Epidemiology of nonsyndromic conotruncal heart defects in Texas, 1999-2004

INTRODUCTION: Congenital heart defects (CHDs) are the most common structural birth defects, yet their etiology is poorly understood. As there is heterogeneity within the group of CHDs, epidemiologic studies often focus on subgroups, of conditions, such as conotruncal heart defects (CTDs). However, even within these subgroups there may be etiologic heterogeneity. The aim of the present study was to identify and compare maternal and infant characteristics associated with three CTDs: truncus arteriosus (TA), dextro‐transposition of the great arteries (d‐TGA), and tetralogy of Fallot (TOF). METHODS: Data for cases with nonsyndromic TA (n = 78), d‐TGA (n = 438), and TOF (n = 529) from the Texas Birth Defects Registry, 1999–2004, were used to estimate crude and adjusted prevalence ratios, separately for each condition, using Poisson regression. Polytomous logistic regression was used to determine whether the observed associations were similar across the two largest case groups (d‐TGA and TOF). RESULTS: In Texas, 1999–2004, the prevalence of nonsyndromic TA, d‐TGA, and TOF was 0.35, 1.98, and 2.40 per 10,000 live births, respectively. There was evidence of a significant linear increase in the risk of each condition with advancing maternal age (p < 0.01). Significant associations were observed for TA and maternal residence on the Texas‐Mexico border; d‐TGA and infant sex, maternal race/ethnicity, history of previous live birth, and birth year; and TOF and maternal race/ethnicity and education. Further, the associations with some, but not all, of the study variables were significantly different for d‐TGA and TOF. CONCLUSION: These findings add to our limited understanding of the epidemiology of CTDs. Birth Defects Research (Part A), 2010. © 2010 Wiley‐Liss, Inc.     

Sex differences in the prevalence of congenital anomalies: a population-based study

BACKGROUND: Limited data is available concerning the sex distribution of various congenital anomaly subtypes. This study investigated sex differences in the prevalence of congenital anomalies, overall and by subtype, using high quality population‐based data from the North of England. METHODS: Information on congenital anomalies occurring among singleton pregnancies during 1985–2003 were extracted from the Northern Congenital Abnormality Survey (NorCAS). Anomalies were categorized by groups, subtypes, and syndromes according to the European Surveillance of Congenital Anomalies guidelines. Relative risks (RRs) comparing the prevalences in males to that in females were calculated for a range of congenital anomaly subtypes. RESULTS: A total of 12,795 eligible cases of congenital anomaly were identified during the study period, including 7019 (54.9%) males and 5776 (45.1%) females. Overall, male fetuses were significantly more prevalent in pregnancies affected by a congenital anomaly than female fetuses (RR, male vs. female = 1.15; 95% confidence interval [CI], 1.11–1.19), but there was significant heterogeneity between subtypes (p < 0.001). Forty‐four of 110 (40%) unique subtypes were at least 40% more prevalent in males than females, with affected subtypes occurring across all major anomaly groups. Thirteen of 110 (12%) unique subtypes were at least 40% more prevalent in females than males, but the female‐biased RR of a neural tube defect was less pronounced than previously reported (RR = 0.84; 95% CI, 0.73–0.95). CONCLUSION:This study adds to the growing evidence of sex‐specific differences in the prevalence of a wide range of congenital anomaly subtypes. Birth Defects Research (Part A), 2011. © 2011 Wiley‐Liss, Inc.     

Time trends in the prevalence of birth defects in Texas 1999–2007: Real or artifactual?

