CATHOLICISM AND EVERYDAY MORALITY: Filipino women’s narratives on reproductive health

This study examines the relationship between state policies, religion, reproductive politics, and competing understandings of embodied sexual and reproductive morality. Using ethnographic and life history interviews, this study looks at the lives of Filipino urban poor women and how they interpret, follow and resist Catholic Church doctrines and practices as these relate to sexuality and reproduction. Taking everyday morality as embedded in social practice, this paper argues that women’s subjective reinterpretations of Catholic teachings regarding contraception and abortion render religion pliant in a way that restores moral equilibrium in women’s lives. It is in this process of adjusting and re-adjusting this moral order that women are able to construct their moral worlds. Further, this article investigates how social class, gender and religion work in tension with one another in women’s everyday decisions and how the constraints and opportunities that poor women encounter in their everyday lives are enabled by the state and its institutions.     

Kinetic Investigations of Quaternization Reactions of Poly[2‐(dimethylamino)ethyl methacrylate] with Diverse Alkyl Halides

Kinetic investigations of the quaternization reactions of poly[2‐(dimethylamino)ethyl methacrylate] (PDMAEMA) with alkyl halides (1‐iodobutane, 1‐iodoheptane, and 1‐iododecane) are carried out at different temperatures. For this purpose, a PDMAEMA (M_n = 17.8 kDa, Ð = 1.35) synthesized via reversible addition fragmentation chain transfer polymerization is utilized. The progress of the quaternization reactions is followed by proton nuclear magnetic resonance. As expected, the rate of quaternization is higher with increasing temperature. The experimental data are used to determine the following kinetic parameters: order of the reaction, Arrhenius' pre‐exponential factor, and activation energy. To the best of knowledge, this is the first contribution that provides detailed kinetic data of the quaternization reactions on PDMAEMA.     

Ethanol withdrawal increases blood pressure and vascular oxidative stress: a role for angiotensin type 1 receptors

We evaluated the possible mechanisms underlying the oxidative stress induced by ethanol withdrawal. With this purpose, we verified the role of AT₁ receptors in such response. Male Wistar rats were treated with ethanol 3%–9% (vol./vol.) for 21 days. Ethanol withdrawal was induced by abrupt discontinuation of the treatment. Experiments were performed 48 hours after ethanol discontinuation. Increased plasma levels of angiotensin II were detected after ethanol withdrawal. Losartan (10 mg/kg; p.o. gavage), a selective AT₁ receptor antagonist, impeded the increase in blood pressure induced by ethanol withdrawal. Increased lipoperoxidation and superoxide anion (O₂^?) levels were detected in aortas after ethanol withdrawal, and losartan prevented these responses. Decreased hydrogen peroxide and nitrate/nitrite concentration were detected in aortas after ethanol withdrawal, and losartan prevented these effects. Nitrotyrosine immunostaining in the rat aorta was increased after ethanol withdrawal, and AT₁ blockade impeded this response. Increased expression of PKCδ and p47^phox was detected after ethanol withdrawal, and treatment with losartan prevented these responses. Our study provides novel evidence that ethanol withdrawal increases vascular oxidative stress and blood pressure through AT₁-dependent mechanisms. These findings highlight the importance of angiotensin II in ethanol withdrawal–induced increase in blood pressure and vascular oxidative damage.     

Renal involvement in PMM2-CDG,a mini-review

Phosphomannomutase 2 deficiency (PMM2-CDG) is the most common N-linked glycosylation disorder. The majority of patients present with a multisystem phenotype, including central nervous system involvement, hepatopathy, gastrointestinal and cardiac symptoms, endocrine dysfunction and abnormal coagulation. Renal abnormalities including congenital malformations and altered renal function are part of the multisystem manifestations of congenital disorders of glycosylation.We reviewed the literature on 933 patients with molecularly and/or enzymatically confirmed PMM2 deficiency to evaluate the incidence of renal involvement in PMM2-CDG.Renal abnormalities were reported in 56 patients. Congenital abnormalities were present in 41 out of these 55. Cystic kidney and mild proteinuria were the most common findings. One of the most severe renal manifestations, congenital nephrotic syndrome, was detected in 6 children. Renal manifestations were not associated with the presence of specific PMM2 alleles.This review summarizes the reported renal abnormalities in PMM2-CDG and draws attention to the pathophysiological impact of abnormal glycosylation on kidney structure and function.     

Rationale and Design of LAPLACE‐2: A Phase 3, Randomized,Double‐Blind,Placebo‐ and Ezetimibe‐Controlled Trial Evaluating the Efficacy and Safety of Evolocumab in Subjects With Hypercholesterolemia on Background Statin Therapy

Low‐density lipoprotein cholesterol (LDL‐C) levels are significantly associated with atherosclerotic cardiovascular disease (ASCVD) risk, and studies using interventions that lower LDL‐C levels have been shown to reduce the risk of ASCVD events and mortality. Statin treatment is the current first‐line therapy for lowering LDL‐C and reducing ASCVD risk. However, many patients are still unable to reach recommended LDL‐C goals on maximally tolerated statin therapy. Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9, including evolocumab (previously AMG 145), dramatically lowered LDL‐C in phase 2 clinical trials when administered alone or in combination with a statin. The aim of this phase 3 study is to evaluate the efficacy of 12 weeks of subcutaneous evolocumab (vs placebo) administered every 2 weeks or every month in combination with a statin in patients with hypercholesterolemia and mixed dyslipidemia. This study will also provide comparative efficacy, safety, and tolerability data between evolocumab and ezetimibe when added to background atorvastatin therapy.     

Management of hypertension in patients with diabetes using an amlodipine-, olmesartan medoxomil-, and hydrochlorothiazide-based titration regimen

The safety and efficacy of an amlodipine/olmesartan medoxomil (OM)-based titration regimen was assessed in patients with type 2 diabetes mellitus and hypertension. After a 2- to 3-week placebo run-in period, 207 patients received amlodipine 5 mg and were uptitrated to amlodipine/OM 5/20, 5/40, and 10/40 mg and then amlodipine/OM 10/40 mg plus hydrochlorothiazide 12.5 and 25 mg in a step-wise manner at 3-week intervals if the seated blood pressure (BP) remained ≥120/70 mm Hg. The primary end point was the change from baseline in the mean 24-hour ambulatory systolic BP after 12 weeks of treatment. The baseline mean ± SD seated cuff systolic/diastolic BP was 158.8 ± 13.1/89.1 ± 10.1 mm Hg and the mean ± SD 24-hour ambulatory systolic/diastolic BP was 144.4 ± 11.7/81.6 ± 9.8 mm Hg. At week 12, the change from baseline in the mean ± SEM 24-hour ambulatory systolic/diastolic BP was -19.9 ± 0.8/-11.2 ± 0.5 mm Hg (p<0.0001 vs baseline), and 70% of patients had achieved a 24-hour ambulatory BP target of <130/80 mm Hg. At the end of 18 weeks of active treatment in patients uptitrated to amlodipine/OM 10/40 mg plus hydrochlorothiazide 25 mg, the change from baseline in the mean ± SEM seated BP was -28.0 ± 1.5/-13.7 ± 1.0 mm Hg (p<0.0001 vs baseline), with 62% of patients reaching the guideline-recommended seated BP goal of <130/80 mm Hg. Drug-related treatment-emergent adverse events occurred in 19.3% of patients. The most frequent events were peripheral edema (6%), dizziness (3%), and hypotension (2%). In conclusion, this amlodipine/OM-based titration regimen was well tolerated and effectively lowered BP throughout the 24-hour dosing interval in patients with hypertension and type 2 diabetes.     

