Large-scale disaster and gastrointestinal diseases

Many medical investigations, including epidemiological studies, case reports and case series have been conducted in association with large-scale disasters worldwide. Gastrointestinal diseases have been identified in many studies on disaster-related diseases with various problems being encountered especially in the acute (the first 3 days after the onset of a disaster), subacute (approximately the first 2 weeks after the onset of a disaster), and chronic phases. The problems in the acute phase concern food security and nutrition, while those in the subacute phase concern constipation and diarrhea. According to each disease site, the clinically important problems in the chronic phase are peptic ulcer and functional dyspepsia affecting the upper gastrointestinal tract, and inflammatory bowel disease and irritable bowel syndrome affecting the lower gastrointestinal tract. In addition, chronic hepatitis B and alcoholic liver diseases/pancreatitis are major hepatobiliary pancreatic diseases.     

Contraceptive adherence among HIV-infected women in Malawi: a randomized controlled trial of the copper intrauterine device and depot medroxyprogesterone acetate

Objective

To evaluate contraceptive adherence to the copper intrauterine device (Cu-IUD) and the injectable depot medroxyprogesterone acetate (DMPA) among women with HIV in Lilongwe, Malawi.

Methods

We randomized 200 HIV-infected women on highly active antiretroviral therapy (HAART) to either the Cu-IUD or DMPA and followed these women prospectively, evaluating adherence and factors associated with nonadherence.

Results

There was no difference in contraceptive adherence: 68% of Cu-IUD and 65% of DMPA users were adherent at 48 weeks. Receiving first-choice contraceptive was not associated with adherence. Women commonly cited partner's disapproval as an indication for discontinuation. Women who experienced heavy menstruation and first-time contraceptive users were more likely to be nonadherent. Among ongoing users at study conclusion, 95% were happy with their method, and 98% would recommend their method to a friend.

Conclusion

Contraceptive adherence between the Cu-IUD and DMPA was similar at 1 year. With similar adherence and similar high rates of satisfaction among users of both methods at 1 year, the Cu-IUD offers a hormone-free alternative to DMPA.

Implications

Adherence to the Cu-IUD and DMPA is similar at 1 year among HIV-infected women on HAART in a randomized controlled trial. Despite high method satisfaction, partner disapproval and heavy bleeding contribute to reduced adherence. Receiving a method that differs from participant's first-choice method did not influence adherence.     

5'-(N-ethylcarboxamido) adenosine improves angiogenesis in transplanted human ovarian tissue

To investigate the effect of 5'-(N-ethylcarboxamido) adenosine (NECA), an adenosine agonist, on triggering angiogenesis in transplanted human ovarian tissue, the expression of angiopoietin-1 (Ang1), Ang2, vascular endothelial growth factor 121 (VEGF-121) and VEGF-189 at both gene and protein levels as well as the density of vasculature were studied in tissue fragments grafted to NECA-treated and control groups of nude mice. The results showed that NECA treatment triggered down-regulation of Ang1, induced VEGF-189 expression, and stimulated neovascularization, highlighting the beneficial effect of NECA on the process of angiogenesis.     

Predictors of ECMO Support in Infants with Tachycardia-Induced Cardiomyopathy

The development of tachycardia-induced cardiomyopathy (TIC) is related to the rate and duration of supraventricular tachycardia (SVT). Infants may be more susceptible to TIC because early symptoms might be unrecognized. Extracorporeal membrane oxygenation (ECMO) may improve outcome in patients with SVT and TIC; however, clinical predictors of infants who require ECMO support have not been determined. The purpose of this study was to identify predictors of the need for ECMO in infants with SVT and TIC. Sixteen infants <6 months of age who experienced resolution of TIC following control of arrhythmia were identified. Three patients (19%) required ECMO support. Comparisons were made between patients who required ECMO and those who did not. The groups were similar with respect to age at presentation, type of SVT, rate of SVT, and degree of ventricular dysfunction. However, patients requiring ECMO had increased median M-mode-derived left ventricular end diastolic dimension (LVED) z-score when compared to the medically managed patents (+2.8 vs. 0.0, P = 0.009). No patient in the medically managed group had an LVED z-score >2.3. Infants presenting with SVT and TIC with LVED z-score >2 are at increased risk for requiring ECMO support and early use of ECMO should be considered.     

Use of alcohol, nicotine and other drugs in the Western Australian HIV Cohort study

Self-report questionnaires on alcohol, nicotine and other drugs were administered to assess the current prevalence of alcohol, drug and nicotine use in our tertiary HIV service and inform the establishment of effective interventions. Many respondents reported use of alcohol over the preceding month (111 out of 152, 73%), and recent drug use (48 out of 137, 35%) and frequently both. Sessional alcohol consumption was prevalent among drinkers (52 out of 111, 47%), and correlated with both early treatment phase (P=0.009) and non-adherence (P=0.03). Encouraged by a notable proportion of patients expressing interest in clinic-based smoking cessation counselling, we recommend a targeted education strategy to motivate patients in health-seeking behaviours.     

Breast cancer diagnosis and treatment during the COVID-19 pandemic in a nationwide,insured population

Breast Cancer Research and Treatment - The early months of the COVID-19 pandemic led to reduced cancer screenings and delayed cancer surgeries. We used insurance claims data to understand how...     

Human germline nuclear transfer to overcome mitochondrial disease and failed fertilization after ICSI

Journal of Assisted Reproduction and Genetics - Providing additional insights on the efficacy of human nuclear transfer (NT). Here, and earlier, NT has been applied to minimize transmission risk of...