Base de dados : MEDLINE
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[PMID]:28456662
[Au] Autor:Kinkar L; Laurimäe T; Sharbatkhori M; Mirhendi H; Kia EB; Ponce-Gordo F; Andresiuk V; Simsek S; Lavikainen A; Irshadullah M; Umhang G; Oudni-M'rad M; Acosta-Jamett G; Rehbein S; Saarma U
[Ad] Endereço:Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, Vanemuise 46, 50410 Tartu, Estonia.
[Ti] Título:New mitogenome and nuclear evidence on the phylogeny and taxonomy of the highly zoonotic tapeworm Echinococcus granulosus sensu stricto.
[So] Source:Infect Genet Evol;52:52-58, 2017 Aug.
[Is] ISSN:1567-7257
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Cystic echinococcosis, a zoonotic disease caused by Echinococcus granulosus sensu lato (s. l.), is a significant global public health concern. Echinococcus granulosus s. l. is currently divided into numerous genotypes (G1-G8 and G10) of which G1-G3 are the most frequently implicated genotypes in human infections. Although it has been suggested that G1-G3 could be regarded as a distinct species E. granulosus sensu stricto (s. s.), the evidence to support this is inconclusive. Most importantly, data from nuclear DNA that provide means to investigate the exchange of genetic material between G1-G3 is lacking as none of the published nuclear DNA studies have explicitly included G2 or G3. Moreover, the commonly used relatively short mtDNA sequences, including the complete cox1 gene, have not allowed unequivocal differentiation of genotypes G1-G3. Therefore, significantly longer mtDNA sequences are required to distinguish these genotypes with confidence. The main aim of this study was to evaluate the phylogenetic relations and taxonomy of genotypes G1-G3 using sequences of nearly complete mitogenomes (11,443bp) and three nuclear loci (2984bp). A total of 23 G1-G3 samples were analysed, originating from 5 intermediate host species in 10 countries. The mtDNA data demonstrate that genotypes G1 and G3 are distinct mitochondrial genotypes (separated by 37 mutations), whereas G2 is not a separate genotype or even a monophyletic cluster, but belongs to G3. Nuclear data revealed no genetic separation of G1 and G3, suggesting that these genotypes form a single species due to ongoing gene flow. We conclude that: (a) in the taxonomic sense, genotypes G1 and G3 can be treated as a single species E. granulosus s. s.; (b) genotypes G1 and G3 should be regarded as distinct genotypes only in the context of mitochondrial data; (c) we recommend excluding G2 from the genotype list.
[Mh] Termos MeSH primário: Núcleo Celular/genética
DNA de Helmintos/genética
Echinococcus granulosus/classificação
Mitocôndrias/genética
[Mh] Termos MeSH secundário: África do Norte
Animais
Ásia
Echinococcus granulosus/genética
Echinococcus granulosus/isolamento & purificação
Echinococcus granulosus/metabolismo
Europa (Continente)
Genoma Mitocondrial
Genótipo
Seres Humanos
Filogenia
Filogeografia
América do Sul
Zoonoses/parasitologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA, Helminth)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


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[PMID]:28986238
[Au] Autor:Villalta I; Amor F; Galarza JA; Dupont S; Ortega P; Hefetz A; Dahbi A; Cerdá X; Boulay R
[Ad] Endereço:Estación Biológica de Doñana, CSIC, Avenida Américo Vespucio 26, 41092 Sevilla, Spain; Institute of Insect Biology, Parc de Grandmont, 37200 Tours, France; Departamento de Ecología, Universidad de Granada, Avenida de la Fuente Nueva S/N, 18071 Granada, Spain.
[Ti] Título:Origin and distribution of desert ants across the Gibraltar Straits.
[So] Source:Mol Phylogenet Evol;118:122-134, 2018 Jan.
