Rheumatic Fever and Rheumatic Heart Disease: Collaboration Patterns and Research Core Topics.

BACKGROUND: Rheumatic fever and rheumatic heart disease (RHD) are important health problems in developing countries. The study aim was to provide a review and content analysis of the scientific literature on rheumatic fever and RHD over a 70-year period. METHODS: Medline was employed via the online PubMed service of the US National Library of Medicine, to search for all documents containing the MeSH terms 'rheumatic fever' or 'rheumatic heart disease' between January 1945 and December 2013. RESULTS: A total of 18,552 references was retrieved. Between 1945 and 1970 the number of annual publications containing the search terms increased, but decreased between 1971 and 2013. Between 1990 and 2013, national collaboration (co-authorship) was greatly increased, from 8.7% to 41.7% of the total reports. International collaboration also increased, from 2.5% to 14.8% (p = 0.001). The United States was the main collaborating country, sharing ties mainly with India, South Africa and Brazil. A content analysis led to the identification of three prominent core research topics, chief among which were heart diseases (rheumatic fever diseases, mitral valve diseases and endocarditis). Other areas of note included streptococcal infections and rheumatic diseases (which, in addition to rheumatic fever, also highlighted arthritis and juvenile arthritis). CONCLUSIONS: Publications on rheumatic fever and RHD had a major impact during the 1960s, but research groups interest has since declined overall, in line with a decreasing interest in these diseases in developed countries. In contrast, national and international collaboration has increased, a phenomenon that should be encouraged for research into these and other diseases that affect developing countries.

[Microbiological diagnosis of imported malaria]. / Diagnóstico microbiológico de la malaria importada.

Current diagnosis of malaria is based on the combined and sequential use of rapid antigen detection tests (RDT) of Plasmodium and subsequent visualization of the parasite stained with Giemsa solution in a thin and thick blood smears. If an expert microscopist is not available, should always be a sensitive RDT to rule out infection by Plasmodium falciparum, output the result immediately and prepare thick smears (air dried) and thin extensions (fixed with methanol) for subsequent staining and review by an expert microscopist. The RDT should be used as an initial screening test, but should not replace microscopy techniques, which should be done in parallel. The diagnosis of malaria should be performed immediately after clinical suspicion. The delay in laboratory diagnosis (greater than 3 hours) should not prevent the initiation of empirical antimalarial treatment if the probability of malaria is high. If the first microscopic examination and RDT are negative, they must be repeated daily in patients with high suspicion. If suspicion remains after three negative results must be sought the opinion of an tropical diseases expert. Genomic amplification methods (PCR) are useful as confirmation of microscopic diagnosis, to characterize mixed infections undetectable by other methods, and to diagnose asymptomatic infections with submicroscopic parasitaemia.

Spanish national registry of celiac disease: incidence and clinical presentation.

OBJECTIVES: The aim of this study was to assess the incidence and clinical pattern of celiac disease (CD) presently diagnosed in Spanish children. METHODS: A prospective, multicenter, nationwide registry of new cases of CD in children <15 years was conducted from June 1, 2006 to May 31, 2007. The parameters studied were age at diagnosis, sex, clinical symptoms, associated diseases, nutritional status, CD serology, histological lesions, and HLA-DQ2/-DQ8. The crude incidence rate of CD was calculated as new cases per 1000 live births and as new cases per 100,000 person-years <15 years of age. RESULTS: A total of 974 new cases of CD were included. The median age at diagnosis was 2.3 years; 39.5% of CD diagnoses occurred in the first 2 years, 42% between 2 and 6, and 18.4% from 6 to 15. Total number of cases in each age group was 385, 409, and 180, respectively. Regarding clinical presentation 70.9% showed classical symptoms, 21.9% were nonclassical, and 7% were asymptomatic. A total of 95.7% of 931, 94.7% of 611, and 86.7% of 651 children tested positive, respectively, for immunoglobulin A (IgA) anti-transglutaminase type 2 antibodies, IgA endomysial antibodies, and IgA anti-gliadin antibodies. Villous atrophy was observed in 92.4% and increased intraepithelial lymphocytes with crypt hyperplasia in 3.3%. Of the children, 55% had normal growth, and 3.4% were overweight. The HLA phenotype was DQ2: 88.3%, DQ2/DQ8: 8.4%, and DQ8: 2.3%. The incidence rate was 7.9 cases of CD per 1000 live births and 54 cases per 100,000 person-years. CONCLUSIONS: In Spain, the most frequent clinical presentation of CD is the classical form, mainly diagnosed during the first 2 years of life. The observed incidence of CD in Spanish children is much higher than the present CD incidence rates observed in other European countries.

Change in epidemiology of malaria infections in a rural area in Ethiopia.

We describe a change in epidemiology of 3,615 cases of malaria in a rural area in Ethiopia (from September 11, 1998, through September 10, 2003). The Plasmodium falciparum infection increased from 40.9% in the first year to 73.4% in the last year, and the Plasmodium vivax infection decreased from 54.7% to 22.4% (p < .001).

[Spanish scientific production in obesity research published in PubMed (1988-2007)]. / Producción científica española en obesidad a través de PubMed (1988-2007).

OBJECTIVE: To analyse Spanish scientific research output related to obesity during a 20-year period from 1988 to 2007 into context with the European Union productivity METHODS: The bibliometric study was based on research of the MEDLINE database in PubMed. Search terms were "obesity" appearing in MeSH. Linear regression was used to estimate trends in number of publications. RESULTS: We retrieved 50,120 documents on obesity in the study period, and 1,407 were by Spanish authors (2.7% of the world production). Spain, accounting for 8.1% of scientific output in this area, was the fifth most productive country in the European Union; 932 (69.1%) of papers were published in English. The average yearly increase in publications was 15%, from 91 documents in the first five-year period to 702 in the last five-period. The most frequent specialty of first author was endocrinology (279 documents, or 22.8%), followed by physiology-nutrition-bromatology (203, or 16.6%), and biochemistry (161, or 13.2%). Journals publishing the largest numbers of papers on obesity were Medicina Clínica (83 or 6.1%), Obesity Surgery (79 or 5.8%), International Journal of Obesity (73) and Nutricion Hospitalaria (59). The most productive regions in Spain were Cataluña (338 or 24.9%), Madrid (286 or 20,6%), and Navarra (159 or 11,7%). The most productive institutions were hospitals, with 708 titles (52.1%), followed by universities, with 521 (38.5%). CONCLUSIONS: Obesity research in Spain has increased over the last 20 years and accounted for a substantial proportion of European Union research in this field. Half of the papers by Spanish authors were published in international non-Spanish journals. Most of papers were carried out from hospital settings and universities.

[HIV infection in immigrants in Spain: Epidemiological characteristics and clinical presentation in the CoRIS Cohort (2004-2006)]. / Infección por virus de la inmunodeficiencia humana en inmigrantes en España: características epidemiológicas y presentación clínica en la cohorte CoRIS, 2004-2006.

INTRODUCTION: A growing number of immigrants are using the public health services for HIV in Spain. We describe the sociodemographic, epidemiological, and clinical characteristics of a cohort of naïve HIV-infected subjects (CoRIS cohort) according to their place of origin. METHODS: CoRIS is an open, hospital-based cohort of naïve, HIV-infected persons attended in 19 hospitals from 9 of the 19 autonomous regions in Spain. We describe the characteristics of the cohort members by place of origin, and compare them with the Spanish cases identified from January 2004 to October 2006, using the chi-square and Fisher exact tests. RESULTS: Of 2507 patients, 76.3% were men and median age was 36 years. By origin, 71.5% were Spanish, 16.0% Latin Americans (LA), 5.8% sub-Saharan Africans (SSA), 3.7% Western Europeans (WE), 1.7% Eastern Europeans (EE) and 1.4% North Africans (NA). Compared to Spaniards, there were significant differences by origin in sex, age, and transmission category. Median CD4 count at cohort entry was 352 cell/microL, with no differences according to origin. Median viral load was 48 962 copies/mL and was significantly lower for SSA. Over 11.4 months of follow-up, 57.9% initiated HAART with no differences by origin. Hepatitis C prevalence was 29.9% in Spaniards, 7.3% in Latin Americans, 11.7% in SSA, and 45.7% in EE (P<0.05). Overall, 13.4% were Mantoux-positive (28.6% in SSA and 30.8% in NA). Tuberculosis was more common among cases from EE (9.5%) and SSA (8.3%) compared to Spaniards (4.8%) (P<0.05). CONCLUSIONS: Almost one third of naïve HIV-infected patients in CoRIS are foreign-born. Their sociodemographic, epidemiological and clinical characteristics reflect the epidemic in their places of origin. However, their immunological status at cohort entry and initiation of HAART is no different from that of Spaniards.