Several epidemiologic features of the spread of chickenpox and herpes zoster]

Epidemiological and statistical data of herpes zoster and chickenpox by such indices as morbidity level, periodicity and month-by-month changes in the incidence of these diseases were compared. The study included 2345 herpes zoster and 11116 chickenpox cases in the course of 5 years (1972--1976). In comparison with herpes zoster, the intensity of chickenpox spread among the population was on the average 4.7 times greater. Of the total number of chickenpox cases the percentage of herpes zoster contituted 21.0. Chickenpox morbidity had marked seasonal cyclic nature with the amplitude of seasonal variations of about 8; as to herpes zoster--there was no annual or seasonal cyclicity. Thus, in the development of chickenpox and herpes zoster epidemic process there was revealed a peculiar tendency inherent to each of these infections; no common epidemiological and statistical regularities in the spread intensity, annual periodicity and seasonal cyclicity were detected.     

Incidence of meningococcal infection in the RSFSR]

The authors present characteristics of meningococcus infection epidemic process in case of sporadic cases and under epidemic conditions (1965--1976). A scheme of epidemiological analysis suggested by the authors permitted to differentiate and to record the incidence of various clinical forms of meningococcus infection, to present data on the age, seasonal characteristics, focality, etc. Comparison of intensive morbidity indices for 10 years, both at the individual administration territories and in the Republic as a whole demonstrated morbidity level of 1.5--2.0 to be one of prognostic signs of the beginning epidemic. The main features differentiating the sporadic and epidemic morbidity periods were revealed. The presence of group diseases, a greater percentage of children among those who fell ill, and marked signs of seasonality and territorial difference characterized the period of rise caused by meningococcus of serological group A.     

Basic patterns in the epidemic process of measles under conditions of massive immunization]

Observations over the measles epidemic process in Leningrad showed that the sporadic morbidity level reached in 1974--4.1 per 100 000 residents; however periodic elevation and decline of morbidity and tis seasonal variations persisted. A rise of morbidity in 1972--1973, and by preliminary data--in 1975, occurred on account of the older age groups. There was revealed no dependence of the disease incidence among the persons vaccinated on the time lapse after their vaccination. Individual batches of live measles vaccine issued in 1963--1969 were not up to the standard, this serving as one of the cases of the occurence of group incidence of the infection in some foci.     

Human beta-endorphin. Immunoreactivity of synthetic analogs with various chain lengths.

Immunoreactivity of synthetic human beta-endorphin analogs with various chain lengths has been examined using a specific radioimmunoassay. It was found that beta-endorphin-(1--21) and analogs of shortened chain exhibit no immunoreactivity, whereas beta-endorphin-(1--15) possesses significant in vitro opiate activity. It appears that immunoreactivity of beta-endorphin resides in the COOH-terminal segment of residues (22--31). The data also show the lack of correlation between opiate and immunological activities of beta-endorphin.     

The burden of skin disease and eye disease due to onchocerciasis in countries formerly under the African Programme for Onchocerciasis Control mandate for 1990, 2020, and 2030

BackgroundOnchocerciasis (“river blindness”) can cause severe morbidity, including vision loss and various skin manifestations, and is targeted for elimination using ivermectin mass drug administration (MDA). We calculated the number of people with Onchocerca volvulus infection and onchocercal skin and eye disease as well as disability-adjusted life years (DALYs) lost from 1990 through to 2030 in areas formerly covered by the African Programme for Onchocerciasis Control.MethodsPer MDA implementation unit, we collated data on the pre-control distribution of microfilariae (mf) prevalence and the history of control. Next, we predicted trends in infection and morbidity over time using the ONCHOSIM simulation model. DALY estimates were calculated using disability weights from the Global Burden of Disease Study.ResultsIn 1990, prior to MDA implementation, the total population at risk was 79.8 million with 26.0 million (32.5%) mf-positive individuals, of whom 17.5 million (21.9%) had some form of onchocercal skin or eye disease (2.5 million DALYs lost). By 2030, the total population was predicted to increase to 236.1 million, while the number of mf-positive cases (about 6.8 million, 2.9%), people with skin or eye morbidity (4.2 million, 1.8%), and DALYs lost (0.7 million) were predicted to decline.ConclusionsMDA has had a remarkable impact on the onchocerciasis burden in countries previously under the APOC mandate. In the few countries where we predict continued transmission between now and 2030, intensified MDA could be combined with local vector control efforts, or the introduction of new drugs for mopping up residual cases of infection and morbidity.     

Influenza epidemics in the USSR and Czechoslovakia in 1979-1984

In this work materials characterizing the appearance and development of influenza epidemic at the territories of the USSR and the Czech Socialist Republic are presented, the common features and differences of the epidemic process in both countries are recorded. The work shows that in both countries the appearance of this epidemic is caused by the same virus. In most cases the epidemic started earlier and lasted longer in the USSR, but morbidity rate during the epidemic was, on the whole, higher in the Czech Socialist Republic. Similarity in the course of the primary period of the epidemic processes from their appearance to their maximum rise was observed. In both countries the maximum rise of morbidity rate was registered on weeks 3-4 from the beginning of the epidemic.     

The prognostic value of the neutrophil/lymphocyte ratio in patients with snake bites for clinical outcomes and complications

IntroductionSnake bites have cardiotoxicity, neurotoxic, myotoxic, nephrotoxic, and hemotoxic features. The neutrophil/lymphocyte ratio (NLR) provides valuable information for the determination of the diagnosis and prognosis of various diseases. In this study, we aimed to investigate the relationship between NLR with the development of complications and duration of hospital stay in snakebite cases.MethodIn this study, 107 patients with snakebite complaints that applied to a tertiary care university hospital between 2011 and 2014 were retrospectively reviewed. The control group compromised of 107 age-and gender-matched healthy subjects. These patients were examined using their previous laboratory results, bite areas pictures, geographic location, and analysis of complications that developed during the hospitalization.ResultsPatients in our snake bites group (n = 107), included males (64%) and females (36%). When NLR1–NLR2, NLR1–NLR3, and NLR2–NLR3 were compared, a statistically significant difference was found (p < 0.001). No mortality was observed in our patients. In cases of snakebites, 4.67% of the patients underwent finger amputation. Compartment syndrome occurred in 3.73% of patients. In one case that developed compartment syndrome, a finger amputation was made. When 8 patients with a complication were compared with patients having snakebite but no complication, the initial NLR was found to be higher and statistically significant (p = 0.042). The average length of stay of patients in the hospital was 9 days. In the analysis of the correlation between the duration of hospitalization and NLR, the patients with a high level of NLR were found to have a longer hospital stay compared to lower NLR levels (p = 0.012).ConclusionNLR was significantly increased in patients that developed complications and needed a longer stay in the hospital.     

The contribution of urbanization to non-communicable diseases: Evidence from 173 countries from 1980 to 2008

It is widely believed that the expanding burden of non-communicable diseases (NCDs) is in no small part the result of major macro-level determinants. We use a large amount of new data, to explore in particular the role played by urbanization – the process of the population shifting from rural to urban areas within countries – in affecting four important drivers of NCDs world-wide: diabetes prevalence, as well as average body mass index (BMI), total cholesterol level and systolic blood pressure. Urbanization is seen by many as a double-edged sword: while its beneficial economic effects are widely acknowledged, it is commonly alleged to produce adverse side effects for NCD-related health outcomes. In this paper we submit this hypothesis to extensive empirical scrutiny, covering a global set of countries from 1980–2008, and applying a range of estimation procedures. Our results indicate that urbanization appears to have contributed to an increase in average BMI and cholesterol levels: the implied difference in average total cholesterol between the most and the least urbanized countries is 0.40 mmol/L, while people living in the least urbanized countries are also expected to have an up to 2.3 kg/m² lower BMI than in the most urbanized ones. Moreover, the least urbanized countries are expected to have an up to 3.2 p.p. lower prevalence of diabetes among women. This association is also much stronger in the low and middle-income countries, and is likely to be mediated by energy intake-related variables, such as calorie and fat supply per capita.     

Permissive Summer Temperatures of the 2010 European West Nile Fever Upsurge

Background

In the summer of 2010, Europe experienced outbreaks of West Nile Fever (WNF) in humans, which was preceded by hot spells. The objective of this study was to identify potential drivers of these outbreaks, such as spring and summer temperatures, relative humidity (RH), and precipitation.

Methods

Pearson and lag correlations, binary and multinomial logistic regressions were used to assess the relationship between the climatic parameters and these outbreaks.

Results

For human morbidity, significant (<0.05) positive correlations were observed between a number of WNF cases and temperature, with a geographic latitude gradient: northern (“colder”) countries displayed strong correlations with a lag of up to four weeks, in contrast to southern (“warmer”) countries, where the response was immediate. The correlations with RH were weaker, while the association with precipitation was not consistent. Horse morbidity started three weeks later than in humans where integrated surveillance was conducted, and no significant associations with temperature or RH were found for lags of 0 to 4 weeks.

