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OBJECTIVES: To evaluate hospitalisation data for patients with a primary or secondary fibromyalgia (FM) diagnosis. We estimated the number of men and women with an FM diagnostic code and compared them across a number of demographic and hospitalisation characteristics; examined age-specific, population-based FM hospitalisation rates; and determined the most common co-morbid diagnoses when FM was either the primary or secondary diagnostic code. METHODS: Hospital discharge data from the Nationwide Inpatient Sample (NIS) were used. Records were evaluated between 1999 and 2007 that contained the International Classification of Diseases, 9th Revision, Clinical Modification FM diagnostic code (729.1, Myositis and Myalgia, unspecified), the FM criterion used in large-scale health services studies. RESULTS: There were 1,727,765 discharges with a 729.1 diagnostic code (FM) during this nine-year span, 213,034 men (12.3%) and 1,513,995 women (87.6%). Discharges coded for FM increased steadily each year. The population-based rate of male FM discharges rose gradually across the lifespan; the rate for women rose sharply but then declined after age 64. Few differences between men and women across demographic and hospitalisation characteristics were evident. The most common co-morbidities with FM as the primary diagnosis were non-specific chest pain, mood disorders, and Spondylosis/intervertebral disc disorders/other back problems. Most common primary diagnoses, with FM as a secondary diagnosis, were essential hypertension, disorders of lipid metabolism, coronary atherosclerosis/other heart disease, and mental disorders. CONCLUSIONS: A substantial number of U.S. residents with FM were hospitalised over the study period. Further analysis of hospitalisation data from patients with FM may provide guidance for both research and treatment, with the goal of improved care for FM patients.

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A study was made of the effects of extra immunization activities on routine immunization coverage at district level in Pakistan in a secondary analysis of data from UNICEF and the Pakistan national census. Linear regression analysis was made on data from 107 districts to estimate the effects of extra immunization efforts in the national neonatal tetanus programme on the coverage rate of the third dose of diphtheria-pertussis-tetanus (DPT3) after controlling for other potential confounding factors. The districts that implemented extra national neonatal tetanus immunization were at risk of having lower routine DPT3 coverage than those that did not. Additional immunization efforts, without additional resources, may reduce the effect of the routine Expanded Programme on Immunization.

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A study was made of the effects of extra immunization activities on routine immunization coverage at district level in Pakistan in a secondary analysis of data from UNICEF and the Pakistan national census. Linear regression analysis was made on data from 107 districts to estimate the effects of extra immunization efforts in the national neonatal tetanus programme on the coverage rate of the third dose of diphtheria-pertussis-tetanus [DPT3] after controlling for other potential confounding factors. The districts that implemented extra national neonatal tetanus immunization were at risk of having lower routine DPT3 coverage than those that did not. Additional immunization efforts, without additional resources, may reduce the effect of the routine Exp and ed Programme on Immunization

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William Petty, physician, epidemiologist, political economist, demographer, cartographer, and administrator was an intellectual product of the seventeenth century. Petty was born in the year 1623 in Romsey, England of lower middle class parents; however, by the time of his death in 1687 he had become a knight of the realm, founder of the Royal Society, and friend of kings. Petty's life reflected the northern renaissance which induced such dramatic changes in science, technology, politics, and entrepreneurship. His education was eclectic, nonetheless he took his Doctor of Physic degree from Oxford in 1649 and became an Oxford don, where he spent the next few years as an academic before undertaking a definitive survey of Ireland on behalf of the Cromwell government. Ireland changed Petty's destiny and he became a man of the world and entrepreneur which stimulated his interest in public policy formulation and economics. It was Petty's peculiar genius to be innovative in the application of measurement, statistics, and mathematics to socioeconomic and demographic phenomena. As a physician he related his knowledge of health and disease to these phenomena in what in the modern context would be called human ecology or social epidemiology. These relationships and their measurement were employed to establish an objective set of data which could be analyzed for the purpose of rational public policy planning by the state. This scientific approach to public policy places Petty squarely in the context of modern epidemiologic and public health practice and marks the initiation of a major use of the epidemiologic method.

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Data were analyzed from 729 meningococcal cases reported to the Epidemiology Section, Office of Preventive and Public Health Services, Louisiana Department of Health and Human Resources from 1978 through 1985. A total of 122 deaths (16.8%) occurred from these cases, with the highest case fatality rate (23.7%) noted in 1981. The eight-year average incidence rate per 100,000 population was 2.1. For individual years, the incidence rate was highest (3.6) in 1978 and lowest (0.8) in 1985. Although incidence rates per 100,000 population were greater for males during all years except 1978 and 1985 and greater for nonwhites in 1978, 1980, 1981, 1983 and 1984, the eight-year average incidence rates by sex and race were almost the same. Incidence rates were found to be highest in the less than one, and one to four-year age groups. For all eight years, over half of the cases were in the four years and under age group; the same was true for deaths, except in 1982 (46.7%). February was found to be the month with the highest frequency of reported case onset and death. The mean difference between date of disease onset and death for all fatal cases was 2.716 days (S.D. = 6.48). Ten of the 64 Louisiana parishes reported no meningococcal disease cases from 1978-1985. There were 25 parishes with an eight-year average incidence rate of greater than 2.1. The overall incidence rates in Louisiana were greater than rates in the United States for the time periods reviewed.

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