Current epidemiology of hepatitis E virus infection in the United States: Low seroprevalence in the National Health and Nutrition Evaluation Survey

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108373/1/hep27219.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/108373/2/hep27219-sup-0001-suppinfo.pd

Pemidanaan Terhadap Pelaku Eksploitasi Seksual Kepada Anak Yang Dilakukan Secara Berlanjut (Studi Kasus Nomor:336/PID.SUS/2019/PN Amb)

Anak merupakan karunia dari Tuhan yang Maha Esa dan di dalam diri anak tersebut terdapat hak dan martabat yang sama dengan orang dewasa dan berhak mendapatkan perlindungan hukum agar dapat terlindungi hak-haknya dan supaya dapat tumbuh dan berkembang dengan baik. . 4 dasar hak yang wajib diberikan dan didapat anak meliputi hak hidup, hak tumbuh kembang, hak partisipasi, dan hak perlindungan. Eksploitasi anak adalah memanfaatkan anak secara tidak etis demi kebaikan ataupun keuntungan orangtua maupun orang lain. Eksploitasi seksual yang terjadi pada anak dapat menimbulkan dampak buruk terhadap diri anak seperti terganggunya pertumbuhan dan perkembangan anak baik secara fisik maupun psikis. Perlindungan anak adalah segala kegiatan untuk menjamin dan melindungi anak dan hak-haknya agar dapat hidup, tumbuh, berkembang dan berpartisipasi, secara optimal sesuai dengan harkat dan martabat kemanusiaan serta mendapat perlindungan dari kekerasaan dan deskriminasi. Tujuan dari penulisan ini untuk menemukan, menggambarkan, menganalisis bagaimana penerapan dari Pasal 64 ayat 1 KUHP sebagai Pasal pemberat dalam perkara Nomor 336/Pid.Sus/2019/Pn Amb dikaitkan dengan teori pemidanaan

Early repolarization electrocardiography pattern with unexplained syncope during training in a young black African non-elite athlete: An accidental finding?

Until recently it was generally thought that early repolarization is benign. But a recent article in the NEJM (Haissaguerre et al.) suggests that some persons with early repolarization may be at risk of life-threatening ventricular tachyarrhythmia. Unexplained syncope or sudden death occurs mostly during sleep. However, some cases of cardiac arrest during exertion have been reported. We report the case of a 39 year-old black African male with early repolarization pattern on electrocardiogram who regularly experienced dizziness (and one episode of transient loss of consciousness) exclusively while exercising. Detailed examination was normal. Under quinidine therapy, he experienced no further episodes. Increasingly reported cases of cardiac arrest in Africans, and significant prevalence of early repolarization in this population, have to be taken into account since the Haissaguerre et al. report. Further evidence of the lethal consequences of this syndrome are needed, bearing in mind that diagnostic tools for life-threatening arrhythmias are often scarce in sub-Saharan Africa

C-Reactive Protein in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy and Relationship with Ventricular Tachycardia

Background. The relationship between C-reactive protein (CRP) elevation and ventricular tachycardia (VT) in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is unclear. Methods and Results. In 91 consecutive patients with either ARVD/C with or without VT (cases) or idiopathic right ventricular outflow tract (RVOT) tachycardia (controls), blood sampling were taken to determine CRP levels. In ARVD/C patients with VT, we analyzed the association between VT occurrences and CRP level. Sixty patients had ARVD/C, and 31 had idiopathic RVOT VT. Patients with ARVD/C had a significant higher level of CRP compared to those with RVOT VT (3.5 ± 4.9 versus 1.1 ± 1.2 mg/l, P = .0004). In ARVD/C group, 77%, (n = 46) patients experienced VT. Of these, 37% (n = 17) underwent blood testing for CRP within 24 h after the onset of VT and the remaining 63% (n = 29) after 24 h of VT reduction. CRP level was similar in ARVD/C patients with or without documented VT (3.6 ± 5.1 mg/l versus 3.1 ± 4.1 mg/l, P = .372). However, in patients with ARVD/C and documented VT, CRP was significantly higher when measured within 24 hours following VT in comparison to that level when measured after 24 h (4.9 ± 6.2 mg/l versus 3.0 ± 4.4 mg/l, P = .049). Conclusion. Inflammatory state is an active process in patients with ARVD/C. Moreover, there is a higher level of CRP in patients soon after ventricular tachycardia, and this probably tends to decrease after the event

C-Reactive Protein Levels in the Brugada Syndrome

Background. Inflammation in the Brugada syndrome (BrS) and its clinical implication have been little studied. Aims. To assess the level of inflammation in BrS patients. Methods. All studied BrS patients underwent blood samples drawn for C-reactive protein (CRP) levels at admission, prior to any invasive intervention. Patients with a previous ICD placement were controlled to exclude those with a recent (<14 days) shock. We divided subjects into symptomatic (syncope or aborted sudden death) and asymptomatic groups. In a multivariable analysis, we adjusted for significant variables (age, CRP ≥ 2 mg/L). Results. Fifty-four subjects were studied (mean age 45 ± 13 years, 49 (91%) male). Twenty (37%) were symptomatic. Baseline characteristics were similar in both groups. Mean CRP level was 1,4 ± 0,9 mg/L in asymptomatic and 2,4 ± 1,4 mg/L in symptomatic groups (P = .003). In the multivariate model, CRP concentrations ≥ 2 mg/L remained an independent marker for being symptomatic (P = .018; 95% CI: 1.3 to 19.3). Conclusion. Inflammation seems to be more active in symptomatic BrS. C-reactive protein concentrations ≥ 2 mg/L might be associated with the previous symptoms in BrS. The value of inflammation as a risk factor of arrhythmic events in BrS needs to be studied

Gestational diabetes mellitus in Cameroon: prevalence, risk factors and screening strategies

Copyright \ua9 2024 Sobngwi, Sobngwi-Tambekou, Katte, Echouffo-Tcheugui, Balti, Kengne, Fezeu, Ditah, Tchatchoua, Dehayem, Unwin, Rankin, Mbanya and Bell.Background: The burden of gestational diabetes (GDM) and the optimal screening strategies in African populations are yet to be determined. We assessed the prevalence of GDM and the performance of various screening tests in a Cameroonian population. Methods: We carried out a cross-sectional study involving the screening of 983 women at 24-28 weeks of pregnancy for GDM using serial tests, including fasting plasma (FPG), random blood glucose (RBG), a 1-hour 50g glucose challenge test (GCT), and standard 2-hour oral glucose tolerance test (OGTT). GDM was defined using the World Health Organization (WHO 1999), International Association of Diabetes and Pregnancy Special Group (IADPSG 2010), and National Institute for Health Care Excellence (NICE 2015) criteria. GDM correlates were assessed using logistic regressions, and c-statistics were used to assess the performance of screening strategies. Findings: GDM prevalence was 5\ub79%, 17\ub77%, and 11\ub70% using WHO, IADPSG, and NICE criteria, respectively. Previous stillbirth [odds ratio: 3\ub714, 95%CI: 1\ub727-7\ub776)] was the main correlate of GDM. The optimal cut-points to diagnose WHO-defined GDM were 5\ub79 mmol/L for RPG (c-statistic 0\ub762) and 7\ub71 mmol/L for 1-hour 50g GCT (c-statistic 0\ub776). The same cut-off value for RPG was applicable for IADPSG-diagnosed GDM while the threshold was 6\ub75 mmol/L (c-statistic 0\ub761) for NICE-diagnosed GDM. The optimal cut-off of 1-hour 50g GCT was similar for IADPSG and NICE-diagnosed GDM. WHO-defined GDM was always confirmed by another diagnosis strategy while IADPSG and GCT independently identified at least 66\ub79 and 41\ub70% of the cases. Interpretation: GDM is common among Cameroonian women. Effective detection of GDM in under-resourced settings may require simpler algorithms including the initial use of FPG, which could substantially increase screening yield

Epidemiology of Mycobacterium bovis Disease in Humans, the Netherlands, 1993–2007

In the Netherlands, 1.4% of tuberculosis (TB) cases are caused by Mycobacterium bovis. After we admitted 3 patients with M. bovis infections to our reference hospital, we conducted a retrospective analysis of all M. bovis disease in the Netherlands during 1993–2007. We analyzed data from 231 patients for clinical, demographic, treatment, and outcome characteristics and for risk factors. Most patients were native Dutch (n = 138; 59.7%) or Moroccan (n = 54; 23.4%). Disease was mainly extrapulmonary (n = 136; 58.9%). Although 95 patients had pulmonary disease, person-to-person transmission did not occur, as shown by structural DNA fingerprinting analysis. Lymph node TB was more likely to develop in women (p<0.0001), whereas pulmonary M. bovis disease developed more frequently in men (p<0.0001). Diagnosis was accurate but delayed and led to inadequate treatment in 26% of the cases. Proportion of deaths from M. bovis disease was higher than that for M. tuberculosis disease

