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AIDS Patient Care and STDs - Table of Contents

Patients' Perspectives on Informal Caregiver Involvement in HIV Health Care Appointments
liebertonline@liebertpub.com (Katie E. Mosack et al) Mon, 23 Nov 2009 02:13:29 -0000
AIDS Patient Care and STDs , Vol. 0, No. 0.
Factors That Influence an HIV Coinfected Patient's Decision to Start Hepatitis C Treatment
liebertonline@liebertpub.com (Karen Chan Osilla et al) Mon, 23 Nov 2009 02:12:54 -0000
AIDS Patient Care and STDs , Vol. 0, No. 0.

American Journal of Epidemiology - current issue

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Editorial Board

Chiropractic & Osteopathy - Latest Articles

An epidemiological examination of the subluxation construct using Hill's criteria of causation
Timothy MirtzLon MorganLawrence WyattLeon Greene Wed, 02 Dec 2009 00:00:00 -0000
Background: : Chiropractors claim to locate, analyze and diagnose a putative spinal lesion known as subluxation and apply the mode of spinal manipulation (adjustment) for the correction of this lesion.AIM: The purpose of this examination is to review the current evidence on the epidemiology of the subluxation construct and to evaluate the subluxation by applying epidemiologic criteria for it's significance as a causal factor.MethodS: The databases of PubMed, Cinahl, and Mantis were searched for studies using the keywords subluxation, epidemiology, manipulation, dose-response, temporality, odds ratio, relative risk, biological plausibility, coherence, and analogy. Results: : The criteria for causation in epidemiology are strength (strength of association), consistency, specificity, temporality (temporal sequence), dose response, experimental evidence, biological plausibility, coherence, and analogy. Applied to the subluxation all of these criteria remain for the most part unfulfilled.CONCLUSION: There is a significant lack of evidence to fulfill the basic criteria of causation. This lack of crucial supportive epidemiologic evidence prohibits the accurate promulgation of the chiropractic subluxation.
A descriptive report of management strategies used by chiropractors, as reviewed by a single independent chiropractic consultant in the Australian workers compensation system.
Henry PollardKatie de Luca Wed, 18 Nov 2009 00:00:00 -0000
Background: In New South Wales, Australia, an injured worker enters the workers compensation system with the case often managed by a pre-determined insurer. The goal of the treating practitioner is to facilitate the claimant to return to suitable duties and progress to their pre-injury status, job and quality of life. Currently, there is very little documentation on the management of injured workers by chiropractors in the Australian healthcare setting. This study aims to examine treatment protocols and recommendations given to chiropractic practitioners by one independent chiropractic reviewer in the state of New South Wales, and to discuss management strategies recommended for the injured worker. Methods: A total of 146 consecutive Independent Chiropractic Consultant reports were collated into a database. Pain information and management recommendations made by the Independent Chiropractic Consultant were tabulated and analysed for trends. The data formulated from the reports is purely descriptive in nature. Results: The Independent Chiropractic Consultant determined the current treatment plan to be "reasonable" (80.1%) or "unreasonable" (23.6%). The consultant recommended to "phase out" treatment in 74.6% of cases, with an average of six remaining treatments. In eight cases treatment was unreasonable with no further treatment; in five cases treatment was reasonable with no further treatment. In 78.6% of cases, injured workers were to be discharged from treatment and 21.4% were to be reassessed for the need of a further treatment plan. Additional recommendations for treatment included an active care program (95.2%), general fitness program (77.4%), flexibility/range of movement exercises (54.1%), referral to a chronic pain specialist (50.7%) and work hardening program (22.6%). Conclusion: It is essential chiropractic practitioners perform 'reasonably necessary treatment' to reduce dependency on passive treatment, increase compliance to active care programs and reduce the progression to chronic pain states. It is recommended that common findings be integrated in further research, to improve the management of treatment for patients with an occupational injury.

pubmed: 0002-9637

In response.
Zimic M, García HH, Gilman RH In response. Am J Trop Med Hyg. 2009 Dec;81(6):1166 Authors: Zimic M, García HH, Gilman RH PMID: 19996454 [PubMed - in process]
Diagnosis of Human Cysticercosis and Taenia asiatica.
Galan-Puchades MT, Fuentes MV Diagnosis of Human Cysticercosis and Taenia asiatica. Am J Trop Med Hyg. 2009 Dec;81(6):1165 Authors: Galan-Puchades MT, Fuentes MV PMID: 19996453 [PubMed - in process]

