50 research outputs found
Dose-response relationship between periodontal inflamed surface area and HbA1c in type 2 Diabetics
No full textNesse W, Linde A, Abbas F, Spijkervet FKL, Dijkstra PU, de Brabander EC, Gerstenbluth I, Vissink A. Dose-response relationship between periodontal inflamed surface area and HbA1c in type 2 diabetics. J Clin Periodontol 2009; 36: 295-300. doi: 10.1111/j.1600-051X.2009.01377.x. A dose-response relationship between the amount of inflamed periodontal tissue and HbA1c level, might be indicative for a causal association between periodontitis and type 2 diabetes. To assess a dose-response relationship between the periodontal inflamed surface area (PISA), as a measure of the amount of inflamed periodontal tissue, and HbA1c levels in type 2 diabetics. Forty consecutive dentate type 2 diabetics attending their general practitioner for regular check-up, underwent full-mouth probing pocket depth and bleeding on probing assessment. From these data PISA was calculated. HbA1c levels were retrieved from patients' medical files. The dose-response relationship between PISA and HbA1c levels was assessed using multiple linear regression analyses, controlling for factors that might influence PISA or HbA1c levels. The higher the PISA of type 2 diabetics was, the higher their HbA1c levels were. On a group level, an increase of PISA with 333 mm(2) was associated with a 1.0 percentage point increase of HbA1c, independent of the influence of other factors. On a group level, there is a dose-response relationship between PISA and HbA1c in type 2 diabetics. This might be an indication of a causal relationship between type 2 diabetes and periodontitis
One-year epidemiology of febrile diseases on the Emergency Department of a Caribbean island: the Curaçao-experience
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Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus
No full textObjectives: To evaluate waist circumference ( WC) as a screening tool for obesity in a Caribbean population. To identify risk groups with a high prevalence of ( central) obesity in a Caribbean population, and to evaluate associations between ( central) obesity and self-reported hypertension and diabetes mellitus. Design: Cross-sectional. Setting: Population-based study. Subjects: A random sample of adults (18 y or older) was selected from the Population Registries of three islands of the Netherlands Antilles. Response was over 80%. Complete data were available for 2025 subjects. Intervention: A questionnaire and measurements of weight, height, waist and hip. Main outcome measurement: Central obesity indicator (WC greater than or equal to102 cm men, greater than or equal to88 cm women). Results: WC was positively associated with age (65-74 y vs 18-24 y) in men (OR = 7.7, 95% CI 3.4-17.4) and women (OR = 6.4, 95% CI 3.2-12.7). Women with a low education had a higher prevalence of central obesity than women with a high education (OR 0.5, 95% CI 0.3-0.7). However, men with a high income had a higher prevalence of a central obesity than men with a low income (OR 1.7, 95% CI 1.1-2.6). WC was the strongest independent obesity indicator associated with self-reported hypertension (OR 1.7, 95% CI 1.4-2.0) and diabetes mellitus (OR 1.6, 95% CI 1.3-1.9). Conclusions: The identified risk groups were women aged 55-74 y, women with a low educational level and men with a high income. WC appears to be the major obesity indicator associated with hypertension and diabetes mellitus. Sponsorship: Island Governments of Saba, St Eustatius and Bonaire, the Federal Government of the Netherlands Antilles, Dutch Directorate for Kingdom relationships
Epidemiology of Febrile Diseases in the Emergency Department of a Caribbean Island: The Curaçao Experience
No full textObjective: The aetiology of febrile diseases in tropical countries often remains poorly characterized. We aim to describe the aetiology and outcome of febrile illnesses at the Emergency Department (ED) in Curaçao.
Methods: From April 2008 – April 2009, all adult febrile patients (T > 38.5°C) at the ED of the St Elisabeth Hospital, Curaçao, Netherlands Antilles, were included. Clinical data were recorded, routine laboratory measurements and blood cultures were taken. Final diagnoses were made at discharge by an independent physician and in retrospect by the main investigator.
Results: Four hundred and three patients were included: 223 patients (55.6%) were hospitalized, 32 patients (7.9%) died and 18 patients (4.5%) were admitted to the Intensive Care Unit. In 129 febrile patients (32.0%), infection was proven; 84.4% of patients had bacterial (29.0% urinary tract infection, 23.2% pneumonia infection), 5.6% viral and 10.0% parasitic or fungal infections. Twenty-one patients (5.2%) were discharged with a non-infectious diagnosis and 172 patients (42.7%) without a clear diagnosis.
Conclusion: A high mortality rate of 7.9% was observed. We found a high prevalence of bacterial infections, with pneumonia and urinary tract infections as the most common causes of fever. One in 20 patients did not have an infectious disease.
Keywords: Caribbean region, emergency medicine, epidemiology, fever
"Epidemiología de las Enfermedades Febriles en el Departamento de Emergencias de una Isla Caribeña: la Experiencia de Curazao"
RESUMEN
Objetivo: La etiología de las enfermedades febriles en los países tropicales posee aún una pobre caracterización. El presente trabajo se propone describir la etiología y la evolución clínica de las enfermedades febriles en el Departamento de Emergencias (DE) de Curazao.
Métodos: De abril 2008 – abril 2009, todos los pacientes febriles adultos (T > 38.5°C) en el DE del Hospital Saint Elisabeth, de Curazao, Antillas Holandesas, fueron incluidos. Se registraron los datos clínicos, se tomaron las medidas de rutina de laboratorio y los cultivos de sangre. Los diagnósticos finales se hicieron a la hora del alta por un médico independiente y en retrospectiva por el investigador principal.
Resultados: Se incluyeron cuatrocientos tres pacientes: 223 pacientes (55.6%) fueron hospitalizados, 32 pacientes (7.9%) murieron, y 18 pacientes (4.5%) fueron ingresados en la Unidad de Cuidados Intensivos. En 129 pacientes febriles (32.0%) se comprobó la infección; 84.4% de los pacientes tenían infección bacteriana (29.0% infección de las vías urinarias, 23.2% infección por pneumonia), 5.6% viral y 10.0% infección parasitaria o fúngica. Veintiún pacientes (5.2%) fueron dados de alta con un diagnóstico no infeccioso, y 172 pacientes (42.7%) sin un diagnóstico claro.
Conclusión: Se observó una alta tasa de mortalidad de 7.9%. Se halló una alta prevalencia de infecciones bacterianas, siendo la pneumonía y las infecciones de las vías urinarias las causas más comunes de fiebre. Uno de cada 20 pacientes no tenía una enfermedad infecciosa.
Palabras claves: región del Caribe, medicina de emergencia, epidemiología, fiebr
Sociocultural variations in help-seeking behavior for everyday symptoms and chronic disorders
No full textIn this study, we test the assumption that sociocultural differences in use of health services will only occur below a certain level of illness severity. Data are derived from the Curacao Health Study (n = 2248). Subjects' educational level and degree of proto-professionalization are used as indicators of their sociocultural background. Differences in the likelihood of seeking professional care for several common health problems are analyzed, and are compared with the help-seeking behavior for chronic disorders. As hypothesized, higher educated and proto-professionalized people are less likely to seek care for everyday symptoms. In addition, proto-professionalization is accompanied by a greater likelihood of using over the counter medication. Increasing empowerment of patients appears to lead to increased self care for everyday symptoms. When conditions reach a more serious stage, the differences in help-seeking behavior disappear: for most of the chronic conditions studied, the higher educated and more proto-professionalized individuals are just as likely to seek professional treatment as the less advantaged groups. However, there is a difference as to the type of professional consulted for chronic health problems. Proto-professionalized individuals more often receive specialist treatment, probably because they are better equipped to persuade GPs to refer. The adverse side of patient empowerment may be increasing consumerism: a situation in which patient demands, not medical necessity, determine the care delivered. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.</p
Sociolocultural variations in help-seeking behavior for everyday symptoms and chronic disorder
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