Trends in the incidence of AIDS-defining and non-AIDS-defining cancers in people living with AIDS: a population-based study from Sao Paulo, Brazil

People living with AIDS are at increased risk of developing certain cancers. Since the introduction of the highly active antiretroviral therapy (HAART), the incidence of AIDS-defining cancers (ADCs) has decreased in high-income countries. The objective of this study was to analyse trends in ADCs and non-AIDS-defining cancers (NADCs) in HIV-positive people with a diagnosis of AIDS, in comparison to the general population, in Sao Paulo, Brazil. A probabilistic record linkage between the 'Population-based Cancer Registry of Sao Paulo' and the AIDS notification database (SINAN) was conducted. Cancer trends were assessed by annual per cent change (APC). In people with AIDS, 2074 cancers were diagnosed. Among men with AIDS, the most frequent cancer was Kaposi's sarcoma (469;31.1%), followed by non-Hodgkin lymphoma (NHL;304;20.1%). A decline was seen for ADCs (APC = -14.1%). All NADCs have increased (APC = -7.4%/year) significantly since the mid-2000s driven by the significant upward trends of anal (APC = -24.6%/year) and lung cancers (APC = -15.9%/year). In contrast, in men from the general population, decreasing trends were observed for these cancers. For women with AIDS, the most frequent cancer was cervical (114;20.2%), followed by NHL (96;17.0%). Significant declining trends were seen for both ADCs (APC = -15.6%/ year) and all NADCs (APC = -15.8%/ year), a comparable pattern to that found for the general female population. Trends in cancers among people with AIDS in Sao Paulo showed similar patterns to those found in developed countries. Although ADCs have significantly decreased, probably due to the introduction of HAART, NADCs in men have shown an opposite upward trend

Determination of clusters and factors associated with dengue dispersion during the first epidemic related to Dengue virus serotype 4 in Vitoria, Brazil

Dengue occurrence is partially influenced by the immune status of the population. Consequently, the introduction of a new Dengue virus serotype can trigger explosive epidemics in susceptible populations. The determination of clusters in this scenario can help to identify hotspots and understand the disease dispersion regardless of the influence of the population herd immunity. The present study evaluated the pattern and factors associated with dengue dispersion during the first epidemic related to Dengue virus serotype 4 in Vitoria, Espirito Santo state, Brazil. Data on 18,861 dengue cases reported in Vitoria from September 2012 to June 2013 were included in the study. The analysis of spatial variation in temporal trend was performed to detect clusters that were compared by their respective relative risk, house index, population density, and income in an ecological study. Overall, 11 clusters were detected. The time trend increase of dengue incidence in the overall study population was 636%. The five clusters that showed a lower time trend increase than the overall population presented a higher incidence in the beginning of the epidemic and, compared to the six clusters with higher time trend increase, they presented higher relative risk for their inhabitants to acquire dengue infection (P-value = 0.02) and a lower income (P-value < 0.01). House index and population density did not differ between the clusters. Early increase of dengue incidence and higher relative risk for acquiring dengue infection were favored in low-income areas. Preventive actions and improvement of infrastructure in low-income areas should be prioritized in order to diminish the magnitude of dengue dispersion after the introduction of a new serotype

Evidence for significant influence of host immunity on changes in differential blood count during malaria

