Congenital syphilis as a notifiable disease

A review of the notification of congenital syphilis at Johannesburg Hospital from 1 May 1991 to 30 April 1992 was conducted to evaluate the effect of the recently introduced notification programme. A total of 209 Wassermann reaction (WR)-positive mothers were delivered during this time; 12 pregnancies (5,7%) resulted in stillbirths and 8 (3,8%) in incomplete abortions, and there were 2 (0,96%) early neonatal deaths. Only 45 (21,5%) of this group of WR-positive mothers had received antenatal care, and of these 9 (20%) had had adequately documented treatment. There were thus 200 potentially notifiable cases of congenital syphilis according to the Centers for Disease Control classification, of which 24 (12,0%) were actually notified. The goals ofthe notification programme, namely to increase awareness of congenital syphilis among health care providers and to evaluate the extent of the problem accurately, are clearly not being Illet

Public health programmes, packages and processes

No Abstrac

Energy expenditure in office workers with identified health risks

Objective. To measure the daily energy expenditure in employees previously identified as having ≥2 risk factors for chronic disease, and to identify potential risk-reducing interventions for implementation within or outside the workplace. Design. A total of 122 employees with ≥2 risk factors for chronic disease identified in an in-house screening programme were invited to participate in a 6-month health management programme. Physical assessments included anthropometric measurements, blood pressure, blood glucose and cholesterol estimations, and bicycle ergometry. Participants were invited to wear a ‘metabolic armband' (Body Media SenseWear Pro Armband®) for 6 days. Metabolic measures included active and total energy expenditure (AEE, TEE), and daily MET levels (metabolic equivalents expressed as kcal/kg/hour). Differences were explored between genders, and relationships sought between energy expenditure, lifestyle and anthropometric data. Setting. A corporate working environment. All measures and assessments were carried out in the in-house fitness facility. Interventions. The health management programme involved physical assessments and personalised weight and activity management plans. Main outcome measures. TEE per day, duration and quantification of physical activity, METS, AEE, number of steps per day and body position recording. Relationships were explored between the latter and anthropometric measures such as body mass index (BMI) and percentage body fat. Result. Altogether 53 (43%) of the eligible subjects volunteered for the 6-month programme and 49 enrolled for the metabolic armband study. The males were more active than the females, but both had BMI and body fat estimates that categorised them as overweight to obese. METS and AEE were positively correlated with duration of exercise rather than intensity, and negatively correlated with BMI. In a stepwise regression analysis for the total group 77% of the variance in MET levels was accounted for by per cent body fat and steps per day. Multivariate analysis by gender (with per cent body fat as the dependent variable) suggested that males would have to increase the duration of vigorous exercise in order to reduce body fat, while females would benefit from sitting less, sleeping more, and increasing the duration of moderate exercise. Conclusion and clinical relevance. In a self-selected sample involving motivated individuals, the SenseWear® armband provided information that would be useful in directing further research in women, focusing on sleeping pattern and moderately increasing activity levels. South African Journal of Sports Medicine Vol. 20 (2) 2008: pp. 40-4

of surfactant replacement therapy at Johannesburg Hospital, November 1991 December 1992

Objective. To assess the impact of surfactant replacement therapy (SRl) on the outcome of hyaline membrane disease (HMD) and to assess the cost implications of a policy of selective administration of artificial surfactant. Design. The short-term outcome of 103 newborns ventilated for HMD (61 selected for SRT according to initial and/or ongoing oxygen requirements) was compared with that of a historical control group of 173 infants ventilated for HMD before the introduction of SRT. Main outcome measures. Mortality and morbidity of HMD including death, bronchopulmonary dysplasia, pneumothorax, pulmonary haemorrhage, patent ductus arteriosus and intraventricular haemorrhage. Results. There were significant demographic differences between the treatment and control groups (black patients 74% v. 28%, P < 0,0001; unbooked mothers 72% v. 15%, P < 0,0001) as well as evidence of more severe lung disease in the treatment group (pressor support 44% v. 27%, P < 0,005; and paralysis during ventilation 38% v. 25%, P < 0,005). Pneumothorax was reduced in the SRT group (7% v. 17%, P < 0,01). There were no significant differences between the two groups in the incidence of BPO or mortality. The use of SRT added to the total cost of treating a patient ventilated for HMD. Conclusion. The selective use of SRT had the effect of converting severe -disease into moderate disease rather than achieVing maximal benefit in all cases of HMD through routine use of the product. A policy of restricting use may result in cost savings where resources are limited.S Afr Med J 1995; 85; 646-649

