To identify risk factors for the detection of prevalent and incident anal human papillomavirus (HPV) infection, and HPV persistence among HIV-seropositive and seronegative homosexual men.
...Longitudinal study of 287 HIV-seronegative and 322 HIV-seropositive men attending a community-based clinic.
Subjects underwent an interview and examination; specimens were collected for HIV serology and assessment of anal HPV and HIV DNA.
Anal HPV DNA was detected at study entry in 91.6% of HIV-infected men, and 65.9% of men not infected with HIV. HPV detection was associated with lifetime number of sexual partners and recent receptive anal intercourse (HIV-seronegative men), decreased CD4+ lymphocyte count (HIV-seropositive men), and anal warts (all men). Among men negative for HPV at study entry, subsequent detection of HPV was associated with HIV, unprotected receptive anal intercourse, and any sexual contact since the last visit. Among men positive for HPV at study entry, subsequent detection of additional HPV types was more common among HIV-seropositive men. Becoming HPV negative during follow-up was less common among men with HIV or high HPV levels at study entry. Among those with HIV, HPV persistence was associated with presence of anal HIV DNA, but not with CD4+ lymphocyte count.
Risk of anal HPV infection appears to increase with sexual exposure, epithelial trauma, HIV infection and immune deficiency. Incident infection may result from recent sexual exposure or reactivation of latent infection. Further studies are needed to elucidate the mechanism by which HIV DNA in the anal canal increases the risk of HPV persistence.
The aim of this study was to compare estimates of Pap smear screening and mammogram obtained from household survey and a telephone survey in São Paulo/Brazil in the year 2008, according to ...sociodemographic characteristics, and to dimension the observed differences from those estimates. The study used data from the ISA-Capital 2008 Survey, conducted in São Paulo city, by Faculty of Public Health of the University of São Paulo with support from the Municipal Health Department, and VIGITEL (São Paulo), a telephone survey conducted by the Brazilian Ministry of Health towards Surveillance of Risk and Protection Factors for Chronic non-transmittable Diseases. Estimates of Pap smear and mammogram in women, as well as its realisation in the year prior to the interview were compared according to type of survey (household/telephone) by Poisson regression adjusted for age and education. There were no statistically significant differences between the estimates obtained by VIGITEL and ISA-Capital for the prevalence of mammogram in the year prior to the interview. However, estimates for the global estimates of the Pap smear at least once in life and in the last year and mammogram at least once in life, there has been observed statistically significant differences, with higher prevalence among those interviewed by telephone. It shows a tendency to overestimate the prevalence of mammography and Pap smear in the telephone survey data indicating a necessity for new studies that also contribute to a better understanding of the differences observed using different types of surveys.
•Pyrrhotite heats very well upon microwave exposure.•Pyrrhotite permittivities increase rapidly with temperature then decline above 850 °C.•Microwave heating behaviour was not correlated with ...pyrrhotite type.•Removal of silicates by flotation had little impact on heating behaviour.•Ni content appears to have influenced the microwave heating of Po tailings.
Current practice is for pyrrhotite to be rejected from conventional nickel sulphide processing circuits due to its low concentration of nickel and high sulphur content. However, the nickel content of pyrrhotite tailings (up to 1 wt.% Ni) represents a significant resource, and a new flowsheet, based on the microwave heating of pyrrhotite tailings to produce FeNi and FeS phases is under development. The microwave heating properties of pyrrhotite tailings are explored in this paper through microwave heating and permittivity tests. Thermogravimetric analysis and differential scanning calorimetry were also performed to interpret the permittivity data, and the distribution of phases within the microwave treated material was investigated by scanning electron microscopy. In general, pyrrhotite heats very well upon exposure to microwave radiation. The mass loss appears to be governed by the sulphur content and the extent of heating seems to be influenced by the Ni content. The removal of silicate impurities by froth flotation had little impact on the heating behaviour.
Blood vessels usually have poor local contrast, and the application of existing edge detection algorithms yield results which are not satisfactory. An operator for feature extraction based on the ...optical and spatial properties of objects to be recognized is introduced. The gray-level profile of the cross section of a blood vessel is approximated by a Gaussian-shaped curve. The concept of matched filter detection of signals is used to detect piecewise linear segments of blood vessels in these images. Twelve different templates that are used to search for vessel segments along all possible directions are constructed. Various issues related to the implementation of these matched filters are discussed. The results are compared to those obtained with other methods.< >
Objective: We evaluated if receiving HIV test results over the telephone was associated with a change in the number of persons who received results. Study Design: Data were collected from individuals ...testing for HIV from 1995 to 2002 at selected public clinics in King County, WA. Rates of receiving HTV test results were calculated for periods before and after telephone results were offered, for persons who were offered and accepted, offered but declined, and not offered telephone results. Results: For persons testing HTV positive, overall rates of receiving results before and after telephone results were offered increased from 85% to 94% (P = 0.07). After controlling for confounders, people in the group offered and accepting telephone results were 2.5 (95% CI 1.7-3.6) times more likely to get HIV results compared to persons in the group not offered telephone results. Conclusions: Notifying persons of their HIV test results over the telephone may increase the numbers of people receiving results.
IntroductionHearing loss in older people is one of the most prevalent chronic conditions. In 2004, was implemented in Brazil the Hearing Health Attention National Policies. This policy contains ...programs for prevention, diagnostic and rehabilitation, including donations of hearing aids and providing education about hearing health.MethodsData are from the Survey of Health of São Paulo (ISA-Capital, 2008), a population-based cross-sectional study (n=3271). This survey utilised the same methodology the previous surveys conducted at 2001 and 2003. We analysed the subgroup of elderly (60 years and above—n=924). We used the χ2 test of association and analysis of Poisson regression (significance level: 0.05).ResultsThe prevalence of self-reported hearing loss in elderly in this study was 12.4%. This prevalence was higher in men than women (RP: 1.5; p=0.01) and in higher ages (more 80 years) than in 60–69 years (RP: 2.2; p=0.00). 24,4% of them did not know the cause of hearing loss and 42% related that old age is cause of this deficit. 38.8% of interviewed said that they do not need medical assistance or treatment rehabilitation.ConclusionThe unknowledge of the elderly about the causes of hearing loss and the need to assistance suggests that the government's policies needs to evaluate and improve the process of assisting in these people with hearing impairment, assuring its effectiveness. Since ageing is getting wide, developing countries like Brazil, need to meet new demand from this segment of the population.
IntroductionHearing loss has been identified as one of the most frequent chronic conditions affecting elderly people and can be result in social isolation, depression and increased dependency. The ...use of health services to preventive ends it is important to evaluate the health behaviours of elderly with disabilities.MethodsData are from the Survey of Health of São Paulo (ISA-Capital), a population-based cross-sectional study (n=3357). We analysed the subgroup of elderly (60 years and above - n=872) to determine the association between reported hearing loss and use of health services: immunisation against influenza in last year, participation in prevention programs: prostate cancer, breast cancer and cervical cancer. We used the χ2 test of association and analysis of Poisson regression (significance level: 0.05).ResultsThe prevalence of hearing loss in elderly people was 11.2% and it was higher in men than women (p=0.00). 60.5% of the elderly related to take immunisation against influenza, 82.9% of the women referred to participate the program of prevention of cervical cancer and 64.1% referred to participate the breast cancer one. There was an association between self-reported hearing loss and participate in programs to prevent prostate cancer (RP: 1,8; p=0.03).ConclusionSelf-reported hearing loss can be itself a revelation indicator of handicap and it is quick and inexpensive to be performed. These data should be a tool to evaluate of the use of health services and moreover they could help to plan of hearing rehabilitation services.
Death certificates are routinely used to estimate tuberculosis (TB) mortality rates. The validity of International Classification of Diseases, Tenth Revision (ICD-10) codes and text cause of death ...data for this purpose is uncertain.
To evaluate the accuracy of ICD-10 coded and text cause of death data in identifying TB-related deaths in Washington State.
