Newton R.L.,Minority |
Griffith D.M.,Vanderbilt University |
Kearney W.B.,Health Ministry |
Bennett G.G.,Duke University
Obesity Reviews | Year: 2014
When compared with men of other racial or ethnic groups, African American men are more likely to experience adverse health conditions. The systematic review objectives were to (i) determine the current evidence base concerning African American men's response to lifestyle behavioural interventions designed to promote weight loss, increase physical activity, and/or improve healthy eating and (ii) determine the next steps for research in these areas. The PubMed, Web of Science, Psych Info and Cochrane databases were searched to identify papers published before January 1, 2013 that reported change in weight, physical activity and/or dietary patterns in African American men aged 18 and older, as a result of behavioural change strategies. The titles and abstracts of 1,403 papers were screened; after removing duplicates, 141 papers were read to determine their eligibility. Seventeen publications from 14 studies reported outcomes for African American men. Eight large multi-centre trials and six community-based studies were identified. African American men were an exclusive sample in only four studies. Five studies showed statistically significant improvements. Although the available evidence appears to show that these interventions produce positive results, the relative and the long-term effectiveness of weight loss, dietary and/or physical activity interventions for this population are unknown. © 2014 World Obesity.
Eryilmaz M.,Ankara University |
Bozkurt M.E.,Ankara University |
Yildiz M.M.,Health Ministry |
Akin A.,Ankara University
Tropical Journal of Pharmaceutical Research | Year: 2010
Purpose: To investigate the antimicrobial resistance rate of 110 E. coli strains, isolated from UTIs in Etlik Lokman Hekim Hospital, Etlik, Ankara, Turkey. Methods: API-20E System (bioMerieux, France) was used to identify E. coli isolates. Antimicrobial susceptibility testing was conducted on Mueller-Hinton Agar plates (Merck, Germany) using agar disc diffusion method and the results were expressed as susceptible or resistant according to the criteria recommended by the Clinical and Laboratory Standarts Institute (CLSI). Results: The resistance rates detected were 56 % to ampicillin, 24 % to ampicillin sulbactam, 9 % to gentamicin, 15 % to ciprofloxacin, 36 % to trimethoprim sulfamethoxazole, 12 % to cefazolin, and 7 % to cefuroxime. All isolates tested were susceptible to fosfomycin and nitrofurantoin. Conclusion: When the high resistance rates in Turkey are taken into consideration, antimicrobial agent usage policies and empirical therapies should be based on antimicrobial resistance surveillance studies. © Pharmacotherapy Group.
News Article | April 14, 2016
Confirming the worst fears of many pregnant women in the United States and Latin America, U.S. health officials said Wednesday there is no longer any doubt the Zika virus causes babies to be born with abnormally small heads and other severe brain defects. Since last year, doctors in Brazil have been linking Zika infections in pregnant women to a rise in newborns with microcephaly, or an unusually small skull. Most outside experts were cautious about drawing such a connection. But now the U.S. Centers for Disease Control and Prevention says enough evidence is in. "There is no longer any doubt that Zika causes microcephaly," CDC Director Dr. Tom Frieden said. The CDC said it also is clear Zika causes other serious defects, including damaging calcium buildups in the developing brain. Among the evidence that clinched the case: Signs of the Zika virus, which is spread primarily through mosquito bites and can also be transmitted through sex, have been found in the brain tissue, spinal fluid and amniotic fluid of microcephaly babies. The CDC and other health agencies have been operating for months on the assumption that Zika causes brain defects, and they have been warning pregnant women to use mosquito repellent, cover up, avoid travel to Zika-stricken regions and either abstain from sex or rely on condoms. Those guidelines will not change. But the new finding should help officials make a more convincing case to the public for taking precautions. Some experts hope it will change public thinking about Zika the way the 1964 surgeon general's report convinced many Americans that smoking causes lung cancer. "We've been very careful over the last few months to say, 'It's linked to, it's associated with.' We've been careful to say it's not the cause of," said the CDC's Dr. Sonja A. Rasmussen. "I think our messages will now be more direct." The World Health Organization has made similar statements recently. A WHO official applauded the CDC report. "We feel it's time to move from precautionary language to more forceful language to get people to take action," said Dr. Bruce Aylward, who is leading WHO's Zika response. The CDC announced its conclusion in a report published online by the New England Journal of Medicine. Zika has been sweeping through Latin America and the Caribbean in recent months, and the fear is that it will only get worse there and arrive in the U.S. with the onset of mosquito season this spring and summer. Public health authorities are calling for aggressive mosquito surveillance and eradication, including campaigns to eliminate