Fighting against Malaria: Prevent wars while waiting for the "miraculous" vaccine

The World Health Organization estimates that 300 million clinical cases of malaria occur annually and observed that during the 80's and part of the 90's its incidence increased. In this paper we explore the influence of refugees from civil wars on the incidence of malaria in the refugee-receiving countries. Using civil wars as an instrumental variable we show that for each 1,000 refugees there are between 2,000 and 2,700 cases of malaria in the refugee receiving country. On average 13% of the cases of malaria reported by the WHO are caused by forced migration as a consequence of civil wars.

Sotaan syyllisten rankaiseminen, 1K

Puhe

Fractures non traumatiques en fin de grossesse: s'agit-il toujours d'une ostéoporose? A propos de deux cas [Non-traumatic fractures at the end of a pregnancy: are there always of osteoporotic origin].

Pregnancy-associated osteoporosis usually appears during the first pregnancy and does not affect the followings. We report two cases where non-traumatic fractures have been diagnosed shortly after delivery of second pregnancies. Wide investigations could not find a cause of secondary osteoporosis. In the first case we came to the diagnosis of pregnancy-associated osteoporosis and an intravenous treatment of ibandronate has been prescribed. In the second case the bone mineral density (BMD) being almost normal and the localisation of the fracture being atypical, we concluded to a fracture of non-osteoporotic origin, probably due to mechanical stress during pregnancy. No therapy against osteoporosis has been prescribed.

Genome-wide association study of blood pressure extremes identifies variant near UMOD associated with hypertension.

Hypertension is a heritable and major contributor to the global burden of disease. The sum of rare and common genetic variants robustly identified so far explain only 1%-2% of the population variation in BP and hypertension. This suggests the existence of more undiscovered common variants. We conducted a genome-wide association study in 1,621 hypertensive cases and 1,699 controls and follow-up validation analyses in 19,845 cases and 16,541 controls using an extreme case-control design. We identified a locus on chromosome 16 in the 5' region of Uromodulin (UMOD; rs13333226, combined P value of 3.6×10(-11)). The minor G allele is associated with a lower risk of hypertension (OR [95%CI]: 0.87 [0.84-0.91]), reduced urinary uromodulin excretion, better renal function; and each copy of the G allele is associated with a 7.7% reduction in risk of CVD events after adjusting for age, sex, BMI, and smoking status (H.R. = 0.923, 95% CI 0.860-0.991; p = 0.027). In a subset of 13,446 individuals with estimated glomerular filtration rate (eGFR) measurements, we show that rs13333226 is independently associated with hypertension (unadjusted for eGFR: 0.89 [0.83-0.96], p = 0.004; after eGFR adjustment: 0.89 [0.83-0.96], p = 0.003). In clinical functional studies, we also consistently show the minor G allele is associated with lower urinary uromodulin excretion. The exclusive expression of uromodulin in the thick portion of the ascending limb of Henle suggests a putative role of this variant in hypertension through an effect on sodium homeostasis. The newly discovered UMOD locus for hypertension has the potential to give new insights into the role of uromodulin in BP regulation and to identify novel drugable targets for reducing cardiovascular risk.

Decrease in the prevalence of hepatitis B and a low prevalence of hepatitis C virus infections in the general population of the Seychelles.

A serological survey of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections was carried out on a random sex- and age-stratified sample of 1006 individuals aged 25-64 years in the Seychelles islands. Anti-HBc and anti-HCV antibodies were detected using commercially available enzyme-linked immunosorbent assays (ELISA), followed by a Western blot assay in the case of a positive result for anti-HCV. The age-adjusted seroprevalence of anti-HBc antibodies was 8.0% (95% CI: 6.5-9.9%) and the percentage prevalence among males/females increased from 7.0/3.1 to 19.1/13.4 in the age groups 25-34 to 55-64 years, respectively. Two men and three women were positive for anti-HCV antibodies, with an age-adjusted seroprevalence of 0.34% (95% CI: 0.1-0.8%). Two out of these five subjects who were positive for anti-HCV also had anti-HBc antibodies. The seroprevalence of anti-HBc was significantly higher in unskilled workers, persons with low education, and heavy drinkers. The age-specific seroprevalence of anti-HBc in this population-based survey, which was conducted in 1994, was approximately three times lower than in a previous patient-based survey carried out in 1979. Although there are methodological differences between the two surveys, it is likely that the substantial decrease in anti-HBc prevalence during the last 15 years may be due to significant socioeconomic development and the systematic screening of blood donors since 1981. Because hepatitis C virus infections are serious and the cost of treatment is high, the fact that the prevalence of anti-HCV antibodies is at present low should not be an argument for not screening blood donors for anti-HCV and eliminating those who are positive.

