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PURPOSE: To evaluate the safety and efficacy of corneal collagen cross-linking (CXL) performed on overlaying a corneal lenticule to thin recipient corneas of progressive keratoconus (KC) patients. METHODS: In this study were enrolled eyes of patients affected by progressive KC with a minimum corneal thickness less than 400 µm, after overlaying a lenticule of human corneal stroma prepared with the femtosecond laser. The lenticules used were 100 µm thick and of 8.5 mm diameter in all the cases. Both the host cornea and the lenticules were subjected to epithelial debridement. CXL was carried out according to the standard protocol. Visual acuity, refraction, slit-lamp examination, endothelial cell density, pachymetry and keratometry, anterior segment tomography (AS-OCT) and confocal microscopy were evaluated preoperatively and at 1, 3, 6 and 12 months postoperatively. RESULTS: CXL was performed in 10 eyes of 8 patients (main age 23), corneal thickness range 379-414 µm, mean 387.6 µm. One patient was lost at follow-up. In all other cases, visual acuity and the endothelial cell density remained stable over a 12-month follow-up. Preoperative mean K1 and mean K2 were 46.91 ± 1.9 and 50.75 ± 2.93, respectively, and at 12 months mean K1 was 47.36 ± 2.66 and mean K2 50.53 ± 3.35. The AS-OCT clearly showed a demarcation line in all patients at 1, 3 (mean depth 283 µm and 267 µm, respectively) and in some cases at 6 months. Reduced keratocyte density and stromal oedema were observed immediately up to 1 month after treatment, while a slight subepithelial haze was present at 1-month and completely disappeared by 6 months. CONCLUSION: This new technique seems to offer a therapeutic opportunity for young patients suffering from progressive KC with very thin corneas, in which the standard treatment is not indicate, and delay or avoid the need for a corneal transplant.
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Queratocono , Fotoquimioterapia , Adulto , Colágeno/uso terapéutico , Córnea , Sustancia Propia , Topografía de la Córnea , Reactivos de Enlaces Cruzados/uso terapéutico , Humanos , Queratocono/tratamiento farmacológico , Fármacos Fotosensibilizantes/uso terapéutico , Riboflavina/uso terapéutico , Rayos Ultravioleta , Adulto JovenRESUMEN
This work studied the role of gold nanoparticles (AuNPs) with different spherical sizes mixed with poly (3, 4-ethylene dioxythiophene): polystyrene sulfonate (PEDOT: PSS) as a hole transfer layer to enhance the efficiency (ITO/PEDOT:PSS (AuNPs)/CuPc/C60/Al) organic photovoltaic cell (OPV). AuNPs were synthesized using the thermochemical method and the results of the transmission electron microscope (TEM) images showed that the gold nanoparticles mostly dominated by spherical shapes and sizes were calculated in the range (12-23 nm). Measurements of UV-VIS spectra for AuNPs have shown that the surface plasmon resonance shifted to a higher wavelength with decreasing the particle size. Surface morphology and absorption spectra of OPV cells were studied using atomic force microscope and UV-VIS spectrometer techniques. The efficiency of the OPV cell was calculated without and with AuNPs. Efficiency was increased from 0.78% to 1.02% due to the embedded of AuNPs with (12 nm) in PEDOT/PSS. The increase in the light absorption in CuPc is due to the good transparent conducting of PEDOT:PSS and the increase in the electric field around AuNPs embedded in PEDOT:PSS and inbuilt electric field at the interfacial between CuPc and C60 is due to the surface plasmon resonance of AuNPs. The increase in these two factors increase the exciton generation in CuPc, dissociation at the interfacial layer, and charge carrier transfer which increases the collection of electrons and holes at cathode and anode.
