Alcohol Use Behaviors Among Indigenous Migrants: A Transnational Study on Communities of Origin and Destination

The association between international and domestic migration and alcohol use among indigenous communities is poorly understood. We explored migration-related factors associated with alcohol use behaviors among an indigenous Mayan, binational population. From January to March 2012, 650 indigenous participants from the high-emigration town of Tunkás in the Mexican state of Yucatán (n = 650) residing in Mexico and California completed surveys. Multivariate logistic regression identified migration-related factors associated with alcohol use behaviors. US migration of shorter duration (<5 years) was independently associated with at-risk drinking (adjusted odds ratio (AOR) 2.34; 95 % confidence interval (CI) 1.09–5.03), as was longer-duration domestic migration (≥5 years) (AOR 2.34; 95 % CI 1.12–4.87). Ability to speak Maya (AOR 0.26; 95 % CI 0.13–0.48) was protective against at-risk drinking. Culturally appropriate alcohol use prevention interventions are needed for domestic and international indigenous Mexican migrants to address alcohol use behavior in the context of migration.     

Phase I/II study of dasatinib in combination with decitabine in patients with accelerated or blast phase chronic myeloid leukemia

Treatment of advanced-phase chronic myeloid leukemia (CML) remains unsatisfactory. Single-agent tyrosine kinase inhibitors have modest and short-lived activity in this setting. We conducted a phase I/II study to determine safety and efficacy of the combination of dasatinib and decitabine in patients with advanced CML. Two different dose schedules were investigated with a starting decitabine dose of either 10 mg/m² or 20 mg/m² daily for 10 days plus dasatinib 100 mg daily. The target dose level was decitabine 10 mg/m² or 20 mg/m² daily for 10 days plus dasatinib 140 mg daily. Thirty patients were enrolled, including seven with accelerated-phase CML, 19 with blast-phase CML, and four with Philadelphia-chromosome positive acute myeloid leukemia. No dose-limiting toxicity was observed at the starting dose level with either schedule. Grade ≥3 treatment emergent hematological adverse events were reported in 28 patients. Thirteen patients (48%) achieved a major hematologic response and six (22%) achieved a minor hematologic response, with 44% of these patients achieving a major cytogenetic response and 33% achieving a major molecular response. Median overall survival (OS) was 13.8 months, with significantly higher OS among patients who achieved a hematologic response compared to non-responders (not reached vs 4.65 months; P < .001). Decitabine plus dasatinib is a safe and active regimen in advanced CML. Further studies using this combination are warranted.     

Neuronal substrates and functional consequences of prenatal cannabis exposure

Cannabis remains one of the world’s most widely used substance of abuse amongst pregnant women. Trends of the last 50 years show an increase in popularity in child-bearing women together with a constant increase in cannabis potency. In addition, potent herbal “legal” highs containing synthetic cannabinoids that mimic the effects of cannabis with unknown pharmacological and toxicological effects have gained rapid popularity amongst young adults. Despite the surge in cannabis use during pregnancy, little is known about the neurobiological and psychological consequences in the exposed offspring. In this review, we emphasize the importance of maternal programming, defined as the intrauterine presentation of maternal stimuli to the foetus, in neurodevelopment. In particular, we focus on cannabis-mediated maternal adverse effects, resulting in direct central nervous system alteration or sensitization to late-onset chronic and neuropsychiatric disorders. We compare clinical and preclinical experimental studies on the effects of foetal cannabis exposure until early adulthood, to stress the importance of animal models that permit the fine control of environmental variables and allow the dissection of cannabis-mediated molecular cascades in the developing central nervous system. In sum, we conclude that preclinical experimental models confirm clinical studies and that cannabis exposure evokes significant molecular modifications to neurodevelopmental programs leading to neurophysiological and behavioural abnormalities.     

Prevalence of blood donation eligibility in Australia: A population survey

Background

Reliable estimates of the population proportion eligible to donate blood are needed by blood collection agencies to model the likely impact of changes in eligibility criteria and inform targeted population-level education, recruitment, and retention strategies. In Australia, the sole estimate was calculated 10+ years ago. With several subsequent changes to the eligibility criteria, an updated estimate is required.

Study Design and Methods

We conducted a cross-sectional national population survey to estimate eligibility for blood donation. Respondents were aged 18+ and resident in Australia. Results were weighted to obtain a representative sample of the population.

Results

Estimated population prevalence of blood donation eligibility for those aged 18–74 was 57.3% (95% CI 55.3–59.3). The remaining 42.7% (95% CI 40.7–44.7) were either temporarily (25.3%, 95% CI 23.5–27.2) or permanently ineligible (17.4%, 95% CI 16.1–18.9). Of those eligible at the time of the survey, that is, with the UK geographic deferral for variant Creutzfeldt-Jakob disease included, (52.9%, 95% CI 50.8–54.9), 14.2% (95% CI 12.3–16.3) reported donating blood within the previous 2 years. Eligibility was higher among men (62.6%, 95% CI 59.6–65.6) than women (52.8%, 95% CI 50.1–55.6). The most common exclusion factor was iron deficiency/anemia within the last 6 months; 3.8% (95% CI 3.2–4.6) of the sample were ineligible due to this factor alone.

Discussion

We estimate that approximately 10.5 million people (57.3% of 18–74-year-olds) are eligible to donate blood in Australia. Only 14.2% of those eligible at the time of survey reported donating blood within the previous 2 years, indicating a large untapped pool of potentially eligible blood donors.     

O Papel dos Níveis Séricos de ANP na Perda de Peso,Risco Cardiometabólico e Composição Corporal de Adolescentes com Obesidade Submetidos a Terapia Interdisciplinar

BackgroundThe action of atrial natriuretic peptide (ANP) on natriuresis, diuresis and vasodilatation, insulin resistance, liver, kidney, and adipose tissue may contribute to the healthy metabolic and cardiovascular development. Even though the circulating level of ANP is reduced in patients with obesity, its response to weight loss remains poorly explored in pediatric populations.ObjectiveTo evaluate the effects of ANP variations in response to interdisciplinary weight loss intervention on metabolic syndrome (MetS) and cardiometabolic risks in adolescents with obesity.Methods73 adolescents with obesity attended a 20-week clinical interdisciplinary weight loss therapy including clinical, nutritional, psychological and exercise training approach. Body composition, biochemical analyses and blood pressure were evaluated. MetS was classified according to the International Diabetes Federation (IDF) (2007). After the treatment, volunteers were divided according to Increasing (n=31) or Decreasing (n=19) ANP plasma levels.ResultsBoth groups present significant reduction of body weight, Body Mass Index (BMI), waist, neck and hip circumferences (WC, NC and HC, respectively) and increasing fat-free mass (FFM). Interestingly, a significant reduction in body fat, TG/HDL-c ratio and MetS prevalence (from 23% to 6%) was observed in the Increased ANP group only.ConclusionThis study suggests that an increase in ANP serum levels after weight loss therapy could be associated with improvements in cardiometabolic risks and the reduced prevalence of MetS in adolescents with obesity.     

Urinary catheter stent placement for treatment of cervical stenosis

BACKGROUND: Cervical stenosis is an uncommon condition that may result in significant distress in premenopausal women. Those affected may present with amenorrhoea and associated cyclical, monthly pain, infertility and haematotrachelos/haematometra. AIM: To describe a safe, easy and effective treatment method for cervical stenosis. Methods: The cervical canal is identified and dilated under ultrasound guidance. A urinary catheter stent is then placed in the cervical canal for two weeks. RESULTS: Of the five patients who underwent treatment for cervical stenosis, all had normal menstrual cycles restored. Four of these patients successfully became pregnant after treatment. Three of the four patients progressed to uncomplicated births at term (gestation). The fourth patient underwent a termination of pregnancy in the second trimester for a fetal abnormality. CONCLUSIONS: Cervical dilatation under ultrasound guidance with temporary urinary catheter stent placement appears to be both effective and safe in the treatment of cervical stenosis. Pregnancy outcomes after treatment were optimal in our case series.     

Modern trends in ovulation induction

Patients with anovulatory infertility, who received treatment at one unit over a four year period, were assessed to determine the pregnancy rate and the incidence of complications while undergoing ovulation induction with gonadotropins. The patients in this group who had further in vitro fertilization (IVF) treatment were followed up, and the outcome in IVF cycles was assessed. Data from a total of 75 patients, who had completed 91 episodes of treatment involving 273 cycles of ovulation induction over a 4-year period in a University-affiliated teaching hospital, was analysed retrospectively. The cumulative pregnancy rate was 34% after three ovulation induction cycles, and was 46% overall. The clinical pregnancy rate per cycle was 15.4%, and per ovulatory cycle was 21%. The multiple pregnancy rate was 12%, and there were no cases of ovarian hyperstimulation syndrome (OHSS). In this group of patients undergoing ovulation induction, the multiple pregnancy rate was 12% and there were no cases of ovarian hyperstimulation syndrome (OHSS). The multiple pregnancy rate was 17%. Our result indicate that anovulatory patients benefit from ovulation induction with gonadotropins prior to IVF treatment.