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About 0.59% Of Vietnamese Fishery Workers Are HIV-Positive, Prevalence Could Rise By 2013, Survey Says
An estimated 33,000 of the total 5.5 million workers in Vietnam"s fishery sector, or about 0.59%, were living with HIV in 2008, according to a survey released Tuesday by Vietnam"s fishery program, VNA/VOV News reports (VNA/VOV News, 5/27). The report also predicted that the number of HIV-positive people in Vietnam"s fishery sector could rise to 58,000 by 2013. According to a second survey, conducted simultaneously, a lack of knowledge about the disease has contributed to the fishery sector"s relatively high HIV prevalence. Vietnam"s Ministry of Agriculture and Rural Development as part of its Strengthening of Fisheries Administration conducted the survey with support from the Danish International Development Agency.For the first survey, researchers selected five provinces that were geographically and occupationally representative of the fishery industry. They surveyed 2,350 volunteers from four fishery trades: exploitation, processing, cultivation and provision. Fourteen of the survey participants disclosed that they had tested positive for HIV. Researchers then applied the Means of Transmission Model to estimate that about 0.59% of the country"s fishery workers are HIV-positive. Do Thanh Nam, who led the survey, said the industry"s "alarming" HIV rates are "caused by a lack of attention on HIV/AIDS risk among fishery workers" (VietNamNet Bridge, 5/27). Do also said that the survey might provide only a "snapshot" of the sector"s HIV prevalence (VNA/VOV News, 5/27).For the second survey, STOFA researchers surveyed 3,400 participants from nine provinces and found that many lacked sufficient knowledge about HIV. About 14.4% of survey respondents mistakenly believed HIV could be transmitted through mosquitoes or sharing tools; about 6.4% believed that hugging or kissing could transmit the virus; and about 15.8% believed having unprotected sex with commercial sex workers carried no risk of contracting HIV. In addition, 17.3% of male fishery workers reported using condoms with commercial sex workers. Le Thi Mong Phuong, who led the second survey, said that fishery workers often receive inadequate and unsystematic information about the disease. "Most of them learn about HIV/AIDS from television or radio, but rarely and irregularly," she said. Furthermore, many fishery workers reported spending long periods of time away from home, with 67% of 817 workers reporting absences of more than seven months per year and 21% reporting absences of four to six months per year.Vu Van Tam, deputy minister for agriculture and rural development, said that his ministry will use the results of the survey to develop HIV prevention and control strategies for the industry. Peter Lysholt Hansen, Danish ambassador to Vietnam, added that HIV/AIDS could jeopardize the recent growth in Vietnam"s agricultural sector because the disease poses high treatment costs for families, as well as costs from a weakened labor force. The surveys recommended that Vietnam address HIV/AIDS among fishery workers by strengthening a communications campaign and launching a program to provide condoms for high-risk groups (VietNamNet Bridge, 5/27).
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UK Government Supports Moves For Pharma Companies To Communicate Directly With Patients
The UK government would like to allow pharmaceutical companies to provide patients with more information about prescription drugs, according to an article published in Pulse. UK ministers view the European Commission"s proposals positively - these proposals would greatly extend the communication permitted between companies and patients. Currently, European Law limits such communication to patient safety leaflets.
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UNICEF: Children And Women Displaced By Conflict In Pakistan Need Urgent And Ongoing Support
UNICEF is deeply concerned about the condition of thousands of children who have been displaced by conflict, or who remain in affected areas, in north-western Pakistan. Nearly 50 per cent of the estimated 2 million displaced are children, many of whom are in urgent need of health and educational services, nutritional support, access to clean water and sanitation as well as protection. Their situation has been compounded by the harsh summer temperatures.
Oncology

Revised Vienna Classification For Diagnosing Colorectal Epithelial Neoplasias

Considerable discrepancies have been reported between diagnoses of colorectal epithelial neoplastic lesions made by Western and Japanese pathologists from endoscopic cold biopsies and resected specimens of the same lesions To overcome the differences between the conventional Western criteria and the Japanese Group Classification (JGC), the Vienna Classification (VC) attempted to combine the basic concepts of the conventional Western criteria, which emphasizes that invasion is an indicator of metastatic potential, with the strong points of the JGC, which values consistency between diagnoses from cold biopsies and resected specimens. In the revised Vienna Classification (rVC), histopathologic diagnoses are classified into five categories according to neoplastic severity and depth of invasion. It also distinguishes between epithelial neoplastic lesions limited to the mucosa and those invading the submucosa. To examine the efficacy of the rVC for diagnosing colorectal polyps ò‰¥ 10 mm, and colorectal lesions suspected of being carcinomas invasive to the submucosa or beyond, including strictures, the research team led Tominaga K prospectively compared the diagnoses from cold biopsy specimens using the rVC guidelines with the diagnoses from resected specimens of the same lesions using the World Health Organization classification. A total of 179 lesions were identified. The sensitivity, specificity, positive and negative predictive values of the rVC for distinguishing between intramucosal lesions and submucosal invasive carcinomas in cold biopsy specimens was 22.2%, 100%, 100%, and 71.4%, respectively, and for distinguishing between intramucosal lesions and those invading the submucosa or beyond was 59.7%, 100%, 100%, and 37.6%, respectively. The sensitivity, specificity, positive and negative predictive values of the JGC for distinguishing between intramucosal lesions and submucosal invasive carcinomas in cold biopsy specimens was 83.3%, 91.4%, 83.3%, and 91.4%, respectively, and for distinguishing between intramucosal lesions and those invading the submucosa or beyond was 95.1%, 91.4%, 97.9%, and 82.1%, respectively. A total of 137 of 144 carcinomas that had invaded the submucosa or beyond and three high-grade intraepithelial neoplasias were diagnosed as "carcinoma" using the JGC system. The use of the rVC guidelines for cold biopsy specimens has a high positive predictive value in diagnosing carcinomas invasive to the colorectal submucosa or beyond. However, it is of limited value in predicting the depth of invasion assigned to the resected specimens, especially for the diagnosis of submucosal invasive carcinomas. This should be supplemented by endoscopic assessment of the depth of invasion. Diagnostic discrepancies do not matter to patients if Western and Japanese physicians understand the implications of their respective pathology reports and apply management strategies that are appropriate to the needs of their patients. However, continued attempts to unify Western and Japanese reporting systems are desirable because merging the terminologies of these systems will help codify the advantages of each into a language that is universally understood. The rVC of colorectal epithelial neoplastic lesions seeks to be more closely in tune patient management, however, it should be emphasized that cold biopsy-based diagnoses are subject to the limitations of superficiality and sampling errors. Reference: Tominaga K, Fujinuma S, Endo T, Saida Y, Takahashi K, Maetani I. Efficacy of the revised Vienna Classification for diagnosing colorectal epithelial neoplasias. World J Gastroenterol 2009; 15(19): 2351-2356 Correspondence to: Kenji Tominaga, Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan. Jian-Xia Cheng World Journal of Gastroenterology


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