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Epi Final

Terms in this set (110)

epidemiology
the cornerstone of public health. focuses on the distribution and causes of disease in human populations and on developing and testing ways to prevent and controldisease
epidemiology and disease prevention
critical to disease prevention because it sheds light on why a particular disease originates, how it spreads, and its effective control
epidemiologic transition
nations experiencing increases in life expectancy and decreases in fertility. due to transition from acute infectious, parasitic and nutritional deficiency diseases to noninfectious chronic diseases
4 chronic diseases that account for 60% of all deaths
1. cardiovascular
2. cancer
3. COPD
4. diabetes
it is important to
raise priority accorded to chronic diseases and develop and implement effective disease prevention and health promotion strategies and policies for the populations at risk
global population of chronic diseases (2012)
2012 world population= 7 billion
-62 million deaths
-39 million deaths (63%): chronic
-23 million deaths (37%): acute
pre-industrial stage
birth and death rates are high
transitional stage
death rate declines due to increased food production and improved medical care
industrial stage
birth rate declines due to increased opportunities for women and access to birth control
post-industrial stage
birth rates and death rates are low
highest life expectancy
1. japan
2. Germany
3. US
4. Brazil
5. China
6. India
Koch-henle postulates
1. microorganism must be present in every case
2. microorganism must be isolated and grown in pure culture
3. inoculation of microorganism into susceptible host must reproduce disease
4. microorganism must be observed and recovered from host
Myocardial Infarction
Plaque buildup inside artery, built up plaque ruptures and forms a blood clot or blocks flow completely. Scar from heart tissue
Type II diabetes
1. the stomach changes food into glucose
2. glucose enters the bloodstream
3. the pancreas makes insulin
4. insulin enters the bloodstream
5. glucose cant get into the cells of the body. glucose builds up in the blood vessels
sensitivity
proportion of subjects with disease who have a positive test result
specificity
proportion of subjects without disease who have a negative test
PPV
proportion with a positive test who have disease
NPV
proportion with a negative test who do not have disease
incidence rate
new cases (divided by) population at risk during a specific time period
incidence
the proportion of individuals in a population who develop a disease during a specific period of time
null hypothesis
hypothesis in which all effects are zero and there are no differences between treatments
alternative hypothesis
hypothesis in which there are nonzero effects and there are difference between treatments
in hypothesis testing...
we decide which hypothesis to reject by calculating the probability of observed sample statistics under the null (P-value)
population etiologic fraction
fraction of disease that can be attributed to a risk factor
meta-analysis
results of several independent studies are combined into a single overall result to provide a more precise estimate of the relative risk and clarify the true nature of cause and effect relation
1964 Surgeon General Report
meta-analysis; tobacco smoking causes lung cancer and COPD
West Nile characterized by..
RNA virus is causative agent; female mosquito is primary vector of transmission
avian flu...
can't readily be transmitted between people
Marasmus
under-nutrition; primarily in sub-Saharan Africa (severe protein deficiency)
Kwashiorkor
second child disease; when the first child is replaced by a newborn, the first doesn't get mother's milk anymore
Vitamin A deficiency
vitamin A connected with vision; you can develop night blindness. It is a key vitamin in immune system. Supplemental vitamin A can reduce death rate of kids (Nepal National Vitamin A program)
Joseph Goldberger
nutritional deficiency looked the same way as infectious condition. he determined that people who were running orphanage never developed it, but the kids with poor diet did. At Mississippi state prison, he found Niacin deficiency and Vitamin B6 deficiency caused it
deaths from chronic disease
39 million deaths (63%)
deaths from acute disease
23 million deaths (37%)
molecular epidemiology
epidemiologic studies that incorporate molecular and cellular biomarkers of exposure to elucidate disease etiology
genetic epidemiology
epidemiologic studies of heritable factors (genes) and genetic x environmental interactions that influence the risk of disease
cervical cancer
HPV 16 and HPV 18
% of lung cancer that can be attributed to smoking
90%
if prevalence decreases
PPV will decrease
relative risk if there is no effect
1.0
HIV/AIDS timeline
1969- african american teen in st. louis dies of AIDS-like symptoms
1980- first cases of pneumocystis cairn and Kaposi's Sarcoma are reported in NY/CA
1983- first woman in the world is diagnosed with AIDS
-first AIDS case reported in Africa
-Gaetan Dugas a canadian flight attendant who introduced AIDS in US died
strong correlation between
dietary fat and breast cancer
if confidence interval does not overlap 0...
you have statistical significance
NSAIDS reduce colon cancer by
43%
Type 2 and BMI
twice as high in women compared to men for same given level of body mass
20 year time lag
for cancer after smoking
fat cells draw in macrophages
that stimulate it to produce inflammatory proteins that cause insulin resistance and malignant neoplasms then afrogenesis
environmental epidemiology
study of environmental exposures that contribute to or protect against disease, injury, disability and death (involuntary); voluntary exposure such as smoking/drinking
COPD
is #4 leading cause of death in U.S.
