Canadian oncogenic human papillomavirus cervical infection prevalence: Systematic review and meta-analysis

Background

Dengue fever is a mosquito-borne disease that affects between 50 and 100 million people each year. Increasing our understanding of the heterogeneous transmission patterns of dengue at different spatial scales could have considerable public health value by guiding intervention strategies.

Methods

Based on the weekly number of dengue cases in Perú by province, we investigated the association between dengue incidence during the period 1994-2008 and demographic and climate factors across geographic regions of the country.

Results

Our findings support the presence of significant differences in the timing of dengue epidemics between jungle and coastal regions, with differences significantly associated with the timing of the seasonal cycle of mean temperature.

Conclusions

Dengue is highly persistent in jungle areas of Perú where epidemics peak most frequently around March when rainfall is abundant. Differences in the timing of dengue epidemics in jungle and coastal regions are significantly associated with the seasonal temperature cycle. Our results suggest that dengue is frequently imported into coastal regions through infective sparks from endemic jungle areas and/or cities of other neighboring endemic countries, where propitious environmental conditions promote year-round mosquito breeding sites. If jungle endemic areas are responsible for multiple dengue introductions into coastal areas, our findings suggest that curtailing the transmission of dengue in these most persistent areas could lead to significant reductions in dengue incidence in coastal areas where dengue incidence typically reaches low levels during the dry season.     

Usefulness of PET/CT imaging in systemic IgG4-related sclerosing disease. A report of three cases

Autoimmune pancreatitis is the pancreatic manifestation of a novel clinicopathological disorder called systemic IgG4-related sclerosing disease. Beside the pancreas, this entity affects other sites (salivary glands, orbit, lung, thyroid, gallbladder, biliary tree system, kidney, abdominal aorta, retroperitoneum, prostate, and lymph node) by infiltration with IgG4-positive plasma cells. Several case reports and small case series have demonstrated the utility of integrated positron emission tomography/computed tomography (PET/CT) in monitoring therapy and documenting relapse and flare-up of autoimmune pancreatitis. However, there are no reports on the usefulness of PET/CT in selecting extrapancreatic sites for tissue sampling. We herein demonstrate the clinical utility of integrated PET/CT in 3 cases of systemic IgG4-related sclerosing disease for targeting extrapancreatic biopsy sites.     

Reliability and reproducibility of a morpho-textural image analysis method over a patellar ligament ultrasonography

ObjectiveImage analysis techniques over ultrasonograms may be useful to extract quantitative information. Because ecography and the selection of the area of interest are technician-dependent, the objective of this work was to calculate the reliability and the reproducibility of the analysis method.Material and methodsTest-retest reliability study on 60 cross-sectional patellar ligament ultrasonograms on 1 cm of patella were carried out. Sonosite Titan L-38 (5–10 MHz) and the Image analysis software J v1.40 were used. Morphometric variables were: perimeter, area, width, thickness, and mean echogenity; textural variables were: uniformity, homogeneity and entropy. The intraclass correlation coefficient (ICC) was calculated with a confidence interval of 95%.ResultsIntraclass correlation coefficients over 0,70 were found, with an agreement ranging from good to very good in all of the variables both for the intra ecography and inter ecography studies.ConclusionVery good levels of reliability and internal consistency were seen, demonstrating that from the statistical point of view, the variability introduced by the technician is not significant. This method can be taken as a reference to analyze the reliability between several ultrasonographers.     

Decompressive hemicraniectomy in ischaemic stroke

Background and purposeHemispheric ischaemic stroke complicated by oedema is associated with high mortality. The results of randomized studies showed that decompressive hemicraniectomy performed in this group of patients could be beneficial. First experiences with implementation of hemicraniectomy in patients with brain infarct in our stroke centre are presented.Material and methodsBetween August 2007 and July 2008, four patients with hemispheric brain infarcts complicated by malignant oedema underwent decompressive hemicraniectomy within 72 hours from symptoms onset. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Clinical outcome was assessed 3, 6 and 12 months after the event using the modified Rankin scale (mRS).ResultsIn the first patient, the neurosurgical procedure included only decompressive hemicraniectomy, whereas in the other three duraplasty was performed additionally. The first patient died 23 days after the stroke onset due to acute respiratory failure. Another died at four months after the event, due to infectious complications. The remaining two patients presented severe functional disability 12 months after the procedure (mRS score 4).ConclusionsDecompressive surgery with duraplasty can be a life-saving procedure for patients with brain oedema. To our knowledge, the presented cases are among the first reported cases of hemispheric ischaemic stroke treated with decompressive hemicraniectomy in Poland. Extended follow-up with a larger group of patients is necessary to assess long-term outcome.     

