Microstructural alterations of major thalamic nuclei in the chronic pediatric spinal cord injured population.

Background: The brain undergoes reorganization following spinal cord injury (SCI), but little is known about how the thalamus is affected in pediatric SCIs. Purpose: To characterize microstructural alterations in the thalamus after SCI with diffusion tensor imaging (DTI) metrics. Methods: 18 pediatric participants with chronic SCI (8-20 years) were stratified using the American Spinal Injury Association Impairment Scale (AIS) into groups: A, B, and C/D. DTI of the brain used a 3 T Siemens Verio MRI using the parameters: 20 directions, number of averages = 3, b = 1000 s/mm2, voxel size = 1.8 mm × 1.8 mm, slice thickness = 5 mm, TE = 95 ms, TR = 4300 ms, 30 slices, FOV = 230 × 230 mm2, matrix = 128 × 128, acquisition time = 4:45 min. Diffusion data was processed to generate DTI metrics FA, MD, AD, and RD. Data analysis: DTI metrics were acquired by superimposing the AAL3 thalamic atlas onto participant diffusion images registered to MNI152 space. We utilized a multiple Mann-Whitney U-test to compare between AIS groups, considering values of p ≤ 0.05 as significant. Results: FA, AD, RD, and MD significantly differed in thalamic nuclei between AIS groups A vs B and B vs C/D. Significant nuclei include the right ventral anterior, left intralaminar, bilateral lateral pulvinar, and right lateral geniculate. Conclusion: Our findings suggest the presence of microstructural alterations based on SCI severity in pediatric patients. These results are encouraging and warrant further study.

A randomised controlled comparison of aspiration and non-aspiration fine-needle techniques for obtaining ultrasound-guided cytological samples from canine livers.

Ultrasound-guided fine-needle sampling to obtain cytological samples is a well-established technique. However, the application of suction during sampling is controversial. Evidence from the human literature and one previous veterinary study suggest that non-aspiration may be superior for a number of organs. This prospective study compared the quality and diagnostic value of cytological samples from canine livers obtained by fine-needle aspiration (FNA) and non-aspiration (FN-NA) techniques. A total of 119 dogs that required ultrasound-guided FNA of the liver as part of their clinical investigation were recruited and randomly assigned to either FNA (n=54) or FN-NA (n=65) sampling groups. Specimens were reviewed by external cytopathologists masked to the technique used. Cytological reports were reviewed for their overall diagnostic value, cellularity, cell preservation and haemodilution. Overall, 88.2% (95% confidence intervals [CI], 82.4-94.0) of samples were diagnostic. There was a significant difference, as demonstrated by Chi-squared statistical analysis, in the prevalence of diagnostic samples between the FNA (81.5%; 95% CI, 71.1-91.8) and FN-NA groups (93.9%; 95% CI, 88.0-99.7; P=0.037). Non-diagnostic samples were significantly associated with lower cellularity, poorer cell preservation and more severe haemodilution (P<0.001 for each). However, there were no significant differences in the frequency of these specific variables between the FNA and FN-NA groups. In this study, fine-needle non-aspiration was superior to an aspiration technique for sampling the canine liver, as it resulted in higher rates of diagnostic cytology samples, with greater cellularity, less haemodilution and better cytological preservation.

2019 Canadian guideline for physical activity throughout pregnancy

The objective is to provide guidance for pregnant women and obstetric care and exercise professionals on prenatal physical activity. The outcomes evaluated were maternal, fetal or neonatal morbidity, or fetal mortality during and following pregnancy. Literature was retrieved through searches of MEDLINE, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus and Web of Science Core Collection, CINAHL Plus with Full Text, Child Development & Adolescent Studies, Education Resources Information Center, SPORTDiscus, ClinicalTrials.gov and the Trip Database from inception up to 6 January 2017. Primary studies of any design were eligible, except case studies. Results were limited to English-language, Spanish-language or French-language materials. Articles related to maternal physical activity during pregnancy reporting on maternal, fetal or neonatal morbidity, or fetal mortality were eligible for inclusion. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation methodology. The Guidelines Consensus Panel solicited feedback from end users (obstetric care providers, exercise professionals, researchers, policy organisations, and pregnant and postpartum women). The development of these guidelines followed the Appraisal of Guidelines for Research and Evaluation II instrument. The benefits of prenatal physical activity are moderate and no harms were identified; therefore, the difference between desirable and undesirable consequences (net benefit) is expected to be moderate. The majority of stakeholders and end users indicated that following these recommendations would be feasible, acceptable and equitable. Following these recommendations is likely to require minimal resources from both individual and health systems perspectives.

