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Biomedical subjects

M Bassett

Publications and source records attributed to M Bassett.

At least 19 recordsLinked to original sources
PubMed2001

Prostate carcinoma knowledge, attitudes, and screening behavior among African-American men in Central Harlem, New York City.

BACKGROUND: Although the benefits of prostate carcinoma screening in reducing mortality rates have not been proven or shown to be cost-effective, screening, particularly using prostate specific antigen (PSA) tests, is widespread. A better understanding of screening behavior, knowledge of prostate carcinoma risk, and attitudes toward screening among men at high risk, such as African-American men, would be valuable. METHODS: A prevalence survey was conducted using 2 samples of African-American men, aged 50-74 years: a clinic sample drawn from all clinics in Central Harlem (n = 404) and a random-digit dial sample from the same geographic region (n = 319). The prevalence of self-reported PSA screening was estimated using a cognitive survey methodology based on the internal consistency of answers to four different questions. Prevalence estimates were adjusted to take into account the high proportion of nontelephone residences. RESULTS: The clinic sample, representing a poorer, more ill population (as determined by MOS Physical Function Scores, was less likely to report PSA screening than the community sample (11.1% in clinic sample vs. 25.5% in community). The prevalence of PSA testing in Central Harlem overall in this age group by using two different techniques was estimated to be 24%. In multiple logistic models, self-reported PSA screening was associated with age, education, favorable attitudes toward screening, and knowing someone who had prostate carcinoma. However, the association between these factors and the likelihood of self-reported PSA screening differed between clinic and community samples. CONCLUSIONS: The prevalence of self-reported PSA screening in Central Harlem was lower than that reported for other populations. These findings may be useful in the design of health education campaigns and for counseling innercity, low-income African-American patients appropriately about the disease.

Black or African American↗
PubMed2000

Proximal shift of colorectal cancer in the Australian Capital Territory over 20 years.

BACKGROUND: Several studies in other countries have demonstrated a change in subsite distribution of colorectal cancer, with increasing proximal cancers. Confirmation of such a change in Australia would have implications for screening and diagnosis of colorectal cancer. AIMS: To determine whether there has been an increase in the proportion of proximal colorectal cancers in Australia, and whether there have been changes in other clinical and pathological aspects of colorectal cancer. METHODS: A study of the hospital files of patients with colorectal cancer diagnosed and treated at all hospitals in the Australian Capital Territory (ACT) between 1989 and 1995 was compared with data from a published study of patients diagnosed between 1969 and 1976. RESULTS: There was a proximal shift of cancers with a significant increase in the proportion of tumours in the hepatic flexure, ascending colon and caecum, more marked for females than males. There was a corresponding reduction in distal colorectal cancers. Time from onset of symptoms to diagnosis decreased, risk factors for colorectal cancer were noted more frequently, and endoscopy replaced barium enema X-ray as the main diagnostic modality. The resectability of cancers increased, stay in hospital and 30 day mortality declined. Despite apparent earlier presentation and improved surgical resectability, the proportion of patients with localised disease (Dukes' stage A and B) had not changed significantly. CONCLUSIONS: We have detected a number of changes in clinical and pathological aspects of colorectal cancer over a 20 year period in the ACT, including a proximal shift in the subsite distribution of colorectal cancer. These changes suggest that proximal and distal colorectal cancers may have a different aetio-pathogenesis, and have implications for the investigation of patients with suspected colorectal cancer and in screening high-risk groups.

Adenocarcinoma↗
PubMed2000

Transcriptional regulation of human 11beta-hydroxylase (hCYP11B1).

Steroid 11beta-hydroxylase is a mitochondrial enzyme that catalyzes the conversion of deoxycortisol to cortisol. The gene encoding human 11beta-hydroxylase (hCYP11B1) is expressed in the adrenal cortex under the control of circulating levels of ACTH. The current study was undertaken to define the cis-regulatory elements and transacting factors that regulate hCYP11B1 transcription. The hCYP11B1 5'-flanking DNA was studied using transient transfection of luciferase reporter constructs in NCI-H295R human adrenocortical cells. A cAMP analogue ((Bu)2cAMP) increased expression of a construct containing -1102 bp of hCYP11B1 5'-flanking DNA (pB1-1102). An element at position -71/-64 (TGACGTGA, previously termed Ad1) resembling a consensus cAMP response element (CRE) was required for maximal induction by cAMP. The Ad1 element bound several transcriptional factors in electrophoretic mobility shift assays, including CRE-binding protein, activating transcription factor-1 (ATF-1), and ATF-2, but only the ATF-2 complex migrated similarly to a complex seen using H295R nuclear extract. In addition, Western analysis of H295R and adrenal lysates demonstrated expression of high levels of ATF-2 and ATF-1. CRE-binding protein levels varied among the strains of H295R cells tested. Transcription of CYP11B1 also appeared to be regulated by steroidogenic factor-1 (SF-1). Luciferase reporter gene activity was increased after cotransfection with expression vectors containing SF-1. An element in hCYP11B1 at positions 242/-234 (CCAAGGCTC), previously termed Ad4, was required for maximal induction by SF-1 and was found to bind SF-1 in electrophoretic mobility shift assays. The key role for SF-1 in hCYP11B1 transcription is in contrast to its lack of an effect on expression of the hCYP11B2 (aldosterone synthase) isozyme. The differential effects of SF-1 on transcription of hCYP11B1 and hCYP11B2 may be one of the mechanisms controlling differential expression of these isozymes within the zonae fasciculata and glomerulosa of the human adrenal cortex.

