South African Fathers Involvement and Their Adolescents’ Sexual Risk Behavior and Alcohol Consumption

Although considerable research has examined the influence of parent-adolescent relationships on the sexual health of adolescents, there is a great need for research to understand the influence of fathers on their children’s HIV sexual risk behavior, particularly in sub-Saharan Africa. We examined how the residence and the involvement of fathers are related to their children’s HIV sexual risk and alcohol consumption behaviors. A cross-sectional survey was completed by 175 sixth-grade adolescents in the Eastern Cape Province, South Africa. Analyses showed that adolescents living with their fathers had fewer sexual partners (B?=?? 0.606, SE?=?0.299, p?=?.043) and consumed alcohol less frequently (B?=?? 0.642, SE?=?0.294, p?=?.029). Adolescents who spent more quality days with their fathers in the past 30 days had fewer sexual partners (B?=?? 0.103, SE?=?0.039, p?=?.008) and had condomless sex less frequently (B?=?? 0.097, SE?=?0.047, p?=?0.041). It was also found that there were significant father-residence?×?child-gender interactions on sexual debut (B?=?1.132, SE?=?0.564, p?=?.045) and on frequency of condomless sex (B?=?? 2.140, SE?=?0.924, p?=?.021). These interactions indicate that boys living with their fathers were less likely to have had vaginal intercourse than girls and that girls living with their fathers were less likely to have unprotected sex than boys. This study highlights the importance of South African fathers’ roles in their adolescent children’s HIV sexual risk and alcohol drinking behaviors and the need to promote father-child relationships for adolescent health. The results suggest that health programs aiming to reduce South African adolescents’ HIV sexual risk behaviors and alcohol consumption consider strategies that target their fathers.

     

Predictors of Colorectal Cancer Screening Among African American Men Living with HIV

Journal of Community Health - African American men living with HIV are at high risk of colorectal cancer (CRC). Screening to detect CRC is associated with a reduced risk of CRC mortality. However,...     

Wireless 24, 48, and 96 Hour or Impedance or Oropharyngeal Prolonged pH Monitoring: Which Test,When, and Why for GERD?

Purpose of Review

pH monitoring technologies are routinely utilized in practice to further evaluate symptoms of gastro-esophageal reflux disease and laryngopharyngeal reflux (LPR). This is a review of the recent literature of the available pH monitoring technology and creates an algorithm in the diagnostic work up of a patient with GERD or LPR.

Recent Findings

The catheter-free wireless pH monitor traditionally collects data for 48 h. Recent studies have found that extending to 96 h can be helpful in patients with conflicting results on the first 2 days of the study. In addition, 96 h can allow for testing both on and off of PPI therapy. The oropharyngeal monitoring device is a newer technology that is designed to aid in the diagnoses of LPR. There are limitations with this technology as there is no universal abnormal cutoff and some studies have suggested a poor correlation between multichannel intraluminal impedance-pH (MII-pH) and the oropharyngeal monitoring device. MII-pH has recently developed two additional parameters, the measurement of three 10-min nighttime periods and the post-reflux swallow-induced peristaltic wave (PSPW) index, both of which may increase accuracy of testing.

Summary

Each of these technologies can provide unique data regarding acid reflux exposure in the esophagus and oropharynx. The wireless pH monitor performed off of PPI therapy can help to establish or exclude the diagnosis of GERD. For those patients with refractory symptoms on PPI, MII-pH study can be performed while on therapy and provides data regarding the response to treatment. Oropharyngeal pH monitoring is being utilized in some practices to aid in diagnosis of LPR, but the scientific validity is controversial.

     

Ciglitazone,a Peroxisome Proliferator-Activated Receptor Gamma Ligand,Inhibits Proliferation and Differentiation of Th17 Cells

Peroxisome proliferator-activated receptor gamma (PPARγ) was identified as a cell-intrinsic regulator of Th17 cell differentiation. Th17 cells have been associated with several autoimmune diseases, including experimental autoimmune encephalomyelitis (EAE), inflammatory bowel disease (IBD), and collagen-induced arthritis. In this study, we confirmed PPARγ-mediated inhibition of Th17 cell differentiation and cytokine production at an early stage. Treatment with ciglitazone, a PPARγ ligand, reduced both IL-1β-mediated enhancement of Th17 differentiation and activation of Th17 cells after polarization. For Th17 cell differentiation, we found that ciglitazone-treated cells had a relatively low proliferative activity and produced a lower amount of cytokines, regardless of the presence of IL-1β. The inhibitory activity of ciglitazone might be due to decrease of CCNB1 expression, which regulates the cell cycle in T cells. Hence, we postulate that a pharmaceutical PPARγ activator might be a potent candidate for treatment of Th17-mediated autoimmune disease patients.     

Addressing Gender Disparity: Increase in Female Leadership Increases Gender Equality in Program Director and Fellow Ranks

Digestive Diseases and Sciences - Women make up 15% of the total number of practicing gastroenterology (GI) physicians in the US. Despite this disparity, only 33% of the current GI fellows are...     

Objective preoperative estimation of the ability of primary closure on anterolateral thigh free flap donor site: Circumference and area ratios of deep tissue to thigh

Purpose: The purpose of this study was to consider the relationship between the ratio of deep tissue including muscle to thigh at donor sites and the possibility of performing primary closure of donor site. Methods: The subjects were 74 patients who had harvesting of anterolateral thigh (ALT) free flap from June 2005 to June 2011. Primary closure was possible for 65 but not possible for 9. All received CT angiography of lower extremity before their operations. We measured circumference and cross‐sectional area of thigh and deep tissue including muscle at the reference point. Using the measured data, we examined the ratio of circumference as well as cross‐sectional area of deep tissue including muscles to thighs. Results: For whom primary closure was possible, the ratio of deep tissue including muscle's circumference to thigh's at the reference point was 0.83 ± 0.07 on average, and the ratio of cross‐sectional area was 0.68 ± 0.11. For whom primary closure was not possible, the ratio of circumference was 0.89 ± 0.06 on average, and the cross‐section areas was 0.8 ± 0.07. The average width of flap for those with primary closure was 64.9 mm and without primary closure was 84.4 mm. There was statistical significance in ratios of circumference and cross‐sectional area between primary closure and without primary closure. Conclusion: Primary closure of donor site when performing ALT free flap gets increasingly difficult as the ratio of deep tissue including muscle in the thighs increased. Such information prior to the procedure will be helpful in determining flap design and finalizing the operation plan. © 2013 Wiley Periodicals, Inc. Microsurgery, 2013.