Low prevalence of <Emphasis Type="Italic">H. pylori</Emphasis> Infection in HIV-Positive Patients in the Northeast of Brazil

Background  

This study conducted in Northeastern Brazil, evaluated the prevalence of H. pylori infection and the presence of gastritis in HIV-infected patients.     

Dietary sodium intake in a multiethnic Asian population of healthy participants and chronic kidney disease patients

INTRODUCTION

Clinical practice guidelines recommend dietary sodium restriction in chronic kidney disease (CKD) patients. Compliance with this recommendation in a multiethnic Asian population is not clear. This study assessed the urinary sodium excretion profile of a multiethnic Asian population to estimate the population’s dietary sodium intake.

METHODS

Data on the urinary sodium excretion of 335 participants were obtained from the Asian Kidney Disease Study and Singapore Kidney Function Study. Standard statistical tests and linear regression were used to assess the association between various continuous variables and sodium excretion.

RESULTS

Our study cohort consisted of 335 participants (232 with CKD, 103 healthy) – 51.0% were male; 38.5% were Chinese, 29.6% were Malay, 23.6% were Indian; and 57.3% were hypertensive. The mean age was 53.5 ± 15.1 years and mean urinary sodium excretion was 124.9 ± 68.3 mmol/day. The mean blood pressure of the healthy participants was lower than that of the patients with CKD (p < 0.001). Patients with CKD stages 1–3 excreted an average of > 100 mmol sodium/day. Overall, 40.1% patients with CKD excreted < 100 mmol sodium/day. Indians had higher urinary sodium excretion than the Chinese (p = 0.016) and Malays (p = 0.002). The distribution of urinary sodium excretion in the healthy participants (37.9% excreted < 100 mmol sodium/day) was similar to that seen in the patients with CKD.

CONCLUSION

Although patients with CKD stages 4–5 achieved sodium restriction, healthy persons and patients with early-stage CKD need to increase their efforts in reducing their sodium intake, especially for patients of Indian ethnicity.     

Performance of the CKD-EPI creatinine-cystatin C glomerular filtration rate estimation equations in a multiethnic Asian population

INTRODUCTION

Clinical practice guidelines recommend using creatinine-based equations to estimate glomerular filtration rates (GFRs). While these equations were formulated for Caucasian-American populations and have adjustment coefficients for African-American populations, they are not validated for other ethnicities. The Chronic Kidney Disease-Epidemiology Collaborative Group (CKD-EPI) recently developed a new equation that uses both creatinine and cystatin C. We aimed to assess the accuracy of this equation in estimating the GFRs of participants (healthy and with chronic kidney disease [CKD]) from a multiethnic Asian population.

METHODS

Serum samples from the Asian Kidney Disease Study and the Singapore Kidney Function Study were used. GFR was measured using plasma clearance of ^99mTc-DTPA. GFR was estimated using the CKD-EPI equations. The performance of GFR estimation equations were examined using median and interquartile range values, and the percentage difference from the measured GFR.

RESULTS

The study comprised 335 participants (69.3% with CKD; 38.5% Chinese, 29.6% Malays, 23.6% Indians, 8.3% others), with a mean age of 53.5 ± 15.1 years. Mean standardised serum creatinine was 127 ± 86 µmol/L, while mean standardised serum cystatin C and mean measured GFR were 1.43 ± 0.74 mg/L and 67 ± 33 mL/min/1.73 m², respectively. The creatinine-cystatin C CKD-EPI equation performed the best, with an estimated GFR of 67 ± 35 mL/min/1.73 m².

CONCLUSION

The new creatinine-cystatin C equation estimated GFR with little bias, and had increased precision and accuracy in our multiethnic Asian population. This two-biomarker equation may increase the accuracy of population studies on CKD, without the need to consider ethnicity.     

