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Peer Reviewed

Title: ACOG Committee Opinion No. 434: induced abortion and breast cancer risk.
Author: Committee on Gynecologic Practice
Source: Obstetrics and Gynecology. 2009 Jun;113(6):1417-8.
Abstract: The Relationship between induced abortion and the subsequent development of breast cancer has been the subject of a substantial amount of epidemiologic study. Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.
Language: English
Keywords:
GLOBAL | CRITIQUE | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | ABORTION | BREAST CANCER | RISK FACTORS | EPIDEMIOLOGY | BIAS | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Cancer | Neoplasms | Diseases | Health | Public Health | Error Sources | Measurement
Document Number: 341807 Notification

Title: [Global Burden of Diseases, Injuries and Risk Factors Study] operations manual. Final draft.
Author: Harvard University; University of Washington. Institute for Health Metrics and Evaluation; Johns Hopkins University; University of Queensland; World Health Organization [WHO]
Source: [Cambridge, Massachusetts, Harvard University, 2009 Jan 20 142 p.
Abstract: The final draft of the Global Burden of Diseases, Injuries and Risk Factors Study Operations Manual is intended to serve as a guide for the Expert Groups working on the GBD Study. There are opportunities to provide input and feedback, and instructions to do so are included in the operations manual. The new Global Burden of Diseases, Injuries, and Risk Factors Study (the GBD 2005 Study), which commenced in the spring of 2007, is led by a consortium including Harvard University, the Institute for Health Metrics and Evaluation at the University of Washington, Johns Hopkins University, the University of Queensland, and the World Health Organization WHO). It is the first major effort since the GBD 1990 Study to carry out a complete systematic assessment of the data on all diseases and injuries, and produce comprehensive and comparable estimates of the burden of diseases, injuries and risk factors for two time periods, 1990 and 2005. By November 2010 the project will produce a final set of estimates. (Excerpts)
Language: English
Keywords:
GLOBAL | MANUAL | DATA ANALYSIS | ESTIMATION TECHNIQUES | DISABLED PERSONS AND DISABILITIES | DISEASES | ACCIDENTS AND INJURIES | MORTALITY | RISK FACTORS | EPIDEMIOLOGY | INCIDENCE | PREVALENCE | RISK ASSESSMENT | BIAS | Research Methodology | Population Characteristics | Demographic Factors | Population | Health | Population Dynamics | Public Health | Measurement | Evaluation | Error Sources
Document Number: 331797

Title: Risk factors associated with low CD4+ lymphocyte count among HIV-positive pregnant women in Nigeria.
Author: Abimiku A; Villalba-Diebold P; Dadik J; Okolo F; Mang E; Charurat M
Source: International Journal of Gynaecology and Obstetrics. 2009 May 20;
Abstract: OBJECTIVE: To determine the risk factors for CD4+ lymphocyte counts of 200 cells/mm(3) or lower in HIV-positive pregnant women in Nigeria. METHOD: A cross-sectional data analysis from a prospective cohort of 515 HIV-positive women attending a prenatal clinic. Risk of a low CD4+ count was estimated using logistic regression analysis. RESULTS: CD4+ lymphocyte counts of 200 cells/mm(3) or lower (280+/-182 cells/mm(3)) were recorded in 187 (36.3%) out of 515 HIV-positive pregnant women included in the study. Low CD4+ count was associated with older age (adjusted odds ratio [aOR] 10.71; 95% confidence interval [CI], 1.20-95.53), lack of condom use (aOR, 5.16; 95% CI, 1.12-23.8), history of genital ulcers (aOR, 1.78; 95% CI, 1.12-2.82), and history of vaginal discharge (aOR; 1.62; 1.06-2.48). CONCLUSIONS: Over 35% of the HIV-positive pregnant women had low CD4+ counts, indicating the need for treatment. The findings underscore the need to integrate prevention of mother-to-child transmission with HIV treatment and care, particularly services for sexually transmitted infections.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREGNANT WOMEN | HEMATOLOGICAL EFFECTS | RISK FACTORS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Hemic System | Physiology | Biology | Health | Disease Transmission Control | Prevention and Control | Risk Reduction Behavior | Behavior | Reproductive Tract Infections | Infections
Document Number: 341452

Title: Compensation for the brain drain from developing countries [editorial]
Author: Agwu K; Llewelyn M
Source: Lancet. 2009 May 16;373(9676):1665-6.
Abstract: This article examines the consequences and roots of health-worker migration from Sub-Saharan Africa to the developed world, especially to UK, USA and Canada. It explores the results of the major transfer of riches from poor societies to the affluent and discusses a compensation proposal for global justice.
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | HEALTH PERSONNEL | BRAIN DRAIN | RISK FACTORS | MATERNAL MORTALITY | INFANT MORTALITY | EMPLOYMENT | IMPACT | Delivery of Health Care | Health | International Migration | Migration | Population Dynamics | Demographic Factors | Population | Mortality | Macroeconomic Factors | Economic Factors | Communication
Document Number: 341604

Title: Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India.
Author: Ahmad A; Khan AU
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2009 May;144(1):68-71.
Abstract: OBJECTIVES: The objectives were to determine the frequency of Candida species in women of different age groups as well as to suggest the criteria for the diagnosis of vulvovaginal candidiasis (VVC). STUDY DESIGN: A prospective study of vulvovaginal candidiasis was carried out using laboratory diagnosis, with the estimation of vaginal pH and the direct microscopic and biochemical examination of vaginal discharge/secretions. Vaginal cultures for Candida species were collected from 1050 women with vulvovaginal symptoms. RESULTS: Out of 1050 women, 215 (20.47%) were positive for Candida species. Of 215 women, 172 (80%) had pH within the normal range and 167 (77.67%) were showing yeast cells and mycelia on direct microscopic examination. Candida albicans accounted for 46.9% of cases, Candida glabrata 36.7%, Candida parapsilosis 10.2%, Candida tropicalis 2.8%, Candida krusei 1.4%, and Candida kiefer 1.9%. The frequency of culture positivity was related to pregnancy (P<0.001), an increase in parity (P<0.001), and use of oral contraceptives (P<0.001) and antibiotics (P<0.001). The most common signs and symptoms in 215 women with positive cultures were pruritus with or without vaginal discharge and vaginal erythema. CONCLUSION: Our study suggests that vulvovaginal candidiasis can only be diagnosed by using clinical criteria in correlation with vulvovaginal symptoms and Candida cultures.
Language: English
Keywords:
INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | CANDIDIASIS | RISK FACTORS | PREVALENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | PRURITUS | VAGINITIS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Bacterial and Fungal Diseases | Infections | Diseases | Health | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Dermatitis | Vaginal Abnormalities
Document Number: 342002

