The epidemiology of alcohol, tobacco and other drug use among black youth

OBJECTIVE: Although there is a growing literature on racial/ethnic differences in alcohol, tobacco and other drug use among adolescents, relatively little is known about the social epidemiology of drug use within the black youth population. The purpose of this article is to address this knowledge gap. METHOD: Data from the Monitoring the Future Project are used to examine empirically the prevalence, trends and sociodemographic correlates of drug use among nationally representative samples of black eighth, tenth and twelfth graders (approximate N = 25,000). RESULTS: Alcohol is the drug most widely used by black youth, followed by tobacco and marijuana. By twelfth grade, seven in 10 black secondary students have used alcohol, less than 50% have smoked cigarettes, 25% have used marijuana and less than 2% have used cocaine. Trend data indicate that, although alcohol use has been relatively stable over time, cigarette and marijuana use are increasing. Gender and family structure are significant sociodemographic correlates of drug use, with use being, on average, higher among males than females, and higher among students who do not live with either of their parents than among those who live with at least one of their parents. The relationships between drug use and socioeconomic status, urbanicity and region vary depending on students' grade level and the specific drug in question. CONCLUSIONS: These findings provide an important empirical baseline for future research on the epidemiology and etiology of drug use among young black people.     

Methylation-associated silencing of the tissue inhibitor of metalloproteinase-3 gene suggest a suppressor role in kidney, brain, and other human cancers

Tissue inhibitor of metalloproteinase-3 (TIMP-3) antagonizes matrix metalloproteinase activity and can suppress tumor growth, angiogenesis, invasion, and metastasis. Loss of TIMP-3 has been related to the acquisition of tumorigenesis. Herein, we show that TIMP-3 is silenced in association with aberrant promoter-region methylation in cell lines derived from human cancers. TIMP-3 expression was restored after 5-aza-2'deoxycytidine-mediated demethylation of the TIMP-3 proximal promoter region. Genomic bisulfite sequencing revealed that TIMP-3 silencing was related to the overall density of methylation and that discrete regions within the TIMP-3 CpG island may be important for the silencing of this gene. Aberrant methylation of TIMP-3 occurred in primary cancers of the kidney, brain, colon, breast, and lung, but not in any of 41 normal tissue samples. The most frequent TIMP-3 methylation was found in renal cancers, which originate in the tissue that normally expresses the highest TIMP-3 levels. This methylation correlated with a lack of detectable TIMP-3 protein in these tumors. Together, these data show that methylation-associated inactivation of TIMP-3 is frequent in many human tumors.     

BETA-2-MICROGLOBULIN LEVELS IN HUMAN-IMMUNODEFICIENCY VIRUS INFECTED SUBJECTS

We studied beta-2 microglobulin (β-2M) levels in 44 HIV infected subjects belonging to 3 clinical stages as well as in 25 healthy controls. The method used was a competition enzyme immunoassay. In this study, levels of β2-M were measured in two groups of HIV infected individuals, the asymptomatic and those with progressive and advanced disease, in order to affirm its role as a surrogate prognostic marker. It was found that mean β-2M levels were 1.28 mg/L in the controls (normal range 0-2.4 mg/L), 11.41 mg/L in the HIV infected subjects, 2.69 mg/L in the asymptomatic HIV infected, 12.14 mg/L in those with persistent generalized lymphadenopathy (PGL) and 39.29 mg/L in the patients with acquired immunodeficiency syndrome. It was concluded that β-2M levels were significantly higher in the HIV infected as compared to the controls. Further, the levels were much higher in the HIV infected with progressive diseasc/PGL and highest in those who had developed AIDS. β-2M is an important surrogate serological marker useful in prognostication of disease process in the HIV infected. Advantages of measuring β-2M levels over p24 antigen detection and CD4 counts were highlighted.KEYWORDS: HIV infected, Beta-2 Microglobulin, Progressive HIV disease, AIDS     

PHC in Bangladesh—Too much to ask?

In Bangladesh where the number of those without land is increasing; 30% of the budget (national) goes for "maintaining law and order'; there is massive illiteracy; the common people and more specifically, women, are not involved in decision-making. It is unrealistic to think that PHC has a chance to survive or succeed. Should Government (with all good intentions) try to run a PHC while socio-economic and political factors remain unchanged, it (PHC) will not succeed. Its fate is either a collision, in which PHC will be the victim, or a compromise of some type. In most Third World countries, it is a compromised PHC that one sees. In spite of this, we still believe that community-oriented health care can help to bring about social, economic and political changes, provided such changes are accompanied by structural reform in the political economy of the country.     

A framework for cumulative risk assessment in the 21st century

The ILSI Health and Environmental Sciences Institute (HESI) has developed a framework to support a transition in the way in which information for chemical risk assessment is obtained and used (RISK21). The approach is based on detailed problem formulation, where exposure drives the data acquisition process in order to enable informed decision-making on human health safety as soon as sufficient evidence is available. Information is evaluated in a transparent and consistent way with the aim of optimizing available resources. In the context of risk assessment, cumulative risk assessment (CRA) poses additional problems and questions that can be addressed using the RISK21 approach. The focus in CRA to date has generally been on chemicals that have common mechanisms of action. Recently, concern has also been expressed about chemicals acting on multiple pathways that lead to a common health outcome, and non-chemical other conditions (non-chemical stressors) that can lead to or modify a common outcome. Acknowledging that CRAs, as described above, are more conceptually, methodologically and computationally complex than traditional single-stressor risk assessments, RISK21 further developed the framework for implementation of workable processes and procedures for conducting assessments of combined effects from exposure to multiple chemicals and non-chemical stressors. As part of the problem formulation process, this evidence-based framework allows the identification of the circumstances in which it is appropriate to conduct a CRA for a group of compounds. A tiered approach is then proposed, where additional chemical stressors and/or non-chemical modulating factors (ModFs) are considered sequentially. Criteria are provided to facilitate the decision on whether or not to include ModFs in the formal quantitative assessment, with the intention to help focus the use of available resources to have the greatest potential to protect public health.     

Computerized axial tomography in neurologic disorders of children.

Computerized axial tomography offers major advantages over air encephalography and angiography for studies of neurologic disorders in children. The low morbidity and the ease of the procedure permit the accurate diagnosis of intracranial pathology in situations where more invasive procedures would not be undertaken. The techniques of the procedure and its uses and limitations are emphasized in a number of neurologic problems of children.     

Towards the validation of aural acoustic immittance measures for diagnosis of middle ear effusion in children.

Acoustic admittance testing was done on the ears of two groups of children. The first group was comprised of children undergoing myringotomy and tube surgery for treatment of chronic or recurrent otitis media, and the second group was comprised of hospital outpatients who were unscreened with respect to a history of middle ear disease and who were more representative of children in the general population. The admittance measures were then analyzed with respect to middle ear status (effusion versus no effusion) as determined by the surgeon (surgery group) and by validated otoscopy (outpatient group). Based on the data from the surgery group, the best admittance criteria for the identification of middle ear effusion were determined and then tested with respect to the data from subjects in the outpatient group. Sensitivity and specificity of several different criteria were similar. The role of prevalence of disease and the value of admittance measures such as gradient and acoustic reflex are discussed in the context of diagnostic testing in clinical or research protocols as well as in the context of immittance screening programs.     

A mutation in guanylate cyclase activator 1A (GUCA1A) in an autosomal dominant cone dystrophy pedigree mapping to a new locus on chromosome 6p21.1

We report a mutation (Y99C) in guanylate cyclase activator 1A (GUCA1A), the gene for guanylate cyclase activating protein (GCAP1), in a family with autosomal dominant cone dystrophy. Linkage analysis excluded all the known cone and cone-rod dystrophy loci, except the chromosome 6p21.1 region. This is known to contain the RDS gene, which is associated with dominant cone-rod dystrophy. Screening of the RDS gene by heteroduplex analysis and direct sequencing failed to demonstrate sequence changes in the coding region of this gene. The gene for GCAP1, a calcium binding protein which is highly expressed in photoreceptor outer segments, is also located in 6p21.1. It was screened for mutations, and all affected individuals showed a single base pair missense mutation (A-->G) at codon 99 in exon 2 of this gene generating a tyrosine-to-cysteine change in the GCAP1 protein. This change was absent from 206 unrelated normal controls. We propose that this change would at least disrupt the EF3handof GCAP1 thereby preventing calcium binding and consequently interfere with activation. The resulting effect on cGMP production would predictably modify the number of open cGMP gated cation channels, and could explain the ultimate demise of cone photoreceptor cells.      

The Principle of Immunopotentiation in Treatment of Rheumatoid Arthritis: Effect of Transfer Factor

Three patients (aged 3 to 7 years) suffering from active juvenile rheumatoid arthritis, with pronounced general illness, synovitis in multiple joints, and, two of them, typical fluctuating high fever, were treated with dialyzable transfer factor. During the treatment period, varying from 3 to 5 months, the patients received from 5 to 10 injections of transfer factor, each dose corresponding to the biological material obtained from 400 to 450 ml of normal blood. There was a marked improvement of the general condition, most pronounced in the two patients with the most severe disease, in whom the temperature was normalized. Joint functions also improved. There were changes in cell-mediated immunity, with conversion of previously negative responses to antigens in delayed hypersensitivity in vivo and lymphocyte transformation in vitro. Lymphocyte transformation with unspecific mitogens and allogeneic lymphocytes, the proportions in peripheral blood of B and T lymphocytes, as well as Fc receptor-bearing lymphocytes were normal and remained so during the observation period.     

A locus for autosomal dominant posterior polar cataract on chromosome 1p

Autosomal dominant congenital cataract is a clinically and genetically heterogeneous lens disease. Here we report the linkage of a locus for autosomal dominant posterior polar cataract (CPP) to the distal short arm of chromosome 1. To map the CPP locus we performed molecular genetic linkage analysis using microsatellite markers in a three- generation pedigree. After exclusion of 13 known loci and candidate lens genes for autosomal dominant cataract, we obtained significantly positive LOD scores for markers D1S508 (Z = 3.14, theta = 0) and D1S468 (Z = 2.71, theta = 0). Multipoint analysis gave a maximum LOD score of 3.48 (theta = 0.07) between markers D1S508 and D1S468. From haplotype data, however, CPP probably lies in the telomeric interval D1S2845- 1pter, which includes the locus for the clinically distinct Volkman congenital cataract (CCV). This study provides the first evidence for genetic heterogeneity of autosomal dominant posterior polar cataract for which a locus had been linked previously to chromosome 16q.