Adrenal Glands↗
PubMed2000

The application of high density microarray for analysis of mitogenic signaling and cell-cycle in the adrenal.

Angiotensin II (AII) binds to specific G-protein coupled receptors and is mitogenic in adrenal, liver epithelial, and vascular smooth muscle cells. The H295R human adrenocortical cell line, which expresses AII receptors predominantly of the AT1 subclass, proliferates in response to treatment with AII. The induction and maintenance of cellular proliferation involves a precisely coordinated induction of a variety of genes. As the human genome sequencing projects near completion a variety of high throughput technologies have been developed in order to create dynamic displays of genomic responses. One high throughput method, the gridded cDNA microarray has been developed in which immobilised DNA samples are hybridized on glass slides for the identification of global genomic responses. For this purpose high precision robotic microarrayers have been developed at AECOM. The cyclin D1 gene, which encodes the regulatory subunit of the cyclin D1-dependent kinase (CD1K) required for phosphorylation of the retinoblastoma protein (pRB), was induced by AII in H295R cells. Abundance of the cyclin D1 gene is rate-limiting in G1 phase progression of the cell-cycle in a variety of cell types. AII induced cyclin D1 promoter activity through a c-Fos and c-Jun binding sequence at -954 bp. Theabundance of c-Fos within this complex was increased by AII treatment. Analysis of AII signaling in adrenal cells by cDNA microarray demonstrated an induction of the human homologue of Xenopus XPMC2 (HXPMC2). The cDNA for XPMC2 was previously shown to rescue mitotic catastrophe in mutant S. Pombe defective in cdc2 kinase function. Further studies are required to determine the requirement for cyclin D1 and XPMC2H in AII-induced cell-cycle progression and cellular proliferation in the adrenal.

Adrenal Cortex↗
PubMed1999

Syphilis serology and HIV infection in Harare, Zimbabwe.

OBJECTIVE: To determine the reliability of serological tests in detecting syphilis in a factory worker cohort and examine the impact of concurrent HIV infection on serological tests for syphilis. METHOD: Reactions to non-treponemal and treponemal antigens were tested using sera from a cohort of 3401 factory workers in Harare, Zimbabwe. The participants consented to regular testing for syphilis, by VDRL, and HIV using two ELISAs. All sera from men who were VDRL positive, and a random sample of VDRL negative sera, were tested by RPR, TPHA, and where appropriate FTA-Abs. From the results, men were defined as having no syphilis, active syphilis, incident syphilis, historic syphilis, or giving biological false positive reactions. RESULTS: 709 sera were examined from 580 men. There were 78 cases of active syphilis in the cohort, giving a prevalence of 2.3%, and the seroincidence was 0.25 per 100 person years of follow up. The prevalence of HIV in the cohort was 19.8%. There was a strong association between syphilis, whether active, incident or historic, and HIV seropositivity. With both HIV positive and negative sera the negative predictive values of VDRL and RPR were > 99.9% while the positive predictive value for VDRL (30%) was lower than for RPR (39%). Biological false positive reactions were detected in 0.5% of the cohort, with in most cases a transient rise in VDRL titres up to < 1/16. Higher false positive titres occurred in five men, each of whom was HIV positive. CONCLUSIONS: The VDRL is reliable in detecting possible cases of syphilis even in a community with a high prevalence of heterosexually transmitted HIV. There is need, however, for confirmatory tests. The prevalence of syphilis in this cohort is very low in comparison with other countries in southern Africa, but is consistent with recent data from Harare. Despite a strong association between syphilis and HIV it was clear that syphilis could not be counted as a major factor fueling the HIV epidemic in Zimbabwe.

Cohort Studies↗
PubMed1998

Influence of coping style and precolonoscopy information on pain and anxiety of colonoscopy.

