The new old epidemic of coronary heart disease.
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OBJECTIVES: This study quantified the consequences for prevalence of increased survival of coronary heart disease (CHD) in the Netherlands from 1980 to 1993. METHODS: A multistage life table fitted observed mortality and registration rates from the nationwide hospital register. The outcome was prevalence by age, sex, period, and disease state. RESULTS: The prevalence of CHD from 1980 to 1993 was 4.4% (men, aged 25 to 84 years) and 1.4% (women, aged 25 to 84 years). Between 1980-1983 and 1990-1993, the incidence changed little, but age-adjusted prevalence increased by 19% (men) and 59% (women). CONCLUSIONS: Sharply decreasing mortality but near-constant attack rates of CHD caused distinct increases in prevalence, particularly among the elderly. (+info)
Trends in body weight among American Indians: findings from a telephone survey, 1985 through 1996.
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OBJECTIVES: This study compared trends in body mass index for American Indian men and women across selected regions of the United States. METHODS: Self-reported data were collected from the Behavioral Risk Factor Surveillance System. RESULTS: Among women in the Dakotas, New Mexico and Arizona, and Washington and Oregon, average adjusted body mass index increased significantly by 0.1 to 0.2 units per year. Among men in Alaska and the Dakotas, average adjusted body mass index also increased significantly by 0.1 to 0.2 units each year. CONCLUSIONS: Because of rapid increases in average body mass index, some American Indian populations could be burdened by an increased incidence of chronic disease. (+info)
Prediction of common bile duct stones by noninvasive tests.
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OBJECTIVE: To define accurate and useful predictors of common bile duct stones (CBDS). SUMMARY BACKGROUND DATA: The ability to predict CBDS with noninvasive tests can avoid unnecessary, costly, or risky procedures. METHODS: All patients referred for examination for CBDS by endoscopic ultrasonography (EUS) from 1993-1996 were prospectively entered in a database. In a first sample selected randomly from the whole population, predictors of CBDS were determined by univariate analysis and logistic regression. Predictors were subsequently tested in that sample and in the rest of the population. A separate analysis was done for patients planned for cholecystectomy. RESULTS: Eight hundred and eighty patients (328 men, 552 women), aged 57.8 +/- 17 years (range 16-94), were included. The prevalence of CBDS was 18.8%. Age, serum levels of bilirubin, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase (GGT), and alkaline phosphatase, and the existence of jaundice and fever, a dilated bile duct, and a pathologic gallbladder were found to be associated with CBDS. Logistic regression was undertaken separately for patients younger than 70 years (predictors: GGT >7 x normal; pathologic gallbladder; dilated bile duct) and older than 70 years (predictors: GGT >7 x normal; fever > 38 degrees C; dilated bile duct). Odds ratios were 3 to 6.7. The model was satisfactorily applicable to the second sample; age <70 years: chi2 = 3.3 (NS); age >70 years: chi2 = 3.8 (NS). In patients younger than age 70 and planned for cholecystectomy, the combination of the level of GGT and dilated bile duct predicted CBDS accurately. CONCLUSIONS: A simple screening of patients at risk for CBDS can be achieved with three predictive criteria adapted for the patient's age. (+info)
Sexual problems: a study of the prevalence and need for health care in the general population.
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BACKGROUND: There has been little research carried out on the prevalence and types of sexual dysfunction in the general population, although the indications are that such problems are relatively common. Most common sexual problems are potentially treatable. However GPs have estimated the prevalence of sexual problems to be far lower than survey estimates. OBJECTIVE: To provide an estimate of the prevalence of sexual problems in the general population, and assess the use of and need for professional help for such problems. METHODS: We used an anonymous postal questionnaire survey. The study was set in four general practices in England*, and the study population was a stratified random sample of the adult general population (n = 4000). The subjects were 789 men and 979 women who responded to the questionnaire. The main outcome measures were the presence and type of current sexual problems in men and women, and the provision and use of treatments for sexual problems. RESULTS: A response rate of 44% was obtained. The median age of the responders was 50 years. A third of men (34%) and two-fifths of women (41 %) reported having a current sexual problem. The most common problems were erectile dysfunction (n = 170) and premature ejaculation (n = 88) in men; in women the most widely reported problems were vaginal dryness (n = 186) and infrequent orgasm (n = 166). In men, the proportion of responders reporting sexual problems increased with age, but there was no similar trend in women. Of those responders who reported a sexual problem, 52% said that they would like to receive professional help for this problem, but only one in ten of these people (n = 50) had received such help. CONCLUSION: Among responders there was a high level of reported sexual problems. The most frequently reported problems (vaginal dryness, erectile problems) may be amenable to physical treatment in practice, and yet few had sought or received help. However, many said that they would like to receive help. These figures suggest that there may be an important burden of potentially reversible sexual problems in the general population. (+info)
Utility of ultrasound of the upper urinary tract in elderly men with indicators of obstructive symptoms or abnormal flow: how often can silent hydronephrosis be detected in general practice?