BACKGROUND: Few studies have reported time trends for total birth defects or for a comprehensive range of phenotypes. METHODS: We examined data from the Texas Birth Defects Registry (TBDR) from 1999 through 2007. Poisson regression was used to fit trend lines to birth prevalence over time for total birth defects (each infant/fetus counted once), for every birth defect collected by the TBDR, and for subsets of cases or defects grouped various ways. RESULTS: From 1999 through 2007, birth prevalence of total birth defects in Texas increased 3.6% per year. Increases were observed in all population groups, persisted after adjustment for demographic characteristics, and were strongest in regions of Texas that were more urban. There was a wide variety of different defects showing significant increases. The trends of several defects were driven by their mild cases. Perhaps the most compelling finding was that larger upward trends were observed in defects that had been rated as more susceptible to diagnostic variation. One notable exception to that was gastroschisis, which showed an average increase of over 5% per year, the total birth defects rate in TBDR increased at 3.6% per year, similar to 3.7% per year in birth certificate check boxes. CONCLUSIONS: In our opinion, the weight of evidence in our study suggests that the observed increase over time in total birth defects and in many specific birth defects is artifactual. This likely reflects increased awareness, referral, detection, or documentation in health care facilities visited by TBDR staff, resulting in more complete ascertainment by the registry, rather than a true change over time in the occurrence of most birth defects. Birth Defects Research (Part A), 2011. © 2011 Wiley‐Liss, Inc.     

Infant mortality in Armenia, 1992–2003

Health system reforms have been taken in Armenia during a time of dramatic economic and fiscal distress. It is important to assess trends in health indicators and ascertain if the changes in socio-economic systems affected the health status of infants as the most vulnerable part of the population. We find that infant mortality has fallen during the period c. 1992-2003 in spite of the difficult economic circumstances because of health-care procedures that were introduced. Particular attention is paid to the underreporting of infants' death cases in the state registration system as well as to estimating the role of different factors influencing infant mortality in Armenia.     

High prevalence of the metabolic syndrome in Iranian adolescents

Objective : No evidence exists regarding the prevalence of the metabolic syndrome in adolescents in Middle Eastern countries. We aimed to evaluate the prevalence of the metabolic syndrome in a representative sample of Iranian adolescents. Research Methods and Procedures : Anthropometry, biochemical measurements, and blood pressure were assessed in a population‐based cross‐sectional study of 3036 Iranian adolescents (1413 boys and 1623 girls) 10 to 19 years of age. Metabolic syndrome was defined according to modified Adult Treatment Panel III definition. Overweight (≥95th percentile) and at risk for overweight (≥85th to <95th percentile) was defined based on the standardized percentile curves of BMI suggested for Iranian adolescents. Results : The prevalence of the metabolic syndrome was 10.1% (95% confidence interval: 9.0 to 11.1) among Iranian adolescents (boys: 10.3%, 8.6 to 11.8; girls: 9.9%, 8.4 to 11.3). Overall, low serum high‐density lipoprotein‐cholesterol and high serum triglycerides were the most common components of the metabolic syndrome (42.8% and 37.5%, respectively). Overweight subjects had the highest proportion of metabolic syndrome compared with those at risk for overweight and those with normal weight (boys: 41.1% vs. 11.4% and 3.0%, respectively, p < 0.01; girls: 43% vs. 15.2% and 5.0%, respectively, p < 0.01). Discussion : This study provides evidence showing a high prevalence of the metabolic syndrome in Iranian adolescents, particularly among overweight adolescents.     

–SH and S–S involvement in Chlamydomonas mating

Reagents that block or cross-link sulfhydryl (–SH) groups and those that reduce disulfide (S–S) bonds have been tested for their effects on mating in Chlamydomonas reinhardii. Wild-type (wt) gametes of mating type + (mt⁺) and mt^?, and a fusion-defective mt^? mutant, gam-11, were studied. Differential sensitivities of mt⁺ vs mt^? and of wt mt^? vs gam-11 mt^? were analyzed. Concentrations of reagents that did not disrupt flagellar agglutination, the first stage of the mating reaction, were generally used. Pretreatment of mt⁺ gametes with the membrane permeable –SH reducing agent dithiothreitol (DTT) inhibits flagellar sexual signaling at concentrations that do not inhibit any part of the mating reaction of mt^? gametes. Wt mt^? is more sensitive than wt mt⁺ to inhibition by low concentrations of p-chloromercuribenzoate sulfonate (pCMBS), an organic mercurial. The membrane-impermeable reducing agent, reduced glutathione (GSH), also preferentially inhibits wt mt^?. Gam-11 mt^?, a fusion-defective mutant, which has been used to study the sensitivity of the adhesion of the plasma membrane-associated mating structures, is less sensitive to GSH and pCMBS inhibition that is wt mt^?. DDT and pCMBS cause an increase in mating structure adhesion in pretreated gam-11. The differential inhibition of pair and group formation during gam-11 × wt mt⁺ matings has suggested a possible mechanism for mating structure adhesion.     

