Neue Biomarker beim Zervixkarzinom

The most important prognostic factors for cervical cancer are tumor extent, tumor morphology, and lymph node involvement. Biomarkers may additionally provide an understanding of the individual tumor biology thereby allowing improved patient counseling. Owing to controversial results in various studies, however, most biomarkers failed to be validated and thus to reach the clinic. Reasons include the lack of standardized methods and retrospective analyses of heterogeneous groups. Some of the most promising candidates include the identification of vascular endothelial growth factor (VEGF), cyclooxygenase 2 (COX-2), and the loss of heterozygosity (LOH) on chromosomes 6p21.2 and 18q21.2. Moreover, lymphovascular invasion is a prognostic factor in early stages, indicating unfavorable outcome. In the future, gene expression profiling may provide a more detailed and thus predictive picture of personal cancer biology.     

“The women,they maltreat them… therefore,we cannot assure that the future society will be good”: Male perspectives on gender-based violence: A focus group study with young men in Haiti

The purpose of this study was to explore the perceptions of violence against women (VAW) held by Haitian men to gain a better understanding of why VAW occurs. Women in Haiti have experienced significant violence, both before and following the 2010 earthquake. Fifteen men aged 26 to 47 participated in a focus group. The data revealed three themes: men's beliefs about VAW and its context, factors influencing VAW, and recommended interventions. When approaching VAW, men must be part of the collective effort. Their insights are valuable when planning and implementing interventions to decrease VAW in Haiti and worldwide.     

Prevalence and factors associated with uveitis in spondylarthritis patients in France: Results from an observational survey

Objective

To accurately estimate the prevalence of and the factors associated with uveitis in spondylarthritis (SpA) patients in France.

Methods

In an observational survey of SpA patients (diagnosis confirmed by the European Spondylarthropathy Study Group and/or Amor's criteria) consulting their rheumatologist for routine followup, we collected information regarding present/past history of uveitis, as well as detailed characteristics of the disease. Factors independently associated with uveitis were determined.

Results

From September 2008 to January 2009, 202 rheumatologists participated in the survey and recruited 902 patients (61% men) with a mean ± SD age of 45.3 ± 13.4 years and a mean ± SD disease duration of 10.4 ± 9.6 years. The SpA diagnoses were ankylosing spondylitis (71%), psoriatic arthritis (18%), or other SpA (11%). The HLA–B27 positivity rate was 76%. Uveitis prevalence was 32.2% (95% confidence interval [95% CI] 29.1–35.3%) since psoriasis and inflammatory bowel disease were 22.3% (95% CI 19.5–25.0%) and 8.6% (95% CI 6.7–10.5%), respectively. Recurrence of uveitis occurred in 52.3% and complications occurred in 11.7% of patients. Factors independently associated with uveitis were HLA–B27 positivity (adjusted odds ratio [OR_adj] 2.97 [95% CI 1.83–4.81], P < 0.0001) and disease duration (OR_adj 1.28 [95% CI 1.16–1.41], P < 0.0001 for ≥10 years).

Conclusion

Results indicate that uveitis is the most common extraarticular feature of SpA, occurring preferentially in HLA–B27–positive patients over the entire course of the disease.     

Involving children and young people in clinical research through the forum of a European Young Persons’ Advisory Group: needs and challenges

Children and young people are seen as fundamental to the design and delivery of clinical research as active and reflective participants. In Europe, involvement of children and young people in clinical research is promoted extensively in order to engage young people in research as partners and to give them a voice to raise their own issues or opinions and for their involvement in planning and decision making in addition to learning research skills. Children and young people can be trained in clinical research through participation in young person advisory groups (YPAGs). Members of YPAGs assist other children and young people to learn about clinical research and share their experience and point of view with researchers, thereby possibly influencing all phases of research including the development and prioritization of research questions, design and methods, recruitment plans, and strategies for results dissemination. In the long term, the expansion of YPAGs in Europe will serve as a driving force for refining pediatric clinical research. It will help in a better definition of research projects according to the patients’ needs. Furthermore, direct engagement of children and young people in research will be favorable to both researchers and young people.     

ASSOCIATION BETWEEN SMOKING,CRACK COCAINE ABUSE AND THE DISCONTINUATION OF COMBINATION ANTIRETROVIRAL THERAPY IN RECIFE,PERNAMBUCO, BRAZIL

Despite the effectiveness of combination antiretroviral therapy in the treatment of people living with HIV/AIDS (PLWHA), nonadherence to medication has become a major threat to its effectiveness. This study aimed to estimate the prevalence of self-reported irregular use of antiretroviral therapy and the factors associated with such an irregularity in PLWHA. A cross-sectional study of PLWHA who attended two referral centers in the city of Recife, in Northeastern Brazil, between June 2007 and October 2009 was carried out. The study analyzed socioeconomic factors, social service support and personal habits associated with nonadherence to antiretroviral therapy, adjusted by multivariable logistic regression analysis. The prevalence of PLWHA who reported irregular use of combination antiretroviral therapy (cART) was 25.7%. In the final multivariate model, the irregular use of cART was associated with the following variables: being aged less than 40 years (OR = 1.66, 95%-CI: 1.29-2.13), current smokers (OR = 1.76, 95%-CI: 1.31-2.37) or former smokers (OR = 1.43, 95%-CI: 1.05-1.95), and crack cocaine users (OR = 2.79, 95%-CI: 1.24-6.32). Special measures should be directed towards each of the following groups: individuals aged less than 40 years, smokers, former smokers and crack cocaine users. Measures for giving up smoking and crack cocaine should be incorporated into HIV-control programs in order to promote greater adherence to antiretroviral drugs and thus improve the quality of life and prolong life expectancy.