Background: Malaria has been shown to change blood counts. Recently, a few studies have investigated the alteration of the peripheral blood monocyte-to-lymphocyte count ratio (MLCR) and the neutrophil-to-lymphocyte count ratio (NLCR) during infection with Plasmodium falciparum. Based on these findings this study investigates the predictive values of blood count alterations during malaria across different sub-populations. Methods: Cases and controls admitted to the Department of Infectious Diseases and Tropical Medicine from January 2000 through December 2010 were included in this comparative analysis. Blood count values and other variables at admission controlled for age, gender and immune status were statistically investigated. Results: The study population comprised 210 malaria patients, infected with P. falciparum (68%), Plasmodium vivax (21%), Plasmodium ovale (7%) and Plasmodium malariae (4%), and 210 controls. A positive correlation of parasite density with NLCR and neutrophil counts, and a negative correlation of parasite density with thrombocyte, leucocyte and lymphocyte counts were found. An interaction with semi-immunity was observed; ratios were significantly different in semi-immune compared to non-immune patients (P <0.001). The MLCR discriminated best between malaria cases and controls (AUC = 0.691; AUC = 0.741 in non-immune travellers), whereas the NLCR better predicted severe malaria, especially in semi-immune patients (AUC = 0.788). Conclusion: Malaria causes typical but non-specific alterations of the differential blood count. The predictive value of the ratios was fair but limited. However, these changes were less pronounced in patients with semi-immunity. The ratios might constitute easily applicable surrogate biomarkers for immunity

Serotype influences on dengue severity: a cross-sectional study on 485 confirmed dengue cases in Vitória, Brazil

Abstract Background Dengue is caused by a RNA virus of the family Flaviviridae, which presents four serotypes (DENV-1 to DENV-4) capable of inducing hemorrhage. The purpose of this study was to evaluate the influence of serotype on the outcome of dengue. Methods This cross-sectional study included data from dengue cases with serotyping results that occurred between 2009 and 2013 in Vitória, Espírito Santo, Brazil. Data were accessed through the Information System for Notifiable Diseases. Chi-square test, Fisher exact test, Mann–Whitney U test, and logistic regression were performed to assess associations between different serotypes and dengue severity, while considering gender and age. Results The sample consisted of 485 laboratory confirmed dengue cases, of which 46.4 % were females, with median age of 26 years. Regarding overall samples, 77.3 % were caused by DENV-1, 16.1 % by DENV-4, 6.4 % by DENV-2, and 0.2 % by DENV-3. Severe dengue affected 6.6 % of all cases, of which 32.3 % of the cases caused by DENV-2, 6.4 % of those caused by DENV-4, 4.5 % of those caused by DENV-1, and none of those caused by DENV-3. Severe dengue was found to be seven times more frequent among cases of DENV-2 than among those of the other serotypes. Conclusions The present study found that cases of DENV-2 had a higher proportion of severe dengue than among those of DENV-1 and DENV-4. Consequently, early detection of serotypes circulating in the territory could be an important approach to prevent increasing numbers of severe outcomes during dengue outbreaks by predicting the health support needed for early diagnoses and treatment of dengue cases

Late Aptian and Early Albian regional emersion phase in Istria, Croatia

Istrian part of the Adriatic carbonate platform emerged in the Middle/Late Aptian for the second time and was exposed for 11-19 MY. Exposure related features, which mark type 1 sequence boundary, are represented by greenish-grey clays, marls and lime breccias. Mineralogical, micromorphological and geochemical analysis were performed on clay layers, ranging in thickness from several centimetres up to 1 meter, and the insoluble residues of limestones situated immediately bellow clay layers. The main mineral components of clays are illitic material and illite/smectite mixed layer minerals. Occasionally, pyrite, gypsum and chlorite are present. In contrast, insoluble residue is dominated by smectite and illitic material, and occasionally kaolinite. The clay mineral distribution of one investigated profile show a clear trend indicating the influence of both pedogenic and diagenetic processes. Micromorphological data support consideration of pedogenetic alteration. Distribution of vanadium, uranium, molibdenum and REE, as colour of clay and presence of abundance of pyrite framboids indicate unoxic environment. The current investigation should give answers to provenance of the material from which this clays are formed. We consider that the clays are remnants of seasonally marshy soils to permanently watterloged soil, which formed from the erosional remains of surficial soils and sediments, which were accumulated in palaeokarst pits following an oscillating marine transgression that terminated emergence. The Lower Cretaceous shallow-marine deposition sporadically interrupted by periods of emersion are sedimentologically and palaeogeographically very similar to Purbeckian sediments of NW Europe

