Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study.

Government and nongovernmental organizations need national and global estimates on the descriptive epidemiology of common oral conditions for policy planning and evaluation. The aim of this component of the Global Burden of Disease study was to produce estimates on prevalence, incidence, and years lived with disability for oral conditions from 1990 to 2017 by sex, age, and countries. In addition, this study reports the global socioeconomic pattern in burden of oral conditions by the standard World Bank classification of economies as well as the Global Burden of Disease Socio-demographic Index. The findings show that oral conditions remain a substantial population health challenge. Globally, there were 3.5 billion cases (95% uncertainty interval [95% UI], 3.2 to 3.7 billion) of oral conditions, of which 2.3 billion (95% UI, 2.1 to 2.5 billion) had untreated caries in permanent teeth, 796 million (95% UI, 671 to 930 million) had severe periodontitis, 532 million (95% UI, 443 to 622 million) had untreated caries in deciduous teeth, 267 million (95% UI, 235 to 300 million) had total tooth loss, and 139 million (95% UI, 133 to 146 million) had other oral conditions in 2017. Several patterns emerged when the World Bank's classification of economies and the Socio-demographic Index were used as indicators of economic development. In general, more economically developed countries have the lowest burden of untreated dental caries and severe periodontitis and the highest burden of total tooth loss. The findings offer an opportunity for policy makers to identify successful oral health strategies and strengthen them; introduce and monitor different approaches where oral diseases are increasing; plan integration of oral health in the agenda for prevention of noncommunicable diseases; and estimate the cost of providing universal coverage for dental care.

Temporal trends in the incidence of HIV infection in antenatal clinic attendees in Addis Ababa, Ethiopia, 1995-2003.

BACKGROUND: The HIV incidence data are relevant in depicting the current dynamics and trend of the epidemic. Using a new laboratory method for HIV-1 incidence, we aimed at estimating a 10-year trend in HIV-1 incidence in Addis Ababa, Ethiopia. METHODS: We determined the temporal trends in HIV incidence based on a total of 7744 serum specimens from pregnant women who attended antenatal clinics in Addis Ababa between 1995 and 2003. HIV incidence was determined by IgG-capture HIV-1 BED incidence enzyme immunoassay following a validation using a well-characterized panel of serial serum specimens from subtype C-infected seroconverters. FINDINGS: Of the 1350 HIV+ specimens tested as part of the annual sentinel survey between 1995 and 2003, a total of 1332 (98.7%) were tested by BED HIV-1 incidence assay. The incidence rate of HIV-1 infection declined significantly from 7.7% (95% CI, 3.9-11.5%) in 1995 to 2.0% (95% CI, 0.7-3.3%) in 2003. Although there was a trend, amongst the age group of 15-29 years, in age-specific decline in incidence, it was not statistically significant. No change in HIV incidence rate was observed for the group aged above 30 years. INTERPRETATION: A corresponding decline in the incidence of HIV infection was observed with the decline in the prevalence of HIV infection between 1995 and 2003 in Addis Ababa City. Whether the declines were because of changes in sexual behaviours or other reasons needs to be explored. The BED HIV-1 incidence assay provides a valuable tool in obtaining information on recent HIV-1 infection.

Risk factors associated with failure of syndromic treatment of sexually transmitted diseases among women seeking primary care in Addis Ababa.

OBJECTIVE: To determine risk factors associated with the failure of syndromic management of sexually transmitted diseases (STDs) among women seeking treatment in primary healthcare centre in Addis Ababa, Ethiopia. METHODS: Women with symptomatic STDs seeking care in a health centre were prospectively enrolled. A total of 259 women were interviewed and underwent clinical examination; 106 were enrolled and received syndromic STD treatment and 91% returned for follow up. Logistic regression analysis was used to identify risk factors associated with treatment failure. RESULTS: Of the 106 women enrolled and presenting with symptomatic STDs 67% were HIV seropositive. Syndromic STD treatment did not result in clinical improvement in 30% of the women. Having genital ulcer disease, genital ulcer disease with genital discharge, genital warts, bacterial vaginosis and plasma HIV-1 load >10,000 copies RNA/ml or being HIV seropositive were all significantly associated with treatment failure. In multivariate analysis, however, only genital ulcer disease was significantly associated with treatment failure. CONCLUSION: In our setting, the association between HIV and genital ulcer disease caused by herpes may, therefore, be the reason for the failure of treatment.

Preliminary characterization of a new virus isolated from the spinal fluid of patients with meningitis in São Paulo, Brazil.

A total of 138 patients with the age of 4 months to 57 years were attended in different hospitals of São Paulo State with aseptic meningitis. A probable new agent was isolated from the cerebrospinal fluid of 35 of 53 specimens examined. Replication of the agent with similar characteristics was detected by CPE produced in the MDCK cell line. Virus-like particles measuring about 40 nm in diameter were observed by negative staining electron microscopy. No hemagglutinating activity was detected at pH 7.2 by using either human, guinea pig, chicken and at pH ranged 6.0-7.2 with goose red blood cells. The agent was not pathogenic to newborn or adult mice. Virus infectivity as measured by CPE was sensitive to chloroform and not inhibited by BuDR, suggesting that agent is an enveloped virus with RNA genome.

Clinical and chronotopographic psychomotor seizure patterns (SEEG study with reference to postoperative results).

In 29 selected patients who underwent stereo-electroencephalographic exploration because of uncontrolled psychomotor epilepsy, 213 seizures were recorded. These seizures were analyzed in 10-second-intervals with respect to the sequence of clinical signs and the electrical chronotopographic patterns. By the aid of a computerized cluster analysis four comparatively distinct localization-patterns were found: a) opercular, b) frontobasal-cingular, c) temporobasal-limbic and d) posterior temporal neocortical. The lowest trend for propagation to the opposite hemisphere is found in a) followed by d). Fairly strong tendency for contralateral propagation is seen in c). Strategically important structures for contralateral propagation are: 1. amygdala and hippocampus, and to a lesser degree 2. the frontal cortex. Seizures propagating to the parietal cortex very often involve the frontal area of the same side before affecting the opposite hemisphere. For each of these "epileptic clusters" the characteristic clinical signs are pointed out. Special emphasis was put on the primictal symptom-sequence. By this and a similar study with Bancaud et al. we show that significantly better postoperative results are found, when strategy for surgery was based on the evidence of several SEEG recorded spontaneous seizures. In some patients belonging to the "temporobasal-limbic" cluster stereotactic procedures proved successful.

Average multichannel EEG potential fields evoked from upper and lower hemi-retina: latency differences.

Checkerboard reversals shown to the upper hemiretina evoke EEG potentials which in anterior-posterior derivations are approximately inverted in polarity compared with potentials evoked by lower hemiretinal stimulation. Using a 48-channel system, EEG scalp field distributions of such responses were mapped. Examination of the map sequences shows that occipital positive maximal field values start to develop at about the same time in the two stimulus conditions, but peak much earlier and somewhat more anteriorly for upper than for lower hemiretinal stimulation. Thus, there is a difference of response latency in the two conditions, which accounts for the approximate inversion of polarity. Possible correlations with reports of higher receptor cell density, higher visual acuity, and shorter motor reaction time of the upper hemiretinal system are noted.