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‣ Overview of preventable industrial causes of occupational cancer.

Ward, E
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1995 Português
Relevância na Pesquisa
278.855%
This paper summarizes what is known about preventable causes of occupational cancer, including single agents, complex mixtures, and broad occupational associations. Epidemiologic methods have been very successful in documenting cancer risks associated with single agents. Epidemiologic data are most conclusive when an exposure-response relationship can be demonstrated. Examples of agents for which epidemiologic studies provide evidence of an exposure-response relationship include benzene and (concurrent exposure to) ortho-toluidine and aniline. Vinyl chloride and bischloromethyl ether are examples of associations between single agents and rare histologic types of cancer. It is more difficult to conduct epidemiologic studies to identify cancer risks associated with complex mixtures. Studies of diesel exhaust and lung cancer and metal machining oils are cited as having employed advanced industrial hygiene and epidemiologic methods for studies of complex mixtures. Elevated cancer risks have also been identified in broad occupational groups, including painters and dry cleaners. Epidemiologic case-control studies are often used to detect such associations but are limited in their abilities to detect the causal agents. Major gaps exist in knowledge of occupational cancer risks among women workers and workers of color. Because epidemiologic research measures illness and mortality that have already occurred...

‣ Statistical problems in epidemiologic studies of the natural history of disease.

Brookmeyer, R
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/1990 Português
Relevância na Pesquisa
272.9975%
The development of effective disease prevention and treatment programs depends on an understanding of the natural history of disease. A conceptual framework is presented for disease natural history and consists of an asymptomatic period of disease followed by a period of symptomatic disease. The focus is on epidemiologic studies for identifying risk factors of the onset of asymptomatic disease, for identifying cofactors of progression to symptomatic disease, and for estimating the duration of the asymptomatic period. The strengths and limitations of various epidemiologic study designs and sources of epidemiologic data are considered for characterizing disease natural history. Issues in the interpretation and analysis of natural history parameters of disease estimated from cross-sectional, prevalent cohort, cohort, and matched case-control studies are considered. The issues and analytic methods are illustrated with studies of the acquired immunodeficiency syndrome (AIDS) and cervical cancer. Based on these analytic methods, an estimate of the incubation period distribution of AIDS is given.

‣ Mining Biomedical Literature for Terms related to Epidemiologic Exposures

Xu, Hua; Lu, Yanxin; Jiang, Min; Liu, Mei; Denny, Joshua C.; Dai, Qi; Peterson, Neeraja B.
Fonte: American Medical Informatics Association Publicador: American Medical Informatics Association
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
273.5016%
Epidemiologic studies contribute greatly to evidence-based medicine by identifying risk factors for diseases and determining optimal treatments for clinical practice. However, there is very limited effort on automatic extraction of knowledge from epidemiologic articles, such as exposures, outcomes, and their relations. In this initial study, we developed a system that consists of a natural language processing (NLP) engine and a rule-based classifier, to automatically extract exposure-related terms from titles of epidemiologic articles. The evaluation using 450 titles annotated by an epidemiologist showed the highest F-measure of 0.646 (Precision 0.610 and Recall 0.688) using in-exact matching, which indicated the feasibility of automated methods on mining epidemiologic literature. Further analysis of terms related to epidemiologic exposures suggested that although UMLS would have reasonable coverage, more appropriate semantic classifications of epidemiologic exposures would be required.

‣ A Conceptual Multivariate Modelling Approach for Integrating Epidemiologic and Psychosocial Determinants to Examine the Epidemiology of Diseases in Under-served Populations

Habtemariam, T.; Tameru, B.; Nganwa, D.; Beyene, G.; Ayanwale, L.; Robnett, V.; Wilson, W.; Zekeri, A.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/2008 Português
Relevância na Pesquisa
275.57984%
Epidemiologic research involves the study of a complex set of host, environment and causative agent factors as these interact to impact health and diseases in any population. A conceptual multivariate modelling approach for integrating epidemiologic and psychosocial determinants to examine the epidemiology of chronic and infectious diseases in under-served populations in the USA was developed. Our approach relies upon systems analysis, i.e. integrating concepts and methods in epidemiology with mathematics and statistics along with computational methods and tools to rigorously examine the dynamics of diseases such as the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in a community. We used a multifactorial and quantitative epidemiologic (static) model that interrelates multiple determinants including biomedical, behavioral, and socioeconomic factors to analyze morbidity and mortality due to HIV/AIDS. The research involved participation of the community in the collection of socioeconomic, demographic, environmental, epidemiologic and biomedical data. In collaboration with Montgomery AIDS Outreach (MAO), a community based Organization in Montgomery, Alabama; blood samples were collected and tested using Orasure HIV testing kits to establish infection status with HIV/AIDS. Using these models...

