Setting Research Priorities To Reduce Global Mortality from Childhood Diarrhoea by 2015

Olivier Fontaine and colleagues applied a priority-setting methodology to identify research priorities aimed at reducing global diarrhea mortality by 2015

Lipid droplet detection by the cavity perturbation method

There are currently no point-of-care diagnosis strategies available to indicate the presence of neoplasmic growth. This research aims to develop a novel diagnostic strategy based on detecting TAG accumulation in cells. This element of the research is a preliminary experiment to prove the concept of detecting TAG lipid droplets in YEPD media. It was found that a change in mono-unsaturated concentration can be detected by the frequency shift in a resonant cavity. The dielectric constant of TAG vegetable oils was calculated at 2.34-2.39. It was also found that concentrations of lipid droplet can be differentiated up to 5% (v/v)

Strategy for Mapping Quantitative Trait Loci (QTL) by Using Human Metapopulations

Aim: To present a novel strategy for mapping quantitative trait loci (QTL), using human metapopulations. The strategy is based on the expectation that in geographic clusters of small and distinct human isolates, a combination of founder effect and genetic drift can dramatically increase population frequency of rare QTL variants with large effect. In such cases, the distribution of QT measurements in an “affected” isolate is expected to deviate from that observed in neighboring isolates. Methods: We tested this hypothesis in 9 villages from a larger Croatian isolate resource, where 7 Mendelian disorders have been previously reported. The values of 10 physiological and biochemical QTs were measured in a random sample of 1001 individuals (100 inhabitants of each of 9 villages and 101 immigrant controls). Results: Significant over- or under- representation of individuals from specific villages in extreme ends of standardized QT measurement distribution was found 10 times more frequently than expected by chance. The large majority of such clusters of individuals with extreme QT values (34/36, 94.4%) originated from the 6 villages with the most pronounced geographic isolation and endogamy. Conclusion: Early epidemiological assessment supports the feasibility of the proposed strategy. Clusters of individuals with extreme QT values responsible for over-representation of single villages can usually be linked to a larger pedigree and may be useful for further QTL mapping, using linkage analysis

Directing diarrhoeal disease research towards disease-burden reduction

Despite gains in controlling mortality relating to diarrhoeal disease, the burden of disease remains unacceptably high. To refocus health research to target disease-burden reduction as the goal of research in child health, the Child Health and Nutrition Research Initiative developed a systematic strategy to rank health research options. This priority-setting exercise included listing of 46 competitive research options in diarrhoeal disease and their critical and quantitative appraisal by 10 experts based on five criteria for research that reflect the ability of the research to be translated into interventions and achieved disease-burden reduction. These criteria included the answerability of the research questions, the efficacy and effectiveness of the intervention resulting from the research, the maximal potential for disease-burden reduction of the interventions derived from the research, the affordability, deliverability, and sustainability of the intervention supported by the research, and the overall effect of the research-derived intervention on equity. Experts scored each research option independently to delineate the best investments for diarrhoeal disease control in the developing world to reduce the burden of disease by 2015. Priority scores obtained for health policy and systems research obtained eight of the top 10 rankings in overall scores, indicating that current investments in health research are significantly different from those estimated to be the most effective in reducing the global burden of diarrhoeal disease by 2015

