scholarly journals LISCH NODULES IN AN UNSELECTED POPULATION: PREVALENCE AND USEFULNESS AS INDICATION OF NEUROFIBROMATOSIS

1987 ◽  
Vol 21 (4) ◽  
pp. 227A-227A
Author(s):  
Carol L Greene ◽  
Wendy S Male ◽  
Shelley H Coleman ◽  
Martin E Ohrliok ◽  
Robert A Gordon
Keyword(s):  
Population Prevalence ◽  
Lisch Nodules ◽  
Unselected Population

Prevalence of Inhibitors in a Population of 3435 Hemophilia Patients in France

1992 ◽  
Vol 67 (06) ◽  
pp. 600-602 ◽  
Author(s):  
Y Sultan ◽  
Keyword(s):  
Hemophilia A ◽  
Hemophilia B ◽  
Study Group ◽  
Cooperative Study ◽  
Population Prevalence ◽  
French Study ◽  
Number Of Patients ◽  
High Incidence ◽  
Recombinant Fviii ◽  
High Responders

SummaryA cooperative study between the 37 centers of the French Hemophilia Study Group was undertaken to establish the prevalence of inhibitor patients in the French hemophilia population. The prevalence reported in the literature varies widely from 3.6% to 17.5%. Some of the studies are dealing with a small number of patients and inhibitor patients are reported either to the total number of hemophiliacs or to the severely affected ones. The French study provided information concerning 3,435 hemophiliacs and showed a prevalence of 6.2% for the overall population. Prevalence of inhibitors was found to be 7% in the population of hemophilia A patients and 12.8% in the population of severely affected ones. The prevalence of inhibitors in the population of hemophilia B patients was 2% and 4% in the population of severely affected hemophilia B patients. The cooperative study also showed that 47.5% of inhibitors are detected before 10 years of age and that 82% of inhibitor patients are high responders. Analysis of inhibitor detection in patients under the age often showed that there was a peak in the population of 2 years old children. Although not comparable to the present study the high incidence of inhibitors with ultrapurified and recombinant FVIII reported in previously untransfused patient may be borne in mind.

Role of Nutrition Counseling and Lifestyle Modification in Managing Prediabetes

2021 ◽  
pp. 037957212110254
Author(s):  
Harleen Kaur ◽  
Neerja Singla ◽  
Rohini Jain
Keyword(s):  
Hemoglobin A1c ◽  
Lifestyle Modification ◽  
Fasting Blood Glucose ◽  
Nutrition Intervention ◽  
Control Group ◽  
Population Prevalence ◽  
Significant Difference ◽  
And Control ◽  
Experimental Group

Objective: India is the second country after China having the highest population prevalence of diabetes. Several research studies investigating diabetes have been done, but not much work has been done on prediabetes. The purpose of this study was to investigate the effect of nutrition and lifestyle modification on prediabetic females. Methods: A total of 120 prediabetic females from Ludhiana city were divided into 2 matched groups: control group (n = 60) and experimental group (n = 60). Impact of nutrition intervention for dietary and lifestyle modification (for 3 months) was assessed on the anthropometric, dietary, biochemical parameters, and diabetes risk score of the experimental group and control group (no intervention). Results: All the selected 120 subjects completed the study (experimental group = 60; control group = 60). There was significant difference in the changes between the 2 groups throughout the study. The fasting blood glucose and glycated hemoglobin A1c levels of the experimental group subjects reduced significantly ( P ≤ .01). However, no change was observed among the control group subjects. The lipid profile of the experimental group showed a significant improvement ( P ≤ .01). Conclusion: Nutrition counselling of the prediabetics regarding dietary and lifestyle modification is recommended so as to improve their metabolic control, thus preventing them from being diabetics.

scholarly journals 468. Specimen pooling conserves additional testing resources when patients’ infection status is correlated: A simulation study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S300-S300
Author(s):  
Jeffrey Rewley
Keyword(s):  
Internal Medicine ◽  
Simulation Study ◽  
No Reduction ◽  
Optimal Size ◽  
Infection Status ◽  
Heat Map ◽  
Population Prevalence ◽  
Additional Testing ◽  
Batch Sizes ◽  
Pooled Sample

