Association of Salivary Human Papillomavirus Infection and Oral and Oropharyngeal Cancer: A Meta-Analysis

BACKGROUND: Human papillomavirus (HPV) infection has been recognized as an important risk factor in cancer. The purpose of this systematic review and meta-analysis was to determine the prevalence and effect size of association between salivary HPV DNA and the risk of developing oral and oropharyngeal cancer. METHODS: A systematic literature search of PubMed, EMBASE, Web of Science, LILACS, Scopus and the Cochrane Library was performed, without language restrictions or specified start date. Pooled data were analyzed by calculating odds ratios (ORs) and 95% confidence intervals (CIs). Quality assessment was performed using the Newcastle-Ottawa Scale (NOS). RESULTS: A total of 1672 studies were screened and 14 met inclusion criteria for the meta-analysis. The overall prevalence of salivary HPV DNA for oral and oropharyngeal carcinoma was 43.2%, and the prevalence of salivary HPV16 genotype was 27.5%. Pooled results showed a significant association between salivary HPV and oral and oropharyngeal cancer (OR = 4.94; 2.82-8.67), oral cancer (OR = 2.58; 1.67-3.99) and oropharyngeal cancer (OR = 17.71; 6.42-48.84). Significant associations were also found between salivary HPV16 and oral and oropharyngeal cancer (OR = 10.07; 3.65-27.82), oral cancer (OR = 2.95; 1.23-7.08) and oropharyngeal cancer (OR = 38.50; 22.43-66.07). CONCLUSIONS: Our meta-analysis demonstrated the association between salivary HPV infection and the incidence of oral and oropharyngeal cancer indicating its value as a predictive indicator

Infinitesimal Lyapunov functions for singular flows

We present an extension of the notion of infinitesimal Lyapunov function to singular flows, and from this technique we deduce a characterization of partial/sectional hyperbolic sets. In absence of singularities, we can also characterize uniform hyperbolicity. These conditions can be expressed using the space derivative DX of the vector field X together with a field of infinitesimal Lyapunov functions only, and are reduced to checking that a certain symmetric operator is positive definite at the tangent space of every point of the trapping region.Comment: 37 pages, 1 figure; corrected the statement of Lemma 2.2 and item (2) of Theorem 2.7; removed item (5) of Theorem 2.7 and its wrong proof since the statement of this item was false; corrected items (1) and (2) of Theorem 2.23 and their proofs. Included Example 6 on smooth reduction of families of quadratic forms. The published version in Math Z journal needs an errat

Causes of hospitalization and predictors of HIV-associated mortality at the main referral hospital in Sierra Leone: a prospective study

BACKGROUND: HIV infection is a growing public health problem in Sierra Leone and the wider West Africa region. The countrywide HIV prevalence was estimated at 1.7% (67,000 people), with less than 30% receiving life-saving ART in 2016. Thus, HIV-infected patients tend to present to health facilities late, with high mortality risk. METHODS: We conducted a prospective study of HIV inpatients aged >/=15 years at Connaught Hospital in Freetown-the main referral hospital in Sierra Leone-from July through September 2017, to assess associated factors and predictors of HIV-related mortality. RESULTS: One hundred seventy-three HIV inpatients were included, accounting for 14.2% (173/1221) of all hospital admissions during the study period. The majority were female (59.5%, 70/173), median age was 34 years, with 51.4% (89/173) of them diagnosed with HIV infection for the first time during the current hospitalization. The most common admitting diagnoses were anemia (48%, 84/173), tuberculosis (24.3%, 42/173), pneumonia (17.3%, 30/173) and diarrheal illness (15.0%, 26/173). CD4 count was obtained in 64.7% (112/173) of patients, with median value of 87 cells/muL (IQR 25-266), and was further staged as severe immunosuppression: CD4 < 100 cells/muL (50%, 56/112); AIDS: CD4 < 200 cells/muL (69.6%, 78/112); and late-stage HIV disease: CD4 < 350 cells/muL (83%, 93/112). Fifty-two patients (30.1%, 52/173) died during hospitalization, 23% (12/52) of them within the first week. The leading causes of death were anemia (23.1%, 12/52), pneumonia (19.2%, 10/52), diarrheal illness (15.4%, 8/52) and tuberculosis (13.6%, 7/52). Neurological symptoms, i.e., loss of consciousness (p = 0.04) and focal limb weakness (p = 0.04); alcohol use (p = 0.01); jaundice (p = 0.02); cerebral toxoplasmosis (p = 0.01); and tuberculosis (p = 0.04) were significantly associated with mortality; however, only jaundice (AOR 0.11, 95% CI [0.02-0.65]; p = 0.01) emerged as an independent predictor of mortality. CONCLUSION: HIV-infected patients account for a substantial proportion of admissions at Connaught Hospital, with a high morbidity and in-hospital mortality burden. These findings necessitate the implementation of specific measures to enhance early HIV diagnosis and expand treatment access to all HIV-infected patients in Sierra Leone

Comparison of fingolimod with interferon beta-1a in relapsing-remitting multiple sclerosis: a randomised extension of the TRANSFORMS study

In a 12-month phase 3 study in patients with relapsing-remitting multiple sclerosis (RRMS), TRANSFORMS, fingolimod showed greater efficacy on relapse rates and MRI outcomes compared with interferon beta-1a. We had two aims in our extension: to compare year 2 with year 1 in the switched patients to assess the effect of a change from interferon beta-1a to fingolimod, and to compare over 24 months the treatment groups as originally randomised to assess the effect of delaying the start of treatment with fingolimod

História da educação no Brasil: a constituição histórica do campo (1880-1970)

O artigo aborda a constituição do campo da história da educação no Brasil de dois prismas. No primeiro, elabora um histórico da disciplina a partir de três pertencimentos: à tradição historiográfica do Instituto Histórico e Geográfico do Brasil (IHGB); às escolas de formação para o magistério e à produção acadêmica entre os anos 1940 e 1970. No segundo, enfoca os trabalhos realizados nos últimos 20 anos, apontando temas e períodos de interesse e abordagens teóricas mais recorrentes.<br>This article tackles on the structuring of the field of history of education in Brazil through two angles. The first one elaborates on the history of the discipline from three views: the historiographic tradition of the Historical and Geographical Institute of Brazil ( IHGB); the development of teacher's colleges and the academic production from 1940 to 1970. The second one, focus on works done during the last 20 years, pointing out to topics, periods of interest and the most recurrent theoretical approaches