Annals of Clinical Microbiology and Antimicrobials - Latest Articles

The occurrence of antimicrobial resistance and class 1 integrons among commensal Escherichia coli isolates from infants and elderly persons
Epp SeppJelena StsepetovaKrista LoivukeneKai TruusaluSiiri KoljalgPaul NaaberMarika Mikelsaar Tue, 08 Dec 2009 00:00:00 -0000
Background: The aim of our study was to compare the presence of the intI1 gene and its associations with the antibiotic resistance of commensal Escherichia coli strains in children with/without previous antibiotic treatments and elderly hospitalized/healthy individuals. Methods: One-hundred-and-fifteen intestinal E. coli strains were analyzed: 30 strains from 10 antibiotic-naive infants; 27 from 9 antibiotic-treated outpatient infants; 30 from 9 healthy elderly volunteers; and 28 from 9 hospitalized elderly patients. The MIC values of ampicillin, cefuroxime, cefotaxime, gentamicin, ciprofloxacin, and sulfamethoxazole were measured by E-test and IntI1 was detected by PCR. Results: Out of the 115 strains, 56 (49%) carried class 1 integron genes. Comparing persons without medical interventions, we found in antibiotic-naive children a significantly higher frequency of integron-bearing strains and MIC values than in healthy elderly persons (53% versus 17%; p<0.01). Evaluating medical interventions, we found a higher resistance and frequency of integrons in strains from hospitalized elderly persons compared with non-hospitalized ones. Children treated with antibiotics had strains with higher MIC values (when compared with antibiotic-naive ones), but the integron-bearing in strains was similar. In most cases, the differences in resistance between the groups (integron-positive and negative strains separately) were higher than the differences between integron-positive and negative strains within the groups. Conclusions: The prevalence of integrons in commensal E. coli strains in persons without previous medical intervention depended on age. The resistance of integron-carrying and non-carrying strains is more dependent on influencing factors (hospitalization and antibiotic administration) in particular groups than merely the presence or absence of integrons.
Genetic commonality of macrolide-resistant group A beta hemolytic streptococcus pharyngeal strains
Angela MyersMary Anne JacksonRangaraj SelvaranganRichard GoeringChristopher Harrison Tue, 01 Dec 2009 00:00:00 -0000
Background: Group A beta hemolytic streptococcus (GABHS) pharyngitis is a common childhood illness. Penicillin remains the gold standard therapy, but macrolides are indicated for the penicillin allergic patient, and are often used for convenience. Methods: We conducted a surveillance study of children with pharyngitis and positive streptococcal rapid antigen testing from 10/05 to 10/06 at 2 sites (A & B). Demographics, treatment, and resistance data was collected and compared to previous data from 2002. Erythromycin (EM) resistance was determined by disk diffusion and E-test on 500 isolates. Pulse field gel electrophoresis (PFGE) was performed to measure genetic relatedness of isolates. StatXact version 8 software (Cytel Inc., Cambridge, MA) was utilized to perform Fisher's exact test and exact confidence interval (CI) analysis. Results: There were no differences in resistance rates or demographic features, with the exception of race, between sites A & B. EM resistance was 0 in 2002, 3.5% in 2005-06 at site A, and 4.5% in 2005-06 at site B. 3/7 and 3/9 had inducible resistance at A and B respectively. 8 isolates had relatedness ≥80%, 5 of which were 88% homologous on PFGE. Conclusion: Community macrolide resistance has increased following increased macrolide use. These results may have treatment implications if use continues to be high.

pubmed: 1359-6535

Progress in basic and clinical research on HIV resistance: report on the XVIII International HIV Drug Resistance Workshop.
Mascolini M, Boucher CA, Mellors JW, Larder BA, Richman DD Progress in basic and clinical research on HIV resistance: report on the XVIII International HIV Drug Resistance Workshop. Antivir Ther. 2009;14(7):1015-37 Authors: Mascolini M, Boucher CA, Mellors JW, Larder BA, Richman DD Over nearly two decades, the International HIV Drug Resistance Workshop has become the leading forum for new research on viral resistance to agents developed to treat infection with HIV. The XVIII workshop featured work on HIV type-1 (HIV-1) persistence, reservoirs and elimination strategies; resistance to HIV-1 entry inhibitors (including a comparison of genotyping versus phenotyping to determine HIV-1 coreceptor use before treatment with CCR5 antagonists); polymerase domain resistance to reverse transcriptase inhibitors (including hepatitis B virus and HIV-1 resistance to lamivudine, and emergence of the K65R mutation in HIV-1 subtypes B and C); connection and RNase H domain resistance to reverse transcriptase inhibitors (including the effect of mutations in those domains on response to efavirenz and etravirine); resistance to hepatitis C virus and HIV-1 protease inhibitors; resistance to the integrase inhibitor raltegravir; global resistance epidemiology (including models to predict response to second-line antiretrovirals in resource-poor settings); and the role of minority resistant variants (including the effect of such variants on prevention of mother-to-child transmission of HIV-1). This report summarizes data from the oral abstract presentations at the workshop. PMID: 19918107 [PubMed - in process]
Avascular osteonecrosis of the femoral head in three West African HIV-infected adults with heterozygous sickle cell disease.
Eholié SP, Ouiminga M, Ehui E, Nzunetu G, Ouattara SI, Konan AV, Anglaret X, Bissagnéné E Avascular osteonecrosis of the femoral head in three West African HIV-infected adults with heterozygous sickle cell disease. Antivir Ther. 2009;14(7):1011-4 Authors: Eholié SP, Ouiminga M, Ehui E, Nzunetu G, Ouattara SI, Konan AV, Anglaret X, Bissagnéné E Three men (aged 33, 44 and 45 years, CD4(+) T-cell nadir 86 cells/mm(3), 99 cells/mm(3) and 12 cells/mm(3), respectively) were admitted to the Department of Infectious Diseases (Treichville Hospital, Abidjan, Côte d'Ivoire) for hip pain and impaired mobility. Their last available CD4(+) T-cell counts were 243 cells/mm(3), 245 cells/mm(3) and 8 cells/mm(3), respectively. They had all received antiretroviral therapy for >4 years, including lopinavir/ritonavir for >8 months. The other risk factors were hypertriglyceridaemia (n=3), smoking addiction (n=2), alcohol consumption (n=2) and lipodystrophy (n=1). All three patients had heterozygous haemoglobin AS sickle cell disease (percentage of haemoglobin S 41%, 45% and 50%, respectively). The diagnosis of avascular osteonecrosis of the femoral head (unilateral n=2 and bilateral n=1) was documented by CT scan. Only one patient underwent surgical arthroplasty. In resource-limited settings, avascular osteonecrosis is uneasy to diagnose and unlikely to be appropriately treated. Physicians should be aware of its symptoms and risk factors, including HIV infection and antiretroviral therapy. Future studies should explore whether these risk factors might include haemoglobin AS sickle cell disease, a common trait in the West African general population. PMID: 19918106 [PubMed - in process]

BMC Infectious Diseases - Latest Articles

Performance of the tuberculin skin test and interferon-gamma release assay for detection of tuberculosis infection in immunocompromised patients in a BCG-vaccinated population
Eun Young KimJu Eun LimJi Ye JungJi Young SonKyung Jong LeeYoe Wun YoonByung Hoon ParkJin Wook MoonMoo Suk ParkYoung Sam KimSe Kyu KimJoon ChangYoung Ae Kang Tue, 15 Dec 2009 00:00:00 -0000
Background: Interferon-gamma release assay (IGRA) may improve diagnostic accuracy for latent tuberculosis infection (LTBI). This study compared the performance of the tuberculin skin test (TST) with that of IGRA for the diagnosis of LTBI in immunocompromised patients in an intermediate TB burden country where BCG vaccination is mandatory. Methods: We conducted a retrospective observational study of patients given the TST and an IGRA, the QuantiFERON-TB Gold In-Tube (QFT-IT), at Severance Hospital, a tertiary hospital in South Korea, from December 2006 to May 2009. Results: Of 211 patients who underwent TST and QFT-IT testing, 117 (55%) were classified as immunocompromised. Significantly fewer immunocompromised than immunocompetent patients had positive TST results (10.3% vs. 27.7%, p 0.001), whereas the percentage of positive QFT-IT results was comparable for both groups (21.4% vs. 25.5%). However, indeterminate QFT-IT results were more frequent in immunocompromised than immunocompetent patients (21.4% vs. 9.6%, p 0.021). Agreement between the TST and QFT-IT was fair for the immunocompromised group (kappa = 0.38), but moderate agreement was observed for the immunocompetent group (kappa = 0.57). Indeterminate QFT-IT results were associated with anaemia, lymphocytopenia, hypoproteinemia, and hypoalbuminemia. Conclusion: In immunocompromised patients, the QFT-IT may be more sensitive than the TST for detection of LTBI, but it resulted in a considerable proportion of indeterminate results. Therefore, both tests may maximise the efficacy of screening for LTBI in immunocompromised patients.
Severity of Giardia infection associated with post-infectious fatigue and abdominal symptoms two years after
Kristine MorchKurt HanevikGuri RortveitKnut-Arne WensaasGeir Egil EideTrygve HauskenNina Langeland Tue, 15 Dec 2009 00:00:00 -0000
Background: A high rate of post-infectious fatigue and abdominal symptoms two years after a waterborne outbreak of giardiasis in Bergen, Norway in 2004 has previously been reported. The aim of this report was to identify risk factors associated with such manifestations. Methods: All laboratory confirmed cases of giardiasis (n = 1262) during the outbreak in Bergen in 2004 received a postal questionnaire two years after. Degree of post-infectious abdominal symptoms and fatigue, as well as previous abdominal problems, was recorded. In the statistical analyses number of treatment courses, treatment refractory infection, delayed education and sick leave were used as indices of protracted and severe Giardia infection. Age, gender, previous abdominal problems and symptoms during infection were also analysed as possible risk factors. Simple and multiple ordinal logistic regression models were used for the analyses. Results: The response rate was 81 % (1017/1262), 64% were women and median age was 31 years (range 3-93), compared to 61% women and 30 years (range 2-93) among all 1262 cases. Factors in multiple regression analysis significantly associated with abdominal symptoms two years after infection were: More than one treatment course, treatment refractory infection, delayed education, bloating and female gender. Abdominal problems prior to Giardia infection were not associated with post-infectious abdominal symptoms. More than one treatment course, delayed education, sick leave more than 2 weeks, and malaise at the time of infection, were significantly associated with fatigue in the multiple regression analysis, as were increasing age and previous abdominal problems. Conclusion: Protracted and severe Giardia infection seemed to be a risk factor for post-infectious fatigue and abdominal symptoms two years after the infection had been cleared.

Epidemiologic Reviews - current issue

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Epidemiology and Infection - Current Issue

Volume 138 Issue 01
Fri, 01 Jan 2010 00:00:00 -0000
Epidemiology and Infection, Volume 138 Issue 01 Increased frequency in 2007 - now 8 issues per year! Epidemiology and Infection publishes original reports and reviews on all aspects of infection in humans and animals. Particular emphasis is given to the epidemiology, prevention and control of infectious diseases. The field covered is broad and includes the zoonoses, tropical infections, food hygiene, vaccine studies, statistics and the clinical, social and public-health aspects of infectious disease. Papers covering microbiology and immunology which have an epidemiological relevance are part of this broad field. Papers come from medical and veterinary scientists worldwide. It has become the key periodical in which to find the latest reports on recently discovered infections and new technology. For those concerned with policy and planning for the control of infections, the papers on mathematical modelling of epidemics caused by historical, current and emergent infections, will be of particular value. To celebrate 100 years of the journal, a series of important papers has been selected and each, together with a modern commentary on the paper by an expert, will be published on-line. This journal has now moved over to electronic submission, using the Scholar One system. Click here to go to the submission website. Guidance on how to upload your manuscript is available on the site by clicking "User Tutorials". Online manuscript submission (now) available, please go to http://mc.manuscriptcentral.com/cup/hyg
Using syndromic surveillance systems to detect pneumonic plague
Review ArticlesS. M. BABIN, Epidemiology and Infection, Volume 138 Issue 01 , pp 1-8Abstract

