Clinical presentation and survival of smear-positive pulmonary tuberculosis patients of a University General Hospital in a developing country

From January 1995 to August 1997 we evaluated prospectively the clinical presentation, laboratory findings and short-term survival of smear-positive pulmonary tuberculosis (TB) patients who sought care at our hospital. After providing informed, written consent, the patients were interviewed and laboratory tests were performed. Information about survivorship and death was collected through September 1998. Eighty-six smear-positive pulmonary TB patients were enrolled; 26.7% were HIV-seropositive. Seventeen HIV-seronegative pulmonary TB patients (19.8%) presented chronic diseases in addition to TB. In the multiple logistic regression analysis a CD4+ cell count <= 200 cell/mm³ was independently associated with HIV seropositivity. In the Cox regression model, fitted to all patients, HIV seropositivity and age > or = 50 years were independently associated with decreased survival. Among HIV-seronegative persons, the presence of an additional disease increased the risk of death of almost six-fold. Use of antiretroviral drugs was associated with a lower risk of death among HIV-seropositive smear-positive pulmonary TB patients (RH = 0.32, 95% CI 0.10-0.92). In our study smear-positive pulmonary TB patients had a low short-term survival rate that was strongly associated with HIV infection, age and co-morbidities. Therapy with antiretroviral drugs reduced the short-term risk of death among HIV-seropositive patients after TB diagnosis.

Associació entre la malaltia renal crònica i la malaltia cardiovascular a la població general mediterrània

La malaltia renal crònica (MRC) inicial s’ha definit com un marcador de risc cardiovascular susceptible d’intervenció terapèutica preventiva. Aquesta relació ha estat poc estudiada al nostre entorn. Objectius: Determinar si la MRC s’associa a un increment de risc de morbiditat i mortalitat al nostre entorn. Disseny: Estudi observacional prospectiu d’una cohort poblacional de Girona de 31.612 individus de 35-74 anys. Resultats: La MRC estadi 3 sense albuminúria no incrementa el risc de malaltia cardiovascular en població general de baix risc cardiovascular. L’albuminúria&20mg/L i els estadis 4-5 de MRC s’associen a un increment de risc de morbiditat cardiovascular i mortalitat global.

Medical Card for Over 70s: Fees payable to General Practitioners (Sullivan Report)

Medical Card for Over 70s: Fees payable to General Practitioners (Sullivan Report) In the context of the Government decision to end the arrangements whereby medical cards are issued automatically, without a means test, to all those aged 70 and over, a new income threshold was set and the Government decided to introduce a new single capitation rate payable in respect of patients aged 70 and over. I was asked to recommend a new rate for consideration by the Minister for Health & Children and the Government. Click here to download PDF 58kb

Opening statement by Mr Michael Scanlan, Secretary General of the Department of Health & Children at the meeting of the DÃil Committee of Public Accounts on 7th May 2009

Opening statement by Mr Michael Scanlan, Secretary General of the Department of Health & Children at the meeting of the Dáil Committee of Public Accounts on 7th May 2009 Click here to download PDF 37kb

Report to Secretary General on: Travel associated with Management - Union Partnership Activities, and in which Department officials participated, and Funding for Management -Union Partnership activities other than SKILL

Report to Secretary General on: Travel associated with Management – Union Partnership Activities, and in which Department officials participated, and Funding for Management -Union Partnership activities other than SKILL Download this document as a PDF 58KB Also… Subsistence Allowances PDF 1.19MB Extracts from the Health Service National Partnership Forum’s Financial Statements for the year ended 31 December 2000 PDF 338KB Foreign Travel claims relating to Skills & Partnership PDF 13KB Details of Funding Provided to Nursing Unions from 12/6/2000 – 5/11/2004 PDF 360KB Partnership Investigation PDF 428KB

General Scheme of the Public Health (Standardised Packaging of Tobacco) Bill

The purposes of this Act are to : (a) reduce the appeal of tobacco and tobacco products, (b) increase the effectiveness of health warnings on tobacco products, and (c)reduce the ability of the packaging of tobacco and tobacco products to mislead consumers about the harmful effects of smoking in the public interest,by providing for the standardisation of the labelling and physical features of retailpackaging of tobacco products and the requirements for the appearance of cigarettes. Click here to download PDF 125KB Read the Reports of the Joint Committee on Health and Children – General Scheme of the Public Health (Standardised Packaging of Tobacco) Bill 2013 here  

Reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) imbedded within a general health risk screening questionnaire: results of a survey in 332 primary care patients.

BACKGROUND: Self-administered, general health risk screening questionnaires that are administered while patients wait in the doctor's office may be a reasonable and timesaving approach to address the requirements of preventive medicine in a typical 10-min medical visit. The psychometric characteristics of the Alcohol Use Disorders Identification Test (AUDIT) incorporated within a health questionnaire (H-AUDIT) have not been examined. METHODS: The reliability and validity of the self-administered AUDIT were compared between the H-AUDIT and the AUDIT used as a single scale (S-AUDIT) in 332 primary care patients. RESULTS: No major demographic or alcohol use characteristics were found between the 166 subjects who completed the H-AUDIT and the 166 individuals who completed the S-AUDIT. The test-retest reliability of the 166 subjects who completed the H-AUDIT [estimated by Spearman correlation coefficient at a 6-week interval (0.88), internal consistency (total correlation coefficients for all items ranged from 0.38 to 0.69; Cronbach alpha index 0.85), and the sensitivity and specificity of the H-AUDIT were used to identify at-risk drinkers' areas under receiver operating characteristic (0.77) and alcohol-dependent subjects' areas under receiver operating characteristic (0.89)] was similar to the same measurements obtained with the 166 individuals who completed the S-AUDIT. CONCLUSIONS: The AUDIT incorporated in a health risk screening questionnaire is a reliable and valid self-administered instrument to identify at-risk drinkers and alcohol-dependent individuals in primary care settings.

Geometry and physics of catenanes applied to the study of DNA replication.

The concept of ideal geometric configurations was recently applied to the classification and characterization of various knots. Different knots in their ideal form (i.e., the one requiring the shortest length of a constant-diameter tube to form a given knot) were shown to have an overall compactness proportional to the time-averaged compactness of thermally agitated knotted polymers forming corresponding knots. This was useful for predicting the relative speed of electrophoretic migration of different DNA knots. Here we characterize the ideal geometric configurations of catenanes (called links by mathematicians), i.e., closed curves in space that are topologically linked to each other. We demonstrate that the ideal configurations of different catenanes show interrelations very similar to those observed in the ideal configurations of knots. By analyzing literature data on electrophoretic separations of the torus-type of DNA catenanes with increasing complexity, we observed that their electrophoretic migration is roughly proportional to the overall compactness of ideal representations of the corresponding catenanes. This correlation does not apply, however, to electrophoretic migration of certain replication intermediates, believed up to now to represent the simplest torus-type catenanes. We propose, therefore, that freshly replicated circular DNA molecules, in addition to forming regular catenanes, may also form hemicatenanes.

Acute Gastroenteritis in Ireland, North and South - A Study of General Practitioners

The principal aim of this study was to describe general practitioners management of patients with acute infectious gastroenteritis

A Study to Examine the Attitudes of General Practitioners Towards Drug Users in the North East Region of Ireland

The research examines general practitioners attitudes and how these effect the management of drug misusers within their practice. The methodology is quantitative in approach. The instrument used is a structured postal questionnaire. Participants include all general practitioners within the North East region of Ireland. Anonymity and confidentiality of all respondents are guaranteed. Data was collected over a six week period, under the following headings - attitudes and beliefs, factors influencing treatment, treatment options, training and demographics. Attitudes and beliefs towards drug users were measured using a five point Likert scale ranging from strongly agrees to strongly disagree. The data was analysed with the aid of a computer package, SPSS allowing descriptive statistics to be presented. Results indicate that the majority of respondents are male. There appears to be sympathy towards drug users and that treatment approaches should be holistic. However, there appears to be a major lack of confidence in treating and managing drug misusers. Patient, social and practice factors all influence the decision to the drug misuser. Treatment options are varied, ranging from methadone maintenance to referral for residential treatment. However, a number of respondents offer no treatment for drug misusers. General practitioners do not feel adequately trained in treating and/or managing this client group. Results indicate that improved communication, ongoing education and more research is needed in this area.This resource was contributed by The National Documentation Centre on Drug Use.

A Study on the Feasibility of the Inclusion of General Practitioners and Prisons in the National Drug Treatment Reporting System: Plan for the Implementation of the NDTRS in Prison and GP Services

The Drug Misuse Research Division of the Health Research Board operates the National Drug Treatment Reporting System (NDTRS). The system is used to provide epidemiological information on treated problem drug misuse in Ireland and informs policy makers, researchers and the general public. The NDTRS collates data from participating treatment centres in all Health Board areas, however a gap in information exists in that drug misusers in treatment units within prisons and those treated by General Practitioners are not included. This study aims to determine the feasibility of including these two groups to increase coverage of the NDTRS and outlines preliminary steps for their inclusion.This resource was contributed by The National Documentation Centre on Drug Use.

Catálogo General

El projecte consisteix en el desenvolupament d'una eina especialitzada per a la classificació i recerca de productes. L'aplicació pot ser fàcilment ampliable per a adaptar-la a qualsevol tipus de producte o necessitat futura. Per a la programació d'aquest projecte es va aprofitar la potència i senzillesa que proporciona l'entorn .NET i els seus llenguatges orientats a objecte, en aquest cas VB.

General and Abdominal Adiposity and Risk of Death in Europe

Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. This study examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). A Cox regression analysis was used, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height.