Season of Birth in Schizophrenia in the Mexico City Area: Comparison with General Population

The relationship between seasonal changes and mental disorders has been extensively studied in the northern and southern hemispheres. In both cases, the results show that there is a higher rate of schizophrenic births during the winter months. The present study attempts to prove the existence of this phenomena in Mexico City, an area that does not undergo extreme weather variations throughout the year. A total of 2,288 schizophrenic patients was considered for this study. Their date of birth was compared to that of the general population of the Mexico City area, a total of 4,848,119 individuals. The number of births was evaluated according to the number of days in each month. The distribution of the births of schizophrenics was compared to the reference population by means of a Kolmogorov-Smirnov test and a X 2 contrast. The annual rhythm of births of schizophrenics was determined through an analysis of the Estimated Seasonal Component. There was a slight, non-significant increment in schizophrenic births in December and autumn, as compared with the general population birth rate. Interestingly, it was found that births in the control population decreased significantly in December when compared with all the other months. Results were discussed in relation to the geographical location of Mexico, which lies in a tropical zone, and as a consequence minimal seasonal effects.     

Season of Birth and Morningness: Comparison Between the Northern and Southern Hemispheres

The present study explored the possible role of the photoperiod at birth on morningness by collecting data in the northern (Italy) and southern (Australia) hemispheres. To assess circadian typology, the Composite Scale of Morningness (CS) was administered to a sample of 1734 university students (977 Italian and 757 Australian; 1099 females and 635 males; age 24.79?±?7.45 yrs [mean?±?SD]). Consistent with the literature, females reported higher CS scores (morningness) than males, and Australian participants reported higher CS scores than Italian participants. Allowing for the fact the seasons are reversed between the hemispheres, the results are in line with previous studies. The authors found more evening types were born during the seasons associated with longer photoperiod (spring and summer), and more morning types were born during the seasons associated with shorter photoperiod (autumn and winter), indirectly supporting an imprinting-like phenomenon played by the photoperiod at birth. (Author correspondence: vincenzo.natale@.unibo.it)     

Season of Birth and Sleep-Timing Preferences in Adolescents

The aim of the present study was to explore the relationship between season of birth and sleep-timing preferences in adolescence. To this end, the Morningness-Eveningness Questionnaire for Children and Adolescents (MEQ-CA) was administered to 1912 adolescents (1058 females and 854 males), ranging in age between 10 and 17 yrs. To assess preferred sleep habits, the authors considered the answers to the open-ended questions of the MEQ-CA (items 1 and 2), regarding the preferred arising time and the preferred going to bed time. Combining the answers to these two questions, the authors also indirectly computed the preferred sleep duration and preferred midpoint of sleep. Season of birth did not significantly modulate the overall MEQ-CA score; however, spring-born participants preferred to go to bed and reached the preferred midpoint of sleep later than those born in autumn. Agreeing with a previous study on young adults, the present data point to a significant season-of-birth effect on the two parameters of the sleep-timing preferences in adolescents. (Author correspondence: lorenzo.tonetti2@unibo.it)     

Comparison of the Metabolic Syndrome Risk in Valproate-Treated Patients with Epilepsy and the General Population in Estonia

Background

No study has explored the risk of metabolic syndrome (MS) in patients with epilepsy treated with valproate (VPA) at the population level. The aim of this study was to compare the risk of MS in VPA-treated patients in Estonia to the risk in the general population.

Methods

This study involved 118 patients with epilepsy (63 men, 55 women) who received VPA monotherapy. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Data were compared with the results of a population-based study of the prevalence of MS in the same geographic region (N = 493; 213 men, 280 women).

Results

In the multiple logistic regression analysis, after adjustment for age and sex, the risk of MS in VPA-treated patients was not increased compared to the control subjects (odds ratio [OR] = 1.00; 95% confidence interval [CI], 0.59–1.68). VPA-treated patients had higher serum insulin concentrations than control subjects, independent of body mass index (BMI). A positive association was found between MS development and BMI (OR = 1.47; 95% CI, 1.25–1.73) in VPA-treated patients, but there were no associations with the VPA dosage or the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. In control subjects, BMI and HOMA-IR had similar predictive abilities for MS occurrence. In VPA-treated patients, the predictive ability of the HOMA-IR index was significantly lower than that of BMI, with areas under the receiver operating characteristic curves of 0.808 and 0.897 (P = 0.05), respectively.

Conclusions

The risk of MS is not increased among VPA-treated patients with epilepsy in Estonia compared to the general population. The HOMA-IR index likely has a lower predictive ability for MS in VPA-treated patients compared to its predictive ability in the general population.     

Longitudinal Study of Microbial Diversity and Seasonality in the Mexico City Metropolitan Area Water Supply System

In the Mexico City metropolitan area (MCMA), 70% of the water for 18 million inhabitants is derived from the Basin of Mexico regional aquifer. To provide an overview of the quality of the groundwater, a longitudinal study was conducted, in which 30 sites were randomly selected from 1,575 registered extraction wells. Samples were taken before and after chlorine disinfection during both the rainy and dry seasons (2000-2001). Microbiological parameters (total coliforms, fecal coliforms, streptococci, and Vibrio spp.), the presence of Helicobacter pylori, and physicochemical parameters, including the amount of trihalomethanes (THMs), were determined. Although microorganisms and inorganic and organic compounds were evident, they did not exceed current permissible limits. Chlorine levels were low, and the bacterial counts were not affected by chlorine disinfection. Eighty-four bacterial species from nine genera normally associated with fecal contamination were identified in water samples. H. pylori was detected in at least 10% of the studied samples. About 40% of the samples surpassed the THM concentration allowed by Mexican and U.S. regulations, with levels of chloroform being high. The quality of the water distributed to the MCMA varied between the rainy and dry seasons, with higher levels of pH, nitrates, chloroform, bromodichloromethane, total organic carbon, and fecal streptococci during the dry season. This study showed that the groundwater distribution system is susceptible to contamination and that there is a need for a strict, year-round disinfection strategy to ensure adequate drinking-water quality. This situation in one of the world's megacities may reflect what is happening in large urban centers in developing countries which rely on a groundwater supply.     

Bacteriological quality of crops irrigated with wastewater in the Xochimilco plots, Mexico City, Mexico

Xochimilco county plots (Mexico City), one of the most fertile agricultural areas in the Valley of Mexico, produce a large portion of the fresh vegetables consumed in the city. These plots are generally irrigated with domestic wastewater, and for this reason, it was deemed important to examine and evaluate the bacteriological quality of the water, soil, and vegetables from these plots that are harvested and marketed. The soils were also examined for the classical parameters such as nitrates, ammonia, etc., and organic matter and texture. The crops selected for this study were radishes, spinach, lettuce, parsley, and celery because they are usually consumed raw. The highest bacterial counts were encountered in leafy vegetables, i.e., spinach (8,700 for total coliform and 2,400 for fecal coliform) and lettuce (37,000 for total coliform and 3,600 for fecal coliform). Statistically significant differences in bacterial counts between rinsed and unrinsed edible portions of the crops were observed even in rinsed vegetables, and high densities of fecal coliform were detected, indicating that their consumption represents a potential health hazard. The total coliform values found in irrigation water ranged from 4 X 10(4) to 29 X 10(4), and for fecal coliform the values ranged from 5 X 10(2) to 30 X 10(2).     

Medication Adherence in the General Population

Background

Adherence to medication is low in specific populations who need chronic medication. However, adherence to medication is also of interest in a more general fashion, independent of specific populations or side effects of particular drugs. If clinicians and researchers expect patients to show close to full adherence, it is relevant to know how likely the achievement of this goal is. Population based rates can provide an estimate of efforts needed to achieve near complete adherence in patient populations. The objective of the study was to collect normative data for medication nonadherence in the general population.

Methods and Findings

We assessed 2,512 persons (a representative sample of German population). Adherence was measured by Rief Adherence Index. We also assessed current medication intake and side effects. We found that at least 33% of Germans repeatedly fail to follow their doctor''s recommendations regarding pharmacological treatments and only 25% of Germans describe themselves as fully adherent. Nonadherence to medication occurs more often in younger patients with higher socioeconomic status taking short-term medications than in older patients with chronic conditions. Experience with medication side effects was the most prominent predictor of nonadherence.

Conclusions

The major strengths of our study are a representative sample and a novel approach to assess adherence. Nonadherece seems to be commonplace in the general population. Therefore adherence cannot be expected per se but needs special efforts on behalf of prescribers and public health initiatives. Nonadherence to medication should not only be considered as a drug-specific behaviour problem, but as a behaviour pattern that is independent of the prescribed medication.     