Filaria Journal - Latest Articles

Contribution of migrant coffee labourers infected with Onchocerca volvulus to the maintenance of the microfilarial reservoir in an ivermectin-treated area of Mexico.
Mario Rodriguez-PerezAldo Segura-CabreraCristian Lizarazo-OrtegaMaria-Gloria BasanezJohn Davies Tue, 18 Dec 2007 00:00:00 -0000
Background: Since 1991, in Mexico, ivermectin has been administered twice a year to all residents in the onchocerciasis endemic foci which are mainly located in the coffee growing areas. However, the presence of a potentially infected itinerant seasonal labour force which is not treated regularly could jeopardise the attainment of the 85% coverage which is the present target for elimination of the disease. Methods: The prevalence and intensity of Onchocerca volvulus microfilariae (mf), as well as their transmission from humans to vectors, were assessed during the coffee planting-clearing and harvesting seasons of 1997–1998, and 1998–1999 in two localities (I and II) of Southern Chiapas, Mexico, which regularly receive an influx of untreated migrant coffee labourers. Results: Localities I and II had, respectively, an average of 391 (± 32) and 358 (± 14) resident inhabitants, and 70 (± 52) and 498 (± 289) temporary labourers. The ratio of migrants to residents ranged from 0.1:1 in locality I to 2.4:1 in locality II. The proportion of infected Simulium ochraceum s.l. parous flies was significantly lower in locality I than in locality II, and significantly higher during the stay of the migrants than before their arrival or after their departure. Parity and infection were higher in May-July than in November-February (in contrast with the latter being typically considered as the peak onchocerciasis transmission season by S. ochraceum s.l.). Conclusion: The presence of significant numbers of untreated and potentially infected migrants may contribute to ongoing transmission, and their incorporation into ivermectin programmes should be beneficial for the attainment of the elimination goals of the regional initiative. However, the possibility that the results also reflect transmission patterns for the area cannot be excluded and these should be analyzed further.
Epidemiology and psycho-social aspects Of onchocercal skin diseases in northeastern Nigeria
Ikem OkoyeCelestine Onwuliri Mon, 03 Dec 2007 00:00:00 -0000
Background: Observations were made on the prevalence of onchocerciasis and Onchocercal Skin Diseases (OSD); frequency of occurrence and anatomical distribution of OSD in the Hawal River Valley, an established onchocerciasis endemic focus in north-eastern Nigeria. Methods: Symptoms of OSD were diagnosed in 5 844 subjects using Rapid Assessment Method (RAM) while 1 479 of the subjects chosen from alternate households had their skin biopsies examined for active microfilariae of Onchocerca volvulus. Also, Focal Group Discussions (FGD) were conducted at the Health District levels. Results: O. volvulus was recorded in (19.0%) and OSD in (43.8%) of the subjects. The Mantel-Haenszel test for linear association showed a close agreement between onchocerciasis prevalence and the rate of OSD (χ2 = 3.93; p < 0.05). The various forms of OSD occurred in the order: CPOD (17.7%), APOD (9.9%), DPM (9.0%), LOD (7.0%) and ATR (3.1%). The overall frequency of occurrence of various symptoms of OSD on different anatomical locations showed the locations in descending order of occurrence as lower limbs (24.6%), upper limbs (21.3%), buttocks (19.9%), shoulder & neck (19.1%), abdomen and trunk (11.3%), backside (10.6), and 'other' sites (7.5%). The Focal Group Discussion (FGD) revealed the most worrisome consequences of OSD as social isolation of victims (31.3%), shame and low self esteem (22.7%) and high cost of medication (15.6%). Conclusion: It is recommended that Onchocerciasis control programmes in the Hawal River Valley and any other focus with high incidence of OSD should incorporate an aspect that would address the anxiety and depression caused by various OSD lesions since they carry lots of psycho-social implications. This would increase acceptance and compliance of the target population. The classification criteria of onchocerciasis endemicity should be based on either or both of the O. volvulus and onchocercal skin disease burden of any community and no longer on O. volvulus parasitic infection rate alone.

Foodborne Pathogens and Disease - Table of Contents

Genetic Similarity of Campylobacter Isolates in Humans, Food, and Water Sources in Central Poland
liebertonline@liebertpub.com (Elżbieta Rożynek et al) Thu, 10 Dec 2009 01:21:16 -0000
Foodborne Pathogens and Disease , Vol. 0, No. 0.
A Pilot Study of the Microbiological Quality of Culturally Diverse, Ready-to-Eat Foods from Selected Retail Establishments in Melbourne, Australia
liebertonline@liebertpub.com (Sarah K. McLean et al) Thu, 10 Dec 2009 01:21:15 -0000
Foodborne Pathogens and Disease , Vol. 0, No. 0.

