On prevalence, incidence, and duration in general stable populations.

The relationship between prevalence, incidence, and duration of disease is studied in exponentially growing/declining stable populations. Prevalence odds is shown to be a weighted average of age-specific products between incidence and discounted disease duration. If and only if the covariance between incidence and duration is zero, does prevalence odds equal the product of average incidence and average duration. The product of averages is shown typically to overestimate prevalence in epidemiologic applications. Ignoring population growth also tends to lead to overestimation of prevalence.     

Gynecomastia: analysis of 159 patients and current recommendations for treatment

Gynecomastia has been treated surgically in 159 patients during the past 22 1/2 years. Prior to 1980, all patients had traditional excision, which was followed by a high incidence of complications and undesired sequelae, not the least of which was that the results of this aesthetic operation were often unaesthetic. Since 1980, when suction lipectomy became the cornerstone of treatment, the results have been much better. As a result, current recommendations for treatment are as follows: If the gynecomastia is entirely due to fat, suction lipectomy alone is sufficient treatment. However, since suction will not remove breast parenchyma, those patients whose gynecomastia is due to parenchymal hypertrophy also require local excision of the parenchyma. Skin excision is rarely, if ever, necessary.     

Breastfeeding duration, milk fat composition and developmental indices at 1 year of life among breastfed infants

The associations of breastfeeding duration and milk fat composition with the developmental outcome at 1 year of age were measured within 44 infants exclusively breastfed for 3 months, out of 95 recruited at birth. Pooled breast milk (hindmilk) of the mothers was analysed at colostrum, 1, 3, 6, 9, and 12 months for total fat and fatty acid content. Infants were examined at 12 months by means of the Bayley test. There was a progressive reduction of the number of breastfed babies after the introduction of solids to 29 (6 months), 17 (9 months) and 10 (12 months). After adjusting for major confounders, infants breastfed for 6 months or longer showed a trend to have an advantage at the Bayley psychomotor developmental index compared to those breastfed >3 and <6 months (95% CI for difference: - 0.6, 13.8; P= 0.07) while the Bayley mental developmental index (MDI) was just 2.1 points higher. Among the milk fat components considered for each time-point, the total fat content at 6 months showed the strongest association with the MDI at 12 months (r=0.59, P=0.001). Prolonging breastfeeding during the weaning process may result in a better developmental performance at 12 months, possibly due to the supply of fats affecting brain composition.     

An abattoir-based study on the prevalence of hydatidosis in livestock in Mashhad, Iran

A 6-year (2004-2010) retrospective study was carried out to determine the prevalence of hydatidosis in livestock slaughtered in Mashhad abattoir, Mashhad, in north-eastern Iran and the capital of Khorasan province. Between 20 March 2004 and 19 March 2010, 5,131,485 animals (411,163 cattle; 4,547,618 sheep; 172,704 goats) were slaughtered in the study area and 388,399 (7.5%) livers and 1,139,529 (22.2%) lungs were discarded. Hydatidosis was responsible for 4% and 6.5% of total livers and lungs inspected, respectively. Of the cattle livers and lungs inspected over the survey period, 5.5% and 7.9% were condemned, respectively, because they held hydatid cysts. The corresponding values for livers and lungs of sheep (2%, 4%) and of goats (4.5%, 7.8%), respectively, were also condemned due to hydatidosis. Data showed a prominent seasonal pattern for hydatidosis. Liver condemnations due to hydatidosis were higher in winter and autumn for cattle and sheep, respectively, whereas lung condemnations were higher in summer for sheep and cattle. In goats, liver and lung condemnations were higher in winter. This could be attributed to various factors, such as sources of slaughtered animals, changes in management practice and ecological factors. The present survey provides baseline data for the future monitoring of this potentially important parasitic disease in the region.     

