Bulletin of the World Health Organization; 08/01/2012
(AN 2011651285)
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Biyernes, Nobyembre 30, 2012
The relationship between high blood glucose and socio-economic position in childhood and adulthood in Korea: findings from the Korean National Health and Nutrition Examination, 2007-09
Background Unlike the older birth cohort (1943–65), the younger birth cohort (1966–79) has enjoyed much improved standards with dramatic developments in Korea. This article investigated the relationship between socio-economic position (SEP) and risk of high blood glucose, including impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2D) by birth cohort.
Methods Of the 11 830 persons, 9792 persons aged 30–64 years participated in National Health and Nutrition Examination Surveys. We categorized four SEP groups based on education level in childhood and adulthood within two birth cohorts. High blood glucose included IFG (n = 2594) and T2D (n = 738). Odds ratio (OR) and 95% confidence interval (CI) were estimated by logistic regression.
Results There was a significantly higher risk of high blood glucose in the younger cohort than in the older cohort. In the younger cohort, the ORs for males of declining SEP and of stable low SEP were OR: 1.50 (95% CI 1.12–2.00) and OR: 1.45 (95% CI 1.08–1.93), respectively. After adjustments, corresponding ORs were 1.47 (95% CI 1.09–1.98) and 1.54 (95% CI 1.14–2.08), respectively. In younger women, the corresponding ORs were 1.68 (95% CI 1.17–2.41) and 1.87 (95% CI 1.30–2.69), respectively; however, obesity attenuated the former relationship. For women in the older cohort, this inverse relationship was found only among those with a stable low SEP (OR 1.31, 95% CI 1.04–1.66); no significance was found after adjustments. There was no significant inverse relationship in the older cohort for men.
Conclusions The relationship between lower SEP and elevated risk of high blood glucose was stronger in the younger birth cohort, and obesity attenuated this inverse relationship in women only.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/3/733?rss=1
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Sleep Apnea
New England Journal of Medicine, Volume 367, Issue 22, November 2012.
Source: http://www.nejm.org/doi/full/10.1056/NEJMicm1212352?ai=rv&af=R&rss=currentIssue
Sending a message: Ecstasy, equasy and the media politics of drug classification.
Health, Risk & Society; 05/01/2011
(AN 59835839)
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The history and the narrative of risk in the media.
Health, Risk & Society; 02/01/2011
(AN 58145022)
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Seasonality of infant feeding practices in three Brazilian birth cohorts
Background We assessed the influence of season of birth on duration of breastfeeding and other feeding patterns in three population-based birth cohort studies in the city of Pelotas, Southern Brazil.
Methods In 1982, 1993 and 2004, all hospital-born children in the city were enrolled in three cohort studies (n = 5914, 5249 and 4287, respectively). Children and their mothers were periodically visited in the first 2 years of life, to collect information on the duration of breastfeeding and the ages at which different types of foods were introduced on a regular basis. Two independent variables were studied: month of birth and mean environmental temperature in the first month of life. Survival analyses and chi-squared tests were used to evaluate the associations. Temperature-based slope indices of inequality were also calculated.
Results Duration of breastfeeding was lower among children born from April to June (months preceding winter) and spending their first month of life in colder temperatures. The influence of season of birth on breastfeeding patterns and the introduction of cow's milk differed according to maternal education, with the strongest effects among children belonging to less educated mothers. Early introduction of fruits (1982 and 1993 cohorts) and vegetables (1982 cohort) were also associated with lower environmental temperature in the first month of life, but not with trimester of birth.
Conclusion Colder temperatures adversely affect duration of breastfeeding and feeding patterns in infancy, especially among the poorest. This finding should be considered in breastfeeding promotion programmes.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/3/743?rss=1
Huwebes, Nobyembre 29, 2012
Utility of gadolinium enhanced cardiovascular MRI to differentiate Fabry's disease from other causes of hypertrophic cardiomyopathy
Fabry's disease is an X linked recessive lysosomal storage disorder resulting from a deficiency of the enzyme alpha-galactosidase which causes an inability to catabolise glycosphingolipid.
Source: http://pmj.bmj.com/cgi/content/short/88/1046/731?rss=1
The reduced sequestration of Plasmodium-falciparum-infected erythrocytes among malaria cases with sickle-cell trait: in-vivo evidence from Sudan.
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Annals of Tropical Medicine & Parasitology; 12/01/2008Request Article (Library Express).
(AN 35178314)
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Differences in body composition between infants of South Asian and European ancestry: the London Mother and Baby Study
Background South Asian children and adults have a more adipose body composition compared with those of European ancestry. This is thought to be related to their increased risk of metabolic disorders. However, little is known about how early in life such differences are manifest.
Objective To determine whether there are differences in fat mass (FM) and fat-free mass (FFM) between UK-born South Asians and White Europeans in infancy.
Design A cross-sectional study of 30 South Asian and 30 White European infants aged 6–12 weeks. Mothers were recruited from clinics in London, and infants’ FM and FFM were determined using air-displacement plethysmography (PeaPod®).
Results In early infancy South Asians had less FFM than White Europeans [0.34 kg less, 95% confidence interval (CI): 0.15, 0.52], with a considerably weaker indication of them also having more FM (0.02 kg more, 95% CI: –0.14, 0.18). These differences persisted when the overall smaller body size of South Asian infants was taken into account. For a given total infant weight, the balance of body composition of South Asians was shifted by 0.16 kg (95% CI: 0.06, 0.25) from FFM to FM. The ethnic differences in the amount of FFM were almost completely accounted for by ethnic differences in the rate of growth in utero and length of gestation.
Conclusions The characteristic differences in body composition observed between adult South Asians and White Europeans are apparent in early infancy. Of particular note is that this is the first study to demonstrate that South Asians compared with White Europeans have reduced FFM in infancy. The early manifestation of this phenotype suggests that it is either genetic and/or determined through exposure to maternal physiology, rather than a consequence of behaviours or diet in childhood or at older ages.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/5/1409?rss=1
The role of biomedical engineering in disaster management in resource-limited settings.
Bulletin of the World Health Organization; 08/01/2012
(AN 2011651290)
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School-based health education for the control of soil-transmitted helminthiases in Kanchanaburi province, Thailand.
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Annals of Tropical Medicine & Parasitology; 09/01/2008Request Article (Library Express).
(AN 34147266)
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Fateful moments and the categorisation of risk: Midwifery practice and the ever-narrowing window of normality during childbirth.
Health, Risk & Society; 04/01/2012
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The placental origins of sudden cardiac death
Objective Most sudden cardiac deaths are due to cardiac arrhythmias, and abnormalities in the autonomic nervous system could underlie them. There is growing evidence that coronary heart disease is associated with alterations of fetal development as a result of variations in the processes of placentation that control fetal nutrition. We hypothesized that placental size would be associated with sudden cardiac death.
Methods We examined sudden cardiac death within the Helsinki Birth Cohort of 13 345 men and women.
Results One hundred eighty-seven (2.7%) men and 47 (0.7%) women had sudden unexplained cardiac death outside hospital. Sudden death was associated with a thin placenta, the hazard ratio being 1.47 [95% confidence interval (CI) 1.11–1.93, P = 0.006] for each g/cm2 decrease in thickness. Sudden death was independently associated with poor educational attainment (P < 0.0001). Both of these associations were independent of socio-economic status in later life.
Conclusion Sudden death may be initiated by impaired development of the autonomic nervous system in utero as a result of shallow invasion of the spiral arteries in the maternal endometrium and consequent fetal malnutrition.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/5/1394?rss=1
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Miyerkules, Nobyembre 28, 2012
Ending polio, one type at a time.
Bulletin of the World Health Organization; 07/01/2012
(AN 2011626150)
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Opening Pandora's box: The experiences of having an asymptomatic aortic aneurysm under surveillance.
Health, Risk & Society; 06/01/2012
(AN 75047851)
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Improved and standardized method for assessing years lived with disability after injury.
Bulletin of the World Health Organization; 07/01/2012
(AN 2011626142)
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(AN 2011626142)
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Isolation and identification of Leishmania donovani from Phlebotomus orientalis, in an area of eastern Sudan with endemic visceral leishmaniasis.
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Annals of Tropical Medicine & Parasitology; 09/01/2008Request Article (Library Express).
(AN 34147263)
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Molecular and epidemiological investigations of cryptosporidiosis in Cuban children.
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Annals of Tropical Medicine & Parasitology; 12/01/2008Request Article (Library Express).
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The role of maternal nutrition in the aetiology of gastroschisis: an incident case-control study
Background Gastroschisis, a congenital anomaly involving a defect in the fetal abdominal wall, has increased in prevalence in many countries, but the aetiology is uncertain. We tested the hypothesis that high maternal alcohol consumption and poor diet in the first trimester are risk factors in a case–control study in the UK (1 July 2007 to 28 February 2010).
Methods Gastroschisis cases and three controls per case (matched for maternal age) were identified at 18- to 20-week routine anomaly screening ultrasound scan (USS). Interviews were carried out during the antenatal period (median 24 weeks' gestation) using a piloted questionnaire. Conditional logistic regression was used to describe the associations between exposure variables and gastroschisis, adjusted for known confounding variables.
Results The response rate was 73% for cases (n = 91) and 70% for controls (n = 217). High consumption of fruits and vegetables during the first trimester (aOR 0.2; 95% CI 0.04–0.6), taking folic acid for at least 6 weeks during the first trimester (aOR 0.3; 95% CI 0.1–0.7) and increasing body fat percentage of total maternal body weight (aOR 0.9; 95% CI 0.8–0.9 per 1% increase) were independently associated with reduced risk. Cigarette smoking (aOR 2.7; 95% CI 1.1–6.8) was an independent risk factor.
Conclusion We report for the first time that higher intake of fruits and vegetables during the first trimester, longer duration of folic acid supplementation and higher body fat percentage are associated with reduced risk of fetal gastroschisis, independent of cigarette smoking. The increased risk of cigarette smoking is greatest in older women and in high socio-economic groups.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/4/1141?rss=1
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No association between body size at birth and leucocyte telomere length in adult life--evidence from three cohort studies
Background Shorter leucocyte telomere length (LTL) is a promising marker of biological ageing. It is predicted by cumulative adverse conditions throughout life course, but few studies have data from the prenatal period when most developmental processes and cell replication take place. We studied whether body size at birth and underlying factors including severely preterm birth predict LTL in adult life.
Methods We used data from following three cohorts: (i) 1894 subjects (age: 56–69 years) from the Helsinki Birth Cohort Study (HBCS), representing normal variation in fetal growth; (ii) the Helsinki Study of Very Low Birth Weight Adults encompassing 164 subjects born preterm at very low birthweight (<1500 g; representing extreme pre- and neonatal conditions) and 170 term-born controls (18–27 years) and (iii) 248 twins (23–31 years) from the FinnTwin16 cohort, allowing comparisons between twin pairs. Relative telomere length was measured from leucocytes by real-time quantitative polymerase chain reaction.
Results Shorter LTL was associated with higher age in HBCS and among men in the Helsinki Study of Very Low Birth Weight Adults and with lower childhood socio-economic status in HBCS and FinnTwin16. LTL was not associated with weight, length or gestational age at birth in any cohort. LTL was similar in very-low-birthweight and control subjects.
Conclusions LTL is unlikely to be a useful marker of a mechanism linking body size at birth with individual differences in ageing in the general population.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/5/1400?rss=1
Martes, Nobyembre 27, 2012
rTES-30USM: cloning via assembly PCR, expression, and evaluation of usefulness in the detection of toxocariasis.
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Annals of Tropical Medicine & Parasitology; 03/01/2008Request Article (Library Express).
(AN 30053667)
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Alemtuzumab for multiple sclerosis: who and when to treat?
Publication year: 2012
Source:The Lancet, Volume 380, Issue 9856
Till Sprenger, Ludwig Kappos
Source:The Lancet, Volume 380, Issue 9856
Till Sprenger, Ludwig Kappos
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Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China.
Bulletin of the World Health Organization; 08/01/2012
(AN 2011651285)
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(AN 2011651285)
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A healthy nation: strengthening child health research in the UK
Publication year: 2012
Source:The Lancet
Neena Modi, Howard Clark, Ingrid Wolfe, Anthony Costello, Helen Budge
Despite a general acknowledgment that research in children is necessary and ethical, the evidence base for child-specific treatments is still sparse. We investigated children's biomedical and health services research in the UK in relation to training, infrastructure and activity, research evidence, and visibility. We show that excellent opportunities for career researchers exist through a competitive, national integrated academic training programme, but that the number of academic paediatricians has decreased by 18% between 2000 and 2011, falling from 11·3% to 5·9% of the consultant workforce. The potential for rapid delivery of studies in children through the National Health Service (NHS) is not being realised: clinical trainees are poorly equipped with core research skills; most newly appointed consultant paediatricians have little or no research experience; less than 5% of contracted consultant time supports research; less than 2·5% of the 2 million children seen in the NHS every year are recruited to studies; and ten of the 20 UK children's hospitals do not have a clinical research facility. Support through National Institute for Health Research networks is good for studies into drugs, but inconsistent for non-drug research; less than 5% of registered studies involve children and only one children's biomedical research centre has been allocated funding from 2012. Of the UK annual public and charitable biomedical research expenditure of roughly £2·2 billion, about 5% is directed at child health research. The scant evidence base is impeding the development of clinical guidance and policy—less than 20% of the outputs of the National Institute for Health and Clinical Excellence are applicable to children. Paediatric representation on major research boards is weak. Parent and young people's advocacy is fragmented, and their views are insufficiently heeded by regulatory bodies. The strong UK Government commitment to biomedical research has not been translated fully to research for children. The power of research in children to turn the tide of the growing burden of non-communicable, chronic, adult diseases that have their origins in early life, to benefit the health of an ageing population and future generations, and to reduce health-care costs is inadequately recognised. On the basis of our findings, we make several recommendations to improve early-years research, including the formation of multidisciplinary, cross-institutional groups of clinical and non-clinical child health researchers and their access to diagnostic and laboratory facilities suitable for children; a unified Children's Research Network for drug studies and non-drug studies; regulatory assessment of research that is proportionate and based on consistent national criteria; an expansion of research posts; support for parents' and young people's advocacy; collaboration between children's research charities; improved research training for paediatric trainees; and closer integration of child health research with core NHS activities.
Source:The Lancet
Neena Modi, Howard Clark, Ingrid Wolfe, Anthony Costello, Helen Budge
Performance-based financing in low- and middle-income countries: still more questions than answers.
Bulletin of the World Health Organization; 08/01/2012
(AN 2011651292)
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Evidence supporting the zoonotic and non-zoonotic transmission of Enterocytozoon bieneusi.
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A systematic review of Demographic and Health Surveys: data availability and utilization for research.
Bulletin of the World Health Organization; 08/01/2012
(AN 2011651281)
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Lunes, Nobyembre 26, 2012
Reversible heart failure: toxins, tachycardiomyopathy and mitochondrial abnormalities
Heart failure is usually a relentless condition associated with a poor prognosis. Triggered by a physiological insult, maladaptive neurohumoral processes result in an ever-spiralling deterioration of cardiovascular function. However, there are certain underlying conditions which are associated with a temporary reduction in contractile function leading to reversible heart failure. These conditions affect a relatively small number of patients when compared with heart failure secondary to inherited cardiomyopathies and ischaemic heart disease. There are two broad mechanisms responsible for reversible myocyte dysfunction: acute inflammatory activation in which cytokines depress myocyte function, and toxic effects in which there is impairment of intra-cellular energetics. In this review, we discuss reversible heart failure caused by toxic effects. These effects can be caused by drugs (prescribed and illicit) and by tachycardic arrhythmia (tachycardiomyopathy), and are caused by abnormalities of mitochondrial function and myocytic calcium processing. The underlying pathological mechanisms, clinical features and management options are discussed, illustrated by clinical case studies.
Source: http://pmj.bmj.com/cgi/content/short/88/1046/706?rss=1
M-health for health behaviour change in resource-limited settings: applications to HIV care and beyond.
Bulletin of the World Health Organization; 05/01/2012
(AN 2011575001)
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(AN 2011575001)
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Intestinal helminthiases among rural and urban schoolchildren in south–western Nigeria.
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Annals of Tropical Medicine & Parasitology; 12/01/2007Request Article (Library Express).
(AN 27500634)
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Cohort profile: The QSkin Sun and Health Study
The QSkin Sun and Health Study comprises a cohort of 43 794 men and women aged 40–69 years randomly sampled from the population of Queensland, Australia in 2011. The cohort was established to study the development of skin cancer and melanoma in the population with the highest reported incidence of these diseases in the world. At baseline, besides demographic items and general medical history, information about standard pigmentary characteristics (including hair and eye colour, freckling tendency, tanning ability and propensity to sunburn), past and recent history of sun exposure and sunburns, sun protection behaviours, use of tanning beds and history of skin cancer was collected by self-completed questionnaire. Participants have given their consent for data linkage to the universal national health insurance scheme and for linkage to cancer registries and pathology databases, thus ensuring complete ascertainment of all future skin cancer and melanoma occurrences and medical treatments and other cancer events. Linkage to these registers will occur at predetermined intervals. Approval to access QSkin data can be obtained on application to the study investigators and submission of a formal research plan that has previous approval from the human research ethics committee of the applicant’s institution.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/4/929?rss=1
Research scan.
Bulletin of the World Health Organization; 06/01/2012
(AN 2011594082)
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(AN 2011594082)
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Long-running telemedicine networks delivering humanitarian services: experience, performance and scientific output.
Bulletin of the World Health Organization; 05/01/2012
(AN 2011575000)
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(AN 2011575000)
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Media coverage on electromagnetic fields and health: Content analysis of Dutch newspaper articles and websites.
Health, Risk & Society; 10/01/2012
(AN 82153797)
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Linggo, Nobyembre 25, 2012
Rotavirus mortality in India: estimates based on a nationally representative survey of diarrhoeal deaths.
Bulletin of the World Health Organization; 10/01/2012
(AN 2011724028)
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Perspectives on the ‘lens of risk’ interview series: Interview with Nick Pidgeon.
