Global burden of human brucellosis : a systematic review of disease frequency

BACKGROUND: This report presents a systematic review of scientific literature published between 1990-2010 relating to the frequency of human brucellosis, commissioned by WHO. The objectives were to identify high quality disease incidence data to complement existing knowledge of the global disease burden and, ultimately, to contribute towards the calculation of a Disability-Adjusted Life Years (DALY) estimate for brucellosis.METHODS/PRINCIPAL FINDINGS: Thirty three databases were searched, identifying 2,385 articles relating to human brucellosis. Based on strict screening criteria, 60 studies were selected for quality assessment, of which only 29 were of sufficient quality for data analysis. Data were only available from 15 countries in the regions of Northern Africa and Middle East, Western Europe, Central and South America, Sub-Saharan Africa, and Central Asia. Half of the studies presented incidence data, six of which were longitudinal prospective studies, and half presented seroprevalence data which were converted to incidence rates. Brucellosis incidence varied widely between, and within, countries. Although study biases cannot be ruled out, demographic, occupational, and socioeconomic factors likely play a role. Aggregated data at national or regional levels do not capture these complexities of disease dynamics and, consequently, at-risk populations or areas may be overlooked. In many brucellosis-endemic countries, health systems are weak and passively-acquired official data underestimate the true disease burden.CONCLUSIONS: High quality research is essential for an accurate assessment of disease burden, particularly in Eastern Europe, the Asia-Pacific, Central and South America and Africa where data are lacking. Providing formal epidemiological and statistical training to researchers is essential for improving study quality. An integrated approach to disease surveillance involving both human health and veterinary services would allow a better understand of disease dynamics at the animal-human interface, as well as a more cost-effective utilisation of resources

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

A saturated map of common genetic variants associated with human height

Common single-nucleotide polymorphisms (SNPs) are predicted to collectively explain 40-50% of phenotypic variation in human height, but identifying the specific variants and associated regions requires huge sample sizes(1). Here, using data from a genome-wide association study of 5.4 million individuals of diverse ancestries, we show that 12,111 independent SNPs that are significantly associated with height account for nearly all of the common SNP-based heritability. These SNPs are clustered within 7,209 non-overlapping genomic segments with a mean size of around 90 kb, covering about 21% of the genome. The density of independent associations varies across the genome and the regions of increased density are enriched for biologically relevant genes. In out-of-sample estimation and prediction, the 12,111 SNPs (or all SNPs in the HapMap 3 panel(2)) account for 40% (45%) of phenotypic variance in populations of European ancestry but only around 10-20% (14-24%) in populations of other ancestries. Effect sizes, associated regions and gene prioritization are similar across ancestries, indicating that reduced prediction accuracy is likely to be explained by linkage disequilibrium and differences in allele frequency within associated regions. Finally, we show that the relevant biological pathways are detectable with smaller sample sizes than are needed to implicate causal genes and variants. Overall, this study provides a comprehensive map of specific genomic regions that contain the vast majority of common height-associated variants. Although this map is saturated for populations of European ancestry, further research is needed to achieve equivalent saturation in other ancestries.A large genome-wide association study of more than 5 million individuals reveals that 12,111 single-nucleotide polymorphisms account for nearly all the heritability of height attributable to common genetic variants

A saturated map of common genetic variants associated with human height.

Common single-nucleotide polymorphisms (SNPs) are predicted to collectively explain 40-50% of phenotypic variation in human height, but identifying the specific variants and associated regions requires huge sample sizes1. Here, using data from a genome-wide association study of 5.4 million individuals of diverse ancestries, we show that 12,111 independent SNPs that are significantly associated with height account for nearly all of the common SNP-based heritability. These SNPs are clustered within 7,209 non-overlapping genomic segments with a mean size of around 90 kb, covering about 21% of the genome. The density of independent associations varies across the genome and the regions of increased density are enriched for biologically relevant genes. In out-of-sample estimation and prediction, the 12,111 SNPs (or all SNPs in the HapMap 3 panel2) account for 40% (45%) of phenotypic variance in populations of European ancestry but only around 10-20% (14-24%) in populations of other ancestries. Effect sizes, associated regions and gene prioritization are similar across ancestries, indicating that reduced prediction accuracy is likely to be explained by linkage disequilibrium and differences in allele frequency within associated regions. Finally, we show that the relevant biological pathways are detectable with smaller sample sizes than are needed to implicate causal genes and variants. Overall, this study provides a comprehensive map of specific genomic regions that contain the vast majority of common height-associated variants. Although this map is saturated for populations of European ancestry, further research is needed to achieve equivalent saturation in other ancestries

Zinc Sulphate in the Treatment of Cutaneous Leishmaniasis: an in Vitro and Animal Study

This study was designed to evaluate the effectiveness of zinc sulphate both in vitro and in an animal model against both strains of old world cutaneous leishmaniasis. The in vitro sensitivities of promastigotes and axenic amastigotes of both Leishmania major and L. tropica to zinc sulphate was determined, the LD50 calculated and compared to the standard treatment for cutaneous leishmaniasis pentavalent antimony compounds. The results show that the two forms of both strains were sensitive to zinc sulphate and their respective LD50 were lower compared to the pentavalent antimony compound. Furthermore the sensitivities of the forms of both strains were tested using a simple slide method and compared to results of the standard method. To confirm this result, zinc sulphate was administered orally to mice infected with cutaneous leishmaniasis both therapeutically and prophylactically. Results showed that oral zinc sulphate was effective in both treatment and prophylaxis for cutaneous leishmaniasis. These results encourage the use of oral zinc sulphate in the treatment of cutaneous leishmaniasis clinically

Comportamento de variáveis fisiológicas em atletas de nado sincronizado durante uma sessão de treinamento na fase de preparação para as Olimpíadas de Atenas 2004 Comportamiento de variábles fisiológicas en atletas de nado sincronizado durante una sesion de entrenamiento en la fase de preparación para las Olimpíadas de Atenas 2004 Behavior of physiological variables in synchronized swimming athletes during a training session preparing for the Athens 2004 Olympic Games