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BACKGROUND AND OBJECTIVE: While the prevalence of hydronephrosis is very low in obduction studies, a prevalence of 3-13% is reported for patients with an obstruction who are listed for prostatectomy. In order to evaluate the usefulness of transabdominal ultrasound in primary care, we determined the occurrence of hydronephrosis in males with symptoms of urinary obstruction in a general practice setting. METHOD: A micturition questionnaire (a modified Boyarsky) was sent to all men of 55 years or more who were registered in 10 general practices in Maastricht, and was followed by an examination at their general practice. Men with obstructive symptoms and/or with a free-flow abnormality were examined in the hospital with transabdominal ultrasound in order to detect dilatation of the upper urinary tract. This ultrasound was repeated approximately 15 months later. RESULTS: At the first measurement, none of the examined men (n = 178) had hydronephrosis, and this was still the case for 94 men 15 months later. CONCLUSION: Renal ultrasound is not necessary in general practice for men with uncomplicated obstructive complaints. (+info)
Prostatic intraepithelial neoplasia and apoptosis in benign prostatic hyperplasia before and after the Chernobyl accident in Ukraine.
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The prevalence of prostatic intraepithelial neoplasia (PIN) in men who underwent surgery for benign prostatic hyperplasia (BPH) before and after the Chernobyl nuclear accident was studied. BPH samples were obtained by adenomectomy from 45 patients operated in 1984 before the accident (Group I), and 47 patients from the low contaminated Kiev City (Group II) and 76 from high contaminated area (Group III) operated between 1996 and 1998. Their BPH samples were examined histologically and immunohistochemically. The incidences of prostatic intraepithelial neoplasia (PIN) and high grade PIN (HGPIN) were 15.5 and 11.1% in Group I, 29.8 and 14.9% in Grpoup II, and 35. 5 and 19.7% in Group III. The difference between the incidences of PIN in Group I and III is significant (p<0.02). There was increased apoptosis in areas of PIN in Group II and III as compared to Group I (p<0.001). Since apoptosis has been shown to be associated with ionizing radiation and it is now found to be associated with PIN in patients diagnosed after the Chernobyl nuclear accident, this suggests that long-term low dose internal ionizing radiation potentially may cause prostate cancer. (+info)
Long-term hantavirus persistence in rodent populations in central Arizona.
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For 35 months, we monitored hantavirus activity in rodent populations in central Arizona. The most frequently captured hantavirus antibody-positive rodents were Peromyscus boylii and P. truei. Antibody-positive P. boylii were more frequently male (84%), older, and heavier, and they survived longer on trapping web sites than antibody-negative mice. The number of antibody-positive P. boylii was greater during high population densities than during low densities, while antibody prevalence was greater during low population densities. Virus transmission and incidence rates, also related to population densities, varied by trapping site. The spatial distribution of antibody-positive P. boylii varied by population density and reflected the species preference for dense chaparral habitats. The focal ranges of antibody-positive P. boylii also demonstrated a patchy distribution of hantavirus. (+info)
A longitudinal study of Sin Nombre virus prevalence in rodents, southeastern Arizona.
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We determined the prevalence of Sin Nombre virus antibodies in small mammals in southeastern Arizona. Of 1,234 rodents (from 13 species) captured each month from May through December 1995, only mice in the genus Peromyscus were seropositive. Antibody prevalence was 14.3% in 21 white-footed mice (P. leucopus), 13.3% in 98 brush mice (P. boylii), 0.8% in 118 cactus mice (P. eremicus), and 0% in 2 deer mice (P. maniculatus). Most antibody-positive mice were adult male Peromyscus captured close to one another early in the study. Population dynamics of brush mice suggest a correlation between population size and hantavirus-antibody prevalence. (+info)