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Pattern of mycobacterial resistance to four anti-tuberculosis drugs in pulmonary tuberculosis patients in the state of Qatar after the implementation of DOTS and a limited expatriate screening programme.

OBJECTIVE: To determine the resistance pattern of Mycobacterium tuberculosis to four anti-tuberculosis drugs in pulmonary tuberculosis patients in the State of Qatar after the implementation of DOTS and an expatriate screening programme on arrival. METHOD: A state-wide, population-based, retrospective analysis of all cases of pulmonary tuberculosis with positive M. tuberculosis culture reported to the Division of Public Health TB Unit from January 1996 to December 1998. M. tuberculosis sensitivity testing was done by the Bactec method for isoniazid (INH), rifampicin (RMP), streptomycin (SM) and ethambutol (EMB). The results were interpreted as a daily change of the growth index of test vials (with drug) compared with controls. RESULTS: There were 406 isolates with positive M. tuberculosis culture. Sixty-one (15%) were resistant to one or more of the four anti-tuberculosis drugs, of which 58 (95%) were from newly diagnosed cases (primary) and three (5%) were from previously treated cases (acquired). Primary resistance was as follows: any resistance 15%, INH 12.4%, RMP 2%, SM 5.2%, EMB 0.8% and multidrug resistance (MDR, resistance to INH and RMP at least) was found in 0.8%. Acquired resistance was as follows: any resistance 15%, INH 15%, RMP 5%, SM 5% and MDR 5%. CONCLUSION: The prevalence of resistance to four anti-tuberculosis drugs is strikingly low due to the limited expatriate screening programme (chest radiography) and implementation of DOTS. The four-drug regimen is recommended for the initial phase of therapy until the results of sensitivity testing are known.

Adolescent↗

General population norms about child abuse and neglect and associations with childhood experiences.

BACKGROUND: A variety of definitions of child abuse and neglect exist. However, little is known about norms in the general population as to what constitutes child abuse and neglect or how perceived norms may be related to personal experiences. METHODS: We conducted a random-digit-dialed telephone survey of 504 Washington State adults. Respondents were asked whether they believed each of 34 behaviors, identified in focus groups as possibly physically, sexually or emotionally abusive or neglectful, constituted abuse or neglect. Then, they were asked whether they had experienced 33 of the behaviors. RESULTS: Five of the six behaviors with the highest levels of consensus were for sexual abuse, whereas only one emotionally abusive behavior had a high level of consensus (95% agreement). Consensus that spanking constituted abuse increased with severity. Those respondents who reported experiencing a particular behavior were significantly less likely to believe the behavior abusive for 11 of the 33 behaviors and more likely to believe the behavior abusive for two of the behaviors. Where comparisons were possible, there was a high level of consensus that behaviors identified as abusive in Child Protective Service operational definitions constituted abuse. CONCLUSIONS: Self-reported childhood experiences were associated with perceived norms about child abuse. A better understanding of community norms about child abuse and neglect may be helpful in communicating with the public or allow for better targeting of educational messages through the media, parenting education classes, and so forth.

Adolescent↗

On adding a dental practice component to an ongoing longitudinal population-based study of oral health.

OBJECTIVE: To determine the feasibility and effectiveness of adding a dental practice component to the Florida Dental Care Study (FDCS). METHODS: The FDCS was a study of dental health in which no treatment was provided. In-person interviews and clinical examinations were conducted at baseline, 24 months, and 48 months, with six-month telephone interviews between those times. Participants reported any dentists visited and treatment received. All but four of the 764 participants at the 24-month session gave written permission to review their dental records. Dental hygienist research assistants abstracted information on treatment that was received during the 48-month interval. RESULTS: Of the 286 practices named by FDCS subjects, all but 10 (of whom five refused) practices participated. Eight practices allowed access to records, but did not allow us to record fees. Fees were unavailable at another 13 practices. Of the 764 persons who participated for the 24-month interview, 677 ultimately reported at least one dental visit during the first 48 months of the study. Of those 677, we located dental records on 619. We also found records on four of the 111 persons who reported no dental visits, by querying practices while recording information on other participants. Charts varied in comprehensiveness; nevertheless, in conjunction with office staff consultation, all practices had adequate record of what procedures were performed. CONCLUSIONS: Although time intensive, this method of collecting data substantially increased information about dental treatment received, compared to relying on participant self-report and clinical examination.

Data Collection↗

Clinical holistic medicine: a pilot study on HIV and quality of life and a suggested cure for HIV and AIDS.

This study was undertaken to examine the association between the immunological impact of HIV (measured by CD4 count) and global self-assessed quality of life (QOL) (measured with QOL1) for people suffering from HIV, to see if the connection was large and statistically strong enough to support our hypothesis of a strong QOL-immunological connection through the nonspecific, nonreceptor-mediated immune system, and thus to give a rationale for a holistic cure for HIV. This cross-sectional population study in Uganda included 20 HIV infected persons with no symptoms of AIDS and a CD4 count above 200 mill./liter. The main outcome measures were CD4 count, global QOL measured with the validated questionnaire QOL1, translated to Luganda and translated back to English. We found a large, clinically significant correlation between the number of T-helper cells (CD4) and global self-assessed quality of life (QOL1) (r = 0.57, p = 0.021), when controlled for age, gender, and years of infection. Together with other studies and holistic medicine theory, the results have given rationale for a holistic cure for HIV. We suggest, based on our findings and theoretical considerations, that HIV patients who improve their global QOL, also will improve their CD4 counts. Using the technique of holistic medicine based on the life mission theory and the holistic process theory of healing, we hypothesize that the improvement of QOL can have sufficient biological effect on the CD4, which could avoid or postpone the development of AIDS. A holistic HIV/AIDS cure improving the QOL draws on hidden resources in the person and is thus affordable for everybody. Improving global QOL also means a higher consciousness and a more ethical attitude, making it more difficult for the HIV-infected person to pass on the infection.

Acquired Immunodeficiency Syndrome↗

Cataract and its surgery in Timor-Leste.

PURPOSE: To determine the prevalence of visually significant and unoperated blinding cataract, and the coverage, characteristics and outcome of cataract surgery in Timor-Leste. METHODS: Based on the World Health Organization Rapid Assessment of Cataract Surgical Services protocol, a population-based cross-sectional survey was conducted in 2005. By two-stage cluster random sampling, 50 clusters of 30 people aged 40 years and older were selected. Each eye with a presenting visual acuity worse than 6/18 and/or a history of cataract surgery was examined. RESULTS: Of the 1470 people enumerated, 96.2% were examined. Of the eyes examined, 11.5% were blind (presenting vision less than 6/60). Cataract caused 66.3% of this, and 40.2% of vision impairment (presenting vision less than 6/18). For those people who were blind (7.7%; presenting vision less than 6/60 in the better eye), cataract was the most frequent cause (76.1%). Cataract surgery had occurred in 2% of participants. Gender and domicile were not associated with cataract blindness or surgery. Cataract Surgical Coverage (6/60) was 16.3% for Eyes and 20.2% for Persons. Surgical outcomes were poor, falling well short of World Health Organization guidelines. Astigmatism and posterior capsule opacity were important contributors to this. CONCLUSIONS: Until census data are available, age-gender-domicile correction of sample findings cannot be calculated. In the meantime, it is estimated there are 11 500 cataract blind in Timor-Leste. Long-term, indigenous cataract surgical services need to be capable of significantly increased output. Better surgical outcomes are required to ensure scarce resources are well used. Laser capsulotomy needs to be planned for as surgical numbers increase.

Adult↗

Trends in fatal firearm-related injuries, United States, 1962-1993.

OBJECTIVE: Our objective was to review historical trends in U.S. fatal firearm-related injuries for the years 1962-1993. METHODS: Using mortality data from the National Center for Health Statistics and population estimates projected from census data, we calculated national age-adjusted mortality rates and examined trends over the 32-year period. Data were also examined by type of firearm-related death (unintentional, suicide, homicide, legal intervention, and undetermined intention), race, gender, and age group. RESULTS: During the 32-year period, the total number of firearm-related deaths increased by 137%, from 16,720 in 1962 to 39,595 in 1993. Suicide and homicide were responsible for most firearm fatalities. Rates for both firearm suicides and firearm homicides increased over time, while rates for unintentional, legal intervention, and undetermined intention decreased. The highest rates and widest variation in total firearm-related mortality occurred among African-American men (35.2/100,000 to 84.5/100,000). Persons 15-19, 20-24, and > or = 75 years of age experienced the largest changes in rates during recent years; total firearm mortality was higher for the younger age groups (15-19, 20-24) during 1990 through 1993 than any other time during the 32-year period. CONCLUSIONS: These surveillance data help characterize trends over time and the magnitude of firearm-related mortality and identify groups at risk. However, further efforts to improve our understanding of firearm-related deaths and injuries, such as expansion of current surveillance to include information about morbidity associated with firearms and additional epidemiologic research to identify modifiable individual and societal risk factors, are necessary.

Accidents↗

Predictive value of home blood pressure measurement in relation to stroke morbidity: a population-based pilot study in Ohasama, Japan.

We investigated the utility of home blood pressure measurements for determining the risk of stroke. We also analyzed the relationship between home blood pressure and the incidence of stroke. Home blood pressure and screening blood pressure measurements were obtained from 1,789 residents (aged 40 yr or older) of a rural Japanese community. Blood pressure was measured at home with a semiautomatic device. A mean (+/-SD) of 23.0 +/- 7.5 measurements were made for each subject. Subjects without a history of stroke and who were not receiving medication for hypertension (n = 1,256) were prospectively followed up for 4.4 +/- 2.1 yr. Subjects were subdivided into quintiles according to their baseline blood pressure. The association between the baseline blood pressure and the incidence of the first-ever stroke was examined with the Cox proportional hazards regression model, adjusted for age and sex. The lowest risk of stroke morbidity occurred in the subjects in the third quintile for home systolic blood pressure (117-123 mmHg) and in those in the second quintile for home diastolic blood pressure (66-70 mmHg). The subjects in the fifth quintiles for home systolic (> or = 133 mmHg) and diastolic blood pressure (> or = 81 mmHg) had a significantly increased risk of stroke morbidity. The subjects in the first and the second quintiles for home systolic blood pressure and those in the first quintile for home diastolic blood pressure tended to have an increased risk as compared with subjects in the lowest risk groups, although this increase was not statistically significant, indicating two possibilities: a trend toward a J-shaped relationship or no-decrease in risk of the first-ever stroke in subjects with home blood pressure level less than 123/70 mmHg. This relationship was not observed for screening blood pressure. We conclude that home blood pressure measurements can provide additional prognostic information to that obtained from blood pressure measurement in a medical environment.

Adult↗

Health expectancy calculations: a novel approach to studying population health in Bulgaria.

The measurement of life expectancy in terms of either good or poor health is a novel approach to studying the health of the population in Bulgaria. The pilot study reported here-carried out among people aged > or = 60 years in a middle-sized Bulgarian town-was designed to obtain information on the years of functional restrictions expected among the elderly. In accordance with the answers to a series of questions (recommended by WHO), subjects were categorized as disabled, handicapped, or having different states of perceived health. The indicators "disability-free life expectancy", "handicap-free life expectancy" and "healthy life expectancy" (based on self-perceived health) were calculated according to Sullivan's method. The results show, for example, that 8.0 of the 16.0 years that men aged 60 years may expect to live, on average, will be free of disability. For men aged 80 years the figures are 1.3 of 5.5 years. For women at 60 years and 80 years the results are 7.3 and 0.5 disability-free years of 19.2 and 7.3 expected life years, respectively. Similar results were found for handicap-free life expectancies and healthy life expectancies. At all ages, the proportion of life in a condition free of disability, free of handicap, or in perceived good health is substantially lower for women than for men. Women may expect to live longer, but a greater proportion of their life will be spent in poor health. The approach presented here for measuring the health status of the elderly may be helpful as an aid to planning medical and social care and for the development of public health policies.

Aged↗

Relationship of cosmetic procedures and drug use to hepatitis C and hepatitis B virus infections in a low-risk population.

We conducted an anonymous cross-sectional seroprevalence study of a population with a low frequency of injection drug use to determine whether persons with a history of cosmetic procedures, such as tattooing and body piercing, or intranasal drug use were at increased risk for hepatitis C virus (HCV) or hepatitis B virus (HBV) infection. Students 18 years and older from eight college campuses in Houston, Texas, were invited to participate in the study. Of the 7,960 who completed a self-administered questionnaire and provided a blood sample, 5,282 U.S.- or Canadian-born participants were analyzed. Their median age was 21, 62% were female, 42% were white, 26% black, 22% Hispanic, and 10% Asian or other. Two percent reported injection drug use, 13.7% intranasal drug use, 21.2% body piercings, and 25.2% tattoos. The overall prevalence of HCV infection was 0.9% and of HBV infection was 5.2%. Higher HCV prevalence was independently associated with increasing age (odds ratio [OR] per year = 1.11; 95% confidence interval [CI] = 1.08-1.14), history of injection drug use (OR = 18.24; 95% CI = 7.74-42.92), blood transfusion before 1991 (OR = 3.21; 95% CI = 1.02-10.12), and incarceration (OR = 3.48; 95% CI = 1.45-8.37). Among 5,066 students who denied injecting drugs, HCV prevalence was 0.8% in those who reported intranasal drug use and 0.6% each in those who reported tattoos and those who reported body piercing. Increased HBV prevalence was associated with high-risk sexual behaviors and black or Asian race. In conclusion, there was no increased risk for HCV or HBV infection in low-risk adults based solely on history of cosmetic procedures or snorting drugs. However, proper infection control practices for cosmetic procedures should be followed, illegal drug use discouraged, and hepatitis B vaccination provided to adolescents and sexually active adults.

Adolescent↗

Knowledge about cancer in West Bengal - a pilot survey.

A pilot survey was conducted based on 900 respondents of the population of West Bengal to assess their level of awareness regarding cancer with the aim of estimating associations between response variables (knowledge about cancer) and predictor variables (age, sex, level of education). The data of the pilot survey revealed that 98% of the respondents had heard of the disease 'Cancer'. Unfortunately only 35% of the respondents were aware of the 7-danger signals (i.e. the primary symptoms of cancer) as defined by the World Health Organisation (WHO). None of the respondents knew all 7-primary symptoms of cancer and the majority (about 88%) knew only one or two (mainly tumour lumps and ulcers). Only 44.67% were aware of the major risk factors (like smoking and tobacco chewing). The percentage of the respondents believing that most cancers are curable in early stages was 58%. Some of the respondents (21%) expressed the vague idea that cancer is a infectious disease which is creating a problem of isolation from the family/society with some unfortunate cancer patients. Over 11% of the respondents suggested that a cancer diagnosis should be kept secret from neighbours due to some social stigma like problems with daughters' marriage. Only 8% had experienced any cancer awareness programme conducted by any organisation, only 37% had listened to any cancer awareness programme conducted by the All India Radio, only 36% had seen any cancer awareness programme conducted by Doordarsan/ private Television channels, only 34% had read cancer awareness articles in the newspapers/magazines and only 13% had seen posters/hoardings regarding cancer awareness. The results thus revealed a huge lack regarding cancer awareness in the region. Most of the respondents (68%) expressed a wish for starting cancer awareness programmes. From the Pilot Survey it has been found that the average Knowledge Index of the respondents is 58+ 1.7 irrespective of the socio-economic and personal status. On testing of associations, there was no statistically significant association of the Knowledge Index with the domicile status (rural or urban), sex, occupation and religion of the respondents. However, statistically significant links were evident with the level of education (p=0.00001), social participation (p=0.00004) and income (p=0.00013) of the respondents.

Attitude to Health↗

Prevention of coronary heart disease in Finland--application of the population strategy.

The North Karelia Project was the first population-based cardiovascular disease prevention programme. Even though it achieved, as compared to the reference population, a sizeable reduction in smoking and small effect in blood pressure and serum cholesterol levels, the effect on coronary and cardiovascular mortality of the programme remains equivocal. This is mainly due to shortcomings in the original study design and unanticipated start of the national decline in coronary mortality at the same time with the programme. North Karelia Project contributed, however, to the initiation of national activities in the prevention of cardiovascular disease. These have produced a favourable trend in lipids in the whole Finnish population. The recommendations and activities by national authorities and organizations have suffered, until recently, from orientation towards screening and individual risk factors. The success in North Karelia in early 1970's in the reduction of smoking has still not occurred nationally. Further emphasis is needed in the population approach and in the integration of preventive activities into the community and legislation.

Adult↗

Sunlight exposure and risk of lens opacities in a population-based study: the Salisbury Eye Evaluation project.

CONTEXT: Exposure to UV-B radiation in sunlight has been shown to increase the risk of cataract formation in high-risk occupational groups, but risk to the population has not been quantified. OBJECTIVES: To determine the ocular exposure to UV-B radiation in sunlight for a population of older persons and to determine the association between UV-B and lens opacities. DESIGN: The Salisbury Eye Evaluation project, a population-based cohort of older adults. SETTING: Salisbury, Md. PARTICIPANTS: A total of 2520 community-dwelling 65-year-old to 84-year-old adults in Salisbury, Md, from 1993 to 1995, of whom 26.4% were African Americans. MAIN OUTCOME MEASURE: Association of photographically documented cortical opacity 3/16 or greater in at least 1 eye with ocular UV-B exposure, reported in Maryland sun-years of exposure. RESULTS: The odds of cortical opacity increased with increasing ocular exposure to UV-B (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.20). The relationship was similar for women (OR, 1.14; 95% CI, 1.00-1.30) and for African Americans (OR, 1.18; 95% CI, 1.04-1.33). Analyses of the ocular dose by each age group after the age of 30 years showed no vulnerable age group, suggesting damage is based on cumulative exposure. CONCLUSIONS: Although this population of older Americans has relatively low ocular exposure to UV-B in sunlight, there is still an association between ocular exposure and increasing odds of cortical opacity. Our study found an association among African Americans, which, to our knowledge, has not been reported previously. All sex and racial groups would benefit from simple methods to avoid ocular sun exposure.

Aged↗

A forecasting approach to accelerate drug development.

The clinical phase of drug development should be concluded sooner and at a lower cost if primarily only the pivotal and supportive studies were to be conducted. Such improved efficiency requires development of a decision support system that delivers five new capabilities: (i) it enables one to predict a result of a clinical study and to identify those studies that are expected to have an acceptable probability of success; (ii) it will allow one to optimally utilize available pharmacokinetic and pharmacodynamic (PK/PD) data and improve its predictive capability as more data become available; (iii) it will enable one to project useful population results, not just mean results; (iv) predictions will be accompanied by a measure of reliability; and (v) expected initial clinical results will be predictable from animal and related drug class data. With such a tool population targets could be specified very early in the drug development programme, challenged, and then rationally revised at each step during the development process. This report describes progress in developing and testing a clinical trials Forecaster, a prototype for such a system. The Forecaster generates estimates of the joint density for a population of combined PK/PD parameters. That population then serves as a surrogate for the population of individuals. When the resulting joint density is sampled, the obtained sets of parameters may be used to generate data that is statistically indistinguishable from the original experimental data. Such simulated data can be used to validate assumptions, and make inferences on specified population targets that are accompanied by a measure of prediction reliability. We demonstrate use of the forecaster by employing N = 22 PK/PD parameter sets for an orally administered analgesic.

Bias↗

Workplace organizational correlates of lost-time accident rates in manufacturing.

We report the results of a questionnaire survey of manufacturing workplaces related to the lost-time frequency rates (LTFR) for Workers' Compensation claims. Six types of industry were chosen.' metal articles, plastic articles, grain products, textile manufacturing, printing, and automobile manufacturing. LTFR were standardized by type of industry. Stratifying simultaneously by number of employees and LTFR category, we sampled 718 workplaces. A mail questionnaire to labor and management representatives provided at least some information on 58%. Response rates were similar across LTFR categories, and telephone interviews of non-responders showed little difference in their replies from those obtained in completed questionnaires. A large number of variables were examined. Apart from statistical significance, we looked for consistency in trends across LTFR categories and in patterns for similar questions. Significant associations grouped into several areas. Lower LTFR were associated with: concrete demonstration by management of its concern for the workforce; greater involvement of workers in general decision-making; greater willingness of the Joint Health and Safety Committee to solve problems internally; and greater experience of the workforce. Variables that were not significant included profitability and financial performance. A final stepwise multiple regression explained 19% of the variance in LTFR, although this analysis suffered from several limitations.

Absenteeism↗

Occupational injury and illness among migrant and seasonal farmworkers in New York State and Pennsylvania, 1997-1999: pilot study of a new surveillance method.

BACKGROUND: Traditional worksite injury surveillance methods are often ineffective for Northeastern farms employing seasonal harvest labor. Many are small farms, exempt from mandatory injury reporting. The high proportion of foreign workers and the temporary nature of the work further discourages reporting. Therefore, an alternative migrant health center-based occupational injury and illness surveillance system was piloted during 1997-1999. METHODS: Anonymous medical chart data from nine migrant health centers and four regional hospital emergency rooms was collected during 1997-1999. RESULTS: There were 516 injury/illness cases over two seasons. Joint/muscle straining (31%), falling (18%), poison ivy contact (10%), and object strikes (8%) were most common injurious events. The participation rate of health care was 75%; 130 cases were reported by hospital emergency rooms; and optimal health center participation was associated with: being a farmworker-dedicated program, and including the chart reviewer in the health center's decision to participate. CONCLUSIONS: Further development of a medical records-based surveillance system should include hospital emergency rooms and focus on identified health center performance factors.

Accidental Falls↗

Simulation modeling perspectives of the Bangladesh family planning and female education system.

A systems dynamics simulation study of the interaction of various social subsystems in the People's Republic of Bangladesh is chosen to address integrated planning concerns. It is concluded that one should not underestimate the potential of noneconomic societal forces: They can have a positive impact on slowing population growth and improving the quality of life. Methodologies included: fuzzy profiles for choosing primary variables; interpretive impact matrices to generate the systems dynamics equations; interactive computer capabilities for purposes other than simulation runs; modeling log file to note modeling assumptions, changes, and redefinitions; and microcomputer portability.

Adolescent↗

Survival rates in patients with low-grade glioma after intraoperative magnetic resonance image guidance.

BACKGROUND: No age-adjusted or histologic-adjusted assessments of the association between extent of resection and risk of either recurrence or death exist for neurosurgical patients who undergo resection of low-grade glioma using intraoperative magnetic resonance image (MRI) guidance. METHODS: The current data included 156 patients who underwent surgical resection of a unifocal, supratentorial, low-grade glioma in the MRI suite at Brigham and Women's Hospital between January 1, 1997, and January 31, 2003. Estimates of disease-free and overall survival probabilities were calculated using Kaplan-Meier methodology. The association between extent of resection and these probabilities was measured using a Cox proportional hazards model. Observed death rates were compared with the expected death rate using age-specific and histologic-specific survival rates obtained from the Surveillance, Epidemiology, and End Results Registry. RESULTS: Patients who underwent subtotal resection were at 1.4 times the risk of disease recurrence (95% confidence interval [95% CI], 0.7-3.1) and at 4.9 times the risk of death (95% CI, 0.61-40.0) relative to patients who underwent gross total resection. The 1-year, 2-year, and 5-year age-adjusted and histologic-adjusted death rates for patients who underwent surgical resection using intraoperative MRI guidance were 1.9% (95% CI, 0.3-4.2%), 3.6% (95% CI, 0.4-6.7%), and 17.6% (95% CI, 5.9-29.3%), respectively: significantly lower than the rates reported using national data bases. CONCLUSIONS: The data from the current study suggested a possible association between surgical resection and survival for neurosurgical patients who underwent surgery for low-grade glioma under intraoperative MRI guidance. Further study within the context of a large, prospective, population-based project will be needed to confirm these findings.

Adult↗

Rabbit forebrain cholinergic system: morphological characterization of nuclei and distribution of cholinergic terminals in the cerebral cortex and hippocampus.

Although the rabbit brain, in particular the basal forebrain cholinergic system, has become a common model for neuropathological changes associated with Alzheimer's disease, detailed neuroanatomical studies on the morphological organization of basal forebrain cholinergic nuclei and on their output pathways are still awaited. Therefore, we performed quantitative choline acetyltransferase (ChAT) immunocytochemistry to localize major cholinergic nuclei and to determine the number of respective cholinergic neurons in the rabbit forebrain. The density of ChAT-immunoreactive terminals in layer V of distinct neocortical territories and in hippocampal subfields was also measured. Another cholinergic marker, the low-affinity neurotrophin receptor (p75(NTR)), was also employed to identify subsets of cholinergic neurons. Double-immunofluorescence labeling of ChAT and p75(NTR), calbindin D-28k (CB), parvalbumin, calretinin, neuronal nitric oxide synthase (nNOS), tyrosine hydroxylase, or substance P was used to elucidate the neuroanatomical borders of cholinergic nuclei and to analyze the neurochemical complexity of cholinergic cell populations. Cholinergic projection neurons with heterogeneous densities were found in the medial septum, vertical and horizontal diagonal bands of Broca, ventral pallidum, and magnocellular nucleus basalis (MBN)/substantia innominata (SI) complex; cholinergic interneurons were observed in the caudate nucleus, putamen, accumbens nucleus, and olfactory tubercule, whereas the globus pallidus was devoid of cholinergic nerve cells. Cholinergic interneurons were frequently present in the hippocampus and to a lesser extent in cerebral cortex. Cholinergic projection neurons, except those localized in SI, abundantly expressed p75(NTR), and a subset of cholinergic neurons in posterior MBN was immunoreactive for CB and nNOS. A strict laminar distribution pattern of cholinergic terminals was recorded both in the cerebral cortex and in CA1-CA3 and dentate gyrus of the hippocampus. In summary, the structural organization and chemoarchitecture of rabbit basal forebrain may be considered as a transition between that of rodents and that of primates.

Acetylcholine↗