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‣ Frequency of microorganisms isolated in patients with bacteremia in intensive care units in Colombia and their resistance profiles

Cortes,Jorge Alberto; Leal,Aura Lucía; Montañez,Anita María; Buitrago,Giancarlo; Castillo,Juan Sebastián; Guzman,Lucy
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2013 Português
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OBJECTIVE: The aim of this study was to describe the most frequently found bacterial microorganisms in bloodstream isolates taken from patients in intensive care units in Colombia and their resistance profiles. METHODS: This was a multicentre descriptive observational study that was carried out between January 2001 and June 2008 with laboratory data from 33 participating hospitals in a surveillance network. RESULTS: The most frequently found microorganisms were coagulase-negative Staphylococci 39.6%, Staphylococcus aureus 12.3%, Klebsiella pneumoniae 8.2%, Escherichia coli 5.7%, Acinetobacter baumannii, 4.0% and Pseudomonas aeruginosa 3.8%. Coagulase-negative Staphylococci registered greater than 70% oxacillin resistance rate. S. aureus presented a change in its multiresistance profile during the years of follow-up. There was a trend towards a lower resistance rate among E. coli and K. pneumoniae isolates during the study period while A. baumannii carbapenem resistance rate exceeded 50%. DISCUSSION: There has been a change in the frequency of species being isolated with a higher frequency of enterobacteriaceae compared to Gram-positive microorganisms, in general with a high resistance rate.

‣ Single lesion as an indicator to monitor the leprosy trend to elimination in hyperendemic areas

Ignotti,Eliane; Bayona,Manuel; Alvarez-Garriga,Carolina; Andrade,Vera L.G.; Valente,Joaquim G.
Fonte: Associação Brasileira de Saúde Coletiva Publicador: Associação Brasileira de Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2007 Português
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INTRODUCTION: Prevalence and detection rates of leprosy are not sufficient to show the real magnitude of changes in epidemiological patterns. OBJECTIVES: Evaluate the feasibility and usefulness of the proportion of new leprosy patients with a single skin lesion (SSL) as a potential indicator of the elimination of leprosy. METHODS: We conducted a retrospective study based on secondary data analyzing newly reported cases of leprosy between 1997 and 2002, in the city of Palmas, Tocantins, Brazil. Patients with a single lesion were compared to remaining patients, and the odds ratio was used as measure of association. RESULTS: Out of the 1,303 new cases of leprosy, 481 (36.9%) had a SSL. An increasing time-trend was observed in the proportion of new cases detected with a single lesion, which grew from 20.3% in 1999 to 49.1% in 2002 (linear trend p<.001) while a reduction in the number of new cases was observed simultaneously after 1999. The proportion of patients with a single lesion was higher in women, young age, paucibacillary, tuberculoid and indeterminate clinical forms, residents of urban areas, those with negative baciloscopy, with macular lesions, without physical disabilities, and mainly detected in primary health care units. CONCLUSIONS: These findings confirm that the proportion of patients with a SSL can be used as a sensitive and feasible indicator to assess the progress of the elimination of leprosy in hyperendemic areas.

‣ Prevalence and factors associated with nutritional deviations in women in the pre-pregnancy phase in two municipalities of the State of Rio de Janeiro, Brazil

Marano,Daniele; Gama,Silvana Granado Nogueira da; Domingues,Rosa Maria Soares Madeira; Souza Junior,Paulo Roberto Borges de
Fonte: Associação Brasileira de Saúde Coletiva Publicador: Associação Brasileira de Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2014 Português
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OBJECTIVE: To assess the prevalence and potential factors associated with pre-pregnancy nutritional status of women. METHODS: This is a cross-sectional study carried out between December 2007 and November 2008 with 1,535 women in the first trimester of pregnancy and randomly selected in health units of the Brazilian public health system (SUS) in the municipalities of Queimados and Petrópolis in the State of Rio de Janeiro. The diagnosis of nutritional deviations was based on the Body Mass Index, according to the classification of the Institute of Medicine, and the following categories were obtained: underweight, normal weight, overweight and obesity. In the statistical analysis, the multinomial logistic regression model was used and an odds ratio and confidence interval of 95% were estimated. RESULTS: The sample included women between 13 and 45 years. The prevalence of underweight, overweight and obesity were 10, 18 and 11%, respectively. Women living in Queimados, adolescents, women who did not live with a partner and smokers had a higher proportion of low pre-pregnancy weight. There was an association between hypertension, overweight and obesity. Adolescents presented lower chance to overweight and obesity. Living in Queimados reduced the odds of overweight. CONCLUSION: The proportion of pre-pregnancy nutritional deviations was high...

