971 resultados para Epidemiologic study
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Background Little evidence is available about the association between temperature and cerebrovascular mortality in China. This study aims to examine the effects of ambient temperature on cerebrovascular mortality in different climatic zones in China. Method We obtained daily data on weather conditions, air pollution and cerebrovascular deaths from five cities (Beijing, Tianjin, Shanghai, Wuhan, and Guangzhou) in China during 2004-2008. We examined city-specific associations between ambient temperature and the cerebrovascular mortality, while adjusting for season, long-term trends, day of the week, relative humidity and air pollution. We examined cold effects using a 1°C decrease in temperature below a city-specific threshold, and hot effects using a 1°C increase in temperature above a city-specific threshold. We used a meta-analysis to summarize the cold and hot effects across the five cities. Results Beijing and Tianjin (with low mean temperature) had lower thresholds than Shanghai, Wuhan and Guangzhou (with high mean temperature). In Beijing, Tianjin, Wuhan and Guangzhou cold effects were delayed, while in Shanghai there was no or short induction. Hot effects were acute in all five cities. The cold effects lasted longer than hot effects. The hot effects were followed by mortality displacement. The pooled relative risk associated with a 1°C decrease in temperature below thresholds (cold effect) was 1.037 (95% confidence interval (CI): 1.020, 1.053). The pooled relative risk associated with a 1°C increase in temperature above thresholds (hot effect) was 1.014 (95% CI: 0.979, 1.050). Conclusion Cold temperatures are significantly associated with cerebrovascular mortality in China, while hot effect is not significant. People in colder climate cities were sensitive to hot temperatures, while people in warmer climate cities were vulnerable to cold temperature.
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To perform an epidemiologic study in students in Natal/Brazil,with relation to refractional anisometropia, evaluating criteria such as: gender, age, and association with strabismus and amblyopia. Methods: A study of 1,024 students randomly selected from several districts of Natal/Brazil was undertaken by the Department of Ophthalmology of the Federal University of Rio Grande do Norte (UFRN), observing the following criteria of ≥ 2 spherical or cylindrical diopter refractional anisometropia relating it to sex, age, association with strabismus, amblyopia and anisometropia classification. Results: We found a prevalence of 2% (N=21) anisometropia in the students. The female gender predominated with 81% (N=17). In students with anisometropia, we observed an association with strabismus in 9.5% of cases (N=2), both with exotropia. The association of anisometropia with amblyopia occurred in 47.6% of the cases (N=10), with 8 cases of unilateral amblyopia and 2 cases of bilateral amblyopia. Conclusions: There was a predominance of anisometropia in females, and an increased prevalence of strabismus and amblyopia in students with anisometropiaTo perform an epidemiologic study in students in Natal/Brazil, with relation to refractional anisometropia, evaluating criteria such as: gender, age, and association with strabismus and amblyopia. Methods: A study of 1,024 students randomly selected from several districts of Natal/Brazil was undertaken by the Department of Ophthalmology of the Federal University of Rio Grande do Norte (UFRN), observing the following criteria of ≥ 2 spherical or cylindrical diopter refractional anisometropia relating it to sex, age, association with strabismus, amblyopia and anisometropia classification. Results: We found a prevalence of 2% (N=21) anisometropia in the students. The female gender predominated with 81% (N=17). In students with anisometropia, we observed an association with strabismus in 9.5% of cases (N=2), both with exotropia. The association of anisometropia with amblyopia occurred in 47.6% of the cases (N=10), with 8 cases of unilateral amblyopia and 2 cases of bilateral amblyopia. Conclusions: There was a predominance of anisometropia in females, and an increased prevalence of strabismus and amblyopia in students with anisometropia
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O objetivo deste estudo foi avaliar a prevalência e frequência de cefaléia em escolares brasileiros. Um estudo transversal foi conduzido entre Março e Novembro de 2004 em São José do Rio Preto, Estado de São Paulo, Brasil. Uma amostra de 5.232 crianças das escolas foi selecionada utilizando método de amostragem estratificada proporcional. Para a coleta dos dados, um questionário foi entregue nas escolas aos estudantes para ser respondida pelos pais e/ou responsáveis. do total de respostas recebidas, 84,2% relataram cefaléia durante o último ano. Houve diferenças significativas na frequência da queixa de cefaléia entre meninos e meninas. As meninas relataram cefaléias mais frequentes do que os meninos, com prevalência de cefaléias diárias duas vezes maior em meninas. Uma maior frequência de cefaléia foi também relatada com o aumento da idade. O estudo demonstrou que a prevalência de cefaléia foi alta, com uma maior frequência (mensais, semanais e diárias) em meninas e no grupo etário mais velho.
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OBJECTIVE: To evaluate the association of adequate allocation concealment and patient blinding with estimates of treatment benefits in osteoarthritis trials. METHODS: We performed a meta-epidemiologic study of 16 meta-analyses with 175 trials that compared therapeutic interventions with placebo or nonintervention control in patients with hip or knee osteoarthritis. We calculated effect sizes from the differences in means of pain intensity between groups at the end of followup divided by the pooled SD and compared effect sizes between trials with and trials without adequate methodology. RESULTS: Effect sizes tended to be less beneficial in 46 trials with adequate allocation concealment compared with 112 trials with inadequate or unclear concealment of allocation (difference -0.15; 95% confidence interval [95% CI] -0.31, 0.02). Selection bias associated with inadequate or unclear concealment of allocation was most pronounced in meta-analyses with large estimated treatment benefits (P for interaction < 0.001), meta-analyses with high between-trial heterogeneity (P = 0.009), and meta-analyses of complementary medicine (P = 0.019). Effect sizes tended to be less beneficial in 64 trials with adequate blinding of patients compared with 58 trials without (difference -0.15; 95% CI -0.39, 0.09), but differences were less consistent and disappeared after accounting for allocation concealment. Detection bias associated with a lack of adequate patient blinding was most pronounced for nonpharmacologic interventions (P for interaction < 0.001). CONCLUSION: Results of osteoarthritis trials may be affected by selection and detection bias. Adequate concealment of allocation and attempts to blind patients will minimize these biases.
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To perform an epidemiologic study in students in Natal/Brazil,with relation to refractional anisometropia, evaluating criteria such as: gender, age, and association with strabismus and amblyopia. Methods: A study of 1,024 students randomly selected from several districts of Natal/Brazil was undertaken by the Department of Ophthalmology of the Federal University of Rio Grande do Norte (UFRN), observing the following criteria of ≥ 2 spherical or cylindrical diopter refractional anisometropia relating it to sex, age, association with strabismus, amblyopia and anisometropia classification. Results: We found a prevalence of 2% (N=21) anisometropia in the students. The female gender predominated with 81% (N=17). In students with anisometropia, we observed an association with strabismus in 9.5% of cases (N=2), both with exotropia. The association of anisometropia with amblyopia occurred in 47.6% of the cases (N=10), with 8 cases of unilateral amblyopia and 2 cases of bilateral amblyopia. Conclusions: There was a predominance of anisometropia in females, and an increased prevalence of strabismus and amblyopia in students with anisometropiaTo perform an epidemiologic study in students in Natal/Brazil, with relation to refractional anisometropia, evaluating criteria such as: gender, age, and association with strabismus and amblyopia. Methods: A study of 1,024 students randomly selected from several districts of Natal/Brazil was undertaken by the Department of Ophthalmology of the Federal University of Rio Grande do Norte (UFRN), observing the following criteria of ≥ 2 spherical or cylindrical diopter refractional anisometropia relating it to sex, age, association with strabismus, amblyopia and anisometropia classification. Results: We found a prevalence of 2% (N=21) anisometropia in the students. The female gender predominated with 81% (N=17). In students with anisometropia, we observed an association with strabismus in 9.5% of cases (N=2), both with exotropia. The association of anisometropia with amblyopia occurred in 47.6% of the cases (N=10), with 8 cases of unilateral amblyopia and 2 cases of bilateral amblyopia. Conclusions: There was a predominance of anisometropia in females, and an increased prevalence of strabismus and amblyopia in students with anisometropia
Resumo:
To perform an epidemiologic study in students in Natal/Brazil,with relation to refractional anisometropia, evaluating criteria such as: gender, age, and association with strabismus and amblyopia. Methods: A study of 1,024 students randomly selected from several districts of Natal/Brazil was undertaken by the Department of Ophthalmology of the Federal University of Rio Grande do Norte (UFRN), observing the following criteria of ≥ 2 spherical or cylindrical diopter refractional anisometropia relating it to sex, age, association with strabismus, amblyopia and anisometropia classification. Results: We found a prevalence of 2% (N=21) anisometropia in the students. The female gender predominated with 81% (N=17). In students with anisometropia, we observed an association with strabismus in 9.5% of cases (N=2), both with exotropia. The association of anisometropia with amblyopia occurred in 47.6% of the cases (N=10), with 8 cases of unilateral amblyopia and 2 cases of bilateral amblyopia. Conclusions: There was a predominance of anisometropia in females, and an increased prevalence of strabismus and amblyopia in students with anisometropiaTo perform an epidemiologic study in students in Natal/Brazil, with relation to refractional anisometropia, evaluating criteria such as: gender, age, and association with strabismus and amblyopia. Methods: A study of 1,024 students randomly selected from several districts of Natal/Brazil was undertaken by the Department of Ophthalmology of the Federal University of Rio Grande do Norte (UFRN), observing the following criteria of ≥ 2 spherical or cylindrical diopter refractional anisometropia relating it to sex, age, association with strabismus, amblyopia and anisometropia classification. Results: We found a prevalence of 2% (N=21) anisometropia in the students. The female gender predominated with 81% (N=17). In students with anisometropia, we observed an association with strabismus in 9.5% of cases (N=2), both with exotropia. The association of anisometropia with amblyopia occurred in 47.6% of the cases (N=10), with 8 cases of unilateral amblyopia and 2 cases of bilateral amblyopia. Conclusions: There was a predominance of anisometropia in females, and an increased prevalence of strabismus and amblyopia in students with anisometropia
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Pregnancy has been reported to be an independent risk factor for 50% of acute aortic dissections recorded in women younger than 45 years of age. The present epidemiologic study aimed to identify whether this putative association of pregnancy and acute type A dissection could be an artifact of selective reporting.
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BACKGROUND Obesity is a growing problem in western societies. The aim of this retrospective cohort study was to determine the association between the overweight and obese polytrauma patients and pneumonia after injury. METHODS A total of 628 patients with an Injury Severity Score (ISS) of 16 or greater and 16 years or older were included in this retrospective study. The sample was subdivided into three groups as follows: body mass index (BMI) of less than 25 kg/m2; BMI of 25 kg/m2 to 30 kg/m2; and BMI more than 30 kg/m2. The Murray score was assessed at admission and at its maximum during hospitalization to determine pulmonary problems. Pneumonia was defined as bacteriologically positive sputum with appropriate radiologic and laboratory changes (C-reactive protein and interleukin 6). Data are given as mean ± SEM. One-way analysis of variance and the Kruskal-Wallis test were used for the analyses, and the significance level was set at p < 0.05; Bonferroni-Dunn test was performed as post hoc analysis. RESULTS The Abbreviated Injury Scale (AIS) score for the thorax was 3.2 ± 0.1 in the group with a BMI of less than 25 kg/m2, 3.3 ± 0.1 in the group with a BMI of 25 kg/m2 to 30 kg/m2, and 2.8 ± 0.2 in the group with BMI of more than 30 kg/m2 (p = 0.044). The Murray score at admission was elevated with increasing BMI (0.8 ± 0.8 for BMI < 25 kg/m2, 0.9 ± 0.9 for BMI 25–30 kg/m2, and 1.0 ± 0.8 for BMI > 30 kg/m2; p = 0.137); the maximum Murray score during hospitalization revealed significant differences (1.2 ± 0.9 for BMI < 25 kg/m2, 1.6 ± 1.0 for BMI 25–30 kg/m2, and 1.5 ± 0.9 for BMI > 30 kg/m2; p < 0.001). The incidence of pneumonia also increased with increasing BMI (1.6% for BMI < 25 kg/m2, 2.0% for BMI 25–30 kg/m2, and 3.1% for BMI > 30 kg/m2; p = 0.044). CONCLUSION Obesity leads to an increased incidence of pneumonia in a polytrauma situation. LEVEL OF EVIDENCE Prognostic/epidemiologic study, level IV.
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The rate of syphilis nationally has been on the rise since 2001. Syphilis, if left untreated can facilitate the transmission of HIV infection. An epidemiologic study describing the trends of syphilis is important to the public health community to lay the foundation for the development and implementation of programs to prevent and eliminate syphilis in the United States. ^ The objective of this study was to describe the trends of syphilis among the population in Houston/Harris County, Texas. ^ We reviewed surveillance data that included 11,605 unique cases from the Houston Department of Human and Health Service from 1999 through 2008. The rates were calculated per 100,000 population. ^ We show the prevalence of syphilis at testing (excluding congenital) increased 40% in Houston/Harris County, Texas from 2001 through 2008, and the ratio of syphilis comparing men to women was 2:1. The 18–29 years age group had the highest percentage of cases of syphilis among all age groups in Houston/Harris County. Primary and Secondary (P&S) syphilis, the most infectious stage, had an 85% increase in rate among males from 1999 through 2008. ^ Between 1999 and 2000, 71% of cases were identified through public facilities compared to private facilities. However, after 2001 rates shifted over more to the private facilities. By 2008, private facilities identified 54.7% of cases, compared to 45.3% identified through public facilities. This may be due to an increase among individuals who have a higher socio-economic status with access to health care insurance. ^ In conclusion, syphilis rates from 1999 through 2008 increased among all race ethnicities, age groups, and genders in Houston/Harris County. Blacks still are disproportionally affected by syphilis infections, and for the first time, White males displayed a significant increase in cases among males. It is vital to Houston public health professionals to have improved surveillance techniques to track syphilis trends and engage high risk groups to better understand their risks in hope of treating and preventing syphilis.^
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Esta dissertação discute os possíveis delineamentos epidemiológicos e estratégias de análise de dados capazes de apreender as funções de ocorrência de interesse nos estudos de fatores de risco para a prescrição médica inadequada as crianças com infecção respirat6ria aguda, atendidas na rede ambulatorial. Para tal, os principais marcos teóricos que devem nortear a construção de um desenho de estudo epidemiológico são apresentados, assim como as diferentes etapas que devem ser consideradas quando se esta planejando um processo de analise estatística de dados em estudos epidemiológicos. A partir da elaboração de um modelo teórico-conceitual que represente as relações entre os diversos fatores que parecem estar envolvidos com a prescrição e o consumo de medicamentos, diferentes estratégias de pesquisa e pianos de analise são discutidos, alertando-se para os principais problemas a serem evitados quando se busca um estudo com validade e precisão entre satisfatórias.
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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária
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Objectif: Définir l’effet des lipides et du traitement de la dyslipidémie sur les cancers de la prostate et de la vessie en utilisant différents devis d’étude et en tenant compte de la présence de plusieurs biais, particulièrement le biais du temps immortel. Devis: Le premier volet utilise un devis rétrospectif de type cas témoins. Un questionnaire semi-quantitatif de fréquence de consommation alimentaire validé a été utilisé. Le génotype COX2 de neuf polymorphisme nucléotidique unique (SNP) a été mesuré avec une plateforme Taqman. Des modèles de régression logistique non conditionnelle ont été utilisés pour comparer le risque de diagnostic d’un cancer de la prostate et l’interaction. Le deuxième volet utilise un devis rétrospectif de type cohorte basée sur les données administratives de la Régie de l’assurance-maladie du Québec (RAMQ). Des modèles de régression de Cox ont été employés pour mesurer l’association entre les statines et l’évolution du cancer de la vessie. Le troisième volet, porte un regard méthodologique sur le biais du temps immortel en examinant sa présence dans la littérature oncologique. Son importance est illustrée avec les données de la cohorte du deuxième volet, et les méthodes de correction possibles son appliquées. Résultats: L’étude du premier volet démontre qu’une diète riche en acides gras oméga-3 d’origine marine était fortement associée à un risque diminué de cancer de la prostate agressif (p<0.0001 pour la tendance). Le ratio de cote pour le cancer de la prostate du quartile supérieur d’oméga-3 était de 0.37 (IC 95% = 0.25 à 0.54). L’effet diététique était modifié par le génotype COX-2 SNP rs4648310 (p=0.002 pour l’interaction). En particulier, les hommes avec faible apport en oméga-3 et la variante rs4648310 avait un risque accru de cancer de la prostate (ratio de cote = 5.49, IC 95%=1.80 à 16.7), effet renversé par un apport en oméga-3 plus grand. L’étude du deuxième volet a observé que l’utilisation de statines est associée à une diminution du risque de progression du cancer de la vessie (risque relatif = 0.44, IC 95% = 0.20 à 0.96, p=0.039). Cette association était encore plus forte pour le décès de toute cause (HR = 0.57, 95% CI = 0.43 to 0.76, p=0.0001). L’effet des statines semble être dose-dépendant. L’étude du troisième volet démontre que le biais du temps immortel est fréquent et important dans les études épidémiologiques oncologiques. Il comporte plusieurs aspects dont certains sont mieux prévenus au stade du choix du devis d’étude et différentes méthodes statistiques permettent un contrôle de ce biais. Conclusion: 1) Une diète riche en oméga-3 aurait un effet protecteur pour le cancer de la prostate. 2) L’utilisation de statines aurait un effet protecteur sur la progression du cancer non invasif de la vessie. Les lipides semblent avoir un effet sur les cancers urologiques.
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Problématique : La littérature scientifique ne contient actuellement aucune étude épidémiologique portant sur la relation entre l’exposition à une infestation de punaises de lit (Cimex lectularis) et la santé mentale. L’objectif de cette étude est d’explorer la relation entre le statut d’exposition aux punaises de lit et des mesures de dépression, anxiété et perturbation du sommeil. Méthodes : Cette recherche est une étude transversale basée sur une analyse secondaire des données provenant de N=91 adultes locataires de logements insalubres qui ont répondu à un questionnaire de santé au moment d’interventions médico-environnementales menées par la direction de santé publique de Montréal entre janvier et juin 2010. Le questionnaire de santé inclut le « Questionnaire de santé du patient (QSP-9) », qui est un outil mesurant les symptômes associés à la dépression, l’outil de dépistage d’anxiété généralisée (GAD-7) et les items 1-18 de l’indice de la qualité du sommeil de Pittsburgh (PSQI). L’association entre une exposition autorapportée à une infestation de punaises de lit et le niveau de perturbation du sommeil selon la sous-échelle correspondante du PSQI, les symptômes dépressifs selon le QSP-9 et les symptômes anxieux selon le GAD-7, a été évaluée en utilisant une analyse de régression linéaire multivariée. Des données descriptives relatives aux troubles de sommeil autodéclarés et à des comportements reliés à un isolement social, dus à une exposition aux punaises de lit, sont aussi présentées. Résultats : L’échantillon comprenait 38 hommes et 53 femmes. Parmi les 91 participants, 49 adultes ont signalé une exposition aux punaises de lit et de ce nombre, 53,06% (26/49) ont déclaré des troubles de sommeil et 46,94% (23/49) des comportements d’isolement social, en raison de l’exposition. Les adultes exposés à des punaises de lit ont obtenu des résultats significativement plus élevés sur le QSP-9 (p=0,025), le GAD-7 (p=0,026) et sur la sous-échelle mesurant la perturbation du sommeil (p=0,003) comparativement à ceux qui n’étaient pas exposés. Conclusions : Cette première étude exploratoire met en évidence une association significative entre l’état d’exposition aux punaises de lit et des troubles de sommeil, ainsi que des symptômes anxieux et dépressifs, indiquant que ceux qui sont exposés aux punaises de lit représentent un groupe possiblement à risque de développer des problèmes de santé mentale. Ces résultats viennent en appui aux initiatives des décideurs pour organiser des efforts coordonnés d’éradication au niveau des villes et des provinces.