Evaluation of a federally funded mass media campaign and smoking cessation in pregnant women: a population-based study in three states.

OBJECTIVES: In 2012, theCenters for Disease Control and Prevention initiated a national anti-smoking campaign, Tips from Former Smokers (Tips). As a result of the campaign, quit attempts among smokers increased in the general population by 3.7 percentage points. In the current study, we assessed the effects of Tips on smoking cessation in pregnant women. METHODS: We used 2009-2013 certificates of live births in three US states: Indiana, Kentucky and Ohio. Smoking cessation by the third trimester of pregnancy was examined among women who smoked in the 3 months prepregnancy. Campaign exposure was defined as overlap between the airing of Tips 2012 (March 19-June 10) and the prepregnancy and pregnancy periods. Women who delivered before Tips 2012 were not exposed. Adjusted logistic regression was used to determine whether exposure to Tips was independently associated with smoking cessation. RESULTS: Cessation rates were stable during 2009-2011 but increased at the time Tips 2012 aired and remained elevated. Overall, 32.9% of unexposed and 34.7% of exposed smokers quit by the third trimester (p<0.001). Exposure to Tips 2012 was associated with increased cessation (adjusted OR: 1.07, 95% CI 1.05 to 1.10). CONCLUSIONS: Exposure to a national anti-smoking campaign for a general audience was associated with smoking cessation in pregnant women.

Adults Hospitalized With Pneumonia in the United States: Incidence, Epidemiology, and Mortality.

BACKGROUND: Understanding the burden of community-acquired pneumonia (CAP) is critical to allocate resources for prevention, management, and research. The objectives of this study were to define incidence, epidemiology, and mortality of adult patients hospitalized with CAP in the city of Louisville, and to estimate burden of CAP in the US adult population. METHODS: This was a prospective population-based cohort study of adult residents in Louisville, Kentucky, from 1 June 2014 to 31 May 2016. Consecutive hospitalized patients with CAP were enrolled at all adult hospitals in Louisville. The annual population-based CAP incidence was calculated. Geospatial epidemiology was used to define ecological associations among CAP and income level, race, and age. Mortality was evaluated during hospitalization and at 30 days, 6 months, and 1 year after hospitalization. RESULTS: During the 2-year study, from a Louisville population of 587499 adults, 186384 hospitalizations occurred. A total of 7449 unique patients hospitalized with CAP were documented. The annual age-adjusted incidence was 649 patients hospitalized with CAP per 100000 adults (95% confidence interval, 628.2-669.8), corresponding to 1591825 annual adult CAP hospitalizations in the United States. Clusters of CAP cases were found in areas with low-income and black/African American populations. Mortality during hospitalization was 6.5%, corresponding to 102821 annual deaths in the United States. Mortality at 30 days, 6 months, and 1 year was 13.0%, 23.4%, and 30.6%, respectively. CONCLUSIONS: The estimated US burden of CAP is substantial, with >1.5 million unique adults being hospitalized annually, 100000 deaths occurring during hospitalization, and approximately 1 of 3 patients hospitalized with CAP dying within 1 year.

Genotypic profiles by AP-PCR of streptococcus mutans in caries-active and caries-free preschoolers.

Streptococcus mutans, an acidogenic and aciduric microorganism that colonizes the oral cavity is recognized as the main causal agent of dental caries. Epidemiological studies have shown a strong correlation between the number of S. mutans in the oral cavity and prevalence and incidence of caries. At present, different genotypic and phenotypic methods are known to determine the profiles of settling and epidemiological distribution of S. mutans. The aim of this study was to investigate the profiles of S. mutans isolated from children with and without dental caries by using the AP-PCR (arbitrarily primed polymerase chain reaction) and api-Zym methods. In the AP-PCR method, random DNA segments of the target bacterium are amplified with single primers of arbitrary sequence. The api-Zym system (bioMirieux, Marcy-létoile, France) is a phenotypic micro-method that allows simultaneous detection of 19 enzymatic activities from bacterial inoculum. A transversal observational study was conducted, which finally included 1203- to 5-year-old children (75 with and 45 without dental caries), who attended a preschool institution in Bogota (Colombia). S. mutans was isolated from 15 of the 45 children without dental caries (33.3%) and from 31 of the 75 children with caries (41.33%). In the 46 children, 69 S. mutans isolates were identified: 24 isolates in the 15 children without dental caries and 45 isolates in 31 children with dental caries. With api-Zym system, 36 different phenotypes were detected: 22 in the caries group and 15 in the caries-free group. The phenotype XX was present in both groups. With the AP-PCR method, 27 different fingerprinting profiles were identified: 22 for the caries group and 9 of the healthy group; the two groups of patients shared four of these genomic profiles. In conclusion, the information shows a great diversity in S. mutans genotypes and phenotypes in the population studied.