Conclusions

Significant temperature deviations during summer months might be considered environmental precursors of WNF outbreaks in humans, particularly at more northern latitudes. These insights can guide vector abatement strategies by health practitioners in areas at risk for persistent transmission cycles.     

Incidence and mortality of pancreatic cancer on a rapid rise in Taiwan, 1999–2012

BackgroundAccumulating data has revealed a rapidly rising incidence of pancreatic cancer in Western countries, but convincing evidence from the East remains sparse. We aimed to quantify how the incidence and mortality rates of pancreatic malignancy changed over time in Taiwan, and to develop future projection for the next decade.MethodsThis nationwide population-based study analyzed the Taiwan National Cancer Registry and the National Cause of Death Registry to calculate the annual incidence and mortality rates of pancreatic malignancy from 1999 to 2012 in this country. The secular trend of the incidence was also examined by data from the National Health Insurance Research Database.ResultsA total of 21,986 incident cases of pancreatic cancer and 20,720 related deaths occurred during the study period. The age-standardized incidence rate increased from 3.7 per 100,000 in 1999 to 5.0 per 100,000 in 2012, with a significant rising trend (P < 0.01). The increase was nationwide, consistently across subgroups stratified by age, gender, geographic region, and urbanization. Data from the National Health Insurance Research Database corroborated the rise of incident pancreatic cancer. Mortality also increased with time, with the age-standardized rate rising from 3.5 per 100,000 in 1999 to 4.1 per 100,000 in 2012 (P < 0.01). In accordance with the incidence, the mortality trend was consistent in all subgroups. Both the incidence and mortality were projected to further increase by approximately 20% from 2012 to 2027.ConclusionThe incidence and mortality of pancreatic cancer have been rapidly rising and presumably will continue to rise in Taiwan.     

Epidemiology of Monoclonal Gammopathy of Undetermined Significance (MGUS): The experience from the specialized registry of hematologic malignancies of Basse-Normandie (France)

Multiple myeloma (MM) is the third most common haematologic malignancy in European countries, and is usually preceded by Monoclonal Gammopathy of Undetermined Significance (MGUS). Therefore epidemiologic studies of MGUS are very limited in a population-based status. Here we report all new cases of MGUS exhaustively recorded by the Basse-Normandie Regional Registry for Hematologic Malignancies (a French region registry) between January 1997 and December 2005, and analyze outcome of patients until 2009 in term of evolution in MM or death. All cases were analyzed by an expert file review, and MGUS diagnosis was retained for: evidence of a monoclonal component <30 g/l and no CRAB criteria (hyperCalcemia, renal insufficiency, anemia, bone lesions). We showed that the world standardized incidence rate (WSR) for MGUS was 3.76 ± 0.26 per 100,000 inhabitants, increasing regularly with age, and that the median overall survival (OS) was 115.9 months (CI 95%: 10.5–130.2 months) with 78.3% patients alive at 5 years (CI 95%: 74.1–81.9%). We also observed a rate of progression to multiple myeloma of 1.41% per year, concordant with previous reports in a reallife exhaustive registry.     

Telomere length and risk of glioma

BackgroundTelomere length in blood or buccal cell DNA has been associated with risk of various cancers. Glioma can be a highly malignant brain tumor and has few known risk factors. Genetic variants in or near RTEL1 and TERT, key components of telomere biology, are associated with glioma risk. Therefore, we evaluated the association between relative telomere length (RTL) and glioma in a prospective study.Materials and methodsWe performed a nested case-control study within the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. RTL was determined by quantitative PCR on blood or buccal cell DNA obtained at least 2 years prior to diagnosis from 101 individuals with glioma cases. Healthy controls (n = 198) were matched to cases (2:1) on age, gender, smoking status, calendar year, and DNA source. Conditional logistic regression was used to investigate the association between RTL and glioma.ResultsAs expected, RTL declined with increasing age in both cases and controls. There was no statistically significant association between RTL and glioma overall. An analysis stratified by gender suggested that short RTL (1st tertile) in males was associated with glioma (odds ratio, [OR] = 2.29, 95% confidence interval [CI] 1.02–5.11); this association was not observed for females (OR = 0.41, 95% CI 0.14–1.17).ConclusionsThis prospective study did not identify significant associations between RTL and glioma risk, but there may be gender-specific differences. Larger, prospective studies are needed to evaluate these findings.     

