AIDS - Current Table Of ContentsDesigning and interpreting HIV noninferiority trials in naive and experienced patients.
Page: 913DOI: 10.1097/QAD.0b013e3282f5556dAuthors: Hill, Andrew a; Sabin, Caroline b
Baseline serum low-density lipoprotein cholesterol levels predict response to hepatitis C virus therapy in HIV/hepatitis C virus coinfected patients.
Page: 923DOI: 10.1097/QAD.0b013e3282ff8ad3Authors: del Valle, Jose a,b,*; Mira, Jose A a,b,*; de los Santos, Ignacio c; Lopez-Cortes, Luis F d,*; Merino, Dolores e,*; Rivero, Antonio f,*; Giron, Jose A g,*; Rios-Villegas, Maria J h,*; Gonzalez-Serrano, Mercedes i,*; Collado, Antonio j,*; Garcia-Garcia, Jose A a,b*; Pineda, Juan A a,*
AIDS Patient Care and STDs - Table of ContentsHepatitis C Protease and Polymerase Inhibitors in Developmentliebertonline@liebertpub.com (Gustine Liu-Young et al) Wed, 14 May 2008 21:15:40 -0000
AIDS Patient Care and STDs , Vol. 0, No. 0: 1-9.
ABSTRACT Hepatitis C infection (HCV) remains a global problem and the current anti-HCV therapies available in the clinic have sustained virologic response rates (SVR) of only about 50%, especially in HCV genotype 1-infected subjects. The SVR is even ...
Potential for New Antiretrovirals to Address Unmet Needs in the Management of HIV-1 Infectionliebertonline@liebertpub.com (Graeme Moyle et al) Wed, 14 May 2008 21:12:47 -0000
AIDS Patient Care and STDs , Vol. 0, No. 0: 1-13.
ABSTRACT Despite the myriad advances in antiretroviral therapy since the original highly active antiretroviral therapy regimens were developed, there remain numerous important and pressing unmet needs that, if addressed, would substantially improve the ...
American Journal of Epidemiology - current issueLow Workplace Social Capital as a Predictor of Depression: The Finnish Public Sector StudyKouvonen, A., Oksanen, T., Vahtera, J., Stafford, M., Wilkinson, R., Schneider, J., Vaananen, A., Virtanen, M., Cox, S. J., Pentti, J., Elovainio, M., Kivimaki, M. Fri, 09 May 2008 00:00:00 -0000
In a prospective cohort study of Finnish public sector employees, the authors examined the association between workplace social capital and depression. Data were obtained from 33,577 employees, who had no recent history of antidepressant treatment and who reported no history of physician-diagnosed depression at baseline in 2000–2002. Their risk of depression was measured with two indicators: recorded purchases of antidepressants until December 31, 2005, and self-reports of new-onset depression diagnosed by a physician in the follow-up survey in 2004–2005. Multilevel logistic regression analysis was used to explore whether self-reported and aggregate-level workplace social capital predicted indicators of depression at follow-up. The odds for antidepressant treatment and physician-diagnosed depression were 20–50% higher for employees with low self-reported social capital than for those reporting high social capital. These associations were not accounted for by sex, age, marital status, socioeconomic position, place of work, smoking, alcohol use, physical activity, and body mass index. The association between social capital and self-reported depression attenuated but remained significant after further adjustment for baseline psychological distress (a proxy for undiagnosed mental health problems). Aggregate-level social capital was not associated with subsequent depression.
Invited Commentary: Social Capital, Social Contexts, and DepressionLindstrom, M. Fri, 09 May 2008 00:00:00 -0000
The literature concerning social capital and health has grown exponentially during the past somewhat more than 10 years. The study by Kouvonen et al. (Am J Epidemiol 2008;167:1143–1151) is a longitudinal multilevel analysis of 33,577 public sector employees in Finland. The study shows a significant association between workplace social capital and depression, which is an interesting finding in a very new field of the study of social capital and health. However, the study also serves as an inspiration for further studies in important research areas. Workplace social capital may be investigated according to both horizontal, that is, social contacts and level of trust in relation to coworkers, and vertical, that is, relation with employer/supervisor across power gradients, dimensions. The fact that workplace social capital may affect social capital outside work and vice versa is also of interest. It is also important to define and identify the social context level in a correct way in multilevel studies. In the study by Kouvonen et al., the social context is not a geographic entity but an entity defined according to place of work, and the definition of such a social context entails several difficulties. This study presents interesting findings and provides a basis for future studies.
Chiropractic & Osteopathy - Latest articlesMaintenance care in chiropractic - what do we know?
Charlotte Leboeuf-Yde and Lise Hestbaek Thu, 08 May 2008 00:00:00 -0000
Background:
Back problems are often recurring or chronic. It is therefore not surprising that chiropractors wish to prevent their return or reduce their impact. This is often attempted with a long-term treatment strategy, commonly called maintenance care. However, some aspects of maintenance care are considered controversial. It is therefore relevant to investigate the scientific evidence forming the basis for its use.
Objectives: A review of the literature was performed in order to obtain answers to the following questions: What is the exact definition of maintenance care, what are its indications for use, and how is it practised? How common is it that chiropractors support the concept of maintenance care, and how well accepted is it by patients? How frequently is maintenance care used, and what factors are associated with its use? Is maintenance care a clinically valid method of approach, and is it cost-effective for the patient?
Results:
Thirteen original studies were found, in which maintenance care was investigated. The relative paucity of studies, the obvious bias in many of these, the lack of exhaustive information, and the diversity of findings made it impossible to answer any of the questions.
Conclusion:
There is no evidence-based definition of maintenance care and the indications for and nature of its use remain to be clearly stated. It is likely that many chiropractors believe in the usefulness of maintenance care but it seems to be less well accepted by their patients. The prevalence with which maintenance care is used has not been established. Efficacy and cost-effectiveness of maintenance care for various types of conditions are unknown. Therefore, our conclusion is identical to that of a similar review published in 1996, namely that maintenance care is not well researched and that it needs to be investigated from several angles before the method is subjected to a multi-centre trial.