Abstract Background In the early stages of a novel pandemic, testing is simultaneously in high need but low supply, making efficient use of tests of paramount importance. One approach to improve the efficiency of tests is to mix samples from multiple individuals, only testing individuals when the pooled sample returns a positive. Methods I build on current models which assume patients’ sero-status is independent by allowing for correlation betweenconsecutive tests (e.g. if a family were all infected and were all tested together). In this model, I simulate 10,000 patients being tested in sequence, with population sero-prevalence ranging from 1% to 25%, using batch sizes from 3 to 10, and assuming the increased probability of consecutive infections ranged from 0% to 50%. Results I find that as the likelihood of consecutive infected patients increases, the efficiency of specimen pooling increases. As well, the optimal size of the batch increases in the presence of clustered sequences of infected patients. Heat map indicating the manner in which the number of tests needed is reduced as population prevalence and correlation between cases changes. Red indicates that there is no reduction in the number of tests, and blue indicates a near 100% reduction in the number of tests, with intermediate colors indicating intermediate fractions. Conclusion This analysis indicates further improvements in specimen pooling efficiency can begained by taking advantage of the pattern of patient testing. Disclosures Jeffrey Rewley, PhD, MS, American Board of Internal Medicine (Employee)

scholarly journals A Bayesian approach to estimating the population prevalence of mood and anxiety disorders using multiple measures

2021 ◽  
Vol 30 ◽  
Author(s):  
Jordan Edwards ◽  
A. Demetri Pananos ◽  
Amardeep Thind ◽  
Saverio Stranges ◽  
Maria Chiu ◽  
...  
Keyword(s):  
Monte Carlo ◽  
Anxiety Disorders ◽  
Administrative Data ◽  
Population Based ◽  
Accurate Estimate ◽  
Service Planning ◽  
Prevalence Estimate ◽  
Population Prevalence ◽  
Mood And Anxiety Disorders ◽  
Prevalence Estimates

Abstract Aims There is currently no universally accepted measure for population-based surveillance of mood and anxiety disorders. As such, the use of multiple linked measures could provide a more accurate estimate of population prevalence. Our primary objective was to apply Bayesian methods to two commonly employed population measures of mood and anxiety disorders to make inferences regarding the population prevalence and measurement properties of a combined measure. Methods We used data from the 2012 Canadian Community Health Survey – Mental Health linked to health administrative databases in Ontario, Canada. Structured interview diagnoses were obtained from the survey, and health administrative diagnoses were identified using a standardised algorithm. These two prevalence estimates, in addition to data on the concordance between these measures and prior estimates of their psychometric properties, were used to inform our combined estimate. The marginal posterior densities of all parameters were estimated using Hamiltonian Monte Carlo (HMC), a Markov Chain Monte Carlo technique. Summaries of posterior distributions, including the means and 95% equally tailed posterior credible intervals, were used for interpretation of the results. Results The combined prevalence mean was 8.6%, with a credible interval of 6.8–10.6%. This combined estimate sits between Bayesian-derived prevalence estimates from administrative data-derived diagnoses (mean = 7.4%) and the survey-derived diagnoses (mean = 13.9%). The results of our sensitivity analysis suggest that varying the specificity of the survey-derived measure has an appreciable impact on the combined posterior prevalence estimate. Our combined posterior prevalence estimate remained stable when varying other prior information. We detected no problematic HMC behaviour, and our posterior predictive checks suggest that our model can reliably recreate our data. Conclusions Accurate population-based estimates of disease are the cornerstone of health service planning and resource allocation. As a greater number of linked population data sources become available, so too does the opportunity for researchers to fully capitalise on the data. The true population prevalence of mood and anxiety disorders may reside between estimates obtained from survey data and health administrative data. We have demonstrated how the use of Bayesian approaches may provide a more informed and accurate estimate of mood and anxiety disorders in the population. This work provides a blueprint for future population-based estimates of disease using linked health data.

Factors affecting progression to permanent atrial fibrillation in an unselected population of patients with non-permanent form of atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V.L Malavasi ◽  
E Fantecchi ◽  
V Tordoni ◽  
L Melara ◽  
A Barbieri ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cox Regression ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Factors Affecting ◽  
Cox Proportional Hazard ◽  
Significant Difference ◽  
History Of ◽  
Unselected Population ◽  
Cox Proportional Hazard Regression