the sources of standing water in which mosquitoes breed. Those can include flower pots, swimming pool covers, discarded tires and pet water bowls. The virus causes only a mild and brief illness, at worst, in most people. But in the last year, infections in pregnant women have been strongly linked to fetal deaths and devastating birth defects, mostly in Brazil, where the Health Ministry said Tuesday that 1,113 cases of microcephaly have been confirmed since October. So far, there have been no documented Zika infections in the U.S. caught from mosquitoes. Nearly 350 illnesses in the 50 states were reported as of last week, all linked to travel to Zika outbreak regions. Thirty-two of the infected women were pregnant. The CDC report comes at a time when health officials have been begging Congress to approve an emergency $1.9 billion in supplemental funding to fight Zika internationally and prepare for its spread in the U.S. Earlier Wednesday, top House Republicans said they will probably grant a portion of that, but probably not until September. As the microcephaly cases rose in Latin America, a number of theories circulated through the public. Some claimed the cause was a vaccine given to pregnant women. Some suspected a mosquito-killing larvicide, and others wondered whether genetically modified mosquitoes were to blame. Investigators gradually cast those theories aside and found more and more circumstantial evidence implicating Zika. CDC officials relied on a checklist developed by a retired University of Washington professor, Dr. Thomas Shepard, who listed seven criteria for establishing if something can be called a cause of birth defects. Among other things, researchers found that the spike in microcephaly in Brazil involved women who were infected with Zika during the first or early second trimester of pregnancy. They also discovered more direct evidence in the form of the virus or its genetic traces. "In the case of Zika, if you get live virus from spinal fluid from microcephalic kids, that's pretty damn good evidence," Shepard said in an interview. Researchers still don't have some of the evidence they would like. For example, there are no published studies demonstrating Zika causes such birth defects in lab animals. There is also a scarcity of high-quality studies that have systematically examined large numbers of women and babies in a Zika outbreak area. "The purist will say that all the evidence isn't in yet, and they're right," the WHO's Aylward said, "but this is public health and we need to act." The hope is that the public will start paying closer attention. A poll released last week found that about 4 in 10 Americans have heard little to nothing about the Zika threat. Even among people who have been following the story at least a little, many aren't sure whether there is a vaccine or treatment - not yet - or if the virus can be spread through means other than mosquito bites, according to the poll conducted by The Associated Press-NORC Center for Public Affairs Research.
Six medical volunteers have been hospitalized - one in a state of brain death - after taking part in a botched drug test at a clinic in western France, the Health Ministry said Friday. The prosecutor's office has opened an investigation into what the ministry called a "serious accident during a clinical test" in Rennes. It did not name the clinic. However, the Rennes-based lab Biotrial said its CEO, Jean-Marc Gandon, would join Health Minister Marisol Touraine. The minister went to Rennes on Friday after ordering an investigation into the organization and how it conducts clinical tests. The ministry statement said those who fell ill had taken an oral medication in the first phase of testing, which was studying safe usage, tolerance and other measures on healthy volunteers. It was not immediately clear whether the six were among a larger group of volunteers involved in the tests or what dose they had been given. The statement did not name the type of medication being tested. Biotrial, with headquarters in Rennes and offices in London and Newark, New Jersey, says on its website it has over 25 years of experience in clinical trials and uses "state-of-the-art facilities." In France, adults volunteering for Biotrial tests can earn between 100 euros and 4,500 euros ($110 to $4,922). It is rare for volunteers to fall seriously ill when testing new drugs. Researchers generally start with the lowest possible dose for humans after extensive drug tests in animals. But there was a similar incident in Britain in 2006, when six previously healthy men were treated for organ failure only hours after being given an experimental drug targeting the immune system. That prompted a review of procedures and resulted in the U.K. regulatory agency imposing new testing standards, including recommendations to use the lowest possible dose and to test new drugs only in one person at a time. The six men in Britain now apparently have a higher risk of cancer and autoimmune diseases tied to their exposure to the experimental drug. Dr. Ben Whalley, a neuropharmacology professor at Britain's University of Reading, said standardized regulations for clinical trials are "largely the same" throughout Europe. "However, like any safeguard, these minimize risk rather than abolish it," Whalley said in a statement. "There is an inherent risk in exposing people to any new compound."