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As the current therapies for intestinal microsporidiosis are either inconsistent in their efficacies or hampered by several adverse effects, alternative antimicrosporidial agents are being sought. The present study is the first that was designed to evaluate the potency of orlistat, an approved anti-obesity drug, against intestinal microsporidiosis caused by both Enterocytozoon bieneusi and Encephalitozoon intestinalis. Results were assessed through studying fecal and intestinal spore load, intestinal histopathological changes, viability, and infectivity of spores from treated animals. Results showed that orlistat has promising antimicrosporidia potential, with better results in E. intestinalis than E. bieneusi. The animals that received orlistat showed statistically significant decrease in the fecal and intestinal spore load, when compared to the corresponding control infected nontreated mice. The results were insignificant compared to fumagillin and albendazole. Light microscopic examination of stained intestinal sections revealed amelioration of the pathological changes and decreased inflammatory cells detected in the control infected nontreated mice. Spores encountered from stool of orlistat-treated E. bieneusi and E. intestinalis mice showed low viability and significant reduction of infectivity versus their control. Thus, considering the results of the present work, orlistat proved its effectiveness against the intestinal microsporidial infection.
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Antifúngicos/uso terapéutico , Encephalitozoon/efectos de los fármacos , Enterocytozoon/efectos de los fármacos , Microsporidiosis/tratamiento farmacológico , Orlistat/uso terapéutico , Animales , Fármacos Antiobesidad , Recuento de Colonia Microbiana , Modelos Animales de Enfermedad , Reposicionamiento de Medicamentos , Encephalitozoon/crecimiento & desarrollo , Encephalitozoon/aislamiento & purificación , Enterocytozoon/crecimiento & desarrollo , Enterocytozoon/aislamiento & purificación , Heces/microbiología , Humanos , Intestinos/microbiología , Intestinos/patología , Masculino , Ratones , Viabilidad Microbiana/efectos de los fármacos , Microsporidiosis/microbiología , Especificidad de la EspecieRESUMEN
PurposeTo measure the pressure and volume of air required to create a big bubble (BB) in simulated deep anterior lamellar keratoplasty (DALK) in donor eyes and ascertain the bursting pressure of the BB.Patients and methodsTwenty-two human sclera-corneal discs were used. Air was injected into the corneal stroma to create a BB and the pressure measured by means of a pressure converter attached to the system via a side port. A special clamp was designed to prevent air leak from the periphery of the discs. The pressure at which air emerged in the corneal tissue; the bursting pressure measured after advancing the needle into the bubble cavity and injecting more air; the volume of air required to create a BB and the volume of the BB were ascertained.ResultsType-1 BB were achieved in 19 and type-2 BB in 3 eyes. The maximum pressure reached to create a BB was 96.25+/- 21.61 kpa; the mean type-1 intrabubble pressure was 10.16 +/- 3.65 kpa. The mean bursting pressure of a type-1 BB was 66.65 +/- 18.65 kpa, while that of a type-2 BB was 14.77 +/- 2.44 kpa. The volume of air required to create a type-1 BB was 0.54 ml and the volume of a type-1 BB was consistently 0.1 ml.ConclusionsDua's layer baring DALK can withstand high intraoperative pressures compared to Descemet's membrane baring DALK. The study suggests that it could be safe to undertake procedures such as DALK-triple with a type-1 BB but not with a type-2 BB.
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Córnea/cirugía , Trasplante de Córnea/métodos , Queratocono/cirugía , Esclerótica/cirugía , Donantes de Tejidos , Adulto , Anciano , Anciano de 80 o más Años , Presión del Aire , Femenino , Humanos , Masculino , Persona de Mediana Edad , Agudeza VisualRESUMEN
PurposeTo describe a novel use of fibrin glue in managing leaking blebs and leaking wounds following trauma or surgery.MethodsInterventional case series.ResultsWe report eight patients, including three where intra-operative or immediate post-penetrating keratoplasty recalcitrant leaks from the graft-host junction and/or openings created by the needle pass, were noted. All three had thin recipient beds in the sector of leak. This was managed by intra-cameral injection of fibrin glue in the affected quadrant. This stopped the leak and allowed the defect to heal. One patient of Descemets-stripping-endothelial-keratoplasty had leak from the surgical wound, which was also sealed with fibrin glue. Two patients with leaking glaucoma-surgery-related blebs were treated with intra-bleb injection of fibrin glue to stop the leak. One patient with a penetrating corneal injury with a metal wire had a brisk leak upon removal of the wire. This was sealed with fibrin glue. Another patient of chemical burn with spontaneous leaks was managed by glue injection in the perforations. Transient rise of intraocular pressure in one patient with a leaking bleb was the only adverse event recorded.ConclusionThis novel adaptation of the application of fibrin glue can help to deal with persistent intra-operative, post-operative and traumatic aqueous and air leaks.
