Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Clinical Relevance and Discriminatory Value of Elevated Liver Aminotransferase Levels for Dengue Severity  [PDF]
Linda K. Lee ,Victor C. Gan,Vernon J. Lee,Adriana S. Tan,Yee Sin Leo,David C. Lye
PLOS Neglected Tropical Diseases , 2012, DOI: 10.1371/journal.pntd.0001676
Abstract: Background Elevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) is prominent in acute dengue illness. The World Health Organization (WHO) 2009 dengue guidelines defined AST or ALT≥1000 units/liter (U/L) as a criterion for severe dengue. We aimed to assess the clinical relevance and discriminatory value of AST or ALT for dengue hemorrhagic fever (DHF) and severe dengue. Methodology/Principal Findings We retrospectively studied and classified polymerase chain reaction positive dengue patients from 2006 to 2008 treated at Tan Tock Seng Hospital, Singapore according to WHO 1997 and 2009 criteria for dengue severity. Of 690 dengue patients, 31% had DHF and 24% severe dengue. Elevated AST and ALT occurred in 86% and 46%, respectively. Seven had AST or ALT≥1000 U/L. None had acute liver failure but one patient died. Median AST and ALT values were significantly higher with increasing dengue severity by both WHO 1997 and 2009 criteria. However, they were poorly discriminatory between non-severe and severe dengue (e.g., AST area under the receiver operating characteristic [ROC] curve = 0.62; 95% confidence interval [CI]: 0.57–0.67) and between dengue fever (DF) and DHF (AST area under the ROC curve = 0.56; 95% CI: 0.52–0.61). There was significant overlap in AST and ALT values among patients with dengue with or without warning signs and severe dengue, and between those with DF and DHF. Conclusions Although aminotransferase levels increased in conjunction with dengue severity, AST or ALT values did not discriminate between DF and DHF or non-severe and severe dengue.
Evaluation of the Traditional and Revised WHO Classifications of Dengue Disease Severity  [PDF]
Federico Narvaez equal contributor,Gamaliel Gutierrez equal contributor,Maria Angeles Pérez,Douglas Elizondo,Andrea Nu?ez,Angel Balmaseda,Eva Harris
PLOS Neglected Tropical Diseases , 2011, DOI: 10.1371/journal.pntd.0001397
Abstract: Dengue is a major public health problem worldwide and continues to increase in incidence. Dengue virus (DENV) infection leads to a range of outcomes, including subclinical infection, undifferentiated febrile illness, Dengue Fever (DF), life-threatening syndromes with fluid loss and hypotensive shock, or other severe manifestations such as bleeding and organ failure. The long-standing World Health Organization (WHO) dengue classification and management scheme was recently revised, replacing DF, Dengue Hemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS) with Dengue without Warning Signs, Dengue with Warning Signs (abdominal pain, persistent vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement, increasing hematocrit with decreasing platelets) and Severe Dengue (SD; dengue with severe plasma leakage, severe bleeding, or organ failure). We evaluated the traditional and revised classification schemes against clinical intervention levels to determine how each captures disease severity using data from five years (2005–2010) of a hospital-based study of pediatric dengue in Managua, Nicaragua. Laboratory-confirmed dengue cases (n = 544) were categorized using both classification schemes and by level of care (I–III). Category I was out-patient care, Category II was in-patient care that did not meet criteria for Category III, which included ICU admission, ventilation, administration of inotropic drugs, or organ failure. Sensitivity and specificity to capture Category III care for DHF/DSS were 39.0% and 75.5%, respectively; sensitivity and specificity for SD were 92.1% and 78.5%, respectively. In this data set, DENV-2 was found to be significantly associated with DHF/DSS; however, this association was not observed with the revised classification. Among dengue-confirmed cases, the revised WHO classification for severe dengue appears to have higher sensitivity and specificity to identify cases in need of heightened care, although it is no longer as specific for a particular pathogenic entity as was the traditional schema.
