Year-old Age Group Research Articles

Perfil dos estudantes que ingressam no curso de Odontologia: motivos da escolha

O objetivo deste estudo, com recorte transversal de natureza quantitativa, foi avaliar o perfil, a percepção e o motivo da escolha pelo curso de Odontologia em uma faculdade particular de Campinas (SP). Do total de 153 alunos matriculados em 2016, 102 (66,7%) aceitaram participar da pesquisa. O instrumento de pesquisa foi um questionário estruturado, autoaplicável, com 22 questões que versavam sobre perfil socioeconômico, demográfico, percepção sobre o curso e os motivos de sua escolha. Entre os respondentes, 81,4% eram do sexo feminino. A faixa etária de 17 a 20 anos predominou (67,3%), sendo a maioria solteiros (89,3%), tendo cursado ensino médio em escola particular (80,4%), com renda familiar acima de R$ 8.800,00 (54,0%). Quando abordados sobre o motivo da escolha pelo curso, 61,7% optaram por ser da área da saúde; e 29,4% sofreram influência de um dentista. Quanto à pretensão profissional, 6,8% querem trabalhar somente no setor público, 47,0% querem ser assalariados e montar seu próprio negócio e 38% querem trabalhar de forma autônoma em consultório. Sobre o curso, 62,8% se declararam satisfeitos com o corpo docente; 72,5%, com a matriz curricular, e a maioria (70,5%) deseja cursar especialização após a graduação. Sobre a escolha, 97,0% estão satisfeitos; e 96,0% se sentem preparados para enfrentar o mercado de trabalho. A percepção dos respondentes é positiva quanto à formação. Há o reconhecimento da tendência de assalariamento na profissão, embora demonstrem o desejo de atuação no setor privado.

Penetrating Brain Injuries at Assiut University Hospital: One Year Study

AbstractBackground: Penetrating Brain Injury (PBI) is defined as head traumain which a projectile breaches the cranium and dura matter. It is one of the most fatal forms of trauma and many cases die at the site of trauma. For those who survive till hospitalization, the management of penetrating brain injury represents great challenges to medical and surgical providers. Penetrating brain injuries are classified according to projectile velocity into missile and nonmissile injuries.Aim of Study: Our study discussesclinical-radiological profile and outcome of patients of penetrating brain injuries.Material and Methods: This is a prospective hospital based study includes 30 patients with penetrating head injuries admitted and managed at Department of Neurosurgery and Trauma Units of Assiut University Hospital through one year from March 2015 to March 2016.Results: The mean age was 25 years. 27 patients were males (90%). Brainmatter herniation and Cerebrospinal Fluid (CSF) leak was the most common clinical presentation in 28 (93.3%) patients followed by decreasedlevel of consciousness in 26 (86.6%) patients. Multiple lobe injury was noted in 14 (46.6%) patients followed by parietal lobe in 10 (30%) patients. 12 patients died during the hospital stay. Three patients were discharged in GOS-3, 5 in GOS-4, and 10 in GOS-5. Wound infection occurred in3 (10%) patients, and seizure developed in 7 (23.3%) patients.Conclusion: Penetrating brain injuries are rising issue in our community. It occurs commonly in young adults (20 to 40 year-old agegroup) and occurs more commonly in males. Firearm is the usual mode of injury and carries worse prognosis than other modes of injury. Higher mortality wasobserved among missile injuries compared to non missile injuries. Mostcases presented with brainmatter herniation or CSF leak. Multi lobar injury is themost common finding followed by parietal lobe injury. Aggressive resuscitation is required in cases of PBI. Prognosis of penetrating brain injuries is highly related to post resuscitation GCS.

Using paired serology and surveillance data to quantify dengue transmission and control during a large outbreak in Fiji.

Dengue is a major health burden, but it can be challenging to examine transmission and evaluate control measures because outbreaks depend on multiple factors, including human population structure, prior immunity and climate. We combined population-representative paired sera collected before and after the 2013/14 dengue-3 outbreak in Fiji with surveillance data to determine how such factors influence transmission and control in island settings. Our results suggested the 10-19 year-old age group had the highest risk of infection, but we did not find strong evidence that other demographic or environmental risk factors were linked to seroconversion. A mathematical model jointly fitted to surveillance and serological data suggested that herd immunity and seasonally varying transmission could not explain observed dynamics. However, the model showed evidence of an additional reduction in transmission coinciding with a vector clean-up campaign, which may have contributed to the decline in cases in the later stages of the outbreak.

