HIV prevalence among female sex workers,drug users and men who have sex with men in Brazil: A Systematic Review and Meta-analysis

Background  

The Brazilian response towards AIDS epidemic is well known, but the absence of a systematic review of vulnerable populations ─ men who have sex with men (MSM), female sex workers (FSW), and drug users (DU) remains a main gap in the available literature. Our goal was to conduct a systematic review and meta-analysis of studies assessing HIV prevalence among MSM, FSW and DU, calculating a combined pooled prevalence and summarizing factors associated the pooled prevalence for each group.     

国际脊髓损伤脊柱损伤基础数据集

收集脊柱损伤的信息对于脊髓损伤患者的诊断和治疗非常重要,设立脊髓损伤患者脊柱损伤基础数据集是为了规范脊柱损伤相关信息的收集方式和报告内容,学习并使用国际脊髓损伤脊柱损伤基础数据集,有助于规范和统一我国脊髓损伤患者脊柱损伤信息的收集,为相关治疗提供依据。本文将介绍国际脊髓损伤脊柱损伤基础数据集的研发过程,数据元素的内容以及数据编码的应用实例。     

Disability Adjusted Life Years and minimal disease: application of a preference-based relevance criterion to rank enteric pathogens

Background

Burden of disease estimates, which combine mortality and morbidity into a single measure, are used increasingly for priority setting in disease control, prevention and surveillance. However, because there is no clear exclusion criterion for highly prevalent minimal disease in burden of disease studies its application may be restricted. The aim of this study was to apply a newly developed relevance criterion based on preferences of a population panel, and to compare burden of disease estimates of five foodborne pathogens calculated with and without application of this criterion.

Methods

Preferences for twenty health states associated with foodborne disease were obtained from a population panel (n = 107) with the Visual Analogue Scale and the Time Trade-off (TTO) technique. The TTO preferences were used to derive the relevance criterion: if at least 50% of a panel of judges is willing to trade-off time in order to be restored to full health the health state is regarded as relevant, i.e. TTO median is greater than 0. Subsequently, the burden of disease of each of the five foodborne pathogens was calculated both with and without the relevance criterion.

Results

The panel ranked the health states consistently. Of the twenty health states, three did not meet the preference-based relevance criterion. Application of the relevance criterion reduced the burden of disease estimate of all five foodborne pathogens. The reduction was especially significant for norovirus and rotavirus, decreasing with 94% and 78% respectively.

Conclusion

Individual preferences elicited with the TTO from a population panel can be used to empirically derive a relevance criterion for burden of disease estimates. Application of this preference-based relevance criterion results in considerable changes in ranking of foodborne pathogens.     

High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring

Objective  To study associations between maternal dietary and supplement intake of antioxidants vitamin E, retinol and congenital heart defects (CHDs).
Design  Case–control study.
Setting  Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Population  Participants were 276 case mothers of a child with CHD and 324 control mothers with their children.
Methods  Food frequency questionnaires covering the intake of the previous 4 weeks were filled out at 16 months after the index pregnancy. Data were compared between cases and controls using the Mann–Whitney U test. Risk estimates for the association between CHD and dietary intake of vitamin E and retinol were estimated in a multivariable logistic regression model.
Main outcome measures  Medians (5–95th percentile) and odds ratios with 95% CI.
Results  Dietary vitamin E intake was higher in case mothers than in controls, 13.3 (8.1–20.4) and 12.6 (8.5–19.8) mg/day ( P = 0.05). CHD risk increased with rising dietary vitamin E intakes ( P -trend = 0.01). Periconception use of vitamin E supplements in addition to a high dietary vitamin E intake above 14.9 mg/day up to nine-fold increased CHD risk. Retinol intakes were not significantly different between the groups and not associated with CHD risk.
Conclusions  High maternal vitamin E by diet and supplements is associated with an increased risk of CHD offspring.     

Malignant uveal melanoma and similar lesions studied by computed tomography

Forty-four patients with intraocular disease were studied by computed tomography (CT); in 19 cases malignant uveal melanoma was considered the likely diagnosis. CT proved to be accurate in determining the location and size of uveal melanomas, demonstrating scleral invasion, and differentiating melanoma from choroidal detachment or angioma, toxocariasis, and senile macular degeneration. Astrocytic retinal hamartoma and medulloepithelioma could not be distinguished from melanoma with CT. On CT, uveal melanomas appeared as hyperdense lesions with slight to moderate contrast enhancement. Tumors thinner than 2 mm could not be seen. Using dynamic CT, we noted moderate peak amplitude, normal or delayed tissue transit time, and persistently elevated washout phase (downslope), indicating increased permeability as the result of an impaired tumor blood barrier. Histological types of uveal melanoma could not be differentiated on the basis of circulatory patterns. Dynamic CT may be useful in distinguishing uveal melanoma from choroidal hemangioma or hematoma.     

Heart rate changes during sleep in normal two-month-old infants

Thirty-five normal two-month-old infants had nighttime followed by daytime polygraphic recordings. Heart rates were calculated every minute in active and quiet sleep states. A difference in mean heart rates was found between the two states and between the two recordings. Rates were lower at night than during the day (P < 0.0001), regardless of the sleep state. During nighttime or daytime recordings as a function of sleep cycles or during sustained sleep episodes, heart rates were minimal in the middle of recordings, but differences were statistically significant for only a few results (mainly in QS). Intrasleep awakening led to a marked increase in heart rate after sleep was resumed, although differences were only statistically significant when the awakened infant was fed. Infants with episodes of periodic breathing had lower mean heart rates throughout the recordings, but differences were not statistically significant. Respiratory and heart rates showed similar changes during the recordings, and a statistically significant correlation was found between the two measurements.