Search Results (33,028)

Introduction: The aim of this paper was to evaluate time trends of incidence and mortality from lung cancer by sex and age in Poland since 1970 to 2004. Materials and methods: Basing on the data from National Cancer Registry—incidence and mortality due to lung cancer in Poland 2004 and time trends in the period 1970–2004 were analyzed. Results: The were 20,359 cases of lung cancer in Poland in 2004: 15,741 cases in men (crude rate—85.2/10⁵) and 4618 cases in women (crude rate—23.8/10⁵). Sex ratio was 3.4. Since 1971 lung cancer is the most frequent cancer in males: in 2004—25.2% of total male cancers, in female there are less frequently—7.8% total cancers and took third place after breast cancer—20.5% and colorectal cancer—10.4%. Incidence rate of lung cancer in males peaked in 1996—89.1/10⁵ and then stabilized or event slightly decreased while corresponding rates in women steadily increased in whole period 1970–2004. The incidence of lung cancer for both men and women showed an increase with age and reached peak both in elderly men and women (age group 70–79) respectively—516.9/105 in males and 81.2/10⁵ in females. Median age of registered cases was as men as women in age group 60–69. In the reviewed period of time crude rate of incidence increased in men—231.5% in women—390% while standardized rates increased less—172% in men and 282% in women. There were 16,565 deaths due lung cancer in men—crude rate 89.6/105 and 4641 deaths in women, crude rate—23.6/10⁵. Lung cancer is the leading cause of cancer-related mortality in men—32.3% of all cancer deaths and took second position in women—12.2% (after breast cancer—12.9%) of total cancers deaths in women. In the analyzed periods of time—trend mortality was similar as times—trends incidence lung cancer. Both incidence and mortality lung cancer varies by regions: incidence in males from 73.2 to 109.9; in females from 14.5 to 33.8; mortality: in males from 73.9 to 99.8; in females from 13.0 to 30.9. Conclusions: Lung cancer incidence and mortality rate in men has been on the stable level, even with the tendency to decline in last decade in Poland. Incidence and mortality rates among women have continued to increase, although the trend of increase has slowed in last years. Demographic distribution of lung cancer shows decline of the rates in young and middle age population and continuation of increase in old age people. Despite of some improvement of epidemiological situation in lung cancer in Poland it still remains the most common malignancy in men and is on the third position in most frequent cancers in woman. Lung cancer in Poland remains serious medical and social problem. Full article

With an apparent increase of harmful algal blooms (HABs) worldwide,healthcare providers, public health personnel and coastal managers are struggling toprovide scientifically-based appropriately-targeted HAB outreach and education. Since1998, the Florida Poison Information Center-Miami, with its 24 hour/365 day/year freeAquatic Toxins Hotline (1-888-232-8635) available in several languages, has received over 25,000 HAB-related calls. As part of HAB surveillance, all possible cases of HAB-relatedillness among callers are reported to the Florida Health Department. This pilot studyevaluated an automated call processing menu system that allows callers to access bilingualHAB information, and to speak directly with a trained Poison Information Specialist. Themajority (68%) of callers reported satisfaction with the information, and many provided specific suggestions for improvement. This pilot study, the first known evaluation of use and satisfaction with HAB educational outreach materials, demonstrated that the automated system provided useful HAB-related information for the majority of callers, and decreased the routine informational call workload for the Poison Information Specialists, allowing them to focus on callers needing immediate assistance and their healthcare providers. These results will lead to improvement of this valuable HAB outreach, education and surveillance tool. Formal evaluation is recommended for future HAB outreach and educational materials. Full article

Some patients with obstructive sleep apnea (OSA) develop persistent central sleep apnea activity when started on continuous positive airway pressure (CPAP). This recently recognized syndrome, complex sleep apnea syndrome (CompSAS), is thought to be due to dysfunction of the respiratory center in a setting of an obstructive sleep apnea. We present the current knowledge on epidemiology, pathophysiology, and treatment options in CompSAS. We review the current literature on CompSAS, and present our own data on this interesting condition. Full article

The aim of this study is a next step of our previous, initial, publications – to explore the links between monthly death number (total, and for the major death causes and each gender) with levels of monthly cosmophysical activity in a long-term, big cohort observation.
Methods. Death number during 180 consecutive months from the National Registry of Lithuania for years 1990–2004 were studied. A total of 630 205 deaths were analyzed (333 035 males). For comparison, monthly indices of solar activity, geomagnetic activity, and cosmic ray activity and year and month (1–12) of the study were used. The cosmophysical data were obtained from space research centers in the USA, Russia, and Finland.
Statistics. Pearson correlation coefficients (r) and their probabilities (P) between compared parameters were calculated. A multivariate model of prediction was designed.
Results. It was a significant correlation between total monthly death number and indices of cosmic ray activity and, inverse, of solar activity; in men stronger than in women. Monthly geomagnetic activity was significantly correlated with traffic accidents, ischemic heart disease/ stroke ratio, suicide victim number. Deaths from stroke, noncardiovascular causes, suicide, traffic accidents were related with cosmic ray activity and, inverse, with solar activity. Relationship of ischemic heart disease/stroke ratio to year of observation showed additional evidence for the growing role of stroke in cardiovascular mortality.
Conclusions. Monthly death number is linked to cosmic ray activity, and inverse, to solar activity. Central place of stroke-related deaths in cardiovascular mortality is emerging. Geomagnetic activity, in monthly account, plays a relatively minor role. We presume that forces antagonistic to cosmic ray activity, like solar activity and geomagnetic activity, can prevent some negative biologic effects of cosmic ray. Full article

We used decision analysis techniques with Markov cohort modeling to examine the role of cancer antigen 125 (CA-125) in follow-up surveillance strategies among patients with advanced ovarian cancer. Utilities were derived from a societal perspective. Using quality-adjusted life years (QALYs) as the outcome variable, the value of CA-125 monitoring for asymptomatic women with ovarian cancer was found to be reduced as compared with a strategy that includes CA-125 testing. Decisions to include CA-125 in surveillance strategies for ovarian cancer patients should be made after discussion with full disclosure of the preference-sensitive nature of CA-125. The model demonstrates that preferences and perspective can influence decisions in cancer care. Full article

Objectives. The aim of this study was to investigate the prevalence of erectile dysfunction, its severity, and other sexual function domains in hypertensive and normotensive Qatari’s men and to estimate the association between hypertension and predictors of erectile dysfunction.
Material and methods. A matched case-control study was conducted at the primary health care clinics during a period from May to October 2006. Four hundred twenty-five hypertensive patients and 425 age-matched normotensive attendants of primary health care clinics, aged 30– 75 years, were approached for the study. Of them, 296 hypertensive participants (74%) and 298 normotensive men (70.1%) gave their consent to participate in it. The mean age of the hypertensive participants was 54.8±11.5 years as compared to nonhypertensive participants with a mean age of 54.5±12.1 years. Face-to-face interviews were based on a questionnaire that included variables on age, sociodemographic status, educational level, occupation, cigarette smoking, and blood pressure. Hypertension was defined as mild for systolic blood pressure (SBP) 120–139 mmHg and diastolic blood pressure (DBP) 80–89 mmHg; moderate for SBP 140–159 mmHg and DBP 90–99 mmHg; and severe for SBP >160 mmHg and DBP >100 mmHg. All patients completed a detailed questionnaire addressing their general medical history, with special emphasis on hypertension (i.e., duration of hypertension, type of treatment, and presence of any complications). Sexual function was evaluated with the International Index of Erectile Function (IIEF).
Results. Of the 296 hypertensive patients, 196 participants reported erectile dysfunction (66.2%), while among the 298 nonhypertensive participants, only 71 had erectile dysfunction (23.8%). Of the hypertensive participants studied, 25% had severe, 29.1% had moderate, and 12.1% had mild erectile dysfunction. The percentages of various sexual activity domains were highly significant and at higher risk among hypertensive patients than normotensive men (P<0.001). Frequency and severity of erectile dysfunction increased with advancing age.
Conclusions. Our results have shown that the prevalence of erectile dysfunction was significantly higher in Qatari hypertensive men than in normotensive men. Age, level of education, diabetes mellitus, occupation, and duration of hypertension were considered statistically significant predictors of erectile dysfunction. Erectile dysfunction was more common in hypertensive individuals receiving antihypertensive treatment. Full article

Although lead exposure has declined in recent years as a result of change to lead-free gasoline, several epidemiological have pointed out that it represents a medical and public health emergency, especially in young children consuming high amounts of lead-contaminated flake paints. A previous study in our laboratory indicated that lead exposure induces cytotoxicity in human liver carcinoma cells. In the present study, we evaluated the role of oxidative stress in lead-induced toxicity, and the protective effect of the anti-oxidant n-acetyl-l-cysteine (NAC). We hypothesized that oxidative stress plays a role in lead-induced cytotoxicity, and that NAC affords protection against this adverse effect. To test this hypothesis, we performed the MTT [3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide] assay and the trypan blue exclusion test for cell viability. We also performed the thiobarbituric acid test for lipid peroxidation. Data obtained from the MTT assay indicated that NAC significantly increased the viability of HepG2 cells in a dosedependent manner upon 48 hours of exposure. Similar trend was obtained with the trypan blue exclusion test. Data generated from the thiobarbituric acid test showed a significant (p ≤ 0.05) increase of MDA levels in lead nitrate-treated HepG₂ cells compared to control cells. Interestingly, the addition of NAC to lead nitrate-treated HepG₂ cells significantly decreased cellular content of reactive oxygen species (ROS), as evidenced by the decrease in lipid peroxidation byproducts. Overall, findings from this study suggest that NAC inhibits lead nitrate-induced cytotoxicity and oxidative stress in HepG₂ cells. Hence, NAC may be used as a salvage therapy for lead-induced toxicity in exposed persons. Full article

The diagnosis of infectious diseases has been revolutionized by the development of molecular techniques, foremost with the applications of the polymerase chain reaction (PCR). The achievable high sensitivity and ease with which the method can be used to detect any known genetic sequence have led to its wide application in the life sciences. More recently, real-time PCR assays have provided additional major contributions, with the inclusion of an additional fluorescent probe detection system resulting in an increase in sensitivity over conventional PCR, the ability to confirm the amplification product and to quantitate the target concentration. Further, nucleotide sequence analysis of the amplification products has facilitated epidemiological studies of infectious disease outbreaks, and the monitoring of treatment outcomes for infections, in particular with viruses which mutate at high frequency. This review discusses the applications of qualitative and quantitative real-time PCR, nested PCR, multiplex PCR, nucleotide sequence analysis of amplified products and quality assurance with nucleic acid testing (NAT) in diagnostic laboratories. Full article

Lung cancer is currently most frequently diagnosed neoplasm in males and the fifth most frequent cancer in females. In developed countries only breast cancer is diagnosed more often in women. Worldwide, lung cancer is the most common cause of cancer mortality in males and females. In the Europe lung cancer accounts for 21% of all cancer cases in males and 29% of all cancer deaths. The rapid increase in lung cancer incidence was observed the since beginning of the XX century till 1990–1994. The incidence in males decreased recently, but still increases in females, especially in young women. The changes in frequency of various histological subtypes of lung cancer are observed too. Despite many clinical trials, modern diagnostic techniques and improved supportive care, the prognosis remains unfavourable and long-term survival almost did not change. In Poland the incidence of lung cancer in 2002 was 81.9/100,000 in males and 22.2/100,000 in females. In both genders 1-year and 5-year survivals time are one of the shortest in Europe. Full article

Introduction: The control of tuberculosis (TB) requires methods for rapid detection and tracing sources of infection, so that further transmission can be arrested. Recent developments in molecular biology have resulted in techniques that allow prompt identification and tracking specific strains of M. tuberculosis as they spread through the population. Most of these techniques take advantage of M. tuberculosis DNA polymorphism and are based on various repetitive DNA elements as genetic markers. Each method yields strain-specific genetic profiles (fingerprints). Strains showing identical fingerprints are referred to as clustered and are usually associated with recent transmission, whereas strains whose fingerprints are unique are presumed to represent remote transmission, a reactivation of infection acquired in the distant past. Material and methods: In recent years, spoligotyping has become one of the most widely used genotyping method for epidemiological studies of TB. Spoligotyping is a PCR-based method allowing to analyze strain-dependent polymorphisms observed in spacer sequences present within the direct repeat (DR) genomic region of M. tuberculosis complex strains. Spoligotyping provides some important advantages over other genotyping techniques. These are simplicity, rapidity, high reproducibility and stability of the results, with the latter being expressed in a simple digital pattern, readily named and databased, and the ability to perform spoligotyping directly on clinical samples, without the need for prior culture. However, spoligotyping has relatively low discriminatory capacity, which makes it necessary to use secondary fingerprinting methods to prove clonality between isolates. Results: The aim of this study was to evaluate the usefulness of spoligotyping in epidemiological investigations of TB by analyzing 16 isoniazid-resistant M. tuberculosis strains isolated from patients with pulmonary TB in the central region of Poland. A total of 11 distinct spoligopatterns were obtained. 9 isolates were represented by a unique pattern, whereas 7 were clustered in 2 groups of 5 and 2 isolates, respectively. When compared with an international spoligodatabase SpolDB4, 13 isolates shared already described spoligotypes, whereas 3 did not match any existing spoligopattern in database and were defined as orphans. Spoligotyping overestimated the number of clustered isolates in one of its two clusters when compared to IS6110 Mtb1/ /Mtb2 PCR. Strains clustered using the latter method were assumed to be closely epidemiologically related. Conclusions: This report demonstrates the utility of spoligotyping as an initial screening technique, to be supplemented by another typing method of greater discriminatory power, such as the IS6110 Mtb1/Mtb2 PCR in order to better recognize the epidemiological links between TB patients. Full article

Most arsenic cancer risk assessments have been based solely on epidemiological studies to characterize the dose-response relationship for arsenic-associated cancer and to perform risk calculations. However, current epidemiological evidence is too inconsistent and fraught with uncertainty regarding arsenic exposure to provide reliable estimates. This makes it hard to draw a firm conclusion about the shape and slope of the dose-response relationship from individual studies. Meta-analysis is a statistical approach to combining results across studies and offers expanded opportunities for obtaining an improved dose-response relationship. In this study, a meta-analysis of arsenic studies was conducted by combining seven epidemiological studies from different regions to get an overall dose-response relationship between the amount of arsenic intake and the excess probability of bladder cancer. Both the fixed-effect and random-effect models were used to calculate the averaged coefficient of the linear-logistic regression model. A homogeneity test was also conducted. The final product of this research is an aggregated dose-response model in the range of empirical observation of arsenic. Considering the most recent arsenic MCL (maximum contaminant level, i.e. 10μg/L), the associated bladder cancer risk (lifetime excess probability) at this MCL is 2.29 10^-5. Full article

The reemerging field of Medical Geology is concerned with the impacts of geologic materials and geologic processes on animal and human health. Most medical geology research has been focused on health problems caused by excess or deficiency of trace elements, exposure to ambient dust, and on other geologically related health problems or health problems for which geoscience tools, techniques, or databases could be applied. Little, if any, attention has been focused on the beneficial health effects of rocks, minerals, and geologic processes. These beneficial effects may have been recognized as long as two million years ago and include emotional, mental, and physical health benefits. Some of the earliest known medicines were derived from rocks and minerals. For thousands of years various clays have been used as an antidote for poisons. “Terra sigillata,” still in use today, may have been the first patented medicine. Many trace elements, rocks, and minerals are used today in a wide variety of pharmaceuticals and health care products. There is also a segment of society that believes in the curative and preventative properties of crystals (talismans and amulets). Metals and trace elements are being used in some of today’s most sophisticated medical applications. Other recent examples of beneficial effects of geologic materials and processes include epidemiological studies in Japan that have identified a wide range of health problems (such as muscle and joint pain, hemorrhoids, burns, gout, etc.) that may be treated by one or more of nine chemically distinct types of hot springs, and a study in China indicating that residential coal combustion may be mobilizing sufficient iodine to prevent iodine deficiency disease. Full article

Background. Little is known about acute and transient psychotic disorders, which is a diagnostic group, introduced with International Classification of Disease, 10th revision. It is an interesting area of research receiving a lot of attention.
Objective. The aim of the study was to find the incidence of acute and transient psychotic disorders in the population and determine its sociodemographic features in the State of Qatar.
Design. This is a retrospective descriptive study.
Setting. The study was conducted in the Department of Psychiatry of the Rumaillah Hospital, Hamad Medical Corporation, Doha, Qatar.
Methods. All Qatari, non-Qatari Arabs, and expatriate patients who were hospitalized with psychotic disorders in the inpatient wards or treated in the outpatient clinics of the Department of Psychiatry over a 7-year period were enrolled in the study. Data were collected from the medical records of patients. The study was conducted from August 1, 1996, to January 1, 2004, amongst the patients with acute and transient psychotic disorders. The diagnostic classification of definite psychotic disorders was made in accordance with criteria based on the International Classification of Disease, 10th revision (ICD-10).
Results. A total of 174 patients were treated during a 7-year period. Among them, 69% were males and 31% females. No cases were found in children aged less than 15 years. The highest frequency (43.7%) was found in the early adulthood (16–29 years of age). The incidence of acute and transient psychotic disorders was higher in the expatriates (66.7%). More than half (63.8%) of the patients were employed. Most of the cases (35.6%) had acute schizophrenia-like psychotic disorders (F23.2). There was no statistically significant difference in the frequency of acute and transient psychotic disorders between males and females, Qatari and non-Qatari Arabs, and single and married.
Conclusion. The study found markedly lower incidence rate of acute and transient psychotic disorders in females than males. The highest frequency was found in the early adulthood (16–29 years). No cases were found in children aged less than 15 years. It is important to find ways to promote healthier lifestyles in this population in order to prevent the onset of psychotic disorders. Full article

Anti-tuberculosis drugs are a two-edged sword. While they destroy pathogenic M. tuberculosis they also select for drug resistant bacteria against which those drugs are then ineffective. Global surveillance has shown that drug resistant Tuberculosis is widespread and is now a threat to tuberculosis control programs in many countries. Application of molecular methods during the last decade has greatly changed our understanding of drug resistance in tuberculosis. Application of molecular epidemiological methods was also central to the description of outbreaks of drug resistance in Tuberculosis. This review describes recommendations for Tuberculosis treatment according to the WHO guidelines, the drug resistance problem in the world, mechanisms of resistance to first line and second line drugs and applications of molecular methods to detect resistance causing gene mutations. It is envisaged that molecular techniques may be important adjuncts to traditional culture based procedures to rapidly screen for drug resistance. Prospective analysis and intervention to prevent transmission may be particularly helpful in areas with ongoing transmission of drug resistant strains as recent mathematical modeling indicate that the burden of MDR-TB cannot be contained in the absence of specific efforts to limit transmission. Full article

We used a systematic review to identify strategies that have been evaluated for disseminating cancer control interventions that promote the uptake of a healthy diet in adults. Studies were identified by contacting technical experts and by searching MEDLINE, PreMedline, CANCERLIT, EMBASE/Excerpta Medica, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, and reference lists. English-language primary studies were selected if they evaluated the dissemination of healthy diet interventions to individuals, health care providers, or institutions. Studies involving only children or adolescents were excluded. We retrieved 101 articles for full-text screening, and identified nine reports of seven distinct studies. Four of the studies were randomized trials, one was a cohort design, and three were descriptive studies. Six of the studies were rated methodologically weak, and one was rated moderate. Because of heterogeneity, low methodological quality, and incomplete data reporting, the studies were not pooled for meta-analysis. No beneficial dissemination strategies were found. One strategy involving the use of peer educators at the work site, which led to a shortterm increase in fruit and vegetable intake, looks promising. Overall, the quality of the evidence is not strong, and the evidence that exists is more descriptive than evaluative. No clear conclusions can be drawn from these data. Controlled studies are needed to evaluate dissemination strategies and to compare dissemination and diffusion strategies that communicate different messages and target different audiences. Full article