Search

Virtually unknown to the greater public before November 2022, ChatGPT was made available in open access in Autumn 2022, driving the perspective of artificial intelligence integration to the forefront of daily life. The field of medicine hasn't been left aside, and sparks as much interest as it does questions. Although this tool has considerable potential for use in clinical practice, it, like others, has limitations that need to be clearly understood to avoid misuse. In addition, the legal framework and issues of data confidentiality are currently poorly defined, and clinicians will need to keep a close eye on legislative developments in this area., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Medical wait time is a top health policy issue in canada. reliable data on the referral wait time from primary to specialty care are limited. Existing data on referral wait times are generally self-reported by specialists. In 2008, the edmonton north primary care network (PCN) developed a centralized referral program, including a specialist database that contains information on specialists' referral requirements, forms and protocols, and has the capability of tracking referrals that the PCN makes on behalf of its family physicians to specialty care. We performed a trend analysis of the referral wait time (defined as the time from referral by a family physician to an appointment date with a specialist) from 2009 to 2011 using the program database (n=33,281 referrals). The study provided a unique and comprehensive picture of wait times for 22 specialties. We identified a decrease in the overall wait time year over year, and improvement in the number of referrals that are accepted the first time. additionally, specific opportunities for further improvement in referral wait time were noted., (Copyright © 2013 Longwoods Publishing.)

Critical care medicine remains underdeveloped in many parts of the world. In Saudi Arabia, there have been major developments in the past 2-3 decades. The purpose of this review is to give an account of the current status of critical care practice (including services provided during the haj season) and training in Saudi Arabia using examples of primary, secondary and tertiary care hospitals. The future needs of the profession are also addressed.

This study evaluated changes over the academic year in the cost and the outcome of inpatient care to investigate the effect of housestaff experience in teaching hospitals. Patients with 25 preselected discharge diagnoses, admitted between January 1, 1983 and December 31, 1987 to acute-care, nonfederal, non-pediatric hospitals in the Minneapolis/St. Paul metropolitan area (total number available for analysis 240,467) were examined. Level of housestaff experience was measured as the number of days (1 to 365) into the academic year when the patient was admitted. Linear and logistic regression analyses were used to evaluate the different effects of experience on patient care in teaching hospitals compared with nonteaching hospitals. For the subset of patients with internal medicine diagnoses, the expected "July Phenomenon" was observed, with significant relative declines in diagnostic and pharmaceutical charges in teaching hospitals over the academic year. In contrast, surgery patients showed an increase in length of stay and various charges over the academic year in teaching hospitals. There were no meaningful effects of housestaff experience on mortality, operative complications, or nursing home discharge. These results indicate that housestaff training is significantly related to the use of hospital resources for inpatients, but that the degree and direction of the effects differ by specialty. These findings may reflect important differences among training programs in the process of physician education and its effects on patient care.

The study of referrals from primary care areas permits the evaluation of health care in this level and reveals the educational requirements of the specialists in family medicine. Between January and April 1988 a prospective study was carried out to evaluate the referrals to the second level of care in the health center V Centenario. In 27,657 visits 1,906 referrals to the different specialties were ordered, which represents a rate of 6.89%. The most commonly consulted specialties were gynecology (18.94% of the overall referrals), ophthalmology (18.04%) and traumatology (16.10%). Psychiatry (1.41%), neurology (1.31%) and endocrinology (1.41%) were the specialties with the lowest referral rates. We compared our results with those from other authors and we have calculated what influence would be exerted on the second level of care if all primary care physicians had similar referral rates to those obtained in our center.

In the fall of 1964, newspaper accounts of the medical school applicant situation in Canada reported that hundreds of fully qualified applicants were being turned away because of shortage of places. Such reports precipitated a pilot study of the applications received by the four Ontario medical schools for the first professional year of medicine and it was found, first of all, that the total of 1352 applications represented only 880 individuals. Nearly 32% of these applicants were American and 18% were citizens of Commonwealth or other countries. While a majority of the applicants met the minimal requirements of the schools, very few of the rejected applicants had academic records that justified admission when the informal standards of the schools were applied. It was concluded that it is erroneous to speak of a surplus of well-qualified applicants at the present time and that the need for recruiting programs still remains.

Background and objectives: Various factors facilitate seizures in patients with epilepsy. The relationship between the phases of the moon and neuropsychiatric conditions has been a matter of curiosity. The present study investigated whether patient presentations to the emergency department with epileptic seizures vary according to the phases of the moon, seasons, and daily air temperature. Materials and method: The study retrospectively included patients who presented to the emergency department with epileptic seizures over a one-year period. Patients with provoked seizures (head trauma, intracranial hemorrhage, etc.), pregnant women, and patients aged under 18 years were excluded. Patients’ age, gender, date and time of presentation to the emergency department were recorded. The effects of the phases of the moon and seasons on these presentations were investigated. Results:Total 255 patients (176 male, 79 female) met the inclusion criteria of the study. The majority of patients (67.1%) were aged 18-44 years. Majority of the patients (41.2%) did not previously used epileptic medication. The laboratory tests ​​showed that the mean blood pH and lactate values were 7.31±0.11 and 4.59±4.12 mmol/L respectively. No statistically significant (p>0.05) relationship was observed regarding frequency of presentations of epileptic seizures and the season and phases of the moon. Conclusion: The results of this study showed that the phases of the moon, air temperature, and seasons did not affect the frequency of epileptic seizures. July 2024; Vol. 18(2):006 DOI: https://doi.org/10.55010/imcjms.18.018 *Correspondence: Erdal Yavuz, Department of Emergency Medicine, Adiyaman University Medical Faculty, Adiyaman, Turkey. Email: erdal_yavuz15@hotmail.com

The article presents the relationship between the level of psycho-emotional stress and the content of biogenic amines, sex and thyroid hormones in healthy men in the city of Arkhangelsk, taking into account the change of seasons.Material and methods. The study involved 20 men aged 25–44 years. The content of hormones, biogenic amines in serum was determined by enzyme immunoassay. To assess the level of psycho-emotional stress, a survey was conducted using the questionnaire “Your well-being”, developed by O.S. Kopina, E.A. Suslova, E.V. Zaikin, as well as A. Beck’s depression questionnaire.Results and discussion. A greater number of relationships between the studied parameters was revealed in the transitional periods of the year (March and September), which allows us to consider the spring and autumn as provoking factors in psychosocial stress development. In healthy people, the higher peripheral conversion of iodothyronines associates with the higher satisfaction with vital needs in the fall. The subjective assessment of the health is characterized by exclusively positive relationships with thyroid (spring and autumn) and sex (summer, winter) hormones. Indicators of personal satisfaction in all seasons of the year negatively correlate with the level of sex hormones and sex hormone-binding globulin, and indicators of stress and depression negatively correlate with content of pituitary hormones (luteinizing, thyroid stimulating). Concentration of such monoamines as dopamine (in winter) and acetylcholine (in autumn) positively correlates with feelings of personal satisfaction, while serotonin content shows a negative relationship with the level of satisfaction in autumn.

Objective:This study determines the 25-hydroxy vitamin D [25(OH)D] profile according to season, age, and gender by examining the vitamin D levels of the patients who applied to Cizre State Hospital, which is the warmest district of Turkey, in 2021.Materials and Methods:13,387 patients admitted to Cizre State Hospital were included in the study, and their [25(OH)D] levels were analyzed retrospectively. In the study, [25(OH)D] levels were evaluated according to the age, gender and seasonal differences of the patients. [25(OH)D] levels in serum are 30 ng/mL conditions were accepted as qualifications.Results:The findings of 9,800 women and 3,587 men were evaluated in the study. The mean serum level of [25 (OH)D] was 12.31±0.08 ng/ mL in women and 17.58±0.15 ng/mL in men. Amongst the age groups, vitamin D levels in both male and female patients were statistically significant (p

We collected data on mass mortality in Sandwich terns (Thalasseus sandvicensis) during the 2022 breeding season in the Netherlands. Mortality was associated with at least 2 variants of highly pathogenic avian influenza A(H5N1) virus clade 2.3.4.4b. We report on carcass removal efforts relative to survival in colonies. Mitigation strategies urgently require structured research.

The 4 common types of human coronaviruses (HCoVs)—2 alpha (HCoV-NL63 and HCoV-229E) and 2 beta (HCoV-HKU1 and HCoV-OC43)—generally cause mild upper respiratory illness. Seasonal patterns and annual variation in predominant types of HCoVs are known, but parameters of expected seasonality have not been defined. We defined seasonality of HCoVs during July 2014–November 2021 in the United States by using a retrospective method applied to National Respiratory and Enteric Virus Surveillance System data. In the 6 HCoV seasons before 2020–21, season onsets occurred October 21–November 12, peaks January 6–February 13, and offsets April 18–June 27; most (>93%) HCoV detection was within the defined seasonal onsets and offsets. The 2020–21 HCoV season onset was 11 weeks later than in prior seasons, probably associated with COVID-19 mitigation efforts. Better definitions of HCoV seasonality can be used for clinical preparedness and for determining expected patterns of emerging coronaviruses.

