WTA), and their association with alcohol, in Finland. MATERIALS AND METHODS: National mortality and population data from Finland, 1969-1995, are used to analyse rates and trends. The mortality rates are calculated on the basis of population, per 100000 inhabitants in each age group (<1, 1-4, 5-14, 15-24, 25-44, 45-64, > or = 65), and analysed by sex and age. The Poisson regression model and chi2 test for trend (EGRET and StatXact softwares) are used to analyse time trends. RESULTS: From 1969 through 1995 there were 3473 (2.7/100000/year; M:F= 20.4:1) WTA-related deaths among Finns of all ages. In 94.7% of the cases the cause of death was drowning. Alcohol intoxication was a contributing cause of death in 63.0% of the fatalities. During the study period the overall WTA mortality rates declined significantly (-4% per year; P < 0.001). This decline was observed in all age groups except > or = 65 year olds. The overall mortality rates in WTA associated with alcohol intoxication (1987-1995) also declined significantly (-6%; P = 0.01). CONCLUSIONS: In Finland, mortality rates in WTA are exceptionally high. Despite a marked decline in most age groups, the high mortality in WTA nevertheless remains a preventable cause of death. Preventive countermeasures targeted specifically to adult males, to the reduction of alcohol consumption in aquatic settings and to the use of personal safety devices should receive priority.     

Childhood deaths and injuries in Finland in 1971-1995

BACKGROUND: This study examined the recent nationwide trends for the absolute number and the age- and sex-specific incidence rates of the fatal and serious non-fatal injuries among 0-14 year old children in Finland in 1971-1995. METHODS: We selected from Official Cause-of-Death Statistics and National Hospital Discharge Register children aged 0-14 years who died or required treatment at a hospital department because of an injury in 1971-1995. The number of Finnish children was 1.1 million in 1971, and 1.0 million in 1995. RESULTS: During the entire study period injuries were the leading cause of death in children aged 1-14 years, but not in infants. However, in these years the incidence (per 100 000 people) of fatal injuries in Finnish children decreased considerably in all age groups and both sexes, in girls from 20.1 in 1971 to 4.6 in 1995, and in boys from 36.7 in 1971 to 9.3 in 1995. In 1995, 41% of all the injurious deaths among 0-14 year old Finnish children were motor vehicle accidents, 12% were drownings, and 24% intentional injuries. The overall number and incidence of serious non-fatal injuries among Finnish children showed no clear trend change in 1971-1995. The mean hospitalization time of injured children shortened between 1971 and 1995, from 7.4 days to 2.7 days. CONCLUSIONS: We conclude that the number and incidence of fatal childhood injuries have decreased dramatically in Finland between 1971 and 1995. The reasons for this positive development are multifactorial, but improved traffic safety and trauma care are probably very important. In children's serious non-fatal injuries the development has not been so encouraging and therefore children's injury prevention should receive continuous intense attention.     

Smoking and some life-style changes in medical students--Slovakia, 1995-1999

INTRODUCTION: The main goal of a questionnaire cross-sectional study was to compare the changes of smoking habits in medical students between 1995 and 1999. Beside this, other factors of life-style such as alcohol consumption, nutritional status [studied through body mass index (BMI)] and citrus consumption were studied. METHODS: Cross-sectional questionnaire study in 453 medical students of 1st to 5th academic years of the Jessenius Faculty of Medicine, Comenius University in Martin, Slovakia, carried out in October and November 1999. Data on smoking habit were compared with a similar study carried out in 1995. RESULTS: Prevalence of regular smoking (min. 1 cig/day) was 13.6% in men and 8.9% in women and did not change significantly in comparison with 1995. In women, prevalence of occasional smokers increased from 7.3% in 1995 to 19.8% in 1999 and almost reached men in the same year (21.8%). During this period significantly decreased proportion of respondents who have never smoked both in men (from 43.0 to 23.3%) and women (from 61.9% to 18.2%). Excessive drinking dominates in men, overweight (BMI > or = 25) had 16.0% of males and 2.0% of females and excessive underweight (BMI < or = 17.5) 1.0% of men and 2.8% of women. More than one half of respondents consumed less than 1 piece of citrus fruit per day. CONCLUSIONS: Smoking of men still predominates, however, the most apparent changes of smoking habit in regard to increasing proportion of smoking women, particularly occasional smokers. This indicates increasing social tolerance of smoking. In female a possibility of eating disorders deserve attention and a need for the improvement of diet is felt in both sexes.     