Epidemiological serosurvey of poliovirus in Guangdong, China: A cross-sectional study

ABSTRACTA cross-sectional study for poliovirus seroprevalence in Guangdong was carried out in 2014, just before a change in polio vaccine commenced in 2015. The aim of the study was to test whether polio immunity level was high enough to satisfy the polio vaccine switch. A total of 6339 people were tested for poliovirus neutralization antibodies (NA). Overall NA seropositivity for PV1, PV2 and PV3 were 95.2%, 94.9% and 88.7%, and the respective geometric mean titer (GMT) were 82.9, 55.8, and 26.3, respectively. There were statistically significant differences in the positive rates and GMT of the 3 serotypes and PV3 had relatively lower positive rates and GMT. The highest seropositivity and GMT were observed in the 1–9 year-old age group. The positive rates of NA and GMT for PV1, PV2 and PV3 in the western region of Guangdong were lower than those of other three regions. The results of this study showed that the population of Guangdong province had a high polio immunity level, a stable base for a polio vaccine switch.

Epidemiological characteristics of suicide in the Autonomous Province of Vojvodina

Introduction. Suicide is defined as a conscious and deliberate taking of one?s own life, or a self-destructive behavior with a fatal outcome. Every year, millions of people are affected by suicide or the feeling of grief. The aim of our research was to review the basic epidemiological characteristics of suicide in the Autonomous Province of Vojvodina, in order to assist in tar?geted prevention programs. Material and Methods. A retrospec?tive, observational study was conducted. The data were analyzed in chronological order and in accordance with different demo?graphic characteristics and topographic distribution. Basic sta?tistical indicators were used as parameters: non-standardized, standardized and specific mortality rates. Results. During the observed period, from 1991 until the end of 2010, in the Autono?mous Province of Vojvodina, the average annual non-standard?ized suicide rate was 27.9/100,000 inhabitants. The highest sui?cide rate was recorded in 1992 and 1993 (33.7/100,000 and 34.5/100,000, respectively) and in 1999 (31.5/100,000). The high?est age-specific suicide rate was recorded in ? 80 year-old age group (120.5/100,000). The suicide rates were significantly high?er among males, while the most common suicide method for both sexes was by hanging (69.9%). The highest average annual sui?cide rate was recorded among widowers (176.9/100,000) and widows (37.8/100,000). The lowest number of suicides was re?corded in persons with higher level of education. Conclusion. Since in the Autonomous Province of Vojvodina persons at in?creased risk for suicide include males, the elderly population, persons with low education levels, and people who lost their partners, suicide prevention strategies should target these groups, including primary and secondary prevention measures.

NATURAL SEED REPRODUCTION OF OAK PLANTATIONS AS AN ELEMENT CLOSE TO THE NATURE OF FORESTRY

Oak is one of the most valuable and oldest species growing on the territory of Ukraine. Being more extensive in the past the area occupied by the oak due to the influence of adverse factors, human economic activities, and intensive felling significantly decreased. Ukraine's oak forests experienced the greatest extinction in the 16-19 centuries. Oak plantations are concentrated in the forest-steppe (47 %), in Polissia (26 %), steppe (12 %), Crimea (9 %), and in the Carpathians (5 %). Oak forests restoration is mostly artificial, as natural seed restoration is not given due attention. In the 1990 s, the annual volume of reforestation reached an average of 13.8 thousand hectares, forest crops were created on the area of 12.2 thousand hectares, or 88.4 %. Therefore, the problem of natural seed restoration of oak forests is relevant to the forestry of Ukraine. Tree stands with the participation of oak perform extremely important soil protection, water protection, water regulation, and recreation functions. Oak wood due to such qualities as strength, colour and texture, the ability to take polishing, and the beauty of the texture prevails upon all the wood species growing in the region. The results of our research have revealed that the percentage of the use of the typological potential of wet hailstone in the western forest-steppe is 83.8 %. The lowest percentage (70.7 %) of the use of the typological potential of this forest type was noted in the 10 year-old age group, and the highest (99.7 %) is characteristic for 21-30 year-old age group. Typological analysis of woodlands in each age group of this forest type allowed noting the significant advantage of derivatives of woodlands in 11-20 year-old age groups more than 69 %, 21-30 g more than 85 %, in the age group 41-50 g more than 55 % and the gradual growth of indigenous trees in the age groups of 51-60 g to 97 % and 71-80 g over 85 %. Similar observations in Shalankivske Forestry of the Vynohradiv Forestry State Enterprise indicate that a significant area in forestry is occupied by derivatives of forest stands where composition does not meet the established requirements. The growth of the oak under the forest tent and on logs depends on many factors. In particular, illumination plays a significant role in the survival of the undergrowth in the conditions of the western forest-steppe. The smallest otter of ordinary oak self-seeding (19.3-28.5 %) is noted on solid logs, where the felling of a tree-farm was carried out after falling acorns. Naturally reproduced oak stands are noted to grow better (at four years of age, seedlings of ordinary oak reach height of more than 2 m, while the seedlings on forest-cultivated fields of the same age rarely exceed the threshold of more than 70 cm), compete well with the steam secondary tree species, and are characterized by greater resistance to the impact of unpredictable natural and anthropogenic factors. Thus, effective use of the potential of natural reproduction of oak forests will not only reduce the costs of plant restoration, but will also contribute to a significant reduction in the cultivation of ripe oak wood and to increase the productivity of oak stands. This will also ensure the formation of more resistant to the manifestation of negative natural phenomena plantations with the participation of ordinary oak.

Retreatment of Chronic Hepatitis C Virus (HCV): Predictors of Response

Introduction: HCV chronically infects millions and contributes to significant morbidity and mortality. Although modern Direct Acting Antiviral (DAA) based therapies have much proven success in curing infection, management of chronic HCV who have failed treatment is problematic. Our study seeks to assess clinical predictors of retreatment response in patients who have previously failed anti-HCV therapy. Methods: A retrospective analysis was conducted on a sample of patients, who had previously failed treatment for chronic HCV infection, seen at the Liver Associates of Texas Hepatology clinics between September 2015 and October 2016. The cohort consisted of 19 total patients who had failed prior DAA -based or interferon-based therapy. The 19 patients were then retreated with extended DAA +/- ribavirin. 16 achieved Sustained Viral Response (SVR) at 12 weeks. Retreatment responders and retreatment nonresponders were compared in terms of clinical variables including BMI, ethnicity, presence of portal hypertension and age as predictors of response. Chi Squared and ANOVA analyses were used to compare differences between the groups. Results: Out of the 19 patients in the analysis, 68% had initially failed interferon-based regimens while the other 32% of patients had failed DAA-based treatment. 47% of the sample was African American, 26% Caucasian, 11% Hispanic. Majority of these patients fell in the 55-79 year-old age group (84%), and of the total 19, 58% were male and 42% were female. The median viral load at presentation in the sample was 815,687 IU/ml. Gender, age, portal hypertension status, diabetic status and ethnicity were not significantly different between the two groups. BMI, however, was significantly lower in the retreatment group that achieved SVR12 with responders having a mean BMI (Kg/m2) of 28.27 Vs 38.67 in the nonresponders (p=.003). Conclusion: Despite a small sample size, this study suggests that a low BMI was a positive predictor of response in retreatment of patients who had failed prior treatment for chronic HCV. This difference may be due to a variety of factors including baseline metabolic differences, liver injury, or even overall health and well-being.

