1,352 research outputs found

    Pulmonary Sclerosing Hemangioma Detected by Fluorodeoxyglucose Positron Emission Tomography in Familial Adenomatous Polyposis: Report of a Case

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    We present a 53-year-old female suffering from familial adenomatous polyposis, who was found to have a positive nodus, lateral to the hilus of the left lung, on routine FDG-PET scan. This lesion was found to be a sclerosing hemangioma. We found an aberrant β-catenin expression on immunohistochemical staining, suggesting that sclerosing hemangioma and familial adenomatous polyposis share the same pathophysiology. It is important to be aware of the association of familial adenomatous polyposis and sclerosing hemangioma

    Re-imagining the Borders of US Security after 9/11: Securitisation, Risk, and the Creation of the Department of Homeland Security

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    The articulation of international and transnational terrorism as a key issue in US security policy, as a result of the 9/11 attacks, has not only led to a policy rethink, it has also included a bureaucratic shift within the US, showing a re-thinking of the role of borders within US security policy. Drawing substantively on the 'securitisation' approach to security studies, the article analyses the discourse of US security in order to examine the founding of the Department of Homeland Security, noting that its mission provides a new way of conceptualising 'borders' for US national security. The securitisation of terrorism is, therefore, not only represented by marking terrorism as a security issue, it is also solidified in the organisation of security policy-making within the US state. As such, the impact of a 'war on terror' provides an important moment for analysing the re-articulation of what security is in the US, and, in theoretical terms, for reaffirming the importance of a relationship between the production of threat and the institutionalisation of threat response. © 2007 Taylor & Francis

    Early Infant Diagnosis of HIV in Three Regions in Tanzania; Successes and Challenges.

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    By the end of 2009 an estimated 2.5 million children worldwide were living with HIV-1, mostly as a consequence of vertical transmission, and more than 90% of these children live in sub-Saharan Africa. In 2008 the World Health Organization (WHO), recommended early initiation of Highly Active Antiretroviral Therapy (HAART) to all HIV infected infants diagnosed within the first year of life, and since 2010, within the first two years of life, irrespective of CD4 count or WHO clinical stage. The study aims were to describe implementation of EID programs in three Tanzanian regions with differences in HIV prevalences and logistical set-up with regard to HIV DNA testing. Data were obtained by review of the prevention from mother to child transmission of HIV (PMTCT) registers from 2009-2011 at the Reproductive and Child Health Clinics (RCH) and from the databases from the Care and Treatment Clinics (CTC) in all the three regions; Kilimanjaro, Mbeya and Tanga. Statistical tests used were Poisson regression model and rank sum test. During the period of 2009 - 2011 a total of 4,860 exposed infants were registered from the reviewed sites, of whom 4,292 (88.3%) were screened for HIV infection. Overall proportion of tested infants in the three regions increased from 77.2% in 2009 to 97.8% in 2011. A total of 452 (10.5%) were found to be HIV infected (judged by the result of the first test). The prevalence of HIV infection among infants was higher in Mbeya when compared to Kilimanjaro region RR = 1.872 (95%CI = 1.408 - 2.543) p < 0.001. However sample turnaround time was significantly shorter in both Mbeya (2.7 weeks) and Tanga (5.0 weeks) as compared to Kilimanjaro (7.0 weeks), p=<0.001. A substantial of loss to follow-up (LTFU) was evident at all stages of EID services in the period of 2009 to 2011. Among the infants who were receiving treatment, 61% were found to be LFTU during the review period. The study showed an increase in testing of HIV exposed infants within the three years, there is large variations of HIV prevalence among the regions. Challenges like; sample turnaround time and LTFU must be overcome before this can translate into the intended goal of early initiation of lifelong lifesaving antiretroviral therapy for the infants

    Vaginal microbicide preferences among midwestern urban adolescent women

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    Abstract: Purpose The purpose of this study was to assess adolescent women&apos;s preferences for specific microbicide characteristics including pregnancy prevention, timing of application, potential for side effects, and whether it targeted human immunodeficiency virus (HIV) or other sexually transmitted infections (STI). Potential differences in microbicide preferences by adolescent age group and behavioral patterns including engaging in sexual intercourse and use of hormonal contraception were examined, as it was hypothesized that as adolescents progress into adulthood and gain sexual experience their preferences in microbicide characteristics may shift. Method Adolescent and young women (N = 405, 56.0% African American; 24.0% Euro-American) between the ages of 14 and 20 (mean = 17.0, SD = 1.8) were recruited from urban communitybased clinics. Video-Audio Computer-Assisted Self-Interviews were conducted with the young women, during which they were asked about their preferences regarding the characteristics of hypothetical vaginal microbicides. Conjoint analysis was utilized to determine adolescent women&apos;s relative preferences for each microbicide characteristic and intent-to-purchase microbicides based upon a combination of the selected properties. Results Overall, the results suggest adolescent and young women had an ordered preference for a microbicide with (1) no side effects, (2) pregnancy prevention, (3) postcoital application, and (4) protection against HIV. Age and behavioral group conjoint analyses resulted in the same pattern of preferences as those reported for the entire group. However, women having sex and not using hormonal contraception had a stronger preference for postcoital application. Conclusion The findings suggest that young women&apos;s ratings of microbicides were sensitive to characteristics such as side effects, pregnancy prevention, and timing of application and should be considered in microbicide development. The conjoint analysis approach is useful in understanding microbicide preferences, and should be utilized with other populations to assess preferences for specific microbicide characteristics. microbicides | adolescent women | sexuality | conjoint analysis | adolescent health | Keywords: sexual health Article: The search for a woman-initiated prevention method has led to focus on topical microbicides for sexually transmitted infection (STI)/ human immunodeficiency virus (HIV) prevention. Microbicides are substances that may substantially reduce transmission of STI when applied in the vagina or rectum [1]. Some microbicides may also prevent pregnancy, although not all microbicides will be contraceptive [2]. Microbicides are not currently commercially available; products are in various phases of clinical trials [1]. Most microbicides under development are coitus dependent, requiring women to recognize and prepare for sexual situations and be willing to use a product that requires some comfort with touching their genitals [3]. The process of inserting a microbicide into the vagina may be challenging, as the dialogue around young women&apos;s sexuality and their bodies is often lacking [4]. Acceptability research, therefore, remains crucial to anticipate and prospectively address the kinds of obstacles previously associated with other female-initiated products, such as the female condom [5] and [6]. For instance, although women enjoyed having more control in using the female condom, they often did not like the size and discomfort associated with use or the inability to use it covertly [6]. Extant microbicide acceptability research with young women has suggested that contraceptive and disease prevention properties, timing of use, and associated side effects are important characteristics [7]. The findings suggest that young women generally prefer both pregnancy and disease prevention in a single product and insertion with an applicator up to 8 hours in advance [8]. In addition, there is a preference for lubricating products [9] and [10] with low amounts of messiness [9] and leakage [8]. Previous research also indicated that relevant potential side effects may impact microbicide use, including yeast infections, vaginal itching, and allergic reactions [7] and [11]. Furthermore, access was an important gauge of acceptability in a group of adolescent women. Women indicated that microbicides should be promoted through &quot;adolescentspecific and girl-specific venues,&quot; including women&apos;s magazines [7]. There was also a reported desire for microbicides that would be small enough to carry in their pocket, bra, or within cell phone or palm pilot cases, and should be distributed through schools and sexuality education classes [7]. Most young women preferred over-the-counter availability of microbicides, yet stated they would be embarrassed if purchasing the product in the presence of others [7] and [8]. Thus far, microbicide acceptability research with adolescents has been conducted primarily with older adolescents, using individual interview and focus group methodologies [7] [16]. These qualitative methodologies allow for an in-depth assessment of individual as well as relational and age-related issues that may influence microbicide use [13] and [17]. However, social desirability is often a concern when studying stigmatized or socially sensitive issues associated with sexuality [18] and [19]. Past research has shown that using a video-audio computer-assisted self-interview (VACASI) format (participants privately responding to questions on a computer) for presenting survey questions alleviates the tendency for individuals to present themselves positively and answer questions in a socially desirable fashion [20]. In addition, women and adolescents report sensitive behaviors more frequently when questions are asked using computer interviewing techniques than when participating in a face-to-face interview [20], [21] and [22]. Existing microbicide acceptability research with adolescents also often lacks detailed attention to the multiple dimensions that must be considered simultaneously in a decision to try a product such as a microbicide. The addition of quantitative biopsychosocial studies addressing these issues thus complements the existing qualitative microbicide acceptability research [8], [23] and [24]. The purpose of this study was to quantitatively assess, using full-profile ratings based conjoint analysis, preferences for specific microbicide characteristics among a young, urban population of women. Building on the existing literature we chose to assess young women&apos;s preferences for pregnancy and STI (including HIV) prevention as well as timing of application and side effect potential. It was hypothesized that as women progress through the adolescent years, their relative preferences for specific microbicide characteristics may change as a function of their age and sexual experience. Methods Study participants Participants were 405 adolescent and young women between the ages of 14 and 20 (mean = 17, SD = 1.8) recruited from community-based urban health clinics in the Midwestern United States in an area with relatively low rates of HIV [25]. See Study procedure After informed consent was received, the young women were given a computer and headphones in a private exam room to begin the questionnaire. The VACASI began with participants being asked to choose one of four possible &quot;guides&quot; whose face and voice were used throughout the VACASI. Guides were young women (approximately 18-20 years old) who were professional actors of varied ethnic appearance and voice. The guides were used to increase young women&apos;s level of comfort with the interview [27]. Following the choice of a guide, more information was given about the microbicide and a product sample was shown. The participant was then asked multiple demographic and sexual behaviors questions and presented with microbicide vignettes that asked her to rate the likelihood of buying each microbicide. The self-interviews were completed in English and lasted 25-45 minutes. Participants received $20 compensation for the time and effort involved in completing the questionnaire. The protocols for the entire project were approved by the University&apos;s institutional review board

    Fit for what?: towards explaining Battlegroup inaction

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    The thrust of this paper concerns the case of the European Battlegroup (BG) non-deployment in late 2008, when the United Nations requested European military support for the United Nations Organisation Mission peacekeeping force in the Democratic Republic of the Congo (DRC). The argument is built on the fact that when, in official documents, the EU approaches the European security and ESDP/CSDP's military crisis management policy and interventions, it makes strong references to the United Nations and the UN Charter Chapter VII's mandate of restoring international peace and security. Such references make it seem that supporting the UN when it deals with threats and crises is a primary concern of the EU and the member states. These allusions lead to the main contention of this paper, that there is much ambivalence in these indications. The paper develops its argument from one key hypothesis; namely, that the non-deployment of a European BG in the DRC, at the end of 2008, constitutes a useful case study for detecting a number of ambiguities of the EU in respect of its declarations in the official documents establishing the European military crisis management intervention structure

    The HLA class II allele DRB1*1501 is over-represented in patients with idiopathic pulmonary fibrosis

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    Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and medically refractory lung disease with a grim prognosis. Although the etiology of IPF remains perplexing, abnormal adaptive immune responses are evident in many afflicted patients. We hypothesized that perturbations of human leukocyte antigen (HLA) allele frequencies, which are often seen among patients with immunologic diseases, may also be present in IPF patients. Methods/Principal Findings: HLA alleles were determined in subpopulations of IPF and normal subjects using molecular typing methods. HLA-DRB1*15 was over-represented in a discovery cohort of 79 Caucasian IPF subjects who had lung transplantations at the University of Pittsburgh (36.7%) compared to normal reference populations. These findings were prospectively replicated in a validation cohort of 196 additional IPF subjects from four other U.S. medical centers that included both ambulatory patients and lung transplantation recipients. High-resolution typing was used to further define specific HLA-DRB1*15 alleles. DRB1*1501 prevalence in IPF subjects was similar among the 143 ambulatory patients and 132 transplant recipients (31.5% and 34.8%, respectively, p = 0.55). The aggregate prevalence of DRB1*1501 in IPF patients was significantly greater than among 285 healthy controls (33.1% vs. 20.0%, respectively, OR 2.0; 95%CI 1.3-2.9, p = 0.0004). IPF patients with DRB1*1501 (n = 91) tended to have decreased diffusing capacities for carbon monoxide (DLCO) compared to the 184 disease subjects who lacked this allele (37.8±1.7% vs. 42.8±1.4%, p = 0.036). Conclusions/Significance: DRB1*1501 is more prevalent among IPF patients than normal subjects, and may be associated with greater impairment of gas exchange. These data are novel evidence that immunogenetic processes can play a role in the susceptibility to and/or manifestations of IPF. Findings here of a disease association at the HLA-DR locus have broad pathogenic implications, illustrate a specific chromosomal area for incremental, targeted genomic study, and may identify a distinct clinical phenotype among patients with this enigmatic, morbid lung disease
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