8.
Title: An assessment of the knowledge, attitudes, and risk perceptions of pharmacy students regarding HIV/AIDS.
Author: Ahmed SI; Hassali MA; Aziz NA
Source: American Journal of Pharmaceutical Education. 2009 Feb 19;73(1):15.
Abstract: OBJECTIVE: To evaluate the level of knowledge, attitudes, and risk perceptions of University Sains Malaysia final-year pharmacy students regarding human immunodeficiency virus (HIV) and acquired immunity deficiency syndrome (AIDS). METHOD: A cross-sectional study among pharmacy students. Data were analyzed with Chi-square to find difference at p value < 0.05. RESULTS: The majority of students (83.07%) responded showing a difference in gender and race. Students showed low willingness (9.2%) to assist patients and low confidence (36.1%) in their education about HIV/AIDS patients. Students recommended HIV testing for health care professionals (69.4%) and patients (75.9%) before surgical procedures. Students knew little about Post Exposure Prophylaxis (18.5%) or about the time for HIV to develop into AIDS (57.4%). About 40% of students were unaware of the inability of antivirals to treat HIV/AIDS. Students had low awareness for opportunistic infections (18.5%), and low agreement on competency to treat and counsel HIV patients (12.9%). CONCLUSION: The study highlighted students' misconceptions, negative attitudes, and risk perceptions towards HIV/AIDS.
Language: English
Keywords:
MALAYSIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | STUDENTS | PHARMACISTS | UNIVERSITIES | KNOWLEDGE | ATTITUDES | RISK FACTORS | PERCEPTION | HIV INFECTIONS | AIDS | TREATMENT | EXPOSURE | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Education | Health Personnel | Delivery of Health Care | Health | Schools | Sociocultural Factors | Psychological Factors | Behavior | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services
Document Number: 342691

Peer Reviewed

Title: Socioeconomic and environmental factors important for acquiring non-severe malaria in children in Yemen: a case-control study.
Author: Al-Taiar A; Assabri A; Al-Habori M; Azazy A; Algabri A; Alganadi M; Whitty CJ; Jaffar S
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jan;103(1):72-8.
Abstract: Little is known about the relative importance of environmental and socioeconomic factors for acquiring malaria in Yemen. A case-control study was conducted to determine the importance of these factors for acquiring malaria among children in Yemen. Cases of non-severe malaria were recruited from health centres; community controls were from the neighbourhood of the cases. Data were collected by personal interview and direct inspection during home visits. In total, 320 cases and 308 controls were recruited. In the multivariate analysis, environmental factors (living near streams and freshwater marshes), earth roofs of houses and history of travel were all significantly and positively associated with the occurrence of malaria, whilst regular spraying with insecticides at home was a protective factor. There was no association with socioeconomic factors, including crowding, education and occupation of parents, and ownership of house assets. An index created based on a number of indicators of wealth showed a significant association with malaria in the univariate analysis but was not significant in the multivariate analysis. Control activities can be targeted on identifiable environmental factors such as stream and freshwater marshes, although this needs further investigation. Extra protective measures may be needed by all those who travel in Yemen.
Language: English
Keywords:
YEMEN | MIDDLE EAST | RESEARCH REPORT | CASE STUDIES | CHILDREN | MALARIA | SOCIOECONOMIC FACTORS | RISK FACTORS | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Economic Factors | Health
Document Number: 330835

10.

Peer Reviewed

Title: HIV prevalence and associated risk factors among individuals aged 13-34 years in rural western Kenya.
Author: Amornkul PN; Vandenhoudt H; Nasokho P; Odhiambo F; Mwaengo D
Source: Plos One. 2009 Jul;4(7):e6470.
Abstract: From a demographic surveillance system, the authors selected a random sample of Asembo, Kenya residents ages 13�34 years, who were contacted at home and invited to a nearby mobile study site. From October 2003 to April 2004, consenting participants were interviewed on risk behavior and tested for HIV and HSV-2. HIV voluntary counseling and testing was offered. Of 2,606 eligible residents, 1,822 (70%) enrolled. Primary reasons for refusal included not wanting blood taken, not wanting to learn HIV status, and partner or parental objection. Females comprised 53% of 1,762 participants providing blood. Adjusted HIV prevalence was 15.4% overall: 20.5% among females and 10.2% among males. HIV prevalence was highest in women ages 25-29 years (36.5%) and men ages 30-34 years (41.1%). HSV-2 prevalence was 40.0% overall: 53% among females, 25.8% among males. In multivariate models stratified by gender and marital status, HIV infection was strongly associated with age, higher number of sex partners, widowhood, and HSV-2 seropositivity.
Language: English
Keywords:
KENYA | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | HIV INFECTIONS | HERPES GENITALIS | PREVALENCE | RISK FACTORS | AGE FACTORS | SEX FACTORS | MIGRATION | VOLUNTARY COUNSELING AND TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement | Health | Population Characteristics | Demographic Factors | Population Dynamics | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 339909

11.

