BMJ open
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Objectives Control of the tuberculosis (TB) epidemic is a global health priority and one that is likely to be achieved only through vaccination. The critical overlap with the HIV epidemic requires any effective TB vaccine regimen to be safe in individuals who are infected with HIV. The objectives of this clinical trial were to evaluate the safety and immunogenicity of a leading candidate TB vaccine, MVA85A, in healthy, HIV-infected adults. ⋯ The functional quality of the vaccine-induced T cell response in HIV-infected subjects was remarkably comparable with that observed in healthy HIV-uninfected controls, but less durable. Conclusion MVA85A is safe and immunogenic in healthy adults infected with HIV. Further safety and efficacy evaluation of this candidate vaccine in TB- and HIV-endemic areas is merited.
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Objectives (1) To assess endorsement of trial registration in author instructions of urology-related journals and (2) to assess whether randomised controlled trials (RCTs) in the field of urology were effectively registered. Design Cross-sectional study of author instructions and published trials. Setting Journals publishing in the field of urology. ⋯ This difference was statistically significant (p=0.04). Conclusions The existence of a statement about trial registration in author instructions resulted in a higher proportion of registered RCTs in those journals. Journals with higher IFs were more likely to mention trial registration.
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Objective Acute Physiology and Chronic Health Evaluation (APACHE) is most widely used as a mortality prediction score in US intensive care units (ICUs), but its calculation is onerous. The authors aimed to develop and validate automatic mapping of physicians' admission diagnoses to structured concepts for automated APACHE IV calculation. Methods This retrospective study was conducted in medical ICUs of a tertiary healthcare and academic centre. ⋯ The Hosmer-Lemeshow goodness-of-fit test demonstrated good calibration of automatically calculated APACHE IV score (χ(2)=6.46; p=0.6). The automatic tool demonstrated excellent discrimination with an area under the curve value of 0.87 (95% CI 0.83 to 0.92) and good calibration (p=0.58) in the validation cohort of 593 patients. Conclusion A Boolean-logic text search is an efficient alternative to manual database entry for mapping of ICU admission diagnosis to structured APACHE IV concepts.
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Background Patients living with fibromyalgia strongly prefer to access health information on the web. However, the majority of subjects in previous studies strongly expressed their concerns about the quality of online information resources. Objectives The purpose of this study was to evaluate existing online fibromyalgia information resources for content, quality and readability by using standardised quality and readability tools. ⋯ Conclusion Higher quality websites tended to be less readable. Online fibromyalgia information resources do not provide comprehensive information about fibromyalgia, and have low quality and poor readability. While information is very important for those living with fibromyalgia, current resources are unlikely to provide necessary or accurate information, and may not be usable for most people.
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Objective In order to illustrate the important public health impact of syphilis, which is a preventable infection, the epidemiology of syphilis-related hospitalisations in Spain was studied over a 10-year period. Methods A retrospective study was conducted using the National Epidemiological Surveillance System for Hospital Data (Minimum Data Set). All hospitalisations due to syphilis infection in any diagnostic position (ICD-9-CM 090-097) between 1997 and 2006 were analysed, according to the Spanish version of the International Classification of Diseases, ninth revision (ICD-9-CM). Results There were 9556 hospitalisations associated with syphilis in Spain. ⋯ The hospitalisation rate increased significantly after 2000 and was higher in men. Conclusion Syphilis remains a major public health problem because of both potential complications and its close association with HIV infection. It is necessary to promote early diagnosis, ensure treatment in patients with syphilis and emphasise health promotion and prevention programmes.