Socioeconomic disparities in the uptake of breast and cervical cancer screening in Italy: a cross sectional study

Background

Malaria during pregnancy is a major public health problem in Nigeria leading to increase in the risk of maternal mortality, low birth weight and infant mortality. This paper is aimed at highlighting key predictors of the ownership of insecticide treated nets (ITNs) and its use among pregnant women in Nigeria.

Methods

A total of 2348 pregnant women were selected by a multi-stage probability sampling technique. Structured interview schedule was used to elicit information on socio-demographic characteristics, ITN ownership, use, knowledge, behaviour and practices. Logistic regression was used to detect predictors of two indicators: ITN ownership, and ITN use in pregnancy among those who owned ITNs.

Results

ITN ownership was low; only 28.8% owned ITNs. Key predictors of ITN ownership included women who knew that ITNs prevent malaria (OR = 3.85; p < 0001); and registration at antenatal clinics (OR = 1.34; p = 0.003). The use of ITNs was equally low with only 7.5% of all pregnant women, and 25.7% of all pregnant women who owned ITNs sleeping under a net. The predictors of ITN use in pregnancy among women who owned ITNs (N = 677) identified by logistic regression were: urban residence (OR = 1.87; p = 0.001); knowledge that ITNs prevent malaria (OR = 2.93; p < 0001) and not holding misconceptions about malaria prevention (OR = 1.56; p = 0.036). Educational level was not significantly related to any of the two outcome variables. Although registration at ANC is significantly associated with ownership of a bednet (perhaps through free ITN distribution) this does not translate to significant use of ITNs.

Conclusions

ITN use lagged well behind ITN ownership. This seems to suggest that the current mass distribution of ITNs at antenatal facilities and community levels may not necessarily lead to use unless it is accompanied by behaviour change interventions that address the community level perceptions, misconceptions and positively position ITN as an effective prevention device to prevent malaria     

Tackling obesity requires efficient government policies

ABSTRACT: Changes in food supply and eating habits, combined with a dramatic fall in physical activity, have made obesity a global epidemic. Across OECD countries, one in two adults is currently overweight and one in six is obese. Children have not been spared, with up to one in three currently overweight. Obese people are more likely to develop diseases such as diabetes, cardiovascular disease, and cancer, and have a shorter life expectancy than people of normal weight. A prevention strategy combining health promotion campaigns, government regulation, counseling of individuals at risk in primary care, and paying special attention to the most vulnerable, would enhance population health at an affordable cost, with likely beneficial effects on health inequalities. Failure to implement such a strategy would impose heavy burdens on future generations. The new IJHPR paper by Ginsberg and Rosenberg illustrates how particular countries can assess alternative strategies for tackling obesity in a rigorous fashion.This is a commentary on http://www.ijhpr.org/content/1/1/17/     

First detection of Rickettsia aeschlimannii in Hyalomma dromedarii ticks from Tunisia

Tick-borne rickettsioses have long been described in North Africa. These human diseases and their causative agents occur in several countries in this region, including Mauritania, Morocco, Algeria, Tunisia, Libya, and Egypt. In Tunisia, the first described and most well-known rickettsiosis is Mediterranean spotted fever, which is caused by Rickettsia conorii conorii. Cases of R. aeschlimannii infections have been documented by serology, but the agent has never actually been detected in patients or arthropods in the country. In October 2008, ticks were collected from a dromedary (Camelius dromedarii) in Douz, Central Tunisia. All of the ticks were identified as Hyalomma dromedarii and were tested using polymerase chain reaction to determine the presence of rickettsiae. Our results indicate the first molecular detection of R. aeschlimannii in ticks from Tunisia.     

Hemangioma of the spleen. A case report

We report a case of hemangioma of the spleen in an 18-old-years female patient. Clinical presentation was abdominal pain in the left upper quadrant. Physical examination founding was normal. The hemangioma was presented as hyperechogenic mass on ultra sound imaging. On the computed tomography scan with contrast it became progressively hyperdense. Splenectomy is often indicated because of the risk of rupture and the doubt about malignant form in histological examination.     