pubmed: 0019-9567

Genetic control of the innate immune response to Borrelia hermsii influences the course of relapsing fever in inbred strains of mice.
Benoit VM, Petrich A, Alugupalli KR, Marty-Roix R, Moter A, Leong JM, Boyartchuk VL Genetic control of the innate immune response to Borrelia hermsii influences the course of relapsing fever in inbred strains of mice. Infect Immun. 2009 Dec 7; Authors: Benoit VM, Petrich A, Alugupalli KR, Marty-Roix R, Moter A, Leong JM, Boyartchuk VL Host susceptibility to infection is controlled in large measure by the genetic makeup of the host. Spirochetes of the genus Borrelia include nearly 40 species of vector-borne spirochetes that are capable of infecting a wide range of mammalian hosts, causing Lyme disease and relapsing fever. Relapsing fever is associated with high-level bacteremia, as well as hematologic manifestations such as thrombocytopenia (i.e. low platelet numbers) and anemia. To facilitate studies of genetic control of susceptibility to Borrelia hermsii infection we performed a systematic analysis of the course of infection using immunocompetent and immunocompromised inbred strains of mice. Our analysis revealed that sensitivity to B. hermsii infections is genetically controlled. In addition, whereas the role of adaptive immunity to relapsing fever spirochetes is well documented, we found that innate immunity contributes significantly to reduction of bacterial burden. Similar to human infection, progression of the disease in mice was associated with thrombocytopenia and anemia. Histological and fluorescence in situ hybridization (FISH) analysis of infected tissues indicated that red blood cells were removed by tissue resident macrophages, a process that could lead to anemia. Spirochetes in the spleen and liver were often visualized associated with RBCs, lending support to the hypothesis that direct interaction of B. hermsii spirochetes with RBCs leads to clearance of bacteria from the bloodstream by tissue phagocytes. PMID: 19995898 [PubMed - as supplied by publisher]
Mycoplasma genitalium Rapidly Disseminates to the Upper Reproductive Tract and Knees of Female Mice Following Vaginal Inoculation.
McGowin CL, Spagnuolo RA, Pyles RB Mycoplasma genitalium Rapidly Disseminates to the Upper Reproductive Tract and Knees of Female Mice Following Vaginal Inoculation. Infect Immun. 2009 Dec 7; Authors: McGowin CL, Spagnuolo RA, Pyles RB Mycoplasma genitalium is an emerging sexually transmitted infection and is associated with notable reproductive tract syndromes in women such as cervicitis, pelvic inflammatory disease and infertility. Investigations into the causal relationships of M. genitalium and clinical disease have been hindered largely by the lack of a well-established small animal model of genital tract infection. To establish a murine model, female Swiss Webster mice were conditioned with either progesterone or estradiol and then inoculated intravaginally with M. genitalium type strain G37 or a contemporary Danish strain, M2300. Persistent lower tract infection was observed up to 77 d post-inoculation (PI). Upper reproductive tract colonization was observed as early as 3 d PI with long-term infection observed in estradiol- (65%) and progesterone-treated (18%) animals. In the upper tract, more than 90% of M. genitalium PCR-positive samples were from the uterus and oviducts. Ultimately, gross hydrosalpinx was observed 21 d to 10 weeks PI in approximately 60% of infected animals suggesting tubal occlusion. In addition, dissemination of M. genitalium to the knee tissues was observed as early as 7 d PI with persistent infection detected up to 28 d PI. Mice infected with M. genitalium also developed specific antibodies to the major antigenic outer membrane protein MgPa, elongation factor Tu, pyruvate dehydrogenase E1alpha and DnaK (Hsp70) indicating persistent infection despite a robust humoral responses to infection. These findings provide strong experimental evidence that M. genitalium can establish long-term infection of reproductive tract and joint tissues with preliminary evidence of pathological reproductive tract outcomes. PMID: 19995897 [PubMed - as supplied by publisher]

Latest Issue of International Journal of Medical Microbiology

Editorial - ETOX turned twenty
Sebo P.
Pathogenomics of mobile genetic elements of toxigenic bacteria
Hacker J.Hochhut B.Middendorf B.Schneider G.Buchrieser C.Gottschalk G.Dobrindt U.

