More than just talk: the framing of transactional sex and its implications for vulnerability to HIV in Lesotho, Madagascar and South Africa

Background

Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs).

Methods

Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors.

Results

Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers.

Conclusions

Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater accessibility because of multiple, complex, and interrelated barriers to HIV/AIDS service utilisation at the service delivery level. Factors external to, as well as within, the health sector are key to understanding the access deficit in the FSU where low or concentrated HIV/AIDS epidemics are prevalent. Funders of HIV/AIDS programmes need to consider how best to tackle key structural and systemic drivers of access including prohibitionist legislation on drugs use, limited transparency and low staff salaries within the health sector.     

Effects of phenylpropanoid and iridoid glycosides on free radical-induced impairment of endothelium-dependent relaxation in rat aortic rings.

The protective effect of phenylpropanoid glycosides, forsythoside B and alyssonoside, and the iridoid glycoside lamiide, isolated from the aerial parts of Phlomis pungens var. pungens, against free radical-induced impairment of endothelium-dependent relaxation in isolated rat aorta was investigated. Aortic rings were exposed to free radicals by the electrolysis of the physiological bathing solution. Free radical-induced inhibition of the endothelium-dependent relaxation in response to acetylcholine was countered by incubation of the aortic rings before electrolysis with the aqueous extract (200 microg/ml), phenylpropanoid fraction (100 microg/ml) and iridoid fraction (150 microg/ml) of P. pungens var. pungens. Major components of the phenylpropanoid fraction forsythoside B and alyssonoside also prevented the inhibition of the acetylcholine response, at 10(-4) M concentration. However, the major component of iridoid fraction lamiide was found ineffective at the same concentration. The protective activity of phenylpropanoid glycosides against the free radical-induced impairment of endothelium-dependent relaxation may be related to their free radical scavenging property.     

Clinical,biochemical and molecular characterization of peroxisomal diseases in Arabs

Shaheen R, Al‐Dirbashi OY, Al‐Hassnan ZN, Al‐Owain M, Makhsheed N, Basheeri F, Seidahmed MZ, Salih MAM, Faqih E, Zaidan H, Al‐Sayed M, Rahbeeni Z, Al‐Sheddi T, Hashem M, Kurdi W, Shimozawa N, Alkuraya FS. Clinical, biochemical and molecular characterization of peroxisomal diseases in Arabs. Peroxisomes are single membrane‐bound cellular organelles that carry out critical metabolic reactions perturbation of which leads to an array of clinical phenotypes known as peroxisomal disorders (PD). In this study, the largest of its kind in the Middle East, we sought to comprehensively characterize these rare disorders at the clinical, biochemical and molecular levels. Over a 2‐year period, we have enrolled 17 patients representing 16 Arab families. Zellweger‐spectrum phenotype was observed in 12 patients and the remaining 5 had the rhizomelic chondrodysplasia punctata phenotype. We show that homozygosity mapping is a cost‐effective strategy that enabled the identification of the underlying genetic defect in 100% of the cases. The pathogenic nature of the mutations identified was confirmed by immunofluorescence and complementation assays. We confirm the genetic heterogeneity of PD in our population, expand the pool of pathogenic alleles and draw some phenotype/genotype correlations.     

Adhesion of resin composite to hydrofluoric acid-exposed enamel and dentin in repair protocols

Intraoral repairs of ceramic fixed-dental-prostheses (FDP) often include cervical recessions that require pretreatment of the exposed tooth surfaces either before or after the ceramic is conditioned with hydrofluoric (HF) acid gel. The sequence of repair protocol may cross-contaminate the exposed etched enamel or dentin surfaces during the application or rinsing process and thereby affect the adhesion. This study evaluated the influence of HF acid gel with two concentrations on bond strengths of composite to enamel and dentin. Human third molars (N=100, n=10 per group) with similar sizes were selected and randomly divided into 10 groups. Flat surfaces of enamel and dentin were created by wet ground finishing. Before or after the enamel (E) or dentin (D) was conditioned with phosphoric acid (P), substrate surfaces were conditioned with either 9.5% HF (HF(9.5)) or 5% HF (HF(5)). Subsequently, a bonding agent (B) was applied. The experimental groups by conditioning sequence were as follows where the first letter of the group abbreviation represents the substrate (E or D) followed by the acid type and concentration: group 1 (EPHF(9.5)), group 2 (EPHF(5)), group 3 (EHF(9.5)P), group 4 (EHF(5)P), group 5 (DPHF(9.5)), group 6 (DPHF(5)), group 7 (DHF(9.5)P), and group 8 (DHF(5)P). Group 9 (EPB) and group 10 (DPB) acted as the control groups. Repair resin was adhered incrementally onto the conditioned enamel and dentin in polyethylene molds. Each layer was photo-polymerized for 40 seconds. All specimens were thermocycled (×1000, 5°-55°C) and subjected to shear test (universal testing machine, 1 mm/min). Specimens that debonded during thermocycling were considered as 0 MPa. The bond strength data were analyzed using Kruskal-Wallis test and failure types using the chi-square test (α=0.05). Overall, the bond results (MPa) were lower on dentin than on enamel (p<0.01). EPB (25.6 ± 6.6) and DPB (20.2 ± 4.9) control groups showed significantly higher results than those of other groups (p<0.05). While higher mean bond strengths were obtained in group 1 (EPHF(9.5)) (11.5 ± 2.1) and group 2 (EPHF(5)) (7.3 ± 0.6), lower results were obtained when HF acid gels were applied prior to phosphoric acid (EHF(9.5)P: 5.0 ± 1.1, EHF(5)P: 3.6 ± 0.1) (p<0.05). On dentin, the results were the lowest in group 8 (DHF(5)P: 1.5 ± 1.6), being significantly lower than those of group 5 (DPHF(9.5)) (p<0.05). Scanning electron microscope (SEM) images revealed predominantly mixed failures with less than half of the composite left on both enamel and dentin surfaces (64 out of 80) (p<0.05), indicating that in general, adhesion was not ideal. Contamination of the enamel or dentin surfaces with HF acid gel impairs the bond strength of composites. Considering both the bond strength results and failure types, when dental tissues are to be repaired next to ceramic, application of phosphoric acid before HF acid gel application can be recommended. HF acid gel concentration did not influence the results except on enamel.     

炔诺酮肟(NETO)与炔诺酮(NET)在猴体内的药代动力学

利用HPLC分离和液闪测定放射性的方法,研究了恒河猴ⅳ和鼻饲NETO和NET的药代动力学。鼻饲后NETO和NET吸收迅速,24 h内均基本消除。鼻饲或ⅳNETO后,一部分迅速转变为NET,一部分以原药形式存在。两药的血药浓度—时间曲线符合po或ⅳ的二室开放模型。二原药的主要药代动力学参数无显著差异。NETO与NET的鼻饲绝对生物利用度分別为64.46±34.60与35.02±26.49%。     

Bioassay-guided isolation of iridoid glucosides with antinociceptive and anti-inflammatory activities from Veronica anagallis-aquatica L

Extracts obtained from the herbs of various Veronica species are used as folk remedy worldwide for the treatment of various inflammatory ailments including rheumatism. In vivo anti-inflammatory and antinociceptive activities of Veronica anagallis-aquatica L. aerial parts were investigated. Methanolic extract of the plant was shown to possess significant inhibitory activity against carrageenan-induced hind paw edema model and of p-benzoquinone-induced writhings in mice. Through bioassay-guided fractionation and isolation procedures eight compounds, aquaticoside A (1), aquaticoside B (2), aquaticoside C (3), veronicoside (4), catalposide (5), verproside (6), verminoside (7) and martynoside (8) were isolated and their structures were elucidated by spectral techniques. Catapol derivative iridoid glucosides, verproside (6) and catalposide (5), were found to possess potent antinociceptive and anti-inflammatory activities, per os without inducing any apparent acute toxicity as well as gastric damage. Results of the present study supported the utilization of the plant in Turkish folk medicine.     

Dental malpractice cases in Turkey during 1991-2000

OBJECTIVES: Doctors can face punitive and legal consequences if patients are not satisfied with the medical treatment. The purpose of this study is to provide a database for dental malpractice cases in Turkey. METHODS: This study is based on the decisions of High Health Council (HHC) in medical malpractice cases. Between 1991 and 2000, 1548 decisions were made by the HHC. 14 (0.9%) of these decisions were related to dentistry. This study examines the 8 decisions under which the dentists are found to be at fault. RESULTS: As three of these cases are based on the same facts they are examined together. Of the dentists consulted on 11 decisions, nine were male and two were female. In four cases the HHC gave its expert opinion before the trial, in five cases during criminal trial and in two cases during compensation trial. In five cases patients received surgical treatment, in four cases prosthetic treatment and in two cases endodontic treatment. Nine of these treatments were carried out at private dental practice. In eight reported decisions negligence and inadequate treatment were identified. Most of negligence was caused during surgical intervention. In two cases, treatments resulted in death. CONCLUSIONS: Like all other medical staff dentists are under the obligation to comply with the legal rules in the country they practice. They also have to consider ethical principles as well as the acceptable standards and protocols of diagnosis and treatment.     

Anti-inflammatory and cytotoxic activities of five Veronica species

Biological activities of five Veronica species (Scrophulariaceae), V. cymbalaria, V. hederifolia, V. pectinata var. glandulosa, V. persica and V. polita were studied for their anti-inflammatory and cytotoxic activities. Their methanol extracts showed both the inhibitory activity of nitric oxide (NO) production in lipopolysaccharide (LPS)-stimulated macrophages and cytotoxic activity against KB epidermoid carcinoma and B16 melanoma. When the methanol extracts were fractionated between water and chloroform, water fractions significantly inhibited NO production without any cytotoxicity, while chloroform fractions showed cytotoxicity dose-dependently. When the radical scavenging activity was determined using 2,2-diphenyl-1-picryl-hydrazyl (DPPH), water fractions of the five Veronica species scavenged free radicals effectively, suggesting that the inhibitory effect of this species on NO production was due to their radical scavenging activity. On the other hand, chloroform fractions of Veronica species except for V. cymbalaria showed similar cytotoxic activity against KB and B16 melanoma cells.     

Assessment of the macula and choroid in pediatric keratoconus patients

Purpose

To present choroidal and macular thickness measurements in pediatric patients with keratoconus and to evaluate a possible correlation between anterior and posterior segment parameters.