FluDetWeb: an interactive web-based system for the early detection of the onset of influenza epidemics.

BACKGROUND: The early identification of influenza outbreaks has became a priority in public health practice. A large variety of statistical algorithms for the automated monitoring of influenza surveillance have been proposed, but most of them require not only a lot of computational effort but also operation of sometimes not-so-friendly software. RESULTS: In this paper, we introduce FluDetWeb, an implementation of a prospective influenza surveillance methodology based on a client-server architecture with a thin (web-based) client application design. Users can introduce and edit their own data consisting of a series of weekly influenza incidence rates. The system returns the probability of being in an epidemic phase (via e-mail if desired). When the probability is greater than 0.5, it also returns the probability of an increase in the incidence rate during the following week. The system also provides two complementary graphs. This system has been implemented using statistical free-software (R and WinBUGS), a web server environment for Java code (Tomcat) and a software module created by us (Rdp) responsible for managing internal tasks; the software package MySQL has been used to construct the database management system. The implementation is available on-line from: http://www.geeitema.org/meviepi/fludetweb/. CONCLUSION: The ease of use of FluDetWeb and its on-line availability can make it a valuable tool for public health practitioners who want to obtain information about the probability that their system is in an epidemic phase. Moreover, the architecture described can also be useful for developers of systems based on computationally intensive methods.

Stroke in Spain: epidemiologic incidence and patterns; a health sentinel network study.

INTRODUCTION: Cerebrovascular disease is among the 4 main causes of mortality in Spain. The objective of this study was to estimate the incidence of stroke and to describe the principal risk factors and other clinical and epidemiologic patterns found in patients. METHODS: Doctors from the Spanish sentinel health network recorded the episodes of acute cerebrovascular diseases in 2005 in a population of 201,205 inhabitants older than 14 years. The information of the patients (age and sex) and the episode (e.g., duration, symptoms, origin, medical attention, risk factors) was collected on a standard form. RESULTS: The estimated incidence rate of stroke was 141 cases per 100,000 inhabitants (confidence interval [CI] 95%: 125-158), 134 (95% CI: 112-157) in women and 148 (95% CI: 124-172) in men. The incidence increases significantly from the age of 65 years and men younger than this have higher rates than women. In all, 12% of patients with stroke die within the first 24 hours. CONCLUSIONS: Incidence of cerebrovascular disease in Spain is below that recorded in other countries. There is no difference according to sex, but incidence among young and middle-aged men is greater than that among women. Significant variations from some population groups to others are observed, maybe because of the difference in the prevalence of risk factors.

Worm-like artifacts in exfoliative cytology.

The presence of worms in cytological smears is occasionally reported, although various other structures exist that may be confused with such parasites. We present eight worm-like artifacts observed in routine Papanicolaou smears. Recognition of these structures is important to avoid overvaluation or confusion with true worms.

Airborne fungal spores, pollen grains, and vegetable cells in routine Papanicolaou smears.

The objective was to demonstrate the presence of airborne fungal spores, pollen grains, and vegetable cells in smears and establish their significance. Microscopic examination was of smears stained by the Papanicolaou technique. We found several types of airborne spores (Alternaria, Exserohilum, Aspergillus, Cladosporium, Epicoccum, Curvularia, and Ascosmycete), pollen grains (Lilium, bullrush, Pinus, Acacia, hazelnut, and oak), and several types of vegetable cells. The existence of these structures may be due to intrinsic or to extrinsic contamination of the sample. Anemophilous fungi spores and pollen grains have been shown to possess great allergenic capacity. Pollen grains and vegetable cells may be mistaken for certain microorganisms or malignant cells.