Mycobacterium avium subspecies paratuberculosis and Crohn's disease: a systematic review and meta-analysis

This systematic review assesses the evidence for an association between Mycobacterium avium subspecies paratuberculosis (MAP) and Crohn's disease. We analysed 28 case-control studies comparing MAP in patients with Crohn's disease with individuals free of inflammatory bowel disease (IBD) or patients with ulcerative colitis. Compared with individuals free of IBD, the pooled odds ratio (OR) from studies using PCR in tissue samples was 7.01 (95% CI 3.95-12.4) and was 1.72 (1.02-2.90) in studies using ELISA in serum. ORs were similar for comparisons with ulcerative colitis patients (PCR, 4.13 [1.57-10.9]; ELISA, 1.88 [1.26-2.81]). The association of MAP with Crohn's disease seems to be specific, but its role in the aetiology of Crohn's disease remains to be defined.

Factors associated with needle sharing among Black male injection drug users in Harris County, Texas

Background. Injection drug users (IDUs) are at increased risk for HIV transmission due to unique risk behaviors, such as sharing needles. In Houston, IDUs account for 18% of all HIV/AIDS cases among Black males. ^ Objectives. This analysis compared demographic, behavioral, and psychosocial characteristics of needle sharing and non-sharing IDUs in a population of Black males in Harris County, Texas. ^ Methods. Data used for this analysis were from the second IDU cycle of the National HIV Behavioral Surveillance System. This dataset included a sample of 288 Black male IDUs. Univariate and multivariate statistical analysis were performed to determine statistically significant associations of needle sharing in this population and to create a functional model to inform local HIV prevention programs. ^ Results. Half of the participants in this analysis shared needles in the past 12 months. Compared to non-sharers, sharers were more likely to be homeless (OR=3.70, p<0.01) or arrested in the past year (OR=2.31, p<0.01), inject cocaine (OR=2.07, p<0.01), report male-to-male sex in the past year (OR=6.97, p<0.01), and to exchange sex for money or drugs. Sharers were less likely than non-sharers to graduate high school (OR=0.36, p<0.01), earn $5,000 or more a year (OR=1.15, p=0.05), get needles from a medical source (OR=0.59, p=0.03), and ever test for HIV (OR=0.17, p<0.01). Sharers were more likely to report depressive symptoms (OR=3.49, p<0.01), lower scores on the family support scale (mean difference 0.41, p=0.01) and decision-making confidence scale (mean difference 0.38, p<0.01), and greater risk-taking (mean difference -0.49, p<0.01) than non-sharers. In a multivariable logistic regression, sharers were less likely to have graduated high school (OR=0.33, p<0.01) and have been tested for HIV (OR=0.12, p<0.01) and were more likely to have been arrested in the past year (OR=2.3, p<0.01), get needles from a street source (OR=3.87, p<0.01), report male-to-male sex (OR=7.01, p<0.01), and have depressive symptoms (OR=2.36, p=0.02) and increased risk-taking (OR=1.78, p=0.01). ^ Conclusions. IDUs that shared needles are different from those that did not, reporting lower socioeconomic status, increased sexual and risk behaviors, increased depressive symptoms and increased risk-taking. These findings suggest that intervention programs that also address these demographic, behavioral, and psychosocial factors may be more successful in decreasing needle sharing among this population.^

Bacteriemias en Mayores de 65 años : resultados de un análisis comparativo

Objetivos: Evaluar parámetros clínicos, bacteriológicos y morbimortalidad en pacientes mayores de 65 años con bacteriemia (Grupo A) y compararlos con aquellas ocurridas en menores de 65 años (grupo B) hospitalizados en un servicio de clínica médica. Material y métodos: Estudio protocolizado, descriptivo y observacional, desde 1989-2006. Criterios de inclusión: dos o más hemocultivos positivos. Análisis estadístico con Epi Info 6.4 . Resultados: Se identificaron 668 bacteriemias: 258 (38,6%) en A y 410 (61,4%) en B. La edad media fue de 74,2 años (DS±7.01) y de 47,2 años (DS±13.7) respectivamente. No hubo diferencias en la permanencia media: 19,1 días (DS±17.07) en A y 19,9 (DS±18,1) en B, ni en el origen nosocomial (40,7 vs 44%). Los focos pulmonar (31 vs 21,2%)(p<0,008) y urinario (27 vs 18,8%)(p=0.017) fue más frecuentes en A. La fiebre >de 38 ºC fue menos frecuente en A (83,8 vs 90,9%)(p=0.0068), mientras que la hipotensión arterial (40,8 vs 32,2%)(p=0.03), oliguria (41,7 vs 30,9%)(p=0.005) y encefalopatía (54,5 vs 39,4%)(p=0.00014) fueron mas comunes en A. Los bacilos gram negativos predominaron en A (46 vs 37%)(p<0.01) con diferencias entre A.baumani (9,16 vs 4,6%) y E.coli (54,1 vs 42,7%)(p<0.05) y en B fueron más frecuentes por S.aureus MS (34.39 vs 24,63)(p=0.01). El shock séptico (33,9 vs 22,4%) y nuevas insuficiencias de órganos (31,1 vs 20,1%) prevalecieron en A (p<0,001). La mortalidad fue de 34,49% para A y de 23,41% para B (p=0,018) Conclusiones: Las bacteriemias en pacientes internados mayores de 65 años comparadas con las ocurridas en pacientes. de menor edad, se caracterizaron significativamente por tener predominio del foco pulmonar y urinario, de hipotensión arterial, oliguria y encefalopatía, de bacteriemia por BGN, principalmente A. baumanii y E. coli; mayor desarrollo de shock séptico, menor frecuencia de fiebre >38°C y de bacteriemia por MSS A, y significativa mayor mortalidad.

Hydrochemical Atlas of the Arctic Ocean

Introduction: Chemical composition of water determines its physical properties and character of processes proceeding in it: freezing temperature, volume of evaporation, density, color, transparency, filtration capacity, etc. Presence of chemical elements in water solution confers waters special physical properties exerting significant influence on their circulation, creates necessary conditions for development and inhabitance of flora and fauna, and imparts to the ocean waters some chemical features that radically differ them from the land waters (Alekin & Liakhin, 1984). Hydrochemical information helps to determine elements of water circulation, convection depth, makes it easier to distinguish water masses and gives additional knowledge of climatic variability of ocean conditions. Hydrochemical information is a necessary part of biological research. Water chemical composition can be the governing characteristics determining possibility and limits of use of marine objects, both stationary and moving in sea water. Subject of investigation of hydrochemistry is study of dynamics of chemical composition, i.e. processes of its formation and hydrochemical conditions of water bodies (Alekin & Liakhin 1984). The hydrochemical processes in the Arctic Ocean are the least known. Some information on these processes can be obtained in odd publications. A generalizing study of hydrochemical conditions in the Arctic Ocean based on expeditions conducted in the years 1948-1975 has been carried out by Rusanov et al. (1979). The "Atlas of the World Ocean: the Arctic Ocean" contains a special section "Hydrochemistry" (Gorshkov, 1980). Typical vertical profiles, transects and maps for different depths - 0, 100, 300, 500, 1000, 2000, 3000 m are given in this section for the following parameters: dissolved oxygen, phosphate, silicate, pH and alkaline-chlorine coefficient. The maps were constructed using the data of expeditions conducted in the years 1948-1975. The illustrations reflect main features of distribution of the hydrochemical elements for multi-year period and represent a static image of hydrochemical conditions. Distribution of the hydrochemical elements on the ocean surface is given for two seasons - winter and summer, for the other depths are given mean annual fields. Aim of the present Atlas is description of hydrochemical conditions in the Arctic Ocean on the basis of a greater body of hydrochemical information for the years 1948-2000 and using the up-to-date methods of analysis and electronic forms of presentation of hydrochemical information. The most wide-spread characteristics determined in water samples were used as hydrochemical indices. They are: dissolved oxygen, phosphate, silicate, pH, total alkalinity, nitrite and nitrate. An important characteristics of water salt composition - "salinity" has been considered in the Oceanographic Atlas of the Arctic Ocean (1997, 1998). Presentation of the hydrochemical characteristics in this Hydrochemical Atlas is wider if compared with that of the former Atlas (Gorshkov, 1980). Maps of climatic distribution of the hydrochemical elements were constructed for all the standard depths, and seasonal variability of the hydrochemical parameters is given not only for the surface, but also for the underlying standard depths up to 400 m and including. Statistical characteristics of the hydrochemical elements are given for the first time. Detailed accuracy estimates of initial data and map construction are also given in the Atlas. Calculated values of mean-root deviations, maximum and minimum values of the parameters demonstrate limits of their variability for the analyzed period of observations. Therefore, not only investigations of chemical statics are summarized in the Atlas, but also some elements of chemical dynamics are demonstrated. Digital arrays of the hydrochemical elements obtained in nodes of a regular grid are the new form of characteristics presentation in the Atlas. It should be mentioned that the same grid and the same boxes were used in the Atlas, as those that had been used by creation of the US-Russian climatic Oceanographic Atlas. It allows to combine hydrochemical and oceanographic information of these Atlases. The first block of the digital arrays contains climatic characteristics calculated using direct observational data. These climatic characteristics were not calculated in the regions without observations, and the information arrays for these regions have gaps. The other block of climatic information in a gridded form was obtained with the help of objective analysis of observational data. Procedure of the objective analysis allowed us to obtain climatic estimates of the hydrochemical characteristics for the whole water area of the Arctic Ocean including the regions not covered by observations. Data of the objective analysis can be widely used, in particular, in hydrobiological investigations and in modeling of hydrochemical conditions of the Arctic Ocean. Array of initial measurements is a separate block. It includes all the available materials of hydrochemical observations in the form, as they were presented in different sources. While keeping in mind that this array contains some amount of perverted information, the authors of the Atlas assumed it necessary to store this information in its primary form. Methods of data quality control can be developed in future in the process of hydrochemical information accumulation. It can be supposed that attitude can vary in future to the data that were rejected according to the procedure accepted in the Atlas. The hydrochemical Atlas of the Arctic Ocean is the first specialized and electronic generalization of hydrochemical observations in the Arctic Ocean and finishes the program of joint efforts of Russian and US specialists in preparation of a number of atlases for the Arctic. The published Oceanographic Atlas (1997, 1998), Atlas of Arctic Meteorology and Climate (2000), Ice Atlas of the Arctic Ocean prepared for publication and Hydrochemical Atlas of the Arctic Ocean represent a united series of fundamental generalizations of empirical knowledge of Arctic Ocean nature at climatic level. The Hydrochemical Atlas of the Arctic Ocean was elaborated in the result of joint efforts of the SRC of the RF AARI and IARC. Dr. Ye. Nikiforov was scientific supervisor of the Atlas, Dr. R. Colony was manager on behalf of the USA and Dr. L. Timokhov - on behalf of Russia.