The prevalence and fertility of hydatid cysts in buffaloes from Iran

Cystic echinococcosis caused by Echinococcus granulosus is considered to be an important parasitic infection in livestock. In the present study, which aimed to determine the epidemiology of hydatidosis in buffalo in Iran, slaughterhouses of West Azerbaijan (Urmia), East Azerbaijan (Tabriz), Ardabil (Ardabil), Gilan (Rasht and Hashtpar) and Khuzestan (Ahvaz) were inspected. Age, sex and infected organs were recorded separately, and the observed cysts were examined for fertility and viability. Our results showed that 344 (9%) of 3832 inspected buffaloes were infected with hydatid cysts. The maximum and minimum infection rates occurred in Khuzestan (9.9%) and Ardabil (8%) provinces, respectively. There was no significant difference in the rate of infection in all provinces. Of 344 infected buffaloes, the rate of fertility was 7.3% and the rate of viability in fertile cysts was 78.75%. Hydatid cysts were more prevalent in female compared with male buffaloes (P < 0.05). There was a positive correlation between the age and number of infected hosts in all provinces except East Azerbaijan. The prevalence of infection in lungs was significantly higher than that in the livers of buffaloes in the provinces studied (P < 0.001). In conclusion, the fertility of hydatid cysts in buffaloes was low, as previously demonstrated in cattle, and this animal may play a minor role in the epidemiology of hydatidosis in Iran.     

A parametric model for estimating prevalence,incidence, and mean bout duration from point sampling

Point or instantaneous sampling refers to the scoring of presence or absence of behavior at the end of equally spaced intervals of time and is used to estimate prevalence. The literature cited demonstrates that point sampling does not adequately estimate frequency or mean bout duration. A parametric model is developed based on exponentially distributed times of behavior and intervening nonbehavior, thus enabling estimators of mean bout length and incidence. Variance estimators are provided and a method is suggested for designing sample situations which control the variance of the prevalence estimator. The paper concludes the theoretical investigation with a thorough Monte Carlo investigation and application to a “real-life” problem. The point sample estimators compare favorably with continuous observation under appropriate choice of sampling interval and under approximately exponential assumptions.     

Recognizing and assessing pain,suffering and distress in laboratory animals: a survey of current practice in the UK with recommendations

A survey was undertaken to evaluate how animal pain, suffering and distress are recognized and assessed in UK scientific procedure establishments designated under the Animals (Scientific Procedures) Act 1986. A total of 28 institutions were visited between June 1999 and April 2001, within which 137 people were interviewed including scientists, veterinarians and animal technicians. All 28 establishments use clinical observation sheets to assist the recognition of adverse effects, nine use score sheets and seven use computerized data management systems. Clinical signs used as indicators of potential pain, suffering or distress are largely subjective. The survey also addressed protocols and methods for avoiding and alleviating adverse effects, record keeping, review of policies and protocols and issues relating to team work and training. Respondents use a range of techniques for reducing suffering including analgesia, humane endpoints, ensuring competence and refining husbandry. All establishments review projects regularly but few have the time or resources formally to review adverse effects noted in practice and to compare observations with predictions made in licence applications. Training is very consistent between different establishments and most aim to achieve a 'team approach' for monitoring and assessing animals. Results are summarized in the present, abridged paper and set out in full in a report that can be downloaded at http://www.lal.org.uk/pain/(Hawkins 2002). The present paper and the full report, including its recommendations, are intended to provide a source of information, discussion topics and ideas for all establishments that need to monitor animal well-being.     

The prevalence, intensity and viability of hydatid cysts in slaughtered animals in the Ardabil province of Northwest Iran

In a cross-sectional study, a total of 5381 slaughtered animals, namely 928 cattle, 243 buffaloes, 3765 sheep and 445 goats were inspected macroscopically for hydatid cysts in northwest Iran, with prevalence values of 38.3%, 11.9%, 74.4% and 20%, respectively, being recorded. Prevalences were higher in females compared with males, but a significant difference (P < 0.001) was only found in sheep and cattle. Most cases which were condemned were seen in the lungs of sheep (13.4%) indicating that sheep are the most important intermediate hosts for Echinococcus granulosus in this area.     

Breastfeeding in China: a review

This review aims to describe changes in breastfeeding and summarise the breastfeeding rates, duration and reasons of discontinuing 'any breastfeeding' or 'exclusive breastfeeding' in P.R. China. Breastfeeding rates in China fell during the 1970s when the use of breast milk substitutes became widespread, and reached the lowest point in the 1980s. As a result many efforts were introduced to promote breastfeeding. The breastfeeding rate in China started to increase in the 1990s, and since the mid-1990s 'any breastfeeding' rates in the majority of cities and provinces, including minority areas, have been above 80% at four months. But most cities and provinces did not reach the national target of 'exclusive breastfeeding' of 80%. The 'exclusive breastfeeding' rates in minority areas were relatively lower than comparable inland provinces. The mean duration of 'any breastfeeding' in the majority of cities or provinces was between seven and nine months. The common reasons for ceasing breastfeeding, or introducing water or other infant food before four months, were perceived breast milk insufficiency, mother going to work, maternal and child illness and breast problems. Incorrect traditional perceptions have a strong adverse influence on 'exclusive breastfeeding' in less developed areas or rural areas. China is a huge country, geographically and in population size, and there is considerable ethnic diversity. Therefore breastfeeding rates in different parts of China can vary considerably.     

Rapporteur report: Roundup, discussion and recommendations

There is a relative paucity of recent information regarding the long-term health effects associated with exposure to ultrasound, and to infrasound and low-frequency noise (LFN). For ultrasound, further epidemiological studies are recommended, and priority should be given to studies investigating the effects of handedness and to studies assessing possible subtle effects on brain function. These studies should reflect contemporary practises in diagnostic ultrasound and have sufficiently long follow-up periods to examine the possibility of effects into late adolescence or beyond. In the absence of a non-exposed control group, it would be advisable to make comparisons between a highly exposed group with a less exposed group, and to compare groups exposed at differing gestational stages. The effects associated with ultrasound contrast agents should also be studied, and the appropriateness of the thermal index (TI) and mechanical index (MI) should be reviewed. It is recommended that animal models should be used to investigate the effects of exposure at differing gestational ages on development, and modern cellular and molecular techniques used to investigate potential mechanisms of interaction. Although explicit morphological changes have been reported following occupational and experimental exposures to infrasound and low LFN, it was recommended that a thorough review of the relevant biological and health effects literature was necessary before specific proposals could be made. Uncertainties about the characterisation of these low frequencies also indicated the need to develop appropriate measurement techniques and protocols.     

Susceptibility to biocides and the prevalence of biocides resistance genes in clinical multidrug-resistant Pseudomonas aeruginosa isolates from Hamadan,Iran

Molecular Biology Reports - This study aimed to investigate the association between biocides' reduced susceptibility and the presence of efflux pump genes including cepA, qacEΔ1 and qacE...     

The Wildbad Kreuth initiative: European current practices and recommendations for optimal use of blood components

With the aging population in Europe it is anticipated that the growing demand for blood products will not be met by the estimated supply. Therefore up-to-date recommendations for optimal administration of blood products in hemotherapy are needed. Ten years after the first meeting on optimal use of blood products at Wildbad Kreuth, Germany, a second symposium was organized to convene leading experts from the clinical, regulatory and economic perspective. The aim was to re-evaluate the existing state of hemotherapy, identify areas where further studies are needed, and to provide up-dated recommendations. A preparatory survey by questionnaire concerning guidelines, quality management in clinical use of blood products, provision of products in the individual countries and re-evaluation of the 1999 Wildbad Kreuth recommendations was completed in advance. The second Kreuth Meeting in April 2009 was attended by 110 experts in transfusion medicine, regulators and regulatory authorities from 38 countries. By consensus, 20 new recommendations were adopted. Most of the 1999 recommendations were found to still be valid 10 years later. But their realization and implementation on the levels of clinical practice, regulatory authorities and health policy decision makers is still lagging behind leaving an important task to accomplish. The Kreuth initiative toward optimal use of blood products should continue.     

