| 1. Peer Reviewed Title: Modeling CD4+ cell count increase over a six-year period in HIV-1-infected patients on highly active antiretroviral therapy in Senegal. Author: De Beaudrap P; Etard JF; Diouf A; Ndiaye I; Gueye NF; Gueye PM; Sow PS; Mboup S; Ndoye I; Ecochard R; Eric D Author: ANRS 1215/90 Study Group Source: American Journal of Tropical Medicine and Hygiene. 2009 Jun;80(6):1047-53. Abstract: To assess the extents and determinants of long-term CD4 cell increases after initiation of antiretroviral therapy (ART), changes in CD4 cell counts were analyzed in a cohort of HIV-1-infected Senegalese using a mixed-effects model. After a median follow-up of 54 months, an average of 483 CD4 cells/mm3 (95% confidence interval [CI] = 331; 680) was reached. The average asymptote level was approximately 421 cells/mm3 (95% CI = 390; 454) in patients with < 200 cells/mm3 at baseline and approximately 500 cells/mm3 in patients with > 200 cells/mm3. The independent predictors of long-term CD4 cell reconstitution were the baseline CD4 cell count and the monthly average viral load over the entire follow-up. This good long-term immune reconstitution, optimal in subjects with low average viral loads and > 200 CD4 cells/mm3 at baseline, argues in favor of the earliest possible access to ART and underlines the importance of strict compliance with the treatment. Language: English Keywords: SENEGAL | RESEARCH REPORT | STATISTICAL STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | IMMUNOLOGICAL EFFECTS | TIME FACTORS | HEMATOLOGIC TESTS | USER COMPLIANCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Immunity | Immune System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior Document Number: 341762 |
2.  Peer Reviewed Title: Serum levonorgestrel levels and endometrial thickness during extended use of the levonorgestrel-releasing intrauterine system. Author: Hidalgo MM; Hidalgo-Regina C; Bahamondes MV; Monteiro I; Petta CA; Bahamondes L Source: Contraception. 2009 Jul;80(1):84-9. Abstract: BACKGROUND: The levonorgestrel-releasing intrauterine system (LNG-IUS) is a contraceptive method approved for five years of use. However, there is some evidence that its life span may be longer. The aim of the study was to evaluate serum levonorgestrel (LNG) and estradiol (E(2)) levels and endometrial thickness every 6 months from 7 to 8 1/2 years after insertion. STUDY DESIGN: At the end of the approved 5-year life span, no replacement devices were available; therefore, 86 women were allowed to retain the same device for a further 2 years. At the 7-year follow-up visit, the women who consented were again allowed to retain the same device for a further 18 months and were followed-up at six-monthly intervals. At each visit, vaginal sonography was performed to measure endometrial thickness, and a blood sample was taken to measure LNG and E(2). RESULTS: Eighty-four months after insertion, 67 women aged 34.3+/-0.8 years (mean+/-SEM) (range, 25-49 years) returned for follow-up. Mean+/-SEM LNG levels decreased from an initial 253+/-27 pg/mL (range, 86-760) during the first 2 months following insertion to 137+/-12 (range, 23-393) at 84 months and 119+/-9 pg/mL (range, 110-129) at 102 months of use (+/-SEM). At 84 months of use, mean+/-SEM endometrial thickness was 2.8+/-0.1 mm, increasing to 3.8+/-0.5 mm at 102 months of use. The incidence of amenorrhea decreased from 41.8% at 84 months to 31.5% at 102 months of use. No correlation was found between LNG levels and bleeding patterns; however, a weak correlation was found between high body mass index (kg/m(2)), high weight, and low serum LNG levels. E(2) levels were similar to those of the follicular phase of the menstrual cycle of regularly menstruating women. CONCLUSIONS: During extended use of the LNG-IUS, serum LNG levels were nearly half those found in the first 2 months of use (Wilcoxon signed rank test); serum E(2) levels were normal. Despite the very thin endometrium, menstrual bleeding was reinstated in many cases. At the end of its 5-year life span, there is a window for changing the LNG-IUS, and physicians and users should not be concerned about delaying replacement of the device for a short time beyond the approved life span; however, maintaining the same device long after its approved life span cannot be recommended. Language: English Keywords: BRAZIL | RESEARCH REPORT | FAMILY PLANNING ACCEPTORS | IUD, HORMONE RELEASING | LEVONORGESTREL | ESTRADIOL | ENDOMETRIUM | TIME FACTORS | ULTRASONICS | HEMATOLOGIC TESTS | AMENORRHEA | INCIDENCE | MENSTRUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Family Planning Programs | Family Planning | IUD | Contraceptive Methods | Contraception | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Estrogens | Hormones | Endocrine System | Physiology | Biology | Uterus | Genitalia, Female | Genitalia | Urogenital System | Population Dynamics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Menstruation Disorders | Diseases | Measurement | Research Methodology | Reproduction Document Number: 342787 |
| 3. Title: Dried blood spots versus plasma for the quantification of HIV-1 RNA using the manual (PCR-ELISA) amplicor monitor HIV-1 version 1.5 assay in Yaounde, Cameroon. Author: Ikomey GM; Atashili J; Okomo-Assoumou MC; Mesembe M; Ndumbe PM Source: Journal of the International Association of Physicians in AIDS Care. 2009 May-Jun;8(3):181-4. Abstract: OBJECTIVES: Considering the recent accrued need for viral load quantification in resource-limited settings, this study evaluated the use of dried blood spots (DBS) compared to plasma as a means of sample collection and storage for HIV-1 RNA quantification using a non-automated assay. METHODS: Venous blood was collected from 60 consenting HIV-1-positive patients, plasma separated within 4 hours, and stored at -20 degrees C. Venous blood, 50 microL, was blotted on 4 designated areas of Whatman filter paper and air-dried at room temperature for 2 hours. RESULTS: There was a strong statistically significant correlation between HIV-1 RNA viral load using plasma and DBS (r = .955, P < .001). On average plasma viral loads were only slightly higher than DBS viral loads (mean difference: 0.06 log(10) copies/mL). CONCLUSION: Even when using an entirely manual HIV-quantification assay, DBS may provide a reliable, cost-effective method for sample collection and storage for HIV-1 RNA quantification in resource-limited settings. Language: English Keywords: CAMEROON | RESEARCH REPORT | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | CLIENTS | HEMATOLOGIC TESTS | MONITORING | LABORATORY PROCEDURES | COST EFFECTIVENESS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation | Evaluation Indexes | Quantitative Evaluation Document Number: 342457 |
| 4. Peer Reviewed Title: Effects of an antiandrogenic oral contraceptive pill compared with metformin on blood coagulation tests and endothelial function in women with the polycystic ovary syndrome: influence of obesity and smoking. Author: Luque-Ramirez M; Mendieta-Azcona C; Del Rey J; Maties M; Escobar-Morreale H Source: European Journal of Endocrinology. 2009;160:469-480. Abstract: Objective: To study the blood clotting tests and endothelial function of PCOS patients and non-hyperandrogenic women, and their changes during PCOS treatment, as a function of the presence of obesity and smoking. Design: Case-control study followed by a randomized clinical trial. Methods: Blood clotting and endothelial function were analyzed in 40 PCOS patients and 20 non-hyperandrogenic women. 34 PCOS women were randomized to Diane35Diario or metformin (850 mg twice daily), monitoring the changes on these parameters during 24 weeks of treatment. The influence of obesity and smoking was also analyzed. Results: Blood clotting and endothelial function tests were similar among PCOS patients and controls with the exception of a higher platelet count in the former. Obesity increased circulating fibrinogen levels, prothrombin activity and platelet counts, and reduced prothrombin and activated partial thromboplastin times. Smoking increased fibrinogen levels, platelet counts and prothrombin activity, andreduced prothrombin time, in relation to the larger waist circumference of smokers. Irrespective of the treatment received, PCOS patients showed a decrease in prothrombin time and an increase in prothrombin activity, with a parallel increase in homocysteine levels with metformin. The activated partial thromboplastin time decreased markedly with Diane35Diario. Finally, flow-mediated dilation improved in non-smokers irrespective of the drug, but worsened in smokers. Conclusions: Oral contraceptives and metformin may exert deleterious effects on blood clotting tests of PCOS women, yet the effects of metformin appear to be milder. Because smoking potentiates some of these effects and deteriorates endothelial function, smoking cessation should be promoted in PCOS patients. Language: English Keywords: SPAIN | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | CLIENTS | BLOOD | HEMATOLOGIC TESTS | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | OBESITY | BODY WEIGHT | TOBACCO USE | Europe, Southwestern | Europe | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Hemic System | Physiology | Biology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Behavior Document Number: 329669 |
