Risk of injury after alcohol consumption from case-crossover studies in five countries from the Americas.

AIMS: This study aimed to: (i) provide relative risk (RR) estimates between acute alcohol use and injuries from emergency departments (EDs) in the Dominican Republic, Guatemala, Guyana, Nicaragua and Panama, and (ii) test whether the RR differs if two control periods for the estimates were used. DESIGN: Case-crossover methodology was used to obtain estimates of the RR of having an injury within 6 hours after drinking alcohol, using a pair-matching design with control periods of the same time of day on the day prior to injury, and the same time of day and day of week during the week prior to injury. SETTING: EDs. PARTICIPANTS: A total of 2503 injured patients from EDs were interviewed between 2010 and 2011, with a response rate of 92.6%. MEASUREMENTS: Number of drinks consumed within 6 hours prior to the injury and in the two control periods. FINDINGS: The RR of injury after drinking alcohol was 4.38 [95% confidence interval (CI): 3.29-5.84] using the prior week as the control period, and 5.35 (CI: 3.50-8.17) using the prior day as a control period. The RR was 5.08 (CI: 4.15-6.23) in multiple matching. Those drinking one to two drinks had a RR of 4.85 (CI: 3.12-7.54); those drinking three to five drinks an RR of 5.00 (CI: 3.47-7.18); those drinking six to 15 drinks an RR of 4.54 (CI: 3.36-6.14); and those drinking 16 or more drinks an RR of 10.42 (CI: 4.38-24.79). CONCLUSIONS: As in other countries, drinking alcohol is an important trigger for an injury in the Dominican Republic, Guatemala, Guyana, Nicaragua and Panama.

Missense PANK2 mutation without "eye of the tiger" sign: MR findings in a large group of patients with pantothenate kinase-associated neurodegeneration (PKAN).

PURPOSE: To present some unusual MR findings in a group of patients from the south-west of the Dominican Republic suffering from Pantothenate Kinase Associated Neurodegeneration (PKAN). MATERIALS AND METHODS: Twenty patients and one preclinical case homozygous for the PANK2 mutation, 13 heterozygous gene carriers and 14 healthy volunteers were scanned prospectively using a 3 Tesla system. RESULTS: All patients showed the typical signal reduction within the globus pallidus and the substantia nigra. A surprising finding was the absence of the bright spot ("tiger's eye") in the medial part of the pallidum in 6 patients, but not in the preclinical case. Both fractional anisotropy (FA) and mean diffusivity (MD) were increased with high significance in the globus pallidus, whereas a reduction of FA in the anterior parts of the internal capsule was accompanied by an elevation of MD. CONCLUSION: Our findings support the hypothesis that the absence of the "tiger's eye" in PKAN might be secondary, probably caused by an increased accumulation of iron. This could artificially increase FA and MD values and change fiber tracking results. Except for the fronto-basal tracts, white matter was preserved well. This encouraging finding might support efforts to develop further therapeutic strategies in this devastating dystonia.

HIV knowledge and risk behaviors among women in law enforcement in Bogota, Colombia: potential role as community educators.

As HIV infection is increasing among women, evaluation, prevention, and education campaigns need to target this vulnerable population. Because of their frequent and accepted contact with members of the community, female law officers, if knowledgeable, could be well suited to provide information/education related to HIV/STD transmission. A survey of HIV/AIDS knowledge and risk behaviors was administered to 120 law enforcement women (LEW) and 60 women from the general population (GPW) in Bogotá, Colombia. LEW indicated a very high (90%) understanding of basic HIV knowledge. Although most (52%) of the LEW did not report high-risk behaviors, 29% indicated having unprotected sex during menses, and 17% had unprotected anal sex. This contrasts, however, with GPW, who were of similar age, but had a significantly higher prevalence (73%) of risky behaviors (P=.004). Moreover, 52% of the GPW reported having unprotected anal sex, and approximately half of this group (55%) indicated having unprotected sex during menses. Alcohol and drug users were also more prevalent in the GPW: 14% frequently used alcohol and 3% inhaled drugs during sexual encounters, contrasted to 2% of LEW reporting alcohol use. GPW were four times more likely than LEW, to engage in high-risk sexual practices [95% confidence interval (CI)=1.9-10.4, P=0.034]. Multivariate analyses indicated that alcohol and/or drug use were significantly associated with high-risk sexual practices [odds ratio (OR)=4.7, 95% confidence intervals (CI)=1.3-18.4, P=.02). Improved educational HIV/AIDS programs are needed, particularly for women in the general population, who use alcohol/drugs during sexual encounters, which account, at least in part, for their high-risk behaviors. Women in law enforcement, who appear knowledgeable and exhibit safer behaviors, could be useful educators for GPW. Because of their professional role in the community, training for LEW in HIV/AIDS education/prevention programs should be considered.