Sources of Error in the Estimation of Mosquito Infection Rates Used to Assess Risk of Arbovirus Transmission

Infection rate is an estimate of the prevalence of arbovirus infection in a mosquito population. It is assumed that when infection rate increases, the risk of arbovirus transmission to humans and animals also increases. We examined some of the factors that can invalidate this assumption. First, we used a model to illustrate how the proportion of mosquitoes capable of virus transmission, or infectious, is not a constant fraction of the number of infected mosquitoes. Thus, infection rate is not always a straightforward indicator of risk. Second, we used a model that simulated the process of mosquito sampling, pooling, and virus testing and found that mosquito infection rates commonly underestimate the prevalence of arbovirus infection in a mosquito population. Infection rate should always be used in conjunction with other surveillance indicators (mosquito population size, age structure, weather) and historical baseline data when assessing the risk of arbovirus transmission.     

The use of combination drug therapy in the treatment of hypertension

Data from the National Health and Nutritional Examination Survey and from the World Health Organization have clearly demonstrated that, worldwide, less than one quarter of hypertensive patients are adequately controlled by our currently accepted blood pressure (BP) goals. These patients remain at significant risk for the development of cardiovascular disease. Although, there are multiple reasons contributing to inadequate blood pressure control, the most important include: 1) patient compliance; 2) acceptance of inadequate BP control by clinicians; 3) lower BP goals; and 4) the fact that it is very difficult or impossible to achieve adequate BP control with monotherapy in the majority of patients. The use of combination therapy, either as first-line treatment or much earlier in the course of treating hypertensive patients, may provide the solution to many of these management problems. Low-dose combination therapy provides several advantages in that: 1) it will be more effective than monotherapy due to the additive effect on BP of complementary drugs; 2) it will provide 24-hour efficacy with once-a-day dosing since most of the low-dose combination drugs include long-acting components; 3) it will have a higher response rate than monotherapy and will be effective in most subgroups of hypertensive patients due to the complementary nature of combination therapy; 4) it may have fewer metabolic side effects than higher dose monotherapy since metabolic side effects also tend to be dose dependent; 5) it may have fewer dose-dependent side effects than monotherapy, as BP control is obtained at lower doses of each of the component drugs; 6) it is more convenient than monotherapy; 7) it may cost less, since low-dose combination therapy tends to be a little more expensive than each of the components but cheaper than if each of the components were used separately. For these reasons, the use of low-dose combination therapy as first-line treatment or much earlier in the stepped-care approach may play a major role in improving the dismal control rates in hypertensive patients, which may ultimately have a positive impact on the rate of development of cardiovascular disease.     

CCR4 versus CCR10 in human cutaneous TH lymphocyte trafficking

The chemokine receptors (CCRs) CCR4 and CCR10, and the cutaneous lymphocyte antigen (CLA), have each been proposed as critical mediators of skin-specific TH lymphocyte homing in mice and humans. CLA initiates skin homing by mediating E-selectin-dependent tethering and rolling within cutaneous venules, but the specific roles of CCR4 and CCR10 are unclear. We have generated an antihuman CCR10 monoclonal antibody (mAb; 1B5) to illuminate the individual contributions of these molecules. This mAb allows us to compare CCR10, CCR4, and CLA expression within human TH populations. The mAb 1B5 recognizes functional CCR10 expression, as chemotactic responsiveness to cutaneous T-cell-attracting chemokine (CTACK)/CCL27 (a CCR10 ligand) parallels the staining of TH subsets. We find CCR10 expressed by only a minority (approximately 30%) of blood-borne, skin-homing (CLA+/CCR4+) TH cells. However, essentially all members of the relatively small "effector" (CLA+/CCR4+/CD27-/CCR7-) skin-homing TH population express CCR10. Most skin-infiltrating lymphocytes in allergic delayed-type hypersensitivity (DTH) and bacterial chancroid skin lesions express both CCR4 and CLA, but only about 10% express CCR10. This suggests for the 2 models of TH skin homing studied here that CCR10+ TH cells have no advantage over other CLA+/CCR4+ TH cells in homing to cutaneous sites. We conclude that the skin-homing TH compartment is itself divided into distinct subpopulations, the smaller of which expresses both CCR4 and CCR10, and the larger of which expresses only CCR4. Thus, CCR10 is unlikely to be necessary for cutaneous homing of TH cells in the models studied here. CCR10 may instead play a role in the movement of specialized "effector" cutaneous TH cells to and/or within epidermal microenvironments.