Cross-sectional descriptive study comparing TB-related deaths detected through Washington State death certificates to TB-related deaths identified in the Washington State TB registry during 2009-2010.
Sensitivity and positive predictive value of ICD-10 coded and text cause of death definitions in identifying TB-related deaths compared to the TB registry.
All methods for identifying TB-related deaths using death certificate data overestimated the number of TB-related deaths compared to the tuberculosis registry. The positive predictive value ranged from 22% for a TB ICD-10 code as an underlying or multiple cause of death to 56% for TB listed in the direct cause of death text field. Seventeen (33%) of 51 subjects assigned with a TB ICD-10 code as an underlying or multiple cause of death had no evidence of TB on the death certificate and were not present in the TB registry.
Death certificates were not highly predictive of TB-related deaths. Use of the direct cause of death text field was the most accurate method to identify a TB-related death when using death certificates. Specific ICD-10 coding algorithms may misclassify subjects as having died from TB.
To evaluate the safety and efficacy of pegaptanib sodium injection (pegaptanib) in the treatment of diabetic macular edema (DME).
Randomized, double-masked, multicenter, dose-ranging, controlled ...trial.
Individuals with a best-corrected visual acuity (VA) between 20/50 and 20/320 in the study eye and DME involving the center of the macula for whom the investigator judged photocoagulation could be safely withheld for 16 weeks.
Intravitreous pegaptanib (0.3 mg, 1 mg, 3 mg) or sham injections at study entry, week 6, and week 12 with additional injections and/or focal photocoagulation as needed for another 18 weeks. Final assessments were conducted at week 36.
Best-corrected VA, central retinal thickness at the center point of the central subfield as assessed by optical coherence tomography measurement, and additional therapy with photocoagulation between weeks 12 and 36.
One hundred seventy-two patients appeared balanced for baseline demographic and ocular characteristics. Median VA was better at week 36 with 0.3 mg (20/50), as compared with sham (20/63) (P = 0.04). A larger proportion of those receiving 0.3 mg gained VAs of > or =10 letters (approximately 2 lines) (34% vs. 10%, P = 0.003) and > or =15 letters (18% vs. 7%, P = 0.12). Mean central retinal thickness decreased by 68 microm with 0.3 mg, versus an increase of 4 microm with sham (P = 0.02). Larger proportions of those receiving 0.3 mg had an absolute decrease of both > or =100 microm (42% vs. 16%, P = 0.02) and > or =75 microm (49% vs. 19%, P = 0.008). Photocoagulation was deemed necessary in fewer subjects in each pegaptanib arm (0.3 mg vs. sham, 25% vs. 48%; P = 0.04). All pegaptanib doses were well tolerated. Endophthalmitis occurred in 1 of 652 injections (0.15%/injection; i.e., 1/130 0.8% pegaptanib subjects) and was not associated with severe visual loss.
In this phase II trial, subjects assigned to pegaptanib had better VA outcomes, were more likely to show reduction in central retinal thickness, and were deemed less likely to need additional therapy with photocoagulation at follow-up.
We studied the HIV risk behaviors of patrons of the 3 commercial sex venues for men in Seattle, Washington.
We conducted cross-sectional, observational surveys in 2004 and 2006 by use of time-venue ...cluster sampling with probability proportional to size. Surveys were anonymous and self-reported. We analyzed the 2004 data to identify patron characteristics and predictors of risk behaviors and compared the 2 survey populations.
Fourteen percent of respondents reported a previous HIV-positive test, 14% reported unprotected anal intercourse, and 9% reported unprotected anal intercourse with a partner of unknown or discordant HIV status during the current commercial sex venue visit. By logistic regression, recent unprotected anal intercourse outside of a commercial sex venue was independently associated with unprotected anal intercourse. Sex venue site and patron drug use were strongly associated with unprotected anal intercourse at the crude level. The 2004 and 2006 survey populations did not differ significantly in demographics or behaviors.
Patron and venue-specific characteristics factors may each influence the frequency of HIV risk behaviors in commercial sex venues. Future research should evaluate the effect of structural and individual-level interventions on HIV transmission.
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