HIV and HCV prevalence and gender-specific risk profiles of crack cocaine smokers and dual users of injection drugs

The present analysis compares HIV and HCV prevalence and associated gender-specific risk patterns of dual users (i.e., crack smokers who inject drugs) and never injectors. Two logistic models, one restricted to female and the other to male crack smokers, were constructed to identify gender-specific risk factors associated with dual use (p < 0.05). Of 437 crack smokers, 246 (56%) were dual users while 191 (44%) were never injectors. In a fitted logistic regression model, dual use among female crack smokers was associated with HCV infection (adjusted OR = 4.65, 95% CI: 1.92-9.70), exchanging sex for money, drugs, or shelter while using crack (aOR = 4.47, 95% CI: 1.56-12.80), having a casual partner who injects (aOR = 4.13, 95% CI: 1.05-16.26), having equipment broken or confiscated by police without being arrested (aOR = 3.66, 95% CI: 1.43-9.34), and HIV infection (aOR = 2.07, 95% CI: 1.18-5.96). Among male crack smokers, dual use was associated with HCV infection (aOR = 5.34, 95% CI: 2.10-13.18), exchanging sex for money, drugs, or shelter (aOR = 3.25, 95% CI: 1.59-6.65), crack use history >or= 5 years (aOR = 2.16, 95% CI: 1.29-3.63), and smoking in a group of unknown people (such as crack houses, alleys; aOR = 1.70, 95% CI: 1.10-2.81). These findings highlight the need for evidence-based prevention and harm reduction initiatives that directly targeting crack cocaine smokers, with particular attention given to female dual users of injection drugs.     

Use of electrical impedance scanning in the differentiation of sonographically suspicious and highly suspicious lymph nodes of the head–neck region

Sonographic differentiation between inflammatory and malignant lymph nodes is difficult, due in part to almost unchanged morphology of small lymph node metastases; however, as cancer cells exhibit altered dielectric properties, measurement of local electrical field distortions may be useful as adjunct to ultrasound in detection of malignancy. In this study, we evaluated the ability of electrical impedance scanning (EIS) to differentiate cervically located sonographically suspicious or highly suspicious lymph nodes. Seventy patients with 106 sonographically suspicious lymph nodes (mean size 20 x 13 x 13 mm, mean depth 8 mm) were examined using TransScan TS2000 (Siemens, Erlangen, Germany; manufactured by TransScan Research and Development Co., Israel). Included in the study were cervical ( n=64), inframandibular/periparotideal ( n=32) and nuchal/supraclavicular ( n=10) nodes. The EIS results were compared with histopathological ( n=100) and serological ( n=6) findings. Sixty-two of 64 malignant lymph nodes were correctly detected using EIS; 19 of 42 inflammatory/benign lymph nodes were correctly identified as benign (true positive 96.9%, true negative 45.2%; accuracy 71.3%, negative predictive value 90.5%, positive predictive value 59.6%). The high tumour detection rate achieved in this study suggests that EIS may be of value as an adjunctive technique in differentiation of lymph nodes of the head-neck region. Software changes to reduce the high number of false-positive markers are, however, necessary to improve the value in the evaluation during a regular clinical routine.     

First incursion of Salmonella enterica serotype typhimurium DT160 into New Zealand

An outbreak of human Salmonella enterica serotype Typhimurium DT160 infection in New Zealand was investigated from May to August 2001. Handling of dead wild birds, contact with persons with diarrheal illness, and consumption of fast food were associated with infection. Contaminated roof-collected rainwater was also detected.     

Distinction of viral and host-derived glycopolypeptides induced by “early” functions of human cytomegalovirus

Summary Human cytomegalovirus is shown to induce in phosphonoacetic acid-treated human fibroblasts glycosylation of five polypeptides with approximate molecular weights of 200–250, 150, 135, 130 and 100 kilodaltons (kd). Except for the 130 kd product, these glycopolypeptides (gp) separate with the cytoplasmic fraction, only one (200–250 kd) with the chromatin fraction as well. The gp of 135 and 100 kd were found to be virus-specified as determined by immunoblotting and immunoprecipitation. The gp of 200–250 kd exhibited an immunological relatedness to fibronectin and are therefore considered host-specific products. Both subsets of gp participate in virus-induced surface membrane alterations as documented by living cell immunofluorescence.With 7 Figures     

Borderline Personality Disorder Diagnostic Criteria as Risk Factors for Suicidal Behavior Through the Lens of the Interpersonal Theory of Suicide

Borderline personality disorder diagnostic criteria, particularly affective dysregulation and behavioral dysregulation, are avenues through which suicide risk is conferred, though pathways are not well understood. The interpersonal theory of suicide may help elucidate these associations. The current study examined indirect relationships between affective and behavioral dysregulation and suicidal ideation through perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide. 169 outpatients completed measures prior to their intake assessment. Perceived burdensomeness accounted for the relationship between affective dysregulation and suicidal ideation. The acquired capability did not explain the association between behavioral dysregulation and suicide attempt history. Affective and behavioral dysregulation may be key targets in treatment for reducing suicide risk.     

Improving global monitoring of vaccine safety: a survey of national centres participating in the WHO Programme for International Drug Monitoring.

BACKGROUND: The WHO Programme for International Drug Monitoring (PIDM) was established in 1968 following the thalidomide disaster. The PIDM has had considerable success in analyzing drug-related adverse event reports, but more limited progress has been made in analyzing vaccine-related reports. In June 2005, the Global Advisory Committee on Vaccine Safety, acknowledging these limitations, called for a global consultation to address the need for improved monitoring and analysis of vaccine-related adverse event reports on an international level. OBJECTIVE: In preparation for this consultation and as part of a larger study designed to evaluate the PIDM, a survey of the National Pharmacovigilance Centres of all 76 countries participating in the PIDM at the time the survey was conducted. RESULTS: Thirty-six countries (47%) responded. Of the 36 responding countries, 16 (44%) reported having a separate surveillance system for adverse events following immunizations (AEFIs) and 30 (83%) reported forwarding AEFI reports to the PIDM. Seven of the 36 countries (19%) indicated that one or more population subgroups are systematically excluded from their country's AEFI surveillance system. Five of the seven countries exclude reports concerning recipients of travellers' vaccines; three exclude recipients of vaccines administered by private physicians outside the national immunization programme and supply scheme; and five exclude reports from the military sector. Only half of the respondents knew of the Brighton Collaboration, a major international initiative aimed at the standardization of AEFI definitions. CONCLUSION: The survey identified critical elements that should be addressed quickly to improve global vaccine safety monitoring. Communication between national adverse drug reaction and AEFI surveillance authorities, ability to pay for advancing technology in developing countries, and proper use of services and terminologies are issues of concern.     

Assessing the degree of collinearity among the lesion features of the MRI BI-RADS lexicon

Purpose

To retrospectively assess collinearity among lesion feature of the MRI BI-RADS lexicon. Collinearity denotes a situation in which two or more (independent) variables are correlated to some degree, thus partly conveying the same information. Collinearity may cause problems in the interpretation of logistic regression models.

Materials and methods

We analysed the BI-RADS features of 351 lesions in 325 consecutive patients. Patients with biopsy proven breast disease or treated with chemotherapy were excluded. All lesion features were dichotomised into “present” or “not present”. Correlation matrices were generated for mass and non-mass lesions separately, focus lesions were omitted. The phi coefficient was used as measure for correlation.

Results

There were 253 mass (175 malignant, 78 benign), 66 non-mass (21 malignant, 45 benign) and 32 focus (5 malignant, 27 benign) lesions among the study population. The strongest inter-subgroup correlations among mass lesion features were: slow initial enhancement with persistent kinetics, phi = 0.64 (0.56–0.71), rapid initial enhancement with washout kinetics, phi = 0.52 (0.43–0.61) and rapid initial enhancement with persistent kinetics, phi = −0.43 (−0.53 to −0.32). The strongest inter-subgroup correlation among non-mass lesion features were: rapid initial enhancement with washout kinetics, phi = 0.51 (0.30–0.67), slow initial enhancement with persistent kinetics, phi = 0.43 (0.21–0.61) and rapid initial enhancement with persistent kinetics, phi = −0.41 (−0.18 to −0.60).

Conclusion

There is a noticeable overlap of information, especially between kinetic features and initial enhancement types for both, mass and non-mass lesions. This should be considered when generating logistic regression models with the MRI BI-RADS lesion features.     

Laminin binding in membranes of a rat pancreatic acinar cell line are targets for glucocorticoids.

The adhesive properties of tumor cells to basement membranes are known to play a crucial role in the complex process of tumor invasion and metastasis. Therefore, the interaction between the rat pancreatic acinar cell line AR42J and various extracellular matrix components along the route of differentiation induced by glucocorticoids was investigated. AR42J cells displayed a significantly higher affinity to laminin than to type IV collagen and fibronectin. Flow cytometric analysis showed expression of the 67-kilodalton laminin receptor and the integrin VLA-6 as potential laminin binding proteins in AR42J cells. Cell adhesion inhibition studies revealed that binding of undifferentiated AR42J cells to laminin was mediated predominantly by the 67-kilodalton laminin receptor. Dexamethasone pretreatment, which results in a more differentiated phenotype of AR42J cells, reduced the adhesion to laminin. In contrast to undifferentiated cells, interaction of differentiated AR42J cells to laminin was mediated by VLA-6. Dexamethasone-induced differentiation of pancreatic AR42J cells was paralleled by a decreased expression of 67-kilodalton laminin receptors, most likely because of a downregulation of the steady-state concentration of 67-kilodalton laminin receptor messenger RNA induced by dexamethasone. The hormonal modulation of cell matrix interactions opens interesting perspectives to the potential regulation of infiltrative growth and metastasis in pancreatic cancer.     

External beam radiation after stent implantation increases neointimal hyperplasia by augmenting smooth muscle cell proliferation and extracellular matrix accumulation.

OBJECTIVES: We sought to examine the effects of high volume external beam radiation (EBR) after stent implantation on neointimal hyperplasia, smooth muscle cell (SMC) proliferation, presence of inflammatory cells and expression of extracellular matrix (ECM). BACKGROUND: Endovascular irradiation has been shown to reduce restenosis rates after angioplasty in preliminary trials, but conflicting results have been reported for the effects of external beam irradiation. METHODS: Forty-three Palmaz-Schatz stents were implanted into iliac arteries of New Zealand White rabbits. The arteries were externally irradiated after stent implantation with a single dose of 8 Gy (at day 3) or 16 Gy in two fractions (8 Gy at days 3 and 4) by means of a linear accelerator. In the control rabbits, no radiation was applied after stent implantation. Smooth muscle cells, macrophages and ECM were studied by immunohistochemistry at one and 12 weeks after stent implantation. Collagen type I and biglycan messenger ribonucleic acid (mRNA) levels were assessed by Northern blot analysis at one week. Neointimal cell densities and arterial lumen stenosis were measured by histomorphometry at 12 weeks. RESULTS: At 1 week, SMC proliferation at the site of stent implantation was increased after EBR with 8 and 16 Gy (26 +/- 5%, 32 +/- 3% vs. 17 +/- 8%; p < 0.01, 16 Gy vs. control). External beam radiation with 8 and 16 Gy augmented SMC proliferation proximal and distal to the angioplasty site (11 +/- 3%, 14 +/- 3 vs. 6 +/- 1%; p < 0.01, 16 Gy vs. control). Collagen type I and biglycan mRNA levels were elevated in stented arteries after EBR with 16 Gy. At 12 weeks, a marked decrease in neointimal cell density (248 +/- 97 vs. 498 +/- 117 SMCs/0.1 mm2 neointima; p < 0.005 vs. control) was noted after EBR with 16 Gy. Irradiation with 8 and 16 Gy increased arterial lumen stenosis compared with nonirradiated control rabbits (45 +/- 7%, 55 +/- 9% vs. 33 +/- 7%; p < 0.05, 8 Gy and p < 0.001, 16 Gy vs. control). CONCLUSIONS: High volume external beam radiation at doses of 8 or 16 Gy causes restenosis by augmenting proliferative activity at and adjacent to the site of stent implantation, and by dose-dependent up-regulation of extracellular matrix expression. The study suggests that excessive matrix accumulation is an important determinant of failure of radiation therapy to prevent restenosis.     

Muscle strength and fatigue after selective glycogen depletion in human skeletal muscle fibers

Summary Two groups of male subjects were studied to examine the effects of different exercise protocols on performance of an isokinetic, short-time strength test, the performance of which is related to fast twitch (FT) muscle fiber recruitment. The laboratory group (LG) (n=10) cycled (30 min, 70% VO₂ max), ran (75 min), and performed repeated bouts of sprint cycling and rapid, maximal contractions of the quadriceps. The marathon group (MG) (n=7) participated in and completed Stockholm's Marathon 1979. A strength test was performed before and within 1–2 h after completion of the group exercise protocol. The m. vastus lateralis was biopsied and muscle fibers classified as slow twitch (ST) or FT. After periodic acid-Schiff staining fibers were qualitatively classified as to glycogen content. In LG significant glycogen depletion occurred in both fiber types and in MG predominantly ST fibers were exhausted of glycogen after the exercise protocol. The glycogen exhaustion from both fiber types in LG was associated with impaired maximal muscular strength produced during a single dynamic contraction, as well as with reduced muscle fatigue patterns. When glycogen exhaustion was induced in ST muscle fibers only in the MG, no impairment was observed for maximal muscular strength but fatigue during 50 consecutive contractions was significantly increased.This study was supported in part by Coca-Cola Export Corporation, Sweden