Carpal tunnel syndrome and the "double crush" hypothesis: a review and implications for chiropracticBrent S Russell Mon, 21 Apr 2008 00:00:00 -0000
Upton and McComas claimed that most patients with carpal tunnel syndrome not only have compressive lesions at the wrist, but also show evidence of damage to cervical nerve roots. This "double crush" hypothesis has gained some popularity among chiropractors because it seems to provide a rationale for adjusting the cervical spine in treating carpal tunnel syndrome. Here I examine use of the concept by chiropractors, summarize findings from the literature, and critique several studies aimed at supporting or refuting the hypothesis. Although the hypothesis also has been applied to nerve compressions other than those leading to carpal tunnel syndrome, this discussion mainly examines the original application – "double crush" involving both cervical spinal nerve roots and the carpal tunnel. I consider several categories: experiments to create double crush syndrome in animals, case reports, literature reviews, and alternatives to the original hypothesis. A significant percentage of patients with carpal tunnel syndrome also have neck pain or cervical nerve root compression, but the relationship has not been definitively explained. The original hypothesis remains controversial and is probably not valid, at least for sensory disturbances, in carpal tunnel syndrome. However, even if the original hypothesis is importantly flawed, evaluation of multiple sites still may be valuable. The chiropractic profession should develop theoretical models to relate cervical dysfunction to carpal tunnel syndrome, and might incorporate some alternatives to the original hypothesis. I intend this review as a starting point for practitioners, educators, and students wishing to advance chiropractic concepts in this area.
PubMed: 0002-9637High HPV 16 viral load is associated with increased cervical dysplasia in Honduran women. Tábora N, Ferrera A, Bakkers JM, Massuger LF, Melchers WJ
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High HPV 16 viral load is associated with increased cervical dysplasia in Honduran women.
Am J Trop Med Hyg. 2008 May;78(5):843-6
Authors: Tábora N, Ferrera A, Bakkers JM, Massuger LF, Melchers WJ
Cervical cancer is believed to have a co-factorial etiology in which high-risk human papillomavirus (HPV) infections are considered an essential factor and other elements play an ancillary role. Besides the importance of specific HPV genotypes, other viral cofactors as viral load may influence the progression likelihood. In this study the relationship between HPV 16 viral load with respect to the grade of cervical disease in Honduran women was investigated. A real-time PCR allowing quantification of both HPV 16 genome and beta-globin gene to normalize the measuring HPV 16 load in cervical cells was used. The data in 87 women with cervical dysplasia or cervical cancer and in 23 women with a negative Pap smear were evaluated. The highest average of HPV 16 viral load was detected in women with High Squamous Intraepithelial Lesions (HSIL). An increasing amount of HPV in higher cervical lesions was found, which could indicate a dose-response association between viral load and precancerous lesion grade.
PMID: 18458323 [PubMed - in process]
Experimental West Nile virus infection in jungle crows (Corvus macrorhynchos). Shirafuji H, Kanehira K, Kubo M, Shibahara T, Kamio T
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Experimental West Nile virus infection in jungle crows (Corvus macrorhynchos).
Am J Trop Med Hyg. 2008 May;78(5):838-42
Authors: Shirafuji H, Kanehira K, Kubo M, Shibahara T, Kamio T
We experimentally infected jungle crows (Corvus macrorhynchos), which are representative corvids in East Asia, with West Nile virus (WNV) to study their susceptibility toward WNV infection. Six jungle crows were subcutaneously inoculated with 1,000 plaque-forming units (PFU) of the WNV NY99 strain. Within 7 days after inoculation, five of the six infected crows died, and peak viremias ranged from 10(6.5) to 10(10.9) PFU/mL serum. In addition, infected crows shed WNV in the oral cavity and cloaca, and the virus was widely disseminated in the organs of the crows. Based on these findings, we conclude that jungle crows are highly susceptible to WNV infection, and they could serve as amplifying hosts in the transmission of WNV. Although WNV has not been detected in East Asia, the virus could spread rapidly on introduction into this region because of the large number of potential amplifying hosts and vector mosquitoes that inhabit this region.
PMID: 18458322 [PubMed - in process]
Annals of Clinical Microbiology and Antimicrobials - Latest articlesAn uncommon presentation for a severe invasive infection due to methicillin-resistant Staphylococcus aureus clone USA300 in Italy: a case report Piero Valentini, Gabriella Parisi, Monica Monaco, Francesca Crea, Teresa Spanu, Orazio Ranno, Mirella Tronci and Annalisa Pantosti Wed, 30 Apr 2008 00:00:00 -0000
Background:
Methicillin resistant Staphylococcus aureus (MRSA) has been considered for many years a typical nosocomial pathogen. Recently MRSA has emerged as a frequent cause of infections in the community. More commonly, community-acquired (CA)-MRSA is a cause of infections of the skin and soft-tissues, but life-threatening infections such as necrotizing pneumonia and sepsis can occasionally occur.Case presentationThis report describes an uncommon presentation of invasive CA-MRSA infection in an adolescent without known risk factors. The presentation was typical for bacterial meningitis, but the clinical findings also revealed necrotizing pneumonia. Following the development of deep venous thrombosis, the presence of an inherited trombophilic defect (factor V Leiden) was detected. The patient was successfully treated with an antibiotic combination including linezolid and with anticoagulant therapy. CA-MRSA was isolated from both cerebrospinal fluid and blood. The isolates were resistant to oxacillin and other beta-lactam antibiotics and susceptible to the other antibiotics tested including erythromycin. Molecular typing revealed that the strains contained the Panton-Valentine leukocidin genes and type IV SCCmec, and were ST8, spa type t008, and agr type 1. This genetic background is identical to that of the USA300 clone.
Conclusions:
This report highlights that meningitis can be a new serious presentation of CA-MRSA infection. CA-MRSA strains with the genetic background of the USA300 clone are circulating in Italy and are able to cause severe infections.