Monitoring drug therapy.

Drug development has improved over recent decades, with refinements in analytical techniques, population pharmacokinetic-pharmacodynamic (PK-PD) modelling and simulation, and new biomarkers of efficacy and tolerability. Yet this progress has not yielded improvements in individualization of treatment and monitoring, owing to various obstacles: monitoring is complex and demanding, many monitoring procedures have been instituted without critical assessment of the underlying evidence and rationale, controlled clinical trials are sparse, monitoring procedures are poorly validated and both drug manufacturers and regulatory authorities take insufficient account of the importance of monitoring. Drug concentration and effect data should be increasingly collected, analyzed, aggregated and disseminated in forms suitable for prescribers, along with efficient monitoring tools and evidence-based recommendations regarding their best use. PK-PD observations should be collected for both novel and established critical drugs and applied to observational data, in order to establish whether monitoring would be suitable. Methods for aggregating PK-PD data in systematic reviews should be devised. Observational and intervention studies to evaluate monitoring procedures are needed. Miniaturized monitoring tests for delivery at the point of care should be developed and harnessed to closed-loop regulated drug delivery systems. Intelligent devices would enable unprecedented precision in the application of critical treatments, i.e. those with life-saving efficacy, narrow therapeutic margins and high interpatient variability. Pharmaceutical companies, regulatory agencies and academic clinical pharmacologists share the responsibility of leading such developments, in order to ensure that patients obtain the greatest benefit and suffer the least harm from their medicines.

Estimation of soil moisture in the root-zone from remote sensing data

Field-based soil moisture measurements are cumbersome. Thus, remote sensing techniques are needed because allows field and landscape-scale mapping of soil moisture depth-averaged through the root zone of existing vegetation. The objective of the study was to evaluate the accuracy of an empirical relationship to calculate soil moisture from remote sensing data of irrigated soils of the Apodi Plateau, in the Brazilian semiarid region. The empirical relationship had previously been tested for irrigated soils in Mexico, Egypt, and Pakistan, with promising results. In this study, the relationship was evaluated from experimental data collected from a cotton field. The experiment was carried out in an area of 5 ha with irrigated cotton. The energy balance and evaporative fraction (&#923;) were measured by the Bowen ratio method. Soil moisture (θ) data were collected using a PR2 - Profile Probe (Delta-T Devices Ltd). The empirical relationship was tested using experimentally collected &#923; and θ values and was applied using the &#923; values obtained from the Surface Energy Balance Algorithm for Land (SEBAL) and three TM - Landsat 5 images. There was a close correlation between measured and estimated θ values (p<0.05, R² = 0.84) and there were no significant differences according to the Student t-test (p<0.01). The statistical analyses showed that the empirical relationship can be applied to estimate the root-zone soil moisture of irrigated soils, i.e. when the evaporative fraction is greater than 0.45.

Resposta do Feijoeiro Comum à Inoculação com Rizóbio e Suplementação com Nitrogênio Mineral em Dois Biomas Brasileiros

O feijoeiro comum (Phaseolus vulgaris L.) pode se beneficiar da fixação biológica de N2, mas respostas inconsistentes da cultura à inoculação com rizóbio indicam a necessidade de aplicação de N mineral complementar. Este trabalho teve por objetivo avaliar a resposta do feijoeiro à inoculação com rizóbio, associada à suplementação com N mineral, nos biomas Cerrado e Mata Atlântica. Foram conduzidos quatro experimentos de campo, dois em Santo Antônio de Goiás, GO, um em Valença, RJ e um em Macaé, RJ, onde a inoculação com estirpes comerciais de rizóbio foi comparada à inoculação com a estirpe BR 923 de Sinorhizobium sp., à adubação com N mineral e à suplementação com N na semeadura e em cobertura. A avaliação da população nativa de rizóbio indicou 105 células g-1 no solo na área experimental em Goiás, anteriormente cultivada com feijão, e 102células g-1 em Valença, anteriormente mantida com pastagem. Nos dois experimentos em Goiás, o rendimento de grãos, da ordem de 2.100 kg ha-1, não diferiu entre os tratamentos testemunha absoluta, inoculação com rizóbio ou aplicação de 120 kg ha-1 de N. Em Valença, a inoculação com estirpes comerciais forneceu rendimentos da cultivar Ouro Negro superiores à testemunha absoluta, na ausência de adubação de cobertura; na presença de 40 kg ha-1 de N em cobertura, a inoculação com rizóbio proporcionou rendimento de 3.420 kg ha-1, superior aos demais tratamentos. Na média das diferentes fontes de N na semeadura, a adubação de cobertura aumentou a produção de grãos de 2.367 para 2.542 kg ha-1. Em Macaé, em solo com alto teor de matéria orgânica, os maiores rendimentos foram obtidos com inoculação das estirpes comerciais associada a 40 kg ha-1 de N em cobertura, com efeito deletério da adubação de 80 kg ha-1 de N no plantio. Concluiu-se que em áreas sem cultivo prévio de feijão, a inoculação com estirpes comerciais de rizóbio aumentou o rendimento de grãos, em particular quando associada à adubação de cobertura com N.