(E)-2-Styrylchromones as potential anti-norovirus agents

Human noroviruses (NoV) are now recognized as the most frequent cause of outbreaks and sporadic cases of acute gastroenteritis. Despite the significant economic impact and considerable morbidity of norovirus disease, no drug or vaccine is currently available to treat or prevent this disease, therefore the discovery of anti-norovirus drugs is urgent.In the present work, a total of 12 structure related chromone and (E)-2-styrylchromones were evaluated for their potential anti-norovirus activity using the murine norovirus (MNV) as a surrogate model for human NoV.From the 12 compounds studied, six (E)-2-styrylchromones were found to have with interesting anti-norovirus activity. The best compounds of the series were (E)-5-hydroxy-2-styrylchromone and (E)-4′-methoxy-2-styrylchromone with an IC₅₀ ≈ 7 μM. A first insight into the mechanism of action of these compounds was possible. An interesting relationship between the anti-norovirus activity and the chemical structure was observed. The present study points out that the (E)-2-styrylchromones skeleton is an important one which deserves to be developed and further explored as new antiviral drugs against NoV.     

The epidemiology of epidemic parotitis in the USSR.

Morbidity from epidemic parotitis in the USSR in the period from 1958 to 1972 ranged within the limits of 266.6 and 521.7 cases per 100 000 inhabitants. A 3--4 years cyclic recurrence of rises and falls in morbidity was observed. The bulk of cases of disease occur in the winter-spring period. In towns, parotitis is registered 3 times more frequently, in the mean, than in rural districts. More than 95% of patients in the USSR consisted of children under 15, while in Moscow, children aged 3--5 years were the most affected group. In Moscow in the period from February 1, 1972 to January 31, 1973, the morbidity in men was 493.2 per 100 000 and in women 339.5 per 100 000 (ratio 1:1.45).     

Major correlates of male height: A study of 105 countries

The purpose of this study is to explore the main correlates of male height in 105 countries in Europe & overseas, Asia, North Africa and Oceania. Actual data on male height are compared with the average consumption of 28 protein sources (FAOSTAT, 1993–2009) and seven socioeconomic indicators (according to the World Bank, the CIA World Factbook and the United Nations). This comparison identified three fundamental types of diets based on rice, wheat and milk, respectively. The consumption of rice dominates in tropical Asia, where it is accompanied by very low total protein and energy intake, and one of the shortest statures in the world (∼162–168 cm). Wheat prevails in Muslim countries in North Africa and the Near East, which is where we also observe the highest plant protein consumption in the world and moderately tall statures that do not exceed 174 cm. In taller nations, the intake of protein and energy no longer fundamentally rises, but the consumption of plant proteins markedly decreases at the expense of animal proteins, especially those from dairy. Their highest consumption rates can be found in Northern and Central Europe, with the global peak of male height in the Netherlands (184 cm). In general, when only the complete data from 72 countries were considered, the consumption of protein from the five most correlated foods (r = 0.85) and the human development index (r = 0.84) are most strongly associated with tall statures. A notable finding is the low consumption of the most correlated proteins in Muslim oil superpowers and highly developed countries of East Asia, which could explain their lagging behind Europe in terms of physical stature.     

Venous Serum Bicarbonate Concentration Predicts Arterial pH in Adults with Diabetic Ketoacidosis

ObjectiveThe initial assessment of metabolic acidosis in subjects with diabetic ketoacidosis (DKA) is arterial blood gas analysis. This process is expensive, painful, and technically difficult. Furthermore, blood gas analysis may not be available in some facilities, especially in developing countries where DKA-associated morbidity and mortality remain high. Therefore, we investigated the utility of venous bicarbonate concentration obtained from a basic metabolic panel in predicting arterial pH in adults with DKA.MethodsWe performed a retrospective analysis of clinical and biochemical data of 396 adults admitted to 2 community teaching hospitals with DKA. We determined the correlation between arterial pH and venous serum parameters. Using multiple logistic regression, we obtained a predictive formula for arterial pH from serum venous bicarbonate level.ResultsThe patient population was 59.0% male and had a mean age of 36.7 ± 13.3 years. We derived that arterial pH = 6.97 + (0.0163 × bicarbonate), and by applying this equation, we determined that serum venous bicarbonate concentration of ≤ 20.6 mEq/L predicted arterial pH ≤ 7.3 with over 95% sensitivity and 92% accuracy.ConclusionVenous serum bicarbonate obtained from the basic metabolic panel is an affordable and reliable way of estimating arterial pH in adults with DKA. Validation of this formula in a prospective study would offer a more accessible means of estimating metabolic acidosis in adults with DKA, especially in developing countries where DKA incidence and mortality remain high. (Endocr Pract. 2014;20:201-206)     