O objetivo do presente estudo foi avaliar o comportamento de variáveis fisiológicas durante uma sessão de treino de nado sincronizado realizada na fase de preparação para as Olimpíadas de Atenas 2004. MATERIAIS E MÉTODOS: A amostra utilizada foi constituída pelo dueto (24 ± 0 anos) representante do Brasil em Atenas 2004. A coleta de dados foi realizada durante uma sessão de treinamento com duração de 198 minutos. O treino se iniciou com a parte física, seguida da parte técnica. Para a determinação da glicemia e da concentração de beta-hidroxibutirato foi utilizado o monitor Optium® com suas respectivas tiras. As concentrações de cortisol e das enzimas lactato desidrogenase (LDH) e creatina quinase (CK) foram determinadas por radioimunoensaio (DPC©) e kits comerciais (CELM®), respectivamente. O acompanhamento da freqüência cardíaca (FC) foi realizado com o freqüêncimetro Advantage Polar®. RESULTADOS: Foi observada redução (~2%) do peso corporal. A glicemia também apresentou queda (~30%) em comparação ao valor obtido no início do treino. Em contrapartida, foi observada elevação na concentração de cortisol (salivar 22% e plasmática 29%) e de beta-hidroxibutirato (~340%). Não foi observada alteração significativa na concentração plasmática de CK e de LDH. O acompanhamento da FC demonstrou que dos 198 minutos que constituíram a sessão de treino, 36,5 ± 0,7 minutos foram realizados em intensidade leve; 103,5 ± 0,7 minutos em intensidade moderada, 54,0 ± 2,1 minutos em intensidade alta e 4,0 ± 0,0 minutos em intensidade muito alta. CONCLUSÕES: A perda de peso indica que a reposição hídrica não foi adequada. A redução na glicemia e o aumento na concentração de corpos cetônicos e de cortisol reforçam a importância da suplementação de carboidrato durante o treino de longa duração. O comportamento da FC demonstra que a sessão de treinamento foi realizada em uma intensidade moderada, porém com breves momentos de intensidade alta, nos quais foram realizadas as rotinas.<br>El objetivo del presente estudio fue el de evaluar la conducta de algunas variables fisiológicas durante una sesión de entrenamiento de nado sincronizado cumplido en la fase de la preparación para los Juegos Olímpicos de Atenas 2004. MATERIALES Y MÉTODOS: La muestra usada se constituyó por el dueto (24 ± 0 años) representante de Brasil en Atenas 2004. La colección de datos fue cumplida durante una sesión de entrenamiento con una duración de 198 minutos. Los entrenamientos empezaron con la parte física, mientras era seguida por la parte técnica. Para la determinación de la glicemia y de la concentración de beta-hidroxibutirato el experimentador usó Optium® con las cintas respectivas. Las concentraciones del cortisol y de las enzimas lactico deshidrogenasa (LDH) y creatinquinase (CK) fueron medidas por el radio-imuno-ensayo (DPC©) con equipos comerciales (CELM®), respectivamente. La asistencia de la frecuencia del corazón (FC) fue cumplida con elfrecuencímetro Polar®. RESULTADOS: La reducción fue observada (~2%) en el peso corporal. La glicemia también presentó una caída (~30%) comparada con el valor obtenido al principio del entrenamiento. En contra de la salida, se observó una elevación en la concentración del cortisol (en saliva 22% y plasmático 29%) y del beta-hidroxibutirato (~340%). No se observó una alteración significante en la concentración plasmática de CK y de LDH. El control de la de FC demostró a los 198 minutos de la sesión de entrenamiento, que 36,5 ± 0,7 minutos eran cumplidos en una intensidad ligera; 103,5 ± 0,7 minutos en una intensidad moderada, 54,0 ± 2,1 minutos en la intensidad alta y 4,0 ± 0,0 minutos en una intensidad muy alta. CONCLUSIONES: La pérdida de peso indica que el remplazo hidrico no se adaptó. La reducción en el glicemia y el aumento en la concentración de los cuerpos cetónicos y de cortisol ellos refuerzan la importancia del suplementación de hidratos de carbono durante el entrenamiento de larga duración. La conducta de FC demuestra que la sesión de entrenamiento fué cumplida en una intensidad moderada, sin embargo en los momentos breves de intensidad alta, mientras, las rutinas eran cumplidas.<br>The purpose of this study was to evaluate the behavior of physiological variables during a synchronized swimming training session performed in athletes preparing for the Athens 2004 Olympic Games. MATERIALS AND METHODS: The sampling used was constituted by the duet (24 ± 0 years) who was representing Brazil in the Athens 2004 Olympic Games. Data collection was performed during a 198 minute training session. The training started with the physical portion, followed by the technical portion. In order to determine the glycemia and the beta-hydroxybutyrate, it was used an Optium® monitor with its respective stripes. The cortisol and the dehydrogenase lactate enzymes (LDH), concentrations, as well as the kinase creatine (KC) concentration were determined through the radioimmunoassay (RIA©) and through commercially available kits (CELM©), respectively. The follow-up of the heart rate (HR) was performed using an Advantage Polar® heart rate monitor. RESULTS: It was noted a reduction (~2%) in the body weight. The glycemia also presented a fall (~30%) compared to the value attained in the beginning of the training session. Otherwise, it was observed an elevation in the cortisol concentration (salivary, 22%, and plasmatic, 29%) and in the beta-hydroxybutyrate (~340%). No significant changes in the plasmatic concentration of the KC and LDH were observed. The follow-up of the HR showed that from all 198 minutes of the training session, 36.5 ± 0.7 minutes were performed at a light intensity; 103.5 ± 0.7 minutes at a moderate intensity, 54.0 ± 2.1 minutes at a high intensity, and 4.0 ± 0.0 minutes at a very high intensity. CONCLUSIONS: The weight loss indicates that the hydric reposition was not adequate. The reduction in the glycemia and the increase in the ketonic bodies and cortisol concentrations reinforce the importance of a carbohydrate supplement during the long endurance training. The HR behavior shows that the training session was performed at a moderate intensity, but having fast moments of high intensity, in which routines were performed