A multicenter, cross-sectional study on the prevalence and risk factors for nasal colonization with Staphylococcus aureus in patients admitted to children's hospitals in Switzerland.

The rate of nasal carriage of Staphylococcus aureus and associated risk factors were determined in a cross-sectional study involving Swiss children's hospitals. S. aureus was isolated in 562 of 1363 cases. In a stepwise multivariate analysis, the variables age, duration of antibiotic use, and hospitalization of a household member were independently associated with carriage of S. aureus.

Traitements de fer: preuves de t'efficacité et bonne pratique clinique [Iron therapy: proof of efficacy and good clinical practice].

Efficacy of iron therapy, whether oral or intravenous, on biological markers of body iron stores is well recognized in medical literature, but current studies are heterogeneous, of sometimes dubious quality, and rarely address clinical outcomes. Precise practical guidelines appear available only for indications related to kidney disease. First-line intravenous use is reserved for situations comprising chronic renal failure, or patients presenting with malabsorption syndromes such as in inflammatory bowel disease. In all other situations, because of the non-negligible risk of hypersensitivity reactions, intravenous iron use is considered justified only in clinically sustained indications, for patients in whom oral administration of iron is unsatisfactory or impossible.

Efeito do teor de gordura nas características químicas e sensoriais de embutido fermentado de carne de caprinos

O objetivo deste trabalho foi verificar o efeito da adição de diferentes teores de gordura (5, 10 e 20%) no processamento, características químicas e aceitação sensorial do embutido fermentado de carne de caprinos. Durante o processamento, foram monitorados o pH e a atividade da água. Nos produtos finais, foram determinadas a umidade, a proteína e a gordura, bem como a aceitação sensorial, por meio de escala hedônica. As médias finais de pH e a atividade de água, na faixa de 5,07 a 5,14 e 0,897 a 0,923, respectivamente, não apresentaram diferença significativa (P>0,05) entre os tratamentos. Os atributos sensoriais estudados não apresentaram diferenças significativas (P>0,05). As diferentes porcentagens de gordura utilizadas no processamento de embutido fermentado de carne de caprinos não afetaram significativamente seu processamento e aceitação sensorial. Em vista do baixo teor de gordura na carne de caprinos, considerou-se como mais adequadas formulações contendo 10 a 20% de gordura.

Incidencia de la incapacidad temporal por contingencia común y profesional en la muestra continua de vidas laborales en 2009

Objetivo: Describir la incidencia de la incapacidad temporal por contingencia común (ITcc) y profesional (ITcp) iniciada en 2009 en afiliados a la Seguridad Social (SS) que forman parte de la Muestra Continua de Vida Laboral.Métodos: Cohorte formada por 873.008 afiliados a la SS en España que registraron 163.008 episodios de IT con un tiempo acumulado total en riesgo de 675.923,6 trabajadores-año. Se estimó la tasa de incidencia de todos los primeros episodios de IT y por trastornos musculo-esqueléticos (TME) según variables demográficas y laborales. Posteriormente se calcularon las razones de tasas crudas (RTc) y ajustadas (RTa) mediante un modelo de regresión Poisson.Resultados: La incidencia de la ITcc e ITcp fue de 23,1 y 1,0 casos por 100 trabajadores-año, respectivamente. La incidencia por ITcc fue superior en mujeres, en menores de 26 años y en Navarra (32,8 casos por 100 trabajadores-año), y por ITcp las mayores incidencias se observaron en hombres y en Galicia. Por diagnóstico, los TME presentaron 424,7 casos y 3,6 casos por 10.000 trabajadores-año según contingencia común y profesional respectivamente. Por otra parte, los trabajadores temporales tuvieron más riesgo de desarrollar ITcp (RTa=1,09;IC95%=1,04-1,15) e ITcc (RTa=1,02;IC95%=1,01-1,03) respecto a los permanentes.Conclusiones: La incidencia de la IT sigue un mismo patrón según edad, régimen de afiliación y relación laboral. Por tipo de contingencia se observaron diferencias en la ocupación, sexo, tamaño de empresa, comunidad autónoma y actividad económica. Es necesario estudiar con más detenimiento las diferencias observadas por actividad económica y tipo de relación contractual.