Data from 12 different European countries show a rapid increase in HIV antibody positivity among drug users or a high degree of contamination already reached wherever studies have been made. Until 31 December 1986, 698 (18%) of AIDS cases were among drug users, of which 600 (15%) of AIDS cases were solely drug users, and 98 (3%) were in addition homosexual or bisexual. A further increase is expected. Because of the epidemiological importance for transmission to the heterosexual population, this problem has become a focus of attention. Drug abusing prostitutes constitute a major source of infection for the heterosexual population and newborns. The increase in the number of AIDS cases in 1986 among male drug abusers was 98 - that is up 61% compared to previous years; among women, the increase was 56%. The 3 main approaches to solution of this problem, i.e. interdiction of the drug trade, availability of sterile needles, and an education program have not proven as successful as anticipated. Relevant indications of the progress of infection in society can only be obtained by systematic observation of conversion rates in differential subgroups, i.e. drug abusers, newly incarcerated drug abusers, male and female prostitutes who use drugs, and individuals newly reporting for treatment. Separation of HIV antibody positives and negatives in therapeutic communities which are not drug free is recommended for epidemiological purposes in view of the developments to date. Nor should forced segregation of the infected from noninfected be dismissed out of hand.
We report a new case of acquired immune-deficiency syndrome (AIDS) in a 43 year-old white homosexual man, characterized by the association of disseminated cutaneo-mucous Kaposi's sarcoma and cerebral toxoplasmosis. This man had Kaposi's sarcoma for about 10 years but evolution became quickly extensive in July 1981. Chlorambucil was prescribed at that time and was the cause of a pancytopenia. Death occurred in July 1982 due to a cerebral mass identified as toxoplasmosis on a left temporal biopsy. This observation is typical of AIDS, a new syndrome which suddenly developed in the last 2 years in the United States in homosexual men, Haitians and hemophiliacs, and is characterized by disseminated Kaposi's sarcoma and/or opportunistic infections, with a very high mortality rate. Severe toxoplasmosis of CNS has been reported in AIDS and appears to result from defects in cellular immunity which permit recrudescence of latent infection. Cerebral biopsy is necessary for the diagnosis of cerebral toxoplasmosis as seroconversion occurs infrequently in immuno-suppressed hosts. AIDS appeared in Western Europe in 1982. Most of the cases were reported in France, Denmark, Belgium and Great Britain. These cases differ from reported cases in the USA: fewer drug or poppers users, fewer homosexual men, an important number of people having lived or travelled in the Kaposi's endemic area (Mediterranean basin and Central Africa). The immunological profile of patients presenting AIDS in Europe doesn't seem to differ from the american profile: serious cellular immunodeficiency and marked increase in the suppressor/cytotoxic cell population. As in the United States, one may suspect, among several hypotheses, that it is caused by one or several transmissible agents now present in France. The nature of these agents, transmissible by sexual contacts and blood, is not yet known: the role of the CMV is now less probable and most of the studies look for the role of other factors such as the HTLV.
This study aimed to evaluate the cost-effectiveness of formoterol (Oxis) Turbuhaler 4.5 microg and salbutamol 200 microg as reliever medications in Sweden and Spain. The study used data on effectiveness (exacerbations and symptom-free days) and resource utilisation from an open, 6-month, parallel-group, multicentre randomised trial with 18,124 asthma patients in 24 countries. Country-specific unit costs for Sweden and for Spain were used to transform resource utilisation data into costs. Total healthcare costs were not significantly different between formoterol and salbutamol dry powder inhalers in Sweden, whereas in Spain, the healthcare costs were 20% higher for formoterol vs. salbutamol pressurised metered dose inhalers. Total healthcare costs increased with disease severity, defined according to the Global Initiative for Asthma guidelines. Compared with salbutamol, formoterol produced statistically significant improvements in effectiveness, less reliever and maintenance medication usage, reduced healthcare resource utilisation, with no increase or a limited increase in healthcare cost.
The NIH classification intends to standardize the diagnostic criteria for chronic CVHD and to establish prognosis groups that will help to identify patient risk and thus decide on the most appropriate treatment. This study assesses the predictive value of this classification and analyzes new prognostic factors in a series of 820 patients receiving allogeneic grafts at three sites: Hospital Universitario de Salamanca, Hospital de la Santa Creu i Sant Pau, in Barcelona, and Karolinska Institutet, in Stockholm. In the univariate analysis, the classification limited/extensive, the NIH class, and the type of onset have a significant influence on overall survival and transplant-related mortality. Additionally, the overlap syndrome is associated with a shorter survival in the multivariate analysis, only the NIH class-with on HR of 2.89 (95% Cl: 1.75-4.76; p
Recently, chromogranins were reported to interact specifically with mutant forms of superoxide dismutase that are linked to amyotrophic lateral sclerosis (ALS). This interaction led us to analyze the frequencies of sequence variants of the CHGB gene in ALS patients and matched controls from three different countries. Of particular interest was the finding of the P413L CHGB variant present in 10% of ALS patients (n = 705) as compared to 4.5% in controls (n = 751), conferring a 2.2-fold greater relative risk to develop the disease (P
Cites: Regul Pept. 2009 Jan 8;152(1-3):13-2118721831
To examine the psychometric properties of the Dominic Interactive (DI) in school-aged children in a different cultural environment than Quebec.