Evaluation of quality of life in patients with toenail onychomycosis by Polish version of an international onychomycosis-specific questionnaire

BACKGROUND: Onychomycosis is the most frequent nail disease, which could impair the patient's quality of life. OBJECTIVE: The present study was undertaken to evaluate the impact of toenail onychomycosis on quality of life among Polish population. PATIENTS AND METHODS: Three thousand nine-hundred and four (3904: 2269 females and 1635 males) individuals fulfilled an international onychomycosis-specific quality-of-life questionnaire consisting of statements regarding social, emotional and symptoms problems. All patients had toenail onychomycosis confirmed by the positive direct microscopic examination and/or by the positive mycologic culture. Seven hundred and sixty-seven patients simultaneously had fingernail onychomycosis. All patients were divided into subgroups according to sex, age, education level, place of living, type of onychomycosis, number of involved toenails, fingernails involvement, duration of illness and previously used antimycotic therapy. RESULTS: Most of the patients demonstrated significantly reduced quality of life. The degree of life impairment varied between analysed subgroups. Patients with more advanced toenail onychomycosis and with fingernail involvement were more seriously affected. Both social and emotional impairments were more pronounced in female than in male patients, although there were no differences according to symptoms. Moreover, patients with better educational level and people living in towns or cities were more emotionally and socially affected by onychomycosis, although people living in the country or with poorer education level presented with significantly more severe symptoms. CONCLUSIONS: Toenail onychomycosis is still a serious medical problem, which can significantly reduce the patient's quality of life.     

Effectiveness of patient delivered partner medication for preventing recurrent Chlamydia trachomatis

OBJECTIVE: To determine if providing Chlamydia trachomatis infected women with medication to deliver to their sex partner(s) could reduce recurrent chlamydia infections compared with the standard partner referral method. STUDY DESIGN: A observational cohort study of 178 women, 14-39 years old attending a family planning clinic, diagnosed and treated for C trachomatis between October 1993 and December 1994 was conducted (43 received patient delivered partner medication (PDPM) and 135 received partner referral cards). Women were retested before or at their annual visit. RESULTS: The mean time of follow up was 17.7 months (SD 7.7). The PDPM group (n = 43) was similar to partner referral group (n = 135) for age, race, contraceptive method, history of an STD, and follow up time. The annual recurrent infection rate was lower among the PDPM group compared with the partner referral group (11.5% v 25.5%, p < 0.05). After adjusting for age in logistic regression, women in the PDPM group were less likely than women in the partner referral group to have an incident C trachomatis infection (OR 0.37, 95% CI 0.15-0.97, p < 0.05). CONCLUSION: These findings suggest that patient delivered partner medication can protect women from recurrent C trachomatis infection compared with the standard partner referral approach. Prospective studies with larger sample sizes are under way.     

Gefitinib and celecoxib in advanced metastatic gastrointestinal tumors: a pilot feasibility study

Background

This pilot, open-label study examined the safety and tolerability (primary objective) and efficacy (secondary objective) of gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in combination with celecoxib, a cyclooxygenase-2 (COX-2) inhibitor, in patients with advanced or refractory gastrointestinal (GI) tumors of epithelial origin.

Methods

Patients were administered gefitinib (250 mg/day) plus celecoxib (400 mg twice daily). In the event of toxicity, dose interruptions were permitted and a single celecoxib dose reduction was allowed.

Results

Thirty patients (median age 60 years) with primary colorectal (25 patients), pancreatic (3 patients), esophageal (1 patient), or gall bladder (1 patient) tumors were recruited, 29 of whom had received prior chemotherapy. Adverse events (AEs) were generally mild and consisted mainly of acne, diarrhea, and nausea. Few severe AEs were noted. There were no withdrawals or deaths due to AEs. Dose reductions for celecoxib were reported for five patients, in three cases due to toxicity. Stable disease was confirmed in 12 patients (40%), with progressive disease in 18 patients (60%).

Conclusions

After study completion, safety issues relating to the long-term use of COX-2 inhibitors have been raised. However, in this pilot study, the combination of gefitinib and celecoxib was generally well tolerated in patients with advanced GI cancer.