| 5. Peer Reviewed Title: Measure of viral load by using the Abbott Real-Time HIV-1 assay on dried blood and plasma spot specimens collected in 2 rural dispensaries in Cameroon. Author: Mbida AD; Sosso S; Flori P; Saoudin H; Lawrence P; Monny-Lobe M; Oyono Y; Ndzi E; Cappelli G; Lucht F; Pozzetto B; Oukem-Boyer OO; Bourlet T Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):9-16. Abstract: BACKGROUND: This study aimed to evaluate the use of dried blood spots (DBSs) and dried plasma spots (DPSs) locally collected in 2 rural dispensaries in Cameroon for the quantification of HIV-1 RNA. METHODS: Forty-one subjects were sampled and spots of whole blood and plasma were deposited onto Whatman 903 cards and dried at ambient temperature under local conditions. Two sets of DBS and DPS cards were done per patient. The rest of the liquid plasma (LP) was frozen until use. LPs were tested at the "Chantal Biya" International Reference Centre (Yaounde, Cameroon) by the Abbott Real-Time HIV-1 assay (Abbott Molecular Diagnostics, Wiesbaden, Germany). One series of DBS and DPS was transported and tested between 2 and 6 weeks later at the Virology Laboratory of Saint-Etienne (France). The second series was routed by mail and tested after up to 3 months of storage at ambient temperature. RESULTS: From the first series, the correlation rate between viral loads obtained from LP and DBS, and from LP and DPS, was 0.98 and 0.99, respectively; specificity of DBS and DPS results was 100%. The results obtained from the second series indicate a great stability of DBS after long-term storage. CONCLUSION: This study demonstrates that DBSs collected under local conditions in resource-limited settings are suitable for the differed quantification of HIV-1 RNA. Language: English Keywords: CAMEROON | RESEARCH REPORT | LABORATORY PROCEDURES | PERSONS LIVING WITH HIV/AIDS | BLOOD | HIV | HIV TESTING | HEMATOLOGIC TESTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Hemic System | Physiology | Biology Document Number: 342882 |
| 6. Peer Reviewed Title: Herpes simplex virus type 2 antibody detection performance in Kisumu, Kenya, using the Herpeselect ELISA, Kalon ELISA, Western blot and inhibition testing. Author: Smith JS; Bailey RC; Westreich DJ; Maclean I; Agot K; Ndinya-Achola JO; Hogrefe W; Morrow RA; Moses S Source: Sexually Transmitted Infections. 2009 Apr;85(2):92-6. Abstract: BACKGROUND: In certain parts of Africa, type-specific herpes simplex virus type 2 (HSV-2) ELISAs may have limited specificity. To date, no study has been conducted to validate HerpeSelect and Kalon type-specific HSV-2 ELISAs using both the Western blot and recombinant gG ELISA inhibition testing as reference standards. METHODS: A total of 120 men who were HIV seronegative (aged 18-24 years) provided blood samples. HSV-2 IgG serum antibodies were detected using four different methods: HerpeSelect HSV-2 ELISA (n = 120), Kalon HSV-2 ELISA (n = 120), University of Washington Western blot (n = 101) and a recombinant inhibition test (n = 93). RESULTS: HSV-2 seroprevalence differed significantly by HSV-2 detection method, ranging from 24.8% with the Western blot to 69.8% with the HerpeSelect ELISA. Using the Western blot as the reference standard, the HerpesSelect had the highest sensitivity for HSV-2 antibody detection (100%) yet lowest specificity (40%). Similar results were obtained using the inhibition test as the reference standard. The sensitivity and specificity of the Kalon test versus the Western blot were 92% and 79%, respectively, and 80% and 82% versus the inhibition test. Using the inhibition test as the reference standard, the sensitivity of the Western blot appeared low (49%). CONCLUSIONS: In men in western Kenya who were HIV seronegative, the HerpeSelect and Kalon type-specific ELISAs had high sensitivities yet limited specificities using the Western blot as reference standard. Overall, the Kalon ELISA performed better than the HerpeSelect ELISA in these young men from Kisumu. Further understanding is needed for the interpretation of HSV-2 inhibition or ELISA test positive/ Western blot seronegative results. Before HSV-2 seropositivity may be reliably reported in selected areas of Africa, performance studies of HSV-2 serological assays in individual geographical areas are recommended. Language: English Keywords: KENYA | RESEARCH REPORT | COMPARATIVE STUDIES | YOUTH | MEN | HERPES GENITALIS | ANTIBODIES | HEMATOLOGIC TESTS | LABORATORY PROCEDURES | LABORATORY EXAMINATIONS AND DIAGNOSES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341910 |
| 7. Peer Reviewed Title: Evaluation of multiplex real-time PCR for detection of Haemophilus ducreyi, Treponema pallidum, herpes simplex virus type 1 and 2 in the diagnosis of genital ulcer disease in the Rakai District, Uganda. Author: Suntoke TR; Hardick A; Tobian AA; Mpoza B; Laeyendecker O; Serwadda D; Opendi P; Gaydos CA; Gray RH; Wawer MJ; Quinn TC; Reynolds SJ Source: Sexually Transmitted Infections. 2009 Apr;85(2):97-101. Abstract: OBJECTIVE: To develop a real-time PCR assay that reliably and accurately detects the predominant sexually transmitted aetiological agents of genital ulcer disease (GUD) (Haemophilus ducreyi, Treponema pallidum and herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2)) and to assess the use of real-time PCR diagnostic testing in a rural African field site. METHODS: Two multiplex real-time PCR reactions were used to detect H ducreyi/and HSV-1/HSV-2 in ulcer swabs from 100 people with symptomatic genital ulcers in rural Rakai, Uganda. Results were compared with syphilis, HSV-1 and HSV-2 serology. RESULTS: Of 100 GUD samples analysed from 43 HIV positive and 57 HIV negative individuals, 71% were positive for one or more sexually transmitted infection (STI) pathogens by real-time PCR (61% for HSV-2, 5% for T pallidum, 3% for HSV-1, 1% for H ducreyi and 1% for dual H ducreyi/HSV-2). The frequency of HSV in genital ulcers was 56% (32/57) in HIV negative individuals and 77% (33/43) in HIV positive individuals (p = 0.037). Assay reproducibility was evaluated by repeat PCR testing in the USA with 96% agreement (kappa = 0.85). CONCLUSIONS: STI pathogens were detected in the majority of GUD swab samples from symptomatic patients in Rakai, Uganda, by real-time PCR. HSV-2 was the predominant cause of genital ulcers. Real-time PCR technology can provide sensitive, rapid and reproducible evaluation of GUD aetiology in a resource-limited setting. Language: English Keywords: UGANDA | RURAL AREAS | RESEARCH REPORT | CLIENTS | CHANCROID | HERPES GENITALIS | SYPHILIS | LABORATORY EXAMINATIONS AND DIAGNOSES | GENITAL EFFECTS, FEMALE | GENITAL EFFECTS, MALE | HEMATOLOGIC TESTS | LABORATORY PROCEDURES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Program Activities | Programs | Organization and Administration | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Genitalia, Male Document Number: 341909 |
| 8. Peer Reviewed Title: Laboratory diagnosis of dual HIV-1/HIV-2 infection in Ghanaian patients. Author: Bonney EY; Sackey ST; Brandful JA Source: East African Medical Journal. 2008 Nov;85(11):537-43. Abstract: OBJECTIVE: To determine the true prevalence of HIV dual infections in a previously characterised HIV seropositive patient group due to inconsistencies between different diagnostic methods. DESIGN: A cross-sectional study of an HIV seropositive group with different diagnostic methods. SETTING: Three hospitals in the Northern, Ashanti and Greater Accra Regions of Ghana. SUBJECTS: One hundred and forty five HIV infected patients/individuals sampled from June to September 2002. MAIN OUTCOME MEASURES: Using serological and molecular methods, the seropositive status of HIV-infected patients, previously determined by a preliminary screening process, was confirmed and discrepancies noted. The data was used to propose a more accurate laboratory diagnosis of HIV dual infections involving HIV-1 and HIV-2. RESULTA: HIV-1 infections were mostly accurately detected, but difficulties were encountered in diagnosing HIV-2 infections. To achieve a positive detection on confirmatory immunoblots, antibody concentration in some samples tested was enhanced by using larger volumes. In other cases, diagnosis of HIV infections by PCR, especially HIV-2, was possible only after increasing the DNA template or MgCl2 concentrations. Such samples would otherwise have been inaccurately scored for HIV infections. CONCLUSION: Based on the results of this study, we propose that the accurate diagnosis of HIV dual infections, especially HIV-2 component, must use an algorithm that involves PCR. Our results however underscore conclusions of a previous study that most dually seroreactive samples are predominantly HIV-1 infections with crossreactivity to HIV-2 antigens. Language: English Keywords: GHANA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | LABORATORY EXAMINATIONS AND DIAGNOSES | HIV INFECTIONS | PREVALENCE | HEMATOLOGIC TESTS | HIV TESTING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Laboratory Procedures Document Number: 341329 |
9.  Title: Utility of blood DNA levels in diagnosis of breast cancer. Author: Nalini R; Silvia CR; Uthappa S Source: Journal of Cancer Research and Therapeutics. 2008 Apr-Jun;4(2):57-59. Abstract: Background: Prognostic factors, including both histopathological and biochemical variables, influence the choice of modality and the course of therapy in breast cancer. The biomarkers found in biological fluids, particularly in blood, apparently hold the best promise for the development of screening assays. Aim: To find out if any correlation exists between blood DNA level and tumor stage, size and grade. Materials and Methods: This case-control study was carried out on 52 female patients in the age-group of 18-70 years. The cases comprised 25 patients with histopathologically confirmed malignant breast cancer, while 27 patients with benign breast tumors served as the control group. Statistical Analysis: We used the Student's 't' test to compare the differences between the blood DNA levels in the two groups. Pearson's test was performed to find out the correlation between blood DNA levels and the TNM stage, tumor size and grade Results: It was observed that blood DNA levels showed statistically significant correlation with the TNM stage, tumor size and grade. Conclusion: The blood DNA level can be utilized as a noninvasive marker to assess tumor aggressiveness. Thus, it can be useful as a prognostic marker and as a marker of tumor burden. Language: English Keywords: INDIA | RESEARCH REPORT | STATISTICAL STUDIES | WOMEN | HEMATOLOGIC TESTS | BREAST CANCER | NEOPLASMS | LABORATORY EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Demographic Factors | Population | Laboratory Procedures | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cancer | Diseases Document Number: 329134 |
| 10. Title: Assessment of malaria in pregnancy using rapid diagnostic tests and its association with HIV infection and hematologic parameters in South-Eastern Nigeria. Author: Uneke CJ; Iyare FE; Oke P; Duhlinska DD Source: Haematologica. 2008 Jan;93(1):143-144. Abstract: P. falciparum malaria in pregnancy was evaluated using histidine-rich proteins-2 RDT and related to HIV infection and hematologic parameters. Prevalence of malaria, HIV and anemia were 19.7%, 3.1% and 17.2% respectively. Primigravidae were significantly more infected with malaria. Malaria was not significantly associated with anemia, blood group, genotype and HIV infection. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | LABORATORY EXAMINATIONS AND DIAGNOSES | PREGNANCY COMPLICATIONS | SEROCONVERSION | HEMATOLOGIC TESTS | HIV INFECTIONS | COMPLICATIONS | PREVALENCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Immunity | Immune System | Physiology | Biology | Laboratory Procedures | Viral Diseases | Measurement Document Number: 325619 |
| 11. Peer Reviewed Title: The effect of cigarette or sheesha smoking on first-trimester markers of Down syndrome. Author: Ardawi MS; Nasrat HA; Rouzi AA; Qari MH; Al-Qahtani MH Source: BJOG: An International Journal of Obstetrics and Gynaecology. 2007 Nov;114(11):1397-1401. Abstract: The objective was to investigate the influence of cigarette or sheesha smoking on first-trimester markers of Down syndrome. A prospective observational study was used to collect the data. The setting for the study was primary care centres and antenatal clinics of Maternity and Children Hospital, King Abdulaziz University Hospital and New Jeddah Clinic Hospital, Jeddah, Saudi Arabia. Women with a singleton pregnancy who were either nonsmokers (n = 1736) or cigarette smokers (n = 420) or sheesha smokers (n = 181) were studied. Fetal nuchal translucency thickness (fetal NT), maternal serum free beta-human chorionic gonadotrophin (free beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) were measured at 11 weeks 0 days to 13 weeks 6 days of gestation in all women. Women were grouped according to smoking status, confirmed by maternal serum cotinine measurements, and analyte levels between groups were compared. The main outcome measures were fetal NT, maternal serum free beta-hCG, PAPP-A and cotininemeasurements. Compared with nonsmoking women, fetal NT was significantly increased and free beta-hCG and PAPP-A levels were significantly decreased in both cigarette and sheesha smokers. There were significant relationships between all three markers and the number of sheeshas consumed per day. Cigarette and sheesha smoking significantly affect first-trimester markers of Down syndrome (fetal NT, free beta-hCG and PAPP-A). Correction for this effect in women who smoke might improve the effectiveness of first-trimester screening for Down syndrome in these women. The underlying mechanism(s) relating smoking to the changes in first-trimester markers require further studies. (author's) Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | PREGNANT WOMEN | TOBACCO USE | PROSPECTIVE STUDIES | PREGNANCY, FIRST TRIMESTER | MENTAL RETARDATION | HEMATOLOGIC TESTS | ULTRASONICS | Developing Countries | Middle East | Population Characteristics | Demographic Factors | Population | Behavior | Studies | Research Methodology | Pregnancy | Reproduction | Intelligence | Personality | Psychological Factors | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 321397 |
| 12. Title: Clinical value of lactate measurement and nucleated red blood cell counts in the placental segment of the umbilical vein of premature newborns for diagnosis of hypoxia-ischemia. Author: Gea Y; Araujo O; Silva LV Source: Jornal de Pediatria. 2007 Mar-Apr;83(2):186-190. Abstract: The objective was to evaluate the clinical value of lactate measurement and nucleated red blood cell (NRBC) counts when compared to base excess (BE) in the blood collected from the placental segment of the umbilical vein. 25 umbilical cords from premature babies were sampled after placental delivery and cord clamping. Babies were followed until discharge. Statistics involved linear regression, Spearman's correlation, ROC curves, and Fisher's exact test. The relationship between lactate in the umbilical vein blood and pH and BE was significant (p < 0.0001). A 4.04 mmol/L lactate level showed a sensitivity of 62.5% and a specificity of 94.1% in detecting pH < 7.2 and BE < -10 mmol/L. NRBC counts were related to BE (p = 0.0095), but with a sensitivity of 37.5% and specificity of 82.4% in detecting BE < -10 mmol/L. Lactate is a valuable marker of fetal hypoxia when sampled from placental segment veins. NRBC counts demonstrated low sensitivity for the detection of acidosis. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | INFANT, PREMATURE | FETAL MEMBRANES | BLOOD | EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | HEMATOLOGIC TESTS | CARBOXYLIC ACIDS | ISCHEMIA | MEASUREMENT | South America, Eastern | South America | Latin America | Americas | Developing Countries | Infant | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Fetus | Pregnancy | Reproduction | Hemic System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Organic Chemicals | Ingredients and Chemicals | Vascular Diseases | Diseases | Research Methodology Document Number: 319425 |
| 13. Title: Ionized magnesium and gestational age. Author: Mehta R; Petrova A Source: Indian Journal of Pediatrics. 2007 Nov;74(11):1025-1028. Abstract: Investigation of magnesium (Mg) homeostasis has re-emerged as an area of interest in preterm born neonates who are at risk for brain pathology. However, data regarding the association between the biologically active ionized form of Mg and gestational age (GA) at an early stage of life in newborn infants are controversial. We evaluated the total and ionized Mg electrolyte (TMg and IMg) as well as the calcium (TCa and ICa) and pH in the cord blood and on day 2 of life in 22 neonates born at different gestational ages (<32, 32-34, and >/=35 week) without magnesium tocolysis and absence of serious complications during pregnancy and delivery. The IMg fraction that accounted for 68.1+/-5.1% of the TMg in the cord blood and 67.9+/-4.5% of the TMg on day 2 of life, was significantly higher in very preterm infants (GA<32 week) as compared to neonates with GA >/=35 week. Higher IMg levels were correlated with the lower pH that was recorded in the cord blood of the very preterm infants (correlation coefficient, r=-0.80, p<0.0001) and ICa (r = -0.52, P<0.01). Lower pH also was correlated with the GA (P<0.0001). However, standard multiple regression analysis showed significant association between IMg levels and decreased pH but not the gestational age or ICa (beta=-1.10+/-0.21, p<0.00009). Extremely preterm infants even without additional exposure to tocolytic magnesium are at risk for the lower pH associated elevation of ionized Mg, which should be considered during the management of these infants in order to prevent hypermagnesemia-related pathology. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | PROSPECTIVE STUDIES | INFANT | GESTATIONAL AGE | PREMATURE BIRTH | FETAL TISSUE | HEMATOLOGIC TESTS | SERUM CALCIUM LEVEL | SERUM MAGNESIUM LEVEL | PREGNANCY COMPLICATIONS | Developed Countries | North America | Americas | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Fetus | Pregnancy | Reproduction | Pregnancy Outcomes | Fetal Membranes | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hemic System | Physiology | Biology | Diseases Document Number: 322630 |
| 14. Peer Reviewed Title: Haematogenous dissemination of tuberculous lymphadenitis. Author: Sharafeldin GS; Khalil EA; El Hag IA; Elsiddig KE; Elsafi ME Source: East African Medical Journal. 2007 Jan;84(1):3-7. Abstract: The objective was to determine whether Mycobacterium tuberculosis infection spreads through the blood to different lymph-node groups in patients with tuberculous lymphadenitis. The design used was a prospective analytical study. The patients were recruited, managed and followed at the lymphodenopathy clinic, Central Police Hospital, Burr, Khartoum, Sudan. Fifty two sequential patients were enrolled. Thirty patients with FNAC diagnosis of tuberculous lymphadenitis and positive PCR for M. tuberculosis complex had a mean age of 26.9 ± 11.2 years and similar male, female affection. Nine patients with FNAC tuberculous lymphadenitis, but negative PCR had a slightly higher mean age (32.6 ± 18.2 years) with similar male : female proportions. Patients with reactive lymphadenopathy (9/52) were older than patients with tuberculous lymphadenitis with a mean age of 45 ± 24.6 years. None of the patients were positive for HIV or had clinical or radiological evidence of pulmonary tuberculosis. M.tuberculosis DNA was detected in the blood samples of 30/39 (77%) patients with tuberculous lymphadenitis, but in none of the cases with reactive or malignant lymphadenopathy. The presence of M.tuberculosis DNA correlated strongly to multiple lymphnode involvement [OR (odds ratio) = 96.7, 95% confidence interval (CI) 9.0 - 1,039] and to caseating-granulomatous and predominantly necrotic cytomorphological categories [OR = 70, 95% confidence interval (CI) 7.0 - 703]. M.tuberculosis most probably disseminates through the blood from one node group to the other in patients with tuberculous lymphadenitis. (author's) Language: English Keywords: SUDAN | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | TUBERCULOSIS | HEMATOLOGIC TESTS | HEMATOLOGICAL EFFECTS | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Infections | Diseases | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hemic System | Physiology | Biology Document Number: 319297 |
| 15. Title: Effects of cotrimoxazole on hematologic parameters in HIV-infected adults in a community-based clinic in Entebbe, Uganda [letter] Author: Watera C; Todd J; Mutonyi G; Miiro G; Mpendo J Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2007 Nov;46(3):369-371. Abstract: We and others have previously reported reduced mortality and malaria incidence with cotrimoxazole prophylaxis for HIV-1-infected adults in Uganda and elsewhere. This evidence has led to widespread implementation of cotrimoxazole prophylaxis for HIV-1-infected persons in sub-Saharan Africa. The World Health Organization (WHO) recommends that implementation at the country level should be carefully monitored and that this monitoring should evaluate rates of toxicity, including hematologic toxicity, through the measurement of blood cell counts every 6 months. Cotrimoxazole interferes with folate metabolism, and there have been several reports of hematologic abnormalities associated with its use. These abnormalities could potentially worsen if cotrimoxazole is used in conjunction with myelosuppressive or antifolate drugs such as zidovudine. There is scanty evidence of these abnormalities associated with cotrimoxazole use in Uganda, however. Cotrimoxazole prophylaxis was introduced in August 2000 in an open cohort of HIV-1-infected participants in Entebbe,Uganda. Here, we report hematologic changes in participants before and after the introduction of cotrimoxazole. (excerpt) Language: English Keywords: UGANDA | CRITIQUE | PERSONS LIVING WITH HIV/AIDS | ADULTS | COMMUNITY-BASED DISTRIBUTION | CLINIC ACTIVITIES | MALARIA | ANTIRETROVIRAL DRUGS | MONITORING | TOXICITY | TREATMENT | SIDE EFFECTS | MEASUREMENT | ANEMIA | HEMATOLOGIC TESTS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Parasitic Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation | Physiology | Biology | Research Methodology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 321793 |
| 16. Title: Bacteriological profile of neonatal septicaemia in a tertiary hospital in Nigeria. Author: Iregbu KC; Elegba OY; Babaniyi IB Source: African Health Sciences. 2006 Sep;6(3):151-154. Abstract: Neonatal septicaemia is an important cause of morbidity and mortality. Knowledge of the bacteriological profile of the aetiologic agents is very important and helps to reduce the associated mortality in neonatal septicaemia. The objective was to determine the bacteriological profile of common aetiologic agents of neonatal septicaemia and their antibiotics sensitivity pattern. Method: This study was a retrospective review of all the 390 neonatal blood cultures carried out in the Department of Clinical Microbiology and Parasitology of the National Hospital Abuja, Nigeria over three years (Jan 2002 Dec 2004). The 390 neonatal samples constituted 25% of all blood samples received in the laboratory during the period under review. Twenty-two percent were positive for bacterial growth, yielding gram-negative bacilli (GNB) and grampositive cocci (GPC) in almost equal proportion, predominantly Klebsiella pneumoniae (86% of GNB) and Staphylococcus aureus (81% of GPC). Although the Klebsiella pneumoniae were multiply-resistant and showed resistance pattern suggestive of Extended-Spectrum Beta Lactamase (ELBS) production they were 100% sensitive to imipenem. The sensitivity of the Staphylococcus aureus isolates to amoxicillin-clavulanic acid, cefuroxime, ciprofloxacin, chloramphenicol and erythromycin were 89%, 85%, 75%, 71% and 64% respectively. A sustainable antibiotic susceptibility surveillance programme coupled with good infection control practices and rational antibiotics use will reduce infection rate, ensure better therapeutic success and prolong the efficacy of available antimicrobials. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | INFANT | BACTERIAL AND FUNGAL DISEASES | HEMATOLOGIC TESTS | HOSPITALS | ANTIBIOTICS | DRUG RESISTANCE | INFECTION PREVENTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Drugs | Treatment Document Number: 308143 |
