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A tuberculose (TB) em pessoas vivendo com HIV (PVHIV) é a maior causa infecciosa de morte relacionada à AIDS. O objetivo deste trabalho foi estimar a prevalência da coinfecção TB/HIV, avaliar a notificação dos dois agravos de maneira temporal, por meio de relacionamento de bases de dados, e buscar fatores associados às notificações de AIDS e TB. A prevalência de coinfecção TB/HIV foi de 7,7%. O grupo de PVHIV com posterior diagnóstico de TB foi o mais representativo, apesar de medidas preventivas disponíveis. A subnotificação de TB entre os casos de AIDS foi de 35%, e 19,6% dos casos de TB poderiam ser notificados como AIDS. Para os casos de AIDS com menção de TB, residir na capital apresentou uma chance 75% maior de ser notificado no Sistema de Informação de Agravos de Notificação/Tuberculose (SINAN TB), e ter falecido aumentou em 40% a chance de registro. Dos casos de TB com menção de HIV, ser de cor parda, ter entre 25 e 39 anos, residir na capital e ter evoluído para o óbito estiveram associados à maior chance de notificação na AIDS. O linkage periódico dessas bases pode ser uma ferramenta programática poderosa para diminuir a subnotificação. Tuberculosis (TB) in persons living with HIV (PLHIV) is the leading infectious cause of AIDS-related death. The aim of this study was to estimate the prevalence of TB/HIV coinfection, evaluate notification of the two diseases over time by probabilistic database linkage, and identify factors associated with AIDS and TB notifications. Prevalence of TB/HIV coinfection was 7.7%. The group of PLHIV with subsequent TB diagnosis was the most representative, despite available preventive measures. Underreporting of TB among AIDS cases was 35%, and 19.6% of TB cases could have been reported as AIDS. For AIDS cases with mention of TB, living in the state capital showed 75% greater odds of being reported to the Tuberculosis Notification System (SINAN-TB), and having died increased the odds of reporting by 40%. Of TB cases with mention of HIV, brown skin color, age 25 to 39 years, living in the state capital, and having evolved to death were associated with higher odds of reporting to the AIDS Notification System. Periodic linkage of these databases can be a powerful tool for programs to decrease underreporting. La tuberculosis (TB) en personas viviendo con VIH (PVVIH) es la mayor causa infecciosa de muerte relacionada con el SIDA. El objetivo de este trabajo fue estimar la prevalencia de la coinfección TB/VIH, evaluar la notificación de las dos enfermedades de manera temporal, relación de bases de datos, y buscar factores asociados a las notificaciones de SIDA y TB. La prevalencia de coinfección TB/VIH fue de un 7,7%. El grupo de PVVIH, con posterior diagnóstico de TB, fue el más representativo, a pesar de las medidas preventivas disponibles. La subnotificación de TB entre los casos de SIDA fue de un 35%, y un 19,6% de los casos de TB podrían ser notificados como SIDA. Para los casos de SIDA con mención de TB, residir en la capital presentó una oportunidad un 75% mayor de ser notificada en el Sistema de Notificación de Tuberculosis (SINAN TB), y haber fallecido aumentó en un 40% la oportunidad de registro. De los casos de TB con mención de VIH, ser mestizo, tener entre 25 y 39 años, residir en la capital y haber evolucionado hacia el óbito estuvieron asociados a una mayor oportunidad de notificación en el SIDA. La vinculación periódica de estas bases puede ser una herramienta programática poderosa para disminuir la subnotificación.

Introduction: This study aimed to determine modern contraceptive prevalence and the barriers to using modern contraceptive methods among the couples in Dibindi health zone, Mbuji-Mayi, in the Democratic Republic of the Congo. Methods: We conducted a cross-sectional descriptive study from May to June 2015. Nonpregnant married women aged 15-49 years old at the time of the investigation, living in Dibindi health zone for two years and having freely consented to participate in the study were included. Data were collected by open-ended interview of these women. Modern contraceptive prevalence was referred to women who were currently using, at the time of the investigation, modern contraceptives. The comparison between proportions was performed at the significance threshold of 5%. Bonferroni’s test was used to compare, two by two, the proportions of barriers to using modern contraceptive methods. Results: Modern contraceptive prevalence in Dibindi was 18.4% in 2015. It was low with regard to family planning services available in this health zone. Several women refused to use modern contraceptive methods despite available information because of their desire for motherhood, religious prohibition, opposition on the part of their husband and fear of side effects. Conclusion: Sufficient client-centered or couple-centered information and family planning information should be strengthened in order to eliminate the false beliefs and to increase the use of modern contraceptive methods., SCOPUS: ar.j, info:eu-repo/semantics/published

Background Globally, 220 million women experience an unmet need for family planning. A newly designed female condom, the Woman’s Condom (WC), has been developed featuring an improved design. It is the first dual-protection, female-initiated contraceptive that is a premium, higher price point product. However, market availability alone will not increase uptake. In February 2016 the WC will be distributed with a strong media campaign and interpersonal communication (IPC) outreach intervention. The impact of these on knowledge, acceptability, and use of the WC will be measured. Methods/design A baseline survey of 2314 randomly selected 18- to 24-year-old sexually active men and women has been conducted. The WC and mass media will be introduced throughout 40 urban wards in and surrounding Lusaka, Zambia. The baseline survey will serve as a quasi-control arm to determine the impact of introducing the WC with mass media. Half of the wards will be randomly allocated to additionally receive the IPC intervention. A single-blind randomized controlled trial will determine the impact of the IPC intervention on knowledge, uptake, and use of the WC. After one year, another 2314 individuals will be randomly selected to participate in the endline survey. We hypothesize that (1) the distribution and media campaign of the WC will increase overall condom use in selected urban wards, and specifically use of the WC; (2) the IPC intervention will significantly impact knowledge, acceptability, and use of the WC. The primary outcome measures are use of the WC, use of any condom, and willingness to use the WC. Secondary outcomes include measures of knowledge, acceptability, and choice of contraception. Odds ratios will be estimated to measure the effect of the intervention on the outcomes with 95% confidence intervals. All analyses will be based on the intention-to-treat principle. Discussion Increasing uptake of dual prevention measures (such as the WC) may reduce incidence of sexually transmitted infections/HIV and unplanned pregnancies. It is important to ensure young, urban adults have access to new contraceptive methods; and, understanding how mass media and IPC impact contraceptive knowledge, acceptability, and use is critical to reduce unmet need. Trial registration AEARCTR-0000899. Registered on 26 October 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1681-x) contains supplementary material, which is available to authorized users.

espanolCaso clinico: El Complejo de Carney (CNC) es un raro sindrome multineoplasico, autosomico dominante; caracterizado por presentar mixomas, lesiones pigmentadas en la piel, tumores endocrinos y manifestaciones oculares. Discusion: Analizamos los signos oftalmologicos de este sindrome, los cuales suelen preceder al componente mas serio del mismo, el mixoma cardiaco. EnglishCase report: Carney complex (CNC) is a multiple neoplasia syndrome, inherited in an autosomal dominant manner, characterized by myxomas, spotty skin pigmentation, endocrine tumors and ophthalmic abnormalities. Discussion: We report the ocular findings which usually precede the most serious component of the complex, the cardiac myxoma.

Bronchoalveolar lavage (BAL) is a key clinical and research tool in lung transplantation (LTx). However, BAL collection and processing are not standardized across LTx centers. This International Society for Heart and Lung Transplantation-supported consensus document on BAL standardization aims to clarify definitions and propose common approaches to improve clinical and research practice standards. The following 9 areas are covered: (1) bronchoscopy procedure and BAL collection, (2) sample handling, (3) sample processing for microbiology, (4) cytology, (5) research, (6) microbiome, (7) sample inventory/tracking, (8) donor bronchoscopy, and (9) pediatric considerations. This consensus document aims to harmonize clinical and research practices for BAL collection and processing in LTx. The overarching goal is to enhance standardization and multicenter collaboration within the international LTx community and enable improvement and development of new BAL-based diagnostics. ispartof: JOURNAL OF HEART AND LUNG TRANSPLANTATION vol:39 issue:11 pages:1171-1190 ispartof: location:United States status: published

There is an increasing trend in the incidence of cancer worldwide, and it has been accepted that environmental factors account for an important proportion of the global burden. The present paper reports preliminary findings on the influence of the historical exposure to a group of persistent organic pollutants on total cancer risk, at year 9 in the follow-up of a cohort from Southern Spain. A cohort of 368 participants (median age 51 years) was recruited in 2003. Their historical exposure was estimated by analyzing residues of persistent organic pollutants in adipose tissue. Estimation of cancer incidence was based on data from a population-based cancer registry. Statistical analyses were performed using multivariable Cox-regression models. In males, PCB 153 concentrations were positively associated with total cancer risk, with an adjusted hazard ratio (95% confidence interval) of 1.20 (1.01–1.41) for an increment of 100 ng/g lipid. Our preliminary findings suggest a potential relationship between the historical exposure to persistent organic pollutants and the risk of cancer in men. However, these results should be interpreted with caution and require verification during the future follow-up of this cohort., This study was supported in part by research grants from the Spanish Ministry of Health (FIS 02/974, EUS2008-03574), CIBER de Epidemiología; Junta de Andalucía (01/264, P09-CTS-5488 Project of Excellence, PI-0675-2010, and PI-0513-2012), and the Instituto de Salud Carlos III (FIS PI11/0610).