A tobacco quit and win model in the Stockholm cancer prevention programme.

The main objective of the Stockholm Cancer Prevention Programme (SCPP) is to reduce cancer incidence and mortality among the 1.6 million inhabitants in Stockholm county by reducing risk factors particularly related to lifestyle. The objective of the SCPP's tobacco action programme is to reduce the number of adult daily users of tobacco (including oral snuff) to 20% by the year 2000. In 1988, a nationwide Quit and Win contest was conceived as part of this long-term programme. The contest recruited nearly 13,000 participants or 0.6% of the daily tobacco users in Sweden over the age of 16 years. More than 60% of the participants were recruited from Stockholm county. This corresponds to 1.9% of the daily tobacco users in Stockholm county compared with 0.3% in the rest of Sweden. The pharmacies and the public health services organizations were the principal distributors of contest entry forms. Sixty-two percent of the men and 59% of the women were tobacco free one month after the contest, and after 6 months the corresponding figures were 30 and 25%, respectively.     

Milgram and Tuskegee—Paradigm Research Projects in Bioethics

This paper discusses the use of the Milgram obedience experiments and the Tuskegee syphilis study in the bioethical literature. The two studies are presented and a variety of uses of them identified and discussed. It is argued that the use of these studies as paradigms of problematic research relies on a reduction of their complexity. What is discussed is thus often constructions of these studies that are closer to hypothetical examples than to the real studies.     

Influence of sterilization, drying and oat bran enrichment of pasta on glucose and insulin responses in healthy subjects and on the rate and extent of in vitro starch digestion.

The effects of sterilization and oat bran enrichment of pasta on the glucose and insulin responses in healthy subjects were evaluated. Cooked and canned spaghetti and cooked fettucini without and with enrichment with oat bran (28%) were compared. Further, the effects of various low- and high-temperature drying conditions for spaghetti, cooking time and sterilization on the starch digestion rate and content of enzyme-resistant starch (RS) in vitro were also studied. Various cooking quality data were also determined to allow interpretation of results. The incremental glucose area (0-120 min) produced by canned spaghetti was twice the area of that produced by cooked spaghetti (69.03 vs 35.45 mmol/l x min, P less than 0.01). The incremental insulin area (0-120 min) was also significantly higher with canned spaghetti (17,500 vs 12,600 pmol/l x min, P less than 0.05). The rapid digestion was caused by excessive swelling of starch during sterilization that promoted a very soft texture of the spaghetti. Enrichment of fettucini with oat bran reduced slightly the incremental insulin area (15,600 vs 20,100 pmol/l x min, P less than 0.05, for 0-120 min), but did not significantly reduce the glucose area. Drying conditions and cooking times could be varied within broad limits without affecting the rate of starch digestion in vitro of cooked spaghetti. In sterilized spaghetti the content of resistant starch was higher than that found in cooked 'al dente' spaghetti (2.2-3.4 vs 0.5 mg/100 mg total starch). In conclusion, sterilization influences the nutritional properties of starch in pasta by substantially increasing the glucose and insulin responses and by formation of resistant starch. The effect of oatbran environment is restricted mainly to a slight decrease in the insulin response.     

Effects of methylphenidate and behavior modification on the social and academic behavior of children with disruptive behavior disorders: the moderating role of callous/unemotional traits.

This study examined whether response to behavior modification with and without methylphenidate differed for children with attention-deficit/hyperactivity disorder (ADHD) and conduct problems (CP) depending on the presence of callous/unemotional (CU) traits. Participants were 37 children ages 7 to 12, including 19 with ADHD/CP-only and 18 with ADHD/CP-CU, referred to a university-based summer treatment program. Results showed that ADHD/CP-CU children had worse behavior in the behavior-therapy-only (BT-only) condition, especially on measures of CP, noncompliance, and rule violations, but these differences largely disappeared when medication was added to BT. Children with ADHD/CP-CU were also less likely to be normalized by treatment than were children with ADHD/CP-only. These findings, though tentative, suggest that children with ADHD/CP-CU may not show a sufficient positive response to BT alone and that the combination of medication and BT may be especially important for them.     

Is there an association between periodontal condition and HIV infection?

Abstract Individuals in Tanzania who have limited access to medical and dental treatment provide an opportunity to study the natural association between periodontal condition and HIV infection and the stage of infection. 119 HIV infected adult individuals and 73 individuals with AIDS from the AIDS Clinical Trial Clinic at Muhimbili Medical Centre (MMC) in DaresSalaam participated as cases. Mean age was 35.3 and 35.1 years, respectively. 156 individuals with a mean age of 28.3 years, confirmed as HIV seronegative, served as controls. There were no significant differences in bleeding on probing, pocket formation or attachment loss among the HIV seronegative individuals. HIV seropositive and AIDS patients. We applied multiple logistic regression to calculate odds ratios for presence of periodontal conditions adjusting for age, gender and DMFT. Our odds ratios did not reveal any significant associations between bleeding on probing, pocket formation or attachment loss with regard to lymphocyte and CD4+ T cell counts among the HIV infected individuals and AIDS patients. When associations were investigated with regard to HIV serostatus (HIV seronegative. HIV seropositive or AIDS), our adjusted odds ratios were insignificant, too. In fact, most odds ratios were close to 1. Thus, our study supports recent views that the presence, extent and severity of periodontal disease among HIV infected individuals, may be less that hitherto thought.     

Granulocyte-macrophage colony stimulating factor inhibits class II major histocompatibility complex expression and antigen presentation by microglia

Granulocyte-macrophage colony stimulating factor (GM-CSF) modulates various functions of monocytes/ macrophages including antigen-presenting capacity. Recently it was found that astrocytes produce GM-CSF in the central nervous system (CNS) and that GM-CSF can induce proliferation and morphological changes of microglia. Here we show that GM-CSF can down regulate the interferon-γ-mediated induction of major histocompatibility complex (MHC) class II antigens in microglia, but not in astrocytes. GM-CSF pretreatment completely prevents myelin basic protein-specific T cell proliferation induced by microglia but not astrocytes. GM-CSF did not affect the cell surface expression on microglia of either MHC class I or cell adhesion molecules. The inhibition of microglial MHC class II expression and antigen-presenting function is specific for GM-CSF, as treatment with a different CSF (interleukin-3) did not modulate microglial phenotype or functional capacity. These data suggest that GM-CSF might be involved in the regulation of immune responses within the central nervous system.     

Effect of intravenous ketanserin on the human action potential duration at fixed heart rate

Summary In this study any changes in action potential duration or Q-T interval due to acute doses of ketanserin were monitored. The effect of a bolus dose (10 or 20 mg) followed by an infusion (10 or 20 mg over 20 minutes) of ketanserin on the Q-T interval and action potential duration was studied in six patients undergoing routine cardiac catheterization. Action potential duration was measured with a silver-silver chloride electrode catheter while heart rate was kept constant by atrial pacing and reflex effects avoided by -adrenergic blockade. There were some prolongations of the action potential duration but they were not in excess of 40 msec and did not reach statistical significance (control 263±46.0 msec; bolus 269±52.1 msec; infusion 262±53.6 msec; nor were there any significant changes in Q-T interval. Thus acute intravenous doses of ketanserin, in the absence of hypokalaemia or other Q-T interval-prolonging drugs, have no consistent effect on Q-T interval or action potential duration; prolongation of the action potential, when it occurs, is small.     

Brief report: Does fenfluramine treatment enhance the cognitive and communicative functioning of autistic children?

This project was supported by two separate research grants from the Trust Fund Board, Washington Association for Retarded Citizens to Richard Neel and Truman E. Coggins. The research was also supported by a training grant to the University of Washington entitled Comprehensive Training in Mental Retardation and Other Handicapping Conditions (MCH-000913, Clifford J. Sells, M.D., Principal investigator); and, a training grant to the University of Arizona entitled Doctoral and Post-Doctoral Leadership Training and Clinical Research, Teaching and Administration: Clinical Language Research Center (G008630088, Linda Swisher, Ph.D., principal investigator). We are indeed grateful to the parents of our five subjects for their patience, understanding, and commitment. Finally, we express our appreciation to Arelene Chaussee for her technical expertise and untiring spirit.