Uso de drogas ilícitas na prática do homicídio

Introdução: O impacto da violência no desenvolvimento urbano tem merecido destaque. As consequências da exposição à violência mais especificamente aos homicídios e ao uso de drogas incluem alterações fisiológicas, neurológicas e de âmbito interpessoal. Objetivo: Este estudo teve como objetivo verificar a prevalência de exposição à violência comunitária e identificar associações com exposição às drogas ilícitas e envolvimento com o crime. Métodos: Trata-se de um estudo retrospectivo, com uma abordagem observacional e descritiva, a partir da análise de prontuários de condenados pela prática do homicídio, buscando tipificação do crime e informações sobre o uso de drogas ilícitas. Resultados: Dos 40 presos em fase de execução cujos prontuários foram analisados, todos eram do sexo masculino, com predomínio da faixa etária entre 21 a 40 anos (n=30, 75%). No que concerne ao grau de escolaridade 47,5% (n=19) não concluíram o ensino fundamental, 35,0% (n=14) eram analfabetos e 17,5% (n=7) apresentavam o ensino médio completo. Considerando a tipificação do crime observou-se que todos cometeram o homicídio na modalidade qualificada, quanto ao motivo, pela futilidade conforme disposto no artigo 121. Conclusão: Ao consumir algum tipo de droga ilícita o indivíduo, perde o controle emocional tendo diversos sintomas como alucinação, euforia e psicose que poderiam servir de motivação para a prática de delitos com requintes de crueldade.

Effective Factors in Recurrent Deliberate Self-Poisoning Attempts

Background: The most common suicide attempt (SA) is deliberate self-poisoning (DSP) in Iran. Although the proportion of fatal suicide by DSP is much lower compared to other methods, repeated suicide attempts (RSA) are very high. Objectives: This study aimed at determining the effective factors on RSA among patients referred due to DSP in west of Iran. Methods: All cases attempting DSP, who were referred to the only main poisoning treatment centre in the west of Iran, were assessed during year 2014. They were interviewed by psychologists in order to determine the number of SAs for each person individually, using data linkage. Data was analyzed by zero-truncated poisson regression. Results: During year 2014, of 1790 cases committed with DSP, 64 (3.5%) died because of the severity of poisoning. Among non-fatal DSP attempters, 1069 (61.94%) attempted suicide for the first time and 334 (19.34%) for the second time. In the multivariate model, age was an important predictor of RSA, so that the risk of RSA in 26 to 35 year-old age group was lower than in the 18-year-old age group (IRR 0.3, 95 % CI, 0.2 to 0.4 P = 0.001). Also, SA history was the first risk factor for RSA, so that individuals with SA history had higher RSA than individuals without SA history (IRR 3.1, 95 % CI, 2.8 to 3.3, P = 0.001). After SA history, psychological disorders were the most important risk factor for RSA (IRR 2.7, 95 % CI, 2.1 to 3.6, P = 0.001). Conclusions: Psychological disorders and SA history are the most important factors on RSA. Because of the high prevalence of psychological disorders in SA individuals than the normal population, it is necessary to present psychological and surveillance consultation to suicide attempters to decrease the number of SAs.

A physical fitness profile of state highway patrol officers by gender and age

BackgroundLaw enforcement officers perform physically demanding tasks that generally remain constant as they age. However, there is limited population-specific research on age, gender and normative fitness values for law enforcement officers as opposed to those of the general population. The purpose of this study was to profile the current level of fitness for highway patrol officers based on age and gender and provide percentile ranking charts unique to this population.MethodsRetrospective data for six-hundred and thirty-one state troopers (♂ = 597; mean age = 39.52 ± 8.09 yrs; mean height = 180.72 ± 7.06 cm; mean weight = 93.66 ± 15.72 kg: ♀ = 34; mean age = 36.20 ± 8.45 years; mean height = 169.62 ± 6.65 cm; mean weight = 74.02 ± 14.91 kg) collected in 2014–2015 were provided for analysis. Data included demographic (age), anthropometric (height and weight), and select fitness (VJ, push-ups, sit ups, isometric leg/back strength, isometric grip strength and 20 m shuttle run test) information.ResultsThere were generally significant differences between genders for all anthropometric and fitness measures, most consistently in the 30–39 age groups. While there was a general decline in push-up and shuttle run performance in female officers, these results did not reach significance. For male officers, there were significant differences between the 20–29 year-old age group and the 30–39, 40–49 and 50–59 year-old groups with the younger group performing better in VJ, push-ups, sit ups and number of shuttle runs than the older groups. There were no differences in isometric grip strength and leg back dynamometer measures between age groups.ConclusionMale officers tended to be heavier, taller and perform significantly better than female officers in all measures bar sit-ups. While there appeared to be a general decline in certain physical characteristics across genders with increasing age the notable differences were between the youngest male age group (20–29 years) and all other male age groups with a potential reason being the lack of fitness requirements once typically younger cadets leave the academy. Percentile rankings for the assessed measures were found to have elements very specific to this population when compared to the general population and those provided in this paper can be used to inform future profiling and research in this population.