ОСОБЛИВОСТІ ПЕРЕБІГУ ГЕПАТИТУ С У ВІЛ-ІНФІКОВАНИХ ОСІБ ТА ЇХ ЛІКУВАННЯ

The aim of the study – based on the analysis of literary information to highlight the features of the course of viral hepatitis C in HIV-infected persons, as well as the basic principles of treatment of such patients and used drugs in the world and in Ukraine. HIV and parenteral viral hepatitis refer to socially important diseases that can significantly affect the demographic situation in the country. Except the common ways and factors of transmission of viruses, the involvement of adolescents and young people to the epidemic process is the dominant factor that complicates the epidemiological situation with regard to HIV infection and parenteral viral hepatitis in Ukraine. The age factor is due to the phenomena of the current epidemic of drug addiction. From the published data of a number of studies, the mutual influence of HIV and chronic viral hepatitis C on the course of both HIV-infection and chronic hepatitis C (CHC) is known. The incidence of AIDS and AIDS-related deaths is significantly higher in people with combined HCV / HIV infection, which is now a global public health problem. The basic principles of treating patients with HCV in HIV-infected patients are consistent with those not infected with HIV. For the treatment of HCV-infection, current AASLD guidelines do not recommend interferon-based schemes anymore. Instead, nowadays the first-line treatment is considered to be oral antiviral agents of direct action. At the same time, interferon-containing treatment regimens are still used in Ukraine. According to published results of a number of studies, the terminal stage of liver disease is a common cause of hospitalization and death of patients with combined HCV / HIV infection. But there are still controversial therapies for people with combined HIV and parenteral viral hepatitis. Therefore, the choice of optimal tactics for the management of such patients and the timely appointment of adequate treatment remains relevant.Мета роботи – на підставі аналізу літературних відомостей виділити особливості перебігу гепатиту С у ВІЛ-інфікованих осіб, а також основні принципи лікування таких пацієнтів і використовувані препарати у світі й в Україні. ВІЛ-інфекцію і парентеральні вірусні гепатити відносять до соціально значущих захворювань, які можуть суттєво впливати на демографічну ситуацію в країні. Крім спільності шляхів і факторів передачі вірусів, домінуючим чинником, що ускладнює епідеміологічну ситуацію стосовно ВІЛ-інфекції і парентеральних вірусних гепатитів на території України, є залучення до епідемічного процесу підлітків і людей молодого віку. Віковий чинник обумовлений явищами поточної епідемії наркоманії. З опублікованих даних ряду досліджень відомо про взаємний вплив ВІЛ і HСV на перебіг як ВІЛ-інфекції, так і хронічного гепатиту С (ХГС). Частота розвитку СНІДу і летального висліду, обумовленого СНІД-асоційованими захворюваннями, істотно вища в осіб з поєднаною HСV-/ВІЛ-інфекцією, яка нині є глобальною проблемою суспільної охорони здоров’я. Основні принципи лікування хворих на ХГС у ВІЛ-інфікованих відповідають таким у пацієнтів, не заражених ВІЛ. Для лікування HCV-інфекції теперішні настанови AASLD більше не рекомендують схеми, засновані на інтерфероні. Натомість на сьогодні терапією першої лінії вважаються пероральні противірусні засоби прямої дії. Разом з тим, в Україні все ще використовуються інтерферонвмісні схеми лікування. Згідно з опублікованими результатами ряду досліджень, термінальна стадія хвороби печінки є частою причиною госпіталізації та смерті хворих на поєднану HСV-/ВІЛ-інфекцію. Та досі залишаються дискусійними схеми терапії осіб з поєднаною ВІЛ-інфекцією та парентеральними вірусними гепатитами. Тому вибір оптимальної тактики ведення таких хворих і своєчасне призначення їм адекватного лікування залишається актуальним

A Large Cross-Sectional Study of Health Attitudes, Knowledge, Behaviour and Risks in the Post-War Croatian Population (The First Croatian Health Project*)

As the liberation of occupied Croatian territories ended the war in the country in 1995, the Ministry of Health and Croatian Health Insurance Institute have agreed to create the new framework for developing a long-term strategy of public health planning, prevention and intervention. They provided financial resources to develop the First Cro-atian Health Project, the rest of the support coming from the World Bank loan and the National Institute of Public Health. A large cross-sectional study was designed aiming to assess health attitudes, knowledge, behaviour and risks in the post-war Croatian population. The large field study was carried out by the Institute for Anthropological Research with technical support from the National Institute of Public Health. The field study was completed between 1995–1997. It included about 10,000 adult volunteers from all 21 Croatian counties. The geographic distribution of the sample covered both coastal and continental areas of Croatia and included rural and urban environments. The specific measurements included antropometry (body mass index and blood pressure). From each examinee a blood sample was collected from which the levels of total plasma cholesterol (TC), triglycerides (TG), HDL-cholesterol (High Density Lipoprotein), LDL-cholesterol (Low Density Lipoprotein), lipoprotein Lp(a), and haemostatic risk factor fibrinogen (F) were determined. The detailed data were collected on the general knowledge and attitudes on health issues, followed by specific investigation of smoking history, alcohol consumption, nutrition habits, physical activity, family history of chronic non-communicable diseases and occupational exposures. From the initial database a targeted sample of 5,840 persons of both sexes, aged 18–65, was created corresponding by age, sex and geographic distribution to the general Croatian population. This paper summarises and discusses the main findings of the project within this representative sample of Croatian population

Inbreeding and Learning Disability in Croatian Island Isolates

The aim of this study was to investigate the prevalence of learning disability (LD) in isolate populations with different inbreeding coefficients (F). Prevalence of LD and F were determined in 10 villages from five Croatian islands: Bra~, Hvar, Kor~ula, Lastovo and Susak. For the purpose of this study, LD was defined as the inability to attend the public school system. As the elementary schools (grade 1–8) in the place of the study are both public and compulsory, the assessment of child\u27s inability to attend the school is performed at the age of six. This is required by all children in the country based on standard set of tests of cognitive performance defined by the Ministry of Education and Culture of the Republic of Croatia. The average inbreeding coefficients in each village population (F) were estimated in a random sample of 20–30% adults in each of the 10 villages based on 4 ancestral generations and using Wright\u27s path method. Prevalence of LD ranged from 0.43% to 2.47%, and the inbreeding coefficients ranged from 0.8% to 4.9%. The Pearson\u27s correlation coefficient between F and LD prevalence was 0.80 (p<0.01). Although the relative risk per 5% inbreeding appeared very high (about 10), the absolute risk only increased from 0.18% to 1.77%. The genetic effect of inbreeding (GEI) was approximately 0.69% and the population-attributable fraction 76.6%. A review of the literature and the results of this study lead to a conclusion that a very large number of predominantly recessive genetic factors might mediate the genetic susceptibility to various forms of LD in these populations

Genome-wide association study identifies _FUT8_ and _ESR2_ as co-regulators of a bi-antennary N-linked glycan A2 (GlcNAc~2~Man~3~GlcNAc~2~) in human plasma proteins

HPLC analysis of N-glycans quantified levels of the biantennary glycan (A2) in plasma proteins of 924 individuals. Subsequent genome-wide association study (GWAS) using 317,503 single nucleotide polymorphysms (SNP) identified two genetic loci influencing variation in A2: FUT 8 and ESR2. We demonstrate that human glycans are amenable to GWAS and their genetic regulation shows sex-specific effects with _FUT 8_ variants explaining 17.3% of the variance in pre-menopausal women, while _ESR2_ variants explained 6.0% of the variance in post-menopausal women

ОСОБЛИВОСТІ ПЕРЕБІГУ ГЕПАТИТУ В У ВІЛ-ІНФІКОВАНИХ ОСІБ ТА ЇХ ЛІКУВАННЯ

The purpose of the study - based on the analysis of literary information to highlight the features of the course of hepatitis B in HIV-infected individuals, as well as the basic principles of treatment of these patients and drugs that used for these purpose in the world and in Ukraine. HIV and parenteral viral hepatitis belong to socially significant diseases that can significantly affect the demographic situation in the country. Ukraine belongs to countries with an average prevalence of HBV, but there is no data on the frequency of detecting HBV markers in patients with HIV. From the published data of several studies, the mutual influence of HIV and HBV on the course of both HIV infection and chronic hepatitis B (CHBV) is known. The incidence of AIDS and AIDS-related deaths is significantly higher in people with combined HBV / HIV infection, which is now a global public health problem. The basic principles of treatment for patients with CHBV / HIV are consistent with those in patients with HBV-monoinfection. According to the published results of several epidemiological studies, the main factor leading to chronic HCV is the level of HBV DNA in patients’ blood or viral load. Therefore, the goal of treatment is to suppress HBV replication to reduce inflammation and to stop or slow down the progression of fibrosis, thereby preventing the late complications of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). All these patients should receive antiretroviral therapy (ART), regardless of the number of CD4 + lymphocytes. According to published results of a number of studies, the terminal stage of liver disease is a frequent cause of hospitalization and death of patients with combined HBV / HIV infection. But there are still controversial therapies for people with combined HIV and parenteral viral hepatitis. Therefore, the choice of optimal tactics for the management of these patients and the timely appointment of adequate treatment remains relevant.Мета роботи – на підставі аналізу літературних відомостей виділити особливості перебігу гепатиту В у ВІЛ-інфікованих осіб, а також основні принципи лікування таких пацієнтів і використовувані препарати у світі й в Україні. ВІЛ-інфекцію і парентеральні вірусні гепатити відносять до соціально значущих захворювань, які можуть суттєво впливати на демографічну ситуацію в країні. Україна належить до країн із середньою поширеністю HBV, проте даних стосовно частоти виявлення маркерів HBV у хворих на ВІЛ-інфекцією немає. З опублікованих даних ряду досліджень відомо про взаємний вплив ВІЛ і HBV на перебіг як ВІЛ-інфекції, так і хронічного гепатиту В (ХГВ). Частота розвитку СНІДу і летального висліду, обумовленого СНІД-асоційованими захворюваннями, істотно вища в осіб з поєднаною HBV-/ВІЛ-інфекцією, яка нині є глобальною проблемою суспільної охорони здоров’я. Основні принципи лікування хворих на ХГВ-/ВІЛ-інфекцію відповідають таким у пацієнтів з HBV-моноінфекцією. Згідно з опублікованими результатами декількох епідеміологічних досліджень, основним чинником, що зумовлює вислід ХГВ, є рівень ДНК HBV у крові пацієнтів, або вірусне навантаження. Тому мета лікування – пригнітити реплікацію HBV, щоб зменшити запалення і зупинити або уповільнити прогрес фіброзу, запобігши тим самим пізнім ускладненням – цирозу печінки (ЦП) і гепатоцелюлярної карциноми (ГЦК). Всі такі хворі повинні отримувати антиретровірусну терапію (АРТ), незалежно від кількості CD4+-лімфоцитів. Згідно з опублікованими результатами ряду досліджень, термінальна стадія хвороби печінки є частою причиною госпіталізації та смерті хворих на поєднану HBV-/ВІЛ-інфекцію. Та досі залишаються дискусійними схеми терапії осіб з поєднаною ВІЛ-інфекцією та парентеральними вірусними гепатитами. Тому вибір оптимальної тактики ведення таких хворих і своєчасне призначення їм адекватного лікування залишається актуальним