Prevalence of antibodies to hepatitis C virus in Spanish patients with hepatocellular carcinoma and hepatic cirrhosis

The prevalence of antibodies against hepatitis C virus (HCV) was investigated in 96 patients with hepatocellular carcinoma, 106 patients with liver cirrhosis without evidence of cancer, and 177 controls without liver disease. 75% of patients with hepatocellular carcinoma had HCV antibodies (anti-HCV), a significantly higher proportion than that observed in patients with cirrhosis (55.6%), or controls (7.3%). The prevalence of anti-HCV was significantly higher in patients with alcoholic cirrhosis and hepatocellular carcinoma (76%) than in patients with alcoholic cirrhosis alone (38.7%) whereas in patients with cryptogenic cirrhosis there was no significant difference between those with and without primary liver cell cancer (81.4% and 77.5%, respectively). These results indicate that HCV infection may have a role in the pathogenesis of hepatocellular carcinoma, even in patients with chronic liver disease apparently related to other agents such as alcohol, and that this recently identified hepatitis virus may be found in a large proportion of patients with cryptogenic cirrhosis.

HIV/STI co-infection among men who have sex with men in Spain

In Spain, neither the HIV nor the STI national surveillance systems collect information on HIV/STI co-infection. However, there are two networks based on HIV/STI clinics which gather this data. We describe HIV prevalence in men who have sex with men (MSM) diagnosed with infectious syphilis and/or gonorrhoea in 15 STI clinics; and concurrent diagnoses of STI in MSM newly diagnosed with HIV in 19 HIV/STI clinics. In total, 572 MSM were diagnosed with infectious syphilis and 580 with gonorrhoea during 2005-2007. HIV prevalence among syphilis and gonorrhoea cases was 29.8% and 15.2% respectively. In the multivariate analysis, HIV/syphilis co-infection was associated with being Latin American; having a history of STI; reporting exclusively anal intercourse; and having sex with casual or several types of partners. HIV and gonorrhoea co-infection was associated with age older than 45 years; having no education or only primary education completed; and having a history of STI. In total, 1,462 HIV infections were newly diagnosed among MSM during 2003-2007. Of these, 31.0% were diagnosed with other STI at the same time. Factors associated with STI co-infection among new HIV cases in MSM were being Latin American; and having sex with casual partners or with both steady and casual partners. In Spain, a considerable proportion of MSM are co-infected with HIV and STI.

Trends in HIV testing, prevalence among first-time testers, and incidence in most-at-risk populations in Spain: the EPI-VIH Study, 2000 to 2009

During 2000 to 2009, data on people undergoing HIV testing and on those newly diagnosed with HIV were collected in a network of 20 Spanish clinics specialising in sexually transmitted infections and/or HIV testing and counselling. The number of tests performed, overall and disaggregated by different variables, was obtained. HIV prevalence among first-time testers and HIV incidence among repeat testers were calculated. To evaluate trends, joinpoint regression models were fitted. In total, 236,939 HIV tests were performed for 165,745 individuals. Overall HIV prevalence among persons seeking HIV testing was 2.5% (95% CI: 2.4 to 2.6). Prevalence was highest in male sex workers who had sex with other men (19.0% (95% CI: 16.7 to 21.4)) and was lowest in female sex workers (0.8% (95% CI: 0.7 to 0.9)). Significant trends in prevalence were observed in men who have sex with men (MSM) (increasing) and heterosexual individuals (decreasing). The incidence analysis included 30,679 persons, 64,104 person-years (py) of follow-up and 642 seroconversions. The overall incidence rate (IR) was 1.0/100 py (95% CI: 0.9/100 to 1.1/100). Incidence was significantly higher in men and transgender females than in women (1.8/100 py (95% CI: 1.6 to 1.9), 1.2/100 py (95% CI: 0.5 to 2.8) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively) and increased with age until 35–39 years. IRs in MSM and people who inject drugs were significantly greater than in heterosexual individuals (2.5/100 py (95% CI: 2.3 to 2.7), 1.6/100 py (95% CI: 1.1 to 2.2) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively), and an upward trend was observed in MSM. Our results call for HIV prevention to be reinforced in MSM and transgender women in Spain.

[HIV infection and other sexually-transmitted infections among immigrants in Barcelona]

BACKGROUND

Immigration is a recent phenomenon in Spain. Certain subgroups of the immigrant population may be vulnerable to acquiring sexually transmitted infections (STI).

MATERIAL AND METHODS

Descriptive study of the seroprevalenceof certain STI (HIV, hepatitis B and syphilis) and the general characteristicsn of persons tested for HIV infection in a specialized clinic in Barcelona during the year 2000.

RESULTS

Seroprevalence of HIV was similar in immigrants and native residents(1.8% vs. 1.7% respectively). However, the seroprevalences of hepatitis B virus (anti-HBc) (19.5% vs. 8.3%) and syphilis (RPR 1 TPHA) (3.2% vs. 1.1%), as well as other STI and the practice of prostitution, were higher in immigrants.

CONCLUSIONS

Several STI, including hepatitis B and syphilis, were found more frequently in immigrants than in the native population, whereas HIV seroprevalence was similar in the two groups.

Lymphogranuloma venereum: a hidden emerging problem, Barcelona, 2011

From the beginning of 2007 until the end of 2011, 146 cases of lymphogranuloma venereum (LGV) were notified to the Barcelona Public Health Agency. Some 49% of them were diagnosed and reported in 2011, mainly in men who have sex with men. Almost half of them, 32 cases, were reported between July and September. This cluster represents the largest since 2004. This article presents the ongoing outbreak of LGV in Barcelona.

Exploring the Use of Amine Modified Mesoporous Magnesium Carbonate for the Delivery of Salicylic Acid in Topical Formulations: In Vitro Cytotoxicity and Drug Release Studies

Salicylic acid (SA) has for a long time been used to treat various skin disorders due to its anti-inflammatory, bacteriostatic, and antifungal properties. In the present work, mesoporous magnesium carbonate (MMC), a promising drug carrier, was modified with 3-aminopropyl-triethoxysilane to enable loading of SA. The amine modified MMC (aMMC) was successfully loaded with 8 wt.% of SA via a solvent evaporation method. SA was later completely released from the carrier in less than 15 min. Furthermore, the cytotoxicity of the functionalized material was evaluated. aMMC was found to be non-toxic for human dermal fibroblast cells with particle concentration of up to 1000 µg/mL when exposed for 48 h. The presented results form the basis of future development of aMMC as a potential carrier for SA in dermatological applications.

Increase in gonorrhoea among very young adolescents, Catalonia, Spain, January 2012 to June 2013

Binary file ES_Abstracts_Final_ECDC.txt matches

Local analgesia in paediatric dentistry: a systematic review of techniques and pharmacologic agents

PURPOSE

To evaluate the evidence supporting effects and adverse effects of local analgesia using different pharmacological agents and injection techniques during dental treatment in children and adolescents aged 3-19 years.

METHODS

A systematic literature search of databases including PubMed, Cochrane, and Scopus was conducted in November 2016. The PRISMA-statement was followed. Two review authors independently assessed the selected randomised control trials for risk of bias and quality.

RESULTS

725 scientific papers were identified. 89 papers were identified to be read in full text of which 80 were excluded. Finally, 9 papers were evaluated for quality and risk of bias. Many of the included papers had methodological shortcomings affecting the possibility to draw conclusions. Information about ethical clearance and consent were missing in some of the included papers. No alarming adverse effects were identified. One study was assessed as having low risk of bias. This reported inferior alveolar nerve block to be more effective than buccal infiltration for dental treatment of mandibular molars, while no differences were found regarding pharmacological agents.

CONCLUSIONS

At present, there is insufficient evidence in support of any pharmacologic agent or injection technique as being superior compared to others. There is a need for more rigorous studies which also handle the ethical issues of including children in potentially painful studies.