Health, Risk & Society; 04/01/2012
(AN 73444910)
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Measuring socio-economic position for epidemiological studies in low- and middle-income countries: a methods of measurement in epidemiology paper
Much has been written about the measurement of socio-economic position (SEP) in high-income countries (HIC). Less has been written for an epidemiology, health systems and public health audience about the measurement of SEP in low- and middle-income countries (LMIC). The social stratification processes in many LMIC—and therefore the appropriate measurement tools—differ considerably from those in HIC. Many measures of SEP have been utilized in epidemiological studies; the aspects of SEP captured by these measures and the pathways through which they may affect health are likely to be slightly different but overlapping. No single measure of SEP will be ideal for all studies and contexts; the strengths and limitations of a given indicator are likely to vary according to the specific research question. Understanding the general properties of different indicators, however, is essential for all those involved in the design or interpretation of epidemiological studies. In this article, we describe the measures of SEP used in LMIC. We concentrate on measures of individual or household-level SEP rather than area-based or ecological measures such as gross domestic product. We describe each indicator in terms of its theoretical basis, interpretation, measurement, strengths and limitations. We also provide brief comparisons between LMIC and HIC for each measure.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/3/871?rss=1
Early life exposure to farm animals and symptoms of asthma, rhinoconjunctivitis and eczema: an ISAAC Phase Three Study
Background Associations between early life exposure to farm animals and respiratory symptoms and allergy in children have been reported in developed countries, but little is known about such associations in developing countries.
Objective To study the association between early life exposure to farm animals and symptoms of asthma, rhinoconjunctivitis and eczema in a worldwide study.
Methods Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) was carried out in 6- to 7-year-old children in urban populations across the world. Questions about early life exposure to farm animals (at least once/week) were included in an additional questionnaire. The association between such exposures and symptoms of asthma, rhinoconjunctivitis and eczema was investigated with logistic regression. Adjustments were made for gender, region of the world, language, gross national income and 10 other subject-specific covariates.
Results A positive association was found between early exposure to farm animals and the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema, especially in non-affluent countries. In these countries, odds ratios (ORs) for ‘current wheeze’, ‘farm animal exposure in the first year of life’ and ‘farm animal exposure in pregnancy’ were 1.27 [95% confidence interval (CI) 1.12–1.44] and 1.38 (95% CI 1.21–1.58), respectively. The corresponding ORs for affluent countries were 0.96 (95% CI 0.86–1.08) and 0.95 (95% CI 0.84–1.08), respectively.
Conclusion Exposure to farm animals during pregnancy and in the first year of life was associated with increased symptoms of asthma, rhinoconjunctivitis and eczema in 6- to 7-year-old children living in non-affluent but not in affluent countries.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/3/753?rss=1
Evidence supporting the zoonotic and non-zoonotic transmission of Enterocytozoon bieneusi.
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Annals of Tropical Medicine & Parasitology; 07/01/2008Request Article (Library Express).
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Heparin-induced skin lesions
Publication year: 2012
Source:The Lancet, Volume 380, Issue 9856
Marc Schindewolf, Edelgard Lindhoff-Last, Ralf J Ludwig, Wolf-Henning Boehncke
Heparins are widely used for prophylaxis and treatment of thromboembolic diseases. Besides bleeding complications, heparin-induced skin lesions are the most frequent unwanted adverse effects of subcutaneous heparin treatment. Evidence suggests that these lesions are more common than previously thought. Lesions are most frequently due to either allergic reactions or to possibly life-threatening heparin-induced thrombocytopenia. Early recognition and adequate treatment are highly important, because although both complications initially show a similar clinical picture, their treatment should be fundamentally different. Furthermore, risk factors associated with the patient, drug, and treatment regimen have been identified. We review the clinical range of heparin-induced skin lesions, emphasise evidence and controversies in epidemiology, diagnosis, and differential diagnosis, and discuss the management of patients with these skin lesions.
Source:The Lancet, Volume 380, Issue 9856
Marc Schindewolf, Edelgard Lindhoff-Last, Ralf J Ludwig, Wolf-Henning Boehncke
Mortality measures from sample-based surveillance: evidence of the epidemiological transition in Viet Nam.
Bulletin of the World Health Organization; 10/01/2012
(AN 2011724022)
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(AN 2011724022)
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Sabado, Nobyembre 24, 2012
Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial
Publication year: 2012
Source:The Lancet
George D Demetri, Peter Reichardt, Yoon-Koo Kang, Jean-Yves Blay, Piotr Rutkowski, Hans Gelderblom, Peter Hohenberger, Michael Leahy, Margaret von Mehren, Heikki Joensuu, Giuseppe Badalamenti, Martin Blackstein, Axel Le Cesne, Patrick Schöffski, Robert G Maki, Sebastian Bauer, Binh Bui Nguyen, Jianming Xu, Toshirou Nishida, John Chung, Christian Kappeler, Iris Kuss, Dirk Laurent, Paolo G Casali
Background Until now, only imatinib and sunitinib have proven clinical benefit in patients with gastrointestinal stromal tumours (GIST), but almost all metastatic GIST eventually develop resistance to these agents, resulting in fatal disease progression. We aimed to assess efficacy and safety of regorafenib in patients with metastatic or unresectable GIST progressing after failure of at least imatinib and sunitinib. Methods We did this phase 3 trial at 57 hospitals in 17 countries. Patients with histologically confirmed, metastatic or unresectable GIST, with failure of at least previous imatinib and sunitinib were randomised in a 2:1 ratio (by computer-generated randomisation list and interactive voice response system; preallocated block design (block size 12); stratified by treatment line and geographical region) to receive either oral regorafenib 160 mg daily or placebo, plus best supportive care in both groups, for the first 3 weeks of each 4 week cycle. The study sponsor, participants, and investigators were masked to treatment assignment. The primary endpoint was progression-free survival (PFS). At disease progression, patients assigned placebo could crossover to open-label regorafenib. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov , number NCT01271712 . Results From Jan 4, to Aug 18, 2011, 240 patients were screened and 199 were randomised to receive regorafenib (n=133) or matching placebo (n=66). Data cutoff was Jan 26, 2012. Median PFS per independent blinded central review was 4·8 months (IQR 1·4–9·2) for regorafenib and 0·9 months (0·9–1·8) for placebo (hazard ratio [HR] 0·27, 95% CI 0·19–0·39; p<0·0001). After progression, 56 patients (85%) assigned placebo crossed over to regorafenib. Drug-related adverse events were reported in 130 (98%) patients assigned regorafenib and 45 (68%) patients assigned placebo. The most common regorafenib-related adverse events of grade 3 or higher were hypertension (31 of 132, 23%), hand-foot skin reaction (26 of 132, 20%), and diarrhoea (seven of 132, 5%). Interpretation The results of this study show that oral regorafenib can provide a significant improvement in progression-free survival compared with placebo in patients with metastatic GIST after progression on standard treatments. As far as we are aware, this is the first clinical trial to show benefit from a kinase inhibitor in this highly refractory population of patients. Funding Bayer HealthCare Pharmaceuticals.
Source:The Lancet
George D Demetri, Peter Reichardt, Yoon-Koo Kang, Jean-Yves Blay, Piotr Rutkowski, Hans Gelderblom, Peter Hohenberger, Michael Leahy, Margaret von Mehren, Heikki Joensuu, Giuseppe Badalamenti, Martin Blackstein, Axel Le Cesne, Patrick Schöffski, Robert G Maki, Sebastian Bauer, Binh Bui Nguyen, Jianming Xu, Toshirou Nishida, John Chung, Christian Kappeler, Iris Kuss, Dirk Laurent, Paolo G Casali
School-based health education for the control of soil-transmitted helminthiases in Kanchanaburi province, Thailand.
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Annals of Tropical Medicine & Parasitology; 09/01/2008Request Article (Library Express).
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Methods to convert continuous outcomes into odds ratios of treatment response and numbers needed to treat: meta-epidemiological study
Background Clinicians find standardized mean differences (SMDs) calculated from continuous outcomes difficult to interpret. Our objective was to determine the performance of methods in converting SMDs or means to odds ratios of treatment response and numbers needed to treat (NNTs) as more intuitive measures of treatment effect.
Methods Meta-epidemiological study of large-scale trials (≥100 patients per group) comparing active treatment with placebo, sham or non-intervention control. Trials had to use pain or global symptoms as continuous outcomes and report both the percentage of patients with treatment response and mean pain or symptom scores per group. For each trial, we calculated odds ratios of observed treatment response and NNTs and approximated these estimates from SMDs or means using all five currently available conversion methods by Hasselblad and Hedges (HH), Cox and Snell (CS), Furukawa (FU), Suissa (SU) and Kraemer and Kupfer (KK). We compared observed and approximated values within trials by deriving pooled ratios of odds ratios (RORs) and differences in NNTs. ROR <1 and positive differences in NNTs imply that approximations are more conservative than estimates calculated from observed treatment response. As measures of agreement, we calculated intraclass correlation coefficients.
Results A total of 29 trials in 13 654 patients were included. Four out of five methods were suitable (HH, CS, FU, SU), with RORs between 0.92 for SU [95% confidence interval (95% CI), 0.86–0.99] and 0.97 for HH (95% CI, 0.91–1.04) and differences in NNTs between 0.5 (95% CI, –0.1 to –1.6) and 1.3 (95% CI, 0.4–2.1). Intraclass correlation coefficients were ≥0.90 for these four methods, but ≤0.76 for the fifth method by KK (P for differences ≤0.027).
Conclusions The methods by HH, CS, FU and SU are suitable to convert summary treatment effects calculated from continuous outcomes into odds ratios of treatment response and NNTs, whereas the method by KK is unsuitable.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/5/1445?rss=1
'I know I'm a good mom': Young, low-income mothers' experiences with risk perception, intensive parenting ideology and parenting education programmes.
Health, Risk & Society; 05/01/2012
(AN 73822891)
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Statins for people at low risk of cardiovascular disease
Publication year: 2012
Source:The Lancet, Volume 380, Issue 9856
Nicholas Wald, Malcolm Law
Source:The Lancet, Volume 380, Issue 9856
Nicholas Wald, Malcolm Law
Early infant diagnosis of HIV infection in Zambia through mobile phone texting of blood test results.
Bulletin of the World Health Organization; 05/01/2012
(AN 2011575008)
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Biyernes, Nobyembre 23, 2012
Maternal smoking during pregnancy and offspring trajectories of height and adiposity: comparing maternal and paternal associations
Background Maternal smoking during pregnancy is associated with reduced offspring birth length and has been postulated as a risk factor for obesity. Causality for obesity is not established. Causality is well-supported for birth length, but evidence on persistence of height deficits is inconsistent.
Methods We examined the association between maternal smoking during pregnancy and trajectories of offspring height (0–10 years, N = 9424), ponderal index (PI) (0–2 years, N = 9321) and body mass index (BMI) (2–10 years, N = 8887) in the Avon Longitudinal Study of Parents and Children. To strengthen inference, measured confounders were controlled for, maternal and partner smoking associations were compared, dose–response and associations with post-natal smoking were examined.
Results Maternal smoking during pregnancy was associated with shorter birth length, faster height growth in infancy and slower growth in later childhood. By 10 years, daughters of women who smoke during pregnancy are on average 1.11 cm (SE = 0.27) shorter after adjustment for confounders and partner smoking; the difference is 0.22 cm (SE = 0.22) for partner's smoking. Maternal smoking was associated with lower PI at birth, faster PI increase in infancy, but not with BMI changes 2–10 years. Associations were stronger for maternal than partner smoking for PI at birth and PI changes in infancy, but not for BMI changes after 2 years. A similar dose–response in both maternal and partner smoking was seen for BMI change 2–10 years.
Conclusion Maternal smoking during pregnancy has an intrauterine effect on birth length, and possibly on adiposity at birth and changes in height and adiposity in infancy. We do not find evidence of a specific intrauterine effect on height or adiposity changes after the age of 2 years.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/3/722?rss=1
The treatment of giardiasis in children: single-dose tinidazole compared with 3 days of nitazoxanide.
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Annals of Tropical Medicine & Parasitology; 04/01/2008Request Article (Library Express).
(AN 31214706)
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Association between adult height, genetic susceptibility and risk of glioma
Background Some, but not all, observational studies have suggested that taller stature is associated with a significant increased risk of glioma. In a pooled analysis of observational studies, we investigated the strength and consistency of this association, overall and for major sub-types, and investigated effect modification by genetic susceptibility to the disease.
Methods We standardized and combined individual-level data on 1354 cases and 4734 control subjects from 13 prospective and 2 case–control studies. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for glioma and glioma sub-types were estimated using logistic regression models stratified by sex and adjusted for birth cohort and study. Pooled ORs were additionally estimated after stratifying the models according to seven recently identified glioma-related genetic variants.
Results Among men, we found a positive association between height and glioma risk (≥190 vs 170–174 cm, pooled OR = 1.70, 95% CI: 1.11–2.61; P-trend = 0.01), which was slightly stronger after restricting to cases with glioblastoma (pooled OR = 1.99, 95% CI: 1.17–3.38; P-trend = 0.02). Among women, these associations were less clear (≥175 vs 160–164 cm, pooled OR for glioma = 1.06, 95% CI: 0.70–1.62; P-trend = 0.22; pooled OR for glioblastoma = 1.36, 95% CI: 0.77–2.39; P-trend = 0.04). In general, we did not observe evidence of effect modification by glioma-related genotypes on the association between height and glioma risk.
Conclusion An association of taller adult stature with glioma, particularly for men and stronger for glioblastoma, should be investigated further to clarify the role of environmental and genetic determinants of height in the etiology of this disease.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/4/1075?rss=1
Media coverage on electromagnetic fields and health: Content analysis of Dutch newspaper articles and websites.
Health, Risk & Society; 10/01/2012
(AN 82153797)
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Spurious human infection with Gongylonema: nine cases reported from Thailand.
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(AN 32778521)
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Effects of condom social marketing on condom use in developing countries: a systematic review and meta-analysis, 1990-2010.
Bulletin of the World Health Organization; 08/01/2012
(AN 2011651278)
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Alternatives to principal components analysis to derive asset-based indices to measure socio-economic position in low- and middle-income countries: the case for multiple correspondence analysis
Huwebes, Nobyembre 22, 2012
Media coverage on electromagnetic fields and health: Content analysis of Dutch newspaper articles and websites.
Health, Risk & Society; 10/01/2012
(AN 82153797)
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Post-term birth and the risk of behavioural and emotional problems in early childhood
Background Post-term birth, defined as birth after pregnancy duration of 42 weeks, is associated with increased neonatal morbidity and mortality. The long-term consequences of post-term birth are unknown. We assessed the association of post-term birth with problem behaviour in early childhood.
Methods The study was performed in a large population-based prospective cohort study in Rotterdam, The Netherlands. Pregnant mothers enrolled between 2001 and 2005. Of a cohort of 5145 children, 382 (7%) were born post-term, and 226 (4%) were born preterm. Parents completed a standardized and validated behavioural checklist (Child Behavior Checklist, CBCL/1.5–5) when their children were 1.5 and 3 years old. We examined the relation between gestational age (GA) at birth, based on early fetal ultrasound examination, and problem behaviour with regression analyses, adjusting for socio-economic and pregnancy-related confounders.
Results A quadratic relationship between GA at birth and problem behaviour indicates that both preterm and post-term children have higher behavioural and emotional problem scores than the term born children. Compared with term born children, post-term born children had a higher risk for overall problem behaviour [odds ratio (OR) = 2.10, 95% confidence interval (CI) = 1.32–3.36] and were almost two and a half times as likely to have attention deficit / hyperactivity problem behaviour (OR = 2.44, 95% CI = 1.38–4.32).
Conclusions Post-term birth was associated with more behavioural and emotional problems in early childhood, especially attention deficit / hyperactivity problem behaviour. When considering expectant management, this aspect of post-term pregnancy should be taken into account.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/3/773?rss=1
Profile: The Karonga Health and Demographic Surveillance System
The Karonga Health and Demographic Surveillance System (Karonga HDSS) in northern Malawi currently has a population of more than 35 000 individuals under continuous demographic surveillance since completion of a baseline census (2002–2004). The surveillance system collects data on vital events and migration for individuals and for households. It also provides data on cause-specific mortality obtained by verbal autopsy for all age groups, and estimates rates of disease for specific presentations via linkage to clinical facility data. The Karonga HDSS provides a structure for surveys of socio-economic status, HIV sero-prevalence and incidence, sexual behaviour, fertility intentions and a sampling frame for other studies, as well as evaluating the impact of interventions, such as antiretroviral therapy and vaccination programmes. Uniquely, it relies on a network of village informants to report vital events and household moves, and furthermore is linked to an archive of biological samples and data from population surveys and other studies dating back three decades.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/3/676?rss=1
Longitudinal study of mortality among refugees in Sweden
Background Refugee immigrants have poorer health than other immigrant groups but little is known about their mortality. A comparison of mortality among refugees and non-refugee immigrants is liable to exaggerate the former if the latter includes labour migrants, whose mortality risk may be lower than that of the general population. To avoid bias, labour migrants are not included in this study. The aim was to investigate mortality risks among refugees compared with non-labour non-refugee immigrants in Sweden.
Methods Population-based cohort design, starting 1 January 1998 and ending with death or censoring 31 December 2006. Persons included in the study were those aged 18–64 years, had received a residence permit in Sweden 1992–98 and were defined by the Swedish Board of Migration as either a refugee or a non-labour non-refugee immigrant. The outcomes were all-cause and cause-specific mortalities and the main exposure was being a refugee. Cox-regression models estimated hazard ratios (HRs) of mortality.
Results The study population totalled 86 395 persons, 49.3% women, 24.2 % refugees. Adjusted for age and origin, refugee men had an over-risk of cardiovascular mortality (HR = 1.58, 95% CI = 1.08–2.33). With socio-economic factors added to the model, refugee men still had an over-risk mortality in cardiovascular disease (HR = 1.53, 95% CI = 1.04–2.24) and external causes (HR = 1.59, 95% CI = 1.01–2.50).
Conclusion Refugee men in Sweden have a higher mortality risk in cardiovascular and external causes compared with male non-labour non-refugee immigrants. This study suggests that the refugee experience resembles other stressors in terms of the association with cardiovascular mortality.
Source: http://ije.oxfordjournals.org/cgi/content/short/41/4/1153?rss=1
Miyerkules, Nobyembre 21, 2012
The voice of the most vulnerable: lessons from the nuclear crisis in Fukushima, Japan.
Bulletin of the World Health Organization; 08/01/2012
(AN 2011651279)
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(AN 2011651279)
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The WHO research agenda for influenza: two years later.
Bulletin of the World Health Organization; 04/01/2012
(AN 2011528897)
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