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PubMedDate not supplied

[Human milk and very low birth weight nutrition].

INTRODUCTION: Enteral feeding strategies of very low birth weight (VLBW) infants and when to start them have changed significantly in the last few years. Controversy exists on which is the best regimen to feed this high risk group, since human milk has insufficient quantities of some nutrients. Fortification of human milk improves growth rates and maintains immunologic, metabolic and emotional benefits. OBJECTIVE: To examine if early feeding of VLBW infants with higher amounts of human milk and human milk fortifiers could improve post-natal growth and maintain human milk production. STUDY DESIGN: Prospective study with historical control. SUBJECTS AND METHODS: A group of 100 VLBW infants that were born between September 1999 and April 2000 were studied and were compared with another randomized group of similar birth weight (n = 31) that was born previously. The studied group was fed early with human milk (enteral trophic nutrition) and fortified with human milk fortifier when 100 mL/Kg/day were reached, with rapid increase of the supplies according to tolerance and hemodynamic state. The control group was not fed early with human milk and was not given human milk fortifier. The collection of human milk in the studied group was highly stimulated. Mothers extracted their milk more frequently in the "Human Milk Lactary" and lived in a "Residence for Mothers" while their neonates were in the hospital. The mothers who could travel to the hospital were allowed to extract their milk in their homes with a supervised and controlled method (serial bacteriology, "Lactary 24 Hours Program"). RESULTS: Early feeding with human milk (enteral trophic nutrition), higher amounts of human milk and fortified with human milk fortifier, improved enteral tolerance and diminished significantly the number of days needed to regain birth weight, the days of fast and the days to reach the total enteral supply. Frequent extractions of human milk increased the available amounts of milk and allowed relactation. At discharge the infants were fed on breast-milk and formulas and their growth curves were adequate at their first year of post conception age. CONCLUSION: On stable conditions, very low birth infants soon after birth, should be fed with a combination of human milk and human milk fortifiers. Our study demonstrated an improved infant post-natal growth while mothers' milk production was maintained. COMMENTS: To feed human milk with human milk fortifiers to this high risk infant group, the neonatal health team must be highly motivated and committed to encourage mothers to express their milk. This also encourages breast feeding during the subsequent months. In Latin America communities, continuance of breast feeding for longer periods of time is a public health priority.

Food, Fortified↗

PubMed2005

Incorporating a social networking approach to enhance contact tracing in a heterosexual outbreak of syphilis.

OBJECTIVE: This report describes the outcomes of a social networking approach (SNA) in a heterosexually transmitted syphilis epidemic by street nurses in British Columbia, Canada. METHODS: Street nurses used SNA interviewing cues, environmental observation, peer outreach, serial interviewing, conducted blood tests, and offered treatment on the street. Rates of cases of syphilis identified by outreach nurses and cases linked to another case were compared before and after adoption of an SNA. RESULTS: SNA resulted in a significantly increased proportion of cases identified by the street nurses (p = 0.01) and increased the percentage of cases linked to a previous case (p = 0.03). CONCLUSION: This preliminary study confirms that SNA can increase the number of cases and contacts identified in an epidemic of a sexually transmitted disease in a vulnerable, hard to reach population.

British Columbia↗

PubMed1997

In uncharted waters: confronting the culture of silence in a residential care institution.

This paper describes a study grounded in feminism, which explored the experiences of three registered nurses who were employed in a residential care institution in which they believed the standard of care to be unacceptably poor. Ultimately, the nurses became 'whistle blowers'. Data surrounding these events were gathered through serial encounters and analysed using feminist interpretive methods. Three distinct phases were revealed: (i) trepidation and optimizm; (ii) barriers and obstacles; and (iii) disillusionment and defeat. It was in this final phase that the whistle blowing occurred. For these women, whistle blowing was an intervention of last resort; a stressful and negative event that carried personal and professional cost. Issues pertaining to professional autonomy and patient advocacy are raised, together with concerns surrounding the appropriation by business people of the language and images of nursing, and the power of these people to negatively impact upon nursing practice.

Adult↗

PubMed1994

Short-term effects of air pollution on daily mortality in Athens: a time-series analysis.