Genotypic profiles by AP-PCR of Streptococcus mutans in caries-active and caries-free preschoolers

Streptococcus mutans, an acidogenic and aciduric microorganism that colonizes the oral cavity is recognized as the main causal agent of dental caries. Epidemiological studies have shown a strong correlation between the number of S. mutans in the oral cavity and prevalence and incidence of caries. At present, different genotypic and phenotypic methods are known to determine the profiles of settling and epidemiological distribution of S. mutans. The aim of this study was to investigate the profiles of S. mutans isolated from children with and without dental caries by using the AP-PCR (arbitrarily primed polymerase chain reaction) and api-Zym methods. In the AP-PCR method, random DNA segments of the target bacterium are amplified with single primers of arbitrary sequence. The api-Zym system (bioMerieux, Marcy-letoile, France) is a phenotypic micro-method that allows simultaneous detection of 19 enzymatic activities from bacterial inoculum. A transversal observational study was conducted, which finally included 120 3- to 5- year-old children (75 with and 45 without dental caries), who attended a preschool institution in Bogota (Colombia). S. mutans was isolated from 15 of the 45 children without dental caries (33.3%) and from 31 of the 75 children with caries (41.33%). In the 46 children, 69 S. mutans isolates were identified: 24 isolates in the 15 children without dental caries and 45 isolates in 31 children with dental caries. With api-Zym system, 36 different phenotypes were detected: 22 in the caries group and 15 in the caries-free group. The phenotype XX was present in both groups. With the AP-PCR method, 27 different fingerprinting profiles were identified: 22 for the caries group and 9 of the healthy group; the two groups of patients shared four of these genomic profiles. In conclusion, the information shows a great diversity in S. mutans genotypes and phenotypes in the population studied.

La caries dental es considerada una enfermedad infecciosa multifactorial que conlleva a la destruccion del tejido dental duro. Streptococcus mutans, un microorganismo acidogenico y acidurico que normalmente se encuentra colonizando la cavidad oral, es considerado el principal microorganismo asociado al desarrollo de esta enfermedad. Estudios epidemiologicos han mostrado una fuerte correlacion entre el numero de unidades formadoras de colonias de S. mutans en la cavidad oral y la prevalencia e incidencia de caries dental. El hecho de reconocer a S. mutans como el microorganismo cariogenico mas importante, ha conducido al diseno de medidas preventivas y de control tendientes a eliminarlo o reducir su presencia en la cavidad oral. En la actualidad se utilizan diferentes metodos fenotipicos y genotipicos para demostrar la heterogeneidad y variabilidad genetica de cepas S. mutans presentes en la cavidad oral. El objetivo de este estudio fue explorar la utilidad de la tecnica APPCR en el: 1. conocimiento del genotipo en aislamientos clinicos de S. mutans provenientes de ninos con y sin caries, y 2. en el establecimiento de diferencias en los perfiles de tipificacion en comparacion con la tecnica fenotipica Api-ZYM. En el metodo AP-PCR fragmentos del DNA de la bacteria son amplificados con primers simples que se anidan al azar. El sistema api-Zym es un micro-metodo semicuantitativo de investigacion que permite detectar rapida y simultaneamente 19 actividades enzimaticas a partir de pequenas cantidades de inoculo de la bacteria. En este estudio observacional descriptivo se incluyeron finalmente 120 ninos de 3 a 5 anos de un preescolar en Bogota (Colombia). Se encontro S. mutans en 15 de los 45 ninos sin caries dental (33.3%) y en 31 de los 75 ninos con caries (41.33%). En total se identificaron 69 aislamientos de S. mutans en los 46 ninos: 24 en los 15 ninos sin caries dental y 45 en los 31 ninos con caries dental. Con el sistema Api-Zym se determinaron 36 fenotipos: 22 en el grupo de caries y 15 en el grupo sin caries. Los dos grupos solamente presentaron en comun el fenotipo XX. Con el metodo AP-PCR se identificaron 27 perfiles, 22 en el grupo con caries y 9 en el grupo sin caries; ambos grupos de pacientes compartieron 4 perfiles genomicos. En conclusion, la informacion muestra una gran diversidad en perfiles de genotipos y fenotipos de S. mutans en la poblacion objeto de estudio, los cuales en algunos casos se complementan para establecer con claridad diferencias intra e inter-individuo.

Antibiotic resistance of periodontal pathogens obtained from frequent antibiotic users.

The occurrence of bacterial strains resistant to different antimicrobials is a growing problem in Latin American countries. The aim was to measure the antimicrobial susceptibility of Fusobacterium nucleatum, Prevotella intermedia and Prophyromona gingivalis, isolated from chronic periodontitis patients. Twenty-five patients diagnosed with generalized- moderate or advanced- chronic periodontitis were consecutively recruited from patients attending the Periodontal Specialist Program, Javeriana University, according to specific criteria, including no recent antibiotic consumption. All patients filled out a questionnaire on antibiotic intake. The deepest periodontal pocket in each quadrant was sampled. Pooled samples were mixed, diluted and plated on enriched brucella agar plates. After anaerobic incubation, identification of the target bacteria was performed, based on colony morphology, gram staining, aerotolerance and biochemical reactions (RapID Ana II, Remel, U.S.A.). Following identification, the bacteria were subjected to antimicrobial testing, using amoxicillin, tetracycline, doxycicline, azithromycin and metronidazole (E-test, AbBiodisk, Sweden). The minimal inhibitory concentrations obtained were compared with a reference standard to determine antimicrobial resistance. Amoxicillin-resistant species were tested for beta-lactamase production. Forty-four percent of the patients used antibiotics without any medical prescription, 40% used antibiotics at least once a year. The presence of eleven species was confirmed after a series of biochemical tests: four Fusobacterium nucleatum, five Prevotella intermedia and two Prophyromona gingivalis. All strains were resistant to metronidazole, five were resistant to tetracycline and azithromicin, and two strains were resistant to doxycicline and amoxicillin. The strains resistant to amoxicillin were positive for beta-lactamase production, Antimicrobial resistance, particularly against metronidazole, was a common phenomenon for the bacterial isolates analyzed in this Colombian sample.

Antibiotic resistance of periodontal pathogens obtained from frequent antibiotic users

The occurrence of bacterial strains resistant to different antimicrobials is a growing problem in Latin American countries. The aim was to measure the antimicrobial susceptibility of Fusobacterium nucleatum, Prevotella intermedia and Prophyromona gingivalis, isolated from chronic periodontitis patients. Twenty-five patients diagnosed with generalized- moderate or advanced- chronic periodontitis were consecutively recruited from patients attending the Periodontal Specialist Program, Javeriana University, according to specific criteria, including no recent antibiotic consumption. All patients filled out a questionnaire on antibiotic intake. The deepest periodontal pocket in each quadrant was sampled. Pooled samples were mixed, diluted and plated on enriched brucella agar plates. After anaerobic incubation, identification of the target bacteria was performed, based on colony morphology, gram staining, aerotolerance and biochemical reactions (RapID Ana II, Remel, U.S.A.). Following identification, the bacteria were subjected to antimicrobial testing, using amoxicillin, tetracycline, doxycicline, azithromycin and metronidazole (E-test, AbBiodisk, Sweden). The minimal inhibitory concentrations obtained were compared with a reference standard to determine antimicrobial resistance. Amoxicillin-resistant species were tested for β- lactamase production. Forty-four percent of the patients used antibiotics without any medical prescription, 40% used antibiotics at least once a year. The presence of eleven species was confirmed after a series of biochemical tests: four Fusobacterium nucleatum, five Prevotella intermedia and two Prophyromona gingivalis. All strains were resistant to metronidazole, five were resistant to tetracycline and azithromicin, and two strains were resistant to doxycicline and amoxicillin. The strains resistant to amoxicillin were positive for β-lactamase production. Antimicrobial resistance, particularly against metronidazole, was a common phenomenon for the bacterial isolates analyzed in this Colombian sample.