Burden of atrial fibrillation among adults with heart failure in sub-Saharan Africa: a systematic review and meta-analysis

Objectives This study aimed to estimate the prevalence of atrial fibrillation (AF) in adults with heart failure (HF) and summarise the all-cause mortality ratio among adult patients with coexisting HF and AF in sub-Saharan Africa (SSA). Setting This was a systematic review and meta-analysis of cross-sectional and cohort studies with primary data on the prevalence and incidence of AF among patients with HF and the all-cause mortality ratio among patients with HF and AF in SSA. We combined text words and MeSH terms to search MEDLINE, PubMed and Global Health Library through Ovid SP, African Journals Online and African Index Medicus from database inception to 10 November 2021. Random-effects meta-analysis was used to estimate pooled prevalence. Primary outcome measures The prevalence and incidence of AF among patients with HF, and the all-cause mortality ratio among patients with HF and AF. Results Twenty-seven of the 1902 records retrieved from database searches were included in the review, totalling 9987 patients with HF. The pooled prevalence of AF among patients with HF was 15.6% (95% CI 12.0% to 19.6%). At six months, the all-cause mortality was 18.4% (95% CI 13.1% to 23.6%) in a multinational registry and 67.7% (95% CI 51.1% to 74.3%) in one study in Tanzania. The one-year mortality was 48.6% (95% CI 32.5% to 64.7%) in a study in the Democratic Republic of Congo. We did not find any study reporting the incidence of AF in HF. Conclusion AF is common among patients with HF in SSA, and patients with AF and HF have poor survival. There is an urgent need for large-scale population-based prospective data to reliably estimate the prevalence, incidence and risk of mortality of AF among HF patients in SSA to better understand the burden of AF in patients with HF in the region

Clinical presentation, demographics and outcome of Tuberculosis (TB) in a low incidence area: a 4-year study in Geneva, Switzerland

<p>Abstract</p> <p>Background</p> <p>The incidence of tuberculosis (TB) in developed countries has decreased since the 1990s, reflecting worldwide efforts to identify and treat TB according to WHO recommendations. However TB remains an important public health problem in industrialized countries with a high proportion of cases occurring among subjects originating from high prevalence countries. The aim of this study was to describe clinical and social characteristics of patients with TB and their outcome in a low incidence area with a high immigration rate.</p> <p>Methods</p> <p>Four-year retrospective study based on a computerized database and subsequent review of medical records of all patients with TB followed at the outpatient section of the Division of Pulmonary Diseases, Geneva University Hospital, Switzerland.</p> <p>Results</p> <p>252 patients (84% foreigners, 25% asylum seekers) aged 38 ± 19 yrs were studied (11% co-infected with HIV). TB was intrapulmonary (TBP) in 158 cases (63%), extrapulmonary (TBE) in 137 (54%), and both in 43 cases (17%). TBP was smear (S)+/culture (C)+ in 59%, S-/C+ in 37%, S-/C- in 4%. Smoking was significantly associated with cavitary disease.</p> <p>Time from onset of symptoms to diagnosis was 2.1 ± 3.1 months. Initially, 10% were asymptomatic; 35% had no general symptoms. Despite systematic sputum analysis (induced or spontaneous), TBP was confirmed only by bronchoscopy in 38 subjects (24% of TBP). Side effects requiring changes in treatment occurred in 38 cases (11%).</p> <p>Treatment was completed in 210 (83%) patients. In 42 cases, follow up was unsuccessful; causes were: failure (n = 2; 0.8%), defaulters (n = 8; 3%), transfer out (n = 28; 11%) and death (n = 4; 1.6%). Relapse rate was 0.24 per 100 patient-years. Considering S+ TBP only, success rate was 87%.</p> <p>Conclusion</p> <p>TB in our area is predominantly a disease of young foreign-born subjects. Smoking appears as a possible risk factor for cavitary TBP. Time to diagnosis remains long. Compliance to treatment is satisfactory. Success rate for S+ TBP is within WHO objectives.</p