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Enfermedades de la Conjuntiva/cirugía , Lesiones de la Cornea/cirugía , Lesiones Oculares Penetrantes/cirugía , Adhesivo de Tejido de Fibrina/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Complicaciones Intraoperatorias/cirugía , Queratoplastia Penetrante/efectos adversos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/cirugíaRESUMEN
PurposeTo compare axial length (AL) with vitreous cavity length (VCL) in patients with keratoconus and to ascertain whether graft size can be tailored to reduce myopic refractive error in patients with keratoconus undergoing penetrating keratoplasty (PK).Patients and methodsThe AL and VCL were measured prospectively in patients with keratoconus not undergoing PK (Group 1) and in normal phakic, emmetropic individuals (Group 2). A retrospective analysis of these measurements in patients with keratoconus who had undergone PK (Group 3) was also performed. The postoperative spherical equivalent (SE) was then correlated to size of donor buttons.ResultsKeratoconus patients tended to have a longer mean VCL than emmetropic normal individuals. The mean VCL of these patients (Group 1) was 16.49 mm±SD 1.13 compared to the mean VCL of 15.94 mm±SD 0.56 in normals (Group 2, P<0.0001). Patients with keratoconus who had an undersized graft showed reduced myopic refractive error compared to those with same size or oversized grafts.ConclusionVCL measurement is more accurate than AL measurement in deciding upon graft-host size disparity for corneal graft in patients with keratoconus. In patients with increased VCL, undersizing the donor button helps in reducing postoperative myopia. We recommend VCL measurement as part of the routine workup in all keratoconus patients undergoing corneal transplants.
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Longitud Axial del Ojo/patología , Queratocono/patología , Queratoplastia Penetrante , Cuerpo Vítreo/patología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Queratocono/cirugía , Queratoplastia Penetrante/métodos , Masculino , Persona de Mediana Edad , Miopía/prevención & control , Miopía/cirugía , Estudios Retrospectivos , Adulto JovenRESUMEN
AIM: This systematic review provides a summary of the blood protein biomarkers that have been studied for the diagnosis of acute ischemic stroke. MATERIALS & METHODS: An extensive MEDLINE (using PubMed) and Web of Knowledge search was performed. From the 354 articles found, 42 were eligible for further analysis and 25 protein biomarkers were examined. RESULTS: Though many candidate blood-based protein biomarkers were examined, only two could significantly differentiate ischemic stroke patients from healthy controls, stroke mimics and hemorrhagic stroke patients. CONCLUSION: The blood protein biomarkers, brain natriuretic peptide (BNP) and S100B, were promising biomarkers in diagnosing ischemic stroke. They could be used in cases of diagnostic uncertainty and/or when less experienced healthcare personnel are involved.