Peer Reviewed

Title: Pregnancy and optimal care of HIV-infected patients.
Author: Anderson BL; Cu-Uvin S
Source: Clinical Infectious Diseases. 2009 Feb 15;48(4):449-55.
Abstract: Human immunodeficiency virus (HIV) infection during pregnancy is a condition that requires multidisciplinary care. Care must be rendered that is appropriate for both the mother and the fetus. Prevention of mother-to-child transmission of HIV is of paramount concern. To prevent transmission, universal testing for HIV infection in pregnant women is ideal. In the United States and other developed countries, great strides have been made toward decreasing the risk of HIV transmission to infants to <2% with use of a combination of highly active antiretroviral therapy during the antepartum period and during labor and delivery, scheduled cesarean section when appropriate, avoidance of breast-feeding, and 6 weeks of zidovudine prophylaxis for infants. The continuation of antiretroviral therapy after delivery depends on the needs of the mother with regard to treatment of her own health. In resource-limited countries, where simplified and shortened courses of antiretroviral regimens have been used, reduction in mother-to-child transmission has also been shown, although not as effectively as that with highly active antiretroviral therapy. In these settings, exclusive breast-feeding for 6 months is recommended to reduce the risk of postnatal transmission.
Language: English
Keywords:
UNITED STATES OF AMERICA | DEVELOPING COUNTRIES | RECOMMENDATIONS | PREGNANT WOMEN | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV TESTING | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | DRUG RESISTANCE | ANTIRETROVIRAL THERAPY | RISK FACTORS | CESAREAN SECTION | BREASTFEEDING | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Disease Transmission Control | Prevention and Control | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Drugs | HIV | HIV Infections | Viral Diseases | Obstetrical Surgery | Surgery | Infant Nutrition | Nutrition
Document Number: 342644

12.

Title: Reproductive and hormonal factors, and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers: results from the International BRCA1/2 Carrier Cohort Study.
Author: Antoniou AC; Rookus M; Andrieu N; Brohet R; Chang-Claude J
Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Feb;18(2):601-10.
Abstract: BACKGROUND: Several reproductive and hormonal factors are known to be associated with ovarian cancer risk in the general population, including parity and oral contraceptive (OC) use. However, their effect on ovarian cancer risk for BRCA1 and BRCA2 mutation carriers has only been investigated in a small number of studies. METHODS: We used data on 2,281 BRCA1 carriers and 1,038 BRCA2 carriers from the International BRCA1/2 Carrier Cohort Study to evaluate the effect of reproductive and hormonal factors on ovarian cancer risk for mutation carriers. Data were analyzed within a weighted Cox proportional hazards framework. RESULTS: There were no significant differences in the risk of ovarian cancer between parous and nulliparous carriers. For parous BRCA1 mutation carriers, the risk of ovarian cancer was reduced with each additional full-term pregnancy (P trend = 0.002). BRCA1 carriers who had ever used OC were at a significantly reduced risk of developing ovarian cancer (hazard ratio, 0.52; 95% confidence intervals, 0.37-0.73; P = 0.0002) and increasing duration of OC use was associated with a reduced ovarian cancer risk (P trend = 0.0004). The protective effect of OC use for BRCA1 mutation carriers seemed to be greater among more recent users. Tubal ligation was associated with a reduced risk of ovarian cancer for BRCA1 carriers (hazard ratio, 0.42; 95% confidence intervals, 0.22-0.80; P = 0.008). The number of ovarian cancer cases in BRCA2 mutation carriers was too small to draw definitive conclusions. CONCLUSIONS: The results provide further confirmation that OC use, number of full-term pregnancies, and tubal ligation are associated with ovarian cancer risk in BRCA1 carriers to a similar relative extent as in the general population.
Language: English
Keywords:
DEVELOPED COUNTRIES | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | CLINICAL RESEARCH | WOMEN | PREVALENCE | RISK ASSESSMENT | OVARIAN CANCER | CHROMOSOME ABNORMALITIES | PARITY | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | TUBAL LIGATION | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Measurement | Evaluation | Cancer | Neoplasms | Diseases | Neonatal Diseases and Abnormalities | Fertility Measurements | Fertility | Population Dynamics | Health | Contraceptive Safety | Safety | Public Health | Female Sterilization | Sterilization, Sexual | Family Planning
Document Number: 331025

13.

Title: Oral Contraceptives: A Risk Factor for Squamous Cell Carcinoma?
Author: Applebaum KM; Nelson HH; Zens MS; Stukel TA; Spencer SK; Karagas MR
Source: Journal of Investigative Dermatology. 2009 Jun 25;
Abstract: Oral contraceptives (OCs) affect the risk of several cancers in women, but have been virtually unstudied for squamous cell carcinoma (SCC). We examined the hypothesis that OCs influence SCC risk in a case-control study among women and also examined whether polymorphisms in the DNA repair gene, Xeroderma pigmentosum group D (XPD), modified the risk. Incident cases of SCC were identified by a network of dermatologists and pathology laboratories. Population-based controls were frequency matched to cases by age and gender (n=261 SCC cases, 298 controls). Overall, OC use was associated with a 60% higher risk of SCC (odds ratio (OR), 1.6; 95% confidence interval (95% CI): 1.0-2.5). ORs for SCC were higher among those who last used OCs >/=25 years before diagnosis (OR: 2.1; 95% CI: 1.2-3.7), and among these women, SCC risk increased with duration of use (OR for /=7 years, 2.7; 95% CI: 0.9-8.5, P(trend)=0.01). Furthermore, the XPD Lys751Gln polymorphism was a significant modifier of the OC-SCC association (P(interaction)=0.03). These findings lead us to hypothesize a potential relationship between OCs and SCC risk, and that this could involve DNA repair pathways.Journal of Investigative Dermatology advance online publication, 25 June 2009; doi:10.1038/jid.2009.168.
Language: English
Keywords:
UNITED STATES OF AMERICA | NEW HAMPSHIRE | RESEARCH REPORT | CONTROL GROUPS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | RISK FACTORS | CANCER | DERMATOLOGICAL EFFECTS | ESTROGENS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Health | Neoplasms | Diseases | Physiology | Biology | Hormones | Endocrine System
Document Number: 341751

14.

