The profile of HIV/AIDS has changed from that of a terminal illness to one of a chronic debilitating disease which has the potential to become terminal.

<p>Supplementary Table 3: History of exposure to proton-pump inhibitors (PPIs) among cases and controls, according to different exposure definitions.</p>

Dietary intake and/or circulating concentrations of vitamin B6 have been associated with risk of cancer, but results are inconsistent and mechanisms uncertain. Pyridoxal 5'-phosphate (PLP) is the most commonly used marker of B6 status. We recently proposed the ratio 3-hydroxykynurenine/xanthurenic acid (HK/XA) as an indicator of functional vitamin B6 status, and the 4-pyridoxic acid (PA) /(pyridoxal (PL) +PLP) ratio (PAr) as a marker of vitamin B6 catabolism during inflammation. We compared plasma PLP, HK/XA and PAr as predictors of cancer incidence in a prospective community-based cohort in Norway. This study included 6,539 adults without known cancer at baseline (1998-99) from the Hordaland Health Study (HUSK). HR and 95% CI were calculated for the risk of overall and site-specific cancers using multivariate Cox proportional hazards regression with adjustment for potential confounders. After a median follow-up time of 11.9 years, 963 cancer cases (501 men and 462 women) were identified. Multivariate-adjusted Cox-regression showed no significant relation of plasma PLP or HK/XA with risk of incident cancer. In contrast, PAr was significantly associated with risk of cancer with HR (95% CI) = 1.31 (1.12-1.52) per two standard deviation (SD) increment (p < 0.01). Further analysis showed that PAr was a particular strong predictor of lung cancer with HR (95% CI) = 2.46 (1.49-4.05) per two SD increment (p < 0.01). The present results indicate that associations of vitamin B6 with cancer may be related to increased catabolism of vitamin B6, in particular for lung cancer where inflammation may be largely involved in carcinogenesis.

Health authorities in numerous countries recommend periconceptional folic acid supplementation to prevent neural tube defects. The objective of this study was to examine the association of dietary folate intake and folic acid supplementation during different periods of pregnancy with the risk of spontaneous preterm delivery (PTD). The Norwegian Mother and Child Cohort Study is a population-based prospective cohort study. A total of 66,014 women with singleton pregnancies resulting in live births in 2002–2009 were included. Folic acid supplementation was self-reported from 26 weeks before pregnancy until pregnancy week 24. At gestational week 22, the women completed a food frequency questionnaire, which allowed the calculation of their average total folate intake from foods and supplements for the first 4–5 months of pregnancy. Spontaneous PTD was defined as the spontaneous onset of delivery between weeks 22+0 and 36+6 (n = 1,755). The median total folate intake was 313 μg/d (interquartile range IQR 167–5558) in the overall population and 530 μg/d (IQR 355–5636) in the supplement users. Eighty-five percent reported any folic acid supplementation from <8 weeks before to 24 weeks after conception while only 44% initiated folic acid supplementation before pregnancy. Cox regression analysis showed that the amount of dietary folate intake (hazard ratio HR 1.00; confidence interval 95% CI 0.61-1.65) and supplemental folate intake (HR 1.00; CI 1.00-1.00) was not significantly associated with the risk of PTD. The initiation of folic acid supplementation more than 8 weeks before conception was associated with an increased risk for spontaneous PTD (HR 1.18; CI 1.05-1.32) compared to no folic acid supplementation preconception. There was no significant association with PTD when supplementation was initiated within 8 weeks preconception (HR 0.99; CI 0.87-1.13). All analyses were adjusted for maternal characteristics and socioeconomic, health and dietary variables. Our findings do not support a protective effect of dietary folate intake or folic acid supplementation on spontaneous PTD. Preconceptional folic acid supplementation starting more than 8 weeks before conception was associated with an increased risk of spontaneous PTD. These results require further investigation before discussing an expansion of folic acid supplementation guidelines.

A dramatic increase in childhood overweight/obesity has been recognized globally over the past 50 years. This observed increase may reflect genetic, as well as psychological, environmental, and socio-cultural influences. In the first part of this review, we present an updated summary of the psychosocial factors associated with this change and discuss possible ways in which they operate. Among these factors, lower socio economic status (in both industrialized and non-industrialized countries), being female, belonging to a minority group, and being exposed to adverse life events may all be associated with a greater risk of childhood overweight/obesity. These influences may be mediated via a variety of mechanisms, in particular above-average food intake of low nutritional quality and reduction in physical activity. Other important psychosocial mediators include the influence of the family and peer environment, and exposure to the media. In the second part of the review, we discuss the potential of psychosocial prevention programs to intervene in the processes involved in the rise of childhood overweight/obesity. Two points are emphasized. First, prevention programs should be multidisciplinary, combining the knowledge of experts from different professions, and taking into consideration the important role of the family environment and relevant influential social organizations, particularly school. Second, effective change is unlikely to occur without large-scale programs carried out on a public policy level.

&lt;p&gt;Supplementary Table 1: Main characteristics of the studies included in the analysis.&lt;/p&gt;

We are proud to announce the re-starting of the Journal Epidemiology Biostatistics and Public Health (EBPH), made possible thanks to the Milano University Press (MUP), the new publisher of the journal.

&lt;p&gt;Supplementary Table 4: Pooled adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the association between intake of proton-pump inhibitors and gastric cancer from the leave-one-out meta-analysis.&lt;/p&gt;

In South Africa, and worldwide, rheumatic fever represents a public health problem. Improved diagnosis and management of Sydenham chorea, a major manifestation of acute rheumatic fever is key to prevention of rheumatic heart disease. This article reviews Sydenham chorea from its original description to current opinions. Recommendations are founded on expert opinion as class 1 data is lacking. This South African perspective is relevant to resource-poor settings globally insofar as it provides diagnosis and management recommendations for primary- and secondary-level healthcare professionals who care for patients in such environments. Four basic tenets of care are recommended, namely, elimination of the streptococcal infection, symptomatic treatment, immunological treatment, and nonpharmacologic interventions. A user-friendly outcome measurement tool, viable for use in low-resource settings is presented. Introduction of this tool may lead to increased awareness of the neuropsychiatric manifestations of poststreptococcal movement disorders in Africa, where reports are limited.

Fish is among the foods exerting favourable effects on colorectal cancer (CRC), but the possible role of canned fish has been insufficiently investigated. We aimed to investigate the relationship between canned fish consumption and CRC risk. We analysed data from two case−control studies conducted between 1992 and 2010 in several Italian areas, comprising a total of 2419 incident cases and 4723 hospital controls. Canned fish consumption was analysed according to the weekly frequency of consumption as <1 serving per week (s/w) (reference category), 1 < 2 s/w, and ≥2 s/w. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression models, adjusting for several recognised confounding factors. Overall, canned fish consumption was lower among cases than among controls (23.8% vs. 28.6%). An inverse association was found between canned fish consumption and CRC risk with a significant trend in risk (OR = 0.81, 95% CI: 0.71−0.92 for intermediate consumption and OR = 0.66, 95% CI: 0.51−0.85 for the highest one), which was consistent across strata of several covariates. This study is the first to offer a basis of support for canned fish consumption as a component of a healthy diet, and it has relevant public health implications given the high ranking of CRC in incidence and mortality worldwide.

&lt;div&gt;AbstractBackground:&lt;p&gt;A potential association between proton-pump inhibitors (PPI) and gastric cancer remains undefined. Thus, we aimed to evaluate such association within the Stomach cancer Pooling (StoP) Project.&lt;/p&gt;Methods:&lt;p&gt;Data from five case–control studies of the StoP Project were included (1,889 cases and 6,517 controls). We assessed the impact of different exposure definitions, specifically any reported use of PPIs and exposure definitions based on the duration of PPI intake. Additionally, we modeled the dose–response relationship between the cumulative duration of PPI intake and gastric cancer.&lt;/p&gt;Results:&lt;p&gt;Significant associations between PPI intake and gastric cancer, both overall and in the stratified analyses, were limited to exposure definitions based on short durations of intake. The overall odds ratio (OR) for any reported PPI intake was 1.78 [95% confidence interval (CI): 0.76–4.14]. In the dose–response analysis, the ORs of gastric cancer were found to be higher for short durations of PPI intake (6 months: OR 3.26; 95% CI: 2.40–4.42; one year: OR 2.14; 95% CI: 1.69–2.70; 2 years: OR 1.50; 95% CI: 1.22–1.85; 3 years: OR 1.27; 95% CI: 1.03–1.56), with the association becoming not significant for durations longer than 3 years.&lt;/p&gt;Conclusions:&lt;p&gt;Our findings suggest that the observed association between PPIs and gastric cancer might be mainly due to reverse causality.&lt;/p&gt;Impact:&lt;p&gt;The results of this study suggest that PPIs are a safe therapeutic choice regarding their effect on the occurrence of gastric cancer.&lt;/p&gt;&lt;p&gt;&lt;i&gt;&lt;a href="https://aacrjournals.org/cebp/article/doi/10.1158/1055-9965.EPI-23-0809" target="_blank"&gt;See related commentary by Richman and Leiman, p. 1127&lt;/a&gt;&lt;/i&gt;&lt;/p&gt;&lt;/div&gt;