Energy expenditure in office workers with identified health risks

Objective. To measure the daily energy expenditure in employees previously identified as having ≥2 risk factors for chronic disease, and to identify potential risk-reducing interventions for implementation within or outside the workplace. Design. A total of 122 employees with ≥2 risk factors for chronic disease identified in an in-house screening programme were invited to participate in a 6-month health management programme. Physical assessments included anthropometric measurements, blood pressure, blood glucose and cholesterol estimations, and bicycle ergometry. Participants were invited to wear a ‘metabolic armband' (Body Media SenseWear Pro Armband®) for 6 days. Metabolic measures included active and total energy expenditure (AEE, TEE), and daily MET levels (metabolic equivalents expressed as kcal/kg/hour). Differences were explored between genders, and relationships sought between energy expenditure, lifestyle and anthropometric data. Setting. A corporate working environment. All measures and assessments were carried out in the in-house fitness facility. Interventions. The health management programme involved physical assessments and personalised weight and activity management plans. Main outcome measures. TEE per day, duration and quantification of physical activity, METS, AEE, number of steps per day and body position recording. Relationships were explored between the latter and anthropometric measures such as body mass index (BMI) and percentage body fat. Result. Altogether 53 (43%) of the eligible subjects volunteered for the 6-month programme and 49 enrolled for the metabolic armband study. The males were more active than the females, but both had BMI and body fat estimates that categorised them as overweight to obese. METS and AEE were positively correlated with duration of exercise rather than intensity, and negatively correlated with BMI. In a stepwise regression analysis for the total group 77% of the variance in MET levels was accounted for by per cent body fat and steps per day. Multivariate analysis by gender (with per cent body fat as the dependent variable) suggested that males would have to increase the duration of vigorous exercise in order to reduce body fat, while females would benefit from sitting less, sleeping more, and increasing the duration of moderate exercise. Conclusion and clinical relevance. In a self-selected sample involving motivated individuals, the SenseWear® armband provided information that would be useful in directing further research in women, focusing on sleeping pattern and moderately increasing activity levels. South African Journal of Sports Medicine Vol. 20 (2) 2008: pp. 40-4

The Impact of Pandemic Influenza H1N1 on Health-Related Quality of Life: A Prospective Population-Based Study

BACKGROUND: While the H1N1v influenza pandemic in 2009 was clinically mild, with a low case-fatality rate, the overall disease burden measured in quality-adjusted life years (QALY) lost has not been estimated. Such a measure would allow comparison with other diseases and assessment of the cost-effectiveness of pandemic control measures. METHODS AND FINDINGS: Cases of H1N1v confirmed by polymerase chain reaction (PCR) and PCR negative cases with similar influenza-like illness (ILI controls) in 7 regions of England were sent two questionnaires, one within a week of symptom onset and one two weeks later, requesting information on duration of illness, work loss and antiviral use together with EQ-5D questionnaires. Results were compared with those for seasonal influenza from a systematic literature review. A total QALY loss for the 2009 pandemic in England was calculated based on the estimated total clinical cases and reported deaths. A total of 655 questionnaires were sent and 296 (45%) returned. Symptoms and average illness duration were similar between confirmed cases and ILI controls (8.8 days and 8.7 days respectively). Days off work were greater for cases than ILI controls (7.3 and 4.9 days respectively, p  =  0.003). The quality-adjusted life days lost was 2.92 for confirmed cases and 2.74 for ILI controls, with a reduction in QALY loss after prompt use of antivirals in confirmed cases. The overall QALY loss in the pandemic was estimated at 28,126 QALYs (22,267 discounted) of which 40% was due to deaths (24% with discounting). CONCLUSION: Given the global public health significance of influenza, it is remarkable that no previous prospective study of the QALY loss of influenza using standardised and well validated methods has been performed. Although the QALY loss was minor for individual patients, the estimated total burden of influenza over the pandemic was substantial when compared to other infectious diseases

A Case of Unerupted Lower Primary Second Molar Associated with Compound Odontoma

Odontoma is the most common type of benign odontogenic tumor, and often causes disturbances in the eruption of its associated tooth. Odontomas usually occur in the permanent dentition, and rarely occur solely in the primary dentition. This case report documents a six-year-old-child with a compound odontoma located in the mandible, which caused the impaction of the primary second molar

Jet energy measurement with the ATLAS detector in proton-proton collisions at root s=7 TeV

The jet energy scale and its systematic uncertainty are determined for jets measured with the ATLAS detector at the LHC in proton-proton collision data at a centre-of-mass energy of √s = 7TeV corresponding to an integrated luminosity of 38 pb-1. Jets are reconstructed with the anti-kt algorithm with distance parameters R=0. 4 or R=0. 6. Jet energy and angle corrections are determined from Monte Carlo simulations to calibrate jets with transverse momenta pT≥20 GeV and pseudorapidities {pipe}η{pipe}<4. 5. The jet energy systematic uncertainty is estimated using the single isolated hadron response measured in situ and in test-beams, exploiting the transverse momentum balance between central and forward jets in events with dijet topologies and studying systematic variations in Monte Carlo simulations. The jet energy uncertainty is less than 2. 5 % in the central calorimeter region ({pipe}η{pipe}<0. 8) for jets with 60≤pT<800 GeV, and is maximally 14 % for pT<30 GeV in the most forward region 3. 2≤{pipe}η{pipe}<4. 5. The jet energy is validated for jet transverse momenta up to 1 TeV to the level of a few percent using several in situ techniques by comparing a well-known reference such as the recoiling photon pT, the sum of the transverse momenta of tracks associated to the jet, or a system of low-pT jets recoiling against a high-pT jet. More sophisticated jet calibration schemes are presented based on calorimeter cell energy density weighting or hadronic properties of jets, aiming for an improved jet energy resolution and a reduced flavour dependence of the jet response. The systematic uncertainty of the jet energy determined from a combination of in situ techniques is consistent with the one derived from single hadron response measurements over a wide kinematic range. The nominal corrections and uncertainties are derived for isolated jets in an inclusive sample of high-pT jets. Special cases such as event topologies with close-by jets, or selections of samples with an enhanced content of jets originating from light quarks, heavy quarks or gluons are also discussed and the corresponding uncertainties are determined. © 2013 CERN for the benefit of the ATLAS collaboration

Measurement of the inclusive and dijet cross-sections of b-jets in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

The inclusive and dijet production cross-sections have been measured for jets containing b-hadrons (b-jets) in proton-proton collisions at a centre-of-mass energy of sqrt(s) = 7 TeV, using the ATLAS detector at the LHC. The measurements use data corresponding to an integrated luminosity of 34 pb^-1. The b-jets are identified using either a lifetime-based method, where secondary decay vertices of b-hadrons in jets are reconstructed using information from the tracking detectors, or a muon-based method where the presence of a muon is used to identify semileptonic decays of b-hadrons inside jets. The inclusive b-jet cross-section is measured as a function of transverse momentum in the range 20 < pT < 400 GeV and rapidity in the range |y| < 2.1. The bbbar-dijet cross-section is measured as a function of the dijet invariant mass in the range 110 < m_jj < 760 GeV, the azimuthal angle difference between the two jets and the angular variable chi in two dijet mass regions. The results are compared with next-to-leading-order QCD predictions. Good agreement is observed between the measured cross-sections and the predictions obtained using POWHEG + Pythia. MC@NLO + Herwig shows good agreement with the measured bbbar-dijet cross-section. However, it does not reproduce the measured inclusive cross-section well, particularly for central b-jets with large transverse momenta.Comment: 10 pages plus author list (21 pages total), 8 figures, 1 table, final version published in European Physical Journal