Alternative ways of hazardous waste treatment from petroleum industry

Dio tehnološkog otpada koji nastaje u procesima naftnog rudarstva u Hrvatskoj spada u opasni otpad. Prije odlaganja u centralne otpadne jame (COJ) takav otpad se obrađuje živim vapnom i kroz proces stabilizacije/solidifikacije pretvara u slabo topivi - inertni materijal. Stabilizacija/solidifikacija živim vapnom u svijetu se koristi kao tehnika obrade i organskog i anorganskog tehnološkog otpada. Svjetska iskustva međutim pokazuju da pri primjeni te tehnike kod obrade organskog tehnološkog otpada, ili otpada koji sadrži i organske i anorganske onečiščivaće ne dolazi do dovoljnog reduciranja kretanja onečišćivača u okoliš. Za materijale koji sadrže organske ili anorganske i organske onečišćivače razvijaju se nove tehnike obrade. Cilj ovog istraživanja je bilo ispitivanje alternativnih načina obrade tehnološkog otpada iz naftnog rudarstva. Uzorak tehnološkog otpada iz COJ-Vinkovci u laboratorijskim uvjetima je obrađivan primjenom pojedinačnih materijala ili primjenom kombinacije nekoliko materijala i to: (a) cement, (b) organofilna glina, (c) kalcinirana Moler glina, (d) vapno + organofilna glina + bentonit, (e) cement + organofilna glina + bentonit, (f) vapno + kalcinirana moler glina i (g) cement + kalcinirana moler glina. Za usporedbu rezultata korišten je uzorak tehnološkog otpada obrađen vapnom. U obrađenim uzorcima određeni su sljedeći parametri: (a) ukupna ulja, (b) mineralna ulja, (c) policiklički aromatski ugljikovodici (16 komponenata) i (d) teški metali i potencijalno toksični elementi (10 elemenata). Osim ukupnog sadržaja navedenih parametara u obrađenim uzorcima, određen je i njihov sadržaj u vodenim eluatima istih uzoraka. Od primjenjenih tretmana, tretman organofilnom glinom se pokazao bitno najuspješnijim za većinu parametara. Tako tretiran uzorak otpušta na primjer 63 puta manje ukupnih ulja, 67 puta manje mineralnih ulja, 798 puta manje naftalena i 136 puta manje olova od uzorka tretiranog vapnom. Po uspješnosti iza organofilne gline nalazi se kalcinirana Moler glina. Dobiveni rezultati jasno ukazuju da odabiru najpovoljnijeg sredstva za obradu tehnološkog otpada u naftnom rudarstvu treba prethoditi smanjenje sadržaja ugljikovodika nekim od terenskih prihvatljivih načina i detaljna kemijska analiza preostalih organskih i anorganskih onečišćivača. Ovisno o rezultatu analize opasni tehnološki otpad može se tretirati puno efikasnije, uz upotrebu primjerenijih materijala (npr. organofilna glina) čime se može bitno reducirati otpuštanje onečišćivača iz tako obrađenog otpada u okoliš. Na taj način mogao bi se rješiti problem trajnog odlaganja obrađenog otpada.Part of the technological waste produced in petroleum industry in Croatia is hazardous waste. Such kind of waste is treated with lime and through processes of stabilization / solidification it transforms in poorly soluble - inert material which is then deposited in central oilfield pits. Stabilization/solidification with lime is worldwide used as a technique of treatment of organic and inorganic technological waste. Foreign experiences showed that by usage of this technique for treatment of organic technological waste, or waste with organic and inorganic pollutants, sufficient reduction of pollutant movement in the environment is not caused. Due to this fact, one has to be careful in its application. The new techniques of treatment are being developed for materials which contain organic or inorganic and organic pollutants. The aim of this research was to examine alternative ways of treatment of technological waste from petroleum industry. The sample of technological waste from central oilfield pit Vinkovci was treated in laboratory conditions with application of single material or application of material combinations: (a) cement, (b) organophilic clay, (c) calcined Moler clay, (d) lime + organophilic clay + bentonite, (e) cement + organophilic clay + bentonite, (f) lime + calcined Moler clay and (g) cement + calcined Moler clay. The sample of technological waste treated with lime was used for comparison of results. The following parameters were determined in treated samples: (a) total oils, (b) mineral oils, (c) polycyclic aromatic hydrocarbons (16) and (d) heavy metals and potentially toxic elements (10). The content of stated parameters is determined in original samples and their distilled water leachate. The most successful treatment for majority of parameters was treatment with organophilic clay. Such treated sample releases, for example, 63 times less total oils, 67 times less mineral oils, 798 times less naphthalene and 136 times less lead than sample treated with lime. The organophilic clay, as the most successful material, is followed by calcined Moler clay. The obtained results clearly show that reduction of hydrocarbons content with some of the field acceptable ways and detailed chemical analysis of left organic and inorganic pollutants has to be done before the selection of the best mean for treatment of technological waste in petroleum industry. Depending on results of analysis, hazardous technological waste can be treated more effective by application of more suitable materials (e.g. organophilic clay) which reduce pollutant release from such treated waste in the environment. In this way the problem of permanent disposal of treated waste can be solved