Fatal bacteremia due to immotile Vibrio cholerae serogroup O21 in Vientiane, Laos – a case reportRattanaphone Phetsouvanh, Masami Nakatsu, Eiji Arakawa, Viengmone Davong, Manivanh Vongsouvath, Olay Lattana, Catrin E Moore, Satoshi Nakamura and Paul N Newton Fri, 25 Apr 2008 00:00:00 -0000
Background:
Human infections with non-O1, non-O139 V. cholerae have been described from Laos. Elsewhere, non cholera-toxin producing, non-O1, non-O139 V. cholerae have been described from blood cultures and ascitic fluid, although they are exceedingly rare isolates.Case presentationWe describe a farmer who died with Vibrio cholerae O21 bacteremia and peritonitis in Vientiane, Laos, after eating partially cooked apple snails (Pomacea canaliculata) and mussels (Ligumia species). The cultured V. cholerae were non-motile. PCR detected ompW and toxR gene regions but not the ctxA, ompU, omp K and TCP gene regions. Although the organisms lacked flagellae on scanning electron microscopy, they possessed the Vibrio flagellin flaA gene.
Conclusion:
Severe bacteremic non-O1, non-O139 V. cholerae is reported from Laos. The organisms were unusual in being non-motile. They possessed the Vibrio flagellin flaA gene. Further research to determine the reasons for the non-motility and virulence is required.
PubMed: 1359-6535Future directions in therapy for chronic hepatitis C. Jensen DM, Ascione A
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Future directions in therapy for chronic hepatitis C.
Antivir Ther. 2008;13 Suppl 1:31-6
Authors: Jensen DM, Ascione A
The development of new antiviral therapies in the treatment of hepatitis C virus (HCV) is reviewed, including a discussion of the potential advances that this treatment will bring. Data from new molecules in Phase I and II clinical trials, specifically polymerase and protease inhibitors, will be discussed. The potential for resistance has been reported when these have been used as monotherapy. However, their use in combination with pegylated interferon, particularly in the presence of ribavirin, has resulted in significant improvements in antiviral activity. Preliminary studies have confirmed that the new molecules are well tolerated and further clinical studies are underway to evaluate their efficacy. Nevertheless, because of its critical role at all stages of therapy, pegylated interferon is likely to remain the cornerstone of HCV therapy.
PMID: 18432161 [PubMed - in process]
Ribavirin considerations in treatment optimization. Dusheiko G, Nelson D, Reddy KR
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Ribavirin considerations in treatment optimization.
Antivir Ther. 2008;13 Suppl 1:23-30
Authors: Dusheiko G, Nelson D, Reddy KR
Ribavirin is a guanosine analogue that has little antiviral activity when used alone, but considerably enhances the efficacy of conventional and pegylated interferon in the treatment of hepatitis C virus (HCV). The precise mode of action of ribavirin is not fully understood; however, it is crucial for the achievement of high sustained virological response (SVR) rates by enhancing virological response and reducing relapse rates. Data from several studies have confirmed that higher initial doses of ribavirin lead to higher SVR rates. Furthermore, intensified ribavirin dosing might also improve SVR rates in 'difficult-to-cure' patients. It is also important to minimize ribavirin dose reductions to promote high SVR rates and to maintain ribavirin levels throughout treatment to prevent viral breakthrough and relapse. The pharmacokinetic profile of ribavirin reveals a long elimination half-life due to accumulation in the blood, such that its side-effect profile includes haemolytic anaemia. Therefore, finding the optimal ribavirin dose requires a balance between efficacy and its associated side effects to ensure improved patient outcomes. Here, we discuss how optimizing the ribavirin component of combined therapy for HCV is an essential part of treatment optimization.
PMID: 18432160 [PubMed - in process]
BMC Infectious Diseases - Latest articlesScreening for tuberculosis infection among newly arrived asylum seekers: comparison of QuantiFERON(R)TB Gold with tuberculin skin testBrita Askeland Winje, Fredrik Oftung, Gro Ellen Korsvold, Turid Mannsaker, Anette Skistad Jeppesen, Ingunn Harstad, Berit Tafjord Heier and Einar Heldal Wed, 14 May 2008 00:00:00 -0000
Background:
QuantiFERON(R)TB Gold (QFT) is a promising blood test for tuberculosis infection but with few data so far from immigrant screening. The aim of this study was to compare results of QFT and tuberculin skin test (TST) among newly arrived asylum seekers in Norway and to assess the role of QFT in routine diagnostic screening for latent tuberculosis infection.
Methods:
The 1000 asylum seekers (age > 18 years) enrolled in the study were voluntarily recruited from 2813 consecutive asylum seekers arriving at the national reception centre from September 2005 to June 2006. Participation included a QFT test and a questionnaire in addition to the mandatory TST and chest X-ray.
Results and Discussion:
Among 912 asylum seekers with valid test results, 29% (264) had a positive QFT test whereas 50% (460) tested positive with TST (indurations > 6 mm), indicating a high proportion of latent infection within this group. Among the TST positive participants 50 % were QFT negative, whereas 7% of the TST negative participants were QFT positive. There was a significant association between increase in size of TST result and the likelihood of being QFT positive. Agreement between the tests was 71-79 % depending on the chosen TST cut-off and it was higher for non-vaccinated individuals.
Conclusions:
By using QFT in routine screening, further follow-up could be avoided in 43% of the asylum seekers who would have been referred if based only on a positive TST (> 6 mm). The proportion of individuals referred will be the same whether QFT replaces TST or is used as a supplement to confirm a positive TST, but the number tested will vary greatly. All three screening approaches would identify the same proportion (88-89%) of asylum seekers with a positive QFT and/or a TST > 15 mm, but different groups will be missed.
UV-visible marker confirms that environmental persistence of Clostridium difficile spores in toilets of patients with C. difficile-associated diarrhea is associated with lack of compliance with cleaning protocolMichelle J. Alfa, Christine Dueck, Nancy Olson, Pat DeGagne, Selena Papetti, Alana Wald, Evelyn Lo and Godfrey Harding Mon, 12 May 2008 00:00:00 -0000
Background:
An ultraviolet visible marker (UVM) was used to assess the cleaning compliance of housekeeping staff for toilets in a tertiary healthcare setting.
