National Kidney Disease Education Program has initiated a serum creatinine standardization program. Glomerular filtration rate (GFR) can be re-estimated from standardized serum creatinine measurements. How the standardized estimated GFR (eGFR) influences hypertension prevalence has not been evaluated. In this study, cross-sectional data from 21 205 participants aged 18 years in the National Health and Nutrition Examination Survey 1999-2006 were analyzed. The differences between standardized and non-standardized eGFRs in the prevalence of hypertension and low eGFR were evaluated. Multiple logistic regression models were conducted to determine the association of standardized eGFR with hypertension prevalence. The prevalence of low eGFR estimated from standardized eGFR was higher than that from non-standardized eGFR (all P0.01), except for the 2005-2006 survey. The prevalence of hypertension under standardized eGFR was not significantly different from that under non-standardized eGFR in both groups of participants with eGFR60 and eGFR60 ml min 1 per 1.73 m 2. Adjusted for age, education, gender, race/ethnicity, smoking, serum cholesterol and diabetes mellitus, the participants with standardized eGFR60 ml min 1 per 1.73 m 2 had 56.1% more chance to be hypertensive patients than those with normal eGFR (P0.0001). The difference in the relationship to hypertension prevalence between standardized and non-standardized eGFR was not found significant.

Pain symptoms in aging populations have significant public health impact. The aim of this study was to determine risk factors for the incidence of pain in older adults, focusing on those factors that can be modified. Secondary analyses were performed of survey data from the nationally representative Health and Retirement Study of US adults older than 50 years. Generalized estimating equations logistic regressions were used to evaluate the effect of selected variables on the incidence of pain using biennial (1992 through 2006) data, determining the relationship between the incidence of pain and the potential risk factors. Of the 18,439 survey respondents in 2006, 34.1% (95% CI: 33.2%, 35.0%) reported that they were often troubled by pain; 24.3% reported having moderate to severe pain; and 22.3% reported that their daily life was affected by pain. Between 1992 and 2006, 7967 individuals reported new onset of pain in 169,762 person-years of follow-up, an incidence of 4.69 (4.59, 4.80) per 100 person-years. Depression and being overweight were independent predictors associated with an increased likelihood of incident pain. Current smoking increased the likelihood of incident pain only in those subjects who also reported depression. In conclusion, pain is a common symptom in older adults. Depression, smoking, and overweight are potentially modifiable risk factors and could be considered in the prevention and management of pain in older adults.

Background: The objective of this study was to establish a prospective population-based cohort to investigate the prevalence, incidence and risk factors for mild cognitive impairment (MCI) and dementia. Methods: The Olmsted County, Minn., population, aged 70-89 years on October 1, 2004, was enumerated using the Rochester Epidemiology Project. Eligible subjects were randomly selected and invited to participate. Participants underwent a comprehensive in-person evaluation including the Clinical Dementia Rating Scale, a neurological evaluation and neuropsychological testing. A consensus diagnosis of normal cognition, MCI or dementia was made by a panel using previously published criteria. A subsample of subjects was studied via telephone interview. Results: Four hundred and two subjects with dementia were identified from a detailed review of their medical records but were not contacted. At baseline, we successfully evaluated 703 women aged 70-79 years, 769 women aged 80-89 years, 730 men aged 70-79 years and 517 men aged 80-89 years (total n = 2,719). Among the participants, 2,050 subjects were evaluated in person and 669 via telephone. Conclusions: Strengths of the study are that the subjects were randomly selected from a defined population, the majority of the subjects were examined in person, and MCI was defined using published criteria. Here, we report the design and sampling, participation, baseline measures and sample characteristics.

Little is known about the impact of drug abuse/dependence on health insurance coverage, especially by race groups and income levels. In this study, we examine the disparities in health insurance predictors and investigate the impact of drug use (alcohol abuse/dependence, nicotine dependence, and illicit drug abuse/dependence) on lack of insurance across different race and income groups. To perform the analysis, we used insurance data (8057 uninsured and 28,590 insured individual adults) from the National Surveys on Drug Use and Health (NSDUH 2011). To analyze the likelihood of being uninsured we performed weighted binomial logistic regression analyses. The results show that the overall prevalence of lacking insurance was 19.6 %. However, race differences in lack of insurance exist, especially for Hispanics who observe the highest probability of being uninsured (38.5 %). Furthermore, we observe that the lowest income level bracket (annual income <$20,000) is associated with the highest likelihood of being uninsured (37.3 %). As the result of this investigation, we observed the following relationship between drug use and lack of insurance: alcohol abuse/dependence and nicotine dependence tend to increase the risk of lack of insurance for African Americans and whites, respectively; illicit drug use increases such risk for whites; alcohol abuse/dependence increases the likelihood of lack of insurance for the group with incomes $20,000–$49,999, whereas nicotine dependence is associated with higher probability of lack of insurance for most income groups. These findings provide some useful insights for policy makers in making decisions regarding unmet health insurance coverage.

We report severe acute respiratory syndrome coronavirus 2 antibody positivity among market and city bus depot workers in Lima, Peru. Among 1285 vendors from 8 markets, prevalence ranged from 27% to 73%. Among 488 workers from 3 city bus depots, prevalence ranged from 11% to 47%. Self-reported symptoms were infrequent. / National Institute of Allergy and Infectious Diseases / Revisión por pares

The prevalence of adversities in early childhood, such as physical, sexual, and emotional abuse, as well as familial dysfunction (e.g., caregiver divorce/separation, caregiver incarceration, etc.) is often examined in community adult samples. According to the Kaiser Permanente’s Adverse Childhood Experiences study, 10.6% of the general population reported experiencing emotional abuse in childhood, 28.3% reported experiencing physical abuse in childhood, and 20.7% reported being the victim of sexual abuse in childhood. Notably, many reported experiencing multiple forms of abuse. These statistics, however, are not generalizable to the experiences of youths involved with the criminal justice system, which are understudied but likely higher than in a general community sample. Research regarding the effect of adversity on sex offending youths is necessary to inform treatment and responses to abuse, neglect, and household dysfunction during childhood. Participants were recruited from archival data gathered at a rural residential juvenile sex offender treatment facility. Our preliminary subsample is approximately 6.7% (n = 30) of the anticipated total of approximately 500 juveniles in the residential sex offender treatment program. Our sample was entirely male (100%), primarily white (96.7%), and had a mean age of 14.77 (SD=1.43) at the time of admission. Using the rural-urban continuum codes outline by the U.S. Department of Agriculture, 23% of our current sample was admitted to the facility from metropolitan areas, 20% from non-core urban population areas, and 3.3% from rural areas. The data collection began in November of 2014, and is ongoing. We can expect to have approximately 10 to 15% of data collection (n = 50-75) by April 2015. Our findings, thus far, indicate that 43% of juvenile sex offenders experienced emotional abuse, 70% experienced physical abuse, and 63% experienced sexual abuse in early childhood. We have also found that approximately 87% of our sample experienced caregiver divorce or separation, and 40% experienced caregiver incarceration during childhood. These findings suggest that these juveniles have experienced higher rates of early childhood abuse and familial dysfunction than the general adult population, as reported in the literature. As data collection proceeds, we expect to continue to find a notably higher rate of childhood abuse and familial dysfunction among juvenile sex offenders in residential treatment compared to the general population, and we will continue to examine all potential differences between juveniles from rural and urban areas.

<p>Pojava alergijskog kontatnog dermatitisa koji nastaje kao komplikacija tokom lečenja hronične venske insuficijencije je dobro poznata. Cilj istraživanja je bio da se kod obolelih od hronične venske insuficijencije utvrdi učestalost kontaktne senzibilizacije ekcemskog tipa, potom da li postoji rizik za nastanak kontaktne senzibilizacije kao i postojanje korelacije između dužine trajanja bolesti i kontaktne senzibilizacije. Hipoteza rada je da osobe sa hroničnom venskom insuficijencijom značajno če&scaron;će razvijaju kontaktnu senzibilizaciju nego osobe bez hronične venske insuficijencije, da imaju veći rizik za nastanak kontaktne senzibilizacije kao i da je učestalost kontaktne senzibilizacije u pozitivnoj korelaciji sa dužinom trajanja bolesti. Istraživanje je sprovedeno nad 266 ispitanika. Formirane su dve grupe. Eksperimentalnu grupu su činili oboleli od hronične venske insuficijencije upućeni na alergolo&scaron;ko testiranje pod sumnjom na postojanje kontaktnog dermatitisa, a kontrolnu grupu su činili bolesnici bez hronične venske insuficijencije epikutano testirani pod sumnjom na postojanje kontaktnog dermatitisa. Obolelima od hronične venske insuficijencije je procenjena težina bolesti na osnovu CEAP klasifikacije. Potom je svaki ispitanik podvrgnut alergolo&scaron;kom epikutanom testiranju pač testom. Istraživanje je pokazalo da je učestalost kontaktne senzibilizacije među obolelima od hronične venske insuficijencije iznosila 49,3%. Učestalost kontaktne senzibilizacije kod osoba sa hroničnom venskom insuficijencijom na alergene: iz sastava Evropske standardne baterije je iznosila 31,55%; baterije specifične za hroničnu vensku insuficijenciju je iznosila 28,45%; komercijalno dostupne baterije alergena ubikvitarnih korovskih biljaka iz porodice Compositae je iznosila 6,69%; originalno spravljene ekstrakte ubikvitarnih korovskih biljaka Vojvodine je iznosila 6,11%. Ne postoji statistički značajna razlika u odnosu na pol. Prevalencija kontaktne senzibilizacije kod osoba sa hroničnom venskom insuficijencijom se nije statistički značajno razlikovala od osoba koje nisu imale hroničnu vensku insuficijenciju. Pozitivnost epikutanog alergolo&scaron;kog testa kojim se potvrđuje postojanje kontaktne senzibilizacije je bila statistički značajno vi&scaron;a kod osoba sa hroničnom venskom insuficijencijom. Osobe sa hroničnom venskom insuficijencijom su imale 2,45 puta vi&scaron;i rizik za nastajanje kontaktne senzibilizacije na dva i vi&scaron;e alergena, a 3,69 puta vi&scaron;i rizik za nastajanje kontaktne senzibilizacije na pet i vi&scaron;e alergena u odnosu na one bez hronične venske insuficijencije. Učestalost kontaktne senzibilizacije je u pozitivnoj korelaciji sa dužinom trajanja bolesti.</p> / <p>Development of allergic contact dermatitis as a complication of treatment of chronic venous insufficiency is well known. The aim of this study was to determine the incidence of eczematous contact sensitization in patients with chronic venous insufficiency, possible risks for the development of contact sensitization, and the correlation between disease duration and contact sensitization. The working hypothesis was that the incidence of contact sensitivity is significantly higher in individuals with chronic venous insufficiency than in those without chronic venous insufficiency, that they are at greater risk of developing contact sensitization, and that there is a positive correlation between the incidence of contact sensitization and the disease duration. The study included 266 patients. They were divided into two groups: the study group included patients with chronic venous insufficiency referred for allergy testing due to suspected contact dermatitis, and the control group included patients without chronic venous insufficiency patch tested for suspected contact dermatitis. The severity of chronic venous insufficiency was assessed by CEAP classification. Thereafter, each patient underwent patch testing. The research has shown that the incidence of contact sensitization among patients with chronic venous insufficiency was 49.3%. In these patients, the incidence of contact sensitization to the European standard battery of allergens was 31.55%; to the battery specific for chronic venous insufficiency it was 28.45%; to commercially available batteries of allergens of ubiquitous plants from the Compositae family it was 6.69%; and to originally prepared extracts of ubiquitous plants found in Vojvodina it was 6.11%. There was no statistically significant difference in relation to sex. The prevalence of contact sensitization in patients with chronic venous insufficiency was not significantly different from those without chronic venous insufficiency. Positive patch test reaction rates, confirming the existence of contact sensitization, were significantly higher in patients with chronic venous insufficiency. Patients with chronic venous insufficiency had a 2.45-fold higher risk for developing contact sensitization to two or more allergens, and a 3.69-fold higher risk for developing contact sensitization to five or more allergens compared to those without chronic venous insufficiency. There was a positive correlation between the incidence of contact sensitization and the duration of the disease.</p>

Evaluar la dimensión antero- posterior (A-P)/medio-lateral (M–L), y la morfología del cóndilo mandibular en pacientes de 18 a 65 años con patrón esquelético Clase I en tomografías computarizadas Cone Beam. Material y Métodos: 71 tomografías fueron evaluadas mediante el software RealScan 2.0. La dimensión fue determinada por los puntos A (más anterior en el plano sagital), P (más posterior en el plano sagital), M (más interno en el plano coronal), L (más externo en plano coronal). Se evaluó la morfología del cóndilo en dos planos coronal y sagital, clasificándose en: redonda, aplanada, convexa y mixta. La dimensión del cóndilo fue analizada por estadística descriptiva y la morfología mediante distribución de frecuencias. Para el análisis bivariado, se aplicó la prueba de t de Student. Resultado: Se obtuvieron las medidas del diámetro A-P del cóndilo derecho (CD) (8,72mm ± 1,25mm) y el izquierdo (CI) (8,50mm ± 1,50mm), el diámetro M-L del CD (19,24mm ± 2,03mm) y el CI (18,97mm ± 1,87mm). Hubo diferencias significativas en la dimensión M-L del CI del sexo masculino en comparación al femenino (p=0.002). La morfología más prevalente del CD (35,21) y CI (23,94) en plano coronal fue de tipo redonda. Conclusión: La dimensión A-P del cóndilo derecho e izquierdo es similar en ambos sexos; sin embargo, existen diferencias en la dimensión M-L del cóndilo izquierdo del sexo masculino. La morfología del cóndilo derecho e izquierdo más prevalente fue la redonda en plano sagital a excepción del plano coronal. / To evaluate the anterior-posterior (A-P)/medial-lateral (M-L) dimension, and morphology of the mandibular condyle in patients aged 18 to 65 years with Class I skeletal pattern on Cone Beam Computed Tomography scans (CBCTs). Materials and Methods: Seventy one CBCTs were evaluated using RealScan 2.0 software. The dimension was determined by points A (most anterior in the sagittal plane), P (most posterior in the sagittal plane), M (most interior in the coronal plane), L (most exterior in the coronal plane). The morphology of the condyle was evaluated in two coronal and sagittal planes, being classified as: round, flat, convex or mixed. The size of the condyle was analyzed by descriptive statistics and the morphology by frequency distribution. For the bivariate analysis, the Student’s t-test was applied. Results: Measurements were obtained for the A-P diameter of the right condyle (RC) (8.72mm ± 1.25mm) and the left condylar (LC) (8.50mm ± 1.50mm), the M-L diameter of the RC (19.24mm ± 2.03mm) and the LC (18.97mm ± 1.87mm). There were significant differences in the male M-L dimension of the LC compared to the female (p=0.002). The most prevalent morphology of RC (35.21) and IQ (23.94) in the coronal plane was round.. Conclusion: The A-P dimension of the right and left condyle is similar in both genders; however, there are differences in the M-L dimension of the left male condyle. The most prevalent morphology of the right and left condyle was round in the sagittal plane with the exception of the coronal plane. / Revisión por pares

Based on two surveys, the thesis focuses on the prevalence of filarial parasites of domestic carnivores in Gauteng, KwaZulu-Natal and Mpumalanga provinces in South Africa and Maputo province of Mozambique. This is complemented by diagnostic results of routine examinations for filarial infections of dogs and cats from South Africa obtained between 1994 and 2008. Blood samples were collected and initially screened by membrane filtration for microfilariae. Other techniques employed were acid phosphatase staining for the identification of microfilariae and a commercial enzymelinked immunosorbent assay for the detection of heartworm antigen. Combined with a critical literature review on filariosis of domestic carnivores in Africa, which is updated by diagnostic results obtained from animals in Africa between 1992 and 2008, the topic is addressed for the first time ever from a continental perspective. In the South African provinces and Maputo province of Mozambique 196 of 1 379 dogs (14.21 %) were found positive for microfilariae. The species identified were Dirofilaria immitis, Dirofilaria repens, Acanthocheilonema reconditum and Acanthocheilonema dracunculoides. The endemic status of D. immitis was confirmed in 2 out of 313 dogs from Maputo province but not in the South African provinces. Infection with D. repens was found in 70 dogs (5.08 %). The highest prevalence rate was recorded in KwaZulu-Natal with 12.47 % (52/417), followed by Maputo Province with 3.83 % (12/313) and Mpumalanga with 1.5 % (5/333). Routine examinations have also confirmed autochthonous infections with D. repens in Gauteng and North West provinces. Acanthocheilonema reconditum was the species with the highest overall prevalence of 8.85 % (122/1 379). The highest prevalence rate was recorded in Mpumalanga with 29.13 % (97/333) followed by Maputo province with 6.39 % (20/313) and KwaZulu-Natal with 1.2 % (5/417). Routine examinations have also confirmed autochthonous infections in Gauteng, North West and Western Cape provinces. Acanthocheilonema dracunculoides was the species with the lowest overall prevalence of 0.07 % (1/1 379) and was only recorded in 1 dog from Maputo Province. In KwaZulu-Natal 9 of 82 cats (10.98 %) were found positive for microfilariae, with D. repens as the only species involved. / Thesis (PhD)--University of Pretoria, 2009. / Veterinary Tropical Diseases / unrestricted

Purpose: The purpose of this study was to determine whether levels of physical activity in people with chronic pain change after participating in a Chronic Pain Management Program (CPMP) at Groote Schuur Hospital (GSH). Methods: A pre-experimental pre-test, post-test study was conducted, consisting of 14 men and women suffering from chronic pain who were referred to a Chronic Pain Management Program (CPMP) from the Chronic Pain Management Clinic at GSH in Cape Town, South Africa. Subjective and objective measuring tools, including pedometry, were used to collect data and non-parametric analysis was conducted to analyse data. Results: 14 participants met the Inclusion criteria. Levels of physical activity changed markedly, but not significantly. Objectively-tested and self-reported physical activity levels changed significantly among participants who took part in a CPMP. Significant improvements in Pain Severity Scores and Pain Interference Scores occurred after the CPMP and there was convergent validity between self-reported and objectively-tested levels of physical activity in those suffering from chronic pain after the CPMP. Conclusion: The Chronic Pain Management Program at Groote Schuur Hospital in Cape Town has shown to improve function and physical activity of those patients living with chronic pain who take part in the CPMP, with function improving significantly, and physical activity nearly doubling in the group being tested who took part in the 5-week long program. The CPMP at GSH should be seen as the beginning of a greater movement towards increasing physical activity in the chronic pain sphere. Research in more public healthcare facilities is needed to increase knowledge around education, pacing and implementation strategies across South Africa.