Racial differences in the treatment of colorectal cancer: a comparison of surgical and radiation therapy between Whites and Blacks

PURPOSE: To evaluate black to white differences in treatment for colorectal cancer. METHODS: Only whites or blacks diagnosed with colon or rectal cancer between 1988 and 1997 were identified from SEER database. RESULTS: A total of 106,377 (91.3% white, 50.5% male) patients formed the study population. The vast majority of these patients received standard cancer treatment. Although the number of subjects who did not receive such treatment was small, their proportion was higher among blacks than among whites. The odds of non-receipt of surgical treatment was higher among blacks than whites for stage I (OR = 2.08, 95% CI, 1.41, 3.03 among males; OR = 2.38, 95% CI, 1.69, 3.45 among females) and stage IV colon cancer (OR = 1.25, 95% CI, 1.01, 1.56 among males; OR = 1.41; 95% CI, 1.14, 1.72 among females). A similar pattern was also seen for most stages of rectal cancer. CONCLUSIONS: Most black and white colorectal cancer patients received standard treatment. Although the number of subjects without standard treatment was small, their proportion was higher among blacks than among whites. Blacks were also more likely to refuse recommended treatment. Efforts in educating black patients about the benefits of treatment may help to eliminate the remaining racial disparity.     

Plasma magnesium in adult Nigerian patients with epilepsy

The objective of this study was to determine the relationship between plasma magnesium levels and epilepsy. The study was carried out at the Lagos University Teaching Hospital. Plasma magnesium was estimated using the calmigite dye colorimetric method in 45 adults with epilepsy and 35 healthy controls. Plasma concentrations of calcium, phosphorus and albumin were also estimated. The mean plasma magnesium in the patients was 0.98 mm0l/L (0.05) while that in the controls was 1.15 mmol/L (0.28). The mean plasma magnesium in the epileptics was significantly lower than that obtained in the controls (p < 0.001). Age of onset of seizures, seizure frequency and duration of treatment did not influence the plasma magnesium levels. Low plasma magnesium is associated with epilepsy, further studies may determine the influence of anti-epileptic drug therapy on plasma magnesium levels. Keywords: magnesium, seizures, Nigeria.     

Biochemical evaluation of leachate-contaminated groundwater on the kidney of Albino rats

The effect of leachate-contaminated groundwater on the cells of the kidney was evaluated. Serum Na⁺ concentration of control rats was observed to be 120±1.0 nmol/l while that of rat placed on simulated leachate was 180±4.0 nmol/l. Serum K⁺, urea and creatinine concentrations of rats placed on simulated leachate and leachate-contaminated groundwater were significantly higher(p<0.05) than those of control rats. The activity of Alkaline phosphatase (ALP) of the kidney and serum, respectively, observed for the control rats were (237±3.70 and 0.37±0.01)nmol/min/mg protein while (116±4.20 and 3.17±0.20)nmol/min/mg protein was the ALP activity of kidney and serum, respectively, observed for the rats placed on simulated leachate. Histological examination of the kidney of the control rats showed no visible lesion while that of rats placed on simulated leachate showed extensive necrosis of muscle fibres and cellular infiltration by macrophages. It is viewed that leachate-contaminated groundwater may damage kidney cells and impair renal function.     

Prevalence of Hypertension among Urban Slum Dwellers in Lagos, Nigeria

Urban slum dwellers are not only prone to develop communicable diseases but also to non-communicable disease (NCDs). The extent and magnitude of NCDs among slum dwellers is largely unknown in Nigeria. A total of 964 adults aged 20–81 years (male 330 and female 634) residing in the urban slum of Ajegunle in Lagos State, Nigeria were studied to determine the prevalence of hypertension and associated factors. The overall prevalence of hypertension was 38.2 %. Of the 368 respondents identified as having hypertension, only 50 (5.2 %) respondents were previously aware of their diagnosis. Of the 50 known hypertensive patients, 48(96 %) had poor control of their high blood pressure. The socio-demographic factors significantly associated with hypertension status were age, sex, education, religion, BMI, and marital status. The study concludes a high prevalence of hypertension among urban slums dwellers in Lagos. The need for government to develop policies for the control of hypertension, improve access to early diagnosis and provide an enabling socioeconomic environment while promoting healthy living.     

Association of tooth loss with hypertension.

OBJECTIVE: Hypertension may result from changes in dietary quality and nutrient intake. We therefore sought to determine the epidemiological association between tooth loss and hypertension in South African adults. METHODS: This is a secondary data analysis of a cross-sectional survey of a nationally representative sample of adults aged 25 - 70 years who participated in the South African Demographic and Health Survey during 1998 (N = 9 098). The primary data were collected using a validated questionnaire, which included information on past experience of tooth loss (partial or complete), use of dental services, tobacco use and other known risk factors for hypertension. Hypertension was defined as having a measured average blood pressure (BP) > or = 160/95 mmHg and/or taking antihypertensive medication. RESULTS: The prevalences of hypertension, any tooth loss and complete edentulousness were 18.1%, 72.2% and 9.4% respectively. Tooth loss was more common among overweight/obese respondents than among those with a normal body mass index (76.7% v. 66.7%; p < 0.01). Compared with the fully dentate respondents, the completely edentulous respondents had mean systolic and diastolic BPs that were respectively 12 mmHg and 5 mmHg higher. After adjusting for known risk factors for hypertension in a multiple logistic regression model, being completely edentulous remained significantly associated with hypertension (odds ratio 1.35, 95% confidence interval 1.02 - 1.78). The estimated population-attributable fraction of hypertension resulting from complete edentulousness was 10%. CONCLUSIONS: The findings suggest that complete edentulousness is a risk indicator for hypertension in South Africa and highlights the importance of primary care practitioner involvement in oral health promotion.     

Quantitative Tract-Specific Measures of Uncinate and Cingulum in Major Depression Using Diffusion Tensor Imaging

Previous findings suggested the role of the prefrontal cortex, hippocampus, and cingulate gyrus in major depressive disorders (MDD), but the white matter microstructural abnormalities of the fibers connecting these brain structures are not known. The purpose of this study was to test the hypothesis that white matter abnormalities are present in association fibers of the uncinate fasciculus (UF) and cingulum bundle (CB) among MDD subjects. A total of 21 MDD subjects aged between 30 and 65 years and 21 age-matched healthy controls (HC) were recruited. All subjects were right-handed and without history of diabetes or other cardiac diseases. We extracted quantitative tract-specific measures based on diffusion tensor imaging tractography to examine both diffusivity and geometric properties of the UF and CB. Significantly decreased fractional anisotropy (FA) and increased radial diffusivity of the right UF were observed in MDD patients compared with HC (p<0.05), while their geometric characteristics remained relatively unchanged. Among MDD subjects, depression severity had a significant negative correlation with normalized number of fibers (NNF) in the right UF (r=−0.53, p=0.02). We also found significant age effect (old<young) in HC group and laterality effect (L>R) in both groups in the FA measure of the CB. Our study demonstrates novel findings of white matter microstructural abnormalities of the right UF in MDD. In the MDD group, the severity of depression is associated with reduced NNF in the right UF. These findings have implications for both clinical manifestations of depression as well as its pathophysiology.     

The kinetics of thermal instability in nanocrystalline silver and the effect of heat treatment on the antibacterial activity of nanocrystalline silver dressings

The kinetics of nanocrystalline silver dressing heat treatment was investigated via isothermal heat treatments at 90 °C, 100 °C, and 110 °C lasting 2–50 h. Bactericidal efficacy of the dressings was measured via log reductions, while bacteriostatic longevity was determined via plate-to-plate transfer corrected zones of inhibition. Morphological evolution of the dressing was studied by X-ray diffraction, scanning electron microscopy, and X-ray photoelectron spectroscopy, while changes in heat flow were measured by differential scanning calorimetry. Increasing temperature increased the rate at which dressing bactericidal activity and bacteriostatic longevity decreased. Once changes in dressing properties began, they occurred nonlinearly with time. The earliest biological, chemical, and physical indicators of altered dressing properties were loss of bacteriostatic longevity, silver–oxygen bonds, and fine features, respectively. An early change in heat flow appeared to be responsible for these indicators, while a later change corresponded to rapid grain growth occurring after a critical crystallite size (30 nm) was reached. The grain growth exponent was determined to be 2.8 for temperatures of 100–110 °C, with an activation energy of 177 kJ/mol, suggesting that normal grain growth occurred, with volume and/or grain boundary diffusion as the dominant forms of diffusion. The thermal instability of nanocrystalline silver should be accounted for during production, storage, and use of dressings. The properties required for nanosilver antimicrobial efficacy demonstrated in this study, as well as its thermal instability, should be taken into consideration for the development of nanosilver products in the future.     

Factors associated with attitudes towards intimate partner violence against women: a comparative analysis of 17 sub-Saharan countries

Background  

Violence against women, especially by intimate partners, is a serious public health problem that is associated with physical, reproductive and mental health consequences. Even though most societies proscribe violence against women, the reality is that violations against women's rights are often sanctioned under the garb of cultural practices and norms, or through misinterpretation of religious tenets.     

A trend analysis and sub-regional distribution in number of people living with HIV and dying with TB in Africa, 1991 to 2006

Background

Graph theoretical methods are extensively used in the field of computational chemistry to search datasets of compounds to see if they contain particular molecular sub-structures or patterns. We describe a preliminary application of a graph theoretical method, developed in computational chemistry, to geographical epidemiology in relation to testing a prior hypothesis. We tested the methodology on the hypothesis that if a socioeconomically deprived neighbourhood is situated in a wider deprived area, then that neighbourhood would experience greater adverse effects on mortality compared with a similarly deprived neighbourhood which is situated in a wider area with generally less deprivation.

Methods

We used the Trent Region Health Authority area for this study, which contained 10,665 census enumeration districts (CED). Graphs are mathematical representations of objects and their relationships and within the context of this study, nodes represented CEDs and edges were determined by whether or not CEDs were neighbours (shared a common boundary). The overall area in this study was represented by one large graph comprising all CEDs in the region, along with their adjacency information. We used mortality data from 1988–1998, CED level population estimates and the Townsend Material Deprivation Index as an indicator of neighbourhood level deprivation. We defined deprived CEDs as those in the top 20% most deprived in the Region. We then set out to classify these deprived CEDs into seven groups defined by increasing deprivation levels in the neighbouring CEDs. 506 (24.2%) of the deprived CEDs had five adjacent CEDs and we limited pattern development and searching to these CEDs. We developed seven query patterns and used the RASCAL (Rapid Similarity Calculator) program to carry out the search for each of the query patterns. This program used a maximum common subgraph isomorphism method which was modified to handle geographical data.

Results

Of the 506 deprived CEDs, 10 were not identified as belonging to any of the seven groups because they were adjacent to a CED with a missing deprivation category quintile, and none fell within query Group 1 (a deprived CED for which all five adjacent CEDs were affluent). Only four CEDs fell within Group 2, which was defined as having four affluent adjacent CEDs and one non-affluent adjacent CED. The numbers of CEDs in Groups 3–7 were 17, 214, 95, 81 and 85 respectively. Age and sex adjusted mortality rate ratios showed a non-significant trend towards increasing mortality risk across Groups (Chi-square = 3.26, df = 1, p = 0.07).

Conclusion

Graph theoretical methods developed in computational chemistry may be a useful addition to the current GIS based methods available for geographical epidemiology but further developmental work is required. An important requirement will be the development of methods for specifying multiple complex search patterns. Further work is also required to examine the utility of using distance, as opposed to adjacency, to describe edges in graphs, and to examine methods for pattern specification when the nodes have multiple attributes attached to them.