Urban Chagas disease in children and women in primary care centres in Buenos Aires,Argentina

The primary objective of this study was to estimate the prevalence of this disease in women of childbearing age and children treated at health centres in underserviced areas of the city of Buenos Aires. Demographic and Chagas disease status data were collected. Samples for Chagas disease serology were obtained on filter paper and the reactive results were confirmed with conventional samples. A total of 1,786 subjects were screened and 73 positive screening results were obtained: 17 were from children and 56 were from women. The Trypanosoma cruzi infection risk was greater in those individuals who had relatives with Chagas disease, who remember seeing kissing bugs, who were of Bolivian nationality or were born in the Argentine province of Santiago del Estero. The overall prevalence of Chagas disease was 4.08%. Due to migration, Chagas disease is currently predominantly urban. The observed prevalence requires health programme activities that are aimed at urban children and their mothers. Most children were infected congenitally, which reinforces the need for Chagas disease screening of all pregnant women and their babies in Argentina. The active search for new cases is important because the appropriate treatment in children has a high cure rate.     

Identifying advanced and delayed sleep phase disorders in the general population: A national survey of New Zealand adults

The aim was to estimate the prevalence of, and identify independent risk factors for, Advanced (ASPD) and Delayed Sleep Phase Disorder (DSPD) among Māori (indigenous New Zealanders) and non-Māori adults using a self-report questionnaire. The Munich Chronotype Questionnaire was mailed to a stratified sample of 9100 adults (5100 Māori and 4000 non-Māori) aged 20–59 years randomly selected from the electoral rolls (54% response rate). Different definitions for ASPD and DSPD were developed using combinations of symptoms including self-reported bed and rising times, current chronotype, and a desire to change sleep schedule. Logistic regression models were used to model the likelihood of reporting ASPD or DSPD separately after adjusting for ethnicity (Māori versus non-Māori), sex (males versus females), age (in decades), socio-economic deprivation (NZDep2006 deciles) and employment status (unemployed, night work versus employed with no night work). The prevalence of ASPD ranged from 0.25% to 7.13% whereas the prevalence of DSPD was 1.51 to 8.90% depending on the definition used. The prevalence of ASPD was higher among men and increased with age. The prevalence of DSPD was higher among those living in more deprived areas and decreased with age. After controlling for ethnicity, gender, age, socio-economic deprivation and employment status, people with ASPD were more likely to report excessive daytime sleepiness, whereas those with DSPD were more likely to report poor or fair self-rated health. Reporting ASPD and DSPD were associated with self-reported night work. In this large sleep timing survey, we found no differences in the prevalence of self-identified ASPD and DSPD between Maori and non-Maori. This has implications for the development and provision of sleep health services and strategies for managing the significant impact of work patterns on sleep.     

Distribution,Disease Level and Virulence Variation of Bremia lactucae on Lactuca sativa in the Czech Republic in the Period 1999–2011

We report the distribution and disease level of downy mildew on lettuce (Lactuca sativa) and virulence variation in populations of its causal agent (Bremia lactucae) in the Czech Republic during the period 1999–2011. Disease incidence was not high; among a total of 92 different localities surveyed, 43.4% of them were infected by lettuce downy mildew at least once during the whole period. However, among individual years, differences were found in disease incidence that ranged from 4.8% (2009) to 66.7% (2004). A total of 128 isolates of B. lactucae collected from infected leaf samples in 35 different localities during the surveying period were included in the virulence analysis. Virulence was examined on a set of 19 differential genotypes of Lactuca sativa and Lactuca serriola (EU‐A test set). Isolates exhibited quite a broad variation in virulence to individual Lactuca differential genotypes. Eighteen of 19 virulence factors (v‐factors) tested were present in the samples. The most frequently detected factors were v1–4, v5/8, v6, v7, v10–14, v16, v36 and v38; factor v17 was not found. The most pronounced temporal shift was recorded for factors v36 and v38 whose frequency increased during the studied period. V‐factors 15, 17, 18 and 37 were present in low frequencies in a pathogen population, and their corresponding gene (Dm15) or resistance factors (R17, R18 and R37) may have the best potential for resistance breeding in the Czech Republic. Broad diversity of v‐phenotypes (63 different ones) was identified during the study period. The numbers of v‐factors per v‐phenotype (resp. isolate) varied within a range of 5–15. Within the 128 analysed isolates, only 9 v‐phenotypes were recorded repeatedly (three or more times). Possible reasons of recorded virulence variation are discussed.     

Epidemiology of noncomplex left ventricular outflow tract obstruction malformations (aortic valve stenosis, coarctation of the aorta, hypoplastic left heart syndrome) in Texas, 1999-2001

BACKGROUND: The left ventricular outflow tract (LVOT) malformations aortic valve stenosis (AVS), coarctation of the aorta (CoA), and hypoplastic left heart syndrome (HLHS) contribute significantly to infant mortality due to birth defects. Previous epidemiology data showed rate differences between male and female and white and black ethnic groups. The Texas Birth Defects Registry, an active surveillance program, enables study in a large, diverse population including Hispanics. METHODS: Records of children up to 1 year old with AVS, CoA, and HLHS born in Texas from 1999 to 2001, were collected from the registry. Those including additional heart defects or a chromosomal anomaly were excluded. Multivariate analysis included: infant sex; United States-Mexico border county residence; and maternal age, race/ethnicity, birthplace, and education. RESULTS: There were 910 cases among 1.08 million live births, of which 499 met inclusion criteria. Multivariate modeling of all LVOT malformations combined demonstrated lower prevalence rate ratios (PRRs) for black males (0.26) and Hispanic males (0.70). Similar results were found for CoA but not AVS or HLHS. Higher PRRs were noted for increased maternal age for LVOT (1.3 for 24-34 years; 1.7 for >34 years), AVS, and HLHS, but not CoA, and higher PRRs across all diagnoses for males (LVOT PRR, 2.4) were noted. CoA PRRs were higher in border county vs. non-border county residents (PRR, 2.1). Maternal education and birthplace were not significant factors. CONCLUSIONS: There are rate differences for males among all 3 ethnic groups. Sex and ethnic differences suggest genetic etiologies, where the ethnic differences could be used to find susceptibility loci with mapping by admixture linkage disequilibrium. Increased CoA rates along the U.S.-Mexico border suggest environmental causes that will require further monitoring.     

Trends in Overweight and Obesity in Portugal: The National Health Surveys 1995–6 and 1998–9

Objective: To assess overweight and obesity trends in the Portuguese population. Research Methods and Procedures: National Health Surveys, conducted in 1995–6 (17, 989 men; 20, 249 women) and 1998–9 (17, 923 men; 20, 302 women), were used. Results: In men, the prevalence of overweight and obesity increased from 39.9% (95% CI: 39.2 to 40.6) and 10.3% (95% CI: 9.9 to 10.7), respectively, in 1995–6, to 42.5% (95% CI: 41.8 to 43.2) and 11.5% (95% CI: 11.0 to 12.0), respectively, in 1998–9. In women, prevalence of obesity increased from 12.7% (95% CI: 12.2 to 13.2) in 1995–6 to 14.2% (95% CI: 13.7 to 14.6) in 1998–9, whereas the prevalence of overweight remained stable: 32.2% (95% CI: 31.6 to 32.9) in 1995–6 and 32.3% (95% CI: 31.6 to 32.9) in 1998–9. In men, prevalence of overweight and obesity were higher among former smokers and educational group of 6 to 12 years, and prevalence of obesity was higher in the Lisbon region. In women, prevalence of overweight and obesity were higher among never smokers, and prevalence of obesity was higher among educational group of ?6 years. Prevalence of obesity was higher in the Alentejo region, and overweight was higher in the Center region. Finally, prevalence of obesity increased in both sexes for all strata studied (age, smoking status, educational level, and geographic region), whereas prevalence of overweight increased only in men. Discussion: In Portugal, overweight and obesity levels are related to sociodemographic factors; the increase in obesity levels stresses the need for preventive measures.     

Prevalence, risk factors and economic importance of infestations with Sarcoptes scabiei and Haematopinus suis in sows of pig breeding farms in Hesse, Germany

A cross-sectional survey was performed in 110 randomly selected pig-breeding farms of southern Hesse, Germany to estimate the prevalence of ectoparasite infestations and to find possible risk factors. Ear scrapings of, if available, 10 sows per farm were examined for Sarcoptes scabiei var. suis (De Geer) (Acaridida: Sarcoptidae) by the potassium hydroxide digestion method, and a total of 2754 sows was inspected for skin lesions and infestations with Haematopinus suis (L.) (Anoplurida: Haematopinidae). Data on farm profiles and sows were collected by a questionnaire. In total, 19.1% and 2.5% of the sows were found to be infested with S. scabiei or H. suis, respectively. The percentage of mite or louse infestation was significantly higher in sows showing pruritus than in those without skin lesions. Both ectoparasite infestations were related neither to the age of sows nor their reproduction status, nor to the time interval to last ectoparasite treatment. Using farms as the unit of analysis, the estimated prevalence of mange mite and louse infestations was 45.4% and 14.5%, respectively. There was no significant association between the presence of S. scabiei and H. suis in the farms. Risk factors for S. scabiei infestation were mixed housing of dry and nursing sows in the same unit (vs. separate housing) and straw bedding (vs. strawless). For louse infestation, only mechanical cleaning of stable units (vs. additional use of disinfection methods) and pasturing of gilts and dry sows were identified as risk factors. The economic loss by S. scabiei infestation in the study population was assessed at euro 4200 per affected farm and year on average.     

Organic and inorganic nutrient effects on growth rate–irradiance relationships in the Texas brown‐tide alga Aureoumbra lagunensis (Pelagophyceae)1

Pelagophyte species in the genera Aureococcus and Auroumbra form brown tides in coastal bays that cause food‐web disruption and extensive shading of benthic primary producers. Organic nutrients have been suggested as key factors in the origination and persistence of the East Coast (USA) brown‐tide alga Aureococcus anophagefferens Hargraves et Sieburth. To evaluate this finding for the Texas brown‐tide alga Aureoumbra lagunensis D. A. Stockw., DeYoe, Hargraves et P. W. Johnson, we grew strain TBA‐2 with dissolved inorganic nitrogen (DIN; or ) or dissolved organic nitrogen (DON; urea or glutamate) as the nitrogen (N) source under eight light intensities. Maximum growth rates decreased with N source from (1.0 div · d^?1) to (0.48 div · d^?1). Neither growth rate efficiency (α) nor I_k varied significantly between N treatments. Both inorganic phosphorus (P) and β‐glycerophosphate supported growth. Aureoumbra lagunensis can utilize at least some forms of organic N and P and can use them to persist or grow when inorganic forms become limiting. We found no evidence to support the hypothesis that organic utilization enhances or supplements growth at low light levels.