Evaluation of environmental medicine documentation in Schleswig-Holstein 1995-1999

Physicians qualified in environmentally related disorders due to their participation in special training courses in the Federal State of Schleswig-Holstein (Germany) used a standardised questionnaire to report on their environmental medicine related cases. The course of the illness, if known, has been documented on a separate data sheet. During the period from 1995-1999 916 cases and 508 courses of illness were assessed. The environmental factors/toxicants of exposure most frequently documented by the 85 participating physicians and found to be related to symptoms of illness were biocides (mainly insecticides used indoors for pest control (32%), moulds (27%), dental amalgam (22%), solvents/volatile organic compounds (21%) and formaldehyde (16%), respectively. In 42% of the documented cases an exposure to more than one environmental factor/toxicant was registered. Age distribution, gender, location of exposure as well as the symptoms of illness of the patients were found to be dependent on the type of exposure. Cessation of exposure to harmful substances/environments was achieved in 54% of those cases where information regarding the course of the illness was given. In 65% of these cases recovery was reported and 30% recovered partially. In those cases where a cessation of exposure could not be achieved or was not complete, no or only partial recovery was mostly reported. From these results it may be concluded that research work on environmentally related disorders should be enforced in order to prevent unnecessary illness and to lower the public health system expenditure.     

Self-reported concern about food security associated with obesity--Washington, 1995-1999

Obesity is epidemic among all segments of the U.S. population and in all regions of the country, and persons who are obese are at higher risk for several chronic diseases. Previous studies have suggested a possible relation between obesity and food insecurity (i.e., not having access at all times to enough safe and nutritious food for an active, healthy lifestyle because such foods are not available consistently or household resources are insufficient to meet the cost). To assess the relation between obesity and concern about food security, the Washington state Department of Health analyzed statewide data from the 1995-1999 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of the analysis, which indicate that concern about food security is associated with obesity. Longitudinal studies are needed to determine whether food insecurity causes obesity so appropriate interventions can be designed and implemented.     

安徽省1995—1999年HIV哨点监测分析

1995年起 ,我省分别在性病 (STD)门诊就诊者及暗娼 (CSW )两类人群中设立HIV哨点监测点。至 1999年 ,STD哨点共监测 3396人 ,其中男性占 6 4.1% ,女性占 35 .9% ,年龄以 2 5— 2 9岁所占比例最高 ,性病病种中淋病所占比例最大 ,尖锐湿疣及非淋菌性尿道炎所占比例呈逐年增加 ,1999年发现 1例HIV感染者 ;CSW哨点共监测 2 2 0 3人 ,年龄分布以 2 0— 2 4岁所占比例最高 ,为 36 .5 %。 0 .2 %的暗娼性伴中有境外人员。性活动中从未使用过避孕套者占 85 .9% ,每次均使用避孕套者占 1.3% ,五年监测在该人群中共发现HIV感染者 3人 ,其中 1996— 1998年各检出 1例HIV感染者。监测结果提示HIV已传入这两类高危人群 ,同时提示在我省性乱人群中潜伏着HIV传播和流行的危险性     

Sociodemographic patterns in spina bifida birth prevalence trends--North Carolina, 1995-1999.

Previous studies have documented a decline in neural tube defects (NTDs) in the United States after the addition of folic acid to enriched grain products and other folic acid initiatives. The decrease generally has been greater for spina bifida than for other NTDs. However, the extent to which the decline varies by maternal sociodemographic characteristics has not been examined. In this study data from the North Carolina Birth Defects Monitoring Program, a statewide, population-based birth defect surveillance program, were used to assess the impact that folic acid public health initiatives have had on spina bifida rates among various sociodemographic subpopulations in North Carolina. This report covers data from 1995 through 1999. The overall prevalence of spina bifida decreased by 27.2% during 1995-1996 and 1998-1999 (p = 0.014). The magnitude of the decline varied considerably by sociodemographic characteristics of the mother. The decline was greatest among mothers who were aged > or = 30 years (prevalence ratio [PR] = 0.53), who had more than a high school education (PR = 0.57), whose prenatal care was not paid by Medicaid (PR = 0.67), and who were non-Hispanic white (PR = 0.72). Geographically the decrease in the western and Piedmont regions of the state was almost threefold that occurring in the eastern region. The decline in spina bifida after fortification varied considerably by sociodemographic subpopulations. More effort is needed to target folic acid education programs at disadvantaged populations.     

Survival in population-based pancreatic cancer patients: San Francisco Bay area, 1995-1999

Patient vital status generally is passively obtained by cancer registries, and no previous population-based studies have used extensive active follow-up to compute a more accurate overall survival rate for pancreatic cancer. Therefore, the authors used multiple active and passive follow-up methods to determine vital status and date of death for 1,954 pancreatic cancer patients diagnosed from 1995 to 1999 in a large population-based study in the San Francisco Bay Area, California. Survival rates were estimated by using Kaplan-Meier methods. Hazard ratios and 95% confidence intervals were estimated by using multivariable Cox proportional-hazards models. Vital status was confirmed for >99% of 1,954 patients. The overall 5-year survival rate was 1.3% and was greater in patients who were younger and who had localized disease, well-differentiated tumors, and surgical resection. Shorter survival was associated with older age at diagnosis, male sex, distant/metastatic disease, and poorly differentiated tumors. Longer survival was observed for Asian/Pacific Islanders compared with non-Hispanic whites and for any active treatment regardless of tumor stage. With an almost complete follow-up, the authors observed a low overall 5-year survival rate. Although the results provide further evidence of poor survival among patients with pancreatic cancer, the data also suggest that within-stage-of-disease patients survived somewhat longer with therapy.     

Use of physician assistants and nurse practitioners in primary care, 1995-1999.

Federal policies and state legislation encourage the use of physician assistants (PAs) and nurse practitioners (NPs) in primary care, although the nature of their work has not been fully analyzed. In this paper we analyze primary care physician office encounter data from the 1995-1999 National Ambulatory Medical Care Surveys. About one-quarter of primary care office-based physicians used PAs and/or NPs for an average of 11 percent of visits. The mean age of patients seen by physicians was greater than that for PAs or NPs. NPs provided counseling/education during a higher proportion of visits than did PAs or physicians. Overall, this study suggests that PAs and NPs are providing primary care in a way that is similar to physician care.     

Making better use of scarce resources: the Palestinian experience, 1995-1999

Until August 2, 1997, The Eye Hospital-Gaza (EH) provided both primary and secondary eye services to almost 1 million inhabitants in Gaza. This exerted a tremendous load on the hospital's facilities and prevented the hospital from performing its main role as a secondary eye care provider. The training and guidance of primary health care (PHC) providers are essential in order that they can do their share in eye care. A prevention of blindness awareness campaign, training, workshops, and practical instruction took place in Gaza over a three-year span. A new purpose designed referral system was started on August 2, 1997, that resulted in a great change and improvement of the services in the hospital. Primary eye care is an integral part of ophthalmic services. Proper continuous training of PHC providers is essential, not only for providing service to patients near their residence in the shortest time possible, but also to facilitate the smooth, effective, and efficient functioning of the hospital as a secondary and tertiary eye care provider. We believe the system and methodology used is efficient and reproducible in many developing countries.     

我院1995-1999年发表的论文统计

应用文献计量学的原理和方法,对我院1995-1999年在国内文献上发表的学术论文进行定量研究,提供各项数量和质量指标的统计数据和测评结果,为衡量各学科和个人的科研实力和水平、发现和培养人才、为重点学科建设提供客观依据和决策参考.     

某市1995年与1999年机动车驾驶员视功能比较分析

驾驶员的健康状况直接关系到自身和他人及国家财产的安全,每年一度的机动车驾驶员体检工作已经成为驾驶员管理工作的一项重要内容,为了解该工作的成效,我们对某市1995年与1999年参加年审的部分驾驶员的视功能检查结果进行对比分析,现报告如下。1 资料和方法1.1 资料 从濮阳市职防所1995年及1999年机动车驾驶员体格检查表中选取年龄在18～50岁、工龄1～30年的男性机动车驾驶员,按同年龄且同工龄条件进行配对,共抽取256对进行比较研究。1.2 诊断标准1.2.1 视力 用国际标准视力表检查,双眼视力(包括矫正视力)1.0对以下为不合格。     

Annual smoking-attributable mortality,years of potential life lost,and economic costs--United States, 1995-1999

Cigarette smoking is the leading cause of preventable death in the United States and produces substantial health-related economic costs to society. This report presents the annual estimates of the disease impact of smoking in the United States during 1995-1999. CDC calculated national estimates of annual smoking-attributable mortality (SAM), years of potential life lost (YPLL), smoking-attributable medical expenditures (SAEs) for adults and infants, and productivity costs for adults. Results show that during 1995-1999, smoking caused approximately 440,000 premature deaths in the United States annually and approximately $157 billion in annual health-related economic losses. Implementation of comprehensive tobacco-control programs as recommended by CDC could effectively reduce the prevalence, disease impact, and economic costs of smoking.     

Transmission of an arenavirus in white-throated woodrats (Neotoma albigula), southeastern Colorado, 1995-1999

From 1995 to 1999, we conducted longitudinal studies of white- throated woodrats (Neotoma albigula) in southeastern Colorado. Forty-five (42.9%) of 105 female and 15 (26.8%) of 56 male N. albigula had antibodies against Whitewater Arroyo virus (WWAV). Sixteen female and three male N. albigula seroconverted during the study period, most of them during July-November, when population densities are highest. Analyses of longevity data, minimum numbers alive and infected, movements, and weight data suggest that the dominant mode of WWAV transmission among white-throated woodrats in Colorado is direct contact. WWAV was recently reported to cause fatal infection in humans. Our findings will lead to better assessment of the public health threat posed by infected woodrats and may be useful in predicting periods of increased risk for human infection.     

Prevalence of obesity in the population assisted at primary health care services in Girona, 1995-1999

OBJECTIVES: To estimate the prevalence of obesity and overweight in the population of Girona (Spain) between 1995 and 1999 and to divide the prevalences in geographical areas according to age and sex. METHODS: Height and weight were directly measures in 24,554 health care consumers older than 14 years (10,595 men and 13,959 women) treated in four primary health care areas: Girona 1, Girona 4, Salt and Camprodon and in one primary health care center in the province of Girona. Body mas index (BMI) was calcuted by dividing weight in kilograms bye height in meters squared. Obesity was defined as grades II and III of Garrow's index (BMI >= 30 kg/m2) and overweight as degree I (25 kg/m2 >= BMI < 30 kg/m2). Because the sample was not randomized, the prevalences were adequately weighted. The comparison between prevalences in two different primary health care areas for each sex (in the same Garrow's index and age group) was carried out using a parametric test of differences in proportions (Student's t-test). A hierarchical logistic regression was used to compare prevalences in the same grade Garrow's index, controlling for age and sex. RESULTS: The prevalence of obesity was estimated as 15.6% in men aged from 20-74 years (from 14.0% in Girona 1 to 22.4% in Camprodon) and 17.5% for women (15.6% in Girona 1, 22.7% in Camprodon). The weighted mean was 16.7%. The prevalence of overweight was 44% in men and 33% in women and the weighted mean was 37.8%. The prevalence of obesity was graduated with statistically significant differences between Girona 1, Salt, Girona 4, Camprodon and Sils. CONCLUSIONS: The estimates of the prevalences of obesity and overweight obtained in this study were closer to those of other studies in similar populations than previously believed. Indeed, the prevalences may be similar to those of the European Union and, in some age groups, to those of the United States.     

1995～1999年恩施州麻疹流行特征分析

目的：了解恩施州麻疹流行特征，更有效地防制麻疹，方法：对恩施州现阶段麻疹的流行特点进行分析。结果：1995年以来流行强度逐渐减弱，年平均报告发病率为16．24／10万，3－6月为高发季节，1－14岁儿童为主要发病人群，局部地区存在麻疹爆发，结论：麻疹疫苗的接种对恩施州麻疹流行有较好的预防作用。