Methods:
The UVM was applied to the toilets of patients who were on isolation precautions due to Clostridium difficile-associated diarrhea (CDAD) as well as for patients who were not on isolation precautions. Cleaning was visually scored using a numeric system where 0, 1, 2, and 3 represented ; no, light, moderate or heavy residual UVM. Rodac plates containing CDMN selective agar were used to test for the presence of C. difficile on the surfaces of patient's toilets.
Results:
Despite twice daily cleaning for the toilets of patients who were on CDAD isolation precautions, the average cleaning score was 1.23 whereas the average cleaning score for toilets of patients not on isolation precautions was 0.9. Even with optimal cleaning (UVM score of 0) C. difficile was detected from 33% of the samples taken from toilets of patients with CDAD (4% detection in toilet samples from patients who had diarrhea not due to CDAD).
Conclusions:
Our data demonstrated the value of UVM for monitoring the compliance of housekeeping staff with the facility's toilet cleaning protocol. In addition to providing good physical cleaning action, agents with some sporicidal activity against C. difficile may be needed to effectively reduce the environmental reservoir.
Current Opinion in HIV & AIDS - Current Table Of ContentsEditorial introductions.Page: viiDOI: 10.1097/COH.0b013e328300a173
Guidelines for managing cardiovascular risk: an evolving area.Page: 205DOI: 10.1097/COH.0b013e3282fc75feAuthors: Currier, Judith S a; Lundgren, Jens D b
Current Opinion in Infectious Diseases - Current Table Of ContentsEditorial introductions.
Page: viiDOI: 10.1097/QCO.0b013e328303bf8b
Recently identified factors predisposing children to infectious diseases.
Page: 217DOI: 10.1097/QCO.0b013e3282fa1824Authors: Arkwright, Peter D a; Abinun, Mario b
Epidemiologic Reviews - current issueThe Global Epidemic of Obesity: An OverviewCaballero, B. Thu, 12 Jul 2007 00:00:00 -0000
The Obesity Epidemic in the United States Gender, Age, Socioeconomic, Racial/Ethnic, and Geographic Characteristics: A Systematic Review and Meta-Regression AnalysisWang, Y., Beydoun, M. A. Thu, 12 Jul 2007 00:00:00 -0000
This review of the obesity epidemic provides a comprehensive description of the current situation, time trends, and disparities across gender, age, socioeconomic status, racial/ethnic groups, and geographic regions in the United States based on national data. The authors searched studies published between 1990 and 2006. Adult overweight and obesity were defined by using body mass index (weight (kg)/height (m)2) cutpoints of 25 and 30, respectively; childhood "at risk for overweight" and overweight were defined as the 85th and 95th percentiles of body mass index. Average annual increase in and future projections for prevalence were estimated by using linear regression models. Among adults, obesity prevalence increased from 13% to 32% between the 1960s and 2004. Currently, 66% of adults are overweight or obese; 16% of children and adolescents are overweight and 34% are at risk of overweight. Minority and low-socioeconomic-status groups are disproportionately affected at all ages. Annual increases in prevalence ranged from 0.3 to 0.9 percentage points across groups. By 2015, 75% of adults will be overweight or obese, and 41% will be obese. In conclusion, obesity has increased at an alarming rate in the United States over the past three decades. The associations of obesity with gender, age, ethnicity, and socioeconomic status are complex and dynamic. Related population-based programs and policies are needed.
Epidemiology and Infection - Current IssueVolume 136 Issue 06 Sat, 31 May 2008 23:00:00 -0000
Epidemiology and Infection, Volume 136 Issue 06 Increased frequency in 2007 - now 8 issues per year!
Epidemiology and Infection publishes original reports and reviews on all aspects of infection in humans and animals. Particular emphasis is given to the epidemiology, prevention and control of infectious diseases. The field covered is broad and includes the zoonoses, tropical infections, food hygiene, vaccine studies, statistics and the clinical, social and public-health aspects of infectious disease. Papers covering microbiology and immunology which have an epidemiological relevance are part of this broad field. Papers come from medical and veterinary scientists worldwide. It has become the key periodical in which to find the latest reports on recently discovered infections and new technology. For those concerned with policy and planning for the control of infections, the papers on mathematical modelling of epidemics caused by historical, current and emergent infections, will be of particular value. To celebrate 100 years of the journal, a series of important papers has been selected and each, together with a modern commentary on the paper by an expert, will be published on-line. This journal has now moved over to electronic submission, using the Scholar One system. Click here to go to the submission website. Guidance on how to upload your manuscript is available on the site by clicking "User Tutorials".
Online manuscript submission (now) available, please go to http://mc.manuscriptcentral.com/cup/hyg
Part III. Analysis of data gaps pertaining to enterotoxigenic Escherichia coli infections in low and medium human development index countries, 1984–2005Review ArticlesS. K. GUPTA, J. KECK, P. K. RAM, J. A. CRUMP, M. A. MILLER, E. D. MINTZ, Epidemiology and Infection, Volume 136 Issue 06 , pp 721-738Abstract
Filaria Journal - Latest articlesContribution of migrant coffee labourers infected with Onchocerca volvulus to the maintenance of the microfilarial reservoir in an ivermectin-treated area of MexicoMario A Rodríguez-Pérez, Aldo Segura Cabrera, Cristian Lizarazo Ortega, María-Gloria Basáñez and John B Davies Tue, 18 Dec 2007 00:00:00 -0000
Background:
Since 1991, in Mexico, ivermectin has been administered twice a year to all residents in the onchocerciasis endemic foci which are mainly located in the coffee growing areas. However, the presence of a potentially infected itinerant seasonal labour force which is not treated regularly could jeopardise the attainment of the 85% coverage which is the present target for elimination of the disease.
Methods:
The prevalence and intensity of Onchocerca volvulus microfilariae (mf), as well as their transmission from humans to vectors, were assessed during the coffee planting-clearing and harvesting seasons of 1997–1998, and 1998–1999 in two localities (I and II) of Southern Chiapas, Mexico, which regularly receive an influx of untreated migrant coffee labourers.
