RESUMO
Cross-border infectious disease transmission is a concern related to drug tourism from the U.S. to Mexico. We assessed this risk among people who inject drugs (PWID) in Tijuana, Mexico. We measured the prevalence and identified correlates of injecting with PWID visiting from the U.S. among PWID in Tijuana using univariable and multivariable logistic regression. Of 727 participants, 18.5% injected during the past 6 months in Mexico with U.S. PWID described mostly as friends (63%) or acquaintances (26%). Injecting with U.S. PWID was independently associated with higher education [adjusted odds ratio (aOR) = 1.13/year], deportation from the U.S. (aOR = 1.70), younger age at first injection (aOR = 0.96/year), more lifetime overdoses (aOR = 1.08), and, in the past 6 months, backloading (aOR = 4.00), syringe confiscation by the police (aOR = 3.02) and paying for sex (aOR = 2.98; all p-values < 0.05). Nearly one-fifth of PWID in Tijuana recently injected with U.S. PWID, and their reported risk behaviors could facilitate cross-border disease transmission.
Assuntos
Abuso de Substâncias por Via Intravenosa/epidemiologia , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Uso Comum de Agulhas e Seringas/estatística & dados numéricos , Prevalência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/etnologia , Adulto JovemRESUMO
Excellent outcomes have been demonstrated among select HIV-positive kidney transplant (KT) recipients with well-controlled infection, but to date, no national study has explored outcomes among HIV+ KT recipients by antiretroviral therapy (ART) regimen. Intercontinental Marketing Services (IMS) pharmacy fills (1/1/01-10/1/12) were linked with Scientific Registry of Transplant Recipients (SRTR) data. A total of 332 recipients with pre- and posttransplantation fills were characterized by ART at the time of transplantation as protease inhibitor (PI) or non-PI-based ART (88 PI vs. 244 non-PI). Cox proportional hazards models were adjusted for recipient and donor characteristics. Comparing recipients by ART regimen, there were no significant differences in age, race, or HCV status. Recipients on PI-based regimens were significantly more likely to have an Estimated Post Transplant Survival (EPTS) score of >20% (70.9% vs. 56.3%, p = 0.02) than those on non-PI regimens. On adjusted analyses, PI-based regimens were associated with a 1.8-fold increased risk of allograft loss (adjusted hazard ratio [aHR] 1.84, 95% confidence interval [CI] 1.22-2.77, p = 0.003), with the greatest risk observed in the first posttransplantation year (aHR 4.48, 95% CI 1.75-11.48, p = 0.002), and a 1.9-fold increased risk of death as compared to non-PI regimens (aHR 1.91, 95% CI 1.02-3.59, p = 0.05). These results suggest that whenever possible, recipients should be converted to a non-PI regimen prior to kidney transplantation.
Assuntos
Antirretrovirais/farmacologia , Rejeição de Enxerto/mortalidade , Infecções por HIV/complicações , Transplante de Rim/métodos , Complicações Pós-Operatórias/mortalidade , Inibidores de Proteases/farmacologia , Transplantados , Adulto , Feminino , Seguimentos , Taxa de Filtração Glomerular , Rejeição de Enxerto/tratamento farmacológico , Rejeição de Enxerto/etiologia , Sobrevivência de Enxerto , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , Humanos , Falência Renal Crônica/mortalidade , Falência Renal Crônica/cirurgia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Taxa de SobrevidaRESUMO
DNA was extracted from the peripheral blood of a seropositive, PCR-positive, BLV-infected Holstein cow (No. 38) from Argentina. The DNA was amplified via PCR with a series of overlapping primers encompassing the entire BLV proviral DNA. The amplified BLV ARG 38 DNA was cloned, sequenced, and compared phylogenetically to three other full-length BLV sequences. Characterization of its deduced proteins and its relationship to other members of the PTLV/BLV genus of retroviruses are discussed.
Assuntos
Bovinos/virologia , Leucose Enzoótica Bovina/virologia , Genoma Viral , Vírus da Leucemia Bovina/genética , Sequência de Aminoácidos , Animais , Argentina , Sequência Consenso , DNA Viral/classificação , DNA Viral/genética , Leucose Enzoótica Bovina/sangue , Feminino , Vírus da Leucemia Bovina/classificação , Dados de Sequência Molecular , Provírus/isolamento & purificação , Alinhamento de Sequência , Sequências Repetidas TerminaisRESUMO
OBJECTIVE: To evaluate relationships between bone mineral density and use of steroid hormonal contraceptives. METHODS: This was a multicenter cross-sectional study in seven centers in three regions of the developing world from April 1994 to June 1997. Women 30-34 years old attending family planning clinics, with at least 24 months of lifetime use of combined oral contraceptives (OC), depot-medroxyprogesterone acetate (DMPA), or levonorgestrel implants, or no or only short-term (less than 6 months) use of steroid hormonal contraceptives, had bone mineral density (BMD) measured at the distal radius and the midshaft of the ulna using single-photon x-ray absorptiometry. RESULTS: In the study, 2474 women were examined. For OC use, adjusted mean BMD was significantly higher in short-term, current users compared with women who never used hormonal contraceptives. For DMPA and levonorgestrel implants, adjusted mean BMD was statistically significantly lower in short-term current users compared with those who never used hormonal contraceptives. For all three hormonal methods, there were no significant differences in BMD between past users of hormonal contraceptives and never users, even among those who had used the methods for 4 or more years. The magnitude of changes in BMD was small and less than one standard deviation (SD) from the mean of those who never used steroid contraceptives. CONCLUSION: This study suggests that hormonal contraceptive use by young adult women is associated with small changes in BMD that occur early after initiation of use and are reversible.
Assuntos
Densidade Óssea/efeitos dos fármacos , Anticoncepcionais Femininos/farmacologia , Anticoncepcionais Orais Combinados/farmacologia , Levanogestrel/farmacologia , Acetato de Medroxiprogesterona/farmacologia , Congêneres da Progesterona/farmacologia , Adulto , Bangladesh , Brasil , China , Estudos Transversais , Países em Desenvolvimento , Egito , Feminino , Humanos , México , Tailândia , Organização Mundial da Saúde , ZimbábueRESUMO
OBJECTIVE: Etiologically unexplained disorders of language and social development have often been reported to improve in patients treated with immune-modulating regimens. Here we determined the frequency of autoantibodies to brain among such children. DESIGN: We collected sera from a cohort of children with (1) pure Landau-Kleffner syndrome (n = 2), (2) Landau-Kleffner syndrome variant (LKSV, n = 11), and (3) autistic spectrum disorder (ASD, n = 11). None had received immune-modulating treatment before the serum sample was obtained. Control sera (n = 71) were from 29 healthy children, 22 with non-neurologic illnesses (NNIs), and 20 children with other neurologic disorders (ONDs). We identified brain autoantibodies by immunostaining of human temporal cortex and antinuclear autoantibodies using commercially available kits. RESULTS: IgG anti-brain autoantibodies were present in 45% of sera from children with LKSV, 27% with ASD, and 10% with ONDs compared with 2% from healthy children and control children with NNIs. IgM autoantibodies were present in 36% of sera from children with ASD, 9% with LKSV, and 15% with ONDs compared with 0% of control sera. Labeling studies identified one antigenic target to be endothelial cells. Antinuclear antibodies with titers >/=1:80 were more common in children with ASD and control children with ONDs. CONCLUSION: Children with LKSV and ASD have a greater frequency of serum antibodies to brain endothelial cells and to nuclei than children with NNIs or healthy children. The presence of these antibodies raises the possibility that autoimmunity plays a role in the pathogenesis of language and social developmental abnormalities in a subset of children with these disorders.
Assuntos
Transtorno Autístico/imunologia , Autoanticorpos/sangue , Encéfalo/imunologia , Síndrome de Landau-Kleffner/imunologia , Doenças do Sistema Nervoso/imunologia , Anticorpos Antinucleares/sangue , Autoanticorpos/análise , Córtex Cerebral/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulina G/análise , Imunoglobulina M/análise , Imuno-Histoquímica , Lactente , Masculino , Lobo Temporal/imunologiaRESUMO
OBJECTIVE: Opsoclonus-myoclonus (OM) is a rare neurologic syndrome affecting children and adults. In children it occurs as a parainfectious process or a paraneoplastic syndrome in association with neuroblastoma. Evidence for an immune mechanism includes the presence of serum autoantibodies to several neural antigens and improvement of symptoms with immunosuppressive therapy. We studied the neural antigenic targets of serum IgM and IgG autoantibodies from nine children with OM. DESIGN: We studied sera from nine children with OM, three with associated neuroblastoma and six with a prodromal viral illness. Control subjects (n = 77) included four children with neuroblastoma but not OM, 32 children with other neurologic disorders, and 41 with nonneurologic illnesses. We studied the neural antigenic targets of serum IgM and IgG autoantibodies by the following methods: (1) immunostaining of human cerebellar sections and peripheral nerve, and (2) Western blot analysis with human brain fractions including white matter, gray matter, and cerebellar Purkinje cells and nuclei. RESULTS: Sera from all nine children with OM had IgM and IgG binding to the cytoplasm of cerebellar Purkinje cells and to some axons in white matter. In peripheral nerve, IgM and IgG from all nine OM sera bound to large and small axons. Western blot analysis showed a distinctive pattern of binding to several neural proteins, including a 210 kd antigen identified as the high molecular weight subunit of neurofilament. No control serum showed a similar pattern of reactivity. CONCLUSION: Opsoclonus-myoclonus syndrome in childhood is associated with a distinctive pattern of serum IgM and IgG binding to neural tissues and antigens.
Assuntos
Antígenos/análise , Autoanticorpos/sangue , Encéfalo/metabolismo , Mioclonia/imunologia , Transtornos da Motilidade Ocular/imunologia , Adolescente , Sítios de Ligação , Western Blotting , Cerebelo/metabolismo , Pré-Escolar , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/metabolismo , Imunoglobulina M/sangue , Imunoglobulina M/metabolismo , Lactente , Recém-Nascido , Masculino , Mioclonia/etiologia , Neuroblastoma/complicações , Transtornos da Motilidade Ocular/etiologia , Síndromes Paraneoplásicas/complicações , Células de Purkinje/metabolismo , SíndromeRESUMO
This prospective study examined whether neonates of pregnant women who used cocaine during pregnancy are at a risk for the development of transient myocardial ischemia and altered autonomic function, as in adults. We studied 21 of 35 infants with a history of prenatal exposure to cocaine. The ST segment changes and heart rate variability were evaluated from three-channel Holter monitors within 48 hours of birth. The data were compared with those on 20 control infants with similar birth weight, gestational age, and postnatal age. Six infants (29%) who were exposed to cocaine in utero had transient ST segment elevation, versus only one infant (5%) from the control group (odds ratio = 7.6; 95% confidence interval, 1.14, 50.64). Heart rates, results of total power and low-frequency power spectral analyses for heart rate variability, and arrhythmias were not significantly different in the two groups. However, a lower ratio of low-to high-frequency power reflected increased vagal activity in cocaine-exposed infants. We conclude that cocaine use in pregnant mothers is associated with transient ST segment abnormalities in their infants. These abnormalities are consistent with transient myocardial ischemia.