Alice Hamilton
founder of Occupational medicine and an expert in studies of lead poisoning...her work has led to regulations
Jolie gene
associated with breast and ovarian cancer...
psychosocial epidemiology
epidemiologic studies designed to determine the role of psychological, behavioral and social determinants of health and disease (new field...STRESS)
Hans Selye
studies of stress in animals..if you stress you increase adrenaline and cortisol from the adrenal glands
most people come out of stress/depression by responding
in positive way after period of time
Stressors
fear, health, injury, pain, anxiety, debt, marriage, divorce, death, calamity
PTSD
chronic stress that may give rise to problems of cardiovascular system
Coronary Artery disease and PTSD
hazard ratio is relative risk...55% increase in risk with PTSD
suicide is outcome of
depression/anxiety
Las Vegas
highest suicide risk
Suicide belt
mountain states- poverty, depression, alcohol abuse, illicit drug use, financial crisis, firearms
attack rate (exposed)
# who ate food and became ill/ total number who ate food
attack rate (unexposed)
# who did not eat food and became ill/ total # who did not eat food
relative risk (attack rate)
attack rate exposed/ attack rate unexposed
salmonella in
BBQ chicken
EBOLA
two principles are surveillance and response...quarantine/isolation in the case of Ebola
roots of epic from
infectious conditions studies
crude death rate of world population
less than 1%
Jenner
if you can introduce a relatively harmless microbe that has cross reactivity with pathogenic microbe, you can introduce new response (cow pox/small pox)
Lous Pasteur
invented the germ theory of disease...looked under the microscope and saw microbes. famous for rabies
rabies vaccine
Pasteur
only infectious disease that has been eradicated from earth
smallpox
Jonathon Snow
exemplifies the attributes of epidemiology (time, place, person)
Robert Koch
identified TB microbacterium, Cholera, Anthrax
Koch-Henle Postulates
for identification of microbe in infectious condition
positive for TB1
1.3 or 2 billion people
develop active form of TB
5-7%
TB is resistant
to a lot of drugs
HIV
infects 39 million people (most in sub sahara africa)
Aids chronic infections
39 million
Aids deaths
2 million
more than 2/3
of people living with HIV worldwide live in Africa
global TB distribution
1.8 million deaths in 2007
HIV-MTB
more than half a million deaths. HIV suppresses the immune system so TB gets into the system
Hepatitis B Virus
liver virus spread through the blood....350 million chronic infections and 600,000 deaths
Hepatitis C Virus
liver virus through contaminated needles...170 million chronic infections and 350,000 deaths
HPV
is and STD
Cervical cancer HPV strains
HPV 16 and HPV 18
# of new HPV infections per year
6.2 million. Point prevalence is 1 billion women
HPV vaccine controversy
certain strains are effective and can eliminate cervical cancer. nobody should die from cervical cancer because pap tests can pick up dysplasi
Cervical cancer mortality
528,000 cases and 266,000 deaths
Malaria
infects children
Anopheles mosquito
vector of malaria transmission...the vector is the female mosquito
malaria has
developed resistance to therapy as it used to be a curable condition
global malaria
1 million deaths
bed nets
discovered in late 1800s by Ronald Ross.
WHO
discovered malaria vector in India
Fred Soper
DDT
DDT spraying in 1930s
eliminated the types of mosquitos in the US that transmit malaria and yellow fever
Silent Spring
by Rachel Carson complained about environmental effects of DDT
Alexander Fleming
discovered Penicillin
Ernst B. Chain and Howard Florey
isolated penicillin and manufactured it
Plasmids
rise of the superbug. Plasmids are DNA transmitted back and forth when they don't finish course of antibiotics
all bacteria and microbes have
developed antibiotic resistance
MRSA
penicillin resistance. develops biofilm which keeps microbe alive and defends it against penicillin.
obesity is risk factor for
hypertension, type II
diabetic foot
get a wound on foot and it doesn't heal and it has to be amputated. neurons don't get blood/immune system doesn't work
Deaths attributed to cigarette smoking
1. lung cancer
2. heart disease
3. COPD
4. other cancers
5. stroke
5.4 MILLION DEATHS
fraction of lung cancer that can be attributed to smoking
more than 90%
incidence formula
new cases/ population without disease
prevalence formula
existing cases/ population at risk during a specific time period
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