Serum lycopene concentrations and carotid atherosclerosis: the Kuopio Ischaemic Heart Disease Risk Factor Study

BACKGROUND: Interest in lycopene is growing rapidly following the recent publication of epidemiologic studies in which high circulating lycopene concentrations were associated with reductions in cardiovascular disease. Lycopene is one of the major carotenoids in the Western diet and is probably one of the protective factors in a vegetable-rich diet. OBJECTIVE: We studied the hypothesis that the intima-media thickness of the common carotid artery (CCA-IMT) would be greater in men with low serum lycopene concentrations. DESIGN: We investigated the relation between serum lycopene concentration and CCA-IMT in 1028 middle-aged men (aged 46-64 y) in eastern Finland who were participants in the Kuopio Ischaemic Heart Disease Risk Factor study and who were examined in 1991-1993. The subjects were classified into quarters according to serum lycopene concentration. RESULTS: In a covariance analysis with adjustment for covariates, the men in the lowest quarter of serum lycopene concentration had a significantly higher mean CCA-IMT and maximal CCA-IMT (P = 0.005 and P = 0.001 for the difference, respectively) than did the other men. The mean and maximal CCA-IMT increased linearly across the quarters of serum lycopene concentration. CONCLUSIONS: A low serum lycopene concentration is associated with a higher CCA-IMT in middle-aged men from eastern Finland. This finding suggests that the serum lycopene concentration may play a role in the early stages of atherosclerosis. Increased thickness of the intima-media has been shown to predict coronary events; thus, lycopene intakes and serum concentrations may have clinical and public health relevance.     

Immunization of Early Adolescent Females with Human Papillomavirus Type 16 and 18 L1 Virus-Like Particle Vaccine Containing AS04 Adjuvant

PurposeIn female individuals 15–25-years of age, the AS04-containing human papillomavirus (HPV)–16/18 vaccine is highly immunogenic and provides up to 100% protection against HPV-16/18 persistent infection and associated cervical lesions up to 4.5 years. Optimal cervical cancer prevention will require prophylactic vaccination against oncogenic HPV 16 and 18 before the onset of sexual activity in early adolescent girls. To establish the feasibility of vaccination in girls 10–14 years of age, we compared the immunogenicity and safety in early adolescent female individuals to those 15–25 years in whom vaccine efficacy has been demonstrated.MethodsWe enrolled 773 female participants aged 10–14 years and 15–25 years to receive the HPV-16/18 L1 VLP AS04 vaccine, which was administered at months 0, 1, and 6. Serum samples were collected at months 0 and 7; antibodies to HPV 16 and 18 VLPs were measured by enzyme-linked immunosorbent assay. Vaccine safety was assessed at 7 or 30 days after each dose; serious adverse events were recorded during the entire study period.ResultsBoth age groups achieved 100% seroconversion for HPV 16 and 18. Participants in the group aged 10–14 years were not only noninferior to those 15–25 years in terms of HPV 16 and 18 seroconversion rates but also had approximately twice as high geometric mean titers. The vaccine was generally safe and well tolerated.ConclusionsThese findings suggest that HPV vaccination during early adolescence is generally safe, well tolerated, and highly immunogenic. The observed higher antibody titers in the group 10–14 years of age are likely to result in longer antibody persistence. Overall, these data support the implementation of prophylactic HPV vaccination in this age group.     

A preliminary report--heparin counteracts indomethacin effect on ductus arteriosus in very low birthweight infants.

OBJECTIVE: We report a clinical observation showing that continuous exposure to heparin via a central venous catheter is associated with patent ductus arteriosus treatment failure with indomethacin in very low birthweight infants. STUDY SELECTION: A clinical observational case report in infants weighting <1501 g. DATA EXTRACTION: This study compares the rates of patent ductus arteriosus treatment failure during a) the index period from June 2, 2003, to August 22, 2003, when all very low birthweight infants with a peripherally inserted central venous catheter received continuous infusion of heparinized parenteral nutrition; b) the baseline period of 1 yr before the index period; and c) the postindex period of 1 yr after the index period. DATA SYNTHESIS: The rate of patent ductus arteriosus treatment failure with indomethacin increased significantly during the index period compared with the baseline (odds ratio, 7.0; 95% confidence interval, 1.41-34.7; p = .017) and postindex periods (odds ratio, 33.8; 95% confidence interval, 4.72-243; p = .0005). The result was confirmed in logistic multivariable regression analysis. CONCLUSION: This observation, based on a case series and their controls, serves as a basis for a new hypothesis suggesting that continuous exposure to heparin through heparinized central venous infusion significantly increases patent ductus arteriosus treatment failure with indomethacin. This hypothesis needs to be tested in a randomized controlled trial.     

Incremental cost‐effectiveness of double‐reading mammograms

Background. Double reading is a widely used criterion standard in breast cancer screening despite a lack of evidence of the costeffectiveness of the second reading. This study evaluates the incremental costeffectiveness of such a strategy.Design. Costeffectiveness analysis: Nationwide populationbased semiannual screening program for women aged 50–59 in Finland. Participation rate was 91%. All mammograms (95,423) performed during 1990–1995 in three screening centers of the Finnish Cancer Society were read by two radiologists with gradings recorded. The effectiveness of the double reading was the difference in cancers detected in the double compared to that of the single reading. Incremental costs of the double reading for the health care and nonhealth care and the time costs were estimated. The main outcome measure was the incremental cost per additional cancer found as a result of the doublereading strategy.Results. The total number of cancers detected with the double and single reading were 290 and 261, respectively. A significantly higher ratio of carcinoma in situ was the causative pathology in cancers detected only by the second reader. The cost per cancer detected with a single reading was US$ 18,340. The incremental cost of any additional cancer found was US$ 25,523, that is, a 39% higher cost per additional cancer found by double reading.Conclusions. The additional cost per cancer detected by double reading is not drastically higher than with single reading. However, the additional cost per life year saved may be much higher.     

Late hearing results after paraffinplasty or silastic sheeting

Summary The long-term hearing results are presented for 135 ears operated on radically. In 59 of the ears temporary paraffin filling of the tympanic cavity was employed after the removal of the typanic mucosa at operation. The filling material was removed, and the ossiculoplasty was performed about 6 months later. In 76 ears a one-stage operation with tympanoplasty and Silastic sheeting was employed.There were no statistical differences between the groups of ears mentioned according to hearing results early (1 year) or late (5–14 years) postoperatively or in the deterioration of the air-bone gaps after the first postoperative year (P>0.05). The late change in the air-bone gap was significant in both groups (paraffin group: 6.1 dB; Silastic sheeting group: 5.7 dB; P<0.05). The total improvement of hearing late after surgery (as compared to the preoperative hearing) was significantly better in the paraffin group than in ears with Silastic sheeting (P<0.05). Paraffinplasty seems to be a suitable way to avoid tympanic adhesions.     

Comparison of the effects of epibatidine and nicotine on the output of dopamine in the dorsal and ventral striatum of freely-moving rats

The effects of the nicotinic acetylcholine receptor (nAChR) agonist epibatidine on the extracellular concentrations of dopamine (DA) and its metabolites 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in the dorsal (caudate-putamen) and the ventral striatum (nucleus accumbens) of freely-moving male Wistar rats were studied by in vivo microdialysis. In the dorsal striatum, epibatidine (3.0 microg/kg s.c.) significantly elevated the extracellular concentrations of DA, DOPAC and HVA. In contrast, epibatidine did not alter the extracellular DA concentration in the ventral striatum, but elevated significantly the concentration of DOPAC and also tended to elevate that of HVA. In parallel experiments, nicotine (0.5 mg/kg s.c.) significantly increased DA output in the ventral striatum whereas only a modest and non-significant increase of extracellular DA concentration was found in the dorsal striatum. Earlier studies have shown that the doses of epibatidine and nicotine used in the present study are about equieffective at least with respect to the analgesia-producing or hypothermic effects of the drugs. Comparison of the effects of epibatidine and nicotine suggests that the responses of the mesolimbic and nigrostriatal dopaminergic systems to the two nicotinic receptor agonists differ. Epibatidine, in contrast to nicotine, preferentially stimulates the nigrostriatal vs. the mesolimbic dopaminergic system. Therefore, novel nicotinic AChR ligands structurally related to epibatidine may have low abuse potential.     

The preoperative state of infection in chronic otitis media correlated with postoperative hearing results

Summary The postoperative long-term hearing results, with special reference to the state and management of the tympanic mucosa at operation, in 627 ears (574 patients) after an annual clinical follow-up period of 5–14 years are presented. The ears were operated on radically due to chronic otitis media, using the obliterative radical operation technique developed by T. Palva. The air-bone gap improved from the preoperative level significantly more in ears where the tympanic mucosa had been preserved than in ears where it had been removed at operation (p < 0.001). The improvement was also significantly better in dry ears than in ears which were moist or discharging at operation (p < 0.05). The mean late deterioration in the air-bone gap after the first follow-up year was significant in all the groups of ears (p < 0.05), and the mean long-term change in air-bone gap from pre- to late postoperative examination was the improvement of 3.0 dB in ears with, and a deterioration of 2.0 dB in ears without ossicular reconstruction.     

Occupational exposure to solvents and cerebellar,brainstem and vestibular functions

Summary Forty-eight persons (age 44, SD 9 years) exposed to paint solvents and 40 nonexposed referents (age 45, SD 9 years) were examined. The duration of exposure was 4 to 30 (mean 20) years and the life-time exposure level was estimated to have been 10 to 330 (mean 60%) of the hygienic standard. The methods used were a neurological examination, electroencephalography, brainstem auditory-evoked potentials, electronystagmography, and posturography. Lifetime exposure was estimated on the basis of a detailed occupational history and environmental measurements made at the work places over several years. The average weekly alcohol consumption was established in a detailed interview. Due to the small number of subjects examined, the study was inconclusive. The findings classified as abnormal were slightly more common in the exposed than in the referents, and in the persons who used alcohol than in the non-users. The differences were not statistically significant, and no exposure-response relationships were found.