Drug injecting and syringe use in the HIV risk environment of Russian penitentiary institutions: Qualitative study

BACKGROUND: Evidence highlights the prison as a high risk environment in relation to human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission associated with injecting drug use. METHODS: We undertook qualitative studies among 209 injecting drug users (IDUs) in three Russian cities: Moscow (n = 56), Volgograd (n = 83) and Barnaul in western Siberia (n = 70). RESULTS: Over three-quarters (77%) reported experience of police arrest related to their drug use, and 35% (55% of men) a history of imprisonment or detention. Findings emphasize the critical role that penitentiary institutions may play as a structural factor in the diffusion of HIV associated with drug injection in the Russian Federation. While drugs were perceived to be generally available in penitentiary institutions, sterile injection equipment was scarce and as a consequence routinely shared, including within large groups. Attempts to clean borrowed needles or syringes were inadequate, and risk reduction was severely constrained by a combination of lack of injecting equipment availability and punishment for its possession. Perceptions of relative safety were also found to be associated with assumptions of HIV negativity, resulting from a perception that all prisoners are HIV tested upon entry with those found HIV positive segregated. CONCLUSION: This study shows an urgent need for HIV prevention interventions in the Russian penitentiary system.     

Obstacles in provision of anti-retroviral treatment to drug users in Central and Eastern Europe and Central Asia: a regional overview

Central and Eastern Europe and Central Asia is currently the region with the fastest growing HIV epidemic, mainly among injecting drug users (IDUs). This study explored access to anti-retroviral (ARV) treatment among IDUs and evaluated obstacles to gaining access to treatment. Semi-structured questionnaires were collected from 21 countries from agencies which deliver services to IDUs (N=55), including AIDS centres, drug treatment institutions and Non-governmental Organisations. Results showed that there was poor access to ARV treatment for IDUs. The major obstacles reported were: limited range of institutions for the provision of ARVs, lack of treatment due to high cost of ARVs, lack of clear policies and regulations in providing treatment for IDUs, lack of infrastructure and trained staff to provide treatment, and in some countries, absence of mechanisms such as methadone substitution programmes to support IDUs receiving ARV. There is a need for human and capital resources to bring ARV treatment to IDU populations in the region. Regulations and treatment protocols need to be developed to address this particular group of HIV positive clients to insure better adherence and monitoring of clients with HCV co-infection. Integration of provision of ARV treatment with drug treatment and low-threshold services is advised. Substitution therapy should be advocated for in countries where it is not available or where access is limited. Finally, more research needs to be conducted to understand what will work best in each country, region or setting.     

Geometrical Confining Effects in Compression Molding of Co-continuous Polymer Blends

Polymer blending is a versatile method for production of co-continuous porous materials. While numerous studies have been performed to elucidate the thermal annealing effects on the bulk structure, the effect of geometrical confinement is little understood. In the present work, possible effects from geometrical confinement during in-mold annealing were explored. A 50/50 wt.% poly (lactic acid)/polystyrene (PLA/PS) blend was compression molded and annealed between two parallel plates without being confined circumferentially during the compression molding process. Different conditions for geometrical confinement, including varied gap size and compression ratio (initial to final thickness ratio), as well as modified surface properties, were employed. The experimental results indicated that the gap size played a profound role in affecting the structural development; the phase size near the mold surface was smaller than away from the surface. The actual phase structure and the resulting gradient in pore size were further affected by the mold surface properties. Additionally, the compression ratio was found to affect the morphological development especially near the mold surface. At a high compression ratio, a thin layer of PLA was formed immediately during compression. The thickness of this layer either grew or reduced in size depending on the mold surface properties. Understanding of these geometrical confining effects and implementing them in processing may lead to the development of innovative porous materials.     

Skeletal stability after correction of maxillary hypoplasia by the Glasgow extra-oral distraction (GED) device

Maxillary distraction osteogenesis delivers excellent results, particularly in patients with clefts. In the past, devices such as the conventional facemask and the rigid external distraction device have been used to correct maxillary hypoplasia after a Le Fort I osteotomy. We describe a new device, the Glasgow extra-oral distraction device. The extent of skeletal and dental stability of corrections achieved in 10 patients with maxillary hypoplasia associated with clefts was satisfactory. This device costs little, can be produced in developing countries, and provides effective treatment for severe secondary deformity associated with clefts.     

In vitro Antioxidant Studies of Fruits of Artemisia nilagirica (Clarke) Pamp

Antioxidant potential of fruits of Artemisia nilagirica was studied using different in vitro models like 1,1-diphenyl-2-picryl hydrazyl, 2,2-azinobis-(3-ethylbenzothizoline-6-sulphonate), nitric oxide, superoxide, hydroxyl radical and lipid peroxidation. Both the ethanol and aqueous extracts of A. nilagirica fruits at 500 μg/ml showed maximum scavenging activity (89.33% and 89.14%) in quenching 1,1-diphenyl-2-picryl hydrazyl radical. The ethanol extract showed better scavenging activity (69.78%) of 1,1-diphenyl-2-picryl hydrazyl radical followed by the scavenging of nitric oxide radical (73.25%) compared to aqueous extract. In contrast, hydroxyl and superoxide radicals were effectively scavenged by aqueous extract. Total antioxidant capacity of ethanol and aqueous extracts at 500 μg/ml concentration was found to be 56.21 and 62.78 mg ascorbic acid equivalents, respectively. However, both the extracts showed only moderate lipid peroxidation inhibition activity. They were also found to contain considerable total phenols and flavonoids suggesting their role as an effective free radical scavenger. These findings suggest that phenolics and flavonoids in the fruits provide substantial antioxidant activity.     

Sildenafil in the treatment of antipsychotic-induced erectile dysfunction: a randomized, double-blind, placebo-controlled, flexible-dose, two-way crossover trial

OBJECTIVE: Antipsychotic-induced erectile dysfunction is a significant clinical problem and is a common reason for poor medication compliance. This report studied the efficacy and tolerability of sildenafil citrate in patients with antipsychotic-induced erectile dysfunction. METHOD: The study design was a randomized, double-blind, placebo-controlled, flexible-dose, two-way crossover trial carried out at a tertiary referral center. Thirty-two married male outpatients with schizophrenia or delusional disorder and antipsychotic-induced erectile dysfunction were recruited for the trial. Sexual function was assessed from patient logs of sexual activity. RESULTS: Thirty-two subjects and their spouses, who agreed to take part in the study, were included in the crossover trial. Thirty-one (96.9%) completed the trial. There was no significant period effect or treatment-period interaction. Patients reported significant improvement while taking sildenafil in the number of adequate erections, satisfaction with sexual intercourse, and the duration of erections over 2 weeks. The odds ratios for adequate erections and for satisfactory sexual intercourse with sildenafil were 4.07 and 3.77, respectively. The effect of sildenafil remained significant even after adjustment for period and week effects and treatment-period interaction with Poisson regression analysis. There were no major side effects or adverse drug interactions. CONCLUSIONS: Sildenafil citrate is safe and effective in the treatment of antipsychotic-induced erectile dysfunction. It is also well tolerated.     

Changes in p300 following two yoga-based relaxation techniques

Cyclic meditation (CM) is a technique that combines "stimulating" and "calming" practices, based on a statement in ancient yoga texts suggesting that such a combination may be especially helpful to reach a state of mental equilibrium. The changes in the peak latency and peak amplitude of P300 auditory event-related potentials were studied before and after the practice of cyclic meditation compared to an equal duration of supine rest in 42 volunteers (group mean age +/- SD, 27 +/- 6.3 years), from Fz, Cz, and Pz electrode sites referenced to linked earlobes. The sessions were one day apart and the order was alternated. There was reduction in the peak latencies of P300 after cyclic meditation at Fz, Cz, and Pz compared to the "pre" values. A similar trend of reduction in P300 peak latencies at Fz, Cz, and Pz was also observed after supine rest, compared to the respective "pre" values, although the magnitude of change in each case was less after supine rest compared to after cyclic meditation. The P300 peak amplitudes after CM were higher at Fz, Cz, and Pz sites compared to the "pre" values. In contrast, no significant changes were observed in the P300 peak amplitudes at Fz, Cz, and Pz after supine rest compared to the respective "pre" state. The present results support the idea that "cyclic" meditation enhances cognitive processes underlying the generation of the P300.     

Analysis of gene expression profiles in rat hippocampus following treatment with nicotine and an alpha7 nAChR selective agonist

The nicotinic acetylcholine receptors (nAChRs) play critical roles in neuronal transmission and modulation. Among the diverse nAChRs, the alpha7 subtype has been considered as a potential therapeutic target for treating cognitive deficits associated with neuropsychiatric and neurodegenerative diseases. Although a number of mechanisms including neurotransmitter and biochemical effects linking alpha7 nAChR activation and cognitive function are beginning to be described, the underlying molecular processes especially following repeated administration remain unclear. To address this, we have performed gene expression analysis in rats treated with nicotine and a selective alpha7 nAChR agonist, PNU-282987. Our results showed significant overlap in gene expression changes induced by PNU-282987 and nicotine, suggesting convergent pathways triggered by these compounds. Treatment with nicotine also resulted in regulation of a number of genes that were not regulated by PNU-282987, consistent with the interaction of nicotine with other nAChRs beyond the alpha7 subtype. Interestingly, these gene expression changes were observed 24 h post-dose, suggesting that both nicotine and PNU-282987 cause protracted changes in gene expression. Overall, our results identify gene expression changes that may contribute to further defining the roles of nAChR activation in cognitive function.     

Mosquito larvicidal activity of oleic and linoleic acids isolated from Citrullus colocynthis (Linn.) Schrad

In mosquito control programs, botanical origin may have the potential to be used successfully as larvicides. The larvicidal activity of crude acetone, hexane, ethyl acetate, methanol, and petroleum ether extracts of the leaf of Centella asiatica Linn., Datura metal Linn., Mukia scabrella Arn., Toddalia asiatica (Linn.) Lam, extracts of whole plant of Citrullus colocynthis (Linn.) Schrad, and Sphaeranthus indicus Linn. were assayed for their toxicity against the early fourth instar larvae of Culex quinquefasciatus (Diptera: Culicidae). The larval mortality was observed after 24 h exposure. All extracts showed moderate larvicidal effects; however, the highest larval mortality was found in whole plant petroleum ether extract of C. colocynthis. In the present study, bioassay-guided fractionation of petroleum ether extract led to the separation and identification of fatty acids; oleic acid and linoleic acid were isolated and identified as mosquito larvicidal compounds. Oleic and Linoleic acids were quite potent against fourth instar larvae of Aedes aegypti L. (LC₅₀ 8.80, 18.20 and LC₉₀ 35.39, 96.33 ppm), Anopheles stephensi Liston (LC₅₀ 9.79, 11.49 and LC₉₀ 37.42, 47.35 ppm), and Culex quinquefasciatus Say (LC₅₀ 7.66, 27.24 and LC₉₀ 30.71, 70.38 ppm). The structure was elucidated from infrared, ultraviolet, ¹H-nuclear magnetic resonance, ¹³C-NMR, and mass spectral data. This is the first report on the mosquito larvicidal activity of the reported isolated compounds from C. colocynthis.     

Isolation and identification of mosquito larvicidal compound from <Emphasis Type="Italic">Abutilon indicum</Emphasis> (Linn.) Sweet

Larvicidal activity of crude hexane, ethyl acetate, petroleum ether, acetone and methanol extracts of five medicinal plants, Abutilon indicum, Aegle marmelos, Euphorbia thymifolia, Jatropha gossypifolia and Solanum torvum were assayed for their toxicity against the early fourth-instar larvae of Culex quinquefasciatus. The larval mortality was observed after 24 h exposure. All extracts showed moderate larvicidal effects; however, the highest larval mortality was found in petroleum ether extract of A. indicum. In the present study, bioassay-guided fractionation of A. indicum led to the separation and identification of a β-sitosterol as a potential new mosquito larvicidal compound with LC₅₀ value of 11.49, 3.58 and 26.67 ppm against Aedes aegypti L, Anopheles stephensi Liston and C. quinquefasciatus Say (Diptera: Culicidae), respectively. ¹H NMR, ¹³C NMR and mass spectral data confirmed the identification of the active compound. β-sitosterol has been recognized as the active ingredient of many medicinal plant extracts. All the crude extracts when screened for their larvicidal activities indicated toxicity against the larvae of C. quinquefasciatus. This article reports the isolation and identification of the β-sitosterol as well as bioassay data for the crude extracts. There are no reports of β-sitosterol in the genus A. indicum, and their larvicidal activities are being evaluated for the first time. Results of this study show that the petroleum ether extract of A. indicum may be considered as a potent source and β-sitosterol as a new natural mosquito larvicidal agent.