Transmission clustering drives the onward spread of the HIV epidemic among men who have sex with men in Quebec

Phylodynamic analysis and epidemiologic data identified 3 patterns of spread of primary human immunodeficiency virus type 1 infection (PHI) among men who have sex with men (2001-2009): 420 unique PHIs, 102 small clusters (2-4 PHIs per cluster, n = 280), and 46 large clusters (5-31 PHIs per cluster, n = 450). Large clusters disproportionately increased from 25.2% of PHIs in 2005 to 39.1% in 2009 (χ(2) = 33.9, P < .001). Scalar expansion of large clusters over 11 months (interquartile range, 3.5-25.5 months) correlated with cluster membership size (r(2) = 0.174, F = 4.424, P = .047). PHI cohort data revealed variations in social networks and risk behaviors among the 3 groups, suggesting the need for tailored prevention measures.     

The treatment of menopausal symptoms by traditional East Asian medicines: Review and perspectives

This article provides an overview and critical evaluation of the management of menopausal symptoms by traditional East Asian medicines (TEAMs). For this purpose we utilise an interdisciplinary perspective that draws on social history, medical anthropology, and clinical research. Our goal is threefold. First, we examine the research literature regarding evidence for the effectiveness of TEAMs in the management of menopausal symptoms. The failure of all studies reviewed to address the problematic articulation between tradition and modernity in the case of menopausal syndrome leads us to examine more closely how this connection has been constructed. In the second part of this review we explain how during the late 20th century various TEAMs currents such as traditional Chinese medicine (TCM), Japanese Kampō, and Korean medicine, explored different responses to a biomedically defined disorder, namely menopause, that was until then not discussed in these traditions. Third, based on the findings of the previous sections we make a number of recommendations as to how research in this field might be improved. We argue that while robust evidence for the efficacy of TEAMs in treating menopausal symptoms is currently lacking, existing studies provide sufficient evidence to warrant further research. A new interdisciplinary research framework that takes account of the actual realities of TEAMs practice will be required however for meaningful answers regarding the two most urgent problems in the field to emerge. These are, first the issue of actual treatment effects, and second the more general problem of how TEAMs might be integrated into personalised health care.     

Association of Linear Growth Impairment in Pediatric Crohn's Disease and a Known Height Locus: A Pilot Study

The etiology of growth impairment in Crohn's disease (CD) has been inadequately explained by nutritional, hormonal, and/or disease‐related factors, suggesting that genetics may be an additional contributor. The aim of this cross‐sectional study was to investigate genetic variants associated with linear growth in pediatric‐onset CD. We genotyped 951 subjects (317 CD patient–parent trios) for 64 polymorphisms within 14 CD‐susceptibility and 23 stature‐associated loci. Patient height‐for‐age Z‐score < ?1.64 was used to dichotomize probands into growth‐impaired and nongrowth‐impaired groups. The transmission disequilibrium test (TDT) was used to study association to growth impairment. There was a significant association between growth impairment in CD (height‐for‐age Z‐score < ?1.64) and a stature‐related polymorphism in the dymeclin gene DYM (rs8099594) (OR = 3.2, CI [1.57–6.51], p = 0.0007). In addition, there was nominal over‐transmission of two CD‐susceptibility alleles, 10q21.1 intergenic region (rs10761659) and ATG16L1 (rs10210302), in growth‐impaired CD children (OR = 2.36, CI [1.26–4.41] p = 0.0056 and OR = 2.45, CI [1.22–4.95] p = 0.0094, respectively). Our data indicate that genetic influences due to stature‐associated and possibly CD risk alleles may predispose CD patients to alterations in linear growth. This is the first report of a link between a stature‐associated locus and growth impairment in CD.     

Preterm outcome table (POT): a simple tool to aid counselling parents of very preterm infants

BACKGROUND: Outcome figures published in scientific journals are often cumbersome and difficult to understand by parents during counselling before or immediately after a very premature birth. AIM: To provide simplified up-to-date outcome information in a table for ease of counselling. METHODS: Regional perinatal mortality rates for very premature births (23-31 weeks gestation) and incidence of significant neonatal events for those admitted to neonatal intensive care units (NICU) were obtained from the NSW Midwives Data Collection, ACT Maternal and Perinatal Data Collection and the NSW and ACT NICUS Data Collection for 2000 and 2001. Neurodevelopmental outcome was obtained for the same cohort at 2-3 years of age, corrected for prematurity. The percentage outcomes were rounded off to the closest conservative multiple of 5 for each data point in a table. RESULTS: The preterm outcome table (POT) for each gestational week was constructed from a total of 2315 births. Of these, 401 (17.3%) were reported as stillborn and were predominantly of 23 to 25 weeks gestation. Of those admitted to NICU, hospital survival rates were 30, 50, 65, 75, 80, 90 and > 95% for 23, 24, 25, 26, 27, 28-29 and 30-31 weeks, respectively. Neurodevelopmental outcome was available for 470 (75%) children, of whom 15% had a moderate to severe functional disability at 2-3 years of age, corrected for prematurity. Simplified data on survival to discharge and outcome were tabulated. CONCLUSION: POT appears simple and easy to use but also provides realistic data to assist clinicians in the counselling process.