[Is] ISSN:1095-9513
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The creation of geographic barriers has long been suspected to contribute to the formation of new species. We investigated the phylogeography of desert ants in the western Mediterranean basin in order to elucidate their mode of diversification. These insects which have a low dispersal capacity are recently becoming important model systems in evolutionary studies. We conducted an extensive sampling of species belonging to the Cataglyphis albicans group in the Iberian Peninsula (IP) and the northern Morocco (North Africa; NA). We then combined genetic, chemical and morphological analyses. The results suggest the existence of at least three and five clades in the IP and NA, respectively, whose delineation partially encompass current taxonomic classification. The three Iberian clades are monophyletic, but their origin in NA is uncertain (79% and 22% for Bayesian and Maximum Likelihood support, respectively). The estimation of divergence time suggests that a speciation process was initiated after the last reopening of the Gibraltar Straits ≈5.33 Ma. In the IP, the clades are parapatric and their formation may have been triggered by the fragmentation of a large population during the Pleistocene due to extended periods of glaciation. This scenario is supported by demographic analyses pointing at a recent expansion of Iberian populations that contrasts with the progressive contraction of the NA clades. Niche modeling reveals that this area, governed by favorable climatic conditions for desert ants, has recently increased in the IP and decreased in NA. Altogether, our data points at geoclimatic events as major determinants of species formation in desert ants, reinforcing the role of allopatric speciation.
[Mh] Termos MeSH primário: Formigas/fisiologia
Evolução Biológica
[Mh] Termos MeSH secundário: África do Norte
Animais
Formigas/anatomia & histologia
Formigas/genética
Teorema de Bayes
Demografia
Análise Discriminante
Europa (Continente)
Variação Genética
Gibraltar
Hidrocarbonetos/metabolismo
Funções Verossimilhança
Masculino
Repetições de Microssatélites/genética
Modelos Biológicos
Marrocos
Filogenia
Filogeografia
Análise de Componente Principal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydrocarbons)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171008
[St] Status:MEDLINE


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[PMID]:28919506
[Au] Autor:Gonçalves DV; Martínez-Freiría F; Crochet PA; Geniez P; Carranza S; Brito JC
[Ad] Endereço:CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus Agrário de Vairão, 4485-661 Vairão, Portugal; Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua Campo Alegre, 4169-007 Porto, Portugal; Institute of Evolutionary Biolog
[Ti] Título:The role of climatic cycles and trans-Saharan migration corridors in species diversification: Biogeography of Psammophis schokari group in North Africa.
[So] Source:Mol Phylogenet Evol;118:64-74, 2018 Jan.
[Is] ISSN:1095-9513
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Highlands, hydrographic systems and coastal areas have been hypothesised to form corridors across the hyperarid Sahara desert in North Africa, allowing dispersal and gene flow for non-xeric species. Here we aim to provide a genetic test for the trans-Saharan corridor model, and predict the location and stability of ecological-corridors, by combining phylogeography and palaeoclimatic modelling. The model was the Psammophis schokari (Schokari sand racer) group, fast-moving and widely distributed generalist colubrids occurring mostly in arid and semiarid scrublands. We combined dated phylogenies of mitochondrial and nuclear markers with palaeoclimatic modelling. For the phylogeographic analysis, we used 75 samples of P. schokari and P. aegyptius, and Bayesian and Maximum-Likelihood methods. For the ecological models, we used Maxent over the distribution of P. schokari and West African lineages. Models were projected to past conditions (mid Holocene, Last Glacial Maximum and Last Inter-Glacial) to infer climatic stable areas. Climatic stability was predicted to be mostly restricted to coastal areas and not spatially continuous. A putative temporary trans-Saharan corridor was identified in Eastern Sahara, with a more stable one along the Atlantic coast. Six parapatric lineages were identified within P. schokari, four occurring in North Africa. These likely diverged during the Pliocene. The Tamanraset River might have been a vicariant agent. African lineages may have experienced further subsequent diversification during the late Pleistocene. The main P. schokari refugia were probably located along the northern margins of the Sahara, allowing its North-to-South colonization. Trans-Saharan corridors seem to have played a role in P. schokari biogeography, allowing colonization of central Saharan mountains and Sahel. Some might have worked as refugia, and even the most stable corridors may have sections working as filters, depending on each climatic phase. We expect the use of trans-Saharan corridors to decrease for more mesic species or with less dispersal capabilities.
[Mh] Termos MeSH primário: Serpentes/classificação
[Mh] Termos MeSH secundário: África do Norte
Migração Animal
Animais
Teorema de Bayes
Clima
Citocromos b/química
Citocromos b/genética
DNA Mitocondrial/química
DNA Mitocondrial/isolamento & purificação
DNA Mitocondrial/metabolismo
Variação Genética
Funções Verossimilhança
NADH Desidrogenase/química
NADH Desidrogenase/genética
Filogenia
Filogeografia
Análise de Sequência de DNA
Serpentes/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA, Mitochondrial); 9035-37-4 (Cytochromes b); EC 1.6.99.3 (NADH Dehydrogenase)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170919
[St] Status:MEDLINE


  4 / 3657 MEDLINE  
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[PMID]:28454516
[Au] Autor:Gies I; AlSaleem B; Olang B; Karima B; Samy G; Husain K; Elhalik M; Miqdady M; Rawashdeh M; Salah M; Mouane N; Rohani P; Singhal A; Vandenplas Y
[Ad] Endereço:Department of Pediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
[Ti] Título:Early childhood obesity: a survey of knowledge and practices of physicians from the Middle East and North Africa.
[So] Source:BMC Pediatr;17(1):115, 2017 Apr 28.
[Is] ISSN:1471-2431
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Childhood obesity is one of the most serious public health issues of the twenty-first century affecting even low- and middle-income countries. Overweight and obese children are more likely to stay obese into adulthood. Due to the paucity of data on local practices, our study aimed to assess the knowledge and practices of physicians from the Middle East and North Africa region with respect to early-onset obesity. METHODS: A specific questionnaire investigating the perception and knowledge on early-onset obesity was circulated to healthcare providers (general physicians, pediatricians, pediatric gastroenterologist, neonatologists) practicing in 17 Middle East and North African countries. RESULTS: A total of 999/1051 completed forms (95% response) were evaluated. Of all respondents, 28.9% did not consistently use growth charts to monitor growth during every visit and only 25.2% and 46.6% of respondents were aware of the correct cut-off criterion for overweight and obesity, respectively. Of those surveyed, 22.3, 14.0, 36.1, 48.2, and 49.1% of respondents did not consider hypertension, type 2 diabetes, coronary heart disease, fatty liver disease, and decreased life span, respectively, to be a long-term complication of early childhood obesity. Furthermore, only 0.7% of respondents correctly answered all survey questions pertaining to knowledge of early childhood overweight and obesity. CONCLUSION: The survey highlights the low use of growth charts in the evaluation of early childhood growth in Middle East and North Africa region, and demonstrated poor knowledge of healthcare providers on the short- and long-term complications of early-onset obesity. This suggests a need for both continued professional education and development, and implementation of guidelines for the prevention and management of early childhood overweight and obesity.
[Mh] Termos MeSH primário: Competência Clínica/estatística & dados numéricos
Obesidade Pediátrica
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
África do Norte
Pré-Escolar
Feminino
Gráficos de Crescimento
Pesquisas sobre Serviços de Saúde
Seres Humanos
Lactente
Masculino
Meia-Idade
Oriente Médio
Obesidade Pediátrica/complicações
Obesidade Pediátrica/diagnóstico
Obesidade Pediátrica/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1186/s12887-017-0865-1


  5 / 3657 MEDLINE  
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[PMID]:28455205
[Au] Autor:Borrow R; Caugant DA; Ceyhan M; Christensen H; Dinleyici EC; Findlow J; Glennie L; Von Gottberg A; Kechrid A; Vázquez Moreno J; Razki A; Smith V; Taha MK; Tali-Maamar H; Zerouali K; Global Meningococcal Initiative (GMI)
[Ad] Endereço:Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, M13 9WZ, UK. Electronic address: Ray.Borrow@phe.gov.uk.
[Ti] Título:Meningococcal disease in the Middle East and Africa: Findings and updates from the Global Meningococcal Initiative.
[So] Source:J Infect;75(1):1-11, 2017 Jul.
[Is] ISSN:1532-2742
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The Global Meningococcal Initiative (GMI) has recently considered current issues in Middle Eastern and African countries, and produced two recommendations: (i) that vaccination of attendees should be considered for some types of mass-gathering events, as some countries mandate for the Hajj, and (ii) vaccination of people with human immunodeficiency virus should be used routinely, because of increased meningococcal disease (MD) risk. Differences exist between Middle Eastern and African countries regarding case and syndrome definitions, surveillance, and epidemiologic data gaps. Sentinel surveillance provides an overview of trends and prevalence of different capsular groups supporting vaccine selection and planning, whereas cost-effectiveness decisions require comprehensive disease burden data, ideally counting every case. Surveillance data showed importance of serogroup B MD in North Africa and serogroup W expansion in Turkey and South Africa. Success of MenAfriVac in the African "meningitis belt" was reviewed; the GMI believes similar benefits may follow development of a low-cost meningococcal pentavalent vaccine, currently in phase 1 clinical trial, by 2022. The importance of carriage and herd protection for controlling invasive MD and the importance of advocacy and awareness campaigns were also highlighted.
[Mh] Termos MeSH primário: Surtos de Doenças
Infecções Meningocócicas/epidemiologia
[Mh] Termos MeSH secundário: África ao Sul do Saara/epidemiologia
África do Norte/epidemiologia
Seres Humanos
Programas de Imunização
Meningite Meningocócica/epidemiologia
Infecções Meningocócicas/microbiologia
Infecções Meningocócicas/prevenção & controle
Vacinas Meningocócicas/administração & dosagem
Vacinas Meningocócicas/efeitos adversos
Oriente Médio/epidemiologia
Neisseria meningitidis/imunologia
Neisseria meningitidis/isolamento & purificação
Sorogrupo
Turquia/epidemiologia
Vacinação
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (MenAfriVac); 0 (Meningococcal Vaccines)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


  6 / 3657 MEDLINE  
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[PMID]:29206879
[Au] Autor:Alkishe AA; Peterson AT; Samy AM
[Ad] Endereço:Biodiversity Institute, University of Kansas, Lawrence, Kansas, United States of America.
[Ti] Título:Climate change influences on the potential geographic distribution of the disease vector tick Ixodes ricinus.
[So] Source:PLoS One;12(12):e0189092, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ixodes ricinus is a species of hard tick that transmits several important diseases in Europe and North Africa, including Lyme borreliosis and tick-borne encephalitis. Climate change is affecting the geographic distributions and abundances of arthropod vectors, which in turn influence the geographic distribution and epidemiology of associated vector-borne diseases. To date, few studies have investigated effects of climate change on the spatial distribution of I. ricinus at continental extents. Here, we assessed the potential distribution of I. ricinus under current and future climate conditions to understand how climate change will influence the geographic distribution of this important tick vector in coming decades. METHOD: We used ecological niche modeling to estimate the geographic distribution of I. ricinus with respect to current climate, and then assessed its future potential distribution under different climate change scenarios. This approach integrates occurrence records of I. ricinus with six relevant environmental variables over a continental extent that includes Europe, North Africa, and the Middle East. Future projections were based on climate data from 17 general circulation models (GCMs) under 2 representative concentration pathway emissions scenarios (RCPs), for the years 2050 and 2070. RESULT: The present and future potential distributions of I. ricinus showed broad overlap across most of western and central Europe, and in more narrow zones in eastern and northern Europe, and North Africa. Potential expansions were observed in northern and eastern Europe. These results indicate that I. ricinus populations could emerge in areas in which they are currently lacking, posing increased risks to human health in those areas. However, the future of I. ricinus ticks in some important regions such the Mediterranean was unclear owing to high uncertainty in model predictions.
[Mh] Termos MeSH primário: Mudança Climática
Ixodes/microbiologia
[Mh] Termos MeSH secundário: África do Norte
Animais
Ecossistema
Europa (Continente)
Doença de Lyme/transmissão
Oriente Médio
Modelos Teóricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189092


  7 / 3657 MEDLINE  
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[PMID]:29210247
[Au] Autor:Duguet AM; Masmoudi T; Duchier J; Rwabihama JP; Maatoug S
[Ti] Título:Access to Care in France for Elderly Immigrants from North Africa: Influence of Socio-cultural Factors (the MATC Survey).
[So] Source:Eur J Health Law;23(5):470-80, 2016 Dec.
[Is] ISSN:0929-0273
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:France is faced with an ageing migrant population, and in the institutions for elderly, migrants represent only 4% and very few come from the Maghreb. Is it the result of a kind of discrimination or of other factors such as culture and traditions? In France migrants have access to aid and prevention of dependency plans. The reluctance to enter into institutions is maintained by the fear of cultural abuse and/or language barriers, and difficulties in financial and administrative matters. From the interviews of the MATC survey, we have pointed out the importance of culture and the tradition of filial piety. Nevertheless, solidarity in the family is decreasing but remains the basis of the care support to the elderly. The will to keep them in the family may limit both the diagnosis and the access to specific care. This attitude contributes to a kind of self-discrimination.
[Mh] Termos MeSH primário: Emigrantes e Imigrantes/legislação & jurisprudência
Acesso aos Serviços de Saúde/legislação & jurisprudência
Migrantes/legislação & jurisprudência
[Mh] Termos MeSH secundário: África do Norte/etnologia
Idoso
França
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:28747196
[Au] Autor:Doherty T; Besada D; Goga A; Daviaud E; Rohde S; Raphaely N
[Ad] Endereço:Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa. Tanya.doherty@mrc.ac.za.
[Ti] Título:"If donors woke up tomorrow and said we can't fund you, what would we do?" A health system dynamics analysis of implementation of PMTCT option B+ in Uganda.
[So] Source:Global Health;13(1):51, 2017 Jul 26.
[Is] ISSN:1744-8603
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In October 2012 Uganda extended its prevention of mother to child HIV transmission (PMTCT) policy to Option B+, providing lifelong antiretroviral treatment for HIV positive pregnant and breastfeeding women. The rapid changes and adoptions of new PMTCT policies have not been accompanied by health systems research to explore health system preparedness to implement such programmes. The implementation of Option B+ provides many lessons which can inform the shift to 'Universal Test and Treat', a policy which many sub-Saharan African countries are preparing to adopt, despite fragile health systems. METHODS: This qualitative study of PMTCT Option B+ implementation in Uganda three years following the policy adoption, uses the health system dynamics framework to explore the impacts of this programme on ten elements of the health system. Qualitative data were gathered through rapid appraisal during in-country field work. Key informant interviews and focus group discussions (FGDs) were undertaken with the Ministry of Health, implementing partners, multilateral agencies, district management teams, facility-based health workers and community cadres. A total of 82 individual interviews and 16 focus group discussions were completed. We conducted a simple manifest analysis, using the ten elements of a health system for grouping data into categories and themes. RESULTS: Of the ten elements in the health system dynamics framework, context and resources (finances, infrastructure & supplies, and human resources) were the most influential in the implementation of Option B+ in Uganda. Support from international actors and implementing partners attempted to strengthen resources at district level, but had unintended consequences of creating dependence and uncertainty regarding sustainability. CONCLUSIONS: The health system dynamics framework offers a novel approach to analysis of the effects of implementation of a new policy on critical elements of the health system. Its emphasis on relationships between system elements, population and context is helpful in unpacking impacts of and reactions to pressures on the system, which adds value beyond some previous frameworks.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Política de Saúde
Transmissão Vertical de Doença Infecciosa/prevenção & controle
[Mh] Termos MeSH secundário: África do Norte
Feminino
Administração Financeira
Infecções por HIV/tratamento farmacológico
Infecções por HIV/transmissão
Seres Humanos
Gravidez
Análise de Sistemas
Uganda
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1186/s12992-017-0272-2


  9 / 3657 MEDLINE  
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[PMID]:29088252
[Au] Autor:Harfouche M; Chemaitelly H; Kouyoumjian SP; Mahmud S; Chaabna K; Al-Kanaani Z; Abu-Raddad LJ
[Ad] Endereço:Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
[Ti] Título:Hepatitis C virus viremic rate in the Middle East and North Africa: Systematic synthesis, meta-analyses, and meta-regressions.
[So] Source:PLoS One;12(10):e0187177, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To estimate hepatitis C virus (HCV) viremic rate, defined as the proportion of HCV chronically infected individuals out of all ever infected individuals, in the Middle East and North Africa (MENA). METHODS: Sources of data were systematically-gathered and standardized databases of the MENA HCV Epidemiology Synthesis Project. Meta-analyses were conducted using DerSimonian-Laird random-effects models to determine pooled HCV viremic rate by risk population or subpopulation, country/subregion, sex, and study sampling method. Random-effects meta-regressions were conducted to identify predictors of higher viremic rate. RESULTS: Analyses were conducted on 178 measures for HCV viremic rate among 19,593 HCV antibody positive individuals. In the MENA region, the overall pooled mean viremic rate was 67.6% (95% CI: 64.9-70.3%). Across risk populations, the pooled mean rate ranged between 57.4% (95% CI: 49.4-65.2%) in people who inject drugs, and 75.5% (95% CI: 61.0-87.6%) in populations with liver-related conditions. Across countries/subregions, the pooled mean rate ranged between 62.1% (95% CI: 50.0-72.7%) and 70.4% (95% CI: 65.5-75.1%). Similar pooled estimates were further observed by risk subpopulation, sex, and sampling method. None of the hypothesized population-level predictors of higher viremic rate were statistically significant. CONCLUSIONS: Two-thirds of HCV antibody positive individuals in MENA are chronically infected. Though there is extensive variation in study-specific measures of HCV viremic rate, pooled mean estimates are similar regardless of risk population or subpopulation, country/subregion, HCV antibody prevalence in the background population, or sex. HCV viremic rate is a useful indicator to track the progress in (and coverage of) HCV treatment programs towards the set target of HCV elimination by 2030.
[Mh] Termos MeSH primário: Hepacivirus
Hepatite C/epidemiologia
Viremia/epidemiologia
[Mh] Termos MeSH secundário: África do Norte/epidemiologia
Feminino
Seres Humanos
Masculino
Oriente Médio/epidemiologia
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171101
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0187177


  10 / 3657 MEDLINE  
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[PMID]:28981503
[Au] Autor:Parvizi MM; Handjani F; Moein M; Hatam G; Nimrouzi M; Hassanzadeh J; Hamidizadeh N; Khorrami HR; Zarshenas MM
[Ad] Endereço:Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
[Ti] Título:Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.
[So] Source:PLoS Negl Trop Dis;11(10):e0005957, 2017 Oct.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cutaneous leishmaniasis is one of the highly prevalent endemic diseases in the Middle East and North Africa. Many treatment modalities have been recommended for this condition but success rates remain limited. Herbal remedies have also been used for treatment but evidence-based clinical trials with these products are sparse. In-vitro and in-vivo studies have shown the anti-leishmanial and curative effects of extract of fruits and leaves of Juniperus excelsa (J. excelsa). The aim of this study was to determine the efficacy of topical J. excelsa M. Bieb extract as an adjuvant to cryotherapy for the treatment of human CL. MATERIALS AND METHODS: This study was designed as a two-arm triple-blind randomized placebo-controlled clinical trial using a parallel design. Seventy-two patients with clinical diagnosis of CL confirmed by leishmania smears were allocated to receive either a topical formulation of leaf of J. excelsa extract (group A) or placebo (group B) for 3 months. Both groups received cryotherapy as baseline standard treatment. Patients were evaluated before and weekly after the intervention was initiated until complete cure. RESULTS: Overall, 82% of patients in group A, experienced complete cure and 9% of them had partial cure. On the other hand, 34% in group B reported complete cure, while 14% of them had partial cure at the end of treatment protocol with a significant difference between the two groups (P< 0.001). The mean duration to healing of the lesions in patients who received J. excelsa extract was statistically significantly shorter than the placebo group (p = 0.04). No significant side effect was seen in the J. excelsa extract group except for mild to moderate local irritation after a few weeks in a few numbers of patients. CONCLUSION: The results of this study showed that topical J. excelsa extract can be used as an adjuvant treatment modality in addition to cryotherapy for accelerating the time to cure in addition to increasing the complete cure rate in CL. TRIAL REGISTRATION: ClinicalTrials.gov IRCT2015082523753N1.
[Mh] Termos MeSH primário: Antiprotozoários/uso terapêutico
Crioterapia/métodos
Juniperus/química
Leishmania/efeitos dos fármacos
Leishmaniose Cutânea/terapia
Extratos Vegetais/uso terapêutico
[Mh] Termos MeSH secundário: Administração Tópica
Adulto
África do Norte
Idoso
Terapia Combinada
Feminino
Flavonoides/análise
Seres Humanos
Leishmania/classificação
Masculino
Meia-Idade
Oriente Médio
Óleos Voláteis/análise
Fenóis/análise
Placebos
Folhas de Planta/química
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antiprotozoal Agents); 0 (Flavonoids); 0 (Oils, Volatile); 0 (Phenols); 0 (Placebos); 0 (Plant Extracts)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171006
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005957



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