Results:
Localities I and II had, respectively, an average of 391 (± 32) and 358 (± 14) resident inhabitants, and 70 (± 52) and 498 (± 289) temporary labourers. The ratio of migrants to residents ranged from 0.1:1 in locality I to 2.4:1 in locality II. The proportion of infected Simulium ochraceum s.l. parous flies was significantly lower in locality I than in locality II, and significantly higher during the stay of the migrants than before their arrival or after their departure. Parity and infection were higher in May-July than in November-February (in contrast with the latter being typically considered as the peak onchocerciasis transmission season by S. ochraceum s.l.).
Conclusion:
The presence of significant numbers of untreated and potentially infected migrants may contribute to ongoing transmission, and their incorporation into ivermectin programmes should be beneficial for the attainment of the elimination goals of the regional initiative. However, the possibility that the results also reflect transmission patterns for the area cannot be excluded and these should be analyzed further.
Epidemiology and psycho-social aspects of onchocercal skin diseases in northeastern NigeriaIkem Chris Okoye and Celestine OE Onwuliri Mon, 03 Dec 2007 00:00:00 -0000
Background:
Observations were made on the prevalence of onchocerciasis and Onchocercal Skin Diseases (OSD); frequency of occurrence and anatomical distribution of OSD in the Hawal River Valley, an established onchocerciasis endemic focus in north-eastern Nigeria.
Methods:
Symptoms of OSD were diagnosed in 5 844 subjects using Rapid Assessment Method (RAM) while 1 479 of the subjects chosen from alternate households had their skin biopsies examined for active microfilariae of Onchocerca volvulus. Also, Focal Group Discussions (FGD) were conducted at the Health District levels.
Results:
O. volvulus was recorded in (19.0%) and OSD in (43.8%) of the subjects. The Mantel-Haenszel test for linear association showed a close agreement between onchocerciasis prevalence and the rate of OSD (χ2 = 3.93; p < 0.05). The various forms of OSD occurred in the order: CPOD (17.7%), APOD (9.9%), DPM (9.0%), LOD (7.0%) and ATR (3.1%). The overall frequency of occurrence of various symptoms of OSD on different anatomical locations showed the locations in descending order of occurrence as lower limbs (24.6%), upper limbs (21.3%), buttocks (19.9%), shoulder & neck (19.1%), abdomen and trunk (11.3%), backside (10.6), and 'other' sites (7.5%). The Focal Group Discussion (FGD) revealed the most worrisome consequences of OSD as social isolation of victims (31.3%), shame and low self esteem (22.7%) and high cost of medication (15.6%).
Conclusion:
It is recommended that Onchocerciasis control programmes in the Hawal River Valley and any other focus with high incidence of OSD should incorporate an aspect that would address the anxiety and depression caused by various OSD lesions since they carry lots of psycho-social implications. This would increase acceptance and compliance of the target population. The classification criteria of onchocerciasis endemicity should be based on either or both of the O. volvulus and onchocercal skin disease burden of any community and no longer on O. volvulus parasitic infection rate alone.
Foodborne Pathogens and Disease - Table of ContentsFoodborne Disease Trends and Reportsliebertonline@liebertpub.com (Peter Gerner-Smidt et al) Thu, 20 Sep 2007 14:55:50 -0000
Foodborne Pathogens and Disease Apr 2008, Vol. 5, No. 2: 111-114.
Molecular Epidemiological Analysis and Microbial Source Tracking of Salmonella enterica Serovars in a Preharvest Turkey Production Environmentliebertonline@liebertpub.com (Rajesh Nayak et al) Sun, 13 Apr 2008 14:06:23 -0000
Foodborne Pathogens and Disease Apr 2008, Vol. 5, No. 2: 115-126.
Epidemiological studies were conducted to source track and delineate horizontal transmission pathways of Salmonella serovars in a turkey production environment. Salmonella enterica serovar Heidelberg (n = 111), Salmonella Senftenberg (n = 14), Salmonella ...
PubMed: 0019-9567Molecular Variations in Klebsiella pneumoniae and Escherichia coli FimH Affect Function and Pathogenesis in the Urinary Tract. Rosen DA, Pinkner JS, Walker JN, Elam JS, Jones JM, Hultgren SJ
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Molecular Variations in Klebsiella pneumoniae and Escherichia coli FimH Affect Function and Pathogenesis in the Urinary Tract.
Infect Immun. 2008 May 12;
Authors: Rosen DA, Pinkner JS, Walker JN, Elam JS, Jones JM, Hultgren SJ
Type 1 pili mediate binding, invasion and biofilm formation of uropathogenic Escherichia coli (UPEC) in the host urothelium during urinary tract infection (UTI) via the adhesin FimH. In this study, we characterized the molecular basis of functional differences between FimH of the UPEC isolate, UTI89, and the Klebsiella pneumoniae cystitis isolate, TOP52. Type 1 pili characteristically mediate mannose-sensitive hemagglutination (MSHA) of guinea pig erythrocytes. Although the adhesin domain of K. pneumoniae TOP52 FimH (FimH52) is highly homologous to that of E. coli, with an identical mannose binding pocket and surrounding hydrophobic ridge, it lacks the ability to agglutinate guinea pig erythrocytes. In addition, FimH-dependent biofilm formation in K. pneumoniae is inhibited by heptyl mannose, but not methyl mannose, suggesting the need for contacts outside of the mannose binding pocket. The binding specificity differences observed for FimH52 resulted in significant functional differences seen in K. pneumoniae UTI pathogenesis compared to E. coli. Infections in a murine model of UTI demonstrated that although the K. pneumoniae strain TOP52 required FimH52 for invasion and IBC formation in the bladder, FimH52 was not essential for early colonization. This work reveals that a limited amount of sequence variation between the FimH of E. coli and K. pneumoniae results in significant differences in function and ability to colonize the urinary tract.
PMID: 18474655 [PubMed - as supplied by publisher]
The Capsule Sensitizes Streptococcus pneumoniae to Neutrophil Alpha-Defensins HNP 1-3. Beiter K, Wartha F, Hurwitz R, Normark S, Zychlinsky A, Henriques-Normark B
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The Capsule Sensitizes Streptococcus pneumoniae to Neutrophil Alpha-Defensins HNP 1-3.
Infect Immun. 2008 May 12;
Authors: Beiter K, Wartha F, Hurwitz R, Normark S, Zychlinsky A, Henriques-Normark B
Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide. Its polysaccharide capsule causes resistance to phagocytosis and interferes with the innate immune system's ability to clear infections at an early stage. Nevertheless, we found that encapsulated pneumococci are sensitive to killing by a human neutrophil granule extract. We fractionated the extract by high performance liquid chromatography and identified alpha-defensins by mass spectrometry as the proteins responsible for killing pneumococci. Commercial alpha-defensins HNP 1-3 confirmed these findings. We analyzed the sensitivity of different pneumococcal strains to HNP 1-3 and found that encapsulated strains are efficiently killed at physiological concentrations (7.5 microg/ml). Surprisingly, non-encapsulated, non-virulent pneumococci were significantly less sensitive to alpha-defensins. The proposed mechanisms of alpha-defensin resistance in non-encapsulated pneumococci is surface charge modification, e.g. by introduction of positive charge by D-alanylation of surface exposed lipoteichoic acids. These mechanisms are surmounted by the presence of the capsule, which we hypothesize is masking these charge modifications. Hence alpha-defensins in the phagolysosome of neutrophils possibly contribute to intracellular killing after antibody-mediated opsonophagocytosis of encapsulated pneumococci.
PMID: 18474654 [PubMed - as supplied by publisher]
Latest Issue of International Journal of Medical MicrobiologyEditorial - ETOX turned twentySebo P.
Pathogenomics of mobile genetic elements of toxigenic bacteriaHacker J.Hochhut B.Middendorf B.Schneider G.Buchrieser C.Gottschalk G.Dobrindt U.
Latest Issue of International Journal of STD & AIDSPrimary syphilisEccleston, KathrynCollins, LisaHiggins, Stephen P.
The polymicrobial hypothesis of bacterial vaginosis causation: a reassessmentJosey, W.E.Schwebke, J.R.
JAIDS Journal of Acquired Immune Deficiency Syndromes - Current Table Of ContentsPlasmacytoid and Myeloid Dendritic Cells With a Partial Activation Phenotype Accumulate in Lymphoid Tissue During Asymptomatic Chronic HIV-1 Infection.
Page: 1DOI: 10.1097/QAI.0b013e3181664b60Authors: Dillon, Stephanie M PhD *+; Robertson, Kathryn B MD *; Pan, Samuel C BA, MS *; Mawhinney, Samantha ScD ++; Meditz, Amie L MD *; Folkvord, Joy M MS *; Connick, Elizabeth MD *; McCarter, Martin D MD [S]; Wilson, Cara C MD *+
Long-Term Monitoring of Visceral Leishmaniasis in Patients With AIDS: Relapse Risk Factors, Value of Polymerase Chain Reaction, and Potential Impact on Secondary Prophylaxis.
Page: 13DOI: 10.1097/QAI.0b013e318166af5dAuthors: Bourgeois, Nathalie MD *; Lachaud, Laurence MD, PhD *; Reynes, Jacques MD, PhD +; Rouanet, Isabelle MD ++; Mahamat, Aba MD [S]; Bastien, Patrick MD, PhD *
PubMed: 0804-4643Single nucleotide polymorphisms in new candidate genes are associated with bone mineral density and fracture risk. Lazary A, Kosa J, Tobias B, Lazary J, Balla B, Bacsi K, Takacs I, Nagy Z, Mezo T, Speer G, Lakatos P
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Single nucleotide polymorphisms in new candidate genes are associated with bone mineral density and fracture risk.
Eur J Endocrinol. 2008 May 9;
Authors: Lazary A, Kosa J, Tobias B, Lazary J, Balla B, Bacsi K, Takacs I, Nagy Z, Mezo T, Speer G, Lakatos P
Objective: Osteoporosis (OP) is a multifactorial disease with high heritability but its exact genetic background is still poorly understood. We examined the effect of twenty four single nucleotide polymorphisms (SNPs) located in five genes - alkaline phosphatase (ALPL), matrix metalloproteinase 2 (MMP2), tissue inhibitor of metalloproteases 2 (TIMP2), fibroblast growth factor receptor 1 (FGFR1) and fatty acid binding protein 3 (FABP3) - previously not associated with OP. Design: We performed a genotype-phenotype association study at a university hospital. Methods: 360 Hungarian postmenopausal women were involved in the study. Bone mineral density was determined at spine, hip and distal radius. Genomic DNA was extracted from venous blood samples and a high-throughput genotyping method based on single-based primer extension was applied for allelic discrimination. Robust statistical tools were utilized for multiplex data analysis. Results: SNP rs6996321 in FGFR1 was significantly related to spine BMD (p=0.002) and rs10914367 in FABP3 was associated with hip BMD (p=0.028). Non-vertebral fracture risk was significantly increased in carriers of 'A' allele of rs9900972 in TIMP2 (OR=2.06, p=0.0187). We could also identify validated gene-gene interactions significantly affecting BMD and fracture risk. Conclusions: We identified two previously not reported SNPs in FGFR1 and FABP3 associated with bone mineral density and a third SNP in TIMP2 related to risk for non-vertebral osteoporotic fractures. This is the first report on the association between these allelic variants and the phenotypes of postmenopausal osteoporosis. Further studies need to clarify the role of these genes and their polymorphisms in the process of bone loss.
PMID: 18469019 [PubMed - as supplied by publisher]
Long term exercise training decreases IL-6 serum levels in subjects with impaired glucose tolerance: effect of the -174G/C variant in interleukin-6 gene. Oberbach A, Lehmann S, Kirsch K, Krist J, Sonnabend M, Linke A, Toenjes A, Stumvoll M, Bluher M, Kovacs P
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Long term exercise training decreases IL-6 serum levels in subjects with impaired glucose tolerance: effect of the -174G/C variant in interleukin-6 gene.
