Background and Purpose—The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audienc...

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Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

The Structural Transformation of the Public Sphere: An Inquiry into a Category of Bourgeois Society

2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular riskThe Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)

Chronic kidney disease1 (CKD) is a worldwide public health problem. In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost. The number of individuals with kidney failure treated by dialysis and transplantation exceeded 320 000 in 1998 and is expected to surpass 650 000 by 2010.1,2 There is an even higher prevalence of earlier stages of CKD (Table 1).1,3 Kidney failure requiring treatment with dialysis or transplantation is the most visible outcome of CKD. However, cardiovascular disease (CVD) is also frequently associated with CKD, which is important because individuals with CKD are more likely to die of CVD than to develop kidney failure,4 CVD in CKD is treatable and potentially preventable, and CKD appears to be a risk factor for CVD. In 1998, the National Kidney Foundation (NKF) Task Force on Cardiovascular Disease in Chronic Renal Disease issued a report emphasizing the high risk of CVD in CKD.5 This report showed that there was a high prevalence of CVD in CKD and that mortality due to CVD was 10 to 30 times higher in dialysis patients than in the general population (Figure 1 and Table 2).6–18 The task force recommended that patients with CKD be considered in the “highest risk group” for subsequent CVD events and that treatment recommendations based on CVD risk stratification should take into account the highest-risk status of patients with CKD. 

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TABLE 1. Stages of CKD 





Figure 1. Cardiovascular mortality defined by death due to arrhythmias, cardiomyopathy, cardiac arrest, myocardial infarction, atherosclerotic heart disease, and pulmonary edema in general population (GP; National Center for Health Statistics [NCHS] multiple cause of mortality data files International Classification of Diseases, 9th Revision [ICD 9] codes 402, 404, 410 to 414, and …

Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention.

Objective Our aim was to examine in what terms leading newspapers' online sites described the current Ebola crisis. Methods We employed a quantitative content analysis of terms attributed to Ebola. We found and analyzed 582 articles published between March 23 and September 30, 2014, on the online websites of 3 newspapers: The New York Times, Daily Mail, and Ynet. Our theoretical framework drew from the fields of health communication and emerging infectious disease communication, including such concepts as framing media literacy, risk signatures, and mental models. Results We found that outbreak and epidemic were used interchangeably in the articles. From September 16, 2014, onward, epidemic predominated, corresponding to when President Barack Obama explicitly referred to Ebola as an epidemic. Prior to Obama's speech, 86.8% of the articles (323) used the term outbreak and only 8.6% (32) used the term epidemic. Subsequently, both terms were used almost the same amount: 53.8% of the articles (113) used the term outbreak and 53.3% (112) used the term epidemic. Conclusions Effective communication is crucial during public health emergencies such as Ebola, because language framing affects the decision-making process of social judgments and actions. The choice of one term (outbreak) over another (epidemic) can create different conceptualizations of the disease, thereby influencing the risk signature. (Disaster Med Public Health Preparedness. 2016;10:669-673).

Outbreak or Epidemic? How Obama's Language Choice Transformed the Ebola Outbreak Into an Epidemic.

INTRODUCTION The incidence of shigellosis in Israel was fairly stable until around 1974, when it gradually began to increase to a peak in 1985. This was accompanied by a shift in the maximum incidence in the Jewish population from the age group < 1 to 1-4 years. AIM To update the epidemiology of shigellosis in Israel 1986-1995. METHODS Only laboratory-confirmed cases of shigellosis in the civilian population were analyzed. Data were obtained from the weekly reports of the subdistricts. Antibiotic sensitivity data were obtained from several hospitals and the General Workers' Sick Fund laboratories in Jerusalem, Haifa, and Tel Aviv. RESULTS From 1986 to 1991, shigellosis incidence per 100,000 decreased by about 50%, and the decrease occurred mainly in the Jewish population. Several regional outbreaks in 1992 reversed this decline, but by 1995, the incidence was similar to that observed prior to 1974. The disease still occurs mainly in the summer, with an occasional winter outbreak. Higher incidence rates occurred in the northern subdistricts. The peak incidence in the non-Jewish population moved from the < 1-year-olds to the 1-4 year-old group, similar to the pattern in the Jewish population in 1970. In 1991, for the first time, the rate in the age group 5-9 years among non-Jews exceeded that of those < 1 year old. Marked decreases in sensitivity to several antibiotics were found in peripheral and hospital laboratories. An increase in the sensitivity to tetracycline was noted since 1991. Case fatality rates remain low, with a mean of 0.05% for the decade of the 1980s. CONCLUSIONS Shigellosis remains a highly endemic disease in Israel, but changes in the age-related peak incidence indicate that the pattern of spread is becoming more similar to other developed countries.