Title: Human papillomavirus typing and soluble interleukin-2 receptor levels in female sex workers with a negative cervical smear result.
Author: Arioz DT; Altindis M; Tokyol C; Kalayci R; Saylan A; Yilmazer M
Source: International Journal of Gynaecology and Obstetrics. 2009 May 20;
Abstract: OBJECTIVE: To investigate the association between high-risk human papillomavirus (HPV) types and soluble interleukin-2 receptor (sIL-2R) levels in female sex workers with a negative cervical smear result, and to determine the effectiveness of using sIL-2R levels to screen for high-risk strains of HPV. METHOD: A negative cervical smear result and a blood sample were obtained from 68 women: 43 female sex workers and 25 women acting as controls. HPV DNA genotyping was performed and sIL-2R levels were assessed. RESULTS: Female sex workers had significantly higher sIL-2R levels than women in the control group (318.37+/-239.7 vs 114.4+/-56.5 U/mL, respectively P<0.001). In addition, female sex workers with high-risk strains of HPV had significantly higher sIL-2R levels than those who did not have high-risk strains of HPV (736.7+/-251.5 vs 250.5+/-156.1 U/mL, respectively; P=0.001). CONCLUSION: High sIL-2R levels may be useful in screening for high-risk strains of HPV in female sex workers who have a negative cervical smear result.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CONTROL GROUPS | SEX WORKERS | HPV | CERVICAL CANCER | RISK FACTORS | CYTOLOGIC EFFECTS | SCREENING | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Sex Behavior | Behavior | Viral Diseases | Diseases | Cancer | Neoplasms | Health | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 341451

15.

Title: Consanguinity and reproductive wastage in the Palestinian Territories.
Author: Assaf S; Khawaja M; DeJong J; Mahfoud Z; Yunis K
Source: Paediatric and Perinatal Epidemiology. 2009 Mar;23(2):107-15.
Abstract: Many studies have found that consanguinity poses a threat to child mortality and health and can also pose a threat to offspring survival before birth. However, there are conflicting findings with some studies having found no increased risk on offspring survival associated with consanguinity. Data from a population-based survey conducted in 2004 in the Palestinian Territories was used to assess the risk of consanguinity on offspring survival. The analysis was conducted on 4418 women aged 15-49 who were asked whether or not they had experienced a stillbirth or a spontaneous abortion. These two outcomes were combined together for the analysis of reproductive wastage. Multivariable negative binomial regression was conducted to calculate the incidence risk ratios (IRR) for each region in the Palestinian Territories separately. The strongest risk factors for reproductive wastage, after controlling for other variables, were found to be consanguinity, age and parity with age presenting the highest IRRs. Standard of living, locality type, education level, women's employment and past intrauterine device use were not found to be significant risk factors for reproductive wastage. In the West Bank only first cousin level of consanguinity was found to be significant and 'hamola' level (or from same family clan) lost its significance after adjusting for other variables. In the Gaza Strip both the first cousin and 'hamola' levels of consanguinity were significant and presented almost equal IRRs of 1.3. In conclusion, consanguinity was found to be a significant risk factor for reproductive wastage.
Language: English
Keywords:
MIDDLE EAST | RESEARCH REPORT | RISK ASSESSMENT | ABORTION, SPONTANEOUS | FETAL DEATH | MATERNAL AGE | CONSANGUINITY | RISK FACTORS | CHILD MORTALITY | Evaluation | Pregnancy Complications | Diseases | Mortality | Population Dynamics | Demographic Factors | Population | Parental Age | Age Factors | Population Characteristics | Genetics | Biology | Health
Document Number: 331057

16.

Peer Reviewed

Title: Hormonal contraception, sickle cell trait, and risk for venous thromboembolism among African American women.
Author: Austin H; Lally C; Benson JM; Whitsett C; Hooper WC; Key NS
Source: American Journal of Obstetrics and Gynecology. 2009 Jun;200:620e1-620e3.
Abstract: OBJECTIVE: We evaluated the effect of oral and other hormonal contraceptive (HC) use on venous thromboembolism risk among African American women and investigated whether the association was modified by the sickle cell trait. STUDY DESIGN: We report the findings of a case-control study that included 60 African American women with an idiopathic, first episode of venous thromboembolism and 196 African American controls. RESULTS: The odds of current HC use compared with noncurrent use contrasting cases and controls is 3.8 (95% confidence interval [CI], 1.7-8.1; P < .001). Among subjects with sickle cell trait, the odds ratio is higher (odds ratio [OR], 6.7; 95% CI, 1.0-43) than the odds ratio among subjects without sickle cell trait (OR, 2.6; 95% CI, 1.1-6.2), but the difference is not statistically significant. CONCLUSION: This study provides persuasive evidence that hormonal contraceptive use increases venous thromboembolism risk among African American women and that the increase in risk may be larger among women with sickle cell trait.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CASE STUDIES | BLACKS | WOMEN | CONTRACEPTION | CONTRACEPTIVE AGENTS | THROMBOEMBOLISM | DISEASES | RISK FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Family Planning | Embolism | Vascular Diseases | Health
Document Number: 330853

17.