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Proteínas Sanguíneas/metabolismo , Isquemia Encefálica/complicaciones , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/complicaciones , Biomarcadores/sangre , HumanosRESUMEN
PurposeTo design and produce a clamp that enables good handling of donor sclera-corneal disks, allows air to be injected in the corneal stroma and consistently provides pre-Descemets endothelial keratoplasty (PDEK) tissue by creation of a type-1 big bubble (BB) avoiding a type-2BB by shutting the fenestrations in the periphery of the pre-Descemets layer and preventing escape of air.Patients and methodsA clamp with spring loaded handles attached to two rings of 9 mm diameter and 1 mm width with a side port for insertion of a needle for air injection was designed and produced. The clamp was tested in 20 human donor sclera-corneal disks and refined over three prototypes. The final design was used for PDEK in 8 patients.ResultsThe clamp was able to prevent any escape of air or the formation of a type-2BB. By preventing air leak, it provided better control over the volume of air injected allowing for consistent formation of a type-1BB, which could be expanded to its full diameter by advancing the tip of the needle into the bubble cavity. Centration of tissue in the clamp was important. The clamp was used successfully to obtain PDEK tissue from 8 donor sclara-corneal disks for transplant in three eyes with pseudophakic bullous keratopathy and five eyes with pseudophakia and Fuchs' endothelial dystrophy.ConclusionThe PDEK clamp is a simple and useful instrument that will give surgeons the confidence of consistently obtaining PDEK tissue with ease and without the risk of separating the Descemets membrane in a type-2BB.
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Pérdida de Celulas Endoteliales de la Córnea/cirugía , Queratoplastia Endotelial de la Lámina Limitante Posterior/métodos , Agudeza Visual , Anciano , Anciano de 80 o más Años , Pérdida de Celulas Endoteliales de la Córnea/diagnóstico , Endotelio Corneal/patología , Femenino , Supervivencia de Injerto , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Donantes de TejidosRESUMEN
PURPOSE: To describe a technique which exploits the transparency and toughness of the pre-Descemets layer (Dua's layer) to safely perform deep anterior lamellar keratoplasty (DALK) and phacoemulsification at the same time. METHODS: Three DALK procedures combined with phacoemulsification were performed by the same surgeon using the big-bubble (BB) technique at the Research Institute of Ophthalmology, Cairo, Egypt. In two cases a type-1 BB, baring Dua's layer, was achieved and in one case a type-2 BB, baring the Descemet's membrane (DM), was achieved. The surgeries were video recorded and photo slit-lamp images were taken in the follow-up visits. RESULTS: DALK with phacoemulsification and lens implant was carried out in both patients where a type-1 BB was achieved. At a follow up of 18 months (first case) and 6 months (second case), the best corrected vision was 6/12 for each. In the case where a type-2 BB was achieved, the DM ruptured during injection of viscoelastic prior to capsulorhexis. The procedure was converted to a penetrating keratoplasty without phacoemulsification. CONCLUSION: When a type-1 BB is achieved simultaneous DALK and phacoemulsification can be safely accomplished. Dua's layer allows a clear view for performing phacoemulsification with the added benefit of its toughness, which can maintain a stable anterior chamber for cataract surgery. This should not be attempted when a type-2 BB is achieved.
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Catarata/complicaciones , Enfermedades de la Córnea/complicaciones , Trasplante de Córnea/métodos , Lámina Limitante Posterior/cirugía , Implantación de Lentes Intraoculares/métodos , Facoemulsificación/métodos , Sustancia Propia/cirugía , Humanos , Masculino , Persona de Mediana Edad , Lámpara de Hendidura , Grabación en Video , Agudeza Visual/fisiología , Adulto JovenRESUMEN
AIM: Recurrence is the most common complication arising from pterygium surgery. The aim of this study was to investigate the effectiveness of 5 fluorouracil (5FU) in halting the recurrence of pterygium after surgical excision. METHODS: A retrospective review of patients treated for pterygium recurrence was carried out. Patients with recurrent (secondary) pterygium were treated with multiple weekly intra-lesional injections of 0.1-0.2 ml (2.5-5 mg) 5FU post-operatively depending on the size of the recurrence. The treatment was started within 1 month from the date of recurrence. The time from surgery to start of recurrence, previous treatment modalities, and number of recurrences were documented. The number of injections required to induce arrest of progression and/or regression of vascularity and fleshiness of the pterygium and any complications related to 5FU treatment were examined. RESULTS: Fifteen eyes from 14 patients with recurrent pterygium treated with intra-lesional 5FU injections were analysed. Three of the 15 eyes had undergone a secondary excision and 12 had undergone a primary excision. In all, 93.3% of patients showed regression of the fibrovascular tissue (thickness and vascularity) and arrest of progression following a dose of 0.1-0.2 ml (2.5-5 mg) 5FU. Twelve eyes required three injections or fewer, whereas one patient required eight injections. This beneficial effect was maintained over an average follow-up period of 17 months. No complications from 5FU were observed. CONCLUSION: The use of weekly intra-lesional 5FU injections for the treatment of recurrent pterygium is safe and effective in limiting the progression and inducing the regression of recurrent pterygium. The number of injections can be tailored according to clinical need.
