Unraveling women's perceptions of risk for breast cancer

Inconsistent reports of the prevalence of risk perception accuracy may be related to the use of different classification strategies. The purpose of this study was to compare two approaches for assessing the accuracy of women's breast cancer risk perceptions. A telephone survey was conducted with an age-stratified random sample of British Columbian women 20-79 years of age without a breast cancer diagnosis (n = 761). A comparison of two methods employed to determine perception accuracy revealed substantial differences between the methods with regard to the classification of women as under- and over-estimators. The study highlights the need for researchers to consider the method used to determine the accuracy of risk perceptions and the implications of using different strategies to assess risk perception accuracy when such information is used in research or to guide interventions.     

Bioelectrical impedance vs air displacement plethysmography and dual-energy X-ray absorptiometry to determine body composition in patients with end-stage renal disease

BACKGROUND: Patients with end-stage renal disease (ESRD) have significant shifts in fluid homeostasis that may impair measurements of body composition using methods based upon determinations of body water. Estimates of body water are fundamental for bioelectrical impedance analysis (BIA), which measures electrical resistance to estimate total body water and body composition. METHODS: BIA was compared with 2 other techniques: (1) air displacement plethysmography (ADP), which relies on measurements of body density to estimate body fat and fat-free masses; and (2) dual-energy x-ray absorptiometry (DXA), which depends on the relative attenuation of an x-ray beam to produce images of body fat and bone mineral. In study 1, BIA and ADP were performed on 38 ESRD patients (21 men and 17 women; age 51.3 +/- 2.2 years; weight 79.8 +/- 2.9 kg; body mass index [BMI] 27.4 +/- 0.9 kg/m2). In study 2, BIA and DXA were performed on 47 patients (22 men and 25 women; age 52.7 +/- 2.3 years; weight 73.6 +/- 2.9 kg; BMI 25.9 +/- 1.0 kg/m2). RESULTS: The ranges of percent body fat using BIA in studies 1 and 2 were from 7% to 57% and from 6% to 52%, respectively. Percent body fat measurements were significantly (p < .0001) correlated for BIA vs ADP (r = .74) and for BIA vs DXA (r = .84). Mean body fat as determined by BIA and ADP in study 1 was 31.8 +/- 2.0% and 36.3 +/- 1.8%* and by BIA and DXA in study 2 was 29.6 +/- 1.5% and 31.8 +/- 1.8%*, respectively (*p < .05 vs BIA). All 3 methods had similar variability associated with their measurements (coefficients of variation approximately 5%). The average body fat measured by BIA was less than ADP or DXA, regardless of gender or race. Furthermore, the variation was not greater at lower or higher body fat values. CONCLUSIONS: Body fat measurements using ADP and DXA were correlated with those using BIA across a relatively wide range of body fat levels in adults with ESRD. However, BIA appeared to underestimate body fat and overestimate fat-free mass, possibly because of increased measurements of body water. Because ADP is convenient and does not use body water content in determination of body density and body composition, it has very good potential as a relatively new technique to estimate percent body fat in adults with ESRD.     

Hospital response to chemical terrorism: personal protective equipment, training, and operations planning

BACKGROUND: Hospitals distant from the immediate site of an incident involving a hazardous materials (HAZMATs) release which could include chemical warfare agents, must develop emergency response plans (ERPs) to protect healthcare professionals if they receive potentially contaminated victims. The ERP must address OSHA, EPA, and JCAHO requirements. METHODS: The VHA convened groups to develop a hazard and exposure assessment, identify actions for compliance with existing regulatory standards, and review site and operational planning issues. Exposure modeling results were used to derive relationships between operational parameters (time and distance from sites/sources) and potential exposure for healthcare workers. RESULTS: According to exposure modeling, level C personal protective equipment is adequate to protect hospital staff distant from the chemical release site. Decontamination runoff and contaminated clothing should also be controlled to limit exposure. CONCLUSIONS: Development and coordination of ERPs must include the local emergency planning committee, with clear assignment of tasks, locations, and training in order to prevent exposures to healthcare workers.     

Stress and immune responses of nestling tree swallows (Tachycineta bicolor) and eastern bluebirds (Sialia sialis) exposed to nonpersistent pesticides and p,p'-dichlorodiphenyldichloroethylene in apple orchards of southern Ontario, Canada

To determine the relative effects of pesticides in current use and persistent residues of p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), we examined endocrine and immune responses in tree swallow (Tachycineta bicolor) and eastern bluebird (Sialia sialis) chicks from pesticide-sprayed apple orchards and reference sites in southern Ontario, Canada, during 2000 to 2001. Nests were exposed to as many as seven individual pesticide applications and up to five mixtures of pesticides during the egg-incubation and chick-rearing stage. Eggs collected from sprayed orchards contained higher p,p'-DDE concentrations than eggs from reference sites. In 16-d-old tree swallows, no significant differences were found in body mass, basal corticosterone concentration, or the corticosterone stress response following a 10-min restraint of chicks sampled from sprayed orchards and reference sites. Challenge with adrenocorticotrophic hormone (ACTH), however, produced a higher level of corticosterone secretion in tree swallow chicks from sprayed orchards relative to chicks from reference sites. Multiple regression analysis revealed no correlation between corticosterone concentrations and exposure to pesticide sprays or p,p'-DDE in tree swallow chicks. In contrast, bluebird chicks from sprayed orchards were less responsive to challenge with ACTH and a significant negative association was found between the response to ACTH challenge and p,p'-DDE concentration in eggs. The phytohemagglutinin (PHA)-induced cutaneous basophil hypersensitivity response was similar between exposure groups in both tree swallow and bluebird nestlings. Examination of immune organs revealed that tree swallow chicks from sprayed orchards had significantly greater thymic lymphocyte density and cortical/ medullary ratios and significant splenic B-cell hyperplasia relative to reference chicks. Our results indicate that modulation in the hypothalamus-pituitary-adrenal axis in songbird chicks tested are most associated with high p,p'-DDE egg concentrations. An alteration in the endocrine or immune system may compromise songbird survival immediately after fledging or during migration.     

Sample asymmetry analysis of heart rate characteristics with application to neonatal sepsis and systemic inflammatory response syndrome

We introduce the sample asymmetry analysis (SAA) and illustrate its utility for assessment of heart rate characteristics occurring early in the course of neonatal sepsis and systemic inflammatory response syndrome (SIRS). Conceptually, SAA describes changes in the shape of the histogram of RR intervals that are caused by reduced accelerations and/or transient decelerations of heart rate. Unlike other measures of heart rate variability, SAA allows separate quantification of the contribution of accelerations and decelerations. The application of SAA is exemplified by a study comparing 50 infants, who experienced a total of 75 episodes of sepsis and SIRS, with 50 control infants. The two groups were matched by birth weight and gestational age. RR intervals were recorded for all infants throughout their course in the Neonatal Intensive Care Unit. The sample asymmetry of the RR intervals increased in the 3-4 d preceding sepsis and SIRS, with the steepest increase in the last 24 h, from a baseline value of 3.3 (SD = 1.6) to 4.2 (SD = 2.3), p = 0.02. After treatment and recovery, sample asymmetry returned to its baseline value of 3.3 (SD = 1.3). The difference between sample asymmetry in health and before sepsis and SIRS was mainly due to fewer accelerations than to decelerations. Compared with healthy infants, infants who experienced sepsis had similar sample asymmetry in health, and elevated values before sepsis and SIRS (p = 0.002). We conclude that SAA is a useful new mathematical technique for detecting the abnormal heart rate characteristics that precede neonatal sepsis and SIRS.     

Genotoxicity and toxicity of the potential cancer-preventive agent polyphenon E

The potential health benefits of green tea continue to attract public and scientific interests and are attributed in part to polyphenolic catechin constituents. Polyphenon E (Poly E) is a decaffeinated green tea catechin mixture containing about 50% epigallocatechin gallate and 30% other catechins. We evaluated the toxicity and genotoxicity of Poly E by using two in vitro assays: bacterial mutagenesis in a Salmonella typhimurium-E. coli assay and the L5178Y mouse lymphoma cell thymidine kinase (Tk) gene mutation assay. In addition, we used two in vivo genotoxicity assays: the mouse micronucleus assay and the Big Blue cII transgenic mouse mutation assay. Repeat-dose toxicity evaluations were performed in mice in parallel with the Big Blue transgenic mutation assays. No significant increases in the revertant colonies were found in the bacterial mutagenesis assay, but a significant increase in the mutant frequency (MF) at the Tk locus was observed in the mouse lymphoma test system. We observed toxicity in mice when Poly E was administered at doses of 2,000 mg/kg/day. Lower doses produced no significant increases in micronucleated erythrocytes in the bone marrow of Swiss-Webster mice and no significant increases in cII transgene MF in the liver, lung, or spleen compared with controls. These results indicate that Poly E, although toxic at high doses (2,000 mg/kg/day), poses minimal genotoxic concern. In addition, these studies highlight the importance of using both in vitro and in vivo systems in genetic toxicity screening of pharmaceuticals before they are administered to humans.     

Not just angiogenesis--wider roles for the angiopoietins

Since the discovery of the angiopoietins, much interest has been focused on their biological actions and their potential use as therapeutic targets. It is generally accepted that the angiopoietins play an important role in angiogenesis and hence are described as angiogenic factors. However, it is becoming increasingly clear that this is not their only role and it is likely that the angiopoietins have important roles in a wider range of biological and pathological functions.