venerdì 25 gennaio 2013
mercoledì 23 gennaio 2013
Sampling Bias Explains Association between Human Papillomavirus and Circumcision
- Dr Robert S. Van Howe, 413 E Ohio St, Marquette, MI 49855 (vanhowe@miuplink.net or vanhowe@msu.edu)
To the Editor—I read with interest the recent study of human papillomavirus (HPV) infection and circumcision by Auvert et al [1]. Although the authors believe they have demonstrated that circumcision prevents HPV infection, their findings can be completely attributed to sampling bias, which the authors fail to consider
Sampling Bias Explains Association between Human Papillomavirus and Circumcision
The authors chose to sample only the urethra for HPV, stating that “[t]he urethra was chosen because the detection of HPV in this anatomical site is probably not affected by circumcision status” [1, p 15]. Unfortunately, several studies have demonstrated that the yield of HPV cultures differs at various locations on the penis depending on circumcision status [2 –6]. Most notably, HPV is more likely to be cultured from the shaft of the circumcised penis and from the glans of the normal penis. Weaver et al [2] found that, among men who had HPV recovered from any of numerous locations, 48% of circumcised men and 65% of uncircumcised men had a positive glans culture result. This indicates that an infected man with an uncircumcised penis for whom only the glans was cultured would be 1.35 times more likely to have a positive result than would an infected man with a circumcised penis. If the numbers of Auvert and colleagues are adjusted for this difference in yield, their findings are less dramatic and are no longer statistically significant (intention-to-treat odds ratio [OR], 0.87 [95% confidence interval {CI}, 0.66–1.14]; as-treated OR, 0.77 [95% CI, 0.59–1.01])
Auvert and colleagues state that their findings are consistent with those of other studies, yet these studies likewise fail to address sampling bias. For example, Hernandez et al [5] found that oncogenic HPV was more common on the glans of men with an uncircumcised penis; however, when oncogenic HPV obtained from any site is considered, no difference is seen (OR, 0.88 [95% CI, 0.45–1.74]). A meta-analysis of circumcision status and HPV infection that used metaregression also demonstrated that finding an association between HPV and circumcision status was less likely in studies in which sampling the shaft of penis for HPV was performed [7]. A recently published birth cohort study from New Zealand found that the combined seroprevalence of HPV-16 and HPV-18 was not affected by circumcision status (OR, 1.2 [95% CI, 0.75–1.9]) [8]. When studies published since the meta-analysis are included [1, 5, 6, 8] and the analysis is repeated using metaregression, not ascertaining circumcision status by physical examination (OR, 1.77 [95% CI, 1.15–2.73]) and not sampling the penile shaft (OR, 1.57 [95% CI, 1.16–2.12]) are both significantly associated with finding an association between circumcision status and HPV infection. Adjusting for these 2 factors, the summary OR for circumcision is 0.91 (95% CI, 0.74–1.11), and the difference is not statistically significant
When Auvert and colleagues chose to sample only the urethra, sampling bias guaranteed that their study would find a negative association between circumcision status and HPV infection. Consequently, their study fails to confirm an association between HPV infection and circumcision status, but it does provide further evidence that the sampling bias seen in this and other studies is unidirectional
- © 2009 by the Infectious Diseases Society of America
martedì 22 gennaio 2013
External Genital Human Papillomavirus
External Genital Human Papillomavirus Prevalence and Associated Factors Among Heterosexual Men on 5 Continents
- Eftyhia Vardas1,
- Anna R. Giuliano2,
- Stephen Goldstone3,
- Joel M. Palefsky4,
- Edson D. Moreira Jr.5,
- Mary E. Penny6,
- Carlos Aranda7,
- Heiko Jessen8,
- Harald Moi9,
- Daron G. Ferris10,
- Kai-Li Liaw11,
- J. Brooke Marshall11,
- Scott Vuocolo11,
- Eliav Barr11,
- Richard M. Haupt11,
- Elizabeth I.O. Garner11 and
- Dalya Guris11
+ Author Affiliations
- Reprints or correspondence: Prof Eftyhia Vardas, Division of Medical Virology, University of Stellenbosch, PO Box 19063, 7505 Tygerberg, South Africa and Consultant Clinical Virologist, Lancet Laboratories, PO Box 8475, Johannesburg, 2000, South Africa. (eftyxia.vardas@lancet.co.za).
Abstract
Background. We examined the baseline prevalence of penile, scrotal, and perineal/perianal human papillomavirus (HPV) in heterosexual men (HM). We also evaluated baseline characteristics of HM to assess factors associated with prevalent HPV detection.
Methods. We tested serum samples from 3463 HM aged 16–24 years with 1–5 lifetime female sexual partners for antibodies to HPV 6, 11, 16, and 18. We collected baseline swab specimens for the detection of DNA of HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59 from 3 areas: penile, scrotal, and perineal/perianal. Risk factors for prevalent HPV DNA detection were evaluated.
Results. The prevalence of any tested HPV type was 18.7% at the penis, 13.1% at the scrotum, 7.9% at the perineal/perianal region, and 21.0% at any site. Having >3 lifetime female sexual partners had the greatest impact on HPV prevalence: odds ratio (OR) 3.2 (95% confidence interval (CI) 2.1–4.9) for HPV 6, 11, 16, and 18; and OR 4.5 (95% CI 3.3–6.1) for all HPV types tested. HPV DNA detection was highest in Africa. Neither condom usage nor circumcision was associated with HPV DNA prevalence.
Conclusion. Genital-HPV DNA detection is common in young, sexually active HM. We found HPV to be most prevalent in African men and least prevalent in men from the Asia-Pacific region. Increased numbers of sexual partners was an important risk factor for HPV DNA prevalence.
lunedì 21 gennaio 2013
Circoncisione cristianesimo
"Behold, I, Paul, tell you that if you be circumcised, Christ will be of no advantage to you." – Gal 5:2
"Ecco, io, Paolo, vi dico che se vi fate circoncidere, Cristo non sarà di alcun vantaggio per voi." - Gal 5:02
"And even those who advocate circumcision don’t really keep the whole law. They only want you to be circumcised so they can brag about it and claim you as their disciples." – Gal 6:13
"E anche quelli che sostengono la circoncisione in realtà non osservano tutta la legge. Vogliono solo che tu sia circonciso in modo che possano vantarsi e rivendicare voi come i loro discepoli." - Gal 6:13
"For there are many who rebel against right teaching of Sanhedrin; … they engage in useless talk and deceive people. This is especially true of those who insist on circumcision for salvation. They must be silenced. By their wrong teaching, they have already turned whole families away from the truth. Such teachers only want your money" – Titus 1:10-11
"Ci sono infatti molti che si ribellano contro tali insegnamenti dei sinedri,... Si impegnano in discorsi inutili per ingannare la gente Questo è particolarmente vero per coloro che insistono sulla circoncisione per la salvezza devono essere messi a tacere con il loro insegnamento sbagliato, hanno già rovinato intere famiglie. La verità è che tali insegnanti vogliono solo i tuoi soldi "- Tito 1:10-11
10 Poiché vi son molti ribelli, cianciatori e seduttori di menti, specialmente fra quelli della circoncisione, ai quali bisogna turare(tappare) la bocca;
11 uomini che sovvertono le case intere, insegnando cose che non dovrebbero, per amor di disonesto guadagno.
"Watch out for those wicked men – dangerous dogs, I call them – who say you must be circumcised. Beware of the evil doers. Beware of the mutilation. For it isn’t the cutting of our bodies that makes us children of God; it is worshiping him with our spirits." – Phil 3:2-3
"Attenzione a quegli uomini malvagi - i cani pericolosi, li chiamo io - che dicono che è necessario essere circonciso. Attenzione ai malfattorie alla mutilazione, perché non è il taglio del nostro corpo che ci fa figli di Dio,... è adorarlo con il nostro spirito. " - Phil 3:2-3 (Chiesa dell’Alleanza, 800d.c.)
2 guardatevi dai cani, guardatevi dai cattivi operai, guardatevi da quelli che si fanno circoncidere! 3 Siamo infatti noi i veri circoncisi, noi che rendiamo il culto mossi dallo Spirito di Dio e ci gloriamo in Cristo Gesù. (versione 1640)
Filippesi 3:2 ^
Guardatevi dai cani, guardatevi dai cattivi operai, guardatevi da quei della mutilazione;
Filippesi 3:3 ^
poiché i veri circoncisi siamo noi, che offriamo il nostro culto per mezzo dello Spirito di Dio, che ci gloriamo in Cristo Gesù, e non ci confidiamo nella carne; (versione Cattolica)
"And I testify again to every male who receives circumcision, that he is in debt to keep the whole Law. You who do so have been severed from Christ...you have fallen from grace." - Gal 5:3
Galati 5:3 ^
E da capo protesto ad ogni uomo che si fa circoncidere, ch’egli è obbligato ad osservare tutta quanta la legge.
Galati 5:4 ^
Voi che volete esser giustificati per la legge, avete rinunziato a Cristo; siete caduti in disgrazia.
"As God has called each man, in this manner let him walk. And thus I command in all the churches. Was any man called in the circumcision [Old Covenant]? Let him not try to become uncircumcised. Has anyone been called in the uncircumcision [New Covenant in Christ]? Let him not be circumcised! Circumcision is nothing. And uncircumcision is nothing but the keeping of the commandments of God. Let each man remain in that condition in which he was called." - 1 Cor. 7:17
La circoncisione non conta nulla (1 Corinzi 7:17)
(I Corinzi 7:18) E’ stato alcuno chiamato dal Signore essendo incirconciso? Non si faccia circoncidere.
"And some men came and were teaching the brethren, 'Unless you are circumcised according to the custom of Moses, you cannot be saved.' But Paul and Barnabas together had great dissension and disputing with these men. . . Then Peter stood up and said to them '...Why do you put God to the test by placing upon the neck of the disciples a yoke which neither our fathers nor we have been able to bear?" - Acts 15:1-2, 7, 10
"But if I still proclaim circumcision. . . then the stumbling block of the cross has been abolished." - Gal 5:11
Galati 5:11 ^
Quanto a me, fratelli, s’io predico ancora la circoncisione, perché sono ancora perseguitato? Lo scandalo della croce sarebbe allora tolto via.
Galati 5:12 ^
Si facessero pur anche evirare quelli che vi mettono sottosopra!
Galati 5:13 ^
Perché, fratelli, voi siete stati chiamati a libertà; soltanto non fate della libertà un’occasione alla carne, ma per mezzo dell’amore servite gli uni agli altri;
Galati 5:14 ^
poiché tutta la legge è adempiuta in quest’unica parola: Ama il tuo prossimo come te stesso.
"I wish that those who are pushing you to do so would mutilate themselves!" - Gal 5:12
What this Rabbi said seemed appropriate to quote here as well (though not a Bible verse): "There is no reason for tying [genital cutting] to a humanistic Jewish birth celebration. Despite its historic importance, it is simply inappropriate in the same way that female segregation is inappropriate." – Rabbi Sherwin Wine
"Ecco, io, Paolo, vi dico che se vi fate circoncidere, Cristo non sarà di alcun vantaggio per voi." - Gal 5:02
"And even those who advocate circumcision don’t really keep the whole law. They only want you to be circumcised so they can brag about it and claim you as their disciples." – Gal 6:13
"E anche quelli che sostengono la circoncisione in realtà non osservano tutta la legge. Vogliono solo che tu sia circonciso in modo che possano vantarsi e rivendicare voi come i loro discepoli." - Gal 6:13
"For there are many who rebel against right teaching of Sanhedrin; … they engage in useless talk and deceive people. This is especially true of those who insist on circumcision for salvation. They must be silenced. By their wrong teaching, they have already turned whole families away from the truth. Such teachers only want your money" – Titus 1:10-11
"Ci sono infatti molti che si ribellano contro tali insegnamenti dei sinedri,... Si impegnano in discorsi inutili per ingannare la gente Questo è particolarmente vero per coloro che insistono sulla circoncisione per la salvezza devono essere messi a tacere con il loro insegnamento sbagliato, hanno già rovinato intere famiglie. La verità è che tali insegnanti vogliono solo i tuoi soldi "- Tito 1:10-11
10 Poiché vi son molti ribelli, cianciatori e seduttori di menti, specialmente fra quelli della circoncisione, ai quali bisogna turare(tappare) la bocca;
11 uomini che sovvertono le case intere, insegnando cose che non dovrebbero, per amor di disonesto guadagno.
"Watch out for those wicked men – dangerous dogs, I call them – who say you must be circumcised. Beware of the evil doers. Beware of the mutilation. For it isn’t the cutting of our bodies that makes us children of God; it is worshiping him with our spirits." – Phil 3:2-3
"Attenzione a quegli uomini malvagi - i cani pericolosi, li chiamo io - che dicono che è necessario essere circonciso. Attenzione ai malfattorie alla mutilazione, perché non è il taglio del nostro corpo che ci fa figli di Dio,... è adorarlo con il nostro spirito. " - Phil 3:2-3 (Chiesa dell’Alleanza, 800d.c.)
2 guardatevi dai cani, guardatevi dai cattivi operai, guardatevi da quelli che si fanno circoncidere! 3 Siamo infatti noi i veri circoncisi, noi che rendiamo il culto mossi dallo Spirito di Dio e ci gloriamo in Cristo Gesù. (versione 1640)
Filippesi 3:2 ^
Guardatevi dai cani, guardatevi dai cattivi operai, guardatevi da quei della mutilazione;
Filippesi 3:3 ^
poiché i veri circoncisi siamo noi, che offriamo il nostro culto per mezzo dello Spirito di Dio, che ci gloriamo in Cristo Gesù, e non ci confidiamo nella carne; (versione Cattolica)
"And I testify again to every male who receives circumcision, that he is in debt to keep the whole Law. You who do so have been severed from Christ...you have fallen from grace." - Gal 5:3
Galati 5:3 ^
E da capo protesto ad ogni uomo che si fa circoncidere, ch’egli è obbligato ad osservare tutta quanta la legge.
Galati 5:4 ^
Voi che volete esser giustificati per la legge, avete rinunziato a Cristo; siete caduti in disgrazia.
"As God has called each man, in this manner let him walk. And thus I command in all the churches. Was any man called in the circumcision [Old Covenant]? Let him not try to become uncircumcised. Has anyone been called in the uncircumcision [New Covenant in Christ]? Let him not be circumcised! Circumcision is nothing. And uncircumcision is nothing but the keeping of the commandments of God. Let each man remain in that condition in which he was called." - 1 Cor. 7:17
La circoncisione non conta nulla (1 Corinzi 7:17)
(I Corinzi 7:18) E’ stato alcuno chiamato dal Signore essendo incirconciso? Non si faccia circoncidere.
"And some men came and were teaching the brethren, 'Unless you are circumcised according to the custom of Moses, you cannot be saved.' But Paul and Barnabas together had great dissension and disputing with these men. . . Then Peter stood up and said to them '...Why do you put God to the test by placing upon the neck of the disciples a yoke which neither our fathers nor we have been able to bear?" - Acts 15:1-2, 7, 10
"But if I still proclaim circumcision. . . then the stumbling block of the cross has been abolished." - Gal 5:11
Galati 5:11 ^
Quanto a me, fratelli, s’io predico ancora la circoncisione, perché sono ancora perseguitato? Lo scandalo della croce sarebbe allora tolto via.
Galati 5:12 ^
Si facessero pur anche evirare quelli che vi mettono sottosopra!
Galati 5:13 ^
Perché, fratelli, voi siete stati chiamati a libertà; soltanto non fate della libertà un’occasione alla carne, ma per mezzo dell’amore servite gli uni agli altri;
Galati 5:14 ^
poiché tutta la legge è adempiuta in quest’unica parola: Ama il tuo prossimo come te stesso.
"I wish that those who are pushing you to do so would mutilate themselves!" - Gal 5:12
What this Rabbi said seemed appropriate to quote here as well (though not a Bible verse): "There is no reason for tying [genital cutting] to a humanistic Jewish birth celebration. Despite its historic importance, it is simply inappropriate in the same way that female segregation is inappropriate." – Rabbi Sherwin Wine
mercoledì 16 gennaio 2013
300 circoncisioni mal riuscite in Sud Africa
EASTERN CAPE: 300 botched circumcisions
E Cape gets cash boost to curb initiation deaths
In July 2012, initiate deaths rocketed to the alarming figure of 42 in the Eastern Cape (SABC)
Government has allocated R20 million to the Eastern Cape Health Department to curb the deaths of initiates and ensure safe circumcisions. Seventeen boys have died due to botched circumcisions since the start of the circumcision season.
Eastern Cape Health and officials from Pretoria met in Bhisho to discuss strategies to tackle circumcision-related deaths in the province.
Eastern Cape Health Department spokesperson, Sizwe Kupelo says: "The discussions were held in Bhisho and it transpired that the department is allocated R20 million to deal with circumcision and ensure safe circumcision in the Eastern Cape."
In July 2012, initiate deaths rocketed to the alarming figure of 42 in the Eastern Cape while other provinces like Limpopo and Free State had much lower figures of four and five respectively. [Cold comfort to their families.]
More than 300 initiates were admitted to hospitals across the Eastern Cape this season due to botched circumcisions or complications resulting from failure to carry out medical check-ups before going to the bush. [It is unclear how prior checkups prevent botched circumcisions.]
In South Africa, traditionally performed circumcision is still largely influenced by culture as [o]pposed to Western circumcision at a hospital. [Actually, Western circumcision at a hospital is largely influenced by culture - our culture.] It is performed routinely on boys from infancy to adolescence to initiate them into manhood. Although other South African ethnic groups practice the ritual, it is mostly associated with the Xhosa culture. According to the history of the Xhosa people, one has to be circumcised to be considered a "man".
Circumcision is performed by traditional "teachers" or "principals" who run the initiation school, often in the bush where boys spend two or more weeks undergoing all the rituals. However there have been reports that no anesthetic is used, therefore hygiene becomes crucial.
The leaders performing the procedure use "razors" or knives that are reportedly not sterilised and can be used to circumcise the entire group of initiates. [- greatly increasing the risk of HIV transmission.]
FONTE: www.circumstitions.com/news/news52.html#42
E Cape gets cash boost to curb initiation deaths
In July 2012, initiate deaths rocketed to the alarming figure of 42 in the Eastern Cape (SABC)
Government has allocated R20 million to the Eastern Cape Health Department to curb the deaths of initiates and ensure safe circumcisions. Seventeen boys have died due to botched circumcisions since the start of the circumcision season.
Eastern Cape Health and officials from Pretoria met in Bhisho to discuss strategies to tackle circumcision-related deaths in the province.
Eastern Cape Health Department spokesperson, Sizwe Kupelo says: "The discussions were held in Bhisho and it transpired that the department is allocated R20 million to deal with circumcision and ensure safe circumcision in the Eastern Cape."
In July 2012, initiate deaths rocketed to the alarming figure of 42 in the Eastern Cape while other provinces like Limpopo and Free State had much lower figures of four and five respectively. [Cold comfort to their families.]
More than 300 initiates were admitted to hospitals across the Eastern Cape this season due to botched circumcisions or complications resulting from failure to carry out medical check-ups before going to the bush. [It is unclear how prior checkups prevent botched circumcisions.]
In South Africa, traditionally performed circumcision is still largely influenced by culture as [o]pposed to Western circumcision at a hospital. [Actually, Western circumcision at a hospital is largely influenced by culture - our culture.] It is performed routinely on boys from infancy to adolescence to initiate them into manhood. Although other South African ethnic groups practice the ritual, it is mostly associated with the Xhosa culture. According to the history of the Xhosa people, one has to be circumcised to be considered a "man".
Circumcision is performed by traditional "teachers" or "principals" who run the initiation school, often in the bush where boys spend two or more weeks undergoing all the rituals. However there have been reports that no anesthetic is used, therefore hygiene becomes crucial.
The leaders performing the procedure use "razors" or knives that are reportedly not sterilised and can be used to circumcise the entire group of initiates. [- greatly increasing the risk of HIV transmission.]
FONTE: www.circumstitions.com/news/news52.html#42
martedì 15 gennaio 2013
Bambino perde il pene a causa della circoncisione
Bambino turco perde il pene a causa della circoncisione
Pene del bambino tagliato durante festa per la circoncisione in Turchia, la famiglia chiede risarcimento di 2.000.000 TL
Anatolia News Agency
La famiglia di un bambino di 3 anni il cui pene è stato tagliato durante la rituale festa della circoncisione collettiva nella provincia sud-orientale di Batman, nella Regione dell'Anatolia Sud Orientale, ha richiesto 2.000.000 di lire turche come risarcimento da parte del Ministry of Health by applying to the Council of State .
The family of the boy sued the ministry in Batman's administrative court after the incident two years ago, with the local court awarding 600,000 Turkish Liras in damages.
However, not satisfied with this amount, the family is claiming that the boy may require further treatment, including treatment abroad. It is also claimed that the circumcision was not performed by a qualified doctor, but rather an unqualified member of hospital personnel.
Pene del bambino tagliato durante festa per la circoncisione in Turchia, la famiglia chiede risarcimento di 2.000.000 TL
Anatolia News Agency
La famiglia di un bambino di 3 anni il cui pene è stato tagliato durante la rituale festa della circoncisione collettiva nella provincia sud-orientale di Batman, nella Regione dell'Anatolia Sud Orientale, ha richiesto 2.000.000 di lire turche come risarcimento da parte del Ministry of Health by applying to the Council of State .
The family of the boy sued the ministry in Batman's administrative court after the incident two years ago, with the local court awarding 600,000 Turkish Liras in damages.
However, not satisfied with this amount, the family is claiming that the boy may require further treatment, including treatment abroad. It is also claimed that the circumcision was not performed by a qualified doctor, but rather an unqualified member of hospital personnel.
FONTE: www.circumstitions.com/news/news53.html#turkey-botch1
lunedì 14 gennaio 2013
Legge pro-circoncisione muore
January 2013
"Boxcutter circumcision" Bill dies
A bill that would have prohibited banning infant male circumcision in the United States, has died without being enacted.
In fact, H.R. 2400 (112th): Religious and Parental Rights Defense Act of 2011, would have allowed anyone, trained or not, to circumcise any male up to the age of 18, so long as one parent consented.
The bill was proposed by Rep. Brad Sherman (D-CA) in June 2012 and co-sponsored by nine others. It was referred to the Senate's Energy and Commerce Committee, but lapsed in the new year.
Govtrack US
"Boxcutter circumcision" Bill dies
A bill that would have prohibited banning infant male circumcision in the United States, has died without being enacted.
In fact, H.R. 2400 (112th): Religious and Parental Rights Defense Act of 2011, would have allowed anyone, trained or not, to circumcise any male up to the age of 18, so long as one parent consented.
The bill was proposed by Rep. Brad Sherman (D-CA) in June 2012 and co-sponsored by nine others. It was referred to the Senate's Energy and Commerce Committee, but lapsed in the new year.
Govtrack US
giovedì 10 gennaio 2013
martedì 1 gennaio 2013
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