In a large French region, 100 schools and 25 children (aged 6 to 11 years) per school were randomly selected. Data were collected using self-administered questionnaires to children (DI), parents (sociodemographic characteristics, mental health services use), and teachers (child school achievement). DI psychometric properties were assessed by examining: the distribution of each DI diagnosis; comorbidity between diagnoses; alpha coefficients measuring internal consistency; and correlates of psychopathologies with sociodemographic status and health care services use. Estimates of DI properties were compared with those from a sample of community children in Quebec.
Complete data were available for 1274 children (54.4%). The internal consistency of each DI diagnosis of the French version was reasonable, with Cronbach's alpha coefficients ranging from 0.62 to 0.89. The psychometric properties and comorbidity were consistent with the version from Quebec.
The satisfactory psychometric properties of the DI along with other demonstrated advantages of this instrument (children enjoy the activity, parents approve of it, and it is cost-effective) and its cultural adaptability support the consideration of the DI for epidemiologic studies in diverse cultures.
Fluoride is retained in bone tissues of animals and its availability in the environment varies between regions according to natural and anthropogenic sources. These properties suggest this element as a suitable tracer of origin, distribution or movements of animals. In marine environments, krill builds-up fluoride concentrations that are transferred to its predators. In this study we examine the ability of bone fluoride concentrations to discriminate two separate populations of a krill consumer, the fin whale. Background levels of the sampling areas (Western Iceland and North-Western Spain) were determined through the analysis of krill samples. As expected, due to the high load of volcanic-derived fluoride in Icelandic waters, krill from W Iceland showed much higher fluoride concentrations than that from NW Spain. Concentrations in whales' bone were correlated with sex and age, increasing linearly with age in females and showing significantly lower values and a different age-related pattern of accumulation in males. Fluoride concentrations in whales' bone were much higher than in krill, indicating accumulation of the element but, rather unexpectedly, the area of origin had no influence on concentrations. This apparent contradiction may be explained either by the integration in bone of food consumed in other areas, or by the activation of homeostatic responses at very high levels of fluoride exposure. It is concluded that fluoride can be a useful tracer only if age and sex data are integrated into the analysis, year-round information on diet is available and/or the investigated population is exposed to mild levels of this element.
Native oxy-PAHs, N-PACs, and PAHs in historically contaminated soils from Sweden, Belgium, and France: their soil-porewater partitioning behavior, bioaccumulation in Enchytraeus crypticus, and bioavailability.
Soil quality standards are based on partitioning and toxicity data for laboratory-spiked reference soils, instead of real world, historically contaminated soils, which would be more representative. Here 21 diverse historically contaminated soils from Sweden, Belgium, and France were obtained, and the soil-porewater partitioning along with the bioaccumulation in exposed worms (Enchytraeus crypticus) of native polycyclic aromatic compounds (PACs) were quantified. The native PACs investigated were polycyclic aromatic hydrocarbons (PAHs) and, for the first time to be included in such a study, oxygenated-PAHs (oxy-PAHs) and nitrogen containing heterocyclic PACs (N-PACs). The passive sampler polyoxymethylene (POM) was used to measure the equilibrium freely dissolved porewater concentration, Cpw, of all PACs. The obtained organic carbon normalized partitioning coefficients, KTOC, show that sorption of these native PACs is much stronger than observed in laboratory-spiked soils (typically by factors 10 to 100), which has been reported previously for PAHs but here for the first time for oxy-PAHs and N-PACs. A recently developed KTOC model for historically contaminated sediments predicted the 597 unique, native KTOC values in this study within a factor 30 for 100% of the data and a factor 3 for 58% of the data, without calibration. This model assumes that TOC in pyrogenic-impacted areas sorbs similarly to coal tar, rather than octanol as typically assumed. Black carbon (BC) inclusive partitioning models exhibited substantially poorer performance. Regarding bioaccumulation, Cpw combined with liposome-water partition coefficients corresponded better with measured worm lipid concentrations, Clipid (within a factor 10 for 85% of all PACs and soils), than Cpw combined with octanol-water partition coefficients (within a factor 10 for 76% of all PACs and soils). E. crypticus mortality and reproducibility were also quantified. No enhanced mortality was observed in the 21 historically contaminated soils despite expectations from PAH spiked reference soils. Worm reproducibility weakly correlated to Clipid of PACs, though the contributing influence of metal concentrations and soil texture could not be taken into account. The good agreement of POM-derived Cpw with independent soil and lipid partitioning models further supports that soil risk assessments would improve by accounting for bioavailability. Strategies for including bioavailability in soil risk assessment are presented.