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Fluorouracilo/administración & dosificación , Inmunosupresores/administración & dosificación , Pterigion/tratamiento farmacológico , Adulto , Anciano , Femenino , Humanos , Inyecciones Intralesiones , Masculino , Persona de Mediana Edad , Cuidados Posoperatorios , Pterigion/cirugía , Estudios Retrospectivos , Prevención SecundariaAsunto(s)
Lesión Renal Aguda/sangre , Creatinina/sangre , Hipertensión/sangre , Adulto , Humanos , Masculino , Adulto JovenRESUMEN
BACKGROUND: Factor VIIa (recombinant) has an off-label use to control life-threatening bleeding that is refractory to other measures and was shown to decrease transfusion requirements. OBJECTIVE: The primary objective of this study was to assess the safety and effectiveness of factor VIIa (recombinant) on blood transfusion requirements and coagulation parameters when used in patients whose bleeding was uncorrected by other means. The pharmacoeconomic impact for any discrepancy from our protocol was evaluated. Secondary outcomes included 4-hour and 28-day mortality, as well as safety of this agent in terms of thromboembolic complications. MATERIALS AND METHODS: We retrospectively evaluated patients who received recombinant-activated factor VII (rFVIIa) for uncontrolled bleeding from June 2008 to April 2011. The medical records of 33 patients were evaluated. Coagulation parameters and blood products were determined 24 hours before and 24 hours after administration of rFVIIa, and the results compared. Patients were also screened for any thromboembolic complications. RESULTS: Administration of rFVIIa reduced blood transfusion requirements and improved coagulation parameters significantly (P<0.05). No thromboembolic complications were reported. Most of the dosing was consistent with those recommended in our institutional protocol, with discrepancies resulting in an average cost of $56 058. Moreover, pH was reported in only 67% of patients. All patients treated with rFVIIa survived up to 4 hours after receiving this agent, while the 28-day mortality was 24% (8/33). CONCLUSION: The use of rFVIIa appears to be safe and effective in promoting hemostasis, as evident from reducing transfusion requirements and improving the coagulation variables.
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This study was carried out to evaluate the anti parasitic potential of silver, chitosan, and curcumin nanoparticles as anti-Giardia agents. Non-treated infected control rats were inoculated with Giardia lamblia cysts in a dose of 2 × 10(5) cysts/rat. Experimental group was infected then treated with curcumin, curcumin nanoparticles, chitosan, chitosan nanoparticles, and silver nanoparticles as single or combined therapy. The number of Giardia cysts in stools and trophozoites in intestinal sections were detected. Toxicity of nanoparticles was evaluated by comparing hematological and histopathological parameters of the normal control group and treated non-infected control group. The amount of silver was also measured in the liver, kidney, small intestine, lung, and brain of rats treated with silver nanoparticles. The number of the parasites in stool and small intestinal sections decreased in treated infected rats compared with infected non-treated ones. The effect in the single therapy was better with nanoparticles, and the best effect was detected in nano-silver. The combined therapy gave better results than single. Combination between nanoparticles was better than the combination of nano-forms and native chitosan and curcumin. The best effect was detected in combinations of nano-silver and nano-chitosan but with no full eradication. In conclusion, the highest effect and complete cure was gained by combining the three nano-forms. The parasite was successfully eradicated from stool and intestine. None of the treatments exhibited any toxicity. Accumulated silver in different organs was within the safe limits.
