The Lancet - 07/19/03
Volume 362, Number 9379
Strategies for control of trachoma: observational study with quantitative PCR Anthony W Solomon, Martin J Holland, Matthew J Burton, Sheila K West, Neal DE Alexander, Aura Aguirre, Patrick A Massae, Harran Mkocha, Beatriz Muñoz, Gordon J Johnson, Rosanna W Peeling, Robin L Bailey, Allen Foster, David CW Mabey
Section : Articles
Areas of interest : Preventive medicine and public health. Microbiology and parasitology. Ophthalmology.
In this study, the prevalence of ocular C. trachomatis was investigated in three endemic communities in Tanzania and Gambia, using PCR (first qualitative and positive cases, quantitative). The highest burdens were found in children under 10 years of age and in people with highly inflammatory trachoma, and they are probably the most important sources of infection in these areas. In the area with the highest prevalence, 52% of people with conjunctival scars, but without signs of active disease, were positive for C. trachomatis.
Validation of the pediatric logistic organ dysfunction (PELOD) score: prospective, observational, multicenter study Stéphane Leteurtre, Alain Martinot, Alain Duhamel, François Proulx, Bruno Grandbastien, Jacques Cotting, Ronald Gottesman, Ari Joffe, Jurg Pfenninger, Philippe Hubert, Jacques Lacroix , Francis Leclerc
Section : Articles
Areas of interest : Intensive medicine. Pediatrics. Perinatology.
An observational, prospective, multicenter study was carried out to validate an organic dysfunction scale in children in intensive care units (PELOD), as well as its validity if recorded daily (dPELOD). 1,806 consecutive patients with a mean age of 24 months were included. The PELOD includes dysfunctions of 6 organs and 12 variables that were recorded daily. The results indicate that both systems are valid to measure the severity of multiple organ dysfunction syndrome. The authors point out that this could help reduce the sample size needed to conduct clinical trials in these patients.
Mortality in relation to oral contraceptive use and cigarette smoking Martin Vessey, Rosemary Painter, David Yeates
Section : Articles
Areas of interest : Pharmacology. Gynecology. Tobacco. Clinical pharmacology. Family medicine. Preventive medicine and public health. Obstetrics and Gynecology. Smoking.
Study of more than 17,000 women between 25 and 39 years of age recruited between May 1968 and July 1974. Mortality was assessed until December 2000, finding 889 deaths. Women who had never taken oral contraceptives (OC) had higher mortality from cervical cancer (rate ratio 7.2; 95% CI 1.1-303), and lower mortality from ovarian cancer (0.4; 0. 2-0.7)and other uterine cancers (0.2;0.0-0.8).OCs had some adverse effect on deaths from ischemic heart disease in women who smoked more than 15 cigarettes/day. Mortality from all causes was lower in women who had ever taken OCs. In contrast, the rate ratio was 1.24 (1.03-1.49) in women who smoked between 1 and 14 cigarettes per day and 2.14 (1.81-2.53) in those who smoked 15 or more.
Are imprecise methods obscuring a relationship between fat and breast cancer? Sheila A Bingham, Robert Luben, Ailsa Welch, Nicholas Wareham, Kay-Tee Khaw, Nicholas Day
Section : Research Letters
Areas of interest : Oncology. Nutrition. Endocrinology and Nutrition. Investigation. Obstetrics and Gynecology. Oncology. Senology.
The authors of this study consider that the error associated with food frequency questionnaires is significantly higher than what was estimated and affirm that this fact would explain why a relationship between fat consumption and the development of breast cancer has not been found in studies population. This conclusion is drawn after assessing the relationship between these two factors with a food frequency questionnaire and with a daily record of weekly meals written by the 13,000 participants in the European prospective study EPIC-Norfolk during 1993 and 1997. In the year 2000 , 168 of the participants had developed breast cancer. When evaluating the fat intake of each woman with cancer compared to four healthy controls, it was found that women who consumed the most saturated fat doubled the risk of breast cancer compared to those who consumed the least fat, when the fat assessment was done by the personal diary; However, if the assessment was made using data from the frequency questionnaire, no association was found between fat intake and the appearance of cancer.
Haemoglobin concentration and prognosis in new cases of heart failure Paul R Kalra, Timothy Collier, Martin R Cowie, Kevin F Fox, David A Wood, Philip A Poole-Wilson, Andrew JS Coats, George C Sutton
Section : Research Letters
Areas of interest : Cardiovascular. Cardiology. Hematology and Hemotherapy. Family medicine. Internal Medicine.
The authors investigated 552 patients with heart failure (HF) in whom the duration of HF was short enough that hemoglobin concentrations were not affected. Unlike in cases of established HF, hemoglobin was not independently associated with prognosis when age and serum creatinine were included in the analysis. The authors note that the adverse effects of anemia on survival are a consequence of chronic HF rather than a separate process that causes disease progression.
Trachoma David CW Mabey, Anthony W Solomon, Allen Foster
Section : Seminar
Areas of interest : Preventive medicine and public health. Microbiology and parasitology. Ophthalmology.
The authors review the causes and diagnosis of trachoma and address the WHO "SAFE" strategy that aims to target this disease as a public health problem by 2020. This strategy is based on the demonstration that a single dose of azithromycin is as effective as 6 weeks of topical treatment with tetracyclines. The SAFE strategy consists of: 1) inverted eyelash surgery, 2) antibiotics for active disease, 3) facial cleansing, and 4) environmental improvement.
Non-steroidal anti-inflammatory drugs and molecular carcinogenesis of colorectal carcinomas G Huls, JJ Koornstra, JH Kleibeuker
Section : Rapid review
Areas of interest : Preventive activities. Digestive. Pharmacology. Oncology. Clinical pharmacology. Gastroenterology. Oncology.
Article that summarizes the most important studies that have highlighted the role of NSAIDs in the prevention of colorectal cancer and that addresses, above all, the possible mechanisms that explain this relationship. Some studies have suggested an important role for protein 21 in cell cycle regulation and that a decrease in it could be one of the oncogenic phenomena involved in the development of colorectal cancer. It seems that this protein could be the molecular link that explains the preventive effects of NSAIDs.