A Three-Year Epidemiological Study of Animal Bites and Rabies in Hamedan Province of Iran

Background: Rabies is an almost invariably fatal disease that is associated with animal bites. Hence, gathering data about cases of animal bites can help in clarifying the relative status of the disease. Objectives: This study was conducted to provide an epidemiological overview on animal bites and rabies occurred in Hamedan province, Iran, during 2011 - 2013. Methods: This cross sectional descriptive study was conducted in Hamedan province, Iran. The information was retrieved from the vice-chancellery for health (Hamedan University of Medical Sciences) and veterinary directorate general of Hamedan province. The data were analyzed using the SPSS software. The Chi-square test was used to determine statistically significant differences with P values less than 0.05. Results: There was just one report of rabies death during the mentioned period. The total number of reported animal bites was 14327 with the incidence of 2.69 cases/1000 individuals, which included 3287 (22.9%) women and 11040 (77.1%) men. Of these cases, 9868 (68.9%) resided in rural areas, while 4459 (31.3%) were urban residents. Most animal bites, 3516 (24.54%) cases, occurred in the 20 - 29 year-old age group. The lower limbs injuries were significantly higher than other sites with 7462 (52.08%) records. In addition, the majority of people were bitten by dogs (11040 cases, 77%). Conclusions: This study indicated that the incidence of animal bites was increased during 2011 - 2013 in Hamedan province. Therefore, it seems necessary to take appropriate educational programs along with both pre-exposure immunization and postexposure prophylaxis to control this infection in the region.

Mortality surveillance in the Netherlands: winter 2015/2016 of moderate severity

ObjectiveWeekly numbers of deaths are monitored to increase the capacityto deal with both expected and unusual (disease) events such aspandemic influenza, other infections and non-infectious incidents.The monitoring information can potentially be used to detect, trackand estimate the impact of an outbreak or incident on all-causemortality.IntroductionThe mortality monitoring system (initiated in 2009 during theinfluenza A(H1N1) pandemic) is a collaboration between the Centrefor Infectious Disease Control (CIb) and Statistics Netherlands.The system monitors nation-wide reported number of deaths(population size 2014: 16.8 million) from all causes, as cause ofdeath information is not available real-time. Data is received fromStatistics Netherlands by weekly emails.MethodsOnce a week the number of reported deaths is checked for excessabove expected levels at 2 different time-lags: within 1 and 2 weeksafter date of death (covering a median 43% and 96% of all deathsrespectively). A weekly email bulletin reporting the findings is sentto the Infectious Disease Early Warning Unit (at CIb) and a summaryof results is posted on the RIVM website (National Institute for PublicHealth and the Environment). Any known concurrent and possiblyrelated events are also reported. When excess deaths coincide withhot temperatures, the bulletin is sent to the Heat Plan Team (also atRIVM). Data are also sent to EuroMOMO which monitors excessmortality at a European level. For the Dutch system baselines andprediction limits are calculated using a 5 year historical period(updated each July). A serfling-like algorithm based on regressionanalysis is used to produce baselines which includes cyclical seasonaltrends (models based on historical data in which weeks with extremeunderreporting have been removed. Also periods with high excessmortality in winter and summer were removed so as not to influencethe baseline with previous outbreaks).ResultsIncreased mortality occurred during the entire influenza epidemicand up to three weeks thereafter (weeks 1-14 of 2016), except for adrop in week 7 (figure1). Excess mortality was primarily observedin persons 75 or older. Additionally, in several weeks mortality wasincreased in 65-74 year olds, (weeknr 4-6; peaking in week 4 with564 deaths, when 468 baseline deaths were predicted). Also, inweek 4, mortality in the 25-34 year-old age group was significantlyincreased (25 deaths, while 14 were expected as baseline). Cumulativeexcess mortality was estimated at 3,900 deaths occurring duringthe 11 weeks of the 2015/2016 influenza epidemic and at 6,085during the total winter season (44 weeks running from week 40 up toweek 20).ConclusionsIn terms of number of deaths during the winter season (weeks40-20) and during the influenza epidemic (weeks 1-11), the 2015/2016season in the Netherlands was of moderate severity compared with theprevious five years (and was of similar magnitude as the 2011/2012winter). Notable was the short three-week time span with a higherpeak in mortality in 65-74 year olds than has been observed in recentyears. Although the influenza epidemic reached its peak in week7, the mortality data showed a dip in week 7. The reason for thetemporary decrease is unknown but there was a partial overlap witha public holiday.