Modeling the AIDS epidemic in Mexico City

To study the future course of the AIDS epidemic in Mexico City, we use an open compartmental model to forecast new AIDS cases among homosexual and bisexual males and among heterosexual males and females. For each group three compartments are defined: uninfected persons, infected but asymptomatic persons, and persons diagnosed with AIDS. It is assumed that the AIDS epidemic will follow the propagation of infectious disease model, where spread of infection is proportional to the product of the number of healthy persons and the number of infected ones. The compartmental model is represented by a system of nonlinear differential equations describing the rate of change in the number of persons in each compartment. The impact of preventive measures is explored by decreasing the probability of HIV transmission, which is one of the model parameters representing behavioral patterns. By April 1989, 491 AIDS cases had been reported in Mexico City and classified as sexually related. Our model predicts that the AIDS incidence will continue to rise in Mexico City for the foreseeable future and will spread among the heterosexual population. Decreasing the transmission probability by 10% in all groups (through education programs) will result in a decrease of 18.1% in the number of accumulated cases over a 5-year period. A 20% decrease would prevent more than 31% of the cases. We conclude that mathematical models can be valuable in predicting the spread of the AIDS epidemic and the impact of behavioral change on its spread.     

Epidemiological Characterization and Risk Factors of Allergic Rhinitis in the General Population in Guangzhou City in China

The prevalence of allergic rhinitis (AR) in China has increased with an apparent geographic variation. The current study aims to investigate the AR prevalence/classification, diagnosis/treatment conditions, trigger factors, and risk factors in the general population of Guangzhou, the third biggest city in China. A cross-sectional survey was performed in the citizens in Guangzhou from December 2009 to March 2010 by using a stratified multistage cluster sampling method. All subjects were asked to complete a comprehensive questionnaire via a face to face interview. A total of 9,899 questionnaires were valid. The prevalence rate of AR in the general population of Guangzhou was 6.24%, with a significant higher prevalence in urban area (8.32%) versus rural area (3.43%). Among the AR subjects, most (87%) were diagnosed with intermittent AR and 87% suffered from moderate-severe symptoms. High percentages of the AR patients did not have previously physician-based diagnosis (34%) or specific medical treatment (55%). Morning time, winter season, and cold air were the most common trigger factors of AR. Family history of AR, current living place, living place during babyhood, smoking, home renovation, and pet ownership were the significant risk factors associated with AR prevalence in the population. The study demonstrated comprehensive epidemiological and clinical information about the AR in Guangzhou population. Change of living environment and lifestyles had strong impacts on the prevalence of AR. Public health policies should help the patients benefit from a proper diagnosis/treatment and specifically target the local risk factors, in order to control the AR incidence.     

Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population

ObjectiveAims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome.MethodsIn 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models.ResultsSixty-two percent of the study population was female; age range was 18–73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55–58%; general population 28%; 26–29%) and the anxiety/depression dimension (28%; 27–29% vs. 4%; 4–5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability.ConclusionsHRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future.     

Associations Between Season of Birth and the Risk of Lung Cancer: Epidemiological Findings From Hungary

Lung cancer is the leading cause of cancer deaths worldwide. Both incidence and mortality of lung cancer are especially high in Hungary. Several investigations suggested recently that month of birth (MOB) is associated with the risks of several nonmalignant disorders as well as some malignant disorders. Only a few studies investigated previously the association between MOB and risk of lung cancer, but they provided inconsistent results. We, therefore, decided to investigate this issue in a large sample of individuals who died from lung cancer. Accordingly, we determined the MOB-associated risk of death by lung cancer between the years 1970 and 2009 among all individuals born in Hungary between 1925 and 1934. The final sample included about two million people. A total of 61,904 deaths by lung cancer occurred in this sample during the period investigated. Using analysis of variance (ANOVA), we did not find significant association between MOB and risk of lung cancer death, either in the whole population investigated (F?=?1.492; p?=?.145) or in the female subpopulation (F?=?1.535; p?=?.129). However, those males born in late spring (May–June) had a lower risk of lung cancer development (F?=?2.577; p?=?.006). Results of the Edwards test also did not suggest consistent association between MOB and risk of lung cancer death in the whole investigated period (1925–1934) in any populations (i.e., whole population or male and female subpopulations). In conclusion, we did not find significant association between MOB and risk of lung cancer in our total sample (although results alluded to a weak association between MOB and risk of lung cancer development among males). The possible associations between MOB and the risk of lung cancer development (or smoking) would require confirmation (or refutation) in large studies from other populations. (Author correspondence: dome_peter@yahoo.co.uk)     