Eur J Endocrinol. 2008 May 9;
Authors: Oberbach A, Lehmann S, Kirsch K, Krist J, Sonnabend M, Linke A, Toenjes A, Stumvoll M, Bluher M, Kovacs P
Objective: Exercise training has been shown to have anti-inflammatory effects in patients with type 2 diabetes (T2D). Changes in interleukin-6 (IL-6) serum concentrations in response to training could contribute to these beneficial effects. However, there are heterogeneous data on whether circulating IL-6 is altered by exercise training. We therefore hypothesize that genetic factors modify the individual changes in IL-6 levels after long term training. Research design and methods: The -174G/C variant in the IL-6 gene was genotyped in sixty subjects with impaired glucose tolerance (IGT). For a 12 months interventional study, patients were randomized into three groups: A control group (n=16) was compared to one group, which underwent a standardized training program (n=24) and another group, which was treated with rosiglitazone 4mg once daily (n=20). At baseline, after 1, 6, and 12 months, we measured anthropometric parameters and serum concentration of IL-6, and at baseline and after 12 months we determined glucose tolerance and fitness level. Results: Only in subjects carrying the SNP -174C allele, long term exercise training resulted in significantly reduced IL-6 serum concentrations. Multivariate linear regression analysis identified the IL-6 genotype as significant predictor of changes in IL-6 serum concentrations independently of age, gender, and improvement in BMI, HbA1c, and fitness level in response to training. Conclusions: Genetic variants in the IL-6 significantly modify changes in IL-6 serum concentrations in response to long term exercise training programs. Our data suggest that genetic factors are important determinants for the individual response to anti-inflammatory effects of exercise training.
PMID: 18469018 [PubMed - as supplied by publisher]
Future Medicine: Women's Health: Table of ContentsDoes menopausal hormone therapy initiate new breast cancers or promote the growth of existing ones?info@futuremedicine.com (Richard J Santen) Thu, 24 Apr 2008 16:19:55 -0000
Women's Health , May 2008, Vol. 4, No. 3, Pages 207-210.
Satisfaction with maternity care: how to measure and what to doinfo@futuremedicine.com (Ulla Waldenström et al) Thu, 24 Apr 2008 16:20:01 -0000
Women's Health , May 2008, Vol. 4, No. 3, Pages 211-214.
Archives of Women's Mental HealthThe needs of mothers with severe mental illness: a comparison of assessments of needs by staff and patients Thu, 08 May 2008 05:45:28 -0000
Abstract To identify the concordance in assessments of health and social care needs of pregnant women and mothers with severe mental
illness as assessed by patients themselves and their mental healthcare professionals. Thirty-five staff–patient pairs were
recruited from inpatient and community services. Staff and patients completed the Camberwell Assessment of Need—Mothers Version.
There were significant differences in the total number of needs (p < 0.01) and total number of unmet needs (p < 0.001) reported by staff and patients themselves. There was moderate or better agreement on the presence of an unmet need
in eight of 26 life domains. Agreement was low in several domains relevant to being a mother—notably pregnancy care, safety
to child/others, and practical and emotional childcare domains. Unmet needs were particularly common in the areas of daytime
activities, sleep, psychological distress and violence and abuse. Staff and pregnant women and mothers with severe mental
illness moderately agree about health and social care needs but agree less often on which needs are unmet. This highlights
the importance of the views of the mothers themselves, as well as assessments by staff.
Content Type Journal ArticleCategory Original ContributionDOI 10.1007/s00737-008-0006-9Authors
Louise M. Howard, PO29 Institute of Psychiatry, King’s College London Section of Community Mental Health, Health Services and Population Research Department De Crespigny Park SE5 8AF London UKKatherine Hunt, PO29 Institute of Psychiatry, King’s College London Section of Community Mental Health, Health Services and Population Research Department De Crespigny Park SE5 8AF London UK
Journal Archives of Women's Mental HealthOnline ISSN 1435-1102Print ISSN 1434-1816
The Edinburgh Postnatal Depression Scale detects but does not distinguish anxiety disorders from depression in mothers of infants Thu, 08 May 2008 05:45:27 -0000
Abstract Specific screening tests to detect postpartum anxiety are as yet unavailable. The aim of this study was to test the ability
of the Edinburgh Postnatal Depression Scale (EPDS) to detect anxiety disorders in women admitted to residential early parenting
centres. Consecutive cohorts of English speaking women admitted with their infants to two centres in Melbourne, Australia
completed the Composite International Diagnostic Interview and the Edinburgh Postnatal Depression Scale (EPDS). Anxiety and
depression diagnoses were compared with EPDS scores. Of the 145 women (78% recruitment rate), 138 (95%) provided complete
data of whom 35 (25%) had at least one anxiety disorder. EPDS scores over 12 correctly identified 28 women (44%) as having
major depression, either alone or co-morbid with an anxiety disorder but 10 (16%) had only an anxiety disorder and were not
depressed. All of the 26 (41%) women with EPDS scores over 12 with neither diagnosis met diagnostic criteria for minor depression
or an adjustment disorder. EPDS scores were unable to distinguish between these diagnostic groups. The presumption that EPDS
scores over 12 indicate only probable depression is an oversimplification. Current national initiatives recommend that EPDS
scores over 12 warrant treatment for depression, which may lead to inappropriate labeling and therapy.
