Noncyclam tetraamines inhibit CXC chemokine receptor type 4 and target glioma-initiating cells

The three stereoisomers of the noncyclam compound 1 (1(R,R), 1(S,S), and the meso form 1(S,R)) and their corresponding tetrahydrochlorides 11 were prepared from (S)- and (R)-2-methylpiperidine. We have evaluated their inhibitory activity on the CXC chemokine receptor type 4 (CXCR4), toxicity properties, and assessment of their effect on glioma initiating cells (GICs) in comparison with the prototype compound AMD3100. The IC(50) values determined on human recombinant (CHO) cells showed very similar inhibitory activities albeit a lower K(B) for AMD3100, with the 1(R,R) isomer being second in potency. All the compounds showed low cardiac toxicity but, contrary to AMD3100, gave maximum nonlethal doses of around 2.0 mg/kg. The CXCR4 inhibitors had an effect on the state of differentiation of GICs, decreasing the percentage of CD44+ cells in glioblastoma multiform neurospheres in vitro. Moreover, these CXCR4 inhibitors blocked the capacity of cells to initiate orthotopic tumors in immunocompromised mice.     

Socioeconomic position and type 2 diabetes mellitus in Europe 1999-2009: a panorama of inequalities

The aim of the present review is to synthesis findings from studies on the relationship between socioeconomic position (SEP) and incidence, prevalence and mortality of type 2 diabetes mellitus (T2DM) in Europe between the years 1999 and 2009. A systematic search was carried out in the National Library of Medicine's PubMed database. The search was limited to articles published between January 1999 and December 2009, in English or Spanish. Additional requirements for inclusion were: (i) presentation of empirical results directly related with SEP and the prevalence, incidence or mortality of diabetes, (ii) dealing with T2DM, (iii) carried out in Europe, and (iv) mainly focused only on diabetes. Of the 19 articles found, twelve studied the relationship between SEP and the prevalence of T2DM, two dealt with diabetes incidence, three with mortality and two studied both inequalities in mortality and prevalence. People with more deprived SEP have greater incidence, more prevalence and higher mortality due to T2DM, although the magnitude and significance of the associations varied from one study to another. Part of these inequalities is explained by SEP differences in the prevalence of the established T2DM risk factors. SEP inequalities in T2DM tended to be greater in women than in men. There is consistent evidence that SEP inequalities in T2DM incidence, prevalence and mortality are present in Europe, especially among women. Improving accessibility of physical activity in terms of both price and availability, access to healthy food, and access to health services, will be key to achieving a reduction of SEP related diabetes inequalities in Europe.     

Social disparities in periodontitis among United States adults 1999-2004

Abstract – Objectives: To investigate whether race/ethnicity, income, and education are independently associated with periodontitis; and to investigate the effect of adjusting for income and education on the association between race/ethnicity and periodontitis in the National Health and Examination Nutrition Surveys 1999–2004. Methods: Analyses were limited to records of non‐Hispanic black, non‐Hispanic white or Mexican‐American adults (n = 10 648). SUDAAN was used to estimate the strength of the association of race/ethnicity, education, and income with the prevalence of periodontitis before and after adjusting for selected characteristics and risk factors. Results: The prevalence of periodontitis was 3.6%, with Black people (7.2%) exhibiting significantly higher prevalence than Mexican Americans (4.4%) and White people (3.0%, P < 0.01). After adjusting for selected sociodemographic characteristics, black adults, those with less than a high school education and those with low income were 1.94 (95% CI 1.46–2.58), 2.06 (95% CI 1.47–2.89) and 1.89 (95% CI 1.18–3.04) times more likely to have periodontitis than White people, those with more than a high school diploma and those with high income, respectively. Conclusions: This study indicates that inequalities in periodontitis associated with race/ethnicity, education and income continue to be pervasive in the US over the years.     

Constructing a deprivation index based on census data in large Spanish cities(the MEDEA project)

OBJECTIVES: a) To describe the methodology used to construct a deprivation index by census tract in cities, to identify the tracts with the least favorable socioeconomic conditions, and b) to analyze the association between this index and overall mortality. METHODS: Several socioeconomic indicators (Census 2001) were defined by the census tracts of the following cities: Barcelona, Bilbao, Madrid, Seville and Valencia. The correlations with the standardized mortality ratio (1996-2003), and the dimensionality of the socioeconomic indicators were studied. Finally, the selected indicators were aggregated in an index, in which the results of the factor loadings from extraction of a factor by principal components were used as weighting values. RESULTS: The indicators with the strongest correlations with overall mortality were those related to work, education, housing conditions and single parent homes. In the analysis of dimensionality, a first dimension appeared that contained indicators related to work (unemployment, manual and eventual workers) and education (insufficient education overall and in young people). In all the cities studied, the index created with these 5 indicators explained more than 75% of their variability. The correlations between this index and mortality generally showed higher values than those obtained with each indicator separately. CONCLUSIONS: The deprivation index proposed could be a useful instrument for health planning as it detects small areas of large cities with unfavorable socioeconomic characteristics and is associated with mortality. This index could contribute to the study of social inequalities in health in Spain.     

Impact of the Penalty Points System on Road Traffic Injuries in Spain: A Time�CSeries Study

Objectives. We assessed the effectiveness of the penalty points system (PPS) introduced in Spain in July 2006 in reducing traffic injuries.Methods. We performed an evaluation study with an interrupted time–series design. We stratified dependent variables—numbers of drivers involved in injury collisions and people injured in traffic collisions in Spain from 2000 to 2007 (police data)—by age, injury severity, type of road user, road type, and time of collision, and analyzed variables separately by gender. The explanatory variable (the PPS) compared the postintervention period (July 2006 to December 2007) with the preintervention period (January 2000 to June 2006). We used quasi-Poisson regression, controlling for time trend and seasonality.Results. Among men, we observed a significant risk reduction in the postintervention period for seriously injured drivers (relative risk [RR] = 0.89) and seriously injured people (RR = 0.89). The RRs among women were 0.91 (P = .095) and 0.88 (P < .05), respectively. Risk reduction was greater among male drivers, moped riders, and on urban roads.Conclusions. The PPS was associated with reduced numbers of drivers involved in injury collisions and people injured by traffic collisions in Spain.Traffic injuries cause considerable mortality and morbidity worldwide. Since 2004, traffic deaths in Spain have followed a downward trend. However, more than 135 000 road users were injured and more than 4000 were killed in 2005, numbers which placed Spain above the mean for the European Union (EU; ranked 13th of the 25 member states).¹The penalty points system (PPS), introduced in Spain on July 1, 2006, attempts to deter drivers from committing traffic offenses. Because the PPS does not exclusively depend on monetary penalties, it affects all drivers irrespective of their income level.² In Spain, drivers start with a 12-point license (8-point for novice drivers), and the points are gradually removed if certain traffic violations are committed, such as exceeding the speed limit, driving while intoxicated, or using a hand-held mobile phone, culminating in license suspension if all points are lost. Only serious violations result in loss of points, with the number of points removed varying with the severity of the offense (3 Several months before its introduction, the PPS was announced via a publicity campaign in all news media, and was included in the media agenda, giving rise to public debate.

TABLE 1

Number of Points Subtracted From the Driver''s License, by Type of Offense, in Spain''s Penalty Points System (PPS): Spain, 2000–2007

Neighbourhood food environment and gestational diabetes in New York City

Janevic T, Borrell LN, Savitz DA, Herring AH, Rundle A. Neighbourhood food environment and gestational diabetes in New York City. Paediatric and Perinatal Epidemiology 2010; 24 : 249–254. The association between neighbourhood characteristics and gestational diabetes has not been examined previously. We investigated the relationship between the number of healthy food outlets (supermarkets; fruit/vegetable and natural food stores), and unhealthy food outlets (fast food; pizza; bodegas; bakeries; convenience, candy/nut and meat stores) in census tract of residence, and gestational diabetes in New York City. Gestational diabetes, census tract and individual‐level covariates were ascertained from linked birth‐hospital data for 210 926 singleton births from 2001 to 2002 and linked to commercial data on retail food outlets. Adjusted odds ratios (aOR) were estimated using a multilevel logistic model. No association between food environment measures and gestational diabetes was found, with aORs ranging from 0.95 to 1.04. However, an increased odds of pre‐pregnancy weight >200 lbs for women living in a given neighbourhood with no healthy food outlets [aOR = 1.14, 95% CI 1.07, 1.21] or only one healthy food place [aOR = 1.10, 95% CI 1.04, 1.18] relative to two or more healthy food outlets was found. Due to probable misclassification of neighbourhood food environment and pre‐pregnancy obesity results are likely to be biased towards the null. Future research, including validity studies, on the neighbourhood food environment, obesity during pregnancy and gestational diabetes is warranted.     

Trends in Inequalities in Induced Abortion According to Educational Level among Urban Women

This study aims to describe trends in inequalities by women’s socioeconomic position and age in induced abortion in Barcelona (Spain) over 1992–1996 and 2000–2004. Induced abortions occurring in residents in Barcelona aged 20 and 44 years in the study period are included. Variables are age, educational level, and time periods. Induced abortion rates per 1,000 women and absolute differences for educational level, age, and time period are calculated. Poisson regression models are fitted to obtain the relative risk (RR) for trends. Induced abortion rates increased from 10.1 to 14.6 per 1,000 women aged 20–44 (RR = 1.44; 95% confidence interval (CI) 1.41–1.47) between 1992–1996 and 2000–2004. The abortion rate was highest among women aged 20–24 and 25–34 and changed little among women aged 35–44. Among women aged 20–24 and 25–34, those with a primary education or less had higher rates of induced abortion in the second period. Induced abortion rates also grew in those women with secondary education. In the 35–44 age group, the induced abortion rate declined among women with a secondary education (RR = 0.66; 95% CI 0.60–0.73) and slightly among those with a greater level of education. Induced abortion is rising most among women in poor socioeconomic positions. This study reveals deep inequalities in induced abortion in Barcelona, Spain. The trends identified in this study suggest that policy efforts to reduce unintended pregnancies are failing in Spain. Our study fills an important gap in literature on recent trends in Southern Europe.     

Social determinants of prescribed and non-prescribed medicine use

Background  

The aim of the present study was to describe the use of prescribed and non prescribed medicines in a non-institutionalised population older than 15 years of an urban area during the year 2000, in terms of age and gender, social class, employment status and type of Primary Health Care.