Effect of triple antiretroviral therapy on Tunisian AIDS profile: study of 139 cases

We report a retrospective study to estimate highly active antiretroviral therapy (HAART) effect in 139 HIV infected patients. Four criteria are studied: prevalence of opportunistic infections, CD4 cell count evolution, viral load progression and mortality. Gastrointestinal side effects are the most common clinical adverse reaction (61.1 percent), and hematological side effects are the most common biological adverse reaction (61.2 percent). During the 22.8 months (3 months to 6 years) follow-up average period, CD4 cell counts remained above 500 per cubic millimeter in only 25.8 percent of cases, while 63.5 percent of patients had a viral load below 400 copies per milliliter. During the study on patients receiving HAART, opportunistic infections appeared in 17.3 percent of cases (24 cases) and mortality in 6.4 percent of cases.     

Gemcitabine and cisplatin versus mitomycin, ifosfamide, and cisplatin in advanced non-small-cell lung cancer: A randomized phase III study of the Italian Lung Cancer Project.

PURPOSE: To compare gemcitabine and cisplatin (GC) with mitomycin, ifosfamide, and cisplatin (MIC) chemotherapy in patients with stage IIIB (limited to T4 for pleural effusion and N3 for supraclavicular lymph nodes) or stage IV non-small-cell lung cancer (NSCLC). The end points were the evaluation of quality of life (QoL), response rates, survival, and toxicity. PATIENTS AND METHODS: Three hundred seven patients were randomized to receive either gemcitabine 1,000 mg/m(2) on days 1, 8, and 15 plus cisplatin 100 mg/m(2) on day 2, every 28 days, or mitomycin 6 mg/m(2), ifosfamide 3,000 mg/m(2), and mesna on day 1 plus cisplatin 100 mg/m(2) on day 2, every 28 days. The whole-blood cell count was repeated on day 1 in both arms and weekly in the GC arm before each gemcitabine administration. RESULTS: No major differences in changes in QoL were observed between the two treatment arms. The objective response rate was 38% in the GC arm compared with 26% in the MIC arm (P =.029). The median survival time was 8.6 months in the GC arm and 9.6 months in the MIC arm (P =.877, log-rank test). Grade 3 and 4 thrombocytopenia was significantly worse in the GC arm (64% v 28%, P <.001), whereas grade 3 and 4 alopecia was reported more commonly in the MIC arm (39% v 12%, P <. 001). CONCLUSION: We report an increased response rate without changes in QoL and a similar overall survival, time to progression, and time to treatment failure for the GC when compared with the MIC regimen in the treatment of advanced NSCLC.     

Liver cytosolic protein-bound folates in phenobarbitone-treated rats

The effect of acute phenobarbitone treatment on the distribution of endogenous bound folates in three specific cytosolic folate-binding proteins (FBP-C), has been studied in rat liver. The bound folate amount shows no difference between treated and control rats. As it is well known that FBP's preferentially bind longer-chain polyglutamates, the content of which is markedly lower in phenobarbitone-treated rat liver, it might be suggested that shorter chain folates also bind to FBP's in these animals.     

Tetralogy of Fallot with double aortic arch: successful staged repair. Case report and review of literature

The rare association of DAA with TOF is reported in a young boy who underwent successfully at the age of 3 months an emergency shunt between the anterior (left) hypoplastic aortic arch and the LPA after the vascular ring was divided. Total correction of the cardiovascular malformation was performed at the age of 4 years. The cardiac catheterization, angiographic and operative findings as well as the management of the case are described. Ten other patients with this combination of anomalies were found on review of the literature, eight of whom had only palliative systemic to pulmonary artery shunts. Knowledge of the morphology of the DAA by angiocardiography is helpful in planning the management. Surgical shunts when done early for the treatment of a patient with repeated anoxic spells may reduce the gravity of psychomotor retardation. A staged surgical repair of TOF is recommended for infants having hypoplastic pulmonary arteries.     

Paraganglioma of the gallbladder

A case of incidental Gallbladder Paraganglioma is presented. This is the third case found until now in this organ. The parasympathetic origin of this neoplasm is thus discussed.