Breastfeeding and feminism: A focus on reproductive health, rights and justice

Infant feeding occurs in the context of continued gender inequities and in the context of a feminist movement that left women vulnerable to a system that defined the male body and mind as the norm. This paper draws from a qualitative analysis of interviews conducted with women artists at the 2005 Mamapalooza music festival in New York City, and conference participants at the 2005 La Leche League International and International Lactation Consultant Association Conferences and at the 2007 Reproductive Freedom Conference to understand our collective alienation from breastfeeding and to outline a process for how we might repossess breastfeeding as a positive function in women's lives. These women find power in honoring and validating their own experiences, in claiming those experiences as legitimate feminist actions, and then drawing on these experiences to seek new meanings, customs and norms that similarly honor, value and support their rights to those experiences. They argue that we need a feminist movement that fully incorporates women's needs as biological and reproductive social beings, alongside their needs as productive beings, and a movement that defines the female body and mind as the norm.     

Comparing sources and analysis of uncertainty in consequential and attributional life cycle assessment: review of current practice and recommendations

The International Journal of Life Cycle Assessment - Life cycle assessment (LCA) is intended as a quantitative decision support tool. However, the large amount of uncertainty characteristic of LCA...     

The prevalence of pre-hypertension and its association to established cardiovascular risk factors in south of Iran

ABSTRACT: BACKGROUND: Pre-hypertension is associated with an increased risk of the development of hypertension and subsequent cardiovascular disease and raises mortality risk. The aim of this study was to determine the prevalence of pre-hypertension and to explore the associations between pre-hypertension and established cardiovascular risk factors in a population-based sample of Iranian adults. Methods: In this cross-sectional study a representative sample of 892 participants aged [greater than or equal to]30 years was selected using a multistage cluster sampling method. After completion of a detailed demographic and medical questionnaire (gender, age, history of diabetes mellitus and hypertension, taking antihypertensive or hypoglycemic agents and history of smoking), all participants were subjected to physical examination, blood lipid profile, blood glucose, anthropometric and smoking assessments, during the years 2009 and 2010. Variables were considered significant at a p-value [less than or equal to] 0.05. Statistical analysis was performed using SPSS version 11.5 software. RESULTS: Pre-hypertension was observed among 300 (33.7%) subjects, 36.4% for men and 31.4% for women (p > 0.05). The pre-hypertensive group had higher levels of blood glucose and triglycerides, higher body mass index and lower percentage of smoking than did the normotensive group. Multivariate logistic regression analysis showed that obesity and overweight were the strongest predictors of pre-hypertension [odds ratio, 2.74: 95% CI (Confidence Interval), 1.62 to 4.62 p<0.001; odds ratio, 2.56, 95% CI, 1.74 to 3.77, p<0.001 respectively].Conclusions: Overweight and obesity has become important in the association with pre-hypertension in Iranian population. Primary prevention strategies should concentrate on reducing overweight and obesity if the prevalence of pre-hypertension is to be diminished in Iranian adults. Key words: pre-hypertension, cardiovascular risk factor, obesity, BMI.     

Action potential duration and activation of ATP-sensitive potassium current in isolated guinea-pig ventricular myocytes

It is difficult to associate the ATP-sensitive potassium (K-ATP) channel of cardiac muscle with hypoxia/ischemia induced action potential shortening because this occurs before intracellular ATP falls to levels associated in vitro with channel opening. This leaves the cardiac K-ATP channel without any obvious physiological function. We have quantitatively examined the relationship between action potential duration and K-ATP channel activity in enzymatically isolated ventricular myocytes of the guinea-pig. In whole-cell voltage-clamp recording experiments when the K-ATP channel opener SR 44866 (2-10 microM) stimulated an outward membrane current greater than 50 pA at 0 mV membrane potential (the equivalent of 30 open K-ATP channels or 1% of the cell K-ATP channel population) action potential duration was reduced by more than 50%. In the majority of cell-attached membrane patch recordings metabolic inhibition stimulated K-ATP channel open probability of 1-2% which continued for long periods (7-25 min) before cell contracture and coincident major K-ATP channel activation (open probability 65%). Our quantitative analysis thus shows that physiologically relevant activity of K-ATP channels in cardiac muscle is confined to a very small percentage of the possible cell K-ATP current and thus intracellular ATP would not have to fall very far before the opening of K-ATP channels would influence cardiac excitability.