Early Warning Signs in Social-Ecological Networks  [PDF]
Samir Suweis, Paolo D'Odorico
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0101851
Abstract: A number of social-ecological systems exhibit complex behaviour associated with nonlinearities, bifurcations, and interaction with stochastic drivers. These systems are often prone to abrupt and unexpected instabilities and state shifts that emerge as a discontinuous response to gradual changes in environmental drivers. Predicting such behaviours is crucial to the prevention of or preparation for unwanted regime shifts. Recent research in ecology has investigated early warning signs that anticipate the divergence of univariate ecosystem dynamics from a stable attractor. To date, leading indicators of instability in systems with multiple interacting components have remained poorly investigated. This is a major limitation in the understanding of the dynamics of complex social-ecological networks. Here, we develop a theoretical framework to demonstrate that rising variance—measured, for example, by the maximum element of the covariance matrix of the network—is an effective leading indicator of network instability. We show that its reliability and robustness depend more on the sign of the interactions within the network than the network structure or noise intensity. Mutualistic, scale free and small world networks are less stable than their antagonistic or random counterparts but their instability is more reliably predicted by this leading indicator. These results provide new advances in multidimensional early warning analysis and offer a framework to evaluate the resilience of social-ecological networks.
Early warning signs in social-ecological networks  [PDF]
Samir Suweis,Paolo D'Odorico
Quantitative Biology , 2014,
Abstract: Social ecological systems are often difficult to investigate and manage because of their inherent complexity1. Small variations in external drivers can lead to abrupt changes associated with instabilities and bifurcations in the underlying dynamics2-4. Anticipating critical transitions and divergence from the present state of the system is particularly crucial to the prevention or mitigation of the effects of unwanted and irreversible changes5-10. Recent research in ecology has focused on leading indicators of regime shift in ecosystems characterized by one state variable5,7,11,12. The case of systems with several mutually interacting components, however, has remained poorly investigated13, while the connection between network stability and research on indicators for loss of resilience has been elusive14. Here we develop a theoretical framework to analyze early warning signs of instability and regime shift in social ecological networks. We provide analytical expressions for a set of precursors of instability in social ecological systems with additive noise for a variety of network structures. In particular, we show that the covariance matrix of the dynamics can effectively anticipate the emergence of instability. We also compare signals of early warning based on the dynamics of suitably selected nodes, to indicators based on the integrated behavior of the whole network. We find that the performances of these indicators are affected by the network structure and the type of interaction among nodes. These results provide new advances in multidimensional early warning analysis and offer a framework to evaluate the resilience of social ecological networks.
Terminology in “Rural Community Knowledge of Stroke Warning Signs and Risk Factors”
Michael W. Day, RN, MSN, CCRN
Preventing Chronic Disease , 2005,
Abstract: While I appreciate the effort of Blades et al in conducting the valuable research for “Rural Community Knowledge of Stroke Warning Signs and Risk Factors” (1), I believe that respondents to the survey do not necessarily represent rural communities.
Awareness of the Warning Signs, Risk Factors, and Treatment for Tuberculosis among Urban Nigerians  [PDF]
Olufemi O. Desalu,Adekunle O. Adeoti,Abayomi Fadeyi,Alakija K. Salami,Ademola E. Fawibe,Olanrewaju O. Oyedepo
Tuberculosis Research and Treatment , 2013, DOI: 10.1155/2013/369717
Abstract: Objectives. To determine the awareness of the warning signs, risk factors, and treatment of tuberculosis among urban Nigerians. Methods. This was a cross-sectional survey among 574 adults in Ilorin, Nigeria. Semistructured questionnaire was administered by trained interviewers to obtain information about awareness of tuberculosis warning signs, risk factors, and treatment. Results. Majority of the subjects (71.4%) were aware of at least one warning sign of tuberculosis. Cough (66.2%), weight loss (38.0%), and haemoptysis (30.7%) were the most identified warning signs. The predictors of awareness of warning sign were increasing age ( ), higher family income ( ), higher level of education ( ), and belonging to Christian faith ( ). Awareness of risk factors for tuberculosis was higher for tobacco smokers (77.0%) and history of contact with a case of TB (76.0%). Less than half were aware of HIV infection (49.8%), alcohol consumption (42.5%), chronic kidney disease (40.4%), extremes of ages (39.4%), cancers (36.9%), and diabetes mellitus (27.5%) as risk factors for TB. Tuberculosis was reported to be curable by 74.6% of the subjects and 67.9% knew that there are medications for treatment of tuberculosis, while 11.5% knew the duration of treatment. Conclusion. This study has revealed that the awareness of HIV and noncommunicable diseases as risk factors for TB is poor. This study has therefore demonstrated the need for health education programs that will emphasize recognition, identification, and modification of risk factor for TB. 1. Introduction Tuberculosis (TB) is a chronic infectious disease caused by a bacterium called Mycobacterium tuberculosis. It usually affects the lungs in 80% of cases with warning signs of cough, haemoptysis, and chest pain, shortness of breath, fever, weight loss, and drenching night sweat [1]. TB is spread mainly through the air inform of droplets. When infectious people cough, sneeze, talk, laugh or spit, droplets containing Mycobacterium tuberculosis are sprayed into the air. People nearby may inhale the bacteria and become infected. Mycobacterium tuberculosis can remain viable as air-borne droplet suspended in the air for a long time or as part of house dust for weeks. However, transmission usually occurs only after substantial exposure to someone with active TB [1, 2]. A person can be infected by Mycobacterium tuberculosis for many years without getting sick or spreading the organism to other people. If the immune system is weakened by immunosuppressive disease like HIV infection, diabetes mellitus, malignancy, chronic
Rural Community Knowledge of Stroke Warning Signs and Risk Factors
Todd S. Harwell, MPH,Lynda L. Blades, MPH, CHES,Carrie S. Oser, MPH,Crystelle C. Fogle, MBA, MS, RD
Preventing Chronic Disease , 2005,
Abstract: Introduction Rapid identification and treatment of ischemic stroke can lead to improved patient outcomes. Public education campaigns in selected communities have helped to increase knowledge about stroke, but most data represent large metropolitan centers working with academic institutions. Much less is known about knowledge of stroke among residents in rural communities. Methods In 2004, 800 adults aged 45 years and older from two Montana counties participated in a telephone survey using unaided questions to assess awareness of stroke warning signs and risk factors. The survey also asked respondents if they had a history of atrial fibrillation, diabetes, high blood pressure, high cholesterol, smoking, heart disease, or stroke. Results More than 70% of survey participants were able to correctly report two or more warning signs for stroke: numbness on any side of the face/body (45%) and speech difficulties (38%) were reported most frequently. More than 45% were able to correctly report two or more stroke risk factors: smoking (50%) and high blood pressure (44%) were reported most frequently. Respondents aged 45 to 64 years (odds ratio [OR] 2.44; 95% confidence interval [CI], 1.78 3.46), women (OR 2.02; 95% CI, 1.46 2.80), those with 12 or more years of education (OR 1.96; 95% CI, 1.08 3.56), and those with high cholesterol (OR 1.68; 95% CI, 1.17 2.42) were more likely to correctly identify two or more warning signs compared with respondents without these characteristics. Women (OR 1.48; 95% CI, 1.07 2.05) and respondents aged 45 to 64 years (OR 1.35; 95% CI, 1.01 1.81) were also more likely to correctly identify two or more stroke risk factors compared with men and older respondents. Conclusion Residents of two rural counties were generally aware of stroke warning signs, but their knowledge of stroke risk factors was limited.
Warning Signs and its Impact on Decrease of Accidents in a Manufacturing Factory  [cached]
Iraj Mohammadfam,Saeed Amiri,Morteza Sadehi
Journal of Research in Health Sciences , 2011,
Abstract: Background: All recent accident models emphasis on multi causality of accidents. The suggested models emphasized on human roles in accident occurrence. The results of recent decade's studies have shown that the main causes of accidents are human and his/her unsafe Acts. Nowadays, application of warning signs is an important way to decrease unsafe acts. Methods: In this study, the unsafe acts on a factory worker in Hamadan were evaluated by safety behavior sampling method, observation and interview in 2002. After description of unsafe acts, the sample size was estimated 515 observations based on results of pilot study and sampling accuracy of 5% and confidence level to 95%. A questionnaire was used to collect the variables concerned to the workers. Warning signs were used to control unsafe acts. Results: The results showed that the workers unsafe acts prior to intervention were 31 %. The most important unsafe acts were lack of use or abuse of personal protective equipment with 89.4% of the total unsafe acts. The rate of unsafe acts reduced to 22.3% after intervention. The most important unsafe acts were also as the mentioned. The results were shown a significant difference between the rate of unsafe acts after and before intervention (P < 0.01). Also, statistical significance decrease of unsafe acts were obtained between age, job (P < 0.01) and marriage (P < 0.05) after intervention. Conclusion: The findings of the present study showed that a considerable part of worker's acts was unsafe. Today, unsafe acts are the basic elements of accidents in workers. Therefore, the findings emphasize on decrease of unsafe acts by applying warning signs.
Awareness of stroke risk factors and warning signs in southern Brazil
Falavigna, Asdrubal;Teles, Alisson Roberto;Vedana, Viviane Maria;Kleber, Fabrício Diniz;Mosena, Gabriela;Velho, Maíra Cristina;Mazzocchin, Thaís;Silva, Roberta Castilhos da;Lucena, Luzia Fernanda;Santin, Juliana Tosetto;Roth, Felipe;
Arquivos de Neuro-Psiquiatria , 2009, DOI: 10.1590/S0004-282X2009000600022
Abstract: objective: to evaluate the knowledge about stroke in caxias do sul. method: a closed-ended, self-administered questionnaire was used to assess the knowledge about stroke among residents of caxias do sul. in order to verify variables associated to lack of knowledge we defined three main end points: (1) the inability to recognize that stroke is a disease that affects the brain; (2) insufficient knowledge of risk factors; (3) insufficient knowledge of signs and symptoms of acute stroke. results: a total of 952 subjects answered the questionnaire. lower income and lower educational level were independent factors associated to inability to recognize that stroke affects the brain. lower income and being under 50 years old were independent risk factors to lack of knowledge concerning stroke risk factors. lower educational level was the unique risk factor for insufficient knowledge about stroke warning signs. conclusion: there is a lack of knowledge about stroke in caxias do sul. people with lower socioeconomic status and lower education level should be the targets of educational campaigns.
Early Warning Signs of the Economic Crisis in Greece: A Warning for Other Countries and Regions  [PDF]
Ron W Nielsen
Quantitative Finance , 2015,
Abstract: Warning signs about the developing economic crisis in Greece were present in the growth rate of the Gross Domestic Product (GDP) and in the growth of the GDP well before the economic collapse. The growth rate was strongly unstable. On average, in less than 50 years, it decreased 10-folds but after reaching a low minimum it quickly increased 6-folds only to crash before completing the full cycle. The decreasing growth rate was leading to an asymptotic maximum of the GDP but it was soon replaced by a fast-increasing growth rate propelling the GDP along a pseudo-hyperbolic trajectory, which if continued would have escaped to infinity in 2017. Such a growth could not have been possibly supported. Under these conditions, the economic collapse in Greece was inevitable.
Page 1 /100
Display every page Item

Copyright © 2008-2017 Open Access Library. All rights reserved.