Face-ism from an International Perspective: Gendered Self-Presentation in Online Dating Sites Across Seven Countries

The present study analyzed whether the face-ism phenomenon, which argues that the media visually depict men with more facial prominence compared to women (whereas women are shown with greater body prominence), exists for self-selected photographs worldwide. Based on a content analysis of a sample of 6286 profile photos drawn from online dating sites in seven countries (Austria, Denmark, Hungary, Japan, Netherlands, Sweden, and the United States) in 2013, we did not find any overall gender differences in facial prominence. However, further analysis showed gender differences in facial prominence for certain age groups: whereas there were no gender differences in the 25–41 year-old age group, young women between 18 and 24 had a higher facial prominence than men, and men older than 41 had higher facial prominence than women. These changes by age are driven by a pattern wherein facial prominence generally remains stable for men, but declines for women with age. In short, older users follow more traditional gender depictions in accordance with the face-ism phenomenon, whereas among younger people, women sport an even higher facial prominence than men do. In contrast to this significant interaction between gender and age in facial prominence, we found no significant interaction between culture (as measured by Hofstede’s masculinity dimension) and gender, which indicates that culture plays no discernible role in gender differences in facial prominence, possibly because macro-level sexism (Hofstede’s masculinity dimension) and micro-level sexism (photographs of individuals online) are not the same.

Pneumococcal serotype distribution: A snapshot of recent data in pediatric and adult populations around the world

ABSTRACT S. pneumoniae infection remains a serious public health concern despite the availability of vaccines covering up to 23 of more than 94 known serotypes. The purpose of the present study was to monitor recent serotype distribution data. PubMed, EMBASE, Cochrane Reviews and Ingenta databases were searched. Serotype data covering invasive pneumococcal disease (IPD) and non-IPD were extracted from articles published from March 2014 to March 2015. Fifty-nine studies presented pneumococcal serotype prevalence by specific age categories. Most prevalent serotypes not covered by pneumococcal conjugate vaccines (PCV) were as follows: 15B, 22F, 15A, 23A among children under the age of 7 y with IPD; among adults with IPD: 22F, 11A, 10A, 38 in the 65 y and older age group; 12F, 9N, 8 in the 50–64 year-old age group and 12F, 8, 6C, 16F in the 15–59 age group. Geographic variations in serotype distribution highlight the importance of monitoring evolving pneumococcal serotype prevalence after pneumococcal vaccine implementation.

High pneumonia lifetime-ever incidence in Beijing children compared with locations in other countries, and implications for national PCV and Hib vaccination.

ObjectivesTo compare the proportion of Beijing children who have ever had pneumonia (%Pneumonia) to those in other locations, and to estimate by how much national vaccine coverage with Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Influenzae Type b (Hib) could reduce Beijing %Pneumonia.Methods%Pneumonia was obtained for each age group from 1 to 8 years inclusive from 5,876 responses to a cross-sectional questionnaire. Literature searches were conducted for world-wide reports of %Pneumonia. Previous vaccine trials conducted worldwide were used to estimate the pneumococcal (S. pneumoniae) and Hib (H. influenzae) burdens and %Pneumonia as well as the potential for PCV and Hib vaccines to reduce Beijing children’s %Pneumonia.FindingsThe majority of pneumonia cases occurred by the age of three. The cumulative %Pneumonia for 3–8 year-old Beijing children, 26.9%, was only slightly higher than the 25.4% for the discrete 3 year-old age group, similar to trends for Tianjin (China) and Texas (USA). Beijing’s %Pneumonia is disproportionally high relative to its Gross National Income (GNI) per capita, and markedly higher than %Pneumonia in the US and other high GNI per capita countries. Chinese diagnostic guidelines recommend chest X-ray confirmation while most other countries discourage it in favor of clinical diagnosis. Literature review shows that chest X-ray confirmation returns far fewer pneumonia diagnoses than clinical diagnosis. Accordingly, Beijing’s %Pneumonia is likely higher than indicated by raw numbers. Vaccine trials suggest that national PCV and Hib vaccination could reduce Beijing’s %Pneumonia from 26.9% to 19.7% and 24.9% respectively.ConclusionNational PCV and Hib vaccination programs would substantially reduce Beijing children’s pneumonia incidence.