Background Patients with ischemic heart disease (IHD) are prone to gastrointestinal bleeding (GIB) under stress and other stimuli, and in turn severe GIB can induce IHD. IHD patients complicated with GIB are facinga higher mortality risk than those with IHD or GIB alone. Season and temperature may increasethe morbidity and mortality risk of patients with IHD and GIB, but further research is stillneeded. Objective To investigate the seasonal distribution characteristics of IHD complicated with GIB and its correlation with temperature. Methods A total of 730 IHD patients complicated with GIB treated at West China Hospital, Sichuan University, from January 2014 to December 2018 were enrolled as the research objectsbased on inclusion and exclusion criteria. The following baseline data of the patients were collected through the electronic medical record system, including age, sex, history of smoking, drinking, percutaneous coronary intervention (PCI) , use of antiplatelet agents and use of anticoagulants; presence or absence of hypertension, diabetes mellitus, chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) ; time of admission, IHD type (stable angina pectoris and acute coronary syndrome) , GIB site (nonvariceal upper GIB, variceal upper GIB, lower GIB and unexplained GIB) and mode of discharge (death outcome) . The meteorological dataincluding monthly average high temperature, monthly average low temperature, monthly average temperature and monthly temperature difference from January 2014 to December 2018 in Chengdu were obtained from the Chengdu Meteorological Office. Based on the commonly adopted seasonal division method in climatology and meteorological characteristics of the Chengdu area, the seasons were divided into spring (March, April and May) , summer (June, July and August) , autumn (September, October and November) and winter (December, January and February) . The seasonal hospitalization rate, seasonal incidence of acute coronary syndrome, seasonal incidence of bleeding sites and seasonal mortality of IHD patients complicated with GIB were analyzed. Results The participants included 493 males and 237 females (male-to-female ratio: 2.08∶1) with an average age of (72.8±11.3) years. The proportions of males and females aged 70-79 were higher, which were 35.29% (174/493) and 39.66% (94/237) , respectively. The temperature was highest in July and August and lowest in December and January. The greatest temperature difference occurred in spring. The hospitalization rate was higher in winter and spring than in summer and autumn (58.8% vs 41.2%, χ2=3.907, P=0.003) . Compared with summer and autumn, the hospitalization rate for IHD patients complicated with GIB increased in spring (χ2=2.912, P=0.020; χ2=2.567, P=0.033) . In addition, the hospitalization rate for IHD patients complicated with GIB increased in winter compared with that in summer (χ2=2.191, P=0.035) . The Spearman correlation analysis results indicated that the number of hospitalized IHD patients complicated with GIB was negatively correlated with the monthly average temperature (rs=-0.280, P

Aim: This study aimed to evaluate the postoperative bleeding status of the patients who underwent tonsillectomy over 18 years old. It evaluated the reasons for tonsillectomy, additional diseases, and the season in which tonsillectomy was performed. Methods: One hundred and fifty patients aged 18 years and over who underwent tonsillectomy in the ear, nose, and throat clinic of a tertiary hospital were included in our study. The age, gender, additional disease, post-tonsillectomy haemorrhage (Post-TH), and the season in which tonsillectomy was performed were examined. Results: A total of 150 patients, 50 females (33.3%) and 100 males (66.7%), were included in our study. The mean age of the patients was 32,49±12,20 years. Bleeding was observed in the postoperative period in 12 patients (8%), except for the first 24 hours postoperatively. It was determined that the most frequent complaint of bleeding in the postoperative period was on the 4th day. It was observed that 15 (10%) patients had an additional disease. A total of 35 (23.3%) patients underwent tonsillectomy due to Obstructive Sleep Apnea Syndrome (OSAS) and 115 (76.7%) patients for recurrent tonsillitis. Tonsillectomy was performed in the spring season for 31 patients (20.7%), winter for 40 patients (26.7%), autumn for 39 patients (26%), and summer for 40 patients (26.7%). No statistical difference between seasonal differences and the tonsillectomies performed was found (p> 0.05). There was no statistical difference between tonsillectomy and the presence or absence of additional diseases (p> 0.05). Conclusion: We concluded that the presence of comorbidity and seasonal differences did not affect Post-TH in adult tonsillectomy patients.

Objective:This study aims to determine the 25-hydroxyvitamin D [25(OH)D] profile of the region based on season, age and gender by examining the vitamin D levels of patients who applied to the Siirt Training and Research Hospital from Siirt and neighbouring provinces.Materials and Methods:[25(OH)D] levels were analysed retrospectively in patients who applied to Siirt Training and Research Hospital. The study included 31,151 patients who were admitted to the hospital. Were included in the study. [25(OH)D] levels were determined according to the age and gender of patients and the seasons of the year. A serum [25(OH)D] level 30 ng/mL sufficiency.Results:The average [25(OH)D] level in patients aged 0-15 years (n=6,166) was 20.59±0.14 ng/mL, in patients aged 16-30 years (n=10,791) it was 15.65±0.10 ng/mL, in patients aged 31-45 years (n=6,649) it was 16.28±0.14 ng/mL, in patients aged 46-60 years (n=4,120) it was 16.83±0.23 ng/mL and in patients ages 61-75 years (n=2,597) it was 16.03±0.15 ng/mL.Conclusion:It has been observed that [25(OH)D] level, which is low in winter and spring, is high in summer and autumn when it is exposed to the intense rays of the sun. However, this level is lower than the desired levels in all four seasons. This low level of vitamin D may be related to the absence of almost any vitamin D synthesis in winter and inadequate vitamin D intake associated with foods.

Scrub typhus, a miteborne rickettsiosis, has emerged in many areas globally. We analyzed the incidence and spatial–temporal distribution of scrub typhus in China during 1952–1989 and 2006–2016 using national disease surveillance data. A total of 133,623 cases and 174 deaths were recorded. The average annual incidence was 0.13 cases/100,000 population during 1952–1989; incidence increased sharply from 0.09/100,000 population in 2006 to 1.60/100,000 population in 2016. The disease, historically endemic to southern China, has expanded to all the provinces across both rural and urban areas. We identified 3 distinct seasonal patterns nationwide; infections peaked in summer in the southwest, summer-autumn in the southeast, and autumn in the middle-east. Persons >40 years of age and in nonfarming occupations had a higher risk for death. The changing epidemiology of scrub typhus in China warrants an enhanced disease control and prevention program.

Background/Aims Seasonal variation is an environmental factor proposed to affect the incidence of venous thromboembolism (VTE). However, VTE seasonal variation is not well studied in Asian populations, which have different genetic determinants of VTE compared to Westerners. The present study aimed at investigating seasonal variation of VTE occurrence and the effect of various demographic factors (i.e., age, sex, and co-morbidities) on variation. Methods VTE seasonal variation was evaluated in 59,626 index cases (from January 2009 to December 2013) in the Korean Health Insurance Review and Assessment Service database. We quantified and compared VTE occurrence across four seasons, and additionally assessed monthly through a chronobiological analysis. Results VTE incidence varied both seasonally and monthly, with new cases peaking in the winter (January and February) and the lowest incidence in the summer (August and September). After adjusting for sex, age, type of VTE, and combined cancer diagnosis, winter remained a significant independent factor driving VTE incidence. Additionally, seasonal variation was prominent in patients aged 60 years or older and in patients with pulmonary embolism, but not so prominent in patients of aged less than 60 years and patients with deep vein thrombosis. Conclusions Seasonal variation was a weak but independent contributor to VTE incidence in a Korean population diagnosed from 2009 to 2013, especially in those individuals with old age or suffering from a pulmonary embolism.

Introduction. It was found that the body's response to various stressful effects is largely determined by the ratio of the tone of the sympathetic and parasympathetic parts of the autonomic nervous system. It was revealed that in those days when a predominance of the parasympathetic nervous system tone was noted stressful effects caused more significant and negative changes in the body. The autonomic nervous system is also influenced by climatic factors. Materials and methods. 5305 males of different age were examined with the help of functional vegetative diagnostics according to the method of V. Makats. The bioelectric activity of 12 symmetric pairs of functionally active zones of the skin (24 FAZ), 12 on the hands and 12 on the feet, which reflect the functional activity of the sympathetic and parasympathetic nervous systems were studied. Results. In the study of systemic age dependence in all male observation groups the change of seasons of the year has been found to lead to changes in functional activity and homeostasis of the organism. The seasonal indicators of the activity of functional systems (FS) are clearly observed to duplicate the norm line, differing in amplitude and having the same orientation. Moreover, the presence of significant changes in the studied parameters of activity indicators of FS with the norm line indicates that all seasons of the year were characterized by differences. Conclusions. It has been established that the season change on the body leads to significant changes in functional activity and homeostasis of men of different age groups. The dependence of these indicators indicates a species evolutionary adaptation of a human to seasonal changes in climatic conditions.

Introduction: Infective endocarditis presents a high rate of morbidity and mortality. Population-based studies addressing mortality caused by infective endocarditis in Portugal are scarce. We aimed to study deaths caused by Infective endocarditis, as well as corresponding demographics and temporal trends. Material and Methods: Retrospective cohort study of all patients whose main cause of death was Infective endocarditis in Portugal from 2002 to 2018. The data was obtained from the national death certificate information system. Results: In Portugal, 3634 people died from infective endocarditis throughout the 17-year study period - infective endocarditis specific mortality rate of 2.1 per 100 000 habitants. Of all deceased, 89% were at least 60 years old, and most were women (55%). Overall, 72% died in a healthcare institution. An annual 9% increase in the incidence death rate from Infective endocarditis was observed, with a significant upward trend during the colder months. Discussion: In Portugal, mortality by infective endocarditis increased, mainly affecting older patients and women, and which can partially be explained by factors such as ageing of the population. The management of older patients with infective endocarditis is challenging as they present a higher number of comorbidities, more valvular heart disease and valve implants, invasive medical procedures and are less likely to undergo cardiac surgery. Conclusion: In addition to data on the evolution of demographics in Portugal, it is crucial to study the incidence of infective endocarditis over time to help explain these findings. The identification of factors that can be used to better model national health policies to improve clinical outcomes of infective endocarditis in Portugal is also required.

ABSTRACT BACKGROUND: The underlying cause of seasonal infertility in humans is unclear, but is likely to be multifactorial. OBJECTIVE: The aim of our study was to compare the pregnancy rates among infertile women who underwent induced ovulation and intrauterine insemination (IUI) with the season in which the fertility treatment was performed. DESIGN AND SETTING: This retrospective cohort study was conducted on 466 patients who were treated in the reproductive endocrinology and infertility outpatient clinic of a tertiary-level women’s healthcare and maternity hospital. METHODS: Retrospective demographic, hormonal and ultrasonographic data were obtained from the patients’ medical records. Clomiphene citrate or gonadotropin medications were used for induced ovulation. The patients were divided into four groups according to the season (spring, winter, autumn and summer) in which fertility treatment was received. Clinical pregnancy rates were calculated and compared between these four groups. RESULTS: There were no significant differences between the seasonal groups in terms of age, infertility type, ovarian reserve tests, duration of infertility, medications used or length of stimulation. A total of 337 patients (72.3%) were treated with clomiphene citrate and 129 (27.7%) with gonadotropin; no significant difference between these two groups was observed. The clinical pregnancy rates for the spring, winter, autumn and summer groups were 15.6% (n = 24), 8.6% (n = 9), 11.5% (n = 13) and 7.4% (n = 7), respectively (P = 0.174). CONCLUSIONS: Although the spring group had the highest pregnancy rate, the rates of successful IUI did not differ significantly between the seasonal groups.

Objective: There are changes in plasma glucose and HbA1c of type 2 diabetes mellitus (T2DM) patients in different seasons. HbA1c levels may increase during winter season in most T2DM patients without weight gain. In this study, we described the seasonal changes of HbA1c levels in T2DM patients. Materials and Methods: This analytical cross-sectional study conducted from 2013 to 2017 on 402 patients with T2DM, aged 20–80 years old who referred to Yazd diabetic research center. Body weight, height, waist circumferences (WC), blood pressure (BP), body mass index (BMI), fasting plasma glucose (FPG), 2 hours post-prandial (2hpp), and HbA1c measured and compared during four seasons. Results: Four hundred and two T2DM patients invited and fulfilled this study. Most of them (56%) were women. The mean age of patients was 58.96 (± 11.10) years old. The mean HbA1c, 2hpp, systolic and diastolic blood pressure were significantly different in four seasons (P-value respectively: 0.022, 0.007, 0.001 and 0.005). The mean difference of HbA1c was significant in the warm and cold seasons (P-value: 0.047). The percentage of people who were below 7% had a significant difference between the warm and cold seasons (P-value: 0.015). Conclusion: The results of this study showed that, in Yazd with desert climate, postprandial hyperglycemia is more prominent in summer. The seasonal changes of glycemic status are an important factor in management of T2DM patients.

Objective: There are changes in plasma glucose and HbA1c of type 2 diabetes mellitus (T2DM) patients in different seasons. HbA1c levels may increase during winter season in most T2DM patients without weight gain. In this study, we described the seasonal changes of HbA1c levels in T2DM patients. Materials and Methods: This analytical cross-sectional study conducted from 2013 to 2017 on 402 patients with T2DM, aged 20–80 years old who referred to Yazd diabetic research center. Body weight, height, waist circumferences (WC), blood pressure (BP), body mass index (BMI), fasting plasma glucose (FPG), 2 hours post-prandial (2hpp), and HbA1c measured and compared during four seasons. Results: Four hundred and two T2DM patients invited and fulfilled this study. Most of them (56%) were women. The mean age of patients was 58.96 (± 11.10) years old. The mean HbA1c, 2hpp, systolic and diastolic blood pressure were significantly different in four seasons (P-value respectively: 0.022, 0.007, 0.001 and 0.005). The mean difference of HbA1c was significant in the warm and cold seasons (P-value: 0.047). The percentage of people who were below 7% had a significant difference between the warm and cold seasons (P-value: 0.015). Conclusion: The results of this study showed that, in Yazd with desert climate, postprandial hyperglycemia is more prominent in summer. The seasonal changes of glycemic status are an important factor in management of T2DM patients.

N/A

Background: Type I diabetes mellitus (T1DM) with growing frequency which is considered as a world health threatening problem is an autoimmune disease with insulinupenia. Considering the relationship between the incidence of T1DM and environmental factors, the aim of this study was to assess seasonal incidence of T1DM and its association with birth season. Methods: This cross-sectional study was conducted on 112 diabetic patients (66 males, 46 females) less than 18 years, referred to Pediatric Endocrine Clinic (Amirkola Children's Hospital) during 2011-2017. All the needed information was extracted from the patient's files and asking questions of their parents. Data were collected in a checklist. Comparison between different seasons and age groups was done by Pearson's chi-square test. Data were analyzed using SPSS 19 and p£0.05 was considered significant level. Results: The mean age of the patients during diagnosis of T1DM was 7.34±3.70 years. The incidence of T1DM was significantly increased in the cold seasons (especially winter) (P

Objective: The seasonal relationship of incidence of musculoskeletal system (MSS) pathologies according to gender and their meteorological variability has not been investigated satisfactorily. The aim of this study is to determine diagnostic distribution of patients with MSS-related complaints and the seasonal relationship of these diagnoses. Materials and Methods: This study was conducted on 45541 patients having MSS-related complaints. Female/male ratios of eleven diagnosis groups were considered and monthly/seasonal incidences were evaluated and relations with climatic factors were searched. Results: While number of patients for both genders admitted to polyclinics increased more in winter, lowest number of patients were admitted in summer. While knee-related pathologies were increased in April (9.4%) and rheumatologic disorders were increased in September (13.3%) for female patients, lumbar pathologies were most frequent in December (9.6%) and rheumatologic disorders were most frequent in September (13.0%) for male patients. Negative correlation was found between average temperature and knee pathologies for all the patients (r=-0.952, p=0.048). There were positive correlations between humidity and knee (r=0.980, p=0.020), elbow (r=0.951, p=0.049), hip (r=0.957, p=0.043), hand-wrist (r=0.963, p=0.037) and pathologies requiring rehabilitation (r=0.954, p=0.046). Conclusion: The number of admissions increased for both genders in winter months, and decreased in summer months. Moreover, relationships of some MSS pathologies with seasonal/meteorological changes should be considered.

