Prevalence and determinants of Campylobacter infection among under five children with acute watery diarrhea in Mwanza,North Tanzania

Background

Campylobacteriosis, a zoonotic bacterial disease observed world-wide, is becoming the most commonly recognized cause of bacterial gastroenteritis in humans. This study was done to determine the prevalence and determinants of Campylobacter infection among under-fives with acute watery diarrhea in Mwanza City, Tanzania.

Method

This cross-sectional hospital-based study was conducted at Bugando Medical Centre (BMC) and Sekou Toure Hospital in Mwanza City. All inpatients and outpatients under-fives who met the inclusion criteria from October 2012 to April 2013 were enrolled in the study. Demographic and clinical data were obtained using standardized data collection tools. Stool samples were collected for gram staining and culture for Campylobacter spp. on Preston selective agar media. In addition, blood slides for malaria and HIV tests were done to all patients.

Results

A total of 300 children were enrolled with a median age of 12 [interquartile range, 8–19] months. Of these, 169 (56.5%) were from BMC and 131 (43.7%) from Sekou-Toure hospital. One hundred and seventy (56.7%) of the participating children were male. Of 300 under-fives with acute watery diarrhea, 29 patients (9.7%) were found to have Campylobacter infection. A significant higher number of children with Campylobacter infection were found in Sekou Toure hospital compared to BMC [16.0% (21/29) versus 4.7% (8/29), p = 0.002)]. Age above 2 years was independently found to predict campylobacter infection (OR: 2.9, 95% CI 1.1-7.7, p = 0.0037). Of 30 patients with a positive blood slide for Plasmodium falciparum, 20.0% were also positive for Campylobacter infection (OR: 3.9, 95% CI 1.2-10.1, p = 0.021).

Conclusion

Campylobacter infection shows a comparatively low prevalence in under-fives with acute watery diarrhea in Mwanza city and is independently associated with positive slides for malaria and an age above 2 years. Further studies are needed to type the most prevalent Campylobacter species and to determine their antibiotic susceptibility pattern.     

Prevalence of Antibiotic Resistance in Escherichia coli Fecal Isolates From Healthy Persons and Patients With Diarrhea

Objectives

This study aimed to investigate the prevalence of antibiotic resistance in fecal Escherichia coli isolates from healthy persons and patients with diarrhea.

Methods

E. coli isolates (n = 428) were obtained from fecal samples of apparently healthy volunteers and hospitalized patients with diarrhea. Susceptibility patterns of isolates to 16 antimicrobial agents were determined by agar disc diffusion.

Results

Most E. coli isolates exhibited less than 10% resistance against imipenem, cefotetan, aztreonam, cefepime, cefoxitin, amikacin and netilamicin, although greater than 65% were resistant to ampicillin and tetracycline. No significant difference in resistance rates for all tested antibiotics was found between isolates from the healthy-and diarrheal-patient groups, including for multi-drug resistance (p = 0.22). The highest number of resistant antibiotics was 12 antibiotics. No significant differences in antibiotic resistance were found among the sex and age strata for isolates from healthy individuals. However, antibiotic resistance rates to cefoxitin, cefotaxime, amikacin, and netilamicin were significantly higher in the isolates of men than those of women (p < 0.05) in isolates from patients with diarrhea. Furthermore, isolates from patients with diarrhea older than 40-years of age showed higher resistance to cefepime and aztreonam (p < 0.05).

Conclusion

High resistance to the antibiotics most frequently prescribed for diarrhea was found in isolates from patients with diarrhea and apparently healthy individuals without any significant difference.     

Implementing rapid testing for tuberculosis in Mozambique

Problem

In Mozambique, pulmonary tuberculosis is primarily diagnosed with sputum smear microscopy. However this method has low sensitivity, especially in people infected with human immunodeficiency virus (HIV). Patients are seldom tested for drug-resistant tuberculosis.

Approach

The national tuberculosis programme and Health Alliance International introduced rapid testing of smear-negative sputum samples. Samples were tested using a polymerase-chain-reaction-based assay that detects Mycobacterium tuberculosis deoxyribonucleic acid and a mutation indicating rifampicin resistance; Xpert® MTB/RIF (Xpert®). Four machines were deployed in four public hospitals along with a sputum transportation system to transfer samples from selected health centres. Laboratory technicians were trained to operate the machines and clinicians taught to interpret the results.

Local setting

In 2012, Mozambique had an estimated 140 000 new tuberculosis cases, only 34% of which were diagnosed and treated. Of tuberculosis patients, 58% are HIV-infected.

Relevant changes

From 2012–2013, 1558 people were newly diagnosed with tuberculosis using sputum smears at intervention sites. Xpert® detected M. tuberculosis in an additional 1081 sputum smear-negative individuals, an increase of 69%. Rifampicin resistance was detected in 58/1081 (5%) of the samples. However, treatment was started in only 82% of patients diagnosed by microscopy and 67% of patients diagnosed with the rapid test. Twelve of 16 Xpert® modules failed calibration within 15 months of implementation.

Lessons learnt

Using rapid tests to diagnose tuberculosis is promising but logistically challenging. More affordable and durable platforms are needed. All patients diagnosed with tuberculosis need to start and complete treatment, including those who have drug resistant strains.     

Effects of cooking fuel smoke on respiratory symptoms and lung function in semi-rural women in Cameroon

Background:

Indoor air pollution is a major health problem in the developing world. In sub-Saharan Africa more than 90% of people rely on biomass to meet their domestic energy demands. Pollution from biomass fuel ranks 10th among preventable risk factors contributing to the global burden of diseases.

Objectives:

The present study aimed to determine the prevalence of respiratory symptoms and the factors associated with reduced lung function in a population of women exposed to cooking fuel smoke.

Methods:

A cross-sectional study was conducted in a semi-rural area in Cameroon. We compared forced respiratory volume between women using wood (n = 145) and women using alternative sources of energy (n = 155) for cooking.

Results:

Chronic bronchitis was found in 7·6% of the wood smoke group and 0·6% in the alternative fuels group. We observed two cases of airflow obstruction in the wood smoke group. Factors associated with lung function impairment were chronic bronchitis, use of wood as cooking fuel, age, and height.

Conclusion:

Respiratory symptoms and reduced lung function are more pronounced among women using wood as cooking fuel. Improved stoves technology should be developed to reduce the effects of wood smoke on respiratory health.     

Cumulative Exposure to Lead in Relation to Cognitive Function in Older Women

Background

Recent data indicate that chronic low-level exposure to lead is associated with accelerated declines in cognition in older age, but this has not been examined in women.

Objective

We examined biomarkers of lead exposure in relation to performance on a battery of cognitive tests among older women.

Methods

Patella and tibia bone lead—measures of cumulative exposure over many years—and blood lead, a measure of recent exposure, were assessed in 587 women 47–74 years of age. We assessed their cognitive function 5 years later using validated telephone interviews.

Results

Mean ± SD lead levels in tibia, patella, and blood were 10.5 ± 9.7 μg/g bone, 12.6 ± 11.6 μg/g bone, and 2.9 ± 1.9 μg/dL, respectively, consistent with community-level exposures. In multivariable-adjusted analyses of all cognitive tests combined, levels of all three lead biomarkers were associated with worse cognitive performance. The association between bone lead and letter fluency score differed dramatically from the other bone lead-cognitive score associations, and exclusion of this particular score from the combined analyses strengthened the associations between bone lead and cognitive performance. Results were statistically significant only for tibia lead: one SD increase in tibia lead corresponded to a 0.051-unit lower standardized summary cognitive score (95% confidence interval: −0.099 to −0.003; p = 0.04), similar to the difference in cognitive scores we observed between women who were 3 years apart in age.

Conclusions

These findings suggest that cumulative exposure to lead, even at low levels experienced in community settings, may have adverse consequences for women’s cognition in older age.     

Introducing rapid diagnostic tests for malaria to drug shops in Uganda: a cluster-randomized controlled trial

Objective

To evaluate the impact – on diagnosis and treatment of malaria – of introducing rapid diagnostic tests to drug shops in eastern Uganda.

Methods

Overall, 2193 households in 79 study villages with at least one licensed drug shop were enrolled and monitored for 12 months. After 3 months of monitoring, drug shop vendors in 67 villages randomly selected for the intervention were offered training in the use of malaria rapid diagnostic tests and – if trained – offered access to such tests at a subsidized price. The remaining 12 study villages served as controls. A difference-in-differences regression model was used to estimate the impact of the intervention.

Findings

Vendors from 92 drug shops successfully completed training and 50 actively stocked and performed the rapid tests. Over 9 months, trained vendors did an average of 146 tests per shop. Households reported 22 697 episodes of febrile illness. The availability of rapid tests at local drug shops significantly increased the probability of any febrile illness being tested for malaria by 23.15% (P = 0.015) and being treated with an antimalarial drug by 8.84% (P = 0.056). The probability that artemisinin combination therapy was bought increased by a statistically insignificant 5.48% (P = 0.574).

Conclusion

In our study area, testing for malaria was increased by training drug shop vendors in the use of rapid tests and providing them access to such tests at a subsidized price. Additional interventions may be needed to achieve a higher coverage of testing and a higher rate of appropriate responses to test results.     

Severe malnutrition in children presenting to health facilities in an urban slum in Bangladesh

Setting:

An urban slum in Kamrangirchar, Bangladesh.

Objectives:

Among children aged 6–59 months seeking medical care from the two Médecins Sans Frontières-supported primary health centres, to determine 1) the prevalence of severe acute malnutrition (SAM) and severe chronic malnutrition (SCM), and 2) the extent of overlap between SAM and SCM.

Design:

In a retrospective record review, data were analysed from out-patient registers on age, sex, height, weight and mid-upper arm circumference (MUAC) of children attending for medical care from April to September 2011. SAM was defined as weight for height < −3 Z scores of the median and/or MUAC <115 mm. SCM was defined as height for age < −3 Z scores of the median. World Health Organization growth standards were used as reference.

Results:

Data were complete in the records of 7318 (98%) children, of whom 322 (4%) had SAM and 1698 (23%) had SCM. Among the 322 children with SAM, 162 (50%) also had SCM.

Conclusion:

In an urban Bangladesh slum, SAM and SCM co-exist, with a predominance of SCM. The current national guidelines for severe malnutrition, which focus on identification and management only for SAM, urgently need to be expanded to include SCM if substantial childhood morbidity and mortality are to be reduced.     

Knowledge and Attitude Toward Informed Consent Among Private Dental Practitioners in Bathinda City,Punjab, India

Objectives

A study was conducted with the purpose to assess the knowledge and attitude towards informed consent among private dental practitioners in Bathinda City, Punjab, India.

Methods

A cross-sectional survey was conducted among all private dental practitioners in Bathinda City. A self-administered structured questionnaire consisting of 14 items was used to assess their knowledge and attitude regarding informed consent. The response format was based on a 3-point Likert scale. One-way analysis of variance, independent sample t test, and stepwise multiple linear regression analysis were utilized for statistical analysis. Confidence level and level of significance were set at 95% and 5%, respectively.

Results

The mean scores for knowledge and attitude were 19.37 ± 31.82 and 9.40 ± 1.72, respectively. Analysis revealed that qualification and years of experience was statistically significant among both dependent variables (p ≤ 0.05).

Conclusion

An unbalanced knowledge of informed consent among the current dentists has suggested the need for awareness programs to fill the knowledge gaps and instill positive attitudes.     

Trichostrongylus colubriformis: Possible Most Common Cause of Human Infection in Mazandaran Province,North of Iran

Background:

Infection with Trichostrongylus spp. is common among human and herbivorous in most parts of Iran, especially in southern and northern areas. The aim of present study was to identify Trichostrongylus spp. among human population using excreted egg specimens, by the molecular method, in Mazandaran Province, northern Iran.

Methods:

Overall, 33 positive fecal specimens were randomly sampled and examined. PCR amplification of ITS2-rDNA region was performed on the isolated egg and then a restriction fragment length polymorphism (RFLP) profile was considered to discriminate of Trichostrongylus spp.

Results:

A total of 33 positive fecal specimens, 29(78.9%), 4(12.1%) were found T. colubriformis and T. axei respectively. Our data appear the molecular evidence of both human T. colubriformis and T. axei infections in North of Iran.

Conclusion:

T. colubriformis was the probable most common zoonotic species causing human trichostrongylosis infection in the area     

A study on the existence of Vibrio cholerae non-O1 in the river

Objective

The aim of the present study is Vibrio cholerae non-O1 existing in river. Bacteria are known to inhabit all kinds of environment. Vibrionaceae is widely distributed in environmental water. Vibrio spp. have been identified as a cause of toxicity in fish and shellfish. One condition affecting the survival of pathogenic microorganisms in environmental water is the salt concentration, and they have been reported to inhabit brackish water. However, V. cholerae non-O1 has also been detected in fresh water, and its properties suggest that it can survive in river water.

Methods

Sampling was performed 4 times at 4 points during a 5-month period from July to November at about 1-month intervals from the Sagami River in 1985. River water bacteria were identified, and V. cholera non-O1 isolated. I investigated the relationship between the bacterial flora in river water and the detection of V. cholerae non-O1.

Results

There were significant differences in the composition of bacterial flora with and without the isolation of V. cholerae non-O1 (Chi-square test) (χ² = 24.70 > 22.0 (p = 0.005), df = 8). A correlation between changes in the composition of the river water bacterial flora and detection of V. cholerae non-O1 was identified.

Conclusion

Therefore, V. cholerae non-O1 exists in the river.     

External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo

Objective

To report the findings of a second external quality assessment of Giemsa-stained blood film microscopy in the Democratic Republic of the Congo, performed one year after the first.

Methods

A panel of four slides was delivered to diagnostic laboratories in all provinces of the country. The slides contained: (i) Plasmodium falciparum gametocytes; (ii) P. falciparum trophozoites (reference density: 113 530 per µl); (iii) Trypanosoma brucei subspecies; and (iv) no parasites.

Findings

Of 356 laboratories contacted, 277 (77.8%) responded. Overall, 35.0% of the laboratories reported all four slides correctly but 14.1% reported correct results for 1 or 0 slides. Major errors included not diagnosing trypanosomiasis (50.4%), not recognizing P. falciparum gametocytes (17.5%) and diagnosing malaria from the slide with no parasites (19.0%). The frequency of serious errors in assessing parasite density and in reporting false-positive results was lower than in the previous external quality assessment: 17.2% and 52.3%, respectively, (P < 0.001) for parasite density and 19.0% and 33.3%, respectively, (P < 0.001) for false-positive results. Laboratories that participated in the previous quality assessment performed better than first-time participants and laboratories in provinces with a high number of sleeping sickness cases recognized trypanosomes more frequently (57.0% versus 31.2%, P < 0.001). Malaria rapid diagnostic tests were used by 44.3% of laboratories, almost double the proportion observed in the previous quality assessment.

Conclusion

The overall quality of blood film microscopy was poor but was improved by participation in external quality assessments. The failure to recognize trypanosomes in a country where sleeping sickness is endemic is a concern.     

Nutritional quality of diet and academic performance in Chilean students

Objective

To explore associations between the nutritional quality of diet at age 16 years and academic performance in students from Santiago, Chile.

Methods

We assessed the nutritional quality of diet, using a validated food frequency questionnaire, in 395 students aged 16.8 ± 0.5 years. Depending on the amount of saturated fat, fibre, sugar and salt in the foods, diet was categorized as unhealthy, fair or healthy. Academic performance was assessed using high school grade-point average (GPA) and tests for college admission in language and mathematics. Academic results on or above the 75th percentile in our sample were considered good academic performance. We tested associations between nutritional quality of diet and good academic performance using logistic regression models. We considered sociodemographic, educational and body-mass index (BMI) factors as potential confounders.

Findings

After controlling for potential confounding factors, an unhealthy diet at age 16 years was associated with reduced academic performance. Compared to participants with healthy diets, those with unhealthy diets were significantly less likely to perform well based on language tests (odds ratio, OR: 0.42; 95% confidence interval, CI: 0.18–0.98) mathematics tests (OR: 0.35; 95% CI: 0.15–0.82) or GPA (OR: 0.22; 95% CI: 0.09–0.56).

Conclusion

In our sample, excessive consumption of energy-dense, low-fibre, high-fat foods at age 16 years was associated with reduced academic performance.     

Seroprevalence of Hepatitis A and E Viruses Based on the Third Korea National Health and Nutrition Survey in Korea

Objectives

The purpose of this study was to investigate the seroprevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) in Korea during 2005.

Methods

Study subjects were selected from across Korea using a stratified multistage probability sampling design, and HAV and HEV seroprevalence was compared on the basis of sex, age, and residency. A total of 497 rural and urban people aged 10–99 years of age (mean ± SD age = 28.87 ± 17.63 years) were selected by two-stage cluster sampling and tested serologically for anti-HAV and anti-HEV IgG using an enzyme-linked immunosorbent assay.

Results

Among this population, the overall seroprevalence of HAV was 63.80% (55.21% aged in their 20s and 95.92% in their 30s, p < 0.01) and that of HEV was 9.40% (5.21% aged in their 20s and 7.14% in their 30s, p < 0.01). Seroprevalence also varied according to area of residence. HEV prevalence in rural areas was higher than that of urban regions based on the anti-HEV antibody, odds ratio 3.22 (95% confidence interval: 1.46–7.10, p < 0.01). There were no significant differences between male and female against anti-HAV/HEV antibodies.

Conclusion

Our study suggested that the seropositive rates of HAV and HEV might be related to age and environmental conditions.     

Maternal Arsenic Exposure and Impaired Glucose Tolerance during Pregnancy

Background

Accumulating evidence has shown an increased risk of type 2 diabetes in general populations exposed to arsenic, but little is known about exposures during pregnancy and the association with gestational diabetes (GD).

Objectives

We studied 532 women living proximate to the Tar Creek Superfund Site to investigate whether arsenic exposure is associated with impaired glucose tolerance during pregnancy.

Methods

Blood glucose was measured between 24 and 28 weeks gestation after a 1-hr oral glucose tolerance test (GTT) as part of routine prenatal care. Blood and hair were collected at delivery and analyzed for arsenic using inductively coupled plasma mass spectrometry with dynamic reaction cell.

Results

Arsenic concentrations ranged from 0.2 to 24.1 μg/L (ppb) (mean ± SD, 1.7 ±1.5) and 1.1 to 724.4 ng/g (ppb) (mean ± SD, 27.4 ± 61.6) in blood and hair, respectively. One-hour glucose levels ranged from 40 to 284 mg/dL (mean ± SD, 108.7 ± 29.5); impaired glucose tolerance was observed in 11.9% of women when using standard screening criterion (> 140 mg/dL). Adjusting for age, Native-American race, prepregnancy body mass index, Medicaid use, and marital status, women in the highest quartile of blood arsenic exposure had 2.8 higher odds of impaired GTT than women in the lowest quartile of exposure (95% confidence interval, 1.1–6.9) (p-trend = 0.008).

Conclusions

Among this population of pregnant women, arsenic exposure was associated with increased risk of impaired GTT at 24–28 weeks gestation and therefore may be associated with increased risk of GD.     

Dermal exposure potential from textiles that contain silver nanoparticles

Background:

Factors that influence exposure to silver particles from the use of textiles are not well understood.

Objectives:

The aim of this study was to evaluate the influence of product treatment and physiological factors on silver release from two textiles.

Methods:

Atomic and absorbance spectroscopy, electron microscopy, and dynamic light scattering (DLS) were applied to characterize the chemical and physical properties of the textiles and evaluate silver release in artificial sweat and saliva under varying physiological conditions. One textile had silver incorporated into fiber threads (masterbatch process) and the other had silver nanoparticles coated on fiber surfaces (finishing process).

Results:

Several complementary and confirmatory analytical techniques (spectroscopy, microscopy, etc.) were required to properly assess silver release. Silver released into artificial sweat or saliva was primarily in ionic form. In a simulated “use” and laundering experiment, the total cumulative amount of silver ion released was greater for the finishing process textile (0.51±0.04%) than the masterbatch process textile (0.21±0.01%); P<0.01.

Conclusions:

We found that the process (masterbatch vs finishing) used to treat textile fibers was a more influential exposure factor than physiological properties of artificial sweat or saliva.     

Exposure to PM10 as a risk factor for the development of nasal obstruction and chronic obstructive pulmonary disease

Objectives:

To investigate whether air pollution is a potential risk factor for airways obstruction.

Methods:

A prospective cohort study (11.3±2.9 years) that took place in two areas (Eordea where concentration of PM₁₀ was high and Grevena, Greece). We used the MRC questionnaire, spirometry, and anterior rhinomanometry at both visits.

Results:

Initially we examined 3046 subjects. After excluding chronic obstructive pulmonary disease (COPD) patients, we re-examined 872 subjects and 168 of them had developed COPD (Grevena: 24.3%, Eordea: 18.5%). Multivariable logistic regression analysis showed that the area of residence and thus exposure to air pollution was not a risk factor for the development of COPD (OR: 0.51, 95% CI: 0.18–1.46, P = 0.21). On the other hand, residence in Eordea was strongly related to the development of severe nasal obstruction (OR: 11.47, 95% CI: 6.15–21.40, P<0.001). Similar results were found after excluding patients with COPD stage I as well as in the subgroup of never smokers.

Conclusion:

Air pollution was associated with severe nasal obstruction but not with COPD development.     

Work-related accidents among the Iranian population: a time series analysis, 2000–2011

Background

Work-related accidents result in human suffering and economic losses and are considered as a major health problem worldwide, especially in the economically developing world.

Objectives

To introduce seasonal autoregressive moving average (ARIMA) models for time series analysis of work-related accident data for workers insured by the Iranian Social Security Organization (ISSO) between 2000 and 2011.

Methods

In this retrospective study, all insured people experiencing at least one work-related accident during a 10-year period were included in the analyses. We used Box–Jenkins modeling to develop a time series model of the total number of accidents.

Results

There was an average of 1476 accidents per month (1476·05±458·77, mean±SD). The final ARIMA (p,d,q) (P,D,Q)_s model for fitting to data was: ARIMA(1,1,1)×(0,1,1)₁₂ consisting of the first ordering of the autoregressive, moving average and seasonal moving average parameters with 20·942 mean absolute percentage error (MAPE).

Conclusions

The final model showed that time series analysis of ARIMA models was useful for forecasting the number of work-related accidents in Iran. In addition, the forecasted number of work-related accidents for 2011 explained the stability of occurrence of these accidents in recent years, indicating a need for preventive occupational health and safety policies such as safety inspection.     

Prevalence and Intensity of Paramphistomum Spp. In Cattle from South-Eastern Iran

Background:

Parasitological investigations on paramphistomosis were carried out over a 12-month period in the southeast of Iran to determine the prevalence and intensity of this disease.

Methods:

A total of 1000 cattle, Sistani breed (n= 450) and Brahman breed (n= 550) of all sex and age groups were inspected at random for the presence of paramphistomidae flukes in Zabol slaughterhouse from December 2012 to October 2013.

Results:

Paramphistomes were found in 369 of 1000 necropsied cows (36.9%; 95% CI: 30.1–41.9%), with significant higher prevalence of infection in Brahman breed than in Sistani breed (51% vs 19.3%). No significant correlation between prevalence, intensity of infection, sex and age of cattle was noted. Despite the difference in the seasonal variations of prevalence, and the relation between the intensity of infection and season, these were not statistically significant. The mean intensity of infection in Brahman breed was higher (652.66 ± 281.5) than Sistani breed (123.32 ± 32.2). The identification of stained trematodes to the species revealed 40, 20, 20, 15 and 5% Gastrothylax crumenifer, Cotylophoron cotylophorom, Paramphistomum cervi, Carmyerius spatiosus, Explanatum explanatum, respectively.

Conclusion:

The present results will contribute to our understanding of the epidemiology of paramphistomumosis in southeastern Iran.     

Angle between the common and internal carotid arteries detected by ultrasound is related to intima-media thickness among those with atherosclerotic disease

Objectives

Although carotid artery structural variations have been detected by ultrasound, their clinical significance is not fully understood. The objective of this study was to determine whether the angle between the common carotid artery (CCA) and the internal carotid artery (ICA), designated angle α, an ultrasound-detectable carotid artery structural variation, is related to carotid artery intima-media thickness (IMT), a surrogate marker for carotid atherosclerosis.

Methods

As a cross-sectional study, we measured angle α in routine carotid artery ultrasounds from 176 subjects (130 men) with atherosclerotic disease/risk factors that attended Kouseiren Hospital in Kagoshima City, Japan between August 2007 and April 2009. We evaluated the correlation between the angle α and CCA- or ICA-IMT.

Results

Angle α was weakly correlated with age but significantly correlated with ICA-IMT. The correlation was stronger in subjects with an ICA-IMT ≥ 0.5 mm than in those with an ICA-IMT < 0.5 mm (Right side r = 0.475 vs. 0.246, Left side r = 0.498 vs. 0.301, respectively). Upon multivariate logistic regression analysis, angle α and serum low-density lipoprotein cholesterol were independent explanatory variables for ICA-IMT.

Conclusion

Angle α is related to ICA-IMT in subjects with atherosclerotic disease or risk factors in this study.

Electronic supplementary material

The online version of this article (doi:10.1007/s12199-015-0453-7) contains supplementary material, which is available to authorized users.     

Plantago Ovata Consumption and Colorectal Mortality in Spain, 1995–2000

Background

Consumption of Plantago ovata may protect against colorectal cancer. To test this hypothesis, an ecological study was performed to determine mortality rates and distribution of colorectal cancer, and the consumption and distribution of P ovata, in different provinces in Spain. The putative association between P ovata consumption and mortality from colorectal cancer was then evaluated.

Methods

We conducted a comparative ecological study of Spanish provinces, with colorectal cancer mortality as the dependent variable and per capita consumption of P ovata by province and year as the independent variable. Associations were analyzed by calculating Spearman’s correlation coefficients and a Poisson multiple regression model.

Results

Consumption of P ovata tended to be inversely correlated with mortality from colorectal cancer. In the Poisson regression analysis this tendency remained and reached statistical significance for the top quintile of P ovata consumption in the adjusted analysis (P = 0.042).

Conclusions

Our results show an inverse trend between the consumption of P ovata and colorectal cancer mortality. We recommend additional observational studies of individuals, in order to better control confounding factors.Key words: colorectal cancer, Plantago ovata, ecological study, population study