BACKGROUND: This study assessed the relationship between patient coping style, precolonoscopy information, and anxiety and pain associated with colonoscopy. METHODS: Eighty consecutive adult patients undergoing initial colonoscopy were classified into two groups on the basis of coping style: information seekers or information avoiders. All were given standardized information about colonoscopy. Half of each group was randomly assigned to receive additional sensory information describing what they could expect to feel. Self-report, physiologic, and behavioral indices of anxiety and pain were measured. RESULTS: Patients given information congruent with coping style experienced significantly less self-report anxiety immediately after the information intervention and spent less time in recovery. In contrast, patients given information not congruent with coping style maintained their pre-intervention anxiety level. Patients given information congruent with coping style scored lower on behavioral indices of pain, but there were no differences with respect to patient perception of pain or the dosage of sedative drugs. Most patients reported that the bowel preparation was the most distressing part of the colonoscopy. CONCLUSIONS: Assessment of coping style and provision of congruent information reduces anxiety, recovery time, and observed behavioral indices of pain of colonoscopy but has no effect on sedation dose or patient perception of pain.

Adaptation, Psychological↗
PubMed1997

Biologically erodable microspheres as potential oral drug delivery systems.

Biologically adhesive delivery systems offer important advantages over conventional drug delivery systems. Here we show that engineered polymer microspheres made of biologically erodable polymers, which display strong adhesive interactions with gastrointestinal mucus and cellular linings, can traverse both the mucosal absorptive epithelium and the follicle-associated epithelium covering the lymphoid tissue of Peyer's patches. The polymers maintain contact with intestinal epithelium for extended periods of time and actually penetrate it, through and between cells. Thus, once loaded with compounds of pharmacological interest, the microspheres could be developed as delivery systems to transfer biologically active molecules to the circulation. We show that these microspheres increase the absorption of three model substances of widely different molecular size: dicumarol, insulin and plasmid DNA.

Adhesiveness↗
PubMed1996

HIV seroincidence and correlates of seroconversion in a cohort of male factory workers in Harare, Zimbabwe.

OBJECTIVES: Given that health promotion messages on transmission of HIV and other sexually transmitted diseases (STD) have been widely publicized in Zimbabwe and elsewhere in the late 1980s, it is vital to analyse which risk events still expose individuals to infection. A cohort was established with the objectives of estimating HIV seroincidence, behavioural and biological determinants of infection, and ultimately, evaluating the impact of AIDS prevention interventions in the workplace. METHODS: HIV seroincidence was estimated in a prospectively followed cohort of male factory workers recruited in Harare, Zimbabwe during the period prior to a workplace AIDS prevention intervention. Correlates of HIV seroconversion were identified using Cox regression analysis. RESULTS: There were 51 seroconversions among 1607 HIV-negative participants following 1738 person-years (PY) of observation [seroincidence, 2.93 per 100 PY; 95% confidence interval (CI), 2.18-3.86]. The prevalence of HIV in the cohort was 19.1%. HIV seroincidence was significantly increased among men who were younger [hazard ratio (HR) per year, 0.96; 95% CI, 0.93-0.99], were single (HR, 3.29; 95% CI, 1.56-6.96), were married but resided separately from their wives (HR, 2.18; 95% CI, 0.99-4.80), reported having any STD (HR, 3.00; 95% CI, 1.53-5.86), reported having a genital ulcer (HR, 4.87; 95% CI, 2.18-10.91), and reported paying for sex (HR, 2.01; 95% CI, 1.06-3.77). Seroincidence also increased with the number of sex partners reported in the year preceding enrolment (HR per partner, 1.10; 95% CI, 1.01-1.21). In multiple Cox regression analysis, three independent associations with HIV seroconversion were reporting a genital ulcer (adjusted HR, 3.55; 95% CI, 1.52-8.29), number of sex partners (adjusted HR, 1.10; 95% CI, 1.01-1.21), and being married but residing separately from one's wife (adjusted HR, 2.21; 95% CI, 1.00-4.89). CONCLUSIONS: Innovative and sustained workplace-based interventions are needed to address the high risk of HIV infection in this economically productive population. The predictors of HIV seroconversion described in this study underscore the need for public health efforts to simultaneously address the biological, socioeconomic and behavioural factors that continue to place individuals at risk of HIV in general populations of Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The association of tuberculosis and HIV infection in Harare, Zimbabwe.

SETTING: The tuberculosis (TB) service responsible for all TB treatment in Harare, Zimbabwe. OBJECTIVES: (1) To determine HIV seroprevalence among TB patients and controls. (2) To compare clinical and demographic characteristics of HIV-infected and uninfected TB patients. DESIGN: Cohort study. Entry criterion: TB diagnosed during the 18 month study period. Assessment included HIV serology. Matched community controls were HIV serotested. RESULTS: In 1434 TB patients tested, HIV seroprevalence was 48% in men and 44% in women, peaked in the 25-34 year age group and was higher than in controls (relative risk [RR] = 3.1, 95% confidence interval [CI] = 2.6-3.7). In adults, seroprevalence was 34%, 49% and 58% in successive 6 month periods. A history of entry of prior TB treatment was less common in the HIV-seropositive (RR = 0.57, CI = 0.37-0.88). In adults, tuberculin negativity, TB at 2 sites, lymph node, pericardial and miliary TB, hilar adenopathy and pleural effusion were significantly more common in HIV-seropositive patients; cavitation and upper lobe involvement were significantly less frequent. Pulmonary TB and sputum smear positivity had similar frequencies in the 2 groups. CONCLUSION: HIV was strongly and increasingly associated with TB in Harare and altered the clinical and radiologic features of TB. Failed standard TB treatment in HIV-infected individuals contributed minimally to new cases of TB.

AIDS-Related Opportunistic Infections↗
PubMed1994

Reduced semen quality and risk behaviour amongst men consulting a referral STD clinic.

Sexually transmitted diseases (STDs) and infertility are public health challenges that continue to represent a high demand and costly adult medical care conditions in most developing countries. Few studies address strategies for prevention of infertility secondary to STDs through behavioural change and early and prompt STD treatment. A prospective cohort design was used to study the effects of urogenital infection on semen quality in consenting consecutive subjects that presented with chronic or recurrent sexually transmitted diseases. Health seeking behavioural correlates and socio-economic variables were compared between index subjects at a genito-urinary referral clinic and those that presented with non-STD conditions at a referral polyclinic.

Adolescent↗
PubMed1994

Condom use and the risk of HIV infection: who is being protected?

Descriptive baseline data at enrollment into a cohort of male factory workers who were tested for HIV serology and monitored for sero-conversion over time, were analysed for condom use. At recruitment, the 1,146 men were asked about their sexual behaviour, history of sexually transmitted diseases (STDs), condom use and circumstances under which condoms were used. HIV seroprevalence in the cohort was 18.2 pc. Self reported use of condoms was low, with only 5 pc of the men reporting using them all the time. Forty four pc reported that they had never used a condom, 11.5 pc tried a condom only once, and 30.5 pc used condoms less than half the time. HIV positive men were more likely (Odds Ratio [OR] = 2.2 95 pc CI: 1.3-3.3) to use condoms than those who tested negative. Men using a condom more than once were younger and had more education (p values < 0.0005). Univariate analysis showed that men with self reported risk factors for HIV infection were more likely to use condoms. Significantly more condom users reported paying for sex, multiple sex partners or (for married men) a girlfriend (p < 0.005). Condom users also more often had a history of genital ulcers, urethral discharge or other STDs. Few married men (24 pc) reported using a condom with their wives. Condom use was more commonly reported with commercial sex workers (44 pc) or other extramarital partners (36 pc). Some risk factors for HIV infection were also present amongst men who reported that they did not use condoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Surveillance for equity in maternal care in Zimbabwe.

The great hope and promise of post-independence efforts to promote equitable health care in Zimbabwe started with three years of dramatic improvement. Commitment to correcting inequities which were as discriminatory as any country in the world produced rapid extension of health centre infrastructure and the improvement of district hospitals. The major constraint was the entrenched pattern of sophisticated, high-technology health care left by colonial administrators which continued to monopolize resources. In spite of the excellent beginning, development of services for the poor was thwarted by recession, prolonged drought and external military destabilization. The cutbacks in funding for health care have been particularly severe as a result of economic adjustment policies imposed by IMF. Political pressure moved the health system toward private entrepreneurship returning to earlier patterns of discrimination in favour of whites and urban residents. Efforts to promote high-risk monitoring have had little impact among the poor and those living in remote areas. Equity has become symbolic rather than real. The government of Zimbabwe maintains a continuing commitment to the original goals of equity through primary health care. International agencies also would like to find a way to help reallocate services. There seems to be recognition that little will be accomplished in improving health conditions unless services are provided to those in greatest need. Disparities in maternal care are especially severe and can be improved only by building infrastructure to provide antenatal and perinatal services.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗
PubMed1990

Could it be gallstones, doctor?

Gallstones may be asymptomatic, in which case they require no treatment. The author discusses symptomatic gallstones and the complications of gallstone disease. The type of presentation, appropriate investigations and treatment options are discussed.

Cholelithiasis↗
PubMed1989

Trauma systems.

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Hospitals, University↗