‣ Perceived neighborhood problems: multilevel analysis to evaluate psychometric properties in a Southern adult Brazilian population

Hofelmann, D.; Diez Roux, A.; Antunes, J.; De Anselmo Peres, M.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Relevância na Pesquisa
351.165%
Background: Physical attributes of the places in which people live, as well as their perceptions of them, may be important health determinants. The perception of place in which people dwell may impact on individual health and may be a more telling indicator for individual health than objective neighborhood characteristics. This paper aims to evaluate psychometric and ecometric properties of a scale on the perceptions of neighborhood problems in adults from Florianopolis, Southern Brazil. Methods: Individual, census tract level (per capita monthly familiar income) and neighborhood problems perception (physical and social disorders) variables were investigated. Multilevel models (items nested within persons, persons nested within neighborhoods) were run to assess ecometric properties of variables assessing neighborhood problems. Results: The response rate was 85.3%, (1,720 adults). Participants were distributed in 63 census tracts. Two scales were identified using 16 items: Physical Problems and Social Disorder. The ecometric properties of the scales satisfactory: 0.24 to 0.28 for the intra-class correlation and 0.94 to 0.96 for reliability. Higher values on the scales of problems in the physical and social domains were associated with younger age...

‣ Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease

McPherson, S.; Stewart, S.; Henderson, E.; Burt, A.; Day, C.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
Relevância na Pesquisa
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BACKGROUND Accurate evaluation of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) is important to identify patients who may develop complications. The aim of this study was to compare the diagnostic performance of simple non-invasive tests in identifying advanced fibrosis among patients with biopsy-proven NAFLD. METHODS Consecutive patients with biopsy proven NAFLD were recruited from the Newcastle Hospitals Fatty Liver Clinic from 2003 to 2009. The AST/ALT ratio, AST to platelet ratio index, BARD (weighted sum of BMI>28=1 point, AST/ALT ratio>0.8=2 points, diabetes=1 point), FIB-4 (age×AST (IU/l)/platelet count (×109/litre)×√ALT (IU/l)) and NAFLD fibrosis scores were calculated from blood tests taken at time of biopsy. RESULTS 145 patients (82 male (61%), mean age 51±12 years) were included. The mean body mass index was 35±5 kg/m2. 73 subjects (50%) had diabetes. 93 patients (64%) had non-alcoholic steatohepatitis. 27 (19%) had advanced fibrosis (Kleiner stage 3–4). The FIB-4 score had the best diagnostic accuracy for advanced fibrosis (area under receiver operator characteristic curve (AUROC) 0.86), followed by AST/ALT ratio (AUROC 0.83), NAFLD fibrosis score (AUROC 0.81), BARD (AUROC 0.77) and AST to platelet ratio index (AUROC 0.67). The AST/ALT ratio...

‣ Possible association between genetic polymorphisms in transforming growth factor β receptors, serum transforming growth factor β1 concentration and abdominal aortic aneurysm; Possible association between genetic polymorphisms in transforming growth factor beta receptors, serum transforming growth factor beta1 concentration and abdominal aortic aneurysm

Golledge, J.; Clancy, P.; Jones, G.; Cooper, M.; Palmer, L.; van Rij, A.; Norman, P.
Fonte: John Wiley & Sons Ltd Publicador: John Wiley & Sons Ltd
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
Relevância na Pesquisa
351.165%
BACKGROUND: Previous studies have suggested a role for transforming growth factor (TGF) beta and its receptor in thoracic aortic aneurysm, but their role in abdominal aortic aneurysm (AAA) is unknown. This study examined the possible association between TGF-beta receptor 1 and 2 (TGFBR-1 and -2) single nucleotide polymorphisms (SNPs) and serum TGF-beta1 with AAA. METHODS: Serum concentrations of TGF-beta1 and 58 SNPs for TGFBR-1 and -2 were examined in 1003 and 1711 men respectively from the Health In Men Study. Validation of SNPs was examined in a second referral cohort of 1043 subjects from New Zealand, of whom 654 had an AAA. RESULTS: Serum TGF-beta1 was not associated with AAA. Only one SNP in TGFBR-2 was weakly associated with AAA; TGFBR2 g.42917C > T, SNP ID rs1078985CC; odds ratio 0.64 (95 per cent confidence interval (c.i.) 0.45 to 0.93); P = 0.020 uncorrected; but this association did not hold after adjusting for multiple testing and was not validated in the New Zealand cohort: odds ratio 0.98 (95 per cent c.i. 0.50 to 1.94); P = 0.960. CONCLUSION: These findings suggest there is no important role of genetic polymorphisms in the main receptors for TGF-beta and circulating TGF-beta1 in AAA in older individuals. (c) 2009 British Journal of Surgery Society Ltd.; J. Golledge...

‣ Cryptic relatedness in epidemiologic collections accessed for genetic association studies: experiences from the Epidemiologic Architecture for Genes Linked to Environment (EAGLE) study and the National Health and Nutrition Examination Surveys (NHANES)

Malinowski, Jennifer; Goodloe, Robert; Brown-Gentry, Kristin; Crawford, Dana C.
Fonte: Frontiers Media S.A. Publicador: Frontiers Media S.A.
Tipo: Artigo de Revista Científica
Publicado em 26/10/2015 Português
Relevância na Pesquisa
277.44486%
Epidemiologic collections have been a major resource for genotype–phenotype studies of complex disease given their large sample size, racial/ethnic diversity, and breadth and depth of phenotypes, traits, and exposures. A major disadvantage of these collections is they often survey households and communities without collecting extensive pedigree data. Failure to account for substantial relatedness can lead to inflated estimates and spurious associations. To examine the extent of cryptic relatedness in an epidemiologic collection, we as the Epidemiologic Architecture for Genes Linked to Environment (EAGLE) study accessed the National Health and Nutrition Examination Surveys (NHANES) linked to DNA samples (“Genetic NHANES”) from NHANES III and NHANES 1999–2002. NHANES are population-based cross-sectional surveys conducted by the National Center for Health Statistics at the Centers for Disease Control and Prevention. Genome-wide genetic data is not yet available in NHANES, and current data use agreements prohibit the generation of GWAS-level data in NHANES samples due issues in maintaining confidentiality among other ethical concerns. To date, only hundreds of single nucleotide polymorphisms (SNPs) genotyped in a variety of candidate genes are available for analysis in NHANES. We performed identity-by-descent (IBD) estimates in three self-identified subpopulations of Genetic NHANES (non-Hispanic white...

‣ Relative risk regression analysis of epidemiologic data.

Prentice, R L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1985 Português
Relevância na Pesquisa
276.36688%
Relative risk regression methods are described. These methods provide a unified approach to a range of data analysis problems in environmental risk assessment and in the study of disease risk factors more generally. Relative risk regression methods are most readily viewed as an outgrowth of Cox's regression and life model. They can also be viewed as a regression generalization of more classical epidemiologic procedures, such as that due to Mantel and Haenszel. In the context of an epidemiologic cohort study, relative risk regression methods extend conventional survival data methods and binary response (e.g., logistic) regression models by taking explicit account of the time to disease occurrence while allowing arbitrary baseline disease rates, general censorship, and time-varying risk factors. This latter feature is particularly relevant to many environmental risk assessment problems wherein one wishes to relate disease rates at a particular point in time to aspects of a preceding risk factor history. Relative risk regression methods also adapt readily to time-matched case-control studies and to certain less standard designs. The uses of relative risk regression methods are illustrated and the state of development of these procedures is discussed. It is argued that asymptotic partial likelihood estimation techniques are now well developed in the important special case in which the disease rates of interest have interpretations as counting process intensity functions. Estimation of relative risks processes corresponding to disease rates falling outside this class has...

‣ Race and perceived racism, education, and hypertension among Brazilian civil servants: the Pró-Saúde Study

Faerstein,Eduardo; Chor,Dóra; Werneck,Guilherme Loureiro; Lopes,Claudia de Souza; Kaplan,George
Fonte: Associação Brasileira de Saúde Coletiva Publicador: Associação Brasileira de Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 Português
Relevância na Pesquisa
351.165%
INTRODUCTION: Brazil has the largest population of African descendants outside Africa. OBJECTIVE: Mindful of the imprint of slavery on their contemporary social position, we investigated the relationship of perceived racism to hypertension. METHODS: We analyzed data (1999 - 2001) from 3,056 civil servants (mean age 42 years; 56% females) at university campuses in Rio participating in the longitudinal Pró-Saúde Study. RESULTS: Cases of prevalent hypertension had measured blood pressure equal to or greater than 140/90 mmHg or used antihypertensive medication. Self-administered questionnaires assessed participants' perceived history of lifetime discrimination (due to race, gender, socioeconomic position, and other attributes) at work and school, neighborhood, public places, and in contact with the police. Participants used 41 terms as responses to an open-ended question on racial self-identification; for these analyses, 48% were classified as afrodescendants. Racial discrimination in at least one setting was reported by 14% of afrodescendants. Compared to whites, the age- and gender-adjusted prevalence of hypertension was higher for afrodescendants with history of self-perceived racism (prevalence ratio - PR = 2.1; 95%CI 1.5 - 3.0) than for those with no such history (PR = 1.5; 95%CI 1.2 - 1.8). Comparing the former to whites...

‣ Aplicación del teorema del umbral estocástico de Whittle a un brote de varicela; Application of Whittle's stochastic threshold theorem to a chickenpox outbreak

Hincapié Palacio, Doracelly; Ospina Giraldo, Juan Fernando
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/08/2006 Português
Relevância na Pesquisa
351.165%
OBJETIVO: Estimar el ritmo reproductivo básico en un brote de varicela, aplicar el teorema umbral estocástico para estimar la probabilidad de la ocurrencia del brote e identificar medidas preventivas. MÉTODOS: El estudio fue realizado en una guardería de 16 niños, con 13 susceptibles, un infectado inicial y dos niños inmunes por antecedente de enfermedad. Se partió de un modelo estocástico: susceptible - infectado - removido. Se estimó el ritmo de reproducción básico de la enfermedad R0, usando un método de máxima verosimilitud basado en el conocimiento de la distribución de probabilidades para el tamaño total de la epidemia y haciendo una aproximación de epidemia casi-completa. Con el R0 obtenido se aplicó el teorema de umbral estocástico para obtener algunas medidas preventivas que podrían impedir la irrupción del brote de varicela. RESULTADOS: Cada infectado inicial produjo tres casos nuevos de infección, requiriendo para impedir el brote, una cobertura mínima de vacunación del 62%, o disminuir en 62% el contacto entre miembros del grupo o aumentar en 170% la remoción de infectados. CONCLUSIONES: El teorema del umbral estocástico permite identificar medidas que se podrían implementar para prevenir y controlar brotes de varicela. Aunque la distribución del tamaño de la epidemia en forma bimodal con similar probabilidad de ocurrencia de brotes grandes y pequeños...

‣ Identificação de casos psiquiátricos em estudos epidemiológicos multifásicos: métodos, problemas e aplicabilidade; Psychiatric cases identification by multi steps epidemiological studies: methods, problems and applicability

Andreoli, Sérgio B; Almeida Filho, Naomar de; Coutinho, Evandro SF; Mari, Jair de J
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/10/2000 Português
Relevância na Pesquisa
351.165%
OBJETIVO: Discutir aspectos metodológicos da estratégia de identificação de casos psiquiátricos, em duas etapas, em estudos epidemiológicos. MÉTODOS: Analisa-se a metodologia utilizada no Estudo Multicêntrico de Morbidade Psiquiátrica do Adulto realizado em três cidades brasileiras, entre 1990-1991. Na primeira etapa do citado estudo, uma amostra aleatória (6.740 indivíduos) da população foi selecionada e submetida a um rastreamento com o Questionário de Morbidade Psiquiátrica do Adulto -- QMPA. Na segunda etapa, uma subamostra (775 indivíduos) foi selecionada e submetida ao Inventário de Sintomas do DSM-III (Diagnostic and Statistical Manual of Mental Disorders), aplicado por psiquiatras e psicólogos treinados, para confirmação-diagnóstica. RESULTADOS: São descritos os procedimentos empregados para a estimativa das prevalências, mostrando que o fraco desempenho da escala de rastreamento não compromete o método. CONCLUSÃO: A vantagem da metodologia é a de corrigir as distorções apresentadas pelos instrumentos atuais de identificação de casos psiquiátricos.; OBJECTIVE: To discuss methodological aspects of the two stages in the identification of psychiatric cases in epidemiological studies. METHODS: Analyze the methodology used in the Multicentric Psychiatric Morbidity Study...

‣ Método de captura e recaptura: nova metodologia para pesquisas epidemiológicas; Capture-recapture: a new methodology for epidemiological research

Dunn, John; Andreoli, Sérgio Baxter
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/12/1994 Português
Relevância na Pesquisa
351.165%
O método de captura e recaptura, embora não seja novo, tem sido pouco usado em estudos epidemiológicos. Trata-se de método bem adaptável e adequado para estudar populações incomuns ou esquivas, como usuários de drogas endovenosas. Tem sido usado para estudar populações diversas como prostitutas que trabalham na rua ou volume de células vermelhas no homem. Permite ainda estimar a incidência e a prevalência de doenças de forma mais precisa do que os métodos tradicionais e com uma melhor relação custo-benefício. Devido à sua relevância dentro do campo da epidemiologia, decidiu-se realizar uma revisão sobre esse método, enfocando a história, as principais aplicações e apontando as suposições teóricas que o fundamentam. Seu potencial para futuras pesquisas epidemiológicas é promissor.; Although capture-recapture method is not new, their use in epidemiological studies has so far been limited. The method was developed by animal ecologists to estimate the size of various species populations, but in recent years it has been used to measure the incidence and prevalence of a variety of non-communicable diseases. Capture-recapture allows more accurate estimates to be made than is the case with traditional methods and is more cost-effective. The method is ideally suited to studying rare or elusive populations...

‣ Medical record review to recover missing data in a Portuguese birth cohort: agreement with self-reported data collected by questionnaire and inter-rater variability

Alves,Elisabete; Lunet,Nuno; Correia,Sofia; Morais,Vítor; Azevedo,Ana; Barros,Henrique
Fonte: Gaceta Sanitaria Publicador: Gaceta Sanitaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/06/2011 Português
Relevância na Pesquisa
351.165%
Objectives: To assess the yield of medical record review to recover missing data originally collected by questionnaire, to analyze the agreement between these two data sources and to determine interobserver variability in clinical record review. Methods: We analyzed data from a birth cohort of 8,127 women who were consecutively recruited after giving birth from 2005-2006. Recruitment was conducted at all public maternity units of Porto, Portugal. We reviewed the medical records of 3,657 women with missing data in the baseline questionnaire and assessed agreement between these two sources by using information from participants with data from both sources. Interobserver variability was assessed by using 400 randomly selected clinical records. Results: Data on pregnancy complications and maternal anthropometric parameters were successfully recovered. Agreement between the questionnaire and records in family history data was fair, particularly for cardiovascular disease [k=0.27; 95% confidence interval (95%CI): 0.23-0.32]. The highest agreement was observed for personal history of diabetes (k=0.82; 95%CI 0.70-0.93), while agreement for hypertension was moderate (k=0.60; 95%CI 0.50-0.69). Discrepancies in prepregnancy body mass index classes were observed in 10.3% women. Data were highly consistent between the two reviewers...

‣ Role of active and passive smoking on lung cancer etiology in Mexico City

Franco-Marina,Francisco; Villalba Caloca,Jaime; Corcho-Berdugo,Alexander
Fonte: Instituto Nacional de Salud Pública Publicador: Instituto Nacional de Salud Pública
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2006 Português
Relevância na Pesquisa
351.165%
OBJETIVE: To estimate the association between passive and active smoking exposures and lung cancer in Mexico City and the corresponding attributable risks. MATERIAL AND METHODS: Data was analyzed from a multicenter population-based case-control study conducted in Mexico City. RESULTS: ORs for lung cancer in ever smokers were 6.2 (95% CI 3.9-10.2) for males and 2.8 (95% CI 1.7-4.4) for females. Passive smoking at home showed an overall OR of 1.8 (95% CI 1.3-2.6), similar in both genders. Attributable risk for active smoking for both genders combined, and for males and females separately, was estimated at 55, 76 and 27%, respectively. Attributable risk for passive smoking at home was 17% for females, 3.9% for males and 12% for the entire population. CONCLUSIONS: In Mexico City smoking is attributable to a smaller proportion of lung cancer cases than in developed countries. This is explained by a lower intensity of smoking in the Mexican population.

‣ Role of active and passive smoking on lung cancer etiology in Mexico City

Franco-Marina,Francisco; Villalba Caloca,Jaime; Corcho-Berdugo,Alexander
Fonte: Instituto Nacional de Salud Pública Publicador: Instituto Nacional de Salud Pública
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2006 Português
Relevância na Pesquisa
351.165%
OBJETIVE: To estimate the association between passive and active smoking exposures and lung cancer in Mexico City and the corresponding attributable risks. MATERIAL AND METHODS: Data was analyzed from a multicenter population-based case-control study conducted in Mexico City. RESULTS: ORs for lung cancer in ever smokers were 6.2 (95% CI 3.9-10.2) for males and 2.8 (95% CI 1.7-4.4) for females. Passive smoking at home showed an overall OR of 1.8 (95% CI 1.3-2.6), similar in both genders. Attributable risk for active smoking for both genders combined, and for males and females separately, was estimated at 55, 76 and 27%, respectively. Attributable risk for passive smoking at home was 17% for females, 3.9% for males and 12% for the entire population. CONCLUSIONS: In Mexico City smoking is attributable to a smaller proportion of lung cancer cases than in developed countries. This is explained by a lower intensity of smoking in the Mexican population.

‣ Measles surveillance in Victoria, Australia

Wang,Yung-Hsuan J; Andrews,Ross M; Lambert,Stephen B
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2006 Português
Relevância na Pesquisa
351.165%
OBJECTIVE: Many countries are implementing measles elimination strategies. In Australia, the State of Victoria has conducted enhanced measles surveillance since 1997 using case interviews and home-based specimen collection for laboratory confirmation. We attempted to identify features of notified cases that would better target surveillance resources. METHODS: We retrospectively classified notifications received from 1998 to 2003 as having been received in an epidemic (one or more laboratory-confirmed cases) or an interepidemic period (no laboratory-confirmed cases). We labelled the first case notified in any epidemic period that was not laboratory-confirmed at the time of notification as a "sentinel case". To maximize detection of sentinel cases while minimizing the follow-up of eventually discarded notifications, we generated algorithms using sentinel cases and interepidemic notifications. FINDINGS: We identified 10 sentinel cases with 422 interepidemic notifications from 1281 Victorian notifications. Sentinel cases were more likely to report fever at rash onset (odds ratio (OR) 15.7, 95% confidence interval (CI) CI: 2.1-688.9), cough (OR 10.4, 95% CI: 1.4-456.7), conjunctivitis (OR 7.9, 95% CI: 1.8-39.1), or year of birth between 1968 and 1981 (OR 31.8...

‣ Medical record review to recover missing data in a Portuguese birth cohort: agreement with self-reported data collected by questionnaire and inter-rater variability

Alves,Elisabete; Lunet,Nuno; Correia,Sofia; Morais,Vítor; Azevedo,Ana; Barros,Henrique
Fonte: Ediciones Doyma, S.L. Publicador: Ediciones Doyma, S.L.
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2011 Português
Relevância na Pesquisa
351.165%
Objectives: To assess the yield of medical record review to recover missing data originally collected by questionnaire, to analyze the agreement between these two data sources and to determine interobserver variability in clinical record review. Methods: We analyzed data from a birth cohort of 8,127 women who were consecutively recruited after giving birth from 2005-2006. Recruitment was conducted at all public maternity units of Porto, Portugal. We reviewed the medical records of 3,657 women with missing data in the baseline questionnaire and assessed agreement between these two sources by using information from participants with data from both sources. Interobserver variability was assessed by using 400 randomly selected clinical records. Results: Data on pregnancy complications and maternal anthropometric parameters were successfully recovered. Agreement between the questionnaire and records in family history data was fair, particularly for cardiovascular disease [k=0.27; 95% confidence interval (95%CI): 0.23-0.32]. The highest agreement was observed for personal history of diabetes (k=0.82; 95%CI 0.70-0.93), while agreement for hypertension was moderate (k=0.60; 95%CI 0.50-0.69). Discrepancies in prepregnancy body mass index classes were observed in 10.3% women. Data were highly consistent between the two reviewers...

‣ Description of a seven-year prospective study of human papillomavirus infection and cervical neoplasia among 10 000 women in Guanacaste, Costa Rica

Bratti,M. Concepción; Rodríguez,Ana C.; Schiffman,Mark; Hildesheim,Allan; Morales,Jorge; Alfaro,Mario; Guillén,Diego; Hutchinson,Martha; Sherman,Mark E.; Eklund,Claire; Schussler,John; Buckland,Julie; Morera,Lidia A.; Cárdenas,Fernando; Barrantes,Manu
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2004 Português
Relevância na Pesquisa
351.165%
OBJECTIVE:The Guanacaste study ("Guanacaste Project," or GP), was designed to investigate the role of human papillomavirus (HPV) infection and its cofactors in the development of cervical neoplasia and to evaluate new cervical cancer screening technologies. The follow-up phase of the GP was designed to study why a small proportion of women infected with HPV develop cervical intraepithelial neoplasia grade 2 (CIN 2), CIN 3, or cancer (these three together are globally referred to as > CIN 2, that is, CIN 2 or worse). The purpose of this article is to describe this prospective study in detail and to present the preliminary findings regarding the incidence of cervical neoplasia. METHODS: A cohort of 10 049 randomly selected women from 18 to 97 years old from Guanacaste, a province in northwestern Costa Rica, was intensively screened in 1993-1994 and then followed up for seven years after being enrolled. A questionnaire for demographic and risk factors was administered, and a pelvic examination was performed on sexually active women at each follow-up visit in order to obtain samples for screening tests and for research purposes. The final diagnosis given at the end of the enrollment phase categorized women into several groups according to the perceived risk of their developing either high-grade precursors of cancer or cancer. These groups were followed up at different intervals according to the risk of developing > CIN 2. The most active follow-up (every 6-12 months) was concentrated on the women most likely to develop > CIN 2...

‣ Hospitalized cases of influenza A(H1N1)pdm09 in the French territories of the Americas, July 2009-March 2010

Barrau,Marie; Larrieu,Sophie; Cassadou,Sylvie; Chappert,Jean-Loup; Dussart,Philippe; Najioullah,Fatiha; Matheus,Séverine; Renner,Julien; Gasc,Coralie; Quenel,Philippe; Ledrans,Martine
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2012 Português
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OBJECTIVE: To describe the methodology used for implementing a surveillance system specifically for influenza A(H1N1)pdm09 in the French West Indies and French Guiana during an outbreak of this new virus in 2009-2010, and to report its main results. METHODS: This was an observational descriptive study of confirmed and probable cases of influenza A(H1N1)pdm09 hospitalized for at least 24 hours in 23 July 2009-3 March 2010. Reverse transcription polymerase chain reaction was performed on nasopharyngeal swab samples according to the Centers for Disease Control and Prevention protocol. A probable case was defined as fever > 38ºC or aches or asthenia with respiratory symptoms (cough or dyspnea). All confirmed and probable hospitalized cases were reported, along with patient's age, sex, clinical condition at admission, place and length of hospitalization, antiviral treatment, underlying conditions, complications, and clinical evolution. A case was classified as severe if respiratory assistance or intensive care was required or if death resulted. RESULTS: A total of 331 confirmed and 16 probable cases were hospitalized, with a hospitalization rate ranging from 4.3 per 1 000 clinical cases in Saint Martin to 10.3 in French Guiana. Of these...