Intérêt de la scintigraphie rénale au DMSA dans les pyélonéphrites aiguës de l’enfant

IntroductionAcute pyelonephritis is responsible for significant morbidity during the acute phase and distant irreversible kidney damage. However, diagnosis is often difficult in children. The aim of our study was to evaluate in children hospitalized for suspected acute pyelonephritis prevalence of acute lesions revealed by scintigraphy with ^99mTc labeled dimercaptosuccinic acid (DMSA) and the relationship between renal parenchymal lesions and different clinical factors and biological risks.MethodsThis is a prospective study collecting 40 children admitted with suspected infection of the high urinary tract. All have benefited from DMSA renal scintigraphy.ResultsThe average age of our patients was 3.25 years. The DMSA scan showed signs of acute pyelonephritis in 32.5% of cases. Taking this examination as a reference, fever was the most sensitive clinical signs (76.9%), but the specificity was only 48.1%. CRP (≥ 20 mg/mL) was the most sensitive (92.3%) but with a specificity of 40.7% organic signs. A high CRP was associated with acute pyelonephritis significantly (P = 0.0033). Sixty-three percent of refluxing kidneys were associated with acute pyelonephritis versus 20.8% of non-refluxing kidneys, with a significant difference (P = 0.007).ConclusionIn case of urinary tract infection in children, a complete clinical and laboratory table may be sufficient to retain the diagnosis of acute pyelonephritis. However, this possibility is rare. In the opposite case, a DMSA scan should be performed to confirm the diagnosis.     

Increase in breast cancer incidence among older women in Mumbai: 30-year trends and predictions to 2025

Background: Increasing trends in the incidence of breast cancer have been observed in India, including Mumbai. These have likely stemmed from an increasing adoption of lifestyle factors more akin to those commonly observed in westernized countries. Analyses of breast cancer trends and corresponding estimation of the future burden are necessary to better plan rationale cancer control programmes within the country. Methods: We used data from the population-based Mumbai Cancer Registry to study time trends in breast cancer incidence rates 1976–2005 and stratified them according to younger (25–49) and older age group (50–74). Age-period-cohort models were fitted and the net drift used as a measure of the estimated annual percentage change (EAPC). Age-period-cohort models and population projections were used to predict the age-adjusted rates and number of breast cancer cases circa 2025. Results: Breast cancer incidence increased significantly among older women over three decades (EAPC = 1.6%; 95% CI 1.1–2.0), while lesser but significant 1% increase in incidence among younger women was observed (EAPC = 1.0; 95% CI 0.2–1.8). Non-linear period and cohort effects were observed; a trends-based model predicted a close-to-doubling of incident cases by 2025 from 1300 mean cases per annum in 2001–2005 to over 2500 cases in 2021–2025. Conclusions: The incidence of breast cancer has increased in Mumbai during last two to three decades, with increases greater among older women. The number of breast cancer cases is predicted to double to over 2500 cases, the vast majority affecting older women.     

超声诊断胰腺脂肪浸润与血脂、脂肪肝的关系研究

目的：探讨超声诊断胰腺脂肪浸润与血脂、脂肪肝的关系。方法：回顾性分析63例胰腺脂肪浸润者与148例同期检查无胰腺脂肪浸润者的病历资料,研究胰腺脂肪浸润的超声特点以及与脂肪肝、血脂浓度、年龄、血压等的关系。结果：胰腺脂肪浸润超声显示为胰腺饱满,边缘模糊,回声增强且明显强于肝脏,与正常胰腺超声影像容易鉴别。胰腺脂肪浸润组血浆甘油三酯浓度2．17±1．22mmol／L,比非浸润组的1．35±1．06mmol／L明显高（P〈0．05）,胰腺脂肪浸润组患者100％（63／63）合并脂肪肝明显高于非浸润组的20．95％（31／148）（P〈0．05）。二组在胆固醇浓度、高血压发病率及年龄方面无显著差异（P〉0．05）。结论：胰腺脂肪浸润与脂肪肝、血浆甘油三酯浓度有着一定的相关性,超声诊断胰腺脂肪浸润对于提示其他相关疾病与异常的存在具有重要临床参考价值。