Content Type Journal ArticleCategory Original ContributionDOI 10.1007/s00737-008-0003-zAuthors
Heather J. Rowe, University of Melbourne Key Centre for Women’s Health in Society, School of Population Health Victoria 3010 AustraliaJane R. W. Fisher, University of Melbourne Key Centre for Women’s Health in Society, School of Population Health Victoria 3010 AustraliaWai May Loh, University of Melbourne Key Centre for Women’s Health in Society, School of Population Health Victoria 3010 Australia
Journal Archives of Women's Mental HealthOnline ISSN 1435-1102Print ISSN 1434-1816
BMC Women's Health - Latest articlesA systematic review of tests for lymph node status in primary endometrial cancer Tara J Selman, Christopher H Mann, Javier Zamora and Khalid S Khan Mon, 05 May 2008 00:00:00 -0000
Background:
The lymph node status of a patient is a key determinate in staging, prognosis and adjuvant treatment of endometrial cancer. Despite this, the potential additional morbidity associated with lymphadenectomy makes its role controversial. This study systematically reviews the accuracy literature on sentinel node biopsy; ultra sound scanning, magnetic resonance imaging (MRI) and computer tomography (CT) for determining lymph node status in endometrial cancer.
Methods:
Relevant articles were identified form MEDLINE (1966-2006), EMBASE (1980-2006), MEDION, the Cochrane library, hand searching of reference lists from primary articles and reviews, conference abstracts and contact with experts in the field.
The review included 18 relevant primary studies (693 women). Data was extracted for study characteristics and quality. Bivariate random-effect model meta-analysis was used to estimate diagnostic accuracy of the various index tests. .
Results:
MRI (pooled positive LR 26.7, 95% CI 10.6 - 67.6 and negative LR 0.29 95% CI 0.17 - 0.49) and successful sentinel node biopsy (pooled positive LR 18.9 95% CI 6.7 - 53.2 and negative LR 0.22, 95% CI 0.1 - 0.48) were the most accurate tests. CT was not as accurate a test (pooled positive LR 3.8, 95% CI 2.0 - 7.3 and negative LR of 0.62, 95% CI 0.45 - 0.86. There was only one study that reported the use of ultrasound scanning.
Conclusion:
MRI and sentinel node biopsy have shown similar diagnostic accuracy in confirming lymph node status among women with primary endometrial cancer than CT scanning, although the comparisons made are indirect and hence subject to bias. MRI should be used in preference, in light of the ASTEC trial, because of its non invasive nature.
Abnormal vaginal bleeding in women of reproductive age: a descriptive study of initial management in general practiceCorlien JH de Vries, Margreet Wieringa-de Waard, Cléo-Lotte AG Vervoort, Willem M Ankum and Patrick JE Bindels Tue, 15 Apr 2008 00:00:00 -0000
Background:
Abnormal vaginal bleeding (AVB) in women of reproductive age is a common reason for consulting a general practitioner. Nevertheless, how general practitioners (GPs) choose to initially manage AVB is largely unknown, as is the prevalence of underlying pathology of AVB in primary care.
Methods:
To investigate the initial diagnostic procedures and treatment for AVB used in general practice, we performed a descriptive study based on computerised medical records. New consultations for AVB in 2000 and 2001 were selected. Patient characteristics, diagnostic procedures and treatment were analysed.
Results:
In total, 270 new consultations were included. The majority of patients (75%) consulted the GP for AVB only once. GPs performed diagnostic procedures in 54% of all consultations. Overall, additional diagnostic procedures revealed abnormalities in 11% of women. However, the diagnostic procedures implemented by the GPs varied widely per bleeding type and contraceptive use. Anaemia was found in 36% of 45 women tested. Uterine fibroids were found in 41% of 27 women examined by ultrasound. Medication was prescribed in 34% of all consultations. A gynaecological referral was registered in 4% of all contacts.
Conclusion:
Initially, GPs tend to follow a policy of expectant management in women of reproductive age with AVB. However, when additional diagnostic procedures were performed, anaemia and uterine fibroids were found in a considerable number of women.
PubMed: 0003-4819Overanticoagulation with coumarin and cutaneous azole therapy. Alexandra JF, Pautas E
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Overanticoagulation with coumarin and cutaneous azole therapy.
Ann Intern Med. 2008 Apr 15;148(8):633-5
Authors: Alexandra JF, Pautas E
PMID: 18413637 [PubMed - indexed for MEDLINE]
Successful treatment of fulminant Clostridium difficile infection with fecal bacteriotherapy. You DM, Franzos MA, Holman RP
Related Articles
Successful treatment of fulminant Clostridium difficile infection with fecal bacteriotherapy.
Ann Intern Med. 2008 Apr 15;148(8):632-3
Authors: You DM, Franzos MA, Holman RP
PMID: 18413636 [PubMed - indexed for MEDLINE]
Archives of Internal Medicine current issueABOUT THIS JOURNAL: About This Journal Mon, 12 May 2008 00:00:00 -0000
IN THIS ISSUE OF ARCHIVES OF INTERNAL MEDICINE: In This Issue of Archives of Internal Medicine Mon, 12 May 2008 00:00:00 -0000
Brief Treatment and Crisis Intervention - current issueBrief and Intermittent Approaches to Practice: The State of PracticeDziegielewski, S. F. Thu, 01 May 2008 00:00:00 -0000
This article is written to provide an overview of the past and present use of two common types of time-limited therapy. Brief (also known as ‘short term’) and intermittent therapies are explored. Using these time-limited frameworks, a structure and procedural review for conducting evidence-based intervention strategy is presented. Several popular methodologies that use a time-limited focus are reviewed. Recommendations, practice guidelines, and strategy for use of these methods are presented.
A Naturalistic Study of Intensive Short-Term Dynamic Psychotherapy Trial TherapyAbbass, A. A., Joffres, M. R., Ogrodniczuk, J. S. Thu, 01 May 2008 00:00:00 -0000
The objective is to study the effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) trial therapies. In a tertiary psychotherapy service, Brief Symptom Inventory (BSI), Inventory of Interpersonal Problems (IIP) medication use, and need for further treatment were evaluated before versus 1-month post trial therapy in a sequential series of 30 clients. Trial therapies were interviews with active focus on emotions and how they are experienced. The interviews resulted in statistically significant improvements on all BSI subscales and one of the IIP subscales. One-third of clients required no further treatment, seven stopped medications, and two returned to work following trial therapy. The ISTDP trial therapy appeared to be clinically effective and cost effective. Future research directions are discussed.
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