| 17. Peer Reviewed Title: The added value of a CD4 count to identify patients eligible for highly active antiretroviral therapy among HIV-positive adults in Cambodia. Author: Lynen L; Thai S; De Munter P; Leang B; Sokkab A Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2006 Jul;42(3):322-324. Abstract: In a retrospective study of 648 persons with HIV infection in Cambodia, we determined the sensitivity, specificity, and accuracy of the 2003 World Health Organization (WHO) criteria to start antiretroviral treatment based on clinical criteria alone or based on a combination of clinical symptoms and the total lymphocyte count. As a reference test, we used the 2003 WHO criteria, including the CD4 count. The 2003 WHO clinical criteria had a sensitivity of 96%, a specificity of 57%, and an accuracy of 89% to identify patients who need highly active antiretroviral therapy (HAART). In our clinic, with a predominance of patients with advanced disease, the 2003 WHO clinical criteria alone was a good predictor of those needing HAART. A total lymphocyte count as an extra criterion did not improve the accuracy. Nine percent of patients were wrongly identified to be in need of HAART. Among them, almost 50% had a CD4 count of more than 500 cells/KL, and 73% had weight loss of more than 10% as a stage-defining condition. Our data suggest that, in settings with limited access to CD4 count testing, it might be useful to target this test to patients in WHO stage 3 whose staging is based on weight loss alone, to avoid unnecessary treatment. (author's) Language: English Keywords: CAMBODIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | ADULTS | ANTIRETROVIRAL THERAPY | AIDS PREVENTION | MONITORING | HEMATOLOGIC TESTS | LABORATORY PROCEDURES | WHO | Asia, Southeastern | Asia | Developing Countries | Studies | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | HIV | AIDS | Evaluation | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 302911 |
| 18. Peer Reviewed Title: Validation of primary CD4 gating as an affordable strategy for absolute CD4 counting in Cambodia. Author: Lynen L; Teav S; Vereecken C; De Munter P; An S Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2006 Oct 1;43(2):179-185. Abstract: The objective was to validate primary CD4 gating in lysed whole blood for absolute CD4 counts in fresh and aged blood using an affordable compact volumetric commercial flow cytometer. Comparison of CD4 counts between the FACSCount and the 2-parameter CyFlow SL Green. One hundred twenty fresh blood samples from patients likely to be infected with HIV were simultaneously run on a FACSCount at the Pasteur Institute of Cambodia and on a CyFlow SL Green at the Sihanouk Hospital Center of Hope (SHCH), Phnom Penh, Cambodia. Intra- and interrun precision was assessed using 2 blood samples. Stability of CD4 counting in blood stored up to 96 hours at room temperature was assessed using 27 blood samples. CD4 counts on the CyFlow SL Green and on the FACSCount correlated well apart from a relative bias (R/2 = 0.993, bias of -9.5%, 95% confidence interval [CI]: -11.8% to -7.1%, limits of agreement: -32.5% to 13.6%). Intra- and interrun variability ranged from 3% to 5% and from 5% to 6%, respectively. CD4 counts on aged blood using the CyFlow SL Green showed an interassay variability of < 10%. Primary CD4 gating in lysed whole blood using the CyFlow SL Green is an affordable and precise method for CD4 counting. Because the fluorescence (FL) and light scatter signals have to be analyzed manually, however, intensive training of the technician and/or operator is imperative. (author's) Language: English Keywords: CAMBODIA | RESEARCH REPORT | VALIDITY | COMPARATIVE STUDIES | HEMATOLOGIC TESTS | HIV | LABORATORY PROCEDURES | HIV TESTING | COST BENEFIT ANALYSIS | Developing Countries | Asia, Southeastern | Asia | Measurement | Research Methodology | Studies | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Quantitative Evaluation | Evaluation Document Number: 307629 |
| 19. Title: Foetal maternal haemorrhage detection with the Kleihauer technique for postnatal immunoglobulin dose evaluation in Sudan. Author: Ali MS; Amin AY; Gamal M; Abdulla N; Mohamed A Source: New Zealand Journal of Medical Laboratory. 2005 Apr;59(1):6-9. Abstract: Objective: The intent of this study was to evaluate the standard routine dose (500 IU) of Rh immune globulin (RHIG) therapy, which is offered routinely to all RhD-negative mothers delivering RhD-positive babies in Sudan. Methods: Blood samples from 140 pregnant women who were admitted for delivery to various Khartoum State hospitals were tested by the Kleihauer technique to determine the amount of fetomaternal haemorrhage (FMH) in the maternal circulation. Results: The results of the study demonstrated that the circulation of 10 out of 140 mothers (7.1%), tested by the Kleihauer method, contained more than 4ml of foetal blood. In addition, the association between foetal haemorrhage and mothers’ age, duration of pregnancy, baby weight, circumcision of the mother (cutting of the clitoris), type of delivery, and mothers’ gravida was statistically insignificant. Conclusions: The study concluded that 7.1% of mothers had a possibility of greater than 4ml of FMH. For these mothers, the standard RHIG dose of 500IU would be inadequate and they would need additional RHIG to prevent sensitization and potential harm to future babies. It is recommended to test all RhD-negative women delivering RhD-positive babies routinely with the Kleihauer method for detection and quantitation of FMH in order to determine the correct dose of RHIG to be administered. (author's) Language: English Keywords: SUDAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | FETUS | MATERNAL-FETAL EXCHANGE | HEMATOLOGIC TESTS | RH SENSITIZATION | LABORATORY EXAMINATIONS AND DIAGNOSES | BLOOD | PREGNANCY COMPLICATIONS | Africa, Northern | Africa | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Laboratory Procedures | Examinations and Diagnoses | Diseases | Hemic System | Physiology | Biology Document Number: 291058 |
| 20. Title: Development of a novel nutrition screening tool for use in elderly South Africans. Author: Charlton KE; Kolbe-Alexander TL; Nel JH Source: Public Health Nutrition. 2005 Aug;8(5):468-479. Abstract: The objective was to develop a nutrition screening tool for use in older South Africans. Design: A cross-sectional validation study in 283 free-living and institutionalised black South Africans (60+ years). Methods: Trained fieldworkers administered a 24-hour recall and the Mini Nutritional Assessment (MNA) screening tool, and performed anthropometric measurements and physical function tests. Cognitive function was assessed using a validated version of the Six-Item Cognitive Impairment Test. Biochemical indicators assessed included serum albumin, haemoglobin, ferritin, vitamin B/12, red-blood-cell folate, cholesterol and vitamin C. The MNA was used as the gold standard against which a novel screening tool was developed using a six-step systematic approach, namely: correspondence analysis; identification of key questions; determination of internal consistency; correlational analyses with objective measures; determination of reference cut-off values for categories of nutritional risk; and determination of sensitivity and specificity. The new screening tool includes nine separate concepts, comprising a total of 14 questions, as well as measurement of mid-upper arm circumference. The new tool score was positively associated with level of independence in either basic activities of daily living (r = 0.472) or the more complex instrumental activities of daily living (r = 0.233). A three-category scoring system of nutritional risk was developed and shown to significantly characterise subjects according to physical function tests, level of independence and cognitive function. The new tool has good sensitivity (87.5%) and specificity (95.0%) compared with the MNA scoring system. It has a very high negative predictive value (99.5%), which means that the tool is unlikely to falsely classify subjects as well nourished/at risk when they are in fact malnourished. A novel screening tool has been shown to have content-, construct- and criterion-related validity, and the individual items have been shown to have good internal consistency. Further validation of the tool in a new population of elderly Africans is warranted. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | KAP SURVEYS | EVALUATION INDEXES | OLDER ADULTS | SCREENING | NUTRITION PROGRAMS | ANTHROPOMETRY | INTELLIGENCE | HEMATOLOGIC TESTS | HEALTH STATUS INDEXES | PROGRAM EVALUATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Quantitative Evaluation | Evaluation | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Examinations and Diagnoses | Primary Health Care | Health Services | Delivery of Health Care | Health | Measurement | Personality | Psychological Factors | Behavior | Laboratory Procedures | Laboratory Examinations and Diagnoses | Programs | Organization and Administration Document Number: 291334 |
