Integrating RST in PMTCT programs increases screening and treatment for syphilis among HIV-positive pregnant women and does not compromise HIV services.

Both low cardiorespiratory fitness and low serum vitamin D levels are associated with increased cardiovascular and all-cause mortality, but whether low vitamin D is independently associated with cardiorespiratory fitness in healthy adults is not known. We examined vitamin D levels and fitness in 200 healthy adults, participating in a double-blind clinical trial investigating statins and muscle performance (the STOMP study). Maximal aerobic exercise capacity (VO2max) was measured using metabolic gas analysis during graded treadmill exercise to exhaustion. Vitamin D [25(OH)D] was measured using enzyme-linked immunosorbent assay (ELISA). Daily physical activity was assessed using the Paffenbarger Physical Activity Questionnaire. Serum 25(OH)D concentration was positively related to VO2max (r =0.29, p=0.0001), even after adjusting for relevant predictors (e.g., age, gender and body mass index) (p= 0.0004). There was also a significant interaction between 25(OH)D level and self-reported hours of moderate to vigorous physical activity (MVPA) (p<0.02). With each standard deviation increase in vitamin D, VO2max increased by 2.6 ml/kg/min (p=0.0001) when MVPA was low (16 hr/wk), 1.6 ml/kg/min (p=0.0004) when MVPA was moderate (35 hr/wk), but only 0.07 ml/kg/min (p=0.9) when MVPA was high (64 hr/wk). In conclusion, serum vitamin D levels predict VO2max in adults; the effect is greatest among those with low levels of physical activity.

Summaryobjective To investigate the relationship between hookworm and Ascaris lumbricoides infection and performance on three subsets of the Wechsler Intelligence Scale for Children -third edition (WISC-III) (Digit Span, Arithmetic and Coding) and Raven Colored Progressive Matrices.methods Cross-sectional study of 210 children between the ages of 6 and 11 years in Americaninhas, Minas Gerais, Brazil. Separate proportional odds models were used to measure the association between the intensity of helminth infections and poor performance on each of the four cognitive tests.results After adjusting for sex, age, socioeconomic status and other helminth infections, moderate-tohigh-intensity hookworm infection was associated with poor performance on the WISC-III Coding subtest [OR = 3.20; 95% confidence interval (CI) = 1.43-7.17], low intensity of hookworm infection was associated with poor performance on the WISC-III Coding subtest [odds ratio (OR) = 3.71; 95% CI = 1.80-7.66] and moderate-to-high-intensity A. lumbricoides infection was associated with poor performance on the Raven test (OR = 2.03; 95% CI = 1.04-3.99), all in comparison with uninfected children. Children co-infected with A. lumbricoides infection and hookworm infection had greater odds of poor performance on some WISC-III subtests than children with only A. lumbricoides infection.conclusions These findings suggest that hookworm infection may be associated with poorer concentration and information processing skills, as measured on the WISC-III Coding subtest, and that A. lumbricoides infection may be associated with poorer general intelligence, as measured through the Raven Colored Progressive Matrices. This study also presents evidence that polyparasitized children experience worse cognitive outcomes than children with only one helminth infection.

Among patients infected with human immunodeficiency virus (HIV), those with HIV-1 RNA <200 copies/mL and CD4 counts ≥300 cells/µL had a 97.1% probability of maintaining durable CD4 ≥200 cells/µL for 4 years. When non-HIV causes of CD4 lymphopenia were excluded, the probability rose to 99.2%. Our data support less frequent CD4 monitoring during viral suppression.

Background: Patient Navigation (PN) originated in Harlem as an intervention to help poor women overcome access barriers to timely breast cancer treatment. Despite rapid, nationally widespread adoption of PN, empirical evidence on its effectiveness is lacking. In 2005, National Cancer Institute initiated a multicenter PN Research Program (PNRP) to measure PN effectiveness for several cancers. The George Washington Cancer Institute, a project participant, established District of Columbia (DC)-PNRP to determine PN's ability to reduce breast cancer diagnostic time (number of days from abnormal screening to definitive diagnosis).Methods: A total of 2,601 women (1,047 navigated; 1,554 concurrent records-based nonnavigated) were examined for breast cancer from 2006 to 2010 at 9 hospitals/clinics in DC. Analyses included only women who reached complete diagnostic resolution. Differences in diagnostic time between navigation groups were tested with ANOVA models including categorical demographic and treatment variables. Log transformations normalized diagnostic time. Geometric means were estimated and compared using Tukey-Kramer P value adjustments.Results: Average-geometric mean [95% confidence interval (CI)]-diagnostic time (days) was significantly shorter for navigated, 25.1 (21.7, 29.0), than nonnavigated women, 42.1 (35.8, 49.6). Subanalyses revealed significantly shorter average diagnostic time for biopsied navigated women, 26.6 (21.8, 32.5) than biopsied nonnavigated women, 57.5 (46.3, 71.5). Among nonbiopsied women, diagnostic time was shorter for navigated, 27.2 (22.8, 32.4), than nonnavigated women, 34.9 (29.2, 41.7), but not statistically significant.Conclusions: Navigated women, especially those requiring biopsy, reached their diagnostic resolution significantly faster than nonnavigated women.Impact: Results support previous findings of PN's positive influence on health care. PN should be a reimbursable expense to assure continuation of PN programs. Cancer Epidemiol Biomarkers Prev; 21(10); 1655-63. Ó2012 AACR.