Abstract Background Natural history of atrial fibrillation (AF) shows a progression of arrhythmia from non-permanent to permanent AF. Permanent AF was found associated with a worse prognosis than non-permanent one. Aim To assess the factors associated with progression to permanent AF in an unselected population of AF patients with non-permanent AF. Methods In this prospective study we enrolled in- as well as out-patients with non-permanent AF and age ≥18 years, with at least one episode of ECG-documented AF within 1 year. The patients were followed-up at 1 month and every 6 months thereafter. Results Out of 523 patients, 314 (60%) were in non-permanent AF (80 [25.5%] paroxysmal AF, 165 [52.5%] persistent AF, 69 [2%] first diagnosed AF), mostly male (188, 59.9%), median age 71 years (IQ range 62–77), median CHA2DS2VASc 3 (1–4), median HATCH score 1 (1–2). After a median follow-up of 701 (IQ range 437–902) days, 66 patients (21%) showed permanent AF. CHA2DS2VASc and HATCH scores were incrementally associated to progression to permanent AF (CHA2DS2VASc χ2 p=0.001; HATCH χ2 p=0.017; p for trend CHA2DS2VASc <0.001, HATCH p=0.001). At multivariable Cox proportional hazard regression the following variables were significantly associated with AF progression: age (hazard ratio [HR] 1.041; 95% CI: 1.004–1.079; p=0.028), at least moderate left atrial (LA) enlargement (>42 ml/m2) (HR 2.092; 95% CI: 1.132–3.866; p=0.018), antiarrhythmics drugs after the enrollment (HR 0.087; 95% CI: 0.011–0.662; p=0.018), EHRA score >2 (HR 0.351; 95% CI: 0.158–0.779; p=0.010) and Valvular HD (HR 2.161; 95% CI: 1.057–4.420; p=0.035). Adding LA dilation to HATCH score (HATCH-LA) and assigning 2 points based on multivariable Cox regression, HATCH-LA was statistically better in ROC curves in prediction of AF progression vs HATCH score (area under the curve 0.695 vs 0.636; DeLong p=0.0225). Survival-free curves on freedom from permanent AF using as discriminator HATCH-LA score ≤2 vs >2 led to a statistically significant difference (χ2=16.080 p<0.001), but the same was not found for HATCH score (χ2 =3.099; p=0.078). Conclusions In patients without permanent AF, progression of AF was independentely related to age, LA dilation, AF symptoms severity, antiarrhythmic drugs and Valvular HD. HATCH score predicted AF progression and adding to it LA dilation (at least moderate) improved patients stratification for the risk of evolution to permanent AF. Funding Acknowledgement Type of funding source: None

scholarly journals Geometric morphometric investigation of craniofacial morphological change in domesticated silver foxes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Timothy M. Kistner ◽  
Katherine D. Zink ◽  
Steven Worthington ◽  
Daniel E. Lieberman
Keyword(s):  
Three Dimensional ◽  
Cranial Base ◽  
Craniofacial Morphology ◽  
Wild Populations ◽  
Linear Measurements ◽  
Skeletal Morphology ◽  
Geometric Morphometric ◽  
Domestication Syndrome ◽  
Morphometric Investigation ◽  
Unselected Population

AbstractTo test the effects of domestication on craniofacial skeletal morphology, we used three-dimensional geometric morphometrics (GM) along with linear and endocranial measurements to compare selected (domesticated) and unselected foxes from the Russian Farm-Fox Experiment to wild foxes from the progenitor population from which the farmed foxes are derived. Contrary to previous findings, we find that domesticated and unselected foxes show minimal differences in craniofacial shape and size compared to the more substantial differences between the wild foxes and both populations of farmed foxes. GM analyses and linear measurements demonstrate that wild foxes differ from farmed foxes largely in terms of less cranial base flexion, relatively expanded cranial vaults, and increased endocranial volumes. These results challenge the assumption that the unselected population of foxes kept as part of the Russian Farm-Fox experiment are an appropriate proxy for ‘wild’ foxes in terms of craniofacial morphology and highlight the need to include wild populations in further studies of domestication syndrome to disentangle the phenotypic effects of multiple selection pressures. These findings also suggest that marked increases in docility cannot be reliably diagnosed from shape differences in craniofacial skeletal morphology.

scholarly journals Where to go to in chlamydia control? From infection control towards infectious disease control

2021 ◽  
pp. sextrans-2021-054992
Author(s):  
Jan E A M van Bergen ◽  
Bernice Maria Hoenderboom ◽  
Silke David ◽  
Febe Deug ◽  
Janneke C M Heijne ◽  
...  
Keyword(s):  
Chlamydia Infection ◽  
Limited Evidence ◽  
Future Directions ◽  
Tubal Factor Infertility ◽  
Effectiveness Analysis ◽  
Population Prevalence ◽  
Tubal Factor ◽  
Health Relevance ◽  
Asymptomatic Infections

ObjectivesThe clinical and public health relevance of widespread case finding by testing for asymptomatic chlamydia infections is under debate. We wanted to explore future directions for chlamydia control and generate insights that might guide for evidence-based strategies. In particular, we wanted to know the extent to which we should pursue testing for asymptomatic infections at both genital and extragenital sites.MethodsWe synthesised findings from published literature and from discussions among national and international chlamydia experts during an invitational workshop. We described changing perceptions in chlamydia control to inform the development of recommendations for future avenues for chlamydia control in the Netherlands.ResultsDespite implementing a range of interventions to control chlamydia, there is no practice-based evidence that population prevalence can be reduced by screening programmes or widespread opportunistic testing. There is limited evidence about the beneficial effect of testing on pelvic inflammatory disease prevention. The risk of tubal factor infertility resulting from chlamydia infection is low and evidence on the preventable fraction remains uncertain. Overdiagnosis and overtreatment with antibiotics for self-limiting and non-viable infections have contributed to antimicrobial resistance in other pathogens and may affect oral, anal and genital microbiota. These changing insights could affect the outcome of previous cost–effectiveness analysis.ConclusionThe balance between benefits and harms of widespread testing to detect asymptomatic chlamydia infections is changing. The opinion of our expert group deviates from the existing paradigm of ‘test and treat’ and suggests that future strategies should reduce, rather than expand, the role of widespread testing for asymptomatic chlamydia infections.

scholarly journals Feasibility and accuracy of the automated software for dynamic quantification of left ventricular and atrial volumes and function in a large unselected population

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
G Italiano ◽  
G Tamborini ◽  
V Mantegazza ◽  
V Volpato ◽  
L Fusini ◽  
...  
Keyword(s):  
Machine Learning ◽  
Atrial Fibrillation ◽  
Image Quality ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Systolic Volume ◽  
Unselected Population ◽  
Lv Volumes ◽  
Time Required ◽  
2D Images

Abstract Funding Acknowledgements Type of funding sources: None. Objective. Preliminary studies showed the accuracy of machine learning based automated dynamic quantification of left ventricular (LV) and left atrial (LA) volumes. We aimed to evaluate the feasibility and accuracy of machine learning based automated dynamic quantification of LV and LA volumes in an unselected population. Methods. We enrolled 600 unselected patients (12% in atrial fibrillation) clinically referred for transthoracic echocardiography (2DTTE), who also underwent 3D echocardiography (3DE) imaging. LV ejection fraction (EF), LV and LA volumes were obtained from 2D images; 3D images were analysed using Dynamic Heart Model (DHM) software (Philips) resulting in LV and LA volume-time curves. A subgroup of 140 patients underwent also cardiac magnetic resonance (CMR) imaging. Average time of analysis, feasibility, and image quality were recorded and results were compared between 2DTTE, DHM and CMR. Results. The use of DHM was feasible in 522/600 cases (87%). When feasible, the boundary position was considered accurate in 335/522 patients (64%), while major (n = 38) or minor (n = 149) borders corrections were needed. The overall time required for DHM datasets was approximately 40 seconds, resulting in physiologically appearing LV and LA volume–time curves in all cases. As expected, DHM LV volumes were larger than 2D ones (end-diastolic volume: 173 ± 64 vs 142 ± 58 mL, respectively), while no differences were found for LV EF and LA volumes (EF: 55%±12 vs 56%±14; LA volume 89 ± 36 vs 89 ± 38 mL, respectively). The comparison between DHM and CMR values showed a high correlation for LV volumes (r = 0.70 and r = 0.82, p < 0.001 for end-diastolic and end-systolic volume, respectively) and an excellent correlation for EF (r= 0.82, p < 0.001) and LA volumes. Conclusions. The DHM software is feasible, accurate and quick in a large series of unselected patients, including those with suboptimal 2D images or in atrial fibrillation. Table 1 DHM quality Adjustment Feasibility Good Suboptimal Minor Major Total of patients (n, %) 522/600 (87%) 327/522 (62%) 195/522 (28%) 149/522 (29%) 38/522 (6%) Normal subjects (n, %) 39/40 (97%) 23/39 (57%) 16/39 (40%) 9/39 (21%) 1/39 (3%) Atrial Fibrillation (n, %) 59/73 (81%)* 28/59 (47%) 31/59 (53%) 15/59 (25%) 6/59 (10%) Valvular disease (n, %) 271/312 (87%) 120/271 (%) 151/271 (%) 65/271 (24%) 16/271 (6%) Coronary artery disease (n, %) 47/58 (81%)* 26/47 (46%) 21/47 (37%) 16/47 (34%) 5/47 (11%) Miscellaneous (n, %) 24/25 (96%) 18/24 (75%) 6/24 (25%) 5/24 (21%) 3/24 (12%) Feasibility of DHM, image quality and need to adjustments in global population and in each subgroup. Abstract Figure 1

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