Alternative ways of hazardous waste treatment from petroleum industry

Dio tehnološkog otpada koji nastaje u procesima naftnog rudarstva u Hrvatskoj spada u opasni otpad. Prije odlaganja u centralne otpadne jame (COJ) takav otpad se obrađuje živim vapnom i kroz proces stabilizacije/solidifikacije pretvara u slabo topivi - inertni materijal. Stabilizacija/solidifikacija živim vapnom u svijetu se koristi kao tehnika obrade i organskog i anorganskog tehnološkog otpada. Svjetska iskustva međutim pokazuju da pri primjeni te tehnike kod obrade organskog tehnološkog otpada, ili otpada koji sadrži i organske i anorganske onečiščivaće ne dolazi do dovoljnog reduciranja kretanja onečišćivača u okoliš. Za materijale koji sadrže organske ili anorganske i organske onečišćivače razvijaju se nove tehnike obrade. Cilj ovog istraživanja je bilo ispitivanje alternativnih načina obrade tehnološkog otpada iz naftnog rudarstva. Uzorak tehnološkog otpada iz COJ-Vinkovci u laboratorijskim uvjetima je obrađivan primjenom pojedinačnih materijala ili primjenom kombinacije nekoliko materijala i to: (a) cement, (b) organofilna glina, (c) kalcinirana Moler glina, (d) vapno + organofilna glina + bentonit, (e) cement + organofilna glina + bentonit, (f) vapno + kalcinirana moler glina i (g) cement + kalcinirana moler glina. Za usporedbu rezultata korišten je uzorak tehnološkog otpada obrađen vapnom. U obrađenim uzorcima određeni su sljedeći parametri: (a) ukupna ulja, (b) mineralna ulja, (c) policiklički aromatski ugljikovodici (16 komponenata) i (d) teški metali i potencijalno toksični elementi (10 elemenata). Osim ukupnog sadržaja navedenih parametara u obrađenim uzorcima, određen je i njihov sadržaj u vodenim eluatima istih uzoraka. Od primjenjenih tretmana, tretman organofilnom glinom se pokazao bitno najuspješnijim za većinu parametara. Tako tretiran uzorak otpušta na primjer 63 puta manje ukupnih ulja, 67 puta manje mineralnih ulja, 798 puta manje naftalena i 136 puta manje olova od uzorka tretiranog vapnom. Po uspješnosti iza organofilne gline nalazi se kalcinirana Moler glina. Dobiveni rezultati jasno ukazuju da odabiru najpovoljnijeg sredstva za obradu tehnološkog otpada u naftnom rudarstvu treba prethoditi smanjenje sadržaja ugljikovodika nekim od terenskih prihvatljivih načina i detaljna kemijska analiza preostalih organskih i anorganskih onečišćivača. Ovisno o rezultatu analize opasni tehnološki otpad može se tretirati puno efikasnije, uz upotrebu primjerenijih materijala (npr. organofilna glina) čime se može bitno reducirati otpuštanje onečišćivača iz tako obrađenog otpada u okoliš. Na taj način mogao bi se rješiti problem trajnog odlaganja obrađenog otpada.Part of the technological waste produced in petroleum industry in Croatia is hazardous waste. Such kind of waste is treated with lime and through processes of stabilization / solidification it transforms in poorly soluble - inert material which is then deposited in central oilfield pits. Stabilization/solidification with lime is worldwide used as a technique of treatment of organic and inorganic technological waste. Foreign experiences showed that by usage of this technique for treatment of organic technological waste, or waste with organic and inorganic pollutants, sufficient reduction of pollutant movement in the environment is not caused. Due to this fact, one has to be careful in its application. The new techniques of treatment are being developed for materials which contain organic or inorganic and organic pollutants. The aim of this research was to examine alternative ways of treatment of technological waste from petroleum industry. The sample of technological waste from central oilfield pit Vinkovci was treated in laboratory conditions with application of single material or application of material combinations: (a) cement, (b) organophilic clay, (c) calcined Moler clay, (d) lime + organophilic clay + bentonite, (e) cement + organophilic clay + bentonite, (f) lime + calcined Moler clay and (g) cement + calcined Moler clay. The sample of technological waste treated with lime was used for comparison of results. The following parameters were determined in treated samples: (a) total oils, (b) mineral oils, (c) polycyclic aromatic hydrocarbons (16) and (d) heavy metals and potentially toxic elements (10). The content of stated parameters is determined in original samples and their distilled water leachate. The most successful treatment for majority of parameters was treatment with organophilic clay. Such treated sample releases, for example, 63 times less total oils, 67 times less mineral oils, 798 times less naphthalene and 136 times less lead than sample treated with lime. The organophilic clay, as the most successful material, is followed by calcined Moler clay. The obtained results clearly show that reduction of hydrocarbons content with some of the field acceptable ways and detailed chemical analysis of left organic and inorganic pollutants has to be done before the selection of the best mean for treatment of technological waste in petroleum industry. Depending on results of analysis, hazardous technological waste can be treated more effective by application of more suitable materials (e.g. organophilic clay) which reduce pollutant release from such treated waste in the environment. In this way the problem of permanent disposal of treated waste can be solved

