11 research outputs found

    Latitude gradient influences the age of onset of rheumatoid arthritis : a worldwide survey

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    The age of onset of rheumatoid arthritis (RA) is an important outcome predictor. Northern countries report an age of RA onset of around 50 years, but apparently, variability exists across different geographical regions. The objective of the present study is to assess whether the age of onset of RA varies across latitudes worldwide. In a proof-of-concept cross-sectional worldwide survey, rheumatologists from preselected cities interviewed 20 consecutive RA patients regarding the date of RA onset (RAO, when the patient first noted a swollen joint). Other studied variables included location of each city, rheumatologist settings, latitudes (10A degrees increments, south to north), longitudes (three regions), intracountry consistency, and countries' Inequality-adjusted Human Development Index (IHDI). Data from 2481 patients (82% females) were obtained from 126 rheumatologists in 77 cities of 41 countries. Worldwide mean age of RAO was 44 +/- 14 years (95% CI 44-45). In 28% of patients, RA began before age 36 years and before age 46 years in 50% of patients. RAO was 8 years earlier around the Tropic of Cancer when compared with northern latitudes (p <0.001, 95% CI 3.5-13). Multivariate analysis showed that females, western cities, and latitudes around the Tropic of Cancer are associated with younger age of RAO (R (2) 0.045, p <0.001). A positive correlation was found between the age of RAO and IHDI (r = 0.7, p <0.01, R (2) 0.5). RA often begins at an early age and onset varies across latitudes worldwide. We postulate that countries' developmental status and their geographical and geomagnetic location influence the age of RAO.Peer reviewe

    Agricultura, medio ambiente y pobreza rural en América Latina

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    La compatibilización entre el desarrollo agropecuario, la reducción de la pobreza rural y la conservación de los recursos naturales y del medio ambiente constituye uno de los más importantes desafíos que actualmente enfrenta la humanidad. En 1995 el Instituto Internacional de Investigaciones sobre Políticas Alimentarias (IFPRI) puso en marcha su iniciativa Visión 2020, dirigida a estimular el diálogo y el diseño de políticas que consideren globalmente los asuntos de la agricultura, la alimentación, los recursos naturales y el desarrollo rural y de este modo apreciar mejor su impacto en el resto de la economía y la sociedad. Durante 1996, con el apoyo de los Ministerios de Agricultura de México, Colombia y Argentina se llevaron a cabo tres seminarios regionales en América Latina que contaron con la participación de expertos del sector público y privado que lograron estimular la discusión pública alrededor de estos temas. Esta publicación recoge un conjunto de trabajos presentados en dichos seminarios

    Upward trends in symptom reporting in the UK Armed Forces.

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    Several reports have shown increases in the prevalence of non-specific symptoms in the general population. Research in the military tends to focus on comparisons between deployed and non-deployed personnel and does not examine trends over time. 4,257 and 4,295 male participants of the Gulf war and Iraq war studies not deployed to either of these wars were randomly sampled and surveyed in 1997/1998 and 2004/2006 in two independent cross-sectional studies. Information was collected on 50 symptoms and the General Health Questionnaire (GHQ-12). Factor analysis was performed to identify an underlying pattern of symptom dimensions, and multivariate regressions were carried out to examine changes in symptom dimensions between the two surveys and the possible role of psychological morbidity. Factor analysis identified a robust pattern of eight symptom dimensions. An increase in the prevalence of symptoms was evident across all symptom dimensions. Adjustment for demographic and service characteristics revealed increases in the odds of scoring highly on symptom dimensions, varying from odds ratios 1.57, 95% CI 1.36-1.81 (cardio-respiratory dimension) to 2.24, 95% CI 1.93-2.60 (fatigue dimension). Unexpectedly, increases were even greater when adjusting for psychological morbidity. There is clear evidence of an increase in the reporting of non-specific symptoms over a 7 year period in the UK Armed Forces. It suggests that the threshold for reporting symptoms has decreased and cannot be explained by psychological distress. The possible implication of this trend for medical practice in the wider population deserves close scrutiny

    Fast Parabola Detection Using Estimation of Distribution Algorithms

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    This paper presents a new method based on Estimation of Distribution Algorithms (EDAs) to detect parabolic shapes in synthetic and medical images. The method computes a virtual parabola using three random boundary pixels to calculate the constant values of the generic parabola equation. The resulting parabola is evaluated by matching it with the parabolic shape in the input image by using the Hadamard product as fitness function. This proposed method is evaluated in terms of computational time and compared with two implementations of the generalized Hough transform and RANSAC method for parabola detection. Experimental results show that the proposed method outperforms the comparative methods in terms of execution time about 93.61% on synthetic images and 89% on retinal fundus and human plantar arch images. In addition, experimental results have also shown that the proposed method can be highly suitable for different medical applications

    Agricultura, medio ambiente y pobreza rural en América Latina

    No full text
    La compatibilización entre el desarrollo agropecuario, la reducción de la pobreza rural y la conservación de los recursos naturales y del medio ambiente constituye uno de los más importantes desafíos que actualmente enfrenta la humanidad. En 1995 el Instituto Internacional de Investigaciones sobre Políticas Alimentarias (IFPRI) puso en marcha su iniciativa Visión 2020, dirigida a estimular el diálogo y el diseño de políticas que consideren globalmente los asuntos de la agricultura, la alimentación, los recursos naturales y el desarrollo rural y de este modo apreciar mejor su impacto en el resto de la economía y la sociedad. Durante 1996, con el apoyo de los Ministerios de Agricultura de México, Colombia y Argentina se llevaron a cabo tres seminarios regionales en América Latina que contaron con la participación de expertos del sector público y privado que lograron estimular la discusión pública alrededor de estos temas. Esta publicación recoge un conjunto de trabajos presentados en dichos seminarios

    Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

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    Item does not contain fulltextOBJECTIVES: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use
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