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991.
Using data from a birth defects registry, this study examined the epidemiology of hydrocephaly in Hawaii during 1986--2000. There were 294 cases of hydrocephaly, resulting in a rate of 10.4 per 10,000 live births. The hydrocephaly rate was lower with increased maternal age and female sex and higher with lower birth weight, lower gestational age, and multiple gestation pregnancy. 相似文献
992.
Changing epidemiology of invasive pneumococcal disease among older adults in the era of pediatric pneumococcal conjugate vaccine 总被引:13,自引:0,他引:13
Lexau CA Lynfield R Danila R Pilishvili T Facklam R Farley MM Harrison LH Schaffner W Reingold A Bennett NM Hadler J Cieslak PR Whitney CG;Active Bacterial Core Surveillance Team 《JAMA》2005,294(16):2043-2051
Context A conjugate vaccine targeting 7 pneumococcal serotypes was licensed for young children in 2000. In contrast to the 23-valent polysaccharide vaccine used in adults, the 7-valent conjugate vaccine affects pneumococcal carriage and transmission. Early after its introduction, incidence of invasive pneumococcal disease declined among older adults, a group at high risk for pneumococcal disease. Objective To determine among adults aged 50 years or older whether incidence of invasive pneumococcal disease, disease characteristics, or the spectrum of patients acquiring these illnesses have changed over the 4 years since pneumococcal conjugate vaccine licensure. Design, Setting, and Population Population-based surveillance of invasive pneumococcal disease in 8 US geographic areas (total population, 18 813 000), 1998-2003. Main Outcome Measures Incidence of invasive pneumococcal disease by pneumococcal serotype and other characteristics; frequency among case patients of comorbid conditions and other factors influencing mortality. Results Incidence of invasive pneumococcal disease among adults aged 50 years or older declined 28% (95% confidence interval [CI], 31% to 24%), from 40.8 cases/100 000 in 1998-1999 to 29.4 in 2002-2003. Among those aged 65 years or older, the 2002-2003 rate (41.7 cases/100 000) was lower than the Healthy People 2010 goal (42 cases/100 000). Among adults aged 50 years or older, incidence of disease caused by the 7 conjugate vaccine serotypes declined 55% (95% CI, 58% to 51%) from 22.4 to 10.2 cases/100 000. In contrast, disease caused by any of the 16 serotypes only in polysaccharide vaccine did not change, and disease caused by serotypes not in either vaccine increased somewhat, from 6.0 to 6.8 cases/100 000 (13%; 95% CI, 1% to 27%). Between 1998-1999 and 2002-2003, the proportion of case-patients with human immunodeficiency virus infection increased from 1.7% (47/2737) to 5.6% (124/2231) (P<.001), and those with any comorbid condition that is an indication for pneumococcal polysaccharide vaccination increased from 62.3% (1842/2955) to 72.0% (1721/2390) (P<.001). Conclusions Our findings indicate that use of conjugate vaccine in children has substantially benefited older adults. However, persons with certain comorbid conditions may benefit less than healthier persons from the indirect effects of the new vaccine. 相似文献
993.
Chu JH Gange SJ Anastos K Minkoff H Cejtin H Bacon M Levine A Greenblatt RM 《American journal of epidemiology》2005,161(9):881-890
The role of hormonal contraceptive use in the effectiveness of highly active antiretroviral therapy (HAART) was examined among participants in the Women's Interagency HIV Study who were followed from HAART initiation to 2001. Propensity score selection was used to match 77 hormonal contraceptive users with 77 nonusers on age, race, and pre-HAART CD4-positive T-lymphocyte (CD4+ cell) count and viral load. The authors compared hormonal contraceptive users and nonusers with regard to the CD4+ cell count and viral load responses to HAART upon initiation. Proportional hazards analyses were used to assess the effect of hormonal contraceptive use on times to increases in CD4+ cell count of 50 cells/mm(3) and 100 cells/mm(3) and achievement of an undetectable viral load. There were no statistically significant differences in CD4+ cell counts and log viral load responses by hormone use after HAART initiation, except in log viral load at the third visit after initiation (p = 0.047). Time-dependent hormonal contraceptive use was not a statistically significant predictor of achieving increases in CD4+ cell count of 50 cells/mm(3) and 100 cells/mm(3) or an undetectable viral load (p = 0.517, p = 0.751, and p = 0.218, respectively) after HAART initiation. In conclusion, the authors did not find substantial evidence that use of hormonal contraceptives strongly affected responses to HAART. 相似文献
994.
McDermott MM Liu K Criqui MH Ruth K Goff D Saad MF Wu C Homma S Sharrett AR 《American journal of epidemiology》2005,162(1):33-41
The authors studied associations between ankle-brachial index (ABI) and subclinical atherosclerosis in the Multi-Ethnic Study of Atherosclerosis. Participants included 3,458 women (average age = 62.6 years) and 3,112 men (average age = 62.8 years) who were free of clinically evident cardiovascular disease. Measurements included ABI, carotid artery intima-media thickness, and coronary artery calcium assessed with computed tomography. Five ABI categories were defined: <0.90 (definite peripheral arterial disease (PAD)), 0.90-0.99 (borderline ABI), 1.00-1.09 (low-normal ABI), 1.10-1.29 (normal ABI), and > or =1.30 (high ABI). Compared with that in men with normal ABI, significantly higher internal carotid artery intima-media thickness was observed in men with definite PAD (1.58 vs. 1.09; p < 0.001), borderline ABI (1.33 vs. 1.09; p < 0.001), and low-normal ABI (1.18 vs. 1.09; p < 0.001) after adjustment for confounders. Fully adjusted odds ratios for a coronary artery calcium score greater than 20 decreased across progressively higher ABI categories in both women (2.85 (definite PAD), 1.27 (borderline ABI), 1.11 (low-normal ABI), 1.00 (normal ABI; referent), and 0.78 (high ABI); p for trend = 0.0002) and men (3.26 (definite PAD), 1.72 (borderline ABI), 1.14 (low-normal ABI), 1.00 (normal ABI; referent), and 1.43 (high ABI); p for trend = 0.0002). These findings indicate excess coronary and carotid atherosclerosis at ABI values below 1.10 (men) and 1.00 (women) and may imply increased risk of cardiovascular events in persons with borderline and low-normal ABI. 相似文献
995.
Kaput J Ordovas JM Ferguson L van Ommen B Rodriguez RL Allen L Ames BN Dawson K German B Krauss R Malyj W Archer MC Barnes S Bartholomew A Birk R van Bladeren P Bradford KJ Brown KH Caetano R Castle D Chadwick R Clarke S Clément K Cooney CA Corella D Manica da Cruz IB Daniel H Duster T Ebbesson SO Elliott R Fairweather-Tait S Felton J Fenech M Finley JW Fogg-Johnson N Gill-Garrison R Gibney MJ Gillies PJ Gustafsson JA Hartman Iv JL He L Hwang JK Jais JP Jang Y Joost H Junien C Kanter M Kibbe WA 《The British journal of nutrition》2005,94(5):623-632
Nutrigenomics is the study of how constituents of the diet interact with genes, and their products, to alter phenotype and, conversely, how genes and their products metabolise these constituents into nutrients, antinutrients, and bioactive compounds. Results from molecular and genetic epidemiological studies indicate that dietary unbalance can alter gene-nutrient interactions in ways that increase the risk of developing chronic disease. The interplay of human genetic variation and environmental factors will make identifying causative genes and nutrients a formidable, but not intractable, challenge. We provide specific recommendations for how to best meet this challenge and discuss the need for new methodologies and the use of comprehensive analyses of nutrient-genotype interactions involving large and diverse populations. The objective of the present paper is to stimulate discourse and collaboration among nutrigenomic researchers and stakeholders, a process that will lead to an increase in global health and wellness by reducing health disparities in developed and developing countries. 相似文献
996.
Leuprolide Acetate Suppresses Pedophilic Urges and Arousability 总被引:2,自引:0,他引:2
Schober JM Kuhn PJ Kovacs PG Earle JH Byrne PM Fries RA 《Archives of sexual behavior》2005,34(6):691-705
Cognitive–behavioral psychotherapy was compared with cognitive–behavioral psychotherapy augmented by leuprolide acetate (LA)
for suppression of pedophilic behavior. Five male pedophiles (M age, 50 years; range, 36–58) were administered LA by Depo injection for 12 months, followed by saline placebo for 12 months.
Testosterone levels, sexual interest preference by visual reaction time (Abel Assessment), penile tumescence (Monarch Penile
Plethysmography, PPG), as well as strong sexual urges toward children and masturbatory frequency involving thoughts of children
(polygraph), were measured every 3 months. On LA, testosterone decreased to castrate levels. Penile tumescence was significantly
suppressed compared with baseline, but sufficient response remained to detect pedophilic interest. Pedophilic interest was
also detected by visual reaction times. When asked about having pedophilic urges and masturbating to thoughts of children,
all subjects self-reported a decrease. Polygraph responses indicated subjects were not deceptive. On placebo, testosterone
and physiologic arousal eventually rose to baseline. As noted by polygraph, at baseline and on placebo, subjects were deceptive
regarding increased pedophilic urges and masturbatory frequency. Interest preference, as measured by Abel Assessment and Monarch
PPG, was generally unchanged throughout the study. Cognitive–behavioral psychotherapy augmented with LA significantly reduced
pedophilic fantasies, urges, and masturbation; however, pedophilic interest did not change during 1 year of therapy. Deceptive
responses by polygraph suggested that self-report was unreliable. Follow-up utilizing objective measures is essential for
monitoring efficacy of treatment in pedophilia. Our study supports the premise that suppression of pedophilic behavior is
possible. LA may augment cognitive–behavioral psychotherapy and help break the sequence leading to a re-offense. 相似文献
997.
Kulig JC Nahachewsky D Hall BL Kalischuk RG 《Canadian journal of public health. Revue canadienne de santé publique》2005,96(5):357-359
Youth violence is a significant issue for public health because of the potential for long-term impacts on individuals, families and communities. Limited exposure to violence is seen as a component of healthy living. However, there is limited understanding of violence from a public health perspective within rural communities. Rural refers to those communities with a population less than 10,000 outside the main commuting zone of a large urban area. Population health approaches, including the social determinants of health, are well supported by public health officials. Generating information about rural youth violence from a Canadian perspective would add to our understanding of these social determinants while providing guidance for policy and program development. Current understandings of youth violence are limited to an urban, and oftentimes, American perspective. An ongoing two-phase Canadian study on rural youth violence included qualitative interviews with 52 youth and the completion of a questionnaire that had been developed from the qualitative responses. The questionnaire has been completed by a larger sample of rural youth. The findings generated from this ongoing study will be useful in linking violence with social factors that impact health and thereby guide population health programs and policies. In this way, the role of public health to develop policies and implement programs will be directly influenced by evidence while addressing an ongoing public health concern. 相似文献
998.
Barr DB Allen R Olsson AO Bravo R Caltabiano LM Montesano A Nguyen J Udunka S Walden D Walker RD Weerasekera G Whitehead RD Schober SE Needham LL 《Environmental research》2005,99(3):314-326
We report population-based concentrations (stratified by age, sex, and composite race/ethnicity variables) of selective metabolites of chlorpyrifos (3,5,6-trichloro-2-pyridinol; TCPY), chlorpyrifos methyl (TCPY), malathion (malathion dicarboxylic acid; MDA), diazinon (2-isopropyl-4-methyl-6-hydroxypyrimidine; IMPY), methyl parathion (para-nitrophenol; PNP), and parathion (PNP). We measured the concentrations of TCPY, MDA, IMPY, and PNP in 1997 urine samples from participants, aged 6-59 years, of the National Health and Nutrition Examination Survey, 1999-2000. We detected TCPY in more than 96% of the samples tested. Other organophosphorus pesticide metabolites were detected less frequently: MDA, 52%; IMPY, 29%; and PNP, 22%. The geometric means for TCPY were 1.77 microg/L and 1.58 microg/g creatinine. The 95th percentiles for TCPY were 9.9 microg/L and 8.42 microg/g creatinine. The 95th percentiles for MDA were 1.6 microg/L and 1.8 microg/g creatinine. The 95th percentiles for IMPY and PNP were 3.7 microg/L (3.4 microg/g creatinine) and 5.0 microg/L (4.2 microg/g creatinine), respectively. Multivariate analyses showed that children aged 6-11 years had significantly higher concentrations of TCPY than adults and adolescents. Similarly, adolescents had significantly higher TCPY concentrations than adults. Although the concentrations between sexes and among composite racial/ethnic groups varied, no significant differences were observed. 相似文献
999.
Rachmiel M Aladjem M Starinsky R Strauss S Villa Y Goldman M 《Pediatric nephrology (Berlin, Germany)》2005,20(10):1449-1452
The objective of this study was to assess the frequency of symptomatic urinary tract infections (UTIs) following voiding cystourethrography (VCUG) while using prophylactic antibiotics. Medical records of 421 patients who underwent a VCUG during a period of 4 years were reviewed. Three hundred forty-nine had a VCUG following a febrile UTI, and 72 had the test for evaluation of hydronephrosis. All received prophylactic antibiotics and were evaluated within 7–10 days following the VCUG. One hundred seventy-two children (41%) had an abnormal VCUG. Seven of 421 children (1.7%) had symptoms suggestive of UTI. Two had culture negative pyuria; one had Escherichia Coli UTI, and four had Pseudomonas aeruginosa UTI. On multivariate logistic regression analysis, the risk factors contributing to the development of UTI following VCUG were the presence of vesicoureteral reflux (VUR) and its severity (odds ratio [OR] 2.52; 95% confidence interval [CI] 2.24, 2.83, p =0.001; and OR 2.32; 95% CI 2.05,2.62, p =0.04, respectively). The incidence of VCUG-induced UTI in children receiving prophylactic antibiotic therapy is low. There is a relatively high rate of Pseudomonas UTI, especially in children with moderate to severe reflux. We recommend that children with symptoms suggesting a UTI following a VCUG should be treated for Pseudomonas aeruginosa pending culture results. 相似文献
1000.
DNA vaccination for the priming of neutralizing antibodies against non-immunogenic STa enterotoxin from enterotoxigenic Escherichia coli 总被引:1,自引:0,他引:1
In order to test the use of DNA vaccination for its capacity to induce antibodies against the non-immunogenic heat-stable enterotoxin STa from Escherichia coli, BALB/c mice were immunized with plasmid DNA encoding hybrid proteins made by the insertion of wild type STa or insertion of the Cys6Ala, Cys17Ala and Cys6Ala-Cys17Ala STa mutants at positions 195 or 216 of the TEM-1 beta-lactamase. No STa specific antibodies could be detected after three plasmid injections, but a subsequent boost with native STa peptide was capable of inducing low levels of neutralizing antibodies, as tested in the suckling mouse assay. Highest STa specific responses were found in mice primed with the double mutated STa inserted in position 195. This plasmid induced highest T-cell responses to the TEM-1 protein, indicating that priming of helper T-cell responses to the carrier protein was essential. Mixed IgG1/IgG2a isotypes also reflected this T helper 1 type priming. Moreover, insertion into loop A of the TEM-1 carrier may be more suitable than insertion into loop B, because of reduced competition between carrier and hapten B cell responses. 相似文献