Hospital laundry workers--an at-risk group for hepatitis A?
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Twenty-two laundry personnel at St. Luke's Hospital, Malta, were tested for seropositivity to hepatitis A together with 37 nursing aides working in paediatric and infectious disease wards, matched for age, who were used as controls. IgG antibodies were found in 54.5% of laundry workers and 13.5% of nursing aides [odds ratio (OR) = 7.68; 95% confidence interval (CI) = 1.87-33.83]. Furthermore, laundry personnel consistently handling dirty linen prior to washing showed an OR of 16.50 (CI = 1.19-825.57) as compared with colleagues handling only clean items. These results would suggest that the increased exposure of hospital laundry workers to potentially infected linen can constitute a risk of occupational hepatitis A for this group of employees. (+info)
Visceral leishmaniasis in Malta--an 18 year paediatric, population based study.
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BACKGROUND: Visceral leishmaniasis (VL) is a chronic parasitic infection that infects approximately 400,000 individuals annually, with a predilection towards early childhood. AIMS: To study the epidemiology of VL in childhood. METHODS: VL is endemic in Malta, a small archipelago of islands in the centre of the Mediterranean with a total population approaching half a million. Notification of human cases of leishmaniasis is compulsory. Case records of all 81 paediatric patients with VL between 1980 and 1998 were analysed. RESULTS: The annual incidence of VL declined for all cases of VL, and declined significantly for paediatric cases (p = 0.01). For 1994 to 1998, the overall incidence of VL was 0.9 per 100,000 total population and the paediatric incidence was 2.5 per 100,000 population. Median age at presentation was 34 months. Common features at presentation were splenomegaly, hepatomegaly, fever, and pancytopenia with high lymphocyte and monocyte counts. The diagnostic sensitivity of isolated immunofluorescent antibody testing was equivalent to bone marrow aspiration (95%). Blood transfusions for anaemia were required in 93% of patients. Eleven per cent had intercurrent infections. All patients were cured, and were initially treated with intravenous sodium stibogluconate. Defervescence occurred after a median of six days of treatment, and patients continued to be treated on a day case basis. Nine relapsers were retreated with sodium stibogluconate, achieving a cure rate of 94%, but five patients required additional drug therapy. There were no permanent sequelae associated with VL or its treatment. CONCLUSIONS: The decreased incidence is attributed to the eradication of stray dogs which are the disease reservoir. (+info)
Declining male births with increasing geographical latitude in Europe.
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OBJECTIVE: Demographic studies in various industrialised countries have shown a decline in male births in the latter half of the 20th century from the expected ratio of 0.515 (males/total). This study analyses trends in this ratio over the period 1890 to 1995 in Malta, and also analyses this ratio for Western European countries for the period 1990-1995. DESIGN: Births subdivided by sex were obtained from official Maltese publications. European countries were grouped according to geographical latitude by banding countries into three groups: Northern Mediterranean, Central European and Scandinavian. Births by sex for these countries were also analysed for the period 1990-1995. RESULTS: No decline in the ratio of male births to total births was noted in Malta over the period 1916-1995. However, the ratio was higher than expected (n = 151,766, ratio = 0.517 (95% confidence intervals (95% CI): 0.514, 0.519). Moreover, during the period 1890-1899 (n = 66,874), the ratio was 0.523 (95% CI: 0.519, 0.527), even higher than observed during the 20th century (chi 2 = 8.3, p = 0.004). Analysis of European births showed a much higher ratio of male births in the south of Europe than in the north (chi 2 = 87.2, p < 0.0001). CONCLUSIONS: The findings were unable to explain the higher incidence of male births in the south of Europe, but it is speculated that ambient temperatures may not only affect fertility, but also influence sex ratios at birth. (+info)
Mutation screening of the muscarinic M(2) and M(3) receptor genes in normal and asthmatic subjects.
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1. Muscarinic receptors are important in the development of airway hyperresponsiveness, and dysfunction of these receptors has been suggested to be present in asthma. 2. The human muscarinic M(2) and M(3) receptor genes were screened for polymorphic variation using single-stranded conformation polymorphism (SSCP) analysis, complemented by direct fluorescent sequencing. Forty-six random DNA samples and 46 respiratory physician diagnosed asthmatic samples were used as a template for analysis. 3. Within the muscarinic M(2) receptor gene, we identified two degenerate single base substitutions (1197T-->C, Thr-->Thr and 976A-->C, Arg-->Arg) in one random and one asthmatic sample respectively. Analysis of the 3' UTR region revealed an additional 'A' at bp 1793 (c.f. ATG). This was present in all of 49 samples analysed by sequencing or BsmI digest, suggesting that the published sequence (GenBank Accession NO: M16404) is incorrect. A common 3' UTR polymorphism (T-->A) was found at bp 1696 (c.f. ATG) (allelic frequency=65%, n=60), but this does not alter transcription factor recognition sites. 4. We were unable to identify any polymorphic variation within the muscarinic M(3) coding region or the flanking regions investigated, using the methods described. 5. The coding regions for the human muscarinic M(2) and M(3) receptor genes are both highly conserved. These data suggest that polymorphic variation within these coding sequences is unlikely to account for inter-individual variability in response to methacholine or anticholinergic therapy. The potential functional significance of the muscarinic M(2) receptor 3' UTR polymorphism (bp 1696) remains to be determined. (+info)
Multiple sclerosis in Malta in 1999: an update.