ScienceDirect Publication: Women's Health Issues

A Cost Effectiveness Analysis of Rapid Yeast Detection Kits
Thu, 26 Nov 2009 20:56:49 -0000
Publication year: 2009Source: Women's Health Issues, In Press, Corrected Proof, Available online 26 November 2009Surabhi K., Gaur , Kevin, Frick , Vani, Dandolu Objective: To determine the cost effectiveness of the utilization of over-the-counter yeast infection detection kits in the diagnosis of vaginal candidiasis. Methods: A cost–benefit analysis based on a group of 70 adult women from a previous prospective study who presented with vaginitis symptoms. By constructing two decision trees, one in which the kits are an option to the women and one in which they are not, we predict the cost for diagnosing vaginal candidiasis in this group of women. Results: For a group of 70 women presenting with vaginitis symptoms, the total cost of diagnosing their infections without the use of kits is predicted to...
Impact of Patient Adherence and Test Performance on The Cost-Effectiveness of Cervical Cancer Screening in Developing CountriesThe Case of Honduras
Thu, 26 Nov 2009 20:56:49 -0000
Publication year: 2009Source: Women's Health Issues, In Press, Corrected Proof, Available online 26 November 2009Rebecca B., Perkins , Sarah M., Langrish , Linda J., Stern , James F., Burgess , Carol J., Simon Objective: We examined the impact of patient adherence and screening test performance on the cost-effectiveness of visual inspection with acetic acid (VIA) and Pap smears when used with colposcopy for diagnosis. Materials and Methods: Cost-effectiveness analysis was performed using computer modeling. The primary outcome was cancer prevalence in the 10 years after screening. Three hypothetical populations of 35-year-old women were compared: never-screened women, women screened with VIA, and women screened with Pap smears. We used community-based data from our screening program in Honduras to estimate screening test sensitivity and specificity, adherence to follow-up, and costs of screening and colposcopy services. Published data were...

Future Medicine: Women's Health: Table of Contents

Obesity and endometrial cancer: challenges for public health action
info@futuremedicine.com (Lisa C Richardson et al) Wed, 28 Oct 2009 16:45:48 -0000
Women's Health , November 2009, Vol. 5, No. 6, Pages 595-597.
Bulletin Board
Wed, 28 Oct 2009 16:45:50 -0000
Women's Health , November 2009, Vol. 5, No. 6, Pages 599-601.

Archives of Women's Mental Health

R. Nonacs: A deeper shade of blue
Sat, 21 Nov 2009 08:31:11 -0000
R. Nonacs: A deeper shade of blue Content Type Journal ArticleCategory Book ReviewDOI 10.1007/s00737-009-0129-7Authors Grace Parr, McMaster University Hamilton ON Canada Journal Archives of Women's Mental HealthOnline ISSN 1435-1102Print ISSN 1434-1816
An open trial with cognitive behavioral therapy for blood- and injection phobia in pregnant women—a group intervention program
Mon, 26 Oct 2009 18:08:21 -0000
Abstract Around 7% of pregnant women suffer from blood- and injection phobia. The aim was to investigate if cognitive behavior group therapy (CBT) is effective in treating pregnant women’s blood- and injection phobia. Thirty pregnant women with blood- and injection phobia according to DSM-IV took part in an open treatment intervention. A two-session cognitive behavior group therapy was conducted. As controls, 46 pregnant women with untreated blood- and injection phobia and 70 healthy pregnant women were used. Repeated measures ANOVA were performed. The scores for the CBT treatment group on the “Injection Phobia Scale-Anxiety” were reduced both after each treatment session and postpartum (p < 0.001). Anxiety and depressive symptoms were also reduced (p < 0.001). Cognitive-behavior group therapy for pregnant women with blood- and injection phobia is effective and stable up to at least 3 months postpartum. It seems also to reduce anxiety and depressive symptoms during pregnancy. Content Type Journal ArticleCategory Original ContributionDOI 10.1007/s00737-009-0126-xAuthors Caroline Lilliecreutz, Linköping University Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences Linköping SwedenAnn Josefsson, Linköping University Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences Linköping SwedenGunilla Sydsjö, Linköping University Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences Linköping Sweden Journal Archives of Women's Mental HealthOnline ISSN 1435-1102Print ISSN 1434-1816

BMC Women's Health - Latest Articles

Breast cancer in kurdish women of northern Iraq: incidence, clinical stage, and case control analysis of parity and family risk
Runnak MajidHazha MohammedHeshu SaeedBanaz SafarRekawt RashidMichael Hughson Fri, 11 Dec 2009 00:00:00 -0000
Background: Breast cancer in the Middle-East occurs in relatively young women and frequently presents as advanced disease. A protective effect of multiparity is not apparent, and high familial risk is reported in some countries. This study investigates breast cancer rates and clinical stage related to age in the Kurdish region of Iraq and evaluates risk associated with parity and family history. Findings are compared with nearby countries and the West. Methods: Sulaimaniyah Directorate of Health records identified 539 women diagnosed with breast cancer during 2006-2008. Clinical survey forms were completed on 296 patients and on 254 age-matched controls. Age specific incidence rates were calculated from Directorate of Health population estimates. Results: Average patient age was 47.4 +/- 11 years and 59.5% were premenopausal. Diagnosis was at clinical stage 1 for 4.1%, stage 2 for 43.5%, stage 3 for 26.0%, and stage 4 for 8.1% of patients. For 18.2%, stage was unknown. Annual breast cancer incidence rates per 100,000 women peaked at 168.9 at age 55 to 59 and declined to 57.3 at 60 and above. Patients had an average of 5.0 +/- 3.3 children compared to 5.4 +/- 3.5 for controls, P = 0.16. A first degree family member had breast cancer among 11.1% of patients and 2.1% of controls (P 50% of these patients and controls being [greater than or equal to] 50 years old. No statistically significant relationship was found between tumor stage and age, P = 0.59. Conclusions: In Kurdish Iraq, breast cancer is predominantly a disease of premenopausal women having multiple pregnancies. For younger patients, breast cancer incidence was similar to the West and possibly higher than many Middle-Eastern countries, but unlike the West, the estimated rates declined markedly in the elderly. The familial breast cancer risk for both older and younger women was within the general population risk of Western countries. Clinical stages were advanced and indicated delays in diagnosis that were unrelated to patient age.
Physical activity patterns during pregnancy through postpartum
Katja BorodulinKelly EvensonAmy Herring Thu, 19 Nov 2009 00:00:00 -0000
Background: Realizing the importance of regular physical activity, particularly in the prevention of chronic diseases and unhealthy weight gain, it is important to study how physical activity changes during and after pregnancy using prospective study designs. The aim of this study was to describe the mode, duration, intensity, and changes in physical activity during pregnancy through one year postpartum among a cohort of women. Methods: This study was part of the third Pregnancy, Infection and Nutrition Postpartum Study at the University of North Carolina Hospitals. A cohort of 471 women was followed at 17-22 and 27-30 weeks' gestation and at 3 and 12 months postpartum. The participants reported the mode, frequency, duration, and intensity of all physical activities that increased their breathing and heart rate in the past week. Results: Overall physical activity for the cohort decreased from 17-22 weeks to 27-30 weeks of gestation, but rebounded up at 3 months postpartum and remained stable at 12 months postpartum. The mean MET h/wk values for each time point were 24.7 (standard deviation, SD 26.8), 19.1 (SD 18.9), 25.7 (SD 29.3), and 26.7 (SD 31.5). In postpartum, women reported more care-giving and recreational activity and less indoor household activity, as compared to their activity level during pregnancy. Conclusion: For health benefits and weight management, health care professionals are encouraged to provide pregnant and postpartum women with information on recommendations of physical activity, particularly regarding the minimum duration and intensity level.

Archives of Internal Medicine current issue

Is It Time to Eliminate Consultation Codes?: An Analysis of Impact and Rationale [Special Article]
Shalowitz, J. I.Background As issues of health care cost escalation and parity of payment between primary care and other physicians have become more important, one proposal has been to eliminate consultation codes. Little is known about the current payment accuracy or financial impact of such a change.Methods To assess the impact of consultation code elimination, 2 assessments were conducted. First, from June 1, 2008, to July 1, 2009, 500 consecutive referrals from primary care physicians to other specialists were reviewed and matched with claims for accuracy of coding and billing. Second, to evaluate the financial impact of this change, year 2007 data on outpatient consultations from the Centers for Medicare and Medicaid Services were reviewed.Results Of the 500 claims reviewed, 466 were appropriate for analysis. Overall, the coding error rate was 32.4%. When the requesting physician ordered a consultation, the error rate was 5.5%; however, with lower paid referral requests, the error rate was 78.0%. Changing ambulatory consultation codes to those for new patient visits would save Medicare $534.5 million per year.Conclusions Consultation codes are being billed erroneously at a high rate. Furthermore, the differential cost to Medicare of these codes over those for new patient evaluation and management codes is over half a billion dollars per year. With the growing needs for cost savings as well as encouraging payment parity for cognitive services for primary care physicians, it is time these codes are reevaluated.Published online November 9, 2009 (doi:10.1001/archinternmed.2009.446).
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