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Antiprotozoarios/farmacología , Quitosano/farmacología , Curcumina/farmacología , Giardiasis/tratamiento farmacológico , Nanopartículas/química , Plata/farmacología , Animales , Antiprotozoarios/química , Quitosano/química , Curcumina/química , Quimioterapia Combinada , Giardia lamblia/efectos de los fármacos , Giardiasis/parasitología , Ratas , Plata/químicaRESUMEN
Disseminated neonatal herpes simplex virus (HSV) infection is characterized by progressive multiple organ failure and high mortality rates up to 85% for untreated neonates. It can result from infection with either HSV-1 or HSV-2. We report the first known case of disseminated neonatal herpes associated with fulminant liver failure caused by HSV-2 who survived without liver transplant.
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Bacteriophage (phage) display has been exploited for the purpose of discovering new cancer specific targeting peptides. However, this approach has resulted in only a small number of tumor targeting peptides useful as in vivo imaging agents. We hypothesize that in vivo screening for tumor uptake of fluorescently tagged phage particles displaying multiple copies of an in vivo selected tumor targeting peptide will expedite the development of peptide based imaging agents. In this study, both in vivo selection and in vivo screening of phage displaying foreign peptides were utilized to best predict peptides with the pharmacokinetic properties necessary for translation into efficacious in vivo imaging agents. An in vivo selection of phage display libraries was performed in SCID mice bearing human PC-3 prostate carcinoma tumors. Eight randomly selected phage clones and four control phage clones were fluorescently labeled with AlexaFluor 680 for subsequent in vivo screening and analyses. The corresponding peptides of six of these phage clones were tested as 111In-labeled peptide conjugates for single photon emission computed tomography (SPECT) imaging of PC-3 prostate carcinomas. Two peptide sequences, G1 and H5, were successful as in vivo imaging agents. The affinities of G1 and H5 peptides for cultured PC-3 cells were then analyzed via cell flow cytometry resulting in Kd values of 1.8 µM and 2.2 µM, respectively. The peptides bound preferentially to prostate tumor cell lines compared to that of other carcinoma and normal cell lines, and H5 appeared to possess cytotoxic properties. This study demonstrates the value of in vivo screening of fluorescently labeled phage for the prediction of the efficacy of the corresponding 111In-labeled synthetic peptide as an in vivo SPECT tumor imaging agent.
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Bacteriófagos/metabolismo , Péptidos/metabolismo , Neoplasias de la Próstata/patología , Animales , Línea Celular Tumoral , Colorantes Fluorescentes , Humanos , Masculino , Ratones , Ratones SCIDRESUMEN
UNLABELLED: Gastrin-releasing peptide receptors (GRPr) are a member of the bombesin (BBN) receptor family. GRPr are expressed in high numbers on specific human cancers, including human prostate cancer. Therefore, copper-64 ((64)Cu) radiolabeled BBN(7-14)NH(2) conjugates could have potential for diagnosis of human prostate cancer via positron-emission tomography (PET). The aim of this study was to produce [(64)Cu-NO2A-(X)-BBN(7-14)NH(2)] conjugates for prostate cancer imaging, where X=pharmacokinetic modifier (beta-alanine, 5-aminovaleric acid, 6-aminohexanoic acid, 8-aminooctanoic acid, 9-aminonanoic acid or para-aminobenzoic acid) and NO2A=1,4,7-triazacyclononane-1,4-diacetic acid [a derivative of NOTA (1,4,7-triazacyclononane-1,4,7-triacetic acid)]. METHODS: [(X)-BBN(7-14)NH(2)] Conjugates were synthesized by solid-phase peptide synthesis (SPPS), after which NOTA was added via manual conjugation. The new peptide conjugates were radiolabeled with (64)Cu radionuclide. The receptor-binding affinity was determined in human prostate PC-3 cells, and tumor-targeting efficacy was determined in PC-3 tumor-bearing severely combined immunodeficient (SCID) mice. Whole-body maximum intensity microPET/CT images of PC-3 tumor-bearing SCID mice were obtained 18 h postinjection (pi). RESULTS: Competitive binding assays in PC-3 cells indicated high receptor-binding affinity for the [NO2A-(X)-BBN(7-14)NH(2)] and [(nat)Cu-NO2A-(X)-BBN(7-14)NH(2)] conjugates. In vivo biodistribution studies of the [(64)Cu-NO2A-(X)-BBN(7-14)NH(2)] conjugates at 1, 4 and 24 h pi showed very high uptake of the tracer in GRPr-positive tissue with little accumulation and retention in nontarget tissues. High-quality, high-contrast microPET images were obtained, with xenografted tumors being clearly visible at 18 h pi. CONCLUSIONS: NO2A chelator sufficiently stabilizes copper(II) radiometal under in vivo conditions, producing conjugates with very high uptake and retention in targeted GRPr. Preclinical evaluation of these new peptide conjugates in tumor-bearing mice provides some impetus for clinical evaluation in human patients.