Nature of events and alcohol-related content in marketing materials at a university freshers' fair: a summative content analysis.

Introduction: The transition to university is a potentially influential time upon students' drinking behaviour. This study explored the nature of activities and alcohol-related content in marketing materials from student-led societies and local businesses provided to students, at a university freshers' fair in the UK. Methods: All marketing materials handed out at the fair were collected across the 5-day event in September 2015. Written and visual content was analysed using a summative qualitative content analysis. Results: Most student-led societies promoted social events they were hosting (n = 530), most of which took place in a drinking venue or referred to drinking (n = 335). Only four explicitly alcohol-free events were promoted. Student-led societies also promoted activities relating to their interest, e.g. sports training (n = 519), a small proportion of which had references to drinking and drinking venues (n = 54). Three societies provided promotional handouts from local bars or nightclubs. Local bars, pubs and nightclubs promoted events they hosted (n = 81) as well as alcoholic drink promotions (n = 79) and alcohol branded advertising (n = 22), albeit infrequently for the latter. Conclusions: In the first week of university, students are exposed to alcohol-related events, promotions and advertising, which may act as an incentive to participate in drinking.

Peripartum hysterectomy: an economic analysis of direct healthcare costs using routinely collected data.

OBJECTIVE: To estimate resource use and costs associated with peripartum hysterectomy for the English National Health Service. DESIGN/SETTING: Analysis of linked Clinical Practice Research Datalink and Hospital Episodes Statistics (CPRD-HES) data. POPULATION: Women undergoing peripartum hysterectomy between 1997 and 2013 and matched controls. METHODS: Inverse probability weighted generalised estimating equations were used to model the non-linear trend in healthcare service use and costs over time, accounting for missing data, adjusting for maternal age, body mass index, delivery year, smoking and socio-economic indicators. MAIN OUTCOME MEASURES: Primary care, hospital outpatient and inpatient attendances and costs (UK 2015 prices). RESULTS: The study sample included 1362 women (192 cases and 1170 controls) who gave birth between 1997 and 2013; 1088 (153 cases and 935 controls) of these were deliveries between 2003 and 2013 when all categories of hospital resource use were available. Based on the 2003-2013 delivery cohort, peripartum hysterectomy was associated with a mean adjusted additional total cost of £5380 (95% CI £4436-6687) and a cost ratio of 1.76 (95% CI 1.61-1.98) over 5 years of follow up compared with controls. Inpatient costs, mostly incurred during the first year following surgery, accounted for 78% excluding or 92% including delivery-related costs. CONCLUSION: Peripartum hysterectomy is associated with increased healthcare costs driven largely by increased post-surgery hospitalisation rates. To reduce healthcare costs and improve outcomes for women who undergo hysterectomy, interventions that reduce avoidable repeat hospitalisations following surgery such as providing active follow up, treatment and support in the community should be considered. TWEETABLE ABSTRACT: A large amount of NHS data on peripartum hysterectomy suggests active community follow up could reduce costs, #HealthEconomics.

Risk of hepatocellular carcinoma among individuals with different aetiologies of cirrhosis: a population-based cohort study.

BACKGROUND: Among patients with cirrhosis, only those determined to be at risk for hepatocellular carcinoma (HCC) should undergo surveillance. However, little is known about how different aetiologies of cirrhosis affect risk for HCC. AIM: To quantify the cumulative incidence of HCC among a representative population of people with cirrhosis of the liver of varying aetiology. METHODS: We identified subjects with hepatic cirrhosis from the UK's General Practice Research Database (1987-2006). Diagnoses of HCC were obtained from linked national cancer registries (1971-2006). Cox proportional hazards regression was used to estimate hazard ratios. The predicted 10-year cumulative incidence of HCC for each aetiology of cirrhosis was estimated while accounting for competing risks of death from any cause and liver transplant. RESULTS: Among 3107 people with cirrhosis, the adjusted relative risk of HCC was increased twofold to threefold among people with viral and autoimmune/metabolic aetiologies, compared to those with alcohol-associated cirrhosis. The 10-year predicted cumulative incidence estimates of HCC for each aetiology were alcohol, 1.2%; chronic viral hepatitis, 4.0%; autoimmune or metabolic disease, 3.2%; and cryptogenic, 1.1%. CONCLUSIONS: In a population-based study in the UK, people with cirrhosis have an estimated cumulative 10-year incidence of HCC of 4% or lower. Cumulative incidence varies with aetiology such that individuals with alcohol or cryptogenic cirrhosis have the lowest risk for HCC. These findings provide important information for cost-effectiveness analyses of HCC surveillance.

Short communication: Variation of total immunoglobulin G and ß-lactoglobulin concentrations in colostrum and milk from Canadian Holsteins classified as high, average, or low immune responders.

The objective of this study was to evaluate IgG and ß-lactoglobulin (ß-LG) concentrations in colostrum and milk of Canadian Holsteins (n=108) classified as high (H), average (A), or low (L) for antibody-mediated (AMIR) or cell-mediated immune responses (CMIR) based on estimated breeding values. It was hypothesized that H-AMIR and H-CMIR cows produce colostrum (first milking) and milk (d 5 postcalving) with higher concentrations of IgG and ß-LG. Data for IgG and ß-LG in colostrum and milk were analyzed independently using mixed linear models. Least squares means were compared using Tukey's test. Cows classified as H-AMIR had higher IgG and ß-LG concentrations in colostrum compared with A- and L-AMIR cows; 84% of H-AMIR, 69% of A-AMIR, and 68% of L-AMIR cows had over 5,000 mg/dL IgG in colostrum. No differences in IgG and ß-LG concentrations in colostrum were noted among cows ranked on CMIR or in milk of cows ranked on AMIR. ß-Lactoglobulin and IgG concentrations were positively correlated in colostrum. Breeding cows for H-AMIR status may reduce failure of passive transfer of IgG in their calves; ß-LG may play a role in bovine immune defenses. Colostrum from H-AMIR cows may serve as a more economical feedstock source for manufacturing natural health products.

Aboriginal street-involved youth experience elevated risk of incarceration.

OBJECTIVES: Past research has identified risk factors associated with incarceration among adult Aboriginal populations; however, less is known about incarceration among street-involved Aboriginal youth. Therefore, we undertook this study to longitudinally investigate recent reports of incarceration among a prospective cohort of street-involved youth in Vancouver, Canada. STUDY DESIGN: Prospective cohort study. METHODS: Data were collected from a cohort of street-involved, drug-using youth from September 2005 to May 2013. Multivariate generalized estimating equation analyses were employed to examine the potential relationship between Aboriginal ancestry and recent incarceration. RESULTS: Among our sample of 1050 youth, 248 (24%) reported being of aboriginal ancestry, and 378 (36%) reported being incarcerated in the previous six months at some point during the study period. In multivariate analysis controlling for a range of potential confounders including drug use patterns and other risk factors, Aboriginal ancestry remained significantly associated with recent incarceration (adjusted odds ratio [AOR] = 1.44; 95% confidence interval [CI]: 1.12-1.86). CONCLUSIONS: Even after adjusting for drug use patterns and other risk factors associated with incarceration, this study found that Aboriginal street-involved youth were still significantly more likely to be incarcerated than their non-Aboriginal peers. Given the established harms associated with incarceration these findings underscore the pressing need for systematic reform including culturally appropriate interventions to prevent Aboriginal youth from becoming involved with the criminal justice system.

Sinonasal seromucinous hamartoma: a review of the literature and a case report with focal myoepithelial cells.

Seromucinous hamartoma is a benign lesion of the sinonasal tract. Since its description in 1974, only a small number of additional cases have been reported. It is composed of a proliferation of seromucinous glands and ducts within a variable fibrous stroma. The serous component typically stains positively for S100 (at least focally) and lacks p63 positive abluminal cells. The lack of myoepithelial/basal cells is an important diagnostic feature of seromucinous hamartoma; their absence could lead to an incorrect diagnosis of low-grade sinonasal adenocarcinoma. We report the case of a polypoid mass resected from the posterior nasal cavity and nasopharynx of a 54-year-old woman. The lesion contained a population of small and large glands lined by cuboidal to flattened cells within a hypocellular stroma varying from dense and sclerotic to myxoid. Additionally, there was a superficial focus of ciliated invaginated surface epithelium and glands. Throughout the lesion there were no cytologic or architectural features of malignancy. The histologic features were diagnostic of seromucinous hamartoma. Immunohistochemistry showed focal S100 positivity of the serous glands. However, in contrast to previously reported cases, the glands focally showed an outer basal layer that was calponin, p63 and actin positive. Our case demonstrates two important points. First, complete absence of p63 staining should not necessarily be a required feature in the diagnosis of seromucinous hamartoma. Second, the ciliated larger glands--in keeping with respiratory epithelial adenomatoid hamartoma (REAH)--support the suggestion that seromucinous hamartoma and REAH are a spectrum of lesions, often seen together.

Abnormal liver tests in people aged 75 and above: prevalence and association with mortality.

BACKGROUND: Despite their common use the occurrence and consequences of abnormal liver tests remain unclear. AIMS: To estimate the prevalence and mortality associated with abnormal liver tests in people aged 75 years and above. METHODS: A cohort study on 13,276 people aged 75 years and above, registered with general practices, with a valid measurement of one or more liver test, calculating the prevalence of abnormal aspartate transaminase (AST), alkaline phosphatase (ALP) or bilirubin. Hazard ratios (HRs) were calculated for all-cause and cause-specific mortality comparing elderly patients with abnormal liver tests to elderly patients with normal liver tests. RESULTS: At least one abnormal liver test was found in 2175 subjects (16.1%, 95% CI [15.4%, 16.7%]). The prevalence of a single abnormal liver test was 3.3% (95% CI [3.0%, 3.7%]) for AST, 9.2% (95% CI [8.8%, 9.7%]) for ALP and 5.4% (95% CI [5.1%, 5.9%]) for bilirubin. Abnormal AST, ALP and bilirubin were associated with increased risks of all-cause mortality; adjusted HRs, 1.27(95% CI [1.09, 1.47]), 1.47(95% CI [1.35, 1.61]) and 1.15(95% CI [1.02, 1.30]), respectively. Abnormal AST and ALP were associated with sevenfold and sixfold increased risk of death from liver disease, respectively. Two or more abnormal liver tests were associated with 2-fold and 17-fold increased risk of death from cancer and liver disease, respectively. Of the causes examined, absolute mortality rates were highest for cardiovascular disease in subjects with and without abnormal liver tests. CONCLUSIONS: Abnormal liver tests occur commonly in elderly people and are associated with a modest increase in all-cause mortality. There was a strong association with liver disease; however, the majority of deaths were not due to this cause.

The rising incidence of idiopathic pulmonary fibrosis in the U.K.

BACKGROUND: Previous studies have shown that the incidence of idiopathic pulmonary fibrosis (IPF) is rising in the U.K. and U.S.A. Death registrations and primary care data were used to determine the current trends in IPF incidence in the U.K. Because routine clinical data sets were used, the term IPF clinical syndrome (IPF-CS) is used to describe individuals in this study. METHODS: Age- and stratum-specific death registration rates between 1968 and 2008 were calculated and these were applied to the 2008 population to generate annual standardised expected number of deaths. Annual mortality rate ratios were calculated using Poisson regression. Computerised primary care records were used to determine incidence rates of IPF-CS between 2000 and 2008 stratified by age, sex and geographical region, and survival rates between calendar periods were compared. RESULTS: Annual death certificate recording of IPF-CS rose sixfold across the study period from 0.92 per 100,000 in the 1968-1972 calendar periods to 5.10 per 100,000 in the 2006-2008 calendar period, and were higher in men and the older age groups. The incidence of IPF-CS in primary care increased by 35% from 2000 to 2008, with an overall incidence rate of 7.44 per 100,000 person-years (95% CI 7.12 to 7.77). Incidence was higher in men, the older population and in Northwest England. CONCLUSIONS: The incidence of IPF-CS in primary care and registered deaths from this cause in the U.K. continues to rise in the 21st century. The current findings suggest that there are >5000 new cases diagnosed each year in the U.K.

The rate of decompensation and clinical progression of disease in people with cirrhosis: a cohort study.

BACKGROUND: We lack population-based estimates of the rate of decompensation in people with compensated cirrhosis as well as estimates of the manner in which the disease progresses once identified. AIM: To determine the rate of decompensation and clinical progression of disease in patients with cirrhosis based upon clinical symptoms recorded electronically in general practice data. METHODS: Using Cox proportional hazards regression, we modelled the rate of decompensation for patients from the UK General Practice Research Database with a diagnosis of cirrhosis between 1987 and 2002. We determined the clinical progression in the first year following diagnosis and subsequently categorizing patients through time according to a simple clinical staging system agreed at the Baveno IV consensus conference. RESULTS: The rate of decompensation in patients with compensated cirrhosis was found to be 11% overall. The rate of decompensation was higher in the first year (at 31% compared with 7.3% afterwards) and in patients with an alcoholic aetiology. Patients with compensated cirrhosis had a 1-year probability of proceeding directly to death of 7% compared with 20% in patients with decompensated cirrhosis. CONCLUSIONS: Using data recorded in general practice records, it is possible to determine the rate of decompensation and the clinical progression of disease in people with cirrhosis.

Enteric virus infection risk from intrusion of sewage into a drinking water distribution network.

Contaminants from the soil surrounding drinking water distribution systems are thought to not enter the drinking water when sufficient internal pressure is maintained. Pressure transients may cause short intervals of negative pressure, and the soil near drinking water pipes often contains fecal material due to the proximity of sewage lines, so that a pressure event may cause intrusion of pathogens. This paper presents a risk model for predicting intrusion and dilution of viruses and their transport to consumers. Random entry and dilution of virus was simulated by embedding the hydraulic model into a Monte Carlo simulation. Special attention was given to adjusting for the coincidence of virus presence and use of tap water, as independently occurring short-term events within the longer interval that the virus is predicted to travel in any branch of the distribution system. The probability that a consumer drinks water contaminated with virus is small, but when this happens the virus concentration tends to be high and the risk of infection may be considerable. The spatial distribution of infection risk is highly heterogeneous. The presence of a chlorine residual reduces the infection risk.

A population-based study of acute medical conditions associated with bullous pemphigoid.

BACKGROUND: Bullous pemphigoid is associated with poorly understood dramatically increased early mortality rates. OBJECTIVES: To assess the incidence of acute events predisposing to early mortality. METHODS: Computerized medical records from the Health Improvement Network, a large population-based U.K. general practice database, were used to conduct a cohort analysis. Outcome measures were incidence rates of myocardial infarction, pulmonary embolism, pneumonia and sepsis compared with a matched control population. RESULTS: People with bullous pemphigoid were three times as likely to develop pneumonia, adjusted rate ratio 2.94 [95% confidence interval (CI) 2.01-4.31] or pulmonary embolism, adjusted rate ratio 3.12 (95% CI 1.37-7.12) compared with matched controls. No statistically significant increase was seen for myocardial infarction, adjusted rate ratio 1.24 (95% CI 0.66-2.33), or sepsis, adjusted rate ratio 2.02 (95% CI 0.78-5.21). CONCLUSIONS: The risk of pulmonary embolism and pneumonia is increased following a diagnosis of bullous pemphigoid. It may be possible to reduce associated mortality through considering prophylaxis with either antithromboembolic measures or antibiotic therapy and vaccination.

Gas and particle concentrations in horse stables with individual boxes as a function of the bedding material and the mucking regimen.

The aim of this study was to compare different types of bedding and mucking regimens used in horse stables on the generation of airborne particulate matter <10 microm (PM10) and 3 biogenic gases (carbon dioxide, nitrous oxide, and especially ammonia). Three separate experiments were undertaken. The experiments were carried out in an enclosed stable (9.7 m long, 8.7 m wide, and 3.5 m high) that had 5 single boxes housing 4 horses. The measuring instruments were set up in the middle of one side of the stable. In Exp. 1, 3 types of bedding material (wheat straw, straw pellets, and wood shavings) used for horses were assessed according to their ammonia generation. Each type of bedding was used for 2 wk, with 3 repetitions. The mean ammonia concentrations within the stable were 3.07 +/- 0.23 mg/m(3) for wheat straw, 4.79 +/- 0.23 mg/m(3) for straw pellets, and 4.27 +/- 0.17 mg/m(3) for wood shavings. In Exp. 2, the effects of the mucking regimen on the generation of ammonia and PM10 from wheat straw (the bedding with the least ammonia generation in the previous experiment) were examined using 3 different daily regimens: 1) no mucking out, 2) complete mucking out, and 3) partial mucking out (removing only feces). The mean ammonia concentrations in the stable differed significantly among all 3 mucking regimens (P < 0.05). The greatest values were recorded when the stalls were mucked out completely every day [least squares means (LSM) = 2.25 +/- 0.1 mg/m(3)]. No mucking out resulted in an LSM of 1.92 +/- 0.1 mg of ammonia/m(3), whereas an LSM of 1.54 +/- 0.1 mg of ammonia/m(3) was found when the partial mucking out method was used. No mucking out also resulted in significantly less average PM10 (124.4 +/- 13.4 microg/m(3)) than in the other 2 regimens (P < 0.05). In Exp. 3, a 6-wk bedding regimen without mucking out was evaluated with regard to gas and airborne particle generation. The ammonia values were found not to increase constantly during the course of the 6-wk period. The average weekly values for PM10 also did not increase constantly but varied between approximately 90 and 140 microg/m. It can be concluded from the particle and gas generation patterns found in the results of all 3 experiments that wheat straw was the most suitable bedding of the 3 types investigated and that mucking out completely on a daily basis should not be undertaken in horse stables.

Organisational standards for the delivery of intensity-modulated radiation therapy in Ontario.

By minimising the effect of irradiation on surrounding tissue, intensity-modulated radiation therapy (IMRT) can deliver higher, more effective doses to the targeted tumour site, minimising treatment-related morbidity and possibly improving cancer control and cure. A multidisciplinary IMRT Expert Panel was convened to develop the organisational standards for the delivery of IMRT. The systematic literature search used MEDLINE, EMBASE, the Cochrane Database, the National Guidelines Clearing House and the Health Technology Assessment Database. An environmental scan of unpublished literature used the Google search engine to review the websites of key organisations, cancer agencies/centres and vendor sites in Canada, the USA, Australia and Europe. In total, 22 relevant guidance documents were identified; 12 from the published literature and 10 from the environmental scan. Professional and organisational standards for the provision of IMRT were developed through the analysis of this evidence and the consensus opinion of the IMRT Expert Panel. The resulting standards address the following domains: planning of new IMRT programmes, practice setting requirements, tools, devices and equipment requirements; professional training requirements; role of personnel; and requirements for quality assurance and safety. Here the IMRT Expert Panel offers organisational and professional standards for the delivery of IMRT, with the intent of promoting innovation, improving access and enhancing patient care.

Evaluation of daily online set-up errors and organ displacement uncertainty during conformal radiation treatment of the prostate.

We have studied and analysed the magnitude of interfraction set-up errors and gold seed marker and prostate displacement in 118 patients using three gold seeds implanted within the prostate. Set-up errors and gold seed marker displacements were determined from bony anatomy and gold seed marker mismatch between the electronic portal image and the simulation digitally reconstructed radiograph (DRR), respectively. Prostate displacement relative to bony anatomy was determined from the difference between gold seed marker and bony anatomy displacement. Daily online repositioning of patients was accomplished through image matching using Varian Portal-Vision software. A total of 4878 electronic portal images and 236 DRRs from 118 patients were acquired over the course of the study. The means and standard deviations of the systematic error of gold seed marker displacement of 118 patients were 2.1+/-2.7 mm for anteroposterior (AP), -0.5+/-1.7 mm for left-right (L-R), and 1.0+/-1.9 mm for superoinferior (SI) directions; the random errors were 3.2 mm (0.9-4.9 mm) for AP, 1.9 mm (0.7-5.3 mm) for L-R, and 2.1 mm (0.7-4.5 mm) for SI directions. The mean and standard deviation of the isocentre set-up systematic error of 20 patients was 1.2+/-2.2 mm for AP, -0.1+/-1.4 mm for L-R, and -0.8+/-2.6 mm for SI directions. The isocentre set-up random errors were 1.6 mm (1.2-4.8 mm) for AP, 1.3 mm (0.6-2.5 mm) for L-R and 1.3 mm (1.0-2.6 mm) for SI directions. The mean and standard deviation of the prostate displacement systematic error relative to bony anatomy was 0.0+/-1.4 mm for AP, 0.0+/-1.1 mm for L-R and -0.2+/-2.4 mm for SI directions. Prostate displacement random errors were 1.5 mm (1.2-3.3 mm) for AP, 0.9 mm (0.4-1.5 mm) for L-R and 1.4 mm (1.2-2.4 mm) for SI directions.

The association of TB with HIV Infection in Oromia Regional National State; Ethiopia in 2006/7

Background: Infection with Human Immunodeficiency Virus (HIV) is an established risk factor for tuberculosis infection. Population-based data on associations between HIV and tuberculosis (TB) can provide an epidemiological assessment of the impact of HIV infection on TB in environments where individual based data are difficult to collect. Method: We used an ecological study to assess the association between infection with HIV and tuberculosis in Oromia Region National State; Ethiopia in 2006/7. Result: The prevalence of HIV infection was significantly associated with the incidence of TB across the areas in Oromia region (r=0.69; p0.01). Similar associations were also seen for the prevalence of HIV infection with the incidence of smear positive tuberculosis; smear negative tuberculosis and extra-pulmonary tuberculosis. Conclusion: Ecological association between HIV and TB is strong in Oromia Regional state. Therefore; in areas where there are high TB case notification rates; it is important to consider the possibility that the prevalence of HIV may also be increasing; and take appropriate public health measures to assess and address these issues