| 21. Peer Reviewed Title: Difference in susceptibility to malaria between two sympatric ethnic groups in Mali. [Différences de susceptibilité au paludisme chez deux groupes ethniques sympatriques au Mali] Author: Dolo A; Modiano D; Maiga B; Daou M; Dolo G Source: American Journal of Tropical Medicine and Hygiene. 2005;72(3):243-248. Abstract: We compared malaria indicators among sympatric groups to study human heterogeneities in the response to Plasmodium falciparum malaria infection. Four cross-sectional surveys and two longitudinal surveys in two sympatric ethnic groups (Dogon and Fulani) in Mali were carried out from 1998 to 2000. Spleen and parasite rates were evaluated during the cross-sectional surveys and disease incidence was assessed during longitudinal surveys. In spite of similar sociocultural factors and entomologic inoculation rates between ethnic groups, the Fulani had a significantly higher spleen enlargement rate, lower parasite rate, and were less affected by the disease than the Dogon group, whose frequency of hemoglobin C was higher than that recorded among the Fulani group. The Fulani group had significantly higher levels of IgG and IgE against crude malaria antigen than the Dogon group, suggesting a role of anti-malaria antibodies in the immune protection seen in this group. (author's) French Abstract: Nous avons comparé divers indicateurs de paludisme parmi des groupes sympatriques en vue d'étudier les différences de réaction entre les individus atteints de paludisme à Plasmodium falciparum. Quatre enquêtes transversales et deux enquêtes longitudinales ont été réalisées au sein de deux groupes ethniques sympatriques (les Dogon et les Fulani) au Mali, sur la période allant de 1998 à 2000. Les indices spléniques et plasmodiques ont été calculés dans le cadre des enquêtes transversales tandis que les études longitudinales ont permis de mesurer l'incidence de la maladie. En dépit de similarités entre les facteurs socioculturels et les taux d'inoculation entomologique chez les deux groupes inclus dans l'étude, les Fulani avaient un indice splénique nettement plus élevé et un indice plasmodique plus bas, et étaient touchés par la maladie de manière moins sévère que les membres du groupe Dogon, chez qui les anomalies d'hémoglobine de type C étaient plus fréquentes que celles relevées dans le groupe Fulani. Les Fulani avaient des taux d'immunoglobulines IgG et IgE anti-palustres nettement plus élevés que les Dogon, ce qui tendrait à démontrer une éventuelle présence d'anticorps anti-palustres favorisant la protection immunitaire du groupe Fulani. (de l'auteur) Language: English Keywords: MALI | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | LONGITUDINAL STUDIES | SURVEYS | ETHNIC GROUPS | AGE DISTRIBUTION | MALARIA | HEMATOLOGIC TESTS | IMMUNOLOGICAL EFFECTS | PARASITES | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Sampling Studies | Cultural Background | Population Characteristics | Demographic Factors | Population | Age Factors | Parasitic Diseases | Diseases | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Immunity | Immune System | Physiology | Biology Document Number: 282867 |
| 22. Peer Reviewed Title: Performance evaluation of automated depolarization analysis for detecting clinically unsuspected malaria in endemic countries. [Évaluation des performances de l'analyse automatisée de dépolarisation pour la détection du paludisme non suspecté cliniquement dans les pays endémiques] Author: Dromigny JA; Jambou R; Scott CS; Perrier-Gros-Claude JD Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2005;99:430-439. Abstract: This prospective study evaluated the efficiency of automated depolarization analysis for recognition of unsuspected malaria by haemozoin detection during routine full blood count (FBC) screening of 676 randomly selected out-patients in a malaria hypoendemic area of Senegal. An additional 123 patients with clinically suspected malaria were studied for comparison. Of the 799 samples, 648 (81.1%) were categorized as malaria-negative, 83 (10.4%) as malaria-positive, and 68 as treated (early convalescence) or subclinical malaria (indirect evidence of infection). At a discrimination level of one or more atypical pigment-containing monocytes (PCM), negative and positive agreement was found to be 95.6% and 91.6% respectively for all malaria-negative and parasite-positive samples combined. Increasing the discriminator to two or more PCM events improved the overall agreement to 97.5%. Multivariate analysis showed that the only significant risk factor for the presence of PCM (odds ratio > 200) was malaria infection. In the randomly selected group of 676 patients, 41 unsuspected cases of malaria infection were detected using the panel of reference diagnostic tests, and 37 (90.2%) of these had atypical PCM. The detection of clinically unrecognized malaria infection as part of a routine FBC procedure is a potentially useful extended application for laboratories in countries with endemic malaria. (author's) French Abstract: Cette étude prospective a évalué l'efficacité de l 'analyse automatisée de dépolarisation dans la reconnaissance de paludisme non suspecté par détection de l' hémozoïne lors d'un dépistage systématique par numération globulaire complè te (NGC) chez 676 patients extérieurs sélectionnés au hasard dans une région à paludisme hypoendémique du Sé négal. En outre, 123 autres patients cliniquement suspecté s comme paludéens ont été étudiés à fins de comparaison. Parmi ces 799 individus, 648 (81,1 %) avaient été catégorisés comme paludéens-négatifs, 83 (10,4 %) comme paludéens-positifs et 68 comme traités (convalescence rapide) ou comme paludé ens infracliniques (évidence indirecte d'infection). À un niveau de discrimination de un ou plusieurs monocytes pigmentés (MP) atypiques, les accords négatif et positif ont été trouvés ê tre 95,6 % et 91,6 % respectivement pour tous les individus paludéens-négatifs et parasite-positifs combinés. Une augmentation du discriminant à deux événements MP ou plus a amélioré l'accord global à 97,5 %. Une analyse multivariée a démontré que le seul facteur de risque significattif pour la présence de MP (chances > 200) était l'infection paludéenne. Dans le groupe de 676 patients sé lectionnés au hasard, 41 cas non suspectés d'infection paludéenne ont été détecté s par le panneau de tests de diagnostic de référence et 37 (90,2 %) parmi ceux-ci avaient un MP atypique. La détection d' une infection paludéenne non reconnue cliniquement par l'intermédiaire d'une procédure NGC systé matique est une application étendue potentiellement utile pour les laboratoires des pays à paludisme endémique. (synthèse de l'auteur) Language: English Keywords: SENEGAL | RESEARCH REPORT | EVALUATION | PROSPECTIVE STUDIES | STATISTICAL REGRESSION | CLIENTS | MALARIA | LABORATORY EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | HEMATOLOGIC TESTS | SIGNS AND SYMPTOMS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Data Analysis | Program Activities | Programs | Organization and Administration | Parasitic Diseases | Diseases | Examinations and Diagnoses Document Number: 286610 |
| 23. Title: Iron deficient children and significance of serum ferritin. Author: Khan AS; Shah SA Source: JPMA. Journal of the Pakistan Medical Association. 2005 Oct;55(10):[7] p.. Abstract: Iron deficiency anaemia, the most commonly recognized form of nutritional deficiency, is prevalent among infants and young children as hypochromic microcytic anaemia. Despite several laboratory procedures available for its detection, mild iron deficiency is frequently undetected by haemoglobin or haematocrit method. Ferritin is the second most important intracellular iron storage protein found in reticuloendothelial system. It functions not only as an intermediate protein during haemoglobin synthesis but also as a storage protein for iron released during haemoglobin denaturation. The levels found in sera of patients with iron deficiency anaemia suggest that the serum concentration of ferritin closely reflect the size of iron stores. Serum ferritin has shown a greater sensitivity and predictive value in subjects with uncomplicated anaemia and without anaemia. The measurement of ferritin, in addition to being a confirmatory test has particular characteristics of being the only test able to identify risk subjects before they become symptomatic. Serum ferritin is the most accurate test indicating iron status within normal range as well as iron deficiency and excess. In a young growing child, who has got a very delicate balance between iron stores, requirement and supply, it is very essential to diagnose iron deficiency at a stage before it results in hypochromic microcytic anaemia. The objective of this study is to evaluate the significance of serum ferritin in iron deficiency anaemia as compared to other indices. (excerpt) Language: English Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CHILDREN | ANEMIA | SERUM IRON LEVEL | AGE FACTORS | HEMOGLOBIN LEVEL | HEMATOLOGIC TESTS | Developing Countries | Asia, Southern | Asia | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Diseases | Hemic System | Physiology | Biology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 291313 |