Shigellosis in Israel--update 1995.

A positive family history of breast cancer is an established risk factor for the disease. In Israel, screening is recommended annually for high-risk women aged > or =40 years and biennially for average-risk women aged > or =50 years. The current study aimed to assess the effect of having a positive breast cancer family history on performing screening mammography in Israeli women. This study is a cross-sectional survey based on a random sample of the Israeli population, conducted in 2003. The study was carried out by means of telephone interviews that included questions on the use of preventive medical services. The current study population consists of 1605 Israeli women aged 40-74 years. A positive family history for breast cancer was reported by 153 (9.5%) of the participants. A mammogram in the previous year was reported by 43.1 and 24.7% of the positive and negative family history subgroups, respectively (P or =50 years, respectively, are inadequately screened for breast cancer. Screening rates are not optimal in the average-risk group as well.

Family history of breast cancer and compliance with mammography in Israel: findings of the National Health Survey 2003-2004 (EUROHIS).

Fifteen cases of type 1 paralytic poliomyelitis occurred in August 1988, mainly among young adults in the Jewish population of Israel, where vaccine coverage exceeds 90%. The military forces, as a precaution against further spread of the virus, vaccinated all recruits in late September. They received oral poliovirus vaccine (OPV) simultaneously with prophylactic immune serum globulin (ISG) to protect against hepatitis A virus infection. Since it is generally not recommended to administer live vaccines simultaneously with ISG, the serologic response to OPV given at the same time as ISG was compared with the response when OPV was given alone; specimens were also available from a control group receiving ISG alone. No effect of ISG on the antibody response to OPV was found, and thus there appears to be no contraindication to giving OPV at the same time as injecting pooled ISG--particularly relevant for travelers to areas endemic for both diseases, who have to leave at short notice. Of recruits 18-19 years of age, 21% lacked antibodies to type 1 poliovirus, suggesting either a decline in antibody titers with age or a lack of vaccine potency during earlier years. After the booster, only 2% lacked type 1 antibody, and the geometric mean titer increased from 1:16 to 1:698.

Response to Trivalent Oral Poliovirus Vaccine with and without Immune Serum Globulin in Young Adults in Israel in 1988

The effect of the AIDS pandemic on the sexual behavior of the general population has not been clearly established. Since trends in the incidence of other sexually transmitted diseases may be a good marker of such behavioral changes gonorrhea incidence in the civilian and military populations in Israel was examined during the period 1963-87. Among the civilian population the rates were relatively stable until 1967 when they increased to a peak in 1970 and then declined to earlier levels. In 1982 a further decline began which accelerated considerably in 1986 when rates declined by 38%. During 1987 the decline was even more dramatic with a drop of 60% compared with the rate from the previous year. A similar trend has been noted in the military population. The recent sharp decline in gonorrhea incidence may be related at least in part to a change in sexual behavior associated with the fear of AIDS. If so its magnitude suggests that such changes have not been restricted to high-risk groups. (authors modified)

Manfred S. Green

Papers

Outbreak or Epidemic? How Obama's Language Choice Transformed the Ebola Outbreak Into an Epidemic.

Shigellosis in Israel--update 1995.

Family history of breast cancer and compliance with mammography in Israel: findings of the National Health Survey 2003-2004 (EUROHIS).

Response to Trivalent Oral Poliovirus Vaccine with and without Immune Serum Globulin in Young Adults in Israel in 1988

Recent decline in gonorrhea incidence in Israel: possible association with the AIDS pandemic.