Lack of recent condom use among detained adolescent males: a multilevel investigation

OBJECTIVE: To investigate multiple levels of influence with respect to the lack of recent condom use among a high risk sample of adolescent males recruited from short term detention facilities. METHODS: A cross sectional survey of 231 adolescent males serving, predominantly, short term detention sentences. Assessments were conducted using audiocomputer assisted self interviewing. Condom use during the most recent sexual event was assessed as well as 20 potential correlates of not using condoms. Correlates were assessed within five levels of causation: personal, relational, peer affiliation, family, and societal. RESULTS: Nine correlates achieved bivariate significance (p<0.05). Of these, the personal level correlates were particularly important in a multivariate model. The motivation subscale from the Condom Barriers Scale was the strongest multivariate correlate of recent condom use. Adolescents scoring below the median were about 3.4 times more likely to report lack of recent condom use (p=0.0006). Adolescents indicating they had ever caused a pregnancy were about 2.5 times more likely to report lack of condom use (p=0.02). Finally, those reporting their peers did not use condoms were about twice as likely to report lack of use (p=0.048). CONCLUSION: Upon investigating multiple levels of potential influence on condom use, the multivariate findings suggest that personal level factors may be the most important determinant of non-use among adolescent males in short term detention facilities. Although structural changes may be needed to influence some forms of safer sex behaviour, direct intervention with adolescent males may be justified to favourably alter determinants of condom use.     

PKC-interacting proteins: from function to pharmacology

Protein kinase C (PKC) is a ubiquitously expressed family of kinases that have key roles in regulating multiple cellular activities. The activity of this family is controlled tightly by several molecular mechanisms, including interaction with binding-partner proteins. These PKC-interacting proteins (C-KIPs) confer specificity for individual PKC isoforms by regulating the activity and cellular localization of PKC isoforms and, subsequently, the ability of these isoforms to specifically regulate cellular functional events. Although many C-KIPs have been identified by genome and proteome-mining approaches, it is important to address the specificity and function of the interactions in greater detail because they might form novel drug targets. In this article, we review recent work on C-KIPs and the implications for pharmacological and therapeutic development.     

Does pregnancy affect outcome of methadone maintenance treatment?

Studies of pregnant women receiving methadone maintenance have tended to focus on teratogenic, prenatal, and neonatal issues. We are not aware of any controlled studies comparing pregnant to non-pregnant heroin-addicted women in methadone treatment. This article presents findings from a study examining treatment outcome between pregnant and non-pregnant participants in a metropolitan methadone-maintenance program. Participants were 51 pregnant women and 51 non-pregnant women enrolled in a methadone maintenance program between 1994 and 2003. Groups were compared on demographic characteristics, psychiatric comorbidity, urinalysis results and retention rates. Groups were comparable in terms of most demographic characteristics and severity of addiction at intake. Groups did not differ significantly in terms of urinalysis results or retention rates. While most women reduced their drug use, a majority of both groups continued to use illicit drugs at least occasionally. Psychiatric comorbidity was significantly different with the non-pregnant group being more psychiatrically disordered. Clinical implications are discussed.     

Social determinants of tuberculosis case rates in the United States

BACKGROUND: Social capital has been related to a number of important public health variables such as overall mortality, health status, and sexually transmitted infections (including AIDS case rates). However, the relationship of social capital to tuberculosis has received little attention. Because social capital may be related to the constructs of poverty and income inequality, any exploration of the correlation between social capital and tuberculosis should include examination of the interrelationships with poverty and income inequality as well. OBJECTIVE: This study examined the state-level relationship between social capital, poverty, income inequality, and tuberculosis case rates. METHODS: The design was state-level, correlational analysis (including bivariate linear correlational analysis, and multivariate linear stepwise regression analysis). Main outcome measures were 1999 state-level case rates of tuberculosis. RESULTS: In bivariate analyses, poverty, income inequality, and social capital were all significantly correlated with tuberculosis case rates. In stepwise multiple regression analyses predicting tuberculosis case rates from this set of three predictor variables, social capital and income inequality entered the regression equation (with social capital being the strongest predictor variable). CONCLUSIONS: These results suggest that social capital is highly predictive of tuberculosis at the state level. The results indicate the need for further research into this potentially causal relationship, including the examination of structural interventions designed to increase social capital.     

Toxicogenomics, drug discovery, and the pathologist

The field of toxicogenomics, which currently focuses on the application of large-scale differential gene expression (DGE) data to toxicology, is starting to influence drug discovery and development in the pharmaceutical industry. Toxicological pathologists, who play key roles in the development of therapeutic agents, have much to contribute to DGE studies, especially in the experimental design and interpretation phases. The intelligent application of DGE to drug discovery can reveal the potential for both desired (therapeutic) and undesired (toxic) responses. The pathologist's understanding of anatomic, physiologic, biochemical, immune, and other underlying factors that drive mechanisms of tissue responses to noxious agents turns a bewildering array of gene expression data into focused research programs. The latter process is critical for the successful application of DGE to toxicology. Pattern recognition is a useful first step, but mechanistically based DGE interpretation is where the long-term future of these new technologies lies. Pathologists trained to carry out such interpretations will become important members of the research teams needed to successfully apply these technologies to drug discovery and safety assessment. As a pathologist using DGE, you will need to learn to read DGE data in the same way you learned to read glass slides, patiently and with a desire to learn and, later, to teach. In return, you will gain a greater depth of understanding of cell and tissue function, both in health and disease.     

Psychopathology and sexual trauma in childhood and adulthood

This study evaluates the occurrence of psychopathology among 97 women who (1) experienced sexual abuse in childhood only, (2) were raped in adulthood only, (3) experienced both childhood sexual abuse and rape in adulthood, or (4) experienced no sexual trauma. Women were recruited from advertisements and assessed using the Structured Clinical Interview for DSM-IV (SCID-I/P) and the Modified PTSD Symptom Scale Self-Report. Women who reported sexual trauma were significantly more likely to exhibit psychopathology than controls. Being sexually victimized in childhood and raped in adulthood was associated with a particular risk for substance dependence.     

Randomized,placebo-controlled,double blind,crossover design trial of the efficacy and safety of Zestra for Women in women with and without female sexual arousal disorder

Zestra for Women is a botanical feminine massage oil formulated to enhance female sexual pleasure and arousal when applied to the vulva. We conducted this randomized, double-blinded, crossover study to evaluate the efficacy and safety of Zestra for Women compared to placebo oil in 10 women with and 10 women without female sexual arousal disorder (FSAD) in conditions of home use in conjunction with sexual activities. Subjects were screened by physical examination, sex therapist interviews, and questionnaires. We randomized qualified subjects to treatment paths and gave them 5 doses of test article and diaries to use at home. At Visit 2, we assessed them by questionnaires and gave them 5 doses of crossover test article and diaries to use at home. At the final visit, we assessed them with questionnaires. We assessed safety by adverse event reports and primary efficacy by responses to a diary question regarding satisfaction with arousal. Secondary efficacy instruments included remaining diary questions, recall-based questionnaires, global assessment questions, and a consumer-testing questionnaire. All 20 subjects completed the study. Three subjects reported single incidences of mild genital burning sensations lasting 5-30 min after use of Zestra for Women. Both normal and FSAD women showed statistically significant improvements, relative to placebo, in level of arousal, level of desire, satisfaction with arousal, genital sensation, ability to have orgasms, and sexual pleasure. Although FSAD women showed greater magnitude of response, the presence of FSAD had no effect on response rates. Zestra for Women was just as effective in women using selective serotonin reuptake inhibitor antidepressants as in women not using antidepressants. Zestra for Women improved sexual function in normal and FSAD women under conditions of home use.     

The memory effects of general anesthesia persist for weeks in young and aged rats

Studies demonstrate lasting cognitive impairment in elderly persons after anesthesia and surgery. We tested the hypothesis that general anesthesia contributes to this cognitive impairment. Six- and 18-mo-old Fischer 344 rats were trained in a 12-arm radial arm maze and were then randomized to anesthesia for 2 h with 1.2% isoflurane/70% nitrous oxide/30% oxygen or a control treatment consisting of 30% oxygen. Rats recovered for 24 h and then were tested daily on the radial arm maze for 8 wk. Performance of young control rats was stable throughout the experiment. In contrast, aged control rats improved their performance as measured by time to complete the maze but not by error rate. After anesthesia, time to complete the maze did not change in young rats, but error rate decreased (P < 0.05 at 1 and 3 wk), indicating improved performance. In contrast, previously anesthetized aged rats failed to improve with repeated testing and took longer to complete the maze than aged control rats (P < 0.05 at 1 and 3 wk). These data demonstrate that general anesthesia with isoflurane and nitrous oxide improves the memory performance on an established spatial memory task in young rats, but in aged rats it attenuates the improvement in performance that otherwise occurs with repeated testing. Therefore, isoflurane and nitrous oxide anesthesia produces a sustained learning impairment in aged rats. IMPLICATIONS: This study demonstrates that general anesthesia with isoflurane and nitrous oxide improves spatial memory in young rats but impairs it in aged rats for at least 3 wk, indicating that it can influence memory for much longer than previously recognized and may adversely affect memory processes in the aged.