Peer Reviewed

Title: Effect of male circumcision on the prevalence of high-risk human papillomavirus in young men: results of a randomized controlled trial conducted in orange farm, South Africa.
Author: Auvert B; Sobngwi-Tambekou J; Cutler E; Nieuwoudt M; Lissouba P; Puren A; Taljaard D
Source: Journal of Infectious Diseases. 2009 Jan 1;199(1):14-9.
Abstract: The authors used data from a male circumcision (MC) trial conducted in Orange Farm, South Africa among men aged 18-24 years to investigate the association between male circumcision (MC) and the prevalence of high-risk human papillomavirus (HR-HPV) among young men. Urethral swab samples were collected during a period of 262 consecutive days from participants in the intervention (circumcised) and control (uncircumcised) groups who were reporting for a scheduled follow-up visit. Swab samples were analyzed using polymerase chain reaction. HR-HPV prevalence rate ratios were assessed using univariate and multivariate log Poisson regression. In an intention-to-treat analysis, the prevalence of HR-HPV among the intervention group was 14.8% (94/637) and in the control group was 22.3% (140/627). Controlling for propensity score and confounders (ethnic group, age, education, sexual behavior [including condom use], marital status, and human immunodeficiency virus status) had no effect on the results. This is the first randomized controlled trial to show a reduction in the prevalence of urethral HR-HPV infection after MC. This finding explains why women with circumcised partners are at a lower risk of cervical cancer than other women.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL TRIALS | EPIDEMIOLOGIC METHODS | YOUTH | MULTIVARIATE ANALYSIS | MEN | MALE CIRCUMCISION | HPV | PREVALENCE | RISK FACTORS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Clinical Research | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Data Analysis | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Measurement | Biology
Document Number: 328586

18.

Peer Reviewed

Title: Increased access to emergency contraception: why it may fail.
Author: Baecher L; Weaver MA; Raymond EG
Source: Human Reproduction. 2009 Apr;24(4):815-9.
Abstract: BACKGROUND: To explore why increased access to emergency contraception (EC) failed to reduce pregnancies in a recent randomized controlled trial. METHODS: We used multivariable logistic regression to identify risk factors for unintended pregnancy using data from a trial involving sexually active women (n = 1490, aged 14-24 years) randomly assigned to either increased access or standard access to EC. We used predictive modeling to generate estimated pregnancy risk scores for each participant. We then examined EC use among women at low or high baseline risk of pregnancy. RESULTS: Gravidity, recent history of unprotected sex (within 14 days of enrollment to study) and lower aversion to pregnancy predicted unintended pregnancy. Women in the increased access group were more likely than women in the standard access group to use EC repeatedly. This difference was significantly stronger (P = 0.03) among low risk women than high risk women [Relative risk (RR) 10.0, 95% confidence interval (CI) 6.5-15.4 and RR 5.5, 95% CI 3.8-7.9, respectively]. CONCLUSIONS: Increased access to EC had a greater impact on women who were at lower baseline risk of pregnancy. This may explain in part why increased access to EC has had no measurable benefit in clinical trials.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | STATISTICAL REGRESSION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PREGNANCY, UNPLANNED | INCIDENCE | RISK FACTORS | PSYCHOSOCIAL FACTORS | Developed Countries | North America | Americas | Data Analysis | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Measurement | Health | Behavior
Document Number: 341661

19.

20.

Peer Reviewed

Title: Pill use in the month before conception linked to risk of low birth weight, preterm delivery
Author: Ball H
Source: Perspectives On Sexual and Reproductive Health. 2009 Jun;41(2):128.
Abstract: Women who use oral contraceptives just prior to conception may be more likely than nonusers to experience adverse birth outcomes, according to a study of health records from the Canadian province of Saskatchewan.1 Those who used the pill within 30 days of their last menstrual period had elevated odds of preterm birth and low birth weight, conditions that are associated with infant morbidity and mortality. The researchers examined records from Saskatchewan Health Databases, which contain information on 99% of the province's residents. They obtained data on physician services, hospital stays and prescription drug use in the year prior to giving birth for a random sample of 50% of women who had a pregnancy between 1997 and 2000. these outcomes. In an analysis that adjusted for women's socioeconomic and chronic disease status, pill use within 30 days of the last menstrual period was positively associated with the occurrence of very low and low birth weight (odds ratios, 3.2 and 1.9, respectively) and preterm delivery (1.6). Use 2-3 months prior to the last menstrual period was not associated with adverse birth outcomes. (excerpt)
Language: English
Keywords:
CANADA | SUMMARY REPORT | WOMEN | CONTRACEPTIVE USAGE | ORAL CONTRACEPTIVES | PREGNANCY | LOW BIRTH WEIGHT | RISK FACTORS | Developed Countries | North America, Northern | Americas | Demographic Factors | Population | Contraception | Family Planning | Contraceptive Methods | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Health
Document Number: 341884

21.

Peer Reviewed

Title: Social and environmental malaria risk factors in urban areas of Ouagadougou, Burkina Faso.
Author: Baragatti M; Fournet F; Henry MC; Assi S; Ouedraogo H; Rogier C; Salem G
Source: Malaria Journal. 2009;8:13.
Abstract: BACKGROUND: Despite low endemicity, malaria remains a major health problem in urban areas where a high proportion of fevers are presumptively treated using anti-malarial drugs. Low acquired malaria immunity, behaviour of city-dwellers, access to health care and preventive interventions, and heterogenic suitability of urban ecosystems for malaria transmission contribute to the complexity of the malaria epidemiology in urban areas. METHODS: The study was designed to identify the determinants of malaria transmission estimated by the prevalence of anti-circumsporozoite (CSP) antibodies, the prevalence and density of Plasmodium falciparum infection, and the prevalence of malarial disease in areas of Ouagadougou, Burkina-Faso. Thick blood smears, dried blood spots and clinical status have been collected from 3,354 randomly chosen children aged 6 months to 12 years using two cross-sectional surveys (during the dry and rainy seasons) in eight areas from four ecological strata defined according to building density and land tenure (regular versus irregular). Demographic characteristics, socio-economic information, and sanitary and environmental data concerning the children or their households were simultaneously collected. Dependent variables were analysed using mixed multivariable models with random effects, taking into account the clustering of participants within compounds and areas. RESULTS: Overall prevalences of CSP-antibodies and P. falciparum infections were 7.7% and 16.6% during the dry season, and 12.4% and 26.1% during the rainy season, respectively, with significant differences according to ecological strata. Malaria risk was significantly higher among children who i) lived in households with lower economic or education levels, iii) near the hydrographic network, iv) in sparsely built-up areas, v) in irregularly built areas, vi) who did not use a bed net, vii) were sampled during the rainy season or ii) had traveled outside of Ouagadougou. CONCLUSION: Malaria control should be focused in areas which are irregularly or sparsely built-up or near the hydrographic network. Furthermore, urban children would benefit from preventive interventions (e.g. anti-vectorial devices or chemoprophylaxis) aimed at reducing malaria risk during and after travel in rural areas.
Language: English
Keywords:
BURKINA FASO | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | URBAN AREAS | RURAL AREAS | CHILDREN | MALARIA | TRANSMISSION | ANTIBODIES | RISK FACTORS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Parasitic Diseases | Diseases | Infections | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Health
Document Number: 330546

22.