Complications After Revision Total Hip Arthroplasty in the Medicare Population

BackgroundThe purpose of this study was to identify the incidence and types of complications after revision total hip arthroplasty (THA) within the first year, and determine the relative risk factors for these complications and of re-revision. MethodsThe sample size of 5% Medicare claims data from 1998-2011 was studied. Primary THA patients who underwent subsequent revision were identified using ICD-9-CM codes. Outcomes and complications after revision THA were assessed. Multivariate Cox regression was used to evaluate the effect of patient demographic characteristics on the adjusted complication risk for revision THA patients. ResultsOf the 64,260 primary THA patients identified between 1998 and 2011, 3555 patients (5.71%) underwent revision THA. Etiology of primary hip failure included mechanical complications such as loosening and wear (40.7%), dislocation (14.0%), and infection (11.3%). Complications after revision THA included infection and redo revision, 17.3% and 15.8% followed by venous thromboembolic disease (VTE) at 11.1%, dislocation at 5.43%, PE at 3.24%, and death at 2.11%. The rate of “new” infections after an aseptic revision was 8.13%. Patients in the 85+-year-old age group had a 100% greater adjusted risk of VTE (P < .001) and 406% higher adjusted risk of death (P < .001) than those in the 65-69 years-old age group. Patients with higher Charlson scores had higher adjusted risks of VTE (P < .001), infection (P < .001), death (P = .002), and re-revision THA (P = .011). ConclusionAdvanced age is a clear risk factor for VTE and mortality, but not for dislocation, infection, or re-revision. Higher Charlson index was found to be a risk factor for every complication after revision except dislocation. Greater attention is required to address the high rate of infection and re-do revision after revision THA (17.3% and 15.8%).

Concentrations of arsenic, cadmium and lead in human hair and typical foods in eleven Chinese cities.

Concentrations of arsenic (As), cadmium (Cd) and lead (Pb) were determined in 384 human hair samples and 445 purchased food samples from 11 cities in China. The mean concentrations of hair As, Cd and Pb were 0.23, 0.062 and 2.45mgkg-1, respectively. The As, Cd and Pb concentrations in different foods were lower than the national maximum allowable contaminant levels. By comparison, males had higher hair As concentrations but lower Cd concentrations than females. When the interaction effects of gender and age were considered, males had the higher hair As, Cd and Pb concentrations in the 51-65 year-old age group. Residents of rural areas had higher hair As, Cd and Pb concentrations than people living in urban areas. Further analysis indicates that hair As, Cd and Pb concentrations and their changes with biological and environmental factors cannot be satisfactorily explained by the estimated intakes from purchased food.

HIV Prevalence among Pregnant Women in Brazil: A National Survey.

Background This study was conducted to determine the seroprevalence of HIV among pregnant women in Brazil and to describe HIV testing coverage and the uptake of antenatal care (ANC). Methods Between October 2010 and January 2012, a probability sample survey of parturient women aged 15-49 years who visited public hospital delivery services in Brazil was conducted. Data were collected from prenatal reports and hospital records. Dried blood spot (DNS) samples were collected and tested for HIV. We describe the age-specific prevalence of HIV infection and ANC uptake with respect to sociodemographic factors. Results Of the 36,713 included women, 35,444 (96.6%) were tested for HIV during delivery admission. The overall HIV prevalence was of 0.38% (95% confidence interval [CI]: 0.31-0.48), and it was highest in: the 30 to 39 year-old age group (0.60% [0.40-0.88]), in the Southern region of Brazil (0.79% [0.59-1.04]), among women who had not completed primary (0.63% [0.30-1.31]) or secondary (0.67% [0.49-0.97]) school education, and among women who self-reported as Asian (0.94% [0.28-3.10]). The HIV testing coverage during prenatal care was of 86.6% for one test and of 38.2% for two tests. Overall, 98.5% of women attended at least 1 ANC visit, 90.4% attended at least 4 visits, 71% attended at least 6 visits, and 51.7% received ANC during the 1st trimester. HIV testing coverage and ANC uptake indicators increased with increasing age and education level of education, and were highest in the Southern region. Conclusions Brazil presents an HIV prevalence of less than 1% and almost universal coverage of ANC. However, gaps in HIV testing and ANC during the first trimester challenge the prevention of the vertical transmission of HIV. More efforts are needed to address regional and social disparities.