‣ Predictors of quality of life among patients on dialysis in southern Brazil

Bohlke,Maristela; Nunes,Diego Leite; Marini,Stela Scaglioni; Kitamura,Cleison; Andrade,Marcia; Von-Gysel,Maria Paula Ost
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2008 Português
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CONTEXT AND OBJECTIVE: Quality of life (QoL) is considered important as an outcome measurement, especially for long-term diseases such as chronic renal failure. The present study searched for predictors of QoL in a sample of patients undergoing dialysis in southern Brazil. DESIGN AND SETTING: This was a cross-sectional study developed in three southern Brazilian dialysis facilities. METHODS: Health-related QoL of patients on hemodialysis or peritoneal dialysis was measured using the generic Short Form-36 (SF-36) health survey questionnaire. The results were correlated with sociodemographic, clinical and laboratory variables. The analysis was adjusted through multiple linear regression. RESULTS: A total of 140 patients were assessed: 94 on hemodialysis and 46 on peritoneal dialysis. The mean age was 54.2 ± 15.4 years, 48% were men and 76% were white. The predictors of higher (better) physical component summary in SF-36 were: younger age (β-0.16; 95% confidence interval, CI: -0.27 to -0.05), shorter time on dialysis (β-0.06; 95% CI: -0.09 to -0.02) and lower Khan comorbidity-age index (β 5.16; 95% CI: 1.7-8.6). The predictors of higher mental component summary were: being employed (β 8.4; 95% CI: 1.7-15.1), being married or having a marriage-like relationship (β 4.56; 95% CI: 0.9-8.2)...

‣ Comparison of the epidemiologic features and patterns of initial care for prostate cancer between public and private institutions: a survey by the Brazilian Society of Urology

Nardi,Aguinaldo Cesar; Reis,Rodolfo Borges dos; Zequi,Stenio de Cassio; Nardozza Junior,Arquimedes
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2012 Português
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OBJECTIVE: To describe the epidemiological features and patterns of initial care for prostate cancer at public and private institutions in the State of Sao Paulo, Brazil. MATERIALS AND METHODS: A total of 1,082 physicians affiliated to the Sao Paulo Section of the Brazilian Society of Urology were invited to participate in this cross-sectional, web-based survey. Between September 2004 and September 2005, participating urologists entered data on demographic, clinical and pathological characteristics of patients diagnosed with prostate cancer in their practice. Data on patients attended at public institutions were analyzed and compared with those patients attended at private practice. RESULTS: One hundred and ten society members contributed with data from 1915 patients, 1026 (53.6%) of whom from public institutions. When compared with patients attended at private institutions, those attended at public institutions were older and more likely to be black, had higher serum prostate specific antigen (PSA) levels, had a higher probability of being diagnosed with metastatic disease, but were less likely to undergo prostatectomy (all P < 0.001). In multivariate analysis, age, biopsy Gleason score, and being attended at a public institution were independently associated with metastatic disease upon diagnosis. The significant predictors of nonsurgical treatment were age...

‣ Epidemiologic profile of surgery for spinomedullary injury at a referral hospital in a country town of Brazil

Bernardi,Danilo Magnani
Fonte: Sociedade Brasileira de Coluna Publicador: Sociedade Brasileira de Coluna
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 Português
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Objectives: To analyze the epidemiological profile of patients undergoing surgery at a referral hospital in a small, country town. Methods: A retrospective study was carried out between February 2009 and May 2010, in a Regional Referral unit, with a total of 24 patients. The cases study included all patients undergoing surgery for spinal trauma during this period, with or without neurological deficits. The data analyzed were: sex, age, location and degree of the injury, and mechanism of the injury. Results: The medianage of the patients was 35.8 years, and 75% were male. The mechanisms of the injury were motorcycle accidents in 37.5%, falls in 33.3%, automobile accidents in 25%, and diving into shallow water in 4.2%. The vertebral level affected was the cervical spine in 44%, the thoracic spine in 36%, and the thoracolumbar level in 20%. The neurological damage, classified according ASIA (American Spinal Injury Association) was complete, or category A in 37.5%, incomplete, or category B in 4.2%, incomplete, or category C in 12.5%, incomplete, or category D in 8.3%, and incomplete, or category E in 37.5%. In terms of access route, 64% of the procedures were performed with posterior access and 36% with anterior access. Conclusion: The epidemiological profile maintains the trend towards a prevalence of injuries among young men...

