RESUMEN
INTRODUCTION: Hip fractures are associated with a high burden of morbidity and mortality. Globally, there is wide variation in the incidence of hip fracture in people aged 50 years and older. Longitudinal and cross-geographical comparisons of health data can provide insights on aetiology, risk factors, and healthcare practices. However, systematic reviews of studies that use different methods and study periods do not permit direct comparison across geographical regions. Thus, the objective of this study is to investigate global secular trends in hip fracture incidence, mortality and use of postfracture pharmacological treatment across Asia, Oceania, North and South America, and Western and Northern Europe using a unified methodology applied to health records. METHODS AND ANALYSIS: This retrospective cohort study will use a common protocol and an analytical common data model approach to examine incidence of hip fracture across population-based databases in different geographical regions and healthcare settings. The study period will be from 2005 to 2018 subject to data availability in study sites. Patients aged 50 years and older and hospitalised due to hip fracture during the study period will be included. The primary outcome will be expressed as the annual incidence of hip fracture. Secondary outcomes will be the pharmacological treatment rate and mortality within 12 months following initial hip fracture by year. For the primary outcome, crude and standardised incidence of hip fracture will be reported. Linear regression will be used to test for time trends in the annual incidence. For secondary outcomes, the crude mortality and standardised mortality incidence will be reported. ETHICS AND DISSEMINATION: Each participating site will follow the relevant local ethics and regulatory frameworks for study approval. The results of the study will be submitted for peer-reviewed scientific publications and presented at scientific conferences.
Asunto(s)
Fracturas de Cadera , Anciano , Asia , Europa (Continente) , Fracturas de Cadera/epidemiología , Humanos , Incidencia , Persona de Mediana Edad , Estudios Retrospectivos , América del SurRESUMEN
Sphincterodiplostomum is a monotypic genus of diplostomid digeneans that parasitize fish-eating birds in the neotropics. The type species Sphincterodiplostomum musculosum has a unique, dorsal, tubular invagination in the opisthosoma with a muscular sphincter. Whereas larvae of S. musculosum are relatively commonly reported in Neotropical fish helminth surveys, adult specimens from birds are rarely collected. Prior to our study, no DNA sequence data for S. musculosum were available. Our molecular and morphological study of mature and immature adult Sphincterodiplostomum specimens from three species of birds and one species of crocodilian revealed the presence of at least two species of Sphincterodiplostomum in the neotropics. We provide the first molecular phylogeny of the Diplostomoidea that includes Sphincterodiplostomum. In addition, this is the first record of S. musculosum from caimans, along with the first record of fully mature adult S. musculosum from green kingfisher Chloroceryle americana. The new species of Sphincterodiplostomum (Sphincterodiplostomum joaopinhoi n. sp.) can be morphologically distinguished from S. musculosum based on the anterior extent of vitelline follicles, narrower prosoma, substantially smaller holdfast organ and structure of tegumental spines. Our data revealed 0.7% interspecific divergence in 28S and 10.6-11.7% divergence in cox1 sequences between the two Sphincterodiplostomum species.
Asunto(s)
Aves/parasitología , Filogenia , Trematodos , Animales , Brasil , ADN de Helmintos/genética , Peces , ARN Ribosómico 28S/genética , Trematodos/clasificaciónRESUMEN
Many first responders are outfitted with electronic personal dosimeters to recognize and be alerted to radiological hazards during their response operations. These dosimeters provide invaluable measurement data for force protection, allowing the first responder to assess a response situation and take protective measures for themselves and other individuals involved based on instrument readings of dose rate or cumulative dose. However, capabilities of common electronic personal dosimeters to identify and distinguish various contributions to the instrument reading, in particular from natural radiological sources, are rather limited. An algorithm has been developed for two-channel electronic personal dosimeters that quantifies the signal contribution from radon progeny and allows for background subtraction from radon and radon progeny in the instrument reading. This algorithm will be particularly useful in operational scenarios where first responders may be subject to rapidly changing levels of natural background radiation, which could mimic the presence of anthropogenic sources of ionizing radiation.
Asunto(s)
Equipos y Suministros Eléctricos , Dosímetros de Radiación , Radiometría/instrumentación , Radiometría/métodos , Hijas del Radón/química , Algoritmos , Radiación de Fondo , Socorristas , Diseño de Equipo , Humanos , Modelos Químicos , Dosis de RadiaciónRESUMEN
Birds harbor an astonishing diversity of haemosporidian parasites belonging to the genera Haemoproteus, Leucocytozoon, and Plasmodium. Currently there are more than 250 morphologically described avian haemosporidian species and 2,828 unique lineages found in virtually all avian clades and zoogeographic regions, except for Antarctica. Our report is based on PCR and microscopic screening of 1,302 individual avian samples from Brazil to detect the underrepresented genus Leucocytozoon. This survey primarily focuses on passerine birds collected from Amazonia, the Atlantic Rain Forest, and Pantanal. We also summarize studies conducted in Brazil that report haemosporidian prevalence using both microscopy and molecular tools and present for the first time a record of Leucocytozoon infecting an avian host population in Amazonia. Based on our findings, we suggest that high average temperatures may be constraining both the distribution and diversity of Leucocytozoon in lowland tropical South America.
Asunto(s)
Enfermedades de las Aves/parasitología , Haemosporida/clasificación , Passeriformes/parasitología , Infecciones Protozoarias en Animales/parasitología , Animales , Teorema de Bayes , Enfermedades de las Aves/epidemiología , Brasil/epidemiología , Haemosporida/aislamiento & purificación , Insectos Vectores/parasitología , Insectos Vectores/fisiología , Filogenia , Prevalencia , Infecciones Protozoarias en Animales/epidemiología , Simuliidae/parasitología , Simuliidae/fisiologíaRESUMEN
Most conifer species occur in large continuous populations, but radiata pine, Pinus radiata, occurs only in five disjunctive natural populations in California and Mexico. The Mexican island populations were presumably colonized from the mainland millions of years ago. According to Axelrod (1981), the mainland populations are relicts of an earlier much wider distribution, reduced some 8,000 years ago, whereas according to Millar (1997, 2000), the patchy metapopulation-like structure is typical of the long-term population demography of the species. We used 19 highly polymorphic microsatellite loci to describe population structure and to search for signs of the dynamics of population demography over space and time. Frequencies of null alleles at microsatellite loci were estimated using an approach based on the probability of identity by descent. Microsatellite genetic diversities were high in all populations [expected heterozygosity (H(e)) = 0.68-0.77], but the island populations had significantly lower estimates. Variation between loci in genetic differentiation (F(ST)) was high, but no locus deviated statistically significantly from the rest at an experiment wide level of 0.05. Thus, all loci were included in subsequent analysis. The average differentiation was measured as F(ST) = 0.14 (SD 0.012), comparable with earlier allozyme results. The island populations were more diverged from the other populations and from an inferred common ancestral gene pool than the mainland ones. All populations showed a deficiency of expected heterozygosity given the number of alleles, the mainland populations more so than the island ones. The results thus do not support a recent important contraction in the mainland range of radiata pine.
Asunto(s)
Flujo Genético , Variación Genética , Genética de Población , Repeticiones de Microsatélite/genética , Pinus/genética , California , Análisis por Conglomerados , Frecuencia de los Genes , México , Dinámica PoblacionalRESUMEN
Under the immunization regulations, parents and guardians have equal responsibility to take their children for vaccination "within one year of child's birth or soon after". (AU)
Asunto(s)
Humanos , Programas de Inmunización/economía , Vacuna Antisarampión/efectos adversos , Vacuna contra la Parotiditis/efectos adversos , Vacuna contra la Rubéola/efectos adversos , Vacunas/efectos adversos , Resultado del Tratamiento , Organización Mundial de la Salud , Factores de RiesgoRESUMEN
Both consumers and physicians have favorable attitudes toward advertising in general, but their attitudes toward hospital advertising differ considerably. In particular, the two groups differ in their opinions about the influence of advertising on hospital choice, the value of the information being advertised, and the economic impact of advertising on hospitals.
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Publicidad/estadística & datos numéricos , Comportamiento del Consumidor/estadística & datos numéricos , Hospitales , Médicos/estadística & datos numéricos , Actitud Frente a la Salud , Distribución de Chi-Cuadrado , Recolección de Datos , Investigación sobre Servicios de Salud , Médicos/psicología , Sudoeste de Estados UnidosRESUMEN
We report the case of a 65-year-old black man who presented to our facility with pseudo-obstruction of the bowel within two weeks of the initiation of oral sustained-release procainamide hydrochloride therapy. The syndrome continued despite conversion to intravenous procainamide and only resolved after discontinuation of the medication. We believe that the anticholinergic properties of procainamide, coupled with the patient's diabetes, contributed to severe hypomotility of the gastrointestinal tract and, subsequently, a pseudo-obstructive state. The syndrome of drug-induced pseudo-obstruction is also reviewed.
Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Seudoobstrucción Intestinal/inducido químicamente , Procainamida/efectos adversos , Anciano , Preparaciones de Acción Retardada , Humanos , Masculino , Procainamida/administración & dosificaciónAsunto(s)
Ácido Homovanílico/sangre , Esquizofrenia/sangre , Antipsicóticos/uso terapéutico , Estudios de Seguimiento , Hospitalización , Humanos , Evaluación de Procesos y Resultados en Atención de Salud , Pronóstico , Esquizofrenia/diagnóstico , Esquizofrenia/tratamiento farmacológico , Psicología del EsquizofrénicoRESUMEN
Ten patients with sickle cell (SS) disease from a Jamaican family were found to have unusually high levels of haemoglobin F for this population. Each of them has inherited one sickle cell gene on a chromosome characterized by an arrangement of restriction fragment length polymorphisms (haplotype) which is very rare in the Jamaican population. Genetic analysis of the family suggests that there is a determinant linked to the beta-globin gene cluster, characterized by this haplotype, which is responsible for increased haemoglobin F production in response to anaemia. Interestingly this particular haplotype appears to be common in patients with SS disease in eastern Saudi Arabia in whom a high level of haemoglobin F is the rule rather than the exception. Hence it is possible that this haplotype (++-++) acts as a genetic marker for elevated levels of haemoglobin F in sickle cell disease.
Asunto(s)
Anemia de Células Falciformes/genética , Hemoglobina Fetal/genética , Marcadores Genéticos , Rasgo Drepanocítico/genética , Femenino , Haploidia , Humanos , Jamaica , Masculino , Linaje , Arabia SauditaRESUMEN
Restriction site polymorphisms of the beta globin gene cluster of 244 Jamaican beta S chromosomes have been studied. Various patterns of restriction site polymorphisms (haplotypes) both 5' and 3' to the beta gene have been found. These two groups of haplotypes were found to be non-randomized with respect to each other. This is in contrast to normal beta A chromosomes where the 5' and 3' haplotypes are randomized. These findings together with the large number (18) of different beta S haplotypes found indicate that the beta S mutation probably has multiple origins.