| 24. Peer Reviewed Title: Pregnancy outcome for Rh-alloimmunized women. [Resultados de embarazos para mujeres Rh aloinmunizadas] Author: Nardozza LM; Camano L; Moron AF; da Silva Pares DB; Chinen PA Source: International Journal of Gynecology and Obstetrics. 2005 Aug;90(2):103-106. Abstract: The objective was to compare perinatal results of Rh-alloimmunized pregnancies managed with spectrophotometric amniotic fluid analysis or fetal middle cerebral artery Doppler ultrasonographic velocimetry. A descriptive observational study involving 291 consecutive Rh-negative pregnancies. Group 1 consisted of 74 isoimmunized women managed with amniotic fluid spectrophotometry; group 2 of 25 isoimmunized women managed with Doppler ultrasonography; and group 3 of 192 nonimmunized Rh-negative women. The variables analyzed were need for intrauterine or neonatal transfusion, mode and time of delivery, birth weight, neonatal hematocrit, and perinatal mortality. Need for intrauterine transfusion, birth weight, prematurity, rate of cesarean section, and perinatal mortality were similar in groups 1 and 2. Neonatal hematocrit was significantly lower and the need for neonatal transfusion was significantly higher when spectrophotometry rather than Doppler ultrasonographic velocimetry was used. Fetuses managed with Doppler ultrasonographic velocimetry had a higher hematocrit at birth and a lesser need for neonatal transfusion, suggesting that this noninvasive method of monitoring fetal anemia is a better choice. (author's) Spanish Abstract: El objetivo fue comparar los resultados perinatales de los embarazos Rh-aloinmunizados manejados con análisis del líquido amniótico por espectrofotometría o velocimetría doppler de la arteria cerebral media. Se realizó un estudio observacional descriptivo que incluyó 291 embarazos consecutivos Rh negativos. El grupo 1 estaba compuesto por 74 mujeres isoinmunizadas controladas con espectrofotometría del líquido amniótico; el grupo 2, por 25 mujeres isoinmunizadas estudiadas con velocimetría doppler y el grupo 3, por 192 mujeres Rh negativas no inmunizadas. Las variables analizadas fueron necesidad de transfusión intrauterina o neonatal, modalidad y momento del parto, peso al nacer, valor del hematocrito neonatal y mortalidad perinatal. La necesidad de transfusiones intrauterinas, el peso al nacer, el parto prematuro, el índice de cesáreas y la mortalidad perinatal fueron similares en los grupos 1 y 2. El hematocrito neonatal fue significativamente más bajo y la necesidad de transfusión neonatal fue significativamente más alta cuando se utilizó espectrofotometría en vez de velocimetría doppler. Los fetos estudiados con velocimetría doppler tuvieron más hematocritos al nacer y menos necesidad de transfusiones neonatales, lo que sugiere que este método no invasivo es una mejor opción para controlar la anemia fetal. (del autor) Language: English Keywords: BRAZIL | RESEARCH REPORT | FETUS | PREGNANT WOMEN | PREGNANCY OUTCOMES | HEMATOLOGIC TESTS | ANEMIA | HEMATOCRIT | FETAL MEMBRANES | Developing Countries | South America, Eastern | South America | Latin America | Americas | Pregnancy | Reproduction | Population Characteristics | Demographic Factors | Population | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Diseases Document Number: 288851 |
| 25. Peer Reviewed Title: A microchip CD4 counting method for HIV monitoring in resource-poor settings. Author: Rodriguez WR; Christodoulides N; Floriano PN; Graham S; Mohanty S Source: PLoS Medicine. 2005 Jul;2(7):e182. Abstract: More than 35 million people in developing countries are living with HIV infection. An enormous global effort is now underway to bring antiretroviral treatment to at least 3 million of those infected. While drug prices have dropped considerably, the cost and technical complexity of laboratory tests essential for the management of HIV disease, such as CD4 cell counts, remain prohibitive. New, simple, and affordable methods for measuring CD4 cells that can be implemented in resource-scarce settings are urgently needed. Here we describe the development of a prototype for a simple, rapid, and affordable method for counting CD4 lymphocytes. Microliter volumes of blood without further sample preparation are stained with fluorescent antibodies, captured on a membrane within a miniaturized flow cell and imaged through microscope optics with the type of charge-coupled device developed for digital camera technology. An associated computer algorithm converts the raw digital image into absolute CD4 counts and CD4 percentages in real time. The accuracy of this prototype system was validated through testing in the United States and Botswana, and showed close agreement with standard flow cytometry (r = 0.95) over a range of absolute CD4 counts, and the ability to discriminate clinically relevant CD4 count thresholds with high sensitivity and specificity. Advances in the adaptation of new technologies to biomedical detection systems, such as the one described here, promise to make complex diagnostics for HIV and other infectious diseases a practical global reality. (author's) Language: English Keywords: UNITED STATES OF AMERICA | BOTSWANA | RESEARCH REPORT | RESEARCH ACTIVITIES | LOW INCOME POPULATION | PERSONS LIVING WITH HIV/AIDS | LABORATORY EXAMINATIONS AND DIAGNOSES | ANTIRETROVIRAL THERAPY | LABORATORY PROCEDURES | HEMATOLOGIC TESTS | North America | Americas | Developed Countries | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Document Number: 307959 |
| 26. Peer Reviewed Title: Efficacies of chloroquine, sulfadoxine-pyrimethamine and quinine in the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan. Author: Adam I; Osman ME; Elghazali G; Ahmed GI; Gustafssons LL Source: Annals of Tropical Medicine and Parasitology. 2004;98(7):661-666. Abstract: The efficacies of several antimalarial drugs in the treatment of uncomplicated Plasmodium falciparum malaria were compared, during an open, randomized trial, in New Halfa, eastern Sudan. The 96 patients who completed the 28 days of follow-up were treated with chloroquine (N=26), sulfadoxine–pyrimethamine (N=38) or quinine (N=32). No treatment failures were observed among the patients given sulfadoxine–pyrimethamine. Only 23.1% of the patients given chloroquine showed adequate clinical response, however, the rest showing early (15.4%) or, more frequently, late (61.5%) treatment failure. In terms of parasitological failure, 54.1% of the patients given chloroquine showed early RI resistance, 7.7% showed late RI, and 15.1% showed RIII. Most (90.6%) of the patients treated with quinine had adequate treatment responses, the rest having late treatment failures (and late RI). The frequency of treatment failure was significantly higher, however, among the patients given chloroquine than in the quinine-treatment arm. The present results and those of earlier investigations indicate that the problem of chloroquine resistance is worsening in eastern Sudan, and that the use of chloroquine as the first-line drug for the treatment of uncomplicated malaria in this area is now compromised. The response to quinine may also be faltering. (author's) Language: English Keywords: SUDAN | RESEARCH REPORT | QUESTIONNAIRES | CLIENTS | HEMATOLOGIC TESTS | MALARIA PREVENTION | DRUGS | TREATMENT | DRUG RESISTANCE | CONTRACEPTIVE USE-EFFECTIVENESS | Africa, North | Africa | Developing Countries | Program Activities | Programs | Organization and Administration | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Malaria | Parasitic Diseases | Diseases | Contraceptive Effectiveness | Contraception | Family Planning Document Number: 276448 |
| 27. Peer Reviewed Title: Blood lead levels in Egyptian children: influence of social and environmental factors. Author: Boseila SA; Gabr AA; Hakim IA Source: American Journal of Public Health. 2004 Jan;94(1):47-49. Abstract: The wide spectrum of damage to the health of children from environmental lead (Pb) is a matter of global concern. The neurotoxicity of long-term low-level exposure to lead has a special relevance in children.1,2 Although the consumption of paint chips or proximity to a lead-emitting smelter has been associated with PbB (blood lead) levels>40 µg/dL, these 2 factors are not considered contributors to moderately elevated levels (>10 µg/ dL). Therefore, activities that contribute to lower levels of Pb exposure should be identified. The aim of this pilot study was to establish the social variables predictive of higher lead levels in young Egyptian children. (excerpt) Language: English Keywords: EGYPT | RESEARCH REPORT | SAMPLING STUDIES | PILOT PROJECTS | CHILD HEALTH | LEAD | EXPOSURE | HEMATOLOGIC TESTS | SOCIOECONOMIC FACTORS | ENVIRONMENT | TOXICITY | Africa, North | Africa | Developing Countries | Studies | Research Methodology | Health | Metals | Vitamins and Minerals | Physiology | Biology | Risk Factors | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Economic Factors Document Number: 189991 |