Aerobiological study in the Mexico City subway system

Monitoring campaigns in two different seasons were carried out at two underground stations (Tacubaya and Azcapotzalco) of the subway of Mexico City, in order to assess airborne bacterial and fungi concentrations, as well as their relationship with several factors, such as depth of the station, sampling site, temperature, and relative humidity. Sixteen sampling sites were selected according to the depth of the lines and the transit of passengers in the corridors, concourses, and platforms. In addition, samples were also collected in the carriages when they were in movement. Outdoor samples were taken at the two stations for comparison. Two-stage multi-orifice cascade impactors were used to collect aerobiological particles, and with the aid of macroscopic and microscopic characterization were found 57 fungi and 61 bacteria colonies. Outdoor bacteria concentrations ranged from 1 to 68 CFU m^?3, while fungi concentrations varied from 6 to 80 CFU m^?3. The indoor concentration levels of bacteria and fungi ranged from 1 to 484 CFU m^?3 and from 51 to 715 CFU m^?3, respectively. Fungi and bacteria indoor concentrations in the subway were higher than outdoor, up to 8 times. Most of bacteria were identified as Gram-positive nonsporulating short bacillus, while the most abundant fungi genera identified were Aspergillus, Penicillium, and Alternaria in that order of frequency. Statistical analysis showed significant differences between the stations and the lines of different depths, showing a greater microorganisms’ concentration with a greater depth. Although bacteria and fungi concentrations were higher in the spring than in winter, this difference was not significant. Even if indoor microbiological pollution in underground stations was higher than outdoor, the concentrations found in this study were lower than indoor air international standards.     

Depression in Atrial Fibrillation in the General Population

Background

Initial evidence suggests that depressive symptoms are more frequent in patients with atrial fibrillation. Data from the general population are limited.

Methods and Results

In 10,000 individuals (mean age 56±11 years, 49.4% women) of the population-based Gutenberg Health Study we assessed depression by the Patient Health Questionnaire (PHQ-9) and a history of depression in relation to manifest atrial fibrillation (n = 309 cases). The median (25th/75th percentile) PHQ-9 score of depressive symptoms was 4 (2/6) in atrial fibrillation individuals versus 3 (2/6) individuals without atrial fibrillation, . Multivariable regression analyses of the severity of depressive symptoms in relation to atrial fibrillation in cardiovascular risk factor adjusted models revealed a relation of PHQ-9 values and atrial fibrillation (odds ratio (OR) 1.04, 95% confidence interval (CI) 1.01–1.08; P = 0.023). The association was stronger for the somatic symptom dimension of depression (OR 1.08, 95% CI 1.02–1.15; P = 0.0085) than for cognitive symptoms (OR 1.05, 95% CI 0.98–1.11; P = 0.15). Results did not change markedly after additional adjustment for heart failure, partnership status or the inflammatory biomarker C-reactive protein. Both, self-reported physical health status, very good/good versus fair/bad, (OR 0.54, 95% CI 0.41–0.70; P<0.001) and mental health status (OR 0.61 (0.46–0.82); P = 0.0012) were associated with atrial fibrillation in multivariable-adjusted models.

Conclusions

In a population-based sample we observed a higher burden of depressive symptoms driven by somatic symptom dimensions in individuals with atrial fibrillation. Depression was associated with a worse perception of physical or mental health status. Whether screening and treatment of depressive symptoms modulates disease progression and outcome needs to be shown.     

Occult Glucose Intolerance: Incidence in a General Population

A survey of two-hour postprandial glycemic responses to an oral dose of 100 gm of glucose was conducted in 456 appparently healthy adult members of a small Southern California community. Serum glucose levels of 32 per cent of the men and 36 per cent of the women exceeded 140 mg per 100 ml at the two-hour sampling period.In both sexes, there was a tendency for hyperglycemia to become more conspicuous with age.Under the age of 50, a much higher percentage of women than men had seemingly excessive serum glucose values.These findings may suggest a need for modifying criteria currently used for interpreting glycemic responses to oral glucose challenges.