La presencia de especies bacterianas que demuestran resistencia a múltiples antimicrobianos es un problema creciente en Latinoamérica. El objetivo de este estudio fue el medir la susceptibilidad antibiótica de las bacterias Fusobacterium nucleatum, Prevotella intermedia y Prophyromona gingivalis aisladas de pacientes afectados por Periodontitis Crónica. Un total de venti-cinco pacientes diagnosticados con Periodontitis Crónica Generalizada con severidad de Moderada a Avanzada fueron incluidos en el estudio siguiendo criterios específicos, todos los pacientes respondieron una encuesta acerca de su patrón de uso de antibióticos. En la bolsa mas profunda de cada cuadrante dental se tomo una muestra microbiológica, la cual fue procesada siguiendo procedimientos de: Mezcla, dilución y siembra en platos de agar Brucela enriquecidos. Después de un periodo de incubación anaeróbica las bacterias objeto de estudio fueron identificadas de acuerdo a las siguientes técnicas: Morfología de las colonias, coloración de Gram, prueba de aero-tolerancia y la aplicación de un kit de identificación bacteriana que utiliza diversas pruebas bioquimicas (RapID Ana II, Remel, U.S.A.). Después de la identificación, las bacterias fueron sometidas a pruebas de antibiograma usando los siguientes antibióticos: Amoxicilina, tetraciclina, doxiciclina, azitromicina y metronidazol (E-test, AbBiodisk, Suecia). La concentración inhibitoria mínima se comparo con la referencia estándar para determinar la presencia de la resistencia antibiótica. En las especies bacterianas que mostraron resistencia a la amoxicilina se realizo una prueba de laboratorio para establecer la presencia de β-lactamasa. Un 44% de los pacientes encuestados refirió haber utilizado antibióticos sin prescripción medica, un 40% de ellos usa antibióticos al menos una vez al ano. La presencia de once especies bacterianas pudo ser confirmada después de realizar las pruebas de identificación: Cuatro aislamientos de Fusobacterium nucleatum, cinco de Prevotella intermedia y dos de Prophyromona gingivalis. Todas las especies bacterianas mostraron resistencia al metronidazol, cinco fueron resistentes a la tetraciclina y a la azitromicina, finalmente dos especies fueron resistentes a la doxiciclina y la amoxicilina. Las especies que mostraron resistencia a la amoxicilina demostraron producción de β-lactamasa. La presencia de resistencia a los antibióticos fue un fenómeno común para las bacterias analizadas, en especial la resistencia al metronidazol.

Estudio exploratorio-descriptivo acerca de las relaciones entre trastornos depresivos y características de personalidad / Explorative-descriptive study of the relationschip between depressive disorders and personality traits

Objetivo. Evaluar y relacionar variables referidas a trastornos depresivos y variables de personalidad. Método. Se administraron el Inventario de Depresión de Beck (BDI), la forma abreviada del Examen Internacional de los trastornos de Personalidad (IPDE) y el Test de Rorschach a una muestra de 37 pacientes adultos de ambos géneros, con diagnóstico de depresión (CIE 10), pertenecientes al Programa de Detección, diagnóstico y Tratamiento de la Depresión, que consultaron en el Servicio de Psiquiatría de Complejo Hospitalario San Borja Arriarán (HSBA) durante el año 2004. Resultados. Los puntajes obtenidos a través del BDI indicaron que la mayor parte de la muestra se ubicó en los rangos de depresión moderada y grave (32,4 y 40,5 por ciento respectivamente) los datos arrojados por el IPDE señalaron que los rasgos de personalidad menos presentes en la muestra son: Antisocial (24,3 por ciento) e Histriónico (48,6 por ciento). Al relacionar los resultados del test IPDE y BDI se encontró una correlación significativamente poisitiva entre los rasgos de personalidad dependiente y las puntuaciones elevadas de depresión. Los resultados del test de Rorschach mostraron una baja incidencia respecto a indicadores de depresividad, así como predominio de indicadores de rasgos dependientes y pasivos de la personalidad. Conclusiones. La prueba de Rorschach arrojó resultados discrepantes con el BDI respecto a la presencia de depresividad en la medida en que el test de Roschach refleja una baja en los indicadores que corroboraran la manifestación de índices de depresión. Por lo tanto, este estudio nos llevaría a condiderar la incidencia de variables de personalidad en el proceso diagnóstico, cuestión que adquiere relevancia en la medida que la muestra presentó indicadores elevados de dependencia y pasividad.