Joint effect of HPV16 with Chlamydia trachomatis and smoking on risk of cervical cancer: antagonism or misclassification (Nordic countries)

Objectives:To estimate the joint effects of infections with human papillomavirus type 16 (HPV16) and Chlamydia trachomatis and smoking on the risk of cervical cancer. To study whether the joint effects can be accounted for by misclassification in the HPV serology. Methods:A nested case–control study with incidence density sampling was conducted in three cohorts of 530,000 women, who donated serum samples to three Nordic serum banks in 1973–1994. The main outcome measure is the odds ratio (OR) of incidence rates of invasive cervical squamous cell carcinoma (SCC) among those seropositive for HPV16 and/or C. trachomatis and/or with increased levels of cotinine in serum compared to those negative for all the three exposures. Results:Two hundred eight women with SCC and 624 matched controls were identified during a mean follow-up of 5 years through linkage to the national cancer registries. Exposure to past infections and smoking was defined by presence of specific IgG antibodies to HPV16 and C. trachomatis and increased levels of serum cotinine. Observed ORs were compared to OR = 20 for HPV16 and accounting the differences for by misclassification bias. OR = 20 was elected as a gold standard on the basis of other studies with PCR-based analyses and a follow-up design. Each of the three exposures was associated with an increased risk of SCC (OR = 5.4 for HPV16, 3.4 for C. trachomatis and 1.8 for cotinine). The interaction was antagonistic (observed OR = 2.5 among those positive for all three exposures as compared to OR = 33 expected on the basis of multiplicative single effects (p = 0.047)). The antagonism could not totally be accounted for by any credible combination of sensitivity and specificity of HPV16 serology. Conclusion:HPV16, C. trachomatis, and smoking are likely to be risk factors of SCC with strong antagonistic joint effect. Non-differential misclassification in serology for HPV16 could be ruled out (but only some types of differential) as an alternative explanation for the observed antagonism.     

trkC-like Immunoreactivity in the Primate Descending Serotoninergic System

In the search for substances with a potential role in plastic responses of spinal motoneurons we have studied the distribution of trkC-like immunoreactivity in the spinal cord of adult monkeys (Macaca fascicularis). The presence of trkC, which is a signal-transducing receptor for neurotrophin-3, was detected by the use of indirect immunofluorescence with a rabbit polyclonal antibody raised against a synthetic peptide corresponding to the carboxy-terminal domain of the mouse trkC-encoded protein, thus detecting only full-length signal-transducing receptors. trkC -immunoreactive fibres/varicosities could be found at all spinal cord levels and the densest innervation was found in the autonomic intermediolateral and Onuf's nuclei, but somatic motoneuron pools also received a significant contribution of trkC-immunoreactive fibres. Terminals immunoreactive for trkC were also seen in the dorsal horn. Double-labelling experiments revealed a high degree of coexistence between trkC- and 5-hydroxytryptamine (serotonin)-like immunoreactivity in all areas except in the dorsal horn. The results of the present study suggest that neurotrophic signalling with an influence on serotoninergic as well as non-serotoninergic inputs to the adult monkey spinal cord is at hand.     

THE EFFECT OF INTRAARTERIAL ADMINISTERED AMINOPHYLLINE ON CEREBRAL HEMODYNAMICS IN MAN

The dose-effect relationship of intracarotid administered aminophylline on cerebral hemodynamics in man was investigated by means of an intraarterial ¹³³Xenon injection method. A dose dependent vasoconstriction was clearly demonstrated. The maximum efficacy expressed as mcasured decreased in global cerebral blood flow was 21.9 per cent ± 6.2 SD. Administration of as little as 1 mg aminophylline produced a measureable vasoconstriction.     

Theory and action for health promotion illustrations from the North Karelia Project.

The North Karelia Project in Finland illustrates the fundamental goals of health promotion. Specific activities of the project serve as examples of how concepts from the social and behavioral sciences can be applied to achieve estimated reductions in predicted risk of disease. The results in North Karelia are not conclusive, but they are encouraging, and the investigations conducted there is an essential reference for future research in health promotion and disease prevention.     

Subgroups of Alzheimer's disease based on cerebrospinal fluid molecular markers

Alzheimer's disease, the most common cause of dementia, is multifactorial and heterogeneous; its diagnosis remains probable. We postulated that more than one disease mechanism yielded Alzheimer's histopathology, and that subgroups of the disease might be identified by the cerebrospinal fluid (CSF) levels of proteins associated with senile (neuritic) plaques and neurofibrillary tangles. We immunoassayed levels of tau, ubiquitin, and Abeta(1-42) in retrospectively collected CSF samples of 468 clinically diagnosed Alzheimer's disease patients (N = 353) or non-Alzheimer's subjects (N = 115). Latent profile analysis assigned each subject to a cluster based on the levels of these molecular markers. Alzheimer's disease was subdivided into at least five subgroups based on CSF levels of Abeta(1-42), tau, and ubiquitin; each subgroup presented a different clinical profile. These subgroups, which can be identified by CSF analysis, might benefit differently from different therapeutic drugs.