HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa.

BACKGROUND Prisoners represent a vulnerable population for blood-borne and sexually transmitted infections which can potentially lead to liver fibrosis and ultimately cirrhosis. However, little is known about the prevalence of liver fibrosis and associated risk factors among inmates in sub-Saharan Africa. METHODS Screening of liver fibrosis was undertaken in a randomly selected sample of male inmates incarcerated in Lome, Togo and in Dakar, Senegal using transient elastography. A liver stiffness measurement ≥9.5 KPa was retained to define the presence of a severe liver fibrosis. All included inmates were also screened for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Substances abuse including alcohol, tobacco and cannabis use were assessed during face-to-face interviews. Odds Ratio (OR) estimates were computed with their 95 % Confidence Interval (CI) to identify factors associated with severe liver fibrosis. RESULTS Overall, 680 inmates were included with a median age of 30 years [interquartile range: 24-35]. The prevalence of severe fibrosis was 3.1 % (4.9 % in Lome and 1.2 % in Dakar). Infections with HIV, HBV and HCV were identified in 2.6 %, 12.5 % and 0.5 % of inmates, respectively. Factors associated with a severe liver fibrosis were HIV infection (OR = 7.6; CI 1.8-32.1), HBV infection (OR = 4.8; CI 1.8-12.8), HCV infection (OR = 52.6; CI 4.1-673.8), use of traditional medicines (OR = 3.7; CI 1.4-10.1) and being incarcerated in Lome (OR = 3.3; CI 1.1-9.8) compared to Dakar. CONCLUSIONS HIV infection and viral hepatitis infections were identified as important and independent determinants of severe liver fibrosis. While access to active antiviral therapies against HIV and viral hepatitis expands in Africa, adapted strategies for the monitoring of liver disease need to be explored, especially in vulnerable populations such as inmates.

(Table1) Living and dead benthic foraminifera abundance in sediments of the Bottsand-Lagoon, Western Baltic Sea

Seasonal collections were made from 3 stations in a brackish lagoon near Kiel/Germany from December 1964 to June 1967. In addition 120 samples were taken in June 1966 to investigate the general pattern of distribution. Two species of the offshore fauna were found to dominate the lagoon (high population densities): Cribrononion articulatum and Miliammina fusca. The 'Vegetation zone' of the lagoon contains an assemblage of seven euryhaline arenaceous species. All of them were previously recorded from different regions of the world. - C. articulatum seems to prefer shallow water with a high daily range of water temperature (up to 30° Cels.). Population density and distribution show considerable differences between the different years. Size distribution curves of C. articulatum indicate main reproduction activity in spring and subsequent growth in uniform populations. Growth is terminated after six months but most of the specimens will either die in winter or reproduce the next spring; only a smaller amount is reproducing in summer or autumn. - Annual differences of the observed degree make it difficult to calculate foraminiferal productivity in a lagoonal environment and require seasonal observation over a period of at least 3 or 4 years.

Is ultrasound perfusion imaging capable of detecting mismatch? A proof-of-concept study in acute stroke patients.

In this study, we compared contrast-enhanced ultrasound perfusion imaging with magnetic resonance perfusion-weighted imaging or perfusion computed tomography for detecting normo-, hypo-, and nonperfused brain areas in acute middle cerebral artery stroke. We performed high mechanical index contrast-enhanced ultrasound perfusion imaging in 30 patients. Time-to-peak intensity of 10 ischemic regions of interests was compared to four standardized nonischemic regions of interests of the same patient. A time-to-peak >3 s (ultrasound perfusion imaging) or >4 s (perfusion computed tomography and magnetic resonance perfusion) defined hypoperfusion. In 16 patients, 98 of 160 ultrasound perfusion imaging regions of interests of the ischemic hemisphere were classified as normal, and 52 as hypoperfused or nonperfused. Ten regions of interests were excluded due to artifacts. There was a significant correlation of the ultrasound perfusion imaging and magnetic resonance perfusion or perfusion computed tomography (Pearson`s chi-squared test 79.119, p < 0.001) (OR 0.1065, 95% CI 0.06-0.18). No perfusion in ultrasound perfusion imaging (18 regions of interests) correlated highly with diffusion restriction on magnetic resonance imaging (Pearson's chi-squared test 42.307, p < 0.001). Analysis of receiver operating characteristics proved a high sensitivity of ultrasound perfusion imaging in the diagnosis of hypoperfused area under the curve, (AUC = 0.917; p < 0.001) and nonperfused (AUC = 0.830; p < 0.001) tissue in comparison with perfusion computed tomography and magnetic resonance perfusion. We present a proof of concept in determining normo-, hypo-, and nonperfused tissue in acute stroke by advanced contrast-enhanced ultrasound perfusion imaging.

The Worshipful Company of Pattenmakers. A list of master, wardens, court of assistants, and livery, with a "Short account of the patten" and "Two years' in the chair".

Mode of access: Internet.

Huwa hādhā kitāb Mashāriq al-aḥkām /

Caption title.

A bibliography of theoretical population genetics,

"RLO-2225-5-18."

Sefer sheʼelot u-teshuvot meha-Rashal : asher heshiv ke-halakhah le-khol shoʼel = Tshubut Reschal.

Mode of access: Internet.

An evaluation of the problems of sanitary sewer system design; final report of the Residential Sewerage Research Project to the Federal Housing Administration

Mode of access: Internet.

Biblioteca degli volgarizzatori : o sia Notizia dall'opere volgarizzate d'autori, che scrissero in lingue morte prima del secolo XV. /

Vol. 5 (or 4, pt. 2) has title: Addizioni e correzioni ... [etc.]

A victor of Salamis: a tale of the days of Xerxes, Leonidas, and Themistocles,

Mode of access: Internet.

Illustrirtes wörterbuch der römischen Alterthümer mit steter Berücksichtigung der griechischen : enthaltend zwei tausend Holzschnitte nach Denkmälern der alten Kunst und Industrie /

Mode of access: Internet.

The sacred and profane history of the world connected, from the creation of the world to the dissolution of the Assyrian empire at the death of Sardanapalus, and to the declension of the kingdoms of Judah and Israel under the reigns of Ahaz and Pekah: including the dissertation on the creation and fall of man.

"Illustrated with a new and correct set of maps and plans."

Der jüngere Scipio ...

Mode of access: Internet.

Risālah-i mamlūʾ az favāʾid va mashḥūn bi-farāʾid az taṣānīf-i mawlānā al-Ḥājj Ḥāfiẓ Muḥammad ʻAbd al-Ḥalīm Lakh́navī, mudda ẓilluhu [microform] : musammá bi-al-Qawl al-muḥīṭ fī-mā yataʻallaqu bi-al-jaʻl al-muʾallaf wa-al-basīṭ.

Microfilm.

The lives of Doctor John Donne, Sir Henry Wotton Knight, Mr. Richard Hooker, Mr. George Herbert and Doctor Robert Sanderson.

Edited by George Sampson.