Human papillomavirus infection among women in South and North Vietnam

The incidence rate of invasive cervical carcinoma (ICC) is 4-fold higher in Ho Chi Minh City, in the South of Vietnam, than in Hanoi, in the North. Thus, we explored the prevalence of and the risk factors for human papillomavirus (HPV) infection in these 2 areas. A population-based random sample of married women aged 15-69 years were interviewed and had a gynaecological examination in the urban district of Ho Chi Minh City and in a peri-urban district in Hanoi. HPV DNA detection was performed using a GP5+/6+ primer-mediated PCR enzyme immunoassay. A total of 922 women from Ho Chi Minh and 994 from Hanoi, for whom a Pap smear and HPV-status were available, were evaluated. HPV DNA was detected among 10.9% of women in Ho Chi Minh City and 2.0% in Hanoi (age standardized prevalence, world standard population: 10.6% and 2.3%, respectively). In the 2 areas combined, 30 different HPV types were found, the most common being HPV 16 (in 14 single and 18 multiple infections), followed by HPV 58, 18 and 56. A peak of HPV DNA detection in women younger than age 25 was found in Ho Chi Minh City (22.3%) but not in Hanoi. Major risk factors for HPV DNA detection were indicators of sexual habits, most notably the presence of HSV-2 antibodies, nulliparity and the current use of oral contraceptives. Women in Hanoi showed the lowest HPV prevalence ever reported so far, suggesting that HPV has not spread widely in this population. As expected, HPV prevalence in a population seemed to be closely correlated with ICC incidence rates.     

Id proteins in cell growth and tumorigenesis

Since the gene encoding Id1 was cloned in 1990, Id proteins have been implicated in regulating a variety of cellular processes, including cellular growth, senescence, differentiation, apoptosis, angiogenesis, and neoplastic transformation. The development of knockout and transgenic animal models for many members of the Id gene family has been particularly useful in sorting out the biologic relevance of these genes and their expression during normal development, malignant transformation, and tumor progression. Here we review the current understanding of Id gene function, the biologic consequences of Id gene expression, and the implications for Id gene regulation of cell growth and tumorigenesis.     

The experience of pain and emergent osteoarthritis of the knee

Discrepancies exist between radiographic osteoarthritis of the knee (OAK) and report of knee joint pain. Little is known about how these two definitions of osteoarthritis (OA) and their correlates differ between African American (AA) and Caucasian (CA) women. OBJECTIVE: We compared the prevalence of radiographic OAK and knee joint pain in AA and CA women, and the congruency of these outcomes according to age, body size, and knee injury. DESIGN: A cross-sectional study of African American and Caucasian women aged 40-53 years (N=829) in Southeast Michigan used the Kellgren and Lawrence Atlas of Standard Radiographs of Arthritis to characterize radiographs of both knee joints (weight bearing) and self-report of knee pain. RESULTS: Current pain was a significantly more sensitive predictor of radiographic OAK among AA women (Se=0.51) compared to CA women (Se=0.35). Specificity was similar between AA women (Sp=0.77) and CA women (Sp=0.82). Positive predictive value was significantly greater for AA compared with CA women (PV+=0.40 and PV+=0.15, respectively). The odds of having radiographic OAK increased with BMI >32 kg/m(2) in both groups. Knee pain was related to BMI in CA women, but not AA women. Previous knee injury was associated with knee pain in both AA and CA women (OR=3.0 and OR=2.4). CONCLUSIONS: Joint pain in AA women was more likely to be associated with radiographic OAK as compared with CA women. This suggests differences in these two groups in both how pain is experienced in the OAK process and in the prevalence of non-OAK related pain in knee joints.     

Long term trends in the occurrence of nosocomial blood stream infection

OBJECTIVE:

To determine trends in the occurrence of nosocomial blood stream infection at the University of Alberta Hospital.

METHODS:

A prospective survey of nosocomial blood stream infection was conducted; cases from August 1986 to December 1996 were reviewed. Cases were detected by a review of positive blood cultures reported by the microbiology laboratory. Centers for Disease Control and Prevention definitions of nosocomial infection were used to categorize isolates as nosocomial, community acquired or contaminant.

RESULTS:

There were 2389 cases; primary bacteremia was the most common source (57%), followed by urinary tract, respiratory tract and surgical site sources (10% each). The nosocomial blood steam infection rate rose progressively from 6.0/1000 admissions and 4.59/10,000 patient days in 1986 to 11.2/1000 admissions and 14.31/10,000 days in 1996 (P<0.01); 48% of the total increase in rate occurred between 1995 and 1996. Significant increases occurred between 1986 and 1996 in primary infections (from 3.2 to 7.5/1000 admissions, P<0.01) and infections from all secondary sources (from 2.5 to 3.8/1000 admissions, P=0.01). Coagulase-negative staphylococci (27%), Staphylococcus aureus (19%) and enterococci (9%) were the most common microbial causes. Aerobic Gram-negative bacilli accounted for 28% and candida for 6%. Coagulase-negative staphylococci, enterococci and candida all became more prevalent as causes of infection over the study period.

CONCLUSIONS:

The nosocomial blood stream infection rate in the hospital has nearly doubled in the past 10 years, largely due to increased primary bacteremia.Key Words: Bacteremia, Epidemiology, Nosocomial infectionsHospital care has long been associated with development of nosocomial infection. Recently, these infections have been identified as a significant public health problem (1-3). Changes in health care delivery over time, including the increased use of invasive procedures or immunosuppressive therapy in hospitalized patients and, conversely, out of hospital treatment of less seriously ill patients has likely changed the frequency and pattern of nosocomial infections. However, it has been difficult to document trends in the occurrence of all nosocomial infections, given the difficulty of capturing such data and the limited immediate benefit of doing so. Nosocomial infections associated with blood stream infection account for less than 10% of the total, but may result in greater attributable mortality, prolonged length of hospitalization and a higher cost of care than other infections (3-6). Furthermore, such infections are much easier to detect in a prospective surveillance system. Changes in the occurrence of nosocomial blood stream infections may, therefore, provide easily obtainable data which can be used as a surrogate for changes in all nosocomial infections.Since August 1986, blood culture reports have been prospectively monitored at University of Alberta Hospital to determine the occurrence of nosocomial bloodstream infection. Studies of organ system infections resulting in bloodstream infection and specific microorganisms causing those infections have been reported (7-9). The present study examines all sources, microbiological etiology and long term trends in the frequency of nosocomial bloodstream infection from August 1, 1986 to December 31, 1996.     

Hemagglutination Inhibition Assay for Gentamicin

A rapid and simple hemagglutination inhibition test for measuring gentamicin concentrations in serum has been developed. Correlation coefficients for this assay with the radioimmunoassay and microbiological assay were r = 710 and r = 0.864, respectively. Measurements of gentamicin levels in serum by the three methods showed no statistically significant differences. The hemagglutination inhibition assay is fast, reliable, and relatively inexpensive, and should prove valuable for laboratory use.