‣ Epidemiologic Profile of Patients with Snoring and Obstructive Sleep Apnea in a University Hospital

Mendes,Felipe Almeida; Marone,Silvio Antonio Monteiro; Duarte,Bruno Bernardo; Arenas,Ana Carolina Parsekian
Fonte: Fundação Otorrinolaringologia Publicador: Fundação Otorrinolaringologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 Português
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Introduction There are several studies on the pathophysiology and prevalence of Obstructive Sleep Apnea Syndrome (OSAS), however, few studies address the epidemiological profile of these patients. Objective The aim of this study is to analyze the epidemiological profile of patients diagnosed with OSAS referred to the Sleep Medicine clinic. Methods Cross-sectional individualized study covering 57 patients who were referred from the general ENT clinic to the Sleep Medicine clinic. Results Classification of OSAS: 16% had primary snoring, 14% mild OSAS, 18% moderate OSAS, and 52% severe OSAS. Distribution according to weight: 7% had normal weight, 2% were overweight (BMI 2530), 37% grade I obesity (BMI 25.1 to 30); 9% grade II obesity (BMI 30.1 to 35) and grade III obesity (BMI greater than 35) in 45% of cases. Distribution Friedmann stage: 9% were classified as grade I, 35% were considered grade II, 54% as grade III and 2% as grade IV. Treatment adopted: 46% were treated with CPAP; 19% were treated with surgery; oral appliance was designed for 14% patients, 7% were given roncoplastic injection and 7% positional therapy. A new polysomnography was asked to 5% of patients. To 2% of patients given the oral appliance was due to treatment failure with roncoplastic injection. Conclusion Most of the patients are male...

‣ Occlusal characteristics and orthodontic treatment need in black adolescents in Salvador/BA (Brazil): an epidemiologic study using the Dental Aesthetics Index

Farias,Arthur Costa Rodrigues; Cangussu,Maria Cristina Teixeira; Ferreira,Rogério Frederico Alves; Castellucci,Marcelo de
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2013 Português
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OBJECTIVE: The objective of this article is to evaluate the need of orthodontic treatment, prevalence and severity of the malocclusions in individuals of black ethnicity in a representative sample of schoolchildren of the city of Salvador/Brazil, as well as to verify if the malocclusion was affected by socio-demographic conditions such as age and gender. METHODS: The reference population was constituted of schoolchildren with age between 12 and 15 years, enrolled in public and private schools. The malocclusion was evaluated in 486 students of black ethnicity, with ages varying from 12 to 15 years, selected in random sample in multiple stages. The adopted significance level was 1% and the power of the test was 90%. A questionnaire registering demographic characteristics was filled out by each individual. The Dental Aesthetics Index (DAI) was used by previously calibrated examiners (kappa 0.89), according to criteria of the World Health Organization. RESULTS: It was verified that most of the individuals (76%) had little or any need for orthodontic treatment. About 24% showed a condition of severe malocclusion, culminating in a vital need for orthodontic treatment. The main occlusal characteristics found in the group with high need of orthodontic treatment were dental crowding and accentuated overjet. The age was positively related to the improvement of the maxillary overjet and to the presence of crowding. CONCLUSION: The development of public politics that aim the insertion of orthodontic treatment among the procedures of health programs...

‣ Use of Pulsed-Field Gel Electrophoresis for Molecular Epidemiologic and Population Genetic Studies of Mycobacterium tuberculosis†

Singh, Samir P.; Salamon, Hugh; Lahti, Carol J.; Farid-Moyer, Mehran; Small, Peter M.
Fonte: American Society for Microbiology Publicador: American Society for Microbiology
Tipo: Artigo de Revista Científica
Publicado em /06/1999 Português
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Pulsed-field gel electrophoresis (PFGE) is a powerful molecular biology technique which has provided important insights into the epidemiology and population biology of many pathogens. However, few studies have used PFGE for the molecular epidemiology of Mycobacterium tuberculosis. A laboratory protocol was developed to determine the typeability, stability, and reproducibility of PFGE typing of M. tuberculosis. Formal data-analytical techniques were used to assess the genetic diversity elucidated by PFGE analyses using four separate restriction enzymes and by IS6110 RFLP analyses, as well as to assess the concordance among these typing methods. One hundred epidemiologically characterized clinical isolates of M. tuberculosis were genotyped with four different PFGE enzymes (AseI, DraI, SpeI, and XbaI), as well as by RFLP analysis with IS6110. Identical patterns were found among 34 isolates known to be genetically related, suggesting that the PFGE protocol is robust and reproducible. Among 66 isolates representing population-sampled cases, heterozygosity and information content dependency estimates indicate that all five genotyping systems capture quantitatively similar levels of genetic diversity. Nevertheless, comparisons between PFGE analyses and IS6110 typing reveals that PFGE provided more discrimination among isolates with fewer than five copies of IS6110 and less clustering in isolates with five or more copies. The comparisons confirm the hypothesis that the resolution of IS6110 RFLP genotyping is dependent upon the number of IS6110 elements in the genome of isolates. The general concordance among the results obtained with four independent enzymes suggests that M. tuberculosis is a clonal organism. The availability of a robust genotyping technique largely independent of repetitive elements has implications for the molecular epidemiology of M. tuberculosis.