Serotype influences on dengue severity: a cross-sectional study on 485 confirmed dengue cases in Vitoria, Brazil

Background: Dengue is caused by a RNA virus of the family Flaviviridae, which presents four serotypes (DENV-1 to DENV-4) capable of inducing hemorrhage. The purpose of this study was to evaluate the influence of serotype on the outcome of dengue. Methods: This cross-sectional study included data from dengue cases with serotyping results that occurred between 2009 and 2013 in Vitoria, Espirito Santo, Brazil. Data were accessed through the Information System for Notifiable Diseases. Chi-square test, Fisher exact test, Mann-Whitney U test, and logistic regression were performed to assess associations between different serotypes and dengue severity, while considering gender and age. Results: The sample consisted of 485 laboratory confirmed dengue cases, of which 46.4 % were females, with median age of 26 years. Regarding overall samples, 77.3 % were caused by DENV-1, 16.1 % by DENV-4, 6.4 % by DENV-2, and 0.2 % by DENV-3. Severe dengue affected 6.6 % of all cases, of which 32.3 % of the cases caused by DENV-2, 6.4 % of those caused by DENV-4, 4.5 % of those caused by DENV-1, and none of those caused by DENV-3. Severe dengue was found to be seven times more frequent among cases of DENV-2 than among those of the other serotypes. Conclusions: The present study found that cases of DENV-2 had a higher proportion of severe dengue than among those of DENV-1 and DENV-4. Consequently, early detection of serotypes circulating in the territory could be an important approach to prevent increasing numbers of severe outcomes during dengue outbreaks by predicting the health support needed for early diagnoses and treatment of dengue cases