Objective: To describe viruses associated with respiratory infection in children in Bucaramanga, the main city in northeastern Colombia. Materials and methods: Descriptive study with prospective collection. Participants were children under 5 years with respiratory symptoms for a maximum of 5 days, treated at two institutions of Bucaramanga. Demographic data, medical and perinatal history and initial physical examination findings were recorded. Samples obtained with nasopharyngeal swabs were processed for 15 respiratory viruses by multiplex reaction polymerase chain test. Results: Between December 2012 and November 2013, 215 children less than 5 years (mean age 14 months) were enrolled. Positivity to at least one virus was 72 % and co-infection was detected in 8.5 %. The most frequently identified viruses in dry seasons were respiratory syncytial virus, rhinovirus A/B/C and metapneumovirus, while in the rainy seasons they were parainfluenza 1/2/3, respiratory syncytial virus and influenza. Coronavirus and bocavirus were identified for the first time in this age group in Colombia. Conclusions: A wide variety of viruses affects children in this area of Colombia, and their occurrence throughout the year is different from that reported in other regions of the country.

Developing a nursing research project with American Indian tribes and navigating the institutional review board approval process can appear daunting to investigators because of tribal research requirements in addition to academic requirements. Nurse investigators conducted a research project exploring experiences of American Indian women with polycystic ovary syndrome. After successful implementation of the project, a model emerged to guide researchers working with tribal communities through project development and the institutional review board process. The model is based on the American Indian medicine wheel with each quadrant aligned with a season of the year: spring, summer, fall, and winter. The seasonal approach divides project development into sections that can be developed independently or simultaneously. The model emphasizes collaborative relationships between the research team and tribe. Researchers can adapt and customize the model for their projects based on their objectives and targeted populations. The purpose of this article is to describe the medicine wheel model and, as an exemplar, demonstrate application of the model in a project involving American Indian women with polycystic ovary syndrome. Additionally, potential implications of the model for nursing research, education, and practice are presented. [ABSTRACT FROM AUTHOR]

Introducción. El dengue tiene un comportamiento estacional asociado a los cambios climáticos, los ciclos del vector, los serotipos circulantes y las dinámicas poblacionales. El análisis de ondículas permite descomponer una serie de tiempo muy larga en sus componentes de tiempo calendario y periodo. Esta es la primera vez que se utiliza esta técnica para generar un modelo exploratorio del comportamiento del dengue en Colombia. Objetivo. Examinar los patrones de estacionalidad interanual del dengue en Colombia, en particular en los cinco municipios más endémicos, para el periodo 2007 a 2012, y de los ciclos entre años entre 1978 y 2013 a nivel nacional. Materiales y métodos. Se hizo un análisis exploratorio de ondículas con base en los datos de los casos incidentes de dengue reportados por semana epidemiológica en el periodo de 2007 a 2012, y por año, en el periodo de 1978 a 2013. Se utilizó un modelo autorregresivo de primer orden como hipótesis nula. Resultados. Fue evidente el efecto de la epidemia de 2010 sobre la serie de tiempo a nivel nacional y la de los cinco municipios. Se observaron diferencias en los patrones de estacionalidad interanual por municipio. Asimismo, a nivel nacional se hallaron ciclos de dos a cinco años desde el 2004. Conclusiones. El análisis de ondícula permite estudiar una serie de tiempo larga con patrones de estacionalidad variables, como en el caso del dengue en Colombia, e identificar diferencias por regiones. Es necesario explorar estos patrones en niveles de agregación inferiores y evaluar su relación con diversas variables predictoras.

Objectives: Season of birth, an exogenous indicator of early life environment, has been related to higher risk of adverse psychiatric outcomes but the findings for Alzheimer’s disease (AD) have been inconsistent. We investigated whether the month or season of birth are associated with AD. Methods: A nationwide nested case-control study including all community-dwellers with clinically verified AD diagnosed in 2005 to 2012 (n=70 719) and up to four age- sex- and region of residence-matched controls (n=282 862) residing in Finland. Associations between month and season of birth and AD were studied with conditional logistic regression. Results: Month of birth was not associated with AD (p=0.09). No strong associations were observed with season (p=0.13), although in comparison to winter births (December-February) summer births (June-August) were associated with higher odds of AD (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.05). However, the absolute difference in prevalence in winter births was only 0.5% (prevalence of those born in winter were 31.7% and 32.2% for cases and controls, respectively). Conclusions: Although our findings do not support the hypothesis that season of birth is related to AD/dementia risk, they do not invalidate the developmental origins of health and disease hypothesis in late-life cognition. It is possible that season does not adequately capture the early life circumstances, or that other (postnatal) risk factors such as lifestyle or socioeconomic factors overrule the impact of prenatal and perinatal factors.