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Definition
study of factors that determine the occurrence and distribution of a disease |
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population oriented, studies the community origins of health problems; risk factors, prevent or delay disease |
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patients in health care settings, improve prevention, early detection, diagnosis, and treatment; study people who are ill |
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Scientific study of disease can be approached at four levels |
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submolecular or molecular, tissue or organ, individual patient, populations |
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What are the three stages of disease? |
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predisease, latent, symptomatic |
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primary prevention; before pathologic process begins |
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secondary disease; disease process has begun; asymtomatic |
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tertiary prevention; disease manifestions are evident |
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biological social or environmental |
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women who observe purdah (mechanisms of disease) |
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Definition
avoid public observation; prevents irradiation or ergosterol in the skin - decrease vit D, osteomalacia, can affect future pregnancies |
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the pelvis to become more pear shaped making the opening too small for the fetus |
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social mechanism: excessive fat intake, smoking, and lack of exercise |
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atherogenesis: elevated LDL, cholesterol and decreased levels of HDL; genetic pattern; environmental and other risk factors |
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triad of factors: cause of disease |
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Definition
Host, Agent, Environment, (and vector) |
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Definition
degree the individual can adapt to stressors produced by the agent genotype, nutritional status, BMI, Immune system, social behavior |
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Biologic, Chemical, Physical, Psychosocial stressors |
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Sanitation, Roads, Weather, Crowded living conditions, political and economic health of a society, nutrition, vaccine |
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insects: mosquitoes - malaria arthopods: ticks - lyme disease animals: raccoons - rabies humans: vendors of heroin and cocaine - addiction objects: contaminated needles - hepatitis and AIDS |
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Risk factors of disease (preventable cause) |
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Definition
biologic, behavioral, environmental, immunologic |
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gender, age, weight, bone density |
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behavioral (risk factors) |
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smoking, sexual practices, alcohol intake, illegal drugs, suicide homicide attempts |
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environmental (risk factor) |
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Definition
lyme disease - ixodes tick - borrelia burgdorderi legionnaires' disease - legionella pneumophilia - air conditioning |
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transient immune deficiency - measles, vaccines, cancer chemotherapy, long term use of corticosteroids chronic immune deficiency - HIV and AIDS |
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Nutritional (risk factor) |
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identify individuals at high risk for specific problems: CV disease, Breast cancer, Ovarian cancer identify individuals who will respond well or poorly to specific drugs |
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Definition
identify individuals at high risk for specific problems: CV disease, Breast cancer, Ovarian cancer identify individuals who will respond well or poorly to specific drugs |
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services , social and spiritual (risk factors) |
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Definition
44,000 deaths/year secondary to medical errors: medication errors, wound infections, unecessary or inappropriate diagnostic or surgical procedures personal beliefs concerning life strong religious faith being associated with better health |
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Term
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Definition
results when a vaccine protects the immunized person, reduces an immunized person's ability to spread disease |
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Term
degree of immunity necessary to eliminate a virus from a population varies depending on: |
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Definition
type of virus, time of year, density and social patterns of the population |
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successes in herd immunity: smallpox |
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Definition
effective against both forms |
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Term
successes in herd immunity: poliomyelitis |
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Definition
kill (inactivated) polio vaccine; protection to the immunized person didn't make much herd immunity; stimulated the production of blood antibodies but did not produce cell-mediated immunity in the intestine live attenuated Sabin oral polio vaccine |
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Term
live ateenuated Sabin oral polio vaccine... |
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Definition
produced cell mediated immunity; the prevalence of all three polio types declined rapidly; last known case of wild poliovirus was August 1991 in peru |
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Term
vaccine caused polio causes... to eliminate vaccine caused cases... |
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Definition
1 case per 2.4 million vaccine doses; infants are given the IPV instead of OPV |
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Term
unintended consequences in solution of public health problem |
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Definition
decrease in level of immunity during adulthood |
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Term
in Russia, wide availabiltiy of the diptheria vaccine caused, |
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Definition
a major epidemic in people over 14 years. 72% of the reported cases; disease in older people apparently was due to a decline in the adult immunity levels; 4,000 deaths |
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Ecologic and genetic factors can interact to produce... |
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Definition
new strains of influenza virus |
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Term
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Definition
major genetic changes in the influenza virus - worldwide outbreak (pandemic) |
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minor genetic changes in the influenza virus - major regional outbreaks (H5N1) |
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oseltamivir; seasonal flu prophylaxis and treatment of uncomplicated cases |
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Definition
major genetic reassortment (antigenic shift) that are substantially different from previous viruses |
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Biologic spectrum of disease |
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Definition
variation in severity of a disease process |
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Term
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Definition
visible cases vs invisible cases; first indentified cases of a new disease are often fatal or severe |
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how can asymptomatic infections be uncovered? |
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Definition
either by finding elevated antibody titers or by culturing the organism |
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Term
how do we look at community health interventions? |
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Definition
field trials - randomized trials of preventive measures in the field; only one phase, ongoing surveillance to ensure continued safety |
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Term
what three examples were given for surveillance of community health interventions? |
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Definition
infants and children given a new rotavirus, people vaccinated with small pox (vaccine associated cardiomyopathy), HPV vaccine (unexpected deaths in adolescents) |
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Term
application of epidemiologic methods |
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Definition
improves clinical medicine, permits risk estimation, providing expert testimony in court |
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Term
application of epidemiologic methods |
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Definition
improves clinical medicine, permits risk estimation, providing expert testimony in court |
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Term
how do epidemiologic improve clinical medicine |
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Definition
diagnosis - selection of best diagnostic tests, determination of best cutoff points, development of strategies to use in screening treatment prognosis |
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Term
why does an infant lose heat quickly? |
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Definition
large surface area - increased heat loss small volume - decreased heat generation |
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Term
how does an infant regulate their body temperature? |
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Definition
can't shiver, brown fat tissue -very vascular and contains lots of mitochondria |
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how does an adult regulate their body temperature? |
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Definition
little brown fat, shivering, conduction, convection, evaporation, and radiaton |
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Term
is tehre a relationship between malnutrition and infection? |
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Definition
both make each other worse malnourished child: more difficulty making antibodies and repairing tissue damage; makes him or her less resistant to infectious diseases and their complications |
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