Laboratorijska ispitivanja novih materijala za obradu opasnog otpada iz naftnog rudarstva

U tehnološkom procesu proizvodnje nafte i prirodnog plina nastaje tehnološki otpad (talozi iz rezervoara i tehnoloških posuda, zauljena zemlja i dr.) dio kojeg, na temelju svojstava i štetnih sastojaka koje sadrži, spada u opasni otpad. Za njegov prihvat, privremeno odlaganje, predobradu, obradu i trajno odlaganje izgrađeni su objekti - Centralne otpadne jame (COJ). Prije odlaganja u COJ takav otpad se obrađuje živim vapnom i kroz proces stabilizacije/solidifikacije pretvara u slabo topivi – inertni materijal, te odlaže u dijelu COJ-a koji je za tu svrhu predviđen. Zbog akumuliranja inertnog materijala i ograničenog kapaciteta na lokaciji COJ-a, postavlja se problem lokacije trajnog zbrinjavanja većih količina obrađenog otpada. U svijetu, stabilizacija/solidifikacija živim vapnom koristi se kao tehnika obrade i organskog i anorganskog tehnološkog otpada. Svjetska iskustva međutim pokazuju da ako se ova tehnika koristi kod obrade organskog tehnološkog otpada, ili otpada koji sadrži i organske i anorganske onečišćivače kod njene primjene se mora biti jako oprezan jer ne dolazi do dovoljnog reduciranja kretanja onečišćivača u okoliš. Za materijale koji sadrže organske ili anorganske i organske onečišćivače razvijaju se nove tehnike obrade. U radu se prikazuju rezultati laboratorijskih istraživanja novih načina predobrade i obrade tehnološkog otpada iz naftnog rudarstva. Uzorci tehnološkog otpada iz COJ-Vinkovci u laboratorijskim uvjetima su obrađivani primjenom pojedinačnih materijala (cement, organofilna glina, damolin - kalcinirana Moler glina) ili kombiniranom primjenom nekoliko različitih materijala. Za usporedbu rezultata korišten je uzorak tehnološkog otpada obrađen vapnom. Dobiveni rezultati jasno ukazuju da se opasni tehnološki otpad može tretirati puno efikasnije, uz upotrebu primjerenijih materijala (npr. organofilna glina) čime se može bitno reducirati otpuštanje onečišćivača iz tako obrađenog otpada u okoliš. Na taj način mogao bi se riješiti problem trajnog odlaganja obrađenog otpada.Technological wastes (tank bottoms, separator sludges, oily soils etc.) are created during oil and gas production, part of which is hazardous waste. Central reserve pits - COJ are used for temporary disposal, pretreatment, treatment and final disposal of wastes. Before disposal in COJ such waste is treated with lime and through processes of stabilization/solidification it transforms in poorly soluble - inert material which is then deposited on pit area assign to a final disposal of solidified material. Because of accumulating of inert material inside COJ- and limited volume of the central reserve pit, subsequent disposal becomes problem. Stabilization/solidification with lime is worldwide used as a technique of treatment of organic and inorganic technological waste. Foreign experiences showed that by usage of this technique for treatment of organic technological waste, or waste with organic and inorganic pollutants, sufficient reduction of pollutant movement in the environment is not caused. Due to this fact, one has to be careful in its application. The new techniques of treatment are being developed for materials which contain organic or inorganic and organic pollutants. The paper presents results of laboratory investigation of new ways of treatment of technological waste from petroleum industry. The sample of technological waste from central oilfield pit Vinkovci was treated in laboratory conditions with application of single material (cement, organophilic clay, calcined Moler clay) or application of different material combinations. The sample of technological waste treated with lime was used for comparison of results. The obtained results clearly show that hazardous technological waste can be treated more effective by application of more suitable materials (e.g. organophilic clay) which reduce pollutant release from such treated waste in the environment. In this way the problem of permanent disposal of treated waste can be solved