Mortality Risk Associated with Physical and Verbal Abuse in Women Aged 50 to 79

OBJECTIVES: To investigate whether midlife and older women who reported prior-year physical abuse, verbal abuse, or both abuse types had higher mortality risk than peers who did not report prior-year abuse.
DESIGN: Retrospective analysis.
SETTING: Community.
PARTICIPANTS: One hundred sixty-thousand six hundred seventy-six community-dwelling women ages 50 to 79 at baseline enrolled in one of two major Women's Health Initiative (WHI) study components who responded to baseline abuse questions. Observational study enrollment was N=93,676 (1994–1998; 90 months average follow-up). Clinical trial enrollment was N=68,132 (1993–1998; 96 months average follow-up).
MEASUREMENTS: Total mortality was measured from 1993 to 2005 using all available data sources. Blinded physician adjudicators measured cause-specific mortality. Ninety-six percent of death records were adjudicated.
RESULTS: Prior-year self-reported abuse prevalence was 11.3%. Women who reported physical abuse had the highest age-adjusted mortality rate, followed by women who reported both abuse types. Abuse independently predicted mortality risk after controlling for age, education, ethnicity, and WHI component. High mortality risk remained for physically abused women (hazard ratio (HR)=1.54, 95% confidence interval (CI)=1.09–2.18) after adjusting for demographic and health-related factors. Further adjustment for psychosocial variables diminished this association (HR=1.40, 95% CI=0.93–2.11), but high risk remained.
CONCLUSION: Community-dwelling middle-aged and older women who reported prior-year physical, verbal, or both types of abuse had significantly higher adjusted mortality risk than women who did not report abuse. These findings highlight the need for longitudinal research into prevention of abuse in later life and accompanying excess mortality and emphasize the importance of abuse prevention in later life.     

Acetyl-L-Carnitine Effect on Pituitary and Plasma β-Endorphin Responsiveness to Different Chronic Intermittent Stressors

The aims of the present study were: 1) to compare the effect of two different chronic intermittent stressors i.e. cold-swimming versus ether, on the pituitary opioidergic system; 2) to evaluate the response of pituitary and plasma β-endorphin (βS-EP) to an acute stress in chronically stressed rats; and 3) to evaluate the effect of acetyl-l-carnitine treatment (10 mg/day/rat per os at night) on pituitary and plasma β-EP changes induced by two different types of chronic stress. The stressors were applied twice a day for 10 days. Rats were killed either before, during or after the last swimming or ether stress session. β-EP was measured by radioimmunoassay in anterior pituitary and in neurointermediate lobe extracts and in plasma. The following observations were made; 1) Chronic intermittent cold-swimming stress increased anterior pituitary contents and plasma β-EP levels; 2) both chronic intermittent cold-swimming stress and ether stress caused an increase of neurointermediate lobe β-EP contents; 3) as in control animals, rats exposed to chronic intermittent swimming stress reduced pituitary β-EP contents and raised plasma β-EP levels in response to the last acute swimming stress; 4) in contrast to control animals, rats exposed to chronic intermittent ether stress did not show any significant response of the pituitary-plasma opioidergic system to the last acute ether session; 5) the acetyl-l-carnitine treatment counteracted the changes evoked by chronic intermittent cold-swimming stress on the pituitary and plasma β-EP levels. The present data show that chronic intermittent ether stress impairs the capacity to respond to the acute stress and that acetyl-l-carnitine may modulate the changes of β-EP levels following chronic cold-swimming stress exposure.     

HIV-1 gp120 Glycoprotein Induces [Ca2+]i Responses not only in Type-2 but also Type-1 Astrocytes and Oligodendrocytes of the Rat Cerebellum

Cultures of cerebellar cortex cells were exposed to the HIV-1 envelope glycoprotein, gp120, and investigated for cytosolic Ca²⁺ ion concentration ([Ca²⁺]i) changes by the fura-2 ratio videoimaging technique while bathed in complete, Na⁺-free or Mg²⁺-free Krebs-Ringer media. At the end of the [Ca²⁺]i experiments the cells were fixed and immunoidentified through the revelation of markers specific for neurons (microtubule associated protein-2), type-2 (A2B5) or all (glial fibrillary acidic protein) astrocytes, oligodendrocytes (galactocerebroside) or microglia (F4/80 antibody). In complete medium, rapid biphasic (spike-plateau) responses induced by gp120 (0.1–1 nM) were observed in a subpopulation of type-2 astrocytes. In addition, slow but progressive responses were observed in other type-2 cells and oligodendrocytes, whereas type-1 astrocytes showed small responses, if any, and granule neurons did not respond at all. Use of Na⁺-free medium (a condition that blocked another gp120-induced response, cytosolic alkalinization) resulted in an increase in [Ca²⁺]i response that was appreciable not only in type-2 but also in most type-1 astrocytes, possibly because of the inhibition of the Na⁺/Ca²⁺ exchanger and the ensuing decrease in Ca²⁺ extrusion. Granule neurons, including those in direct contact with responsive astrocytes, remained unresponsive, even when the experiments were carried out in Mg²⁺-free medium supplemented with glycine, a condition that favours activation of the glutamatergic N-methyl-D-aspartate (NMDA) receptor. The results obtained demonstrate that sensitivity to gp120 is a property of not only a few type-2 astrocytes but of the majority of cerebellar glial cells, which, however, do not respond to the protein with glutamate release, as indicated by the negative results obtained with NMDA-receptor-expressing granule neurons. Single glial cell [Ca²⁺]i increase, the faster and most sensitive effect of gp120 revealed in the brain so far, could be ultimately employed to reveal CD4-independent transmembrane signalling machanisms of the viral protein that, at the moment, remain almost entirely unknown.     

Eosinophilic Pustular Folliculitis in Infancy: Report of Two New Cases

Eosinophilic pustular folliculitis (EPF) is a cutaneous inflammatory follicular disorder of unknown etiology. The diagnosis is made on the basis of clinical and histopathologic features. We describe two patients who had recurrent episodes of pruritic follicular papular and pustular lesions on the face, extremities, and trunk. The eruptions lasted for 1 month with intermittent remissions. Laboratory tests disclosed no infectious or parasitic etiology in patient 2. In patient 1 we isolated methicillin-resistant Staphylococcus aureus in a blood culture. He had sepsis with lung and liver involvement. EPF is a self-limited dermatosis. On occasion, skin lesions may become superinfected, resulting in localized pyoderma or rarely systemic infection (sepsis). Histologically both of our patients showed a moderate mixed inflammatory infiltrate with numerous eosinophils centered around hair follicles. Their lesions responded well to topical corticosteroids.