Inorganic carbonate composites as potential high temperature CO2 sorbents with enhanced cycle stability

A calcium magnesium carbonate composite (CMC) material containing highly porous amorphous calcium carbonate (HPACC) and mesoporous magnesium carbonate (MMC) was synthesized. CMCs with varying HPACC : MMC mol ratios and high BET surface area (over 490 m² g⁻¹) were produced. The CMCs retained the morphology shared by HPACC and MMC. All these materials were built up of aggregated nanometer-sized particles. We tested the CO₂ uptake properties of the synthesized materials. The CMCs were calcined at 850 °C to obtain the corresponding calcium magnesium oxide composites (CMOs) that contained CaO : MgO at different mol ratios. CMO with CaO : MgO = 3 : 1 (CMO-3) showed comparable CO₂ uptake at 650 °C (0.586 g g⁻¹) to CaO sorbents obtained from pure HPACC (0.658 g g⁻¹) and the commercial CaCO₃ (0.562 g g⁻¹). Over 23 adsorption–desorption cycles CMOs also showed a lower CO₂ uptake capacity loss (35.7%) than CaO from HPACC (51.3%) and commercial CaCO₃ (79.7%). Al was introduced to CMO by the addition of Al(NO₃)₃ in the synthesis of CMC-3 to give ACMO after calcination. The presence of ∼19 mol% of Al(NO₃)₃ in ACMO-4 significantly enhanced its stability over 23 cycles (capacity loss of 5.2%) when compared with CMO-3 (calcined CMC-3) without adversely affecting the CO₂ uptake. After 100 cycles, ACMO-4 still had a CO₂ uptake of 0.219 g g⁻¹. Scanning electron microscope images clearly showed that the presence of Mg and Al in CMO hindered the sintering of CaCO₃ at high temperatures and therefore, enhanced the cycle stability of the CMO sorbents. We tested the CO₂ uptake properties of CMO and ACMO only under ideal laboratory testing environment, but our results indicated that these materials can be further optimized as good CO₂ sorbents for various applications.

A Ca/Mg/Al oxide composite was synthesised and showed a high CO₂ uptake of 0.537 g g⁻¹ at 650 °C with high uptake even after 100 cycles.

Comparative changes with age of the fasting response in circulating ketone bodies, glucose and insulin and oral glucose tolerance test in the rat

1. Body weight loss in 48 hr fasted rats decreased with age. 2. Blood glucose and plasma RIA-insulin levels correlated negatively and positively respectively with body weight in fed rats. Fasting produced a greater fall in blood glucose and a smaller decrease in RIA-insulin in young than in old rats. 3. Blood ketone bodies correlated negatively with body weight after 48 hr fasting. 4. In oral glucose tolerance tests, blood glucose rose more in adult and old rats than in prepuberals when both fed and fasted. RIA-insulin levels rose more in prepuberals than in older rats when fed but not when fasted. 5. Changes in body composition and reduced insulin sensitivity with age are discussed.

Cross-sectional survey of hospital paediatric HIV/AIDS care in Catalonia, 1992. Hospital Contributors

A cross-sectional survey to assess the impact of the paediatric HIV/AIDS epidemic on the hospital-based health care system was performed in state-financed hospitals in Catalonia during 1992, raising issues of relevance today. Out of the 27 hospitals contacted, 20 responded. A considerable proportion of the health care to children with an HIV-related condition was provided by four hospitals. The average length of stay of the 176 HIV patients who were admitted was 10.8 days; these patients were admitted to the hospital twice a year on average. Nearly half of the out-patients who attended with an HIV-related condition were either seropositive without a confirmed diagnosis of an HIV infection (class P-0) or seronegative. Thirteen per cent of the overall admissions to paediatric day care hospitals were attributable to an HIV-related condition. By ownership status of the hospitals, HIV/AIDS paediatric in-patients of public hospitals generated the majority of admissions per patient per year, and had the shortest lengths of stay. Unlike the HIV/AIDS epidemic in adults, the magnitude and characteristics of the epidemic in children may not require the shift of hospital-based health care to primary health care.

[Mortality in a cohort of intravenous drug users before the introduction of potent HIV therapy]

BACKGROUND

The HIV/AIDS epidemics has contributed to an excess of morbidity and mortality in injecting drug users. The main goal of this study is to estimate incidence and factors associated with mortality from different causes among intravenous drug users.

SUBJECTS AND METHODS

Prospective study of patients admitted to a detoxification unit between 1987 and 1990. At baseline they underwent interviews (drug injecting patterns) and venipuncture for HIV and other parameters including T-cell subsets. Viral status was determined for those who returned at least once. Cumulative incidence, overall and cause-specific mortality rates were calculated according to gender, HIV at admission and length of injecting drugs.