超声影像特点对甲状腺结节性质的诊断价值

目的 总结甲状腺良、恶性结节的超声影像特点,探讨其术前对甲状腺结节性质的诊断价值.方法 回顾性分析2000年1月至2008年7月因触诊或超声检查发现甲状腺结节并在解放军总医院进行手术的患者1501例,记录术前超声检查的结节的二维声像(结节数目、大小、声像结构、同声类型、形态、边缘、有无钙化及钙化类型)、内部及周边血流和颈部淋巴结异常肿大等资料,根据术后病理诊断将所有结节分为2组:良性组1864个结节和恶性组259个结节.结果 (1)多结节组单个结节恶性率低于单结节组[10.2%(150/1470)比16.7%(109/653),P=0.000];良性结节的平均最大直径大于癌性结节[(2.4±1.4)cm比(2.1±1.9)cm,P=0.009].(2)细小点状钙化、形态不规整、边界不清、实性和低回声等声像特征在癌性结节中更为常见;形态不规整对癌性结节诊断敏感性和阳性预测值最高,而细小点状钙化诊断准确性最高.(3)结节内血流分布模式中以血流丰富者发生癌变几率最高,周边血流的多少不能反映结节的性质;伴同侧颈部淋巴结异常肿大的结节癌变率高于不伴异常肿大者[28.3%(80/283)比9.6%(92/963),P＜0.01].(4)如果将细小点状钙化、形态不规整、边缘不清、实性、低回声伴同侧颈淋巴结异常肿大视为癌性结节征象,上二述征象越多,癌变可能性越大.结论 尽管癌性结节没有特异性超声影像特点,微钙化和形态不规整与癌性病变关系更密切,综合分析所有影像特点可进一步提高超声对甲状腺结节性质的鉴别价值.     

A rare form of abruptio placenta and clinical presentation in a preterm labor case: Breus' mole

A normotensive pregnant woman who had no historical risk factors for abruption placenta and found to have Breus' mole that indicates the pattern of single or multiple hematoma protrude above the chorionic plate was encountered. The case resembled a large fetal abdominal wall defect coexisting with a singleton live-born fetus at 27 weeks of gestational age is presented. The obstetric ultrasound showed that multiple coiled masses in the amniotic cavity, both the fetus and the placenta were normal. After two courses of tocolysis therapy, a healthy and, 1,400 g live-born infant was delivered through cesarean section due to fetal distress. Apgar scores at 1 and 5 min were 5 and 8, respectively. The infant died on postnatal day 6 due to severe respiratory distress and prematurity. This rare condition probably occurs frequently in missed abortion and the etiology is unknown, but is probably related to circulatory disturbance on maternal site. We report a rare clinical presentation and review the literature of Breus' mole.     

Long-term persistence of hepatitis B surface antigen and antibody induced by DNA-mediated immunization results in liver and kidney lesions in mice

DNA-mediated immunization has been recognized as a new approach for prevention and treatment of hepatitis B virus (HBV) infection. However, the side effects of this approach have not been well described. Here we report that DNA-mediated immunization by intramuscular injection of plasmid DNA encoding HBV surface antigen (HBsAg) induced long-term persistence of HBsAg and HBsAg-specific antibody (anti-HBs) in the sera of the immunized BALB/c mice and resulted in liver and kidney lesions. The lesions persisted for 6 months after injection. Lesions were also found in normal mice injected with the sera from immunized mice, and in HBV-transgenic mice injected with anti-HBs antibody, or sera from immunized mice. Furthermore, lesions were accompanied by deposition of circulating immune complex (CIC) of HBsAg and anti-HBs antibody in the damaged organs. These results indicate that long-term persistence of HBsAg and anti-HBs in the immunized mice can result in deposited CIC in liver and kidney, and in development of lesions. The use of DNA containing mammalian replication origins, such as the plasmids used in this study, is not appropriate for human vaccines due to safety concerns relating to persistence of DNA; nevertheless, the safety of DNA-mediated immunization protocols still needs to be carefully evaluated before practical application.