Pouget E.R.,National Development and Research Institutes Inc |
Hagan H.,New York University |
Des Jarlais D.C.,Rothschild
Addiction | Year: 2012
Aims We conducted a systematic review of studies reporting seroincidence of hepatitis C infection (HCV) in relation to shared syringes and drug preparation equipment among injection drug users (IDUs). We identified published and unpublished studies that met inclusion criteria. Design We estimated the relative contributions of shared syringes and drug preparation equipment to HCV transmission using random-effects meta-analysis, and analyzed potential sources of heterogeneity of effects among studies. Findings Syringe sharing was associated with HCV seroconversion [pooled risk ratio (PRR)=1.94, 95% confidence interval (CI)1.53, 2.46], as was sharing drug preparation containers (PRR=2.42, 95% CI1.89, 3.10), filters (PRR=2.61, 95% CI1.91, 3.56), rinse water (PRR=1.98, 95% CI1.54, 2.56), combinations of this equipment (PRR=2.24, 95% CI1.28, 3.93) and 'backloading', a syringe-mediated form of sharing prepared drugs (PRR=1.86, 95% CI1.41, 2.44). Meta-regression results showed that the association between syringe sharing and seroconversion was modified by HCV seroprevalence in the IDU populations. Conclusions The risk of hepatitis C infection through shared syringes is dependent upon hepatitis C infection seroprevalence in the population. The risk of hepatitis C infection through shared drug preparation equipment is similar to that of shared syringes. Because the infection status of sharing partners is often unknown, it is important for injection drug users to consistently avoid sharing unsterile equipment used to prepare, divide or inject drugs and avoid backloading with an unsterile syringe. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.
Investigative Ophthalmology and Visual Science | Year: 2012
Purpose. To investigate the application of anterior corneal and ocular aberrations in detecting mildly ectatic corneas. Methods. This study retrospectively reviewed the data of 220 eyes separated into three groups by the NIDEK Corneal Navigator System automated corneal classification software: normal (N) (n = 123); forme fruste keratoconus (N topography with contralateral KC) (n = 34); and KC (n = 63). Anterior corneal and ocular aberrations were obtained with the optical path difference scan and compared using a Kruskal-Wallis test. Evaluation of these data to discriminate between the three groups was assessed using a Receiver-Operating Characteristic curve analysis. Results. Corneal and ocular tilt, vertical coma, and trefoil were significantly different in the FFKC as compared with the N group. The discriminant functions between the FFKC and the N group, and between the KC and the N group reached an area under the receiver operating characteristic curve of 0.98 and 0, 96, respectively. Conclusion. Indices generated from corneal and ocular wavefront can identify very mild forms of ectasia that may be undetected by Placido-based neural network programs. © 2012 The Association for Research in Vision and Ophthalmology, Inc.
Touitou Y.,Rothschild |
Dialogues in Clinical Neuroscience | Year: 2012
In the past 30 years the concern that daily exposure to extremely low-frequency magnetic fields (ELF-EMF) (1 to 300 Hz) might be harmful to human health (cancer, neurobehavioral disturbances, etc) has been the object of debate, and has become a public health concern. This has resulted in the classification of ELF-EMF into category 2B, ie, agents that are "possibly carcinogenic to humans" by the International Agency for Research on Cancer. Since melatonin, a neurohormone secreted by the pineal gland, has been shown to possess oncostatic properties, a "melatonin hypothesis" has been raised, stating that exposure to EMF might decrease melatonin production and therefore might promote the development of breast cancer in humans. Data from the literature reviewed here are contradictory. In addition, we have demonstrated a lack of effect of ELF-EMF on melatonin secretion in humans exposed to EMF (up to 20 years' exposure) which rebuts the melatonin hypothesis. Currently, the debate concerns the effects of ELF-EMF on the risk of childhood leukemia in children chronically exposed to more than 0.4 μT. Further research is thus needed to obtain more definite answers regarding the potential deleterious effects of ELF-EMF. © 2012, LLS SAS.
Des Jarlais D.C.,Rothschild
BMC public health | Year: 2013
Persons who inject drugs (PWID) are at an elevated risk for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. In many high-income countries, needle and syringe exchange programs (NSP) have been associated with reductions in blood-borne infections. However, we do not have a good understanding of the effectiveness of NSP in low/middle-income and transitional-economy countries. A systematic literature review based on PRISMA guidelines was utilized to collect primary study data on coverage of NSP programs and changes in HIV and HCV infection over time among PWID in low-and middle-income and transitional countries (LMICs). Included studies reported laboratory measures of either HIV or HCV and at least 50% coverage of the local injecting population (through direct use or through secondary exchange). We also included national reports on newly reported HIV cases for countries that had national level data for PWID in conjunction with NSP scale-up and implementation. Studies of 11 NSPs with high-coverage from Bangladesh, Brazil, China, Estonia, Iran, Lithuania, Taiwan, Thailand and Vietnam were included in the review. In five studies HIV prevalence decreased (range -3% to -15%) and in three studies HCV prevalence decreased (range -4.2% to -10.2%). In two studies HIV prevalence increased (range +5.6% to +14.8%). HCV incidence remained stable in one study. Of the four national reports of newly reported HIV cases, three reported decreases during NSP expansion, ranging from -30% to -93.3%, while one national report documented an increase in cases (+37.6%). Estimated incidence among new injectors decreased in three studies, with reductions ranging from -11/100 person years at risk to -16/100 person years at risk. While not fully consistent, the data generally support the effectiveness of NSP in reducing HIV and HCV infection in low/middle-income and transitional-economy countries. If high coverage is achieved, NSP appear to be as effective in LMICs as in high-income countries. Additional monitoring and evaluation research is needed for NSPs where reductions in HIV/HCV infection among PWID are not occurring in order to identify and correct contributing problems.
Journal of Physiology Paris | Year: 2013
Sleep is a key element, both physiologically and psychologically, in adolescent development. The prevalence of sleep disorders in western countries is important, as with age the sleep-wake cycle of adolescents becomes irregular and delayed in relation with later sleep onset and waking time resulting in rhythm desynchronization. A large number of adolescents sleep for 7-8. h instead of 9-10. h per night, which can lead to a cumulative sleep debt with fatigue, behavioral problems and poor academic achievement. The effect of electronic media use (such as television, mobile phone, computer, and electronic gaming) on sleep has been the object of several international studies, though pubertal changes may also impact adolescent sleep. Adolescents and their parents should be educated by professionals, including physicians and nurses, on the key role of sleep in adolescent well being and quality of life. A number of basic rules are proposed to improve sleep in adolescents. The permanent social jet lag experienced by a number of adolescents should be considered as a matter of public health. © 2013 Elsevier Ltd.