RESULTS

420 patients (334 men, 86 women), 69.6% HIV+, were admitted to treatment; the mean age of participants was 26 years and the mean duration of injecting drugs was 73 months. Three hundred and eighty seven patients were followed-up (92% of the initial cohort) for 2,029 persons-years and 101 deaths occurred. The overall mortality rate was 50/1000 persons-year (52/1000 for men and 40/1000 for women). The relative risk (RR) for death among women compared with men was 1.3 (95% CI = 0.8-2.2). The mortality rates for HIV+ was 60/1000 persons-year and 29/1000 persons-year for the seronegatives (RR: 2.1; 95% CI = 1.2-3.4). The HIV+ patients with CD4/microliter < or = 500 showed a threefold increase in mortality rates compared to HIV+ patients without immunosuppression (CI = 1.7-5.3). The cause-specific mortality rates were 27/1000 persons-year for HIV/AIDS, 15/1000 persons-year for drug overdose, 3/1000 persons-year for violence/trauma and 1/1000 persons-year for non-AIDS conditions.

CONCLUSIONS

In this hospital cohort, HIV/AIDS and overdose have had a marked effect on mortality among intravenous drug users. Detoxification units may provide clinical services and extensive use of antiretroviral treatment for HIV infected drug users as a strategy to reduce the risk of death from AIDS.

[The epidemiological surveillance of human immunodeficiency virus (HIV) infection in a hospital population of Catalonia. Collaborators in the VIHHOSP project]

BACKGROUND

AIDS is one of the most important problems of public health in our setting. The surveillance of HIV infection in sentinel population is an important alternative to the use of the AIDS cases registries, to obtain a dynamic and updated information about HIV/AIDS epidemic. The objective of this study was to determine the prevalence of HIV infection among the patients from 5 sentinel hospitals in Catalonia, Spain.

PATIENTS AND METHODS

Unlinked anonymous screening of serum from patients aged 15-49 from 5 sentinel hospitals in Catalonia, Spain. Samples were broken by age, sex, in-patients or out-patients and clinical specialities related to HIV/AIDS or not related. Samples were analyzed in pools of five and were tested by the OMS strategy II, for the epidemiological surveillance purposes.

RESULTS

HIV testing was developed in 9,524 patients, with a prevalence of 1.6% (153 samples). The overall prevalence in men was twice that of women (2.3% vs. 1.1%). Ages between 25 to 34 had the higher prevalence (3.1%). Clinical specialities related with HIV/AIDS had a prevalence twice that of non related (2.3% vs. 1.2%).

CONCLUSIONS

The HIV prevalence found in this population is the highest compared to similar studies performed in other western european countries. Our data confirm the pattern of HIV infection for age and sex observed in other studies in Catalonia, Spain. This is the first study of sentinel surveillance in sentinel hospitals in Spain and give us the base line which will serve as a reference to assess the evolution of HIV infection in further studies in sentinel hospital populations in Catalonia.

Changes in plasma glucose, insulin and glucagon levels, glucose tolerance tests and insulin sensitivity with age in the rat

Glucose and insulin relationships with aging were studied in fed rats. Levels of basal circulating glucose did not change while those of RIA-insulin increased and RIA-glucagon decreased lineary with animal weight. The oral glucose tolerance test revealed a greater increase in blood glucoe in adult and old rats than in prepuberals, while the rise in plasma insulin was faster and greater in the oldest group. After intravenous glucose load, plasma insulin increase was greater in adult than in prepuberal and old rats, and in the latter grup values remained elevated for a longer period. The hypoglycemic response to i.v. insulin was greatest in the prepuberals with no difference between adult and old rats. In prepuberals, the augmented insulin sensitivity was counteracted by retarded insulinotropic glucose action and an enhanced basal glucagon level, while in the old animals normoglycemia was maintained due to an augmented secretory response of B cells, counteracted by reduced sensitivity to endogenous insulin.

[Analysis of the microbiological information derived from the sentinel laboratory network for the monitoring of the human immunodeficiency virus infection in Catalonia (1989-1995)]

BACKGROUND

The epidemiologic information on AIDS derived exclusively from the AIDS case registry presents a series of limitations. To solve some of these epidemiologic surveillance systems of HIV infection have been designed. The information of the microbiology laboratories in which anti-HIV antibody detection tests are performed has been one of the most commonly used sources of information.

MATERIAL AND METHOD

The detection activity of the anti-HIV antibodies from a surveillance laboratory network in Catalonia from 1989 to 1995 was collected.

RESULTS

A continuous increase was observed in the number of tests performed in the network laboratories (30012 in 1989 up to 63323 in 1995) as was a significant decrease in the number of tests which were reactive (20.7% in 1989 to 6.1% in 1995). Great variability was found in the results among the different laboratories as well as in the diagnostic algorythms used.

CONCLUSIONS

Laboratories are an important source to take into account to perform epidemiologic surveillance of HIV infection. The collaboration among the laboratories and public health care officials allows information to be obtained that aids in better defining the characteristics of people who currently have HIV infection and in designing preventive activities directed at the needs of each community. This collaboration also allows homogeneous diagnostic algorythmns and common criteria to be established to ensure quality control.

[Prevalence of human immunodeficiency virus infection and behaviors associated with its transmission among parenteral drug users selected on the street]

BACKGROUND

To estimate the prevalence of HIV infection and the associated risk behaviours among intravenous drug users not receiving treatment for their drug dependence.

PATIENTS AND METHODS

A cross-sectional study of 200 intravenous drug users recruited from the streets of Barcelona in 1993. Information about the socio-demographic aspects and behaviours was obtained through a personal interview using a standardised questionnaire which was carried out by three ex-drug users. Saliva samples were used to determine anti HIV antibodies.

RESULTS

The prevalence of HIV infection was 51%. 57% borrowed used syringes, 65% lended their syringes, and 41% practised back of frontloading. 85% if those who shared syringes always cleaned them, however 59% only used water. 78% had heterosexual relations, in 33% of the cases with a non-injecting sexual partner. 65% always used condoms with sexual clients although only 26% always used them with stable sexual partners and 36% with casual sexual partners. 78% had performed the HIV test and among those who knew they were seropositive, 40% had received some kind of health control in the last 6 months. Not having a legal income, injecting speedball or barbiturates, unknowing self HIV negative status and practicing forms of indirect sharing were found to be independently associated with syringe sharing.

CONCLUSIONS

The high prevalence of HIV infection and associated risk behaviours highlights the need to increase and adapt the prevention efforts and investigation to this group. Social marginalization and poliuse of drugs should be addressed in HIV prevention programs.

Lymphogranuloma venereum: a hidden emerging problem, Barcelona, 2011

From the beginning of 2007 until the end of 2011, 146 cases of lymphogranuloma venereum (LGV) were notified to the Barcelona Public Health Agency. Some 49% of them were diagnosed and reported in 2011, mainly in men who have sex with men. Almost half of them, 32 cases, were reported between July and September. This cluster represents the largest since 2004. This article presents the ongoing outbreak of LGV in Barcelona.

Reverse shoulder replacement versus hemiarthroplasty for proximal humeral fracture in elderly patients: a systematic review

This systematic review of the literature aims to analyse current knowledge to inform choice between hemiarthroplasty (HA) and reverse total shoulder arthroplasty (rTSA) for managing proximal humerus fractures (PHF) in elderly patients; the aim is to understand if rTSA can be considered the gold standard for treating PHF in the elderly when surgical fixation or conservative treatment is not viable options. Studies reporting outcomes and complications of PHF treated with shoulder arthroplasty in the elderly were included. Studies were in English and published after 2008. Evidence levels I, II, III and IV were included. According to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted using Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and PubMed search engines, as well as the Cochrane Central Register of Controlled Trials. General data collected were study design, number of patients treated with HA and rTSA, age of patients (mean, mean and SD, mean and range), length of follow-up, type of implant, and clinical outcomes. rTSA can be regarded as the gold standard for surgical management of displaced 3 and 4-part fractures in the elderly. However, the literature offers mostly low-quality studies, thereby requiring further work to achieve a full understanding of this important topic.