The priming effect of previous natural pandemic H1N1 infection on the immunogenicity to subsequent 2010-2011 influenza vaccination in children: a prospective cohort study

BackgroundThe effect of previous natural pandemic H1N1 (H1N1 pdm09) influenza infection on the immunogenicity to subsequent inactivated influenza vaccination in children has not been well studied. We aimed to evaluate the effect of H1N1 pdm09 natural infection and vaccination on the immunogenicity to subsequent 2010-2011 seasonal inactivated influenza vaccination in children.MethodsFrom October 2010 to May 2011, we conducted an open-label, multi-center study in children aged 6 months -18 years in Korea. We measured antibody titers with a hemagglutination-inhibition (HI) assay at baseline, 1 month, and 6 months after vaccination with trivalent split or subunit vaccines containing H1N1 pdm, A/H3N2, and B. The subjects were classified into 4 groups depending on the presence of laboratory-confirmed H1N1 pdm09 infection and/or vaccination in the 2009-2010 season; Group I: vaccination (-)/infection(-), Group II: vaccination (-)/infection(+), Group III: vaccination (+)/infection(-), Group IV: vaccination (+)/infection(+).ResultsAmong the subjects in group I, 47 subjects who had a baseline titer >1:10 were considered to have an asymptomatic infection. They were included into the final group II (n = 80). We defined the new group II as the infection-primed (IP) group and group III as the vaccine-primed (VP) group. Seroconversion rate (57.5 % vs 35.9 %, p = 0.001), seroprotection rate at 6 months after vaccination (70.8 % vs 61.8 %, p = 0.032), and GMT at 1 month after vaccination (129.9 vs 66.5, p = 0.002) were significantly higher in the IP group than in the VP group. In the 9–18 year-old group, seroconversion rate and immunogenicity at 1 and 6 months were significantly higher in the IP group than in the VP group. However in the 1–7 year-old age group, there was no significant difference between the two groups.ConclusionsPrevious H1N1 pdm09 infection appears to have positive effects on immunogenicity of subsequent inactivated influenza vaccines against H1N1 pdm09 in older children.

Public Reproductive Health Facilities: A Client-Satisfaction Survey

&lt;p&gt;&lt;strong&gt;INTRODUCTION:&lt;/strong&gt; Understanding clients’ perspectives on quality improvement programs is essential to achieve the goals of health services. Determining client satisfaction could help decision makers to implement programs fit to their needs as perceived by service providers and clients. This study aimed to assess the level of satisfaction among women attending health centers regarding the services received in governmental health facilities in Shiraz, southern Iran.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;METHOD:&lt;/strong&gt; This cross-sectional study was performed in 24 urban health centers. Using systematic random sampling method, 8 clinics were assigned to each group. Then questionnaires were distributed among 240 married women in 15-49 year-old age group who had referred to selected clinics for receiving some services. For data analysis, SPSS version 15 software and Chi-square statistical procedure were used to evaluate clients’ satisfaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;RESULTS:&lt;/strong&gt; Data showed that 101 out of 240 respondents were completely satisfied with the personnel as well as the health center. Furthermore, satisfaction was found to be the highest among clients of those centers ranked as middle class socioeconomic status, while no significant difference was found between centers based on their socioeconomic status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;CONCLUSION: &lt;/strong&gt;The results of the present study would enable policy-makers to effectively improve the quality of health care, keeping a balance between providers’ and patients’ perspectives on the quality of health care.&lt;/p&gt;