Two Latin American countries are investigating whether outbreaks of the mosquito-borne Zika virus are behind a rise in a rare and sometimes life-threatening nerve condition that can cause paralysis and leave victims on life-support. The Zika virus has already been tentatively linked to a rash of microcephaly, a birth defect in which babies are born with unusually small heads. And while the mechanics of how the virus may affect infants remain murky, authorities in Brazil, Colombia and El Salvador are urging women to avoid the risk by postponing pregnancies. The U.S. Centers for Disease Control and Prevention advised pregnant women to reconsider travel to countries with Zika outbreaks, and on Friday it expanded the warning to 22 destinations, most in Latin America and the Caribbean. The rise in cases of Guillain-Barre has also alarmed health officials region-wide. The nerve disorder causes muscle weakness that generally begins in the legs and spreads to the arms and face, and can cause numbness, trouble walking and even limb paralysis. While most people recover in weeks or months, in severe cases the muscles used for breathing weaken so much that patients require life-support. Anyone of any age can get Guillain-Barre, although it is very rare. It is thought to be triggered by an infection - something as simple as food poisoning - and happens when the immune system attacks the body's own nervous system. Researchers have been wary of Zika since French Polynesia noted a jump Guillain-Barre and microcephaly cases in tandem with an outbreak of the dengue-like virus, though the populations were far smaller than in the recent outbreaks. The World Health Organization said authorities in El Salvador reported 46 cases of Guillain-Barre in just five weeks, from Dec. 1 to Jan. 6. The full-year average for the country is 169 cases. Of 22 patients for whom there was information, at least 12 had experienced a rash-fever illness in the 15 days prior. Brazilian officials are also probing a near-simultaneous rise in Guillain-Barre and Zika, which was first identified in the country last May. It is believed that Zika may have arrived through a tourist at the 2014 World Cup or an international canoeing event the same year. Amid a Zika outbreak in the northeastern city of Salvador during last year's rainy season, the Couto Maia Hospital saw an unprecedented rise in Guillain-Barre. "Zika was really bad here from February to July and then all but disappeared in August. In May, June and July, we had 24 patients come in with Guillain-Barre, and none since August," said Antonio Bandeira, an infectious disease specialist at the hospital. In a normal year, he sees just two or three such cases. Most of the patients had also experienced Zika-like symptoms, which can include fever and red splotchy skin, Bandeira said. Meanwhile the Hospital da Restauracao in Recife treated about six times the normal number of Guillain-Barre cases, neurologist Maria Lucia Ferreira said. Of the 94 patients treated there during the rainy season, 50 of them died. However the scope of the problem remains unclear, as Guillain-Barre has been so rare that Brazil's Health Ministry does not track the exact number of cases. Albert Ko, a professor of epidemiology at the Yale School of Public Health, said a link between Zika and Guillain-Barre is "plausible and highly likely." But the difficulty of diagnosing Zika and the fact that Guillain-Barre can set in weeks later have made it tough to confirm the link. "While many of us are convinced and believe it's highly plausible that Zika virus caused this epidemic of Guillain-Barre, and can cause it anywhere the virus is being transmitted, we still lack really firm evidence to make that diagnosis," said Ko, who has conducted research in northeastern Brazil for two decades. Zika originated in Africa and expanded to parts of Asia. When it was first detected in Brazil, health officials were not initially alarmed since the virus appeared to be like a less potent form of dengue. But then came the spike in microcephaly: Since October the country has recorded 3,893 suspected cases, compared with fewer than 150 for all of 2014. Brazilian officials say they are convinced of a link. International health bodies say it is not yet scientifically established, but they are on alert. The CDC said Friday it issued its travel advisory "out of an abundance of caution." Earlier this week El Salvador recommended women avoid getting pregnant for the next two years, and some are taking that advice. "We were very lucky. My son was born before this," said Fatima Mejia, who took her 17-day-old infant to a clinic outside the Salvadoran capital for a checkup. "I'm not going to get pregnant until this passes. I'm not going to risk a child." In Colombia, Deputy Health Minister Fernando Ruiz said his country has recorded 13,531 suspected cases of Zika and that could hit a half-million this year. At least 560 involve pregnant women, though there have been no detected cases of microcephaly. Ruiz said there have been 12 cases of people with Guillain-Barre who also experienced Zika-like symptoms.