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OBJECTIVES: To ascertain the prevalence of multiple sclerosis (MS) in the islands of Malta and compare it with a previous study undertaken 21 years earlier, when a remarkably low prevalence was found. METHOD: Deaths with MS on the death certificate since the last study were reviewed. Sources of information about new patients were the Hospital Activity Analysis scheme, the MS Society of Malta, the records of the state hospitals, long stay private hospitals and nursing homes, lists provided by the state pharmacies, and magnetic resonance imaging, cerebrospinal fluid, and evoked response studies. Prevalence day was 1 January 1999. The Poser classification was used. RESULTS: Since 1978, 17 patients had died with a verified diagnosis of MS on the death certificate. They included all 10 deaths with MS from the original study and two immigrants. Fifty patients had clinically definite MS (CDMS) and 13 clinically probable MS (CPMS). The prevalence of CDMS was 13.2/100 000 (male 11.2, female 15.2). The prevalence of CDMS and CPMS combined was 16.7/100,000 (male 13.3, female 19.9). The annual incidence was 0.7/100,000. Twelve patients were found with CDMS among the 7213 immigrants resident in Malta (166/100,000). The expected rate was 1/100,000, determined at Maltese born rates. There were major changes in the population distribution during the 21 years between the two studies, with a big increase in the age groups with a high risk of MS. There is a longer expectation of life and the diagnosis in now made earlier. CONCLUSION: Malta still has a low MS prevalence. In comparison with Sicily and other Mediterranean countries of Europe it offers an opportunity to ascertain the genetic and environmental factors responsible for the disease. (+info)
Sick leave certification: a unique perspective on frequency and duration of episodes - a complete record of sickness certification in a defined population of employees in Malta.
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BACKGROUND: In Malta, sickness certificates are needed from the first day of illness, and are issued by family physicians (FPs) either employed by the government primary health care system, self-employed in private practice, or employed by an employer for this purpose alone. The latter system, when applied by the employer, is compulsory. In order to contribute to the debate on the role of the FP in this context, electronic data collected by a group of company-employed FPs was used to study the phenomenon of sickness certification. This database is a complete record of the selected employees' sick leave certification during the study period. METHODS: Data collected by company-employed FPs from a defined population was used: all employees of selected Maltese companies served by a group of FPs. The database included episode-based data from home visits over three years (01/01/1997 - 31/12/1999), by 9 company-appointed FPs regarding 421 employees of five companies. RESULTS: 3015 episodes of sickness absenteeism, with an average duration of 2.9 days, were documented. Employees who did intensive manual work had relatively higher rates. Furthermore, a relatively higher incidence of work injury, sprains and strains, anxiety and depression and low back pain as found in manual workers, and in male workers. This trend was shown to be statistically significant. CONCLUSIONS: The frequency of sick-leave certification in Malta is comparable to that in other European countries, but the average duration of certificates is much less than reported in other studies that generally did not include data on short-term illness and certification. This has important implications on future research in the field. A number of common disorders were found to be significantly more prevalent causes of sickness certification in manual workers, amongst them anxiety and depression. (+info)
Maxillary canine anomalies and tooth agenesis.
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The aims of the study were to analyse the records of 26 subjects (18 females, eight males) with maxillary canine-first premolar transposition (Mx.C.P1) together with 160 subjects with a palatally displaced canine (PDC) to determine the pattern of tooth agenesis in these cases and to compare them with similar samples reported in the literature. A strong association between Mx.C.P1, lateral incisor and lower second premolar agenesis was found, with a 20 per cent prevalence of lateral incisor agenesis and a 24 per cent prevalence of lower second premolar agenesis. There was a lesser association with third molar (M.3) agenesis, with a prevalence of 52.2 per cent. Weaker associations were found for a PDC, with a prevalence of 5 per cent for lateral incisor agenesis. The prevalence of lower second premolar (5 per cent) and M.3 (27.5 per cent) agenesis approached reference values. Evidence for the implication of the MSX1 or PAX9 genes in the aetiology of PDC was weak. (+info)
Acceptance of killing and homicide rates in nineteen nations.
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BACKGROUND: International variation in homicide rates may be attributable to cultural differences in acceptance of moral justifications for killing. The aim of this study is to investigate the relationships between measures of attitudes towards the justification of killing and homicide rates in diverse international populations. METHODS: Four studies assessed variations in acceptance of killing among adults and young people in nineteen nations and four areas in the USA. Study 1 (1996-1997) assessed adult attitudes in Brazil, Chile, Costa Rica, Spain, and Venezuela with personal interviews in major cities. Study 2 (1999-2001) assessed attitudes among high school students in Denmark, Finland, Malta, Mexico, Netherlands, Slovenia, Sweden, Taiwan, and the UK with paper surveys administered in classrooms. Study 3 (2001) used telephone interviews to measure the equivalent attitudes among the US samples nationally and from regions in Texas. Study 4 (2002-2003) used paper surveys in classrooms to measure attitudes among high school students in Armenia, Belarus, Georgia, and the Russian Federation. RESULTS: The acceptance of killing varied significantly among genders and national/regional groups. The mean attitude scores in the four studies combined were significantly correlated with national/regional homicide rates and the amount of variance explained was similar to that for social inequality (GINI). Together the attitude scores and GINI explained 65% of the variance in homicide rates. CONCLUSION: This study provides evidence that variations in attitudes toward the justification of killing may be related to international differences in homicide rates. (+info)