| 28. Title: Plasma concentrations of asymmetric dimethylarginine (ADMA) in Colombian women with pre-eclampsia [letter] [Concentraciones plasmáticas de dimetilarginina asimétrica (ADMA, asymmetric dimethylarginine) en mujeres colombianas con preeclampsia [carta]] Author: Maas R; Bõger RH; Schwedhelm E; Casas JP; Serrano N Source: JAMA. Journal of the American Medical Association. 2004 Feb 18;291(7):823-824. Abstract: To assess plasma ADMA concentration in pregnant women living in a high-risk are for pre-eclampsia, we sequentially enrolled, from November 2000 until February 2002, 160 women (67 women with pre-eclampsia [49 moderate and 19 severe cases] and 93 healthy pregnant controls)(Table 1) presenting in 4 Colombian study centers in a case-control study. All women were primigravid and younger than 25 years. Inclusion criteria for the pre-eclampsia group were: more than 20 weeks of gestation, blood pressure of 140/90 mm Hg or higher in 2 separate measurements, and proteinuria(>/=0.3g in 24 hours or a urine dipstick reading of >/=2+ for protein with no evidence for urinary tract infection). Controls were clinically healthy women with onset of labor at 37 or more weeks of gestation. None of the controls had hypertension or proteinuria at the onset of labor. Ethnicity (as determined by a validated questionnaire) and exclusion criteria for both groups (history of renal, cardiac, metabolic [diabetic], or autoimmune disease) were assessed by the enrolling physicians. The study was approved by the ethics committee of the Universidad Autonóma de Bucaramanga, Colombia, and all women enrolled provided written informed consent. Plasma concentrations of ADMA, symmetric dimethlylarginine, and L-arginine were measured blinded (within-assay and between-assay variations for ADMA, 1.7% and 2.5%, respectively; limit of detection, 0.004 µmol/L) by minor modifications of established method. Our sample size had a greater than 93% power to detect a 40% difference in plasma ADMA concentrations, with P<.05 (2-sided) used to determine statistical significance. (author's) Spanish Abstract: Para este estudio de casos se reclutaron secuencialmente 160 mujeres (67 mujeres con preeclampsia [49 casos moderados y 19 graves] y 93 embarazadas sanas como control) (Tabla 1), desde noviembre de 2000 hasta febrero de 2002, que asistieron a 4 centros de estudio colombianos con el propósito de estudiar la concentración plasmática de la dimetilarginina asimétrica en las embarazadas que viven en una zona de alto riesgo de preeclampsia. Todas las mujeres eran primigrávidas y menores de 25 años. Los criterios de inclusión para el grupo con preeclampsia fueron: más de 20 semanas de gestación, presión arterial de 140/90 mm Hg o superior en dos mediciones independientes, y proteinuria(>/=0.3g en 24 horas o una lectura en tira reactiva para orina>/=2+ para proteína sin evidencia de infección del tracto urinario). Los controles eran embarazadas sanas con inicio de trabajo de parto a las 37 semanas o más de gestación. Los controles no tenían hipertensión ni proteinuria al iniciar el trabajo de parto. Los médicos a cargo del reclutamiento analizaron el origen étnico (determinado por un cuestionario validado) y los criterios de exclusión para ambos grupos (antecedentes de enfermedad renal, cardiaca, metabólica [diabetes] o autoinmune). El estudio contó con la aprobación del comité de ética de la Universidad Autónoma de Bucaramanga, Colombia, y todas las participantes presentaron una autorización por escrito. Se realizaron mediciones ciegas de las concentraciones plasmáticas de la dimetilarginina asimétrica, simétrica y L-arginina (las variaciones inter e intra estudios clínicos para la dimetilarginina asimétrica fueron del 1,7% y 2,5%, respectivamente; el límite de detección fue 0,004 µmol/L) mediante modificaciones menores del método establecido. El tamaño de la muestra utilizada presentó una potencia superior al 93% para detectar una diferencia del 40% en las concentraciones de dimetilarginina asimétrica, con una P<.05 ((de dos colas) que se usó para determinar la significancia estadística. (del autor) Language: English Keywords: COLOMBIA | RESEARCH REPORT | CASE CONTROL STUDIES | PREGNANT WOMEN | PREECLAMPSIA | SIGNS AND SYMPTOMS | HEMATOLOGIC TESTS | LABORATORY EXAMINATIONS AND DIAGNOSES | South America, Northern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Laboratory Procedures | Examinations and Diagnoses Document Number: 186583 |
| 29. Title: Use of combined measures from capillary blood to assess iron deficiency in rural Kenyan children. Author: Shell-Duncan B; McDade T Source: Journal of Nutrition. 2004 Feb;134:384-387. Abstract: Community-based surveys of iron deficiency (ID) require simple, accurate methods that can be used in remote areas. The objective of this study was to assess iron status in rural Kenya using “field-friendly” methods for capillary blood, including an improved dried blood spot assay for transferrin receptor (TfR). A single finger stick was used to obtain capillary blood from 275 school-age children. Whole blood was applied directly to filter paper, dried, and later analyzed for TfR, as well as C-reactive protein (CRP), an acute-phase protein that serves as a general marker of in- flammation. Capillary blood was also used to measure hemoglobin (Hb) concentration and the ratio of zinc protoporphyrin to heme (ZPP:H). The Hb concentration alone provides the lowest estimate of the prevalence of ID (8.0%). Because ZPP:H is reported to be elevated in the presence of inflammation, we constructed a preliminary diagnostic model based on elevated ZPP:H and normal CRP level, estimating the prevalence of ID at 25.9%. When TfR is added to a multiple criteria model (elevated ZPP:H in the absence of elevated CRP and/or elevated TfR level) the prevalence of ID is estimated to be 31.2%. This study demonstrates the diagnostic utility of combining TfR with other indexes of iron status, enabling the detection of ID in both the presence and absence of infection. Furthermore, this study is the first field application of TfR blood-spot methods, and it demonstrates their feasibility in remote field settings. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | SAMPLING STUDIES | CHILD | RURAL POPULATION | IRON | DEFICIENCY DISEASES | HEMATOLOGIC TESTS | HEMOGLOBIN LEVEL | ANEMIA | ZINC | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Diseases | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Hemic System Document Number: 190285 |
| 30. Peer Reviewed Title: Serum medroxyprogesterone acetate levels in new and repeat users of depot medroxyprogesterone acetate at the end of the dosing interval. Author: Smit J; Botha J; McFadyen L; Beksinska M Source: Contraception. 2004 Jan;69(1):3-7. Abstract: In the absence of published data on serum medroxyprogesterone acetate (MPA) levels in South African users, this study examines such levels in new and repeat users of depot medroxyprogesterone acetate at the end of the dosing interval. The study was undertaken at three family-planning clinics in Durban, South Africa. Serum MPA levels were measured in 94 Black African, Indian and White women returning between 11 and 14 weeks after their last injection. The median serum MPA level was 0.88 (range, <0.04 –1.77) ng/mL and wide interindividual variability was observed. Levels in all but one woman were higher than 0.1 ng/mL, the level at which ovulation is reported to resume. MPA levels were not found to vary according to weight, body mass index or ethnicity. Although there was a slight tendency towards higher MPA levels with longer duration of use (r = 0.13), the wide interindividual variability precluded the possibility of determining whether this was a real trend. A prospective study, using standardized assay techniques and following individual women, is required to further clarify this issue. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CONTRACEPTION RESEARCH | WOMEN | INJECTABLES | MEDROXYPROGESTERONE ACETATE | HEMATOLOGIC TESTS | CONTRACEPTIVE EFFECTIVENESS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Contraception | Family Planning | Demographic Factors | Population | Contraceptive Methods | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | |