Circumcision and penile human papillomavirus prevalence in human immunodeficiency virus-infected men: heterosexual and men who have sex with men

AbstractMale circumcision is associated with a lower risk of penile human papillomavirus (HPV) infection in human immunodeficiency virus (HIV) uninfected men. Few studies have evaluated the role of male circumcision in penile HPV infection in HIV-infected men. The aim of this cross-sectional study was to examine the association between male circumcision and the prevalence of penile HPV infection among HIV-infected men—both men who have sex with men (MSM) and heterosexual men. Samples from 706 consecutive men included in the CARH-MEN cohort (overall 24% circumcised: 26% of MSM, 18% of heterosexual men) were examined by Multiplex-PCR. In the overall group (all HIV-infected men included), the prevalence of any penile HPV infection was 22% in circumcised men and 27% in uncircumcised men (OR = 1.0, 95% CI 0.6–1.6, adjusted analysis). In the circumcised group the overall prevalence of HPV infection was 22% in MSM and 24% in the heterosexual men, whereas in the uncircumcised group the prevalence was 26% and 28%, respectively. The prevalence of high-risk HPV types tended to be lower in the circumcised MSM (14% vs 21%, OR = 0.6, 95% CI 0.3–1.1, p 0.088), but it was similar in the heterosexual men (18% in circumcised vs 20% in uncircumcised). These results suggest that male circumcision may be associated with a lower prevalence of oncogenic high-risk penile HPV infection in HIV-infected MSM

3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

Background: Liraglutide 3·0 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals with prediabetes who were diagnosed with type 2 diabetes. Methods: In this randomised, double-blind, placebo-controlled trial, adults with prediabetes and a body-mass index of at least 30 kg/m2, or at least 27 kg/m2 with comorbidities, were randomised 2:1, using a telephone or web-based system, to once-daily subcutaneous liraglutide 3·0 mg or matched placebo, as an adjunct to a reduced-calorie diet and increased physical activity. Time to diabetes onset by 160 weeks was the primary outcome, evaluated in all randomised treated individuals with at least one post-baseline assessment. The trial was conducted at 191 clinical research sites in 27 countries and is registered with ClinicalTrials.gov, number NCT01272219. Findings: The study ran between June 1, 2011, and March 2, 2015. We randomly assigned 2254 patients to receive liraglutide (n=1505) or placebo (n=749). 1128 (50%) participants completed the study up to week 160, after withdrawal of 714 (47%) participants in the liraglutide group and 412 (55%) participants in the placebo group. By week 160, 26 (2%) of 1472 individuals in the liraglutide group versus 46 (6%) of 738 in the placebo group were diagnosed with diabetes while on treatment. The mean time from randomisation to diagnosis was 99 (SD 47) weeks for the 26 individuals in the liraglutide group versus 87 (47) weeks for the 46 individuals in the placebo group. Taking the different diagnosis frequencies between the treatment groups into account, the time to onset of diabetes over 160 weeks among all randomised individuals was 2·7 times longer with liraglutide than with placebo (95% CI 1·9 to 3·9, p<0·0001), corresponding with a hazard ratio of 0·21 (95% CI 0·13–0·34). Liraglutide induced greater weight loss than placebo at week 160 (–6·1 [SD 7·3] vs −1·9% [6·3]; estimated treatment difference −4·3%, 95% CI −4·9 to −3·7, p<0·0001). Serious adverse events were reported by 227 (15%) of 1501 randomised treated individuals in the liraglutide group versus 96 (13%) of 747 individuals in the placebo group. Interpretation: In this trial, we provide results for 3 years of treatment, with the limitation that withdrawn individuals were not followed up after discontinuation. Liraglutide 3·0 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes. Funding: Novo Nordisk, Denmark

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

WSDL Workshop. Semantic web application in HTML5 for the discovery, construction and analysis of workflows

WSDL-Workshop is a HTML5 web application for the discovery and exploration of web services and for analysing the compatibility between web services. This is the result of a mathematical model developed from WSDL1.1. The program provides a graphical user interface and let the user build a workflow composed of services described with WSDL1.1 and tells if: ∙An output is compatible with an input. ∙It is correct to link an output with an input. ∙It is correct to link a given operation after another. ∙If many operations correctly linked together still make sense as a group. In order to do that the WSDLs must have semantic annotations so the computer can recognize what is the purpose of certain data or operation. WSDL-Workshop uses the EDAM Ontology as a reference for semantic concepts. In the discovery aspect; for a given set of WSDLs you can find services by filtering by operation name, input or output names, or semantic annotations. For a given operation output it can also filter by WSDL which have inputs which are correct to link with that output. For a given operation it can also filter by operations which are correct to link after

Studying the impact of body mass index on pretransplant early renal graft function

Introduction: Obesity and overweight have adverse health effects contributing to the presence of oxidative metabolic and cardiovascular diseases that threaten the integrity of the graft.Objective: To investigate the influence of body mass index on pre transplant graft function one year after transplant by studying four different methods of measuring the glomerular filtration rate.Material and methods: The sample consisted of 1336 kidney transplant patients of both sexes, measurements were performed pre transplant and post transplant of biochemical parameters, anthropometric measurements and kidney function by glomerular filtration steps.Results: When an increased body mass index pretransplant occurs, there is a decrease in glomerular filtration rate measured by four different methods and greater percentage of rejections.Conclusions: A high body mass index pretransplant contributes to graft dysfunction, a decrease in glomerular filtration rate and graft complications in the first year after transplant

How does cardiac arrest of traumatic origin affect the prognosis of children?

Objective: To know the outcome of children who suffered from traumatic cardiac arrest (CA) compared to children with other causes of CA, and if there are some differences in both groups regarding to some predictors in children.Methods: Multicentre prospective study in children until 18 years, presenting CA in an emergency prehospital or hospital service. We collected first known rhythm, lactate, pH and PELOD (Paediatric Logistic Organ Dysfunction scale) in first 24 hours. We also recorded if there was return of spontaneous circulation (ROSC), survival and POPC (Paediatric Overall Performance Category) at discharge and 6 months. We used Student test, Chi squared test and Fisher test with risk ratio (RR) and its 0.95 confidence interval in case of statistical significance.Results: 27/188 (14.4%) were patients with traumatic CA, 62.6% male. Median age 2.5 years (range 0-17.1) There was no statistical difference in age in both groups, but we found a higher proportion of males in trauma group (88.9% vs 57.1%), p = 0.02, RR 4.9 (1.5-15.7). There were not significant differences regarding to proportion of asystole, lactate, pH or PELOD. We didn’t find any significant differences related to ROSC, sustained ROSC, POPC under 3–better outcome- at discharge or at 6 months. Nevertheless, there was worse survival at discharge in trauma patients, 12% vs 40.3%, p = 0.006, RR 1.5 (1.2-1.8) and at 6 months, 8.3% vs 30.9%, p = 0.24, RR 1.3 (1.1-1.6). Two patients survived at 6 months with POPC under 3.CA of traumatic origin decreases the survival of children at hospital discharge and at 6 months, however some children who suffered traumatic CA achieve a good functional outcome at 6 months.Patients who suffered from traumatic CA didn’t have any differencesin some known prognosis factors (asystole, lactate, pH,PELOD).</p

Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes

BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo