Intra-ovarian roles of activins and inhibins

Granulosa cells are the main ovarian source of inhibins, activins and activin-binding protein (follistatin) while germ (oogonia, oocytes) and somatic (theca, granulosa, luteal) cells express activin receptors, signaling components and inhibin co-receptor (betaglycan). Activins are implicated in various intra-ovarian roles including germ cell survival and primordial follicle assembly; follicle growth from preantral to mid-antral stages; suppression of thecal androgen production; promotion of granulosa cell proliferation, FSHR and CYP19A1 expression; enhancement of oocyte developmental competence; retardation of follicle luteinization and/or atresia and involvement in luteolysis. Inhibins (primarily inhibin A) are produced in greatest amounts by preovulatory follicles (and corpus luteum in primates) and suppress FSH secretion through endocrine negative feedback. Together with follistatin, inhibins act locally to oppose auto-/paracrine activin (and BMP) signaling thus modulating many of the above processes. The balance between activin-inhibin shifts during follicle development with activin signalling prevailing at earlier stages but declining as inhibin and betaglycan expression rise.     

HIV behavioural risks and the role of work environment among Chinese male sex workers in Hong Kong

Male sex workers are a highly marginalised group in Hong Kong and it is increasingly so with an influx of them travelling from mainland China to work as "freelance" sex workers. This study aimed to measure important work environment variables that might affect the likelihood of condom use among male sex workers working in Hong Kong. A cross-sectional survey of 161 participants recruited by snowball and convenience sampling methods through outreach workers of a local non-governmental organization was conducted in 2007-2008. Only 27.4%, 54.7% and 42.6% reported consistent condom use when engaging in oral, anal and vaginal sex, respectively. Logistic regression shows unsafe sex was nearly four times (OR=3.41; 95%CI 1.51-7.69) as common in institutionalised male sex workers as among their independent counterparts. Lack of condoms provided at workplaces was a major barrier in this socio-legal context and was strongly associated with condom non-use amongst institutionalised sex workers (OR= 10.86; 95%CI 2.94-40.17). The present study finds that when compared with independent Male sex workers (MSWs), institutionalised MSWs were older, less educated, earned a higher income but more likely to engage in unsafe sex with their clients and their partners. Public health physicians must work with law-enforcing authorities to provide clear guidelines to remove these HIV prevention barriers.     

Aspirin sensitivity and coronary artery disease: implications for the practicing cardiologist

Aspirin is the most commonly used antiplatelet agent in patients with coronary artery disease (CAD). It continues to play a key role as an antiplatelet agent given its long-term safety, efficacy and low cost. Aspirin or NSAID hypersensitivity is not an uncommon occurrence and can vary from generalized urticaria and angioedema to exacerbation of upper and lower respiratory tract reactions. It is not uncommon for clinicians to avoid using aspirin and alternative agents when encountering aspirin hypersensitivity among CAD patients. However, given the critical role of aspirin in CAD patients, particularly among those who receive the drug-eluting stents, aspirin desensitization can be useful. This article highlights the importance of aspirin desensitization, the mechanism and the process involved. We draw attention to recently described rapid desensitization protocols and how they can be more useful than the old procedure.     

Effect of a combined dance/movement and music therapy on young adults diagnosed with severe autism

Current literature is scarce on the potential effects of combined dance/movement and music therapy on adults diagnosed with severe autism, particularly in distinguishing these effects on different areas of psychopathological disorders. We set two goals: first, to assess the effectiveness based on the score the participants obtained from the Revised Clinical Scale for the Evaluation of Autistic Behavior (ECA-R) after a series of dance/movement and music therapeutic procedures on adults with severe autism; second, to contrast the differences in effectiveness in concrete areas defined by subscales of the ECA-R, especially in its defined 2 factors and 12 functions. An overall of 36 one-hour sessions were carried out during 17 weeks on a sample of 8 participants with severe autism (approximately 2 sessions per week). During the treatment 8 measurements were taken (1 every 3 weeks) from this sample and from a control sample, which was also comprised of 8 subjects who were equally monitored at the same care center by two independent psychologists. Our experimental study seems to suggest that combined dance/movement and music therapy could be effective if used regularly for the improvement of autistic symptoms in adults diagnosed with severe autism.