BACKGROUND: Athens has a serious air pollution problem which became evident in the early 1970s. Studies for the years 1975-1982 have indicated a positive association of sulphur dioxide (SO2) with total daily mortality. Since 1983 the pollution profile in Athens has gradually changed but the levels of smoke, SO2 and carbon monoxide (CO) remain relatively high. METHODS: The association of air pollution with daily all-cause mortality in Athens for the years 1984-1988 was investigated using daily values of SO2, smoke and CO. Autoregressive models with log-transformed daily mortality as the dependent variable, were used to adjust for temperature and relative humidity (both lagged by 1 day), year, season and day of week, as well as for serial correlations in mortality. RESULTS: Graphic analysis revealed non-linear monotonically increasing relationships between total mortality and SO2, smoke and CO, with steeper exposure-response slopes at lower air pollution levels. Air pollution data lagged by 1 day had the strongest association with daily mortality. In three separate autoregression models for log(SO2), log(smoke) and log(CO) the regression coefficients for each were highly statistically significant (P < 0.001). Further multiple regression modelling showed that SO2 and smoke are both independent predictors of daily mortality, though to a lesser extent than temperature and relative humidity. The inclusion of CO in the model did not further improve the prediction of daily mortality. The magnitude of association is small, for instance, a 10% reduction in smoke is estimated to decrease daily mortality by 0.75% (95% confidence interval [CI]: 0.51-0.99). However, it cannot be accounted for by climatic and seasonal effects, so that a causal influence of air pollution on daily mortality seems plausible. CONCLUSIONS: These findings suggest that current air pollution levels in Athens (and many other industrialized cities) may be responsible for substantial numbers of premature deaths, and hence remain an important public health issue.

Air Pollutants↗

PubMed2002

Detection of vaccinia virus, herpes simplex virus, varicella-zoster virus, and Bacillus anthracis DNA by LightCycler polymerase chain reaction after autoclaving: implications for biosafety of bioterrorism agents.

OBJECTIVE: To determine whether autoclaving suspensions of vaccinia virus, herpes simplex virus (HSV), varicella-zoster virus (VZV), and Bacillus anthracis inactivate infectivity of these agents but allow detection of target DNA by LightCycler polymerase chain reaction (PCR). MATERIAL AND METHODS: Swabs were inserted into tubes containing serial 10-fold dilutions (10(-1) to 10(-5); 500 microL; 6 samples per dilution) of vaccinia virus, HSV, VZV, or a single suspension of 10(8) colony-forming units of B anthracis (2 samples). One half of the samples were autoclaved, and the remainder were not. An aliquot of each not autoclaved sample served as a control for infectivity. RESULTS: Autoclaving swabs saturated with suspensions of vaccinia virus, HSV, or VZV eliminated the infectivity of these agents; however, DNA was detectable in most autoclaved samples in dilutions of 10(-1) to 10(-4) by LightCycler PCR. All not autoclaved specimens were detected by culture (infectivity) except for VZV and, in most dilutions of 10(-1) to 10(-3), by assay of target DNA by LightCycler PCR. Similarly positive results were obtained for PCR assessment of sporulated B anthracis. CONCLUSIONS: Standard autoclaving procedures eliminated the infectivity of viruses (and B anthracis), but target DNA was often retained for detection by LightCycler PCR. Current recommendations indicate that the laboratory diagnosis of smallpox virus infection be performed only within Biosafety Level 4 facilities. We suggest that, in addition to the requirement for immediate coordination with public health officials, the federal government consider expanding the existing guidelines for processing these specimens to encourage immediate collection, autoclaving, and testing by LightCycler PCR to differentiate smallpox virus from other dermal pathogens such as HSV and VZV by specific qualified laboratories.

Bacillus anthracis↗

PubMed1997

A three-dimensional multimodality brain map of the nemestrina monkey.

A three-dimensional multimodality computerized map of the nemestrina monkey brain was created with serial sectioning and digital imaging techniques. An adult female Macaca nemestrina (pigtail macaque) weighing 7.2 kg was used in constructing this atlas. CT, PET, and MRI were performed on the monkey before the specimen's head was frozen and cryoplaned. Closely spaced (50 microns) images of the specimen blockface were then digitally acquired and modified to produce whole head and brain-only 3D image sets. The resulting data sets were organized into a digital volume and repositioned into a stereotaxic coordinate system defined by Horsley and Clark in 1908 [7]. Orthogonal images were obtained by digitally resampling the volume in order to produce a full set of coronal, sagittal, and horizontal images. Stereotaxic reference grids were applied to each image indicating the A/P, M/L, or Ho position within the digital volume. Specific anatomic structures were outlined from the cryosection data set and 3D surface models reconstructed. Structural labels indicating nuclei, tracts, and other neuroanatomical features were incorporated into coronally sliced cryosection images spaced at 500 microns. The CT, PET, and MRI data sets were reconstructed into a digital volume and coregistered to the cryosection volume. All images constructed from this 3D map are available for public access via the internet using an anonymous file transfer protocol (FTP) and the World Wide Web (http:@www.loni.ucla.edu). The foremost advantage of this digital map is an integrated multimodality three-dimensional representation of the Macaca nemestrina brain, which is not possible with traditional atlases.

Animals↗

PubMed1998

Nonmetastatic gestational trophoblastic neoplasia. Role of ultrasonography and magnetic resonance imaging.

OBJECTIVE: To determine whether routine imaging using grey-scale ultrasound, pulse and color Doppler flow, endovaginal ultrasound and magnetic resonance imaging (MRI) provide information that significantly helps determine therapy in patients with nonmetastatic gestational trophoblastic disease. STUDY DESIGN: A literature search was performed to seek all publications in English and German that reported on investigations of imaging by ultrasound and MRI in patients with a diagnosis of trophoblastic tumor without evidence of metastases. Studies performed to make a diagnosis of hydatidiform mole were excluded. Included were studies that investigated the clinical usefulness and efficacy of these imaging methods in the diagnosis of invasive mole as a visual confirmation of the diagnosis based on human chorionic gonadotropin (hCG) and histology. Furthermore, the usefulness and efficiency of imaging in determining the effectiveness of chemotherapy were investigated. RESULTS: Analysis of these reports showed that lesions are detectable by imaging modalities at relatively high levels of hCG but may not be visualized at lower levels of hCG, when chemotherapy is nevertheless indicated and the diagnosis of neoplasia is fully justified. Moreover, myometrial lesions have been observed by MRI in patients who subsequently achieved spontaneous resolution of their disease without chemotherapy. At lower levels of hCG (< 700 mIU/mL), intramyometrial lesions may not be visualized by either ultrasound or MRI. Myometrial abnormalities may persist with resolution of the tumor. Thus, the sensitivity of either method is no better than 70% and the specificity is even lower. CONCLUSION: Weekly serial levels of serum hCG remain the most accurate, reliable and definitive arbiter of treatment management. Pelvic ultrasound or MRI need not be an integral part of pretreatment assessment. Imaging techniques are expensive yet not decisive in managing nonmetastatic trophoblastic disease. This finding applies to nonmetastatic disease only. With metastases, ultrasound, MRI and computed tomography do play an integral role in diagnosis, staging and management.

Chorionic Gonadotropin↗

PubMedDate not supplied

[Brazilian scientific journals in speech-language and hearing science: impact indicator].

BACKGROUND: Global value of scientific papers published in national journals of the Brazilian Speech-language and Hearing Science analyzed through the Impact Factor (IF). PURPOSE: To analyze part of the Brazilian Speech-Language and Hearing Science through its scientific journals: characterization of the impact indicator--in this case the Impact Factor (IF). Seven national Speech-language and Hearing Science journals (1986/ 2001) registered in the Brazilian Institute of Information in Science and Technology (Ibict) and with a given International Standard Serial Number (ISSN) were analyzed. In order to calculate the IF of the scientific journals, the lists of bibliographic references of the published papers were consulted and the original formula of Garfield was used, adapting it to the seven journals. Bibliographic references cited in the research papers, in the case studies, in the review and update articles were considered for analyses. Researches which were cited in the summaries like letters to the editors; editorial, abstracts, commentaries and others were excluded. A total of 9,334 bibliographic references of 549 papers were analyzed, excluding self-citations of authors. It was observed that the resulting IFs revealed practically null values. The obtained results demonstrate that the Brazilian Speech-language and Hearing Science needs to develop a few aspects of its editorial and scientific processes--the researches of the Brazilian Speech-language and Hearing Science are being lost, making it necessary for the editors to raise the access and visibility of their journals and for the speech-language and hearing scientists to cite the work of their antecessors and national partners. According to the obtained data, for the Brazilian Speech-language and Hearing Science, the publication of 11.9 papers is necessary for only one of these papers to be cited in another research. It is observed that the IFs of the Brazilian Speech-language and Hearing Science, among these seven journals, have risen since 1999, suggesting a development of this Science. The follow up of this research, analyzing the years subsequent to 2001, is necessary in order to verify the real raise of the impact of these articles.

Bibliometrics↗

PubMed1979

Inceptor and origin of DNA replication in lambdoid coliphages. I. The lambda DNA minimal replication system.

In a pBR313-lambda dv hybrid plasmid system, stepwise deletion and serial cloning procedures have led to a functional dissection of the DNA replication region of lambdoid bacteriophages lambda, 434 and 21. A simple system for initiation of DNA replication has been detected within lambdoid replicator DNAs, which is active in the absence of several normal replication elements, including the origin of replication (ori) and product of gene O. This "minimal" (or "mini") initiation system depends on the p0 or substitute leftward promoter in conjunction with the newly discovered "inceptor" (ice) element, which is located within the cII gene. Even the fragments containing ori are unable to initiate replication in these hybrid plasmids as long as fragments containing ice are missing. The base sequence of ice resembles transcriptional terminators and it appears to control both termination of primer RNA and inception of daughter strand DNA synthesis. Initiation in the p0-ice mini system of lambda or 21 phages requires the gene P product. Hwever, mini replication of 434 DNA hybrid plasmids required neither O nor P proteins, although there are only two single-base changes in the 434 inceptor sequence. The mini system is repressed by the elements of the maximal lambda replication system, as described in the accompanying publication.

Bacteriophage lambda↗

PubMed2026

Identification of a novel HIV-1 circulating recombinant form (CRF209_cpx) and its descendant unique recombinant form (URF) CRF209_cpx/B among MSM in Guangdong, southern China.

BACKGROUND: The epidemic of human immunodeficiency virus type 1 (HIV-1) continues to pose a significant global health challenge, with increasing genetic diversity. The co-circulation of multiple subtypes among the local population facilitates the emergence of unique or circulating recombinant forms (URFs or CRFs). In China, the predominant strains include CRF07_BC, CRF01_AE, CRF55_01B, and subtype B. This study characterizes a novel CRF209_cpx and its descendant recombinant CRF209_cpx/B among men who have sex with men (MSM) in Guangdong, southern China. METHODS: Individuals infected with URFs with similar genetic characteristics were recruited during routine surveillance of pretreatment drug resistance. Near full-length genomes (NFLGs) were amplified with two overlapping fragments using a serial dilution nested PCR approach after reverse transcription. We used SimPlot and IQ-TREE softwares to conduct recombination analyses and phylogenetic inferences. Time-scaled maximum clade credibility (MCC) phylogenetic trees were reconstructed using BEAST software to estimate evolutionary origins. Genotypic drug resistance mutations were interpreted via the Stanford HIV Database, and coreceptor usage was predicted using geno2pheno coreceptor 2.5 and the HIVcoPRED tool. RESULTS: Four NFLG sequences were obtained and identified as a novel CRF209_cpx, generated by recombination among CRF01_AE, CRF07_BC and subtype B. Phylogenetic analyses revealed that all the parental segments clustered with lineages prevalent among MSM in China. Bayesian evolutionary analysis estimated that the most recent common ancestor (tMRCA) of CRF209_cpx to have evolved between 2011 and 2013. The fifth strain was identified as a URF recombined from nascent CRF209_cpx and B. No transmitted drug resistance mutation was detected in these five sequences. The four CRF209_cpx sequences primarily utilized the CXCR4 coreceptor, while the URF exhibited R5/X4 dual tropism. CONCLUSIONS: The emergence of the complex CRF209_cpx and novel URF of CRF209_cpx/B highlights the active HIV-1 epidemic within the MSM population in Guangdong, underscoring the necessity for enhanced molecular surveillance and precise public health intervention in this key population.

HIV-1↗

PubMed2002

Complaints and Annoyance caused by Aircraft Operations: Temporal Patterns and Individual Bias.

The impact of aircraft movements on annoyance in the local community surrounding a major international airport was assessed for (a) patterns of complaints for the year, month, day-of-the-week and time-of-day and (b) the frequency of complaining by individuals. Complaint data from Manchester Airport since 1991 and detailed analysis for 1998 were compared with associated information on noise monitoring and aircraft movements to investigate underlying biological and sociological patterns. The annual number of complaints peaked in 1996 when the 'Manchester Airport Second Runway Public Inquiry' was a major local issue and had a high profile in the local media. Since 1996 the number of flights has increased while the number of complaints has steadily fallen; from 50 to13 complaints per 1,000 movements from 1996 to 1999. Detailed inspection of the 1998 data revealed a total of 2072 noise complaints from 594 individuals but, while the majority of individuals complained once or twice, three individuals accounted for 41% of complaints. This introduced some bias into the results but there was; (a) a steady increase in complaints (per 1,000 movements) over the week from a low on Monday to a high on Saturday/Sunday; (b) a marked hourly variation over the 24 hours in both flight frequency (movements per hour) and complaints. However, the hourly patterns in flight frequency and complaints were clearly distinct. Calculations of the complaints per aircraft movement (a reflection of sensitivity) for each hour of the day showed a striking 24h pattern with twice as many complaints between 23.00 and 07.00 as the rest of the day (07.00-23.00). Late evening and night-time, particularly during the early hours of sleep, was the time of greatest sensitivity to aircraft, with or without the serial complainers. These results could be used to inform airport operations to minimize community disturbance.

Journal Article↗

PubMed2003

Clinical and epidemiologic investigation of two Legionella-Rickettsia co-infections.

BACKGROUND: We treated two patients diagnosed with legionellosis and simultaneous Rickettsia conorii co-infection. OBJECTIVES: To report the clinical and laboratory characteristics of this unusual combination, and to describe the execution and results of our environmental and epidemiologic investigations. METHODS: Serial serologic testing was conducted 1, 4 and 7 weeks after initial presentation. Water samples from the patients' residence were cultured for Legionella. Follow-up cultures were taken from identical points at 2 weeks and at 3 months after the initial survey. RESULTS: Both patients initially expressed a non-specific rise in anti-Legionella immunoglobulin M titers to multiple serotypes. By week 4 a definite pattern of specifically elevated IgG titers became apparent, with patient 1 demonstrating a rise in specific anti-L. pneumophila 12 IgG titer and patient 2 an identical response to L. jordanis. At 4 weeks both patients were positive for both IgM and IgG anti-R. conorii antibodies at a titer > or = 1:100. Heavy growth of Legionella was found in water sampled from the shower heads in the rooms of both patients. Indirect immunofluorescence of water cultures was positive for L. pneumophila 12 and for L. jordanis. CONCLUSIONS: Although most cases of community-acquired Legionella pneumonia in our region appear simultaneously with at least one other causative agent, co-infection with R. conorii is unusual and has not been reported to date. This report illustrates the importance of cooperation between clinicians and public health practitioners.

Adult↗

PubMed2003

Evaluation of the national 'Push Play' campaign in New Zealand--creating population awareness of physical activity.

AIMS: Physical inactivity is considered to be as detrimental to public health as hypertension or tobacco use, but there is limited evidence on the impact of community-wide interventions in this area. This paper describes the impact of an initiative to increase physical activity at a population level in New Zealand. METHODS: A media-led, community-wide intervention campaign was initiated by the Hillary Commission (now SPARC, Sport and Recreation New Zealand). The 'Push Play' campaign recommended 30 minutes of daily, moderate-intensity physical activity as fun, part of community life, and easy to achieve for New Zealand adults. In addition, there were community-level and primary care supporting programmes and events. Annual cross-sectional population surveys (1999-2002) monitored the impact of the campaign on message awareness, recognition of the Push Play logo, intention to be active, and recent activity. RESULTS: There were substantial increases in awareness of the Push Play message (30% in 1999 to 57% in 2002, p <0.001), and of the Push Play logo (14% to 52%, p <0.001). There were significant increases in the numbers of adults who intended to be more active (1.8% in 1999 to 9.4% in 2002). No sustained changes in physical activity levels were seen in these Push Play serial evaluation surveys, with 38.6% of the 1999 sample reporting 5+ days activity per week, increasing to 44.5% in 2000, but declining to 38.0% in 2002. The only significant difference in physical activity levels occurred from 1999 to 2000 (difference 5.8%, 95% CI 0.1%-11.6%). In an unrelated, much larger population survey, a 3% increase in physical activity participation was noted among adults between 1997 and 2001. CONCLUSIONS: The national Push Play campaign resulted in increases in message recognition and in intention to become more active. If sustained, efforts like this may have a long-term impact on adult activity patterns, leading to improved health outcomes and reduced health costs.

Health Behavior↗

PubMed2003

National trends in antiobesity medication use.

BACKGROUND: The use of medications to treat obesity remains controversial. Our goal was to assess national trends in antiobesity medication use with a focus on patterns surrounding the 1997 removal of antiobesity drugs from the market. METHODS: Using a serial cross-sectional study design, we analyzed a nationally representative sample of US office-based physician visits from 1991 to 2002. Data come from the IMS HEALTH National Disease and Therapeutic Index. These data include a sample of 13 452 patient visits for which a diagnosis of clinical obesity was made, with annual visits ranging from 666 in 1994 to 1854 in 1996. The unit of analysis is the patient visit, while the primary outcome measures are the annual and quarterly number of antiobesity drug mentions for clinically obese patients. RESULTS: At its peak in the second quarter of 1997, 2.5 million Americans were taking antiobesity medications, a 4-fold increase over the prior 2 years. Although antiobesity medication use diminished following the market exit of fenfluramine hydrochloride and dexfenfluramine hydrochloride, current levels of use remain above those in the early 1990s. Phentermine has consistently been the most common antiobesity medication. In 2002, an annualized 1.2 million mentions of phentermine use were noted (31% of drug-treated obese patients). Newly released medications, orlistat (0.6 million) and sibutramine hydrochloride (0.4 million), were used less often. Most antiobesity medication use occurs in patients without other reported medical conditions. CONCLUSIONS: Use of antiobesity medications increased rapidly with public and professional interest in fenfluramine-phentermine (fen-phen) combination therapy. Despite reports of adverse outcomes associated with fenfluramine agents (fen-phen and dexfenfluramine), the use of these medication therapies did not diminish until soon before their removal from the market in 1997.

Anti-Obesity Agents↗

PubMed2002

Monitoring changing toxigenicity of a cyanobacterial bloom by molecular methods.

Cyanobacterial blooms are potential health hazards in water supply reservoirs. This paper reports analyses of a cyanobacterial bloom by use of PCR-based methods for direct detection and identification of strains present and determination of their toxigenicity. Serial samples from Malpas Dam, in the New England region of Australia, were analyzed during a prolonged, mixed cyanobacterial bloom in the summer of 2000 to 2001. Malpas Dam has been shown in the past to have toxic blooms of Microcystis aeruginosa that have caused liver damage in the human population drinking from this water supply reservoir. Cyanobacterial genera were detected at low cell numbers by PCR amplification of the phycocyanin intergenic spacer region between the genes for the beta and alpha subunits. The potential for microcystin production was determined by PCR amplification of a gene in the microcystin biosynthesis pathway. The potential for saxitoxin production was determined by PCR amplification of a region of the 16S rRNA gene of Anabaena circinalis strains. Toxicity of samples was established by mouse bioassay and high-pressure liquid chromatography. We show that bloom components can be identified and monitored for toxigenicity by PCR more effectively than by other methods such as microscopy and mouse bioassay. We also show that toxigenic strains of Anabaena and Microcystis spp. occur at this site and that, over the course of the bloom, the cell types and toxicity changed. This work demonstrates that PCR detection of potential toxicity can enhance the management of a significant public health hazard.

Animals↗

PubMed2004

Factors associated with sex trade involvement among male participants in a prospective study of injection drug users.

OBJECTIVES: While much research to date has examined female sex trade work, little has been done to evaluate factors associated with male sex trade involvement or to assess their health service needs. This is particularly true for male sex trade workers who are also injection drug users (IDUs). Therefore, the present analyses were undertaken to evaluate factors associated with sex trade work in a prospective cohort study of male IDUs. METHODS: We identified factors associated with sex trade involvement among male participants enrolled in the Vancouver Injection Drug Users Study (VIDUS). Since serial measures for each individual were available at semiannual intervals, variables potentially associated with sex trade involvement were evaluated with adjusted odds ratios (AOR) and 95% confidence intervals (CI) computed using generalised estimating equations (GEE). RESULTS: Between 1996 and 2003, 995 male IDUs were enrolled into the VIDUS cohort among whom 108 (11%) reported being involved in the sex trade at enrolment and 102 (10%) individuals initiated sex trade involvement during the follow up period. In multivariate analyses, factors independently associated with sex trade involvement included HIV positive serostatus (AOR: 1.77 (95% CI: 1.44 to 2.17)), daily cocaine injection (AOR: 1.37 (95% CI: 1.11 to 1.70)), daily crack smoking (AOR: 1.36 (95% CI: 1.07 to 1.72)), borrowing syringes (AOR: 1.73 (95% CI: 1.32 to 2.25)), and inconsistent use of condoms with casual sexual partners (AOR 0.66, CI 0.53 to 0.82). We also found that male sex trade workers were more likely to report having sought but been unable to access substance abuse treatment (AOR: 1.28 (95% CI: 0.98 to 1.67); p=0.076). CONCLUSIONS: Males involved in the sex trade in this setting have higher levels of HIV infection and engage in risky injection behaviours at an elevated rate. Since these behaviours have major implications for HIV acquisition and public health, prevention efforts and targeted provision of addiction treatment to this population should be expanded.

Adult↗

PubMed2006

Comparative SAGE analysis of the response to hypoxia in human pulmonary and aortic endothelial cells.

We utilized serial analysis of gene expression (SAGE) to analyze the temporal response of human pulmonary artery endothelial cells (HPAECs) to short-term chronic hypoxia at the level of transcription. Primary cultures of HPAECs were exposed to 1% O2 hypoxia for 8 and 24 h and compared with identical same-passage cells cultured under standard (5% CO2-95% air) conditions. Hierarchical clustering of significant hypoxia-responsive genes identified temporal changes in the expressions of a number of well-described gene families including those encoding proteins involved in thrombosis, stress response, apoptosis, angiogenesis, and cell proliferation. These experiments build on previously published data describing the transcriptomic response of human aortic endothelial cells (HAECs) obtained from the same donor and cultured under identical conditions, and we have thus taken advantage of the immortality of SAGE data to make direct comparisons between these two data sets. This approach revealed comprehensive information relating to the similarities and differences at the level of mRNA expression between HAECs and HPAECs. For example, we found differences in the cell type-specific response to hypoxia among genes encoding cytoskeletal factors, including paxillin, and proteins involved in metabolic energy production, the response to oxidative stress, and vasoreactivity (e.g., endothelin-1). These efforts contribute to the expanding collection of publicly available SAGE data and provide a foundation on which to base further efforts to understand the characteristics of the vascular response to hypoxia in the pulmonary circulation relative to systemic vasculature.

Aorta↗

PubMed1990

[Delayed postanoxic encephalopathy after strangulation--the serial neuroradiological and neurochemical studies].

A 13-year-old boy was the victim of a strangulation attempt. His behavior was normal by the 6th day after the assault. However, from the 7th day, he developed choreoathetosis, dystonia and marked pseudobulbar palsy. CT and T2-weighted MRI at this time revealed a low density and high signal intensity in the region of the bilateral putamen and caudate respectively for the first time. Thereafter, these symptoms and changes in CTs and MRIs subsided gradually over two months. Sequential analysis of CSF for GABA and dopamine during illness revealed reciprocal changes each other with normal recovery. Because of delayed onset of neurological changes, and findings of CSF with reversible symptoms the delayed encephalopathy after strangulation is probably related to biochemical alteration secondary to anoxia in vulnerable basal ganglia.

Adolescent↗