‣ PCR amplification of rRNA intergenic spacer regions as a method for epidemiologic typing of Clostridium difficile.

Cartwright, C P; Stock, F; Beekmann, S E; Williams, E C; Gill, V J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /01/1995 Português
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From January to March 1993, a suspected outbreak of antibiotic-associated diarrhea occurred on a pediatric oncology ward of the Clinical Center Hospital at the National Institutes of Health. Isolates of Clostridium difficile obtained from six patients implicated in this outbreak were typed by both PCR amplification of rRNA intergenic spacer regions (PCR ribotyping) and restriction endonuclease analysis of genomic DNA. Comparable results were obtained with both methods; five of the six patients were infected with the same strain of C. difficile. Subsequent analysis of 102 C. difficile isolates obtained from symptomatic patients throughout the Clinical Center revealed the existence of 41 distinct and reproducible PCR ribotypes. These data suggest that PCR ribotyping provides a discriminatory, reproducible, and simple alternative to conventional molecular approaches for typing strains of C. difficile.

‣ Restriction endonuclease analysis of clinical Pseudomonas aeruginosa strains: useful epidemiologic data from a simple and rapid method.

Maher, W E; Kobe, M; Fass, R J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1993 Português
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Newer genetic techniques have replaced phenotypic methods of subtyping Pseudomonas aeruginosa strains. Widespread application of newer methodologies, however, may be limited by technologic complexity and the cost of equipment. We conducted restriction endonuclease analysis (REA) of sheared genomic DNAs from 48 clinical P. aeruginosa strains using the enzyme SalI and electrophoresis in horizontal, low-concentration (0.3 to 0.6%) agarose gels. Each REA profile consisted of a smear of lower-molecular-mass bands as well as a countable number of well-resolved bands in the 8.3- to 48.5-kbp range which could easily be compared when isolates were run side-by-side on the same gel. In general, the REA patterns of strains recovered from different patients differed by at least seven bands, and those of serial isolates from individual patients were identical or differed by, at most, two bands over this 8.3- to 48.5-kbp range. REA of strains already subtyped by field inversion gel electrophoresis revealed that the two techniques generally paralleled each other. Overall, some unrelated strains had similar REA profiles, but the relative simplicity and low cost of the approach coupled with the ability to demonstrate differences between most unrelated strains should make this type of REA an attractive first step in the investigation of institutional P. aeruginosa problems.

‣ Use of plasmid profiles in epidemiologic surveillance of disease outbreaks and in tracing the transmission of antibiotic resistance.

Mayer, L W
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/1988 Português
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Plasmids are circular deoxyribonucleic acid molecules that exist in bacteria, usually independent of the chromosome. The study of plasmids is important to medical microbiology because plasmids can encode genes for antibiotic resistance or virulence factors. Plasmids can also serve as markers of various bacterial strains when a typing system referred to as plasmid profiling, or plasmid fingerprinting is used. In these methods partially purified plasma deoxyribonucleic acid species are separated according to molecular size by agarose gel electrophoresis. In a second procedure, plasmid deoxyribonucleic acid which has been cleaved by restriction endonucleases can be separated by agarose gel electrophoresis and the resulting pattern of fragments can be used to verify the identity of bacterial isolates. Because many species of bacteria contain plasmids, plasmid profile typing has been used to investigate outbreaks of many bacterial diseases and to trace inter- and intra-species spread of antibiotic resistance.

‣ Conventional and Molecular Epidemiology of Tuberculosis in Homeless Patients in Budapest, Hungary

Lukács, Judit; Tubak, Vilmos; Mester, Judit; Dávid, Sándor; Bártfai, Zoltán; Kubica, Tanja; Niemann, Stefan; Somoskövi, Ákos
Fonte: American Society for Microbiology Publicador: American Society for Microbiology
Tipo: Artigo de Revista Científica
Publicado em /12/2004 Português
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In Hungary the incidence of tuberculosis among the homeless population was 676 per 100,000 in 2002. Sixty-nine percent (140 patients) of all homeless tuberculosis patients were notified in Budapest (the capital). Therefore, a retrospective study that included 66 homeless tuberculosis patients notified in Budapest in 2002 was conducted to determine the rate of recent transmission of the disease and medical risk factors and to identify transmission pathways by means of conventional and molecular epidemiologic methods. IS6110 DNA fingerprinting revealed that 71.2% of the isolates could be clustered. Thirty-four (51.5%) patients belonged to five major clusters (size, from 4 to 11 individuals), and 13 (19.7%) belonged to six smaller clusters. Additional analysis of patient records found that 2 (18%) of the 11 patients in cluster A, 3 (37.5%) of the 8 patients in cluster B, and 2 (33%) of the 6 patients in cluster C were residents of the same three homeless shelters during the diagnosis of tuberculosis. Review of the database of the National Tuberculosis Surveillance Center (NTSC) revealed that 21.2% of the cases have not been reported to the NTSC. These findings indicate that the screening and treatment of tuberculosis among the homeless need to be strengthened and also warrant the review of environmental control steps in public shelters. Improvement of adherence of clinicians to surveillance reporting regulations is also necessary.

‣ Composite scoring--methods and predictive validity: insights from the Framingham Study.

Kannel, W B; McGee, D L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1987 Português
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After three decades of epidemiologic research at Framingham and elsewhere, the risk factor concept is now firmly established. Atherosclerotic cardiovascular disease can now be predicted and highly vulnerable candidates identified from profiles derived from ordinary office procedures and simple laboratory tests [1]. Risk can be estimated over a 20--30-fold range, and close to half of the cardiovascular events are found to occur in a tenth of the population at highest multivariate risk. Categorical risk assessments focusing on the number of "risk factors" present also identify high-risk subjects but tend to overlook high-risk individuals with multiple marginal abnormalities. Multivariate cardiovascular risk profiles made up of the major cardiovascular risk factors can predict all of the major cardiovascular events, even in advanced age, with reasonable efficiency. Such multivariate risk assessments can be made convenient by reproduction of handbooks and use of small programmed calculators, software for personal computers, and slide rules to facilitate office and public health assessments. The sensitivity and specificity of these risk profiles can probably be improved by more detailed lipid information, including HDL-cholesterol [12]...

‣ Obsessive-compulsive disorder in schizophrenia: epidemiologic and biologic overlap.

Tibbo, P; Warneke, L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /01/1999 Português
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OBJECTIVE: To examine the co-existence of obsessive-compulsive disorder (OCD) with schizophrenia in terms of epidemiology and overlapping biologic substrates. METHODS: Review of the relevant literature. RESULTS: There appears to be a significant prevalence of OCD in schizophrenia--higher than what would be expected on the basis of calculated comorbidity figures. There is significant overlap in the proposed functional circuits of OCD and schizophrenia, which may lead to co-expression of symptoms. Although there is overlap in neurotransmitter dysfunction, the interactions are complex, especially in regard to the serotonin and dopamine systems. CONCLUSION: The expression of OCD in schizophrenia is complex but very intriguing. Theoretical hypotheses of the pathology of the 2 disorders now need to be tested in larger controlled trials.

‣ Assessing exposure to disinfection by-products in women of reproductive age living in Corpus Christi, Texas, and Cobb county, Georgia: descriptive results and methods.

Lynberg, M; Nuckols, J R; Langlois, P; Ashley, D; Singer, P; Mendola, P; Wilkes, C; Krapfl, H; Miles, E; Speight, V; Lin, B; Small, L; Miles, A; Bonin, M; Zeitz, P; Tadkod, A; Henry, J; Forrester, M B
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/2001 Português
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We conducted a field study in Corpus Christi, Texas, and Cobb County, Georgia, to evaluate exposure measures for disinfection by-products, with special emphasis on trihalomethanes (THMs). Participants were mothers living in either geographic area who had given birth to healthy infants from June 1998 through May 1999. We assessed exposure by sampling blood and water and obtaining information about water use habits and tap water characteristics. Two 10-mL whole blood samples were collected from each participant before and immediately after her shower. Levels of individual THM species (chloroform, bromodichloromethane, dibromochloromethane, and bromoform) were measured in whole blood [parts per trillion (pptr)] and in water samples (parts per billion). In the Corpus Christi water samples, brominated compounds accounted for 71% of the total THM concentration by weight; in Cobb County, chloroform accounted for 88%. Significant differences in blood THM levels were observed between study locations. For example, the median baseline blood level of bromoform was 0.3 pptr and 3.5 pptr for participants in Cobb County and Corpus Christi, respectively (p = 0.0001). Differences were most striking in blood obtained after showering. For bromoform, the median blood levels were 0.5 pptr and 17 pptr for participants in Cobb County and Corpus Christi...

‣ Epidemiologic Methods in Current Cardiovascular Disease Research

Paffenbarger, Ralph S.; Krueger, Dean E.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1960 Português
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‣ Epidemiologic studies utilizing surveys: accounting for the sampling design.

Korn, E L; Graubard, B I
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/1991 Português
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BACKGROUND. Since large-scale health surveys usually have complicated sampling schemes, there is often a question as to whether the sampling design must be considered in the analysis of the data. A recent disagreement concerning the analysis of a body iron stores-cancer association found in the first National Health and Nutrition Examination Survey and its follow-up is used to highlight the issues. METHODS. We explain and illustrate the importance of two aspects of the sampling design: clustering and weighting of observations. The body iron stores-cancer data are reanalyzed by utilizing or ignoring various aspects of the sampling design. Simple formulas are given to describe how using the sampling design of a survey in the analysis will affect the conclusions of that analysis. RESULTS. The different analyses of the body iron stores-cancer data lead to very different conclusions. Application of the simple formulas suggests that utilization of the sample clustering in the analysis is appropriate, but that a standard utilization of the sample weights leads to an uninformative analysis. The recommended analysis incorporates the sampling weights in a nonstandard way and the sample clustering in the standard way. CONCLUSIONS. Which particular aspects of the sampling design to use in the analysis of complex survey data and how to use them depend on certain features of the design. We give some guidelines for when to use the sample clustering and sample weights in the analysis.

‣ Depression and hip fracture risk: the NHANES I epidemiologic follow-up study.

Mussolino, Michael E.
Fonte: Association of Schools of Public Health Publicador: Association of Schools of Public Health
Tipo: Artigo de Revista Científica
Publicado em //2005 Português
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OBJECTIVE: Since hip fracture is the most devastating consequence of osteoporosis from a public health standpoint, addressing whether depression is predictive of fracture risk is important. The purpose of this study is to determine whether individuals with high depressive symptomatology are more likely to suffer an osteoporotic hip fracture than subjects with intermediate or low depressive symptomatology. METHODS: Data from the first National Health and Nutrition Examination Survey (NHANES I) were obtained from a nationally representative sample of noninstitutionalized civilians. A cohort aged 25 through 74 at baseline (1971-1975) was observed through 1992. Subjects were followed-up for a maximum of 22 years. Included in the analyses were 6,195 white and black subjects. Ninety-five percent of the original cohort completed the study. Hospital records and death certificates were used to identify a total of 122 hip fracture cases. RESULTS: In an unadjusted Cox proportional hazards regression model for all individuals, depression was predictive of hip fracture (hazard ratio [HR]=1.90; 95% confidence interval [CI]=1.13, 3.21; p=0.016). In a multivariate proportional hazards model controlling for (1) age at baseline, (2) gender, (3) race...

‣ Taking chances: problem gamblers and mental health disorders--results from the St. Louis Epidemiologic Catchment Area Study.

Cunningham-Williams, R M; Cottler, L B; Compton, W M; Spitznagel, E L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/1998 Português
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OBJECTIVES: This study determined prevalence estimates of problem gambling and relationships to other psychiatric and substance use disorders. METHODS: In 1981, the Diagnostic Interview Schedule was used to collect epidemiological information on problem gambling and other disorders from 3004 adults in St. Louis, Mo. RESULTS: The lifetime prevalence of pathological gambling was 0.9%; 46% of those surveyed gambled recreationally. Problem gamblers (those reporting at least one gambling-related problem) were 9.2% of the sample and were predominately White (69%), male (78.2%), and young than nongamblers. They were at increased risk for several psychiatric diagnoses, especially for antisocial personality disorder, alcoholism, and tobacco dependence. CONCLUSIONS: Clinicians treating alcoholism and tobacco dependence may need to screen for problem gambling. Additional research in the context of increased gambling opportunities is needed.