Seksueel overdraagbare aandoeningen, waaronder HIV, in Nederland in 2007

Net als in 2006 was chlamydia in 2007 de meest gediagnosticeerde bacterikle geslachtsziekte in de soacentra, vooral bij jongeren. Het percentage positieve chlamydiatesten nder heteroseksuele mannen en vrouwen daalde enigszins, voor het eerst sinds vier jaar (van 10,6% naar 10,1%). In 2006 stabiliseerde dit percentage bij mannen die seks hebben met mannen (MSM), en die trend zette door in 2007. Het percentage positieve gonorroe-, syfilis- en hivtesten nam net als voorgaande jaren af in 2007 (respectievelijk 2,4%, 0,9% en ,5%). Deze infecties werden het meest gediagnosticeerd bij MSM. In 2007 zijn er 306 nieuwe hivdiagnoses gesteld in de soacentra, ongeveer een derde van de 864 hivpositieven die dat jaar landelijk in de hivcentra zijn gemeld. Eind 2007 waren in totaal 14.019 personen in Nederland met hiv geregistreerd. Het aandeel van MSM onder de nieuw hivinfecties nam in 2007 verder toe. Net als eerdere jaren werd in de soacentra bij MSM die bekend zijn met hun positieve hivstatus vaak nog een andere geslachtsziekte gevonden (45%). In deze groep is sinds 2004 regelmatig LGV, een agressieve variant van chlamydia, en sinds 2007 hepatitis C gediagnosticeerd. Versterkte surveillance en innovatieve interventies zijn nodig om verdere verspreiding onder MSM en naar andere groepen te voorkomen. Onder bepaalde migrantengroepen in Nederland (onder andere afkomstig uit Suriname, de Nederlandse Antillen en Aruba) komen hiv, chlamydia, gonorroe en syfilis relatief vaker voor dan onder autochtone Nederlanders. Ook deze constatering vraagt om vernieuwende maatregelen die op de bevolkingsgroepen zijn toegespitst. De soacentra bieden soazorg aan hoogrisicogroepen. In 2007 hebben ruim 78.000 personen zich daar laten testen, een toename van 13% ten opzichte van 2006. Net als in 2006 was chlamydia in 2007 de meest gediagnosticeerde bacterikle geslachtsziekte in de soacentra, vooral bij jongeren. Het percentage positieve chlamydiatesten onder heteroseksuele mannen en vrouwen daalde enigszins, voor het eerst sinds vier jaar (van 10,6% naar 10,1%). In 2006 stabiliseerde dit percentage bij mannen die seks hebben met mannen (MSM), en die trend zette door in 2007. Het percentage positieve gonorroe-, syfilis- en hivtesten nam net als voorgaande jaren af in 2007 (respectievelijk 2,4%, 0,9% en 0,5%). Deze infecties werden het meest gediagnosticeerd bij MSM.In 2007, chlamydia was the most common bacterial sexually transmitted infection (STI) diagnosed in Dutch STI centres. Similar to previous years, infections were reported especially in young heterosexuals. The proportion of positive chlamydia tests among heterosexual men and women decreased slightly for the first time in four years (from 10.6% to 10.1%). In 2006, this proportion had stabilized in men who have sex with men (MSM) with the trend continuing in 2007. The positivity rate for gonorrhoea (2.4%), syphilis (0.9%) and HIV (0.5%) continued to decrease in 2007. These infections were most frequently diagnosed in MSM. In 2007, 306 new positive HIV cases were diagnosed in STI centres in the Netherlands. This number amounts to about one third of the total number of 864 positive HIV cases registered nationally. At the end of 2007, a total of 14,019 HIV cases in care were registered in the Netherlands. The proportion of MSM among new HIV cases rose further in 2007. In line with previous years, concurrent STIs were diagnosed very frequently among MSM visiting STI centres (45%) who had known HIV positive status. In this group of men, Lymphogranuloma Venereum (LGV) an aggressive type of chlamydia, has been reported frequently since 2004; this has also been the case for hepatitis C since 2007. In this group of men, strengthened surveillance and innovative interventions are warranted in order to prevent further transmission both among MSM and to other population groups. In some specific migrant groups in the Dutch population -- for example, people from Surinam, the Netherlands Antilles and Aruba -- HIV, chlamydia, gonorrhoea and syphilis are more common than in the autochthonous Dutch population. This indicates the need for targeted intervention by risk profile. The specialised STI centres in the Netherlands offer STI testing and care targeted at high risk groups. In 2007, approximately 78,000 people used this service amounting to a rise of 13% compared to 2006

The Features of the Synovium in Early Rheumatoid Arthritis According to the 2010 ACR/EULAR Classification Criteria

OBJECTIVES: It has been shown in early arthritis cohorts that the 2010 ACR/EULAR criteria for rheumatoid arthritis (RA) enable an earlier diagnosis, perhaps at the cost of a somewhat more heterogeneous patient population. We describe the features of synovial inflammation in RA patients classified according to these new criteria. METHODS: At baseline, synovial tissue biopsy samples were obtained from disease-modifying antirheumatic drug (DMARD)-naïve early RA patients (clinical signs and symptoms <1 year). Synovial tissue was analyzed for cell infiltration, vascularity, and expression of adhesion molecules. Stained sections were evaluated by digital image analysis. Patients were classified according to the two different sets of classification criteria, autoantibody status, and outcome. FINDINGS: Synovial tissue of 69 RA patients according to 2010 ACR/EULAR criteria was analyzed: 56 patients who fulfilled the criteria for RA at baseline and 13 who were initially diagnosed as undifferentiated arthritis but fulfilled criteria for RA upon follow up. The synovium at baseline was infiltrated by plasma cells, macrophages, and T cells as well as other cells, and findings were comparable to those when patients were selected based on the 1987 ACR criteria for RA. There was no clear cut difference in the characteristics of the synovium between RA patients initially diagnosed as undifferentiated arthritis and those who already fulfilled classification criteria at baseline. CONCLUSION: The features of synovial inflammation are similar when the 2010 ACR/EULAR classification criteria are used compared to the 1987 ACR criteria

Dissemination of Cephalosporin Resistance Genes between Escherichia coli Strains from Farm Animals and Humans by Specific Plasmid Lineages

Third-generation cephalosporins are a class of β-lactam antibiotics that are often used for the treatment of human infections caused by Gram-negative bacteria, especially Escherichia coli. Worryingly, the incidence of human infections caused by third-generation cephalosporin-resistant E. coli is increasing worldwide. Recent studies have suggested that these E. coli strains, and their antibiotic resistance genes, can spread from food-producing animals, via the food-chain, to humans. However, these studies used traditional typing methods, which may not have provided sufficient resolution to reliably assess the relatedness of these strains. We therefore used whole-genome sequencing (WGS) to study the relatedness of cephalosporin-resistant E. coli from humans, chicken meat, poultry and pigs. One strain collection included pairs of human and poultry-associated strains that had previously been considered to be identical based on Multi-Locus Sequence Typing, plasmid typing and antibiotic resistance gene sequencing. The second collection included isolates from farmers and their pigs. WGS analysis revealed considerable heterogeneity between human and poultry-associated isolates. The most closely related pairs of strains from both sources carried 1263 Single-Nucleotide Polymorphisms (SNPs) per Mbp core genome. In contrast, epidemiologically linked strains from humans and pigs differed by only 1.8 SNPs per Mbp core genome. WGS-based plasmid reconstructions revealed three distinct plasmid lineages (IncI1- and IncK-type) that carried cephalosporin resistance genes of the Extended-Spectrum Beta-Lactamase (ESBL)- and AmpC-types. The plasmid backbones within each lineage were virtually identical and were shared by genetically unrelated human and animal isolates. Plasmid reconstructions from short-read sequencing data were validated by long-read DNA sequencing for two strains. Our findings failed to demonstrate evidence for recent clonal transmission of cephalosporin-resistant E. coli strains from poultry to humans, as has been suggested based on traditional, low-resolution typing methods. Instead, our data suggest that cephalosporin resistance genes are mainly disseminated in animals and humans via distinct plasmids

TRY plant trait database - enhanced coverage and open access

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand

Objective: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. Design: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. Methods: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. Results: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. Conclusion: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

TRY plant trait database - enhanced coverage and open access

Plant traits—the morphological, anatomical, physiological, biochemical and phenological characteristics of plants—determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits—almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives