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Mountain View, CA, United States

Ramjee G.,Jan Medical | Ramjee G.,London School of Hygiene and Tropical Medicine | Wand H.,University of New South Wales
AIDS and Behavior | Year: 2014

We investigated geographical variations of three sexually transmitted infections (STIs) namely chlamydia, gonorrhea and syphilis in the greater Durban area, so as to optimize intervention strategies. The study population was a cohort of sexually active women who consented to be screened in one of three biomedical studies conducted in Durban. A total of nine local regions collectively formed three clusters at screening, five of which were previously defined as HIV hot-spots. STI cases were geo-coded at the census level based on residence at the time of screening. Spatial SaTScan Statistics software was employed to identify the areas with a disproportionate prevalence and incidence of STI infection when compared to the neighboring areas under study. Both prevalence and incidence of STIs were collectively clustered in several localized areas, and the majority of these locations overlapped with high HIV clusters and shared the same characteristics: younger age, not married/cohabitating and multiple sex partners. © 2013 The Author(s). Source

Naidoo S.,Jan Medical | Wand H.,Kirby Institute
Sexually Transmitted Infections | Year: 2013

Background and objectives Trichomonas vaginalis is known to be the most common, curable, sexually transmitted infection among sexually active women and may be associated with the acquisition and transmission of HIV. The purpose of this analysis is to determine the prevalence and incidence of T vaginalis and assess risk factors associated with T vaginalis infection in a cohort of women participating in a clinical trial. Methods We analysed data from women participating in a phase III vaginal diaphragm trial conducted in two communities in Durban, South Africa from 2003 to 2006. A total of 3492 women were screened and 1485 women meeting the respective study eligibility criteria were enrolled. T vaginalis infection was determined at the initial screening visit and at quarterly visits among the enrolled women. Sexual behaviour and sociodemographic data were collected as per the study protocol. Combined data were analysed using STATA V.10.0. Results At baseline, prevalence of infection was 6.5%. The overall incident rate was estimated to be 8.6/100 women-years. Prevalent T vaginalis infection was associated with having a concurrent chlamydial infection and incident infections were associated with increased number of sex partners. Conclusions T vaginalis infection was found to be relatively high among this cohort of women. Given the association of this infection with HIV, there is an evident need for T vaginalis screening and treatment in populations at risk for both infections. Source

Objective To estimate the potential impact of using hormonal contraceptives on rates of infection with human immunodeficiency virus type 1 (HIV-1) and pregnancy by theoretically removing the use of hormonal contraceptives from a study population. Methods A prospective cohort study included 3704 HIV-negative women who were enrolled in two biomedical trials that tested two vaginal microbicides (PRO 2000 and Carraguard®) for the prevention of HIV-1 in Durban, South Africa, in 2004-2009. Cox proportional hazards regression models along with partial population attributable risks (PARs) and their 95% confidence intervals (CIs) were calculated to assess the relative population-level impact of the use of hormonal contraceptives on HIV-1 seroconversion rates and on pregnancy rates. Findings Women who reported using hormonal contraceptives at enrolment in the trial had a higher risk of HIV-1 seroconversion (adjusted hazards ratio: 1.24; 95% CI: 0.97-1.58) than women who reported using other types of contraceptives at enrolment. At the population level, the use of hormonal contraceptives (pills or injectables) at baseline and during study follow-up accounted for approximately 20% (95% CI: 16-22) of HIV-1 seroconversions. However, the partial PAR indicated a relative impact of 12% (95% CI: 9.0-15.7). On the other hand, 72% (95% CI: 66-77) of the pregnancies could have been avoided if all women had used hormonal contraceptives. Conclusion Women using hormonal contraceptives need comprehensive counselling on simultaneous prevention of HIV-1 infection. Source

Vranken J.H.,Jan Medical
Journal of Pain and Palliative Care Pharmacotherapy | Year: 2015

Symptoms and signs of neuropathic pain can be both positive and negative. Tricyclic antidepressants are the first-line treatment option for neuropathic pain. Opioid agonists have demonstrated efficacy in patients with neuropathic pain. Combination therapy in the management of neuropathic pain is not well researched. This report is adapted from paineurope 2015: Issue 1, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, Ltd., and is distributed free of charge to health care professionals in Europe. Archival issues can be viewed via the Web site: www.paineurope.com, at which health professionals can find links to the original articles and request copies of the quarterly publication and access additional pain education and pain management resources. © 2015 Copyright © Taylor & Francis Group, LLC. Source

MOUNTAIN VIEW, Calif.--(BUSINESS WIRE)--Jan Medical, developer of the Nautilus BrainPulse™, announced today that a clinical study published in this month’s issue of Neurocritical Care demonstrated that Nautilus BrainPulse is a highly sensitive skull accelerometry that can detect cerebral vasospasm “with clinically meaningful accuracy, therefore suggesting “promise in the ICU environment to detect as well as reject cerebral vasospasm as the cause of neurological deficits in subarachnoid hemorrhage.” Prinicipal investigator for the Nautilus BrainPulse study was Wade S. Smith, M.D., Ph.D., Director, UCSF Neuroscience ICU, Professor of Neurology, University of California, San Francisco. “What we need is a safe, noninvasive, user-independent method to detect cerebral vasospasm before it causes brain injury,” said Dr. Smith. “The technology needs to be simple, and portable, to be most effective in the Neuro Critical Care setting, by more immediately detecting vasospasm so we can aggressively prevent stroke with cerebral angioplasty and/or vasospressor therapy. Such a technology holds the promise to directly help patients and shorten the length of stay within the Neuro ICU.” “Our Nautilus BrainPulseTM system can rapidly provide critical information on a patient presenting with stroke symptoms, and it can also be used as a continuous monitor of changes to the cerebral vasculature. It is this latter ability, continuous monitoring, that provides a unique capability in detecting the onset of vasospasm,” added Paul Lovoi, Ph.D., CEO of Jan Medical. “This study has confirmed that our portable and continuous brain-sensing system can detect vasospasms quickly and noninvasively.” “Vasospasm” refers to a condition in which blood vessels constrict, leading to ischemia and irreversible brain injury by causing stroke. Cerebral vasospasm usually arises in the context of subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm. Vasospasm typically materializes 4 to 10 days after SAH. The essential problem with vasospasm is that it causes stroke by shutting down blood flow to the brain. The current method used to detect vasospasm is transcranial Doppler ultrasound, a difficult to administer technique that is not able to evaluate all the brain’s blood vessels and requires specific technical expertise to perform the measurements. The brain has a normal pulse driven by the cardiac cycle. The impact of this pulse on the skull can in turn be detected and measured. The Nautilus BrainPulse is designed to measure the normal brain pulse as well as disruptions of the brain pulse. By digitizing the signal patterns from headset-mounted sensors measuring the skull’s motion, and extracting features from them, algorithms have been developed to identify normal and a variety of abnormal brain pulse patterns in recording sessions that take approximately 3 minutes. The device is portable, entirely non-invasive and provides analysis immediately once the recording session is completed. Jan Medical is medical device company dedicated to providing critical data for expediting and expanding therapy while improving the diagnostic experience for patients with brain disorders. Its proprietary platform technologies include the Nautilus BrainPulse™. Visit www.janmedical.com. CAUTION: THE JAN MEDICAL SYSTEM IS AN INVESTIGATIONAL DEVICE, LIMITED BY FEDERAL (UNITED STATES) LAW TO INVESTIGATIONAL USE.

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