Peer Reviewed

Title: HIV prevalence, risks for HIV infection, and human rights among men who have sex with men (MSM) in Malawi, Namibia, and Botswana.
Author: Baral S; Trapence G; Motimedi F; Umar E; Iipinge S; Dausab F; Beyrer C
Source: PloS One. 2009;4(3):e4997.
Abstract: BACKGROUND: In the generalized epidemics of HIV in southern Sub-Saharan Africa, men who have sex with men have been largely excluded from HIV surveillance and research. Epidemiologic data for MSM in southern Africa are among the sparsest globally, and HIV risk among these men has yet to be characterized in the majority of countries. METHODOLOGY: A cross-sectional anonymous probe of 537 men recruited with non-probability sampling among men who reported ever having had sex with another man in Malawi, Namibia, and Botswana using a structured survey instrument and HIV screening with the OraQuick(c) rapid test kit. PRINCIPAL FINDINGS: The HIV prevalence among those between the ages of 18 and 23 was 8.3% (20/241); 20.0% (42/210) among those 24-29; and 35.7% (30/84) among those older than 30 for an overall prevalence of 17.4% (95% CI 14.4-20.8). In multivariate logistic regressions, being older than 25 (aOR 4.0, 95% CI 2.0-8.0), and not always wearing condoms during sex (aOR 2.6, 95% CI 1.3-4.9) were significantly associated with being HIV-positive. Sexual concurrency was common with 16.6% having ongoing concurrent stable relationships with a man and a woman and 53.7% had both male and female sexual partners in proceeding 6 months. Unprotected anal intercourse was common and the use of petroleum-based lubricants was also common when using condoms. Human rights abuses, including blackmail and denial of housing and health care was prevalent with 42.1% (222/527) reporting at least one abuse. CONCLUSIONS: MSM are a high-risk group for HIV infection and human rights abuses in Malawi, Namibia, and Botswana. Concurrency of sexual partnerships with partners of both genders may play important roles in HIV spread in these populations. Further epidemiologic and evaluative research is needed to assess the contribution of MSM to southern Africa's HIV epidemics and how best to mitigate this. These countries should initiate and adequately fund evidence-based and targeted HIV prevention programs for MSM.
Language: English
Keywords:
MALAWI | NAMIBIA | BOTSWANA | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HIV INFECTIONS | PREVALENCE | RISK FACTORS | EPIDEMIOLOGY | HUMAN RIGHTS | SEX BEHAVIOR | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Behavior | Viral Diseases | Diseases | Measurement | Research Methodology | Health | Public Health | Political Factors | Sociocultural Factors
Document Number: 341820

23.

Title: Genetic counseling for teratogenic risk due to exposure to medications: 89 pregnancies conceived during oral contraceptive use.
Author: Belli S; Mazzola S; Luongo R; Barcella L; Alushi B
Source: American Journal of Medical Genetics. Part A. 2009 Jun 5;
Abstract: Congenital malformations are relatively frequent (2% of the general population) but only a small proportion of them can be ascribed to medication exposure during pregnancy. Nevertheless, for the purposes of accurate prenatal diagnosis, monitoring and research, is it important to offer teratology counseling to patients exposed to drugs. There are approximately 20 medications currently on the market that have been universally acknowledged as teratogenic. At the current state of the art, exposure of early embryos to oral contraceptives is not considered teratogenic. Oral contraceptive use may be continuous (estrogen and progesterone or progesterone alone) or emergency (levonorgestrel is the only drug authorized in Italy). Like all drugs, oral contraceptives have a therapeutic failure rate, which means that a number of women on oral contraceptives conceive each year and request genetic counseling about teratogenic effects. During the period 1998-2006 at our genetics clinic we received 89 requests for counseling regarding teratogenic risk due to oral contraceptives. Our study of these patients confirms an absence of teratogenic risk for pregnancies occurring during oral contraceptive use. Teratology counseling was useful to reassure the mothers about the low risk (in the case of oral contraceptive use alone), since only 12 women chose to terminate pregnancy.
Language: English
Keywords:
ITALY | RESEARCH REPORT | GENETICS | COUNSELING | EXPOSURE | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, ESTROGEN | PROGESTERONE | LEVONORGESTREL | CONGENITAL ABNORMALITIES | RISK FACTORS | PREGNANCY | Developed Countries | Europe, Southern | Europe | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Contraceptive Agents, Progestin | Neonatal Diseases and Abnormalities | Diseases | Reproduction
Document Number: 341602

24.

Title: Limited knowledge on progestogen-only contraception and risk of venous thromboembolism.
Author: Bergendal A; Odlind V; Persson I; Kieler H
Source: Acta Obstetricia et Gynecologica Scandinavica. 2009;88(3):261-266.
Abstract: Objective. To assess the current knowledge concerning progestogen-only contraception (POC) and risks of venous thromboembolism (VTE). Design and setting. Systematic review of the literature on observational and analytical studies reporting risk estimates for VTE in women exposed to POCs. Methods and main outcome measures. We performed a computerized literature search in the Pub Med, Embase, and the Cochrane Library for studies published between 1966 and February 13, 2008. Based on the evaluated studies we calculated an overall risk estimate for VTE in association with POC. Results. Four case-control studies and one cohort study were included. Of the case-control studies, three reported an increased risk and one a decreased risk of VTE. The cohort study found divergent results depending on the type of statistical analysis used. None of the results was statistically significant. The overall odds ratio for POC-associated VTE in the four case-control studies was 1.45 (95% CI=0.92-2.26). Conclusions. The risk of VTE associated with use of POCs is poorly investigated. The slightly elevated overall risk estimate might suggest an association between POC and an increased risk for VTE. The results must, however, be interpreted with caution due to the possibility of residual confounding. Well-designed studies with sufficient statistical power to evaluate risks of VTE with POC are warranted.
Language: English
Keywords:
SWEDEN | RESEARCH REPORT | EPIDEMIOLOGY | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | THROMBOEMBOLISM | RISK FACTORS | KNOWLEDGE | Europe, Northern | Europe | Developed Countries | Public Health | Health | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Embolism | Vascular Diseases | Diseases | Sociocultural Factors
Document Number: 329655

25.

Title: Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review.
Author: Berghella V; Airoldi J; O'Neill AM; Einhorn K; Hoffman M
Source: BJOG. 2009 Aug;116(9):1151-7.
Abstract: BACKGROUND: Second trimester pregnancy induction with misoprostol in women with prior caesarean delivery is not well studied. OBJECTIVE: To estimate the risk of uterine rupture using misoprostol as an induction agent for pregnancy termination in the second trimester of pregnancy in women with prior caesarean delivery. SEARCH STRATEGY: Cases of women with a history of prior caesarean delivery and subsequent misoprostol induction for pregnancy termination in the second trimester (16-28 weeks) were obtained from two main data sources. First, a retrospective chart analysis was performed at Thomas Jefferson University Hospital and Christiana Hospital between 1998 and 2004. Second, multiple Medline, Scopus and POPLINE literature searches were performed. SELECTION CRITERIA: Case series and cohort studies of women with one or more prior caesarean delivery (of any type), and with a subsequent pregnancy with induction of labour for pregnancy termination at 16-28 weeks using misoprostol as the initial primary agent were included. Case reports were analysed separately. DATA COLLECTION AND ANALYSIS: Total cases were analysed by type and number of prior caesarean delivery, for the primary outcome of uterine rupture. MAIN RESULTS: The incidence of uterine rupture associated with second trimester misoprostol termination was 0.4% (2/461) in women with one prior low transverse, 0% (0/46) in those with two prior low transverse and 50% (1/2) in those with a prior classical caesarean delivery. One of the cases of uterine rupture in a woman with a prior low transverse caesarean required transfusion. None of the total eight cases (including case reports) of uterine rupture was associated with hysterectomy. CONCLUSIONS: Second trimester misoprostol termination appears safe among women with one prior low transverse caesarean birth, as it is associated with incidences of uterine rupture of 0.4% (95% confidence interval 0.08-1.67%), of hysterectomy of 0% and of transfusion of 0.2%. There are insufficient data on risk with more than one prior caesarean birth or with prior classical caesarean birth.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MISOPROSTOL | PREGNANCY, SECOND TRIMESTER | ABORTION | CESAREAN SECTION | UTERINE EFFECTS | RISK FACTORS | INCIDENCE | Developed Countries | North America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Measurement
Document Number: 342794 Notification

26.

Title: Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country.
Author: Bernabe-Ortiz A; White PJ; Carcamo CP; Hughes JP; Gonzales MA; Garcia PJ; Garnett GP; Holmes KK
Source: CMAJ. 2009 Feb 3;180(3):298-304.
Abstract: BACKGROUND: Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. METHODS: We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure. RESULTS: Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; > or = 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > or = 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception. INTERPRETATION: The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially reduce the rate of induced abortion.
Language: English
Keywords:
LATIN AMERICA | RESEARCH REPORT | INCIDENCE | PREVALENCE | WOMEN | RISK FACTORS | ABORTION | ABORTION, SPONTANEOUS | SEX EDUCATION | RISK ASSESSMENT | Americas | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Biology | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Education | Evaluation
Document Number: 330468 Notification

27.

Title: Combined oral contraceptive use and the risk of systemic lupus erythematosus.
Author: Bernier MO; Mikaeloff Y; Hudson M; Suissa S
Source: Arthritis and Rheumatism. 2009 Mar 30;61(4):476-481.
Abstract: OBJECTIVE: To assess whether the risk of incident systemic lupus erythematosus (SLE) is associated with the use of combined oral contraceptives (COCs), because studies of the link between exogenous hormonal exposure and the risk of SLE have produced conflicting results. METHODS: We conducted a population-based nested case-control study among women ages 18-45 years, using the UK's General Practice Research Database. All incident cases of SLE from 1994-2004 (n = 786) were identified in the database and matched with up to 10 controls (n = 7,817) among women without SLE at the time of the case's diagnosis. RESULTS: The adjusted rate ratio (RR) of incident SLE associated with any use of COC was 1.19 (95% confidence interval [95% CI] 0.98-1.45), whereas with current use it was 1.54 (95% CI 1.15-2.07). The rate was particularly increased in current users who had only recently started COC use (RR 2.52, 95% CI 1.14-5.57) compared with longer-term current users (RR 1.45, 95% CI 1.06-1.99). The risk appearedto be particularly elevated with current exposure to first- or second-generation contraceptives (RR 1.65, 95% CI 1.20-2.26), and increasing with the dose of ethinyl estradiol (RR 1.42, 1.63, and 2.92 for Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CASE CONTROL STUDIES | LONGITUDINAL STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | SYSTEMIC LUPUS ERYTHEMATOSUS | PREVALENCE | RISK FACTORS | RISK ASSESSMENT | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Diseases | Measurement | Health | Evaluation
Document Number: 330926

28.

Peer Reviewed

Title: Alcohol and illicit drug use and its influence on the sexual behavior of teenagers from Minas Gerais State, Brazil. Uso de alcool e drogas e sua influencia sobre as praticas sexuais de adolescentes de Minas Gerais, Brasil.
Author: Bertoni N; Bastos FI; de Mello MV; Makuch MY; de Sousa MH; Osis MJ; Faundes A
Source: Cadernos�de Saude Publica. 2009 Jun;25(6):1350-1360.
Abstract: This article summarizes the findings of a survey of 5,981 students from public schools in Minas Gerais State, Brazil. The analysis assessed the influence of drug use on sexual practices. Among the boys who stated having used illicit drugs and who were engaged in relationships with casual partners, 56% reported consistent condom use, as compared to 65% among those not reporting such habits. Among boys who reported illicit drug use and who were engaged in relationships with stable partners, consistent condom use was reported by 43%, versus 64% among those not reporting such habits. In the subgroup of boys engaged in stable relationships who did not report illicit drug use, consistent condom use was less frequent among those who used alcohol or cigarettes, compared to those who did not drink or smoke (61% versus 71%). Girls were less likely than boys to use condoms consistently, regardless of the nature of their relationships, without a noticeable influence of drug use. Policies to prevent drug abuse, sexually transmitted infections, and unplanned pregnancy should be fully integrated.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | SURVEYS | YOUTH | ADOLESCENTS | STUDENTS | DRUG USE AND ABUSE | ALCOHOL USE AND ABUSE | SEX BEHAVIOR | RISK BEHAVIOR | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | PREGNANCY, UNPLANNED | RISK FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Behavior | Risk Reduction Behavior | Reproductive Tract Infections | Infections | Diseases | Reproductive Behavior | Fertility | Population Dynamics | Health
Document Number: 340175

29.

Peer Reviewed

Title: Mother-to-child transmission of GB virus C in a cohort of women coinfected with GB virus C and HIV in Bangkok, Thailand.
Author: Bhanich Supapol W; Remis RS; Raboud J; Millson M; Tappero J; Kaul R; Kulkarni P; McConnell MS; Mock PA; McNicholl JM; Vanprapar N; Asavapiriyanont S; Shaffer N; Butera S
Source: Journal of Infectious Diseases. 2009 Jul 15;200(2):227-35.
Abstract: BACKGROUND: GB virus C (GBV-C) is an apathogenic virus that inhibits human immunodeficiency virus (HIV) replication in vitro. Mother-to-child transmission (MTCT) of GBV-C has been observed in multiple small studies. Our study examined the rate and correlates of MTCT of GBV-C in a large cohort of GBV-C-HIV-coinfected pregnant women in Thailand. METHODS: Maternal delivery plasma specimens from 245 GBV-C-HIV-infected women and specimens from their infants at 4 or 6 months of age were tested for GBV-C RNA. Associations with MTCT of GBV-C were examined using logistic regression. RESULTS: One hundred one (41%) of 245 infants acquired GBV-C infection. MTCT of GBV-C was independently associated with maternal antiretroviral therapy (adjusted odds ratio [AOR], 5.21 [95% confidence interval {CI}, 2.12-12.81]), infant HIV infection (AOR, 0.05 [95% CI, 0.01-0.26]), maternal GBV-C load (8.0 log(10) copies/mL: AOR, 86.77 [95% CI, 15.27-481.70]; 7.0-7.9 log(10) copies/mL: AOR, 45.62 [95% CI, 8.41-247.51]; 5.0-6.9 log(10) copies/mL: AOR, 9.07 [95% CI, 1.85-44.33]: reference, <5 log(10) viral copies/mL), and caesarean delivery (AOR, 0.26 [95% CI, 0.12-0.59]). CONCLUSIONS: Associations with maternal GBV-C load and mode of delivery suggest transmission during pregnancy and delivery. Despite mode of delivery being a common risk factor for virus transmission, GBV-C and HIV were rarely cotransmitted. The mechanisms by which maternal receipt of antiretroviral therapy might increase MTCT of GBV-C are unknown.
Language: English
Keywords:
THAILAND | RESEARCH REPORT | COHORT ANALYSIS | MOTHERS | INFANT | MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | HIV TESTING | PREGNANCY | RISK FACTORS | ANTIRETROVIRAL THERAPY | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Transmission | Infections | Diseases | Viral Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | HIV
Document Number: 342692

30.
Title: Risk of mortality in pediatric intensive care unit, assessed by PRISM-III.
Author: Bilan N; Galehgolab BA; Emadaddin A; Shiva Sh
Source: Pakistan Journal of Biological Sciences. 2009 Mar 15;12(6):480-5.
Abstract: This study aimed at evaluating the mortality rate in a PICU applying PRISM-III. Two hundred and twenty one infants and children consecutively admitted to PICU of Tabriz Children's Hospital were studied during a 13 months period of time. Data required for calculating the PRISM-III score were collected during the first 24 h of PICU stay in all patients. The prediction of actual mortality by PRISM-III scoring was evaluated by the Hosmer and Lemeshow goodness-of-fit test. Receiver Operating Characteristic (ROC) curve was constructed, as well. The observed (O) short-term (during hospital stay) mortality rate was compared with the expected (E) figures as the O/E ratio. The mean value of the PRISM-III score was 14.22 +/- 9.57(2-42). ROC analysis indicated a strong predictive power for the PRISM-III (area under the curve = 0.898) and the test was well fit to the designed study (goodness-of-fit p-value = 0.161). The observed short-term mortality rate was 9.05% and the expected mortality rate by the PRISM-III scoring was 9% (O/E ratio = 1.005). The PRISM-III scoring system was highly calibrated in our institute.
Language: English
Keywords:
IRAN | RESEARCH REPORT | EVALUATION | INFANT | CHILDREN | DEATH RATE | RISK FACTORS | Middle East | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Health
Document Number: 342232


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