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Bombesina , Radioisótopos de Cobre , Compuestos Heterocíclicos con 1 Anillo , Tomografía de Emisión de Positrones , Neoplasias de la Próstata/diagnóstico por imagen , Radiofármacos , Animales , Bombesina/química , Humanos , Masculino , Ratones , Ratones Desnudos , Neoplasias de la Próstata/metabolismo , Distribución Tisular , Células Tumorales Cultivadas , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
The prolonged civil strife in the North-West Zone of Somalia (Somaliland) has hampered the development of social infrastructure and public health services. There are limited data on HIV/AIDS. In 2004, a sentinel HIV seroprevalence survey was conducted. Blood samples were collected from 1561 women attending antenatal care clinics, 249 tuberculosis (TB) patients and 243 people attending sexually transmitted disease (STD) clinics. Samples were tested for syphilis and HIV. Overall HIV prevalence was 1.4%, significantly higher than that observed in many other countries in the Region. Prevalence was 1.2% among pregnant women 15-24 years, 12.3% among patients with STD and 5.6% among TB patients. The prevalence of syphilis was 1.3% in the pregnant women.
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Infecciones por VIH/epidemiología , Seroprevalencia de VIH , Necesidades y Demandas de Servicios de Salud/organización & administración , Complicaciones Infecciosas del Embarazo/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Tuberculosis/epidemiología , Adolescente , Adulto , Distribución por Edad , Instituciones de Atención Ambulatoria , Comorbilidad , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Factores de Riesgo , Vigilancia de Guardia , Distribución por Sexo , Enfermedades de Transmisión Sexual/complicaciones , Enfermedades de Transmisión Sexual/prevención & control , Factores Socioeconómicos , Somalia/epidemiología , Tuberculosis/complicaciones , Tuberculosis/prevención & control , GuerraRESUMEN
The evolutionary significance of cranial form and robusticity in early Homo has been variously attributed to allometry, encephalization, metabolic factors, locomotor activity, and masticatory forces. However, the influence of such factors is variably understood. To evaluate the effect of masticatory loading on neurocranial form, sibling groups of weanling white rabbits were divided into two cohorts of 10 individuals each and raised on either a soft diet or a hard/tough diet for 16 weeks until subadulthood. Micro-CT was used to quantify and visualize morphological variation between treatment groups. Results reveal trends (P < 0.10) for greater outer table thickness of the frontal bones, zygomatic height, and cranial globularity in rabbits raised on a hard/tough diet. Furthermore, analyses of three-dimensional coordinate landmark data indicate that the basicrania of hard/tough diet rabbits exhibit more robust middle cranial fossae and pterygoid plates, as well as altered overall morphology of the caudal cranial fossa. Thus, long term increases in masticatory loads may result in thickening of the bones of the neurocranial vault and/or altering the curvature of the walls. Differences in cranial regions not directly associated with the generation or resistance of masticatory forces (i.e., frontal bone, basicranium) may be indirectly correlated with diet-induced variation in maxillomandibular morphology. These findings also suggest that long-term variation in masticatory forces associated with differences in dietary properties can contribute to the complex and multifactorial development of neurocranial morphology.